Good Intestines

“The road to health is paved with good intestines.”

I can now chuckle over that old medical quip as, after eight days in hospital, my own alimentary system resumes normal operations after a sudden and largely unexplained collapse of that aptly-named and entirely useless sliver of flesh, the appendix.

For those of you with a morbid interest in such matters, I’m happy to provide a few details. 

The offending organ burst, or as the hospital put it, perforated – a word I had previously associated with stamps.  The appendix was not removed, even if a quick snip normally falls into the category of standard operating procedure.  In my case the wretched thing had somehow become enveloped by the lower intestine – a natural act of self-protection – and taking it out would have required cutting into perfectly good surrounding tissue, turning what had been a minor procedure into a major one.  The surgeons decided instead to leave it in place, with every expectation that, under a ferocious assault of antibiotics, it will wither and die. 

I can only hope they are right.

Whatever was done, or not done, to me, was performed under the auspices of that much-maligned public body, the National Health Service. 

My American friends expressed horror.  How could you, they wrote, leave the treatment of such a serious, possibly life-or-death event to an organisation of renowned incompetence?  What they really meant was something quite different – namely, how could I leave my treatment to the devil’s own agency in the form of a socialist experiment that should have been allowed to expire with the fall of the Soviet Union?

Americans are resolute and united about very few things these days, but ‘socialised medicine’ is one of them.  They hate it as an infringement on the American ideal of rugged self-sufficiency. 

All I can say in response is that, for all its manifest defects, the NHS remains as effective in the fields of diagnosis and emergency treatment as any of its private equivalents in Britain, and I dare say the world.  Indeed, the doctors and surgeons who practice in the public sector are the very same who practice in the private.  The obvious difference is the facilities in which they practice.  Private hospitals tend to be modern and have private rooms and, arguably, better food.  Public hospitals can all too often present the grim infrastructure of an earlier age, public wards and, I can testify, execrable food (provided by a publicly-listed company called Mitie).

The NHS comes under fire in the press almost daily these days, with lurid stories of neglect, inefficiency and muddle.  My response to those attacks can only be one that is based on personal experience.  From the time I described my symptoms, I was ‘processed’ with great expedition, from the initial diagnosis, through admission, to the surgical procedure itself.  My surgeon – clearly a man so harassed he had little time for charm – took the time to inform me what action he expected to take, based on a pre-operative scan, and what he thought he might find during the course of further probes in the operating theatre.  Afterwards, he explained everything that had been done.

As reassuring as he and his surgical team was, the facilities in which they performed left much to be desired on several levels.  The hospital to which I was admitted, St. Helier, in Carshalton, a suburb of south London, is a vast sprawling white Lubyanka built, I would guess, in the 1930s, a ghastly, forbidding and inaccessible structure.  On my ward, we merrily referred to it as St. Hell.  The eavesdropping nurses, we noticed, smiled rather than scolded.  Most, incidentally, were from islands other than Britain.

From buildings such as St. Hell – and there are many like it across the land – emerges the NHS’s essential contradiction: excellent medical work is done in awful places.  Some may be dangerous places.  Each and every day St. Hell’s grim routine of organised chaos struggles with the pressures of an unremitting demand for its services.  Beds are at a premium.   Each and every day the place somehow survives looking a little the worse for wear, metaphorically like a battered but still defiant ring fighter. 

After my operation, I transferred myself to a private hospital for the brief period of recuperation.  As excellent as my treatment at St. Hell’s had been, I had no wish to live for a single hour longer than necessary watching the staff’s daily battle to cope, or the constant influx of patients, most of them in a far more vile predicament than mine.  I can unashamedly afford my creature comforts, and I’m sure St. Hell was glad of the bed.

I remain nevertheless an unrepentant advocate of the NHS.  Asked to take care of 63 million people, without profit or praise, it is the noblest of causes.  No other organisation on the planet is called on to undertake such an enormous task.  If the structure sometimes creaks and groans under the strain, it is hardly surprising.

It must be made to work better, no doubt, at whatever the cost to the public purse.

I would say that, wouldn’t I, since the NHS has just arguably saved my life. 

Well, yes of course I would.  Wouldn’t you?