Ann Clwyd: my husband died like a battery hen in hospital
Ann Clwyd has said her biggest regret is that she didn’t “stand in the hospital corridor and scream” in protest at the “almost callous lack of care” with which nurses treated her husband as he lay dying in the University Hospital of Wales in Cardiff.
Clwyd, the Labour MP for Cynon Valley since 1984 and Tony Blair’s former human rights envoy to Iraq, told the Guardian she fears a “normalisation of cruelty” is now rife among NHS nurses. She said she had chosen to speak out because this had become “commonplace”.
Describing how her 6’2” husband lay crushed “like a battery hen” against the bars of his hospital bed with an oxygen mask so small it cut into his face and pumped cold air into his infected eye, Clwyd said nurses treated the dying man with “coldness, resentment, indifference and even contempt”.
Owen Roberts died on Tuesday, 23rd October from hospital-acquired pneumonia.
For what it’s worth, my own experiences of watching people die in NHS hospitals have been around as good as it is reasonable to expect such a thing to be. However this is not the first such blast of raw emotion directed against the NHS from a bereaved relative that I have read, merely the first from a Labour MP.
To take another example, Anthony Browne, former health editor of the Observer, and former passionate believer in the NHS, wrote:
Last week’s report into the case of Thomas Rogers, the 74-year-old grandfather who bled to death after lying undiagnosed on a trolley in an accident and emergency ward at Whipps Cross Hospital for nine hours, is shocking. What is even more shocking is that it is hardly unusual. Equally awful stories worm their way out past NHS obstruction every week. And nothing changes.
He was right about nothing changing; the “last week” mentioned in the article was in 2001. I have reposted that article several times over the years. It does not stop being relevant, alas. Again, for what it’s worth, my own experience of Whipps Cross Hospital was quite a lot better than that – I take a forgiving attitude towards the fact that the midwife had to run out into the corridor and yell, “Where’s the fucking obstetrician?”, given that they were trying to deal with multiple women in labour. Things tend to get fraught anywhere when there is a crisis. However the deaths of Mr Roberts and Kane Gorny, who died of thirst due to neglect, or the baby Edward Brown, who was born and died in a hospital toilet while nurses declined to assist because they did not have the training, did not happen as a result of any overwhelming crisis. Whether the problem is that efforts to make nursing more academically prestigious have made some nurses believe it is beneath them to supply the most basic needs of patients, or increased paperwork, or some other factor, NHS nursing care seems to fail more often than it used to. It cannot be because of “cuts”. The last financial year for which there was a reduction in the percentage of central government expenditure devoted to the NHS was 1996/97. And that was one of only seven decreases in all the years since 1950/51. No government has dared blaspheme against the state religion.
A recent blog post by Tim Worstall describes the lack of understanding that surrounds this embarrassing condition. He recalls his experiences as a chronic sufferer since childhood:
When at primary in Bath, good strong Bathonian. And the standard Eng middle class at home, like what I speak now. Of[f] we move to Italy to the Forces school when I’m 8. My mother still remarks on the near cockney (probably closer to what we would call estuarine now) that my brother and I both picked up in weeks. And started speaking as we walked through the doors of the school and dropped the moment we left them.
A SORAS survivor among his commenters, ‘Chris’, had an even more overwhelming attack,
“When I came back to England from British Guiana at 11, to attend an almost all-white boarding school, I had a strong Guianese accent – for about 10 minutes”
Another commenter, ‘Richard’ was a witness as the syndrome struck down a friend.
“… [he] said he could hear his accent change, in 2 or 3 stages, over the train journey home at the end of term.
Be aware that initial symptoms can seem trivial – hearing a person who has lived in England for half his life say, “put it down by there” within seconds of setting foot of the platform at Swansea station may not, at first, seem cause for concern. However without treatment “by there” can become interjections of “mun” or even “Ych y fi” with terrifying speed.
Although the disease is most common in its homolocutic form, in which people suddenly revert to an accent they thought they had abandoned years ago but did actually have at one time, it also has a heterolocutic variant.
At the London SORAS support group, I recently met Berenice (28) who blames the loss of her job at an advertising agency specialising in political campaigns on the heterolocutic form of the disease. At a creative meeting, she prefaced her query as to whether an advert suggesting that first time female voters might like to grant Ed Miliband the traditional jus primae noctis would really resonate with the youth demographic with the words “Not being funny or nuffink”, and was fired on the spot. Berenice was infected after discussing the weather with a work experience girl.
Some sufferers choose to carry an information card or medical alert bracelet in order to assist first responders when the victim himself can no longer communicate verbally in a way normal people can understand. ‘Quentin’ (not his real name), a plumber’s mate struck down with the disease after installing a combi boiler in this right posh house up on Primrose Hill, is very grateful he did. While just about still able to speak comprehensibly he called an ambulance to say he had “the most frightful case of SORAS” before lapsing into a kind of idiodialect in which the only words medical staff could understand were “yah” and “darling.” It was only his desperate gesticulation towards the bracelet while strapped to a medical trolley that stopped him being wheeled into the genito-urinary ward.
Related conditions such as TIGFAF – Talking In a Generic Foreign Accent to Foreigners – can be even more distressing.
“Many explanations have been offered to make sense of the here-today-gone-tomorrow nature of medical wisdom — what we are advised with confidence one year is reversed the next — but the simplest one is that it is the natural rhythm of science. An observation leads to a hypothesis. The hypothesis (last year’s advice) is tested, and it fails this year’s test, which is always the most likely outcome in any scientific endeavor. There are, after all, an infinite number of wrong hypotheses for every right one, and so the odds are always against any particular hypothesis being true, no matter how obvious or vitally important it might seem.”
Gary Taubes. I was going to use this for the Samizdata quote of the day but the SQOTD slot has been taken but this is too good not to put up. Taubes – as discussed recently by Natalie Solent here – is one of those people uprooting some conventional wisdom about diet and health. Here is Taubes’ website.
This is probably very unscientific of me, but my approach to a lot of these views on health and fitness is to take a slightly Aristotelian “middle way” approach: moderation in all things, decent exercise, balanced diet, and plenty of sleep. (As my wife reminds me, this also means I watch my intake of red wine, which I have over-indulged in over the past).
I suffer from gout, a nasty sounding term which is also bloody unpleasant. One of the contributory factors, from what I read, is sugar. So I am on a very low sugar diet, drinking lots more water and exercising a lot in the gym, with a blend of weights and interval training. It seems to be doing the trick for my general health and physique and the gout is at bay, although I get the occasional twinge. One of my colleagues at work runs triathlons and suffers from gout, so it is not necessarily caused by drinking port all day.
The US business and health guru, Timothy Ferris, has some interesting things to say about gout and how to defeat it.
So, Glenn Reynolds makes me buy this book. It hasn’t made me any thinner yet, despite my having followed the world’s most popular diet strategy: Getting Thin by Reading About It. Never mind. I shall talk about it instead.
I do not know if Gary Taubes has any particular political views, but if the case he makes is true his book has political implications. In extreme summary it says (a) the experts, the official health guidance, the posters in doctors’ surgeries, the healthy eating lesson plans – all wrong; (b) it’s not fat that makes you fat, it’s carbs; and (c) eat as much meat as you want. Eat almost nothing but meat, if you like. No need to go hungry.
(a), if true, will please the C-AGW sceptics. So much for scientific consensus. It will also please the libertarians and minarchists. So much for government advice.
(b) and (c) will distress everyone who has ever worn a mung bean. Fat and meat good. It’s so… so… American.
(c) is especially annoying to some because, if Taubes is correct, the solution is relatively easy. How vexatious to think that these self indulgent fat slobs might escape just punishment! And how troubling to think that the obesity “epidemic” might be solved without the assistance of counsellors, coordinators or facilitators.
Things do not break entirely one way. One of the other messages of the book is that it is not the case that fat people are fat because calories in exceeded calories out. Anti-Puritans though many libertarians claim to be, they rediscover their inner Cromwell when it comes to that sort of equation. When they – oh hang it, when we – hear the pathetic excuses of fatties that they are fat because of genes or metabolism we rather enjoy pricking the bubble of their delusions. It is like being a deficit hawk, but for calories. Only this man Taubes says it really might not be their fault.
Anorexia is a nasty eating disorder, and although in the prosperous West there seems to be more fretting about obesity than the other extreme, there is no doubt that people who, for whatever reason, don’t eat enough to protect their health, represent a serious health issue. But as ever, I get irritated at the “victim culture” that is sometimes wittingly or unwittingly promoted in public discussions of the issue. Case in point was earlier this week on the BBC.
The state broadcaster’s morning current affairs show featured a young woman who had almost died as a result of this condition, and some shocking photos were shown. During the course of the discussion with the presenters, the argument from the woman (I did not get the name) was that she had been strongly influenced into her under-eating by a desire to look like the models and actresses seen in glossy magazines and on TV and movies. Such pictures are often enhanced, ergo, such enhancement is evil and there should be a law against such activity so as to prevent impressionable people from being led astray, etc.
At no point did either presenter, or another woman who was representing the modeling industry, say something like this:
“I am very glad you have recovered your health and are eating a proper diet and don’t feel a need to starve yourself to `look good’”. The fact that photos of such supermodels/actresses or whoever might appear to show that it is acceptable to be very thin does not, and should not undercut your own responsibility for your health. You have a mind, so use it. You have free will; you are not a piece of clay in the hands of the advertising industry, the movie business, or modelling agencies. You are an attractive young person who can, and should, think for yourself. Finally, curves on women are fabulous, and anyone who thinks for a second that the opposite sex is turned on by skeletons needs their head examined. So take charge of your life, and don’t expect the State to censor things because you lacked self-control earlier in your life. Thanks for appearing on our show and now let’s go over to Carole for the weather forecast.”
But they didn’t say that. Pity.
From the Radio Times, about a programme this evening on BBC3 TV, entitled I Woke Up Gay:
Documentary about Chris Birch, who used to be a rugby-playing lad with a girlfriend and a job in a bank. However, his life was radically changed by a stroke when he was just 21, and he is now a gay hairdresser with an interest in fashion and interior décor.
The question I ask with my title is of course an attempt to get a smile, if not a lol, but it is also serious. Has anyone gay suffered a stroke and emerged from it straight, with the overwhelming desire to ditch the hairdressing and instead to get a girlfriend and a job in a bank and to take up rugby? Either way, I think the answer would be interesting. Seriously, is this kind of thing a one way street, or can it work in both directions?
Neither answer would obey the gods of Political Correctness. If a stroke can turn you gay, but not make you straight, that would suggest that gays are, at least in some sense, the result of something a lot like brain damage. They are, sort of, a mistake. If a stroke can turn you straight, then maybe those crazy Christians who say that they can straighten out gays may after all be onto something.
A relative of mine recently had a stroke. He lost his peripheral vision and can no longer drive, but otherwise no change. Still no interest in fashion, or not that anyone in the family has heard about.
All this reminds me of that Woody Allen movie (I can’t recall which – they’re all a blur) where someone gets a smack on the head and wakes up right wing.
I entirely realise that strokes are frequently very unfunny. I’m sure we all know about friends or relatives who were not as lucky as my relative, or as Chris Birch was, kind of. I certainly do.
The programme airs at 9pm, and is repeated at 12.30pm in the very small hours of tomorrow morning. I will record it.
In one of my many jobs I had to look over thousands upon thousands of staff records. I learnt many things. Among them was that plenty of those staff who had had significant time off for stress or other mental problems not only returned to their old jobs and performed satisfactorily but went on to success and promotion. Before this I had believed in my heart of hearts that a month off for stress was about the limit. Anything more than that and the person was a write-off in terms of doing any useful work ever again, although it might not be politic to admit it.
Perhaps not by coincidence a month off for stress was about the limit of what had befallen anyone I knew well enough to be told about it. Since I began to think more deeply about this issue I have twigged that other people I know have almost certainly had bouts of mental illness they did not make public. My impression is that the libertarian and intellectual types likely to be reading this are more likely than average to have experienced mental illness.
There is a lot to agree with in what the Mental Health Foundation says about mental illness – it is common, most people who experience it either get better or can manage it, it need not be a barrier to success in many fields, public fear of the mentally ill is out of all proportion to the risk they actually present.
I just wish they wouldn’t over-egg the pudding. These words from the Mental Health Foundation article I linked to above are typically evasive:
Many people believe that people with mental ill health are violent and dangerous, when in fact they are more at risk of being attacked or harming themselves than harming other people.
Pardon me, but the fact that the mentally ill are more at risk of being attacked or harming themselves than of harming other people says nothing whatsoever about the absolute level of risk that they will harm other people.
Annoyingly, the Mental Health Foundation didn’t have to raise my hackles by indulging in this common evasion. The absolute risk that a mentally ill person will attack you is very low. It is higher than the risk that a non-mentally ill person will attack you, but only slightly. I don’t have the numbers to hand, but I have seen them and that is the position. Why the Mental Health Foundation cannot just show some confidence in their own position and give the numbers I do not know, unless it is that to acknowledge the obvious truth that, yes, a very small minority of mentally ill people really can be dangerous would mess up their nice simple victimhood and “anti-discrimination” agenda.
As a libertarian, I think all forms of discrimination should be legal, including those I find irrational or even morally abhorrent, but put that aside. The link correctly says,
The Equality Act 2010 makes it illegal to discriminate directly or indirectly against people with mental health problems in public services and functions, access to premises, work, education, associations and transport.
It is not illegal to discriminate against people with mental health problems when appointing someone to a job, promoting them, or firing them. There is a movement afoot that it ought to be. Many compassionate people, correctly perceiving that discrimination against those who are suffering or have suffered mental illness is often irrational and hard-hearted, are being edged towards supporting a move to make it a crime.
That movement had a setback the other day. A JetBlue pilot suffered a meltdown and had to be restrained by passengers at the request of the co-pilot, who had locked him out of the cabin. Scary. Also memorable and quotable in debate.
Wishing the pilot well for the future is not incompatible with a firm belief that it would be irresponsible to allow him back at the controls of an airliner. There are also a good many less dramatic situations in which an employee being mentally ill ought justly to be grounds for reassignment or dismissal. A pretence this is not so harms the interests of mentally ill people. There is little an organisation fears more than taking on an employee who turns out to be “trouble” and there are good reasons for this fear. That was another thing I learnt from my thousands upon thousands of personnel records. One came to dread the thick files; the ones trailing stapled-on appendices and confidential notes directing you to yet other files; files that bulged with long, messy, sad stories of warnings and final warnings and appeals and getting the union involved and even the union giving up and offloading the troublemaker onto some other department only for it all to start up again.
If ever discrimination on the grounds of mental illness does become illegal, or even publicly unacceptable, be sure it will continue to be practised in secret – and the secrecy will make it more unfair. Instead of basing their assessment of suitability on the plain answers to plain questions in application forms, they will go by code words, or a quiet (and often slanderous) word in confidence at the canteen.
I used to know a little girl with severe mental and physical disabilities. She had to be lifted and moved dozens of times a day as she was unable to walk or crawl. It was a source of great worry to her parents how they would cope when she grew up and could no longer be lifted easily. More distant, but greater, was their fear concerning she how would be cared for when they died. Their fears did not come to pass for the saddest of reasons; she herself died when she was still quite small.
I thought of that family when I read about Ashley. Ashley is another little girl with severe mental and physical disabilities; even more deeply disabled than the child I once knew. Ashley is fourteen, but is described as having the cognitive abilities of a three month old baby – in truth, if the description of what she can and cannot do is correct, a three month old baby is better able to communicate than she is. Her parents share the same fears as those of the parents of the girl I knew. They have taken drastic action: they have had her treated surgically and with hormones so as to ensure, within the limits of the technology, that she remains a child for the remainder of her life.
“It was carried out in the belief that her quality of life would improve as it would save her from physical discomfort and pain”, reports the Telegraph. The Guardian, which ran opposing comment articles on Ashley’s case, suggests that another motive was to reduce the effort of lifting her and hence extend the time for which her parents could care for her. I wonder if an unmentioned further reason – one that sounds ghastly but might make sense given human nature – was to try to ensure better care for Ashley when her parents are gone by keeping her cuter. It is a sad fact that many people will find their protective instincts aroused by the sight of a mentally disabled child (or apparent child), yet flinch at the sight of a mentally disabled adult.
Ashley cannot consent and cannot withold consent. This procedure might help – no, it very likely will help to give her the best quality of life possible, for as long as possible in the care of those who love her. Yet the potential for abuse is horrible. Her body is being irrevocably altered for the convenience of those who care for her (but that convenience is no small thing, and convenience is too weak a word; whether they can cope is a major determinant of her quality of life.) If we can do this to Ashley, what else can we do to future Ashleys? More severe modifications to more severely disabled people? To less severely disabled people? To any people?
… to save the NHS, says Ed Miliband.
My first thought was, gosh, that’s nice, three months in which to kill it. I suspect that I am in a minority: the outpouring of love, loyalty and vows to defend the NHS unto death coming from the Guardian commenters to this report and to Miliband’s own article resemble nothing so much as the frenzied cries of “Deus vult!” that greeted Pope Urban II when he declared the First Crusade. I further suspect that when it comes to this issue the knights of the Guardian would indeed get support from the peasants of the Sun and the Daily Mail.
Heigh-ho. Just for the record, I shall repost an article that is now more than ten years old. It is by Anthony Browne, once Health Editor of the Guardian‘s Sunday sister, the Observer, and at one time a passionate supporter of the NHS:
Even as you read this, in almost every hospital in the country, there will be elderly, vulnerable people left for hours and sometimes days on trolleys. Each year, thousands of British people – the young, the old, the rich, the poor – die unnecessarily from lack of diagnosis, lack of treatment and lack of drugs. They die and suffer unnecessarily for different reasons, but there is just one root cause: the blind faith the Government has in the ideology of the National Health Service, and our unwillingness to accept not just that it doesn’t work, but that it can never work.
This morning I was prodded by the scourge of epidemiocracy, Chris Snowden, to read this piece by Theodore Dalrymple. What most struck me was not the main argument (I find predictable agreement almost as wearing as disagreement) but this piece of supplementary information:
A higher proportion of the Dutch population smokes than average for a developed country (27 percent), and fewer Dutch people are aware of secondhand, or second-lung, smoke — that breathed in from other people’s tobacco — than any other comparable country.
Why should that be? I think it demands an explanation. Certainly the Dutch population cannot easily be classed as ill-educated or poorly-informed. (I have been sworn at by a drunk tramp on an Amsterdam tram who switched instantly to English invective when he realised that it was going to be more effective in my case.) My mind leapfrogged towards ideas about the Dutch liberal tradition. They choose not to know, because they do not like to hassle people about their private behaviour, perhaps…
Unfortunately there are no sources quoted. When I looked for stats and background info, I found something even odder. That remarkable factoid contains no truth. → Continue reading: Facts and attitudes
Even as supplied by an unscrupulous underground market and taken blind by consumers in a variety of unsuitable ways, they really aren’t very dangerous:
According to the ONS data, in 2010 there were more helium deaths  than cannabis, ecstasy, mephedrone and GHB related deaths put together.
‘Helium?’ you may ask… It’s classed as a drug but no, it doesn’t do anything. But it is so hard to buy anything reliably lethal in the UK that helium is a sophisticated means of self-asphyxiation for suicide. So even those 32 cases should not be classed under malign side effect of drug-use. Death in those cases was a positive result.
Say what you will about the environmentalist and Guardian columnist Mr George Monbiot – not, apparently, the prototypical moonbat but merely a moonbat – he does have integrity. I have no doubt his recent conversion to a belief in the benefits of nuclear power cost him many friends in the green movement.
This article will not win them back. In it Mr Monbiot and Justin McCurry write that
The Green party’s former science and technology spokesman is promoting anti-radiation pills to people in Japan affected by the Fukushima nuclear disaster, that leading scientists have condemned as “useless”.
Dr Christopher Busby, a visiting professor at the University of Ulster, is championing a series of expensive products and services which, he claims, will protect people in Japan from the effects of radiation. Among them are mineral supplements on sale for ï¿¥5,800 (£48) a bottle, urine tests for radioactive contaminants for ï¿¥98,000 (£808) and food tests for ï¿¥108,000 (£891).
Launching the products and tests, Busby warns in his video of a public health catastrophe in Japan caused by the Fukushima explosions, and claims that radioactive caesium will destroy the heart muscles of Japanese children.
He also alleges that the Japanese government is trucking radioactive material from the Fukushima site all over Japan, in order to “increase the cancer rate in the whole of Japan so that there will be no control group” of children unaffected by the disaster, in order to help the Japanese government prevent potential lawsuits from people whose health may have been affected by the radiation. The pills, he claims, will stop radioactive contaminants attaching themselves to the DNA of Japanese children.
Regarding that claim, Monbiot and McCurry write:
Gerry Thomas, professor of molecular pathology at the department of surgery and cancer at Imperial College, London, describes his statements about heart disease caused by caesium as “ludicrous”. She says that radioactive elements do not bind to DNA. “This shows how little he understands about basic radiobiology.” Of the products and services being offered, she says, “none of these are useful at all. Dr Busby should be ashamed of himself.”
UPDATE: George Monbiot has also put up a blog post on Christopher Busby in the Guardian Environment section. There is fierce debate in the comments between pro-and anti-nuclear Guardianistas. Meanwhile the Green Party have made no statement on all this that I can see.