Clear Margins

My hospital experience – a hell of a privilege check

31 December 2022

The main Glasgow Royal Infirmary building, which is right between where my parents grew up, in tenements that were pulled down in the 60s to make way for the motorway

The building I was in lol a wee bit less picturesque, the only window I saw out of had a lovely view of the motorway

In spite of myself I’m finding the looming new year has me looking back at what happened this year with an urge to try to make sense of it whatever that means. My top takeaway from being in hospital was a sizeable privilege check. As someone who came from poverty and now earns the kind of money that would have seemed unimaginable to folk from my background this happens fairly regularly. For my own sense-making reasons here’s a rundown of my experience going into hospital for cancer surgery in March 2022. To be clear, the NHS is amazing and the doctors and nurses do their absolute best with impossible constraints.

Day 1: Pre-op

I arrived at Glasgow Royal Infirmary at 7am. The hospital is in the city centre and the parking situation is not ideal, meaning I had to walk a fair distance from the car to the day surgery entrance. No one is allowed with you into the waiting area, so my partner was turned away at this point. You’re sitting there with your wee bag next to several other folk who are also getting surgery, looking at the telly with BBC 1 on it like this is a perfectly normal scenario, turning up to get cut open and have organs removed then find out if you still have cancer. Aye, bit weird.

I was taken into a wee room where a nurse admitted me, asking a long list of questions I’d have to answer a total of three times between here and the operating theatre. She gave me a hospital bag to put my stuff in, and a gown to change into, along with inexplicable underwear that looked like the string shopping bags your grannie used. I had to put a pair of compression socks on, it was bloody hot at the time and the room was in the bowels of a 1970s building with no air conditioning, so I was knackered by the time I got them on.

The surgeon came in for a chat, running through everything he was going to do, with language I didn’t quite recognise and that revealed part of my surgery was going to be robotic. This was the first time I’d met him in person as my consultation for treatment planning was done by another oncologist on the team – my surgeon had phoned to talk things through with me the week before on his day off, so that I wasn’t encountering him for the first time right before my operation.

The anaesthetist popped in too, asking questions like “what is important to you” to which I said a quick recovery. She explained they might give me a spinal injection in which case I’d be sat on the edge of a bed and would fall unconscious before being taken to theatre, but that they might end up not giving me this type of anaesthesia (spoiler alert: they did not).

With my hospital gown, dressing gown, and slippers on, carrying my glasses case in my hand (the nurse said take this so that my specs would be there when I woke up), another nurse led me to pre-op. Surprisingly this involved walking through public parts of the hospital, with folk milling around. The nurse told me about her own cancer surgery she’d had successfully a few years before.

The pre-op area was a long room with only one other patient in it – who bizarrely had the exact same name as me, which I mentioned to the pre-op nurse who told me they also had a doctor with the same name, I’m like well make sure you don’t mix me up with her then lololol.

I sat on a chair with my specs case in my hand and answered the list of questions for the last time. The other patient was getting the spinal injection and wheeled into theatre. The anaesthetic nurse and her student (everyone has a student with them) came up and said ok we’re going to walk with you into the operating theatre. This I was not expecting. She said when we get to the theatre there are going to be lots of people in there – they’re all there for you. She was not lying, another half a dozen folk were in there waiting to greet me (not including the surgeon who I believe they prefer to come in after you’re out).

I sat down on a big mechanical bed that moved up like a transformer when I sat on it, and the folk all kind of descended on me, in a kind way lol. One distracted me to one side while another started putting a cannula in the back of my other hand. They took my specs, held a mask over my face, the anaesthetist told me to imagine I was somewhere lovely and peaceful, and that’s the last thing I remember before waking up.

Day 1: Post-op

When I woke up in post-op I was immediately in pain. I hesitate to mention this because I don’t want to scare people, it’s highly unusual, but it happened because I hadn’t had a spinal injection, and they couldn’t give me more morphine because my respiration rate was too low. There followed what I believe was a slight fuck-up with my pain meds over the next couple of days. The wards are so busy and the staff so overstretched that they essentially treat everyone the same way – something that generally benefited me tbh although not in this case. At the end of the second evening an older nurse who had returned to help during the pandemic realised I had been under medicated for pain.. Everyone in the ward is being treated for gynaeoncology, and they really don’t have the bandwidth to treat you as an individual.

The ward was a bit of a contrast with what happened before that to say the least. Going from the level of attention and state of the art looking equipment in the theatre to the chaos of the ward was kind of shocking. I had hoped for a private room but was actually very glad to be in a shared ward, because the patients help one another out. Everything was broken, my bed didn’t work, the toilet was leaking all over the floor, the air conditioning wasn’t functioning and patients were fainting in the bathrooms. In spite of this the nurses do an incredible job of keeping everything together, and in good spirits, god only knows how.

Glasgow is a city with a lot of deprivation, and the experience of being in the ward was a massive privilege check for me. Something I think people who don’t come from poverty don’t always understand is that it causes a level of chaos in people’s lives that makes it hard to get a solid footing and to even make the best of what few opportunities are available to you.

There was no PCA (patient controlled analgesia), the button activated pain relief I’d seen relatives use following major surgery like mine. I don’t know what the reason for this was, but I do know that the nurses are having to manage the reality of widespread addiction and all sorts of destabilising goings on in people’s lives while helping them recover from cancer treatment.

I’m vegetarian and am fortunate enough to mostly eat fresh fruit and veg. I thought the hospital food would be bad, but wasn’t quite expecting there to be no fresh fruit or veg in sight. My dismay at this was put into stark perspective when I noticed the nurses deliberately delaying a patient’s discharge for a couple of hours so that they’d get a hot meal. Coming from where I come from, this could very easily have been my path in life, so it was an exercise in understanding how fortunate I’ve been.

Shoutout to the nurse I have to assume stole a carton of orange juice from a staff member's lunch for a young lassie who didn't fancy eating. 🏆

My surgeon came for a visit 12 hours after I'd seen him in the morning and after his second long surgery of the day before doing it again the next day..

Day 2

Most of the patients on the ward had already had chemo, many for ovarian cancer, which tends to present later. This meant that they were enduring what was the hardest experience of my life, after chemo had already annihilated their body’s systems. This also made the one size fits all recovery pathway problematic.

When my mum was getting surgery for colon cancer a few years ago, the practice of rapid recovery was being trialled. This approach holds that patients should be encouraged to get up out of bed as soon as possible. It worked fantastically well for my mum, but at that time they were only recommending it for laparoscopic (keyhole) surgery, not for open surgery. By the time I got mine it had become the default approach including for open abdominal surgery, so we were all strongly encouraged to get up the day after surgery. With my pain meds still not having been corrected, this was pretty unpleasant. It was even worse for other patients who’d already gone through chemo, some of whom got very upset at being coerced into getting up. It worked out well for me and I had a remarkably fast recovery, but idk, it seemed cruel and a bit indiscriminate for some.

After a slow process of sitting up and getting around to the side of the bed, I was walked to the bathroom, shuffling an inch at a time with someone carrying the various things I was attached to. In the bathroom I sat on a seat while a nurse washed me, indignity and loss of control are a hell of a learning opportunity is all I’ll say.

The second day was my worst for pain, but I was determined to be a good patient and get a distinction lololol. When the nurses commented on how well I’d done sitting up in the chair all day I lapped it up big time, but looking back on how much pain I was in, this probably was not a sign of the best mental health situation. When my partner came to visit at night I was in so much pain I was trying not to move, and it was pretty distressing for him to see tbh.

When one of the nurses was handing over to another at the change of shift she pointed at me, immobile and stuck in a weird position having slid down the bed, saying “that wan’s rarin to go” I was like “aye I’m aboot tae leap out of this bed any second” yep, bad patter is how you know you're still you.

Day 3

The plumbing situation reached a crisis point and they decided to get plumbers in to fix it. The nurse asked if we’d need to get moved out of the room and the plumber casually said aye, to which he received a barrage of abuse “aye the nhs has loads of spare beds mate do you watch the news” etc.

We got moved into a much bigger ward. You’re encouraged not to close the toilet door in case you collapse or need help, so when a plumber blundered in thinking it was empty, he received the most hilarious verbal abuse I have ever heard in my life. About a dozen Glasgow women shouting “did you walk in on that wumman ya useless prick” etc – I just remember clinging to the bars on the side of my bed because laughter was so painful.

On this day I asked if I could get myself a shower, I needed a nurse to detach certain things from me in order to do that. This is when I realised they’re waiting for you to prompt certain things, asking for xyz as a sign of recovery. This time I showered myself but remained seated, using the nice smelling things my mum and best pal had given me. When the registrar came around I made sure to ask if I could get home the following day, to which she replied “why not!?”

We got moved to another ward, third one in total. This was rough because by this time my recovery was on a clear upwards trajectory, but the lassie I’d been next to since day one was having a tough time. She’d had a lot of chemo and was struggling to keep food / meds down, and they couldn’t get access to a vein because they’d collapsed after all the chemo. It felt very weird being on this trajectory while the person next to me was not.

My mum came for a visit, during which she did the obligatory running around helping other patients, such is the state of the NHS..

Day 4

Each night I was in hospital someone in the ward was very sick overnight. You get regular checks anyway so the chances of getting any sleep are slim. The night just kind of turned back into day. The building has very few windows so you don’t see daylight or feel fresh air.

I got up and walked to the shower, and stood up in it – easily the hardest physical feat I’ve ever accomplished, fuck yer ultramarathons. I was determined to get home because it was a Friday and if I didn’t I’d have been stuck there until the Monday. There was an emergency and the normal rounds didn’t happen, so the nurse got all my discharge stuff ready so that when doctor appeared they just had to confirm I could go.

The discharge stuff included a lot of medication, injections the nurse showed me how to give myself, and some equipment the less said about the better. She got my consent to send my GP a letter outlining “the bits ye’ve not got” – the NHS systems are extremely not connected to the extent that my normal doctor wouldn’t have known any of this was happening.

The nurses changed my dressing, which looked like a wax strip over the wound. The wound itself was held together with glue, with no stitches to remove, and hard to believe the site of major surgery. That said, what had seemed like an abstract concept of getting operated on, became a bit more visceral when I saw the wound lolwelp.

The last time my partner had seen me had been two days before, when I could barely move, so seeing me dressed and walking around was something of a shock. When we stepped outside the hospital into the mayhem of Alexandra Parade, it was sunny, the fresh air and chaos of Glasgow on a Friday late afternoon just as folk leave their jobs ready to go bananas on what was the first summery feeling day of the year. I stood taking it all in like Alice in Wonderland, a very surreal moment.