Many thanks to Mike Jennings for sharing this story. Mike is Consultant Physician and Geriatrician at the Northern General Hospital in Sheffield working in acute general and geriatric medicine. His recent and current roles at the University of Sheffield have included being Academic Co-ordinator for Geriatric Medicine, and Faculty Director of Learning and Teaching for the Faculty of Medicine, Dentistry and Health.
“It’ll be a spinal, Mike”. The orthopaedic surgeon said it so matter-of-factly. He conveyed a sense of it being his preferred MO – perhaps he likes to engage in polite conversation with his patients as he rearranges their hind-quarters. “Blimey, a spinal anaesthetic” thought I. Hmmmm, not sure I could cope with all that drilling, and sawing, and hammering – and, as one of my surgical “friends” pointed out to me, in jest, the smell of burning flesh! Anyway, a spinal anaesthetic it was. I remember waking up (apparently it was 20 minutes into the operation) and the anaesthetist saying “Are you alright, Mike?” and I replied through the oxygen mask “Yes, I’m absolutely fine, thank you!” feeling an enormous sense of relief that I was indeed feeling absolutely chipper!
I was aware of the aforementioned orthopod, a nice man, big powerful hands (come in handy in his trade) behind a large plastic sheet, but I looked away and focussed my attention on the anaesthetists’ dials and knobs as a way of distracting myself lest I lose it and start panicking. I was aware of my right leg being pulled about a bit and I swear I heard a bit of banging and a pop (was this the hip socket coming out?) but the whole thing was certainly no worse than going to the dentist. I’m a medic, have been for 35 years, but modern medicine often amazes me still – and one of the best things about being 59 is that I have had the opportunity to witness medical advances at close quarters. Keeping up with it all has sometimes been a bit of a strain but golly it’s been a privilege.
So, how had I arrived here in this predicament – a beneficiary of “the greatest medical advance of the 20th century”? Well it all started in June 2013 when we were away on a dancing weekend, “dancing with the stars” (highly recommended, btw, if you are a dancer).
I got back pain, then groin pain and I confidently diagnosed a “bad back” and a flare-up of arthritis in my hip caused by walking funny ‘cos of the back trouble. I carried on dancing (a passion, nay addiction of mine), playing golf (another addiction), and started taking pain-killers (something I have never done with any regularity – I’m not a great believer in pills!). I increased the frequency of my visits to the local swimming pool, and even went for a back massage which actually worked, for a few days. It didn’t get better. Colleagues said “get a scan” but actually scans don’t tell you what’s wrong so I soldiered on believing that a holiday (in bella Italia) would heal it. It didn’t. So, by now 3 months down the line I went to see a specialist and X-rays showed that I had moderate to severe osteoarthritis of the right hip. “So, the 64K dollar question” I said to the specialist, “when is that going to need replacing”. “Can’t tell, really, maybe soon, maybe in 10 years time”. Off to physio, went I, then podiatrist for insole (right leg 1cm shorter than left leg apparently). The effect of this piece of kit was instant, and nice, but sadly, short-lived. Back to the specialist who arranged a steroid injection into the aberrant hip joint. A week of bliss ensued – almost pain-free, but then relapse kicked in and with it the inevitable realisation that an operation was coming in 2014………..
Things were bad, even worse in retrospect as I look back on it. I took more pills than I could shake a stick at, dance lessons ceased for 5 weeks (would sit and watch my wife dance with the teacher), and I stopped golfing. Sitting for 1-2 hours in committees produced hip pain, ward rounds were particularly challenging (“I have a lot of pain, doctor” – not as much as me my dear, thought I). On one occasion I had to ask the junior doctor to slow down as we walked between wards ‘cos I couldn’t keep up with her! I had pain in bed at night. One Saturday night after we had been to a “social” dance I lay in bed in tears, as much because of the frustration as the pain. Another effect I noticed was that I was becoming slightly self-conscious about using my brolly as a walking stick. I wouldn’t dare cross Whitham Road other than on the pedestrian crossing – moving swiftly to dodge cars or bikes was not an option. So, when the surgeon offered me “the option” an operation it was a no-brainer – I was knife-bound!
It went very well – the op…….and the aftermath. The nurses were brill, the care excellent – the NHS is amazing – and all for “free”!! Yes, I know, I’m in the trade and a consultant, so they gave me special treatment. Nope, they treat everybody as special. Actually I think most of the staff didn’t know “who” I was. When the nurse on nights asked me “Do you want some biscuit” with my painkillers (they can cause stomach ulceration and so should be taken with food) I said “No thanks, it’s Ok, trust me I’m a doctor!” She laughed!!
The first few weeks were challenging. Walking on crutches, showering, eschewing alcohol (things were bad!), the essential post-lunch nap, sore heels, sleeping on the back (and the compulsion to turn on to ones side in bed – this is forbidden because it may cause dislocation of the prosthetic joint), getting up 3 times in the night to pee loadsa water and yet trying not to disturb the wife (impossible), the pain in the legs first thing when making the reviving first cup of tea and then trying to get back upstairs back to bed with said cuppa. But these are all soon forgotten when vestiges of normality return. Problem is being in the know. You “know” what can go wrong. “Is this leg swelling normal or do I have a blood clot in my leg?” Anyway nothing did go wrong…………….
So, here I am, a year later, back at work (went back after 12 weeks, struggled at first, but holidays helped), keeping up with the junior docs on ward rounds, coping with my patients’ pains, swimming, golfing, and dancing , and slowly but surely getting back to normal activities.
I know I’m a better doctor for the experience. Now I know what chronic pain is, what it feels like to be disabled, the psychological effects of pain and the restriction of activities, the effort that is sometimes needed just to stay happy and not get down, the challenge of the walking frame and the crutches, the humbling effects of dependence, the gratitude felt when assisted by another person to perform an activity which is normally done automatically and without thinking. I’m a Geriatrician and have been for 22 years but now I feel I have a better understanding of what it might be like to be old……..
I know more about the NHS – the system I’ve worked in for 35 years. It’s remarkable, underestimated, but should be cherished by those who are treated in it and certainly by those who work in it – yes, there are issues to be addressed with demographic change and as societal expectations continue to rise but we have been meeting those challenges for nearly 70 years so why shouldn’t we continue to do so?