The politics of the hospital ward

Before the op, I was going to write a jaunty piece about how getting yourself ready to go into hospital is like getting ready to go to a wedding. Both require new clothes – that is unless you feel confident that your jimjams – dressing gown, slippers and, for goodness’ sake, knickers – are all presentable.

Now, back home after quite a major op for bowel cancer, I’m not feeling quite so jaunty. At a time when the NHS is described as broken and in need of reform, I know I’ve been lucky. I was diagnosed early, had a brilliant consultant surgeon whose communication skills were equal to his surgical skills, and a specialist nurse who was able to talk me through my many anxieties. If I’m less jaunty and find it hard to talk about my time in Ward 23 of Edinburgh’s Western General Hospital, it’s partly because recovery is slow and partly because, for a dozen days, Ward 23 became my home and the other patients became – well, my clan. There’s a kind of unique and slightly strange intimacy about sharing a ward.

I think that maybe the world is divided into those who, given a choice, would prefer to be in a ward and those who want a room to themselves. I’m a ward woman myself. If I’m going to be ill, I like company. Also, drama. There are five of us in Ward 23 – five women with bowel problems in a ward with one toilet. Four of us are over 70 (the eldest being 87), and one is in her fifties.

My bed in Ward 23 is by the window. I feel I have been gifted with sky. Beyond the sky is a view of the Pentlands (Robert Louis Stevenson’s ‘hills of home’), and on a sunny day, looking down on the roof of the Hospital Research Office, I sometimes see a russet fox settling down for a snooze. As do I.

A ward is a new country which you need to navigate. Hell, it is a new country. Firstly, you need to suss out the hierarchy of nurses, nurse assistants, visiting doctors, and top-of-the-grade consultants. Green scrubs seem to equal doctors. Green scrubs travel the wards in packs, hats still worn as if they’ve just this minute come from an operating theatre. Some are maybe students. Consultants are known by their lack of any uniform. If a man appears in jeans and a T-shirt, he’s probably a top consultant, surgeon or professor.

Lower down the order are the cleaners, who arrive early, avoid eye contact, and need to be tall to reach up and clean the tops of things. They possess an impressive range of mops and cloths. Last, but far from least, is volunteer Bob, who comes with a trolley of tea, coffee, soft drinks, biscuits, jokes and music. He’s reliably regular and always welcome.

But mostly your life depends on the nurses. There aren’t enough of them, and they work incredibly hard. To thrive in Ward 23, you need to become aware of change-over times, because it’s no good pressing your buzzer – and we all have a buzzer, even if at times one or other of us can’t find it, someone else will buzz for you – during change-over times. You can hear them in the distance chatting and laughing and hopefully exchanging information about their patients, not just ignoring our buzzers.

Catching the eye of a nurse has something in common with catching the eye of a waiter in a busy restaurant. In the ward, it requires tact and courtesy. The nurse may be attending someone in a worse state than you, or, irritatingly, she or he might be just chatting about grandchildren while you’re clenched in pain and desperate for help. It’s a case of choosing your moment, recognising when another patient is more needy than you.

Some nurses you take to, some you don’t. You become aware that the amount of compassion required of a nurse is beyond what most of us can manage. Then, just when you feel you’ve accomplished some kind of a relationship with one nurse, she’s off for the next three days. A new one appears, and you have to start your trying-to-be-a-good-patient routine all over again.

But the patients! The patients. My compañeros! What a conflicting relationship this is. There are those in a worse state than you. You are very, very sorry while also being glad that your own situation is not as bad.

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In Ward 23, Babs, whose bed is across the way from mine, is the most ill and, from time to time, has to drag herself to the toilet, clutching her nightdress about her. Her tall, well-bred husband visits and eats her grapes. One Sunday, when Bob’s trolley is off duty, Babs’s husband brings us all coffee and takes orders for newspapers. Babs is in considerable pain. The green scrubs pull her curtains and gaggle round her like hens. We can’t help but hear that her cancer has come back. She’s also grieving because her son is moving to Dubai and taking the grandchildren with him. She won’t tell him. One morning, he brings them to visit – a trio of beautiful, blonde children. The nurses make a fuss of them. We all love and enjoy meeting them, are heartened by their youth, and hate their Dubai-deserting parents.

At the far end of the ward is Tessa (84). Tessa is getting ready to go home. Of the five of us, she seems the most quietly stoical. She has cheery pink hair, nails to match and likes cruising. She’s probably Catholic because, on Sunday, the chaplain comes, draws the curtains round her and performs some kind of mass. We all listen in. Tessa has other visitors. She tells us that they are Sisters of Mercy. Tessa has chummed up with Carol (87). The nurses love Carol because she’s a very well-behaved granny who does what she’s told. She shares her chocolate buttons. When Tessa goes home, Carol curls up on her bed and wilts.

Now there’s an empty bed in Ward 23 and Jean arrives. She’s much younger than the rest of us – probably in her early forties. Whatever’s wrong with her is very wrong and looks like the consequence of an accident. Jean can’t get out of bed on her own and has limited mobility. She has hordes of rather glamorous young visitors and loves glossy magazines. She tells me it’s going to be weeks before she can walk again. By her third day in Ward 23, she’s beginning to look a little optimistic. Perhaps it’s just her age, but she seems to be in a different order of illness to the rest of us. She’s here for the long haul.

Every day, one of the assistant nurses hands out menu sheets for breakfast, lunch and supper, and we tick our choices. Sometimes, by the time you reach supper, you can’t remember if this is what you asked for or not. And does it matter? Perhaps life itself is like a menu sheet, and we all tick our choices, though sometimes life does it for us.