The Milk of Human Kindness

This morning I had an irate customer on the phone.   I knew I was in for trouble when I could hear the ‘I’m going to give you a piece of my mind and won’t stop until I am done’ tone in his voice.  The man carried on, he proceeded to tell me we were unprofessional, that if we didn’t want his work we should just say and that he wanted/needed it to be done before Christmas.  Why did he want it done before Christmas?  Was the birthday myth of some small child who had, apparently, changed the world, the pivot of his whole year?  If he was so worried about Christmas why didn’t he draw upon his Christian spirit and stop with his berating when he knew he had said all he needed to say?  Why didn’t he listen to my apologies and my understanding of his frustration?  Was HE really such a good Christian that his day praising the birth of some long fêted deity would be ruined by us?  After I had put the phone down, I cried.  No, I sobbed.  I cried out the months of frustration, the worry both on a personal and professional level.  I sobbed at my own weakness in creating a world of smoke and mirrors where outwardly everything ‘seems’ fine and dandy.  I cried because I don’t need reminding by a stranger of my own inadequacies but most of all I cried for selfishness and lack of kindness.  I don’t hold any Christian views, that is my choice and my right.  I don’t despise those who do either, everyone has a right to chose their own beliefs. 

The ‘man in the van’, who lives down the unmade road that runs past our house, was treated to some human kindness from my husband and me last week.  It was freezing cold and we had some leftover supper from the night before, it was going in the bin.  We cogitated over taking it to him.  What if he was a mad axe murderer, a lunatic, a paedophile (what a world we live in that, that should cross our minds)   He shunned all human contact and lived in the back of his van.  We caught on to what we were doing, we were assuming the worst of a man who for his own reasons had decided he neither wanted, or needed, human company.  We were judging him and forming an opinion without any factual evidence to support that judgement.   In taking his decision to live as he did he had made enemies, not just physical enemies (someone had smashed the side window of his van recently) but also those who did not understand, nor want to understand him.  They fear what they cannot understand and refuse to try and change.  Peter accepted the food graciously, he also accepted the fire cement that my husband took up to seal around his dangerously leaking, home-made, log burner.  On Friday he moved on.  He will be back.  Over the summer he has obviously found solace in that small, undisturbed part of the world that borders so closely onto my own. 

On Christmas Day if Peter is back I will take him a lunch, not to celebrate a birth that supposedly happened 2,000 years ago but just to acknowledge he is on this planet too.  He might not leave a massive footprint when he goes, he may be shunned for his looks and his lifestyle, but he is here, he walks the same piece of rock and molten lava that we do.  He doesn’t rant and rave about the inadequacies of others; he sits quietly on the periphery of everyone else’s world, living how he chooses.  Whether his decision is driven by fear, disillusion, heartbreak, misery or just pure madness I do not know.  I do know who I would rather spend time speaking to on the lead up to that day of families and festivities and it isn’t the customer who left me feeling utterly inadequate this morning.   Kindness when given doesn’t expect anything in return, it isn’t given out of pity or to appear patronising.  What kindness does do, hopefully, is make a small difference to someone’s day and best of all, it doesn’t give a damn what day of the year it is!

A Story of Frustration

It is very difficult to write a piece objectively about a relative and the care they have received during a stay in hospital.  The following words are not a criticism aimed at any one person or event.  It is merely the story of a woman and her struggle to retain dignity in testing circumstances. 

My mother in law is an amazing woman.  In May she will be 70 years old, she was orphaned as a child and brought up by an Aunt, she and my father in law married young and had four children, up until quite recently my parents in law also fostered children, in excess of 35 of them.  My mother in law has cared for her grandchildren whilst her own children went out to work and she has always been extremely active.  Her faith in God is unshakable and she has the kindest heart of anyone I know. 

In August MIL went to her GP complaining of severe back and leg pain, eventually she was sent for an X ray and informed that her hip was fine and no fracture was visible.  Four weeks later she was in utter agony eventually taking herself back to the hospital and refusing to leave until she was given another X Ray, despite being told ‘your hip is not broken we have done one X ray we do not need to do another’ In desperation my MIL said, ‘well I cannot and will not leave, until you do’.  She was right her X ray showed a fracture.  The words uttered to her? ‘You cannot go home Mrs Lamont, your hip is broken, you must have had a fall since your last X ray, did you? Oh and by the way you will need surgery tomorrow’.  Sometimes the patient knows their own body.

The repair plate was inserted and MIL bounced back with such vigour that even the nursing staff were amazed with her ability to cope and within a week she was discharged home.  Life was difficult for her, she struggled to get in and out of bed and get to the bathroom.  Eventually it was so painful getting in and out of bed she took to sleeping in her reclining chair in the lounge, snatching pockets of sleep as the pain would allow her.  The pain grew worse.  The physiotherapist assured MIL that this was a natural result of hip surgery, but MIL was scared and in pain.  After approximately 10 days, despite encouragement from family members and assurances things would improve MIL was at rock bottom.  The pain in her leg was excruciating and she no longer believed our words of reassurance all she knew was her world of utter misery and pain.  When she could stand it no longer she made my brother in law drive her to the hospital and demanded (yet again) another X ray. She was right, the screws in her plate had come lose and were constantly, unbeknown to us, scraping against her muscles with every move she made.  Sometimes the patient knows their own body.

Mother in Law had to wait in hospital for a week whilst a special Titanium plate was ordered in to replace the original that now had to be removed.  Her spirits were low and we tried to encourage her that this time it would be better and to try and get her to focus on how well she felt immediately after the first plate insertion.  Eventually the second plate arrived and MIL underwent her second operation in less than 6 weeks.  Her recovery this time was slow, she was nauseated, constipated, down hearted and had needed a blood transfusion following the operation.  She wasn’t helped by a bout of diorehea 3 or 4 days after the operation that incapacitated her for 24 hours.  Whether this was caused by 2 days of laxatives (due to constipation caused by the drugs) or a ‘bug’ we are yet to find out.

Her recovery was harder for her; she depended on the help of the nurses far more and felt like a burden.  A feeling that was alien to this strong and vibrant woman and she cried more often, especially if she couldn’t raise a nurse in time enough for her to get to the bathroom and this resulted in her ‘having an accident’.  It was hard to stay calm for her and each day we just kept telling MIL and ourselves she was a day closer to going home.  

It was about this time I did decide to put my foot down, MIL felt she was being treated as ‘needy’ by some of the nursing staff and after a while of letting the situation calm down and there being no improvement, I rang the ward.  I actually rang the ward because MIL had been told she would be going home this particular day and had got herself dressed and sat in a chair waiting, refusing to eat, in case she had sickness or diarrhoea in the ambulance on the way home.  When I rang the ward it was gone 6pm and she was still waiting, crying to herself in her chair.  The nurse was icy, until I gently reminded her that my MIL was normally a strong, kind hearted, independent, Christian woman and that the nurse should perhaps review her notes and realise this was MIL’s second repair in 2 months and she just wanted to go home.  The nurse and I agreed no ambulance would come that day and that I would explain this to her, NOT the nurse, as I could persuade MIL to return to her bed.  I rang MIL and gently broke the news to her and promised her faithfully that no matter what happened the following day I WOULD get her home and my heart ached as she sobbed down the phone to me.  The following day my sister in law and I booked a wheelchair taxi just in case and informed MIL.  Eventually at 3.p.m. the ambulance arrived and MIL went home.

This time Mil’s attitude was different, she seemed permanently down hearted and she worried constantly about the plate in her hip and fretted constantly about her recovery.  Her wound started to weep blood and puss.  After a few days there was no improvement, in fact the wound had become sore and constantly weeping.  MIL was returned to hospital the week before Christmas, the following day she returned to theatre to have the wound re-opened and washed out, swabs and tests were carried out and we waited and waited. MIL needed yet another blood transfusion.  She sat in hospital for Christmas and between Christmas and New Year we flew out to visit. 

It was now 10 days since MIL’s ‘wash out’ and her mood was optimistic as she was beginning to feel physically better as the antibiotics appeared to be holding the infection at bay, or so it seemed. Time was running out on our visit and my Sister in Law decided to stop being patient and ‘demand’ some answers and managed (eventually) to get an appointment with the ward Doctor.  We carefully explained that mother was a strong, optimistic woman and this was not the person we knew was sat in the side ward on her own that he saw.  We asked if the infection was in the bone or the plate and were assured that they did not know that for sure but that they had some results back and MIL had 2 infections in her wound (whether this was in the bone, plate or soft tissue they didn’t know!) one was a common streptococcal infection usually found on the skin, the 2^nd they were surprised by, it was a bug most commonly found in the bowel but was now present in MIL’s wound! (Remember the laxative incident!) The plan of campaign was to put MIL on an intravenous drip of antibiotics for SIX months and oral antibiotics for 12 weeks but they were confident this would cure the problem and once the wound had stopped weeping MIL would be allowed home to be cared for by the Community Nurse.  Things were looking up, or were they?  Time passed and we returned home assuring MIL that although she had to have IV antibiotics for 6 months at least it was clearing the infection and ensuring that it was totally eradicated. MIL accepted this and everything seemed calm.  Sometimes the family know the patient’s body.

MIL stayed in hospital and the wound improved but still continued to leak, we asked for the results of the plate and bone tests they weren’t very forthcoming.  Then the infection control team got involved and said that MIL could indeed go home the following Monday.  I was uneasy, I lay in bed and fretted, something wasn’t right, it didn’t feel right, but was I just worrying, fussing, being over protective of a woman I love to pieces and had been through such a hard time?  I spoke to my husband, without trying to worry him anymore than he was. I tried to explain that something didn’t ‘feel’ right and eventually I rang my sister in law (a qualified and practising Community Nurse) I suggested (after a conversation with a friend who has extensive experience in the hospital environment) that we asked that MIL was not discharged until we were certain that the infection was under control and until we had, had an in depth conversation with the surgeon.  What ensued was a maelstrom of events!  

My sister in law and I drew up a list of questions and eventually managed to secure a meeting the following morning after informing the surgeon that MIL was due to be discharged that day with a weeping wound.  The surgeon was unaware of this and an ultra sound scan of her wound was ordered, it showed a ‘large’ pocket of infection inside MIL’s hip near the joint.  We were also informed that the infection was indeed in the plate and that as a result MIL needed urgent surgery to remove the plate with the option of traction or cement spacers (laced with antibiotics) being placed into the hip.  It was devastating news, utterly devastating, this would be operation number 4 in as many months and with each operation MIL’s recovery time was slower and more traumatic to see. Sometimes the family knows the patient’s body.

MIL had her operation on Wednesday; she was very sick, very emotional, very sore and very downhearted.  The family are worn out.  We feel frustrated and hopeless because we live in the East of England and can’t be there as much as we want.  My father in law who has never been separated from his wife has barely had her at home since August/September and there seems to be no end to this misery as MIL now faces a total hip replacement in 6 – 8 weeks IF the infection can be got under control.  In the words of the surgeon following MIL’s operation this week, ‘it was a good job we got that plate out when we did’ excuse me but weren’t your hospital all set to discharge MIL on Monday leave her on IV antibiotics for 6 months, withdraw them and then ‘see what happened’?.  If I weren’t so concentrated on MIL and her wealth fare I would have gone into orbit.  Today news breaks of 3 small, newborn babies dying of infection at The Royal Victoria Hospital and a deep cleaning operation to clear the infection that has devastated 3 families and robbed them of the most exciting time of their lives. 

My MIL told me yesterday she just wanted to die, she doesn’t, she just feels that way at the moment and I can understand why.  I will let you into a secret, I don’t think we are anywhere near the end of this debacle and I am worried about the future.