Lock-down Diaries #8.

Hello once again my wonderful, faithful and remarkably ever-increasing little band of followers. I am beginning to feel a bit like Robin Hood and his Merry Men, and Women obviously. Fergysrambles is most definitely an “equal opportunity employer”although I am afraid I don’t pay very well. All are welcome and it appears the offer has been taken up on a scale I had not really contemplated before.

If you want to know about it and what I have been up to since the last entry, you know the drill by now, simply press the “read more” button below and I’ll bore you rigid once again.

I do hope that this entry will be published a lot quicker than the last one which was delayed due to “circumstances beyond my control” as the saying is.

When I checked my messages today I had another notification from WordPress (the place I prepare my site before publication) informing me that I had yet another “spike” in my views. In the light of this I decided to have a good look at my stats which I rarely do, primarily because it is all a bit technical for me. What I discovered, when I did finally master the technology, completely amazed me. We are just past half way through the year and so far in 2020 I have had visitors from an incredible 43 countries although somewhat oddly one of those “countries” was shown as the European Union, however that works. I suppose it just shows the pervasive brainwashing of that odious cabal.

Before I start writing what I am sure will be yet another massive entry I am going to alert you to another little game I am going to play with you all. I do like to keep you on your toes, it’s fun. In previous entries all over my site I am always quoting song lyrics or titles and normally write something like “”all things must pass” as George Harrison once famously put it”. I use this as an example as I know I have referenced that particular lyric before. What I am going to do from now on is drop a few into the narrative without referencing them, lyrics and titles.

What I’d like you to do is drop me a one line message here if you spot them, it does not have to be elaborate as I don’t want to waste more of your time than you already expend reading this rubbish. By all means write more if you want, I am always up for a chat.  Just cut and paste the quote from my text and say where you think it is from i.e. artist and song. It will be a bit of a laugh and a good way to a) interact with you which is what I am loving more and more about this site the more viewers I get and b) test your musical knowledge. Most of it will be 70’s / 80’s rock as that is what I am into but there will be something for everyone. There may be titles as well as lyrics so keep your eyes peeled.

Of course, I am ever in your hands and if you think this is a stupid idea and of no value then please feel free to tell me, I have a tough hide, not impervious to surgical scalpels as I have found out recently but tough enough that I don’t get offended easily so feel free to hit me with your best shot. If it seems puerile to you, let me know. Back to the narrative now about my stats.

I was just sitting here thinking about someone in Qatar, Cambodia, Latvia, Hong Kong or wherever else reading what I write here and it is literally mind-blowing. Again thanks to each and every one of you. The rate of technological advance never ceases to amaze me and when I think that a mere two generations ago all four of my grandparents were born before the Wright brothers took to the air in 1903 it almost beggars belief.

The Wright’s landmark achievement was less than 120 years ago and now anyone in the world with a power source, a basic computer (or mobile ‘phone) and an internet connection can read my ramblings about everything under the sun which I find difficult to get my head round. The dates put my birth roughly halfway on that scale between the first powered flight and today’s technological age, is it any wonder I get confused sometimes? At the current exponential rate of advance (if indeed it is advancement but that is another argument) where we might be in another 120 years can surely be nothing but the wildest conjecture even by the greatest minds.

Enough of all this attempted profundity which has undoubtedly fallen flat on it’s backside and back to things I can speak of with a degree of knowledge as they happened to me in the last couple of weeks.

I should begin, as is so often the case, with an apology. I had got you all prepared for more gruesome images and issued the relevant warnings etc. and then they didn’t materialise. The reason is that I had originally intended to document my entire hospital stay in one Diary entry but after it had gone on so long I decided it made sense to break when I got admitted to the Royal London once again. It would have become totally unwieldy otherwise. I’ll tell you now there is nothing gory in this entry so feel free to read away.

You will remember that I had been re-admitted to the Royal London Hospital and I was eventually settled into a bay of four beds which I had it all to myself as you can see. Again, the photo was taken the next morning as I wasn’t really in much mood to get handy with the camera at that point.

Later on in the evening Doc. Goh came round to see me for a chat, having studied whatever scans I had had. He said to me a thing I mentioned right at the top of the last epic, which seems like a thousand paragraphs ago, that I had been too good a patient. I was baffled. He asked me again what I had been doing since my discharge and I told him how I had been following instructions to the letter. He said, “Thought so, your immobility has led to another couple of clots”. What? Are you joking, Doc? I told him I had done exactly as ordered and he said he understood but it hadn’t really worked to my advantage. He explained that they were veinal clots, which was the only respect I had erred in with my self-diagnosis as mentioned above, and he intimated that while they were serious they were not quite in the same league as the arterial clots I had been admitted with first.

It was probably the only time in the three sagas of hospitalisation in the last ten months that I felt a little down-hearted. I had done everything required of me and it had still gone horribly wrong. I was a slightly unhappy bunny that night. I didn’t even have the will to take images of the sunset and the magnificent view over the City of London. I really was a bit down then. The Doc had said I was good to mobilise as far as the bathroom so at least I could get out of bed but I had nobody to talk to and I was looking at I knew not what. More surgery? I didn’t fancy that with the state my leg was in. More drugs? I had no idea.

That night I had more needles stuck in me, (subcutaneous blood thinners (Tinzaparin), a type of injection which I now know nurses call subcut and which I like to show off with), any amount of obs and so I settled down to a night of BBC iPlayer documentaries which really have kept me sane since Chinese virus house arrest. It was a long night and if I slept for two hours in fits and starts, that was it.

When I awoke I was still alone, which was nothing to do with CoVid or I would not have been on an open ward but presumably because there just had not been many admissions the night before. As I mentioned in the last Diary, that ward is meant to be gastro-enterology but in the current situation it has been changed to an admissions ward. I didn’t sleep a lot and the images above were taken at 0509 in the morning.

 

The one great joy of 10E is that it is high up as the name suggests and the bays face West so you get a great view over the City of London i.e. the commercial and financial hub, arguably the most important in the world although that position may be currently under threat for number of reasons. The images above give an indication of the view, complete with the hospital roof and safety railing. I don’t know who needs to go out there or why but I can tell you I would not be doing it. I just don’t like exposed heights. Still, if you have to be ill I suppose there are worse vistas to contemplate as you recover.

I knew exactly what the routine was going to be, obs at 0600, breakfast at 0700, handover at 0830 and then into another day, and so it proved.

There is nothing cooked for breakfast in the hospital so I resorted to my usual cereal, toast with a banana sliced on top and sugar (a childhood favourite of mine which I revived) and coffee. It’s not a bad breakfast and fairly filling and it brings me on nicely to the subject of hospital food which is outsourced to a company called Serco who are probably best known to most Britons for a series of blunders in letting often dangerous prisoners escape from their custody ( they dabble in, and fail miserably at, prisoner transportation as well). I won’t elongate what will probably be a lengthy entry here but just enter “serco prison escape” into your preferred search engine and you’ll get more reading than even I can provide on a good day.

In 2014 they had to repay £68.5 million they had overcharged (for which read stolen from) the Government for tagging offenders. It was subsequently fined a further £19.2 million for this fraud plus investigative costs of £3.2 million. The judge presiding said they had “engaged in quite deliberate fraud against the Ministry of Justice in relation to the provision of services vital to the criminal justice system.” As far as I can see, and almost needless to say, nobody has ever faced trial for this staggering theft.

Serco runs the infamous Yarl’s Wood Immigration Detention Centre where it uses the residents as slave labour, paying them as little as £1 per day and where allegations of sexual abuse are rife. A spokeswoman for the charity Women for Refugee Women, said “Serco is clearly unfit to manage a centre where vulnerable women are held and it is unacceptable the government continues to entrust Serco with the safety of women who are survivors of sexual violence.”

I could go on but I won’t but it bffles me why the Government still entrusts them with important contracts including feeding the poor patients of the RLH. It is no wonder it is chaos. Still, the last figures they published for the Financial Year 2018 show a profit of £80.5 million so at least the shareholders are getting a good dividend and the bosses a healthy bonus and that is all that matters, isn’t it? Who is worried about patients starving? Not Serco, that is for sure.

Malnutrition is known to be a major problem in hospitals, especially amongst long-term patients and the biggest ever survey on the subject was published in 2018. Treatment of malnutrition generally in the country amounts to £23.5 billion, which corresponds to ~£370 per capita of population. Frightening but hardly surprising with a proven failed organisation like Serco at the helm of many NHS trusts and continuing to be granted huge contracts in the face of their obvious incomptence. Obviously I would never write anything libellous (I cannot afford lawyers like Serco or Government ministers can, nor would I give them a penny anyway) but you cannot help but wonder just why this situation exists. As always I’ll let you make up your own mind, you are all intelligent people.

I have reproduced an image here from a previous diary as to what Serco thought was sufficient food to sustain an adult male from about 1730 in the evening until an uncooked breakfast thirteen and a half hours later. The next hot food was about 19 hours away. Disgusting and unacceptable.

If you have a look closely at the menu here (I’ve cropped and blown it up to help you) you will see that in addition to the three meals of the day there are supposed to be four “tea trolley” runs serving hot and cold drinks and snacks. These are before breakfast, yes a cup of tea or coffee before breakfast, mid-morning, mid-afternoon and in the evening after supper. When I was in the QEQM in Margate I often found myself refusing another coffee as my back teeth were swimming but at least the offer was there.

I understand there are very peculiar circumstances at present but on 10E they managed at least a couple of tea runs in the day whereas on 3E I spent a total of about 11 days over my two visits and saw the tea trolley once, it just didn’t happen. I can only ascribe this to the idleness of the catering staff, further examples of which follow.

Another pet peeve is that they are supposed to come round for your lunch order after breakfast and take your supper order after lunch. They do this on 10E but not 3E where the catering staff demand, and none too politely, your orders for both meals as you are still eating your breakfast. Again, I have provided photographic evidence above from the menu. I really am not making this up or moaning for the sake of it. I would not be one to knock the NHS at any time as I think they do a brilliant job under extremely trying circumstances even without the current madness. It is not the NHS, it is the outsourced ancillary staff that seem to be the problem.

At one point during this incarceration I was chatting to a nurse and I told her that the NHS had literally saved my life twice in ten months and that was not hyperbole but merely a statement of fact. Had I not had my ulcer treated it would have poisoned and killed me and if I had not had my leg treated it would have had to be amputated and if not it would have gone gangrenous and killed me. The young nurse (whose name I know but shall remain nameless to save her blushes) seemed a bit thrown by this statement but I merely use the anecdote to indicate that I yield to no man in my admiration of a medical service that, even with years of underfunding and mismanagement still provides what I believe to be the finest medical service in the world.

Sadly, we are back to the food and another moan. I would be embarrassed to serve the standard size meal as a kiddie meal in a restaurant as it would not fill an average eight year old. The menu clearly states that large portions were available and yet it was only after much repetition and complaining that the obviously incompetent “Ward Host” (what a pretentious and ridiculous name for a dinner lady, on a par with Refuse Disposal Operative for binman) finally got the message and I stopped feeling hungry all the time. It is bad enough to be ill but to be ill with a stomach unnecessarily rumbling from lack of sustenance in a hospital is completely unacceptable.

Despite the difference in the view I much prefer 3E as I have grown somewhat fond of it recently, odd as that may sound. In an ideal world, if they would swap the catering staff on 10E and 3E then the latter would be the best ward around although that is something of a flight of fancy.

It was Friday and that was good because Friday is fish and chip day, haddock which is nicely done although the chips can be a bit hit and miss, sometimes badly underdone. The only slight problem with fish and chips is the choice of vegetables as peas, mushy or garden, would be the traditional accompaniment or even baked beans at a stretch but, as you can see, I have green beans. Back again to the menu which offers a “choice of seasonal vegetables” and there are three on offer every day so pick any three from diced carrots, cabbage, green beans and sweetcorn, that is all they seem to do. Presumably they are all always seasonal wherever they choose to import them from.

This leads me onto another idea (told you this was going to be an epic, I do hope you loaded yourself up with a nice drink and some snacks or you’ll be wilting by the end).  I have heard about a scheme recently where farmers are offering “ugly fruit and veg” for sale in supermarkets. In years past, the big retail chains would only take what their idea of “perfect produce” was, notions promoted by marketeers and admen. With the backlash against food waste, which I loathe, they started selling mis-shapen fruit and veg under the clever tagline of “looks a bit odd but still tastes the same” or something like that. Previously, they had either let it rot on the ground or possibly sold it cheaply for pig food or whatever. Why don’t the NHS alleged food suppliers come to some sort of arrangement with farmers to take up the surplus of “imperfect” fruit and veg? They can keep costs down and for a lot of the veg is going to be diced anyway to make it more easily chewed and digested so it does not matter. Seems like a no lose situation to me. Perhaps they already do it but somehow I doubt they have the smarts.

I am surprised they do not offer baked beans in the RLH as they are high in fibre and protein and generally regarded as being a good, healthy food. Most importantly they are cheap, especially if bought in bulk, and in a situation where economy is paramount this must be a factor. I would think that garden peas would be at least as cheap as green beans and again fairly healthy.  Bizarrely, you can get baked beans in a jacket potato but only there and not as a vegetable, it is completely perverse.

I have just spent about an hour trying to find out how much is spent per day per patient on food in the London and it is impossible. There are some old sensationalist newspaper articles from years ago and Freedom of Information Act responses also dating back years but nothing recent for Bart’s Trust which the London comes under now.

One rather old figure I did come across was that Bart’s was spending £13 or thereabouts on daily feeding per patient. Now, I don’t know how that cost was worked out and whether it includes transport (virtually no hospitals have their own kitchens any more and everything is shipped in from remote kitchens often hundreds of miles away) and paying staff like the idiots on 3E but that amount amazed me.  Even without the benefits of bulk buying, and they obviously garner considerable savings from the normal retail price, I could feed myself like a king for that money. That amounts to over £90 per week.

I do not skimp myself when I am eating especially now that I have regained my appetite and I cannot remember ever spending £90 on a big shopping in my local supermarket even including buying a new frying pan! It is utterly ridiculous.

What I did find out definitively is that Bart’s is the biggest NHS Trust in the country with in excess of 16,000 staff over five sites and 1,255 A&E patients every day which proves my point from the last Diary about how permanently busy A&E at the London usually is. With my compulsion to find things out I might even submit an FOI request about the daily spend on feeding patients, the results of which I shall furnish in due course here in the diaries.

I am rather liking the immediacy of these diaries, or as near immediacy as I can manage given the amount of time each entry takes me and my viewing figures certainly seem to bear out the value of doing it. OK that may just indicate that you are a bunch of ghouls who like looking at nasty images of festering wounds but somehow I doubt it. You all seem to be totally trustworthy, straight and sincere and you never castigate me for my almost obsessional ramblings. I think the company I have here is pretty sound and it pleases me.

Perhaps you are all just too polite and well brought-up but I doubt that as well. I know a lot of you personally and I know you all have very well-developed minds of your own from which I can only conclude that I must be getting this at least partially right if I am not being hit with even very civil and veiled criticisms of my style, if it can be called such. I am very much a one trick pony and this is the only way I can write. On yet afain with the narrative (eventually, I hear you cry with relief).

I had most of the day to myself, usual obs (they never go away) and I used to joke with the nurses that I could take my own which I probably could with a five minute course on which button I needed to press on the mighty obs computer to inflate the BP cuff. Certainly I can put a sensor on my own finger (always the other hand to the arm you have the BP cuff on – told you I know this stuff), and I am sure I can manage to put a disposable sterile cover on the thermometer and stick it in my own ear without mishap.

I know I had a standing joke in the QEQM hospital about taking my own handover (see my earlier entry from last year about that) and that was going to be my next mission, taking my own obs although I doubted they would allow it. Shame, I could do my own subcut injections (I had to “prove” to a nurse that I could stick a tiny needle into my own belly before they would give me injections to take home. I passed (you don’t say after two months of it last year!) I would have liked to be the NHS’s first self-sufficient patient. How cool would that be? Get a robot obs machine to come to your bedside and say in a computer generated voice “Good morning, Mr. Campbell, time for your obs. Please put the cuff on your arm” and so on and so forth. I am sure it is feasible with modern technology.

It must be utterly infuriating for medical professionals who find themselves in hospital and unable to do simple tasks that they do daily for a living. There is an old saying that nurses make the worst patients and I can understand why. Then again, if patients do become self-sufficient, how many of these utterly magnificent people would be out of a job? Doesn’t bear thinking about although I am surprised successive Governments have not thought of it as yet another money saving and dangerous idea. Let’s be honest, they have had plenty before.

Perhaps they could outsource “patient classes” to Serco so you could be trained before elective surgery and do everything for yourself in hospital. What an utterly appalling thought and I wish I had not just had it. Indeed I am nearly afraid to publish it lest some Dominic Cummings or one of his acolytes takes it to heart. As I am composing this a terrifying thing has just happened.

I just looked up Dominic Cummings on Google to check on the spelling of his name (I do like to get things right here) and on Google he is shown as “Dominic Cummings, political leader”. How? Why? Who ever voted for him? Has he ever even sat on a Parish Council? No. He is one of that detestable breed known as the political class but he has the smarts to not actually put himself up to the public scrutiny of the ballot box.  For those readers lucky enough not to be aware of the Brotosh political class, Cummings is a “special” advisor to the Prime Minister and the allegations are the he effectively runs the country.

Cummings is an arrogant and utterly offensive human being, a coward happy to hide behind the power of his political “Masters” who he seems to have cleverly turned into his political servants. He flouts the Chinese virus law with impunity by driving near enough the length of England South to North to visit his second home but is too big for any senior police officer to challenge, cowardly bastards that they are now but such is the modern police service.

It is a sadly watered down version of the police force we once had in this country and an appalling indictment of senior officers hoping against hope for a knighthood or lucrative position with G4S or, dare I say it, Serco?. Forget morals and what you are supposed to be doing, it is very much the “I’m all right Jack” ethos at that level.

Cummings is evidently above the law, backed by his boss the PM (notwithstanding that he had been in Intensive Care himself with the Chinese virus) and with no mandate whatsoever. He is just a very clever, devious individual capable of wreaking havoc on the country without any form of accountability.

I know it is hugely unlikely he will ever read this although who knows what illegal contacts he has in GCHQ monitoring any mention of his nationally disliked name? He actually has no legal power in my country above that of any other citizen to make a citizen’s arrest etc. in very limited circumstances. When your minions report back, Dominic, please sue me. I’ll defend myself in Court (damned if I am paying those other charlatans the lawyers) as it will be my finest hour before I die. Then again, I do not expect you to have the balls to do it. You always hide behind others, your protectors, whilst you get rich without risk.

Nice work if you can get it. Go on, I dare you, face me man to man, but that was never really your style, was it? Interesting that you are shown as a former nightclub owner in Durham. You are flying high now. Remember Icarus.

Well now, I am not quite sure how I moved apparently seamlessly from being quite sick in the RLH to a rant against the disgusting Cummings, it is just the way my mind goes when I get into one of these Kerouac “stream of consciousness” gigs. I do apologise for using Kerouac as an example all the time but he is the only author I know, with my limited education in English literature, that writes in such a style.

Let’s get me back in bed before I alienate you all completely. It appears that hospital stories and gory pictures “sell” on the blog front so I’ll get back there now.  After my nice haddock and chips, which were actually fully cooked this time, and completely incongruous but tasty green beans I took into the sticky toffee pudding and custard which is easily the best dessert on the menu, and I have tried them all. It is a dish I would never contemplate eating in a restaurant, in fact I usually skip dessert unless there is something particularly appealing, and usually move straight to the cheeseboard.

I am quite happy to admit that I am a turophile and, no, that is not a sexual perversion, it means a lover of cheese. I know that philos is the ancient Greek word for lover as in philosopher which means a lover of knowledge and it has evolved into modern English with words like Francophile (a lover of everything French) Sinophile (a lover of all things Chinese) and so on but it was clear that a board of Neuf Chatel, Emmental, Gruyere, Stilton and (perhaps my favourite and sadly much overlooked now) Sage Derby.

Yes, they offered cheese as a breakfast option but I knew it was going to be cheap mild cheddar, matured for about 25 minutes and then stuck in a plastic package in a portion of about an inch and a half by an inch by about a quarter. You know what I am talking about, that horrible pre-packaged garbage beloved of economy class in-flight caterers, low-budget hotels and British Rail. Let’s call it what it is and I do apologise for my indelicacy as I know my Auntie Valerie reads this (sorry Val and I hope you had a nice fish and chips with the girls) but it is complete shit and a disgrace to the cheese-makers art.

I might even add a couple of bits of cheese and a knife to my “hospital bag” as I have no doubt I’ll be in there again sooner rather than later. I might actually upgrade myself to my larger but much older and more basic kitbag as it holds more. I learn more every time as to what I need to survive hospital. I swear I am going to write a book soon. “Hospital bags and how to pack them”, or “Hospitals in Southeast England I have known and loved” or even “How to endure Serco catering and live”. I reckon there has to be a bestseller in there somewhere.

After lunch I just settled down to an afternoon of doing not much, except the never-ending obs which was the only human contact I had but that is not a problem. Even without Chinese virus house arrest, I regularly sit indoors for days on end without speaking to another soul. No, I am not a recluse, at least not in the accepted sense of the word, I do like company but I am equally happy sitting on my own doing computer stuff and cooking etc. if I have nothing specific to do. If the weather is bad in winter and I don’t fancy a walk I’ll often not go out the door for a couple of weeks. I usually have enough food to keep me going.

I cannot even remember what I was doing, either reading one of my books or watching documentaries or whatever and the next thing I knew was that two porters arrived. They had to be for me as there was nobody else there. “Hi guys, where is it this time? Radiography?” I should explain that the last person to know anything about their treatment in a hospital is the patient so I was thinking that I must be due some sort of scan as I had not had one that day. No, wrong again. “3E” said one of the two bods and I could see one of the nurses with my notes. 3E? Oh, happy day! Fergy was going back to his old stomping ground and was a bit of a happy bunny at that news.

I got myself gathered together and off we went with the two porters pushing me and the nurse bringing the bedside table with all my kit in it. It is a clever system where they move you and everything belonging to you in one piece without unloading personal gear etc. and then re-loading it at destination, it seems to work well.

Down in the lift and I remember thinking what would they do in the event of a fire where you are not supposed to use the lifts. I think the main towers are about 17 floors high and how you would get bed-bound patients out I do not know. I am sure they must have a plan for it but it would be a nightmare. Anyway, we were not engulfed in a sudden conflagration and I was wheeled into 3E.

I went past the private room where I had first been whilst waiting for my CoVid results, then past the first of the nurses station where the Portuguese day sister who I knew quite well and one of the nurses who I was also friendly with both waved and one of them shouted, “what are you doing back here”? to which the obvious reply seemed to be, “I missed you all so much I booked myself in for another stay”. Quickly moving on (these porters re busy people and don’t hang about for idle chit-chat) and past the bay I had been in before where I saw Victor still in his bed by the window but I was past before I could even call to him. On down to the far end of the ward, where I had never even ventured before, and a sharp right into another four bed bay where I could see that I was completing the complement.

I was pushed past an old guy on the right who I was to find out later was called Jeff, an Asian guy on the left whose name I think was Rashim but I am not sure. Friendly enough if you spoke to him but kept himself pretty much to himself with his earphones in. He was to do me a huge favour a few days later. I was propelled towards the left hand far bedspace which was the prime position in the room as it had a West facing window and a South facing one which would catch the sun all day should there be any. Happy days.

Opposite me was a young guy with glasses and rigged up to a TPN through a central line. If you don’t know what a TPN is, have a look here. It is a detestable thing that I spent hooked up to for nearly four weeks when I was in the QEQM having my ulcer sorted. It is basically a means of putting nutrition directly into your system without having to bother about the usual gastro-intestinal tract and is used a lot after gastro surgery.

Brakes on and I’d landed, back in 3E and I genuinely felt a sense of being in the right place. I know it is a vascular ward so it was the right place in terms of my condition(s) but it bizarrely felt somehow comforting to be back there amongst people I knew. It sounds daft I know, but there you have it.

The guy opposite waved over and said, Hi there, I’m Mark” so I introduced myself in turn and that was to be the start of a great friendship but I fear you will have to wait for further details. I promise I am not trying to tease you but it is now the afternoon of the 14th of July and I had an early appointment with the nurse to get this leg sorted tomorrow so I could really do with my dozette and I want to get this published first. Also, it will take me a long time to get the images sorted so I think this makes an appropriate break.

I’ll try to get the next Diary done as soon as I can, let’s be honest I can’t really go anywhere and hopefully we’ll get through the juicy bits of both my left leg and my latest sojourn back on 3E so stay tuned and spread the word.