A Trip to the Eye Clinic
Having almost fully retired and already drawing a pension, albeit rather smaller than I’d hoped, I knew that the sun would not shine for ever but I still hoped that I would see out my days with some clarity.
Walking my Labrador one Sunday evening I was aware that one eye was seeing more than it should do, but with less acuity than usual. Monday was a pre-booked ‘in-laws day’ so my own health was irrelevant. On Tuesday at 0815 I rang the NHS’s 111 service and explained my symptoms; they told me to get to A&E within the hour, which I did.
At A&E I was seen within 30 minutes by a charming nurse who triaged me and decided that I needed to go straight to the eye clinic, even though she told me there was, officially, a waiting list of several weeks; once there I was again triaged and handed over to a pony-tailed SHO with designer stubble. Being an old fart I judged on appearance - but soon came to realise my error. With considerable care he examined me and made a provisional diagnosis and then went in search of a Consultant to validate his thoughts. A particularly attractive young East European Consultant, in a blouse that was unbuttoned rather more than decorum dictated, came in and briskly and efficiently took over. With my head in the brace, she looked deep into my eye and ordered, “Look lower, look lower!” My embarrassment at what I saw meant that I deferred but eventually overcame my shyness and looked downwards, whereupon she confirmed the diagnosis. When I asked why this had happened, she looked at me and said, “You are over 60, you have had cataract surgery and you are male, do I need to go on?” Fearing that her next observation might include comments on my weight and baldness, or worse, I agreed that that was as far as I needed to know.
The young SHO was then sent in search of the Duty Consultant, who was due to run a laser clinic that afternoon, and told that he was to ensure that I was added to the list. Following the SHO at a trot, as she told me, we came to a diminutive Consultant, of Chinese origin, who was just finishing a sandwich. Whilst still chewing he told me to sit and put my head in another brace, whereupon he too confirmed the diagnosis.
He then gave the SHO – and me - a rapid refresher in ocular anatomy and pathology and finished by saying “I had an early lunch as my list is so long but it’s not due to start for another ten minutes. Would you be willing for me to operate now?”
Twenty minutes later the lasering was completed and both Consultant and SHO were patting themselves on their backs for a ‘neat job, well done.’ Naively I asked if I could have a photograph of my retina, to which he replied that the austerity cuts had left his department without a camera. Suddenly, he jumped up and started running out of his office, calling me to follow. We arrived at another department and, whilst he fired up their camera, about the size of an old fashioned VDU computer, he explained that he knew this department had been mothballed and so we could borrow it without questions, before he had to start his list. Proudly showing me a large coloured print I then asked if it also showed a coloboma, to which he burst out laughing. Not, it turned out, in response to my diagnostic ineptitude but with the reply “that’s dirt on the lens but we have to wait for next year’s budget for it to be cleaned!”
By 1315 – just five hours after initial contact - I was outside, phoning my wife for a lift home. All of the NHS personnel that I had contact with that day, from 111 to the Consultants and the nurses and SHO in between, exhibited not only great professionalism but also empathy and efficiency – and I will forever be grateful.
During lockdown I have regularly joined others clapping to pay tribute to ‘our marvellous NHS’ every Thursday evening but my own genuine gratitude for the outstanding people of the NHS is tinged with sadness at the administrators who make them practice in such conditions; no self respecting equine practice would tolerate standards being compromised for the want of a few quid. We must be careful that we put only the people of the NHS on a pedestal, not the organisation, whist continuing to seek improvement in the management of this behemoth.
Dr Jeremy Mantell MRCVS