A few months ago, completely out of the blue, I learnt that I had a problem with the flow of cerebral spinal fluid (CSF) in my head. It was caused by a thing called a Chiari Malformation – which I’d probably had since birth.
I had an operation to reduce the risk of potentially serious problems developing in the future. Actually there were five separate stages to the operation…this image I found on instagram sums it up quite succinctly
I’m not surprised the whole thing took around 7 hours to complete. It’s impossible not to be in awe of the skill of the surgeons who can do this sort of thing inside your head…and leave you up and about a few days later [A quick glance at the diagrams in this information sheet will be more than enough details for most].
I’ve no idea how much this sophisticated kind of treatment might have cost. I tried searching the NHS England National Tarriff but couldn’t find anything. A search of US healthcare sites on Google would suggest tens of thousands of dollars.
The NHS does the big stuff really well and I am very grateful.
But the small stuff? Not so good.
Finding out whether I was actually going to have an operation was hard work. I’d had a provisional date for months but had been told my Consultant needed to take my case to his team meeting. I had to chase and chase to finally get confirmation of the date just over a week before it happened.
We arrived at 7am on the designated day with a bag containing the items listed in a fact sheet I was given at my pre-op. We were shown to the day room where other couples sat looking apprehensive and unsure about what would happen next. Grim doesn’t come close. This space was where people in pain and about to undergo brain surgery waited for three hours or more. I get tyres changed at Kwik-Fit and I’m pretty sure they would be ashamed of this if it were their customer waiting area. (The sign on the wall, by the way, asked people not to move the bin. The thought never crossed my mind.)
No one explained what exactly was going to happen or how long it would take before anything happened. Eventually I was invited to another room to talk to a very friendly anesthetist. Then after another hour or so a doctor invited me and my wife Jo to join him in another room where he went through all the things that might go wrong with the operation and asked me to sign a consent form. It all really sunk in for Jo at this point.
Another long wait and then a nurse asked us to join her…this time in a sort of store room come office with just a curtain to screen it off. All the information and blood samples I had given at my pre-op had got mislaid so the nurse took more bloods and asked me lots of questions I’d already answered once. The curtain opened and someone in a gown burst in. They were ready to take me down for my anesthetic. “Ooh! quick, put these on!” said the nurse thrusting a gown and support stockings into my hands. So in a tiny space I stripped off and tried to work out how to do the gown up while an impatient trolley man stood waiting and the nurse double checked my post code.
If it wasn’t Alan Ayckbourn enough already, at this point my Consultant showed up. It seemed that the junior doctor who did my consent form had forgotten to mention something horrible that might happen so he had to quickly run through the whole grisly process again. This is when it got a bit too much for poor old Jo.
Finally I was ready to be wheeled away.
“What about my bag?” we asked.
The nurse looked around.
“Well you could leave it here I suppose but it might get nicked!”.
So my bag, carefully packed with all the things the hospital had advised me to bring with me that morning, was left with Jo to take home; and I waved goodbye as I disappeared down the corridor on the trolley.
The operation went well. I was discharged from hospital. After a few weeks recovery at home I went back to work and life has soon picked up its old rhythm. I have a rather nice scar on the back of my neck but I can’t see it so I often forget it’s even there.
But I don’t think I’ll ever forget those first three hours in the hospital and how they made us feel.
There has to be a lesson here for any of us involved in designing services or making investment decisions. It’s really important to get the big things right but the small things; the things that might not cost much (or which might even be free) can leave an even more lasting impression on those using our service; and not always the one we’d like them to have.