A 21st Century Comedy of Errors

The main players in this incident packed story are Dr Kathleen Finan, medical consultant at Sligo General Hospital, Dr Una Clyne, urological consultant at Sligo General Hospital and Dr Kilian Walsh, urological consultant at Galway University Hospital.  There are two separate scenes, Sligo University Hospital ( now referred by SGH) and its murky corridors and a much inferior hospital to its big brother, Galway University Hospital (now referred as DUH) with its bright and breezy corridors hiding inefficiency and bad practice, but they are the two biggest hospitals in Ireland’s western province of Connaught, which provided most of the labour to rebuild Britain after the 2nd World War, which only proves these two hospitals are good at shovelling shit.

As I told you in my previous trilogy of blog postings, Two weeks of Trauma in late April and early May this year, that Helen, my wife of 43+ years had felt unwell, the local doctor advised I take her to SGH, where she had a heart attack (sic) and they helicoptered her down to GUH as the only way of saving her life.  GUH had the equipment, SGH did not.  GUH stabilised her condition and because they thought that she had had a heart attack, they gave her an angiogram, to find where the clot formed and the incision formed by the procedure became infected causing two further procedures to cut out infected flesh leaving a 100mm x 50mm hole in the top of her right thigh.  The results from the angiogram proved inconclusive.  No blockages found in the venous system, no stents needed: head scratching was the order of the day.

This drama started on 11th April and she was returned back to SGH on 18th April and released from there on 25 April to be tended by the local District Nurse.  The heart was not the problem now, it was responding to treatment and the wound caused by the angiogram was being treated professionally and well by the District Nurse.  The good news on that front was on the 18th July some 14 weeks after the angiogram, our wonderful District nurse Cait Daly struck Helen off her list and pronounced the wound completely healed.  A pity as I found her most efficient and caring.  The problem now was that in their scans of the vital organs in their search for the cause of the supposed heart attack (sic) they by chance had found a spot (sic) on her left kidney.  Dr Finan had noticed this but as she was no expert in Urology she referred us to Dr Clyne who said she was.  We saw her at an out-patients clinic in Sligo on about 25th May.  Dr Clyne, a large contemptuous woman, started to explain the problem.  Her bedside manner would put the fear of God in anyone.  We started to ask pertinent questions.  “Don’t ask me that, I’m only a surgeon” she said.  The upshot was that the spot (sic) was 8cm long and over 2cm was considered to be malignant and she was referring us immediately to Dr Walsh in GUH, the top bollocks in terms of kidneys in the west of Ireland.  So much for her claim to only being a surgeon.

Whilst we awaited Dr Walsh’s invitation we had an out-patients clinic on about 10th June with Dr Finan, a serious, concerned humourless lady who showed us how Helen’s heart, badly swollen after the heart attack (sic), had returned to roughly its normal shape and was improving by the day and by the way it wasn’t a heart attack, it was a pulmonary oedema.  This we were told some two months after the incident.  A pulmonary oedema is where the lungs fill with fluid, the heart looks for oxygen, does not get any and starts to close down.  Why or how this came about she was not able to answer.

However she showed us the scan on Helen’s kidneys, the right perfectly clear and kidney shaped, the left covered totally by a black shroud.  The spot (sic) had become an ogre.  We expressed our concern at the lack of contact from Dr Walsh at GUH.  She rang his secretary who said she knew of the referral and would shortly be posting out an appointment.  This was the 10th June, nearly two months after the discovery.

By the 10th July even our GP was getting concerned and rang GUH Urology appointments who told him that Helen would be given an appointment shortly but that they had only been notified on 28th June.  Porkies immediately crossed our mind.  Either Dr Clyne who was supposed to have notified GUH on about 25th May, or Dr Walsh’s secretary who said she knew about it on 10th June were lying or more than likely lax in their communication methods.  Our GP gave me all the contact details and told me to pursue the matter on a daily basis and suggested it would possibly be quicker if we sought a private appointment as opposed to one from out-patients.

After three more days of telephoning GUH and relating our story I eventually got through to a nice lady called Una in Urology appointments who said she would do her best to process the matter but having no faith now in the system I decided to go for the private appointment and rang Dr Walsh’s secretary who said that the doctor was going on holiday for a month and that the earliest date she could give me was 26th August, I took it and was told to bring €150 for the appointment when we arrived in August.

The following day Una in Urology appointments was as good as her word and an out-patients appointment came through the post for 18th July.  I cancelled the private appointment but was wary of this months holiday that Walsh was about to take.

18th July was a fine summer’s day as we presented ourselves at GUH at 2.00pm for the 3.30 appointment which was being held in the fairly new prostate clinic opened in 2009 so the plaque on the wall said by none other than a cousin of mine Mary Harney, Minister of Health at the time.  I thought the gods must be with us as we waited expectantly.  They unfortunately were not.

Mr Walsh, a tall lean man, as well as being top bollocks in kidneys was humourless and useless without notes, called us in to the room, sat us on two chairs and sat at his desk with his back to us as he pressed keys on his computer, flicked through his file of notes, occasionally turning his head to the side to presumably see if we were still there.  He went back to Helen’s file flicked through the pages once again, did some one fingered typing on the screen in front of him and then swivelled round in his chair and said to Helen, “you have been seriously ill” and spewed out a load of medical terms which by their tone seemed to suggest seriousness. ” The trouble is” he said “I have only got the notes from your stay here in GUH in April.  I have no idea of the improvement in your condition since then nor have I the results of the scans taken in Sligo.  They have not sent us any of your notes.  If I consider operating on you with the information I have in front of me the operation might kill you.”  Assurance in deed from the top bollocks.

“I don’t know what to do” he said with one eye on his forthcoming holiday.  Helen suggested he went on the internet and pick up the notes from SGH.  He shook his head “Impossible he said our two systems are incompatible, if we need information of this type we rely on the post”.  Technology raised its head and farted.  It is only July 2016 and the two hospitals rely on a system introduced in the 1840s.  When Ireland sells itself to the world it talks of its high tech philosophy, there is no country finer.  If Kilian Walsh is top bollocks in kidneys, Ireland is the same in technology.  My arse!

Mr Walsh sighed and said all we can do is start from the beginning again and send you for more scans, more bloods, more x-rays and we will see you again in two months time.  Obviously these malignant tumours get on fairly well without intervention.  This did not seem to be much of a Plan B.  SGH could have been on the far side of the moon for all he was concerned and besides as he knew and probably thought that we didn’t, he was off on a month’s holiday and fuck it, if she is still there when I get back I should have all the information I want, if not so be it.

Helen mooted the idea of having all the tests done on the same day to save multiple 160 mile trips.  “No chance” said Mr Top Bollocks.  It makes me wonder why consultant doctors are so humourless, contemptuous, so lacking in empathy, in fact so devoid of emotion but I suppose if looking at the dead and nearly dead all their lives such feelings come naturally.  I can only thank God for my endocrinologist Dr Wilma Lourens in SGH who puts all the rest of them to shame with her gentle coaxing, concern and humour.

And as a last thought considering the number of patients shuttled between the two hospitals by helicopter and ambulance each year, surely it must be within the wit of somebody in the Health Executive to make the two computer systems compatible even if they have to draft in some 12 year old from the local National School.  We now await that far off day in mid-September when Dr Walsh has all his notes and feels well enough to give us his best prognosis.  If you have a God pray for us, our problem is we don’t, so we have no Plan C.

Hark, I hear the postman delivering mail and lo and behold how efficient, two days after our abortive visit to Galway, we have another appointment with Dr Walsh.  Not in six weeks or even two months but in 11 weeks time, 24 weeks after the tumour was discovered.  My how the time flys, how lucky we are in having doctors willing to go that extra few yards and how lucky we are at having tumours willing to wait.

And one very last thing I would like to praise the kindness and sympathy of Noirin, the nurse in Walsh’s out-patients clinic who showed on the day what the medical professionals need to be aware of when dealing with patients.  Knowledge and surgical skills are one thing but care and appreciation of a patient’s condition is a far bigger deal altogether.

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