Heartbroken by the rows of trolleys packed back to back in corridors at 2 am in a darkened A&E department. Most seem to hold an elderly patient grey-faced and loosely bandaged in a twisted blanket embalming the old and sick. Heads hang off necks too weak to support them. The trolleys are bereft of pillows with cold and plastic surfaces easier to wipe down and clean. Their inhabitants, if strong enough, repeatedly plead for pillows to any passing staff member. Pillows are banned now along with much of the expected humanity one would hope to find in a place of healing.
They usually only end up here as a last desperate resort. When really in pain beyond endurance or unable to draw breathe properly, the elderly, like my mum at 89, break their daily vow never to go to hospital, and 999 is dialled. Mum’s ambulance had raced from Limavady to Ballymoney to collect her as Coleraine Hospital had all their available ambulances parked outside A&E unable to offload patients. My Mum was shaking uncontrollably for hours with severe back pain, vomiting, and breathing fast shallow gasps of air until we eventually called the emergency services.
The ambulance arrived in response to the call in just over half an hour and the dispatcher stayed on the call talking to me while we waited. A team of three determined ambulance personnel arrived with loads of equipment and quickly checked measured blood and heart measurements. They administered pain relief and insisted on taking my mum to the hospital. They said there were just too many worrisome medical indicators and we reluctantly agreed. They decided to go to Antrim hospital because of the queues outside Coleraine A&E. But when we arrived outside Antrim A&E there was a five-hour wait in the car park. My poor 89-year-old mother gasped in agony at the hardness of the stretcher in the back of the ambulance. The wait seemed never-ending, those trolleys are not designed for comfort. During that long and unbearable night, I was struck that so many elderly and vulnerable patients are lying for hours and hours waiting for help in such conditions. Some die on these hard-cold trolleys outside hospitals and it seems to go on getting worse and worse instead of being improved. We wouldn’t let a badly injured dog howling in pain sit in the back of the van outside a vet’s so why do we expect the vulnerable, the ill, and stoic elderly to endure such conditions?
Shame on this system of abuse. Is it due to a lack of funding, gross incompetence, a lack of staff, shortage of beds or equipment, staff burnout, or GPs hiding in the trenches while emergency services face all the flack? I have no idea, what is wrong with the system. I cannot fault the kind ambulance staff or the over-pressured hospital staff but it is not acceptable. Too many are in corridors or in the back of ambulance vans suffering pain and whatever we are doing is not fixing it. On my worst days, I wonder how truly awful everything will have to get before we throw off this strange stupor and make even small changes to improve these conditions. I know there are amazing souls working their hearts out to try and make a difference it’s just I just feel we need to do more than just applaud them.
When we had eventually entered A&E mum’s trolley was wheeled into a corridor filled with other patients on trolleys end to end like carriages of a train awaiting a missing engine. In the nearby ward, there is a shouting angry man and there seems to be three staff remonstrating with him. I think they want him to wear an oxygen mask but he doesn’t want it and shouts violently and aggressively, he pulls it off and the staff tries to reconnect it. Their arguments go on hour after hour and there is a tiny part of me rather ashamed to resent that this nosy intoxicated patient is draining all the efforts of so many staff. After all, the softly moaning old lady two trolleys away may need more help but is not getting much attention. Another patient in the ward is a young teenager who has tried to commit suicide and two staff try to convince her to stay rather than discharge herself immediately. Her father arrives and joins the team pleading that the results from blood tests need to be checked before she can leave. She is dressed and standing close to the ward door trying to push past them as they valiantly encourage her to stay. This discussion lasted a good 40 minutes and was conducted with a lot of shouting. It seems that, like in most places, those that have the energy to protest louder get a lot more attention. Even here in this world of sickness and pain, it is the noisy demanding patients that drain valuable resources their way. The very ill and old have little energy or will to make such demands and just endure the lack of attention, the noise, and the disturbance.
I stayed by my Mum all night, beside her trolley, on a plastic chair kindly provided by a night nurse. In the early hours of the morning, I could rub her sore back, and whisper answers to her questions. In this frightening and foreign place, we had each other. My Mum hates hospitals and on the rare occasions, she has had to go in refuses to eat or drink and seems to withdraw into herself not speaking to staff. She can lose so much of her body weight in days. When the morning shift arrived, I was told to leave the A&E immediately.
Perhaps if the health system all had looked efficient and professional I would have accepted this better. But in the chaos of so many patients and shortage of staff, I felt that I was being asked to desert a loved one to uncertain unsteady hands. I was told they would do some tests on my Mum and I needed to leave but when they finished the tests they no longer allowed me to enter the A&E. I remonstrated with staff to no avail and waited in a closed hospital café restless like a dog that has left its post. A nice passing nurse, from a different department, let me back in with her card and I found mum had been moved to a different alcove, she seemed more withdrawn and silent. The nurse in charge found me back in her A&E and was understandably annoyed and insisted I leave immediately. I am ashamed to say after an hour or so outside I followed a passing cleaner into A&E who kindly let me in behind her. This time the head nurse was angrier to find me back again beside my Mum. I felt like a loyal dog that was being chased from the side of its owner but even embarrassment and shame could not stop me from wanting to be there with mum. I felt sorry for the already short-staffed A&E department that I was being so unreasonable. But another part of me could not condone deserting my Mum. That seemed an even larger more unforgivable wrong.
I have no answers. I know so many died alone during this pandemic far from loved ones. The privilege of those last moments of being there, where it is hardest to be, at the passing of a dear one was denied. It feels inexcusable and we sense so many other mistakes were made. It is difficult to rectify them all or even reflect on the lessons that need to be learned. So many hearts have been broken. Perhaps one solution is to find our humanity again and ensure it is expressed in all the different settings that matter. One of the important lifelines for those who are ill may well be loved ones. Even some animals will not leave a wounded family member, surely such instincts should be supported by institutional systems rather than blocked or denied?
In this depressing world of increasingly isolated living, that leaves so many alone and afraid we must rebuild the vital links with family, friends, and neighbours that fortify all of us. There are times that instinctually you feel the direction of flow is in a negative direction and you need to consciously head the opposite way. Perhaps rebuilding broken or neglected human bonds is the upstream movement that all of us need to focus on in these testing times.
