“When I go into hospital for an operation, I always re-read Ulysses.” I would have taken the speaker as a resident of ‘Pseud’s Corner’ until I remembered that after a high-impact landing on my left shoulder brought a skiing holiday to an abrupt end, I read Ulysses. Well, it was that or Danielle Steel in German.
But passing time while you are condemned to the sick role but not actually feeling unwell is very different from being properly ill. Could anybody in bed with flu manage to get through Ulysses? That would be a diagnostic test, like dropping a £20 banknote on the floor and checking whether the patient gets out of bed to pick it up. If you can, you haven’t got flu.
So what helps the sick recover? A good story, heavy enough not to feel that your brain is rotting but light enough to be held by weak hands and enjoyed by a fuzzy brain, certainly. Long books to while away the long hours seem a good idea. Perhaps War and Peace: an involving tale with a huge cast of characters, and it comes in two easy-to-manage volumes. But it is 1500 pages. If somebody gives it to you as a patient, do they know something you don’t?
Surroundings are important. Research has confirmed what we all know intuitively: patients get better faster if they can see trees from their sickbed. Unfortunately the outlook from most old city hospital wards is Victorian industrial grime or 1960s stained concrete. Hospitals built during the second World War were designed with plenty of space to reduce the risk of an enemy bomb demolishing the whole facility, but by now the green spaces have been filled in with car parks and Portacabins. Modern hospital design tends to the vertical. Recently I visited a 10th floor ward. One bay had an uninterrupted view of the weather, always changing, always interesting. However, the other bay looked out on two nearby office blocks, attractive enough in a Richard Rogers-lite way when seen from a distance, but angular and uncomfortable seen from close range.
Most hospitals have realised there is money to be made from providing distraction from the inevitably mildly depressing reality of a hospital ward. If the cricket is essential to your wellbeing or the suspense of waiting for the next episode of Emmerdale is bad for your heart, the price demanded for plugging into the bedside entertainment system may be worth paying. Some channels may be free – radio, for example, although why can you listen to Radio 4 and Classic FM but not Radio 3? Who makes these decisions?
The healing properties of art are well known, though outside of outpatient departments, patients rarely get to see it. Yet it can benefit the health of other hospital residents: in my SHO days the row of original prints along the long corridor of a hospital nourished my spirit as I staggered down to see yet another ?MI at 3am. It’s a shame that the view from most hospital beds is the intimidating battery of apparatus on the wall behind the bed of the patient opposite. A tangle of coloured tubing and cabling might suggest a painting by Joan Miró, though he’s perhaps not the most therapeutic of artists.
Visitors are a welcome distraction, but making the visit a therapeutic pleasure rather than a trying duty can be hard. The geography of the bed, the drip stands, the locker, the table and the chairs makes impossible the comfortable intimacy of home or even of the counsellor’s consulting room. You can’t easily share a crossword or even the cricket. In the hubbub of the ward companionable silence is very difficult, a chaste but comforting cuddle almost impossible. Though you may be able to sit on the bed next to your relative for a few minutes if the nurses are prepared to turn a blind eye.
The reality is that if you are in hospital, you are in hospital, and classy curtaining and Monet prints will not disguise even a private room. Better entertainment, good food and a pleasant outlook help. Having visitors when you are in hospital is like having visitors when you are in prison. They are welcome and valued, and they may even be able to smuggle in a treat or two, but the situation is still abnormal. What really makes a difference is the staff. When you are sitting there waiting for a theatre slot to become vacant or for the drip to finish, a smile is the best thing that can happen to you. It lifts the spirits, it eases pain and fear, it makes you feel part of the human race. When I think back to my days as a hospital doctor, I just hope I smiled.
First published in NASGP Newsletter 'The Sessional GP' October/November 2009
Judith Harvey was a research scientist, ran the VSO programme in Papua New Guinea and taught in a Liverpool comprehensive school before going to medical school. She has been a partner, a salaried GP and a locum, an LMC chair and a long-time supporter NASGP. Her charity, Cuba Medical Link, enables medical students to go to Cuba for their electives.
Judith has now published all her articles from the NASGP website as a new book Perspectives: A GP reflects on medical practice and, well, just about everything…