About the Book
Welcome to Hospital Babylon, where patients get lost, the healthy get sick and spare kidneys get flown in from the Indian subcontinent.
Meet the doctors who sleep with nurses. Nurses who sleep with patients. And patients who spit, scream, vomit and fight. There are doctors who pump up breasts, plump lips and steal Class A drugs from patients in cardiac arrest. There’s the doctor who cops a feel and Doctor Feelgood, who will give you anything and everything you need…
Now is your chance to find out why a private room costs over £1,000 a night. Who is changing your bedpan? Holding your hand as you go under? What do they do to you while you’re out cold? And what happens when it all goes wrong?
Packed with true stories, revealing anecdotes and shocking anonymous confessions from some of the medical world’s most eminent professionals, Hospital Babylon is a riveting account of twenty-four hours in the life of an Accident and Emergency department. Hilarious and appalling, it will make you think twice about signing that consent form…
Contents
Cover
About the Book
Title Page
Dedication
Acknowledgements
Prologue
7–8 a.m.
8–9 a.m.
9–10 a.m.
10–11 a.m.
11 a.m.–12 p.m.
12–1 p.m.
1–2 p.m.
2–3 p.m.
3–4 p.m.
4–5 p.m.
5–6 p.m.
6–7 p.m.
7–8 p.m.
8–9 p.m.
9–10 p.m.
10–11 p.m.
11 p.m.–12 a.m.
12–1 a.m.
1–2 a.m.
2–3 a.m.
3–4 a.m.
4–5 a.m.
5–6 a.m.
6–7 a.m.
About the Author
Also by Imogen Edwards-Jones
Copyright
Hospital Babylon
IMOGEN EDWARDS-JONES & Anonymous
For Jane G
With love and thanks for absolutely everything
Acknowledgements
With very grateful thanks to the extremely talented and highly entertaining doctors, nurses, shrinks, consultants and midwives who I interviewed for this book. I am wholly indebted to them for their humour, generosity, trust, patience, hard work, endless explanation, great anecdotage, and most of all their time. I couldn’t have done it without them. Thank you also to the wonderful Eugenie Furniss, the handsome Doug Young, the fabulous Laura Sherlock, the dashing Larry Finlay, and all at Transworld for their fabulousness. Nothing would get done, written or indeed published without you. Thank you all.
Prologue
All of the following is true. Only the names have been changed to protect the guilty. All the anecdotes, the situations, the highs, the lows, the drugs, the excesses, the waste, the sadness and the insanity are as told to me by Anonymous – a collection of some of the finest and most successful consultants, doctors, nurses and physicians in the country. The hospital, for legal reasons, is fictionalized, but the incidents and cases are real. Narrated by Anonymous, all these stories have been condensed into a twenty-four-hour time frame. But everything else is as it should be. The drunks vomit, the addicts keel over, babies are born and young men continue to shoot and stab each other – and doctors and nurses clear up the mess.
7–8 a.m.
I am sweating and shaking and feeling really quite nauseous. My head is pounding like some shit seventies disco due to extreme dehydration, and if I didn’t know better I’d swear I can actually hear my liver screaming. This isn’t good. This is not very clever. Even this bus window my head is currently using for support is making me feel ill. I can barely stomach the smell of the tepid bacon sandwich in my bag, let alone eat it. Christ. I haven’t felt this rubbish in years.
Normally I am quite professional when it comes to a hangover. Well, at least I was, in the olden days when I worked an almost hundred-hour weekend – Friday morning till Monday evening – with about two hours’ sleep a night. Thursday night was party night, even if I did have to work a solid four days afterwards. It was a matter of pride. We used to down as much vodka as we could and still make it back to the halls of residence, where we’d buddy up with a fellow pissed student doctor and spend the next twenty minutes trying to cannulate each other, sticking IV drips into each other’s arms with litre fluid bags attached and then settling back for a big old snooze while we gently rehydrated ourselves, so as to turn up at work the next day bright-eyed, relatively bushy-tailed and totally devoid of hangover. Occasionally this master plan would go tits up, so to speak. If you were one of those restless flailing-around-in-the-bed drunks, you had to be careful. My room mate Julian was one, and I lost count of the number of times he kicked the IV stand over and knocked the bag to the ground, lower than his heart, so that instead of hydrating himself he bled into the thing like some unconscious haemophiliac. We’d wake up the next day and it was like there’d been a murder. Bloody blood bloody everywhere. The worst time was when he lost over a litre and ended up having to do a shift hungover, exhausted and completely anaemic.
Not that it made that much of a difference. Both of us were pretty shit on Friday mornings. We used to do cardiology and eventually the poor bastard consultant got rather bored of teaching us – or, more precisely, dragging us kicking and stinking around the ward as we scratched down some notes and smiled vacantly at patients. No one ever answered him when he posed supposedly intellectually fascinating conundrums. It must have been quite frustrating for the old boy. Julian and I would get through the morning somehow and then carbo-load at lunch in the hospital mess, shovelling in as much fish and chips and ketchup as we could get down our gullets, and then we’d go back to the ward ready for action, redoing the notes and consultations we were supposed to have done before lunch. The only evidence that we had been there before was traces of our scrawled handwriting. We would, of course, have no memory of it at all.
But still, sitting here on the bus, I rather wish I had bothered to root around for a vein last night, as I would be feeling a hell of a lot better than I am now. Even my tongue feels thick and spongy and too big for my mouth. The problem is my girlfriend, Emma, doesn’t like IVs in the house. She’s a civilian. She works in an office and keeps normal hours and has a normal life and doesn’t think that self-medicating is OK, or indeed charming, and I haven’t been with her for long so I am trying to keep on the straight and narrow so as not to scare her away. Put it this way: she hasn’t met Julian yet.
Sadly, I haven’t seen him for a while either. He’s off doing obstetrics down in some provincial hell hole in the south-west, getting in his requisite number of complicated births, or whatever this week’s government guidelines are, before he can move on to something a little more relaxing and a little less on the front line. I can’t believe he is now specializing in obstetrics and gynaecology, but then he has always been a bit crazy. It doesn’t seem very long ago now that he was donning a crash helmet on the roof of the Royal London, about to run like a bastard towards the edge of the building, hoping to hurl himself over its side, into the helicopter safety nets.
On long hot balmy summer days a gang of us juniors used to gather together to get extremely drunk and have barbecues on top of the hospital. We’d pack a whole load of stuff – beer, bangers and IVs – and head for the roof in the hope that the fire brigade didn’t ring the red bat phone downstairs and scramble a chopper and the trauma team for some severe incident or other. Anyway, as the sun went down we’d knock back the beers, burn the sausages and get out the propofol. Otherwise known as ‘milk of amnesia’, propofol is very fast-ac
ting and is used to knock patients out – some, most famously Michael Jackson, a little bit more profoundly than others. We used to race with it. We’d start in the middle of the helipad, put a helmet on, inject the propofol and then run as fast as we could towards the edge of the building before keeling over. The aim was to sprint as fast as you could and flop over the side into the safety nets, to be hauled out a few minutes later as you came round. Fall short, as I did, and you ended up passing out on the roof and grazing yourself on the helipad. Needless to say, Julian got to the nets every time.
He was also, by all accounts, excellent at the Sux Races at one London hospital. These legendary events take place in a particular ward where the corridors are nice and long. Julian and co. would inject suxamethonium, an incapacitating drug we sometimes use before intubating someone, and then run as fast as they could down the corridor before they became paralysed. The person who managed to sprint the furthest before twitching frantically and becoming completely immobile was, naturally, the winner. Total paralysis, but fully conscious with it – a kind of living hell, really. The dangers of the game are obvious. Although try to tell doctors about drugs and they always think they know best. But, just because we’re familiar with their names, components and side effects doesn’t actually mean we totally understand them.
That doesn’t stop us from helping ourselves, if and when we fancy it. I have certainly lifted a few bits and bobs, vials and pills, in search of a good time. Nothing too serious, like diamorphine, which is about two grand an ampoule and requires more signatures than the Kyoto Protocol to get your hands on, but some more entertaining things like the odd canister of nitrous oxide, or laughing gas, to get a party going, or a few GTN patches here and there. Glyceryl trinitrate dilates the blood vessels. It’s more usually used to treat angina or a heart attack, but pop one on before sex and it makes the whole thing go with much more of a bang, so to speak. So does Cialis. A milder form of Viagra and prescribed for erectile dysfunction, it is so popular at a mate of mine’s shrink practice that they usually run out of their Friday delivery of the stuff by lunchtime. It is so regularly pilfered by the doctors and the staff that last week when he prescribed some for a patient he had to go through his partner’s desk to get his hands on a packet or two.
I look out of the window. It’s my stop. I’d better get a move on. It may be my last day in A&E but I can’t be late. I say it’s my last day; it is not my last day as a doctor. I have spent the last eight years of my life training to be one so that would be a bit of a waste. It is my last day in this particular Accident and Emergency. I’m doing the eight a.m. to six p.m. shift and then I’m off to another hospital, St Patrick’s, up the road, to do a six-month stint in Acute Medicine before I get sent somewhere else again. But this week it’s all change. It’s all change everywhere in the NHS. It’s the first Wednesday in August. The day when all the new student doctors, freshly graduated from medical school, take up their posts, and also the day when every doctor all over the country who is still training moves. The consultants and nurses stay, but the rest of us, like some huge rotating carousel, are released back into the community and moved on to pastures new. They always say the first Wednesday in August is the worst day of the year to get ill. You are 6 per cent more likely to die on ‘Black Wednesday’ than at any other time of year. Wherever you are in the country, whatever NHS department you are in, everyone is new. The newly qualified junior doctors have no idea what they are doing. And the rest of us don’t know where the toilets are, let alone how to turn the oxygen on, who’s in charge of the morphine, or which is the quickest way to the intensive care unit. It’s like some morbid medical double whammy.
But that’s tomorrow. We still have today to get through first. And it’s raining. It’s supposed to be summer. It’s so typical. It’s not even real rain. It’s drizzling. It’s grey, it’s drizzling, and my head hurts. Still, only one more shift to go and then freedom! Well, perhaps not freedom, but maybe a bit of respect?
A&E is universally acknowledged to be the worst department to work in in the whole hospital, and that includes the renal unit, Geriatrics and Sexually Transmitted Diseases. It is viewed as the worst mainly because it is hard to do a good job. A&E is still about waiting times and getting people in and out as quickly as possible. All you can do is just enough either to patch them up and send them home or move them through the system to somewhere else. When we call up another department asking for tests or a bed, we are usually met with a long litany of sighs and an attitude of general irritation at the idea of yet another hopeless referral from A&E. Outside the charming confines of medicine, people think that Accident and Emergency has a whiff of glamour, a touch of George Clooney about it, with plenty of striding around, some fondling of a stethoscope, and the occasional helping hand given to distressed women giving birth. But inside medicine they look down on us somewhat. The phrase ‘Jack of all trades’ gets bandied about a lot, and in a world which is all about specializing and where knowing an awful lot about a thyroid is considered very important, being good at lots of things is not something to aspire to.
Walking through the main entrance to the hospital, I nod vaguely at the dozy-looking bloke on main reception. He looks completely through me. I’ve only been working here for six months, smiling and nodding at him nearly every day, and still my face draws a blank. I’m not sure what it would take to burn any sort of image into his uninspired brain. I pass the newsagent selling crisps, carnations and cheap faded paperbacks, and on up the stairs to A&E.
Through the swing doors, and the air is stultifyingly thick. I never know why hospitals are always so damn hot. They say it’s to keep the old and infirm warm, but I always think, much like they turn the temperature up in aircraft when they want the passengers to fall asleep, they use the heat in here to keep the patients docile.
And then the smell hits me. That hospital smell. Sweet and sickly. A heady cocktail of disinfectant, damp clothes, dust, rotting food, stale breath, urine and illness. Normally I can cope with it, but today it makes me retch and my eyes water. I’ll be used to it in a minute. What I wouldn’t give for two litres of Hartmann’s fluids and a 1-gram IV of plain old paracetamol. If I am very very nice to Sister, I wonder, might she actually give me some? Then again, I could always pinch it before my shift starts. Although we had an anaesthetist last week who pinched an anti-emetic called metoclopramide to stop herself from feeling lousy; unfortunately she had a bit of a reaction to it and ended up twitching and convulsing on the floor in front of her own patient. Not a good look. I think perhaps I shall stick to a full fat Coke from the drinks machine instead.
Just along the corridor from the waiting room are the staff changing rooms, divided up into sexes, though we share the old tin lockers and rows of school pegs with the male nurses. The nurses have their own lockers but for some reason the doctors have to share. I suppose they think we won’t be here long; either that or they think we don’t have anything worth pinching. I have to say that I’ve learnt to bring nothing into this hospital that I don’t mind ‘sharing’ with others. Everything gets nicked here. I don’t know who does it. The doctors? Nurses? Orderlies? Cleaning staff? Patients? Anything that is not nailed down or sewn into your pockets gets lifted. iPhones are a particular favourite so I always try and hide mine – not that I have the time to chat or text. Still, as one sanguine old consultant once said to me when his medical instruments disappeared, ‘It is a great measure of how good they are.’
I dump my old jeans and T-shirt in a fortuitously empty locker, hide my iPhone in a hanky in my jeans pocket and leaf through the pile of blue scrubs on the bench to find something resembling my size. They are colour-coded around the neck as well as having a coloured cord hanging off the trousers which announces to the world that you are small, medium, large or extra-large, which is fine if you are a bloke but less fine for some of the girls who have to declare their ever-expanding plumpness to the entire community every time they slip on a white large or a pink extra
-large top. We wear scrubs because we are more or less guaranteed to be sprayed in blood, urine or vomit at least once during the shift. The consultants who run the show and are therefore one step away from the general public used to wear suits, or just shirtsleeves – their arms were supposed to be naked from the elbow down for hygiene reasons. These days, however, they have to wear aprons which make them look like senior nurses, or, as one livid bloke put it the other day, ‘like we are manning the bloody cheese counter at Tesco’. It is not a popular change, as you can imagine.
But then there are many changes around here that are not at all popular. One of the least popular is the alterations they’ve made to doctor training. Doctors used to be quite a strong body. We are a bolshie lot, hard to sack and control. However, the way to disempower us is to train too many of us, creating more training posts than there are jobs available, so that we end up in limbo, swilling around in the system, vainly hoping that something will turn up. We get a lot of these limbo doctors in A&E. With no consultancy available to them, they end up working locum shifts here in order to make ends meet.
Although all this is about to change again with the new government’s plan. Quite what a huge effect it will have on us is anyone’s guess. Some of us are excited, but most are not. Past experience has shown that when it comes to change, the NHS is about as flexible as an 85-year-old geriatric with gout. There are corridors, wings and whole hospitals that are atrophied with initiatives and good intentions. Most of us expect a huge haemorrhage of cash followed by a mad-dash attempt to resuscitate the beast, while the rest of the medical profession watches on, shaking its head, saying, ‘I told you so.’ Or it could work!
A short walk down the corridor, I go into the common room to eat my now cold bacon sandwich and get a Coke from the drinks machine. It is not the most salubrious of places with its filthy sofas, biodegrading chairs and ancient botulin-riddled fridge, but it’s a place to store your lunch, munch on your crisps, and get the gossip. A clutch of medical posters curl off the wall, alongside lists of pink, blue and green teams for the nurses’ rotas, as well as a cork noticeboard filled with handwritten notes about flat shares or lame adverts for yoga, aqua-aerobics or the early signs of diabetes.
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