Royal Hobart Hospital Experiences

Radial Ulnar Nerve Relocation

Back in the early 90s, I lost all sensation in the left hand portion of my left hand. This was diagnosed as a pinched nerve at my elbow and I was duly booked for surgery to relocate the radial ulnar nerve deemed responsible. Following surgery, I had been informed by the surgeon that I would need to discuss matters with a physiotherapist prior to leaving the hospital. On the day I was to leave, no physiotherapist had come to see me and I explained that to the nurse who insisted it was time for me to leave. Her superior told me that if I didn’t leave forthwith, she would have me ejected by the security staff. She told me that I was not scheduled to see a physiotherapist. I was also told that the numbness in my hand at that time would gradually go away over the next few days.

Some three days later, I went to see my GP as I was concerned about the lack of feeling and coldness in my hand. She told me that the bandage was far too tight, and that far from feeling returning to it, I was perilously close to losing my arm due to lack of blood circulation!

Some three weeks after the surgery, I returned to outpatients for my first post-operative consultation. The surgeon cheerily asked me how the physio was going. When I told him that I had not been allowed to see the physiotherapist, he gloomily informed me that his prognosis of six weeks’ recovery would now take six months. It entailed holding a house brick in my left hand while balancing a hot water bottle across my elbow for a couple of hours a day over several months. While I eventually was able to straighten my arm, full strength never returned.

Acute Bronchitis

In the winter of 2007 I had a wedge resection performed on my left great toe to relieve an ingrowing toenail. The following day, I began suffering from what I eventually learned was acute bronchitis. My wife agreed to take me to the Royal when late that evening I became anxious about the severity of my symptoms. Having not been to Emergency since the recent renovations, we went in through the door nearest the old Emergency entrance where we were confronted by a security officer. He immediately had me sit while he fetched a wheelchair and subsequently wheeled me to emergency.

After the usual irritating, but understandable wait of several hours, I was seen by a doctor. She put me on oxygen and subjected me to the usual barrage of tests and questions. Eventually, she decided that I was a chronic asthmatic, gave me a Ventolin inhaler and told me to go and see my GP after the weekend. Far from being a chronic asthmatic, I had suffered but one mild asthmatic attack one very stressful spring day in 1975.

My wife and I arrived home around nine in the morning and I went to bed for some much needed sleep that lasted for all of about two hours! Around nine in the evening, I began to feel as though I was suffocating and the Ventolin didn’t seem to help very much. I became very panicky and my wife called for an ambulance. After staying awake all of the previous night and most of the day, she wasn’t feeling at all well herself by this time. Although it was a cold winter’s night, I found it much easier to breathe the cold, denser air outside which is where the ambulance officers found me shortly after they were called. When they gave me oxygen I told them how grateful I was as I thought I was dying. They told me I felt that way because I was dying!

At the hospital, I was given a seat in the Emergency waiting room and the oxygen was taken away with the trolley I had arrived on. Several hours later, the same doctor as on the previous night called me to come into the treatment area. I asked for a wheelchair as the lack of oxygen was beginning to take its toll. My hands and presumably the rest of me had become cyanotic. She refused and demanded that I walk into the treatment area. I was barely through the door when I began to lose consciousness. The last thing I remember was her saying: “You’ll have some interesting bruises in the morning!” Indeed I did have a very interesting bruise: on my stomach immediately to the left of my navel. It was about 100 mm in diameter and took a couple of weeks to go away.

The following several hours were a nightmare, alternating between panic attacks when I could not get my breath despite the oxygen mask, and falling asleep from exhaustion. Sleep lasted for all of a few seconds since the monitoring equipment detected the reduced oxygen in my blood and awoke me by beeping loudly. I was also forced to breathe via a nebuliser for several minutes. The effect was to make breathing even more difficult and when I attempted to remove the mask over my nose and face, was physically restrained from doing so. I now knew what it was like to suffocate!

Eventually, I was taken to a bed in a ward and attempted to lie down on it. Unfortunately, when I lay down I could not get my breath, so I sat on the bed and waited for what seemed an eternity, though in truth it was only two, or three hours. Eventually, a nurse came and hooked me up to the oxygen and showed me how to raise the head of the bed, so I could sit rather than lie down. Each time I nodded off, I was confronted by a nurse and another barrage of questions seemingly identical to the last. What is your name? What is your date of birth? Etc…

The following day, my son purchased me some suitable changes of clothing and I decided I desperately needed a bath. Hospitals do not have baths, only showers. Piffle! Remember the wedge resection on my great toe? The GP who performed it had told me in no uncertain terms to keep it dry until it was fully healed lest it become infected. The nurse I requested a plastic bag from in order to keep it dry told me I was being “old-fashioned”. Nevertheless, I insisted, so with very bad grace she stuck a plastic bag over my foot, but refused to tape it in order to make it waterproof. I had my shower and my foot became wet. The toe became badly infected and I spent the ensuing two weeks on antibiotics. Don’t these bozos know anything about prevention being better than cure? Or the bacterial antibiotic resistance problem?

While most of the nursing was more than acceptable quality, there were two other disturbing events while I was recovering in the hospital. The first was that for the initial two days, I had a blood sugar test twice a day. After the third such test, the nurse said sternly: “You’re not a diabetic!” “I know,” I replied. “So why did you say you were?” she rejoined. “I didn’t,” I responded. “Yes you did,” she said very loudly and angrily. “No, I did not!” I said. “Of course you did. It says so here on your chart,” she yelled and stomped off in a great huff.

The second occurred in relation to the regular blood pressure and oxygen checks. The oxygen level is detected by a clip that goes on a fingertip, and the pressure through the use of a pressure cuff on an upper arm. Usually, the nurse placed the cuff on my left arm and the clip on a right hand finger. On one occasion, the nurse declared: “Oh, my! Your oxygen is way down!” I pointed out that might be because the pressure cuff was restricting the blood flow to my left arm, the same arm as the oxygen-detecting clip, and so the oxygen was presumably being depleted by the cuff. “Oh, I never thought of that!” said the nurse. Don’t nurses get taught about basic human physiology?

Bladder Cancer

In 2007 my GP arranged to have my waterworks tested. I had been suffering from the need to piddle several times a night and usually the cause of that is an enlarged prostate gland. After several weeks, I received a letter with an appointment date in April 2008. Consequently, my wife and I believed we would be safe arranging a holiday interstate in July. Hah! Several weeks later, I was informed that the date for assessment was now the 19th of June and to ensure that I had an ultrasound the week prior. I had the ultrasound on the 4th and I was informed there was a polyp in my bladder.

Now I am familiar with coral polyps, but it seemed unlikely that my bladder contained a coral reef, so I looked the word up in my trusty Oxford English Dictionary. Lo, it told me that it was an eight-, or ten-tentacled cephalopod, such as an octopus, or squid. While pondering this bizarre information, I prayed to (then almost a saint) Mary McKillop for a mackerel, while suspecting it would turn out to be a cod!

The 19th of June appointment was cancelled (there’s a pattern here) and on the 15th of July, I finally had my preoperative consultation with a young English registrar. He explained about pee-hole surgery (similar to keyhole surgery except I provide the keyhole). There were two alternatives. The first, (flexible cystoscopy) to have a look under local anaesthetic and investigate the nature of my polyp. The second (rigid cystoscopy), under general anaesthetic and remove the offending tissue for biopsy (to see whether it was malignant, or benign). I chose the latter option; the registrar agreed; the registrar obtained agreement from the surgeon. A few days later, I received a letter informing me that I would have the operation on the 22nd of July.

On the 22nd of July, I presented all scrubbed up and hungry as hell having obediently fasted. After several hours, I was told there was no post-operative bed available. Note well that at this point, I still had my usual equanimity. I had been forewarned that there was a bed shortage and that emergencies pre-empt merely urgent (Category 1) cases like mine. The hospital staff told me that it was hospital policy to perform Category 1 surgery within thirty days. I have since learned that the hospital loses funds when it fails to meet this commitment.

The next appointment was on the 4th of August, somewhat longer than 30 days after the original diagnosis on the 4th of June. Again, there was no bed available and I was offered the flexible cystoscopy in lieu of the rigid variety. After all, I was told, there was a small chance that there was nothing there. I agreed and despite my usual disinterest in allowing men to fiddle with my naughty bits, proceeded to provide the keyhole for the registrar to peek inside my aquarium. The good news was that there was no sign of any problem with my prostate, but the 6th of June diagnosis of a polyp was completely bang on. Yet the offending tumour was neither squid, nor octopus, not even a mackerel, or cod. It turned out to be a cauliflower albeit not the sort I grow in my garden!

The following day, the hospital telephoned to see how I was bearing up. The procedure of the previous day can on very rare occasions have untoward consequences. I assured the caller that all was reasonably well and asked when I was booked for the “real thing”. I was firmly told that hospital policy was that patients were not to be informed of such by telephone, only by letter. Hitherto, I had been telephoned and the confirming letter arrived a couple of days afterward.

The following Monday, there being no letter, I telephoned and was told that hospital policy forbade my being told by telephone. I asked if it would help if I arranged to have the necessary overnight stay in the private hospital that shares the same site. No, this was also “against hospital policy”.

By Wednesday the 20th of August, my equanimity was rapidly disappearing. My two (adult) sons had lost theirs weeks before. My sister, a surgical nurse who lives interstate was also becoming quite frantic and had asked a urological surgeon she works with if he could help. His belief was that it was more likely that I would be operated on earlier locally than if I were to commence proceedings in his hospital.

I telephoned the hospital to check on progress only to be informed that I had already had the necessary operation. “Bullshit!” I hinted. I was firmly told that I was no longer on the waiting list as I had received the rigid cystoscopy on the 4th of August. When I attempted to explain, I was told that the records showed my case as complete. It took several requests and the odd swear word, or three to be put through to someone to whom I could complain. She, however, was not available, and it was an anxious wait before I was again informed that the hospital records showed my surgery had already taken place. My equanimity was replaced by something closely resembling blind, unreasoning panic! If you’ve ever read Kafka, you’ll know what I mean. The complaints person said she would call me later in the day, or early the following morning. My boss, who had earwigged the conversation, congratulated me on my self-control in such difficult circumstances.

Late in the day, I called my GP to ask once more if she could help. I had asked her a week before if she could do anything to hurry things up. She said she had called the hospital and that she had been promised they would call and give me a new appointment. She called me at home that evening to say that the hospital claimed to have called me several times, but I had not been available! Yes, we have a message recording service at home — and voicemail at work. More bullshit! That evening, there were, for the first time, two messages on Message Bank from the hospital asking me to call the following day.

I called hospital and asked to speak to the person who had requested I call in the previous day’s messages. She was in a meeting and would call me back “in half an hour”. Three and a half hours later, she called. The one who left the messages the previous evening, not the complaints person who had promised to call. Now, there are some golden rules for dealing with angry people over the telephone, and by this time I was very, very angry. When the caller asked how I was, I told her that I was very, very angry. The first golden rule is to listen (the second is to agree and the third to try and understand why the person is feeling the way they do and attempt to resolve the cause). The caller flatly refused to listen. She told me to shut up while she tediously described the history of my problem, that I had been booked for a rigid cystoscopy, that a flexible cystoscopy was given in its place and so on. Now I am not a child and talking down to someone as if they are some ignorant idiot is not the way to defuse an angry person. When I attempted to interject, she started telling me she hadn’t deliberately been ill, or deliberately forgot to update the record that took me off the waiting list. Nor was it her fault that there were no beds available when I presented for surgery. Since she gave me no chance to speak, I have no idea why she supposed I thought her actions were deliberate, or malicious. Or why it might be her fault that there were no beds available. Clearly, if I was to discover whether I was back on the waiting list, or how long I was expected to wait, I wasn’t going to glean such information from this lunatic woman! I told her that I was about to lose my temper and rather than do that, I was hanging up the phone.

A few days later I went to a local quiz night and after drinking a couple of glasses of chardonnay went to take a piss. One of the characteristics of benign prostate enlargement that come with age is that pissing becomes all too frequent. On this occasion though I couldn’t no matter how I tried. I asked my wife to call an ambulance. When the ambulance arrived I asked to be taken to one of Hobart’s private hospitals. The ambulance workers told me both were closed it being late. I would have to go to the dreaded Royal!

When I was attended to at the Royal, the very young doctor seemed to be out of her depth[1] and under the complete control of a much older nurse. She informed us both that I was fantasizing about having bladder cancer; I was merely suffering from a common complaint among “gentlemen of your age.” She said that every Anzac Day the Royal was inundated with war veterans who had a few too many beers and were unable to urinate. She inserted a catheter into my bladder, attached a collection bag and instructed me to replace it when full with the spare she gave me. I was to return to the hospital two days later.

My wife collected me from the hospital and took me home, almost an hour’s drive away. Once there I looked at the urine collection bag and it was filled with tiny clots of dark, venous blood. I asked my wife to call the hospital for instruction. Margie was told that it was utterly impossible for the bag to contain blood clots, but if she thought it absolutely necessary, to take me into the hospital for assessment. I sat in the waiting room all night unattended. At 9 am, a rather large, butch-looking nurse barked: “Anyone who thinks their problem needs attending to in less than the next sixteen hours can go to Hobart Private. Their emergency department just opened.”

I staggered out of the door to walk the hundred metres or so to Hobart Private in the adjacent building. I was in agony. Every step moved the catheter’s exit tube and my penis was by now extremely sore. Fortunately, a young nurse coming on duty at Hobart Private saw my predicament and ordered me to wait while she fetched me a wheelchair. Once in the emergency department, I was assessed as having been very badly cathetered and some anaesthetic gel applied to my poor, sore penis. The doctor told me that the catheter was not the correct sort and that SOP was for the administration of antibiotic for those in my situation. The catheter I had meant that the antibiotic would need to be administered through a cannula since changing catheters was not advisable.

Within an hour the urologist in charge of my cancer (Frank Redwig) had arrived to see me even though it was Sunday. He was most apologetic that I had not been given either his, or the registrar’s mobile number. Had I been able to telephone either of them, the shenanigans with the Royal’s emergency staff would have been avoided. I told Frank that I was more than happy to pay for the required operation to remove my cancer to take place in Hobart Private despite the cost. He replied that in either case he would be the surgeon performing the procedure and it made more sense that it be done at the Royal. He promised that he would find me a bed the following day and that the procedure would take place ASAP.

The nurses at Hobart Private were most concerned that I would be paying for my stay there. I said that was fine by me. Then one declared: “I think we should bill the Royal” and that is what must have occurred for I never received a bill. The stay was a day longer than predicted by Frank Redwig. The food was streets ahead of that served next door. Much to my delight that included Molly’s peas, an heirloom variety of mangetout I had introduced to Tasmania some years previous.

After the operation, I was informed that the cancer was a transition cell carcinoma, benign rather than malignant. I was however unable to pass urine. Frank had nicked a minor artery and the blood had formed a very large clot in my bladder. While I waited for a surgical theatre to become available, I was allowed no analgesia due to the possibility that such drugs would interfere with anaesthesia. It was a long wait and the level of pain I experienced rapidly climbed to excruciating (10/10).

One of the nurses was a great aid during these hours. She coached me with my breathing and that provided some small relief. When you are experiencing pain at that level it is very difficult to maintain sufficient concentration. I recall that at one stage I asked her to marry me; with my wife’s permission of course. Eventually, after what seemed an eternity, I was admitted to theatre. Just as I left, the nurse asked me several questions as required. One was: “Do you have any prostheses?” I replied, “No, but I wish I had a prosthetic dick!”

As I was being administered the sedative just before entering the operating theatre, the anaesthetist congratulated me on how well I had endured the previous few hours. He told me that the level of pain was as high as it is possible to experience (on a par with child-birth). I had always been petrified of experiencing extreme pain and felt justifiably pleased with myself. I could endure such.

The rest of my stay on this occasion was unremarkable. It was I think the only one where I returned with a very large box of Belgian chocolates for the nurses to share. You might think I would have been annoyed by the error that occurred when the artery was nicked during the initial procedure. Some weeks before I had remarked to the registrar, Spencer, that he looked as if he needed a long holiday. He had replied that holidays were out of the question and that he’d been on duty for more than 24 hours. If, as I suspect, he performed the procedure,[2] it was no great surprise an error had occurred. We all make mistakes.

Stroke

Friday Night

I awoke in what was obviously a moving vehicle. Someone was calling my name and asking me questions. I answered the voice, but whoever was speaking couldn’t hear what I was saying. I could hear my responses, but he couldn’t. I wrinkled my brow and he asked me to signal if I could understand what he said. I did and commenced signing words using the sign language Roland, Neil and myself had learned as teenagers. He said he couldn’t understand sign language. After some frustrating exchanges limited by the yes/no format, he handed me a clipboard to write on.

Our communication improved somewhat, but the jolting of the vehicle made writing difficult. He explained that I had suffered a stroke. From time to time, he tested the strength of my limbs, flashed a light in my eyes and it was clear that my left arm and leg were considerably weaker than usual. Mainly I dozed on the way to the hospital and wondered how debilitating my new condition would be. I had intended to finish the woodshed extension on this weekend.

At the hospital, I was subjected to much the same requests and manipulation of my arms, legs, hands and feet. At some point, I also had my head inserted into a scanner of some description. Later, I was told that the brain scan indicated that something had occurred in my brain, presumably a blood clot. Sometime during the ensuing few hours, my ability to speak returned. Every time I dozed off, there was another voice waking me up to ask the same interminable questions. I remember thinking how stupid they must be to not remember what I’d said five minutes ago.

Saturday

Eventually I fell asleep; briefly. I returned to wakefulness as if trying to swim through cold molasses. The voice calling my name was strident and I obeyed the commands hoping the voice would go away. I tried to explain that I was very tired, and I was finding it extremely difficult to stay awake, but the voice didn’t seem to care.

Suddenly, a loud, piercing, urgent and shrill beeping kind of noise started up. It hurt my ears and made understanding what was being said to me impossible to understand. I asked for the noise to be stopped and a very loud female voice yelled at me that there was no need to swear; there were children and ladies present. This made me very angry and I said that if they shut the stupid sound off there would be no need for me to swear. The female voice said that I had made the noise by bending my arm. I pointed out that I had bent my arm because that was what the doctor had told me to do. Female voice continued to berate me and making a concerted effort, I stood up.

I said as firmly as I could that I was not prepared to put up with what they were doing to me and that I was leaving. Unfortunately, I no longer had any clothes other than my trousers, underpants and socks. Another female, who seemed somewhat more rational than the previous two, told me I was free to go. But go where, in the small hours of a cold Hobart morning? If I was patient, rational voice said, there was a bed reserved for me and I would be able to sleep. As badly frightened as I was, I did my best to calm down. Being told that my wife was on her way in helped.

Someone tried to get me to take some Lipitor. The heart specialist had told me that when I was prescribed this drug by the hospital that it was irrational to prescribe anti-cholesterol drugs when the patient had normal cholesterol levels and an excellent ratio of HDL to LDLs. Following his advice, I had stopped taking it and the short-term memory problem I had been experiencing went away. Why, I asked myself, do they want me to lose my short-term memory? It couldn’t possibly be for atherosclerosis since a recent angiogram had shown my arteries to be squeaky clean.

Eventually, Marguerite turned up with my clothes. My recollection of the next few hours is very blurry. I had been awake for over 24 hours and every time I started to fall asleep I was awakened.[3] Presumably, whatever had happened in my brain was also taking its toll.

I was given a barely edible lunch. I asked if I could have some cheese, but was told no, I had to eat what I was given. I asked the nurse for my meds: anti-hypertensive for my blood pressure, beta blocker for my heart condition and NSAID for my osteoarthritis. I was told that they hadn’t arrived from the pharmacy. I pointed out that my wife had brought them in with her and they had been taken away from me. Nothing doing.

A doctor came to see me and subjected me to the same limb manipulations and shining of lights in my eyes as everybody else. I tried to explain how I was feeling, but she didn’t want to know. I was particularly anxious about not being allowed to take my meds. My GP had told me it was very bad juju to miss my anti-hypertensive and beta blocker. The hospital doctor said I could have tramadol for the pain. I asked if I could go across the road at lunch time. My favourite city Chinese restaurant had recently relocated there and they serve excellent food. Under no circumstances was I to leave the hospital she told me. She also told me that I might not have had a stroke after all, but a seizure. When I later told a nurse what I had been told, the nurse said that only an idiot would believe that: “Look at your face”, she said. When I looked in a mirror, my left eyelid and the left side of my mouth were drooping. I used my phone to do a bit of Googling on the internet and that confirmed the nurse’s diagnosis. I could find nothing about those symptoms in conjunction with seizures.

Later in the day, the physiotherapist came to see me. He was the first person I had conversed with (apart from my wife) who seemed to have any sympathy for my plight. He relieved a lot of my anxiety. He had me walk about for some minutes and announced that I was fine to walk wherever I wanted to go. When I told him of my desire to have Laksa at Dumpling World he said it would do me the world of good, so that was where I had lunch with my wife. I told him what had been happening to me and how badly I felt. He said he would have the Grievance Officer see me on Monday.

When I returned to the hospital, I asked about my meds and was told that they still hadn’t arrived from the pharmacy. Again I was told that they didn’t want me taking my own meds since “providing free meds is hospital policy”. When I said that this was contrary to my GP’s advice, I was told that GPs don’t know what they are talking about. I was given a tramadol. It killed the physical pain, but the side effects, a gone-away feeling in the stomach and dizziness, increased my feelings of anxiety. I noticed that when the nurses did the obs that my blood pressure was increasing.[4] I wondered why, if I had suffered a stroke, weren’t they doing anything to bring my blood pressure under control.

At dinner time (a sorry affair that was largely inedible), I managed to eventually prevail on a nurse to allow me to take my anti-hypertensive and beta blocker, but not the NSAID for my arthritis. The nurse who did this agreed that I should take the essential meds next around the middle of the following day before returning to the usual early morning routine.

I resolved to talk to my sister (a highly qualified nurse specialising in neurology). She later confirms my impressions and suggests I fly to Melbourne and she will ensure that I receive appropriate medical treatment.

Sunday

Breakfast was dry toast and water. Prisoner number 102045065 could have had jam, instant coffee, apple juice, sugar (lots of that), cornflakes, milk… I asked if there was cheese and was told no. They are definitely in favour of Type II diabetes around here. Reading the obverse of tomorrow’s menu confirms that. They recommend lots of high GI food, rather than protein and fat. I could have drunk the tea, but the water provided was tepid and the tea made from it undrinkable.

Somewhat to my surprise, I was given my NSAID! The morning obs have my systolic blood pressure at 190! I was told not to worry about it; “it’s only a little bit high”. Why are they treating me as if I’m some kind of idiot? Isn’t anything over 180 extremely dangerous?[5] Is it not the case that high blood pressure is a primary factor in provoking strokes? My anxiety levels have gone through the roof along with my blood pressure. My confidence in the medical abilities of these people has plummeted through the floor. I am dismayed and frightened.

Marguerite and I went to Dumpling World for lunch. I had seafood, rice and fresh, stir-fried vegetables; delicious. We decide that it’s probably best to let the doctors do their tests, just in case they are correct that I have had a seizure, rather than a stroke.

After lunch, I asked for my meds. It wasn’t until some hours after lunch that the nurses finally accede to my requests. So much for taking them with food!

Monday

The nurse won’t let me have my NSAID because it’s the “wrong dose”. I explain it has to be the correct dose since the drugs being given to me are those prescribed by my GP and provided by me. Apparently the hospital doctor disagrees with my GP. The “correct” dose is 100mg rather than 1,000mg so I can’t have one. She does give me my antihypertensive and beta blocker. And a tramadol. She returns later and gives me my NSAID; my GP had apparently prescribed the correct dose after all. But now I’m off my face on bloody tramadol. Why anyone would take hypnotics for recreation is beyond me. I feel dizzy, faint and can barely think straight. My stomach performs flip-flops and tears roll uncontrollably down my cheeks. I am very depressed.

Late morning a female doctor (not the same one as before) arrives with a young male intern. I attempt to explain how I’m feeling, but they don’t want to know. She says what happened on the weekend had nothing to do with her! She berates me for leaving the hospital on my walks and for taking tramadol. I point out that I didn’t want to take tramadol; it was given to me instead of the NSAID that I wanted to take. She says it’s depressing the threshold for having a seizure. Now I feel even worse than earlier. I can barely understand what she is saying to me. All I can think of is getting the tests over and done with so I can go home and have a nice hot bath.

They move me to another ward. We go through a door that locks behind us. I ask about this and the nurse tells me that it’s to keep people in for their own good. I ask why I am being put here and she says that it was the only available bed. I sit on the edge of the bed and recall that there was a list called “spare beds” on a display in the neurological ward; there seemed to be quite a few. This is not the neurological ward and I am a neurological patient. Presumably I need neurological nurses, not nurses who specialise in dealing with patients who need to be locked up. I go to the nurse at reception and query what is happening. I am told that unlike the other patients, I am free to leave whenever I wish. All I have to do is press the button at the side of the door and the door will be opened for me. I return to the room they had shown me, collect my belongings and return to reception. I ask for my meds. The nurse tells me that they are not my meds; “They belong to the hospital.” Now I am really panicking and go to the locked door. I press the button, but the door remains locked. I press the button several times, but the door does not unlock.

I phone my wife and try to tell her what’s happening. I suspect I am incoherent; I’m now so badly frightened I can’t stop shaking. Margie agrees to rescue me as soon as possible.

When Margie arrives, one of the nurses explains that yes, I am free to leave any time I want. So why won’t they allow me to leave if I am free to leave? I need to sign a consent form. So where is the form? I want to sign it. We are told that we have to wait until a doctor arrives with it. We wait, interminably it seems to me, but in truth “only” two or three hours. One of the patients approaches us and says, quietly, that if I want to get out, I need to calm down. If I remain in my current state they are just as likely to get a couple of heavies to come and “deal with” me. I breathe slowly and deeply and suddenly recall some sage advice I received from a friend some years ago.

I take a pen and some paper from my bag and approach one of the nurses. “By what Authority are you holding me?” I ask. The nurse looks startled and says he will have to find another nurse to answer my question. The other nurse, when he arrives, seems just as startled when I ask the same question: “By what Authority are you holding me?” He goes to the telephone and this time the doctor arrives within a few minutes. I sign the form and Marguerite asks, yet again, for my meds. I explain that since they are unopened packages, I cannot have the prescriptions filled until I have used a sufficient amount.[6] I threaten to report the nurse as a thief for depriving me of my property. After a brief delay, my meds are returned to us[7] and we beat a hasty retreat.

It’s not every day that you get to play the lead part in a Franz Kafka novel, albeit one Kafka never got around to writing. I wouldn’t recommend it; not even to my worst enemy.

Broken Leg

I hadn’t seen Rod for decades. As often happens with someone you once knew well, we set about reminiscing over a few drinks. We were joined by his ex, Jocelyn, so that meant a few drinks more… When my wife and I returned home with me somewhat worse for wear, the rain was bucketing down. It was a Friday evening and Margie turned on the television to watch her favourite TV show. The equinoctial gale-force wind had turned the TV aerial to point at right angles to the transmitter and we live in the fringe area for reception. Despite the weather and Margie’s misgivings, I go into the garden to turn the aerial to point in the correct direction.

The aerial is mounted on a star picket next to the septic tank. That area of the garden is smothered with a low growing shrubbery to disguise the tank. After I return the aerial to point where it’s supposed to point, I stepped onto the edge of the septic tank, rolled my ankle and I heard a loud, distinctive snap. I fell to the ground and spent an uncomfortable fifteen minutes or more calling out. When the TV show had finished, Margie finally decided to discover why I hadn’t returned to the house.

At first she attempted to drag me to the stair leading up to the deck in front of the house. Eventually I managed to persuade her that the exercise was futile; I was far too heavy and she was hurting my leg. Belatedly she went to call the ambulance and covered me with a raincoat against the bucketing rain and wind. When the ambos arrived, they injected me with morphine and I dozed on the way to hospital. I can recall the words of the anaesthetist as I was being taken into the surgical theatre: “If I had any say, you wouldn’t be receiving treatment.”

When I recovered consciousness, I was taken to a hospital bed where I fell asleep. I awoke in the small hours to see two nurses struggling to put up the privacy curtain around the (unoccupied) bed opposite. They were wearing Tyvek biohazard suits and complaining because they were unused to the task. I dozed off again.

In the morning, I commented on the night’s event and asked what it was all about. I was told I was fantasizing, but a day nurse later complained about the shit job somebody had done putting up the curtain. I was sore and itchy from neck to knees on my rear and wondered if there was a connection with the events of the night before. I asked a nurse to have a look at my back only to be told that I was there only for the purpose of having my fractured leg treated. If there was anything else wrong with me that was “just tough.”

Some time that morning I was visited by a doctor who said that he had pinned the bones in my leg and I would be having a plaster cast made later. In the afternoon a physiotherapist instructed me on how to exercise during the week or so I would be in hospital. He said it was vital as I would otherwise lose too much muscle tone and find getting about on crutches more difficult.

At this time I was receiving the anti-depressant drug Effexor X. When the nurse gave me my meds, I remarked that the Effexor was a different dose to the one I normally took. The nurse told me “We don’t make mistakes like that!” Unfortunately, it was half the normal dose and adapting to a dosage change takes a couple of weeks. The effect of the change is for the patient to become more depressed during that time. I was utterly miserable.

I was initially glad when I was shifted to a different ward and bed later that day. The monkey bar wasn’t attached to the new bed, so I asked a nurse if I could have one. She assured me I could, but in almost the whole of the eight remaining days of my stay I wasn’t allowed to exercise as instructed by the physiotherapist. On the last day I was visited by my son and when I remarked on the lack of a monkey bar to him, the nurse next to us said: “Here it is!” and reached under the bed where it had been all along. “All you had to do was ask!”

It was with great relief that I was at last given crutches and the physiotherapist instructed me in their use. This was especially important in relation to ascending and descending stairs safely. I still say to myself “Good boys go to Heaven and bad boys go to Hell” when using stairs. My right leg is still much weaker than the left so it’s the “bad boy”.

I was given a replacement cast made of lightweight fibrous material. After it was cast, the bloke who made it cut it in half so that it could be easily removed when necessary. He also instructed me to immediately return if any of certain symptoms became apparent. When my leg became somewhat inflamed and itchy, I phoned the relevant department at the hospital. I was told to turn up and I would be seen by a doctor. When doing so, I was told off for turning up without an appointment. Disconsolately, I took a seat and steeled myself to leaving unattended. Fortunately, the plaster-caster was walking past while I rested and he asked why I was there. Upon being told, he said to come into his plastering room. When he inspected my leg he said it was nothing to be very concerned about. It was a common enough occurrence and was nothing more than a mild allergic reaction. He told me to leave the front half of the cast off as much as possible and apply some skin lotion to the affected area. I had plenty of skin lotion. When I went to my local GP and asked about my sore and itchy back, he told me that I had received first degree burns. Presumably this was from the heating pad on which I’d been placed after the surgery on my leg had been turned up to full.

The GP at university who had prescribed Effexor said she had been phoned by the hospital regarding dosage and she had told them the correct dose and they definitely were giving me half the correct amount. I resolved to stop taking the drug; I wasn’t particularly happy with its effects. This was a most unpleasant experience and while I had less trouble than some, it was extremely difficult.

Congestive Heart Failure

Some years prior[8] to being diagnosed as suffering from congestive heart failure, I had been sent to the cardiac unit at the Royal by my GP. The practice nurse had performed an EKG and that showed I had an abnormal heart rhythm. The Royal performed an angiogram and despite my slightly elevated blood cholesterol, this showed no furry deposits on my artery walls. This was probably because my diet consisted of largely Mediterranean and South East Asian cuisine. The ratio of HDL to LDL was the inverse of that usually associated with elevated cholesterol. I was advised to take the drug Lipitor (a statin that reduces cholesterol level).

The overnight stay was, as usual where the Royal is concerned, fraught. I was instructed that under no circumstance was I to move from my position reclining in bed. I suffered intense pain and the only relief provided was paracetamol. Paracetamol has never generated any detectable pain relief when I have taken it and this occasion was no different. The pain eventually overcame me and I regained consciousness lying on the floor next to the bed in a tangle of cables and pipes.

I was somewhat sceptical of the advice I’d been given by the doctor and so made an appointment to see Hobart’s leading heart specialist for a second opinion. That turned out to be that the doctor at the Royal’s advice was “irrational.” I should quit taking the statin as that was serving no useful purpose. It had caused me to become mentally confused; perhaps that was its purpose. The advice that I needed a surgical operation on my heart was apparently bunkum. I was advised to just live with it, give up cigarette smoking[9] and continue to eat well.

All went well for nearly a decade. I very gradually lost my puff as they say. This was not associated with any detectable loss of lung function. When I presented to my GP quite out of breath and wearing my carpet slippers because I couldn’t get my feet into my regular shoes, the look of alarm on his face was worth quids.[10] He had the practice nurse give me an EKG while he called for an ambulance. The ambo applied another set of electrodes and the same occurred at the Royal so I was fairly bristling with them. The diagnosis was that I was suffering from a worsening of my tachycardia. Dr Kylie Butcherine prescribed a diuretic (frusemide). I was given an echocardiogram and that indicated my heart function was way below what it needed to be. The exit fraction was about 20% of normal. This rather brief stay in the hospital was the only one where nothing untoward happened.

On my first outpatient attendance with the cardiologist Dr Nathan Dwye, I was instructed to reduce my fluid intake and double the amount of frusemide. Taking two doses daily of this drug that makes you produce lots of urine put a severe dent in my life. We live nearly an hour’s drive from the city. There is no toilet facility in our Subaru Forester, nor do the buses that convey commuters between our locale and the capital. When I read up on the literature regarding heart failure, I discovered that the advice to limit fluid intake to no more than two litres per day was deprecated by both the US and European major cardiology associations. There was no detectable reduction in mortality. The only effect of note is to discomfit patients.

Dr Dwyer refuted my complaint saying that the pointlessness of fluid restriction was something he taught his students. Unfortunately for Nathan, my wife had been present at our first encounter and recalled that I had indeed been advised to restrict my fluid intake. She also pointed out that this advice was also contained in the literature I had been given — in two places, not just one.

Nathan also prescribed a relatively new drug, ivabradine (Coralan) and a doubling of the beta blocker bisoprolol. He suggested that my condition could also be improved by having a pacemaker/defibrillator implanted into my chest. When I accepted the suggestion some 24 hours or so later, Nathan said that I had been the quickest any of his patients to take up the offer. I had already done my reading up on the issues and decided that lengthening my expected lifespan was a good idea. This being Australia, the $AU60,000 cost was nothing for me; there are advantages to living in a welfare state.

A few weeks later, I was admitted to hospital for the device to be implanted in my chest. The St Jude pacemaker is about the size of a matchbox though somewhat thinner. It resynchronises electrical impulses in the heart’s four chambers, improving the heart’s ability to pump blood to the body effectively and efficiently. This particular device also includes a defibrillator so that if the heart stops it generates an electric current to re-start the heart or shock it back into its correct rhythm. This particular device also connects wirelessly to a device that sits on the head of my bed to telephone information about my condition to the technologist in charge of my device’s settings.

I was told the operation to implant the device would be completely painless. The initial part of the procedure certainly was, though it took somewhat longer than usual. Anaesthesia was local and the surgeon apologised for the delay. Given I had no yardstick to measure this by, I accepted the apology. He said that while humans are all structured similarly, we are by no means identical and he had to find his way implanting the electrodes where they were needed by gently pushing the leads down my arteries. Finally the time came for inserting the device itself. When the surgeon’s scalpel made the much larger incision for this, the pain was immense. The anaesthetising nurse hadn’t topped up the anaesthetic and the initial anaesthesia had worn off. I swore and the nurse chastised me for swearing in front of the ladies present! He said that he had “become distracted.” The surgeon congratulated me on my self-control in the face of such pain as he lifted the flap of skin and inserted the device.

In the ward where I was sent to recover, a nurse asked me how I was feeling. When I said I was in very much pain, she said that she was only prepared to give me half of a 5 mg oxycodone tablet. This was clearly insufficient, but she was adamant. At evening meal-time when the other patients in the ward were being given their medications, I asked about mine. I was told the cardiologist had left instruction that I was to receive no medication apart from paracetamol. I took the meds from my bag having woken up to the idea that this sort of bullshit was likely to happen. The nurse became incensed and told me I was “breaking the law.” I told her that I was perfectly aware of the law and the Tasmanian Charter of Health Rights and Responsibilities. This includes “The right to receive health services free from any harassment, exploitation, abuse, deception, assault or fraud.” I said I was perfectly willing to not take any particular medication if she could provide sufficient reason why I should not. To this she reluctantly agreed. The other patients in the ward cheered when I had clearly won the round as it were. I will not list each of the medications; that would be tedious. For example, she objected to me taking ivabradine on two counts: that the hospital pharmacy had never heard of it and that the hospital did not approve of over-the-counter medications. I cannot believe that the hospital pharmacy did not possess a copy of MIMS.[11] Ivabradine was registered by the Therapeutic Goods Administration on 27 August 2012 for the indication: “Treatment of chronic heart failure – Treatment of symptomatic chronic heart failure of NYHA Classes II or III and with documented left ventricular ejection fraction (LVEF) less than or equal to 35% in adult patients in sinus rhythm and with heart rate at or above 77 bpm, in combination with optimal standard chronic heart failure treatment.

and

Treatment of coronary artery disease — Treatment of chronic stable angina due to atherosclerotic coronary artery disease in patients with normal sinus rhythm, who are unable to tolerate or have a contraindication to the use of beta-blockers, OR in combination with atenolol 50 mg once daily when heart rate is at or above 60 bpm and angina is inadequately controlled.”

The nurse was clearly playing fast and loose with the truth. At least I got to take most of my medications for a change. To allow her a minor victory I didn’t take the ivabradine. I did get to take my biocurcumin,[12] a potent and safe anti-inflammatory and vitamin D3 that reduces the likelihood of depression.[13] When I asked if I could take a walk to relieve my muscle pain and gas pain this nurse told me that under no circumstances would that be allowed. I was attached to a heart monitoring device and was confined to bed until such time as it wasn’t needed.

When the night nurse came on duty, I asked her for some analgesia for pain relief. She cheerfully allowed me a full 5 mg tablet of oxycodone. When I mentioned that her predecessor had told me that the cardiologists had said I wasn’t allowed any medications other than paracetamol, she said “There’s nothing in your clinical notes about that!” When I asked if it was OK to take a short walk up and down the corridor, she said: “Why not?” I expected her to unhook me from the machinery next to the bed. When I asked she expressed surprise. She told me the halter-monitor I was wearing was battery operated so that I could walk to the toilet etc.

Spinal Operation

I waited several years for an appointment to see a neurologist regarding my lower back pain. When I asked how far I had progressed up the waiting list I was told my first appointment was at least a couple of years away. Consequently, I made an appointment to see a specialist at the Calvary private hospital. The neurologist there advised me to undertake an MRI, but that was impossible due to the necessity of turning off my heart implant. It was designed such that it was impossible. The whole kit and caboodle would need to be removed. Presumably sans anaesthetic. A CAT scan was done instead. I was referred to the hospital’s physiotherapist who did a splendid job of teaching me some simple exercises that gave me much better control of my lower back pain. The scan clearly showed I had a herniated disc and it was pressure from that on nerve roots at L3-L4 that was causing me considerable pain.

This doctor wrote to the Royal’s neurologist explaining the issue and recommending treatment ASAP. He also told me that the reason I was treated so shabbily at the Royal was I was just too damned nice. He asked had I not noticed that the people who behaved badly were treated promptly? His advice was to “treat them like the cunts they are” and I would fare much better. He also pointed out that spending thousands of dollars for him to perform the surgery made no sense when my taxes had already paid for surgery by the excellent surgeon working at the Royal. He also refused to bill me and bulk-billed Medicare instead.

Shortly after this I received a letter from the Royal telling me I had been removed from the waiting list. The reason given was my lack of response to a questionnaire I had received in the mail; a questionnaire I had completed and returned. When I phoned the Royal to query this, I was told that the letter from the neurologist at Calvary had not been received. When I finally attended my first appointment at the Royal, I took a copy of the Calvary report with me. The Royal’s neurologist told me he didn’t need the copy I had with me; he already had that information directly to hand via the computer system they share.

I subsequently had a consultation with the surgeon who told me that the problem with my spine wasn’t entirely clear from the computerised tomography. I needed to undergo further imaging with X-ray opaque dye injected into my spinal cavity. This would reveal much before he cut his way into me. He also said that the odds on the success of the treatment of my spine was around 80%. I gave the go-ahead as my condition was worsening though I had managed to slow down the rate of degeneration.

When I attended my next consultation with the neurology team I was told that I had turned up for no reason. The appointment had been cancelled. The nurse agreed that I had not been informed of this, but seemed incapable of understanding why I was angry. I live almost an hour’s drive away and my wife has to take time off work to convey me there and home again. Travel has become difficult for me now that I am disabled; what we used to call a cripple.

On the day of the CT scan with injected contrast material (iodine), I took with me what is called a patient advocate. I have a friend who is a retired consultant anaesthetist[14] and he agreed to arrive at the hospital with me and introduce himself and his role to the radiology team. He discusses the procedure with the radiologist who subsequently informs his support team that he was making a few changes to the usual procedure. While the procedure had been declared painless, the needle used to inject the dye hit a nerve and my pain level went from perhaps 1/10 to 10/10! The radiologist told me I had to stand up as the dye wasn’t percolating quickly enough. I had read up on the procedure and it was my understanding that the SOP was for the table on which I was lying be tilted to achieve the required effect. I attempted to stand, but the combination of my spinal condition that makes walking so terribly difficult and the pain meant I could not do so. I asked for assistance and the person nearest promptly moved away. The radiologist yelled that I was “wasting everyone’s time” by refusing to stand (that is, do something I was incapable of). I was to put it mildly, distressed. The radiologist then ordered me to lie back down and he completed the scan.

In recovery, a nurse informed me that I was scheduled to leave at 4 pm. I said: “No; I’m scheduled to leave at 2 pm. That’s when my wife is coming for me and I will be leaving then.” About half an hour later, another nurse came to the bed and declared that I would not be leaving before 4 pm. I again contradicted the nurse who said that it was up to her when patients left the ward as it was she who was in charge. I told her that it was my right to choose, and that I had been informed that was the time to have my carer come for me. The nurse responded that I had no rights and her word was law in her ward. I explained that I had been advised to remain with a responsible carer for 24 hours after the procedure and it was my intention to do so.

The nurse initially refused to countenance my leaving until I called her a stupid cunt. I demanded that a doctor be made available to sign a consent form so I could leave rather than follow her advice of catching a taxi. I had been told to bring no valuables so I did not have the $150 dollars or a credit card for cab fare, or my mobile phone to inform my wife of the unwanted change of plan. I felt sullied by the necessity to use such abusive language, but as per the advice from the private surgeon, it worked its magic.

A young man from neurology arrived with the consent form. I asked him what the reason for arbitrarily extending my stay was. He declared that there did not appear to be a reason; just that it was a requirement being imposed on me. He warned me that the consent form included absolving the hospital from any responsibility for my decision. I told him I had no confidence in the hospital whatsoever. I had been assured the procedure would be relatively pain-free and the pain had reached 10/10. I had been abused for refusing to stand up and that had been tantamount to insisting I fall and likely injure myself. Finally, the nurse had deliberately lied to me when she said I had no rights in her ward. I was perfectly aware of the law and the Tasmanian Charter of Health Rights and Responsibilities. Indeed, there was a poster in the foyer of the Wellington Clinics, presumably placed there by the hospital, advising patients of their rights. She must think me an utter fuckwit and that was why I had abused her.

My wife duly arrived and I left nearly an hour later than planned with nothing untoward having happened. In point of fact, very little if any observing of my condition after the initial obs around mid-day had taken place during the several hours I had spent there.

The day of the surgery arrived and I recall nothing prior to regaining consciousness after the procedure. I had a mouthful of tubes and was unable to draw breath. I attempted to remove the obstruction to my breathing and someone grabbed my hands preventing me doing so. It seemed an eternity until the obstruction was removed. This reminded me very much of being suffocated against my will during the episode when I had acute bronchitis. Eventually of course I was permitted to breathe. I immediately asked for the prognosis only to be told the promised surgery had not taken place.

I was told that upon being flipped over to face down, my blood pressure had dropped precipitously and remained close to zero for about two hours. The ensuing time had been spent ensuring my survival. I was on the way to the ICU as my condition was still critical. My stay in the ICU was as bad as any previous stays in the Royal Hobart Habattoir.

I had been cathetered and paradoxically this made urination far more difficult than if I had not been. I had to exert much effort to void urine and it caused me ever so much pain. When I informed the nurses they assured me that the catheter was “performing as expected.” I also had something new to me; inflatable wrappers on my lower legs that every so often squeezed them. This too caused much pain and I was informed they were also “performing as expected.” I was eventually moved to a more normal ward where I made no notes regarding my stay; either during or afterward.

For the second time in my life I was assailed by gout — in both great toes this time. I had arrived at the Royal on foot and departed by wheelchair. When I arrived home I took a large dose of prednisolone and the pain departed not long after. On the prior occasion when I had gout in my right great toe, my GP diagnosed it to be a result of restricting my fluid intake. Sure enough, drinking extra water did the trick. One of the cardiologists had told me my GP should have prescribed a drug for this and continued to consume less fluid. The drug would have been an anti-inflammatory. He would later tell me that prednisolone was completely ineffective against pain, somewhat contradicting this claim. He also wanted me to stop taking oxycodone. When I pointed out that he also wanted me to exercise, and that I could not exercise when in pain, he became very huffy.[15]

This was a particularly low point in my life. I was told that there was no hope of remediating my pain and that I would never be allowed any procedure requiring general anaesthetic ever. It was far too risky.

Pneumonia

A little over a month after my aborted surgery, I became seriously ill with pneumonia and was conveyed to the hospital by ambulance. On the second day after being admitted, I became critical (difficulty breathing) probably because my diuretic (frusemide) had been withheld. The decreased fluid loss meant that extra fluid was accumulating in my lungs. I was literally drowning. My bed was surrounded by more than ten nurses/doctors/aids etc and I was administered salbutamol (Ventolin) in luxury amounts. My protests that this wasn’t working were ignored.[16] What would I know?

When I was on the edge of consciousness, I heard Dr Serena Parker say through gritted teeth, “Give him some frusemide.” The frusemide was put in my drip and perhaps five minutes later I was breathing properly again. When I related this to my retired anaesthetist friend a week or so later, he remarked: “They didn’t put the salbutamol in your drip, then.” I told him no, they administered it with a spacer. I asked how he knew and he responded: “You’re still alive.”

I have long been pre-diabetic. That is, I exhibit insulin-resistance, but not sufficient to require medication. At home, my diet is largely protein and fat with limited carbohydrates. I consume plenty of meat, fish, cheese, eggs and vegetables. The carbohydrates I favour are for the most part low glycemic index. While in hospital the foods I’m given are said to be “a scientific diet”. Breakfast consists of jam, fruit, fruit juice, breakfast cereal, several packets of cane sugar, cold toasted white bread… mostly high GI carbs and minimal protein and fat. I’m told that eggs, cheese and fish that I usually break my fast with are “very bad” for me. On this occasion, my blood glucose is 16 mmol/l or more and I become insulin-dependent like my sister is and my mother and uncle were.[17]

I was sharing a ward with three other patients, two of whom were demented. They slept during the day, and as is common with dementia-sufferers, they became frightened at night and very noisy as a consequence. This made sleep almost impossible for me and after two sleepless nights was relieved to be moved into a ward nearby where there were only two beds and my companion was very quiet. I was assured by the nurse that I would be assured of a good night’s sleep for which I expressed my eternal gratitude.

A different nurse came on duty later in the day and he regaled me with his experiences in the army and how he’d done terrible things that he was sure nobody other than his superior officers would approve of. In other words, a complete and utter wanker. I happen to know/suspect that one of my friends actually did those sorts of things, but even his wife wasn’t sure. It’s part of their ethos that they do not talk about what they do.

A few hours after I fell asleep, I was awoken by the wanker. “Get out of fucking bed you old cunt! I haven’t got all night.” From behind me I heard an aid say: “Oh dear; he’s broken his phone!” When I didn’t pack my gear quickly enough, they started throwing things into a plastic bag. My portable computer (an ASUS Zenbook) was thrown into the bag and the charging lead ripped from the socket in the machine. I was ordered into a wheelchair and my bag of belongings put in my lap. Clutching the bunch of tulips my lovely wife had given me that day, I was wheeled at breakneck speed to another part of the hospital.

While I held on as well as I could, I was fearful of falling to the floor and indeed the tulips fell from my grasp as I held on during the bumpy ride.[18] For this I was roundly cursed (called a fucking, stupid cunt) and I feared being taken to some dark corner of the building for a jolly good thrashing. Eventually I was delivered intact to a new part of the hospital. I attempted to use my phone to call my wife, but it was too badly broken to make a reliable connection. I asked the nurse for a telephone so I could call her and I was given one. Margie promised to come and collect me as soon as she could.

I decided to check on the fate of my precious Zenbook. It was as hot as blazes and quite close to the battery bursting into flame as the lithium-ion batteries in a notorious model of Samsung smart-phones had done earlier that year. The machine had been on the charger and was in standby mode when it had been so roughly thrown into the bag with my clothes. Needless to say it no longer works. Nor has the Galaxy Note phone even after replacing the broken screen.[19]

I waited for Margie and the nurse, later joined by a female doctor, they attempted to persuade me to get into bed. I told them that after my recent frightening experience I would find it immensely difficult, if not impossible, to sleep. The nurse assured me I was safe now, and I responded: “How can you convince me of that?” She said: “I’m a qualified, professional nurse.” I said: “As was the nurse who just scared me shitless and destroyed my property.” Eventually, I discovered one of these two women had phoned my wife and told her not to collect me. This was a clear breach of the Tasmanian Charter of Health Rights and Responsibilities. When I told them I knew my rights, they capitulated and an hour or so later, some four hours or thereabouts after my ordeal had begun, my wife collected me and took me to a place of safety: my home.

Bladder Infection

Around Christmas time, I attended a clinic with the hospital’s urologist to discuss my bladder cancer. There was only one brief relapse quite some years ago. I started to tell the urologist about the problem with the catheter while I was in the ICU and the ongoing problem of incontinence that had been the result. She said that she refused to believe me. In February 2019 the pain and accompanying stench became too much. My GP diagnosed an infection when assessing my semi-annual blood test and prescribed antibiotics, but it was too little, too late. I developed a fever and was once more taken by ambulance to the Royal. There, a bacterial bladder infection was diagnosed and I was put on anti-biotics and given a diuretic. Apparently the more urine you pass, the quicker the infection will be cured.

When the bottle I had been provided to urinate into became close to full, I asked a nurse for a fresh bottle. She told me: “That’s not among a nurse’s duties!” The bottle overflowed when I next needed to piss and the bed was wetted. I informed a nurse and an aid came to assist in changing the soiled bedclothes. They were not pleased. I was made to stand by the bedside and I asked for assistance standing as I cannot do so for very long. Once more I was told: “That’s not among a nurse’s duties!” and I fell to the floor as the nerves controlling my legs became numbed. I was left to lie there while they finished replacing the bedclothes.

My stay on the ward I was moved to was mercifully brief and mostly uneventful on this occasion. For once I was allowed to take the ant-inflammatory ibuprofen. I queried the nurse supplying it as breakfast was some time away. She said that if I didn’t take it immediately, I wouldn’t be allowed to take it at all. Foolishly, I decided to take the risk. Consuming ibuprofen on an empty stomach risks a stomach bleed. On this occasion I experience intense gastric reflux and requested some pantoprazole which is what I am usually given when I suffer gastric pain. When I am told I have to wait, I text my wife to bring some from home. While I rarely suffer gastric reflux at home, I keep some on hand as it is very effective. I nearly always suffer some gastric pain while in hospital.

My wife arrived on her way to work and has forgotten to bring the drug with her. I ask her to go to the pharmacy for some; it’s an over-the-counter drug. She returns empty-handed telling me that the pharmacy had refused to supply pantoprazole to her. I remain in awful pain for somewhat more than four hours when the nurse finally relents and I am allowed to take the drug. I have missed out on breakfast very little of which I can be bothered eating anyway. I lie in bed pining for a seafood laksa, tom yum or stir-fried vegetables from the Asian restaurant less than 200 metres away.

Conclusion

It might seem from the above that the staff at the Royal are uniformly awful, but that is far from the truth. There are nurses and doctors who truly care; it’s just that they appear to be outnumbered, outgunned and outmanoeuvred. Jerry Pournelle’s Iron Law states:

“…in any bureaucratic organization there will be two kinds of people: those who work to further the actual goals of the organization, and those who work for the organization itself. Examples in education would be teachers who work and sacrifice to teach children, vs. union representatives who work to protect any teacher including the most incompetent. The Iron Law states that in all cases, the second type of person will always gain control of the organization, and will always write the rules under which the organization functions.”

Missing here are the many outpatient clinics I have attended and they have mostly been bad also. On one memorable occasion I was suffering 10/10 pain and my wife called the ambulance. Upon arrival at ERD when I was eventually attended to was told that pain relief medication could not be prescribed and to take an additional 4 grams per day of paracetamol.[20]

My greatest fear as I approach the end of my life is to be admitted to the Royal Hobart Hospital for further torture.

[1] I have since discovered that it’s far from unusual for doctors and nurses to graduate with no practical experience of such things as inserting catheters and cannulas.

[2] The Royal Hobart Hospital is a teaching institution.

[3] Sleep deprivation is a cause of brain seizure as noted by the CIA in an instruction book on torture.

[4] Systolic pressure was over 200. I cannot recall the diastolic pressure.

[5] “Medication Is ABSOLUTELY NECESSARY To Prevent Heart Attack and Stroke”

[6] My medications were prescribed under Regulation 24. That meant not only were they subsidised under the Pharmaceutical Benefits Scheme, I could have all repeats issued at the one time for one dispensing fee thus saving me several hundred dollars a year.

[7] When I open the bag upon returning home I discover the boxes of pills have been roughly torn open and several pills removed: bisoprolol and candesartan HCTZ.

[8] Early this Century — I have lost my notes taken at the time.

[9] It perplexes me that doctors always ask how many cigarettes one smokes. No regard to the mass of tobacco, or the fact that most modern cigarettes contain very little tobacco. Most brands in Australia are not allowed to use the word tobacco in the product description because they do not contain a sufficient quantity. I roll my own, and I calculate that I typically smoked the equivalent of no more than five typical tailor-mades per day. Quite why the medical profession prefers numerology to science is a mystery to me.

[10] When he sent me to the Royal after an alarming reaction to a beesting, he had telephoned me there. When I asked why, he said that the look of panic on my face when he told me that was where I needed treatment, he was afraid I might not present. The effect he had felt incompetent to treat was a watery blister about 75 mm across and 20 mm or so raised above skin level. Several staff at the hospital asked for permission to photograph it!

[11] The Monthly Index of Medical Specialities or MIMS is a pharmaceutical prescribing reference guide published in the United Kingdom since 1959.

[12] Extracted from turmeric, the ingredient that gives curry its yellow colour.

[13] Since my vitamin D3 was discovered I have taken 2,000 IU per day in wintertime and 1,000 IU in summertime. I have experienced only one period of depression since and that was only a few hours in length. I used to suffer for weeks at a time.

[14] Dr Conlon did not remain for the procedure, just the preliminary stage.

[15] Since I had received excellent advice from the neurologist, I decided to give the cardiologist at Calvary a go. Warrick Bishop proved to be just as irrational as MacFadden. He advised me to stop taking the diuretic frusemide and that worsened my congestive heart failure. My GP picked that up when he checked my ankles for swelling an hour or so after I’d seen Bishop for the second time.

[16] There is abundant evidence in the literature that salbutamol has no therapeutic benefit for cardiac asthma. Even where salbutamol is effective (pulmonary asthma) the 30% of patients who respond poorly do not have an improved response to elevated dosage. The only effect on me is to increase my heart rate (tachycardia); that is, it worsens my heart failure.

[17] My fasting glucose was 6 mmol/l when recently measured by a nurse at the Royal prior to a colonoscopy. She congratulated me on my taking my diabetes meds and I responded that I took none; I merely ate a sensible diet. She was enraged and said: “You can’t cure diabetes!” I responded that I never made that claim, but she appeared to be telling me that I had.

[18] The hospital is undergoing extensive renovations and the floor was quite uneven in places as a consequence.

[19] There was no response to the letter I sent to the hospital regarding this incident.

[20] The recommended paracetamol dosing for adults and children 12 years and over is 500 to 1000mg every four to six hours as necessary, with a maximum of 4000mg in any 24 hour period. Source: https://www.tga.gov.au/community-qa/recommended-paracetamol-doses