The World I Fell Out Of. Andrew Marr
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and they did it as best they could. They personified the essence of the NHS’s immense soft power – that world-famous humanitarian ethos of unquestioning free care, of embracing whatever sickness or disaster or disease is cast by the tide upon the doorstep. It’s a kind of warm, fuzzy feeling, a mixture of pride, altruism, generosity and compassion, and it’s the NHS’s most persistent asset. It’s what makes staff walk miles through the snow to get to work, or extend their shifts if no cover is available. It’s the ethos that says: It’s what we do. It’s what we’re good at. We might have little, personally, but we are professionals welcoming anyone. Our jobs, working for the NHS, give us importance and status. We belong to something great. As a result, kings and commoners alike get treated, mostly, with courtesy and kindness. A form of unwritten morality. The public have the same sense of ownership. Their warm, fuzzy feeling tells them, It’s free because it’s ours. You notice, after a while, that for some this brings an unrealistic sense of entitlement – to the best of treatment, to decent meals, to shorter waiting times. Which also means an entitlement to moan when these things are not delivered. Just as you notice the many who remain humbly grateful for the care they receive, however compromised it is by lack of resources.
There was, of course, the occasional member of staff like Nettles, whose ignorance made you dread interaction with them, especially in your helpless state. Nettles was small but heavy-footed, blonde and calculating, a woman who, as the old saying goes, you wouldn’t take a broken pay packet home to on a Friday night. I had taken a dislike to her for her lack of compassion over the sick bowl. The feeling was clearly mutual. The next time I spoke to her I could tell, just from the expression on her face, that my English accent jarred. I had lived long enough in Scotland to be sensitive to this. I was, in her eyes, judged simply a snob.
Hospital, in some ways, is like life on steroids, highly coloured. There were all the human emotions you could recognise, hyper-inflated. But it also contained another world of unfamiliar rituals and undercurrents, of strange protocols and jargon. Infection control was an essential but self-perpetuating hospital industry, and when you were learning independence with a constrained body, it often made life as difficult for you as it did for the germs. Every morning, after the cleaners had done the floors, the auxiliary nurses were tasked with sterilising the meagre surfaces in our personal areas: the over-bed table must be cleared and wiped; everything on top of the locker must be put away in the drawer to allow it to be wiped to prevent dust. Only our personal box of straws, a flag of long-term helplessness, could remain out. Every day, trying to become independent, I would place things where I could just about grip them with my feeble right hand. On the table, my glasses, my transistor radio, which I had developed enough finger power to turn on, my headphones, my laptop, my picnic mug with an open handle. With these small totems of normality within reach, I could retreat into my own world and pretend. On the bedside table, there was toothpaste and a toothbrush, which I was just learning to hold, spitting into a plastic beaker. I was fiercely protective of these things. They represented gains, hard-won goals.
And every day, after their break and before lunch, the auxiliaries would descend, like Valkyries, and sweep everything aside, moving, rearranging, pushing the table out of reach, smashing the precious little pretence of privacy. And of them all, the most thoughtless by far was Nettles. I watched her on days when I couldn’t go to the gym, a master of hiding from work she didn’t want to do, but Queen Jobsworth of wiping and cleaning, as she placed my table beyond my reach, swept my possessions into drawers I was too weak to open, unplugged my laptop, and pushed my mug to the back wall. Tidying, always tidying, wiping, intruding, controlling. When I pleaded weakly with her to leave my things out, she gave me a death stare and told me it was against the rules. She was hard and cold and unkind. I started to hate her; I fantasised about shooting her with an AK-47; I learnt to recognise the distinctive drag of her footsteps at night and cowered low.
All totally irrational, of course, and I feel guilt now, but at the time it was hard to describe the daily frustration of seeing stuff inches away, and being unable to reach it. The only way to get hold of it, to be empowered again, was either to use the buzzer to call another hard-pressed member of staff, which I hated doing when it wasn’t urgent, or to wait until a friendlier auxiliary was passing. Like prisoners we learnt which guards to ask favours of. A ward needs a Nettles: she served the purpose of making the rest of the staff look as if they were bathed in a warm light of kindness and compassion.
In her own insensitive way, I suspect, she thought she was just following orders, because the ethos of the rehabilitation ward was teaching patients independence. We were to learn self-help, so that when we were released to our old lives we would be able to cope with as much as possible. New staff recruits were actively taught that they must stand back and let patients struggle to do things for themselves, for only that way would we become accustomed to what life was going to be like at home. Patients weren’t sick, as such, they were disabled and could be lazy; staff mustn’t be too compassionate. Their job was training people for freedom. Re-enablement. Intelligent staff grasped the subtlety of this; they could judge when to hang back and when to weigh in; the less thoughtful, let’s say, weren’t quite so nuanced.
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