Not Any Human Heart, My Human Heart

 

Last week I saw my own heart beating.

I have seen a human heart beating before, but not my own.

Many years ago I did a post-registration nursing course and part of that involved watching certain operations performed. I was watching a spinal operation. The surgeons accessed the patient’s spine via their ribs and deflating their lung. I looked over one of the surgeons’ shoulder and down into the patient’s open chest. There I saw that person’s heart actually beating, its rhythmic, synchronised beating. The heart was so beautiful, a rich purple colour. Its movement was smooth but also strong, as it pumped blood, it contracted and expanded so noticeably. As I looked down into that patient’s chest, I saw the very spark of that person’s life. Their heart beating and driving the life that filled their body. It’s an image I have never forgotten.

Last week, I had an echocardiogram, an ultra sound scan of my heart. These scans have revolutionised diagnosing heart conditions, and there is heart disease in my family.

I have never had one before but I know how they work, I used to perform leg assessments on patients, using an ultra sound probe. I expected to lay back on an examination couch while a technician pressed an ultra sound probe back and forth across my chest, staring at their little monitor which I couldn’t see.

My first surprise was that there was a second monitor, on the examination room’s wall, were I could plainly see my scan. As the woman performed my echocardiogram, I could see its images on that second monitor too. On the screen, I watched the actual beats of my heart, the padam-padam of it pumping my blood.

I watched the blood rush into my right atrium, and moments later be pulled into my right ventricle. I saw that being repeated in my left atrium and ventricle. I saw my mitral valve, the valve between my left atrium and left ventricle, snap open and closed, like a stage trap door. I watched the outer muscles of my heart’s myocardium work, compressing and relaxing, compressing and relaxing, with their smooth but strong movements. I saw the blood pushed out of my heart, through a surprisingly wide artery, in a remarkably fast and strong wave. I watched my own life, beating away, on an oblong, flat screen monitor, in real time.

Up there on the monitor, was the image of my very life, the thing that keeps me alive. This was the spark of life, my spark of life, my heart beating. It was fascinating and I couldn’t take my eyes off that monitor. I was watching my own heart beating, watching the very thing that is keeping me alive.

The woman performing my scan explained each stage of it, what part of my heart she was scanning and what would be involved, always making sure I was comfortable. She was very attentive and caring, not just performing her task with no care about me except that she got the results that she needed to. Unlike so many other technicians I’ve met. To my shame, I cannot remember her name. She did introduce herself but I was far too focused on watching my scan, on that big monitor. At the end of the scan, she told me she was a nurse too.

I left the hospital with a feeling of being alive, of new life breathed into me. I had seen my own heart beating and strangely it had energized me. I wasn’t firing on all cylinders, I didn’t skip along the pavement outside the hospital or rush along the street, it was an extremely cold day. But I have found I have more energy and impetuses to do those things I want to do, I am writing more again.

I saw my own heart beating, saw my own life in front of me, on a flat screen monitor, and in return I got back so much.

Drew

What Has the NHS Ever Done for Us?

The NHS was founded 70 years ago today (1). I’m a child of the NHS. I was born into the NHS (It is a lot older than me) and I have lived all my life under the NHS. It is the only healthcare system I have known and but it is the only healthcare system I would want to live under.

The NHS is a very different organisation to the one I was born into. Back then, in the mid-sixties, it was a very patriarchal organisation, doctor knew best and doctor made all the decisions for you. But society as a whole was very like that, men in authority and in power (and the vast majority were men) made the decisions for us. It was only in the seventies that attitudes began to change.

When I started my nurse training nurses had just stopped wearing hats and aprons and I was repeatedly referred to as a “Male Nurse”, which I objected to even back then. There was still so much attention paid to how well you made a patient’s bed, perfect hospital corners, and there was just talk about the “extended role”, there were nurses who refused to give IV drugs because they said it wasn’t part of “basic nursing care.”

The job I do now is vastly different to the one I was trained to do, apart from the fact that I work in the community and I was trained to be a hospital nurse, and that’s the way it should be. My job has evolved into that of a healthcare professional, specialising in patient care, it has evolved into a role that patients require, not just what we think they need.  In the same way, the NHS had changed, unfortunately not always for the good.

I have experienced many of the changes in the NHS, so many of them driven by political ideology and not always by clinical need, and many of those changes haven’t benefited the NHS, but the NHS has survived them. The NHS has also weathered many scandals, I have lived through more than my fair share of them, and it has still kept the public confidence, this year 57% of the public said they were satisfied with the NHS (2). How the NHS has survived all these things, I feel, is due to the dedication of its staff, we are still the greatest resource the NHS has.

The NHS was the first national healthcare system were access to treatment was based on citizenship rather than what you had paid into a scheme or your ability to pay for your treatment (3). This means treatment is determined on need, and not ability to pay or have you paid enough into an assurance scheme. It is free at the point of need. For me, this is still the best system, a system based around patient care and not ability to pay/fund your treatment.

In the last year of my nurse training, I considered moving to the United States to work, once I’d qualified. On a holiday there, that year, I had an informal visit to a Phoenix hospital, in Arizona. I was shocked at how much of a nurse’s work was taken up with billing patients for their care. Everything a nurse did for a patient had to be recorded so that the patient would later be charged for it. Patient care could also be determined by their ability to pay, such as some patients receiving cheaper dressings because the nurses knew the patient couldn’t afford the more expense ones, even if that expense dressing was the one for their wound.

Our press likes to talk about the “failings” of the NHS, and my blog has been very critical of the way the NHS is treated, but the NHS is still one of the best healthcare systems in the world. This is not just me talking big, last year the Commonwealth Fund found that the NHS is the best, safest and most affordable out of eleven different developed countries (4), including Canada, the United States, Germany, France and the Netherlands (5). I am proud of this, we all should be proud of this and singing this from the rooftops.

What is the alternative to the NHS? A private healthcare system, like the United States has and has been muted by different right-wing politicians down the years? If that was the case my parents probably wouldn’t have been able to afford to have me, I was their third child. Two and a half years ago I broke my ankle at work (Read more it about here), I could never have afforded the surgery and treatment it cost to repair it, which is anything from $13,000 to $22,000 plus (6).

I work as a Community Nurse, as part of a District Nurse team in Islington, North London. The majority of my patients could not afford to pay for the treatment they receive, yet for many of those patients our care is a lifeline.

I am proud that my country has the NHS and has had it for seventy years. I am also proud to work for the NHS because I have seen first hand how the NHS has changed people’s lives and how the NHS has maintained the quality of people’s lives. And I will continue to shout as loud as I can to protect the NHS because I’ve looked at the alternatives and I don’t like them.

Drew Payne