August 3, 2021

Spanners at Midnight - Patient's Story

Written by Mrs Margy Lewis

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HOW IT BEGAN

It was a bright sunny May morning. I was enjoying my cycle ride into Cambridge from Haslingfield village. I was on my way to St Martin’s church for an international women’s meeting that I was leading. It was around 9.30am. At the traffic lights I caught up with a huge Ainscough crane lorry. It was turning left and I was going right over Hills Road bridge. I thought I’d overtake it while the lights were red and be safely in the red cycle block when the lights changed. However, the traffic lights turned green sooner than I expected; usually the red lasts one minute forty five seconds. I had often timed it. I realised I had made a bad decision as the huge vehicle came up alongside me. I moved into the hatched area and while looking to see if I could get out of its way was hit while I was looking at the other side of the road. The next thing I knew I was lying on my back across the road on a traffic island. The lorry had gone. Did the driver know he had hit me?

A group of people quickly gathered round and dialled 999, another phoned my husband. They talked to me, held my hand and generally tried to hold my attention. I looked down. I couldn’t see my injured leg except for bare bones sticking up in the air. “Don’t look further”, I thought. Bother. I was wearing a particularly nice summer dress and sandals and had felt rather smart. Now it would all be dirty! The paramedics arrived and gave me some ketamine that put me out. Next thing I knew I was about to go into the operating theatre. It was now noon and I had been woken up to sign the consent form. A female doctor told me they would have to take the leg off as it was so badly damaged. I didn’t want that and said so, but did I have a choice? She said if they kept it, it would mean ten operations and take about a year to get better. That was a mighty shock. By this time my sister and a friend had appeared and I asked them to pray with me before they cut my dress off. With much difficulty they found a seam and undid it. It took a time and I sensed a growing impatience round me. I lay there and thought, “This is a bad situation, what Bible verses can I think of to steady me?” ‘Where does my help come from?My help comes from the Lord who made Heaven and earth. He will not suffer thy foot to be moved’. Oh, was this God’s word to me or my wishful thinking that the foot would not be moved? Anyway, it was helpful.

DAVID’S STORY

I remember vividly the day it happened. I had just collected our lawn mower which had been cleaned after I had accidentally filled it with diesel fuel. The phone went and someone called Lala phoned to talk to me. She played down the seriousness of it. I told Margy’s mother who lived three doors away and then dashed into the car. The traffic in Brooklands Avenue was stationary so I parked in the allotment car park and ran towards Hills Road. A man in the road was shouting to drivers to turn round because there had been a major accident. My heart sank. I pushed my way through the police and medics to see her lying on a stretcher on the road with the ambulance ready to take her to Addenbrooke's. When they discovered I was her husband they took me on tot he pavement and said that her leg was all right down to the knee and then her foot, but in between there was a nasty mess. I shot back to the car and drove to Addenbrooke's. She was lying waiting to go into theatre. I kissed her and off she went. I went home to wait for news. In spite of ‘phoning we couldn’t find out if they could save the leg or had had to amputate. Tina her sister had been there and a friend from church. Eventually our eldest daughter got through to the nurse in the recovery room – who went to see if her foot was still there. The orthopaedic surgeon had decided he could save the leg.

 

THE OPERATION

When I woke after the operation I reached down to see if I’d had an amputation. No, the leg was still there. This first op. was to clean the wound. A couple of days later I had another to put skin grafts over the injury, but they hadn’t taken quite enough skin and would need to take another graft. On the tenth day there was another operation, this time to take a muscle and insert it into the leg, a flap. I went down to theatre at 9.00am and was in recovery by about 6.00pm. A long day’s work for the plastic surgeon - all the little blood vessel and veins and nerves had to be tied off and then reattached in a new position; very delicate and intricate work performed under a microscope. I was just coming round when I was handed the phone. It was my daughter. Although I was just conscious, I could scarcely speak to her. My voice was really hard to find. It was a huge effort and sounded in my boots. She had had to get over lots of hindrances, only the next of kin could speak to the patients. “Yes”, she had replied, “but Margy’s husband is deaf.” Good ole Rosie. She wasn’t going to let anything stand in her way of finding out how I was. Sips of cold water felt like nectar, so welcome!

POST-OP

I was taken up to a room on my own, wonderful! Well actually the reason was to keep away from infection. I had a bear hugger over my leg which was to keep it at body temperature, the best condition for a flap to ‘take’. The plastic surgeon Mr. Abood appeared at intervals to check with the doppler that all was going well and there were constant observations from the nurses. The next morning my book was on the floor and I asked the person in scrubs to please pick it up. He did. Later I discovered it was a doctor. I couldn’t tell. I wouldn’t have asked a doctor to do that. Someone said, “But he wouldn’t have minded. It told him that you were OK if you wanted to read.” I had a morphine pump to self -medicate. After one dose I had what I’d call an hallucination. It was different from a dream. I was going round an upland garden and little tricks and jokes were being played on me by gnomes and imps.They weren’t unpleasant but it was a bit weird. I didn’t realise the source of it. Next day and after another dose, I saw angels in black dancing over my head and waving black flags. Strange. I thought, “No more morphine if I can help it. Those two doses were enough.” They had made me sleep too. I was pretty restricted with a catheter, drip in one arm and a canula in another, awkward for eating and sitting myself up in bed.

My husband visited me every day for the five weeks I was in hospital. He had driven over when phoned about the accident but was unable to park the car or get near because of all the stationary traffic. Each day he came up with get well cards, I was inundated with them, little gifts and messages, the newspaper and other requests I’d made.

I had lots of visitors and I was really pleased to see them, they brightened up the day. There were some strange mixes of people: tennis club friends meeting Chinese associate professors. I remember one international friend from Vietnam. Her English was really hard to understand and for a time I couldn’t remember her name. She offered to do my nails but she also sat quietly with me. It was surprising what a still person’s presence could convey of strength, support and thoughtfulness. She also brought some dried seaweed with her. When I nibbled it, it tasted rather nice. I was given lots of fruit and little treats. I had to send some lovely cherries home with David as I just couldn’t manage to eat them.  There was a heat wave that June and from 4pm until 6pm I sweltered, even with the windows open. Having a leg injury is not an embarrassing part of the body to talk about and people could relate to it. I was grateful for the many messages of support. I even heard from a nursing sister I’d worked with over fifty years ago.

One daughter had paid the rental for the TV. I managed to watch a bit of Wimbledon and an Andy Murray match but then it went wrong. An outside company looked after it and despite it being reported, it was three weeks before it was mended. David brought in a little radio and I’d listen to classic FM. Another daughter brought me a small purple tablet. I am not technically minded but slowly, slowly I began to send messages and find out info. The general news was upsetting for many people: the fire at Grenfell Towers had happened, the Manchester bombing was still in the news. David brought along the Daily Telegraph and we did the quick crossword and also played Upwords together. Several friends sent flowers, but they are no longer allowed in hospital so David enjoyed them at home.

I found my appetite had shrunk to half its normal size and I chose the light options for lunch. There were long gaps between tea being served around 5.30am and then nothing till breakfast at8.45am next morning. Being in a single room I was usually served at the end of the round. By then the tea was stewed and tepid. There is a big difference in pleasure in a cup of hot tea in a white china mug and a plastic beaker in a holder that is half full of tepid tea. Was there no chance of an orderly making a fresh pot of tea for those at the end of the round? I had got used to proper coffee at home and found the hospital coffee ghastly and I’m not generally fussy. I learned to ask visitors to get a decent carton of coffee from the cafe and bring it up to the ward.

The food was pretty good with a big choice of menu until it came round the third time. I was very surprised to be visited by a dietician. I knew I’d lost weight having to starve for all the anaesthetics and times when I was prepared for an operation but it was postponed. I thought I’d lost about a stone and a half. The dietician agreed I was OK when she heard about what had happened and suggested I asked for a cake at tea time. Fancy being told to eat cake! I did discover you could actually ask for quite a lot of things like banana to go on cereal, bits of cheese to goon marmalade, cups of tea in the night. I recalled what one visitor had said,“You have to look out for yourself.” One nurse told me that my injuries were among the top ten that she had seen in all her years of nursing! I was surprised by that and it set me thinking. Was a little bit of me wanting to boast about the injuries?

The police interviewed me in hospital and decided the accident was 50/50. Half his fault, half mine. I had been wearing a crash helmet and had a dayglow flash on the back of the bike which was a write off. A pity. It had served me for thirty years, been serviced regularly and I was very fond of it. It had baskets front and back, a skirt shield, lights, bell, pump.  I used it so much it almost felt part of me. Goodbye red Raleigh rider.

 

DAVID’S SIDE

So the hospital visits began, first to the orthopaedic wards as she waited for another op., then to ‘M’ in a single room after the surgery. I established the routine of an afternoon visit with a rucksack of books, drinks, letters and cards and the stuff she wanted fromhome. There were often other visitors with her which was great unless a strict nurse insisted on limiting the number. I managed to reduce the cost of parking to I think, under £10.00 a week and sometimes cycled the six miles during the baking days of summer.

One of my tasks was to communicate. Cards, flowers, gifts and letters flowed in. Flowers were not allowed in hospital so the house was colourfully adorned. Neighbours knocked on the door, the phone was active and there were Emails galore. People in the village stopped me to ask how she was. About fifty folk in Wallington wanted to pray –so I sent periodical messages to our former church secretary as the communicator there. Folk asked me how I was coping. Suddenly I had to fend for myself. Many villagers and friends invited me for meals and ‘Ma’(Margy’s mother) did a lot.

 

HOME FOR A SPELL

After five weeks in hospital I was sent home for a week before returning for more surgery. I had a small temporary frame around my foot. It had rather sharp projections and I was afraid of damaging my good leg with it. I could hop around with a frame. It was lovely to see the garden in full bloom. There was the box of bedding plants I’d grown which was still waiting to go in. I’d been going to plant them the day after the accident, but they looked very sorry for themselves gasping for water. The tomatoes in the greenhouse had just survived and they revived after a good drink. Friends came and did an hour in the garden. It did me good to be home. David had talked to an occupational therapist friend in the village about bed sand he’d ordered a recommended one. He also vacated his study to make a bedroom downstairs. His huge desk was dismantled, the filing cabinets and some bookcases were all removed to the spare room. It was a cluttered, uninviting space. The study became my bedroom for the next two and a half years. We arranged to have the downstairs bathroom converted to a wet room and the local builders came along within seven weeks. Perhaps it helped that my elderly mother had been godmother to the builder’s wife and gently chivvied him. I was gathering various aids: a table to fit over my recliner chair, a small white table, a gadget to pick up bits. David had a wheelchair from the Red Cross, but they only loaned it for a month then wanted it back. When I returned from hospital after my next visit I came with frame, wheelchair and perch chair.That went temporally into the garage, the wheelchair into the conservatory. I didn’t want the living room to look like a sick room. I acquired a locker to fit by my chair for essentials like glasses, phone, notebook and pen and latest book and tablet and scissors and pills and, and, and...

I returned to hospital to have a frame fitted. It had been described to me as a metal cage with metal rings round it. I thought it would be like the mesh around a young sapling to stop animals nibbling the bark. When asked if I knew what they were going to do I repeated back what had been told me, except they hadn’t told me the half. I awoke with this huge contraption on my leg, four metal rings yes, a big foot plate, and thirty metal pins going through my leg with various nuts, screws, prongs and projections. The surgeon told me I’d be changing them myself four times a day following a chart. It felt as if I had two heavy bricks attached to my ankle.

 

THE LONG HAUL

I wished I’d met a patient pre op. who had had this procedure, or at least seen pictures of the external fixator, a Taylor Spatial Frame. Despite my nurse’s training I had not seen anything like this before. I would have felt prepared rather than aghast. I didn’t know what was coming my way. I didn’t know it would require my 80 year old husband having to lie on the floor on his back with a torch in his mouth to see the numbers on the screw, and then to turn the screw with a spanner. Did the doctors know what they were actually requiring? It would have been helpful if they had checked it could be done. It is one thing for a tall healthy physio to turn the spanner standing at the side of a raised bed with an assistant to hold the leg. It is another to do it at home without someone to hold the leg up except me. I thought about the alternatives: being in residential care, having a district nurse come in at midnight to do it. I discovered they had refused to take on this duty. At least I was at home but it was a herculean task for David with his arthritic fingers. His response was, “But we did it.”

Now Addenbrooke's has produced a booklet showing just how to move the screws, at what times and with helpful pictures. I wish it had been brought out earlier, it would have been very useful. At Frame we had looked up what advice other hospitals gave and found a hospital in Birmingham that gave guidance. Somehow, with dressings on my leg when discharged and then visits from the district nurse, I missed out on instructions for looking after the pin sites. It didn’t matter much.  I had a daily shower and they stayed clean apart from just once when I had a slight infection. It wasn’t until I heard a bout a fellow patient’s trouble with his pin sites that I realised how fortunate I’d been in that area.

The purpose of all this was to direct the new bone growth to the place where it could connect up with the ankle, though I would no longer have an ankle. The bone was stimulated to start growing by being freshly broken with a hammer. My foot had been badly injured. It just stayed attached held on by skin and an artery. The tibia and fibula bone were shattered in too many places to be united. My leg was now about 8 inches shorter than the other one.  When I eventually sat at the dining room table I had to place a couple of pillows under it so it didn’t dangle. The rest of the time it had to be kept horizontal. This had to be sustained till the bone had grown to be as long as the other leg. If all went well it would grow at the rate of 1mm a day. It took seven months to height of both knees, balancing a tray with a glass of water on it. Thankfully my body had been fit and the bone growth good (faster than some of the younger patients).

I was warned that this stage would be painful, especially at night, but I would have pain killers. “Every patient gets addicted to their painkillers,” the surgeon said. I thought I would try to not let that happen. Most of the time the pain was controlled by Paracetamol; two on settling down and another two around 2.30am. When I was busy by day I didn’t think about it, but in the lonely watches of the night it gnawed away. I asked the GP for something stronger, but after using them for a couple of nights I reverted to the Paracetamol. I think I was fortunate that my pain threshold was high.

Throughout this whole convalescent time the pain has not been the dominant factor as it is for some people. I don’t have feeling on my leg. I can feel the muscles inside but I can’t feel a pinprick on the skin.

August I was home again – hopping around with my frame. A neighbour lent us a ramp to get the wheelchair down from the conservatory. I didn’t want David to push me up or down as he had developed atrial fibrillation and shouldn’t lift heavy objects or pull or push them. Even though I felt desperate to get outside I thought I’d rather have a husband and be indoors than sunshine but no husband. It needed a strong friend to visit and take me down the ramp. Our youngest daughter came down from Scotland and did a mass of cleaning and tidying and David became chief cook and bottle washer.

I felt badly at the jobs he had to take on: emptying a commode, doing the household shopping, the laundry. He had never put on the washing machine or hung out washing. Nor had he cooked. After forty six years of traditional roles he had to adapt to the ‘new man’ style of domestic management. He never did the ironing. I found I could do that if he brought the ironing board and iron to me. But he was gracious and uncomplaining. We did fall out once over the temperature of the fridge. He had it on the highest number. I found the food at the back was full of ice so needed a longer time to cook. Consequently, the cooking time I told him was wrong. I then altered the fridge temperature. He was furious, and that was rare for him. I decided I’d have to climb down. We couldn’t afford to fall out. But the kitchen for this time could not be my domain as it had been. After a while he could produce a decent Sunday lunch of roast chicken and trimmings.

The first month after I came out church folk provided meals. There was a lot of variety and we enjoyed them very much.The only trouble was returning the right dish to its owner afterwards. We felt we couldn’t go on depending on folks’ kindness indefinitely and that we needed a housekeeper. I asked my eldest daughter to make a notice to put up in the village shop. She went along to see how other notices were worded and came back all excited. There was someone offering housekeeping duties for a few hours a week. I contacted her and asked for a reference. This was given by a Scottish professor who recommended her warmly. She ‘did’ for his mother in the village.So Noleen came along on Thursdays and Fridays and took over cleaning, cooking and other odd jobs. She was quick, bright, cheerful and punctual, and a joy to have around. The rest of the time she is a teaching assistant.

My sister started coming over from Cambridge on Monday mornings and that was good too. It was a chance to get to know her again and really helpful in all sorts of ways. With these arrangements David only had to produce meals for two or three days. We had different people coming to the house and church folk were really good about coming to visit. As well as reading, I started embroidering a cushion with butterflies and made a cover to go over the frame on my leg. I also made dresses for the two year old twin granddaughters.  About this time one of my tennis partners, a former nurse and church friend offered to come round every morning to help me shower and dress. She also helped with massage and exercises. She arrived promptly every weekday at 8.30am. I had particular trouble getting tights over the frame. We cut off the left leg above the knee as I still wanted it to be as long as possible for warmth. Another struggle was knickers. The leg openings were not wide enough to go over the frame. I mentioned this to the physio who said, “You have to be creative.” I got another friend to slit the sides and put Velcro on. We looked up possible purchases on the internet but at £20.00 a pair decided to home make them. I couldn’t get into trousers and got really tired of the skirts I could wear.

I received monthly visits from the community physio and had a variety of exercises that I faithfully did twice a day. At first they seemed impossibly hard, especially lifting the leg with the frame off the bed, but with practise it became possible and certainly stopped any muscle wastage. The exercises were boring but necessary. I spent about an hour on them altogether in the course of a day. I also made a cover for the frame. In the winter I crocheted a woolly one and in the summer a cotton one. It felt better not to have the distorted leg and frame in full view when I went out. Some people couldn’t bear to see the frame and leg. One twin was scared by it and wouldn’t come near me, another adult friend couldn’t bear it either. My young grandson thought the frame used for walking was excellent for acrobatics and balancing acts and enjoyed himself on it.

 

DAVID’S VIEWPOINT

After two months Margy came home. We prepared for her to live downstairs. My study became her bedroom, with a robust orthopaedic bed. Her brother Richard and nephew Chris moved my study upstairs and into the garage, a major task that included a filing cabinet and a big heavy desk that had belonged to my father. I worked in the two front bedrooms, one of which had been Margy’s study, for the next two years or so. They were much warmer than my old one.

 

THE FLY EPISODE

I had an unscheduled visit to hospital. August had been pleasant. I had sat on a recliner by an open window and tried to get a bit of sun. The blue bottles buzzed in but I took no notice. I was having visits from the district nurse to change the dressings under the frame every 2 to 3 days as the skin oozed a lot. One morning I woke up and was surprised to see a fly crawl out of my bedclothes. A few days later I discovered it had laid eggs under the dressing and maggots were crawling out. Ugh. These were not the sterile hospital kind specially bred but common or garden bluebottle maggots. The District Nurse was coming that morning and she phoned the hospital. I was admitted and put on intravenous antibiotics. The nurse-led skin department picked off the maggots. I was none the worse and home by the end of the week. Unfortunately I missed the visit from the Occupational Therapist. I had waited eighteen weeks for this, but because I had to go into hospital I was put back to the bottom of the waiting list. I never did see an OT at home though the physio arranged for an OT assistant to fit two bars outside the back door.

 

OUTPATIENTS AND TRANSPORT

I was seen by Mr. Krkovic. He it was who saved my leg. Other doctors would have had it off. He reckoned it was much better to preserve than remove. After all, thinking ahead to when you are eighty-five and have to get up in the night, it is much easier with your own leg than having to fit on an artificial one. It is also cheaper. I readily agreed with these sentiments. Initially I was seen every two weeks. I was x-rayed and shown how the bone was growing. That gave a tangible sense that something was happening. Usually I had to wait to be seen. It could be an hour or more, but once you got in to see Mr. K he gave you his time with no sense of hurry. One thing he said was really helpful and reassuring, “There will be problems but we shall overcome them.” Those times were really important and there was a considerable build up to them. I usually had a list of questions written down to ask him. It was no simple matter getting to that point!

There was a ‘frame nurse’ attached to the outpatients. She knew all about the technical aspects of frame management, but more emotional support would have been appreciated. When the gap between appointments stretched out to six weeks it seemed an awfully long time on my own with no emotional support. It would have made a huge difference to have had a friendly phone call / zoom / skype call for twenty minutes or so every fortnight. Not because anything was wrong, but because I needed that interest, concern and understanding. I also needed someone with a lot of emotional intelligence and excellent grasp of English, someone attuned to nuance and how different characters express their condition. One time I was unsettled by the nurse saying, “I worry about your mental health.” I wanted to ask, “Why, I’m not depressed. Are you saying I’m kidding myself that I’m doing alright?” Her question seemed without basis and was undermining and not supportive.

I had to travel by hospital transport as my leg had to remain extended. I had to be ready two hours beforehand before my appointment sometimes in order to pick up another patient. I remember one occasion when the transport was running late and instead of heading to hospital, we went off to Sawston to collect a dialysis patient. I was worried about arriving late and afraid of missing my slot. However, the transport people were used to running late and would phone Outpatients to tell them we were on our way. One time I wasn’t picked up until after my appointment time. For someone who hates to be late this was a tension and anxiety. I might have a 2.30pm appointment and would arrive at 2.50pm, go off to Xray (that taking another half hour), then wait to see Mr. K about 4.30pm. By the time I came out, the cafe was closed and hopes of a cuppa scuppered. Then there would be the wait for transport. If I arrived about 5pm I could have to wait two hours, sometimes more. When I enquired why I was told, “Well the ambulance has to goto Godmanchester first, then the staff have to have a break.” I was at their mercy.  It could be a long wait for the loo from 2.30pm till 7.45pm. Sometimes around 6.00pm a nurse would appear and offer a welcome sandwich and cup of tea. I was fortunate if I was home by 7.45pm.The longest I had to wait was three hours. Later I learned to avoid hospital transport whenever possible. Once I could bend my leg to fit inside a normal car, my husband would drop me off and I’d go home by taxi, but that wasn’t until much further down the line. With a taxi I’d be indoors within half an hour of leaving the doctor. It was worth the expense.

 

HOSPITAL AGAIN

One time I had to make an extra visit to Addenbrooke's as the frame screws were stuck. It needed all the strength of the doctor to budge them with the spanner. Another time I was asked to go in to reduce the swelling of my ankle, just for a few days. I was admitted to a big ward of twelve patients and my foot elevated on a huge pouffe. Apparently Mr K’s experience was that it just didn’t work at home despite patients' protestations that they carried out his instructions. I was not very happy. I was surrounded by confused, dementia patients. It was impossible to hold a conversation with them. The first night one patient kept shouting for two hours from 11pm. The nurses couldn’t silence her. Eventually, at about 1.00am a doctor came and sedated her. It happened again the next night and the next. I tried ear plugs but they didn’t work for me. It was misery. Surely she could betaken out and put in a side room rather than keeping eleven patients awake? Then I was moved to a less acute ward of 3 patients, a long way from the other one. But it wasn’t all good news. I rang for a bed pan but no-one came. Once I rang thirty times over the course of twenty minutes. The body’s urges are not made to be controlled that long. When asked why they didn’t come the nurses said, “We just get used to hearing the bell. Sometimes we don’t hear it.: The nurses may not have heard the patients’ bells, but we did. It was really tiresome and wearisome.

Now it was September my school friend was holding a dinner party for her French friend who was over from Nice. We had looked forward to this for ages. I really wanted to go. Could I go out just for the evening, taking a taxi both ways? I asked the doctor who said we can’t keep you here against your will. But I also thought I couldn’t expect anyone to help me go out and I couldn’t navigate the lifts on my own. Very reluctantly I had to miss it. I had to put my recovery before pleasure. It was a shame. The few days I’d been told I’d be in stretched out to nineteen.

 

AUTUMN

Back home, I was reading a lot of books. Many friends belonged to book clubs and I reckon I read most of the books on their lists. My friends from the Society of Recorder Players came round fortnightly and we played quartets together and enjoyed a very pleasant afternoon together, ending with tea and cake. Another tennis friend would come round with home-made soup. She was going through a divorce, it was harrowing. She got a whippet puppy; dog grew steadily and became the love of her life. He always came too.

 

On Sundays my husband was involved helping in the local church. I longed to get back to St. Martin’s in Cambridge.I missed services. I’d never been away from church for three months before. Sunday mornings the district nurses had been coming, but now their visits were a little further apart and I thought I’d try to return. So I took the wheelchair in a taxi where the centre ramp was scarily steep. It took ages to arrange the seat belt and secure the wheelchair. There was a welcome reception waiting for me outside which was very warming. The cost seemed high at £18.00 each way, but you pay for what is important to you. I kept all the receipts against the day when the legal case might be settled and I’d get expenses reimbursed. Meanwhile a friend helped me to apply for disabled attendance allowance. She volunteered at the Citizens Advice Bureau and knew how to fill out forms, all twenty two pages of them! In November I started getting £70.00 a week. Just about all of this would go on taxis.

 

A NEW PROJECT

A grateful friend whom David had pastored heard of my situation and sent me £500 to take up a new hobby. What a fantastic opportunity. But what could I do? I thought I’d study art history and maybe take an A level in it. This would give me something to work for and feel worthwhile. How could I go about it? How to find a tutor? I wrote to one of the lecturers whose talks I’d attended at the University of the Third age, didn’t hear anything back and thought she wasn’t interested. But I was eventually contacted by someone who was willing to come to the house – Deborah. Later I had a really nice letter from the person I’d first approached who had been ill, in hospital and had to cancel her lectures that term, but she had passed my name on and this is how Deborah connected with me. She travelled over each week for a tutorial. She didn’t think I’d be able to do an ‘A’ level in 6 months. One of my recorder friends had worked for an exam board and gave me the address of the syndicate.  I got hold of the syllabus and we started working through it. I loved it.

Preparing for an exam gave me something to work for. I’d done a course at school on the history of European painting when I was 16 and not thought about it since, though I’d taken to it at the time. I concentrated on the Renaissance. I’ve watched TV programmes on it and went on visits with Deborah to the Fitzwilliam Museum. Fortunately, my sister is also interested in history of art and she pushed the wheelchair round and enjoyed her talks. I worked through the last few years’ exam papers; I’d do a couple of hours in the morning on most days. I found it really difficult to remember dates. There was so much to take in. I had to drill those dates into my head, going through them every day.

I enjoyed spending sunny mornings in my study bedroom, usually for a couple of hours at a time. It was rewarding trying to get my thoughts into order and to write an answer to a question.

 

I was to sit the exam at the Christian Science Church in Panton Street, but a few days before the date the venue was changed to the Centre for Sixth Form Studies in Lensfield Road. I had to be there for 8.45am. This would be in rush hour and require stopping on double yellow lines. John, one of the trusty Polish taxi drivers, said he’d guarantee to get me there in time and wheel me up the long steep slope. The staff were thoughtful and kind and made it as easy as possible to sit the exam. I was the only one taking it and sat alone in a small room with just the invigilator. I enjoyed the exams. There was not a moment to spare. I had decent papers and to my amazement and delight I got an A* for it. As a next step, Deborah invited me to be part of one of her regular art history groups in Swaffham Prior. I didn’t think I could possibly get the ten miles out there. But David volunteered to drive me and I’ve gone on studying Flemish masters and other courses since and enjoyed the company of others interested in the same subject.

 

PROGRESS  

By January 2018 my bone had grown well. It was ahead of schedule and I said to the consultant, “Your skill, God’s power and people’s prayers have done this.” He smiled! It was not expected that someone of 73 would do as well as this. However, as the bone grew so the knee tightened up in a flexed position. Mr. K said it would take about a year to straighten. Every day I spent about an hour doing exercises. I’d had the footplate of the frame removed in January and straightaway the oozing that had been such a nuisance stopped. I should now be able to get in the car. The other inconvenience was flaking skin. I’d have a small snowfall around my chair every day. It did take about a year until the knee could comfortably straighten.

Once the bone had grown it had to strengthen. This would take twice as long as the actual growing time. It felt as though nothing was happening. I mentioned this to a young doctor at church who said, “But you are growing blood vessels and muscles round the bone and that’s important.”  That was consoling.

It was a dull period. We had had to cancel our holiday to the Canaries in January. I’d also hoped we might go on a singing tour to Athens with the Really Big Chorus at Easter. I’d always wanted to seeGreek marvels and here was the opportunity. Would I be better enough to go? I asked one of the doctors who said I’d be on crutches. Actually, on closer examination we realised it would be too active for my husband, never mind me, so we had to drop that. I’m glad the doctor hadn’t said, “No you couldn’t possibly do it,” and that we ourselves had realised it. Doctors have to be so wise in what they say to their patients and their manner of saying it, not casting down nor delivering unrealistic hope.

At one appointment Mr. K said I could start walking. I could hardly believe my ears. I’d have a built-up boot. I thought I’d have to wait a year before walking until the bone strengthening had completed, but two days later, with the physio, I took my first steps after eleven months, teeny tiny ones. It didn’t hurt. In fact, it was no trouble to walk across the room with the frame. Here was progress!

 

FRAME

Back in the autumn I’d asked the doctor if there was anyone I could talk to who was ahead of me in recovery. He gave me the name of a former patient after getting her permission and she came to see me before Christmas. I found it very helpful. She walked normally with no limp, but also showed me her scars from where the pins had gone through her leg. All she could not do was run. She gave me lots of little tips and underlined ‘you have to look out for yourself’.

I thought about other people struggling on their own, wearing a fixator. The recovery time is long and you need lots of encouragement and to meet others in the same situation. I thought of those with conditions that had support groups: MS, cancer, Parkinson’s. I wondered whether to try and set a group up for frame wearers. I wasn’t madly keen to; my first priority was to get better and not take on other responsibilities. However, ideas kept coming about what the focus should be. FRAME seemed a suitable title.  F for the frustrations... they needed airing and facing up to, R for rehabilitation… all those exercises from the physio, but also needing motivation to continue with them, A for adaptations. (Clearly we had to have big ones for our house and Occupational Therapists had waiting lists of fourteen weeks before they could see someone. What were you to do during that time? Obviously it had to be self-help) M for medication… it would be helpful to hear from doctors what they prescribed and why, to learn more about painkilling drugs. E for ending… stopping being a patient. I talked to a friend at church who is a psychotherapist and asked if she’d like to be involved. She would and she had two friends who might also help. We drafted a letter and invitation card and talked with Mr K who was all in favour of it and would give out letters to the ten to fifteen patients he had with frames.

I heard back from one, Roger. He and his wife would come to the first meeting on the last Friday in April 2018. We were able to meet in St Thomas’ ChurchHall which had a car park, was on ground level with easy access, a good kitchen and was quiet and peaceful. The idea was to meet off hospital premises so people were people not patients. The church was willing to give the use of the hall for free, so 6 of us met. Two psychotherapists, one discharge nurse, Roger, his wife Sue and me. Over tea and cake we started to share our stories. Comments made were constructive and useful and I felt supported. I hadn’t expected that. I thought I’d be giving support. I enjoyed it. It was a relief to talk deeply about what was happening to you at all levels.

We had a doctor who specialised in bones come and talk to us, another doctor came who was a specialist in pain relief. Mr. K was willing to ask the chief physio to come but while we were such a small number it didn’t seem right to ask for that. One time Sue, who had been a primary school teacher, had us make felt bowls. While concentrating on that it was relaxing and we had something to show for our time. We were sometimes joined by Louise who was a liaison social worker for a solicitor’s firm. But no more frame patients came.

The time went quickly. Roger and Sue came from the other side of Bury St Edmunds. We met other patients at the outpatients’ clinics. Sometimes they had come from Norwich or Watford. We could see why they weren’t coming to a support meeting when they were having to travel such long distances. Hospital transport could only take people to the hospital, not somewhere a mile away. Reluctantly we realised we would need to meet on hospital premises. Gerry worked at the hospital and knew all the red tape we would have to go through with safeguarding, permissions, etc., also, there was great pressure on rooms. We were offered one high up and a long way away from clinic. It would take at least another ten minutes to get there using lifts which was not convenient or realistic. Eventually we decided we would have to set up shop actually in the clinic, in a corner. The cafe was too noisy and public, but I had been waiting in clinic one lunchtime and found it completely empty. Unfortunately, coronavirus has put paid to any meetings there at the moment.

 

TAXIS

I used wheelchair adapted taxis two or three times a week. I wanted to be part of the wider world. As well as getting to church services, I attended some U3A lectures in a wheel chair. I learned to have an extra half hour in hand in case they were late.

On one occasion I was taking part in a church service when the Cambridge Marathon was on. I’d ordered a taxi 15 minutes early but it didn’t come. It was 47 minutes late. At Trumpington we met the runners and there was a one-way road system which caused a big delay. I arrived very cross, 20 minutes late. I’d allowed extra time for the taxi, but he was just late and didn’t care. You can’t preach if you are angry. Actually, I was still in time for my bit. The church warden said, “Margy, we didn’t worry– we knew you’d get here – you’re so reliable – we’d arranged to switch things round if necessary.” I asked her to pray with me to calm me down. By this time my anger was subsiding and I was able to give the message.

 If the taxis were running late I’d phone Panther the taxi firm. I’d get a message ‘Your taxi is a silver-greyMercedes and will arrive in 5 minutes!’ Sometimes it did and sometimes it didn’t. On one occasion I had an Italian driver when it had been snowing (in retrospect I probably shouldn’t have expected to go). No gritting had been done. It was rather a fearsome 7 mile journey. The driver crossed himself several times. On arrival he had to clear the snow with his foot in order to get the wheelchair down the ramp without slipping himself. It was rather hairy. He didn’t have a spade or shovel. He went home after that feeling in a state of shock. No more driving in the snow. Later that morning the sun came out and the snow melted in no time and I got home with no hazards.

Another time I was in the taxi going towards the town over Hills Road bridge. Suddenly, for no reason and with no signal, we could see a car cross into our lane right in front of us. The driver braked fiercely and by a nano-second avoided hitting him. The other driver stopped in a driveway and my taxi driver got out to yell at him. Why had he done it? Everyone in both cars was really shaken but no-one was hurt. My driver was angry on my behalf. “She’s already had an accident – why are you causing another one?” I said, “Thank the Lord no-one is hurt.” When he dropped me off at home he said, “God saved us.”

I met lots of Bangladeshi drivers from Sylhet, and others from Poland, Albania, Morocco, Tunisia, India, Germany and Turkey. Very occasionally an English one and they had always done something else first. One had worked as a stockbroker in the city, another been a builder, another a landlord, another a carpenter.  Their usual reason for becoming a taxi driver was being their own boss, working the hours they wanted. They could fit lifts round family life, visit their mother-country when they wanted and generally enjoyed their job. In all the dozens of trips I did I had two women drivers.They were very good! Their cars were modern, smooth, equipped with the latest devices: sat nav, phone, internet for contactless paying. I progressed from wheelchair taxi with leg out in front of me, to leg down, to frame, to crutches. It was the Polish drivers who jumped out to help me with the crutches.

 

SOLICITORS

David

The police visited Margy in hospital a few days after the accident and told us to contact solicitors. Barr and Ellison were on site at the hospital and we began to work with them about liability. I then discovered that our house insurance covered legal costs for personal injuries up to £100,000. We were, required to move to their solicitors so we transferred to Irwin Mitchell, a large national company that had a branch in Cambridge.

We have a huge file of all that followed. The big issue was to establish who was liable for the accident and to what degree. The police initially reckoned it to be 50/50 The accident was caused by a huge crane-bearing lorry turning left out of Brooklands Avenue into Hills Road. Margy was turning right to go over the bridge at that time and the back wheel crashed into her. She was left with a life changing injury. The lorry driver didn’t even know he had hit anything until the police caught up with him at Brampton and found tissue on marks on the wheel some hours later. In spite of several cameras on the lorry no-one knows exactly how and where the accident happened. Witnesses came forward but none saw the actual impact. Margy recalls being stationary on her bike with her left foot on the ground waiting for the lights to change. She had moved into the hatched area approaching two small islands to distance herself from the lorry and was looking to avoid traffic coming round the corner and down into Brooklands Avenue. If the lorry had swung over to those hatched lines when it hit her then its driver would have been largely liable for the accident.

In the solicitor’s file were photographs galore of witness statements, reports of difficult dialogue with the lorry company’s insurers and a CD of the sequence of pictures on the lorry’s cameras. The solicitors reckoned liability to be 70% the driver’s fault and 30% Margy’s. There were careful lists of all the solicitor’s expenses and of ours too, as well as dialogue with the solicitors in our home and their office. Eventually it was arranged for a traffic expert to calculate exactly what happened: when and where - based on the evidence of the cameras, the damage to the bike, the marks on the lorry and on one of the traffic islands.

It was concluded that the impact had happened where the pedals of Margy’s bike had left an indentation on the island. If that was correct, the lorry had not gone onto the hatched lines. This demonstrated that the driver had done nothing wrong, except perhaps failing to see Margy in the few seconds she was visible on his cameras, as well as not taking the turn slowly enough.

Margy says she would never have left the hatched area and tried to push through the narrow gap between the lorry and the island. If that is where the impact happened the lorry must have dragged the bike and her onto it. The legal team did not feel confident to take it to court and so it was all dropped – two and three-quarter years of investigation and no compensation. We were at least covered for the costs of the solicitors by our insurers and a ‘no win no fee’ contract. I don’t know whether the insurers paid the solicitors.

The costs we had were considerable -£8,000 for the wet room, £6,000 for the automatic car (Margy’s ankle cannot flex for a clutch), £5,000 for taxis. Then there was car parking, the house-keeper, gardening – the total was around £40,000. Somehow the money was there. We were given £5,000 and Margy received a weekly disabled allowance of £70.00 a week. I did write to Ainscough, the lorry firm, pointing out the innate, if not legal injustice of the accident – but they never replied.

 

Margy again. It was a shock and disappointment to receive nothing. I felt the traffic expert was keen to find me at fault, suggesting I had tried to slip through the gap between the lorry and traffic islands. I was upset that he didn’t seem to believe my account. I guess he was just doing his job, but I felt accused of wrongdoing. His results were to be taken as more reliable than my word. No compensation, nothing to be reimbursed for all those taxi rides. I had kept the receipts carefully. Was I going to feel bitter and hard done by, that it wasn’t fair? People whose feelings were offended were getting compensation of a couple of thousand pounds and that was very different from actual physical hurt. I think someone must have been praying for me as I suddenly found a Bible verse came to mind: ‘Keep your life free from love of money and be content with what you have’  (Hebrews 13:5). That was a challenge but also the best possible attitude to have. My school friend, a solicitor, said,“That’s the best advice you could have.” So, no dreams of cruises in sunny waters or expensive travel trips. Also, no being sorry for myself and having a ‘poor me’ attitude. I did have a lot to be thankful for.

 

ASSESSMENT

The solicitors arranged for a medical assessment of me just over a year after the accident by both plastic surgery and orthopaedic consultants for legal purposes. Both were of the opinion I would be better off having an amputation. The orthopaedic consultant said that I’d never walk more than 100 yards unsupported. I was dismayed by this; it wasn’t expected and I was quite shocked. I contacted Mr K. asking for a serious talk with him which my husband would also attend. To my huge relief he totally disagreed with them. If I wanted an amputation (I did not) I would have to find another surgeon. That was a huge relief. He was sorry I’d been disturbed by their suggestion.

I was very glad to have the FRAME group to go and talk to about it all. When I mentioned not walking alone more than 100 yards, Jane said why 100? Part of me wanted to show the orthopaedic consultant I’d do more. But was that feasible? Did I have to reconcile myself to very limited walking? I just didn’t know. The doctor was the one with experience, he should know what he was talking about.  My brother took the view ‘well you don’t need to walk far to enjoy the twins, potter round the garden’... maybe not, but I did nurture hopes of one day being able to walk in the Pyrenees.

 

HOLIDAYS

I couldn’t get into a normal car because of the plate over the end of my foot, nor could I manage steps. We were going to Tenerife in the Canaries in January 2019. The car Saga had sent to collect us had two steps despite what we had said. I knew I couldn’t clamber up them but I was jolly well going to get to the Canaries. David fetched a step; I could get on to that. By dint of stretching up backwards I could feel the seat behind me and I just managed to haul myself in. Dropped off at Stansted, we rang the external bell for assistance. It didn’t work. David went off to find someone and at 5.30am I shivered outside. It was bitterly cold. The assisted transport had no record of my coming but helped anyway. We followed that up with Saga later. At the other end there was a coach with two steps up. Why was our request for no steps ignored? Did they just hope it would be OK? I really didn’t want to sit on the steps in an undignified way, shuffling on my bottom, frame on leg trying to get higher. Eventually they sent another car which was fine.

We visited Tenerife a second time and were able to be out and about much more. It was hillier than we expected. After the first day venturing along the coastal path, we realised we couldn’t go on doing this. We hired a mobility scooter and this gave great freedom. I watched others go up steep hills that I would never have thought possible if I hadn’t seen them do that. There were lots of inviting looking cafes along the seafront. One morning we thought we’d stop for an ice-cream. I proceeded towards a sunny table but to my horror bumped hard into it, knocking over chairs. By mistake, instead of stopping I’d speeded up. I was driving the scooter like a bike. I thought I was putting on the brake but it was the opposite. Embarrassment all round and some very cross Germans whose coffee had been spilt. ‘She shouldn’t be allowed near a vehicle’. Fortunately, after 30 minutes with fresh drinks they were smiling and talking to us and saying it was just anaccident and accidents happen. Whew! We didn’t go there again, despite the excellent ice-creams!

The first trip we had aimed to enjoy the sun, swimming and food and these didn’t disappoint. No trips or tours, just books and puzzles and games. Meals were selected from a central buffet. I had a young waiter who took it upon himself to help me. He’d carry the plate, serve the helpings and rush round. I had to choose very quickly, but it was a help though.

Coming back in the aircraft was difficult. There wasn’t room to use the frame for walking and I had to cross various uneven thresholds at different angles with the crutches. What a relief to eventually reach my wheelchair again after landing. It seemed the crew thought all those with assisted passage could walk OK, if not for long distances. I didn’t come into that category. However, it was great to go away and come back tanned and relaxed. It was worth the hassles.

 

HOSPITAL AGAIN

On holiday my bad foot had become very droopy and I couldn’t really stand on it. It protruded and looked extremely unsightly.Walking had become very awkward; my foot had turned in and over. Something was wrong. I saw Mr. K. and he said the bones had disunited between my leg and foot. I would need an ankle fusion. I was prepared for a two hour operation but was actually in theatre for four. Something had gone wrong. Mr. K. had had to pull really hard to get the bones to align and had to shave off some bone to make that happen. He had then inserted a long metal rod. That is what had taken the time. I’d had the incision on the outside of my foot. For a few days I had a fizzy feeling from it but not much pain. The big drawback was putting no weight on it for three months. I had to hop everywhere using the frame which was a lot of effort. This was end of January 2019.

 

I kept a diary of this time in hospital

Feb.2rd           Op took 4 hours, not 2. More complicated than expected. Heel soft – wire up the tibia and talus. Wouldn’t go in easily, usually does. Straightened foot - plaster cast put on it. Shortened it by 1 cm – up to 2cm acceptable. Woke up, expected to go to bathroom, found I was attached to a drip for pain management, had oxygen spectacles on and a foot drain, 3 tubes in different directions. Felt marooned in bed. Bother, back to bedpans. When I came round felt very comfortable and woozy – kept thinking I was in my bed at home. It was after 6.00pm, not 4.00pm as I expected. Dozed on and off. Transferred to M3, offered a sandwich. Asked if there were crackers and cheese - yes - couldn’t open cheese packet, had to use teeth in the end. Settled down for night about 10.00pm but couldn’t sleep. Started reading at 3.00am till 5.30am. Blood pressure taken every so often, foot inspected for colour and movement - all OK. Had to keep O2 mask on as O2 level low. Surprised.

Feb.3rd           Good night despite slightly spilled bedpan and the business of changing sheets. Worries. What will happen at end ofthree months non weight bearing? May I get more visitors today – make a way of keeping Sunday special. David came, and Brenda and Colin. Mr. K came round. He doesn’t usually on a Sunday. He said, “This is a small blip. It will get better and it will fit into the time frame of 2 years, give or take a month or two. The heel will heal, the foot will straighten, you will walk again.” He doesn’t see it ending in an amputation. Quite willing to sign form cancelling holiday going to see the bulbs in Holland on a Dutch Cruise in April.

Tues. 5th Feb.            Promise of going home today. Was moved ward again. Back to D8 full of dementia elderly. No conversation possible but at least at night only murmurings, no shoutings like 18/12 before. Dressing taken off. Drain removed. Fibre glass splint fitted. Take taxi home. David relieved.

In October I saw a programme about disabled veterans meeting a physical challenge in Australia’s outback. They ended up at the Invictus Games and meeting Prince Harry and Megan. It gave me insight and understanding. It had taken one veteran 3½ years to walk again unsupported.

Another time I saw someone in a wheelchair abseiling down a rock face. How much is it determination, practise and training to do these things? I didn’t want the doctor’s expectations to be the final word checking my aspirations, but nor did I want to be unrealistic or foolish.  

More recently I saw an interview with Frank Gardiner, a journalist who had been shot six times when reporting on the Iraq war. He is now in a wheelchair. He had a spinal cord injury plus internal ones. His life had been in the balance and he was in hospital for five months.However, he was back at work, albeit with sometimes unforeseen frustrations such as having to wait ages for a lift, making him late for giving a report on the BBC news. But he managed his disability well. It had become just part of his life now.

 

SHOPPING

I missed going to the shops, especially Tesco! I wanted to choose for myself what we needed. I sent for a disabled driver’s badge. It lasted for a year. There were plenty of disabled drivers’ spaces at Tesco, but I hated going in the wheelchair with a trolley for the disabled attached to it. The basket was too small. By the time there were a few cereal packets in it you couldn’t see over the top, neither could you reach things. One day I saw a chap on a mobility scooter. He had limped past me outside, now he was sailing past me. I enquired about it at Customer Services and yes, I could use one. That transformed shopping. I could reach much further, I could see and be under my own steam, and the basket was much larger. In fact, David and I could divide the shopping list up and we became much quicker. Quite often my mother (aged 100) came with us.

A year later my disabled badge needed renewing. I was refused a new one. Broken legs didn’t qualify. I appealed and answered lots of questions over the phone. My chief concern was being able to open the car door wide enough to get the crutches out. I was granted a new badge. The rules had become more stringent, but badges were given to those with non-visible disabilities. Extra places were not provided. Once at the gardencentre I’d seen a wealthy couple use a disabled parking place. They certainly appeared in no need of it. It was just more convenient for them. They had no badge.

I am now driving an automatic car regularly. I’m still slightly apprehensive about parking on the road, having to open the car door against traffic, and I check the parking before I venture somewhere new.

I had been to the town centre once by taxi but now I felt ready to try the Park and Ride. We’d just go to John Lewis and the bus would stop outside. It worked fine. The following week I went on my own. There was easy disabled parking, the bus came as expected. I just went again to John Lewis and home again without feeling desperately tired. Life was opening up.

We had a few days away near Stratford on Avon. One of my joys was seeing an old-fashioned material shop where lots of fabrics were on display. My wheelchair just fitted through the door very snugly. There was a wonderful choice. I bought seven different lots of material and all the bits for sewing dresses for the twin granddaughters: zips, buttons, elastic, stiffening fabric, even a couple of old-fashioned patterns. It was the unexpectedness of it which so pleased me.

 

RESUMING HOBBIES

I went back to The Society of Recorder Players. It met in the music department of Chesterton Community College, tucked away at the back and really hard to find. Sometimes David took me and the first couple of times came and collected me too. Then I thought a taxi home would be better. One friend went right to the entrance of the college to direct him. Later, a friend from Thriplow gave me a lift home when she was playing. I enjoyed those Wednesday evenings, being part of a group with various recorders being played. We had good conductors and everyone was concerned to make life as easy as possible for me: moving a music stand over for me, carrying bags. I thought the controlled breathing was probably also good for me.

I joined in the local choir again. The first year it was from a wheelchair, but even then I managed to sing in the concert. The next year I was standing up using a frame. Next year I was on crutches and managing to stand just like everyone else.

I also got back to U3A lectures inBridge Street. Now in the second year of recovery I was in a wheelchair and going to Italian classes. It was a real squeeze as the rooms were full. I had to ring for a ramp to be put down to get up the steps at the entrance. I could just get into the lift at an angle. They practised a fire drill and I had to get into a sort of metal cradle which was half wheeled downstairs. It was all quite an adventure.

 

FRAME REMOVAL

I was longing to get the frame off. I’d had it on for almost 18 months. I was looking forward to being more comfortable in bed, wearing a whole pair of tights, having a bath and being less encumbered. One of the iron rings was digging into my foot and almost buried. I emailed the frame nurse asking for advice and whether my appointment could be brought forward. In the end I was seen 10 days earlier. Mr. K. Started the process of dynamisation - loosening the screws prior to them coming off. It was quite uncomfortable, as he had said. My thigh was heavy and uncomfortable especially when I had it up. It was achy and more difficult to walk. The discharge from my leg was increasing. It was an unpleasant time but I told myself not to worry. My leg was swollen to grotesque proportions but I was told it would get less. At last, under sedation which seemed more like an ordinary anaesthetic, it was removed. What an anti-climax. I’d expected my leg to be light and easy to move. It wasn’t. The frame weighed 2.5 kgs, the rest of the weight was fluid in my leg. Fortunately, sleeping at night instantly improved and I was considerably more comfortable. Two days after the removal I had the dressings off and was fitted with an orthopaedic boot with a built-up heel. Actually, it was hard to keep the boot from slipping off. I asked an engineering friend if he could suggest ways to secure it. The solution he came up with was to use one of the legs cut off from my tights and tie it round.

I’d had a cough and cold when the frame was removed and it wouldn’t go. I was feeling pretty fed up. Was I getting depressed? Or was it just the November blues? I’d had one morning about a year previously when I’d felt fed up and 'why bother’? I was bored with my own company, the restrictions, the dreariness, being dependent. There was a long list. But at lunch I said to David how I was feeling:properly sorry for myself. I thought, “This won’t do, stop being negative. Start looking forward to the holiday in the Canaries.” Fortunately, this was enough to check the downward spiral.

 

MEDICATION AND RELATED MATTERS

At the time of the accident I was fit and healthy. I was regularly cycling 40-50 miles a week, mostly into Cambridge or over to Shelford to babysit our middle daughter’s twins one day a week. I was playing tennis in the village club and actually due to play against an Ely team on the Friday evening of the accident. I wasn’t on any medication. In fact I was slightly embarrassed at my good energy and freedom to do things that most people my age, 72, no longer did.  

After the operation I was on an antibiotic drip and had a morphine pump that I used twice. I had fragmin blood thinning injections into my abdomen for months and months, and oral analgesia as necessary. I used to take paracetamol at night and then again about 2.30. I did try something stronger but didn’t like it or find it very effective, so I went back to the regular paracetamol. I hardly took any in the day when I was distracted by other things, but through the nights there was a deep ache that stopped me sleeping. However, the lack of sleep, sometimes only about 4 hours, didn’t seem to matter by day. To my surprise I didn’t feel particularly groggy, so I stopped fretting about it. I had to sleep on my back. The frame dug into my right leg. I tried it on a pillow but then found it was making my thigh ache. Eventually the frame nurse suggested putting a pillow between my legs; I was able to lie sideways and that helped the sleeping. Actually, for me the pain wasn’t the worst thing. I think I was fortunate. Other people in a frame had much greater pain. For me it was nothing like the pain I experienced when I had a perforated uterus from a slip of a doctor’s scalpel – that was like the second stage of labour. I think I have a high pain threshold. I was never watching the clock to see when I could take my next dose of pain killer.

More mundane matters needed attention. After coming back from holiday I developed athlete’s foot in both feet. The itching was intense. The cream from the chemist soon cleared it up but I have to take care in that area. I mentioned the flaking dry skin before. Once the frame was off, I could moisturise it with cetrabyn which I still use every day. The cetrabyn was also invaluable when I developed a strange rash during lockdown. Thankfully, as I was at the surgery having my dressing done a doctor saw it and diagnosed pityriasis. At night my back felt on fire and so had an antihistamine to reduce the itchiness which went on for weeks. After about 6 weeks the acute phase subsided a bit, but it was still uncomfortable for another 8 weeks

I had lots of courses of antibiotics. As well as the IV ones after the operation, I had them for a urinary infection, a pin site infection with the frame, for the maggot incidents. Another shock occurred about 6 months after the ankle fusion. The Addenbrooke's pharmacy phoned to ask if I could collect some more antibiotics. David went up to collect them. I expected a small cardboard packet with some capsules in foil. Instead, he was carrying a large green plastic bag full of different tablets. There were 588 in all. Three different kinds, some to be taken 3 times a day, others 4. What was wrong? Had I got osteomyelitis and not been told? No-one had prepared me for this. I asked about them at my next appointment with Mr. K. He said the scrapings he’d taken at the ankle fusion had grown something but mostly the tablets were prophylactic for an open fracture. This was necessary even though it was two years after the fracture. I had another three rounds when I developed cellulitis after a mosquito bite in the Canaries. One of the bites just by my ankle developed into an ulcer. Even though it was dressed twice a week by the GP nurses, it took six months to heal. After a further course it slowly improved, along with regular compression bandages.

In fact, those compression bandages had a very positive affect. They reduced the swelling noticeably. I needed a tighter regular compression stocking than that given in hospital. This continued the reduction in size, so much so that my orthopaedic shoe was far too large and loose. I was afraid it would cause a sore and went back to the department. Alex fitted me for a new shoe but even that was too big, so effective had the compression been. I am currently awaiting the latest adaptation.

 

I had a swelling on the back of my heel which really stuck out and made any shoe very uncomfortable. Mr. K. said it was a loose screw and needed removing. What was the cause? Did it matter? Was the fusion coming undone? I was told sometimes the thread on the screw wears out, sometimes it works loose. What makes it do that I asked? Sometimes it can be exercise and that was probably the reason in my case. I was walking a mile every day to collect the papers from the village shop. I was also doing a lot of gardening requiring lots of weight shifting, bending, twisting. Did this contribute? I had a morning in hospital for a general anaesthetic and a straightforward operation which only took ten minutes. I had a large bandage to wear for a fortnight, then to be removed at the GP surgery. I could just squeeze into my too-big shoe! My worry was that my foot and leg would start swelling up again as I wasn’t wearing the compression stocking. I was due for another fitting at the Orthotics Department the day after the bandage was removed. Not best timing!

Another small matter I had to take medication for was a fungal infection in the nails of my right foot. I’d had it for about ten years. I’d tried the medicated nail varnish but it didn’t work. I wasn’t too bothered about it but it was unsightly. I didn’t want it to spread to my bad foot and was prescribed a six-month course of Itraconazole. Amazing how one little blue capsule can clear away the infection in a toe nail. They are all beginning to look normal again now.

 

DAVID’S VIEWPOINT

Right at the beginning we acknowledged that we were both in it together. I guess I became her full-time carer. There were inevitable demands through the day. When I had to be away a few nights her friend Vicky came to stay. It was exhausting but I enjoyed it. Ever since myatrial fibrillation started, I had begun to feel I was doing less and less about the house and garden and was becoming more of a drone. Now, anything but! At the very least it was a way of saying thank you to Margy for what she had been doing in the house and garden. What is more, she never complained about her lot. I recall no moaning or self-pity – instead a steady determination to put up with her condition and at times, helplessness, and a working towards her next target she had set herself – walking with frame, crutches, stick.

At times I was tired out. One reason was I didn’t give myself enough time to sleep. After saying goodnight to her I would go upstairs about 11pm for a long bath – that got longer and longer, not getting to bed till after midnight – my fault! Since she came back upstairs, we have kept to a much tighter schedule.

My kitchen experience was positive. At first we were almost overwhelmed with too much food. Our village church arranged a main meal for us at lunch time three or four days a week. It was intriguing to discover the different meals people cooked – and the containers they came in. It was a job to remember which container belonged to whom. I put a few in the freezer but most were eaten with enjoyment on the spot. Occasionally I looked out of the window anxiously at 1 pm to see if anything was coming. The only time it didn’t was when someone thought we ate our main meal in the evening. Ma also provided meals, but probably I cooked twice a week with careful instruction from Margy: how much rice? How long on the hob? How do I cook mince? I would never say I became confident but was hopefully competent enough to produce an adequate meal, even without the frills. At least we didn’t buy ready meals, though we did try them for a few days.

I learnt the layout of food at Tesco in Royston. There was more of a skill in buying food than I had realised – the type of bananas, vegetables, wrapped or unwrapped, where are the sweet pastry cases? Which meat to go for from the fresh meat counter? Which food to put in which bag at the checkout counter and where are the batteries?

The only issue that nearly came between us was the temperature of the fridge. While she was in hospital the weather was hot, the food became softer and the food smelly. I discovered it had stopped working and was irreparable. The electrician advised me to throw away the food. I had a job finding a replacement fridge. They were either too tall to fit under the cupboards or only 2/3 of the size of the old one. I eventually bought a smaller one and put the indicator on 5 or 6. When she came home Margy found the food at the back frozen and wanted it no higher than 3 or 4. We settled on 4 to 5.

Since Margy has taken over the cooking again I can ask intelligent questions about how she got that extra flavour – and appreciate the work and experience that goes into making a tasty meal.  

For 2  years, her chief vehicle of transport was a wheelchair. The Red Cross accused us of keeping the one they loaned for too long, so we had to return it. In the end we had one from the hospital. It had a light frame that folded neatly and parts that detached, so it was comparatively easy to lift into the back of our Ford Escort. If some part failed (and it did), a chap came and replaced it very quickly. He had been in a wheelchair himself and knew how important it was to have one working well. Margy was not keen for me to push her because of my fibrillation. Managing to push the wheelchair down the ramp out of the conservatory was very awkward. I found not pushing the wheelchair difficult but thought she might be wise in this. It was not easy to find a pusher, especially with rough village pavements. Once, a niece was taking her round the village and pushing her backup from the road to the path. The camber was bad and nearly turned her over. She put a hand on the ground and didn’t fall out but it was a close thing. In the end I did push the wheelchair and was none the worse for it. We took it to the Canaries twice and had special treatment at the airports. Pushing her on sloping promenades was not much fun so we hired a mobility scooter. Now I had to look smart to keep up with her, but it enabled us to explore more of Grand Canaria and Tenerife. She hardly used the chair in the second holiday – and we never even thought of taking it on a self- catering holiday in Constable country.

She cycles round the village and drives an automatic car. Clearly, she would never drive a car needing two fit feet so we bought an automatic from her brother. It’s a Volkswagen Golf, a boon on Haslingfield’s poor roads. We have now sold the old Ford that served us so well, and are back to being a one car family.

Before her accident I had been the sick one – not able to lift, push the mower, dig the garden, but suddenly our roles reversed. I needed to be fit enough to care for Margy. That took me out of myself. Now she is so much better, life is near to normal again. That is great but there are some things she may never be able to do again, so there are different ways in which we can do things for each other. That is healthy. On holiday recently we could walk roughly at the same speed – she with crutches and I on my wobbly arthritic knees with the aid of two sticks. I would never, never have wished that accident to happen to her, but one good thing God has given us out of it is a mutuality – many areas in our home life where we can both give and receive from each other.

 

RESILIENCE

Collins Dictionary says resilience is 'recovering quickly from a shock, able to return to normal after stretching…’  I had had a bad trauma. How traumatised was I from it? My body showed the shock of it some months later when quite a lot of hair came out. It did quickly regrow. I hoped I could avoid Post Traumatic Stress Disorder. The psychotherapist in hospital talked with me several times, and with some trepidation I mentioned how I didn’t want to talk about the bones I’d seen sticking up in the air while I lay on the ground. I didn’t want to see them coming back to me again and again but having mentioned them, that was the end of it. Was I nervous about going along the road where the accident occurred? The first time I wondered if I’d be troubled. I was in a taxi and felt quite safe and unbothered. Now, when I go along that road I don’t often think about it.

I’ve often been asked how I had stayed so positive. My reply would be along the lines of, ‘Well, I never doubted that I’d get better. My earlier life toughened me up, faith made a big difference. I trusted the doctor.”

Did this really help? Yes, I think it did. My father didn’t want us to be soft and unconsciously exposed us to toughening up experiences like swimming in the sea in the Easter holidays when the water was really cold. Some people were wearing their fur coats, but as father went in, we did too. You had to take the plunge and not shiver on the brink. We camped in the summer holidays. Sometimes it rained. It wasn’t pleasant pitching tents in the wet but there was no way out. You had to do it so you did.

Thankfully as a child I was physically strong and healthy. I remember going carol singing aged 16 with my sister. We were cycling down Hills Road when a car swerved in rather close. Our handlebars got entangled. Tina fell clear, but I fell with the bikes and hurt my ankle. I sat on the pavement a few minutes then tied my headscarf round the ankle and got back on my bike and went carol singing. I couldn’t actually walk on the foot and was sent home early. The parents bandaged it up with wide strapping. The swelling hadn’t reduced after a few days so I was sent for an X-Ray that showed I’d cracked the fibula and chipped the tibia. The dressing stayed in place, no splint, no plaster cast – just three months off sport. I never had painkillers (no-one offered it) and I never thought of it. Actually it was more painful than the injuries after the accident, especially in the night.  

Well, those were a couple of examples of being toughened up physically but what about mentally and emotionally?  Before starting nursing, I went to Switzerland. A family friend had arranged for me to work for a family, look after the children etc. In my naivety I’d thought if I work really hard, perhaps they’ll want to take me with them when they visit Argentina. Hm... my oral French was weak and there were a lot of misunderstandings. There was no contract. I worked from 6.30am till bedtime. I had a day and a half off each week, but was still expected to wait at table on my day off if I was there.Three of the six children were still living at home, but they were all at school. My main job was cleaning. I was isolated, hard-worked and homesick. I wrote a weekly letter home describing what I was doing. My mother and siblings said, “Come home,” my father said, “See if you can stick it out, it isn’t forever.” It wasn’t. It was actually just seven weeks.

I then went on to help in a camp in the Jura mountains for deprived children from London. It was funded by the father of the household I was working for. I’d been told the camp was hard work, but after my experiences in Lausanne it was fun, and I enjoyed it. Later I discovered that it was a Swiss custom for young girls on leaving school to go to a part of the country that spoke the other language and be a ‘Jeune Fille’, a household help. Doing housework was the norm even if you had to wash the coal!

Did faith play a part in developing endurance? Yes, a huge part. During one Sunday in Lausanne the family had all gone to their Derby Brethren fellowship service. I didn’t qualify. They considered the English church too liberal, so I stayed at home. I found an English hymn book, and started playing hymns on the piano. I remember playing ‘O Jesus I have promised to serve Thee to the end / Be Thou for ever near me, my Saviour and my friend… with tears streaming down my face. It helped to try and sing it even though I was choked up – the words spoke to my hungry heart. Just keep on keeping on.

 

WHAT DIFFERENCE DID FAITH MAKE?

I’ve already mentioned that time waiting to go into theatre when I had to sign the consent form for an amputation and now recognising the shock of that. One moment I’d been riding along a pleasant avenue, following a familiar route. A couple of hours later I was on a stretcher about to have a leg chopped off. For me that prospect was mutilation. I thought the injured part should be specially cared for rather than removed, but I didn’t have much option. My mind had thought, “What verse of scripture can I focus on to keep calm? I am in trouble.” I‘d remembered part of Psalm121, ‘Where does my help come from? My help comes from the Lord who made heaven and earth. He will not suffer thy foot to be moved’.

It was strange to recall it in the old authorised version but that was the one that specifically mentioned foot. Later I looked up the rest of the psalm. Verse 7 says ‘The Lord will keep you from all harm, he will watch over you all your life: the Lord will watch over your coming and going both now and for evermore’. Little did I know how much coming and going I would be doing with the hospital: many, many appointments, X-Rays, blood tests, surgeries, physio, admissions. I lookback at the aptness of those words and smile!

It was my practice to have a daily time of Bible reading and prayer. I wanted to keep this up in hospital in order to keep to regular routines as far as possible but without expecting too much of myself. I settled on reading a couple of psalms a day. I was often awake at night for quite long stretches. I read in Psalm 63:6 ‘On my bed I remember you. I think of you through the watches of the night’. Here was someone else who had been awake at night and I could follow his example in what he thought about.

I have also mentioned the verse from Deuteronomy 31:8 amplified version that challenged me to accept hardship and difficulty, ‘It is the Lord who goes before you.

He will march with you. He will not forsake you or let you go.  Let there be no cowardice or flinching, neither become depressed, dismayed or unnerved with alarm’. The middle section seemed so fitting. The bones that had joined the ankle bones had detached themselves and my foot was all askew. I needed the ankle fusion to secure them in place. Was I dismayed? I was. Was all that frame wearing to no avail? Would I be able to walk? I’d have to hop for three months.I wouldn’t be able to bend my ankle. How would I get shoes on? Lots of dismal prospects confronted me, but also God’s word - ’Let there be no cowardice or flinching, neither become broken in spirit, depressed, dismayed or unnerved with alarm’. I was dismayed, but hang on a minute; I had a surgeon who had said, “There will be problems, but we shall overcome them.” He knew how to fixit. I wasn’t left to make the most of a bad job, I was fortunate.  There was the time when an assessing doctor had said I’d be better off with an amputation. Mr. K. had completely disagreed. Thank goodness we were on the same side and that fear was scotched. That same doctor had reckoned I’d never walk more than 100 yards unsupported and this assessment had seemed such a weight on my prospects. Again, those words of scripture boosted me. I wasn’t prone to panic or anxiety but I did need to keep a grip and let God’s word speak to my emotions. You can receive bad news. Accept it, face into it. This is part of ‘the march’ through easy patches and hard ones.

Another verse that brought joy to my heart was from Isaiah 58:11, ‘The Lord will guide you continually, he will satisfy your needs in a sun scorched land and make your bones strong. You will be like a well-watered garden, like a spring whose waters never fail’. I applied my situation to being like a sun scorched land – a dry period, uncomfortable, but my needs would be satisfied. ‘He will make your bones strong’ – how specific was that? Before the ankle fusion the heel had become soft and spongy. It needed to become hard and strong. Then comes the promise of being like a watered garden: thriving, productive, fruit bearing.

 

BOOKS

Books, books and more books: a pile of twenty waiting to be returned, sitting on the hall table, a box of books under the bed from a school contemporary of David’s, friends’ books, a pile waiting to be returned to the village telephone kiosk library, plus books in David’s study occupying two walls of bookcases. What a joy, what a release, what an escape.

On reflection, I wish I had planned my reading, but hadn’t known how important it would be, nor how much time I would spend reading. I always had a book on the go. I had resolved that I wouldn’t watch daytime television; instead, I read. It passed the time, stirred my interest in the wider world, gave me something to talk about beyond the accident and the aftermath. As I think about it now, I wish I had thought of joining a book club. There were a couple in the village but the prospect of the fuss of it: transport, frame, specs and the disruption to the group with all my stuff put me off ever really considering it. Visitors usually talked about what they had discussed at book club and passed on the name of a good read.

I did keep a list of all I read. There were so many different genres. My eldest daughter is a primary school teacher and acquainted me with some of the popular authors for that generation. Now I know the sort of fantasies that David Walliams and Michael Morpurgo write! Ire-read some of the classics I’d tackled in my twenties. This time, War and Peace made a lot more sense now I knew a bit more European history. Jane Austin I hadn’t touched since taking O levels back in 1960. Now I could compare the TV production and the novel and enjoy both; this obsession with class and money! I bored myself to sleep with Walter Scott’s Ivanhoe. The Duchess of Devonshire was another soporific one! I renewed my acquaintance with John Buchan’s mysteries and was thoroughly disappointed with the novel’s end of 39 Steps, having seen a nail biting finish on TV.

How other people live has always been of interest. Chris, my next door neighbour, had lived abroad in SE Asia and had lots of books about these countries. I read novels about India, Japan, China,Kashmir. For my birthday I had books about refugees from The Lebanon, Syria,Crete, N. Korea, Iceland during the time of the Barbary pirates (my aunt came from Iceland) and others on a lighter note about Italy and Jordan. My niece was engaged to an Iranian and I was able to give her the book ‘The Saffron Kitchen’- a real insight into the mind of an Iranian woman who had married an Englishman. I enjoyed Bill Bryson on his many travels. My brother-in-law had had a relation who had been in meetings with Gertrude Bell. She knew the Middle East better than many an ambassador before it was divided up after the war. He lent me a book about her.

I gained many insights from this genre in understanding other people’s lives and cultures. The historical novel came in many forms and different periods: from Romans in Britain up to the second world war, in slender volumes or great thick Ken Follett ones. Often David would read the same one and we’d discuss it later. How nasty, short and brutish life could be!  I bought the whole Poldark series and enjoyed them one sunny June, sitting outside in the afternoons. There were the Tudor intrigues, monastic mysteries and last century Agatha Christies, the Grantchester Series and more recently, Stella Rimmington MI5 books.

Sometimes I read a Joanna Trollope or Maeve Binchy novel, and yes, sometimes I read late because I had to find out what happened. I loved exploration and adventure books: Mallory’s fatal climb of Everest, living in the winter in Alaska, stories of risk taking and attempts to break records even if they didn’t all end happily.

I enormously enjoyed biographies from Terry Waite’s ‘Taken on Trust’ to Michelle Obama’s ‘Becoming’, from Tara Westover’s ‘Educated’ to Kate Adie’s ‘The Kindness of Strangers’. I chuckled over some of the medical ones such as ’This is Going to Hurt’ by Adam Kay, and loved ‘Call the Midwife ‘by Jennifer Worth. They recalled my days working in Lambeth at St. Thomas’s Hospital. I had visited an old lady, Jean, that lived in bed and sent me out to get her snuff and a drop of the hard stuff. She kept her coal in the bath. My midwifery days in the 60s were not that different from the ones in the East End.

I learned to avoid the exciting, stimulating stories just before sleeping, or else I’d lie awake, too caught up in the events of the book. Up to this point I’ve read over three hundred books. Do I remember them all? No, I don’t, especially the titles. But that doesn’t matter. I have been entertained by witty or comic writers, maddened by the ponderous prose of some 19th century novels and pleased by the purity and sweetness of some of the natural history books.

There were some Christian ones that were very helpful. Edith Schaeffer’s book on ‘Affliction’ was both strengthening and challenging. She discusses the reaction of Job to his sufferings and applies some of the lessons to the present day. Despite all his afflictions, Job never curses God despite all the troubles Satan pours upon him loss of children, home, health, poor friends. Today, people may experience a catastrophic event of loss, disappointment, injustice or illness. Despite this, they still do not curse God? In the cosmic struggle between good and evil where Satan has done his worst, God’s power is seen in those who suffer but still honour him. I prayed to be one of those people. I also found Meg Warner’s book ‘Resilience’ useful.

Books have been a comfort, a time-filler, an encouragement, a bore, a joy. They have been presents. They have been borrowed, bought and passed on. The house is full of them. What would I have done without them?!

 

THE HEALTH SERVICE THEN AND NOW

I started my nurse training at St.Thomas’s hospital in 1963 at the Nightingale School of Nursing. We all had to read Miss Nightingale’s ‘Notes on Nursing’ and be aware of our heritage. The patient was to be treated as an honoured guest!

The initial three months of preliminary training were in the country, just outside Godalming. It was rather like a boarding school. Being in the Surrey countryside, we had lots of fresh air and good food. Was it to build us up before encountering folk from the slums still in Lambeth, with people in poor health and poverty?

We had nurses’ homes to live in and coaches to take us to and from the hospital. A home sister supervised the nurses’ home. You had to get permission to be out after 11.00pm and definitely had to be back by midnight. Parents were probably rather glad that their offspring lived in these protected surroundings in the big city. We accepted the rules with good grace. After a tough and tiring day, at least you could chat to friends over a goodnight drink and talk of your experiences. In the third year you could live out, and we all did sharing together with friends. When my niece recently trained as a nurse in a London hospital, she had to find her own lodgings at her own expense and pay her travel expenses. No friendly colleagues to go back home to.

Appearance was important hair off the collar, neat and tidy, polished black shoes, clean nails, clean apron, no laddered stockings. I was sent back to change mine when I was spotted walking over to a ward with a ladder. A glance at your uniform told other staff what stage of training you had reached. I was shocked by the appearance of some of the staff today. They looked slovenly with long strands of hair drooping round their faces. We were told that hair drops bacteria and that was why it was important for it not to dangle over dressings. I was told that the rate of cross infection today though, was extremely low. Was this because procedures were all carried out in disposable gloves and aprons by all staff, doctors included?

We worked a 48 hour week with 1½ days off aweek. Sometimes we were on a short morning, going on duty at 7.15am and going off at 9.15am to return again at 12.45am until 8.55pm. The fifteen minutes off for a drink and thirty minutes for lunch were not counted in our hours.

The nurses’ dining room was large and spacious. In summer you could go out on to the embankment of the Thames and catch a few minutes of sunshine. The food was very good. (I was shocked when I got a main meal at Addenbrooke's. There was no separate dining room for staff. A section of the café had a notice saying it was for staff only but staff, visitors and patients all had to queue together in the same cramped space. I thought it could be vastly improved to give more privacy and respite to staff on a busy day).

We had routines at set times: meals, drugs, bedpan rounds, drinks rounds, washing. Today it is different. No bedpan rounds, you have to ask for one which really doesn’t work well. You don’t want to have to ask all the time. When you want one, there is no-one around and if you buzz, there may or may not be someone who answers it. I once waited twenty minutes to bursting point. Back in my day (!) there was a bedpan round before every meal and you were then comfortable and ready to enjoy your meal. Today, instead of a bedpan round, there is a blood pressure round. An obsession with taking blood pressures has replaced something that was much more important to the patient. Now it seems the nurse is more concerned to fill in a chart that will be inspected than in the patient’s comfort. There was absolutely no need to take my blood pressure yet again when I was dressed and going home in half an hour. No longer did nurses seem to observe their patients as we did when taking pulses and respirations. We felt the patients’ skin, watched their breathing, exchanged a few words. I sometimes wondered if there was anyone in charge. I almost never saw them if they were. Did they just look at observations on a chart? How can they report on a patient if they haven’t seen or spoken to them? The two occasions I saw someone in charge was when I was being moved to yet another ward because of pressure on beds. That was my third ward in four days. You don’t exactly feel welcome when you get pushed around like that.

The other time was different. It was the first time of putting my bad leg that had the flap over the edge of the bed. It was watched very carefully by the sister / nursing officer who certainly knew her stuff and was really pleasant to me. Once upon a time the sister used to do her round of all the patients every morning asking how they were, telling them of any procedure: x-ray, scan, change of medication and that all important question ‘have you had your bowels open?’ Your answer was recorded in her book and a laxative given if needed. After 10 days of not going, I had the nasty need for a manual evacuation of bowels. Could it have been avoided?

Some practices have improved. Every medicine round I was asked if I had any pain and an analgesia was given if necessary. Also, on the drugs trolley was a notice asking people not to disturb the nurse while administering drugs. Both are improvements on my day.

I missed the sensitive apportioning of food at meal times in the modern system. Back in the olden days the sister dished out an appropriate amount for the patient knowing their sickness, appetite and what was happening to them that day. Patients had been sat up and made comfortable, mobile ones gathered to share a meal together at a central table. Today, overlarge portions were served, sometimes by male nurses who must have imagined we had the same sized appetite as them. When told to leave anything we didn’t want, I wasn’t happy. I don’t like waste and I like to leave an empty plate.

However, I never saw or heard a nurse being reprimanded. In my day, sometimes there was a tearful nurse after a tongue lashing. I was impressed particularly by the Filipino nurses. They were well turned out and did a very good job. They could do with a course of assertiveness training though. They had a hard time dealing with belligerent, bellicose patients who were totally un-co-operative. I thought they should have had better back-up. Security was slow to respond to calls for support, especially at night.

One outstanding difference today from the 1960s is the amount of night noise. Sometimes it felt as if night was treated as if it was day: voices at normal volume, beds pushed around, lights on. Machines bleep and flash, blue lights loom, there is an ‘acceptable level of noise’. Patients are warned in a booklet about coming in as a patient to wear an eye mask and ear plugs at night. Little packs are given out. There are bumps and bangs, trolleys being moved, sirens in the distance and buzzers being pressed. I’d like to see a study about the use of buzzers: who is pressing them, how often, what for, how long before a buzzer is answered, who is answering them? When the patient asks, “Why didn’t you come?” the easy answer, “We were short staffed,” may not be the whole answer. Some nurses working at the other end of a long ward of different rooms just hear it as a distant noise that they shut out, others think, “I must finish looking after one of my patients first,t he health care assistant should answer it.” Others are busy on computers at the nursing station. The patient waits and no-one comes. When the person next to you is pressing the buzzer for 20 minutes you feel jangled and annoyed by the noise and lack of response. Oh for the days of the long open ward where you could see and hear everybody and everyone was willing to answer the call of ‘nurse’…

On one stay in hospital I was in a three bed ward where an elderly patient was next to me. She slept all the time except mealtimes when she had to get out of bed and when the nurses insisted she should walk to the loo. The other patient and I were concerned that she was sleeping so much. It turned out she was being given nightly sleeping tablets. The nurses never saw or realised how much time she spent sleeping the days away. We did tell them.  

If I’m critical of the new style of nursing, it is a different story with the doctoring. Then, doctors were seen and treated as demigods. The ward had to be absolutely silent when a consultant was teaching medical students. His teaching was top priority. Now doctors are far less formal, less self-important and much more approachable and better at communicating with their patients. Back in the 1960s, medicine was almost a hereditary occupation. If your father was a doctor you were much more likely to get into medical school. It was reckoned you had a much better idea of what you were going into, knew how to approach patients and had had a host of medical stories in your background. Now there is a much more diverse intake.

I was relieved when Mr. K. called me Mrs. Lewis. I didn’t want him calling me by my Christian name. I wasn’t a friend; it wasn’t a relationship of pals but a professional one with recognised boundaries. He was the doctor, I was the patient. We were not equals. He had the knowledge to deal with my injuries and trauma and I was in his hands. I could ask questions, seek re-assurance, be told what to expect. I was not on a level with him, nor did I expect to be. But what was most important was that I did trust him. When I asked, “Will I walk again?” he had said, “Yes, but not so far.” He never lied, though once he didn’t say the full extent of how bad things were.

In the 1960s the NHS worked well. There was a pretty good match between supply and demand. There were far fewer investigations, scans and procedures, so costs were less. All patients were treated equally. The systems were hierarchical and authoritarian, but they worked. People did not live so long, so there were fewer geriatric patients needing a lot of care and there were also more hospital beds. When I went for an interview for sponsorship for my Health Visitor’s training, I was asked what I thought of the Health Service and what was its future. I replied I thought it was in a state of flux. It still is!

The pandemic has revived discussion of hospital buildings: how well ventilated are they ? Is the central heating system of circulating air spreading infection? Oh for the long light wards with windows, that when open, bring in fresh air. Please don’t put me in a room with no natural light, that feels like a cell. Let me see trees, plants, birds, not a blank wall. Revisit Florence Nightingale views on light and ventilation.

Also, what about flowers? They have been banished. What is the real reason? Are they just in the way? Do they take up valuable space?  Are they a source of infection? Did they really give out carbon dioxide at night and need to be moved out of the ward? Can their value to the patient for pleasure and increased well-being be set alongside the disadvantages? Does everything have to be so clinical? Based on my recent experience, if I had the choice I would have the nursing of the 1960s but the doctoring of today. I think the ‘apprenticeship model’ equipped nurses much better for the regular reality of life and business on the wards. You learn from doing, you are part of the team, you count, you aren’t just an observer. You learn to be quick and methodical, you have good role models. Was the training of yesterday so stimulating for nurses that had a higher level of education? No, it wasn’t. Sometimes I thought I’d like to use my brain more, but as a preparation for life it was excellent; you learned to do things no matter how tired you were. You knuckled down to unpleasant jobs, you were expected and expected yourself to cope, no matter what was thrown at you, while remaining ‘civil, courteous and pleasant'. You met people from all walks of life, both as patients and as NHS workers. I am so glad I had that training.

I have had to use a huge number of NHS services: A and E, ward nurses, trauma and orthopaedic surgeons, plastics surgeon, anaesthetists, physiotherapists, occupational therapist in hospital, psychotherapist, laboratory staff, radiologists, dietician, chaplain and associates, transport, community physio, district nurses, general practice doctors, ‘Provide’, wheelchair repair service. I have probably omitted some. Allied to all these services are the grants available. I claimed Disability, and Carer’s and Attender’s allowance which can be claimed after six months. No-one at hospital told me about it? It was just a friend who had worked at Citizen’s Advice Bureau.  

 

CONCLUDING THOUGHTS

I am hugely grateful for the Health Service and that it is free. We were reminded that we could have been ruined by expenses if we were in America. I am amazed at the expertise of the doctors and what they can do. I am relieved to have had an orthopaedic surgeon who conserves limbs and a plastic surgery consultant who can make such a fine job of grafts and flaps. I don’t have the fibula bone no ran ankle. I am full of gratitude to them.

I am grateful and relieved to be as well as I am.

After nearly four years I have an active life. I have a disability in that I need to walk with a stick and have a thick leg but I am not defined by it. If I wear trousers you wouldn’t know anything was wrong. The larger than normal shoe is hardly noticeable. I am more sedentary now but able to cook, garden, walk around the village and nearby countryside, look after grandchildren and do housework (but not carry the ironing board). Although I have cycled round the village many times, I find that being unable to extend my foot after the ankle fusion, a real hindrance. I don’t want to have to put a foot down to wait for traffic, so I don’t expect to cycle in traffic again. I can’t wear ordinary shoes but have to have specially made orthotic ones. They look rather like hiking boots. I do wish I could wear a nice pair of shoes!  I can drive, join in with public life, be an active church member, sing in a choir, play in a recorder group. I can’t dance and I won’t be playing tennis again, but that would have had to stop sometime. I can play croquet. I can fling a frisbee but not run to catch it. I can manage an escalator. I am slower at getting things done. Probably the greatest disadvantage is not being able to carry things. I don’t trust myself to carry a full tray, especially if it has glasses of water on it. Although I can carry the laundry basket outside to peg out the washing, I am bent right over and take time to unbend after lowering it.  If I want to cross a busy road with the twins and hold their hands, that is complicated. They each have to carry one of my crutches. Just holding their hands gives me the steadiness I need. I find it difficult to reach up above my head to lift things down, as the lifting muscle was moved from under my arm to make a flap for the leg. I’m quite surprised how often I miss it.

On longer walks I use crutches, especially if I don’t know what the terrain will be. One crutch is fine for fairly short walks and at home I just use the walking stick. My cry goes up,“Where have I left my stick?” Often I forget to use it, or it is inconvenient as I need two hands free. I can manage to nip upstairs without a stick, but need a bag to carry stuff up and downstairs. The other morning I managed the whole time without it as I couldn’t remember where I’d left it.

I feel I have adjusted to my circumstances and don’t fret about my limitations. The crutches sit in the porch ready to be picked up for my trip to the paper shop. A variety of sticks stands in an umbrella stand by the front door so I can find a substitute when I’ve forgotten where I left my regular one.

Mr. K’s words ‘there will be problems but we will overcome them’ were true. The biggest problem was the ankle and tibia bone separating, but he performed an ankle fusion. The greatest shock was when two examining doctors both said I’d be better off with an amputation, but Mr. K said, and stuck, to his ‘I totally disagree’. There were physical and emotional problems, but they were resolved.

Can I hope for any further improvement? I simply don’t know. It would be a great bonus. Meanwhile, I want to try and ‘be content with what I have’

At my last hospital appointment, a doctor I’d never met before, but who was about to become a consultant, sat down beside me to have a talk. He had been present in theatre when I was first brought in after the accident. He sat down beside me, took my foot tenderly and examined it. Then he said, “It’s miraculous.” He also said, “We shall be talking about this to medical students for years to come.”

 

I have a few hints of do’s and don’ts:

 

Margy Lewis

    April 2021

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