State-of-the-art surgery and instant oats
Just shy of a month from my cancer diagnosis, I was assigned a slot for the operation: a state-of-the-art robotically assisted total hysterectomy. These wondrous machines are a recently acquired capability, and NHS Scotland is proud of them. As the surgeon described it, after the delicate robotic arms clipped away the ligaments under her guidance, my uterus and all the trimmings would simply be ‘taken out down the way’.
A friend who works in hospitals advised treating the process as a long-haul flight: pack snacks, earplugs and eye mask, and prepare to be bored. Very bored.
The airport experience began with the bizarrely banal admissions process. I booked a 7am taxi and was driven, with my modest daypack—my ‘cabin luggage’—through an industrial estate to Glasgow Royal Infirmary. Following the surgeon’s instructions, I entered through the maternity ambulance bay and walked down a long, low-ceilinged institutional tunnel. I could’ve been visiting a 1980s Cold War bunker. (Surely the best signposted ‘secret bunker’ in the world is this one, in Fife.)
In Day Admissions, a windowless room inside the bunker, people whose afflictions were hidden inside them, like mine, sat waiting on rows of vinyl chairs. One girl turned up after me with a case large enough to be hold luggage. What treatment required her to pack for a month? Flanked by her family, she seemed oddly cheerful.
It was like waiting for a delayed flight, without the food vouchers. People were called up, disappeared, then released back into the waiting area. After about the third call up, they’d reappear, transformed from civilians into patients, wearing surgical gowns, compression stockings, slippers and dressing gowns. The knee-length stockings were white, an anachronistic eighteenth-century effect that added to the overall strangeness. Luggage was tagged and deposited on a trolley, along with a white plastic tie-top bag of patient clothing. People who hadn’t brought dressing gowns were led back into the tunnel double-wrapped in theatre gowns. The Hold Luggage Girl came out wearing what seemed to be a pink fluffy onesie, an incongruous, homely touch.
I envied her this cosiness. When I’m hungry, I get cold, and in a fasted state, I was distinctly chilly in the waiting room. I wished I’d brought my own fluffy dressing gown rather than my austere cotton Japanese house-coat.
Various staff asked me the same questions—current medications, medical history, allergies—I’d been asked during the pre-op consultation. My name and date of birth were verified at every step. I wasn’t going to come out minus my appendix rather than my cancerous womb. This was somewhat reassuring.
I sat in Day Admissions from 7am to about 1pm. I finished the Booker-shortlisted novel I’d borrowed from the library. To be honest, it was rather dull, but the alternative was to read my phone, like everyone else, or to watch breakfast TV on the wall-mounted screen.
Eventually it was my turn for the compression tights (size S), and the indignity of a theatre gown that seemed to be missing a tie at the back.
In the prep room, I hopped onto the surgical bed as instructed by the anaesthetist and in obedience to this greater process, of which I was a central but passive part. Through the panes in the theatre double-door, I could see the big round lights and the shapes of people in surgical gowns, preparing to inflict curative medical violence on my helpless body. Internet images for gynaecological surgery, which I’d looked up in the name of both scientific and morbid curiosity, show nothing recognisably human, a square of ballooned flesh in the midst of blue surgical drapes, pierced by robotic spider-arms swathed in plastic. Very soon, that was going to be me.
‘Go to your happy place,’ said the anaesthetist, feeding a needle into the top of my right hand.
I was completely alert, chilled and trembling slightly from hunger and anxiety. It did not seem possible that very shortly I’d be unconscious. I thought of my lovely couch, then my bath (with podcast and end-of-day drink), then my couch again, with hot water bottle, book and cup of tea. Which was my happiest place? Could I only have one? Is it sad that my happy places are both supine and domestic, not wilderness locations of staggering majesty or the throes of some significant activity, in a pure flow state? Perhaps I was too literal about ‘place’.
After the magic of anaesthesia wore off, I woke up in pain, in the recovery ward. The nurse gave me morphine, which vaguely impressed me (the granddaddy of wicked drugs!). I was wheeled through long corridors, a disorientating, recumbent commute, to a room of three other women, and parked in the remaining cubicle.
I was offered tea and toast, the first food in 24 hours. My throat was sore after the intubation, and I couldn’t swallow the toast, a scratchy wholemeal variety spread thinly with margarine. I asked if I could have some honey. The tea trolley attendant shook her head. Was this such a luxurious off-menu request?
A long, formless afternoon was followed by a mostly sleepless night. I was tethered to the bed by a catheter, and my belly was very sore and full of gas. For abdominal surgery, they pump you full of it. The wind pain is worse than the surgery pain, and painkillers don’t help. When I tried to turn on my side, I felt the tug of the catheter tube. Every movement required careful forethought. Turtled and helpless on my back, I asked for the call button to be unhooked from the wall and laid on the bed so I could use it.
The shift nurse came by regularly to check my blood pressure and oxygen, waking me up. The compression stockings had been removed in theatre. I asked if I should still be wearing them, like the other women on my ward, and the nurse sighed and said, why do they always take them off, I’ll get you some more, but she didn’t. Rather than nag a busy person, I resorted to my flying-to-Australia ankle circles and buttock squeezes to avoid DVT.
I was trapped in an understaffed economy-class section of a plane with a well-meaning but overworked crew. On a recent Lufthansa flight from Singapore to Frankfurt, there were only two flight attendants in economy class; they simply turned out the lights for 13 hours and one sat off-duty in a jump seat.
My first step to autonomy was the removal of the catheter. After that, in order to win release, I had to pee into what looked like a cardboard cowboy hat with fluid measurements inside, three times. I emptied the jug of water and kept watch for the breakfast trolley. By this time, I would’ve welcomed a British Airways economy class meal. What I got was far, far worse: instant oats and instant coffee. Being in a Scottish hospital, I’d expected a vast, steaming pot of porridge to come riding on the meal trolley, the obviously superior option to Rice Krispies, cornflakes and the other industrial breakfast food on offer. What I got was a Cup Noodle-style pot of instant oats, a watery, tasteless grey slop. Shame, NHSGGC! The only nod to Scottishness or flavour were two sachets of salt. There was no fruit or fruit juice, no yoghurt, not even the option of throat-grating toast and margarine.
I wasn’t the only one doing the pee challenge. One woman was wanting out for the weekend, very reasonably, since nothing would be done to her until Monday. At regular intervals, the alarm went off in our shared bathroom and one of my neighbours would emerge, crossing paths with a nurse who’d snap on a pair of blue gloves from a wall dispenser and retrieve a filled pee-hat. We didn’t get around to introducing ourselves, but there was a camaraderie in our complete lack of dignity.
By this time, I could sit up, but I had nothing to read except my phone. Of the piles of books around my flat, I’d only brought the one. The NHS does not supply in-flight entertainment systems. Another point in BA’s favour.
At lunchtime, I had my first substantive meal in almost two days: a small bowl of very salty (packet mix?) carrot and lentil soup and a baked potato with coleslaw. The options were coleslaw OR cheese; you couldn’t have both. (I asked.)
The surgeon dropped by to say the operation had gone well. Back in July, I’d had no notion of cancer. I’d lived with the awful, transformative knowledge for a month, and now my reproductive system, an invisible but palpable part of me, and its malign outgrowth had been removed. The sudden void would be filled by other organs, the way people in a crowd shuffle together to fill a space. Here, my usually efficient imagination failed me. My overriding visceral sensation was not of loss or emptiness but gas pain. My feelings were struggling to catch up.
Despite the removal of the guilty organ, which was away on its own separate path, for purposes of histology, research and teaching, unmoored from the mothership of my body, I was not yet officially cancer-free. The little black doom-cloud still floated over my head. In two weeks, said the surgeon, I’d hear back whether I needed radiotherapy. I was still in cancer limbo.
‘You can stay as long as you need,’ she said, patting the end of bed.
This was kindly meant, but I needed to be at home so I could feed myself properly. A lengthy stay in hospital would surely lead to malnutrition. I couldn’t quite manage the contradiction: after providing me with sophisticated, world-class surgery, which would cost around £10,000 in a private hospital, the NHS had apparently budgeted 1p a day to feed me.
I suspect Kate Middleton has undergone something similar, and I don’t imagine she’s had to send William to Tesco Express to fetch her some yoghurt and fruit.
A doctor came by, doing the rounds with an entourage of students. I showed off my swollen Franken-belly, with its five bloodied dressings.
‘Is there anyone at home to look after you?’ the doctor asked.
I hate this question. Living alone, in a medical context, is regarded as a liability, and it always makes me feel like a saddo. I assured the doctor that a friend was going to take me home and sit with me for a bit. He didn’t seem fully happy with this, but I was ticking all the boxes, peeing in all the hats, and I really, really wanted a decent cup of coffee and a toasted sandwich.
A nurse appeared with a box of blood-thinning injections and a small sharps safe. I sat through her 30-second briefing in horrified silence. During pre-operative blood tests, I’d almost passed out, to the disgust of the day-hospital nurse.
Added to this misery was a ban on baths for at least three weeks. This is why a person needs two happy places, at minimum.
I had to ask several times to have my cannulas removed so I could escape. My friend was already driving in circuits around the hospital. Hurrying to get dressed, I found, on the chair by the bed, a pair of compression stockings, one size too big. I tossed them into my tagged patient clothing bag along with the sharps safe and the box of syringes.
The nurse said that the bus stop directly outside the hospital entrance was the best place for my friend to collect me. I waited, light-headed, feeble and stiff with pain, clutching the plastic bag and breathing the fumes from the passing traffic. At least I didn’t have to queue at passport control or wait for my luggage to arrive on a carousel.