Month: November 2013

Fascinating scans!

Posted on

I had my first meeting with my oncologist on the Thursday. This was a hastily scheduled meeting as a result of the findings on the CT scan to my head. Mum and Shirley came to this meeting, as well as my MacMillan nurse. A couple of minutes into the meeting there was a knock at the door. It was the Scottish Asian doctor. ‘Is it OK if I sit in on this?’ He clearly wasn’t expected at the meeting, he just wanted to follow my case. I was very impressed!

First the oncologist asked me some background questions. Had I ever smoked? No. Did I do much exercise? I answered no to this too, maybe not strictly true, but I certainly haven’t done much for a while. How much did I drink? Maybe eight to ten pints a week. He said that they thought the cancer started as a lung cancer, so he was surprised to hear that I had never smoked. I told him that I had worked as a bus driver in Central London for three years. When I was there if I picked ‘sleep’ out of the corner of my eye, or blew my nose into a handkerchief, the results were like a black goo. He said that that sounded similar to heavy smoking. Thinking back afterwards, for the next four years I drove buses for a different garage. In that garage three out of the five routes went through Central London. So I was exposed to this pollution for the best part of seven years. This was in the early nineties, when particulates from diesel engines were much worse than they are now. Also there was no Central London congestion charge, so the traffic was at least twice a heavy.

Then he proceeded to take us through the results of the scan. He started with the lungs. One lung is unaffected. The entrance to this lung looks like a small satsuma, maybe two inches in diameter. The entrance to the other lung looks like a grape, maybe one inch in diameter. This explained why I was coughing. My brain was saying to my lung: ‘there’s some kind of blockage, try to clear it!’ No amount of coughing is going to clear a tumour. It turns out that I coughed so hard that I fractured a rib! It also explains why I get out of breath so easily. I am effectively operating on one and a half lungs. The lesions are not confined to the lungs though. He pointed out two small lesions on my liver. He said that they were too small at the moment to affect it’s function, thankfully. Then he showed me lesions on the glands that sit above my lungs. He then had to alter the settings of the scan in order to reveal the lesions in my bones. On some ribs, all down my spine, on my pelvis and on my femur. I said: ‘you scanned my chest and my head, but you didn’t scan me below the waist. How do you know there aren’t more lesions there?’ He said that there may well be lesions elsewhere, but they’ll all be treated, as the drugs work pretty indiscriminately! Finally he showed me the CT scan of my brain. There’s a small 15mm tumour in the right hemisphere of my brain. This gives rise to a risk of fitting. As a result I am not allowed to drive for the next two years, and I am never allowed to drive a bus again!

Seeing these scans and hearing the report of what was wrong with me, I was shocked to the core! Despite this I thought that it was really interesting. I just wish the scans weren’t scans of my body, and all this wasn’t making me so ill!

Mum asked the oncologist: ‘how could this happen to him, he’s young and fit?’ I decided to try and reply: ‘as I understand it, it’s my own cells that are causing this cancer, and my immune system is helping them. As I’ve got a good immune system, it’s working really hard to try and kill me!’ The oncologist said that this wasn’t quite true. What happens is that the immune system doesn’t fight the cancer cells because it doesn’t see them as foreign bodies. He went on to say that lung cancer cells are even better at preventing the immune system from attacking them because they release a chemical that inhibits the immune response. I said: ‘surely there’s people doing research to try and block the action of that chemical.’

‘I’m doing research into that!’

‘Well if you’re looking for a volunteer,’

‘We can’t use research as a first line of defence, but I’ll certainly bear you in mind for the future. You’re an ideal candidate!’ I thought to myself: ‘I’ve just walked into the right consulting room!’

As a parting gift the oncologist handed me a three month sick note, which he said may be extended!

Advertisements

Gallows humour scrabble

Posted on Updated on

I sent an email to my two best friends inviting them out for a drink:

Subject: Oh shit!

Either of you guys up for a drink tonight? I’m not much better than I was at the weekend, but I’ve been told I don’t need to carry on with the antibiotics. I need a bloody drink!

I didn’t want to reveal the news in an email, but I had hoped that there were enough subtle hints there to prepare them for what I had to say. There’s the title for starters. Then there’s that swearword. Anyone who knows me well would be surprised to see that written so deliberately in print.

Mike’s reply: can do mate.

Darren’s reply: Sorry can’t make tonight. Can do tomorrow.

I arranged to meet Mike.

When Mike arrived at the pub I pretty much told him straight away. He was sitting opposite me. He got up and came to sit by my side. He was clearly knocked for six. My email had done nothing to prepare him for this news.

Mike is a keen user of Twitter. One of his responses was: ‘you should sign up to Twitter and write about this!’ He almost immediately apologised for trivialising things. He had just sown the seed for this blog!

We sat there for several minutes and the conversation was pretty grim. I hadn’t come to the pub to sit and wallow in misery. To lighten the mood I said: ‘let’s play scrabble, but every turn you have to try and play gallows humour!’ Throughout the game I tried to achieve this, even if it meant a crap score. Mike certainly entered into the spirit of it, but every now and then he was more tempted by a good score. As a result he beat me hands down. We had thought of applying a gallows humour bonus. You’ d get an extra 20 points for a very nice example of gallows humour. If we had played with this bonus, the game might have been closer. I may have even beaten Mike!

gallows humour scrabble

The best piece of gallows humour was the apparently innocent word: radio. Mike tried playing: cyto-. ‘That’s a prefix’ I complained. Almost immediately I regretted being such a jobsworth as it was great gallows humour. Mike took it back and offered up cowl instead. I really enjoyed that evening. It turns out that laughter is the best medicine. Also humour can be like chocolate: the darker the better!

Sometime that evening Mike tweeted:

My best mate from school just told me he has lung cancer, with secondaries in bones and liver. He’s a non smoker, late 40s.

He later said to me he got loads or responses of sympathy and support and he felt a bit strange, as though he was the one looking for attention. But I reassured him and said: ‘that is part of your way of dealing with it. You need support too and you got it from there!’

He later tweeted:

Thanks for the responses. I’m fucking shocked right now. Eamon seems ‘all right’ oddly.

No privacy

Posted on Updated on

Overnight in the hospital ward there was a constant stream of attendees at my bedside. Maybe two or three times throughout the night a nurse would come to monitor my pulse, blood pressure and temperature. They also asked if I was in any pain. Some time in the wee hours, maybe two in the morning, a lady came to ask me some questions. She was filling out some form, asking me things like: was I single or married; who was my next of kin and suchlike. I’m sure I had already answered all these questions when I had been admitted to A&E earlier that evening, but I guess that’s a completely different hospital department. I wondered: ‘if I had been asleep, would she have woken me to ask these questions?’ Given how badly I’ve been sleeping recently, and that I hardly slept a wink that night, I would have been furious to have been woken for this! Even later that morning, maybe four o’clock, a nurse came to my bedside saying she was going to take some blood samples. I protested that I had already given blood samples when I was admitted through A&E. She said: ‘no this is different.’ I stuck to my guns. ‘The doctor took some blood and split it into four different phials.’ I didn’t want my arm to start resembling a pin cushion. She said she’d go away and check. She came back five minutes later and apologised, saying I was right!

There were five or six other beds in my room just off the ward. All of them were occupied. Whenever hospital staff have to treat someone or consult with them, they can protect their dignity by drawing a curtain around the bed. However no curtains can stop you hearing what’s going on, and it doesn’t take much imagination to fill in the rest of the picture.

The next morning, three female hospital staff attended the bed of a young man diagonally opposite me to my left. He was much younger than me and had a poor grasp of English. The ladies dutifully pulled the curtain around his bed and proceeded to question him. It quickly became clear that they were testing him for dementia. He was very young, so I guess they suspected early onset dementia, or else he had had some kind of head trauma or stroke (there were no outwardly signs of this). At first they asked him to give his home address. In his broken English he gave his address in a strange form, but gave it nevertheless. There was a little bit of confusion at this point, because this was not the address they had on his form. I think the form had his brother’s address. The questions then moved on to the day of the week and the date. I had been off work for over a week now. I wondered if I would answer this question so easily on this particular day. The next question was: ‘who is the Queen?’ Now I guess the questioner was expecting the answer: Elizabeth II. I thought to myself: ‘for a non native English speaker, this was such an unfair question.’ I also thought there are other ways of answering this question. She’s the head of state, for instance. Also depending what country he was from, there could be an equally valid alternative answer. The test did not get any fairer. ‘I’m going to give you an address and I want you to remember it: 5 Flower Road.’ After prompting again he repeated back the address. ‘Now I want you to count backwards from twenty to one.’ ‘Twenty two’ he parroted. She tried to reiterate her instructions. Given the confusion they had already had over addresses, she was onto a loser. So she tried to prompt him to count down by starting the sequence herself. He realised what she wanted and continued to count down, but with his poor English he started making mistakes when he reached ten. To be fair to the assessors they realised that the test was unfair on him, so they tried to think of a member of staff who spoke the same language as this gentleman. Some time later they returned with another man. He managed to deliver the question about counting backwards from twenty down to one, but of course now the answer came back in his native tongue. So the assessors could not really do their job properly! I have no idea what was the outcome of his assessment!

Overnight and in the morning, lying awake in my bed, I overheard the consultations of every patient in that room and learned quite a lot about what was happening to them. In the bed diagonally opposite me on my right was a young English man. I’m quite sure that he had heard the young lady doctor telling me that she suspected that I had cancer. I also think he overheard me breaking my news to Mum, which was an emotionally charged conversation. Despite this he never commented on it, although we did exchange some pleasantries. I knew exactly why he was in hospital too. I’ll keep that to myself, as he respected my privacy!

Breaking the news

Posted on Updated on

After spending the night in hospital, the next morning I received several visitors to my bedside in quick succession. I’m not sure of the exact order. There was probably the usual nurse taking my pulse, blood pressure and temperature. Then there was a Sikh doctor. He started by asking me what I’d been told the night before. I told him that the doctor had said they suspected I had lung cancer. I remember asking him if that meant I could stop taking the antibiotics I had been given, because I was attributing my difficulties sleeping to them. He said I could. I don’t remember too much else of this particular conversation. Another visitor was a friendly young Irish lady. We were chatting for a little while before she said: ‘do you know who I am?’ She then introduced herself as my MacMillan nurse. In the UK all cancer patients are allocated a MacMillan nurse to help you deal with all the massive changes that receiving a cancer diagnosis brings to your life. The next visitor was a very nice young male, Asian doctor, with a beautiful Scottish accent. He filled me in on what was in line for me that morning. Apparently I had to go for a CT scan of my head, and then go to for an ultrasound guided biopsy. After that I would be able to go home.

Running through my head at this time was how I was going break my news to people. My Mum was due to go to an exercise class that morning, so I figured she’d be busy until I got home. I felt that I didn’t want to be alone with my Mum when I told her, because I thought it might be difficult for me deal with her reaction. So I had to try and speak to my sister Shirley, or my brother, Brendan to see if they could be there with me. I got dressed and went up to the hospital entrance to get a paper. Then I sat on a bench and tried to get in touch with Shirley. She wasn’t answering her mobile! I was pretty sure that Brendan was away in Ireland, so I phoned my sister, Nicola, who lives in the South coast.

Nicola is trained as a nurse, so Mum often phones her to discuss the health of various family members. Nicola was well aware of Mum’s concerns for my health recently, and I think Mum must have phoned her last night after I had been admitted to hospital. I told Nicola that it was suspected that I had cancer. My voice broke a little as I said this. I could hear emotion in Nicola’s reaction, but what I remember most of this conversation was a very matter of fact response. Something along the lines of: ‘I knew this was something serious. I thought it could be one of three things: pneumonia, TB, or cancer.’ This conversation my sound very cold, coming from my sister, but somehow for me it was very reassuring. She may have taken her lead from me – the manner in which I had informed her – or she may have just reacted like this because she knows me so well and knows that that is how I would want to discuss this.

I went back down to the ward. I still had the problem of getting someone to accompany me when I informed Mum. I decided to text Brendan to ask if he was still in Ireland. ‘Yes, why do you ask?’ came back the reply. ‘It’s a long story. Best not discussed by text.’ I figured he didn’t need to know right now. Let him enjoy his time away. I sat there thinking: ‘he’s going to call back isn’t he!’ Sure enough there was his call. This was a difficult conversation. Brendan and I are very close. He was struggling to know what to say. I tried to lighten the conversation towards the end: ‘enjoy the rest of your break and see you on Sunday!’

I tried Shirley’s mobile several more times to no avail. Then I decided to distract myself and started reading the paper. A nurse came to inform me that my Mum had called and was going to come in to see me. I still had to find someone to be with me when I informed Mum. I decided to ask the MacMillan nurse to do this. This was not ideal. I had only just met this lady. Mum turned up that afternoon, with no suspicion of what she was about to hear. She took the news very hard. For me this was the first time I had seen someone’s reaction in person. This was the hardest moment for me!

Shuttle bus

Posted on Updated on

I went to the hospital the next day for my x-ray. It’s a bus ride away, but thankfully it’s a very short walk at either end of the journey. Nevertheless, in the state I was in it was still quite an ordeal. I didn’t have to wait too long for the x-ray and the lady said: ‘we’ll send the report back to your doctor, so you’ll hear from him.’ I got the bus home and slid back to my perch on the couch (of despair!)

That afternoon I got a call from my doctor! ‘Something showed up on the x-ray, you have to go back in for a more detailed scan. It’s possible they may want to keep you in overnight. Go to the accident and emergency department. I’ll send them a letter. You don’t have to come by the surgery to pick it up.’ That was a BIG relief. ‘They’ll be expecting you!’

This all sounded very strange. My previous experiences of accident and emergency departments didn’t fit with this scenario. They are chaotic places where people turn up at random and wait hours to be seen. But sure enough, when I went to the reception and said she should be expecting me she said: ‘oh yes, here’s the letter.’ I only had to wait half an hour! I asked the man that led me through to the waiting room for the scan if was true that I may be admitted, and he confirmed this.

I was to have a CT scan of my chest. The staff at the scanner were lovely. They explained that I would have one normal scan, and then they would inject a dye to do a second scan. When it came to the point where she was to inject the dye she asked: ‘are you allergic to seafood?’ I was nonplussed. I didn’t reply. Then after a moment I said: ‘I thought you asked me if I was allergic to seafood!’

‘That’s right.’

‘Strange question.’

‘The dye we use is iodine. If you’re allergic to seafood, you might be allergic to iodine.’

‘I don’t know. I don’t like seafood.’

‘Well we’ll soon find out’ she said cheerily, as she proceeded to inject the iodine. I didn’t suffer any adverse effects.

Once the scan had finished she said: ‘that’s it, you can go now.’

‘I don’t have to wait?’ I was half expecting to be admitted.

‘No you can go.’ I assumed that she had had a preliminary look at the scan and decided it was OK. So I got the bus back home and settled down on the couch hoping to watch that night’s live football on the telly.

About half an hour before the football was due to start I got a phone call from the hospital. ‘Is that Mr. Blunt? What happened? We were expecting to admit you tonight! Come to the accident and emergency department, they’ll be expecting you.’ So for the third time that day I had to make that now arduous bus journey. Mum wanted to come with me, but I told her not to. I figured she’d just be waiting around for ages and then I’d be admitted and she’d be sent home. I think she felt I was pushing her away. When I arrived at the hospital, this time the department was busy. Also now I was just there to be admitted to a ward.

I was seen quite quickly by a triage nurse. She’s the one that takes your blood pressure, pulse and temperature. She puts a cuff on your arm, a clamp on your finger and a thermometer in your ear all at the same time. I remember thinking: ‘this feels very mechanical.’ I think the people at the original walk-in clinic did the same thing. Now a triage nurse in an accident and emergency department has a lot of potentially seriously ill people to get through, so it’s understandable there, but in a surgery the more humane way to proceed would be to carry out each procedure separately. It’s just a small thing, but it makes a big difference.

I had to wait another two hours, maybe longer, to be seen by a doctor! It was a lovely young lady doctor. She took some blood from me and split it into four different phials. I said to her: ‘I knew what they were looking for when I came in for an x-ray, but I don’t know why they did these scans.’ She said she’d come down to the ward and explain. I was in bed when she arrived, and she drew the curtains around my bed. It was about 11:30pm on a Tuesday evening. She said that there were a number of possibilities but top of the list was cancer! ‘Were you expecting that?’ I found myself saying that I thought it might be a possibility. Then she said: ‘I’m sorry to have to be saying this to you, I’m not sure if I should have told you!’ I reassured her that she did the right thing, and anyway I had asked. Then I said: ‘would it be OK if I made some phone calls?’ She replied: ‘If you can use your phone on an plane, it’s hardly going to interfere with hospital machinery. Don’t mind what the nurses say!’

I thought: ‘who should I phone?’ Definitely not mum. She was at home by herself. Sure she would be very worried, but I couldn’t tell her this, at least not right now. My brother Brendan would have been my preferred choice, but he was away in Ireland. I would also be happy to speak to my sister Shirley. But at 11:30 at night? When there was school for all her boys the next day, and Andrew and her would have work. I kept it to myself. I had been having trouble sleeping for some weeks now. I certainly didn’t sleep that night!

Into the system

Posted on

The surgery phone line opens at something like half eight, so I was determined to get up early on Monday and ensure I got an appointment as soon as possible. For once I had a bit of decent sleep and didn’t manage to make the call until mid morning. I explained that I had just filled in the registration forms on Friday but was told that I could make an urgent appointment if necessary. The lady on the phone asked my name. ‘There’s been a problem with your registration, because you didn’t give your last address!’ Remember I haven’t lived there for eight years, and hadn’t needed to recall it in the meantime. Luckily, when I saw the practice nurse at the walk-in clinic, she had tried to access my notes on her system. I had been registered at a student practice in Norwich. They knew I no longer lived there, so I wasn’t on their books any more. This meant that the practice nurse couldn’t access my notes. However, when she tried, I did get a glimpse of my previous address and I remembered the road name. So I gave it over the phone to the surgery receptionist. ‘Do you know the postcode?’ WHAT? I haven’t lived there for eight years! It came straight into my head, I know not from where! ‘I’m afraid we haven’t got any slots this morning, try phoning back at two!’ I slumped back onto the couch in a pit of despair. I would have to get straight on the phone at two.

The problem with the registration really worried me. Also I was worried that I wouldn’t get to see the doctor that day. If I was to take any more time off work, I needed a doctor’s certificate. I was straight onto the phone at two. For about five minutes I kept getting the same message: ‘the surgery is closed between the hours of one and two.’ COME ON GUYS, it’s five past. Eventually I did get through and was mightily relieved when I was told I could come in at three something. She obviously didn’t say three something, it’s just that I was so concerned about my registration problems that as soon as I put the phone down the actual time had gone from my head. I went upstairs to my room and searched high and low for my previous address. Going upstairs and doing the search wore me out. Thankfully I found an old bank statement. Now it was about two twenty and I had to get there for three something. I thought: ‘it might have been three ten, or quarter past, I’d better get a move on!’

I was shattered when I got there. The receptionist must have thought I ran there. She said: ‘you know you’re really early!’ My appointment was three forty. I told her that I had found a letter with my previous address, so she took it to make a copy. As she did that I asked why not having my previous address would hold up the process. Her reply shocked me. Doctors get a certain amount of funding for each patient they register. The people giving out that funding look for any excuse to block the registration, believing it to be a bogus claim. I thought to myself: ‘does that mean if I couldn’t find my last address I’d be blocked from registering anywhere?’ I hope that could not be the case!

Sitting waiting in the surgery I still felt a fraud!

The doctor was great. I explained that I had had the cough for ten weeks now. Also I bought in the packaging from the two courses of antibiotics I had taken to no avail, in order to show him. He did a similar check to the people from the walk-in clinic, but he did one thing they hadn’t done. You’ll probably be familiar with it, we’ve all had it done before. He tapped in various places on my back. Following this he sat down and said he was concerned. I had a long term cough that hadn’t been shifted by two very good courses of antibiotics. Also as a result of the tapping he could hear that there was some problem with my lung. He booked me in for an x-ray. He said it was a walk-in clinic at the hospital, so I could go any time tomorrow, but I should try to go early. I saw him typing out the requisition form for the x-ray, which he handed me anyway. On it he put ?pneumonia. So I knew what he was looking for. But he also said: ‘in the absence of any other evidence I have to assume this is a chest infection for now, so I’m going to prescribe an even stronger course of antibiotic.’ He also gave me a sick note for another week.

A suspected chest infection

Posted on Updated on

Some time between summer and mid September 2013, a juggling friend, Joseph, said to me: ‘your passing would be much better if you weren’t so out of shape.’ This is typical of Joseph’s banter. I thought he was right too (I wasn’t going to say that to him though!) I thought this might be an age thing – as you age you have to work harder to keep the same level of fitness. It transpires the reason I am so out of shape is that I am ill!

Thinking back, the first symptom was that I was struggling to keep strenuous passing patterns going for any length of time. But at that point, it didn’t seem like I was ill. The first feeling of illness was a chesty cough. I often suffer from coughs, so I thought nothing of this. There was also an unexplained shoulder pain. It felt like I had bashed my shoulder really hard against something, but I don’t remember any such incident. There wasn’t one! The cough got worse. I had some quite nasty coughing fits. But I still thought: ‘give it time and it will go away!’ But I gave it a lot of time.

I had another problem that contributed to my procrastination about seeking help. I had not seen a doctor since I moved from Norwich eight years ago, and was still registered there. So after about eight weeks of suffering with this very nasty cough I went online to find my nearest NHS walk-in clinic. There was one about a mile away, which is open long hours, seven days a week. That was ideal. I wandered up there one Saturday, got an appointment and was pleasantly surprised by how quickly I got seen. I explained to the doctor that I had had this cough for eight weeks. He was quite concerned. He asked if I had lost any weight. I said no, because I was not aware that I had. It turns out I had lost a stone and a half in those eight weeks! He took my blood pressure, pulse and temperature. He never said so, but they were all normal – my pulse was high, but within the normal range. Then he listened to my chest as I breathed in and out deeply. He said it was a concern if a cough persists for more than four weeks and ideally he would send me for a chest x-ray, but he couldn’t do that because I wasn’t his patient. Really, I needed to register with a local doctor. He had to assume that I had a chest infection, so he prescribed a course of antibiotics. I was happy, I had a diagnosis and now had access to the cure. So I went away, and dutifully took my antibiotics. They seemed to have no effect until Thursday, when I thought I felt a bit better. The course finished on Saturday. By Monday I was back to the dreadful coughing fits.

I was having coughing fits maybe twice a day. Often in the afternoon and evening. When I had them they were severe. I would cough until I wretched and occasionally there would be spots of blood because I had coughed so hard. Once they were over, I would appear quite normal for the rest of the day, although I did get out of breath very easily.

At work on Monday (yes, I was still going to work!) I had a horrendous coughing fit! This was during a break between picking up passengers. I then had three ladies to take a short distance before my lunch break. I thought: ‘I can take these three ladies to their club, then call in sick, return my bus to the depot, and my relief driver would very easily make the next pick up in plenty of time.’ When I picked up the second lady, the step on my bus would not go back under the minibus. I kicked at it for about five minutes but to no avail. So I had to call in a breakdown as well as reporting sick!

I returned to the walk-in clinic. I felt like a fraud, because I was in one of those lulls between the coughing fits, so appeared outwardly normal. This time I had to wait a little longer for the appointment and my heart sank when I was called in by the practice nurse. I thought maybe they had me down as a hypochondriac and wanted to get rid of me. I told the practice nurse my story. She did the same tests as the doctor had done and she said to me: ‘I can’t see anything wrong with you, you look well to me!’ Despite her protestations, she said she would get one of the doctors to sign a prescription for a stronger set of antibiotics. Once again, I left there happy.

The next day I got a call from my manager, asking me when I expected to return to work. I said that I’d been put on antibiotics, so if they started to do the business, I hoped to be better by Thursday! I spent the next two days on the couch watching daytime T.V. Sometime on Wednesday I decided to phone work. I was in one of those lulls, when I appeared outwardly fine. I said that I thought the antibiotics were doing the trick, but looking at the very long list of side effects I didn’t think it would be safe for me to return to work before I finished the course. One of the common side effects was difficulty sleeping at night. To be honest, I hadn’t had a decent night’s sleep for several weeks! Another possible side effect was drowsiness. I’d spent two days mooching on the couch, so it wasn’t clear if I was experiencing this, I hadn’t really tried to do anything. But the leaflet said if you experience drowsiness, then you shouldn’t drive or operate heavy machinery. So I explained that I would finish the course on Monday, so I should be fit to work then. When I put the phone down I thought that I must have sounded fine to him and I didn’t feel too bad. Once again I felt like a fraud! That afternoon and evening I had two disgusting coughing fits.

I spent the rest of the week on the couch. The antibiotics weren’t working. I had to get registered with a doctor! So on Thursday I went online to find a decent local practice. I spotted one with decent opening hours and good patient reviews which was a bus ride away but only about a mile or so. I marked that as my first choice. My second choice was closer, but not reachable by bus. Also the walk there involves half a mile up a steep hill. Usually these points about accessibility wouldn’t cross my mind. I regularly used to walk the three miles to work. But in my current state they were crucial. I headed off to my first choice. The journey there was hard, because there was a bit of a walk at either end of the bus ride. The receptionist asked: ‘what’s your postcode?’ When I gave it to her she said: ‘I’m sorry you’re outside our catchment area.’ My second choice was maybe ¾ of a mile away. Usually a short walk, but I had to get a bus. There was still a walk to the surgery. Knackered, I sloped up to the door only to see a sign saying ‘the surgery closes at 2 on Thursdays.’ That’s not what it said online! My stomach was churning with rage. Now I had to face the long walk home, but still not registered with anyone. On the way home I passed a surgery that was opened. I hadn’t checked it out online before, so I consulted my phone. It only had one doctor, and didn’t have great reviews. In my current state I was sorely tempted to say: ‘sod it! I need a doctor.’ But I wandered home, dejected.

The next morning I phoned work again. Again I was in one of those lulls. However the pills weren’t working. So I said: ‘I know I said I’d try and come in on Monday, but if you asked me if I could work tomorrow, I’d have to say no. Monday’s three days away, so it’s hard to say what I’ll be like then. Also I’ll be taking two of these pills on Sunday and the last one on Monday, so really I can’t come in then!’ After the call I felt the same as before. ‘I’m a fraud.’

That afternoon I struggled up to my second choice surgery to try and register. The receptionist gave me a map with their catchment area marked out and asked if I lived within it. My insides knotted, but thankfully I live right on the edge! There were two forms to complete. First the registration form, but also a form outlining my current state of health and any medication I’m on. I wrote that I had a chest infection and was on antibiotics. Also the receptionist probably saw the state I was in when I arrived at the surgery. She took my forms and said: ‘it usually takes seven days to register, but if you need and urgent appointment we can try and fit you in.’ I was still feeling like a fraud (!) so I said: ‘I think the antibiotics might be starting to work, so I won’t ask for an appointment now.’ The surgery doesn’t open over the weekend so that condemned me to another two days of suffering. The journey home was downhill so should have been easier. Naturally, I suffered another severe coughing fit.