“ Passing Failure”- CHAPTER 1-5

Working Kidney Quotient: Mum two; Dad two; me two (WKQ: 2+2+2= 6)
CHAPTER ONE: DETERIORATION BY DEGREE
CHAPTER TWO: THE FINALS COUNTDOWN
CHAPTER THREE: DIALYSIS DAYS
CHAPTER FOUR: HEY LOOK. NO KIDNEYS!
CHAPTER FIVE: NO LONGER HALF WELSH, HALF IRISH
CHAPTER SIX: REJECTION LETERS, REJECTION EPISODES
CHAPTER SEVEN: BACK AND FORWARD
CHAPTER EIGHT: AN UNQUALIFIED SUCCESS
CHAPTER NINE: HOW’S YOUR KIDNEY BEEN?
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CHAPTER ONE: DETERIORATION BY DEGREE
“One, two, three, four, five, six, buzz, eight, nine, ten, eleven, twelve, thirteen, buzz, fifteen, sixteen, buzz, eighteen”, thud. You probably recognise this playground game of buzz: cannot say anything with a seven in or divisible by seven .It was during one of these games a dinky car arrived in our sitting circle and I picked it up and threw it outside the circle and then carried on with the game. The one part of the game that was new was being kicked at the number nineteen by the car owner. At first I felt nothing and when the school bell went I stood up and became aware of a sickly feeling in my right side, which at the time I did not even know that was where the kidneys are located and even what they do.
Before going into class for my least favourable Friday morning test which I usually do not do particularly well in, I went to the toilet for a pee but what came out was thick, bright red, fresh blood. I then went into class to take the test – where I got my best every mark for - and when it was over I became more aware of the sickly feeling again. I explained it to the teacher and what had happened. I had to do a performance pee-, which was to be the first of many- because he apparently did not believe me. Then an ambulance was called.
I ended up in hospital for a month and missed school (yippee!) I had to lie flat on my back 24 hours day, as that appeared to the doctors to be the best way of trying to get my kidneys to stop bleeding. I had to do everything (that’s everything) lying completely flat. For instance I had to be fed laying flat and would drink by one of the nurses slowly lifting my head each time I wanted a sip.
I remember that my uncle brought in an Airfix model kit of a plane. It was very difficult gluing all the bits together when it was already in mid air but occasionally it lay on my stomach having crash-landed due to my aching arms. Putting the little man in, who I understand was the pilot, was tricky. After resting my arms I lifted the plane up into view and would then see his bottom staring at me but at least he was now in the cockpit. To avoid any complaint from the Civil Aviation Authority I needed to secure him to his seat pretty fast in time for his first solo flight. Peering directly upward up with glue in hand and at risk of a glue dollop raid at twelve o’clock I persevered. In this ward it was difficulty getting much sleep with all the other children, some crying for their mother and others moaning in pain but shuteye of this threatened kind is something I did not have in mind.
Suddenly there was a lot of commotion. A boy was trolleyed in to a bed bay and the curtains were quickly whished around him. I heard screaming for about 20 seconds. What’s he done? Is it some kind of punishment? Did he wet the bed or something? If so I might be in real trouble as I was still not allowed to leave mine. Then slowly all the attendants at his bed left and the curtains were drawn back revealing a boy who I later learnt had broken his leg and had to have it put back in place.
I remember thinking thank god I am only here for a little kidney problem.
After about three weeks I could lift my head and rest it on my elbow and sip drinks by myself and then eventually was allowed to sit up.
Then very late into my stay I could get out of bed and walk around. After being on a high hospital bed for so long I felt like a tiny little leprechaun walking along the floor.
I was able to leave the hospital after a month, only coming back to visit a friend who I had made who was there for some time after me
I failed my eleven-plus and went to a secondary school where all the other failures went. The successful pupils went to a grammar school. I do not think at the time there were any comprehensive schools about.
∻∻
Arthur Smith, comedian, writer and broadcaster wrote, “The first chapter of most biographies is nearly always worth ignoring. Our hero went to school and got into scrapes? Big deal” I agree. However this book is not an autobiography and not about heroes. The following needs to be mentioned early on or you might miss something later on.
∻∻
Years passed by without any other real problems apart from the occasional kidney infection helped away by drug treatment.
Bleeding was becoming so common that I used to doublethink when I went to the toilet and had asked myself what colour was supposed to be. I got worried about the possibility of being caught during a bleeding episode (that’s in the not swearing sense of the word) and so did the shy male thing and got into the habit of peeing in one of the cubicles. I was already embarrassed by being occasionally teased for having unusually red lips and accused on several occasions of wearing lipstick. I have since questioned whether that was a side effect of the kidney condition.
My family moved up to the North of England and the school had an unusual set up in terms of how they taught the science subjects. They did not do chemistry at all and just before the start of the CSE/ O level two-year course the boys were expected to do physics ( budding scientists you see) and the girls were expected to do biology (nurses you see). In my previous school we did all three so consequently they were ahead of me and so any chance of catching up and doing well in the sciences was lost.
I left home for collage and a few months later got glandular fever just before x-mas and my folks came to pick me up because I could not survive very well in the student residents on my own during the holidays. My tongue was so swollen that when I spoke I had to use my hands to put it back in my mouth, which I did not do very often because no one could really understand what I was attempting to say. I was soon hospitalised as I was not drinking enough and there was a real concern that the resulting dehydration might damage my kidneys.
At hospital I became aware of the growing seriousness of my already vulnerable kidney condition and the marked concern about my high blood pressure.
“ Very unusual for someone of this age to have such high blood pressure”.
It was said with such excitement it sounded to me like aggression as if I was somehow to blame. I heard this at the bottom of my bed, not directed at me or relayed on later but just two doctors talking to each other. It was not even a case of a poor beside manner. They had not even got that far: it was a poor bed end manner. The conversation was about my health and me but it did not include me. It taught me two things: do not let it happen again: interject and secondly watch the silent eye contact doctors were having with each other: I thought it meant something was seriously up or they were not sure what to do.
I was not totally ignored during the conversation they would break off from the conversation and turn to me and ask something like if I had moved my bowels today and a give a quick summary of what they would be doing before they left my bedside. (What is the collective noun for doctors? a diagnostic of doctors?)
I was to discover I had Polycystic kidneys*. This is where you have slowly growing cyst on each kidney but as they grow the functional part of the kidney is lost. It is a hereditary condition. An American web site (see back of book for the address) dedicated to this condition states that it is “the most common genetic, life threatening disease affecting an estimated 12.5 million people world wide…In fact, PKD [Polycystic Kidney Disease] affects more people than cystic fibrosis, muscular dystrophy, haemophilia, Down Syndrome and sickle cell anaemia combined”. My computer has no problem with these medical conditions and as I look above what I am presently typing the only word with a squiggly red line underneath it is – and I am about to introduce a third one – polycystic. When I click on it it tells me I must mean “polycentric”. I inherited it off my mum but at this time she had few problems and only discovered herself that she had passed the condition on to me. It was only diagnosed after the school attack I did not realise the serious significance until during my hospital stay with glandular fever. Previously relatives on my mum side from a generation or so ago had died prematurely but no one knew why but it now emerged that it may have been due to this condition. It has been suggested that in previous centuries people have died of this condition but they have been diagnosed as suffering
*Aren’t footnotes irritating? You have to leave the part of the page you are reading to read the minor little point and then find your place again. Why do they do it? Either it is important, in which case put it in the main text or if not put it at the back of the book. What I cannot stand is…………
……….the one that goes over the page. Now it is not even a footnote but a head note and now you are miles away from where you were when happily reading before you were sent over here. I will not be doing any footnotes but explaining the medical point and give the reference there and then.*
from Bright’s Disease. This still interests sufferer’s grandchildren today as I discovered recently on the internet. “My Grandmother died of Bright’s Disease. In the 1800’s and early 1900 many kidney disorders /infections were grouped under this name”
Like the kick in the playground a crash in a car was another unfortunate incident that accelerated the kidney deterioration process. I was in the back seat behind the driver coming back from a party and the car skidded on some ice, crashed into a railway bridge and I smashed into the back of his seat. We all had to quickly get out as we thought the car might topple over on to the railway track below.
My two friends in the front went through the windscreen but they were able to get out of the car but this time using a more traditional point of exit. I had a dead leg and couldn’t get out very fast.
Eventually, once I was reminded about the precarious position of the car, I hobbled across the road and immediately lay down. Then the ambulance arrived. The two friends who went through the windscreen had been looking over me to ask what was wrong and enquiring why was I not standing up. The blood from their facial cuts went all over me when the ambulance man asked me where I was bleeding from. I explained the blood was not mine.
When I got to hospital my problem turned out to be internal bleeding as I soon discovered when I went to the loo. I told the doctors about my kidney condition but as it was not fresh blood I was discharged and told to contact my GP. The next day my GP came to visit and I was sent back into hospital.
I phoned my family to tell them about the accident and that my kidneys were injured. This was very distressing for my Mum as she felt guilty (ping) as she knew only too well that I had inherited the problem off her. And it in turn made it more difficult for me as I felt guilty (pong) that I had inadvertently upset her. In future - as I surely knew there was going to be a future in this – I knew that I should mainly speak to Dad and he could gauge how much to revel to her.
My bleeding did not stop and so I had a investigative operation, which involved a tube being inserted down the centre of my penis, a investigative operation known as a cystoscopy, to see, with the aid of a small camera, where I was bleeding from: whether it was one or both kidneys.
As a general anaesthetic was needed I wasn't able to eat or drink anything for 24 hours beforehand (“Nil By Mouth”). This is to prevent suffocation if you were to vomit while unconscious.
I was offered my last meal until 24 hours later: kidneys in gravy! In those days hospitals did not provide a choice of meal.
*There you are. Only kidding
Usually I was very polite but on this occasion I muttered something under my breath and decided to go without. Kidneys in gravy! And that was on the same day when a man in the same ward had a part of his kidney removed.
When you fall asleep and wake up you know you have been unconscious. You just do not know exactly how long for until you look at the clock. However when you come round after a general anathestic you have no sense of time passing. It is strange but it is as if it is just a moment later and you do not appreciate that many hours may have gone by.
When I came round from my general operation I was not hungry but very thirsty. I made a few request for water but the nurses were very busy and I was promised one later .I waited for the next nurse to
pass by but from the speed she was walking knew she had something far more important to do. Eventually I decided to go to the tap at the corridor sink and drinking straight from it. Them I heard a nurse loudly proclaim: “Michael. What do you think you are doing in your bare feet drinking straight from the tap.” I tried to explain and was met with “ Well why didn’t you ask?” .I was getting told off ….not for the last time in a kidney ward.
It was discovered that I was bleeding from both kidneys. I stayed in hospital for longer to see if it would stop. This time I was not restricted to my bed and having to lie flat for weeks.
“Fire! Fire! Michael there’s a fire” I looked up from my bed during a quite afternoon at the ward and saw one of the nurses with a big grin on her face. Apparently I was seen as calm, on the surface at least, and several times one or two of the nurses would tease me in this way to try and get some reaction from me.
One of the last duties of the night shift nursing staff was to wake the patients up at 6.30 am, which annoyed me, as it was so pointless, and purely for the administrative convenience of the hospital. It was a real palaver. It involved readjusting the top of your bed by pulling out the backrest and repositioning the many pillows. All this extra junk at the top of the bed made it near impossible to go back to sleep once the nurse departed. I soon realised it was pointless to argue so when they finished and retreated back to their staff room I re positioned the pillows, pushed back the back rest and went back to sleep. It was a silly rule: waking patients at 6.30 am ready for breakfast at 8.30.am to assist with the shift switch.
During this hospital stay at one late evening I heard a nurse say to another patient “ wake up time to take your sleeping pills” What? Well there is justification for this: it ensures a good night sleep for those who nap through out the day and consequently cannot sleep properly at night but it did not half sound stupid to me.
In the bed next to me was very ill old man. So much so it was difficult to even get an acknowledgement let alone a conversation out of him to help the day go by. One morning when I woke up and looked across he was gone. All his belongings had also been removed .His bed was made up ready, presumably, for the next patient. The cleaner was there making the final touches. It took me some time to realised he must have died in the night because nothing was said and you were just left to speculate.
On talking to the cleaner I discovered the real local dialect. Several months of hanging around mostly middle-class students and lectures and I hadn't yet acquainted myself with the local accent. I had to go to hospital to discover it.
Recalling this reminds me of the story that apparently emanated from Bolivia. A bed in an intensive care unit had a very poor record in survival rates. The doctors were suspicious and concerned as patients in that bed were not the most serious yet they died so they set up a camera on the bed 24 hours day. The reason quickly became apparent. When the night cleaner took her vacuum cleaner near the bed she carried the plug to the wall and pulled out the socket for the essential life support system, put her plug in, cleaned around for five minutes and then replace the original plug.
While convalescing I was in the TV room watching a hospital drama and believe it or not this episode was based on the story of someone with renal failure. I was the only one in the room and another patient turned up but as soon as he realised what the subject was, walked out while making comments suggesting there was something wrong with me. There was:I had renal problems but so had he. As he was leaving I said he could turn it over if he wanted.
I must have been in a minority but I wanted to learn as much as I could even from crass TV hospital programme. Some people tend to want to know as little as possible. While some patients do not ask or are afraid to ask I was one who was always asking questions.
I nurse came into the room as she needed to take my obs and after taking my pulse commented that I would never die from a heart attack which I took to mean I had a slow and strong pulse.
One of the younger patients was a man with an usual problem: he could not ejaculate. There was a blockage. Although it may have reduced the laundry costs it prevented him and his wife from starting a family. He told me the day before the operation that when he was about to be shaved a male nurse auxiliary arrived with a cutthroat razor. If that was not bad enough just before he began the shaving he took out his glass case and when my ward mate looked up noticed the extent of the magnification on the lenses and held his breath while the auxiliary held the future prospects of his family in his hand.
The bleeding would not stop and so it was decided that I should be discharged. I went to convalesce at my parent’s home. When I returned my Christmas holiday housing benefit had been stopped because I had not signed on thus I had rent arrears, which complicated matters, as I was one of joint tenants. After several letters explaining my position I was given my housing benefit back.
I continued to bleed for a few more weeks but eventually it stopped. Some months later I was invited to the hospital for an experimental operation. It was to see if they could stop the kidney function deterioration by bursting some of the larger cysts. This entailed lying on my back and an X-ray being taken. When this happened all that doctors and nurses would hide behind a screen in the corner of the x ray room.I got a bit worried. If this is their regular place what's the radiation doing to me? I wanted to ask if I could join them! Of course the occasional radiation is not going to harm me but the medical staff need to protect themselves because they are near the radiation most weeks. When they located the sites of the larger cysts I was able to watch live on the “TV” monitor as they put this six-inch needle into my back and I could see fluid been drained out of the cysts and trickle down my back.
Unfortunately the experiment didn't work and very slowly the deterioration expected of polycystic kidneys continued. There continues to be no treatment for polycystic kidneys.
I switched courses and had to do summer jobs to pay for first year of a law degree because the local authority wouldn’t let me have a second first year grant, which was fair enough. I then did several holiday jobs and term time bar work. I knew I was fortunate in the sense they temporary jobs were just that and I was able to think in terms of a career unlike the people I was to work with who did not have the opportunity to hold such a high and might goal but just were please to have a job. I found it strangely consoling in that if I were to become a solicitor (Class A :professionals) I would have at least known what it was like doing manual work and taking the usual step of school to college to solicitors practice. So I spent a bit of time at Class E (unemployed and student) as well as Class D (manual) and plan the nifty trick of leap frogging through all the other Classes proving t's artificiality. Thankfully this archaic system has since been changed but I do not know how accurate the new categorisation is
The Fitter's Mate.
“Will you join the union?”
“Sure”
“Ok you start on Monday. You know how to get to the paper mill”
“Yeah”
I did not but as the paper mill was reputed to be a mile long I am sure I ‘d find it. When I arrived at work they were shocked to find I was not in the union
“ But I am willing to join. I did not realise I had to go off and join in time for Monday. I just assumed I could join now.”
“Oh no lad. You ‘ll have to go into town and join now. Have you got transport”.
“I ‘ve got a push bike”.
“OK. Off you go. Join and then come back a soon as possible”.
I discovered it was a “closed shop”. The term I heard about all the time in the media in their quest to knock the unions. I was now about to join one.
The job title was “ fitters’ mate” which I thought would require a few years apprenticeship but it did not. The mills were closed for several weeks in the summer for the entire machinery to be fully serviced.
The job was pretty straightforward: I followed the fitter around all day like a lost little puppy, ready to jump up to him when asked and hand him a tool with the excitement of someone bored out of his tiny little mind. He checked and repaired the machines and I was his gofer. The only snag was he clocked off at 4.30pm each day and I clocked off at 6pm but the rules were that I could not work without the fitter and equally I could not be seen to be lounging around so for one and half hours at the end of each day I had to look busy which was very difficult. It was Ok to do nothing looking at your fitter working but you could not do nothing not looking at your fitter working. I would just walk around with a big spanner in my hand pretending to be on an errand.
The Tar Sprayer
I found another job, which meant getting up at about 4.30 a m every morning (who said students were lazy) and cycling down to the docks. Once while cycling along the side of the harbour in the early morning twilight I did not see a chain between two concrete pillars and a second later I was lying on my back, my bike several feet away. I got up, picked up my vacuum flask, shook it realising it was smashed and thought why am I up this early doing this job for. The job itself entailed standing on the back of a tar-spraying lorry for the resurfacing of roads, the responsibility of the local council. Unfortunately the council in question was miles up the motorway hence the early start.
The first run of the road was easy: we just had all the vents on and sprayed the road with the gravel lorry slowly driving backwards just behind with its load tilted up. So far so good. Then it got a bit tricky, because when you did the second run of the same stretch not all the taps were needed as you crouched and looked under the back of the sprayer you increased and decreased the amount of taps needed, depending on how wide the road was at any given point.
When the tar sprayer driver beeped his horn to indicate he was about to stop and the gravel truck driver should follow suit. Once when he did not I became aware of the risk and I dived off the lorry and on looking up from the pavement with cut elbows saw the gravel truck crash in to the lorry where I was standing a few seconds before.
One time the tar spryer was bombing along at 8 miles per hour I lost my bobble hat and it fell off the back of the tar lorry only for me to look back at the next bend in the road and see my nice Steve Hillage type bobble hat become part of the new resurfaced road.
The tar lorry-driver I had the privilege to work with always showed a bit of irritation every time I called his lorry a van. He was very proud of his van, sorry lorry, and at every opportunity he told people where he had tar sprayed and I used to hear it time and time again: “yes I sprayed in Bristol, Exeter, Devon, Gloucestershire, Turkey, Somerset.” We all used to take the mickey out of him: “yes I’ve eaten lots of different sandwiches containing corned beef, cheese, ham, beef, turkey.” He hated students and used to relish attempting to humiliate me in front of his pals particularly about the fact I hadn't got a proper job and was still studying at my age. We were eventually laid off unfairly because the company kept on others who started work after us. They probably knew we would not be with them for years to come but the fact remains we were treated poorly. I think it ‘s called unfair dismissal.
The Press Operative
I'd to attend a portakabin to fill out an application form for a job in a warehouse. I was left to fill the form in with another bloke when our potential new boss left the portakabin and as I was filling it out I looked up and this man in his fifties just stared at the sheet and then looked pleadingly at me. I realised he couldn't write and I suggested I would fill it out for him. He jumped at the offer. As I passed it back to him our potential new boss returned and looked at me and said, “haven’t you filled out that form yet?”
The job was totally piecework there was no basic wage you got a half penny for every piece of metal you processed and I had no idea how much I would earn at the end of the week. I did know however it was going to be tax-free, being a student and so it was worth the risk.
The job mainly involved putting a flat round disc into a press, closing the safety cage and pressing the foot pedal so that the press would crush the disc into a cup, the shape needed for part of a piece of scaffolding.
I would arrive at my post at 7.30 am and even before I started I thought not another day putting the flat piece of metal in the press, closing the cage with my right hand, putting my foot down to activate the press, pick up the next round flat disc, and start all over again. This was piecework. At eye-level I saw “000001” and then I did a plate and I saw “000002” I couldn't take it. I found a long piece of industrial cloth and wrapped it around the counter to hide it from view.
After a few days I was told that if I did not speed up I would be “asked to leave”.
They needed at least 5,000 a day. I had only done 4,000 but nobody told me that was insufficient. The next day I had to do something so I asked the bloke with the forklift to move the flat discs container in a bit towards me and to put the empty one directly behind me. I then speeded up by being able to get to the next disc quicker and being able to throw the finished product over my shoulder. Initially I was bad at throwing accurately because I would hear the disc miss its container and bounce or roll along the factory floor but eventually got the hang of it consoling myself with the fact that the missed ones can be put in the container during the tea brake. Once I quickly looked behind and noticed an older member of the work force just watching me and I heard him shout across the warehouse “Hey Bert come and have a look at this”
What didn't help was I had effectively over shot. 4000 was a minimum, 5000 was seen as good. I reached 6000 and had now inadvertently set a new rate for my working “colleagues”. When I say colleagues I use the term very loosely: they hated me. I was a student, which was bad enough in itself; I did not pay income tax on my earnings and I had now set an increased daily rate of out put. They no doubt thought I was a goody goody two shoes. But if I hadn’t sped up I would have been booted out.
I had made myself very unpopular. The other workers began throwing things at me when my back was turned when I worked on the press. Folded up industrial gloves bounced off the back of my head on numerous times. For a few days I was temporarily moved to another job because they had a sufficient store of these cups and after a tea break when I went to use the fixed drill stand it just fell apart having been tampered with.
There was also fun to be had during the breaks, especially the mid-afternoon and mid morning breaks. Once I was just about to sit-down and a steaming tea bag would be thrown on my chair. Another time I would put my hand in my pocket and someone would have dropped some thin sheet-metal that can cut your quite easily if you are not careful.
When I eventually explained I had to leave and go back to college I was asked to stay. I then told them about the incidents and I was told I should have reported it. It would have made it worse. I would have been totally ostracized. My strategy was to get them to realise I was not what they thought I was but I ran out of time.
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In the first year of the degree we did tort (civil wrongs like negligence, nuisance, defamations etc); administration law; contract law and the history of law where we were still in the twelfth century by Easter and, judging by the gown the lecturer wore he thought we were still in the eighteenth.
If you said “R v Smith” as it was worded he would go nuts and shout, “It is not a football match “ Apparently you are supposed to say “Crown Against Smith”
Often in the middle of a lecture theatre containing about a hundred students he would stop and complain that no one was taking any notes. Then in unison everyone would look around like lear cats thinking “oh it’s not just me then but I am not going to write down all that rubbish about Henry the bloody Second or whatever his number is.”
During the exam at the end of the first year we were honoured with his appearance as one of the invidulators when for this special occasion he would not only wear the gown but the mortarboard. When he slowly walked up the little lanes separating the rows of students we all had to be ready for when his cape whooshed past as we all grabbed hold of our spare pen or pencil case to stop them being knocked off the desk by the floating cape.
The first year had the biggest percentage of failures, which was about a third (well that’s a fraction but you now what I mean). This, I guess, was due to not being able to think the way the law wanted you to or being away from home with a student grant and not having taken the course very seriously throughout the year.
In the second year we did crime, equity and trusts, land law and two subject options. During the summer break we lost the land law lecturer as he was killed in driving accident. He appeared to be character as the year before he entered the first land lecture in a three piece suit with a severe black brief case, walked up to the lecture stanchion, opened up his brief case and took out a large piece of turf, slammed it down on the table in front of him and said “This is land”.
The two options I choose were employment law and accounts, as they were part of the solicitor’s final course so I would hopefully be making life easier for myself in the future.
However the popular options were company law and conveyancing (money, money, money) and so this resulted in some of the small tutorial rooms being full to capacity and other subjects were half empty.
Well at the start of one of these tutorials there was a shortage of chairs and the latecomers had to go next door to pinch one.
“He who comes to equity must come with a chair”. (That is a really good joke if you were a law student)
The accountancy lecturer had just been in the national press for having a nuclear fallout shelter in his back garden. Hold on for just a mo. This guy had built this fallout shelter for his family and was willing to advertise the fact! He clearly had not thought this through. I am sure, however he had all his food tins down there. But did it ever cross his mind if there was a four minute warning everyone would come round kill him and his family and take it over. “Get out. This is my property. I ‘ll call the local constabulary”. Oh will you know. There ‘s a four-minute warning and we are now into our last minute .I doubt if there are any police officers in their warm canteen checking their expenses willing to respond to his call, assuming he has a working staffed phone line in the first place. I could imagine that when people purchase their place in the fallout shelters that on the day – the last day – when they show their passes to get in it will not go so swimmingly. There will be other people trying to get in who have not got a valid pass. “Well I have not got a pass but I am a friend of Malcolm. Oh go on let me in. Tell you what you can have my house.”
He always used to give prolonged analogies in his lecturers referring to aspects of accountancy. Maybe to keep us - and himself - awake. One day it was about thinking ahead. Today’s analogy was about when he was cementing his front drive (“Hey everyone I know where there might be another fall out shelter: in his front garden!”) and his wife brings him out a nice cup of tea and he puts his shovel in the bucket of cement and has a nice chat with his wife (“ Oxygen? No we will not need that. We will only be down there for a few hours”) when he went back to the bucket, had a sip of my tea and horror!
“ No sugar!” I said and I should not have done. The anecdote was taking ages. Get on with it!!
I distinctly remember the first employment law tutorial. The lecturer, strangely in my opinion, went around the group asking each of us in turn what s/he thought about trade unions. What has our opinion got to do with anything? I was to be asked last as he started at the other end of the table. Everyone was negative and I heard stuff like “ they’re so irresponsible”: “they are on strike at the drop of a hat”, “nothing but trouble". “They have far too much power…do you know one day at my uncle’s factory they put the head of the Manager on a spike and walked around the town centre demanding special chocolate biscuits for their tea breaks. I ask you”. Or was it the Assistant Manager?
Then it was my turn. I disagreed with everyone and said something to the effect that trade unions have no power and that is why they strike.
I think that particular lecturer should have kept his noise out of each student’s political opinions and concentrated on his own contact of employment because he took up another post as a head of another law department leaving us students without a lecturer and the Poly had to find someone to fill in where employment law was not his main subject.
The Night Shift Worker
During the summer holidays I got a few temporary jobs. One involved night shifts filling and emptying containers of books and gifts etc. We had a supervisor who also didn't take kindly to students especially when we suggested alternative ways of working which would have made the job easier and quicker. When the fool pulled down a series of boxes to make it easier to extract from the front of the large container they landed on me and gave me a black eye.
This backfired on us later as we found out that when his boss asked him how we were doing he just slagged us off and we are both sacked. Days later I phoned to speak to the boss and on being told when he was next in, cycled to the warehouse to point out the true situation; we were hard working and his supervisor was lying. When I got there I was told he was too busy to speak to me and I felt an idiot but I could not just do nothing. I felt I had to at least attempt something.
The Old Oil Barrell Rejuvenator
The next job involved tarting up old used oil barrel. A classic clocking on clocking off conveyor belt system existed with stop/start sirens throughout the factory. We were barely human. It started off as that empty oil barrel all dented and smashed up and you had a particular job depending on where you were bought on to the conveyor belt. My station involved taking all the tops off and if the top was stiff all you could do was lift it out to stop barrels accumulating and put it back on the belt when you try again to take the top off during a slack period. If you were unlucky you had three or four in a row all with stiff tops. Chaos ensued, as you had to put all these barrels around you on the shop floor. Sometimes barrels would turn up with skull and crossbow stickers. It was seen as macho to not wear the mask that you were given but after a while I thought it was stupid not to wear it because of the fumes you could not avoid inhaling when you managed to open a barrel. You had 15-minute mid-morning and mid-afternoon break and if you went back to your position the conveyor belt had already started up, the person ahead of you went crazy as he would be presented with a barrel with the top still on.
A friend was working there with me and as he did not have any money for lunch we had to rush to a bank in the fifteen-minute midmorning break. So when the siren went we rushed to his car. I queued at a bank, constantly looking at my watch deciding when I had to give up and go back. We got the money, did a Starsky and Hutch drive back and when the engine stopped we heard the siren and with a simultaneous high pitched squeak, both ran back to our stations and I spent the first minute pulling barrels off the conveyor belt to unblock it and working twice as heard so as to get an opportunity to put the barrels back on the belt. He is now a senior partner in a firm of solicitors so if anyone will be borrowing money next time it will be me.
The Building Site Labourer
I found yet another temporary job on a building site. I helped put the scaffolding up around a house in order to be able to build a new roof and plaster the outside walls. Early on I put tiles in a bucket and hoisted them up to the roof with a rope and pulley, then I made the cement in yes a cement mixer and each morning the 4 year old daughter of next-door watched me as if I was painting the Mona Lisa. She asked me what I was doing and I explained I was “feeding the monster as each morning he has porridge for breakfast”. During the day when she escaped from her house and then her mum would come out and grab her and take her in. At the end of the day I had to clean the cement mixer out and threw in a large breezeblock to help scrape the cement from the inside. On being asked what I was doing by my young apprentice I explained the monster had now had his evening meal and was finishing off with cheese and biscuits (I only work with middle class cement mixers)
When the building was complete we were told that there was no work and that all that was left was for us to clean up the site and continued to be paid at the same hourly rate.. This was not really thought through. If they had said as soon as you clean it up I ‘ll pay your £100 but he didn’t. We were being laid off and so we took our time. It was pointless rushing.
The Bartender
During term time I was employer as a part time bar worker. I was asked to pour the contents of the drip trays into the standing pint of beer, which I promise to do but never did. After a few months the landlord explained that since I had been in charge of the bar net profits were down 5%. I was very proud of myself.
**
I went on a sponsored hitch hike to Paris during the charity student rag week. After carrying a metal framed rucksack on my back for several hours however my kidneys started to bleed again so I had to carry it a different way which would also relieve the resulting aching kidneys that had also developed that weekend. One of the charities that the money was going to was the renal unit that I was getting rather familiar with. My kidney function was being regularly checked at that very same hospital.
During my check ups I had several requests by doctors to help them rather than always them helping me. Once I was party to a series of tests on a new drug. I agreed but at my last session another doctor from another part of the hospital was there asking me if would like to partake in yet another series. This was even before I had time to roll my shirtsleeves back down and button them up. I thought this was a bit quick and rather pushy so I said no. I thought they were taking me for granted.
I was once asked to attend a lecturer and have all the student, no doubt queuing up in turn having a good feel of my enlarged kidneys. I turned this down as I felt I was getting close to becoming part of a freak show and possibly only there to liven up this particular doctors lecture that week.
But I am sure other patients would have loved all the attention. For me it would have been a long embarrassing session and no doubt I would be there in my underclothes or hospital gown being prodded by people of my own age, possibly thinking poor bastard he must be the same age as me. However I did allow single medical students to exam me after my doctor had checked me over in that game of “What’s wrong with this one then?”
I always felt guilty saying no but I had so many requests and I think I had done my bit and I think I was going through enough as it is.
Each check up involved the examinations of blood and urine. Samples were taken. Did you know a urine test is the only test you have to pass before you can even take it? When the blood was taken I would press my fingernail into my skin on the other side of my thumb nail to distract from the pain about to begin elsewhere which was important in case I jumped when the needle went in. Some of the staff were better at it than others. The results indicated my kidney function was slowly deteriorating and I was affecting my blood pressure and I was now anaemic so blood pressure and iron tablets were prescribed to be taken daily and indefinitely.
While waiting in a greengrocer-cum–off-license with some friends on the way to a party four loud skinheads came in and started to shout and behave rather unruly. I was at the counter and one of them tapped me on the shoulder and said something. I turned around I said “sorry?” and he said, “Are you trying to be funny?” It is moments like that that you know you have walked into a situation when some one is trying to pick an argument to provoke a fight. I tried to be as pleasant and amenable as possible and then four of them attacked me. Two hitting me on the head with their bike helmets and the other two kicking me in the legs. Initially I was not defending myself as I was stupidly trying to fathom out why they were beating me up. Also at that time I often would keep my elbows near my sides as an extra precaution against being accidentally knocked in that area. When ever I went into a room, whether it was bar or lecture room, if there was ever a choice and would instinctively go for the seat with a back or one with most back protection such as those chairs that had sides as well. Sometimes you can become totally helpless. A few months earlier a friend of mine had crept up behind me and simultaneously grabbed either side of my waist and squeezed. It was just a jocular gesture but turned out to be very painful to me because of its location. He did not immediately release his hold I spontaneously turned around and thumped him. It seemed quicker than having to explain the situation and make a request that he remove his hands. I was not prepared to point at some library “silence” sign, put one finger to my lips and then thump him. I immediately apologised profusely and tried to explain. He sort of understood and then I nervously awaited my next few visits to the toilet to see if my kidneys were about to bleed again.
Oh where was I? Oh yes I remember: getting beaten up. When I gathered my senses I started to fend them off, remembering to stay standing whatever happened because once on the floor – or “decked” as I understand is the common parlance in the ruffian community - they could easily kick me in the kidney region which would mean I would probably be on dialysis earlier than even the doctors had expected. Eventfully one of the shop assistants said “right lads that’s enough” “ which I found particularly odd. It was not as if we were all rehearsing for a play. It was four against one. Anyway I was please as punch that I managed to stay on my feet. I then walked out of the shop and from a distance I could see my friends walking back towards the shop asking me what I had been doing. They had been waiting for me and were totally oblivious to the friendly little ruck. I had an odd story to relay.
Still standing up and still up for the party we went to it. Once there one friend was trying to get me – of all people - to have a drinking contest. His choice of weapon was some home made brandy wine that he had just found a bottle of. I was first to down the first glass, which was going to be my last, and he said, “ double or quits “ so we agreed to a second round. Still contemplating the earlier incident that evening, realizing that I was one of those few young men who was only too aware of his non-invincibility, his very extreme vulnerability. So in a fit of pique tipped my next glass on the carpet and held the empty glass to my chin while he was still gulping his down. He, still blessed with the vanity of youth and full health then, realizing he had lost again said “double or quits” again. I placed the contents of my glass in the same place and the sticky pool on the carpet got bigger. Other friends looked on not knowing how it was all going to end. After failing another four or five times to beat me as the stakes were raising my drinking companion was a bit worse for wear and a bit surprised I had beaten him every time. It ended up not being a contest of double or quits but for him, one of double or squits. He got is own back as he ended up sleeping on my floor in my sleeping bag.
“Dear Michael, Your recent renal results show a marked deterioration in your kidney function and I think the time has come for you to have a fistula fitted. Please will you come to the unit tomorrow afternoon? Yours sincerely.”
That was near enough the content of the letter I got from one of the young hospital doctors so I went to law library in the morning with the intention of leaving my books there, popping up to the hospital to have this fistula thing fitted and then returning to my books that evening.
When I arrive at a hospital after listening to what the doctors had in mind I realised I would be in hospital for several days which was not mentioned in the letter so I had to go back to the library and collect my bag, dump them at my flat and head on back to the hospital.
I politely pointed out to the doctor who had written the letter that it was not clear that I had to stay over. She said it was obvious. By that she meant if you know about fistulas it was obvious you could not have such an operation and go home the same day. I realised it was counter productive continuing the discussion as I was in her hands for the next few days and should be antagonising anyone but concentrating on discovering what the operation entailed.
It took some explaining to the nurse who was given the task of settling me in to the ward I did not own any pyjamas. All those patterns and hardly anyone sees them and then only for a very short while. The little chest pocket always used to amuse me. What is so important that cannot be left on the side of the bed?
As it turned out this fistula fiasco required an operation on my arm, which involved the artery in the middle of it being linked up to the vein just below the surface. This is always necessary to allow blood to quickly flow out of your body as otherwise you would not be able to dialyse which involves your blood being “cleaned” and been put back in again. The operation involved me stretching out my left arm, which was hidden behind a board to prevent me seeing the operation taking place. A nurse stood by me to make sure I was OK and that the local anaesthetic was working. There was no real pain but I could feel what was going on.
During one moment I felt what must have been my artery being tugged and felt it all the way to top of my upper arm.
Back at the ward I would initially have my observations (“obs”) taken every 15 minutes. Normally they are pulse, temperature and blood pressure. My extra ob was directed at my heavily bandaged arm as it was being checked to see if there was still a stronger pulse, a throbbing sensation, which indicated that arterial blood from the artery, was flowing into the vein. The fistula needs to grow before it can be used and over a period of weeks the vein will grow to many times its usual size ready for needles to be put in for the time I will need dialysis. During that hospital stay my blood pressure prescription was increased to keep it under control.
A friend incredibly offered to give me one of his kidneys. I did not take it very seriously at first until that is he told me he had been to the renal unit and spoken to the doctors. He told me that they were not very encouraging which is the correct response to take because the onus had to come from him. Anyway he was not a relative and the chances of him being compatible were very unlikely. Sadly he has since died which in itself is ironical for two reasons: he was a perfectly healthy young man and is no longer with us while I still am and by the time his body was found it was not possible to donate his kidneys or any of his other organs to someone who could have benefited from them.
The third year of my degree involved Jurisprudence (the theory of law); Family law; Evidence; Criminology and a dissertation (just a project really) of your choice.
I now was told because my kidney function was worsening that would have to go on to a low protein diet of 65 grams per day and I had to drink two liters of fluid every day. This is not so easy when you are not thirsty and having to do it every day is a chore. However it was essential so as to flush out all toxic substances that otherwise would be left inside me. The reduced protein and increased flushing out would reduce some of the feelings of sickness and tiredness.
My daily protein diet meant that I could have two ounces of meat at each of my two daily meals. There were also vegetable protein units. For example one slice of bread was a vegetable unit, which weighed about three grams. I was allowed to replace a meat unit with an egg, an ounce of cheese or one and half ounces of fish. I was given a pair of scales and had to weigh everything I ate from then on. It was now not just fish that need scales to survive. Staying a vegetarian was going to be very difficult.
I got to know the owner of an Indian restaurant as I regularly used to go there after a late session at the law library. Once I advised him on some legal problems he had. I was still only on a low protein diet and so was still able to eat out and have vegetarian dishes. I had kept with my vegetarian diet as I had a theory after reading a small booklet. It suggested that meat produced sulphur toxins and so if I reduced that, by remaining a vegetarian, you never know, I might delay the day, which by now was only a question of time, when I would go on to dialysis. I mentioned this to my Dad and he relayed it on to my Mum’s renal consultant at another hospital. He thought that there might even be something in it. My Mum’ s kidneys were still holding on and she was not restricted to any diet but taking medication to try and hold back the process. Anyway I digress. The restaurateur promised me a meal on the house when my exams were over for helping him with is legal problem.
I was still studying at the student union building and they had recently installed a drinking machine where you could get cold drinking water without putting money in the slot for the cold drinks where the coin gave you cup and powder. Once while I was helping my self, as I had already drank to many cups of coffee, one of the porters saw me and said:” I see getting something for nothing eh?” I replied, “Well it’s only water “ He was non too plussed and I could tell he thought I was behaving like a thief.
Down the nightclub I was a regular at I was walking through one of the many corridors and one bloke picked the pint of water I had in my hand, tipped the contents on the floor and while handing me back the empty glass said ”When you comedown here you drink proper drinks” and his mates looked on smirking. I walked away but after about three steps I stopped and decided to turn around and confront him even though he was bigger and taller than me - although I am 6 foot 2 - and twice as broad and thought what the hell. Wow I might end up in hospital, not necessarily the ward I had in mind.
“Do you know why I am drinking pints of water?” I then explained and his attitude changed. On future occasions when I walked along his favourite corridor he would acknowledged and turned the next corner still holding on to my pint of water
This extra fluid exasperated another symptom that was very noticeable: swollen ankles at the end of the day. It is called odema and is a result of the kidneys not being able to do their job properly of getting rid of fluid. It would also put you of you food and you would not feel hungry so much if you did not eat because with all the extra fluid in your body some pressed up against you stomach and gave the impression of being full.
I used to ask at bars for a pint of water because although I still could drink beer after a pint or so I would be setting my self up for a bad hangover especially if I tried to drink 2 liters a day!. This was usually handed over reluctantly and very occasionally I was charged or refused it when I would then explain why I would get my pint but even more reluctantly.
The fistula was slowly growing. If I read a broadsheet newspaper holding it up right sometimes the side of the paper would touch the fistula and you would hear a strange russelling sound until I readjusted how I was holding the paper. Sleeping already difficult became more so because if I slept with my head on or near my left arm I would hear a very loud throbbing seashell ocean sound so I had to sleep with my arm well away from my head.
Sometimes it got a bit embarrassing when someone would try and get my attention, say in a loud party /disco and inadvertently touch my arm and immediately pull away thinking I had just given them an electric shock. So then I would have to explain everything and then s/he would get his/her friends to come over and touch my arm astounded at the effect.
“Have you been eating garlic?” When someone asks you this, especially if it is at a groovy disco you cannot very well say “No. My breath smells.” You really have to lie and say “yes”. Years later I learnt that this is one of the other common symptoms of renal failure. So now people can say to someone who has halitosis. “Are you in the later throws of final stage renal failure …or have you been eating garlic?”
*******
CHAPTER TWO: The Finals Countdown
The symptoms of renal failure are non descript: general feeling of tiredness all the time; shortness of breath, pale skin, irritability, loss of appetite, lack of libido/sex drive, nausea, vomiting, itchy skin, poor concentration, leg cramps, restless legs, swollen hands or ankles, poor sleeping, headaches, puffiness around the eyes, changes in frequency you pass water and increased thirst. The first six are the direct result of anaemia generally.
If you had one or two of these you would not think :I’ve got renal failure. Most people from time to time will have some of them but not continually, nearly all at the same time. I was suffering from chronic - slow, long term- as opposed to acute - or quick - renal failure; a slow deterioration over years. There is no treatment. All the doctors can do is reduce the symptoms and possibly slowdown the process. You take blood pressure tablets to control your blood pressure and with the diet you limit your protein intake to reduce the toxins in the body that the kidneys cannot get rid of. So you have to drink a lot and cut down on salt – sodium - as it will increase your blood pressure.
I had been told to drink India tonic water because it contained quinine and, although also helpful for malaria, reduced the night cramps, I would be woken up by. I eventually worked out that if I got out of bed and crouched down and put my body weight on my toes, this would stretch out the twisted muscles and the cramps would ease temporarily. I also understood that the more regular the “jumps”or sudden realisation that you were falling while falling asleep was due to oncoming renal failure.
I was also getting nightmares. According to my flat mate I used to scream during them but I did not recall a thing when I awoke.
I was also getting a bad skin rash, psoriasis which according to the alternative medics was the body trying to get the toxins out of my body by a different route. Well we will take that with a bit of ….salt. Well you can: I ‘d better decline.
I was increasingly having more problems, aches and pains. Before one of my regular check ups I was not feeling too bright and in a sense was glad the appointments had a come at that time as I thought I needed reassuring whether the day had finally come. I walked a few miles to the hospital and when I got that, once all the tests were taken, the two doctors looked at each other without talking and I knew things were getting worse. My blood pressure was very high. I was told I was going to be admitted to hospital. I waited outside the consulting room and two porters turned up with a wheel chair. I told them I could walk but they insisted and I knew it was no use arguing so I got in and I was pushed through the hospital. I was annoyed and embarrassed that I had to use a wheel chair. I had just walked miles to get there without any problems. Maybe I was refusing to admit how ill I really was or acting like an injured, cornered animal, not allowing anyone near me who was only trying to help or - as would like to think - I did not want to see myself as an institutionalised hospital patient because then I may give up fighting it and accepting I was now a long term patient which I knew was around the corner.
Around the corner of the next corridor was the exit door to the ambulance as it, with me inside, was going to another hospital. The two porters had difficulty lifting me up on to the back of it. I asked if they wanted me to get up and on myself. They said no but after another 30 seconds of faffing about I said this is ridiculous and got out of the chair and hopped on the ambulance. The porters said thanks. I knew they could not invite me to hop on or for me to be allowed to walk down the corridor because if anything happened they would be possible be insurance complications or allegations of negligence, By me hopping on my self they could not be held liable, I do think this obsession with hospital authorities covering their back can get a bit extreme sometimes.Maybe they should get me to sign a consent form but they will probably have to hand me the pen at the last moment in case I stab my eye out with it.
By now my kidneys were about eight pounds each -they should weigh about 2 pounds - and so my stomach was extended. I looked like I had a beer gut and some people teased me about it thinking that is what it was. Also comments were made about my suntan but it was not but my skin was changing to a muddy colour, another new developing symptom.
As the symptoms are non descript you generally feel run down and tired and lethargic or to use a Bill Bryson quote, suffer from “a severe disinclination to boogie”. I had been like this for a year or so but then did not even realise it as it slowly catches up with you.
Consequently you are seen as unfit and a hypochondriac. If I had a gaping wound I would have got more sympathy. Obviously my close friends and of course my relatives who were in another part of the country were pretty concerned but am sure some people thought that with my longish hair, my weight and odd coloured, unhealthy skin complexion: that I was a “smack head”, that I was taking heroin. In fact one of the consultants told me he had to go to a prison cell in the middle of the night to help release one of his patients as he was arrested for suspicion of being “on drugs”. The police had mistaken the similar appearance. After checking his arms for needle marks and finding his fistula he had some explaining to do but even so that is no reason to arrest someone.
If someone said “How are you?” or “How’s it going?” I took it as an actual question and gave them an update on my renal failure latest news. Unfortunately on many occasions, looking back, I misread the remark and they were just greetings like “awright” and that seemed to alienate some fellow students and no doubt I was down as a whinger (“Stop going on about your bloody kidneys”) and possibly someone to stay clear of.
Walking along one of the Poly corridors I would occasionally spot someone on crutches brought about by a motorbike or skiing accident. They were having the fire door opened by about three or four fellow students. I felt resentful that these, what I called the weekend disabled, were being helped and I was not and even accused of being a hypochondriac as nothing was a visible as plaster of paris or wooden sticks. Admittedly no one could assist. It was not as if I could borrow someone’s kidney for a day. It was worse when I was along a corridor towards an on coming student with crutches on the other side of the fire and I had to hold the door open for them.
As a bigger cynic then me once said “you’ll find sympathy in the dictionary between shit and syphilis”. I did not want sympathy I just wanted a bit of empathy. I only found that in the dictionary but I found it between eczema and enema.
I was a real regular with the GP who was resident on the Poly campus, which was handy. During one meeting (it would be incorrect to call it a consultation as he could not do anything and most of the prescribing was taken off his hands by the hospital unit but I still needed to see him) he pulled out a letter that was dated the day I was born and I read the sentence that mentioned even then as a few hours old baby that my kidneys were noticeably enlarged or as I recall the word that was used, palpable but baby fat and my general growth hid it for many years until they enlarged further. My Dad told me that I spent the first few days in an incubator because I was apparently premature and needed a blood change because the blood of my mother was interacting with that of the baby’s- me.
During my many periods of waiting to see the GP I got so familiar with the waiting room that if anyone removed all the health information posters I could put them all up in the exactly the same place. I could spot a new one very easily. I ‘d also always check the plants because as Erma Bombeck said” Never go to a doctor whose office plants have died” Who ‘s Erma Bombeck I hear you cry. Well she was an American humour columnist who died in 1996. She had Polycystic Kidneys. We are everywhere.
I remember once queuing up to see the receptionist and at the front of the queue I heard: “I was given these tablets for my cold three days ago but they do not work. Is there anything else the doctor could give me”
It is quite incredible how people think doctors have a drug for everything. One poster in the waiting room stood out, as it was new. It was trying to relieve these naïve people of their perverse misconception stating that you may not necessarily leave the doctors surgery with a prescription. Dr Phil Hammond, now also a campaigning comic for a better health care and broadcaster tells in one of his shows how his previous boss had plans to put up a sign in his GP waiting room stating: “If you have the flu fuck off” such was the amount of time wasters at his surgery. Most people who say they have the flu are wrong anyway. They may have a cold, sore throat and sneeze occasionally, poor things, but unless they ache all over and hardly have the energy to get to a surgery they probably have not got flu. There is a poster often found on walls in hospitals saying as follows: “Antibiotics don’t work on colds or most coughs and sore throats “
Along with these regular visits to the GP during the run up to my finals I had my hospital check ups. I was also told that at that time only about 7% of my kidneys were working. That’s not 14 % but 7% in total. About a month before my law degree finals were to start I asked how long do they think my kidneys will last for before they completely collapse and I would have to start dialysis. The hospital doctor said, “I would say about a month.” So my kidneys would collapse at about the same time of my finals.
It was getting really difficult revising or, for some parts of the course should I say, simply vising. It all seemed so pointless. In a few months time I could be on a kidney machine possibly for the rest of my life. I doubt if I could use the degree assuming I passed it. I would often get to the law library sit down open the books and just stare at them, not being able to concentrate, rereading the same sentence over and over again as I was not taking anything in. This was especially difficult with the apparent need in law to have long sentences that can go on far too long. Often found in archaically written legal documents such as contract clauses and Acts of Parliament. The only way I could make head or tail of it was to play “find the verb.” It can be difficult at the best of times. You have a go.
“If and whenever the said rent hereby reserved or any part thereof shall be in arrear for twenty one days after any of the said days hereinbefore appointed for payment thereof (whether the same shall have been formally demanded or not) or if there shall be any breach non-performance or non-observance of all or any of the covenants agreements and conditions herein contained and on the part of the Lessees to be performed or observed then and in any of the said cases it shall be lawful for the Lessor to re-enter into and upon any part of the demised premises in the name of the whole and thenceforth peaceably to hold and enjoy the same as if these presents had not been made without prejudice to any right of action or other remedy of the Lessor in respect of any antecedent breach of any of the covenants by the Lessees hereinbefore contained.”
Hello. Hello. You can wake up now. When I would read something like this for the first time I would usually lose the thread, and then after a few more punctuation free lines, I would slowly lose the will to live. I had to find the crux of the sentence and work backwards. For instance, in this example, at line eight after cutting through the word and phrase jungle you are met with “shall be lawful for the Lessor to re-enter”. Right then you‘ll be evicted if .. and then I would start again.
Who cares that there are 109 exceptions to the law on hearsay.
So what that there are different conditions to successfully apply for an ouster as opposed to a non-molestation injunction.
Who gives a fuck about the rules on competent and compellable witnesses?
Who gives a fiddler’s fart that you have to be employed full time for at least 6 months before you claim unfair dismissal .In fact not even the government or any since because over the following years it went up to one year then two, than back down to one. So you can be unfairly dismissed if you have worked for less than a year unless one of the few exceptions applies.
I used to revise at the student union building, one of the reasons being that if I attempted to study at my flat I would soon find things to do. The fridge needs defrosting. I really have to do it now. Must clean the carpet and so have to go out to the shops to just buy that one particular brand of carpet cleaner. All false strategies to avoid the inevitable. I was in no physical state to do non-essential duties anyway
The student union building had a restaurant on the top floor. One day the meal included four fish fingers as a serving together with the usual dollops of different types of vegetables. By now I had given up the battle to remain a vegetarian as it was becoming too difficult with my low protein diet. Four fish fingers to me meant two meat units (three fish fingers) plus some thing extra. I was still trying to stick rigidly to the diet as I was trying to avoid the increased tiredness and nauseous that would ensue brought upon by the extra toxins in my body that my massive fluid intake could not help get rid of and therefore I would end up revising even less.
“Just three fish fingers please”
“It is the same price as four. You might as well have four”
“No it ‘s OK I just want three thanks”
“You might as well have four. I cannot charge you less: I ‘ll have to charge you for four even if you have three”.
“That’s OK. I don’t mind”
“I tell you what. I ‘ll give your four. You look as if you could do with feeding up if you do not mind me telling you ”. (Gee thanks) “Go on have four. It will be good for you”
“LOOK! I do not want you fucking fourth fish finger!!” I yearned to say but ending up saying:
“OK”
By then I had given up trying to explain my diet so I took my unwanted full plate away and then had to eat my way around the unwanted fish finger determined not to breach my diet because I knew if I did it once it would be slippery slope to breaching it again and again and feeling even more rotten.
I was discussing matters with the head of the law department. He pointed out that I did not have to take the exams. I could still get my degree, which would be based on my course work. It was something called an “aggretate” degree. This was not an honours but an ordinary degree and so the mark I would get in my dissertation, or thesis, which I had been plugging away at during the year could not be included as they were are only supposed to undertaken for the honours degree. Even right at the beginning of the year I had a problem with it. The title was found to be unacceptable by the external examiners because one word in it, decriminalisation, was not English but an Americanism. (Hurrah. My PC has not gone and underlined the word in dispute in a squigily red line and so it is a UK word as it is now in the UK language software.)
I refused to back down and eventually they relented. The purpose of my project was to extend on the idea contained in a legal article I had read where it was suggested that because there was a big a gulf between civil and criminal law, that a “third way” could be introduced. This was to dissuade people from partaking in certain activities but not to criminalize them. At the moment someone can sue you in the civil court and get an enforceable judgment against you. The state can prosecute you in the criminal courts and on conviction you can be sentenced. But what if you breached, what was termed a contravention. For example, the so-called “victimless crimes” such as drug taking and prostitution.
Deciding whether to just jettison all the work I had put into it was a difficult decision to make. Like many things when you are under pressure whether it be a death in the family or a divorce arrangement you have to make a big decision in very trying times. I obviously wanted an honours degree. An ordinary degree very rarely counts for much and I am already going to be up against it when applying for a job in the future with the medical history I am about to create for myself. Also the work I put in to my dissertation would count for nothing and I got a B for it. There were no A s and Bs were rare. I had to make a decision soon. The Poly was trying to help but was restricted by the degree authority rules. It was like being a TV quiz show contestant.
“Our first contestant is Michael O’Sullivan. Hello Michael. How are you feeling?”
“Well actu…”
“Well nice to hear that. Are you nervous Michael? Don’t be nervous Michael ”
“Without further ado let’s begin. Do you know the rules they are very simple? If you want you can take home the aggretate degree tonight. That’s safe. You can keep that. And you’ll have no exams to take. But if you want you can gamble and go for an honours degree. This will mean you can use your thesis towards you final degree which will all be a waste of time if you take home the aggretate degree But if you take your exams and fail then I am afraid Michael you will go home empty handed with nothing. Is that clear Michael?”
“Sort of”
“Well before you make your decision I’ d like you to tell us a little bit about your project”
“Er dissertation “
“Oh yes sorry, dissertation. So what was it about?
“A commentary on the decriminalisation of certain crimes”
“Oh that’s sounds interesting. You must be very clever”
.“No, just copied chunks from obscure legal periodicals and linking long paragraphs with a few of my own sentences like everyone else”
“Ok then times catching up with us. Start the clock.”
“Tick tock, tick tock”
“So have you made your decision?
“Tick tock, tick tock”
“Er yes”
“Tick tock, tick tock”
“Well what’s it to be Michael: the aggretate degree or the honours degree assuming you do not flunk your forthcoming exams. Have to hurry you”
“Tick tock, tick tock”
“I‘ll go for the honours degree”
“Well I am sure you have made the right decision”
“Thank you Michael for playing “Big decisions you’d rather not make at the moment!”
If I fail then it will be “…and let’s see what you would have won”
A few weeks before the finals began I was sitting at my friend’s desk up in the library waiting for him to return, and I looked down at his notes and thought they were strangely familiar. Although I was doing a law degree and he was taking a social science degree I realised that they were identical notes to my non-law option entitled “criminology”. He was doing a half-module entitled “Deviance”. (Well the law department had to call it something legal sounding didn’t they?) When he got back I asked him who his lecturer was and found out it was the same as mine. I then asked him when his exam was. It was four days before mine, which would be the last exam of my law degree finals. I then had an idea and went to the library issue desk and got out the past papers for the last few years of both exams and discovered the first ten questions were identical! The Social Scientists like the lawyers had to answer four questions but they had twenty questions to choose from while we had ten.
Looking back it's probably that this social science lecturer did not appreciate that the left wing socialists in the social science degree sometimes mix socially with those awful right wing reactionary law students. There was an element of truth in this because I remember a discussion outside a lecturer theatre with about six other law students about capital punishment and I was the only one against it. However there were others in the year that would have sided with me but no doubt we were a minority. Anyway with this gem of a discovery I decided to put revision on this subject on the back burner. Anyway by now I had effectively stopped intensive revising and decided to revise when I felt up to it and just attend the exams and hope for the best.
It did look as if my kidneys were trying terribly hard to prove that doctor right as a day or so before the first exam I started to get severe headaches. I was already on blood pressure tablets to keep it down and under control. My GP discovered it had gone up and my dose was increased. I took the exams with these headaches but my GP suggested I visit him just before each one so that we would have a record as they could help if I flunked them.
My friend’s Deviance exam was in the middle of my week of exams so I took time out from staring at my law textbooks and waited outside his exam room for it to finish. I felt like some dope head waiting for his drug dealer. In fact I was beginning to look like some sort of unhealthy drug addict with my pasty, ghost like appearance and unhealthy looking skin with my tired, drawn look and increasingly visible fistula. My skin had changed to an even muddier colour brought about by the anaemia and the very low renal function. So much so comments on my recently acquired sun tan increased. I very nearly responded by enabling the next person they met to comment on their recently acquired broken nose.
My social scientist friend came out of the room, gave me the paper and I went back to stare at a different page of my lecture notes. I picked out four questions and they all came up, as planned, in the exam a few days later.
My degree and exams were over. I just had to wait and see if I passed or failed and possibly regret not accepting the aggretate degree.
I had nothing much to do after the exams were over. It was a massive anticlimax. I could not go anywhere or plan anything. I had to stay in town and go to my hospital check ups and wait. I was effectively marooned. While other students could go on holiday or to their hometown or even start jobs or further careers, I had to wait for the fateful day, the mother of all check ups that was to result in being told my time was up. Where you learn you will need to start dialysis which was daunting not only because you were to be artificially kept alive but did not know when a possible transplant might present it self, if at all.
I tried to carry on as best I could which was to join an employment agency and I was given a job at a NHS laundry. Ironic or what? I had to cycle miles each morning because of the inadequate bus service and only lasted three days .I was knackered before even starting the days work which was surprisingly hard work: pulling soaking wet clothes out of industrial washers, untangling them as they moved along a conveyor “bath” and putting them in large industrial dryers. One morning while on route and already late I phoned the agency explaining I was not going in. They told me do not bother coming into their office again. I explained my health problem and they said we might be able to consider you again for less strenuous work such as an office type job if you get a doctor’s letter, which I did but was never offered another job.
I therefore realised I was too unfit to do manual work but although the doctors could not do anything to delay the inevitable I made a few feeble attempts to try and put off the fateful day. I had several appointments with a homeopathy doctor who was also a qualified and practising GP. His appointments cost £5 a consultancy, which I had a few of. That’s appointments a swell as fivers.
I even saw an Acupuncturist who charged much more but only had one appointment. It involved lying on his couch with loads of tiny needles in all parts of me. In fact the only part that was a needle free zone was where my kidneys were. I lay there for ages after he left the room and for moment I thought it might have been early closing and he had forgotten about me.
I did not expect a cure but I could not just do nothing and wasting a bit of money seemed worth it at the time, as I could not very well spend it on much else. What could I do with the money? A slap up meal? A holiday? New clothes? I suppose I could buy a nice new pair of pyjamas. No, my mind was elsewhere.
During one very long walk, which I tended to do a lot, I went a bit too far.
After a while I got an ache in my side and I could tell that walking was agitating my enlarged kidneys. I decide to rest and sat down against a tree in a small park waiting for the pain to subside so I could walk back. But when I decided to get up and walk back I could not move. The stop had meant it was now even more painful than ever to start walking again. At one stage I thought of calling someone over but then thought better of it. What chance of anyone willing to help. For a start I did not show any clear visible physical problems Eventually I went for it and once I got walking again the pain diminished. When I got home and lay on the bed I then realised I was in the same predicament again. I could not move.
I decided to phone the ward to see if they could explain why this was happening and the nurse who answered, who knew me, said they would send an ambulance to bring me in straightaway.
For me this looked like the turning point: although part of me was relieved that once in hospital I would not have to move and I would be fed, it meant I would no longer have to look after myself. As it turned out a few days in hospital resulted in being able to walk without pain and I was discharged but the kidney function continued to get worse.
I was now about to be introduced to a far stricter diet. Far worse than the low protein one. Potassium restrictions. Salt (sodium) restrictions. Phosphorus Restrictions. A low protein diet was easily manageable compared to these. Not only had you to think hard before deciding whether you could eat anything that was put in front of you but the consequences of breaching it could be fatal.
You have to stay off the salty food as it increases your already high blood pressure. You have to stay off high potassium food because otherwise you may have a cardiac arrest.
You therefore had to know your onions and not have them raw or fried. I was not going to be buttering many parsnips as there was total ban on artichokes, broccoli, brussels sprouts, pumpkins, squash, fresh tomatoes, tomato juice, paste and puree, vegetable juice, baked beans, pinto beans, mushrooms, peppers, spinach, turnips, sweet potatoes, and all pulses such as chickpeas, Soya beans, fried beans and lentils etc.
Nowadays there are so many theme names for cafes and restaurants such as an Eatery, a Fryery and a Carvery. (They are so new the spell checker on my computer has had to be over ridden so I can type this bit.) Well if anyone was mad enough to set up a cafe for renal patients it would have to be called a Boilery.
All the vegetables that you could have had to be boiled well and
the water they were cooked in discarded. Anywhere else potatoes would be on this “do not touch” list but I guess reluctantly dieticians allowed it because of the English traditional diet but they had to be boiled for forty minutes. That’s the potatoes: not the English or the dieticians. Of the permissible vegetables you were only allowed about two cups each day.
On the fruit front the diet was not a bowl of cherries nor a bowl of grapes, a bunch of bananas; grapefruits, oranges, apricots, avocado, cantaloupe, honeydew, kiwi, mangoes, nectarines, papaya, fresh pears, fresh peaches, pineapples, rhubarb, watermelon, figs, greengages, prunes, (where are you when I need you) and all dried fruits (eg apricots, currants, dates, prunes, peaches, raisins and sultanas)
Similarly you had to stay away from orange juice, prune juice, pineapple juice, grapefruit juice and tomato juice.
Of the allowed fruits you were allowed three cups where, for example, a medium size apple could count as a half-cup or a fruit unit.
It was no good hunting down an obscure fruit or vegetable not on the list and assume it was OK .It probably was not. You could not expect every type know to be listed, just the most common. Not on my list were Lima beans, Swiss chard, succotash, cantaloupe or papaya. They are all high in potassium and dangerous. Any such list has to be treated as a non-exhaustive list. Now if you eat anything from the total ban, like say a couple of grapes, it would not be fatal but would be equivalent of something worth while eating such as a whole apple
A pie in the shop is pie in the sky because you have no idea what is in it - how much potassium or salt - which is a problem with nearly all pre-packaged or precooked meals
You have to avoid nearly all canned foods pickled vegetables, ready-made meals, smoked or processed meat, fish and poultry and bacon, ham, sausages, cold cuts, hot dogs, hamburgers, corned beef, anchovies and sardines etc.
Are you getting the picture? I have not finished yet.
You can't even put your faith in cheeses because of the salt and of course the protein was already restricted. You are to avoid chocolate and milk products. Milk. Once your first meal. Now a risky food to consider. You could have it with a bowl of the cereal – the right kind not full of dried fruit or high bran type –and with your limited amount of tea each day but it was not only a “meat” protein unit but also high in potassium. God does indeed move in mysterious whey’s
Your have to avoid all biscuits etc with nuts and chocolate and the same for any desert some puddings that these contents and custard or yoghurt.
Coffee is not your cup of tea or hot chocolate or similar drink products.
The diet was a balancing act between having too much protein, salt and potassium and malnutrition. You still had to get your modicum of fresh fruit and vegetables each day. So what will the fashionable renal failure patient be eating this season? Well I ‘ll take you shopping later.
I bumped into the Indian restaurateur and he asked me when I was going to take up his offer of a free meal he had kindly promised due to the legal help I had given him. It was extremely difficult to explain I could not eat it. I felt he did not understand and was never totally convinced of my explanation.
I got two letters in the post one day. One letter was clearly from the hospital as it was a few days after my previous check up. I did not open that one first as the other was from the Poly. My exam results. I passed and got a 2.2 honours degree. The head of the law department had hand written “Well done” but I did not know if he had written that on all of them or just on mine.
The hospital letter said something like “Dear Michael, You kidney function has reached a level when you will need to start dialysing. Please can you come into the unit tomorrow afternoon”
I phoned my parents to tell them the exciting news .As far as the exam result was concerned I said it was a bit like a bald man winning a brand new hairdryer.
CLICK……………………………….. . WKQ: 2+2+0=4
CHAPTER THREE: Dialysis Days
Many people have no idea what dialysis entails. Some think you are connected to the machine 24 hours a day hoping for a transplant to release you from being chained to the machine. This situation conjures up images of the old fashioned iron lung that polio victims were connected to. Others think you go into a big box type thing, probably with your head sticking out of the top like you see in those steam bath machines in the old American films and some how things happen inside that do the job that a kidney should do. Then you come out feeling like you’re new born and you can get back to your original normal life until, that is, the next time you have to go back on. You can eat and drink what you like as long as you get back for your next appointment with the machine. By this time you will be crawling to the machine on your hands and knees for your next session, feeling ill and desperate to get back on the machine.
It is however nothing like that at all.
In a 2001 broadcast of a BBC Radio Four programme entitled “Doing what comes naturally”, Dr Jonathan Miller said: “….few of us fully understand the importance of the kidney and why it is so difficult to do without it and why does life come to a standstill if we cannot produce urine. It is because the kidney is one of the most important mechanisms maintaining the physiological stability of our internal environment without which the cells, which we are composed of, would be unable to survive or thrive. Hugh de Wardener, a kidney specialist, has devoted his life to the analysis and treatment of the “apparently humble kidney.”
Hugh de Wardener: “The kidney is really to keep you in balance. You eat salt and water. You only need a certain amount so all the excess goes out through the kidneys. There a cataract of stuff which filtered through in a drop that comes out and the in between is controlled by nerves, hormones, substances, concentrations which tell the tubules, the tubes what to do. So really the kidneys are servants of …” “…. the consistency of the internal environment”. Dr Miller finishes off the sentence in this radio program after they exchanged French phrases meaning the same thing but meant nothing to me. It really annoys me when people start using French expressions not appreciating that we are not all au fait with them.
I thought of an analogy to try and explain the position you are in when you suffer from renal failure. Imagine your body is not a temple but a boring sink. Bear with me on this one. The plughole is your kidney function. When you eat or drink it is a bit like someone turning the tap on. If you have good functioning kidneys - or an unblocked plughole - you are OK. However much you gorge your self the sink will never ever appear to fill up. It will flow out virtually as soon as the water arrives.
If you have acute renal failure someone suddenly puts the plug in. This means that whenever you drink or eat - turn the tap on – the sink begins to fill and it will eventually over flow and disaster: a wet kitchen lino!
If you have chronic renal failure the flow is hindered. The sink is not about to overflow but begins to fill up. Not yet anyway. So to slow the process down your intake – tap flow - is restricted. The sink takes longer to empty and something looks wrong, as the water is no longer gushing straight out. Eventually the sink gets totally blocked and you had better do something before you have to get the kitchen mop out again.
A kidney machine will try and keep the mop cupboard firmly closed. What it does – still on the stupid analogy – is it acts as a pump every so often it is activated to lower the dangerously creeping level of the sink where the plug is effectively sealed and the tap trickle cannot be reduced any further.
At first the nurses put you on the machine, insert the two needles in your fistula arm where the vein is now massive and very visible. The needles are wider than the ones you have for taking blood or are used in hospitals for injecting medicines. Your blood leaves your body to be “washed” by going through the kidney machine containing the artificial kidney and back in by way of the other needle. Very long bloodlines can be seen entering and leaving your body. Your blood goes in and out of your body many times during the allocated hours you are attached to the machine.
Dialysis fluid and water are pumped into the machine. Meanwhile so is your blood. They pass each other only separated by a membrane which is full of tiny holes that are so small blood cells can not pass through but the toxins can. The toxins will be drawn to the dialysis fluid because nature will want to level out the density of the two liquids: the less dense fluid and the very dense blood fluid heaped with toxins. This process is called diffusion.
The dialysis fluid contains bicarbonate and calcium, supplements your body needs that your kidney and diet can no longer provide to try and avoid bone disease. This is also diffusion but going the other way.
I recall reading somewhere that in the very early years of dialysising fluid that the patients began to suffer from dementia until it was discovered the cause of it was the aluminium in the fluid, which was getting into the brain. In October 2001 there was a scare in Spain, Croatia and the USA over what was discovered to be contaminated dialysate where patients were dying due to air bubbles forming in their blood during a dialysis session. Baxter International Inc eventually accepted liability and compensated the relatives.
The most basic role of the machine is to get rid of excess water. This is ultrafiltration. Also known as “u” .. “f” .. ing. Sounding like the beginning of a censored comment by the patient when bloodlines are accidentally stood on or someone trips over them possibly resulting in your needles being pulled out and your blood going everywhere but where you want it, back into your body.
However dialysising also gets rid of the good stuff so that is why you have to take vitamin tablets and calcium capsules. There is no point taking them just before or during your session on the machine, as they will simply be dialysised straight out of your body.
The first few session begin to get rid of the back load of toxins in your blood. You are then supposed to feel much better than you have been for ages. It is ironically known as “the honeymoon period”. I did not appreciate any miraculous change. I did not achieve a feeling of well-being; just not as ill. No doubt other patients have different symptoms reducing experiences once the backlog is removed. I am not sure if the NHS leaves it as late as possible because of budget restrictions or that, given the choice, patients would rather put off the day for as long as possible regardless of the extra accumulating symptoms
The symptoms while on or shortly after coming off can include: vomiting, cramps, fatigue, irritation, itching, fainting, temporary loss of vision, chest pain. The first four were my favourite.
Haemodialysis is seen as the more aggressive form of dialysis compared to the other type known as peritoneal dialysis (PD). PD takes place inside the peritoneal cavity but I guess you are non the wiser. This cavity is inside the abdomen and contains liquid but has the capacity to expand the quantity of liquid. Bags of special fluid are drained in and out. It is a gentler form of dialysis for those who are unable to cope with haemodialysis. Dialysis outside the body, haemo (blood) is the most common form. For the average patient the advantages outweigh the disadvantages.
The renal transplant unit was at one end of the hospital grounds and the dialysis unit was at the other. Since the hospital was built this branch of medicine, transplanation, had developed considerably. Now there was lack of space and money was needed to build a new building that could incorporate both units. This eventually happened in the mid 1990’s.
I started haemodialysis in the renal unit. You gradually increase your hours depending on your blood results. Once you are well enough you have your sessions at the dialysis unit where the mode of transport was something resembling a milk float but where you could be wheeled on to. This was the unit where you are trained for eventual dialysis at home.
Soon I was given a regular schedule. It was five hours on the machine three days a week, Monday, Wednesday and Saturday. The fistula vein grows even more with use and it gets easier to put the needles in which by now you are encouraged to do yourself. After a few weeks I was being very gradually trained up to be able to manage the whole process myself: setting up the machine, taking your obs; weighing yourself; injecting the locals and the heparin starter dose. Heparin is a drug extracted from pigs that prevents your blood from clotting. Without it dialysis would not be easy.
Only then do you insert the needles and start the session. Then simply wait five hours or whatever time you have to do, being careful that you do not knock your needles out when you sleep or doze possibly forgetting that you are on the machine. I used to be very nervous about the occasional air pocket in the lines. I knew a lengthy one could be fatal if it passed through your heart. Nurses always reassured me that they had to be very long and not be just an inch long, which was what I would usually have to contend with. I never got to know what was a serious length.
An hour before you are due to “come off” you would turn off the heparin so your blood resumes its clotting capability for when you take the needles out.
Then it’s time to clean up the machine and tidy the cubicle for the next patient, washing the artificial kidney, which can be reused about ten times before it is too clogged to be of any further use. The five hours are only part of it when taking into account all your duties you have either side of each session. It may be for even longer when there are delays or you weigh more than your normal weight usually due to drinking too much. The machine does the work your failing kidney tried to do so now you have to reduce your fluid intake. You no longer need to continually flush your kidneys out by drinking large quantities as the machine is now doing the equivalent task.
Three times a week an ambulance would take me home and pick me up for the next session. On one occasion I left my usual calling card and threw up all over the inside of the driver’s nice clean ambulance just as he pulled up outside my home.
“ Blooourrrr”
“ Sorry about that mate.”
“Oh that’s alright. Bye”
“Bye. Cheers. Probably see you day after next at 7.30 in the morning”
On my free days I had the luxury of waking up when I felt like it. The neighbours’ curtain usage was on overtime as they were very interested why an ambulance was always picking me up.
My flat mate had also completed his degree and he had left town I was on my own in the flat and the landlord wanted me out so he could re-let it and no doubt charge more. I was in no mood to search for a new flat mate or contest possession proceedings. I had to look around for somewhere else to live. I found a room in a shared house that was a few miles nearer to the hospital, which I thought would be an advantage.
I had been told that if I was to have any chance of a transplant
my kidneys would need to be removed. The intention was to do it within the next few weeks. I was told to come in to hospital as an in-patient rather than just for the next session. I had no time to unpack or even meet all the people in the house.
My previous operations had all been mainly investigative or explorative if you exclude the fistula fitting: some requiring a local and some a general anaesthetic. This was to be my first real operation or major operation that would include an element of risk. I was told that a very small percentage of patients die on the operating table but you can play so many games with statistics. For instance older people are more likely to be at risk so immediately that average figure was misleading in my situation.
I have always enjoyed the stories of people who misunderstand the concept of statistics. There is the story of the sailor who stuck his head through the hole made by one of the enemy’s canons thinking that statistically it was now very unlikely that the next one would hit that part of the ship again. Or the person who always took a bomb on board a plane he was travelling on because statistically the chances of there being two bombs on the same plane were astronomical. The same distorted logic still happens today. For instance some lottery ticket buyers where shown on a TV documentary recording numbers that came up assuming the numbers that haven’t come up for a while are bund to appear soon.
I would console myself with the fact that I would never know if I had not survived the operation. I would only know if I did. A certain percentage of the population die in hospital but a lesser percentage die in delicatessens so maybe I should have a word with the surgeon and see if he would be kind enough to do the operation there, just this once.
There is no turning back when they take out both kidneys; it’s transplant or machine. I used to ponder if you can stay alive after both kidneys were removed. I had not heard of it before. There is always a part of you thinking maybe my kidneys are just having a bad year, renal horribilis, they might recover, and maybe I should leave them in. What if it is possible they may improve. If I have them taken out that’s it. I will be totally dependant on the machine.
I phoned my family and told them what the doctors had decided to do and they seemed a bit shocked, as it was not something we ever had in mind. Yes remove them when there is a transplant but surely not before.
I arrived at the hospital with my stuff for what was expected to be a two-week stay. We all had our own NHS private room due to the extra problems kidney patients have: the continual threat of cross infection by half of us being immune suppressed and the other half being run down from being dialysis patients. You will not be too surprised to learn that my room had a bed and the usual bedside cabinet. It also had a urine bottle (after tomorrow who knows when I‘ll next be using that, probably for throwing up into when the vomit container call out does not get the immediate response you hope for); the usual resuscitation stuff and a radio system installed in the wall that hardly ever worked and when it did it was only hospital radio so you couldn’t even try and forget where you were whilst listening to the radio.
“Hello to Bert who just had an operation today. Hope it all went well Bert. Get well soon says Jeff, Mark and all the lads. See you down the local very soon.”
“Well, Alison your mum and dad say get well soon and keep on taking the tablets and you will be out and about and fit as a fiddle again in no time at all ”
“ And a special get well for Melanie from all your family and friends. Hope you are recovering well and hope to see you soon back to your all tricks /right as rain/back working in your garden/fully recovered in the not too distant future.”
Just a few examples that I would hear interspersed with the standard joke about the nurses and the hospital food (try dialysis hospital food Mr DJ, which for me was ironically more varied than I could cobble together myself).
The night before the operation the surgeon came to see me and told me that my kidneys would be removed from the front and spoke about the machine keeping me “alive, in the meantime, so we can hopefully find you a successful transplant.” It was a breath of fresh air when he said that. The straightforward language, the bluntness in contrast with the cagey speak I was usually met with. It encouraged me to ask more direct questions. I wanted to ask: will it hurt? Should I give up thinking about fathering children? Can I have my favourite teddy with me for when I come round?
I was told my operation (medical term: bilateral nephrectomy ) was the next morning and as such I could not have anything to eat or drink 24 hours before. (“nil by mouth”). All my body hair had to be shaved (“ knees to nipples” as it was tactfully put) and there was the usual parade ground inspection by a nurse to check you had not missed a bit.
I then got into my white, very revealing theatre gown, which was open down the back and hardly worth the effort in attempting to tie the few little cotton strips available to prevent, if you’re lucky, revealing your bottom to the world.
That well-known organisation, the Hospital Infection Society published a report in April 2002 recommending further research into this standard pre operative practise. Need embarrassed and traumatised patients have to wear the ridiculous gown and the hat: have removed all rings and jewellery that are nowhere near where all the activity will be taking place. The Patients Association, at the time of writing, is trying to get the government to finance this research and answer that perennial question: should you have to take your underwear off for a knee operation?
I took my “pre med”: a tablet to calm you down in preparation for the operation, which is supposed to make you sleepy and, if you are lucky, sleep. I was then handed a consent form to sign, I did not bother to read it. At this stage what could you actually do if you were unhappy with paragraph four? You’re as nervous as hell, you are hopefully feeling drowsy, you are in no mood to read a newspaper headline let alone two pages of small print.
When you go to the operation theatre you are faced with hospital staff in white gowns and masks. It is as if you’re back in a pram when bodiless heads are looking down at you. Looking past them you see others. It is as if you are back stage at a Klu Klux Klan rally although some blue (or was it green) uniforms are about. At each stoppage along the route to “theatre” my wrist bracelet was checked to make sure they were not taking two healthy kidneys out of another patient. A white substance in a syringe was put into my arm as someone says “a little prick” which did not help. Then another stranger puts a funny contraction over my face and says “breathe deeply”. Flash back to a young boy when your mum sticks a hanky in your face and says “blow” such is the total vulnerability you are placed in. Then I am asked to count to backwards from ten. Ten, nine, eight, seven ….. zzz….zzzz.
When I came round I was in some pain. I was told I could not have any painkillers for the time being because my blood pressure had dropped and if I took any drugs I was likely to have a cardiac arrest. I had to wait for my body to adjust to the lack of kidneys. The pain was, how should I put it, as if someone had got a knife and cut the front of my lower stomach from one side to the other and then sowed it back up again. It gave me a small glimpse into what it would have been like being injured in battle during the middle ages, lying there and having to put up with it. They, of course, did not know about modern medical assistance. I could not even rely on the magic sponge that professional football players have access to. My pain was obviously not as bad as the pain as seen on these professional football players when they are badly tackled but unlike them I did not make a sudden miraculous recovery as soon as I got a free kick or penalty or the other player got yellow carded but I did have a vague recollection of wearing an oxygen mask.
It was not so much the pain level itself, although that was bad enough, but the continual pain from which there was no respite, not knowing when you could get some pain relief and how long it was going to last.
I appreciated the quandary the medical team were in. They obviously wanted to ease the pain for me but could not risk it. Every fifteen minutes my blood pressure would be taken to see if it had gone up so I could safely take painkillers. It did not do so for several hours. Every quarter of an hour my blood pressure was taken again. I would look pleadingly at the nurse to see any flicker of a smile to indicate it had risen so that she could go and get a doctor to prescribe something. Sometimes a particularly considerate nurse would take my blood pressure even more frequently to see if there was any sign of improvement.
Eventfully it showed some sign of moving up but it was a very long and painful wait for it to recover sufficiently so I could get some pain relief. During this time I was asked if there was anything I wanted and apparently I was later to learn I had said something like “a revolver and one bullet” so I must have been aware and not in complete agony but now looking back it was as if it was someone else who had gone through those long drawn out hours.
The first few days I was restricted to my bed and had bed baths. The first real baths were a bit painful when easing yourself in and out, feeling like you were about ninety-five years old. My scar was covered with waterproof adhesive as soon as the last stitch was made at the end of the operation. When it eventfully came off just before the stitches were to be removed it was not much fun due to all the new hair growth underneath.
I wanted to see my kidneys. Apparently this was very unusual request. I did not want to give them one last kicking for old time sake but this time with me no longer attached. No. I was just curious as to what they looked like. Eventually, after a few gentle reminders I gave up asking because I soon realised I was wasting my time and after a few days who knows where they had got to but if there was a local pie shop with a very good deal ……..
“Body disequilibria” is apparently what it’s called: when, without any kidneys you return to the kidney machine and your body gets even more confused than normal. Dialysis was now worse then before. Now I would get headaches after being “plugged in” and it lasted the full session. It is a type of headache I would associate with migraine: all embracing, nothing could take your mind off it. Lying down in a dark room and waiting for it to go away seemed the only course of action. I created my own dark room by pulling the blankets over my head but this was problematic with the commotion in the unit; worrying that if I moved my arm I would dislodge my needles and then have to come out of my little hideaway and readjust them. I could not take any painkillers because as soon they got into my blood stream the dialysing would clear them out. Nurses were very sympathetic and I would occasionally hear a voice “How’s the headache Michael”. “Sorry but I cannot give you anything until you come off.” “One hour to go Michael. If you still have it then we can give you something”
I took the painkillers when I “came off” but this disequilibrium took hold in another form: the shock of coming off the machine.
When I returned to my bed I was retching for several hours
(bloooourrgh… “Oh painkillers. Leaving already? Don’t go. I was hoping I could introduce you to my bloodstream”). I initially retched continually, gulping like a hippo to get my breath and then at about five second regular intervals for an hour or so when it gradually reduced in frequency. By then I had not only nothing to bring up, not even bile, but I was sore internally from the activity and lets not forget the small matter of the operation scar that I was trying to hold with one hand as it was noticeably more painful each time I retched.
I was not even able to talk to the nurses in complete sentences without being interrupted by my little, uncontrolled physiological need.
“Michael you have not completed your menu cards for the next few days ”
“Well…blouuuur….could you read out the choices ……blooourr”
“So for tomorrow’s dinner you want fish fingers and boiled cabbage and for dessert?”
“Blouuur……..”
“Sorry?”
“Bloouuur…………”
“Blamange ? No Michael you know you cannot have blamange you know it is not for dialysis patients. It is high in potassium and is a meat unit due to all the milk”
“No ….bluuuurrhh”
“Blueberry pie but that ‘s got fruit in it. Very high in potassium. You’re being silly now”
I am a bit but you get the picture. On one occasion a nurse actually asked such questions during this time. It was the strangest period, while I was concentrating on taking my next breath between my retching, once in the distance I could hear from down the corridor an argument with someone who was insisting on seeing a patient but was being refused. I thought I had recognised the voice but could not place it. Then there was more retching and when it subsided for a while I would continue to try and recognise the mystery voice.
Anyway I am not trying to suggest that the nurses were oblivious to my condition or did not care. Far from it. In fact I remember one saying “Your poor thing. What are they doing to you over there? Surely there is something that can be done” At the time I was in mid fake discharge mode and was unable to say any thing even though I wanted to acknowledge his concern.
The next day after the session the headache reduced but by the time it had gone completely the next dialysis session was due and it was to all begin all over again. I got worried. Will this go away or will I have it until I get a transplant. I was assured it would.
Slowly but surely my sore body adjusted but it had at least one less duty to perform. Now there was no chance of getting rid of any fluid naturally; if you have no kidneys you cannot produce urine so you cannot pee. A few weeks earlier I was being asked to drink two litres of fluid a day. This was drastically reduced when the machine took over but now the machine could perform the duty and anything I now drank had nowhere to go. It was trapped in my system, in my blood supply. Any extra weight found on me by the weigh-ins just before each session could not mean anything other than that I had drunk too much which meant more time on the machine to get rid of it. I was told that a possible risk of over drinking could result in a brain haemorrhage. But since then I have checked and cannot find anything to substantiate this claim. The first stage is oedema in the ankles. Then if you drink even more you are likely to get water on the lungs (pulmonary oedema) likely to cause breathing difficulties.
Once I had had a breakfast cereal and early morning tea any more fluid beyond a pint for the rest of the day was a possible risk. Fluid obviously includes milk in cereal or custard if you managed to program your diet to allowing such consumption. If you sweat or cried you lost fluid so you could replenish any lost fluid. Tips to manage thirst included sucking ice cubes; a glass of ice cubes was equivalent to a glass of water; using mouthwash and sucking a sour boiled sweet
Over the next few days I was beginning to notice problems with
thinking straight when nurses or visitors spoke to me. After a few words of my reply I completely lost my train of thought. I forgot what I was trying to say and there were long silences when people were waiting for me to finish a simple sentence. The operation had initially affected my body. Now it was affecting my mind. I began to develop an ache in my fistula arm that came and went. I couldn’t sleep at night because of it.
My mental state appeared to worry the doctors more than the earlier physical symptoms did after the bilateral nephrectomy as I was to discover when I spotted the silent eye contact between them at the bottom of the bed during the ward round. (A concern of doctors?) I knew something was up but not sure what. I often thought I was going mad but I recalled the saying that if you think you are going mad then you couldn’t be. I was told they would get a psychiatrist to visit me. “Nothing to worry about but we just need to find out what the matter is.”
After a brief introductory chat the psychiatrist said he was going to ask me a few simple questions and I was not to be worried if I could not answer them correctly. He took his wristwatch off and pointed at the strap and asked me what it was called. I searched for the word in my confused mind but I could not remember it. He pointed at one of the hands and asked what it was called. After a brief panicky search through my mind I realised I did not know. He got off his chair and came up close to me to show that he was pointing at the winder and asked me what it was called. I did not know! I was getting exasperated that I could not find the words and concerned what the significance was for the impending diagnosis. After about five or six questions in which I could only answer about one he told me there was nothing to worry about. I was just in shock after having my kidneys removed and it is likely to be temporary and I should be OK soon
He then continued to explore my mental state and commented on the fact that losing my kidneys and having renal failure at such a young age must be traumatic and how did I cope. I answered something to the effect that I braced myself for the worse so that if it happened I would be prepared and if it did not then it could only be good news. He said that was very unhealthy. So I waited for him to tell me what I should do. He continued the conversation but did not make any suggestions. So there I was not really expecting help and when he began showing concern I was enthusiastically awaiting some tips but they never came. More fool me. I was crestfallen. I thought he was about to give me some helpful advice. Should have seen it coming really.
Years later I read into this and my “ unhealthy” attitude. I read that perpetually anxious people have their own form of bullet proofing which consists of setting expectations low, preparing for the worst possible outcome and planning how to prevent it from happening. It is termed “defensive pessimism” by Julie K Norem, a psychologist and professor at Wellesley College, Massachusetts. She says, “ This focuses them on things they can do, and away from the anxiety. An awful lot of people do learn how to do it for themselves in a concrete way.” Barbar S.Held, also a psychologist and professor but this time based at Bowdoin College, in Maine argues that the “tyranny of the positive attitude” should end because it may well back fire and make the person feel even worse. I discovered this from the American Psychological Association. Their web site is at the back of the book.
Suddenly I re-emerged. From where I do not know. I was on a bed and attached to some machine and I felt I had just landed from another planet, a parallel universe. I was aware of my surroundings but no clue as to how I got there. There was a lot of commotion around me: of the people working in the room and another person to my right on the adjacent machine. When I tried to speak I realised I could not and panic gripped me as I thought I had gone mad and I was trapped in my body and it would now be impossible to communicate with anyone else ever again. I thought I might be trapped in my own little world bubble forever. You sometimes hear of nurses saying, usually on TV, “it’s very sad he can understand everything you are saying but cannot communicate” or “I am afraid he is totally unaware so don’t be alarmed if he shows no indication of recognising you”. I am not sure what’s worse. I was the former but everyone else might think I was the latter. (Dramatic I know but that’s how I felt at the time.) Then the patient in the adjacent bed asked me a question I suddenly snapped out of it. (I’ll name that universe in one) and answered her. Then all the nurses in the room looked at me and one said “Michael you’re speaking again. We have not heard anything from you for the last three days!”
I was so relieved I wept, which set off all the nurses. I then started to panic thinking that this was only temporary and I would slip back into my desolate, lonely private bubble, demanded a pen, paper and started to write down the names of anyone I knew so that they could come and help me if I was to slip back inside it again. I eventually calmed down asking questions of the previous three days. The nurses explained I had effectively become mute. To this day I cannot remember a thing about that period. It must have been due, once again; to the shock to my body having it’s enlarged kidneys removed. After all at about eighteen pounds it was like giving birth to twins or even triplets.
Loss of memory is often seen as amusing by the non-afflicted. It is not. There appears to be this image that the rest of your mind is working perfectly but one small aspect remembering who you are and your history is wiped clean. But your mind, in my case, was in total disarray. Earlier I could not find the words I was looking for. As if someone had mysteriously removed that particular word from the folder containing that type of word, which was held within a folder in a cabinet drawer in my little brain. I felt as if the entire contents of everything in each folder in every single drawer had been tipped onto the floor in the room where all the cabinets are held. I would then in my mind be rushing around picking up a single piece of paper, trying to make sense of it and see if it could help.
I returned to my room and began staring at the patterns on the curtains in my room, seeing strange faces and being amazed at how strange it was to be lying on a metal legged structure with soft foam material on top which was placed in the centre of the room. It was as if I had never before laid on a bed in my life. I then began reminiscing about my school holidays.
***
As a schoolboy I used to work on my uncle's farm in North Wales. He used to run it with his sister, my auntie. It had not taken up all the modern techniques because milking by hand and dry stonewalling was still practised. The hens were free range. I used to collect the eggs twice a day hunting in all the ingenious places they were laid.
I would accompany my uncle up the mountain to check on the sheep occasionally helping him and the sheep dogs bring a few sheep or sometimes the whole flock, down to the farmhouse. At first I was in the lower ranks of his employ: merely a trainee sheepdog but eventually was able to order the dogs around in Welsh myself. The neighbouring farmer ordered his sheepdogs just by a series of whistles. Once I hid behind a tree, copied him and watched as total chaos ensued on the mountainside. The sheep dogs where getting confused with the contradictory instructions and the farmer was getting more and more annoyed with them as he was unable to hear me.
Some of my uncle’s sheep dogs would take a fancy to smashing and gulping down the raw egg they came across. They soon stopped after receiving a free gift: an egg that had had its natural contents removed by use of a syringe and replaced by mustard carefully ensuring the shell was not broken apart from a tiny hole. Cruel you may say but it stopped them.
One particular farmer in the next valley was sceptical of his neighbour’s supposed new electric fence. He wanted to see it in action. He picked up his faithful sheep dog, stuck his nose on the fence – that’s the dogs not his. Now that is cruel – but as he was standing in a puddle he got the electric shock and the dog did not feel a thing as the shock went through the dog’s body.
A few valleys north of the farm is the supposed grave of a legendary dog. The translated inscription reads:
“GELERT’S GRAVE
In the 13th century Llywelyn Prince of North Wales had a palace at Beddgelert. One day he went hunting without Gelert the faithful hound who was unaccountably absent. On Llewelyn’s return, the truant stained and smeared with blood joyfully sprang to meet his master. The prince alarmed hastened to find his son and saw the infant’s cot empty. The bedclothes and floor covered in blood the frantic father plungened his sword into the hound’s side thinking it had killed his heir. The dogs dying yell was answered by a child’s cry. Llewelyn searched and discovered his boy unharmed but near by lay the body of a mighty wolf which Gelert had slain. The prince filled with remorse is said never to have smiled again. He buried Gelert here. The spot is called
BEDDGELERT”
This legend is now a tourist spot and easy to search for on the internet.
While I was at school my parents used to deliver me to the farm during the Easter and summer holidays. In the summer I was usually in the open fields, involved in all stages of the hay harvest. It began with the cutting of the grass and a few days later the turning of the top - dry but no longer green - grass. While my uncle used the grass cutter, then the hay turner, I was spreading out the cut grass to get it to dry out fully especially in parts of the field the tractor missed or could not get to. He nicknamed me “Michael the Pykle”, the name for the pitchfork.
Next, the tumbler was pulled around the fields by the tractor, which turned up all the hay to really puff it up and dry it out. Finally the bailer arrived on the scene together with local farm labourers taking the bails to the haylofts. By now I was the “Townie”
In the later years I got to drive the tractor and sometimes even the bailer! Most of the hay fields were in the valley but there was one field above the road. One day I got a bit cocky. I drove in top gear while using the hay turner on part of the field with a steep incline and one of the tractor wheels came off the ground. In my panic I thought the hay turner was over balancing because it was in the “up” position so I lifted the lever to what I thought would bring it down but it was already down and by moving the lever I had moved it up which was all it took to guarantee that the tractor would turn over. On realising this I decided to jump off. However as I landed I looked up and the hay turner was coming down on me. I lifted my knees up in a pathetic attempt to protect my self but miraculously, the engine was still running and the turner started to press down on me when the wheels of the tractor hit the ground, the tractor moved on scraping off me.
During the school easter holidays there would at times still be a complete snow blanket over the North Welsh hills. I would take sheep cake around the fields. I also emptied out the barns of multi-layered cowpats and gave the cattle their cattle cake. I was amazed at how they could put their tongue in each nostril but obviously not at the same time.
After observing my uncle inject a few ewes with something I was sent on an errand to inject one miserable looking ewe with what looking back must have been a foot and mouth inoculation. She was about a mile or so from the farmhouse. I nervously walked to an old house ruin where she was last seen, with syringe in hand. When I got there I filled the syringe ensuring no air remained within before I was to inject. On previous occasions I had been an assistant to other farm animals having jabs just in to the muscle. For instance calves would be given a jab where you would rhythmically tap them on their hind with one hand and then, in time, inject the needle held in your other hand and the calf would not feel a thing. Nor did you, unless you forgot to remove your other hand in time. I had to inject this ewe into the vein. It meant withdrawing some of her blood into the needle to check on a good flow and then injecting the drug. Who would have thought years later I would be injecting myself several times a week with the local anaesthetic and the heparin, not to mention the dialysis needles.
Easter was also lambing time and one of my regular duties was to roam the 365 acre hill farm twice a day looking for any lambing problems. There are certain high marks on the hills where you could walk to and peer down, sometimes using binoculars, looking down to avoid having to walk those extra miles. You would have to look out for newly born lambs or ewes with problems. I was looking out for the two-headed monster: not an uncommon problem during lambing. Once in a while the lamb was trapped inside the mother and although the head was visible it was at this stage that the natural birth was in need of a helping hand. This involved releasing the front little hoof from inside the mother. First I had to catch the mother, put her on her side, pull out the lamb, and clear all the afterbirth from its mouth to get it bleating and stand back. As if you had just lit the touch paper on bonfire night waiting to see if anything would spark off. Occasionally the mother ewe would be so exasperated - if they have that mental capacity - at having been in such a predicament for what could be many hours that she would simply walk away and disown the lamb. In these cases I had to carry the lamb down to the farmhouse. Often when I had retreated there would be a happy ending, the mother would begin to lick all the afterbirth off and I knew the lamb would be all right on the mountain and would not end up on my back.
One time I had caught a ewe in this predicament, released her new born and while I was helping it to breathe for the first time, mumsy decided to make a break for it. She ran across this mountain brook that had a deep pool when just then her second lamb was born ….. straight into the pool and started to drown.(“LAMBSY WAMBSY:BORN:8.15 AM.DIED 8.I5AM”) I looked around this very bleak Welsh hilltop for a telephone kiosk so I could change into my Super Shepherd outfit but there wasn’t one, more to the point there wasn’t time. I quickly rushed into the brook, pulled out the lamb, put her/him with her brother/sister and crossed the brook to find mum (“You’ve got a beautiful baby boy …or er girl er or two . er. You’ve got twins”). I eventfully found her, chased her back over the other side of the brook to the newborn twins. Luckily she took to them and I did not have to carry both of them down to the farmhouse on my back.
When a farmer has to take a lamb in it can also be due to the mother dying at birth. Once I saw a fully conscious ewe being eaten alive by crows, I could see inside her rib cage with its beating heart. At the top of a mountain in a situation like that all you can do is slit its throat to end the misery and concentrate on saving the lamb.
The orphan lambs were initially left by my auntie’s kitchen fire where they were given cows milk from a bottle. The strategy is to try and pair these lambs with ewes that have lost theirs. The ewe will shun the orphan lamb unless you deceive her by skinning the dead newly born lamb and get the orphan to wear it as a winter coat. They did not have a choice. On coming out of the changing room, I never heard once any of them say: “Well I am not sure. I think I want to try the first one on again.” I winced shortly after they were put together for the first time because as soon as the starving lamb went for a teat the ewe would head but her and send her flying against the side of one of the hay bails which were the material to build the enforced family home in one of the barns. The ewe is eventually convinced that the lamb is hers after she gets fed up with head butting it a few times and having been stuck together for so many days. Then the dead lambs coat is removed and once my uncle is happy with the new family relationship you stick them out in the field again until humans decide they want to eat them.
*
Why did I now recall my life as a schoolboy “on the farm”. Maybe it was simply the freedom, the outdoors, the countryside and the healthiness compared with me now stuck in hospital. It could even be me subconsciously recalling the time I was looking after other beings as opposed to now, solely dependant on others. But I doubt it. It could be that it was a place I recall from my earliest memories that I can still and do visit. A link from early years to now. I definitely got a good basic grounding on the ferociousness of nature.
***
It was during the night that being in my own little private room was the worst. It was due to the long never ending periods of quietness, elongated by the reduced night staff, few distractions compared with the many people moving through the ward during the day: cleaners, doctors, visitors and nurses. It was only an occasional visit by a nurse to do my obs. One night I pressed the buzzer as I was desperate to speak to someone. I was in a terrible state and blubbering. Although the balance of my mind had returned I was now unable to cope with the realisation of what was in store for me once I was eventually discharged. The ward member of staff who answered my buzzer sat with me for an hour or more.
I was still not yet ready to be discharged. I got into a routine at the hospital as I had still not stabilised. For instance my blood pressure was still all over the place.
As I slowly recovered the ward routine took hold. In the morning my “obs” were taken, the last duty of the night shift nurses and then a hour or so later breakfast arrived brought by the day shift nurses. Gone were the days when the night shifts last duty was waking you up, sitting you up, pulling up the front of the bed structure and rearranging the pillows so you could not go back to sleep.
My drugs would arrive in their familiar tiny eggcup like container. Once that and breakfast in bed was over I had to be prepared for the doctors visit – the ward round which meant a bath beforehand. While out of my room it would be cleaned up and my bed made. I do not mean the carpenters came in and measured me up for one but I wish they had done so as all the beds were too short for me. After my bath I sat in the chair waiting for them to finish while saying, “I would not bother, as soon as I get back in I am going to pull up all your fancy work.” I am six foot two and if I did not destroy their skilful work I would be hanging out of the top of the bed like a baby kangaroo in it’s mother’s pouch.
Then the wait for the doctors round around the whole ward, together with full entourage. This image is often associated with James Robertson Justice in that 60’s film characterisation but in reality junior doctors are in my experience not treated like that. Most of the time it was fine but occasionally I got a bit peeved. Everyone talking about me or rather my body. I would occasionally be asked a question like have you moved your bowels today. Often I would interject and say sorry to interrupt but this is my body. Slowly I got more involved in the discussions. (what about a gathering of doctors?)
Then it was elevenses and the attempt to catch the paper delivery person, making sure you don’t end up having to buy a paper you would not normally under any circumstances take a first glance at. Usually it was already too late as the previous wards had left you with little choice. In the later few weeks of my long stay I often walked to the other end of the hospital ground to buy a proper newspaper.
Obs again then menu cards would arrive where you would pick your dialysis choice for the next few days and then wait around for lunchtime. New faces. a nurse shift changed. More drugs. After lunch a few hours wait before possible visitors, afternoon tea, dinner, supper with new faces again another nurse shift. More obs in the middle of the night obs then the next day
But do not forget that was every other day. On alternate days I was dialysing, coming off dialysis at mid afternoon and brought back to my room.
One day I was lying on my bed attempting to read what was on that clipboard always found at the bottom of all hospital beds. I was trying to understand all the squiggly lines and funny numbers when I heard “You shouldn't be reading that Michael”. A nurse had just arrived.
“Why not?”
“They’re for the doctors. Not for you”
“But I am entitled to know what’s happening. It is my body”
“Well you should not”
Once this particular nurse had left I ignored her instructions and continued to fathom out my systolic and diastolic blood pressure figures, why they moved up and down from one day to the next. My temperature and pulse appeared to stay the same but blood pressure appeared to be a problem and I think the main reason I was not being discharged. I really wanted to learn more about my medical condition. The doctors were too busy and I sensed I was asking more questions than the average patient.
Now don’t get me wrong I am not about to relate incidents to knock the ward, the hospital or the NHS generally. Far from it. This hospital has kept me alive and does so at each dialysis session and will continue to do so. I do feel, however, it is important to relay these incidents on so other patients stop being so passive in their treatments.
“What’s that one?”
“It’s a new drug that the doctor prescribed you today”
“Well she did not tell me she was going to. What’s it for?”
“Just take it Michael. She prescribed it just now. It is for you”.
“Sorry I am not taking it until I know what it is”.
Thankfully we did not get involved in the “it will make you better” scenario. The nurse left not too pleased and to be fair the doctor came back when she was free, explained why she was prescribing it and I was happy and took the drug. She was probably too busy to get into the habit of explaining everything she decided upon or rush back to me if she made a decision once she had seen me.
Another occasion, another nurse.
“No the dose is wrong”
“What do you mean”
“I am not on that dose”
“Come on Michael just take the drug. Don’t be awkward”
“I am not being awkward. Look you go and check. If I am wrong
I ‘ll apologise. If you’re wrong you can apologise”
Nurse leaves room not too pleased. Returns. Hands me eggcup with dose corrected and leaves.
I tended to stay in my room, the nurses saw it as unhealthy and at meal times suggested that I should join all the other mobile patients in the day room to eat my meals. They craftily stopped bringing my meals to my room and reported it was waiting for me on the table in the dayroom. All it had to offer were jigsaws. The majority tended to be of Lady Di and Prince Charles, which did not actually aid my delicate stomach. The photo, which the jigsaws were most frequently based on, were so familiar as they were plastered everywhere since their engagement and wedding that you could do the jigsaw without the photograph.
During one bedside chat with a nurse she was encouragingly trying to cheer me up and said:
“…and another thing: now you haven’t got a spleen when you get a transplant in the future it is more likely to take”
“No spleen. What do you mean no spleen?”
“Oh hasn’t anyone told you. When they took your kidneys out they also took out your spleen. Very common in your type of situation.”
“Well fine but why didn’t anyone tell me. What does the spleen do?” I asked urgently
She said something like “The spleen is a secondary source of white cell manufacturer so the body has less ammunition to attack a future transplant.”
“While we are on the subject is there anything else I should know. Did they take out my left lung?” was my sarcastic retort.
I was more surprised than annoyed at this news. I was not even aware what the spleen did but I did sadly realise then that whatever it does I will never be able to vent one ever again. I was sure no one told me. I am all ears when I am told news about my medical condition. It is feasible, I suppose that after the op someone said that it was a success, if such a word can be used in this situation, but I must have missed it, as I was otherwise engaged. “Your great aunt has just sent you a £5 postal order and we also took out your spleen”. If I was told I was possibly not in the right condition to pay attention.
In the process of writing this book I had another go at finding out what a spleen actually does. I will now quote from the Daily Telegraph’s “The Family Encyclopaedia of Medicine & Health ( a quid in a book club introductory offer if you must know),“The spleen is an important organ of the body” (Oh shit!) “Its main function is to act as a filter for the blood and to make antibodies….. very few ill effects seem to result from its removal..” (phew!) But hang on. You just said it was an important organ. It cannot be that important if there are very few consequences. “ The appendix and your tonsils are an important part of your body. Do not leave hospital without them” It continues: “…, although it is possible to see changes in peripheral blood, such as the presence of Howell-Jolly bodies.” But nothing in this book about what they are.
What about Bailliere’s Nurses Dictionary? The spleen “manufactures lymphocytes and breaks down red blood corpuscles.” That’s cleared that up then. “Lymphocyte - a white blood cell formed in the lymphoid tissue. Lymphocytes produce immune bodies to overcome infection.” “Corpuscle – a small protoplasmic body or cell, as of blood or connection tissue.” “Protoplasm- the essential chemical compound of which cells are made.”
This is a good example of why it is very risky looking through medical books especially those not intended for the general public. GPs, especially must curse the internet when patients come into their surgery with pages from obscure web sites. After all if you are not very careful you could easily die of a misprint.
I had a splenectomy. How many more ectomies am I going to have before my mortal coilectomny?
Most of the nurses I got on with really well. It was only occasionally I had a bit of friction. Another sister came in to see me because I had apparently been “rude to one of her nurses”. I must have said something that was not pleasant but I didn’t shout, raise my voice or swear. I am sure sometimes I may have been a bit blunt but to come in like that after one incident was a bit much. This young nurse may have been hurt but maybe I should have been told look I know you must be going through a bad time but could you be a bit more careful what you say. This nurse probably went home to her own bed and never even mentions the incident ever again. A senior nurse tells me off. I would have been in that small room, between dialysis sessions for about 5 weeks by then about to go crazy all over again.
There were occasions when there was a shortage of nurses even after you take into account the agency nurses that are brought on to the ward when it is particularly under staffed. You have to remember in such a ward you cannot have nurses with cold and flu like symptoms ready to pass it onto the patients.
Because the ward could clearly do with more members of staff I would suppress my desire to ask questions? When one or two of the doctors took out a pen and paper and draw diagrams as to what was happening I would lap it up but not always understanding it. I sometimes felt guilty that I may have been over doing it and expected one day they may get their own back and I would hear a commotion outside my room when in would be trolleyed an overhead projector and the lights would come on. “Right settle down everybody. Nurse Jenkins. Lights. Right tomorrow at fourteen hundred hours we will be entering the patient here with the hope of getting to a destination here. Any questions? Yes you at the back. No you. Yes. No not you. To your left. No. The person lying in the bed. Sorry? Is he? Oh I see. Yes Patient Michael.”
One Sunday afternoon my parents were visiting me and a person walked in, acknowledged me, and picked up the sacred clipboard. He was wearing a jumper that clearly wasn’t a recent xmas prezzie. He asked me a few question and then left. My Dad wondered who he was. I explained he was the surgeon. “My God. I thought he was the gardener.” I thought that was great: he had popped into the unit during his day off to check on his patients, which was commendable, to possible return to his garden. Who knows? Who simply cares? But a good illustration of the end of pomposity such as wearing of the bow tie, which incidentally I understand was worn in preference to the tie as it would not get in the way when leaning over the patient during the examination.
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Although I was very grateful for the contact from my friends and relatives I really had a problem with the get well card. I have just had both my kidneys removed. How on earth am I going to get well? Most people get ill, see the doctor, get better. There is this assumption firstly that doctors can fix you up with a wonder drug or if not time is the great healer and you will get better naturally. Long ago I realised doctors could not do anything for my polysystic kidneys. They could not give a drug to me or operate on them to make them better.
A friend phoned and then he asked me if he could borrow my bike which I thought was a little undiplomatic. I did not know how long before I could ride it again. It reminded me of the film on WW1 “All quiet on the Western Front.” Someone asked this soldier who had just had both his legs amputated if he could have his new boots. A few weeks later my friend phoned to report that the bike had been stolen.
One of the many concerns patients have about being in hospital is the increased likelihood of constipation, usually due to the drugs you take particularly for general anaesthetics (surgeons do not want to see moving intestines once working inside you) and possibly the sedentary lifestyle. Why else do doctors regularly ask how regular you are? Years later a friend of mine was going into hospital for an operation and asked me for tips, being a bit of an old timer on the subject, as to what she should do to reduce this problem. All I could do is suggest fruit and fruit juices. A luxury I did not have on account of low fluid and low potassium diets. It is a real problem. Often found amusing by the non-afflicted.
Like all kidney patients my haemoglobin (iron count) was low, possible half of what it should be. I was prescribed iron tablets every day. But they bung you up. I was told that only about 5% can be absorbed into your system so 95% is not, consequently it leaves you, turns your motions completely black and in turn your already low mood. I thought the discomfort compared with slight increased iron count did not make it worthwhile. I did something I had never done before and have never done since: I stopped taking them as prescribed but instead I took them only on alternate days. I vowed I would compensate by being extra vigilant in not losing blood going on and off dialysis, which can so easily happen. You do this by always ensuring all the blood gets back into you at the end, not leave anything in the lines, making sure your needle does not slip out and send arterial blood spurting out of your arm like a garden hose. I thought I could maintain my hyberglobin that way rather than take these stupid tablets and get further bunged up into the bargain.
Well I got caught. The sister confronted me with a tiny black round tablet showing it to me between her thumb and forefinger. I had carelessly forgotten to discard it and left it on my bedside table. While most people my age were out enjoying the summer months, possible partaking in the pursuit of “recreational drugs” on the beach, at parties, in their flats, here I am in hospital getting “busted” for not taking drugs!
My secret rebellious decision was too late. I was not moving my bowels enough .I was given suppositories. Great. It was like a horse race where the familiar starting call is at the end. We will call it the Queen Victoria Suppository Handicap.
“They’re all squeezed into the paddock…. Waiting for the starters gun ….. a bit of a delay .. the tension is mounting…and the blankets are thrown aside and he’s up…. no he’s not…. he’s got his toes trapped in one of his sheets ….. he’s escaped and he’s up…. he ‘s out of bed … slippers….. he’s found his slippers ….the other slipper….he cannot find the other slipper…… . he’s out in the open corridor……. coming up to the final hurdle……. the toilet …….someone else is in there …... he’s sprinting down the main corridor and he is heading for a very tight finish .. he is in the toilet …..toilet seat is down……pyjamas bottoms…. string………..in a knot …… and they’re off.”
I had to rush out of my room, standing by the nearest ward toilet were three or four nurses chatting and when they saw me one said, “here he comes”. Not very nice. They’re not always angels you know. I began to wonder if they had a bet on in their little syndicate guessing the time when the patient would come flying out of their room with that uncomfortable urgency on their face.
So many patients have from time to time this difficulty. It is something most people do not want to talk about so it goes unnoticed. We need national demonstrations, people in the street with placards such as: “WE ‘RE GOING POTTY!”; “WORKING BOTTOMS FOR ALL.”; “DOWN WITH TOILET SEATS!”; “SUPPOSITORIES- YOU KNOW WHERE YOU CAN STICK THEM” and “FREE THE CHOCOLATE HOSTAGE”. I would of course insist that the money was ring fenced.
Just after elevenses one day I saw a divine sight: my biggest fear: a bloke with an oddly arranged collar: a vicar. He was coming this way. I prayed he wasn't going to ask me to. As it turned out he didn't impose his beliefs on me, automatically assuming I had, or should have them. I was a devout atheist. We had a nice chat but I could not talk about my condition to him. What would he know? How could he help? What could he say that would change anything?
I was brought up a Roman Catholic and soon realised you cannot seriously inherit a belief. I began looking out for the spare thunderbolts and after a few years of having no religious beliefs and no burn marks I realised I was going to survive. To make things a little awkward for me I learnt that some of my relatives were praying for me.
When I realised that I was going to have renal failure the standard reaction is “why me” and “what have I done to deserve this.”
I cannot understand religion but appreciate many find solace within it. I have often noticed situations where some people appear to turn to religion through weakness or despair: never through happiness or strength. Renal failure was simply a condition, a hereditary condition or a genetic disorder that my mum had inherited from her parents. For me, there was no point looking to anyone for help. You cannot complain of the physiological make up you inherited anymore than you can complain that water is too wet or not wet enough.
Grapes as a gift for a hospital patient are an old cliché. One day a friend brought in a bunch of grapes plus a load of pornographic magazines. This fails on so many levels. Where do you begin? I could not touch the grapes: massive potassium content and the porn magazines! I had to get him to take both straight back out when he left. If the nurses ever found out my life could be hell. In a sense I find it cute when you get hospital visitors that, not having been hospitalised, have this notion that you are not really ill but confined to bed and waiting to be discharged. So many people leave hospital able to put the stay completely behind them as a slight inconvenience now totally cured.
A nurse mentioned to me in passing one morning that an elderly patient along the corridor in the ward had asked her to ask me if I could get her some cannabis. A certain ambivalence initially came over me. Why would people think I was a prime candidate to possibly know this sort of information? Is it because I was a student and they all smoke pot don’t they. Or that I appeared street wise or so untogether that I must be on something other than the prescribed varieties of drugs. Anyway I did not know or want to know who it was but had to explain that I could not help. It was a kind of request I bet many kidney patients consider, bearing in mind they cannot drink, or drink enough to get inebriated but smoking dope may allow a bit of escapism from their present plight.
I am afraid I initially kept the degree ceremony quiet from my parents but when I realised they really wanted to go I relented. Several friends on the course refused point blank to go but you are not doing it for your self but for your parents. I was let out from hospital for the afternoon .I still had a saline drip tap in the upper part of my hand due to a drug course I was on at the time. I tried as best I could to cover it up and no one spotted it.
Dad and me were more concerned about Mum. Although her kidney function was satisfactory she was constantly getting kidney infections, which is something I hardly ever got in the later years (and for the time being it was going to be pretty difficult to get.) At the ceremony she complained of feeling very hot which usually was associated with her having another kidney infection and she was worried that she might faint.
It was weird being out of the hospital and seeing all the familiar faces and young people who were not nurses or doctors for the first time in about six weeks. My degree seemed like it ended years ago now. Some had just returned from a summer holiday abroad. Some had already enrolled and started at the Poly again for the one-year postgraduate Solicitor’s Final Course. I asked around about what the course was like, one lecturer very diplomatically warned me about how this course would be nothing like the degree and very intensive. Every other day I would be popping off for dialysis sessions. This and my other soundings confirmed what I believed: that it was going to be very difficult to get through the course let alone pass the exams.
The head of the law department came up to my dad after the ceremony and said “your son has got more spunk in his little finger than I have in the whole of my body”. So that’s where it’s all been hiding.
At the ceremony each of the exciting and proud new graduates were called up in turn to take their parchment which was really a blank piece of rolled up paper tied up with red ribbon that you did not even take home afterwards. I was told by several of my friends that I got the biggest applause when I walked up to receive mine. I did not notice as I was concentrating too much on making sure I did not fall flat on my face and rip out the needle for the drip awaiting me back at the ward.
We were all given an opportunity to have our photograph taken which I suppose is the most important thing of the day: keeping a record for posterity. I was asked by the photographer if I wanted four different photos or just the one. Assuming the latter would be cheaper if we bought four I went for it. I latter learnt that was not the case. So with nearly two months in hospital within a matter of minutes of a temporary discharge I managed to get myself ripped off. I felt a complete prat: with the piece of black cardboard on my head and half a batman’s outfit. At least everyone looked equally stupid.
My parents drove me back to the ward, travelled back to their home and I went back into the normal ward routine and prepared myself for dialysis the next day after experiencing the strange, fleeting glimpse of the outside world.
One of my friends was encouraged by the nurses to take me for a car journey to further the process of getting me ready for my eventual discharge which was looming as my blood pressure had begun to settle but it did not go according to plan. “Stomachchurn Countryside Tours – get out and about! Feel that uncomfortable feeling, then get ready for that unsettling feeling as you go over each pot hole, round each sharp bend in the country lanes and then, when the feeling becomes more intense, ask the driver to stop, open the front passenger door and for a short moment wonder at the colourful pretty, genetically perfect wild flowers on the road verge and throw up all over them”

READY WHEN YOU ARE WITH SECOND HALF OF BOOK!!

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