Tuesday, 3 June 2008

An uninteresting patient

So John came home on Friday, and some semblance of normal life is being resumed here at Grillou. The last couple of weeks have left their scars, though - and I don't mean the one in his brain.

Rewinding a week or so, it was slowly becoming clear to both of us that being a patient in a world-class (so I'm told) neurosurgery centre is not entirely a good thing if it turns out that you actually have no need for surgery. The boss doctor and his trail of young white-coated accolytes spent some ten days doing scan after scan to try and find whatever 'anomaly' in John's brain had caused his haemorrhage; meanwhile, his blood pressure hovered at a scarily high level. "Isn't it possible," I ventured to suggest to Le Professeur, "that the hypertension might actually be the cause of the bleed?". "Bof!" said Le Prof, before going on to tell me that the haemorrhage was in completely the wrong place for that to be the case.

Now maybe I'm cynical (moi?) but I can't help thinking that hypertension is probably - well, rather boring if you're a neurosurgeon. Neurosurgeons like opening up brains and performing complex manoeuvres inside them; they like working at the cutting (!) edge and saving lives against all the odds. It's glamorous, rather chic and right up there in the highest echelons of the profession. Hypertension, on the other hand, requires medical rather than surgical intervention -and we all know what surgeons think about medics. In a nutshell, John was stuck in the middle of a load of hospital politicking.

I remained unconvinced by Le Prof's scepticism, and we entered into what became une vraie bataille to get another diagnosis. John was feeling more and more unhappy and unsafe as he was fast losing confidence both in his doctors and in the nursing team, whose treatment at times bordered on maltreatment. Finally, halfway through last week, he spent 36 hours under the auspices of the cardiovascular unit, where we encountered - yes, a team of human beings. The difference was absolutely startling; suddenly, he was being seen as a person, not just a body part. His straight-talking cardiologist was somewhat taken aback to discover that nobody had so far done blood tests or even taken a history, and that John's blood pressure had been allowed to remain at its very high level for 10 days (and even more taken aback to find that several days' readings were absent from his dossier). She swung into action there and then, and finally things started to move.

After a battery of tests, John has in fact come out as an extraordinarily healthy person (the cardiologist nearly fell off her chair when she saw how low his cholesterol count was - but then this is south-west France, the spiritual home of duck and goose fat!) ... except for his errant hypertension, which so far as she is concerned was the undoubted cause of the bleed. There's no obvious cause, which means it's quite probably a simple quirk of genetics; hypertension of this kind has no symptoms, and is apparently known as the 'silent killer' for that reason. We're neither of us doctor types, so it simply hadn't ever been picked up (though we've since discovered that it was already 'in the family'). Anyway, after another 24 hours back in neurosurgery hell, John was discharged with nothing but bad grace, a pack of scan pictures and a prescription for a hefty cocktail of drugs for a quick-and-dirty reduction in his blood pressure.

The positives: most importantly, he survived, with, it seems, minimal damage. The odds on this were not what you'd call great. His French has improved, thanks to endless conversations with his room-mate, a patois-speaking farmer from St Gaudens (and it now has a bit of an Occitan twang!); he's been prise en charge by an excellent, honest and above all human team of medics that he trusts; his blood pressure has already started to drop ... and he's stopped snoring! I in my turn have learned that I can negotiate, advocate and do battle in my second language; I've found my way around a previously unfamiliar system; I've met some great people at the hospital, including the daughter and son-in-law of John's room-mate, who are professional foster parents and co-incidentally live in the next village to us; and I've had some ideas for a future project of my therapy association. The negatives: well, you've read about most of them. Time to move on.

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