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1 hour ago
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I had this thing on the back of my shoulder, which a dermatologist at an NHS hospital looked at. He was brisk, verging on brusque. He said it was either one complicated-sounding thing or the other, but I distinctly heard the word “carcinoma” in there somewhere. He said I’d have to come back and have it taken out, and then they would see whether or not it was a carcinoma. Great. When? We’ll write to you, he said. I suggested that, if cancer was a possibility, then a bit of hurry-up might be called for. To which he said: “Oh, it won’t make any difference now. The only thing that would have made any difference was if you’d come sooner.” To me, this sentence argued against itself somewhat. Time was either of the essence, or it wasn’t. I even flirted with the idea of interpreting “won’t make any difference now” as his way of saying I was doomed anyway.
I called the dermatologist I had previously seen about it privately, and she told me not to be silly, it would be fine. A GP I know said the same. I thanked my lucky stars that I’m privileged to have access to such people.
Two weeks later, I was back in for the excision, performed by the same guy I’d seen before. This time, he said he was pretty sure it was cancer, cancerous, a carcinoma, whatever. What is the right bloody word to use anyway? This obviously raised the question, if it is cancer, then what do we do? “Then,” he said, “we have to have a conversation.” Honestly, I don’t think there’s a way of hearing this without it sounding ominous. But by now I was almost past caring. All I wanted him to do was stop saying worrying things and, instead, whip out his scalpel, go in as deep as he fancied, and dig the bastard thing out. This he did. He told me to get the stitches taken out in 10 days’ time, and he would either call or write with the results of the tests.
On the way home, something dawned on me: if there were now to be a problem with the wound or, like in some horror film, the excised growth reanimated and came bursting up through the stitches, I had no means of contacting this dermatologist. I doubt I would ever have had cause to talk to him, but I would have liked to have known the option was there. So what would I have done? Gone back to my GP, I suppose, taking up their valuable time.
A week later, a letter arrived from the hospital. With trembling hands, I opened it. Imagine my exasperation on finding this was not notice of my results, but notification of the original appointment for the excision. Terrific. And still no one to speak to.
This, more than anything, is what matters to me. I don’t care about the shabbiness of hospitals, confusion over appointment times and places, even the poor communication skills of some doctors. I just want to know there’s a number to call, which will get me someone relevant to talk to.
But there isn’t. I know this, because when I had no choice but to call, there was no one remotely helpful on the other end of the line. Twenty-three days after the excision, my phone pinged with a message saying there was stuff to read on my NHS app. This was last Thursday. There were two letters on there – one inviting me to an appointment to see a new dermatologist at a different hospital on Monday, the other to an appointment in March with yet another dermatologist at the original hospital. No test results then. Obviously too grim to relate by letter. The first appointment was presumably to give me the bad news – that I was done for – and the second would be just to check I was dead.
I got a grip. I called the number on the letter. Apart from anything else, I’d be 200 miles away on Monday so needed the appointment to be over the phone. The number, of course, went to some central admin call centre. “I will escalate the request,” the woman said. I emailed. Nothing back. Then, ping! Oh, this will be it. Nope. Just a text confirming the appointment. Then, another ping! This one, surely? No. This was yet another confirmation, generated for the NHS by a company called DrDoctor – “award-winning technology and expertise to transition the NHS to a hybrid model of healthcare”. There were emails too. And also, so help me God, an automated phone call seeking my feedback on the quality of service. By now I wanted to flush my phone down the toilet. This crap masquerades as communication, but communication is either two-way or it’s nothing. So this was nothing. Plenty of DrDoctor, but no actual doctor.
Drowning now in an alphanumeric soup of different passwords and usernames, I dug deep into the apps. One of them, ostensibly from the trust but “powered by Patients Know Best” – told me the test results weren’t due until 18 December. The founder of Patients Know Best, I read, was motivated by his frustration at “witnessing patients experience suboptimal care as a result of disjointed information sharing”.
I decided not to drive the 200 miles to the hospital for the Monday morning appointment. This was just as well, because if I had done so I would have been sitting in the waiting room when my phone rang with the telephone appointment I’d requested. I was too beside myself with gratitude to moan much about not being informed that this would be happening. “Admin’s a totally different department,” the nurse on the phone said, apologetic but helpless. She was kind, she was knowledgable, she was all I’d wanted. It took just five minutes.
Oh yes, I almost forgot, it was a squamous cell carcinoma. All removed and won’t spread. So not nothing, but not serious. Needs keeping an eye on. Whatever, I don’t care, because I now have this skin cancer nurse’s email. The human contact feels as good as any treatment or cure.
