The Show Goes On

Do you remember the television series called M*A*S*H?  It was a medical drama/black comedy and the show followed a team of doctors and support staff stationed at the 4077th Mobile Army Surgical Hospital (MASH) in South Korea, during the Korean War. The series won countless awards and the final show was one of the most watched television shows ever.

Now Ireland has it’s very own version of the same show which can be viewed in most A&E departments around the country, any day of the week. The only difference between this show and the real M*A*S*H is that no-one’s laughing at the Irish version as it ain’t one bit funny.

British-based freelance journalist and author, Diane Taylor visited a friend at Tallaght Hospital’s A&E in Dublin last week. She was shocked by what she saw. Here is her account of that experience (with thanks to the Irish Times online).

“I was impressed by the modern, spacious, hospital buildings at the Adelaide and Meath hospital in Tallaght. Sensible health promotion posters covered the walls of the reception area and dispensers of disinfectant hand rub were clearly visible in triplicate throughout the public areas.

Only the huddles of visitors and dressing gown-clad patients at the entrances inhaling deeply on their cigarettes sullied the wholesome image of the place.

I had just flown in to Dublin from London to spend a few days working with Kathy O’Beirne on the sequel to her book ‘Don’t Ever Tell ‘, a story of childhood abuse in various institutions in Dublin.

But the work plans had to be abruptly halted when Kathy called me to say she had been rushed to hospital with complications to a chronic medical condition. I headed straight to Tallaght Hospital to see her.

The hospital has the largest emergency department in the Republic, with 80,000 patients streaming through its doors every year. The A&E waiting area was full, but not bulging the way I’d often seen A&E departments look at London hospitals.

Those waiting to be seen appeared remarkably resigned and those administering the triage system seemed to be working in a calm and ordered way.

I explained to the two security guards that I had come to see someone receiving treatment in the department and was nodded through the swing doors.

What I found on the other side of the doors shocked me. Lined up on trolleys stretching as far as the eye could see along the corridor were seriously ill patients waiting for beds.

Some lay on bloodied sheets, many were attached to one or more drips and quite a few were elderly.

It wasn’t clear who was unconscious and who was sleeping, but what was clear was that everyone on the trolleys – 35 people in all – were very unwell and needed to be in a proper bed in the relatively tranquil environment of a ward rather than in the frenetic setting of a corridor in A&E.

Kathy lay groaning with pain on one of the trolleys. There were some splattered drops of dried blood on the floor under her trolley. She had a tube up her nose running down her throat and into her stomach, a tube in her arm and a bag attached to a tube running from her abdomen draining out some foul liquid, which was causing her intense pain.

A cocktail of drugs had been administered to her and she was extremely distressed to be so exposed when she was feeling so ill. Sometimes she cried, at other times she appeared to be slipping in and out of consciousness. The other patients on the trolleys appeared similarly discomfited by their surroundings.

Now and again, ambulance staff hurried past the patients lying on the trolleys, dodging the drip stands and other bits of medical equipment as they delivered the emergency cases they had decanted from their vans to the waiting doctors and nurses.

It was distressing for both the patients being rushed in and the patients who were lying, prone, on the trolleys to catch glimpses of one another.

When doctors or nurses examined or administered treatment to those on trolleys, there was no privacy for the patients. Everything was carried out in full view of whoever happened to be walking past at the time.

The nurses kept on shaking their heads when patients and anxious relatives asked them when a bed was likely to become available.

“We just don’t know, we’ve got 35 people waiting. It’s terrible but there’s nothing we can do,” said one.

“I used to work in a hospital in London and people there complained about the state of the NHS – but they don’t know how lucky they are with conditions there, compared with the kinds of things going on here,” remarked another.

“The average waiting time on a trolley before getting a bed is 24-48 hours, sometimes longer,” explained a third nurse.

While all hospital emergency departments expect spikes in admissions at certain times – such as after a major accident or during a winter flu epidemic – neither scenario was in evidence when I was in the hospital.

On the contrary, it was a beautifully sunny October day – nothing out of the ordinary seemed to be happening. The staff said that this situation was not a blip – but, rather, the norm.

When the noxious substance had finished draining out of Kathy’s abdomen, the nurse said that she could remove the tube snaking its way from her nose into her stomach.

“You’re not going to pull the tube out of my stomach here in the corridor, are you?” asked Kathy, aghast.

“Well, where else am I going to take you?” replied the nurse. The tube was duly pulled out of Kathy’s stomach in full view of whoever happened to be walking past. Kathy was mortified.

I’m no health service expert, but during my various visits to A&E departments in London over the years I have never witnessed the kinds of scenes I saw at Tallaght.

After 24 hours on a trolley, with no prospect of a bed on the horizon and only the offer of another trolley in a day ward as a substitute, Kathy could take no more.

Her resistance to infection was low and, with various tubes stuck into different parts of her body, coupled with her extremely close proximity to other sick patients lying on trolleys and the new emergencies being rushed through the corridor, she feared leaving the hospital sicker than when she arrived.

So she opted to go home. She was warned that she was leaving against medical advice and was asked to sign a form accepting responsibility, should any medical complications arise.

She flicked through the “signing out” book and was amazed by the large number of other patients in recent weeks who had also decided to get out before their treatment was complete.

In the six hours that I spent in the corridor I saw nothing but dedicated professionalism and kindness from the doctors, nurses and auxiliary staff in the A&E unit, all working in intolerable conditions.

But it did not stop me from leaving the hospital with the impression that what I had witnessed in Tallaght Hospital’s emergency department was more reminiscent of a makeshift field hospital hurriedly established in the wake of civil war or some other disaster in a developing country, rather than the biggest A&E department in a thriving European country”.

I don’t suppose our Minister for Health will win any awards for this production but you can be sure that her finale will be one of the most watched shows ever.

11 Responses to The Show Goes On

  1. Baino says:

    You know, someone should go in with a camera and photograph these scenes of devastation and get them published on the front page of EVERY Irish Newspaper. These horror stories are intolerable. As Governments bail out banks and fat cats, poor people like this are suffering indignity and he risk of infection and deterioration

  2. Grannymar says:

    Tallagh is a new hospital, what hope is there for any of the old ones?

    I am sure school children could organise them better than those paid enormous salaries to do so!

  3. elly parker says:

    Baino – it has been done and widely reported in the media here, yet the government seems unable to fix the problem.

    Steph – Every time an “exposé” like this is written, we are immediately besieged with calls to better fund, staff and organise the HSE.

    Coming from a large corporation, I’ve been trained to think ‘outside’ the box – considering this problem in the shower this morning, my first thought was “If we can’t provide more funding and support, then how could we cut the amount of admissions? That would lead to the same amount of staff dedicating more time to each patient, and beds wouldn’t be as over-subscribed.”

    The oft-quoted statistic states that 40% of hospital admissions are alcohol-related. I’d assume that a reasonable percentage are drug related too. Yet our government is in the pocket of the vintners and refuses to change any laws relating to alcohol – look at the recent budget – 50c on a pack of fags, yet nothing on a pint.

    And why not follow the example of the Netherlands and decriminalise/legalise marijuana? It would lead to: increased tax revenues for the government, more employment as shops would need to open to sell it, relieve the burden on our drugs enforcement squad and allow them to chase the harder drugs, possibly even less shootings due to drugs (that one is a bit of a stretch).

    To paraphrase a recent election slogan – “A little done, a whole fecking load more to do!”

  4. Steph says:

    Hi! Elly – great to get your views on this.

    You’re absolutely right! There’s little point in continually throwing more money at the health service if they fail to address the root cause of the problems causing the chaos in A&E. The lack of beds in the system is another huge contributor to the backlog in A&E and we all know what Harney has done to solve that problem – nothing – except throw money at co-located private hospitals which have failed to materialise *sigh*

    Alcohol is a major component of A&E attendances yet nothing has been done to address that problem either. Our government is clearly lacking the ability to think ‘outside the box’ when they target the elderly with cutbacks instead of tackling the real drain on our resources.

    Now, I’m off to put on my marching shoes to go join the pensioners’ in their protest at the Dáil!

  5. Steph says:

    My apologies to Baino and Grannymar

    I was on the Dart to town when I suddenly realised I’d omitted to thank you both for your comments above. Blame Elly 😉 Her comment arrived just as I was about to turn off the computer to leave for the rally and I got distracted by it.

    The rally was brilliant! Up to 15,000 people attended, many on walking frames and sticks and some in wheelchairs. The atmosphere was fantastic with a great sense of camaraderie amongst the crowd, many of whom had travelled from far and wide to be there.

    All the speakers got a great cheer except for the poor Junior Minister for the Elderly, Maire Hoctor, who was booed off the stage. No-one was interested in hearing her deliver an apology from Fianna Fáil.

    Within moments of arriving outside the Dáil, I bumped into an old lady from my locality who was there on her own (aged 86) on her walking stick (following a knee replacement 6 months ago) and she was very proud to be part of the rally. I also chatted with Janette Byrne, spokesperson for Patients Together, a non-political group that highlights the faults within the health service.

    Today, it really felt like people power and I was very glad to be a part of it.

  6. Grannymar says:

    Glad it went well.

    I hope that the people power keeps chipping away until something is done to improve the situation.

  7. Steph says:

    Thanks! GM

    I feel sorry for all the pensioners tonight as my bones are certainly aching from walking the streets. I met many elderly people today who had left home in the early hours of the morning to reach Dublin by train in time for the rally and they still wouldn’t be home yet. I do hope they don’t suffer too much as a result. It just goes to show the depth of feeling out there that these old folks were prepared to risk their health to make their feelings known. I take my hat off to them.

  8. Aisling says:

    My sister came down with Acute Tonsilitis, either that or the Mumps. It was never quite established because the staff were so busy. She went to Blanchardstown Hospital where she spent five days and nights in A&E on a trolly. She didn’t eat properly, or sleep since there were lights on 24hrs over her head. She wasn’t given a proper bed in a ward because she wasn’t sick enough with anything serious, yet the doctor’s kept trying to get her out of the hospital while she was still unwell. She needed to be there because her throat was so closed up she couldn’t eat, drink or breath properly. I seriously hope that Ireland’s health ministers get their act together.

  9. Steph says:

    Aisling – Hello and welcome.

    Your sister’s experience sounds all too familiar and is a sad reflection of the situation in our A&E departments today.

    I’m sorry to say it but hospitals are no longer the safest place to be when ill. If your treatment doesn’t require IV medication then the best place to be nursed, is at home. Rest and good nutrition are half the battle and you definitely won’t get that in hospital. Had your sister received proper reassurance about her condition, I’m sure she would have fared much better at home.

  10. Aisling says:

    Hello Steph and thank you.

    It would have been great to get some reassurance indeed! Unfortunately she required IV medication and treatment because that was the only was she could get fluids into her body – likewise with medicine. I’m thankful that I’m not as sick as I used to be – I was one of those constantly chronically ill babies … that continued until I was eight. I doubt I could handle being in the health care system. I just felt at odds with the hospital at the time. They were telling us contradictory things – she’s fine, send her home/she desperately needs fluids now, keep her here at all costs! Agh, what to do?!

    I’d much rather stay at home when sick instead of going somewhere I know will make me worse!

  11. Steph says:

    Cheers! Aisling

    I know exactly what you mean about the lack of information in A&E. It causes almost as much stress as the illness itself.

    I would imagine that your sister had a tonsil abscess. It’s a condition called quinsy and has symptoms very similar to what you describe. In the good ol’ days, patients with quinsy were always admitted for IV antibiotics x 5 days minimum. Now they just give 12-24 hours of IV antibiotics in A&E and then send you home on oral antibiotics. If adequate reassurance is given, this is the best option for most people. Unfortunately, your sister was too sick to go home and seems to have fallen between two stools!

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