Tuesday, December 12, 2006

Warfarin Clinic Blues

Last July I developed a DVT when my clot of an orthopaedic surgeon neglected to put me on Heparin or some such anti-coagulant while I was laid up with a broken ankle. The result of this neglect is that I have to attend the Warfarin Clinic at St. Michael's Hospital at regular intervals to get blood tests. These tests indicates the viscosity or whatever of my blood and are used to fine tune my Warfarin dose. Because I went into hospital initially via A&E, I stuck to this routine because it seemed less hassle than trying to get a haemotologist of my own - these are as scarce as unicorns in the Irish medical scene.

But it's a grim gig - this vigil in St. Michael's waiting room. No matter what time I go in, the same situation prevails. The waiting room is like an ante-room to the graveyard. The lame and the halt predominate. They are mostly women and there's hardly a soul under eighty. The men have presumably all died by that stage. There are multiple sticks, zimmer frames, and a few wheelchairs. The sit there resignedly as the criminally understaffed clinic winds its weary way through them. There's usually one Philipino guy going flat out and a palpably uninterested female nurse of mature years who spends most of her time wandering in and out with shopping bags and cups of tea. There are 60 people ahead of me - so I resign myself to a wait of over an hour.

The waiting room is cramped and stuffy - hard seats jammed together - some Sky channel spewing garbage over the mute throng - their clots developing apace as they sit immobile and endure. I walk around outside in the gale force winds.

Coming back I see a large hunched female dressed in what looks like a billowing blue marquee lurch towards the entrance to the clinic. My first thought is that if a gust of wind gets under that I'll see something that could damage me for evermore. Inside, her loud assertive middle-class tones ring out in dramatic contrast to the apologetic rare-old-dub mumbles of the regular clients. And then it hits me, this apparition is Maeve Binchy. I feel a twinge of admiration for the egalatarian impulse that brought her to a public hospital rather than a fancy Dalkey surgery. How will she manage the cramped seats and the long wait I wonder. How will the seats manage I also wonder.

I need not have worried myself. She's greeted by the clinic's Nurse Ratchit (a tight ship and no mutuinous nonsense character) and ushered into a private room. My turn comes up but the jaded lifer who is to take my blood hurries off to this private room with her needles and her pillow and I am left trembling on the brink.

Eventually I get to the Philipino guy and get the business done. But I am hopping mad. I'm sure my blood came hurtling out when he jabbed me. I want to make a scene but I also want to get my results back quickly so I leave the clinic. I wait outside a bit to see if I can interview Binchey on her way out. But there's no sign of her - no doubt she's getting a cup of tea and a wholemeal biscuit.

Now I can forgive Maeve Binchey her insipid and banal novels; but I cannot forgive this cavalier abuse of a public facility. And as for the compliant administration, well that's a darker issue. Their willingness to compromise in a small matter like this, suggests an indifference to their passive patients that is reflected in the appalling nature of the service and facilities they preside over.