Interview 20

Age at interview: 63

Brief Outline: Was diagnosed with colorectal cancer in 2004. Because of complication (idiopathic thrombocytopenia, diagnosed in 2000), short stay in intensive care was planned, following surgery. Spent 8 days in intensive care and 18 days in general ward.

Background: Occupation: retired NATO international staff. Marital status: married. Number of children: 2. Ethnic background: White British.

He said that he was cared for by fantastic and caring nurses of every nationality.

And I can remember a great deal about it. And the wonderful thing about Intensive Care is that, in my experience, it was exactly as advertised. It was intensive and it was very, very caring. And intensive in that all the time there's a nurse at a station within reach so you're monitored with machines that have flashing lights and bells and all sorts of things like that, that warn the staff if anything goes wrong. And care in that every one I met in Intensive Care, and that was doctors, but mainly nurses of just about I should think every nationality on earth, they were wonderful. And I can only speak from my own experience but they were truly wonderful and made me feel quite welcome and good about it all.  

I think probably the message is in all that I said somewhere, I'm not sure where but' Don't be afraid. These people are, they're the best. They wouldn't be in Intensive Care if they were not the best. And there's lots of them, you know, they don't have the same problems of staff shortage up there, or down there or wherever you are. And you couldn't get better treatment. I don't believe you could have better treatment. If there were anything that had struck me in Intensive Care as being below par I would have mentioned it and in my case I was probably very lucky. I was very lucky. That was not so, they were just fantastic, all of them. And it's because of the racial ethnic mix in our health service staffing, it's a jolly good place to take on board, to get to appreciate our common humanity. 

He was glad he hadn't visited ICU before surgery for cancer because it might have made him more...

So when you were going for the operation, did they say you would be spending a few days in Intensive Care?

Yes. Before the operation they said you will of course go, after the operation, which was fairly late in the day. I was last on the list on a very busy surgeons' list. They said you will go into recovery and then you will probably wake up in Intensive Care. And I think that's what happened. All I remember is waking up in Intensive Care.

Had you been offered the chance to look at the Intensive Care Unit and, just having...?

No, I hadn't. And I'm not sure that that would have helped me particularly because I might have found it a bit alarming actually because, as I say, there are all these machines, a very, very high population of machines and bells and lights and drips and drains and people in there of course, not at their best.

So one could only have visited pre-op and I might have found it a bit daunting. As it is, you wake up and you're drugged and you're not in top form after the op and I was on self-supply morphine.

Did you know that, when you would be in Intensive Care, that you wouldn't be able to move very much because you've got...?

I didn't take that on board, though God knows I've watched ER often enough [Laughs]. 

I didn't really understand that. And again I'm not sure that it would help to be told all the things that might happen, and might go wrong in Intensive Care. I think probably the way it was done, they said, "you will go to Intensive Care." The way it was done was probably the right way for me. I don't think I would have been reassured to know that I was going to have a urine bag, a blood supply, a wound drain, oxygen. There were others, a main line into the artery. You're fairly tethered and I don't, I wouldn't have liked to know that in advance because in advance of course I was as mobile as I am at the moment. When you're in Intensive Care, all that doesn't matter as much because you can't do physical training there, you know.

He had one nightmare but this was no worse than any other he might have had outside the hospital.

In Intensive Care, did you have any dreams that you remember or...?

Interestingly, that was a question that was asked by the lady who came to see me from post-Intensive Care, from the post-Intensive Care team, fairly soon after I'd gone back down to the general ward. My answer then and now is I remember one appalling nightmare. I still remember it very vividly. But no more appalling than the nightmares that one can have, you know, off morphine or at any time, so I wouldn't say that that nightmare, which does not recur, was particularly linked to Intensive Care. I suppose it must trigger it to a certain extent but, no, I didn't have a lot of nightmares there.

He felt calm and accepting because there was nothing he could do but rely on the help of others.

The anaesthetist explained to me that that carried, the epidural would have carried an extra risk, so it was the morphine clicker. And I don't know whether it was because of the morphine but I actually felt very calm and at peace with the world in a way in Intensive Care because you realise that you, there's not much you can do. You can't even move about because of all these tubes and things. 

I think it's, because you're on drugs you are not as I have all my life done, worrying about survival and worrying about where the next dreadful disease is going to hit you. You kind of lose your hypochondria when you're really ill. You know. And you have to sort of throw yourself on their expertise and accept it. And I did have a very calm sense of acceptance and I mean, it sounds a bit silly, but it's almost a spiritual experience. What do I mean by that? I mean that for a second time in your life, the first time being when you're an infant, it's out of your power.  

You can't do anything. You know, my little grandson, he's now getting into the, at the age of two, he's beginning to feel his own power and he's then saying, "No. Go away." But before that they can't. And it's, in Intensive Care you're a bit in that state of the infant who has to trust his mother and father and grown ups, and that's quite a refreshing and spiritual sort of thing I found.

The physiotherapists 'saved his life' because they helped him with breathing difficulties he had.

They're wonderful, cruel ladies and they have to be of course and they have to get you moving because, I realised that, 26 days lying on your back is not good especially when you're ill and it's not good for your muscles and I still feel that now.  Yes, they did come and bully me and they bullied me much more when I went back to the general ward and in fact one of them, I think, probably, it sounds a bit dramatic to say 'saved my life' but when I went back to the general ward I was having great difficulty, which probably had started in Intensive Care, in breathing. And one of the things that the physiotherapist encourages you to do is to breathe. And I found that I could only breathe in to a very brief count of three and then it blocked. What was happening was that I was filling up with fluid, pondweed green fluid. And that was splinting the lungs and stopping me from breathing. 

And the physiotherapist said, "This is not right." This was out of Intensive Care, back on the general ward. She said, "This is not right, you should be able to breathe more than that and also you're really blown up. Like, you know, a sheep in Far from the Madding Crowd [laughs]. And so they did a scan and it was fluid, it was bile I think basically and that was the very worst thing that happened to me [laughs] the whole time, was the tube up the nose and down into the stomach to drain this fluid off.  

I remember the physiotherapist came in one day and said, "Today we do stairs." And it was again one of those times when I was feeling particularly jaded and weary and I said, and she had a young, I think doctor with her, I'm not sure. And I said, "Must we do stairs today?" And she said, "We have boxes to tick." [Laughs] So I did stairs. And she ticked the box. I did the stairs without any difficulties. This was probably after 12 days on the general ward, I expect. 

He had plenty of information from nurses before surgery for bowel cancer, including pamphlets and...

Did you know much about Intensive Care at that stage?

Nothing. Nothing at all, no. I might have said to you before we started recording, the only times I've been in hospital before I was not in Intensive Care. And this, varicose veins in Belgium, and varicose veins in Cyprus [laughs]. So, you know, a world of experience of varicose vein operations but not Intensive Care. 

And, throughout this time did you feel that you had all the information you needed at the stages that you needed it or were there times where you felt, "I don't feel I really know what's going on." Or, "I would like to know more."?

I felt that I was very well provided with information and pamphlets. For example, by the stoma nurses, they sat me down and explained what might happen before the operation. Will it be an ileostomy? Will it be colostomy? Here are pamphlets, and you can come back to us and ask questions, which in fact I have done and I'm going to see one of them on Monday with a question. And I felt that I knew where I could go to get information, which is always the most important thing, where do you go to get your answers? Because there is an assigned nurse. In fact, it's not one nurse, it's probably several, a team, but you are told Mary X is your assigned nurse and she'll come and see you, which she does at the beginning of the process. And her sidekicks are, and here's the number. And you can phone them at any time which I haven't actually done but I have asked questions because I bumped into this anonymous, this, no not anonymous, this imagined Mary X, I bumped into Mary X in the corridor at the hospital and I did have a question, you see. And she was perfectly happy then to deal with that. And I know that I could phone her now if there was something that was bothering me and she might not be able to answer it but she'd put me onto somebody who could.