What-if-itis

I haven’t been here much recently. Apart from having given up Twitter for Lent, which always impacts on my blogging (largely because I subside into a soupy state of ill-informed parochial content), I’ve been doing my bit in my extended family’s concerted recent efforts to drain the resources of the NHS.

I found myself sitting two nights ago on the children’s ward of the local hospital, with my youngest, in the self-same bed that his sister had vacated four days earlier after scheduled surgery. A call to the GPs, following a concerned pick-up request from nursery on the grounds that he was struggling to breathe and was distressed, resulted in an appointment a few hours later, without any need on my part to claim emergency. The GP saw us quickly, assessed him thoroughly, spoke to her counterparts at hospital, and dispatched us for the treatment both parties felt he needed. A&E triaged him efficiently, treated him swiftly, and liaised with their colleagues on the children’s ward to bring us upstairs to a clean, quiet ward and a packet of sandwiches for a hungry little boy who’d missed his tea.

Whether it was the sandwiches, the nebuliser, or just that miraculous ability of children to go from death’s door to absolutely fine as soon as they’re within ten feet of a medic, he was, by the time we saw the paediatrician who wanted to check him over, patently well enough not to need the precious hospital bed he was sitting next to (my lap winning out, eventually, over the magic up-and-down mechanism). There were more than hints from the doctor of overreaction, which I can understand, given how No3 was presenting at 11pm. The fact that his oxygen levels at 4pm had been low enough to warrant strong suggestions, from health professionals, for an ambulance (suggestions which we didn’t act on) seemed to count for little.

The ward was jammed with sick children, and in fact closed to new admissions while we were there. I can understand the frustration at having well kids blocking beds, though it was annoying to be accused of having rocked up to Casualty on a whim and a cough. This time, I know that any overreaction wasn’t mine. I don’t think that, actually, there was any at all, given the bald facts of his medical history and his condition when he first saw the GP.

As we sat on the busy ward, though, hearing the endless incoming calls from Urgent Care and A&E, I wondered how we judge “overreaction”. It’s easy to see in someone else’s decision to visit the doctor a fidgety hypochondria. We all know that Other People, demanding antibiotics, are threatening the medical profession’s ability to fight disease. The over-anxious mother, whisking her child off for inspection the moment he or she exhibits the slightest sniffle, is a stock image. But who is really to blame?

Driving home on Tuesday night at midnight, tired with the worry and the late night, irritated with the implication that I’d been wasting time, I thought about the culture in which we raise our children and are encouraged to take responsibility for our own health. I drove past adverts in bus shelters from Cancer Research, beseeching commuters to go and get checked out a variety of apparently innocuous symptoms that have the (usually tiny) potential to be anything but. There are tragic stories in every newspaper, every magazine, about clues missed and opportunities lost to catch a disease before it progressed too far. Facebook (and Twitter, when I’m on it) do excellent jobs of allowing campaigns to raise awareness of various health conditions, too often, sadly, arising from personal loss, which yet can’t help but contribute to a sort of pervasive anxiety and a distorted perception of risk.

Given the context in which we live, I don’t think it’s altogether fair to sneer that parents (actually, usually mothers) are excessively cautious in their concern. It’s silly, though tempting, to hark back to the innocence of earlier days. Ignorance killed. It still can. We’re caught in an impossibly difficult position between being expected to follow our “instinct” to divine when our children are seriously ill (an instinct which I must be lacking, since the only time that any of my children really did need very urgent intervention was – oops! – the time when I was happy to dismiss his symptoms as a slight cold)  while knowing when not to bother the doctor with trivialities. And all the time, whether we realise it or not, our judgement is shaded by the exhortations not to ignore, not to delay, not to dismiss…just in case.

It’s hard to have faith in the statistics and confide in the expertise and professionalism of our doctors, when we’re constantly being reminded of the one-in-a-millions. They don’t feel so rare when you hear about them every day. We’re frightened of getting it wrong, because we see, so clearly, what can happen when we do.

I don’t know what the answer is. Financially and practically, it’s obviously impossible to subject every person in the country to a comprehensive overhaul, or to investigate to the nth degree any small niggle to eradicate any possibility of it developing into something more sinister. I feel sorry for health care professionals, operating under so many constraints, whose reassurance seems nowadays to have a limited shelf-life, and who can’t help but be haunted by the spectre of getting it wrong. Whatever cures and medical advances the next few years hold, I suspect that what-if-itis is going nowhere.

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