Life Abroad – Part 51: KNEE JERK ON NHS!
Posted on October 31st, 2013

Dr.Tilak Fernando

Eye has not seen, nor ear heard, neither have entered into the heart of man, the things which God hath prepared for them that love him” (Corinthians 2:9 NKJV)

This column has exposed two individual incidents previously of the UK National Health Service’s bungling where a Sri Lankan anaesthetist, who worked in the same hospital once, died of clinical misadventure and about another Sri Lankan who suffered a severe headache being prescribed variety of strong drugs by his General Practitioner continuously and rebuffing the patient’s claims maintaining that ‘there was nothing wrong with his head’ until one day he started puking a blackish liquid followed by hiccupping.

This warranted to call an emergency doctor home who sent the patient immediately by calling an ambulance to the nearest neurological hospital at 23 hours; the patient was seen by a House Officer only at 8 am in the following morning.

Hospital too released the patient declaring “there was nothing wrong with him”, but the patient’s family insisted on a Senior Registrar to carry out a MRI of the patient which showed he was suffering from Subdural Haematoma. Urgent surgery managed to drain the blood out. If not for persistent demands made by the patient’s family to the Senior Registrar when he was released, the patient would have been ‘six feet under’ today!

The latest

Last week a friend (known to me from London) who likes to remain anonymous wrote to me about his disappointing experience with his London GP which is equally baffling. He had visited his GP in NW London for eighteen months in connection with a knee disorder but on every occasion the GP had put it simply down to ‘normal age related wear and tear; the GP only prescribed strong painkillers to relieve the pain.

At one stage the patient became wary of taking strong painkillers continuously and thought to himself thus: “Now I am 58, and by the time I reach 80 I may die of Liver or Kidney failure, if I were to continue this strong painkiller Co-cordimol”!

Finally he made a request to the GP that he be referred to an Orthopaedic consultant which only fell on deaf ears. Due to persistent appeals the GP finally referred the patient to a hospital for a knee X ray, instead to an Orthopaedic Consultant!

The furious patient responded by stating, “The General Practitioner was more interested in saving money out of his budget allocation rather than dedicating his services to help patients for whom he had committed and taken an oath in becoming a medical man!”

Even after reading the X ray results sent to the GP from the Hospital, none of the four partners in the GP Practice wanted to refer the patient to an Orthopaedic consultant! Such contemptible action finally dampened the spirits of this Sri Lankan who had a clean record of paying his National Health Insurance Contributions for decades.

Final decision

When the excruciating pain in the knee became unbearable, the disappointment and the exasperation combined together made him decide to get back to Sri Lanka. This goes on record as a clear cut case where an agitated British resident, disturbed and distressed to the core for the lack of healthcare in the NHS, deciding not only to stop visiting his General Practitioner anymore but seriously considering to throw the towel in and get back to his roots in Sri Lanka seeking solace.

Finally, when he arrived in Sri Lanka quite recently, the first thing in his mind was to find a reputed orthopaedic consultant with a good track record of successful operations in the past.

Providence plays tricks on individuals, from time to time, which no one is able to comprehend. That may be why when Mr. X was contemplating one evening at his cousin’s home at Wellampitiya, she suggested a name of a prominent Orthopaedic Consultant at Sri Jayawardenapura Hospital, who happened to be an old Anandian and a class mate of her lawyer husband.

Mr.X wasted no time in channelling the consultant at Sri Jayawardenapura Hospital. Finally he was introduced to the Surgeon friend by his relative giving a full history of his case and how he had fared in the UK with the NHS GPs

Getting down to business

The X-Ray photograph which was taken in a London, only a few weeks ago, helped the Sri Lankan Orthopaedic Surgeon to study and disclose to the patient in a medical jargon which Mr. X understood as ‘the cartilage being partly worn out and some parts of it were rubbing against the nerves’.

Mr. X was prescribed some medication as a ‘test run’ to see whether it could help him overcome his knee problem, failing which he was advised that the only solution would be to undergo keyhole surgery (Arthroscopy). Two weeks of drug administration did not help the patient and the decision was taken by the Orthopaedic surgeon to perform keyhole surgery.

Somewhat nervous Mr. X was taken into the operating theatre at Sri Jayawardena Hospital on a Sunday morning where the Surgeon was waiting to help this human being to relieve his months old knee problem.

The Surgeon managed quite successfully to remove ‘the wasted parts’ of Mr. X’s cartilage from his affected knee by Arthroscopy, with the help of local anaesthesia.

The patient was able to see every action and detailed movement of the scalpel by the surgeon on a screen while a lady anaesthetist standing by the patient explained to Mr. X exactly what the surgeon was doing.

Speedy Gonzales

Within thirty minutes of the operation, the patient was back in the ward; on the same evening he was discharged and allowed to go home. Two weeks later his stitches were removed and some drugs were given to the patient for a limited period as a follow up of the operation.

Mr. X, who has recovered fully from his ailment and mental affliction, is jubilant now and he boasts about being like “speedy Gonzales on the road”.

This Sri Lankan could not be blamed for his personal experience and adverse comments on the NHS doctors in the UK where all his endeavours failed which made him abandon the Country as a direct consequence, may be due to some rotten eggs in the National Health Service, which sceptics say it is not rational to blame the NHS wholesale for it!

The jubilant Mr X sends a message across to his fellow Sri Lankans at home ‘not to waste any money in going to the West when there are so many skilled doctors in Sri Lanka who really know their onions’. Referring to this particular Orthopaedic Consultant/Surgeon at Sri Jayawardenapura Hospital, Mr. X likes to call him as ‘Jeewaka’ who gave his life back again.

My friend in his email wrote to me further thus: “I am not going to disclose the details of the GP or GPs Practice Group who treated me in London, but we should appreciate what our local doctors can do with their knowledge gained from local medical schools and post graduate studies”.

Specialists are not God!

This incident sharpens the memory of the writer where a retired Consultant (known to him in London) who worked for the NHS for over twenty odd years suddenly became disabled with numerous complexities associated with Parkinson’s disease. Being unable to make an accurate diagnosis by many specialist professors in the medical field in the UK he was being treated for Atypical Parkinsonism.

Once he was referred to the National Hospital for Neurology and Neurosurgery, Queen Square, London as a private patient for a comprehensive test report, from head to toe. Even after such investigations at an expense, the final outcome was that not a single neurosurgeon or the professor who treated him could pinpoint and diagnose what the patient was exactly suffering from, except to tag along with the existed recommendation of treating for Atypical Parkinsonism’ !

Disappointed retired NHS Consultant-patient politely put a question to his medical professor who was treating him for years thus:

“Professor……., I have served the NHS for 20 years as a consultant and have saved thousands of peoples’ lives. Queens is supposed to be the Temple of Neurology, yet I am amazed why you are unable to pin point and say what exactly is wrong with me. If you are able to say so to me to my face after all these tests, I wonder what chances any normal patient would expect out of such expensive tests”.

Quite courteously and diplomatically the answer came from the Professor of Neurology ……., who was in charge of the patient, “Dear Doctor ……, this may be the Temple of Neurology, but unfortunately we are not God!”

This sumps up the British NHS!‚ 

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