Once a service that embodied health, it is now being sucked of life.  Our NHS is disappearing before our very eyes; are we being blind to its plain-sighted destruction, or have we just come so far down the road that we’re simply accepting of its fate, that there’s no way now of seeing past or through this?

Beneath the deepening cracks, we are becoming more collectively an underworld of broken beings, trapped in the breaks and cuts of an even more broken healthcare system.  Sounds too dramatic, right?  Then let me share with you a small snippet of my latest story.

TW:  This is a long and brutally honest post, so please bear with me…

Some certain events from this past month, and beyond, have perhaps been the scary reaffirmation of such fears, that we are indeed in great trouble.  As both a patient who both owes my literal life, yet also some lifelong scars of trauma and neglect, to our NHS, and as a medical student, training towards working as a Doctor in the very same system that is actively disintegrating before me, I now struggle to comprehend any sort of future in, or with, the NHS.  And it hurts.  It really hurts.  It hurts so much that I almost feel guilty to even have to think about the very real possibility of not having an NHS, to live, work, and die in, in my own lifetime. 

Of course, I won’t go as far as thinking about the ‘will I die, as a person with multiple chronic illnesses and disabilities, if I can no longer access this supposed national health service?’ Too much has happened these past few years for that to be a troubling factor for me.  But what I do worry about is my loved ones; my future family, and children – will they grow up in a country without an NHS, and if so, what will it mean for their health and happiness if we cannot afford healthcare otherwise, or if they too inherit the same genetic illnesses I have?  Will my grandparents have a good death when the time comes?  Or will they be one of the thousand more scores of elderly patients forgotten about on the cold floors of their empty homes, as the social care sector also collapses, or in the corridors of dangerously overstretched emergency departments, either on hard chairs too sore for their brittle bones, or, if they’re lucky, lying on trolleys with the side-rails up, scared and unfamiliar by their chaotic surroundings?  I have already lost one dear grandparent to medical negligence on an understaffed ward in Wales, four years prior.  Just two months ago, I was the medical student on a twilight shift in a busy emergency department.  An elderly lady had been wheeled into Resus from the Majors area.  She had been lying on a trolley out in the corridor, waiting many hours to be seen without a proper bedspace, yet she had silently gone into cardiac arrest, unbeknown to anybody else around her.  By the time she reached us next door, her estimated time of death was already announced.  We were a sinking ship even from the very second’s start of that shift.  All I could think about was my own Grandma.  

But I also know, that the story I am about to share, alone, will mean nothing, and change nothing.  In a human health service, we are now just merely numbers, dehumanised and quantified, both patients and staff alike, on some government body’s back-room desk, waiting for some game of dice.  And I’m not the only one.  A recent anonymous poll I sent out on my social media channel, Instagram, brought in over 400 responses of scared, dissatisfied, neglected and burnt out people – many patients, relatives of patients, but also doctors, nurses, and other allied healthcare professionals (AHPs), trying, time and time again, to stay afloat in their workplace, and ‘safeplace’, perhaps hoping somewhat that things will soon change for the better.  If that isn’t enough to choke back the tears in our tracks, a hard read I found, whilst scrolling from my own hospital bed, then I don’t know what else there is to say.  This is just how my most recent experience has ‘played’ about.  As a bed number, as a face on the dice, and as a tickbox on a broken agenda

I was visiting London on a day trip early August when an emergency arose and I required urgent medical help.  Without delving into the clinical details that necessitated my admission, I was kept in, at Hospital A, where it was agreed I’d require urgent stomach surgery to fix the problem.  I remained in this hospital for just over a week, each day being told I could be on the surgery list; pre-op assessments completed, visit from the anaesthetist done, stockings on and all gowned up, ready to go.  Except, it never happened.  On the last day, I was told that the surgery would no longer take place because the doctors felt this had to be done by my ‘usual medical team’ – in other words, the doctors who were looking after me and my complex medical conditions on the longer term.  The big catch here was that I had no team.  I had nobody looking after me.  After a 17-month long hospital admission less than a year previously, in which my life indefinitely changed forever, I came home, with no support out in the community, no discharge letter, and no follow-up.  I had become one of the many thousands, if not more, patients who had been slipped from the system entirely.  In that time I became a ‘nobody’, and I came to the conclusion that, if nobody was caring for me, then why should I care for myself?  With that, my mental health also silently declined, as did my physical health.  Again, I was told I was “not eligible” for psychological support, nor would I even make a waiting list within the next 2 years.  Nevertheless, I learnt to suffer in silence, and with my return back to medical school as a soon-to-be Doctor being the refreshing distraction that I needed and wanted, I decided I was better off continuing to ignore my deteriorating health.  Besides, when did any health system ever look out for the health of its own staff, after all?  This was after 17 months of sheer bedridden hell; COVID-19, ICU admissions, watching other patients die either side of me, contracting sepsis eight times, surgical procedures that were so incredibly painful that I would scream deliriously for weeks on end afterwards, and all in a time where I was also being gaslit, where I had lost all my dignity, and was unable to have comfort from any of my loved ones due to the pandemic’s visiting restrictions.  

I was thus told by Hospital A to go elsewhere.  Bearing in mind I had travelled down to London for the day, so at this point I only had the blood-stained clothes I came down on the train in.  Nothing else.  It was also a late Friday evening, which happened to coincide with another day of national train strikes.  My journey back would be long and complicated, never mind impossible.  I was weak, fatigued, and in great pain.  Thankfully, my parents were able to make the 2 hour drive to collect me.  Through tears of upset and frustration, confused by this sudden change in my (no) treatment plan, I rang the ‘Out of Hours’ (OOH) service, and a 24hr nursing helpline, specific to patients with gastrointestinal illnesses and medical devices like myself.  Both services urged I seek medical help back at the hospital.  Hence, I was told to present back to the Emergency Department – this time, at my local hospital closer to my parents’:  Hospital B. 

The pain, in this time, had been steadily increasing, given that my initial accident and need for intervention was now quite a while ago.  In all this time, I had acidic stomach contents constantly spewing out from my broken tube – a pH of 1.5, which had now caused widespread blisters and burns to the skin across my abdomen.  It had gone mottled brown and purple, still bleeding and oozing.  The inflammation had doubled, and even I could tell it was infected.  But the local Emergency Department at Hospital B turned me away.  They were a small district general hospital (DGH) who did not specialise in the medical conditions or medical devices I had.  I was told to instead go elsewhere.  Again.

That night I was hysterical with pain.  It was the longest night I had had in a very long time.  Yet again, I rang my community nurses and emergency OOH teams in desperation, for advice and direction.  Where else would I possibly go?  What if I had nowhere left to turn to?  Why would nobody help me?  I needed to go to another hospital – a larger, more tertiary hospital that was better equipped to help me.  I also resorted to reaching out on my social media channels – something I would never normally do in such personal and sensitive circumstances.  But I had run out of every other option.  Hospital C was recommended over and over again by countless strangers.  It also happened to be that my family required to take a trip in that direction.  It was en-route, so it made sense.  Myself, the family, the dog, the house and the kitchen sink, all bundled in the car, and we made our way to Hospital C, hopeful that I would finally be helped, and put out of my misery.  

I stayed in Hospital C for a long while.  But I didn’t feel at ease being there.  Quite early on in my admission there, one doctor (perhaps somewhat obliviously?) gaslit me, through a form of guilt-tripping that I must’ve researched this all before, that I must’ve planned on coming here for help, as if it was all instrumented beyond my desperation.  At this point, I made the swift decision to remove myself from Twitter entirely – humiliated and upset, but more so angry and ashamed in myself for reaching out for help.  I deactivated my account, and went silent, instead bottling it all up.

In this time, the inflammation caused had worsened so much that my tube had to be removed at the bedside – an incredibly painful and unpleasant procedure.  I was found to have high infection and inflammatory markers, as a result of the delay in my care and treatment, so I would be commenced on a course of intravenous antibiotics whilst the abdomen had time to heal and the swelling to subside.  

“Promise me you’ll be able to replace the tube as soon as there’s a surgery slot?” I said to the doctors.  I was reassured that this would be the case, and I finally felt at ease.  Safe and listened to.  I was on continuous two-hourly morphine doses at this point.  A week later, I developed a high fever and became septic.  I had yet another infection, and was commenced on yet another course of intravenous antibiotics.  And then the doctors – a new team, having changed around as they do on a weekly basis, came and broke the bad news the following day.

“We’ve decided not to do the surgery”.  I would be left without the drainage tube that had kept me above water for so long; it would not be replaced.  “…Because you don’t live in the catchment area of this hospital.  We are not taking on any new patients outside of this geographical area”.  Speechless.  I had been admitted in emergency circumstances, prepared for surgery and strung along – Hospital C had one duty of care, all of which was ultimately dismissed, because it came down to politics and finances.  I was going home without any action.  Yet.  Again.  

The sheer anger, upset, and fear for my future up ahead, was inexcusably soul-destroying, and it was at that very moment when I realised truly brutally, the NHS is in a mess.  The NHS is no longer delivering the care it is supposed to deliver.  The NHS is no longer a national health service, but a political minefield and a postcode lottery.  The NHS, had yet again, failed me, spectacularly, and it was breaking my heart, just as it was breaking my already broken body, and no-longer trusting mind.  My GP, although powerless, no thanks to facing the same brick walls in the system, was amazing.  Sometimes, just having a little cry down the phone, both of us, both frustrated and hurt by a broken system, was all I needed, to know that someone else at least empathised with my losing battle.  Even if it changed nothing.  

And then, this is when all hell really broke loose – the cracks that eventually come together to form one big irreversible break, all of which could’ve been avoided if it had been glued or fixed earlier.  Back at home, for the shortest of time, whilst myself and my family tried to figure out, as did my GP, in the sheer abyss and loss we were faced with, what to do next, I stopped breathing – vomiting, choking, and unconscious.  My family had no choice but to watch this terror unfold before them, my sister, also a medical student at home for a weekend of rest, having to provide BSL (basic life support), (and force) to her older sibling.  Paramedics and a back-up emergency crew had never come so fast – something, now I know the story of, I am so incredibly grateful for, and could never fault.  Rushed to yet another hospital – Hospital D, at speed, I was eventually stabilised.  The history of presenting complaint, something all healthcare professionals start off with when recording a patient’s journey to the front door, showed flaws in every chronology; to put it bluntly, as the dumbfounded and saddened paramedic too reflected, this was all completely avoidable, had Hospital A, B, or C, actually taken responsibility for the initial-onset medical emergency that was now piling back to four weeks prior.  It then had me wondering – if this could’ve all been avoided, could I too have saved the ambulance service, already overstretched and under-resourced, a trip to the hospital, where they could’ve been elsewhere on the road seeing to another patient in need?  

Fast forward, through all the pain, anguish, and disbelief, I am now awaiting this (still) very much needed surgery, this time at Hospital E.  But how have we got to the point where a patient is required, under acute or emergency circumstances, to fight for their right of care, at five different hospitals before being treated?  FIVE?  Unsurprisingly, my experiences as a patient being let down by a struggling NHS, not just in these past few months, but these past few years, has meant me losing a lot of trust in the healthcare profession – which is beyond ironic, given that I am also working within that same system, towards helping others requiring the same service (albeit I hope, receiving a much better standard and process of care).  Because of this breakdown in trust, I am finding it hard to acknowledge that I may finally be turning a corner in who looks after me, how, and where.  It’s personally too early to put those hopes up or let those walls down…and I’m usually the most optimistic optimist that people know.  

What I will say though, perhaps most importantly, is that none of this has happened or is happening because of malicious intent.  For the most part, the individuals within this system are forever working hard and lovingly to do the very best for their patients, and I am incredibly lucky to be able to say I get to work with many of these heroes on a day to day basis.  It’s important to stress that the general public should NOT be ousting their hate and frustrations onto the very people trying to make it better.  The staff working within the NHS are the only things, beings, actually keeping the NHS alive – goodwill being its only fuel.  But, like everything, goodwill gets burnt out, and used up, too.  And our staff?  The living, working body of this otherwise fractured system?  – We, they, are just as vulnerable and as human as you are.  Instead, it’s the system – all the people, structures, and things far higher up that need (and should) be taking responsibility; finances, politics, cuts, resources, and ultimately, our government.

I can’t help but fret, not just as a patient, but also a medical student, over what I’m getting myself into.  The more I experience such neglect and error, the more I question what I am truly getting myself in for, through my future career as a Doctor, not ever having that guarantee that I will be able to make a difference to patients’ lives in the way they actually want and need it, or knowing if their care will be misled or detrimentally impacted when the understaffing, under-resourcing, the politics, and the cuts, get too much.  It is, without doubt, the most mentally and emotionally crucifying thing, to have to sit on that fence (or in this case, edge of the hospital bed), every single day, swinging between either capacity of patient and healthcare worker, the effects and experiences just as bleak as one another.  And, like I’ve said, I’m not the only one…

“I have been on both sides of the curtain as a patient and doctor…” one social media user said.  “As a patient I have felt let down and dismissed.  I have experienced long wating times and declining mental health as a result.  I have equally felt the effects as a doctor of a stretched NHS, knowing the system is letting people down”.  

Another user heartbreakingly said:  “I’m a nurse and my mum is dying of cancer.  Her care has been diabolical and I’m so disappointed in the NHS.  I used to be so passionate but seeing how others provide care to my loved one has made me question my career and I’m thinking about leaving for good”.  

And another nurse; “I am a nurse, qualified nearly 20 years ago.  I got diagnosed with bowel cancer 5 weeks ago and am yet to start treatment.  I feel completely let down bt eh service and everything has felt like a fight to get to this point.  We shouldn’t be fighting for treatment we desperately need”. 

Reading through over 400 anonymous comments, I, whilst struggling to process my own recent experiences from the hospital bed, have been struggling to comprehend this largely collective experience of so many.  Heartbreak, fear, guilt, frustration, helplessness, and anger.  If only I could take all these comments in one big book to our government’s front door – but I know deep down, we are just numbers, and the NHS has come way too far past its dehumanisation and destruction.

And still, the outpouring of comments kept coming.  One described our NHS as “the most amazing and most horrific place coexisting as one”. 

“It is heart-breaking being a patient and a doctor in a system with so much potential for good but is failing people left, right, and centre.  I’ve given up asking for help with my condition because I know the chances of being seen and understood are non-existent”.  

“I’ve been a doctor for 5 years and the state of the NHS makes me truly sad  That being said, system errors aren’t the fault of the individuals working within a broken service”.  

And the biggest stone to the throat?

“It’s died”.  

I then shed a tear.  

A broken NHS cannot be fixed by broken people.  Nor can broken people fix a broken NHS.  It’s as simple as that.  And yet, people are being broken because of It – patients and staff.  But the latest Health Secretary, Thérèse Coffey MP demands we instead “increase our performance and productivity”?!  Run purely on the burnt-out goodwill of each other alone, scarce of sustainable funds and thus safe resource, manpower and its devotion to provide and care is the only thing left of the NHS that remains human.  And we still come back to it – back to work in our miserable setups as staff, back to the ‘front-door’ for unguaranteed care as patients.  Why?  Perhaps we are all still holding onto that small glimpse of hope that the NHS will somehow turn around, and regrow?  But, something just tells me…I really don’t know.  And for those who have already sussed it, and can afford to – well, our valued healthcare workers are leaving the profession altogether.  And our patients – so exhausted and lost, are resorting to private healthcare.  But what about those who simply have no other choice?  Really, I’m still trying to find out those answers too.

Something needs to change, or we will lose the NHS forever.  And when we do, the NHS will die.  Plus with it, a grief, beyond anything else, that you and I have experienced these past few years, we may never recover from.  I’m sure we all feel the same.  I’m also sure that so many of you realise the enormity of how lucky we are to even have a national health service, compared to our other world neighbours – free at the very point of care, and a privilege most of us have only ever known in our own lifetimes.  

Still, some things are beyond fixing.  I know that from being a medical student.  Some things we just can’t pick out and put back together from the wreckage of a roadside accident.  Our NHS may be a toy car trying to run on flat batteries and no wheels – but with initiative, sense, and the actual component parts to physically replace those flat batteries and new wheels, surely then it’s not impossible to turn things around?  Or am I, amidst all this delusional standstill of time, and discomfort, being too much of a wishful thinker?  At least for now though, I will, for the sake of our NHS, strive to remain hopeful, optimistic, and the last bit of trusting, that I at least will be fixed back to baseline, so I can return back to the wards in scrubs and my stethoscope soon.  The girl to the right of the photo will be the person I forever manifest, even in these testing times.  For that, I am not ready to give up just yet.  Regardless, I will always be grateful.  

And so, one last offload to our blinded government?:  Open your eyes to our words and deep cracks – please, don’t break us anymore…

I am one of the broken ones, in a broken NHS…

(NB:  Thank you to everyone who anonymously submitted their thoughts, opinions, and experiences on the current state of our NHS.  I was prompted to write this brutally honest blog post after my own unimaginable experience, being carelessly flung about in a system where I should’ve been able to access emergency medical care.  The fact that it had become so shambolic, was perhaps the wake-up call, as both a patient and as a medic, that our NHS really is in trouble.  The anonymous comments will be shared in the ‘Highlights’ section of my Instagram page: @alexandraelaineadams, for anybody who wants to read them.)