Stroke Ward

NHS WardThese people were young once. They had homes, jobs, families, arguments, dates on Friday nights and sleepy Saturdays that followed. They combed their hair that was once a colour besides grey, they watched television, they drove too fast, they drank too much, they washed their cars and did the shopping. Time seemed to be on their side, but time is also cruel: body parts wear out, the eyes dim, the lungs don’t suck in air as readily as they once did, and blood vessels harden. If one is unlucky, then parts of the brain will be attacked by a shadow enemy, leaving a patch of the mind shrouded in darkness either from a rush of blood or a lack of it. That which makes us human: our thoughts, our dreams, our perceptions are all under assault from a stroke. The wreckage washes up onto the Stroke Ward, where nurses, doctors, support staff and therapists are all lost in lightly masked perplexity as they try to reassemble the pieces.

The stroke ward I’ve been visiting is not in a particularly attractive hospital. An acquaintance of mine wanted a black marker to write under he plaque commemorating its opening by the Queen Mother that it hadn’t been updated since. The furniture is rough and ready, covered in cheap light brown veneer, and the apparatuses around the beds seem dated. A plastic container with a tube of unknown purpose looks like it has been hanging there since the 1950’s. The curtains around the beds belong in the windows of a Seventies bungalow. The paint on the walls is in that territory between cream and faded yellow, and the green linoleum floors have a gloss that has been acquired from many years of polishing and re-polishing. One rare nod to modernity is a combination phone and television for which one has to pay in order to watch anything, despite most of the patients having paid both taxes and license fees for most of their lives. Never mind: the LCD screen of the mini-televisions flicker annoyingly, so no one uses them. There is a vague scent of rubbing alcohol and bland hospital meals in the air.

As the evening comes in, the visitors begin to flow out, and there is merely the beep of a the occasional heart monitor which suggests all is well. The patients themselves are mostly silent, in some cases curled up in the foetal position. They were young once, and to the original position in which they entered life, they return.

Patients don’t often speak to each other. However, I saw one woman wearing thick glasses and dressed in a magenta top turn to another who seemed impossibly frail with deep set blue eyes and bony limbs and say reassuringly, “you’re getting better, darling”. They then talked about sleep: sleep and rest are the great healers in the Stroke Ward. Yet if a patient was to be hit by a stroke right then, it’s not at all clear that a doctor’s healing hand could stop it. Perhaps he or she could limit the damage, but no doubt harm would be done.

At the end of visiting hours, a matron shouts out “Time please!” as if she was taking last orders at a bar. She’s not the head matron: a poster on the wall indicates what the various uniforms mean. A head matron wears a blouse of black with orange piping; nurses wear dark blue, assistants wear brighter shades. The matron in this case is stuck on indigo.

“Time please!” she shouts again when visitors fail to leave. An older man in a white shirt and dark trousers kisses his wife goodbye and folds his gnarled hand tenderly around hers, their grandchildren dressed in jeans shorts and florescent tank tops depart. She looks longingly after them as they leave. The shadows lengthen, the golden sunlight which has been streaming through the window turns orange, and then starts to fade. A few patients are already asleep. Sleep and rest, yes. Perhaps lost abilities, like being able to stand or open an eyelid, will be within the gift of Morpheus. If not, the physiotherapist will return in the morning to challenge them to grasp the Zimmer frame and hobble slowly down the old green linoleum lined hall towards the nurses station surrounded by trays full of black binders full of patient cases. Old muscles will try to respond to the brain’s commands and desires: they were young once, surely enough of that spark remains to resume their lives for however long they have left.

As the nurses and staff continue to busy themselves, it’s clear there are Eastern European, Filipino and London accents all removed far from home. A nurse with a strong Polish accent visits patients one by one and calls each of them “My darling”. She asks if they are comfortable. Pillows are adjusted. Then the day shift changes in a locker room back into their civvies after handing over to their nighttime counterparts. A junior doctor looks like she hasn’t slept in 48 hours, her eyes are filled with weariness as well as compassion: whatever makeup she wore at the start of her shift has faded away, slight and honest blemishes are apparent, a thin layer of hair covers her upper lip, the stethoscope remains tied around her neck like a talisman yet it also looks as if it’s ready to strangle her. But her evident fatigue doesn’t matter: she downs a coffee and continues to grapple with the shadow enemy, the disease which can hit the memory, the reflexes, the balance, the face. But in the end all she or the nurses can do is wait, administer medicine and painkillers, write reports, and keep a steady watch.

In the day room there are stacked up chairs in leaning towers and racks full of pamphlets from the Stroke Association for both patients and carers, trying to wrap up trauma in a package of reassurance. There are too many posters hanging in the day room which read “If it matters to you, it matters to us”. This contrasts with the hard edge in the voices of some of the staff. The razor of frustration cuts through the veneer of service: sometimes there are just too many questions, too many demands, too many doctors whose natural urge is to pass out in a chair in a day room and recall what it was like to be a vibrant undergraduate who could go out to the pub on occasion and becoming a doctor seemed to be a prospect without downsides.  “Time please!” may be just as much a plea as well as a command.

Celebrity Masterchef is on the television but no one is watching the obscure luminaries make a mess of a prawn cocktail, not least by trying to fry shellfish in vinegar rather than oil; rather, a black wheelchair with one female patient is set facing the window. She is dressed in pale nightgown, has white hair and is perched up on her elbows on the arms of the wheelchair. Perhaps her positioning in the room is thoughtless: all one can see from her vantage point is another wing of the hospital which is clad in brown plaster. Perhaps it was merely so the patient could feel the remaining rays of the sun on her face, presumably a joy for someone who is mainly confined within the rabbit warren of the ward.

One by one the last wakeful patients get ready to sleep, the final few stubborn visitors depart after saying “I love you” once again, white cotton pyjamas are donned, eyes shut. To sleep, perchance to dream and to heal. Maybe tomorrow, maybe it will be time to liberate oneself for the strange tang of the hospital food, the stringent regulations of visiting hours, the indignity of needing help to go to the bathroom. Perhaps one can go home to family and friends and a familiar bed and no longer have one’s nose pressed up against the facts that they’re no longer young and all that they were has just been under threat. In dreams, maybe they are still young, driving a polished blue Morris Minor down a country road which passes by Whitehaven and its dramatically inclined view of the sea, and picnics are consumed in green meadows as the summer sun comes streaming down. Maybe tomorrow, the distance between dreams of the past and the living now will be less.

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