What a retired doctor thinks of the health system under pressure

Dear Sir,

I am a retired doctor (GP and Palliative care).

I went to the Casualty Department in the South West Acute Hospital (SWAH) on Monday last – not a lightly taken decision.

I felt poorly for about three weeks. I have a good GP who did as much as he could but could not access a test for me, which had to come via a hospital doctor.

Over the weekend I felt worse – I felt afraid, if I am honest. After speaking with my GP to discuss my options, I concluded that I had no option but to go to Casualty.

I am a carer, so had to make provisions. I packed an overnight bag and left home. It was emotional.

I went to the Casualty reception and told my story. I said I was breathless and felt poorly; the kind woman asked me to expand on “poorly”, and I couldn’t. The receptionist gave me a wristband, and as I made my way into the body of the waiting area, a woman, herself awaiting attention, leapt up and offered to put the band on my wrist. I am moved when I think about it.

I was triaged by a capable nurse and went back to the waiting area. I had blood tests by a medical student. And back to the waiting area; then the long sit, and the long observation.

I eventually discerned those of us awaiting a doctor’s attention, including elderly people in wheelchairs with their adult children. I have sat with my late mother in the Casualty department of my old teaching hospital in Dublin, awaiting attention – an experience I won’t forget.

I met some lovely people. People in challenging life situations who asked if they could get me a drink.

In my mind, I felt that if I wasn’t seen by 6.30pm, I would have to leave and return to my husband. Naively I thought that I would be seen, and the test organised that my GP could not arrange. But I knew at 5pm that that door had closed!

At 6.30pm, my name was called, and I headed into the body of the Casualty department. It was full; calm, industrious, but full.

People lined up in wheelchairs awaiting who knows what – a bed in the hospital, a transfer to another hospital, a transfer home.

Even thinking about it now startles me. The place was full. And there were two other waiting areas.

The capable, alert and kind doctor listened and examined me, and the nurse attended to me. The doctor confirmed what I thought, which was a relief in itself, and said I did not merit admission – another relief.

Some tests were done, and I was discharged home. I passed one of my patients, aged 90 – we recognised each other, and had a wee exchange.

What are my impressions?

When we move over to the community of the sick, we are relying on the kindness of other people.

There is something special in the people I have met in Fermanagh and Tyrone. A decency and a compassion.

I’ve heard an expression used here:

“Keep your lamp lit!” I think the community of Tyrone and Fermanagh have their lamps lit.

Advocacy on behalf of the sick and the vulnerable is something those who are well and strong have to do.

There is undoubtedly problems of capacity and access. I understand that GPS are overwhelmed. This is not recent or new. Put a value on nurses, doctors, carers, domestics, porters. I feel obliged to write this.

Yours faithfully,

Dr. Rachel Long, retired GP and Palliative Care doctor,

Enniskillen.