Tuesday, 20 April 2021

Serious questions must be asked for sake of patients

UNTIL last year I would have dismissed this thesis as far-fetched. However, I am writing this in a hospital car park while Ann and Sally (not their real names) are visiting an elderly and vulnerable relative. We shall call him John.

John was admitted to the hospital in December for tests concerning an age-related condition. A few days later, all visiting was stopped without warning.

It has been eight weeks. Information has been hard to come by. John was moved to another hospital, then moved back again a few days later.

In January we discovered that John had tested positive for covid-19. He is poorly, they said, but claimed it was a mild strain. John was put on oxygen and seemed to be getting better. But last week the family were called — the doctor would like to speak to you in person.

So Sally, John’s wife, who has been beside herself alone at home, will only this morning see her partner of more than 40 years.

Still the questions come: how can someone visit in lockdown? Is it bad news? There is the feeling of being trapped in some hideous machine, which consumes you even as you are swept along by it.

Overall, the well-meaning system has removed any control from John, Ann or Sally. There is just a sense of powerlessness and frustration.

Please do not think I am picking on the NHS. Think of the appalling patronisation many tens of thousands of families have endured from the social and for-profit care home sector during the pandemic, while their parents, grandparents and other loved ones have been totally incarcerated, imprisoned “for their own safety”.

Visits denied and all parties without a voice or a choice. They have not hugged their loved one for a year. It is like a living bereavement, a relational torture chamber. Somehow, saying “I love you” on Zoom or through see-through screens just doesn’t cut it. There is no intimacy. The difficulty is that no agency or business can really care for any relation with the same knowledge (back story) as a member of a family. There is no history, no memory, just the blunt physicality of needs which increase with age.

No one should have to die in an institution. It smacks of the unwantedness of the workhouse, it drifts too carelessly towards the convenience of state sanctioned euthanasia.

There is the long shadow of the well-meaning doctors of the Third Reich who happily did their duty signing off the “useless mouths” of the handicapped and the frail.

Haven’t we learned anything in the years in between? Yes! We have learned to worship the bottom line, which means it is more important for some business models to keep families apart and to trample on love and compassion. This is brutal; an exercise of raw power of which Nietzsche would have been proud.

People who need help are perhaps already weak and vulnerable. But why should it be that “to be cared for” means that they must be even further disempowered?

If care really is the exercise of power, it behoves us to be vigilant because we know that power corrupts and absolute power corrupts absolutely.

In these days, when we fall over ourselves to produce safeguarding policies, and to ensure that no individual can work with anyone, young or old, without all the proper training and accreditation, we need, I believe, to ask more serious questions of the deeper cultures in the caring institutions and businesses themselves, cultures (“powers”) that are far larger than the many thousands of kind and long-suffering employees that work for them. Here, there be monsters.

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