I had not anticipated posting anything here until after my appointment at UCLH next wednesday, but, as ever, events have prompted me to come back and bore you all to tears again......................
The minor and slightly laughable bit is that I have now received a total of 3 letters inviting me to the clinic next week. 2 offer the same appointment time, the third offers a time when the clinic is not actually running! A quick telephone call cleared this one up, but more resource needlessly wasted (both their and mine). This was entertaining, but not really worthy of note.
The real reason for this post is the telephone call that I received this evening.............
A junior doctor had evidently been detailed to call me following the multi-disciplinary team meeting at which my MRI scan and biopsy results were discussed. I feel a bit sorry for him as he was obviously given the "crap" job. It did not help that his accent was extremely heavy and his ability to understand me was probably compromised by the differences in accent. The upshot was that they had decided that focused therapy was not appropriate for me; would I like them to refer me back to Medway for surgery or radiotherapy? After a couple of minutes, it became patently obvious that discussing this over the telephone was a) not appropriate and b) was, as the americans put it, way beyond his pay grade. I patiently explained that neither was an option that I would seriously consider so no thanks, I would discuss this at next week's appointment. I don't think that this was the answer that I was expected to give. Poor chap, it wasn't his fault that he was given the difficult person.
If I accept the statement from the junior doctor that focused therapy is not for me, that seems to leave two choices, neither of which is acceptable to me: submit to one of the old fashioned treatments with their attendant high risk of long term disability, or let nature take its course. It was whilst pondering this one (and coming down on the side of nature rather than intervention) that a thought struck me:
The NHS is geared to specialists taking on whole conditions and doing whatever their particular branch of the specialty is to effect a "cure". What they are not good at is applying their skills in combination with other specialists and sharing the treatment between them. If focused therapy can get rid of most of the problem, but not all of it, then it seems quite logical to me for them to deal with whatever they can and leave the rest. I can then consider using one of the older, cruder, methods to deal with whatever is left and minimise the potential collateral damage.
The above approach may be a step too far for the NHS as there is little incentive for them to do anything that does not fit into their strict protocols, or requires imagination, so the second issue is one of incentive. Now call me cynical, but the one thing that I have found to unite 98% of consultants (Bob and Alastair excepted) is money........lots and lots of money........so adequate treatment might require a foray into the world of private medicine. A pity, given that the NHS has the skills, but if it is unwilling to deliver treatment that people want, there is no real option. A real cynic might say that bits of it are geared to sending people down that route, after all most NHS consultants also have a private practice..................
A song? This very short theme tune sort of sums up the NHS:
https://www.youtube.com/watch?v=F9S7yhD5M9A
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