A Professional Opinion

Getting across a city at rush hour is never straightforward; especially when one is not familiar with said city. But with appropriate planning and preparation it need not be stressful surely? Unless of course the purpose behind the journey is less than straightforward. Loaded with expectation and no expectation as the travelling companions seek a second opinion on a rather significant matter. Significant to the passenger and the driver not to the person they will be seeking the professional insight from.

The day started later than was possibly ideal but things need to be attended to when one is planning to be away for several days. The self employed person is never really off duty; the expansion of technology frankly gives ones clients unrealistic expectations unless one is quite firm! Preparations complete one points the car in the general direction of one’s destination fully expecting to arrive in approximately four hours with little recollection of the bits in between! Motorway driving has a mind numbing effect – heavens they all look the same give or take a lane or two.

Of course the one bit of preparation that would have assisted was checking the traffic news specifically the roadworks on the M42 around Birmingham! Parked on said motorway for 45 minutes provided the time to check out the usefulness of Twitter; yes funnily enough one wasn’t the only one caught unawares! Was it reassuring to know that other drivers had taken an hour to drive a distance normally traversed in 10 minutes? No it wasn’t!

Arriving at ones destination the road is being resurfaced but the work men have been warned of one’s arrival and helpfully allow one to drive on the unmade surface. Grumpily one thought of the £500 recently spent on new tyres and hoped the damage would be minimal (it was). We grew up on an unadopted road; public guardian-less the care falls to the properties that abut the lane. In this case the 8 residents plus the penniless parish church; accordingly this maintenance has been part of a collective agreement. Thank heavens for the firm hand of the law to administer the contract; one resident, an employee of the local constabulary, did the deal and collected the cheques.

Following a quick coffee we get on the road allowing an hour for a 20 minute journey armed with an A-Z and instructions from the RAC routefinder.  Neither proves to be foolproof with the high spot being the directions from the private hospital we are going to dispensing with conventional measures of distance – just how far is ‘two minutes’? The passenger and the driver have different approaches to resolving the challenge facing them; the driver is distrustful of random pedestrians never dreaming of asking for directions! In ones defence the 3 young men available for a quick consultation resembled members of the Artic Monkeys (not unreasonable an assumption as we are in the band members home city)!

Still we arrive in plenty of time for the 6pm appointment with let’s call him Dr England (to distinguish him from Dr Wales (of whom more later). Temporary relief is provided by a cute toddler in a pushchair who joins us in the lift. Small persons are intrigued by black crutches for some reason; cute toddler looks from the sticks, to the person holding the sticks and to his father enquiringly as if an answer to an unformed question will be forthcoming. Bless him he doesn’t have the words – possibly because he doesn’t look old enough to actually having mastered the power of speech yet! What one wonders is the world like at his age? Is one in a constant state of bemusement?

Given this is a private appointment there is only one piece of information required by the receptionist; ones credit card. Directed to chairs in a long corridor we assume the patient waiting pose. The patients clutch clipboards complete with poorly designed forms. Quite how some of the information is relevant defies one. Somehow ones expectations of the ‘private’ sector are higher with such things being disproportionately irritating. Consequently one is not exactly relaxed when at precisely 1755 a suited gentleman with a black rucksack rushes passed.

One has noticed this changeover behaviour of consultants switching from day time NHS to evening private appointments. The rucksack seems to be the bag of choice replacing a briefcase one would once have expected. Dr England calls our name and the Spinster heaves herself into an upright position careful to pause to balance before moving gracefully towards the consultation room. Speed in this case is of the essence for quite the opposite reason; rubber tipped crutches have a tendency to stick to carpets of a corporate nature with an increased risk of taking a tumble should ones concentration slip! Appearance is everything as the ‘disabled’ tend to attract attention especially in one so young (ha ha).

Handing over the referral letter brought from the GP Dr England opens the fat envelope proceeding to scan and read it out loud at the same time. He asks me to clarify the train of events, to fill in the gaps and make sense of the random information presented to him. Unfortunately (said with irony) the GP (or the practice administration) have only attached correspondence up to 2007. The purpose of the appointment is to seek a second opinion on the current assessment i.e. the diagnosis in the 2012 correspondence which is missing. This omission will be pointed out in due course.

After tapping, pricking, poking and prodding me Dr England asks a series of baffling questions – it’s not the questions rather the way in which he asks them.  Reaching a point where he has sufficient information Dr England asks why we have come as – brace yourself this is the key phrase – ‘Dr Wales is a very good neurologist’.  Ah they know each other; they are professionally acquainted and at that point it becomes clear there will be no second opinion. Dr England notes the need to be careful, cautious as to how the matter is handled. I make it easy for him by agreeing Dr England should write to the GP with his observations; the treatments he would consider if I was his patient.

As a patient one is told one has a right to a second opinion; to choose where one is to be treated and given the impression the patient is supreme. Nothing could be further from the truth. Putting professional sensibilities on one side the health authority/body where the patient resides is the one that has to agree to pay for the treatment. Simple it is not. Of course it would be preferable to be treated in Wales but if the local gatekeepers decline to open the gate no amount of private WD-40 will oil the wheels sufficiently to release the resources the patient may (or may not) require.

We leave none the wiser; well that’s not quite true as Dr England seems (given the limited information presented to him) that one could benefit from one of three courses of treatment available. But unless Dr Wales is of the same opinion frankly this is meaningless. So on receipt of the letter from Dr England to the GP I will arrange to have a discrete conversation about how to proceed when I see Dr Wales in November. Already based on the same information (and seeing me at the clinic) there is no sense of urgency; unless the definition of urgency is one particular to the professionals responsible for one’s ‘care’.

The regular cancelling and rearranging of appointments coupled with the inability to attend appointment because parking is not available no longer surprises me. It’s wearing and tedious but this is the way it is. Are things worse in Wales than in England? I genuinely don’t know. But I confess the professional reluctance to question a colleague quite so openly did surprise me; it leaves one feeling powerless as if the system will always correct itself, seldom (if ever) in the patient’s favour.

The problem is once one has done it; raised the question; consulted someone else the proverbial cat is out of the bag prowling around unbidable. Caution is called for to avoid the land mine you have unwittingly unearthed blowing up in ones face. Cynically one hopes there isn’t a professional gathering bringing Dr England and Dr Wales together before one has put ones duck in order. Like finding out ones partner is playing away, one tiptoes around the ‘issue’ finding ways to draw out the poison without being further poisoned oneself. In both cases a relaxing evening oiled by alcohol runs the risk of loosening one’s tongue with conversation drifting from one thing to another….

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