Monday, June 24, 2024
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Old before my time – our man on the NHS front line


WHAT’S going to happen to us when we get old? I’m starting to get glimpses of what it feels like now, thanks to recent bouts of cancer, chronic wounds and compression bandaging.

For three months I had inappropriately brutal dressings for a wrongly diagnosed condition, which felt like someone was pressing a thumb into my open wound for 24 hours a day! It hurt so much that no volume or combination of drugs could numb the pain. (You can see a picture here. Warning: it’s not pretty.)

In sheer desperation, I stopped listening to Dr Slow-Titration from my GP practice and guzzled anything and everything in any combination, from opioids to ‘best avoids’.

What Dr Take-It-Slow didn’t appreciate was that when you’ve had no sleep for days, and nothing touches the sides of your neuropathic torture, you don’t have time to start with one molecule of Gabapentin and slowly work up. You want as many analgesics numbing your neurons as possible without killing you. Sleep deprivation is a killer too.

In desperation you’ll swallow every mood changer available – paracetamol, Tramadol and – oh, Phukitol! – several cans of Kronenbourg.

With your legs encased and feet bound, medieval torture-style, in ‘stump bandaging’, you can barely put a foot on the ground without wincing. So you’ll need a zimmer frame.

Constant pain, fragility and complete powerlessness – this is what Old feels like. Every bus journey is now a potential bone-breaking hazard. On boarding it’s vital that you get to your seat before the bus starts lurching. You have three seconds before the first surge pulls you forward and four seconds before the driver stamps on the brakes. The doddery get tossed around like kittens in a tumble dryer.

If you’ve visited an old people’s home you may think you have some empathy, but you have no idea how demoralising powerlessness feels until it happens to you. I sort of understood why many older people give up on eating. It’s not just the quality of the food or the fact their choices are often ignored. Staff misinterpret their cautious consumption and whip their food away when it’s only half eaten. It’s an easy mistake to make for a young person: my dad could take five minutes to move a floret of cauliflower on to his fork and raise it to his mouth. Only for it to tumble off at the crucial moment. Mind you, the vegetables I had went nowhere as they’d been boiled into oblivion.

If you put your fork down in exasperation, a ‘helper’ will materialise and in haste to clear all the plates up before the end of their shift cease your nutrition for the day. ‘All finished,’ they’ll say, without waiting for an answer.

But the real hell of being in medical care is not the carers, doctors or nurses, it’s the other patients, as I have written before. You look around at all the other sad cases, with tubes coming out of their noses, skinny legs sticking out under their gowns and more tubes draining their vital organs. Thank God I’m not that bad, you think. But they are looking at you and thinking exactly the same thing.

The best you can hope for is a friendly neighbour with good social skills. In my experience, they all love to talk but few actually listen. (Much like work, really. But at least when some boring freelance technology hack has got you by the Vol au Vents, you can escape. There is no mobility here.) Pretty soon you will have heard your neighbour’s entire repertoire of anecdotes. That won’t stop them telling you again.

That is when you feel really lonely. The impotence of not being able to control your environment is bad enough. If you are stuck in a hospital bed your curtains are constantly swished without your consent because someone in charge wants ‘complete visibility’ on the ward. You DO have a pot to pee in – but you can’t guarantee doing it in private.

You aren’t any less powerless if you find a chair to perspire in. You have no power to open the window and the wards are always over-heated. Which is why the staff can never bear to be there too long.

There is no point watching the telly. It’s odd that old people are the main TV audience, yet everything seems to be aimed at millennials, who never look at a glowing screen any bigger than their hand. The point of all the modern game shows on TV is to keep Richard Osman in employment. 

With nothing entertaining on TV the only chance of escape is a fascinating conversation. That’s not going to happen.

Is there any hope for baby boomers when we hit the skids?

Technology could save us from despair, says my artificial intelligence advisor Chetan Dube, founder of IP Soft. He says Chatbots will soon be as emotionally intelligent and empathetic as humans, and he has been advising the House of Commons on the future of AI in education.

I have two concerns. Firstly, I’m worried because politicians believe everything they are told about technology (I’ve seen it happen time and again in the last 20 years).

Secondly, the gap between man and machine has closed – but only because machines have made humans dumber. Somehow machines made us dependent on them. If the computer goes down, business comes to an end. Nobody has a contingency plan for using their brain.

That oblong screen sucks out your intelligence and turns you into a networked, approval junkie incapable of independent thought. As a result, a whole generation of young people have stopped thinking for themselves, sleepwalked into GroupThink and started to believe what creepy brand managers tell them.

Is Dube likely to pull the wool over our leaders’ eyes? That’s a discussion for another time. By 2025 he promises, Amelia (IP Soft’s chatbot) may be empathetic enough to hold a conversation with me. At least she will remember whether I’m a diabetic or not, which makes a massive difference to the amount of pain you must endure when having a wound dressed. Diabetics’ wounds often create no pain, but on the other extreme, we non-diabetics with Pyoderma Gangrenosum have nerve endings with heightened sensitivity. So when a nurse scrapes your raw flesh with a gauze, she assumes you won’t feel anything. But you will scream and hit the ceiling, then writhe in agony for the rest of the day.

Can Dube and AI liberate nurses from their endless admin? Will doctors and nurses be more aware of the correct condition of each patient? Will Amelia, my digital chat doc, save me from dying of loneliness? These are points I intend to put to Mr Dube.

Meanwhile, at the age of 59, I know what it’s like to be old. Good grief, I’ve got to get healthy again!

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Nick Booth
Nick Booth
Nick Booth is a freelance writer.

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