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What being in a coma told me about the NHS

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‘Unless I see the nail marks in his hands and put my finger where the nails were and put my hand into his side I will not believe.’ John 20:25

THE most interesting part of my recent enforced eight-week ‘sabbatical’ in a leading hospital in the South West was the coma bit which distracted me for the first few days.

I don’t mean ‘interesting’ by contrast with the seven weeks of recovery which followed, although it was certainly that. What I am suggesting is that the experiences I had while hooked up to machines (which, without really consulting me, were effectively announcing that I was dead) were very real to the ‘me’ that was busy ignoring the diagnosis of the machinery by continuing to survive.

These experiences were not dream-like, being less ephemeral and more structured than that. They were more like quirky, rich stories with structure and an internal consistency. They seemed to be extended over time, and were populated by characters some of whom, it later turned out, had taken the names of medical staff attending to me – people I have still not (consciously) met. They were not ‘near-death’ experiences, although they were experiences which took place when I was close to death.

It had never occurred to me before that you could experience that level of deep unconsciousness. It seems to involve a contradiction. How can you experience the unconscious? The very possibility invites questions of deep religious, ethical, metaphysical and political significance, which ultimately will depend on the answer to this question: what counts as a proper understanding of the relationship between brain and consciousness – between body and soul?

 I’m going to suggest where I think we tend to go wrong when we think about our bodies, and I’ll use my hospital experience as a basis for these speculations. Any argument I make will be shaped by a Christian world-view, I hope.

An extended period of hospitalisation subjects the patient to a twofold exercise in reductionism: the soul (or if you prefer ‘the human person’) is assumed to be identical with the human body which in turn is taken to be reducible to some set of numbers (blood pressure readings, blood-sugar ratios, oxygen saturation figures etc). How does this affect the patient? Either physically or mentally (or even – whisper it softly – spiritually).

High dependency care is structured such that no person exposed to it is allowed the impertinence of sleep (not a trivial thing) and to this quasi-sadistic end is deployed the ‘observation round’: a never-ceasing carousel of minor but irritating physical invasions seemingly designed to confiscate from the patient any residual belief that he or she is more than a collection of numbers entered into a file. The absurdity of this constant intrusion came to remind me of that Escher etching in which tiny figures are constantly climbing a staircase merely and inevitably to arrive where they started.

I’m probably sounding churlish. You may think that I should be grateful the hospital saved my life, and should acknowledge that my recovery was enabled by the medical team which watched over me according to their treatment protocols. And that’s all well taken. But I attribute my survival more to the intercessory prayers of my 14-year-old son than to the crash team who, I later learned, were all too willing to write me off. And while I am grateful to the professionals who tended to me, I reserve the right (which I will now exercise) to argue that, intended kindness aside, NHS treatment is often founded upon a deep metaphysical confusion regarding what we are as human persons.

A common misconception is that we Christians take the soul to be in some way housed within the body like a ‘ghost within a machine’, and that bodily death releases the soul and allows its subsequent flight towards God, Heaven and the Saints. This is incorrect both scripturally and theologically. Christian theology {following Aquinas) argues that the relationship between body and soul is one of subtle interdependence. The former does not so much house the latter as commingle with it.

Thus, in scripture we see a sort of appropriate valorisation of the human body: it is bodily resurrection that is the promise of Christian salvation. Thomas wishes to inspect the physical wounds of the risen Christ to be certain that he is in the presence of a transformed, resurrected body and not merely a ghost.

My ‘coma episode’ convinced me that the calibration between body and consciousness is so finely tuned that trauma which affects the former – through illness and, possibly, the attachment of those machines which lied that I was dead – can ground significant, other-worldly alterations in the latter. And my recovery journey persuaded me that NHS treatment protocols wrongly conceive of the human body as being no more than a biological organism fully describable in the language of numbers.

But the meaning of a human life is not to be found in a set of numbers which track the life of a biological organism any more than the meaning of Shakespeare’s 20th sonnet lies in the fact that it is 154 words in length. This is why long-term hospitalisation has a spiritually deleterious effect on the patient: because it involves a constant encouragement that he surrenders to the relentless quantification of his spiritual core.

This matters in the context of the NHS because it has become, as an institution, the most effective ‘influencer’ in the UK. And if it is, as I contend, carrying out its mission guided by a fundamental misconception of what we are – spiritual as well as biological parts of the natural order – it will occasionally go very wrong. We saw this in the shameful Archie Battersbee episode in which the religious views of Archie’s parents were discounted, and God was expelled from the treatment room.

The NHS in its present iteration is morally unsustainable. Yes, it is capable of outstanding works of care. But it also acts as a factory of submission, in which those being cared for are encouraged to surrender to a Godless orthodoxy which pays mere lip service to patient autonomy.

Take that from one who knows.

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Sean Walsh
Sean Walsh
Sean Walsh is a writer.

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