The Runton Diaries

Rock Climbing With The School Bully, Part I

Nov 7th, 2022

Public Service Announcement: We’ve just changed our WordPress subscription, so if this looks terrible, I can only apologise.

Is bullying all bad though? It’s a question worth asking. For example, a colleague of mine goes rock climbing with another colleague who used to bully him at school, which is both heart-warming and bleak. Well, this isn’t entirely true, as it’s actually a climbing wall, not larking about on a cliff or whatever. When I was told the news, I said ‘That mate, is not only bleak, it’s Dave Dee, Dozy, Bleaky, Mick and Tich’ surprising myself that a lesser known Sixties pop group was the conduit for my enthralled incredulity. They were from Devon I think, and did a not-unlikeable tune called Bend It, which I should like to re-record as Balls To It for a larf. Anyway. The reference went viral among the three other people in the room – appropriately, now I come to think of it, as it was a room in the pathogen lab – and led to a lengthy pile-on from all corners consisting of being up the bleak without a paddle, an insistence that bleak is the word a la the popular disco film Bleak starring John Travolta, and culminating in a warning to not eat too much chicken and bleak pie in case you get bu-leakmia. Nonetheless, childhood misery (in what we may safely assume was a secondary school) is the Highball Centre on Twickenham Road’s gain, so that’s the main thing.

Before we go any further, I should like to point out that my focus upon endemic bullying within the NHS is merely as a starting point for a new trade union. Working in a hospital is certainly awful, but it would be wrong to suggest that every corner of the National Health Service is a well-spring of human misery. In fact, my part – Radiology – functions more like a clinic than a hospital, and has a relatively sedate atmosphere. The first time I assisted with a trans-vaginal biopsy illustrates this: I attached the ECG cables wrongly and had to fiddle about sorting it all out, causing a delay. This can not only stress the patient, but shortens the time anaesthetic will be effective. Instead of being a dick about it, the consultant said to the patient ‘It’s OK – Paul’s used to working on bigger cases in our main theatres’, de-escalating the situation nicely. I greatly appreciated this and thanked him afterwards. Similarly, when an early patient-fetching expedition saw me crash into almost literally everything in the entire hospital, my colleagues explained that the bed was faulty and reported it to Maintenance, who sent a little man to take it away, covering up the fact that I was drunk.

Anyway. This was to have been a much longer post. I am turning it into a two-parter, though, as I have to pop round and see my old dear, who just rang to inform me that she has been buying gardening stuff. I hate the outdoors, and have insisted that I am only going round on the understanding that I am not helping in any way whatsoever with any actual gardening. To her credit, she has adjusted well to life in Norfolk and enjoys growing joyless vegetables such as courgettes on her allotment. However, she recently admitted to me that she ‘has always been in awe of strimmers’, and I am keen to see how a person in awe of strimmers reacts when they actually buy one.

Photards:

Main: A theatre trolley being prepared for, by the look of things, a standard drainage procedure.

Top: A staircase of my acquaintance, East Block, Norwich and Norfolk University Hospital.

Lower: As the UK’s only baseball fan, I took annual leave to watch the World Series, and when I came back my LA Dodgers mug was broken. I am treating it as a Hate Crime.
The Secret Trade Unionist

Oct 27th, 2022

Public Service Announcement: I should like to point out that I do not wear a nylon uniform at work. I wear scrubs and, like everyone else, I mainly use them to write confidential patient information on when in theatre.

The first time I floated the idea of a trade union for non-clinical NHS cannon fodder to a nurse she laughed a Cadbury’s Hero into her face mask, which then rebounded into her lungs and caused her to cough and laugh for about six minutes. I chose her as confidante because she once told me about an affair she’s been having in her head for the last fourteen months with one of the doctors and, while involuntarily choking with laughter on a Cadbury’s Hero was not the most encouraging response, it was at least honest. That said, unless you have very specific carnal requirements, I can think of few situations less sexy than working in a hospital, which is disappointing considering that all my prior medical experience came from watching Carry On Doctor. Actually, now I come to think of it, two junior staff were openly flirting with each other while my current girlfriend was giving birth to my son. This was a heart-warming triumph of youthful romance, what with everything else that was going on at the time. I wonder if it was a Tinder date. Anyway, I didn’t feel terribly romantic myself, but that was because it was four in the morning, I was very tired, and I fancied a Kit Kat.

Attempting to discuss the issues that might cause a new union to come into existence, I mentioned to my nurse friend the bullying for which our hospital is widely celebrated. She replied that the NHS ‘always been like that’ and if ‘people don’t like it, they can leave’, rounding off with ‘it’s always the same sort of people who complain’. I pointed out that yes, it would be people being bullied who would tend to complain about bullying, to which she shrugged. This is, incidentally, an apparently perfectly nice nurse who does yoga and says ‘Namaste’ a lot, and further justifies why I insist that my son never trusts a hippy.

Her comments have been far from uncommon in my covert reconnaissance, along with stuff about the NHS employing the ‘…wrong sort of people’ and that nothing can be done because ‘…society is broken’. Still, as well as speaking with nurses, another part of my groundwork has been speaking to the various Wellbeing Leads to gauge their opinion on this bullying issue and as, somewhat remarkably, she is also the Wellbeing Lead for my part of the hospital, it saved me a bit of time. I probably spent this stealing birthday cake from one of the wards while pondering how much faith you would have in our Domestic Abuse Champion if they said you were getting battered at home because you were the wrong sort of partner.

There’s a few things to point out, though. For a start, the attitude to bullying in the NHS is more of a resigned acceptance than a concerted effort, because all it takes for evil to triumph is for good people to do nothing, and so on. I’m not sure that, given the chance, NHS staff are any more likely to bully people than bus drivers or bricklayers or biochemists, it’s just that the NHS provides the perfect environment for bullying to take place. Also, pecking orders exist. They just do, and aren’t necessarily a bad thing as they can work for everyone. In the NHS, the pecking order is more toxic the further you are down it, because it is built upon bullying, and this is why those of us at the bottom need to unionise.

Then again, I do come across occasional prospective union members who put forth sentiments to the effect that when they look after patients they feel important, so they don’t mind being regarded as an idiot in a nylon uniform by more senior staff. I don’t really know where to begin with Uncle Tom nonsense like this. I usually start to explain that while it’s nice to be important to patients, it would also be nice to be important to our employers, but then give up because I find this kind of Escher drawing of a conversation makes me angry and depressed, like tapas and Sudoku, and I don’t want to have to speak to a Wellness Lead about it afterwards.

According to a study published by the British Medical Journal in 2018, the annual cost of bullying to the NHS is £2.28bn. This money would employ 91,000 nurses every year. Before long, we would all be nurses, and no one would ever be ill again. Even if this figure had since halved, the NHS that people are so proud of would still be, in terms of an employer, a national disgrace. In 2019, 20.6% of staff witnessed bullying behaviour, with only 48.9% of these bothering to report it. As my son will doubtless testify, I am no hippy. I will never go to San Francisco, or wear trousers in my hair. I am a capitalist, and we are the only people who can save the NHS, because we understand that stopping people being dicks saves an awful lot of money. To the barricades, everyone!

Picters:

Main: My dog surveying the landscape for things to chase.

Inset top: Just fuck off.

Inset middle: It’s not all bad though. Look at these prime cuts from the Pheno One Be Lit! playlist! You could well be enjoying this if you have surgery in our unit, which makes a failing vascular system worthwhile in many ways. Note especially Runaway Boys by rockabilly mentalists the Stray Cats, from a time when leaving home to be a rent boy in, presumably, Piccadilly Circus was a perfectly reasonable career choice if you weren’t predicted decent GCSE grades. I will always prefer pop to rock and roll because it is better, but the radiographer who suggested this has indeed picked a banger.

Inset lower: No surprise to see Groove Is In The Heart in the mix. My son usually claims this as his favourite tune, along with You Really Got Me by the Kinks and the Beatles’ All You Need Is Love. However, the first tune he liked was the Rolling Stones’ cover of Around and Around by Chuck Berry. I had to mention this one nursery school parents’ evening, because in his little year book they had it down as Five Little Ducks Went Swimming One Day.
Some Cat’s Birthday, Somewhere

Oct 20th, 2022

Public Service Announcement: the hospital mission statement has recently changed.

A regular feature of my working day is stealing supplies from around the hospital. This is necessary, because a) our own stuff often don’t turn up and b) it is a larf. To this end, I encourage my fellow NHS cannon fodder to imagine that, instead of carting a patient about the place in a hospital bed, they are instead piloting a Viking longship in the ninth century, and the hospital is a monastery on the Isle of Iona. This initially drew a few blank stares but once I explained what the Isle of Iona is, and the significance of the Viking raids there, they embraced the idea with great enthusiasm and now return from jaunts to A & E or the ‘Big C’ cancer unit with drugs, nephrostomy bags and urine bottles, of which we never have enough. I have suggested we solve this with a grit tray along the centre of our ward like you would have if the patients were all cats but, thanks to the magic of stealing, these days are a thing of the past. As we enter the last weeks of 2022, my unit’s boast is that any mammal of any size can urinate in comfort. Actually, I think this should be the mission statement for the entire hospital, rather than the current one – ‘Our vision is to provide every patient with the care we want for those we love the most’ – which is just annoying.

My personal mission statement is that ‘It’s always some nurses’ cat’s birthday somewhere’ and I frequently remind my gallant team of this, as it means that cake is also up for grabs around the wards. It is usually found on the draining board of the small sink units outside the linen stores which are the impromptu staff room on most of them, along with the ‘I’m Not A People Person’ mugs – another strong contender for the hospital mission statement, now I come to think of it – and endless boxes of fucking Cadbury’s Heroes. This is unless you find yourself in paediatrics, which is all crisps for some reason. I’m not convinced that cholesterol is the evil substance it is made out to be, having read everything and spoken to everyone I can find about it during my current concerns about peripheral arterial disease, and am instead blaming refined sugar and processed foods. Sadly, I love these things very much, so am unable to share in the bounty of birthday cake theft. This is troubling, but now that being a wellness coach has replaced being a primary school teacher as career of choice for young middle class women, there are at least plenty of people to talk to about it.

Such is the plunder available that I have long thought it would be possible to survive at work by just eating cake and Cadbury’s Heroes. Imagine my surprise when I realised that some of the cannon fodder I am seeking to unionise actually do. I’m pretty sure they will be stealing biscuits and whatnot from stuff the patients get bought in by their families and so on, too. I’ve done that, if it’s those mad Christmas seashell chocolates or Ferrero Rochers or whatever although, being a gentleman highwayman, I tell the patient I am stealing stuff while doing it. Also, my motivation is gluttony rather than malnutrition, but I now know there are patients who have food brought in for no reason other than to feed staff. This is insanity. I know staff that order sandwiches and such for fictitious patients so they have something to eat, and that a blind eye is often turned to this, but patients actually feeding their carers is madness. Awful. It would be nice to be as proud of the NHS as people who don’t work in it are, but I’m afraid I am not.

Then again, this sort of thing is why unionising the cannon fodder might be a good idea. Also, I do have the germ of an idea about how to spark this into life, in the form of my personal development review. This is where you bang on about all the stuff you’ve done in the year and set goals and so on. I have spent most of the last year being appalled and horrified, so I don’t have much to say. I could set my goals for next year as being less appalled and horrified, I suppose, but might refuse to take part altogether on the grounds that I have no faith in the management of the NHS, which would lead to some interesting discussions when it gets escalated. My case in point would be the manager who actually writes my personal development review, who caused a member of staff to leave by repeatedly shouting at her, in anger, in front of colleagues, that the only reason she goes to football is because she is racist and homophobic. She was a Norwich fan, too, and they are a lovely bunch. She could’ve complained, but the person she would be complaining to is a close friend of the manager concerned – they go on holiday together and whatnot – so she understandably felt that this was pointless and now works in Pizza Express, where at least there is quite a lot of food about, I should think. Yes, I understand that it is tiniest conceivable spark, but that’s all you need really.

Anyway. The rest, as they say, is histology. In case you are unfamiliar, this is the clinical study of cellular structures and, come to think of it, would’ve been a more appropriate remark while justifying the theft of hospital supplies then going on about Vikings and the Isle of Iona. Hindsight is a wonderful thing.

Picters:

Main: A cannulation trolley of my acquaintance.

Top inset: The scrubbed floor of one of our operating theatres. You’d think that a flooring material that retains the slightest splash of iodine with the permanent appearance of a bloodstain would be seen as a design flaw, but it appears not.

Middle inset: The baffling and recently changed hospital mission statement.

Lower inset: Sid larking about in some woodland a couple of years ago.
Up North, Kicking Up Fuss

Oct 7th, 2022

Public Service Announcement: Since writing this post, the Royal College of Surgeons has ruled that Jungle is too mental for a clinical setting, although breakbeat hardcore is OK if it’s not too hectic.

Following on from our last chat, the topic of a Spotify playlist for surgery has been a hot one at work. This stemmed from thoughts about what I would want as the soundtrack to my own vascular surgery, should I ever require it as a result of peripheral arterial disease. It should be stressed that this is an as-yet unconfirmed condition, pending an MRI scan which I’ll pop down to East Block Level 2 for at some point, but my doctor and I are pretty sure I’ve got it. Countering her advice, I suggested that instead of lowering my cholesterol to combat arterial deterioration, I instead increase it so I form a natural immunity, a tactic for which I also lobbied when Nid was diagnosed with a nut allergy, although this was rejected by his mother who feared that if he didn’t have a food intolerance the other mums at yoga would think he was working class.

As I am fond of saying ‘I know we’re supposed to care for the patients – but are we though?’, and this extends to their Spotify choices for surgery, because there are six staff in an operating theatre, and quite often the patient is unconscious or a bit sulky, and anyway it can’t always be about them. The consensus among the medical professionals of my acquaintance is that the playlist should be bangers rather than classics, a banger being defined as a tune that you basically like and everything, but don’t often listen to but, when you do hear it, realise it’s mental. Classics are merely considered to be good, or ground breaking, or otherwise remarkable. This rules out the fresh new sound of my own beloved Beatles, as everything they did was classic, with no

identifiable bangers in sight, although as they were inventing not only popular music as we know it but the cultural landscape it would inhabit until the end of time, they were quite busy. My contributions were Groove Is In The Heart by Dee Lite, Incredible by M Beat ft General Levy, and Original Nuttah by UK Apache and Shy FX. Incidentally, it’s Pheno One Be Lit! on Spotify, ‘Pheno One’ being the primary operating theatre in my unit, in case you fancy it while facing surgery of your own.
I love the diet that contributes to peripheral arterial disease – or peripheral arterial delicious, as I like to call it – so I can’t complain when my blood vessels buckle under the resultant tsunami of cholesterol. Still, my signature dessert – two jam doughnuts in half a pint of double cream – is off the menu for a couple of weeks which, as I understand it, is how long chronic arterial conditions take to sort themselves out. To celebrate my lactose dependency, I also pioneered what my sister-in-law refers to as ‘double dairy’, which is a lot of double cream mixed with a lot of Cornish ice cream – refreshing at any time of day. Remarkably, I’m not fat. It would be easier if I was, because I could sort it out by taking up smoking in order to keep my appetite down. An average working day for me involves walking around 23,000 steps and cycling between 15 and 40 miles, so I am in shape and everything, it’s just that my customary celebration of the striking of each waking hour with four Mars bars and fifteen chocolate Hob Nobs may have to be re-thought before I end up having my legs amputated, which is the endgame of the condition if you aren’t careful.

I was about to say how much I approve of the reference to ‘eggs fried in butter’ that appears in Original Nuttah when I remembered my other playlist contribution: Street Tuff by the Rebel MC and Double Trouble. This was huge at West Ham during my teenage years, mainly I suspect due to the ‘Up North, kicking up fuss’ line. I

suggested this appear on the stickers we plastered upon pub windows, letter boxes and lamp posts on jaunts to the featureless frozen wasteland beyond Waltham Abbey, this being when you could travel cheaply on Inter City services by simply refusing to pay. At the time, they carried the line ‘Out Of Control And Heading Your Way / West Ham ICF Wrekin’ The Second’ and, while I liked ‘Wrekin’ The Second’ for the pleasing half rhyme, culturally colloquial spelling, and reference to what was then the Second Division of the football league, I questioned the plausibility of being out of control and heading towards something. ‘Out Of Control But Heading Your Way’ made more sense, I would explain on long journeys back from Blackburn or Sunderland or Hull, but agreed that the sentiment lacked punch, unlike the people I was talking to. Looking back, I suppose the paradox had a certain ring, and was certainly popular, as I am sure faded shreds of sticker in tiny forgotten corners of the north of England will testify to this day.

Medical, cultural and sub-cultural points of order aside, there is a new trade union to organise, as a couple of posts ago. The imagined course of action is a thrilling call to the barricades followed by a dramatic and acclaimed victory, but I cannot think of a single historical precedent for this. You could argue that Napoleonic France, Soviet Russia and Nazi Germany achieved it in theory, if you overlook the paranoid industrial slaughterhouses that all three became for the entirety of their existence, but I suppose the Peasants’ Revolt is nearer the mark. However, this tends to be remembered for what it was, rather than what it did, which tells you something. In any case, I am suspicious of the word ‘peasants”, as no group of people has ever referred to themselves thus, suggesting that the events are not being told from the perspective of the people in whose name they allegedly took place – which sounds to me like our old friends the middle class fiddling about with the narrative again.

Incidentally, I am aware of how equating my thoughts about conditions for lower grade staff within the NHS with some of the most important events in European history sounds, and also that it is a conversation that, for now, exists only in my inner dialogue. We are all capable of declaring war upon our circumstances and those of our peers, but I am aware that sooner or later you have to be – here we go again – Gavrilo Princip outside a Sarajevo delicatessen with a pistol in your pocket, watching an Austrian Grand Duke rolling towards you in a large car. I imagine that’s the awkward bit, really.

Picters:

Main: beach at Weybourne, height of the tourist season.

Inset top: Phone which I am supposed to carry at work in case I need to be contacted. I tend not to carry it.

Inset middle: This is not Pheno One, but Q-Artis Three, pretty much the same thing except it doesn’t get used much due to the weight of the machinery pulling the ceiling down.

Inset lower: My scrubs always end up with stuff written all over them by the end of a shift. It’s like the last day of school or something. They are nature’s notebook, as far as I am concerned.
To Pass The Time Along

Sep 21st, 2022

Public Service Announcement: This is a slightly bitty post, as I am experimenting with writing entirely on work time, either while waiting for the East Block lift, which is never in a hurry, or in the cardiovascular outreach office, an airless cupboard which has not seen natural light since 2002.

I was on a train recently when the driver announced via the public address system that we were ‘to prepare ourselves for dreadful news’. As my old friend Rachel pointed out from distant Nebraska, this is not a comforting way to address passengers on a mass transit system but, as we were still in Norwich station waiting to set off, there seemed little immediate cause for alarm. The news was that the Queen had died, and that the moment Smiths fans had been waiting for since 1986 had finally arrived. Well, not me, as I am both a Smiths fan and a monarchist, but still. The lady on the seat next to me immediately turned and said ‘My God! What do we do now?’ and I said there was no point asking me as I couldn’t believe it, even though we had been following the news of her physical deterioration at work all day. The Queen had, in fact, passed away as I was cycling onto Riverside from Barrack Street via the Bishop’s Bridge roundabout on the way to the station. Upon arriving home, I woke Nid to pass on the unhappy news. He had a considerable cry but, after his concerns about ‘what happens to the Spitflier’ (the Spitfire we saw during the Jubilee celebrations which he believed the Queen to be piloting) were addressed he promised to ‘defend the new King’ and went back to sleep. Thus, in our corner of the Realm, the three hundred year reign of lovely old Queen Elizabeth II was consigned to history.

Still, in the midst of life we are in death, as Agatha Christie, who should know because she was murdered on the Orient Express, would doubtless remind us, and my work up the hospital is an unending opportunity to contemplate mortality. Consider, for example, a nephrostomy, which is a surgical procedure whereby a thin tube is inserted percutaneously into your kidney to Lyin’ Eyes by the Eagles. It’s always Lyin’ Eyes by the Eagles, because patients under local anaesthetic can listen to their music of choice, and those with compromised urinary function love the Eagles. Lyin’ Eyes pops up on the ‘This is the Eagles’ Spotify playlist just as the catheter goes in, and during Tequila Sunrise, I will say ‘OK Ray/Joan, I need you to take a deep breath, deep as you can, and hold it till I tell you, OK?’ in my ‘now-pay-attention’ hospital voice.

(Tone of voice is more important than you might think. In common with people dealing with children or dogs, I have to use my ‘now-pay-attention’ voice, because if they don’t take a deep breath, they will enter cardiac arrest as New Kid In Town starts. If this was to happen, I assume the background music would return to Chaka Demus and Pliers’, cover of Twist and then Shout, which gets more airtime than you would otherwise expect in a clinical environment, because younger patients usually want ‘stuff from the 90s’. This, then, is the soundtrack to interventional surgery in the Norwich and Norfolk University Hospital in the second decade of the twenty-first century. Abba also feature regularly and, as an after thought, we will all have to get used to them singing about the ‘Dancing King’ now. It’ll be an adjustment but we’ll get used to it I expect.)

Anyway. I never tell Eagles fans they are a breath away from cardiac arrest during a nephrostomy. This raises an ethical point, as the information is clearly relevant and, assuming they have the capacity to understand, should they not know? I would argue that to do so could worry the patient out of a procedure which, equally clearly, it is in their best interest to have. Conversely, if I was too jocular, they might not take it seriously and inhale their way to the mortuary which, as the person who would have to wheel them there, only adds to my workload. My work is full of dilemmas like this.

Then again, I have learned that no good songs have ever been written about being on a highway in your mid-forties, thinking about some stoner you had a go on twenty years previously, which seems to be pretty much all the Eagles’ lyrical content concerns itself with, apart from the unforgettable Hotel In California, which is presumably about doing the same thing but drunk. The pleased-with-itself music of American baby boomers is fucking insufferable. Actually, I shall revise that, as I once sold a load of t shirts to the Doobie Brothers, most famous for Listen To A Bit Of Music, at Camden Market and they were a right larf. At around the same time, I sold stuff to Jon Squire of the Stone Roses, either Cagney or Lacey from Cagney and Lacey, the Blue Man Group and the lady responsible for shredding and burning Taylor Swift’s underwear after her two shows at the Shepherd’s Bush Empire. What halcyon days they were.

If I ever find myself having a procedure – not beyond the realms of possibility, as I appear to be presenting symptoms of peripheral arterial disease – I want twenty five minutes of white noise played as my music of choice, the same as at my funeral. At my funeral, I’ve always wanted to have a list of names of a) the people in the congregation I never really liked and b) why I never really liked them read out as I am gathered unto God, so there is a running order to be worked out there. Maybe white noise, then the names of a) the people in the congregation I never really liked and b) why I never really liked them, then a minutes’ applause (as is the modern way), then the national anthem, then speed dating among the single members of the congregation to lighten the mood. Yes, that sounds lovely.

So there we are.

Photards:

Main: Northrepps church.

Inset top: An operating theatre, aka procedure room or suite or lab. I’m lobbying to get a pool table put in to make it less formal.

Inset middle: The ‘box’. If you are ‘running’ for a theatre you sit here and prepare anything that might plausibly be required during a procedure in case someone in the room asks for it. It’s relatively simple to run for a specialised room like this, but in main theatres it is extremely complicated and requires skill, speed, and detailed knowledge.

Inset lower: Scrub room with trough-style urinal.