Seven in the evening Elsie reaches for the remote.
Eight O’clock, Sandra, carer, should have arrived.
She left that day
No notice required
As none is required of her boss
To bin her.
She is zero hours
Elsie on the floor seven until eight the next morning.
A puddle of urine.
Carpet burns on knees and elbows
as she has struggled to stand,
Heating is off overnight,
Austerity and all that.
Gaynor, carer #two arrives, find Elsie, she calls an ambulance.
Ambulance reaches Elsie by one in the afternoon.
It is a busy day
Threatening get priority.
Little old ladies are put to the bottom of the stack;
A virtual pile of clinical priority.
Can I have an ambulance? An old woman has fallen.
Is she breathing?
Is the moving?
Is her injury threatening to life or limb?
No, she is in a lot of pain.
Can you call the GP?
I’ll never get through (Tory lack of NHS investment)
An ambulance will be dispatched.
Can’t say. Call us back if things change, here is your reference. Goodbye.
All this time, getting on for 16 hours, Elsie remains on the floor.
‘Don’t move her’
Gaynor is told.
‘Nothing to eat or drink’
Gaynor ignores this,
Offers Elsie tea and a digestive.
To the local hospital.
X Royal Infirmary, we will call it.
XRI is full.
Too many patients arriving and not enough leaving.
Call it what you like,
Time and space collude to create a situation.
Elsie waits outside the A&E for three hours.
The paramedics talk with her,
Administer intravenous fluids into her blue veins,
Eventually Elsie is moved to the A&E
She is triaged
Moved from stretcher to trolley.
X-rayed, pin-pricked and palpated,
Stripped of her dirty clothing
And hospital gowned,
The last time Elsie was in hospital was 50 years before when her son was born.
The lights and noise and busyness of people rushing overwhelms.
She is left alone in a corridor.
No bays for Elsie.
We are full you see.
Elsie is incontinent.
She lies in her wet.
She hates herself and wants to die.
She feels pain and indignity.
She feels the darkness growing.
Or there are beds,
Yet those beds are occupied by other patients who should not be in hospital,
They should be elsewhere,
People cannot get home as following their three day or two-week stay, with them being old and frail, the trauma of the experience so profound (A&E and people like Elsie re-live this trauma seven days a week, 24 hours a day), they are diminished, their autonomy has weakened (institutionalisation), their ability to walk, eat, toilet has disappeared overnight, as will happen to Elsie. A process of clinical infantilisation has begun, the seventh age of decrepitude.
To return home, these folk require carers.
Carers like Gaynor and Sandra who is now working at Aldi on the living minimum wage (£10.90 an hour), a beyond the minimum (£9.50) she was earning as a ‘carer’.
Please care for our old and vulnerable yet we will not care for you, you are on your own, managing your finances, your bills, your future.
And so, thanks to Brexit and yes, Covid did not help, there are not enough carers in the country.
Consequently, old folk remain in beds for days and weeks longer than necessary.
The Tory claim to build, was it, 40 new hospitals? A pipedream, wholly unnecessary, when what was required was to allow people decent wages and job and housing security.
And yet, you, the Tory, doesn’t grow rich on the happiness of others, it is the contracts awarded to multinationals that line their coffers.
Elsie is moved to a ward; her inpatient stay is uneventful (see below).
She waits three weeks to return home.
Gaynor (the one who hasn’t gone to Lidl) has been allocated a different old lady, it will be someone else when Elsie gets out, like being released from prison.
During this wait, Elsie deteriorates, hospital acquired pneumonia then a pressure ulcer and a fall on the ward.
All this time she is diminishing, fading.
Her family visits.
She does not recognise them.
It is the delirium. A shade falling over, taking her away. A dark tunnel.
The night before the day of discharge Elsie dies.
She was an old woman after all, and old women die these days.
A sequence of events, initiated by, let’s ask?
Was it Brexit that led to a fall in the numbers of European workers available to support our job market (I am told our island is too ‘full’ small for all these Poles and Romanians, I don’t agree), or, was it the Covid, Climate Crisis and the mis-treatment of animals in a wet marked in Wuhan, or maybe the overcrowding in Chinese cities that process the world’s tat, sold on Amazon at a Prime price. Maybe it was the middle managers who do too little. Who lack the ability to create systems to undo the burden of Tory austerity that makes the energy companies rich and Elsie and her friends shiver in bed at night; it could have been the A&E department for working inefficiently, too much chatter and banter between those nurses and doctors, the inspector observes; none of this creates capacity, none of this finds a solution to support Elsie who when she fell, just fell, didn’t break any bones; a helping hand to return her to the chair would have sufficed and life might have continued. Maybe Sandra, through her lack of professionalism killed Elsie – a kind of indirect manslaughter. What about the bosses who previously ran teams of carers, supporting with pension and personal development who have allowed those folk to trade places with casual workers. Who can blame Sandra for wanting to earn a little more dough when the price of milk and eggs and cheese has skyrocketed? Who killed Elsie? Was it her son for not forcing her to move-into his large house? Maybe granddaughter Emily whose noise and bustle discouraged Elsie. What do you call murder of a grandparent, not parricide, who knows, not something to contemplate. Recent evidence has shown, the longer an older person lies on the floor and the longer they spend in an A&E department the greater the likelihood of their dying. Who killed Elsie? Does it matter? Stalin called one death a tragedy, a million a statistic. Is Elsie a dot on a graph or a person, a tragedy, or a decimal point?
It could have been different.
We live in an age of unimaginable wealth.
More money and prosperity has never before existed.
A little less greed and everyone would be fine.
Something is wrong with the minds of those in power in the UK.
Some say it is that they didn’t receive enough love as children. Perhaps the long days at boarding school mangled their brains. Switched-off empathy. What killed their compassion? What made them think of ‘me’ rather than ‘us’ – they will laugh at Ubuntu and wonder why England are ejected from the World Cup (a prediction).
Little nation, little island; sing me to sleep.