Two weeks ago I suffered a cyclist’s worst nightmare. No, it wasn’t a MAMIL (for my non cyclist friends, that’s a middle aged man in Lycra) with cable ties coming out his helmet riding up next to me and informing me, in a Tony Abbott-like tone, that my cycling knicks were see-through (that already happened for real about two months ago).
Nope, it was a crash. A bad crash. A crash in the warm up lap of the third of a four race series, known as the Bay Crits. I had been getting my no-longer see through rear end well and truly handed to me in the previous days by riders from teams such as Orica Green-Edge and Wiggle Honda who had world and national champions dominating their rosters. I was just glad to be lining up against them with some of my new Bicycle Superstore teammates and our new team boss, Chris Savage. We had been having a blast and one of our team, Kristy had been smashing it in the top ten everyday. It was a hoot.
Then came the first corner at Portarlington, normally a nice little sleepy bayside town which for a January day most years, hosts one of the toughest races in the Bay Crits. Down I went negotiating a corner at slow speed when my front wheel lost traction. All at less than 20km/hour. Unfortunately my left hip took all the impact and I knew immediately that I wouldn’t be eating the dinner of my choice that night. A couple of green whistles of Penthrox later, my by now new paramedic besties (at least in my temporarily very happy morphine induced eyes), pulled into what would become my new home for the next five days, the Geelong Hospital.
After some X-rays and a whole lot of cutting clothing, inspecting and hearing words I didn’t understand, I ended up with a badly broken hip and quickly jumped to the head of the queue for immediate surgery. Four screws and a nice big plate later to hold them in place and a nerve compression to boot, I was wheeled into the general orthopaedic ward. As I kept being reminded by most professionals I came into contact with over the next five days, I was very unusual. I’ve been called that many times but this time it was to do with the fact that 90% of people who break their hip are over 60 years old. I’m not in that category for another couple of decades at least.
My Granny Bradley broke her hip when I was about 15. I felt like I was going back in time when I was discharged with my wheelchair, crutches, walking frame, special raised toilet and shower seats. I never ever understood how difficult it must have been for an older person to deal with such a debilitating injury. That would explain why the mortality rate associated with hip fractures in older people is extremely high. Approximately 20% of people who sustain such a fracture die within 12 months of sustaining the injury. Only 1 in 4 make a complete recovery.
These words aren’t meant to be about the crash or indeed, cycling. They’re about the images and stories I’ve been unable to get out of my opiate-assisted mind since entering the ward where my fellow patients well and truly fitted the 60 years plus category and the view that I have that somehow we’ve got this stuff all wrong. If it were about school dinners, I’d already have found a way to contact Jamie Oliver and ask him to help sort it out.
First of all, I am no expert. I certainly don’t profess to be. All I can and am offering is the first hand insight from a younger inpatient into what is mostly an older person’s world. I’m also a systems thinker in my day job so I can’t help but think about this stuff. These musings are not about blame or pointing fingers; in fact, I want to know what I can do to help and am determined to find some way with the time on my hands that I now have. I also feel strongly that this isn’t just one ‘issue’ with one solution. To really address some of these challenges within our health system requires us to not get fixated on one aspect. In my uneducated view, it’s prolonged and involves all aspects of society – education, parenting, health, welfare, government, communities and individuals. It’s a question of values.
With that out of the way, the staff at Geelong hospital and especially the nurses were amazing. Truly amazing. They work their absolute backsides off, have empathy and are very good at what they do. But they work within the confines of a broken system. And I don’t think they’re alone.
The amount of times I heard comments from the staff to do with budget cuts, hours of pay and the associated impacts that had in patient care was eye opening.
The people in my ward had phenomenal stories to tell. Ian checked in feeling unwell and quickly underwent surgery to remove his foot. He was trying to cope with what lay ahead for him in his now vastly changed life. The old man opposite me who unfortunately was too ill to ask him his name, became weaker and weaker throughout the day and when he was taken away for further treatment, he never returned. The man diagonally opposite me fell in his garden and seemed to have given up the fight. He never got out of bed the time I was there, even with the repeated and gentle attempts by the great Physio staff.
On my trip down to Physio to get some practice on ‘stairs’ with my new crutches, Agnes, a lady in her 80’s who also fractured her hip was ripping it up on the parallel bars. She was almost interested in a race. I hope she bucks the 12 month trend.
The time to listen
What struck me most in my stay in hospital was that these old folks all had stories. They had chapters of books to tell, families and loved ones to talk about. Past careers and adventures to share. But there wasn’t anyone to listen. Like as in really listen. Sure they had a few visitors for an hour or so a day but the rest of the time, it was just them.
The nurses and staff were just too busy to have time to let them tell their stories and just listen. What was interesting was even how the old folks were spoken to; lots of raised voices and a tone that resembles how we address children. My old mate opposite me before his breathing became too laboured to continue speaking even told the nurse he wasn’t deaf! Again, this isn’t about belittling the wonderful job nurses or hospital staff do but I do feel I witnessed a form of institutionalism in both the staff and the patients. Assumptions are made perhaps too freely about the mind frame and ability of patients. They are treated as one and not as individuals.
When my father was ill and spent months in hospital in Ireland, I saw the same thing. Well meaning staff yet significant failures at systemic levels in training, leadership and effective and compassionate communication with the families were present.
I personally had technology out the wazoo. The iPad to find out who won the damn race anyway and to have a check of the next day’s horoscopes. The phone to receive and make calls to friends, families and receive beautiful texts of support and love from well wishers. I couldn’t help but feel bad that my fellow patients didn’t have such methods to communicate. What hit me though, was that when I reach that age, I probably won’t have the number of people in my life to send and make such wishes of support that I do now. Many will be gone. I may not still have friends who brought me my favourite homemade quinoa porridge in a real bowl, or Fro Yo yogurt from down the street and fresh, juicy nectarines wrapped in nice paper. Friends who cooked me three days worth of fresh food because they knew how important it was. Teammates who had driven eight hours the day before and who had kids at home who stopped by and ‘kidnapped’ me for fresh air and a few hot laps of the streets of Geelong in the wheelchair. Other amazing people who just dropped in on their way home from work to say hello. People who just rang to say they were thinking of me. I was in a city an hour and half from my home and I’ve never felt so close to home. Because of them.
What’s the answer?
I don’t know is the short one. What I do know though is that we all need to drop the egos, the blame game and start from a place of respect. Respect for these wonderful people who gave us life and air. These frail men and women who, just like us, want and desperately need to have social connection and to be heard. We need to start listening with our hearts and our time. We need to free pressure from our hospital staff.
What if for instance we re-modelled our school curriculum to include visits to hospitals and nursing homes for young people to hear oral history directly from our elders of society? What if, the big corporates and government actively encouraged and provided time release for an hour a week for staff to visit hospitals and nursing homes? What if, we had bus pick up and drop off spots for the public to go and visit on the weekends? Of course, there would be the necessary security checks and all that stuff but that’s something a smart team can come up with a way to work through. What if, we each gave $5 a year to buy a bunch of flowers for each old person in hospital just to tell them we’re sending love and thinking of them? I’d gladly sacrifice my plant that was given to me upon receiving my Aussie citizenship.
Two interactions will stay with me forever whilst I was in Geelong hospital. I had a rough night, vomited all over myself and I don’t mind saying, was in pretty excruciating pain. I had one of the most beautiful souls I’ve ever met in my life not bat an eyelid at having to clean me up, talk me gently through the pain and tell me I’d be ok. She spent time with me, held my hand and told me about her kids. I’ll never forget it.
The following morning the pain has subsided and for the first time, I had my appetite back. All I wanted was some toast. My breakfast arrived and these two slices of bread were in a plastic bag, with what looked like cereal in a plastic bowl and a cup of water with a tea bag in a plastic cup. I asked the service lady if I could please have the bread toasted, to which she replied ‘The policy has changed, we don’t toast bread anymore’. I was too upset to even respond and ate nothing. I actually cried from frustration.
I don’t know about you but as an athlete and a person, I am acutely aware of the connection between good, nutritious food and healing. How the hell can we expect our elderly, who as we saw above, have enormous odds against them anyway for survival, let alone recovery, to heal if we can’t even give them what any reasonable person should expect and for them, probably have had their entire life: a slice of toast and a cup of tea in a normal cup. It’s the small things after all that make a difference.
Melbourne has endured its hottest series of days on record this week – four days over 41c. In a news program this week about the heatwave, a nursing home was visited and it gleefully showed the residents being served ice cream. What did they get it served in? Polystyrene cups and plastic spoons. I’m not sure about you but how many of us eat from such vessels at home on a normal basis from such things? The very message I believe this sends, however well meaning and subtle, is of ‘throwaway’ and a strong sense of temporary.
I’ve learned a lot in these past two weeks. I’m no saint and I don’t have any magic wands. I’m also not naïve to the challenge and the financial cost of any long term solution. However, if we ask ourselves the question about the type of country we want to be and if we subscribe to the view that you can tell a lot by a nation, as to how it treats its elderly, then we have some real work to do.