/ 3 January 2003

New Year thoughts on my medical past

Some seven years ago, as a penalty for a lifetime of heroic cigarette smoking, I was faced with a straightforward choice: undergo what in medical slang is called a ‘cabbage” — a rough and ready acronym for Coronary Artery Bypass Graft — or standby for a major heart attack within a foreseeable future. In other words: undergo a cabbage and thereby gain enough extra life-time to go home and slowly become one. After three seconds consideration, I made the choice and was admitted to the cardiac unit at the vast Tygerberg hospital in Parow.

Some post-operative complications — also related to the chimney-like smoking habits of my past — had me in intensive care for four weeks.

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There’s nothing as gratifying as talking about how bravely one suffered during one’s surgical adventures. I’d love to go on and on about ‘my” bypass but I won’t. This, this first column of the new year is meant to be an inadequate salute to the medical staff you will encounter if you end up in one of the Western Cape’s so-called ‘public” or ‘state” hospitals. I hope I can describe them in terms suitable to the quite astonishing dedication and compassion they show. These are very undervalued people.

Subsequent to Tygerberg time I’ve spent three nights in Cape Town’s even vaster Groote Schuur hospital and again experienced the same unsparing level of human warmth and professionalism. It is any hospital’s nursing staff that has to deal with patients at the closest range. In these institutions the nurses work long and arduous hours: they seem never to be off their feet.

These are people who labour for salaries that are little more than pittances. The current government Department of Health prefers to spend its budget on glitzy international symposia, Sarafinas and all the rest of it. Remember that futile international Aids conference in Durban? The government-sponsored NGO, loveLife, splashed out no less the R10-million on the three hours of an obscenely extravagant opening ceremony and fireworks display. The same loveLife haemorrhages money in full-page Sunday news-paper advertisements and in the support of a growing band of HIV/Aids freeloaders; money that would be far better spent on improving the salaries of basic medical staff.

I know of one nurse-aide who, in 1995 and after 28 years of unbroken service, was taking home R760 a month. At her hands, during a critical time while I was clocking up my cabbage-miles, I have never known such unfaltering, unquestioning help, such uncomplicated human kindness. But you won’t have to wait long to see a television news bulletin containing some ministerial crony raving on bitterly about the flow of disenchanted South African nursing staff, off to the United Kingdom, Canada, the Gulf states or elsewhere and to reasonable levels of reward for dedication.

It has become almost an obligation for newspapers and television to publish regular horror stories about our public health services. Without doubt some of these are as dreadful as reported. I would hate to have to rely on the medical facilities available to the public in, say, the rural hospitals of the Eastern Cape or Mpumalanga, places where the corruption is all but designed by central government. But my own experiences in Tygerberg and Groote Schuur put into serious doubt the near-hysterical news-paper articles depicting these hospitals as being critically without necessary drugs, equipment and staff.

Shortages and bureaucratic fumbling there certainly must be, but take a sojourn in the wards of Groote Schuur or Tygerberg and witness at first hand, if only, the fastidious cleanliness, the professional and present staff, the astonishing standards of nursing care and efficiency.

Then there’s cost. State hospital fees are calculated according to patients’ income. A quote obtained by a friend of mine at a private clinic for a fairly routine operation, involving three or four days in hospital, was in the region of R50 000 — not to include the surgeon’s and anaesthetist’s fees.

The Groote Schuur ‘private patient” cost for the same procedure was around R12 000 — doctors included. As someone observed: ‘I’d rather go to a place where the primary goals are healing, not making whopping profits out of illness or injury.” An unearning pensioner underwent major spinal surgery followed by 11 days in hospital. Total cost: R52. But then patients at ‘Grotties” don’t check in to find cute welcoming notes and coy little baskets of chocolates on their pillows, little bowls of flowers. (For which they later are charged!)

To end on an even happier note. In my column two weeks ago the word ‘supersede” was misspelt. This was not of my manufacture.

A week or so before that, the column reflected on the several tons of ‘political nightsoil” constituting those members of the New National Party crossing the floor to the African National Congress. I thought my pun ‘Abluta Continua” quite clever. That also got changed. The well-meaning soul who did the deed has been dragged to the Mail & Guardian‘s staff discipline suite and there soundly flogged by the Acting Chief Quark-Jockey.

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