I’m taking a break from writing about history or books this week to return to something more personal.
Decades of use and abuse have resulted in me wearing out my elbow joint. I used to think that the elbow was one of the less important joints (and I am incredibly grateful that it was my elbow rather than knees or hips) but it turns out that once your elbow packs in, so does a lot of control in your wrist and hands. Plus, in my case, it triggered rheumatism that led to joints everywhere else coming under a lot of strain. The upshot is that I’ve been seeing the inside of hospitals quite a lot lately. And that’s made me think about the NHS, an institution that is, understandably, coming in for a lot of criticism these days. Perhaps you are American – I know this blog gets American readers – and you may be one of those people who believe that socialised healthcare is bringing Britain to the brink of communism. Or you are one of the small but increasingly vociferous number of Brits who think that spend on the NHS is out of control and we would be better off with some sort of insurance based system. So it’s worth a quick reminder of what actually happens when you get sick.
Firstly, to be fair to the NHS’s critics, you spend a lot of time moving through the system until you belatedly arrive at the right place. In my case, the right place was a rheumatology consultant at my local hospital. As I began to panic that my body was suffering from more and more aches and pains and bits of it were increasingly often refusing to do what they were supposed to do, she reassured me that modern drug treatments meant that everything was going to be OK. I was put on to the standard medication for the sort of rheumatism I was suffering from. (There are different sorts. Who knew?) When it didn’t work, this was supplemented with another. There was definite progress but I was still far from well.
Had I been paying for my own treatment or having it funded by an insurance company, I strongly suspect that would have been the end of the story. As it was, my consultant explained so there is a newish drug that should do the trick but that, as it is ridiculously expensive and I will have to take it for the rest of my life, she would have to make a special case and get it approved for use with me. It took a couple of months and then I moved onto it and the change has been spectacular. All the aches and pains vanished and, although there is some residual damage here and there, I’m basically sound except for the elbow that created the problem in the first place. My rheumatology consultant admitted that even her wonder drugs could do nothing for it. The elbow was literally just worn out. (An X ray showed that where cartilage should provide a relatively friction-free surface to the bones in the joint, there was nothing.)
Elbows are notoriously complicated joints, enabling you to move your forearm at all sorts of weird angles, rotating it as you do so. I was not surprised to learn that my local hospital could do nothing about it. However my consultant referred me to another nearby hospital where they told me that elbow replacement is now an option. There was a long waiting list – around a year – but I wasn’t even absolutely sure that I wanted it. After all, I could sort of get by with just my left arm and I developed lots of ways of working around the problems with my right. As time went on, though, things began to get worse and a routine checkup pointed out that I could no longer pretend it didn’t need dealing with. So I was moved up the list and, surprisingly quickly, I was in hospital having my arm cut open.
That was just over a week ago and I am amazed at how much the new improved elbow is already capable of. I can, for example, write my name. (My inability to write for the past few months has been hideously embarrassing, even though I use a keyboard for most things.) And I can open a jam jar and eat with a knife and fork. Once the dressings are off, I look forward to the really exciting stuff like being able to touch my nose.
And, overseas readers, what has this cost me?
Nil, zada, zilch, nothing.
That’s for an innovative and hideously expensive drug that has fixed one problem and surgery that didn’t even exist when I was younger that has fixed the other.
Seeing the NHS from the inside, it is all too clear that it’s a mess. It’s grown so much that even the hospital is a collection of buildings, some quite old, some brand new, all connected by miles of corridors. Expensive MRI scans have gone missing, my GP frequently doesn’t read all he is sent about treatment protocols, I get caught up in ridiculous arguments about which bit of the NHS bureaucracy picks up the bill for some of the dozens of blood tests that I’ve been given, though that’s nothing compared to the overall costs of my care.
It’s a ridiculous system which relies on dedicated, underpaid staff going above and beyond in a system that has massively outgrown the structures that were set up in 1947. But the important thing is that it works. Creakily, slowly, sometimes inefficiently, but it gets there. I am better. I have friends who are only still alive and active and happy because the NHS has saved them.
Yes, it could be more efficient. Yes, it could be more streamlined. But you know what it needs most? It needs money.
I haven’t seen any of the most recent studies, but I’ve seen studies in the last 10 years that have compared costs and outcomes across different health systems. The British system is not the best in the world – but it does provide the best outcomes for the budget that it is given.
I am older, though not that old, and the problems I have had are increasingly being seen in younger people. Nor are they “complex needs”. Bodies wear out, and as the population gets older, so more bits need to be repaired or replaced. If you are young and healthy, you may not see money spent on people like me as a particularly wise investment. But I was young and healthy not that long ago and eventually you will be old and you will need medical care. (Or you will be dead, which not everybody sees as a preferred alternative.)
The sad truth is that everybody, everywhere, wants to see the best possible medical care available to them and the people around them but nobody wants to pay for it.
Next time any government tells you that they can square the circle without putting up taxes or cutting services, they are lying.
Look after your NHS. One day, god willing, it will be looking after you.
I had my elbow replaced on Tuesday. Yes, I didn’t know you could do that either. I was planning a piece about the wonders of the NHS but it turns out that after surgery you do a lot of falling asleep, so it’s going to have to wait for next week.
I keep promising to cut back on the amount of time I spend on blogging and other social media and now, with over 56,000 words of my first rough draft of what I’m still calling Burke and the War of 1812, I just want to get that finished, so no proper blog post this week. I’m a bit disenchanted with the blog right now because there really does seem to be very little engagement with it so, honestly, what’s the point? Last week, out of the pure goodness of my heart, I offered a free copy of the audio book of Dark Magic to anybody who wanted it. (Halloween is coming up so it seemed appropriate.) And nobody has asked for a copy. I know I undersold it because it was supposed to be just a bit of fun, but nobody?
And, of course, because I really want to write, now there seem to be loads of other things going on. I’ve been enjoying the last of summer/beginning of autumn at Kew Gardens, volunteering in Marble Hill House and, obviously, getting in the odd bit of tango. Today I’m off to explore a Tudor house in Hackney, tomorrow is the London Halloween skate (pictured) and next week I’m going to Southampton for the Wellington lecture. Something’s got to give and this week it’s the blog. Sorry about that.
I saw a picture somewhere on social media posted by an author who is writing their first vampire book. I can’t find it now, but it showed a couple (presumably vampires) in a dance hold.
It will be fun if someone else produces a vampire tale featuring dancers with, let’s say, specialist dietary requirements, but I hope, dear readers, that you won’t forget that you saw it here first. My ‘Galbraith & Pole’ series (three so far, but there will be more) started with Something Wicked which features murder, mystery and tango.
They say you should write about what you know and I’m putting together this blog post between Monday night’s tango and Wednesday night’s tango with a couple more evenings of tango planned for the weekend. It’s fair to say that the references to tango in the book are well researched.
The idea of tango-dancing vampires came on one of my many visits to Buenos Aires, a city almost as famous for its spectacular cemeteries as for the celebrated dance. You seem to see so many more people after dark then are around in the day and, first thing in the morning, it’s easy to believe that the weary, somnambulant creatures propping themselves up on public transport are related to the Undead.
Buenos Aires street scene. Note that the dancers stay in the shadows
Chief Inspector Pole is not your typical vampire. He’s urbane and sophisticated and has been known to cook with garlic just to make a point. But mess with him and you can see a more ruthless side to his character. Fortunately, he uses his powers for good – mostly.
If you haven’t read my Urban Fantasy books before, give Something Wicked a go. It’s just £2.99 on Kindle.
Amazon reviews
Here are some of the things people have said about it on Amazon:
If you enjoy light, amusing and elegant humour and would relish the thrills and chills of the supernatural kind, then Something Wicked is definitely for you.
Cleverly-conceived, well-written and excellently plotted
I shall never look at Brompton Cemetery in quite the same way again!
A really great read! Who knew a story about vampires, detectives and tango could be so entertaining?!
Some of us who show people round Marble Hill House took a busman’s holiday this week and went to visit Pope’s Grotto.
Marble Hill House
Alexander Pope is important to the story of Marble Hill because he was a great friend of the first owner of the house, Henrietta Howard. Henrietta probably moved here partly because Pope owned house a little way further up the Thames just beyond Twickenham. He was very interested in gardening and his garden was, at the time, quite well known. Unfortunately for him, most of it was on the other side of the road from his house which had a lawn stretching down to the river but little space for the elaborate garden design he wanted. So, this being the 18th century and Pope being quite well off, he built a tunnel under the road to access the rest of the garden. The tunnel was built out from the cellars of the house and the whole underground work was decorated as a grotto, which expanded to have side passages and even an underground waterfall. It was probably the inspiration for the grotto that Henrietta had built at Marble Hill, but his was much larger and more elaborate.
Grotto at Marble Hill
Unfortunately, in the course of 300 years It deteriorated quite badly. His house was demolished and a new building constructed over the grotto. People I know who saw it when we first moved to Twickenham said it was little more than a gloomy cellar with some rocks stuck on the wall. Fortunately, if 18th century grottoes are your thing, over the last few years it has been opened up and substantially restored. Although it was originally decorated with bits of mirror and glass to make a sort of shiny pretty space, Pope later developed an interest in geology and decided to make the whole thing into a sort of mystical mine decorated with different kinds of stones and minerals. We have descriptions of it from the time allowing us to replace many of the rocks that have been lost. The effect is simultaneously gloomy (it’s quite dark down there) and rather pretty. You can definitely feel transported back to Georgian times.
More on grottoes
Coincidentally, Deborah Swift has just written about grotto’s in her newsletter. Here’s the LINK. They are very different to Pope’s and Henrietta’s!
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We’re still working the last of summer for all it’s worth. This week we went to Burghley to see the house started in 1555 by William Cecil, the Lord High Treasurer to Queen Elizabeth. He was the most important politician in the country and built Burghley as his legacy, something that would be handed down through his family, a constant reminder of his power and influence. Not that he had much time to spend there as it is buried away near Peterborough, 90-odd miles from the court in London.
It worked out pretty much as he had planned.
Although the exterior would be recognisable to William Cecil, inside it has been substantially gutted and rebuilt. Only the splendid Tudor kitchens remain largely unchanged.
The rest of the house was remodelled by the 5th Earl of Exeter in the 17th century and then again by the 9th Earl in the 18th. The great long galleries were broken up into smaller (but still enormous) rooms, mainly, it seems, to provide extra wall space to display a ridiculous number of paintings. The family still lives in the house, which must at times feel like camping out in an art gallery.
The 9th Earl commissioned Capability Brown to landscape his grounds. Brown also made changes to the house, including demolishing an entire wing that was obstructing the view!
The design of the rooms features a lot of dark wood and vast paintings of wars and ancestors. Perhaps surprisingly for the English aristocracy, there is little overlap between the two. The Cecils were not a particularly martial family but were better known as collectors. Besides their paintings, they bought porcelain (especially from Japan) and fine furniture. (There are some wonderful marquetry cabinets.) The overall effect is rather overwhelming and surprisingly unphotogenic, hence the absence of photos on this blog. The design works by just being so very, very big. It’s too large to capture well in a picture. It’s also notable for a distinct absence of lightness of touch or humour. It’s about impressing you guests (there have been visits from Queen Victoria and Elizabeth II) not about welcoming them with tea and cake.
We were there for hours and I know of a lot more about Japanese porcelain than I did when we arrived. It’s arguably the finest Elizabethan House in England and well worth a visit, but I definitely wouldn’t want to live there.
The grounds are beautiful. There’s an ice house for regular readers of this blog who have seen photos of the others I’ve collected. It’s the first one I’ve visited outside West London, although there are examples all round the country.
There’s a sculpture garden too, which displays some interesting works. I was relieved to discover that the 21st century family have exactly the lightness of touch in their choice of sculptures that seems to have escaped previous generations of collectors. It’s not every sculpture collection that includes a mouse on a surfboard.
If you’re visiting, make sure you leave time to look round the nearby town of Stamford, which is lovely.
