And there follows a small contribution from your humble interlocutor about two friends of mine. As regular readers will know whilst the following stories are “true” they are composites of more than one individual’s experience in each case and reflect the “patient experience” rather than identifying an individual.
So with all of that said, first let’s meet Dud. Dud has worked in light industry all his life. Of course by light industry we only mean not building steam engines or other very very heavy things. He’s worked with metal in heat and dust and smoke for years. He’s also been partial to the odd fag, to be sure (American readers take note: Fag = cigarette in “proper” English like wot is spoke in Ambridge), and as a result of all of these factors he’s developed that persistent shortness of breath that is COPD. He needs three inhalers several times a day to get by. That hasn’t stopped him working well past retirement age, his skills being too valuable to the company to loose. A few months ago his chest took a bit of a nosedive, he started coughing a lot more and he ended up in hospital. While he was in the nice docs did a chest x ray and found a nasty looking “shadow” at the top of one lung. Dud put two and two together, decided he wasn’t liking the arithmetic and quickly persuaded them to let him home without a lot more testing and probing. He’s on oxygen, is comfy, and is looking forward to sitting up for nights on end to watch the test matches from Down Under. We haven’t talked about his diagnosis, because we don’t need to. In the end the only thing he’s worrying about now is how much his treatment is costing and whether he deserves it!
Pete lives in Penny Hasset, a stones-throw from Ambridge. He’s been barman, cleaner and general factotum to the Penny Hasset Working Men’s club for decades. Though never a smoker he’s worked around smokers for most of his working life. From quite an early age he was identified as having bronchiectasis. This, for the uninitiated, is a poorly understood condition of susceptibility to recurring destructive chest infections that slowly but surely erode the normal architecture of the lung, leaving in their wake cavities which fill with phlegm which in turn render the sufferer more susceptible to infection. Three years or so back Pete had a really bad infection—bad enough to warrant admission to hospital with pneumonia. While he was there he developed respiratory failure and came home with both oxygen and night time ventilation. Against advice he went back to work. He lasted six months before I prevailed on him to be signed off. He was gasping, and the lifting his job entailed was patently far too much for him. Three months after signing him off the benefit docs asked him in for a medical, where they asked him a few questions, got him to do a few trivial physical jerks, and passed him fit to return to work. This despite me filling in a form explaining his need for long term oxygen therapy and night time ventilation.
So Pete gamely struggled back to work. At least by now there was a smoking ban so his working conditions were a little better, but come the following winter he had another exacerbation, a long spell off work, and finally lost his job. Thus far I’ve been able to persuade him he really ought not be looking for another, and again thus far, the B.A. docs appear to have seen sense and have accepted my latest report and stopped hassling him.
Thank you Dr Jest. If any other doctors, nurses, social workers, care workers etc would like to share their stories please send them to us at thebrokenofbritain@gmail.com