I’m interested, I ask for more. So she tells me of a time when she was younger, being pulled out of a sudden deep pit of snow by somebody’s hand. Nearly suffocated. “Whose hand?” I ask. “Nobody’s, it just felt like a hand. My father was many yards away.”
I tell her my stories, how during the last five years I’ve had terrifying car accidents. In one a young guy ran a red light and sideswiped me, totaling the car. In the other I skidded across an icy highway on a dark-black night, off the four-lane road into a void that turned out to be a gentle rise. Not a scratch on me. “I’ve been healthy all my life,” I say, “then two near misses.” I don’t mention the obvious hit – the death of my son five years ago, but it’s on my mind.
Now seventy years old, I’m hyper-aware of how bodies, as Metamorphoses puts it, “can change to assume new shapes.” I try to stay in shape, work out three times a week at the gym, erasing various aches and pains with the jock’s little helper, Ibuprofen. “Never a day in hospital since I was a child,” I tell the Czech woman, “and just like that, two accidents over which I felt I had no control, and it could have been curtains.”
Coming to a pause in our stories, we shake hands and part without saying goodbye. And just like that, an intimate conversation between strangers is over, both of us willing participants in Tino Sehgal’s improvisational script about what it means to connect with others. Later that evening, after dinner with friends, I begin to feel ill.
The next day I'm shuffling between bed and toilet in our Fleet Street flat. I’m okay when I’m horizontal, but on my feet I’m a little dizzy. Could be flu or a bug or food poisoning. By the next evening, feeling a little worse, now easily tired, I search for fleet street doctors on the web and find the Fleet Street Clinic a hundred yards away.
Soon I’m reporting my symptoms to a young, extremely pleasant doctor from Berlin. As I tell him my troubles, he googles. After he checks my heart rate and taps my stomach, he’s pretty sure I have a virus that has penetrated my inner ear, and that unless it’s a rare chronic variety, I should be okay in a few days. He advises me that it would be better, however, if I didn’t travel back home the next day as planned. He prescribes me £12.50 ($20) worth of painkillers “just in case your stomach hurts” and sends me off with a printout about Labyrinthitis and Vestibular Neuritis from patient.co.uk. My fifteen-minute consultation in a private clinic in London costs me £70 ($111), meds not included.
Later that evening the nice young doc calls me to say that if I don’t feel better in the morning, “it might be a good thing to come in for a blood test.” The next day I insist that Cecilia take her flight back to the States. “I’ll rest for a few days, get rid of this virus, and come home later. I’ll be okay. I know my way around England,” I reassure her, “I don’t feel like an outsider.”
I grew up in Manchester before leaving for California in 1963. I have relatives here. Moreover, two of my closest friends from San Francisco have just arrived to spend the year in London. “Don’t worry,” I tell Cecilia, “Mark and Lydia will help me if I need them.”
Cecilia leaves at dawn. I get up, but the room is spinning. By now, as a later medical report notes, my stools have become decidedly offensive. I pop a couple of Imodium with a view to getting myself plugged up for the journey home. I don’t trust myself to take a shower without falling and I no longer trust the private medical system to provide an inside track to recovery.
At my niece’s urging, I call the National Health System’s help line. A screener takes my details and within an hour I’m being quizzed on the phone by a nurse who takes his time to get all the details right. Later that morning, accompanied by Mark and Lydia, a GP at a local NHS clinic asks a few questions, puts her finger up my ass, and dismisses the diagnosis of inner ear virus. “It’s melena, you’re bleeding in your stomach, you’re clinically anemic,” she says, sure of herself, and refers me to University College Hospital. “The medical team is waiting for you in Emergency.”
I crumple to the ground outside the clinic while Mark tries to run down a taxi. I feel like I have seen the future and it doesn’t work. During the short journey from clinic to hospital, I’m getting worse, more disoriented and physically incompetent than I have ever felt in my life. “I’ll always remember you at that moment,” recalls Lydia a few days later. “You suddenly looked old and frail. Like an old man.” She hesitates. “Something about the shape of your body, the way you bent over. You were deteriorating in front of me.”
By the time we arrive at the hospital, I can’t make it to the emergency room. Mark puts me in a wheelchair and zig-zags me into the waiting room. “He’s deteriorating,” Lydia says to the receptionist. She’s scared. So am I, imagining the worst.
A combination of events – my initial denial that it was blood down there, taking an over-the-counter drug that masked my symptoms, and the private doctor’s quickie misdiagnosis – had combined to put me at risk. The acute medicine team at University College Hospital moves quickly on my case. A relay of doctors confirms that I’m suffering from bleeding ulcers, no other pathology, not the stomach or colon cancer I feared. The nursing staff surrounds me with care and compassion. “Not to worry, darling, you’ll be better soon.”
And they were right. Three days later, seven pounds lighter, topped up with three liters (5.2 pints) of blood, I’m on the mend. Ibuprofen, I’m told, is the likely culprit. “Three weeks of Omeprazole capsules and you should be fine,” says the discharge doctor.
The care I receive from the NHS in England is comparable to the care that I would have received from Kaiser, my Health Maintenance Organization in California. Except a tourist from England with an acute problem would not have been admitted to Kaiser because it’s a members-only organization, linked for the most part to work-related health insurance. And if this same tourist had staggered into another hospital, the first order of business would have been the matter of payment.
At University College Hospital in London, money was never discussed. I remember a nurse informing me that the “overseas team will no doubt visit you,” but they didn’t. I must have racked up quite a bill: x-rays, an EKG, blood tests, gastroscopy, lab analysis, and ICU-like care for the first twenty-four hours.
I tell one doctor that I’m a long-time resident of the United States and a British citizen, but nobody asks to see my passport or check my identification. I don’t have travel insurance. Aside from £60 ($95) required by the Neaman Practice for their diagnosis and £25 ($40) for a big bundle of optional phone and telly services at the hospital, there’s no charge. It costs me about twice as much – a change fee – to re-book my flight home with United Airlines.
After I’m discharged, I revel in the everyday, but feel compelled to return, not as a patient but as a visitor to see Michael who is in the bed next to me during my last twenty-four hours in hospital. We find common ground very quickly. We’re roughly the same age and class background, and share similar experiences as ex-pats, he in Spain, me in California. Our politics are very different – I read the Guardian and New Statesman, he reads the Daily Mail and Spectator – but neither of us is interested in ideological combat. Bigger issues are on our minds.
Michael and I have both been healthy all our lives, never in hospital since we were kids. “I had a pain in my stomach,” he tells me. “Went to see some doctors and they told me I had inoperable cancer. I said no to chemo, what’s the point.” The docs told him he had about three months to live. “How long ago was that?” I ask. “Three months,” he replies, looking me in the eye. “It’s all over for me. I’m going to die very soon. Look,” he says, opening up his puny hospital gown to show me up close how the cancer has bloated his once lean and handsome body. He wants out of the hospital now, this minute. He craves his garden and the intergenerational household that he shares in London with his wife, daughter, and grandchildren.
“And you?” he asks. I tell him the dice rolled lucky for me this time.
My last day in London, we talk personally about our families. I tell him about the death of my son Daniel. Michael tells me how difficult it was to let his granddaughter know about his own looming death. I give him the piece of slick, black-green jade that I always carry with me on trips for good luck. “It’s from a place in northern California called Big Lagoon. I found it on the beach. It keeps me grounded about what’s important,” I say to Michael.
It’s difficult to say our goodbyes, both of us teary. “I wish we had met under better circumstances,” concludes Michael. “Me too,” I reply. When we shake hands, I feel the jade warm in his palm. “I’ll put a hole in it and wear it around my neck,” he says with a lovely smile.
The writer is recuperating at home in Berkeley and is back at work. Michael Johnstone died at Trinity Hospice in London on September 20th.