Long In The Toothache - Short Story by Margaret Wilde

Long In The Toothache

"These Fat Depressives: they’re always complaining of pain; they’re never happy unless they’re moaning." The consultant was musing to himself. He was a very important man. He hadn’t much time to spare for this silly woman.

He glanced at the notes. She’d complained of an acute abscess to her dentist nearly a year ago and then come afterwards to the Dental Hospital with the same complaint. Well, clearly she couldn’t have had it all that time. She couldn’t have put up with the pain.

True, she’d kept going back to her dentist. But that was the way with Depressives: obsessive about health, always wanting attention. The dentist hadn’t pandered to her, sensible fellow. He hadn’t taken any X-rays. As he’d told the woman last summer when she’d had her breakdown, that proved the ‘pain’ was just her nerves.

Coincidence that she had, after all, developed an abscess on that tooth, and it must have been there a while or the bone wouldn’t have rotted so far. Still, it would have been chronic. Lots of people had so little discomfort from chronic abscesses that they were only discovered in the course of other dental treatment. The pain of acute abscesses was of a different order of magnitude altogether, though they all become chronic if left untreated.

He knew how to deal with Depressives: Shock Treatment. It never failed. Let them know you’ll stand none of their nonsense. They needn’t whine to you for sympathy. If only everyone would treat them in the same way. They’d soon snap out of their silly behaviour then. He prided himself on his decisiveness.

She entered his room nervously. Her eyes were puffy. She appeared tired and confused. Of course, she was on Librium and amitriptyline.

"You Fat Depressives!" he greeted her. "You grind your teeth, don’t you?"

"No," she replied, and started to cry.

"All Fat Depressives on amitriptyline grind their teeth."

"Well I don’t." The silly woman was weeping copiously and blowing her nose. What a mess she looked! No wonder no-one had ever wanted to marry her.

"The last three Fat Depressives I had all ground their teeth. Why should you be any different?"

"I’m not a Fat Depressive; I’m a person. And I’ve got a lot of toothache. My mouth is a sheet of pain."

"A bit of sensitivity: we all get that as we get older. Don’t be childish. The fact is you grind your teeth while you’re asleep and that makes them hurt a bit."

"But I don’t sleep! That’s the point! I’m in too much pain. That’s why I had the breakdown. I’m so desperately tired."

"Rubbish, Woman! Of course you sleep. You just think you don’t. Pull yourself together!"

“And I’m very concerned about my work. I have a good honours degree and a distinction on teaching – but how can I give of my best to my pupils when most of my concentration is focussed on this excruciating pain and I’m so tired I can’t think properly?"

Ah that was it! She needed something to blame for poor performance in the work situation! – A classic example of neurosis!

He raised his voice to drown hers: "It is no good being hysterical with me, Young Woman. You’ve got to learn to be quiet and listen. You Neurotics are fond of the sound of your own voices."

"Tell me, Mr Lambert, don’t ‘Depressives’ ever get toothache? I have had an acute abscess left untreated for nearly a year; I have had a just-detected cracked cusp which has been painful for almost as long, one tooth just filled because it had decay and another still awaiting treatment. There are sympathetic pains all over my mouth. I am in torment."

"Stop exaggerating. - You Fat Depressives are all the same. You eat oranges and drink fizzy drinks all day, don’t you? I know these fad diets."

She looked bewildered at the change of direction of his questioning. "I don’t eat oranges. My teeth hurt too much. I never drink fizzy drinks. And I’m not normally fat. The amitriptyline holds water in my body and has caused me to gain two stones. – But what has any of this to do with the abscess, the decay and the cracked tooth?"

"Fat women always claim they never eat. - I’ll make you a bite-guard to wear at night to stop you from grinding your teeth."

She realised the advantage to the Dental ‘Mafia’ of covering up gross diagnostic errors over such a long period, but surely a consultant would have had a greater allegiance to truth and scientific exactitude than to negligent incompetents, professional colleagues or not. Surely he must realise that it was stretching credulity and coincidence too far to maintain that an abscess, a cracked tooth and two decayed teeth had all appeared by magic on the day that, fighting her appalling weariness, she had made a scene and insisted that her ex-dentist write a note for the Dental Hospital to have another look at the abscess!

The interview was at an end. He had not looked at her teeth, of course. You didn’t need to, with Depressives. The diagnoses were always the same: tooth-grinding, ‘target teeth’, acidic foods, sugary drinks, imaginary pain and exaggeration.

Well, he’d do the operation to remove the abscess and the rotting bone in June. At the same time he’d excise the scar from a previous mouth operation as it had healthy nerve tissue trapped in it. There was no urgency. She was a healthy woman in no pain and could wait four months.

He informed her doctor that she was just a Depressive. It wasn’t possible to have pain in so many teeth. "We have a Pain-Prone Neurotic here, Doctor. If I were you I’d treat any pain she complains about with a pinch of salt. These people waste a lot of our time."

The day of the operations came. He had not told her what to expect. She lived alone and would have made suitable preparations had she known how ill the operations would make her, how long they would take, how much blood she would lose. She was in ghastly pain in some other teeth. They had been treated at last, but the trouble had gone on so long before they were treated that they were taking months to ‘settle down’. Her tongue was exquisitely sore from contact with rough edges of temporary crowns and from encountering oil of cloves – balm for aching teeth but corrosive to tongue and gums. She was desperate, absolutely desperate – genuinely suicidal because of the continual pain, tension and lack of sleep. - She forced herself to remain calm. Some relief was at hand.

He had a student to assist him. He talked ‘at’ the patient. - It was only a local anaesthetic despite the operations lasting well over an hour. She had her mouth open and the scalpel and aspirator in it. Blood and saliva were removed as they appeared. She was unable to reply even if she had wanted to.

"Well Miss – Er -, you will have followed the Falklands Campaign. Brave men. They know what genuine suffering is."

As he cut through the gum during the apicectomy he accidentally cut deeply into the dentine of the perfectly healthy tooth next to the abscessed one. – God! - That’d be painful when the anaesthetic wore off! Rather her than me! Still, she’d be in shock today and it wouldn’t be absolute agony till tomorrow. It’d do her good to have some real pain for a change, anyway.
She was, after all, extremely fortunate to get the services of so eminent a dental surgeon on the National Health!

The following day, after a night of sitting upright to keep the swelling to a minimum, she was amazed to discover its actual extent. Her nostrils were splayed out to either side far wider than the outer corners of her eyes. The space left was too narrow for breathing. She had to breathe through her mouth. Blood and saliva ran down her chin. The upper lip was so swollen that it extended right over her lower lip, touched her chin and turned up at the bottom so that the inside was on the outside, so to speak. She strongly resembled the snouted Trolls she had once seen in a performance of ‘Peer Gynt’.

All was stiff – stiff as a board, she started to think, but realised that if a board were pressed, its rigidity would resist. If this stiffness were to be pressed, what would happen? The blood-gorged flesh would surely tear internally? She must try to keep very still and not touch it or stretch it.
But it was necessary to eat and drink to restore her strength after the loss of blood.

This was not only painful; it was extremely difficult. Her lips did not make a seal, since the upper was so much bigger than the lower. To drink in the normal way was impossible, as the upper lip was unusable. She had to introduce a small spoon into her mouth and ‘pour’ a little liquid from it into the bottom of her mouth and then bend her head backwards for it to reach her throat. It was a messy, immensely slow business.

She had not believed her ordeal could worsen so much. The healthy tooth which had been damaged by the surgeon’s carelessness astonished her by being the most harrowing of all the teeth. The scar excision had proved a much bigger operation than she had been led to expect. Painful throbbing extended from her mouth, up the side of her nose and as far as the outer edge of her left eye.

Her mouth was to her the very jaws of Hell.

The sweet focus was her TONGUE.

How deliciously sensitive the tongue to delight! – How agile a member when all had been well with her mouth! But for three months now it had been constantly chafed by the temporary crown and sticking-up point of the tooth which had been cracked. She had been embarrassed at school by having to use chewing gum to cover the sharp point. This was effective but it had to be continually chewed in order to function. If just left on the point without chewing, it went flaccid and soft in the heat of her mouth and slipped its mooring.

But how was she to chew? – With the great need for inactivity for healing to take place and the swelling to subside?

Unhappily, there proved to be no choice. The tongue’s demands were the most strident. She chewed all day – and all night, since the pain from the tongue would not allow her to sleep. In sleep the chewing gum would leave the tooth, the tongue would relax onto the point and the pain would wake her from that tiny sleep.

How could this torture have been allowed to happen? If an I.R.A. prisoner had been made to suffer as she had, Amnesty International would have intervened. But she was allowed no advocate. Her torturers were the prosecution, judge and jury.

She could feel the tight flesh tearing as she chewed. She could feel the stitches tugging through the delicate skin. She knew that she was doomed.

Lack of sleep. Horrendous pain.

She had the stitches out a week later and begged that the sharp point be ground down. It was, a little, but the remaining tooth tissue had to be conserved at all costs, apparently, even the possible cost of her sanity. She had no strength to argue and her tongue did not permit much speech.

Three days after this the migraines began. She took paracetamol and embarked on a futile expedition to find and purchase a glue to stick the chewing gum into position. She obtained some, but the glue remained in position and the gum slid off! Then the next shopkeeper told her that the glue was poisonous.

The fifth migraine in a day – she had not believed so many were possible in a day – attacked her on her way home. It was the end. No-one would help her. No-one understood her wretchedness and it increased when she sought to explain it. since this involved moving her tongue. So many teeth hurting; gums throbbing; face painful; head pounding; eyes aflame and unseeing.

As a stumbling, purblind, weary, yet supremely lucid and logical act, in order at last to end the pain and blessedly to go to sleep, she stepped in front of the approaching car.

………………………………….

Notes.

Every word I have put into the mouth of the surgeon in talking to me is what Mr Reg Dinsdale (I have used a pseudonym in the story) actually said to me, but there was more than this, of course.

I have telescoped two ghastly interviews into one.

Much of what ‘she’ says in the story was actually written for the surgeon, as I was far too ill to speak much.

He did look in my mouth actually, to see if an apicectomy on the Upper Left 2 would be feasible. But this was only after he had made his ‘diagnosis’ – of Depression and Tooth-grinding!

The car stopped (end of story). I felt contrite that I had frightened the driver – though it was not a pre-meditated act. I went to Dr Hazel Radley and told her I had just attempted suicide. – Please would she help me to get the dental treatment I needed? – Coldly she told me not to be silly. – I was not in pain, she assured me.

Margaret Wilde

Fighting the System: NHS Complaints Procedures

The first feature article I wrote for Mensa’s monthly glossy magazine was about medical and dental negligence and the uselessness, cruelty and bias of the NHS Complaints Procedures, and was entitled ‘Fighting the System’. In the years since then there will have been changes to the Complaints Procedure, but I am confident that it still harms complainants rather than helping them or reforming the system.

This is a slightly shortened version of the article:

Fighting the System

An abscess flared up on one of my front teeth. Talking was difficult and sleep impossible. My dentist said there was nothing wrong. So I went to the Dental Hospital. The pain – sudden, acute, accompanied by swelling, most severe when biting – was exactly characteristic of an acute abscess. But the pain was discounted and the abscess not treated.

When you have toothache you chew in strange ways to avoid exacerbating it. This puts unnatural pressures on teeth and it is easy to crack them. This happened to me. A cracked cusp, a separate agony, went untreated. Tooth-brushing was an ordeal and could not be as thorough as before the pain. Decay started, causing further severe toothache. This also went untreated. It was almost a year before the abscess was treated. It was over two years before I obtained treatment for all the dental disorders causing the toothache!

If consulted by a man with an abscess and weeping in agony, surely the most negligent dentist would take note of the signs and symptoms and would treat the abscess in its acute phase, ending the pain. In a full year of many attendances at the Sheffield Dental Hospital I was constantly insulted and left in agony. One consultant called me ‘You Fat Depressives’, plural, instead of using my name. It was clear that he habitually addressed suffering women in this way.

I eventually found a dentist brave enough to try to put things right. He dealt with the gross infections, etc but tragically much of the pain had by this time become chronic, which often happens when the cause is not dealt with promptly.

I heard from other women who had had their pain derided or been told that it was ‘nerves’ or ‘all in the mind’. One Rotherham woman had endured agony from trigeminal neuralgia for 13 years before someone (a neurosurgeon in private practice) took her pain seriously and operated. The pain then stopped. Trigeminal neuralgia mainly attacks women and its only symptom is pain. It is not uncommon for people to kill themselves because of severe toothache or because of trigeminal neuralgia, so intense is the pain.

Thirteen years of needless agony. Why does such cruelty flourish? The answer is many-faceted, of course. It includes ignorance and arrogance. Pre-eminent, however, is the health professional’s demeaning attitude towards women, coupled with the scandalous fact that in this country doctors and dentists are accountable to no-one, not to the patient, not to the hospital, not to the NHS.

Women are sub-human, second-class citizens whose voice need not be heeded. Everyone knows, don’t they, that whatever a woman complains of, the ‘real’ cause is usually psychological, and instead of investigation and treatment all she needs is a brusque injunction to pull herself together and a prescription for tranquillisers and anti-depressants. That’ll settle her!

In my desperate efforts to obtain the treatment I needed I turned to every health agency. All pretended that negligence does not occur. No-one insisted that my teeth be examined and my agonising toothache dealt with. The health agencies and the people to whom complainants must address complaints are financed by the DHSS or the NHS and by definition not impartial. The Complaints Procedure routinely adds to the difficulties of complainants rather than dealing with their complaints of negligence.

Why are the legislators not moved to effective remedial legislation? There are many reasons, I suppose; laziness, fear, the myth of medical infallibility, the desire to keep in with medics and their retinues, the fact that most MPs use private medicine rather than the NHS and that when they do use the NHS they get preferential treatment. Surely, also, a lack of imagination – failure to comprehend the scale of the suffering, the profound and terrible difficulties of damaged victims – trapped in pain and distress and worry, trapped in misunderstanding, trapped in bewilderment that those to whom they turn for help and from whom they have been led to believe they will receive it, adopt a confrontational stance. There is no-one in the entire edifice of the Health Service from whom victims of medical negligence can be assured of receiving help. They do not know where to turn.

In the Sheffield Star of August 20th 1986, the Administrator of the Sheffield Family Practitioner Committee is quoted as saying of complaints that most of them ‘were dealt with amicably, although in some cases the patient was struck off’. Dealing with complaints is clearly thought of as a matter of smoothing ruffled feathers or of placating/punishing the complainant, rather than of examining faults that need to be put right. If you made a complaint about trains, you would not consider it resolved by being forbidden to travel by train any more, would you? Why should a complaint about a doctor be considered resolved by crossing the complainant off his list?

When in the press someone criticises the medical profession, another person is certain to write in to protest that they themselves received wonderful treatment. e.g. the dreadful way that Sue Arnold was treated at the Moorfields Eye Clinic in London, reported a few months ago in her column in the Observer magazine. The following week someone wrote about their wonderful treatment there. If you publicised finding a dead mouse in a loaf, no-one would dream of writing to say that they had had a loaf from the same shop and it hadn’t had a dead mouse in it! Officials aver that the public makes few complaints about the Health Service. Like saying that most of our loaves don’t contain dead mice.

The official claim disregards the justifiable fears many people have about making a complaint. You risk being struck of a doctor’s list (and often the family of the complainant is also struck off) and may find it difficult to get a doctor at all.

The main reason for outraged complaint is being treated as sub-human. As I was. Callously left in agony which could easily have been treated and which I clearly could not treat myself. Agony for which it was impossible to get relief without the treatment that was being denied me. Abscesses and caries cannot ‘get better’. There has to be professional intervention.

By allowing medics to insult people under the guise of diagnosing them, by allowing honourable people to be treated in this appalling way, humanity is defiled. By categorising the person who then complains as a nuisance who must be pacified if possible and quelled if not, no-one is safe from such defilement.

There are moves to tinker with the Complaints Procedure. The Primary Health Care leaflet, with the Government’s proposals for discussion on health services outside hospital, suggests that there should be informal conciliation procedures to settle less serious complaints quickly and effectively. Again the ruffled feathers syndrome. Complainants do not want conciliation, they want remedial action taken about the complaint. Officially, negligence does not occur. So nothing is done about it.

It would be salutary to cause to be published a sample of the complaints of the last year and what the Complaints Procedure did about them. This would show it up for the charade it is. One only hears of anything being done if the matter is given publicity, which seldom helps.

That suffering, ill, exhausted people damaged by the medical profession have the right to redress in the civil courts is no right at all. Only 3% or 4% of cases get to court and they take a minimum of 4 years to get there. Everything is weighted against the victim, especially the hostile attitude of the Health Authorities. In any case, action in the civil courts has only individual relevance. General reform cannot result.

What victims most need is remedial treatment. There is no provision for this. What can be more important than the right to urgent remedial treatment when you have been harmed by hospital personnel? Gross medical negligence is compounded by the implacable unhelpfulness of the Health Authorities.

The NHS should be accountable to the consumer – i.e. the patient. Medical and dental staff have absolute power to give or to withhold necessary investigation and treatment to patients, to treat them with insolence, to defame their characters in privileged communications, etc. provided only that they call this the exercise of ‘clinical judgment’. (Compare this with, in recent times in Parliament, the ritual incantation that a matter is one of ‘national security’ and as such no-one has the right to question it.) Such power is clearly dangerous, is open to abuse and is clearly being abused. Terrible suffering like mine would be totally prevented if medical and dental staff were accountable.

Negligence

There can be nothing in this country more heinously unjust than the lack of help for the suffering victims of medical negligence. Patients have no protection whatsoever from the ignorance, incompetence, negligence and sometimes sheer malice of doctors and dentists. People who are not victims of the system are unaware of the situation. That negligent doctors and dentists incur neither censure nor sanction from the system ensures that negligence flourishes.

It is a moral imperative for caring people to do what they can to bring a speedy end to this cruelty.

The Complaints Procedure needs to be scrapped and replaced by a system providing immediate help for the victim of negligence (I don’t mean money; I mean remedial treatment and support) and an independent inquiry into the negligence with the purpose of apportioning responsibility and instituting reform to protect potential future victims. I stress that I am not interested in legal redress. I am asking for legislative action to remedy a national scandal.

The Health Ombudsman defines instances of medical negligence as matters of clinical judgment, and matters of clinical judgment, conveniently for negligent doctors and dentists, are outside his terms of reference. So he does not help. His reply to my letter made clear that he had given scant attention to my arduously compiled material. My evidence was ignored.

This state of affairs is independent of who the individuals are who become victims, being only dependent on the deficiencies of a system which allows the magic phrase ‘clinical judgment’ to override reason, humanity and justice. Clinical judgment cannot, by definition, obtain, where clinical diagnostic procedures have been waived. To pretend otherwise is an abuse of language, an abuse of trust, effectively an abuse of power and in practice a physical and psychological abuse of individual victims.

These abuses are systemic and must be rooted out. The powerless and suffering need protection from such cruelty.

There was a public inquiry about Wendy Savage, a doctor neither negligent nor incompetent, and about whom no patients had lodged complaints. There are no inquiries into real cases of negligence, initiated by the victims. Health professionals would be much more careful if their actions were to be subjected to public scrutiny.

Margaret Wilde

The uselessness and cruelty of the NHS Complaints Procedures: FIGHTING THE SYSTEM.

The first feature article I wrote for Mensa's monthly glossy magazine was about medical and dental negligence and the uselessness, cruelty and bias of the NHS Complaints Procedures, and was entitled 'Fighting the System'. In the years since then there will have been changes to the Complaints Procedure, but I am confident that it still harms complainants rather than helping them or reforming the system.

This is a slightly shortened version of the article:

Fighting the System

An abscess flared up on one of my front teeth. Talking was difficult and sleep impossible. My dentist said there was nothing wrong. So I went to the Dental Hospital. The pain - sudden, acute, accompanied by swelling, most severe when biting - was exactly characteristic of an acute abscess. But the pain was discounted and the abscess not treated.

When you have toothache you chew in strange ways to avoid exacerbating it. This puts unnatural pressures on teeth and it is easy to crack them. This happened to me. A cracked cusp, a separate agony, went untreated. Tooth-brushing was an ordeal and could not be as thorough as before the pain. Decay started, causing further severe toothache. This also went untreated. It was almost a year before the abscess was treated. It was over two years before I obtained treatment for all the dental disorders causing the toothache!

If consulted by a man with an abscess and weeping in agony, surely the most negligent dentist would take note of the signs and symptoms and would treat the abscess in its acute phase, ending the pain. In a full year of many attendances at the Sheffield Dental Hospital I was constantly insulted and left in agony. One consultant called me 'You Fat Depressives', plural, instead of using my name. It was clear that he habitually addressed suffering women in this way.

I eventually found a dentist brave enough to try to put things right. He dealt with the gross infections, etc but tragically much of the pain had by this time become chronic, which often happens when the cause is not dealt with promptly.

I heard from other women who had had their pain derided or been told that it was 'nerves' or 'all in the mind'. One Rotherham woman had endured agony from trigeminal neuralgia for 13 years before someone (a neurosurgeon in private practice) took her pain seriously and operated. The pain then stopped. Trigeminal neuralgia mainly attacks women and its only symptom is pain. It is not uncommon for people to kill themselves because of severe toothache or because of trigeminal neuralgia, so intense is the pain.

Thirteen years of needless agony. Why does such cruelty flourish? The answer is many-faceted, of course. It includes ignorance and arrogance. Pre-eminent, however, is the health professional's demeaning attitude towards women, coupled with the scandalous fact that in this country doctors and dentists are accountable to no-one, not to the patient, not to the hospital, not to the NHS.

Women are sub-human, second-class citizens whose voice need not be heeded. Everyone knows, don't they, that whatever a woman complains of, the 'real' cause is usually psychological, and instead of investigation and treatment all she needs is a brusque injunction to pull herself together and a prescription for tranquillisers and anti-depressants. That'll settle her!

In my desperate efforts to obtain the treatment I needed I turned to every health agency. All pretended that negligence does no occur. No-one insisted that my teeth be examined and my agonising toothache dealt with. The health agencies and the people to whom complainants must address complaints are financed by the DHSS or the NHS and by definition not impartial. The Complaints Procedure routinely adds to the difficulties of complainants rather than dealing with their complaints of negligence.

Why are the legislators not moved to effective remedial legislation? There are many reasons, I suppose; laziness, fear, the myth of medical infallibility, the desire to keep in with medics and their retinues, the fact that most MPs use private medicine rather than the NHS and that when they do use the NHS they get preferential treatment. Surely, also, a lack of imagination - failure to comprehend the scale of the suffering, the profound and terrible difficulties of damaged victims - trapped in pain and distress and worry, trapped in misunderstanding, trapped in bewilderment that those to whom they turn for help and from whom they have been led to believe they will receive it, adopt a confrontational stance. There is no-one in the entire edifice of the Health Service from whom victims of medical negligence can be assured of receiving help. They do not know where to turn.

In the Sheffield Star of August 20th 1986, the Administrator of the Sheffield Family Practitioner Committee is quoted as saying of complaints that most of them 'were dealt with amicably, although in some cases the patient was struck off'. Dealing with complaints is clearly thought of as a matter of smoothing ruffled feathers or of placating/punishing the complainant, rather than of examining faults that need to be put right. If you made a complaint about trains, you would not consider it resolved by being forbidden to travel by train any more, would you? Why should a complaint about a doctor be considered resolved by crossing the complainant off his list?

When in the press someone criticises the medical profession, another person is certain to write in to protest that they themselves received wonderful treatment. e.g. the dreadful way that Sue Arnold was treated at the Moorfields Eye Clinic in London, reported a few months ago in her column in the Observer magazine. The following week someone wrote about their wonderful treatment there. If you publicised finding a dead mouse in a loaf, no-one would dream of writing to say that they had had a loaf from the same shop and it hadn't had a dead mouse in it! Officials aver that the public makes few complaints about the Health Service. Like saying that most of our loaves don't contain dead mice.

The official claim disregards the justifiable fears many people have about making a complaint. You risk being struck of a doctor's list (and often the family of the complainant is also struck off) and may find it difficult to get a doctor at all.

The main reason for outraged complaint is being treated as sub-human. As I was. Callously left in agony which could easily have been treated and which I clearly could not treat myself. Agony for which it was impossible to get relief without the treatment that was being denied me. Abscesses and caries cannot 'get better'. There has to be professional intervention.

By allowing medics to insult people under the guise of diagnosing them, by allowing honourable people to be treated in this appalling way, humanity is defiled. By categorising the person who then complains as a nuisance who must be pacified if possible and quelled if not, no-one is safe from such defilement.

There are moves to tinker with the Complaints Procedure. The Primary Health Care leaflet, with the Government's proposals for discussion on health services outside hospital, suggests that there should be informal conciliation procedures to settle less serious complaints quickly and effectively. Again the ruffled feathers syndrome. Complainants do not want conciliation, they want remedial action taken about the complaint. Officially, negligence does not occur. So nothing is done about it.

It would be salutary to cause to be published a sample of the complaints of the last year and what the Complaints Procedure did about them. This would show it up for the charade it is. One only hears of anything being done if the matter is given publicity, which seldom helps.

That suffering, ill, exhausted people damaged by the medical profession have the right to redress in the civil courts is no right at all. Only 3% or 4% of cases get to court and they take a minimum of 4 years to get there. Everything is weighted against the victim, especially the hostile attitude of the Health Authorities. In any case, action in the civil courts has only individual relevance. General reform cannot result.

What victims most need is remedial treatment. There is no provision for this. What can be more important than the right to urgent remedial treatment when you have been harmed by hospital personnel? Gross medical negligence is compounded by the implacable unhelpfulness of the Health Authorities.

The NHS should be accountable to the consumer - i.e. the patient. Medical and dental staff have absolute power to give or to withhold necessary investigation and treatment to patients, to treat them with insolence, to defame their characters in privileged communications, etc. provided only that they call this the exercise of 'clinical judgment'. (Compare this with, in recent times in Parliament, the ritual incantation that a matter is one of 'national security' and as such no-one has the right to question it.) Such power is clearly dangerous, is open to abuse and is clearly being abused. Terrible suffering like mine would be totally prevented if medical and dental staff were accountable.

Negligence

There can be nothing in this country more heinously unjust than the lack of help for the suffering victims of medical negligence. Patients have no protection whatsoever from the ignorance, incompetence, negligence and sometimes sheer malice of doctors and dentists. People who are not victims of the system are unaware of the situation. That negligent doctors and dentists incur neither censure nor sanction from the system ensures that negligence flourishes.

It is a moral imperative for caring people to do what they can to bring a speedy end to this cruelty.

The Complaints Procedure needs to be scrapped and replaced by a system providing immediate help for the victim of negligence (I don't mean money; I mean remedial treatment and support) and an independent inquiry into the negligence with the purpose of apportioning responsibility and instituting reform to protect potential future victims. I stress that I am not interested in legal redress. I am asking for legislative action to remedy a national scandal.

The Health Ombudsman defines instances of medical negligence as matters of clinical judgment, and matters of clinical judgment, conveniently for negligent doctors and dentists, are outside his terms of reference. So he does not help. His reply to my letter made clear that he had given scant attention to my arduously compiled material. My evidence was ignored.

This state of affairs is independent of who the individuals are who become victims, being only dependent on the deficiencies of a system which allows the magic phrase 'clinical judgment' to override reason, humanity and justice. Clinical judgment cannot, by definition, obtain, where clinical diagnostic procedures have been waived. To pretend otherwise is an abuse of language, an abuse of trust, effectively an abuse of power and in practice a physical and psychological abuse of individual victims.

These abuses are systemic and must be rooted out. The powerless and suffering need protection from such cruelty.

There was a public inquiry about Wendy Savage, a doctor neither negligent nor incompetent, and about whom no patients had lodged complaints. There are no inquiries into real cases of negligence, initiated by the victims. Health professionals would be much more careful if their actions were to be subjected to public scrutiny.

SPEECH IMPEDIMENT - Short Story by Margaret Wilde

SPEECH IMPEDIMENT

“Does that hurt?”

Rigid with agony, breathing arrested mid-inspiration, fingers digging into the arms of the chair, thrust skull pinning the headrest, she waited for the end of eternity – waited for the drill to stop. It stopped.

Limp and drained, she breathed again.

“Did that hurt?” he asked impassively.


Margaret Wilde ©2007