I didn’t mean to vomit over the doctor. I’d normally have felt more embarrassed

A sudden illness brings home the importance of community – and of the privilege of belonging

Tumour: my surgeons found a large mass hanging in the loops of my intestine. Photograph: E+/iStock/Getty

Tumour: my surgeons found a large mass hanging in the loops of my intestine. Photograph: E+/iStock/Getty

 

I didn’t mean to vomit over the doctor. I’d normally have felt more embarrassed about splattering him with the mess in my stomach. But it was only liquid, even if it was warm and dark and generally unpleasant. And, exhausted after vomiting at home like this for several days, I was almost past registering that I was spewing bile at him.

The doctor, a junior medic, was in the middle of feeding a tube up my nose and down my throat, to relieve the build-up in my stomach. He probably wasn’t overly surprised when the bile that had been bubbling up my oesophagus found the intrusion a good reason to brim over. So he just carried on.

That was on my first day in hospital, late last summer, after I had arrived in the emergency department the evening before. A different young doctor had admitted me to a surgical ward in the middle of the night – an obstructed bowel, he believed. I’d assumed he was on the night shift. He turned out to be on the day shift, too, reappearing several times during one of those mammoth stints you hear about but can’t quite comprehend.

A large mass hanging in the loops of my intestine had squeezed one section shut, like a foot on a hosepipe, which was why the bile had been left with only one route out of me

Forty-eight hours later, my surgeons found a large mass hanging in the loops of my intestine. As it had grown it had gradually squeezed one section shut, like a foot on a hosepipe, which was why the bile had been left with only one route out of me. They cut it all away, along with some of my bowel, whose severed ends they then joined together.

I smiled when the young doctor who’d admitted me stopped by the next day to say he’d come into the operating theatre to see if his diagnosis was correct. He would have scrubbed up and joined in, but three surgeons were already at the table. So he’d just watched.

The doctor, who wasn’t long graduated, had planned to be in Australia by last summer, travelling and working with friends, but Covid had changed all that. So here he was, staying on, answering Ireland’s call. And his diagnosis had been spot on.

I spent 16 nights in hospital in all, on a ward where some people were patients for even longer than that, and where some of their diagnoses were terminal. So I felt lucky to go home to my family, even though one of the surgeons had to tell me, the day I left, that the histopathology report was back and that the mass had turned out to be a Gist, or gastrointestinal stromal tumour: a type of cancer.

Lucky, too, to hear a few days later, after I’d told one of my new oncologists that I’d had cancer before – non-Hodgkin’s lymphoma, for which I’d had radio- and chemotherapy 28 years earlier, as a college student in England – that if you had to choose two types of cancer to have, a Gist and non-Hodgkin’s lymphoma were pretty good candidates.

You need medication you couldn’t possibly afford by yourself, so the community you’re a part of covers the bill. And that’s after it has already picked up the tab for your surgery

My recent surgery had removed all traces of the disease. The tumour had been pretty big, however, growing undetected for a year or more. So my consultant prescribed a high-tech medicine to stop another Gist forming. It’s just one tablet a day; it’s called a tyrosine kinase inhibitor, and it blocks the proteins that Gist cells use as chemical messengers, to signal to each other to grow.

But each tablet costs €33.90, according to one HSE price list I found. Which means a 30-tablet box costs €1,017. And I’ll be taking them for between three and five years. I pay €114 a month towards the cost, under the drugs payment scheme, but the HSE picks up the other €903. So my oncologist has in all likelihood committed the health service to paying at least €30,000 to keep me in good health.

It may seem crass to calculate it in financial terms. But it’s easy to forget what it means, and what it means can feel almost overwhelming. You need medication you couldn’t possibly afford by yourself, so the community you’re a part of covers the bill. And that’s after it has already picked up the tab for your surgery and all those nights you spent on the ward.

(After I left, my health insurer paid the hospital €800. It’s the maximum annual charge for being treated as a public patient, but it can’t have gone very far towards my care, which also involved radiographers, physiotherapists, dieticians, caterers, cleaners and porters – not to mention the extraordinary nurses. One of them, chatting one day, was thrilled her five-year-old had started school that morning. On a momentous day for her family, it put her 13-hour shift in yet another fresh perspective.)

But clubbing together is the principle behind all our public services, from healthcare, the emergency services and education to street-sweeping and environmental stewardship: we combine our resources so that everybody can get what they need, and so that we become more than the sum of our parts.

It’s the meaning of community, of the meitheal, of helping each other through life, especially when we’re at our most vulnerable. The way we put it into practice can be far from ideal, but we should never abandon it.

I’d solemnly and sincerely declared my fidelity to the Irish nation and my loyalty to the State by signing a form on the bonnet of my local peace commissioner’s SUV

That I owe Ireland’s health service my life has made it a particular privilege to have become an Irish citizen since I left hospital. My naturalisation certificate didn’t quite drop through the letter box the next day – that would have been an improbable ending to a Covid-interrupted application process that lasted almost three years – but it may as well have done, so glad did it make me feel after 25 years here.

The pandemic meant there’d been no swearing of an oath at a citizenship ceremony before I could receive my certificate; instead I’d solemnly and sincerely declared my fidelity to the Irish nation and my loyalty to the State by signing a form on the bonnet of my local peace commissioner’s SUV – we were masked, sanitised and outdoors, on a petrol-station forecourt – and posting it back to the Department of Justice.

But the official letter that arrived with my certificate was as heart-warming as the ceremony might have been. “Today marks the start of a new chapter in your life, one that you have chosen to share with us, your fellow Irish citizens,” part of it read. “We will celebrate your achievements, support you in difficult times and ensure that you always have a place to call home.”

You have already supported me in my most difficult time. And this is definitely home. I’ll do all I can each day to repay the privilege.

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