The present system of annual check-ups for those who have had successful cancer treatments is an arduous ordeal they could do without, writes Dermot Walsh
Those living with or under the shadow of cancer have cause to bless the HSE for bringing in Prof Tom Keane and thank him for releasing them from the regular application of stress, anxiety and frustration that masquerades as the check-up.
The health service does not go in much for feedback or questionnaires. Maurice Neligan might remind his profession that the patient is the customer, as he did at last November's Céifin Centre conference, but the HSE had to wait for Prof Keane to come along to tumble to the realisation that putting the patient through the wringer is not a good idea.
Any patient could have told the HSE this, as they talk about it often enough. And especially so in those weary, wearing hours of waiting when the survivors are summoned for their check-up.
From mid-morning on check-up day, the Brandon suite at Cork University Hospital is forebodingly crowded. There are lots of people, but not a lot of life. A television flickers above mostly inattentive heads, crowded together in the main body of the suite, with others seated down each side of the corridor, onto which the consultation rooms open.
There is no talk, except for the formal exchanges with the administration nurses who keep piles of files in order behind the reception desk. At various intervals, a doctor steps into the corridor and calls out a name, at least twice, often even more times, before the person materialises from the mute mass of humanity.
There is virtually no talk. Certainly no smiles, and laughter would be an intrusion. Eyes are avoided. If there are murmurs, they are hushed exchanges between patients and the companions that some patients have with them. Most are spouses or children, attending not only as drivers or idle company, but also to go into the consultation with the patient in search of answers that have never been given.
It's a hospital but nobody needs to ask their neighbour what the complaint is. Everyone knows what everyone else is suffering from. But there's no consolation or bond in this shared knowledge. Nobody talks about cancer.
Some try to occupy their minds with a newspaper or the small selection of dated magazines, but concentration proves elusive. They sit in silence, even though they prefer not to be alone with their thoughts. Each one is sealed in a cocoon of fear and anxiety. Each one waiting for the blood to do the talking.
The blood tells all. Once checked in, each out-patient is dispatched to the blood tests room. These days, it's a highly efficient operation with many more staff than in the days before the HSE, and the continuous stream of patients flows smoothly.
With a phial of blood and documents in hand, the patient then moves on to the lab where again there is rapid turnaround and the patient returns to the Brandon suite. In their hand they carry the printout of the blood-test results, in an envelope that is not sealed.
But many have learned to read the test results for themselves. Others just prefer not to know.
The results are handed in and then the waiting begins. The wait is not going to be a short one. It is going to be an hour at least and anything up to two hours. Sometimes even longer. And for what?
For a young doctor, whom you have never seen before in your life, to call you into a consultation room, cast his or her eye over a file, which in my case chronicles 15 years of treatment and care for Hodgkin's disease, go through the routine of a physical check and then tell you what the blood test is telling him or her.
The patient departs knowing that it is highly unlikely that the same doctor will crop up at the next or any future check.
And while this is all going on, back in the Brandon suite the silent patients sit and wonder why they could not be saved journeys from Dingle or Limerick by having their blood samples taken nearer home, forwarded to a reliable lab and then passed onto the medical experts.
Then, if there is cause for concern, the patient can be asked to attend. Because in that case, there would be something to attend to.