David Nicholls

David Nicholls

Extraordinary Machine

I was born and then, for years, nothing much.

I had jabs and check-ups of course, and dentistry – free in those days – and at fifteen my first pair of NHS spectacles, the silver-framed John Lennon specs I craved so much that I flunked the eye test to get them. At university there was an occasional GP visit; the cold self-diagnosed as glandular fever, the rashes and bad skin that came with forgoing fresh vegetables and sunlight. But there were no calls for an ambulance, no catastrophes.

Our two children were born in London hospitals and we took it for granted that there would be tests and scans, letters and leaflets and someone to answer the phone when the moment came. I’m not sure any birth can be described as straightforward, least of all by the father, but both children were healthy and for the next ten years, our encounters with the NHS were common-or-garden rashes, sore throats, a stitch in the scalp for my son when a trampoline party got out of hand. Each time we thanked the courteous, efficient staff and went back to our normal lives. Like electricity or water in the tap, healthcare would always be there, free at the point of delivery, based on clinical need and not the ability to pay. My father died in a hospital, cared for by compassionate staff. Beginnings and endings – perhaps that was all we’d ever need from the NHS. Perhaps there would be no disasters.

We were in Amsterdam on a half-term family trip when we noticed that my daughter was quieter than usual, not herself. Relaxation was discouraged on this holiday and so perhaps she was just exhausted by all that enforced sightseeing, the stomping from museum to landmark to museum. But on returning home, she remained pale and listless, pushing away her food, sleeping too much, the whites of her eyes the colour of butter. We took her to the GP, expecting that there’d be a few days off school. Some blood was taken.

And then, in a lab somewhere, a note was taken, a phone call was made and somehow it was as if some extraordinary machine had come into life. We were told to go to hospital now, immediately, to pack a bag, she might be staying. On the ward, there were more tests, a cannula was fitted, large doses of antibiotics, vitamins and steroids administered. There was no diagnosis but we were left in no doubt that this was serious and would require more than a day off school.

Questions. Had we come back from abroad? India? No, Holland. Eaten any seafood or raw meat? Gone swimming in rivers? Scans showed swelling and scars on her liver, the word ‘cirrhosis’ was used, surely a mistake because that’s what alcoholics got and this was a ten-year-old girl. Throughout the injections and ultrasounds and consultations, she was patient, polite and upbeat but every now and then a wet glint in her eye betrayed her fear. A harrowing biopsy and then the diagnosis: auto-immune hepatitis, the body attacking itself. We celebrated her eleventh birthday on the paediatric liver ward.

She remained in hospital for the best part of two months, my partner and I taking turns to stay over, sleeping uneasily on the pull-out bed by her side, fidgeting through the perpetual jet lag of hospital life. During the long days, we’d watch the young patients come and go, many in a far more precarious state than our daughter, the parents fraught and haggard. We learned the nurses’ names and acclimatised to the rhythm of the ward, saw the long shifts begin and end and came to understand that the events which had seemed so terrifying and life-altering to us were the daily business of the staff. The machine had not come into life. It had been running all the time, and it was the quiet expertise, patience and dedication of the staff that kept it humming away.

Now, in this current crisis, it is operating at its highest pitch and with the additional dark twist that those who work to save the lives of others are putting themselves at risk in doing so. God knows we owed a debt already, but every time I turn on the news these days I’m reminded of the limitations of the words ‘thank you’.

Some day the crisis will pass, albeit with a terrible toll, and the NHS will return to the everyday task of keeping 70 million people alive and well. In the meantime, as I write, my daughter is upstairs in her bedroom, learning the endings of French verbs. She is fine, happy and healthy thanks to the workings of that extraordinary organisation – something for which we will always be grateful, will never take for granted.

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