16
The Grand Round
It is just over two years since Tom died. We see Stephen, our GP, from time to time. One day he talks to us about the fact that, despite all the pain we have faced as a family, we have, in his view, dealt with Tom’s death openly and well. He and Pippa, Tom’s oncologist, believe that others could benefit from hearing about Tom’s care, not just from a medical but from a personal perspective. He tells us about the Grand Round – which sounds to us like a secret Masonic ritual. It turns out to be a weekly open meeting, at Addenbrooke’s Hospital in Cambridge, for all the medical staff from any discipline who wish to attend. It lasts an hour and involves two presentations, of 20 minutes, each followed by 10 minutes of questions. Then there is a buffet lunch provided. He does not want to put us under any pressure and suggests we take some time to think about it and then contact him if we want to talk about it further.
There is something redemptive about the idea that our experience may be of help to others. So, after a lot of discussion, we agree to be involved. We meet with Stephen and Pippa and decide that it would be best for us all to speak, each in turn, taking up the narrative as it impinged on us personally. We decide to write a full script so we all know and are happy with what the others will say.1 It will also make it easier to keep to time.
By chance, we have recently experienced the death of my mother, also in Addenbrooke’s Hospital, following a severe stoke in the nursing home where she had lived for the past two years. Her excellent care, as she lay dying in hospital, and the very thoughtful and compassionate way in which a junior doctor told us what was happening and invited us to be involved in the decisions about her treatment, has also made us very thankful for the NHS. Part of what we want to say is, simply: ‘Thank you.’
The big day comes and the lecture theatre is crammed with about 500 doctors, nurses and other healthcare professionals. The event is chaired by one of the professors, clearly a man who enjoys being in charge. First up is a research student studying Parkinson’s disease. He is nervous – not helped by interjections from the professor. ‘Come on, doctor,’ he barks, ‘get to the point. You’ve already had ten minutes and haven’t told us anything new yet.’ It does not bode well, but it also makes me determined not to be intimidated.
Our turn arrives. Stephen introduces the theme and we are under way. To our surprise people are very quiet and attentive. Mercifully the professor does not interrupt. Neither do we overrun. Annie and I talk about what, on the whole, has been a very positive experience of the NHS – swift to act, multi-disciplinary, skilled, caring and coordinated. We do have a few gripes – about not being listened to initially regarding Tom’s vomiting reaction, about the use of language and about the undisguised enthusiasm among some medics when confronted with Tom’s unusual presentation of melanoma – a fascinating case rather than a deeply painful human tragedy.
In the question slot at the end the professor, without realizing it, amply illustrates our point about not listening and using inappropriate language by saying to us: ‘Well, of course, you were lucky. You had a very clear diagnosis.’ I cannot believe what I am hearing. I turn to look at him. ‘No,’ I reply, firmly, ‘we were extremely unlucky. Tom’s diagnosis was not good news. It was terrible news. It was a death sentence.’ There is what seems like a nod of understanding from most of the people in the lecture theatre. They, at least, do not miss the point.