Nil By Mouth

For various reasons, I was categorized as a Nil By Mouth prisoner (NBM and, to us hardened old recidivist lags, a badge of honour) when I was taken down and transferred to the maximum security Ward T08 of that notorious gaol, the University College Hospital London, the bleak and sober sixteen floor exterior of which glowers forebodingly over Euston Station much as the old NKVD headquarters did over Lubyanka Square in Moscow.  Banged immediately into solitary confinement I was warned that I had been scheduled for re-educational medical experiments that could happen at any time of day or night, this uncertainty clearly forming part of the psychological process used to break inmates down mentally and physically before ‘treatment.’

I, however, am made of stern stuff so after three days, recognizing my sense of humour remained undimmed, the Commissar Registrar relented and at 6am I was told I could eat.  Being English, I naturally asked for a cup of tea (to affirm my political unreliability, I asked for it NATO standard). 

Time passed and still no tea.  For three days, unable to sleep as various trainee doctors and nurses under the guidance of their more senior colleagues poked, snipped and photographed my wound while collectively monitoring my progress, I could hear the tea trolley and the food trolleys being pushed along the corridor outside my spartan cell.  Deprived as I was of any means of telling the time (apart from the view of the sun rising over the Shard, the Eye and other noteworthy structures of central London through the full width picture window of my cell, and the clock on the wall), I knew it was important to maintain some measure of time to avoid going insane so I used the trolleys as my watch.  Tea trolley at six.  Breakfast trolley at eight.  Soup trolley at eleven.  Dinner trolley at 12.30 (it’s a lunch trolley but they are all solid working class socialists here).  Soup or snack trolley at five.  Beverage trolley soon after.  Supper trolley at 1800.  Beverages on demand after that.

My arm had been fitted with cannulas to facilitate the injections of truth serums, hallucinogens and mind control drugs, a cocktail designed to further disorientate and break down my will as well as litres of salt water.  Left alone I tried to disconnect the tubes, or at least (in case I was being observed covertly through the multi-channel TV and entertainment centre) roll over onto them to block the flow but the flow rate was monitored electronically so all my attempts to foil their dastardly chemical therapy failed when the alarm sounded. 

I noticed some Lomonosov flower vases on the comfortable looking armchair next to my multi-way electrically adjustable prison cot (with its softly sprung, crisp cotton sheet bedecked paillasse).  I knew they were Soviet era vases because they were a funny shape, would not stand up properly and appeared to be made of recycled cardboard not porcelain.  I resolved, therefore, to harness my years of healthy living and regular training along with the Zen like calm I am noted for to expel as much of this chemical brew as possible by secretly passing it under the bed clothes into these vases.  I quickly learned that the ‘trustees’ employed on menial tasks here are not as indoctrinated as the institute would probably like for, at presumably great personal risk if discovered, the trustees would quietly sneak out the filled pots and replace them with empty ones.  I tried engaging these unfortunate souls in conversation a few times in the hope I might use them as a conduit to get messages to no doubt anxious friends outside but none of them spoke any language I could recognize.  Clearly there was method to my captors’ sadism.

For three days the trolleys had not been stopping at my cell but, worryingly, they were not stopping now that I was no longer categorized NBM.  By ten I realized I had fallen for that most basic of ploy: promise the inmate what he really wants, then let him torture himself with unending anticipation.  My suspicion was confirmed when I was informed that they were, after all, going to take me to the theatre.  London is famous for its theatres and many long running shows but in this place, ‘the theatre’ is an unpleasant euphemism for a chamber of horrors so sophisticated, even the evil swine operating in it have to train intensively for a decade before they are deemed mentally stout enough to live with the emotional consequences of their traumatic trade. To maintain their anonymity in society, these ’Gentlemen Professionals’ are accorded no rank or title of respect but are merely referred to as ‘Mr.’

The golden rule of resisting torture is to hold out as best you can for at least 48 hours after which by all mean spill the beans, at least you will have given time for anyone you might incriminate to escape.  Let’s face it, you’re dead anyway.  For this reason, my brother (who had bravely stayed with me) and I decided that he should flee to the safety of Germany while he still had the chance.  He managed to clear out just thirty minutes before they came for me.  Our parting was sombre rather than emotional.  ‘Vive La France!’ he declared somewhat confusingly.  ‘Fuck the Pope!’ I rejoined, more for something to say than any bizarre conviction I held.

With a delightful irony, I was asked to sign a form attesting my desire to undergo the procedure they had planned for me and at 15.30 hours on Sunday the 4^th of May, just four foodless and drug fuelled days since I had kissed my weeping wife and child goodbye and eight days before what would have been my fifty fifth birthday, they administered the first lethal injection.  ‘Zis vill make you feel varm und fuzzy,’ I heard the heartless Wagnerian nurse say.

‘There’s a hole in my sock!’ and indeed there was.  I realized it was me talking.  I was confused.  I did not recall having pulled socks on but not only was I wearing socks, very tight knee length socks, my toes were sticking out the ends.  I was embarrassed.  In addition, my lower legs were encased in thick plastic bags with tubes in them.  I realized I was back in my cell.  The clock on the wall said 8.30.  It was an analogue clock but since it was dark outside and both the Shard and the London Eye were lit up I knew it was evening.  My throat hurt and I realized something was clamped to my face.  I tried to pull it off but my arm was pulled up short by the tubes running into it.  ‘Breathe normally,’ said a soft voice, ‘it’s just oxygen. ‘  I looked down at my leg, for the first time in weeks completely free of pain.  A big chuck had gone from the upper thigh.  It was stuffed with something black and spongy out of which came a clear plastic tube which led to a machine next to me which gurgled and hissed.  ‘Can you feel it sucking?’ someone asked me.  ‘No,’ I said.  I could not feel anything.  I felt all warm and fuzzy.  I was floating in the most comfortable place I had ever experienced.  ‘I need a pee,’ I said.  A trustee passed me a Lomonosov cardboard vase and I eased springs into it.  I drifted off to sleep.

I woke up early the next morning feeling great, really fantastic.  During the night I had only been vaguely aware of comings and goings as medical staff checked my temperatures and pressures and reset the drip alarm after I had rolled onto the tube again.

 ‘You can eat now!’ said the night duty nurse, ‘breakfast is from about eight, can I get you a cup of tea in the meantime?’  If he’d have served it to me soaked in his underpants I would have drunk it.  He came back with my tea and a little cup with seven various capsules and tablets to take.  Various people came in and inspected the wound.  To all when asked the same question, I said I felt great, I was just very hungry.  I’d be able to eat soon, they all promised me. 

The night shift handed over to the day shift.  I could have sworn I heard the breakfast trolley.  A nurse came in towing the temperature and pressure machine.  As she hooked me up I told her I was really hungry.  ‘Can you eat?’ she asked me in a really thick Filipino accent.  ‘Like a Ravenous Bugblatterbeast,’ I told her.  ‘That’s nice,’ she said before repacking her kit and leaving, closing the door behind her.

A trustee came in to change the bags in the various bins around the room.  ‘Any chance of a cup of tea?’ I asked him.  ‘I don’t know,’ he said, ‘I’ll go and ask.’

By now I had concluded that all those responsible for the preparation and distribution of food in this otherwise magnificent medical establishment were born out of wedlock and were Fascists.

A ten, the doctors from the day before came in and had a chat. 

‘How do you feel?’ they asked. 

‘Hungry,’ I said.

‘Haven’t you eaten yet?’ They exclaimed.

‘I’ve had a cup of tea,’ I said.

‘Well, you’ve missed breakfast,’ they pointed out with a breath-taking disregard for how I might take such an appalling disclosure.

‘Can one of you do me a favour?’ I asked, suddenly suffused with a horrible thought, ‘could you look on the other side of my door and see if there isn’t a notice pinned to it saying perhaps ‘nil by mouth’?’

The doctor came back into the room clutching just such a card.

Duly summoned, a ward nurse hurried into the room. 

‘You must be starving, you poor dear, would you like some breakfast?’

‘Yes please,’ I said, my spirits soaring.

‘What would you like?’

‘Full English?’ I said mentally already half way through it and slavering like a Nile crocodile.

‘Kitchen’s closed, I can do you cornflakes?’

But, I was back on the food supply map of the University College Hospital London and the flood gates opened.  No sooner had I finished the cornflakes and another cup of tea and a friendly face stuck itself round my door asking me if I wanted a bowl of soup.  It was leek and potato and was rich, creamy, full of flavour.  It was divine!  Lunch was served, filets of chicken breast served with pasta tossed in a creamy mushroom sauce with broccoli and for dessert, a tasty fruit salad with a hint of vanilla. Heavenly.  The vegetable soup in the afternoon was thick, colourful and delightful on the palate.  Supper was a salmon filet gently poached in a herb cream sauce over a bed of some exotic and crispy brassica, unfamiliar to me but all the more pleasing because of it.  This time dessert was a decadently thick chocolate mousse with a tangy orange reduction.  Each meal came with fresh fruit juice, mineral water, a yoghurt and a choice of tea, coffee or hot chocolate. 

 

The following morning I had porridge, toast and marmalade for breakfast washed down with tea, coffee and hot chocolate.

‘The food here is fantastic,’ I told John, ex Royal Navy, now NHS, one of the regular nurses looking after me during the day.

‘Yeah,’ he laughed as he went about setting up the temperature and pressure machine, ‘they all say that!’

Then he looked at me closely, lying there in bed all chipper.

‘You’re serious, aren’t you?’ He asked in wonder, as if I was some new and interesting example of alien life form.

‘It’s brilliant,’ I told him.  ‘This hospital is fantastic.  The staff are all friendly and helpful and very kind, the doctors are really nice and professional, they talk to you as if you are an intelligent human being and make you feel part of the process.  Everyone goes out of their way to keep me informed and make sure I am comfortable.  I am in what amounts to a luxury en suite hotel room in the centre of the best city in the world with a million dollar view, most of the nurses and female doctors are drop dead gorgeous and the food is ACE!  What’s not to like?’

‘Blimey,’ he said, ‘honestly, no one has ever put it like that before.’

‘You know you are a bit of a star?’ he went on. ‘Well you were a bit of a star anyway, everyone heard about this bloke who came walking in off the street from Africa with an exotic infection, that made you  star straight away but now that you are on a ward they all talk about the man in bed 35 who always has a joke for everyone and never complains.’

‘Ah,’ I said, ‘but they’ve never seen the inside of an Angolan hospital, have they?  They wouldn’t think I was so special then’

There are a lot of things that reinforce the Great in Great Britain.  The NHS is one of them.

Having said that, I was nil by mouth again from last night until three this afternoon when my next op was cancelled because the plastic specialists from the Royal Free could not get over so, after another good feeding frenzy this afternoon, I am now nil by mouth again in anticipation of going into theatre sometime tomorrow.  The surgeon was with me just now and told me the op has now been classed as an emergency so will go ahead whether the plastics people are there or not as they do need to get in there, do a bit more debriding and confirm the progress of the infection has been halted.  It was a very deep infection she said. The thing that irritates them, and me, is that so far they have not identified what’s causing it so they will be cutting out a few more samples to test.  Either way, as the registrar said, this will not be a quick fix so, looking at the bright side, it looks as if I will have time to give up smoking after all…

Oh, there was a hilarious moment when the surgeon came to see me this evening.  They are all brisk and efficient and with me do not waste time mincing words.  ‘Sorry you missed out on the op today,’ she said, ‘but your op has now ben classed as an emergency so I will at least change the dressing.’  I was appalled and for the next few moments stopped listening to what she was saying.  This morning as they prepped me to go down to theatre they dressed me in a gown and laid upon the bed the new vacuum dressing and a few bits and pieces telling me these had to go with me down to theatre.  They were still lying on the bed.

I looked at my thigh, at the hardened sponge of the old vacuum dressing pushed into and stapled to the hole in my thigh and tried to imagine her removing that, swabbing the wound out and stuffing and stapling a new dressing in.  Here, in this room.  Don’t forget, on the day of my arrival, they had been so alarmed, a surgeon had come down to A&E and there and then, after I refused the offer of morphine, proceeded, scalpel and tweezers in hand, to cut away all the dead flesh with me wide awake watching and feeling his every move.  Her replacing the dressing in a similar manner was not, to my suddenly fevered mind, beyond the realms of possibility.  I must have looked awfully scared and sick when I stared wildly back at her and said, ‘What?  Now?’ because she burst out laughing and said, ‘Now?  Christ no!  You’d be in agony and you’ll bleed like a pig!  No, we’ll do this under general anaesthetic tomorrow!’

She may have thought that was a weird and unusual thing for me to say but I’ll bet she has never seen what goes on inside an Angolan hospital either.

 

As an aside, (apparently I am not nil by mouth for another hour so I have asked the very kind gentleman who has just changed the bag on my thigh vacuum cleaner for another cup of tea because I have learnt to stay awake when I can eat and drink, and sleep as much as I can when I am NBM), I will share with you this observation, the purpose of which is to demonstrate how politicians can always get what they want by asking questions in such a way, they already know they will get the answers they want before asking the question.

If I asked you whether HS2 would be of economic benefit, a considered (rather than emotional) response would likely be, yes.  Don't forget, I did not ask you if the economic benefit was worth the investment, I merely asked if the project would be of economic benefit and yes, of course, it would have to be, if only to the companies and their employees building it.  Having received the answer he wanted, the politician would then spin that 'yes' to proof the majority want HS2.

If, on the other hand, I said:

HS2 is going to cost 70 billion pounds.  Would you rather that money was spent on a faster rail link or the NHS? 

What do you think the overwhelming response would be?

I have a packet of Jaffa Cakes calling to me and a vase that needs filling.  Ta Ta fer now.