A Tale Of Two War(d)s by Dr Leyla Sanai
I worked for years as a physician, an intensivist, and a consultant anaesthetist, and had more letters after my name (MbChB MRCP (UK) FRCA (Lond)) than in it, but this isn’t the reason I’m grateful to the NHS. The reason I will always defend doctors and nurses is because I’ve had 41 operations (44 including the 3 in this admission) and hundreds of hospital admissions as a result of two auto immune illnesses that hit me in my thirties, scleroderma and antiphospholipid syndrome. The vast majority of doctors and nurses who have cared for me have been wonderful - compassionate, conscientious, and clinically competent.
These illnesses have left me with a heart damaged by heart attack, severe coronary artery disease, heart failure, lung disease, a damaged kidney, muscle wasting, skin involvement, and a leg, large bowel, fingers, dominant thumb and toe all lost to gangrene.
Around two months ago, a devastating accident at home caused a cauldron of boiling soup to pour into my lap, leaving me with severe burns. After treatment at home for a week, I was admitted with sepsis, low blood pressure, and infected burns.
The burns unit at the London hospital to which I was admitted is one of the most impressive centres of excellence I’ve ever seen. A handful of consultants and a team of nurses work vigilantly at all hours to provide life-saving treatment to patients. I was placed in a single room and underwent three operations, including de-sloughing and two skin grafts. I was a tricky patient because of my co-morbidities, and I’m full of admiration for the burns surgeons, anaesthetists, and nurses who ensured I received the best treatment in the world. I was so touched and impressed that I wrote glowing tributes to these members of staff on social media. The nurses and doctors really were - and still are - my angels.
But after five or so weeks, my burns had improved to the point where I needed dressings changes every two days but no other specialist care. I was still dependent on high concentrations of inhaled oxygen, though, so the burns staff reasonably looked to transfer me to the care of the physicians.
I was seen by a kind registrar in medicine, and a warm consultant medic. Both were extremely helpful, and arranged a number of investigations. Part of the problem was my heart failure had worsened. The consultant medic warned me against hammering me too hard with diuretics, to make me pass water, as that can damage the kidneys, something I remember well from my years as a consultant.
The following day, a different registrar came to see me, this time from respiratory medicine. She told me my diagnosis was Adult Respiratory Distress syndrome, a lung condition which can occur in critically ill patients as a result of sepsis, trauma, or burns. This made sense, and I had already suggested the diagnosis to my excellent Burns team.
I told her I was immunocompromised; had been on the shielding list, and was admitted to hospital around once a year with pneumonia. The respiratory registrar said she would arrange for me to transferred to a single room on a medical ward, and agreed that I should not be on the respiratory ward, where there were many patients with infections and a wing of side rooms for patients with covid.
I made contemporaneous notes in social media about what was happening at each stage, with profuse praise for staff.
That evening, just as a visitor arrived, a nurse on the Burns unit came into my room to say I was being moved. She started packing up my stuff, and I rose, still attached to my oxygen, to help her. I apologised to my visitor and said it was probably best if he left. The evening meal arrived, and on seeing that I was being moved, it was taken away again.
I was moved on my bed down a lift and through corridors to…the respiratory ward, I was puzzled as the respiratory reg said she didn’t want me to be on this infection-filled ward. I watched as a respiratory ward nurse pointed to a room crammed with seven patients. I was to be squeezed in there. Next to this ward was a wing reserved for Covid 19 patients.
At this point, I started panicking. Here I was, prone to any infection going. Everyone from my GP to my hospital rheumatology consultants in Glasgow and The Royal Free had told me I was immunocompromised. I knew I was immunocompromised - just the previous year I had been admitted with pneumonia to a Glasgow hospital, an admission marred by a nurse giving me another patient’s medications and then gas-lighting me that they were mine. It was only by pulling my fevered head off my pillow and booming ‘I’m a consultant anaesthetist and I want to see the Sister in Charge’ that I managed to receive a profuse apology - from the Sister; the nurse who gave me the wrong drugs had simply fled rather than apologising, even though I had those wrong meds in my hand, and was attached to the wall oxygen in a single room, so could hardly have obtained them from anyone else.
Every year I’m admitted to hospital with some sort of infection. And I had all these co-morbidities that put me at high risk. And now, being transferred from the burns unit, I was dependent on high flow oxygen to maintain even quite average saturations of 95 - 96%. So Covid or another infection would finish me off.
I didn’t want to de-humanise the women in the 8-bedded ward; think of them as sources of infection. They too were frightened, ill parients. But as I looked at that crammed room, the women lying so close to each other they could have held hands, many of them with TVs blaring, others with visitors, still other chatting to each other, several eating, child visitors scampering about munching crisps, I felt a dread.
I felt like death and couldn’t breathe even on my high flow oxygen. The thought of being squashed in that sardine tin with closed windows, breathing the fetid-sweet smell of rotting grapes, other people’s spicy and meaty food, recycled breath, and piquant farts, assaulted by that cacophony of noises, was enough to make me choose discharge home instead. I would rather lie breathless in my quiet room at home than be subjected to numerous sleepless nights and constant aural din.
There were practical considerations too. Having had most of my large bowel cut out meant I needed to poo around 8 times a day, often unpleasant liquid diarrhoea. Was it fair to impose my own constant occupation of the loo on 7 other patients in the tiny shared loo? My fingers can’t manage button toilet flushes, I would be mortified at having to leave the loo unflushed for other patients to see. I can’t manage any toilet door locks - how would I let the others know I was in there? People could walk in on me in the loo or shower. I felt sick.
By this time I was in a panic. I asked the lovely burns nurse who had accompanied my bed up, Gino, to please pull my bed into the corridor. The cloying warmth of the ward was making me feel more breathless. He did, and comforted me as I started to cry. My breathlessness increased, and he urged me to slow my breathing and calm down, while turning my oxygen up as my saturations plunged and I gasped for breath.
Eventually, two burns ward managers came to see me. Both told me that there was nothing written in the notes to say I should be in a separate room. I told them the registrar had told me she would request it. They denied adamantly that there was any reference to a single room in the notes she had made. One told me I had been in ‘his’ high dependency room for 5 weeks. Well pardon me for being ill. When I was septic at the start, the intensive care consultant, summoned by the burns team because of my BP of 65mmHg, had pleaded with me to allow myself to be admitted there, but I asked him whether I could try conservative measures first, and thankfully they worked.
I couldn’t recall meeting the female manager before, but she seemed to know me. She said they had checked with the consultant on call for respiratory and there was no reason why I couldn’t be on a shared ward. But the consultant on call knew nothing about me. Again I told her the reg had said I’d have a single room as I’m immunocompromised. Again I was told that this was recorded nowhere.
I told her I felt safer in a single room or on the burns unit. She said my burns were nearly healed. This was news to me as I could feel the slough (dead skin) exudate and blood seeping through my thigh bandages on the left. I said that I knew the burns staff were happy with me being on another ward but that they still wanted to do my dressings every two-three days. I asked how she knew that my burns were ‘nearly healed’. She said she ‘saw images’ of them. I said they hadn’t taken any images since I was admitted 6 weeks ago, and told her I had photos of their progression on my phone which I had taken at each dressings change. Did she want to see the ones from yesterday, to see that I was telling the truth about them still being sloughy and open?
No, she said, she had seen the images of them at every dressings change. But no photos had been taken of them for 6 weeks. I tried to show her photos of the burns the day before. ‘I’ve seen them’, she said, moving away.
‘Even yesterday?’
‘Yes.’
‘How? No one has taken any photos for 6 weeks.’
‘No, they take images at every dressings change.’
To have someone blatantly lie to you when you’re not only sobbing with distress but also panting for every breath and dependent on huge amounts of oxygen to keep you alive, messes with your head. I could believe that the reg may not have written I should have a single room - maybe she had been busy and forgotten. But to be told that my bleeding, ravaged, yellow liquid-oozing thighs were being photographed during my 10 minutes dressings change while I was fully awake and conscious, as recently as the day before, and while there had never been any cameras present, was utterly bizarre.
Eventually, an hour or two of sobbing later, someone agreed to phone the burns consultant, who agreed I could be moved back to my blissful single room on the burns ward until a suitable room was found for me.
I cried non-stop. Tears of relief, but also tears at my poor prognosis with ARDS - most patients die, and survivors are usually the young and fit.
Later that night I felt calmed by the sweet burns nurses, and the next day, the humane, kind, cheery burns consultant was as chirpy as ever. He came back later with a man who he introduced to me as a respiratory consultant, and with the calming Burns sister and the respiratory reg I had seen the day before.
The first thing the respiratory consultant did after introducing himself was to switch my oxygen, running at 4 litres/minute, off. He then talked to me and I told him as much history as I could, but I was becoming more and more breathless. He said I had right heart failure. I said I thought I had ARDS? He waved that off. ‘No, no.’ And yet his reg, standing next to him, was the one who told me I had ARDS, just the day before.
He told me they were going to keep giving me diuretics - twice the dose I was on before admission plus another one in addition - so three times the strain on my only properly working kidney. I raised concerns about my kidney function going off. He assured me that wouldn’t happen.
After 10 mins of breathless talking off oxygen, my sats had dropped from an acceptable 96% to a frankly dangerous 88%. I was sucking in air through my nose and mouth, gasping, like a dying fish. I was aware of using my accessory muscles of respiration, heaving my chest out and my diaphragm down vigorously, tensing my shoulders, anything to get that oxygen.
‘Breathless’, I said to him. ‘88%.’ I motioned to the pulse oximeter tracing.
‘Oh, that’s probably not accurate’, Dr X boomed jovially.
I reminded him I have severe coronary artery disease. My left anterior coronary artery - known as ‘the widow-maker’ - was blocked completely as seen on a recent MRI. A CT angio had shown widespread atheroma, a tight stenosis in the right coronary artery, and heavy calcification throughout, a prognostic indicator of vastly increased risk of heart attack and death.
‘Coronary artery patients should have their sats kept above 96%’, I gasped.
‘Really?’ Dr X mused, relaxed, seeming to rather enjoy my distress.
I gawped at him. Even a medical student knows about maximising oxygen delivery to diseased hearts. In my case, I was anaemic, with a haemoglobin of 8.7dl, about two thirds the minimal normal level. Haemoglobin carries oxygen to the body inside the red cells. In addition to having far fewer red calls per litre than fit women, my red cells each carried much less haemoglobin. What little haemoglobin I had was only 88% saturated with oxygen rather than the usual 100% - a vast decrease. My systolic failure (inability of heart to contract well) means that less blood was ejected by my heart at each stroke. The diastolic failure (inability of my heart to relax) meant my coronary arteries couldn’t dilate as much as in a normal person. My scleroderma already predisposed my coronary arteries to go into spasm. So my oxygen delivery was dangerously, critically low. On top of that, my oxygen consumption - the amount of oxygen I was using, and needed - was far higher than normal. I was breathing fast, and using accessory muscles of respiration, so more energy was being expended. And burns greatly increase the metabolism of a person as re-making new skin and healing damage requires a lot more energy than usual.
This consultant must have known that.
‘I worked as a physician and have full [post-grad physicians’ exams] MRCP’, I panted. ‘I also worked in intensive care, and as a consultant anaesthetist.’
Dr X’s eyes glittered - resentment? Dislike?
There is no place for personal feelings about patients in medicine. The Hippocratic Oath decrees First, Do No Harm,
‘No reason why you can’t be in a shared room’ he added. I opened my mouth, told him about the immunocompromise, said my consultants in my usual hospitals could confirm it.
‘Naa.’
Plaintively I told Dr X about my pneumonias. My steroid dependent asthma. My hundreds of admissions.
‘A quarter of my patients have that’, he snorted.
I was getting tired, so tired.
The lovely burns consultant, Dr W, had left the room a while before, but the Ward Sister and the respiratory reg were still there.
‘Cut her oxygen from 4 litres/minute to 2 litres/minute’, Dr X said smoothly to the Ward Sister. ‘Change her to nasal cannulae.’
Now the respiratory registrar loomed in my sightline. I had admired her and liked her the day before, but I was disappointed that she hadn’t owned up to telling me I had ARDS. The reg said she was going to take a sample of blood from my ear. She did not mention any potential side effects. Patients should always be told of possible complications for any invasive procedure. My arteries are so diseased and have been so operated on that they are not suitable for arterial blood gases, so the ear was the only option. But why not believe the saturations?
She sliced my ear with a blade. It stung. Then she began to squash and knead my ear lobe for blood to fill the capillary tube. After about ten minutes, the consultant said ‘that should be enough.’ He swept out of the room.
The registrar left to analyse the blood gases. The gentle burns ward sister placed the nasal cannulae on me, at the reduced rate of 2 litres/minute, and I inhaled the oxygen in relief.
After a few minutes, the reg appeared again. She said the sample had been insufficient. As she bent to slash my earlobe again, I asked her why she had told me she would ask that I should have a single room that night?
‘I did write in the notes that you were for a medical bed, preferably a single room, and not necessarily on the respiratory ward’, she said stiffly.
If she had, both burns managers who swore there was nothing in the notes about a single room had been lying.
The reg squished and milked my earlobe painfully again for what felt like eternity. I could feel blood trickling down my neck, coating my hair. A huge puddle had accrued on the new lambswool blanket my husband had bought for my long hospital stay.
The reg left to analyse the blood gas again and the Sister tried to stop my ear bleeding.
The reg returned with the blood gas. ‘Quite good’, she said. I asked to see it. My oxygen concentration was just above 8KPa. Extremely low. Dangerously, heart-attack inducingly low for a cardiac patient like me who also had anaemia. My carbon dioxide level was low at 4.5 Kpa. The only time a doctor can ever justify putting a hypoxic - oxygen starved- patient on very low flow O2 of 2 litres/min is if they *retain* carbon dioxide, ie if their carbon dioxide level is high. This is because a tiny proportion of life-long smokers rely on a hypoxic respiratory drive. I am not a smoker and have never been one. I was not retaining carbon dioxide and had never done so - my CO2 was low.
‘So you still want me on low flow oxygen despite the severely low oxygen?’ I asked the reg. She muttered something and left the room.
Meanwhile my ear was pouring blood again. Over the next four hours, it continued to coat my neck and hair in a slick of blood. On several occasions the nurses cleaned me with damp cloths, but applying pressure to the ear would not stop the blood pouring. By 5pm, my saturation was 88% and I was sobbing. The nurses fetched the burns consultant, Dr M, who applied pressure for another 10 mins while being soothing. I said I didn’t understand why I was purposefully being oxygen starved. He asked the ward sister to phone the respiratory consultant to tell him my sats were only 88%, and could we turn she oxygen up. She returned looking sober, reporting that he said we could not turn the oxygen up.
Tearfully, I explained to the burns consultant why oxygen starvation was bad for those with severe coronary artery disease. He nodded, but he was in a difficult position. In the end he said that as a patient, I had the right to input into my healthcare as well, and that unless the respiratory consultant explained *why* he wanted me hypoxic, my oxygen could be turned up.
The relief was immense. The nurse turned the oxygen to 3 litres/minute. On that, my sats were around 93 -94%, a level that could not upset the most cost-cutting manager trying to reduce oxygen bills, though still not ideal for my heart.
My ear bled again after the consultant left, and 90 minutes later, after seceral hours of blood loss, the Ward Sister inserted steristrips.
I had tweeted my respiratory consultant’s decision to keep my oxygen low. It was a factual tweet, and the decision had been witnessed by others, so there was no legal problem with it. I had even tagged the CEO of the hospital in it, hoping she would ask him why he had made such strange decisions. Now I tweeted my gratitude at the Burns consultant, decreeing that I loved the burns unit staff.
The next day was quiet. The burns consultant told me sweetly on the ward round that they were looking for a bed for me. No respiratory staff members came to see me at all.
And then ominously, at around 6pm, two Trust managers came to see me in my room. I was alone. They were officious. It was the woman who did the speaking. I knew there was trouble, but in the manner of people who want to seem reasonable, they started off pretending they were there to see me on another matter. So for the first few minutes, amidst meaningless management jargon such as ‘moving forwards’ (we’re hardly going to move backwards), they assured me they were looking for a bed for me. I knew that, the burns consultant that day had stated it on the ward round, everyone on the ward knew it. So why were they here?
That became apparent in the second half of the meeting, after 8.5minutes of waffle. I was reprimanded for writing a tweet naming a staff member - referring to my tweet about the respiratory consultant. I protested that I had only tweeted what was true. I was told that didn’t matter, I had breached the trust rules. If I did anything wrong again, I would receive my ‘last warning’ and I would be ejected.
This was all delivered in calm tones, as if I was being given my menu options for the next meal. I made it clear that I felt that this was censorship since my tweet was completely factually true and therefore not libellous. But firmly and steadily, as if talking to a toddler, they reinforced that this was a breach of Trust rules and that if it happened again, a process would be set in motion to eject me.
All delivered very reasonably and calmly, with lots of managerial waffle. And of course, stated as the second reason to see me, the first being that they are ‘wanting to reassure me they are still looking for a bed.’
Boy, did I let them have it both barrels. Said the whole reason I’d tweeted his name to the Trust CEO was so he could be investigated for rendering a hypoxic patient even more hypoxic. Said the blood gas had clearly confirmed hypoxia but he had still refused to let them turn my oxygen up, even when nurses had phoned him hours later. Said thank goodness a burns consultant agreed with me that I was entitled not to be hypoxic, and turned my O2 level up again. Said I had bled for 4 hrs after reg had sliced my ear lobe twice and no one from the respiratory team had bothered to come back and try and stop bleeding. Said I wanted to put in a formal complaint about him and that I wanted to be transferred to another respiratory consultant. Said that I didn’t appreciate trying to be censored or silenced.
I said this all calmly but with fire blazing beneath the surface. This kind of silencing was surely what happened in non-democracies run by autocrats or theocrats - not a democratic country where free speech is paramount. Or has it got to the stage where the NHS is a religion, and those who talk about sub-standard care are apostates? This particularly rankled since I had always defended the staff in the NHS; always passionately argued that if the NHS received adequate resources, it would be a wonderful system. After all, we have fewer doctors, fewer beds, and fewer intensive care beds per 1000 head of population than most other developed countries. The population demographics have been changing too - not just in the UK - with many older people with multiple co-morbidities. And of course, technological and pharmaceutical advances have been made at such a rate for every stage of illness - investigation, treatment, management of side effects - that costs have escalated. In the 1960s, a patient with a heart attack would be left on bed rest. Now, there are clot buster drugs, angiograms, stenting, bypass gratfing, even heart transplant.
Even on this admission I had written dozens of complimentary comments about the care I received. The burns unit was one of the most impressive places I had been in as a patient. The doctors were exemplary as were the nurses. And the international range of those gentle, conscientious nurses was testament to the benefits of hiring excellent professionals from abroad; most were Phillipino, one from New Zealand, and so on.
I told my friend the bestselling writer and retired neurosurgeon Henry Marsh about the Trust’s threat of eviction. He was horrified, and exclaimed at what terrible optics it would be. I wondered whether they would just tip my bed up depositing me in the gutter, and mulled over how long I would last without oxygen.
Interestingly, when I consulted the Trust’s rules, I noticed they had breached one of their own pledges by seeing me late in the evening, alone, unannounced:
‘When we talk to you about the incident, we would recommend that you have someone with you who you trust, feel comfortable with and who can support you during this time.’
After another full day of not being seen by any of the respiratory team, I was transferred to a small windowless single room on the respiratory ward under a different consultant. The malign respiratory consultant had been wrong - even shrivelled up with vast doses of diuretics, I still need 3 litres/oxygen a minute. And when I had raised concerns with him about the huge dose of diuretics, he had patronisingly waved me off - but my urea, a measure of renal dysfunction, had gone up from 4 to 12.9. The registrar’s two slashes of my earlobe and no attempt to stop the bleeding had caused my haemoglobin to drop further. I had told the doctors that I had a heart attack in 2020 as a result of my haemoglobin dropping. That was what had caused the heart failure in the first place. So to be so carelessly - spitefully? - treated rankled.
Although all the nurses and doctors on the respiratory ward seemed kind, the medical care was lacking. Every day I was given paracetamol, a drug I had pointed out early in my admission, deranged my liver function tests and should not be given. Two of my essential drugs, diltiazem, and losartan, were omitted regularly despite my having clearly specified that they were essential to stop my remaining bowel from becoming ischaemic. I was seen by a different doctor each day, sometimes a registrar, sometimes one of two consultants, but never with a nurse present, so there was no continuity. In the fantastic Burns Unit, although there was by necessity a different consultant each day, it was obvious that the consultants liaised very closely every day and evening, and the whole team of registrars and nurses accompanied the ward round every day.
I was told I would have a non-urgent chest x-ray on the Monday morning. This was not carried out on the Monday. At 2:30 am on the Tuesday morning, I was woken by a porter wanting to take me for this non-urgent x-ray. I refused to go. This XR had still not been done by the night before discharge. The consultant asked me if I wanted it and I said it was a bit late since I was going home.
One of the features of my Scleroderma is that I develop ulcers in my fingers which then become severely infected and the infection spreads to the bone. One of my fingers had swollen to twice its size, and I pointed this out to a consultant. I know that the immediate treatment is antibiotics, but they refused to give me any, and so I am now at home with a bone infection, on antibiotics.
A very junior doctor was asked to take blood from my indwelling line and had no idea how to undo the clamps or that I should not be sitting bolt upright. I should add that with lines like this that go straight into the heart, if the line is opened by someone inexperienced when the patient is sitting, an air embolism into the heart, will kill the patient straight away.
My blood count had dropped further as a result of the ear slasher.
I was given an iron infusion as I had already had three blood transfusions. No one told me that the kind of iron I would be given needed to be given in two goes. Most of the first lot went down the sink because of a huge air bubble in the giving set. I forgave this immediately, the nurse was lovely and none of us is born knowing how to deal with problems. But I was never told that I was to have a second dose. In fact I only found out about this on my way out of the ward the afternoon I was discharged. At 4:50pm, the great nurse looking after me placed my discharge summary in one of my plastic bags. I took it out to read it, and it was only then that I found out I had been given a form of iron which needed to be given on two different occasions. And that a date had been set for me to come and have the second lot next week, a date I had never even been told about leave alone had an appointment card about. In addition, the indwelling line which can stay in for many months and which was placed in under considerable trouble and radiation at the beginning of my stay had been pulled out, so there was no way for me to receive this iron infusion.
The Respiratory team had all gone home (at 4.50pm! I don’t think I ever left an NHS afternoon session before 5:30 pm). So I was told to phone the next day to sort this out. The next day I phoned six times. The first time I explained the situation at length to a sympathetic person. I was told to phone again after 2 pm. When I phoned after 2 pm, my first three phone calls were not picked up. The next one was picked up and I waited 18 minutes to speak to a doctor, who basically gave the most token apology and said that if I wanted the appointment could be cancelled, or else I could come in and go through the whole risky radiation and pain and time of the indwelling line being inserted again, days after it had been removed. With a devil and deep blue sea choice like this, I chose to forgo the iron infusion.
We don’t expect the world from the NHS. I’m not going to complain that my toilet door was swollen so I couldn’t budge it and had to leave it open; nor that my disabled hands couldn’t use the flush. Nor that it was so cold in my room at the icy corridor entrance to the ward, especially for someone who had dropped to 40 kg - a BMI of 14.3 - that I cried with cold until a kind nurse provided me with a theatre hot air device. Nor that I heard the automatic doors open and close hundreds of times a day. Nor that there were days when all I ate was mashed potato, which provided none of the protein I needed. If you are used to eating healthily, make sure someone brings in your food because everything on the menu is crammed full of saturated fats and stodge with almost no protein, and the vegan menu only has one of the allegedly four options available - fartogenic spicy beans and (yes, really) fried potatoes.
Most patients do not complain if mistakes are made as long as staff are honest and apologetic.
But those who lie, and those who - like the respiratory consultant, I believe - allow their personal irritation at a patient and their powerful position abuse their position of trust, are not cut out for work in the caring professions.
And what are the solutions? Ensure wards are well-staffed and happy, like the exemplary burns unit. Make sure patients are seen by the consultant every day. Do not leave junior doctors to do tasks they cannot to do. Pay clinicians - those who placed themselves at the highest risk of death during the pandemic - fairly, which means as close a rise to the inflationary rate as our broken coffers will allow (not the ridiculous 17% requested by nurse leaders; we are all suffering.). Ask for constructive feedback from patients and discuss it in whole team meetings every week. Log critical incidents - serious mistakes - anonymously on a national database accessible to all clinical staff, so others can learn from mistakes.
Finally, do not cover up for rogue practitioners. There is no room in medicine for those who don’t genuinely have the best interests of those they serve at heart.
1- At the time my ear had been bleeding for three hours and my saturation had been 89% for three hours, when the nurse phoned the respiratory consultant to ask whether she could turn my oxygen up and he refused. She also told him I had been bleeding for three hours from the slash that his registrar had made in my ear and he didn’t come to see me, and nor did he send his registrar or anyone else. My saturation when I took the photograph was 89%, as recorded by the nurses on the ward in the contemporaneous notes.
2 - A photo taken the following morning. You can see that once my FiO2 had been reinstated by my burns consultant the previous evening, my colour had improved. I have been transformed from a patient who looks as if she is dying to one who looks as if she may survive. My saturation then was 96 - 98%.
A Tale of Two Wards: the very best and very worst of the NHS in seven weeks.
This is the stuff of nightmares, imagine how the rest of us, who lack the medical knowledge, would have survived such a situation. Thank you for denouncing it.