I’m glad that the NHS generally still refers to me as a patient. True, every once in a while I’m a “service user” and I “access care” for my mental health but when it comes to my knee injury they use the old term. Which is rather apt because being patient is what it is all about.
This week I went for the 6 month follow up from the keyhole surgery. The surgeon launched in to (another) little lesson on what they had done, he used lots of interesting terminology and it was all going swimmingly until I reported to him that I still have discomfort in my knee. He repeated what he had just said, this time with a little more recourse to English rather than medical speak. He seemed dismayed when I explained that whilst it was true to say that I had a better range of movement and notwithstanding the fact that I had ridden to the appointment (hence the rather fetching outfit) I was still in quite a bit of pain.
He queried me on what I had done for rehabilitation (engaged a private physio, got on my bike, started doing yoga and pilates as there was no NHS provision). This answer didn’t seem to register with him. He asked why I hadn’t told anyone about this pain and seemed somewhat forlorn when I pointed to the notes from my previous check up where my concerns had been dismissed and I’d been told to wait a few more months.
So as I write I’m waiting on another MRI scan, which should happen somewhen in the next 8 weeks though nobody could suggest when that might be, even though I could happily have trotted round to the relevant department clutching my notes.
The whole experience got me thinking about feedback. In the treatment for my mental health I’ve generally been accepted as an expert in my own condition. Not the sole expert obviously but my psychiatrist and therapist and to a lesser extent my GP have all been partners in evolving a treatment regime. In physical health I’m not an expert surgeon, I’m not the machine which takes interesting pictures, I’m merely the guy that has a problem which the professionals will fix.
Which led me to ponder some facilitation I’ve been doing recently. The organisation concerned places a real emphasis on time served and formal qualifications. Some of the people I’ve been training are lacking in both but brimming with ideas. As we’ve discussed innovation and problem solving they recounted tales of being knocked back, ignored and overlooked. Again and again they’ve been told to “wait and see”, that “we don’t do it like that round here” and my all time favourite “we’ve always done it this way”. It’s as if their colleagues could only see the existing way of working and were ready to discount clear evidence from their more junior colleagues.
I’m left wondering what will give them the credibility they so desperately need in order to make change happen. I don’t have a good answer beyond “it’s better to ask for forgiveness rather than permission” so we’ve worked on their confidence, on solutions focus and on presenting their ideas but I feel it’s going to be a long old haul getting the organisation to buy in to it. “Wait and see” indeed!
This is another post where I don’t have a homily, an uplifting quote or a solution. I’m left in the same position as the people I’m training. Trying to convince a higher authority that I know what I’m talking about and that maybe they’d like to trust me.
The knee may or may not need more surgery. The doctor has stated that this discomfort may be what I have to live with as more surgery may be counterproductive, further degrading the joint. Having said that, it is definitely stronger and I’m able to ride 40-45 miles currently without any issue. Seeing as that is the case (and who knows how slowly the wheels turn within the NHS) I’m still intending to carry out my ride for Mind. I had a really good response when I first started training and I’m looking to push on in my fundraising so please do head over and donate – you’ll find the sponsorship page here