BATTLES FOR HEALTH
Amusing health care interactions– when old old age does make a difference
Dr Bob Boland & Team – Draft 13–Feb. 22, 2017
Characters:
Bill – MD humorous retired
Kate – proud French retired MD –wife of Bill
Will – angry retired – Electronic Scientist
Pamela– very patient Psychologist – wife of Will
DS- veryformal GP Dr Sydney
DC– very careful CIDP Consultant – Dr Henri
DG- Emergencycasual care – Dr George
Others players. Paramedics, Nurses, Driversetc.
Act 1 – Battles in France (page 3)
Act 2 – Battles in England (page 17)
Act 3 – Revolutions (page 44)
STORY
The play is designed as an amusing story about old old people interacting with
health care systems with unlimited demand and limited resources develop a culture in which doctor time, is considered to be much more important than patient time, and patients are expected to be obedient in following instructions with no complaints. This inevitably leads to boring battles for health, in both cash and culture.
The play recounts some intriguing realities of health careservices: waiting, suffering, testing, diagnosis, treatment, success, failure and confusion. So sometimes patients feel neglected and all mixed up together, with battlesto survive and finally be dischargedto home and family.
The play is a mixture of fact and fiction. It pays tribute to wonderful care and achievements of overworked health care staff in complex environments, who try so hard to meet the needsthe ever increasing number of older and older people.
In 2016, people may retire at 65 years but with the new wonderful medical research (even deep brain stimulation) etc. theymay well live on by to 95 years or even 100 years of age, before gently ¨passing on¨.
What to expect in the future? A whole range of dynamic NHS solutions become available to resolve the impossible problem of health care for old old people, which may involve a complete cultural change. Hopefully to resolve impossible healthcare battles, we need to laugh … and be very patient, until the key cash and cultural motivators becomes available?
ACT 1 – BATTLES IN FRANCE
BillWill
Kate & Pamela(wives)
Bill: Welcome Will and Pamela, my dear old friends,coming from France to my English Wiltshireparadise, for my 88th birthday party.
Will: Bill, it is great to see you and Kateagain, looking so slim and active. News: we have at last moved to Wiltshire in the UK.
Kate: Great news. We shall now see more of you both. And Pamela you look so well What is it like to be a retired psychologist?
Pamela: I am well but alas Will has problems, which seem need all of my old professional skills to resolve them.
B: What news of your adventures and problems, Will?
W: A long story, but am only 84 and yet every day seems to give me anew traumatic health care adventure.
B:Well, as an old old MD, I must ask you for your French complaints, please.
K: And, as a French MD, now retired in the UK with it’s complex NHS, how could you possibly complain our wonderful free French Health Care System? I will defend it to the end!!
W: Well, I am sorry Kate, but I was furious with health care in France. The doctor time is considered to be much more important than patient time. We old old patients must be obedient like ten year olds, follow instructions,and never complain.
B: Perhaps you will find it just the same with then NHS in the UK?
W: Well health care for older people may inevitably lead to boring health care battles, unless something in these se health care systems are changed, for the increasing mass of us older, who seem to live on indefinitely.
B: If you managed to get to 85?
W: Well by 2040 20% of people will live to over 90 years, and patients over 65 years of age will take up 70% of the health care costs. That will leave so little for children and the working population!!! The younger working population will have to pay for it!!! They may even dare to protest!!!
P: Patience, my dear Will. Solutions to health care systems will be found. So easy to criticize. Finding solutions for old people health care, will take time. So Will my dear, you have already overcome impossible health problems, so now just sit back and laugh.
B: But what is your health problem, Will?
W: Heart, arthritis, IBS, and complex illness etc. is that enough? I am surprised to be still around. Enough?
B: Yes indeed.
W: Yes and health care service is terrible with: waiting, suffering, testing, diagnosis, treatment, success, failure and confusion. Sometimes I feel completely neglected and mixed up together. In hospital, I have to battle to survive and finally be discharged to home and family saying: ¨¨Hooray.I got home again!! I have made it!!!¨¨
B: I agreeWill, but you have to laugh too. The road to health is paved with not only good intentions, but also good intestines! Mine are terrible!! Just like one in every ten old men today!!! I am only 88 with IBS and my daily visits with Dr Alzheimer, I seem to forget about all of my problems, laugh, and always say yes to my wife.
P: So Dr Alzheimer gives you an advantage? A pain for Kate?
B: I never thought about it before. With a little bit Alzheimer I do easily forget my pains and problems. That is so convenient. And I never forget to lways say yes to my dear wife Kate, and so we have no arguments. Good thing to learn Will?
K: Bit hard for me, but I bear it, and laugh too.
W: But I get so angry with the Health Care . I think I will have to learn a bit of Alzheimer, learn to say yes to Pamela,and enjoy it, even though I am well past middle age.
B:Yes, middle age? It is when you are sick and still believe you’ll feel better in the morning. What do you think,dear Kate?
K: Yes dear Bill, but you laugh all the time and so easily forget all my good advice for keeping you out of trouble.
P: Will would like to be the same.
K: Yes, in 2017 do live a little longer than the men.
B: About ten years!!
K: So 2017 is the time for Women’s Empowerment, after 3000 years of man domination with wars. Now is the time for women to vote not for politics but for women empowerment. Not for wars … but for peace and care of children …
P: I am with you, Kate. We really can manage everything better ourselves.Better than the men. OKWill??!!!
W: Not really, but for now I will say, Yes dear.
P: Well done.
B: From now on, always say yes to women, and there will never beany trouble at home.
W: I am a fast learner, Bill!
B: I agree. Only women can resolve the terrible problems of family, business and politics at home and abroad in: Egypt, Afghanistan, Libya, Iraq, Africa etc.
K: So we have no choice, Pamela. In the family, male domination is over. The men must take our good advice at last.
P. But my Will is angry and not just the same as your Bill. He always has a good excuse, for not remembering or not doing what I, so gently,suggest for him to do. ButI must be gentle, now he is just out of hospital for the 99th time. Hard to believe? But still complaining, of course.
B: 99th time. You may claim for the Guinness Book of Records? So what was the trouble this time, Will. The usual alcoholproblem again?
P: Alcohol seems to be the best medication for a happy life.
W: No no. No jokes please. Bill. I have had a very tough time. Not really 99 times but so many hospital visits it seems like 99. In my life, inhabiting hospitals was my only vacation.
B: Perhaps there is a better place to spend a vacation?
W: But there must be a better way to care for people like me. But it takes time
B: Wellhealth systems must have worked well for you Will. You are still here. More or less?
W: Yes for the moment. Just hanging around for my next health care battle.
B: Must we give these overworked doctors some credit? They give ushighly expensive medicines but they don’t always work. They make no guarantee that the medication will cure our health problems. But they do their best, and are always so optimistic, with alternative more expensive medications. Drug companies make huge profits. So hospitalization of one old patient may cost thousands!!!
P: Yes, perhaps they do their best to make cash for the drug companies? We need to find solutions to old people health careproblems , but it will take time. We must be gentle.
W: We have to show the real health battle field to the public. Here is an example:
DARK AND LIGHT AGAIN
SCENE A
Hospital Emergency Room
Doctor & patient
P: Doctor I thank you for seeing me here in the hospital emergency room-
D: Your very welcome, Bob. What is the trouble?
P: Shoulder pain from and accident. But I have questions.
D: Go ahead-
P: Why did I have to wait four hours to see you?
D: Because we are so busy. Hospital beds 95% occupied, health staff 150%overworked, key hospitals admission sometimes delayed for 60 days, and a hundred old feeble patients ready for hospital discharge with nowhere to go. Is that enough?
P:Is that all?
D: And sometimes critical surgery is delayed 30 or more days by lack of available beds- Sometimes cancer treatment is delayed for 60 days by staff overworked by staff shortages. Is that enough?
P: Why not use the cash to hire more staff and help old people to have somewhere to discharge to.
D: The government does not provide enough cash. So much spent on drug treatment often costing $20,000 per old patient. You can’t let him die. No enough cash.
P: Oh dear. I stop complaining. It’s a battle field. A battle crisis indeed.
D: Well the pharmaceutical companies must be happy. Making expensive necessary or even unnecessary medications . Who knows? They have unlimited expensive alternative medications, for every possible problem youmay or may not have. If in doubt, here is a new pill or treatment. Is that enough?
P: Enough. I give up.
D: Bye for now!
DARK AND LIGHT AGAIN
BACK TO ACT 1
W: So it is a health battle with a shortage of cash and too much demand for health care. …. So now for my health care, I prefer gin and tonic.
B: But I am very interested to hear your adventures, Will. Please?
W: Really? Not too boring.
P: Yes. I have heard them over and over so many times. Boring!
B: Not at all. Theysound exciting to me. Tell us all, Will. We are old doctors!!
K: Me too please? I am very curious to get your reactions to the French health care system for old people.
W: Well after my 99th experience, in all modesty, I do feel that I am an expert in health care. At 84 I am just a bit late to enrol for medical school, but I have had so many battles in French hospitals. And even now, as we have come to live in the UK, I may fight new battles with the NHS in England.
P: You certainly will!!
K: Well, I am French, so I must tell you,that health care is much better in France than ion UK.
B: Yes dear, everything is better in France than UK!! Agreed. Even the Queen will agree. She loves French wine and may actually be drinking a bit too much, but I would never say so.
K: You just did!!
W: Well? Like this …
DARK AND LIGHT AGAIN
SCENE B
Doctor and Patient in Limoges Hospital
D: In our small Limoges hospital. Nearly all patients are in small three-bedded rooms, sharing the toilet (when available) with the inmates in the neighbouring cell.
P: Inmates? The word Cell sounds a bit like the Bastille? A bit like the revolution and the fall of the Bastille. But I like my privacy.
D: Alas our cells in France have no curtains and beds are less than a metre apart. So all sorts of weird treatments of the most intimate kind, are performed in limited view of everyone.
P: Perhaps you designed it as a French health care theatrical entertainment? A sort of hospital continual Folies Bergers entertainment of so many exciting procedures going on?
D: Well the French are very open about naked bodies in so many ways. But when the patients are obese and over 50, they tend to keep huge fat bodies covered up, and change the subject.
P: But Why always so crowded?
D: So many old old people, want to come in for free care. So the staff arecontinually overworked and have to keep moving the furniture around. It’s terrible!
P: Moving furniture around? Is that our French health care?
D: Well you see with such a crowd of patients, we health care staff have to fight our wayaround, a bit,to get access to and fully treat each patient?
P: You staff were seeming to be always rushingabout. But yet the French nurses still seemed to spend hours and hours sitting in front of computers.
D: All of us have the same problem with computers , for the unlimited quantity of health care data, which must be recorded. I seem to spend more computer care than patient care? Shame!Seems impossible but probably due to all the paperwork we have to do.
P: I give up! It’s a health care battle!
D: We do our best. Bye for now!
DARK AND LIGHT AGAIN
BACK TO ACT 1
W: So that is the situation in a little hospital in France
K: As French doctor, I protest. Our French health care, all free, is much better than the UK.
W: So you see the problem? But in France things are so different from UK. Not so much supervision of nursing staff. Especially for dripping!
B: What is dripping please?
W: You see, I am now an expert onthe patient suffering from IV drips. Intra-venous treatment with medications etc.?
B: Are you a bit of a drip too, Walter?
W: Hopefully not. Now let me explain. In French hospitals, TV takes your mind off IV Drips! But it creates problems.
DARK AND LIGHT AGAIN
SCENE 3
Patient & NURSE
P: I do not like the TV on all the to time. But perhaps it takes my mind off my IV drip!! It is very difficult to move around with an IV drip. I have to sit down …so I watch TV. Tough for us patients and very trying for you Nurses too. I have to marvel how you still retain your encouraging good French humour.
N: Thank you for saying something nice about us nurses.
P: Yes, as a suffering patient I appreciate all you do. But why do you keep the TV on all the time in every room? I have now got used to it non-stop 24 hrs of French TV day and night.-
N: Good for the patients. Gives them something to think about.
P: Seems that sexy aggressive French TV is part of the French health care treatment. Perhaps seeing crime and sex on TV, distracts us from our pains and suffering. A bit like self - hypnosis?
N: Don’t dare to say hypnosis to a nurse or a doctor, or he will add two extra pills to your daily medication.
P: Yes, but back to TV. Perhapswe see worse things happening to other people on TV.
N: Perhaps it makes personal suffering, is less painful?
P: Yes, it does help me to feel a bit better. Perhaps when I see people beaten up and shot all the time, I feel a bit better with my little aches and pains.
N: Bye for now!
DARK AND LIGHT AGAIN
BACK TO ACT 1
P: Will, do you remember in France, when asked for and got one of those handful of those private personal one only rooms? There you could even choose the TV station.
W: Too true Pamela, my love. I sometimes got a ¨chambre seule¨ for a short time, but . nothing was private. They always had a large pane of clear glass in the door, so all could still be seen from the outside. My key worry was toilets being so far away down the corridor, so it motivated me to get better quickly.
B: I with my IBS, I am always worried about just getting to the toilet on time!!! I generally make it, except once a month. Oh dear.I never thought of hospital toilets being therapeutic.
P: Toilets to motivate health recovery? News to me. As an experienced, psychologist, I have never ever thought, that trouble getting to the toilet, would be a French motivation to ¨get well soon”.
K: That is a bit insulting to French health care !! But I won’t remark about it. I will pretend I did not hear it.
W: Well France is so different from UK. Some French nurses seemed to do just what they liked, with almost no supervision. No concern with hygiene official protocols. Perhaps that is due to too much wine in the French culture?
K: You English are so critical of everything non-English. Was it really so hard to get to the toilet and even take a shower in a French hospital?
B: Once a month?
W: Well, I should not tell you this …
B: But of course you will.
W: Well, I was once in a hospital in Villeneuve-sur-Lot, and there was only one bathroom for 70 people, in 35 two-bedded rooms
K: That does seem to be a problem.Do I have to laugh or cry?
B: One bathroom for 70 people, must have caused many battles and disasters, with such a long queue to get in? And you still survived all of your complex illnesses. Well done indeed by the toilet.
W: Toilets! Key to joy.