The VATS surgery is booked

Whatever else may be said of the NHS, or waiting times, or general dismay at the service sector, the Royal Papworth Hospital is hyper-efficient. My appointment was at 15:10 yesterday and we arrived 10 minutes early. The outpatients reception area is a vast high-roofed, cavern-like hall with a large number of vertical double-sided screens scattered at intervals, each with a surrounding halo of comfortable chairs. I gave my name to the receptionist and was told to take a seat until my name appeared on one of the screens. Ann went off to the lavatory as I walked into the hall to find a vacant seat near one of the screens. I was no further than halfway across when my name started flashing in urgent letters to "go to corridor B, room B2". Happily, Ann was still waiting outside the door at the far end so I had to bellow up the room to call her to quickly join me. 

Mr Andrew Peryt, the Clinical Lead for Thoracic Surgery at Papworth, is a serious Polish surgeon who was brusque and direct in his approach. He specialises in adult thoracic surgery with a major interest in lung cancer treatment. He dived straight into explaining what he intended to do, and what the percentage risks were for wedge resection of the lung, or removal of the whole lower lobe if he were unable to extract the cancer easily. He even provided an exact date and time when he would operate, with an assessment of how long I will take to recover under the different scenarios. The whole procedure will be done as a "Video-Assisted Thoracoscopic(VATS) resection or lobectomy". We were with him no longer than twenty minutes, after which he shooed us from the room to greet his next patients. The nurse in her turn then ejected a couple of people from an examination room to go through a little more detail. The room had only one chair which she insisted I took, so Ann had to sit on the examination table while the nurse knelt on the floor to go through everything.  

The day had started in a funny way when I received an email from a journal called Galaxies. Some while ago, I sent a new paper in to them for possible publication, but had heard nothing back. Today's email said the paper had been rejected, and I could see the reasons in the attachment. I sighed the usual disappointment, then read it more closely. A couple of weeks ago, I had reviewed a paper for them and advised rejection, and it was this paper that had been rejected by the second reviewer as well. So I still don't know the fate of my paper. Then I heard that a friend of mine from medical school days, Ann Carter, had died. She was a wonderful character, but had refused to enter a deep relationship with anyone. Years later, she told me the reason: her mother had died from Hutchinson's chorea, and she was frightened to marry in case she developed it and went like her mother. In those days there were no tests, but by the time tests came in, she was old enough to know she had not got it, and too old for children anyway, so she remained single. 

Then came the strange meeting at Papworth. We left in somewhat of a daze, without time to talk to each other or sit quietly to mull over the information. We went on to Edwin and Andre who provided a fine meal cooked by Edwin, and where I could take a Monkey Shoulder to unwind a little. Only later did we realise we had been presented with a fait accompli. We had not been given any opportunity to discuss alternatives (e.g. doing nothing, or the possibility of having chemo or radiotherapy). Somehow, despite the efficiency of it all and the fact that I would probably have opted for surgery anyway, we felt cheated and angry at the way it had been handled. Now I am busy with teleconference calls with the pharma company I work for (still earning pennies while I may), but I will try to contact the nurse later and ask why we had no preliminary consultation or discussion.