The view from the queue

”Where's Danny?” The words were out before I was conscious of what prompted them. My wife and older son were waiting for me as I emerged from the customs hall at Heathrow airport, but my accident prone younger son was prominently absent. I had been lecturing at a medical school in the Middle East for a week and as I waited in the queues at Heathrow anxiety about my family, and Danny in particular, had begun nagging at the back of my mind.

A month later I took Danny for his follow up appointment at the fracture clinic of our local hospital. The fracture of his clavicle, caused during a wicked stunt involving a mountain bike and a large log, was healing without problems and there was no reason to expect any hitches at the clinic. We live within half a mile of the hospital and arrived early. The receptionist took Danny's appointment card in a rather absentminded way and asked us to sit down. At that moment, the notes trolley entered the clinic and Danny's appointment card—in fact, our entire existence was forgotten.

I was not aware that we had been overlooked. I was unaware, too, that the receptionist's error was to afford me an experience rarely gained by doctors: I sat in the waiting room throughout an entire outpatient clinic. Fracture clinics are very much like any other clinic, including my own: always busy, often overbooked, and frequently interrupted and delayed by a half expected or totally unforeseen circumstance. This was no exception, but we were well prepared. I had packed a carrier bag of amusements: a selection of games, several toy figures, half a dozen of Danny's favourite books, and my own novel. We were lucky to find seats in the crowded waiting area; once seated, Danny took out his toys and I read my book. What I did not expect was everyone else's lack of preparedness.

After about five minutes Danny asked if the boy sitting across the aisle could borrow some toys. When I looked up I saw a room which seemed to be full of children, all of whom seemed to be staring at our carrier bag as Danny dug out more figures. Over the next few minutes several children drifted over to look longingly at the bag or to ask what it held. For the next three hours we provided a toy lending library to children whose parents had brought them along completely unprepared.

The children were not particularly polite but at least they were grateful and most thanked Danny or me as they returned borrowed toys or books, and nothing was lost or broken. Their parents (and many of the other adults present) had less excuse for being disagreeable or offensive: nobody was reading, knitting, or passing the time agreeably. There were few conversations, and what there were seemed to start with “Isn't it terrible?” and continue with complaints about waiting times (few people waited longer than 20 minutes) and lack of amusement.

I am no angel and my patience ran thin by the time my third inquiry elicited the response that, no, we had not been booked in. I was yet more aggrieved to be given the impression that, somehow, this was my fault. But, as the afternoon progressed, my greatest annoyance was reserved for those waiting alongside me.

What impressed me was that it was not the children who showed the most intense impatience but their parents, and those who were quickest to reach boiling point seemed to me to be members of a generation previously proud to claim, “We made our own entertainment.”

The sense of patience—the feeling of being content to wait—seems to be like the sense of security or trust: it evaporates the moment anyone questions it. We are no longer expected to be patient or secure or trusting. Indeed, to be so is to be seen as passive and lacking drive. Instead, we must complain, and not just about major problems or maladministration but about any minor inconvenience which crosses our mind. This is not merely our right, we are reminded, it is our duty—for how else are improvements in the service to be made? In short, we must abandon the virtues of give and take in favour of a lemming-like stampede to the front of the queue. This is the culture of complaint whose anthem is muzak and motto is, “It's disgusting,” where whingeing is elevated to an art form and patience is a personality disorder.

There is, of course, right on both sides. The hospital service has many problems at the “customer interface.” Crowded waiting rooms that herd people together will amplify individual niggles; staff who are overworked or inadequately trained cannot provide a welcoming reception; and doctors and other clinical staff sometimes forget that they have the great responsibility of making it all worth waiting for. But hospitals cannot be expected to service the impatience of those who do not bother to cater for their own needs.

A month later I waited in a different queue, this time in a corridor of a major teaching hospital. As each new arrival joined the end of this queue the sensor of the nearby automatic doors was set off and let in the wind and rain. There were no seats, no refreshments, no indication of expected waiting time. Only two members of staff were available instead of the usual four, and one of those was called away to cover a crisis. Progress was slow, everyone was agitated and irritable, and the talk was of how terrible—indeed, disgusting—it all was. Again, nobody in the queue was prepared for the wait. The only book I was carrying was my cheque book since, after all, it was the queue for the bank.—TEIFION DAVIES is a senior lecturer in community medicine in London