Intended for healthcare professionals

Practice A Patient’s Journey

Left atrial myxoma

BMJ 2013; 347 doi: (Published 26 July 2013) Cite this as: BMJ 2013;347:f4430

Re: Left atrial myxoma

Susie Layton's desciption of her treatment for left atrial myxoma encapsulates the problems within the NHS. Although she was diagnosed and appropriately treated, the process of diagnosis and treatment fell far below expectations. Why was she sent home to to wait for an outpatient ECHO when her ECG was grossly irregular? Why was she discharged so early with so little support? Did nobody assess her home circumstances?

Hospitals are bursting with technology and innovation but patients are at the periphery of medical treatment. Doctors, nurses and other carers are caught up in a whirl of processes which do nothing to improve the wellbeing of the patient. Innovations such as "enhanced recovery" are a byword for early discharge.

Of interest is the patient's descriptions of the ear piercing noise of the monitors on the coronary care unit. Patients are subjected to a cacophony of noise in all hospital wards, mostly unnecessary. Alarms on infusion devices and monitors are mostly ignored, so why have them? - a flashing display would alert staff to a problem just as effectively. A decent night's sleep is well nigh impossible on most hospital wards due to the noise of these devices along with disruptive patients, noisy doctors and nurses and admissions / transfers and deaths.

The only hint of humanity that I could find in Mrs Layton's journey was that the surgeon who operated on her phoned her husband when she was in the recovery room. The rest of her story reminded me of a Dickensian workhouse.

The debacle of North Staffs will continue to haunt the NHS until patients are firmly at the centre of medical management rather than inconvenient appendages.

Competing interests: No competing interests

23 September 2013
Terence Kirkpatrick
Consultant Anaesthetist
Lesley Kirkpatrick