BATTLES FOR HEALTH
Amusing health care interactions – when old old age does make a difference
Dr Bob Boland & Team – Draft 14 – March 8, 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 - very formal GP Dr Sydney
DC – very careful CIDP Consultant – Dr Henri
DG - Emergency casual care – Dr George
Others players. Paramedics, Nurses, Drivers etc.
Act 1 – Battles in France (page 3)
Act 2 – Battles in England (page 14)
Act 3 – Impossible Revolutions (page 41)
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 care services: waiting, suffering, testing, diagnosis, treatment, success, failure and confusion. So sometimes patients feel neglected and all mixed up together, with battles to survive and finally be discharged to 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 needs the ever increasing number of older and older people.
In 2017, people may retire at 65 years but with the new wonderful medical research (even deep brain stimulation) etc. they may 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 motivators, cash and cultural change become available?
ACT 1 – BATTLES IN FRANCE
Bill Will
Kate & Pamela (wives)
Bill: Welcome Will and Pamela, my dear old friends, coming from France to my English Wiltshire paradise, for my 88th birthday party.
Will: Bill, it is great to see you and Kate again, looking so slim and active. I am only a xoung 84. Our news is that last year we 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 psychological skills to resolve them.
B: What news of your problems, Will?
W: Battles for health care in France.
B: Well, as an old old MD, I am curious.
K: And, as a French MD, now retired in the UK with the terrible NHS, how could you possibly complain our wonderful free French Health Care System?
W: Well, I am sorry Kate, but I was furious with health care in France. The doctors consider their time 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: So patients …must be patient. That seems reasonable.
W: Well health care for older people leads to boring health care battles, as we old old people live on indefinitely.
B: You may even manage to get to 85?
W: Well by 2030 to over 90 years, using up all the health care costs, for the younger population to pay !!!
P: Patience, my dear Will. New 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, now just sit back and laugh at yourself.
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 the French health care service was terrible with: waiting, suffering, testing, diagnosis, treatment, success, failure and confusion. I felt completely neglected and lost. In hospitals, I battled to be discharged to home and family saying: ¨¨Hooray. I got home again!! I have made it!!!¨¨
B: I agree Will, 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 (Internal Bowel Syndrome) 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? Must be a pain for Kate?
B: I never thought about it before. With a little bit Alzheimer I forget my pains and problems. So convenient. But I never forget to always say yes to my dear wife Kate, and so we have no arguments. Good thing for you to learn, Will?
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. OK Will??!!!
W: Not really, but for now I will start now to always say, Yes dear.
P: Well done.
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 always angry. He is just out of hospital for the 99th time. But still complaining, of course.
B: 99th time. Perhaps you could make a claim for the Guinness Book of Records? Was it the usual alcohol problem again? 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 visis . In my life, inhabiting hospitals was my only vacation.
B: Perhaps there is a better place to spend a vacation? Like here with us. Battles for health, 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 hospital battle.
B: We must we give these overworked doctors some credit? They give us highly expensive medicines but they don’t always work. They make no guarantee that the medication will cure our health problems.
K: Yes, but they do their best, and are always so optimistic, with alternative more expensive medications. Drug companies make huge profits.
P: Yes, perhaps they make cash for the drug companies? But surely no need for old people to have battles with health care. Must be some creative solutions?
W: Let me show you a health battle. 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 a 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 get the cash to hire more staff and help old people to have somewhere to discharge to.
D: The government does not believe in a free health service. They want business to be involved so you have to pay, and will not waste money for nothing. So much spent on drug treatment for old old patients, often costing $20,000 per old patient. We can’t let you die off for not enough cash. We cannot cure you old ones, we can only keep you going.
P: Oh dear. I stop complaining. It’s a battle field. A battle crisis indeed.
D: Well the pharmaceutical companies are happy. Making expensive necessary or even unnecessary medications . Who knows? They have unlimited expensive alternative medications, for every possible problem you may 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 of cash and too much demand for health care. But for my health care, I prefer gin and tonic.
B: Me too. More of your battle adventures in France, Will. Please?
W: Not too boring?
B: Not at all. All exciting to me as an old old doctor!!
K: Me too please? As a French doctor, I am proud of the great free French health care system, which cares so well 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.
K: 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? Let me tell you about a French battle in Limoges …
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. 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 treatments of the most intimate kind, are performed with just a limited view of everyone.
P: Perhaps you designed it as French health care theatrical entertainment? A sort of hospital continual Folies Bergers with so many naked exciting procedures going on?
D: Well we French area bit open about naked bodies in so many ways. But the patients that are obese and over 50, do tend to keep their bodies covered up..
P: But why is the hospital always so crowded?
D: So many old old people, want to come in for free care. So the staff are continually overworked and have to even 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 huge crowd of patients all close together, we health care staff have to fight our way around, a bit, to get access to and to fully treat each patient?
P: You all seem to be always rushing about, except some French nurses spend hours and hours sitting in front of computers.
D: All of us have the same problem with an unlimited quantity of health care data, which must be recorded. Even I seem to spend more time on 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 and fight on. Bye for now!
DARK AND LIGHT AGAIN
BACK TO ACT 1
W: So that is the situation in one little hospital in France
K: As French doctor, I protest. Our French health care is free and much better than the UK.
W: But in France things there is not much supervision of nursing staff. Especially for dripping!
B: What is dripping please?
W: You see, I am now an expert on the patient suffering from IV drips. Intra-venous treatment with medications etc.?
B: Are you a bit of a drip too, Will?
W: Hopefully not. Now let me explain. In French hospitals, TV takes your mind off your IV drip, that otherwise creates problems. Like this experience of mine:
DARK AND LIGHT AGAIN
SCENE 3
Patient & NURSE
Is it
P: Nurse, that TV is on all the time. Is it to takes my mind off my IV drip!! It is very difficult to move around with an IV drip. I have to sit down …and just 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 must you keep the TV on all the time in every room? I now get used to non-stop 24 hrs of French TV.
N: Good for you patients. Gives you something to think about.
P: Is sexy aggressive French TV is part of French health care treatment? Perhaps seeing big crime and sex on TV, distracts us from our little 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. Perhaps when we see worse things happening to other people on TV, it makes personal suffering, is less painful?
N: Does it help you to feel a bit better?
P: Perhaps when I see people beaten up and shot all the time, with my little pains seem less important?
N: Bye for now!