An appointment letter for a mammogram arrived. Of course I threw it out. Then a few weeks later the breast screen program people texted me, to confirm my appointment. I rang the number but got lost in the phone system and did not bother continuing. I thought I would just not turn up. I have written before about the choices made by people experiencing precarity of work and finances. It gets overwhelming, the worry and the grittiness and the focus you need to get by. One more thing to deal with, and it goes in the bin. I am not particularly interested in a mammogram. There are lots of false positives with them, there is no family history of breast cancer, it is travel costs and hassle and I am really only in a position to think a week ahead.
Let us consider. A child is admitted to hospital requiring a nebulizer after his umpteenth asthma crisis. He is there for two days. His mother doesn't visit. The nurses are disparaging when she turns up to get him upon discharge, and they lecture her about his health and her care of him. In fact, when he is admitted, she thinks that is one less crisis to manage. It's not that she doesn't love him, but her teenager has started to self harm and the Police have called about her brother who is living with them because he has nowhere else to go, and everybody around her eats and nobody pays the rent. Her generosity with time and attention has just about reached breaking point. The lecture is all she needs. So her boy goes home, and she has to take time off work because he is not well enough for school, and she doesn't get paid. So when the brother gets to spend the weekend in the cells it is another little break for her, because he is a complication she can't handle right now. It's not that she doesn't love him, but her boy is sick again and it's been raining for days and the carpet is wet with mould and so on and so on.
So, some weeks later I got a call from someone called Patti from the breast screen program wanting me to confirm my appointment. Can I just cancel it, I said, and she said no. Look, I said, I work in different jobs off and on each day and I am on call all the time in case I get work. If I don't work I don't get paid. I can't just pop out for some appointment. I have no idea what work I will have on the day you've given me. She was pretty understanding, Patti was. She offered me an appointment in the evening. I demurred. She insisted. I caved.
Goodness she was persistent, our Patti, and very pleasant with it. And so naturally I considered the issues facing the mental health service, also part of the public health system. In mental health, no one texts and phones to remind patients of their appointments, and no one offers that much flexibility. If you don't go to your appointment, the clinician you were booked to see heaves a sigh of relief because they have a whole hour to do something else. If everyone came to their appointments, the whole system really would grind to a shuddering halt. What does the clinician do with the hour suddenly at their disposal? Move on to the next crisis of course.
Sounds about as functional as the woman with the asthmatic child above. And slightly less functional than I am. Go figure.
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