Thursday, 21st May, 2024

[Day 1466]

I suppose today started, in a manner of speaking, when in the middle of the night I got up and sent off two emails to people who might be able to ease the bureaucratic logjam issue which I have with the hospital attempting to get Meg discharged. The first of these was to the specialist nurse who looks after Meg and knows our situation intimately and I thought I might be of use as an advocate. The second was the ‘Falls’ nurse who was one of the community based occupational therapy team and who Meg and I have found extraordinarily helpful in the past, not least because we have seen her twice in about the last ten days. The upshot of all of this is that both were incredibly sympathetic but in the last analysis, they were as powerless as I feel myself to be. This morning I rang the number for the Bromsgrove area team of social services and was amazed hen our previous social worker answered the telephone. I explained our plight and really indicated that our newly allocated social worker should be picking up the pieces but I did get the advice that it was really down to the hospital based teams at this stage. I had intended that I would try to spend some of the day today in what might be called ‘field work ethnography’ This betrays my earlier professional life as a sociologist because those sociologists that like to study the minutiae of social life and to understand ‘what goes on around here’ use a technique called participant observation although today ethnography is the broader and more inclusive term. The whole point about participant observation as one of the initial ‘gurus’ in the field explained in his study of street corner Italian gangs in Boston (I believe) is that one collects data by being immersed in social situations as a genuine participant – but not so immersed that one loses all objectivity and academic rigour. The most famous quote from his book is that ‘I started as being a non-participating observer but I finished by being a non-observing participant’ This is the classic balancing act of this style of work and classical social anthropology (to which Meg and I were fully exposed in our undergraduate education at Manchester University) used participant observation extensively but in the British case, the Empire (as was) was a huge natural laboratory for these types of studies, Later generations of sociologists spread their attention to factories, schools and particular hospitals. Hospitals have always been a favourite locale for ethnographers because if they are actually inpatients they are truly participants – but may well have a lot of time on their hands to write up field notes based upon the observations they make during their stay. I engaged in a semi-serious style of this type of ethnography because when I had a period of teaching IT to public administration students in the Complutense University of Madrid, I wrote a sort of diary which I transmitted on a weekly basis to my colleagues at what was then called Leicester Polytechnic. This I called ‘Carta de Madrid’ and I had in mind the series by Alastair Cooke named ‘Letter from America’ which was broadcast on Radio 4 for years. I did a similar thing when I worked n Jakarta (although now it was called ‘Letter from Jakarta’ These missives were largely based on a diary format (what I actually did all day) but I allowed myself a little bit of self-reflection as I encountered new situations. This line of work even continued into my PhD because I did incorporate some participant-observation studies of paediatric clinics in Leicestershire – I tried to interview parents of the children to ascertain what they though of as being a ‘quality’ consultation with the consultant but incorporated some of my own observational data as well.

Back to today – mid morning, we were delighted to at last have a consultation with a hospital based Occupational Therapist – we had already seen the physiotherapist last Monday morning. But if our spirits of an early discharge were raised they were soon to be considerably dampened. The two reports have to be combined and then set forth as data to the hospital ReAblement team who then have to specify what needs to be put in place before discharge and that the end of the day the local authority based social services then have to put forward a care package to take over from the NHS Reablement team and all of the costings and the resources for this have to be agreed. I doubt this will be done in a day and am desperately hoping that it might be put in place by tomorrow, Friday but of course then the weekend intervenes and nothing will be forthcoming from anybody on a Saturday or a Sunday which means two more days in hospital for Meg. Having said that, she was more tranquil than yesterday and indeed had a very long sleep straight after lunch about which I was pleased at one level but somewhat worried at another level because too much sleep during the day may result in periods of restlessness in the middle of the night which is the last thing that we need. But I was quite proud of the way that Meg was coping and she was keeping her agitation levels down but there was at least one other demented female on the ward who was both deaf and not averse to mouthing the most extreme and rude opinions about the staff who were desperately trying to provide her with a modicum of nursing care, which was proving to be difficult in the extreme.