Pass the Parcel

Ron White 

Hi Ronald White

Justyna has your White Stuff parcel and will be delivering it today.

We'll deliver your parcel: Between 11am and 1pm

To this address: Ronald White  18 Milton Close

Even before Covid lockdown, there had been a move towards on-line shopping, which the constraints of the pandemic have greatly accelerated. Today, we’re all used to receiving confirmation of orders received, notification of consignment, tracking information, and as the parcel nears its destination, an email announcing its imminent arrival.  Hermes, the Greek god of boundaries, roads and travellers, thieves, athletes, shepherds, commerce, speed, cunning, wit and sleep as well as being a divine messenger has now added to his crowded portfolio by becoming the god of parcel delivery. 

Why my interest in parcels? Well, the story begins with lockdown in March 2020.  I had returned from New Zealand and Australia, and just as the threat of Covid and lockdown constrained our lives, discovered that I had some discomfort in the lower part of my digestive tract.  I mentioned this to a friend.

‘Oh, you haven’t got Covid, have you?’

‘No, I don’t think so,’ I somewhat testily replied, ‘Digestive problems aren’t listed among the symptoms!’

And there the matter rested. The lockdown had some benefits. As a recreational cyclist, I enjoyed navigating the virtually traffic free roads, and travelled along some routes which in normal times I would avoid.  The weather for the most part was sublime. Sitting in the dappled shade of my garden, reading, listening to podcasts or music, or just doing nothing was one of summer’s pleasures. 

Meanwhile, I was regularly receiving email warnings from the NHS regarding stomach cancer.  None of the symptoms listed matched mine, while the male model sported a ‘dad bod’, and looked like he should be joining Weight Watchers.  So, these warnings were dismissed.  

Despite my regular cycling rides, I joined the masses in discovering that the bathroom scales weren’t wrong: I’d put on a bit of weight, although I wasn’t yet like the figure in the NHS warning. So, I decided that a change of diet was in order, and that this might usefully affect my tummy problems. Out went the biscuits, the nibbles, the creamy sauces, and in came lots of salads and vegetable rich soups.  To my surprise, the kilos started to melt away. Gosh, this diet thing’s easy!  

Then, one day neighbour Pauline appeared at the door, bearing a saucepan. 

‘We thought you had lost weight,’ she said, ‘so here’s some soup. It’s got pasta in it.’ 

‘That’s kind of you, Pauline. But I have been trying to lose a bit of weight.’

‘Well, the soup will do you good.’

Maybe the neighbours had noticed something that had escaped my attention. But not that of the scales. My weight loss project had been successful as far as the fit of my pants was concerned. Those jeans that had been verging on the uncomfortably tight were now a svelte fit.  But the scales kept telling me that I was still losing weight.  Two kilos (good), three kilos (OK), four kilos (what’s going on?) five kilos (there must be a mistake!), six kilos (this really is getting out of hand), seven kilos (help!), eight kilos (this has got to stop!) And it did. My weight stabilised. But there was something wrong: the jeans were now hanging lose. I had lost appetite. And those stomach pains were still gnawing away, like an unwelcome rodent. Time to act!

Reluctantly, I decided to make use of the sacred NHS, in which the ‘S’ doesn’t stand for sacred, although the NHS is said to be the closest the British have got to a religion, but for service, which puts it in line with Hermes, the parcel delivery service.  I decided to metaphorically transform myself into a package and to despatch it via the NHS.  Step one was arranging an appointment with my GP, one of the youthful members of our local practice, who listened to my history, palpated my tummy, and announced that he would refer me for a scan.  The parcel was sent on the next stage of its journey,  involving a triage or sorting procedure of the kind which, no doubt, packages in the Hermes system undergo.  In my parcel’s case, this meant having a chest X-ray and then some detailed interest in and examinations of the lower regions of the alimentary canal, culminating in a colonoscopy and RT scan. At each stage, the parcel was handed on from one specialist to another, always with the possibility that it would be dropped or forgotten at some point in its journey.  Fortunately, the data on the parcel’s contents arrived safely at the next key stage: the MDT.  Another acronym was added to the medical lexicon: the multi disciplinary team.  

Having had its contents examined by the MDT, the parcel was sent on to another team at the Churchill hospital in Oxford where there were handlers who had the expertise to deal with it.  This information was to be given to me by Mr Lucian Goian, colorectal surgeon.  ‘Who he?’ I wondered. A search on the RBH list of staff members was unhelpful, so I did a web search which produced a namesake: a Romanian football player!  Well, at least that confirmed that Mr Goian was probably Romanian. 

Finding out who your parcel handlers are is difficult. While the Churchill website has quite detailed information on its specialists, RBH provides nothing. Yet, even Hermes could tell me that Justyna was my local courier, who likes spending time with her kids and gardening.  I may not want to know about my medical handlers’ domestic affairs and recreational preferences, but I would like to learn something of their professional background and expertise.  If one hospital can provide such information, why not all of them?

Anyway, I soon got to meet Mr Goian, who had the compact build of a footballer, was dressed in a dark navy suit, sported a modestly patterned tie, and, despite lockdown constraints, kept his dark hair short and neat. His alert dark brown eyes appeared above a mask which obscured one of the most important cues to personality and meaning. It was like meeting a half person. 

‘Mr White, we have sent your details to Churchill because we don’t have the expertise here to deal with your case.  Their MDT will review your data, and let us know how they plan to proceed.’

‘How long will that take?’

‘Several weeks. But you don’t need to worry. You’ve had your tumour for several years.  They start off as just one cell and it takes a long time for them to grow. A few weeks won’t make any difference.’

So, my parcel would be parked in Oxford for some time. After two weeks, and without any tracking information from either hospital, I began calling Churchill to find out what their handlers had done with my parcel. The conversation went like this:

‘I would like to find out the status of my case, please.’

‘Do you have your NHS number?’

Scrabbles around to find number, duly dictated. Tapping of keyboard. 

‘I’m afraid that nothing has happened yet.’

Daily calls continued, until eventually I was told that the person concerned had tried contacting me on both my numbers the previous week. Why on earth didn’t she leave a message? Anyway, she told me that my parcel had been returned to RBH, so I needed to speak to someone there.  

Panic!  What did this portend?  Had Churchill decided that they couldn’t handle my parcel either?  Did they say, ‘there’s nothing we can do for him’? The next day, one of the RBH team called to confirm that the parcel was now back with them, with a request that RBH provide a course of chemotherapy to shrink the contents of the parcel.  This was partly reassuring, and was shortly followed by an appointment at very short notice with my next handler, oncologist Dr Freebairn. 

A tall woman, probably in her fifties, masked Dr Freebairn stood during our meeting, taking notes, and was authoritative but friendly. When she discovered that I was a New Zealander, she said that she and her husband and family had spent 2019 in Dunedin. Although she didn’t specify, I suspect that her husband had been lecturing at the medical school where, coincidentally, my older brother had trained many decades ago.   I asked about the journey I was now starting on.

‘We’ll come to that.’

After which she explained the medical issues of the contents of my parcel, and that she was proposing a course of chemotherapy, or possibly of immunotherapy, after which the position would be reviewed and decisions made regarding the next stage of the journey.  We discussed my present symptoms — mostly my increasingly painful stomach cramps — and she prescribed a laxative ‘which you can pick up at the dispensary’, and blood tests. So, it would be off to Vampire Corner again!  

‘I’ll see you again on 12^th April, and I’ll book you in for chemotherapy starting on 19^th April.’

Outside in the waiting room, Nicky, the colorectal nurse, advised me to go to Bracknell for chemotherapy. 

‘It’s much nicer there. It’s new, you can park, and there’s free parking.’

Practicality supersedes medical criteria when choosing a treatment venue!  What she failed to tell me is that reaching the hospital involves navigating the nine circles of hell, otherwise known as the Bracknell roundabouts, that the route to the hospital isn’t signposted, and that in any case, it isn’t called a hospital, but is the ‘Bracknell Health Space’. Who are they trying to fool? Obviously not the locals, who more prosaically refer to it simply as ‘The Cancer Hospital’.  

The next day I received a phone call from Mr Goian’s secretary. Could I, at very short notice, see him at 1 o’clock today?  Why? I wondered. And when I turned up, it turned out that there had been confusion thanks in part to my sharing the same initials as another patient. Thinks: isn’t this why we have NHS and hospital numbers?  Mr Goian was prolix in his apologies for having brought me in on a wild goose chase. He summarised what was happening to my parcel, and that at the end of treatment, the MDT would review the situation and make recommendations.  

‘It will be a team decision.’ So, don’t blame me! 

I suppose that disclaimer was meant to be reassuring.  I just hope that the team of handlers really does find the most effective way of treating the contents of my parcel.  In the meantime, I think I will transfer my allegiance from Hermes, god of parcel deliveries, to Asclepius, god of medicine!