Freedom and Control – a personal reflection

Our UCFORUM chairperson, Rodney Eivers has been greatly challenged by a hearing deficit and has had to compensate for this in conversations and seminars. He has started on the long process of cochlear implant and the experience at the Mater Hospital in Brisbane has invoked serious reflection on the way in which ‘control’ and ‘freedom’ played out through the process. Much of what he says carries over into life generally for those of us who are aging but not only for the aged! The reflection takes us beyond the hospital experience to our interaction with government and society and poses a challenge to all of us.

A Day in Hospital – Freedom and Control

This week I experienced a rare overnight stay in a large public hospital.

With age comes deteriorating performance of many of the body’s organs. While taking advantages of health advances, backed by empirical research including attention to diet and exercise, I have generally lived a philosophy of letting nature take its course.

In the matter of my hearing, however, this has become a less and less viable philosophy. With a step-by-step resort to hearing aids and pleading for family and friends project their voices more clearly it became increasingly clear that I was losing the struggle.

So much so that in going out with a group I would place myself at the end of the table to avoid having to talk with companions and risk giving or receiving errors in conversation.

It only takes one word or even one consonant or vowel to lead to misunderstandings.

I once was told. so, I thought, to “put the cats out”.  I had interpreted the request as “put the car out”.  On another occasion, in a telephone conversation recording a bank account number I wrote down “two” instead of “three”.  You can see that such mistakes in communication can lead potentially to drastic outcomes.

I came to the conclusion that it was time to go for the ultimate in aural technology – a cochlear implant. This a process by which a microphone transmitter is planted into the cochlear of the ear sending electronic message directly to the brain.

And so began the process. It took longer than it might have, began. Partly this may have been because I slipped into the public rather than the private hospital system. My family charged me with being stingy and potentially displacing someone financially poorer and with a greater need. They had a point but the truth was that I got started with the public hospital financing because their service was the most appropriate one I found on the internet. When we got going, I found they were doing such a good job that I continued on with them. But, what with this being “elective “surgery and the added disruptions of Covid-19, it has taken nearly two years since we got to this week’s point.

A week before the scheduled visit to the hospital my family had asked, “Are you worried about the coming surgery? “They knew I had experienced some anxiety earlier in the year about the potential for fatal anaphylactic shock from the contrast dyes used in some scans. I responded that I had felt some nervousness at the beginning of the week but now, without going as far as saying I was looking forward to it, I replied that I had become curious about the coming experience.

The opportunity to satisfy that curiosity came when I entered the front door of the designated hospital. I learned straight away that hospitals are institutions of control. Covid-19 has not helped in this respect. After the required QR Code check in, adjustment of mask and the washing of hands, I was then instructed to separate from my accompanying “responsible” person and make my way to the fifth floor for further instructions. From thence forward I was shuffled along from one staff member to another and from one sheet of questions to another and from one room to another.  There are so many staff employed in a major public hospital that one comes to understand how government health services lead to so many battles on health funding between the federal and state authorities.  It is a very live issue between Anastacia Palaszczuk and Scott Morrison and Co as I write. Care of our health truly is labour intensive and I do not decry that amount of person power that it requires. I merely make the observation.

The next control, “Take off your clothes”. (I had assumed that as it was my head that was to be doctored my scalp would be the only part of my body required to be accessible.

After clocking in and confirming that I was indeed to be a guest of the hospital for that night I was led by a female nurse round to a small cubicle. She dropped a bundle of folded clothing on to the low bench inside the cubicle.  “Now take off your clothes and put these on”, she said.

I said, “What everything?”

She responded. “Yes everything.  I’ll be standing just outside when you’re ready.” She drew the curtain and departed.

Well, such was my confusion and not wanting to keep her waiting that I struggled to make head or tail of how make the dressing change-over including the intricacy of fastening the belt of a dressing under-gown which opened at the back rather than the front.

In due course I cautiously opened the curtain to emerge and called the nurse who had actually moved away little. I can imagine she had to stifle a great laugh when she pointed out that I had placed the rather flimsy see-through hospital underpants on top of my head as a shower cap. Back to the cubicle to get that sorted out and later another different nurse withdrew, from a hidden crevice in the very comfortable hospital dressing over-gown, a shower cap for my use.

Another feature of hospitals, as probably most of you, my readers, well know, is that there can be a lot of waiting around. Another stop was the day surgery lounge. This was comfortably fully occupied by other patients, mostly in armchairs, As with the clothing, we had also been divested of all reading material so in this waiting room the only entertainment was a very large television screen attached high up on the wall and dominating the room.

Another “control” was that I had no authority to change the channel nor could I know what my fellow occupants of the room would consider good entertainment. The result I was that I found my sitting through an hour or so watching one of the commercial channels. This displayed the activities of a bunch of hedonistic Australians enjoying the facilities of some resort in Thailand at the cost of nearly $1,000 per night per person. The crudity of their behaviour left me cringing as a fellow Australian and feeling for the gentle Thai staff who were “forced” to pander to such antics in order perhaps to support their families bordering on poverty. I am happy to say of my countrymen  and women that there are other Australians who do live and work in these South East Asian countries under more austere environments to bring better living conditions to the inhabitants.

Although I may give the impression that these “controls” in the hospital were repressive this is not really the case. I actually found it in some ways a blessing. I did not have to make all the decisions myself. Moreover, once I entered that hospital door and willingly committed myself to being a patient there, I could not change it.  I might was well just relax and enjoy this period of helplessness. I have a personality foible. That is, that I have to be always “doing something”. This becomes more urgent with advancing years into the 80s when there is not that much time left to “do something” It is also a fact that in my day-to-day life with family and business commitments I find it hard to find excuses to allow me to not “do something”.

There is another element of this acceptable control. In today’s state-of-the art hospitals  you get carted everywhere. Once the process starts you don’t have to walk. You get wheeled from room to room. You are not allowed to get up and walk away from the bed. The bed goes with you.

And there are some sensual pleasures in this environment. Although, happily it was not an issue for me, one can imagine the surge of relief which comes to people in serious pain having access to powerful analgesics. The overwhelming majority of staff are women. In this era of “#metoo” perhaps one may be forgiven the mild erotic tingle which comes from ministrations of female staff sliding pressure stockings up one’s legs or dabbing the sensors of monitoring devices on to strategic patches of bare skin. There is also a pleasant sensuousness from the pulsating of the pressure stockings, on the calves, when they are electrically activated.

But in addition to the inherent kindness and compassion of the female staff there is a place for the male staff as well. There comes some assurance that they are available for the heavy lifting, and security if agitated patients seek to break away from the overriding “control” – not that such an event was my experience this time. One tiny Vietnamese nurse struggled to get my heavy cabin bag onto my lap in the bed so I could pick out a few items. After an attempt at lifting, it she laid it on the floor, I leaned over the guard rail, and with her bending from the waist down we managed cooperatively to successfully extract the goods.

I liken this hospital situation to something I wrote some years ago about “being on the right train”.  One can suppose that one misses the right connection      for a railway journey and discovers that the train is going in the wrong direction from that intended. You can’t change trains until you get to the next station. The result is that in the meantime you can have optional attitudes. You can stew and fret with anxiety that you will miss an appointment or be late home.  Or you can sit back relax, enjoy the passing view or perhaps have a short nap. For those few extra minutes, you can then indeed consider yourself to be “on the right train”.

So it was with my stay the hospital. Nevertheless, I appeared at one stage to have lost a couple of hours of my lifetime. At one point after another period of waiting and a brief conversation with the surgeon I was wheeled into an adjoining room. The surgeon disappeared – presumably to attend to another patient – and one of the staff was fiddling with the canula on my wrist.

“It’s about time we got started”, I mused.

I reached up to scratch an itchy point on my eyebrow. In some puzzlement my hand landed, not on a patch of hairy skin, but a bulky bunch of towelling about the size of a Sikh-like turban wound round my head.

I looked up at the clock on the wall.  Yes, it was all over! I had completely lost awareness of two hours of my life.

Not that this was necessarily a bad thing under the circumstances. With a cataract- removal operation under local anaesthetic some years earlier there was no pain. I had, though, the unsettling experience of sensing somebody scratching around on my eyeball with a scalpel. Then there are tales told of patients being inadvertently operated on while still fully awake.

There followed a night, restful although largely sleepless, as I mentally drafted these notes in relation to freedom and control.

“Freedom!” the anti-vaxxers shout. But such freedom, if granted can nullify the blessings derived from the control imposed by up-to-date health research and hospital care. This, of course, includes vaccination.

It is also observable that some people prefer control to freedom. A renowned classic book title by psychologist Erich Fromm was “Escape from Freedom”. It relates to the Nazi era in Germany. We continue to see acceptance of such control today in Communist countries such as China and Russia. It was noted the other day that the recidivism for some of our criminals approaches fifty per cent. Some behavioural scientists claim that part of this is because some people actually find life in gaol satisfying. They are well fed and looked after and don’t have to make decisions for themselves. I have long advocated a case for provision of institutions where people who are incapable of looking after themselves, with or without criminal inclination, may be permanently accommodated.

So let those of us, who do value the freedom to make our own decisions, use wisely the opportunities we have to do that. Let us also be sensitive to the desirability of yielding control where appropriate to our governing authorities and institutions such as our hospitals and government health advisors where it better meets the good of ourselves and our neighbours.

Rodney Eivers , 7th October 2021

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