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| The NHS staff who rallied to my son’s aid show there is hope, even in bleak times | The NHS staff who rallied to my son’s aid show there is hope, even in bleak times |
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| Fri 22 Dec 2017 15.34 GMT | |
| Last modified on Fri 22 Dec 2017 22.00 GMT | |
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| There has been so much bad news this year that I thought I’d offer a little sparkle of something more heartening. Perhaps it might serve as a reminder that even those clouds that have darkened our skies most – the menacing dominance of technology, the strained state of our public services – are, every now and again, lined with a trace of gleaming silver. | There has been so much bad news this year that I thought I’d offer a little sparkle of something more heartening. Perhaps it might serve as a reminder that even those clouds that have darkened our skies most – the menacing dominance of technology, the strained state of our public services – are, every now and again, lined with a trace of gleaming silver. |
| The story begins with an accident. Cycling home from school, my 16-year-old son, Jacob, was knocked off his bike by a van that had veered into the cycle lane. I rushed to pick him up and took him to our nearest hospital, the Homerton, in east London. By the time we got there, the pain in his left leg was so bad he couldn’t get himself out of the car. It took a nurse and an orderly to prise him from the front seat and into a wheelchair. | The story begins with an accident. Cycling home from school, my 16-year-old son, Jacob, was knocked off his bike by a van that had veered into the cycle lane. I rushed to pick him up and took him to our nearest hospital, the Homerton, in east London. By the time we got there, the pain in his left leg was so bad he couldn’t get himself out of the car. It took a nurse and an orderly to prise him from the front seat and into a wheelchair. |
| One sign that things might be serious: there was next to no waiting in A&E. Instead, he was rushed through the various stages – X-rays and the like – until they declared that his kneecap had been broken. The registrar on duty told us surgery was a strong possibility: two operations, one to put in the various bits of metal needed to heal the shattered knee; another to take them out again. | One sign that things might be serious: there was next to no waiting in A&E. Instead, he was rushed through the various stages – X-rays and the like – until they declared that his kneecap had been broken. The registrar on duty told us surgery was a strong possibility: two operations, one to put in the various bits of metal needed to heal the shattered knee; another to take them out again. |
| That long night on the ward counts as the first cause of cheer. What I saw was yet another advertisement for the wonder that is the NHS. Just as their counterparts had done when they ushered Jacob into the world 16 years earlier, the NHS staff we encountered – from the most senior consultant to the guys in the plaster room – inspired genuine awe. Not just their professional skill and methodical calmness under pressure, but their generosity, humour and sheer human warmth were a marvel to behold. | That long night on the ward counts as the first cause of cheer. What I saw was yet another advertisement for the wonder that is the NHS. Just as their counterparts had done when they ushered Jacob into the world 16 years earlier, the NHS staff we encountered – from the most senior consultant to the guys in the plaster room – inspired genuine awe. Not just their professional skill and methodical calmness under pressure, but their generosity, humour and sheer human warmth were a marvel to behold. |
| I know this is a common reaction. I know almost everyone has an NHS story. But that makes this phenomenon all the more remarkable. If we can still speak of the glory of this nation, then surely it is the NHS. | I know this is a common reaction. I know almost everyone has an NHS story. But that makes this phenomenon all the more remarkable. If we can still speak of the glory of this nation, then surely it is the NHS. |
| And I use the word nation in its fullest sense. For the overnight team that treated my son was led by a doctor from Greece and nurses whose roots ranged from east London to east Africa. This was the Britain we showed off to the world at that Olympics opening ceremony in 2012, before we decided that an infusion of talent from across the planet was a problem rather than a blessing. | And I use the word nation in its fullest sense. For the overnight team that treated my son was led by a doctor from Greece and nurses whose roots ranged from east London to east Africa. This was the Britain we showed off to the world at that Olympics opening ceremony in 2012, before we decided that an infusion of talent from across the planet was a problem rather than a blessing. |
| But that wasn’t the only ray of light in the gloom. The next morning an anaesthetist arrived to prepare Jacob for the operation. With the fearlessness of a teenager, my son was unfazed. But I was anxious. | But that wasn’t the only ray of light in the gloom. The next morning an anaesthetist arrived to prepare Jacob for the operation. With the fearlessness of a teenager, my son was unfazed. But I was anxious. |
| Then the surgeon, Vivek Gulati, appeared. Getting straight to the point, he announced that there was no need for an operation after all. Via a WhatsApp group he had shared Jacob’s pictures, fully anonymised, with senior orthopaedic surgeons around the country – including one in Worcester, one at the Royal Free in London, and another at Northwick Park in Harrow – and five had pinged back a verdict in seconds. “Unanimous view, five out of five,” he said. “No need for surgery.” Jacob was young; his bones would heal. A cast, followed by a brace, would be enough. | Then the surgeon, Vivek Gulati, appeared. Getting straight to the point, he announced that there was no need for an operation after all. Via a WhatsApp group he had shared Jacob’s pictures, fully anonymised, with senior orthopaedic surgeons around the country – including one in Worcester, one at the Royal Free in London, and another at Northwick Park in Harrow – and five had pinged back a verdict in seconds. “Unanimous view, five out of five,” he said. “No need for surgery.” Jacob was young; his bones would heal. A cast, followed by a brace, would be enough. |
| 'It's cheering to hear of a small effort to create something that helps people rather than hurts them' | 'It's cheering to hear of a small effort to create something that helps people rather than hurts them' |
| Obviously, I was relieved for my son. But the notion of this informal, collective WhatsApp consultation intrigued me. Later Gulati explained that for him and his peers, orthopaedic surgeons specialising in lower limbs, this had become a standard tool. They all started work early, many with a commute that allowed them to check their phones. They could assess the others’ images and pool their expertise, confident the service was secure and encrypted (and with an agreement among themselves to destroy the pictures once they had been analysed). | Obviously, I was relieved for my son. But the notion of this informal, collective WhatsApp consultation intrigued me. Later Gulati explained that for him and his peers, orthopaedic surgeons specialising in lower limbs, this had become a standard tool. They all started work early, many with a commute that allowed them to check their phones. They could assess the others’ images and pool their expertise, confident the service was secure and encrypted (and with an agreement among themselves to destroy the pictures once they had been analysed). |
| No one had told these colleagues to do it. There was no directive from on high. Nor had they waited for the multibillion-pound, NHS-wide IT system – seemingly promised for decades – to come on stream. They had simply grabbed hold of an available technology and used it, giving patients the benefit of several top consultants’ wisdom in a matter of seconds. | No one had told these colleagues to do it. There was no directive from on high. Nor had they waited for the multibillion-pound, NHS-wide IT system – seemingly promised for decades – to come on stream. They had simply grabbed hold of an available technology and used it, giving patients the benefit of several top consultants’ wisdom in a matter of seconds. |
| This shift is not just technological. It also represents a change in mindset. “Surgeons used to be these godlike figures,” Gulati, 38, told me. Now they understand that no one person ever has all the answers. “Thanks to new technology, there are so many more ways to do things. And it’s great to canvass opinions.” | This shift is not just technological. It also represents a change in mindset. “Surgeons used to be these godlike figures,” Gulati, 38, told me. Now they understand that no one person ever has all the answers. “Thanks to new technology, there are so many more ways to do things. And it’s great to canvass opinions.” |
| It turns out the WhatsApp group is not the only example. Gulati’s colleagues in Nottingham compare notes on complex cases via Skype, with the main hospital acting as the hub for several smaller clinics. Elsewhere, and during a particularly tricky operation, a surgeon was assisted by a junior doctor who communicated via FaceTime with an outside expert who gave practical, immediate advice minute by minute. | It turns out the WhatsApp group is not the only example. Gulati’s colleagues in Nottingham compare notes on complex cases via Skype, with the main hospital acting as the hub for several smaller clinics. Elsewhere, and during a particularly tricky operation, a surgeon was assisted by a junior doctor who communicated via FaceTime with an outside expert who gave practical, immediate advice minute by minute. |
| That outsider was, as it happens, from a company that supplies some of the specialist equipment (think of the plates and screws that would have gone into Jacob’s knee). These reps have witnessed so many operations and applications of their products, and are themselves so highly trained, that, says Gulati, they have become “a massive fount of knowledge” for the NHS. | That outsider was, as it happens, from a company that supplies some of the specialist equipment (think of the plates and screws that would have gone into Jacob’s knee). These reps have witnessed so many operations and applications of their products, and are themselves so highly trained, that, says Gulati, they have become “a massive fount of knowledge” for the NHS. |
| Some will grow edgy at that, suspecting creeping privatisation. But Gulati is an adamant opponent of any such thing, and evangelical in his belief in the NHS’s mission. It’s just that when he sees a resource, he wants to use it – whether it’s WhatsApp or a commercial company that can give his patients faster, better treatment. | Some will grow edgy at that, suspecting creeping privatisation. But Gulati is an adamant opponent of any such thing, and evangelical in his belief in the NHS’s mission. It’s just that when he sees a resource, he wants to use it – whether it’s WhatsApp or a commercial company that can give his patients faster, better treatment. |
| None of this is going to change the world. But in the age of Brexit and Trump, when there are people in power apparently bent on destroying things that work, it’s cheering to hear of a small effort to create something that helps people rather than hurts them. | None of this is going to change the world. But in the age of Brexit and Trump, when there are people in power apparently bent on destroying things that work, it’s cheering to hear of a small effort to create something that helps people rather than hurts them. |
| It might be the volunteers I saw at Grenfell Tower setting up a human chain to pass along blankets and food. Or the girls who gathered to hear Ariana Grande sing again in Manchester, two weeks after a terrorist had killed 22 people. Or those Guardian readers, many stretched themselves, who rang in last weekend to make a donation for homeless people. Or a WhatsApp group of top doctors, sharing what they know. | It might be the volunteers I saw at Grenfell Tower setting up a human chain to pass along blankets and food. Or the girls who gathered to hear Ariana Grande sing again in Manchester, two weeks after a terrorist had killed 22 people. Or those Guardian readers, many stretched themselves, who rang in last weekend to make a donation for homeless people. Or a WhatsApp group of top doctors, sharing what they know. |
| Whatever it is, it’s worth pausing to realise that no matter how dark things look, there are always points of light. Sometimes we might struggle to see them. But they’re there. | Whatever it is, it’s worth pausing to realise that no matter how dark things look, there are always points of light. Sometimes we might struggle to see them. But they’re there. |
| • Jonathan Freedland is a Guardian columnist | • Jonathan Freedland is a Guardian columnist |
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