Fun British Word of the Day-Mac-as in a raincoat, not a computer as discovered when asked if I had one I replied no, I have an IBM and 5 minutes of conversation ensued to figure out the confusion.
I apologize for the length of yesterday’s entry and I promise they’ll get shorter as the culture shock wears away.
My second day was dedicated to a full 8 hour meeting on emergency preparation. We began with the H5N1 pandemic flu plan which the Brits have accepted as a looming certainty rather than a strong possibility as our professors I believe taught us. It was great because we toured the hospital to see which doors would be locked, which wards would be closed off and how patients would be isolated while allowing critical departments such as maternity or critical care to remain operating.
Brian, whose last name escapes me, came from the Strategic Health Authority to guide us in these matters because the island is very small and sometimes isolated politically from the rest of the mainland. Taking inspiration from our med soci assignment, I asked Brian what the ethical considerations were for selecting patients for a limited number of ventilators. This especially applies to the island which has a population of 130,000 and could only dedicate 40 beds to the pandemic. Though he said ethical standards were emerging, the general consensus among critical care doctors was that they would handle the decisions themselves and did not need outside, governmental intervention. After all, they deal with bed shortages on a daily basis and know best how to handle them. Bed shortages, especially in critical care units, was a significant and unpopular problem before Tony Blair’s government and though they have doubled since, more room is still needed. When pressed Brian said the ethical standards would follow a first come, first serve ideology and then additional decisions would be made only on overall health without attention to social or economic factors. So sadly, our friend the physician (person D?) would have been left without a ventilator. The one exception would be VIP’s who would be given preference. I assume this would be the same in the states though we might not admit it on a public level.
We spent the remainder of the afternoon discussing the heat wave, ship wreck, and fuel crisis plans and then presented them to the Isle of Wight Council politicians. There is a fuel strike to begin this next weekend by truck drivers so the fuel crisis has very real applicability. One physician complained that they were striking when they made 35,000 pounds (~70,000 usd) which is much more than physicians here on the island.
One thing that strikes me about the British is the amount of drinks that are offered to me at any given hour of the day. During my 2nd day I had 3 cups of coffee, 1 of tea, and a hot chocolate and I accepted less than ½ of the offers. Someone unable to say no would die of a caffeine overdose here. And it seems to be a standard act of courtesy, not stratified by importance or bound to anyone's role in that setting. For instance, one of the Isle of Wight Council members was to begin the meeting but was late. However, upon entering out of breath, she took the time to ask me if I wanted coffee. I said no of course but she insisted and took another 10 minutes to brew and pour me a cup…and then the meeting started.
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