Friday, 28 April 2017

Adventures in UK Healthcare, Part 2: Or, My Immersion in England's North East

“Would you like vodka or gin in this cocktail?” the anesthesiologist asked as he put me under, just prior to my surgery at University Hospital of North Durham in March.

It’s the last thing remember, before I woke up 5 hours later. At least I had gone to sleep smiling.

That anesthesiologist looked more like Gene Parmesan than any other person I’ve ever met, and he and I already had quite the repartee going. I’d met him an hour beforehand, in a consultation room where we ran through some basic pre-surgery questions.

Gene Parmesan
But when I first walked into that consultation room and greeted him, he’d startled me by exclaiming, “Well, there’s an accent that feels like home!”

I couldn’t tell if he was joking. He did not sound American to me. “Really?” I said. “Where are you from?”

When he said, “Glasgow,” I was even more confused.

“You think I’m Scottish?” I said. It’s possible that my American accent has been altered somewhat by 20 months of living in England, but I’d never dreamed a Scottish person would take me for one of their own.

But I understand now what happened. When I first spoke to him, his ear caught out a sound that was, at least, different – an accent that didn’t belong to the North East of England.

In my room at the Durham hospital,
March 2017
In the Durham hospital, it seemed, everybody was local: almost all of the staff, and every other patient but me. I was immersed in North Eastern culture as never before. Of all the patients and nurses and nurses’ aides who spent their days on Ward 9 with me, I was the only non-English person. Everyone was white as the snow except for the doctors who dashed in and out on occasion, many of whom were of African or South Asian descent. The only accents I detected that were not North Eastern belonged to those fleetingly-heard doctors, too.

That Scottish anesthesiologist, I think, felt some instinctive affinity for me – or my voice – simply because I didn’t sound like almost everyone else in our milieu. Though he and I ultimately agreed our accents are not the same, in the Durham hospital we did have in common a sense of standing out in a crowd.

I was in that hospital for 5 solid days, and I kept my ears open. The North Eastern accent became a kind of background music that played all day long and all night. I was so immersed in this particular sound, I heard it even as I fell asleep.

The North Eastern accent is very distinctive: to my ear, it is high-pitched and lilting, with extra emphasis on the long vowels. It was also, to my ear, exotic. It was strange to me; it was new.

It’s not what I’m used to in Durham, which may be surprising, since Durham is a town set smack dab in the middle of England’s North East. But Durham is an anomaly in this region. It simultaneously partakes and does not partake of the local North Eastern culture.

While I’d never claim to be an expert on North Eastern culture, I think I can say that the popular musical and film Billy Elliot tried to capture certain aspects of it. If you’ve seen the movie, you’ll know that Billy Elliot – filmed in County Durham – portrays this part of England as far from the centers of political power and wealth.[i] The North East of England was once defined by blue-collar jobs such as shipbuilding and mining. Now, as those jobs have disappeared, the region is on the whole economically depressed. These circumstances, combined with the North East’s geographical isolation from England’s capital and larger cities, cause some to view it as a sort of English backwater.

On the other hand, it is a part of the country where communities are close-knit and people are generally very friendly, and the pace of life is gentle, laidback.[ii] People seem proud to belong here – to identify as being Geordie.[iii] There’s even a vocabulary particular to the region – a vocabulary I find entrancing. Here’s a sampling of it, based on notes I took from my Durham hospital bed:  

Eeeee =           Oh my; oh my God

            Bairn =            Child; kid

            Champion =    Awesome (e.g. “Eeeee, that’s champion!”)

            Aye =              Yes; sure

            Ta =                Thanks

            Us =                Me (e.g. “Go on & give it to us!” – as the speaker extends a hand)

            Me =               My (e.g. “She was me mentor in school.”)

Meself =         Myself

            Dead =            Very; extremely (e.g. “My garden was dead sunny yesterday.”)

            Canny =          Quite a (e.g. “He’s a canny lad;” "I've a canny few syringes here.”)

            Pinch =           To borrow (e.g. “Can I just pinch that folder off you?”)


There's the North East of England!
If I’ve gotten any of the above vocabulary wrong (or attributed a North Easternism to an expression that is actually more widely used), I hope my UK friends will forgive. The point is, all this North Eastern-ness felt new to me. In the local hospital, I was surrounded by it for the first time. It is possible, I learned through this hospital stay, to live in Durham for a while, as I have, and never interact much with North Eastern culture.

Within the context of the North East, the town of Durham often feels like a world set apart. As the home of a World Heritage Site cathedral and castle, as well as a world-class university, Durham has a very different flavor than most of the surrounding small towns, many of which were mining towns in the last century. Walking around Durham most days, you’re more likely to hear Southern accents (the university students and profs) – or languages other than English (tourists and expatriates) – than you are to hear the local accent.

Durham, in my experience, is a surprisingly cosmopolitan town. Even today, in my yoga group, 6 of us were standing around afterward, and someone said, “I think each one of us is from a different country!” It was true. We went around the circle and each said our home country: Germany, Iran, Poland, Sri Lanka, England, and the US.

Durham Cathedral
Adding to this international atmosphere is the fact that various blockbuster films have been shot in Durham over the years, including Elizabeth and some of the Harry Potters. Even as I write this, the latest installment in The Avengers is being filmed in Durham Cathedral. (Dave called from his office to tell me. He’s been watching the film crew set up there all morning.) Does this mean that Robert Downey, Jr. is now prowling the streets of Durham? I can only hope this is true.

It makes sense, given my own predilections and life experiences, that I’d be drawn to this more global aspect of Durham, and that my friends here are – almost exclusively – fellow expatriates, or English people from different regions. In the classic “town and gown” divide, I’ve lived almost entirely on the “gown” side.

The Durham hospital, for me, was where local and global cultures finally met.

Some of the gowns in the town!
By the morning of the day after my surgery, I felt more or less like myself, at least mentally speaking.[iv] I began to converse with anybody who walked into my hospital room. The younger nurses’ aides, especially, found my Americanness to be a great novelty. “I’m so glad you are here,” they’d say kindly, as a way to make me feel welcome. Sometimes they asked, “How do you stand being so far from home?”

Or they’d joke with me about how I’d have to write to my family to say how well I’d been treated in Durham. “Tell them you’ve got a penthouse suite with a view of the sea!” one nurse quipped. Really it was a room about 10 feet square, with no TV or WiFi, nor yet with a toilet or shower. (Those were a ways down the hall.) My room over looked the emergency room entrance, one floor below – my window open, I heard ambulance crews unloading there every night – with the sea about 10 miles away.

One nurse’s aide stopped alongside my bed to list all the places she’d lived. She counted them off on her fingers. Consett, Chester-le-Street, Bishop Auckland. To someone (moi) used to the wide spaces of the US, those towns are all suburbs of Durham – a 20 minutes’ drive at the most. “But I got homesick there,” the aide said of her residence in those other towns. “I had to come back to Durham.”  

Lake Louise, in the Canadian Rockies
Summer 1992
It would be easy – too easy – to paint the staff of Ward 9 as provincial. But that wouldn’t be a fair representation. They were as lively and interesting a mix as you might found in any town Durham’s size, if you look hard enough. One nursing staff member had spent a week in Toronto, on a birthday trip with her father; from there they’d flown to Calgary, rented a car, and driven across the Canadian Rockies to Lake Louise and Vancouver. She listed the places of interest they’d driven through, and one by one I remembered those places, too – from the same drive I’d taken, with my friend Jennifer Lindberg, when we were in our mid 20s.

There was also the male nurse, obviously gay, whom I’ll call Andy. With his Geordie haircut and a fully, beautifully made-up face every morning, he sang 80s pop songs as he made his rounds – and was obviously a favorite among the staff. Andy was the one who determined, my second day on the ward, that my bed was too short for me. He went to the trouble to find an extra block of foam and to wedge it at the bottom of my hospital bed, to give my mattress more length. 

Cup of tea, with NHS logo, and
my compression-stockinged feet
Meals on Ward 9 were a big part of the day. At least, they provided regular markers of the day passing. Breakfast at 8:00; a hot drink and biscuits (i.e. cookies) at 10:00, then lunch at noon. (I was often delighted to have, as a cross-cultural experience, the choice between fish and chips or pork pie.) Around 5:00 we had tea – in other words, supper – and then a hot drink again. My last several days on the ward, I often missed the hot drinks cart as it came around because I was in the halls, walking. By then, however, the nursing staff knew all about me. They’d leave a cup of tea by my bed – black, with one packet of sugar, the way I like it – without having to ask anymore. Once when I came back to my room and found my tea waiting, Andy winked and said, “We’ll be charging you board next!”

While 5 days seemed a very long time to stay in the hospital, the memories I took away are of people’s almost unmitigated good humor and kindness. The staff consulted me about when I wanted my morphine drip stopped, and when I was ready to have the Novocaine-administering ports in my abdomen removed as well – and finally, when I wanted to go off Codeine. (In this way, by the time they released me, I was no longer taking anything but Paracetamol, i.e Tylenol.)

Walking the halls of Ward 9
I also remember the nurse who brought me a fan in the night when my temperature rose, and then directed the breeze deliciously onto my face. Another nurse, seeing me pace the short hall of Ward 9 for an hour – I was restless! and I wanted the exercise! – encouraged me to get dressed and wander the hospital freely.  

Of course, there were aspects of my hospital stay that felt strange, even alien. There was the aforementioned room, Spartan by most US standards, with the bathroom away down the hall. (I was grateful, though, not to be a room with 5 or 10 beds, as I’d been warned could easily happen. As I walked around Ward 9 myself, I spotted several rooms with multiple beds—all of them occupied. It seems, on this count, I simply lucked out.)

But as strange as some features of a UK hospital stay seemed to me, I know I was strange to the people who took care of me, too. They handled me with good grace. Sunday lunch, for example, is a huge deal in England. It’s usually a “Sunday roast” – a meal comprised of roast meat, roast potatoes, Yorkshire pudding, and some sort of nominal veg. Apparently it is as an important and cherished a Sunday tradition as going to church used to be.

But when Andy came around, Sunday lunchtime, to offer the beloved Sunday roast, I asked, “Could I just have a sandwich instead?”

Sunday roast
He did not, or could not, hide his horror from me. “A SAND-wich?!” he said, with one hand at his throat. I might as well have said I felt like eating a baby puppy.

But to his credit, once he got over his shock, Andy found a cheese sandwich for me.


[i] And if you haven’t seen Billy Elliott, I recommend it; the film is funny and tender and genrally brilliant.

[ii] To paint in broad strokes, I might say that the North East of England – politically, economically, and culturally – is to the rest of England as the South of the U.S. is to the rest of that country.

[iii] The term “Geordie” used to refer to anyone from England’s North East. If I understand correctly, it’s often used more narrowly now, for inhabitants of Newcastle and its suburbs.

[iv] This essay, apparently, will not dwell much on medical matters. But I did come through surgery well; I did recover from it very quickly. My surgeon wanted me to stay in the hospital for what seemed a long time, however, because I lost a fair bit of blood during the operation; he wanted to get my hemoglobin levels back up before he let me out onto the streets.

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