Monday 12 January 2015

Ion Jinga: I want to pay tribute to the nurses and doctors who saved my friend

Last week someone very dear to me had a serious health problem. When performing aqua-gym, my friend suddenly felt a sharp pain in the back of the head

Ion Jinga, the Romanian Ambassador to London, meets the police officers Photo: Paul Grover for The Telegraph
The pain became immediately an unbearable headache. An ambulance arrived within 15 minutes. After a preliminary evaluation, the nurse suspected a vascular problem and decided to take the patient to the hospital.
Which one? There were three hospitals to choose from. The ambulance decided to take my friend to Charing Cross Hospital because of the seriousness of the symptoms. "There they have top equipments and one of the best neurosurgical teams in London", the nurse said. It was certainly an inspired choice and it proves how important is to have well trained people on the ambulance when the time runs out fast and every minute could be decisive in saving a life.
It took 20 minutes to get to the Accident and Emergency department at Charing Cross. The patient was registered and placed on a bad, waiting for further investigation. There were many people there, all with medical problems and I was afraid of delays that could be fatal. But a doctor arrived almost immediately.
After a first medical check, the patient was taken for a scanner examination. Ten minutes later bleeding was found on the brain. The news was devastating for us. Then, a lady approached us. She said: "Maybe I do not look like a doctor, but I am. When I have seen the symptoms, I knew it is bleeding on the brain". She was supportive and empathic. It was exactly the kind of help we needed. Her name is Dr Fey Probst, an A&E Consultant. It was Dr Probst who alerted the Neurosurgical Department and a neurosurgeon came to see us in A&E. As it probably happened in our case, many patients owe to her their lives. Later, I discovered that she also teaches young doctors.
Certainly, they have a lot to learn from her. When the surgeon came, I was thinking: "How good it would be now to find here a Romanian doctor, one of the 5,000 Romanian doctors and nurses working in the NHS.". After quite a long conversation in English, I asked him "Where are you from?" The answer was "I am from Romania." His name is D. Robert Iorga and he is a member of one of the best neurosurgical teams in London.
A second scanner examination followed, this time with dye (contrast material). Now the bleed was absolutely clear and the doctors suspected an aneurysm. It was 3.00 pm.
The next step: Dr Ramesh Nair, a consultant neurosurgeon in the Neurosurgery Department, came to see us. British friends told me Dr Nair is one of the best in the UK. He is specialised in neurosurgery, with special clinical interests in neurovascular and skull base surgery and research interests in subarachnoid haemorrhage.
Sympathetic with the patient, sober and mastering the situation, he laid out two options for us: either to wait and see how the symptoms are evolving or to perform an angiogram; he recommended the angiogram.
An angiogram of the head is an X-ray test that uses a special dye and camera to take pictures of the blood flow in the blood vessels of the head. In this specific case, the cerebral angiogram was envisaged to look at the four arteries (four-vessel study) carrying blood to the brain. During an angiogram, a thin, soft tube called a catheter is placed into a blood vessel in the groin (femoral artery). The catheter is guided to the head area. Then an iodine dye is injected into the vessel to make the area show clearly on the X-ray pictures.
An angiogram can find a bulge in a blood vessel (aneurysm). It can also show narrowing or a blockage in a blood vessel that slows or stops blood flow. An abnormal pattern of blood vessels (malformation) or abnormal vessels near a tumour can be seen. This picture is not very much encouraging when you are the subject of such an examination.
The first night spent in hospital has passed without any sleeping,with perfusions to stabilize the low blood pressure, to prevent arteries' spasms and additional bleeding, and to monitor basic vital functions. The angiogram was scheduled next morning but it had to be delayed until noon because the blood pressure was too low. Then, at 12.00 the patient was taken to the Radiology Department.
The examination was to be performed by Dr Ian Colquhoun, consultant neuroradiologist, a specialist in head and spine diagnostic and interventional neuroradiology. He is considered by his peers as being one of the best in this job.
The discussion with him was like an ice-cold shower: he explained the risks of the procedure, the high percentage of successful outcomes, but also the possible dramatic consequences if something goes wrong. I knew it was his duty to be honest and to present all the alternatives.
He gave hope and confidence, but the patient has to sign a written consent for the intervention. The choice was between dying or paralysing at any moment in the future if the cause of the bleeding is not known, or taking the risks of the angiogram and finding out what happened in your brain in order to prescribe the appropriate medical treatment.
At 12.30 the angiogram started. After one and a half hours, Dr. Colquhoun came out with a smile: no aneurysm was found, the blood vessels were all in a good shape, the quantity of blood on the brain is small and it will be re-absorbed by the body without any other consequences. The patient has to stay for a while in the hospital, atreatment will be prescribed for the next couple of weeks, efforts have to be avoided for two months and then everything will be back to normal. After the most difficult 24 hours in my life, the silver lining in the cloud hanging over me appeared.
Visiting Charing Cross Hospital every day for a week, I had the unique opportunity to see how the medical team and the staff working there perform. I have met highly qualified doctors and nurses, native British, but also from India, Romania, Slovenia, Belgium, Africa, Latin America or Asia (thank you, nurses Emma, Sylvie, Pauline and Kwame Anthony).
I pay my gratitude to all these people. I have a great admiration for them because they are so incredibly devoted to their patients. The same appreciation goes to the auxiliary staff which discreetly and efficiently helps to keep the medical care at Charing Cross Hospital at the highest possible professional standards.
Most of them are "immigrants". They came to the UK for professional accomplishment or for a better life, because this is very much possible here for highly skilled specialists and people who work hard.
Quite often, they are vilified by the tabloid media and their presence is sometimes used as a ping-pong ball in the political debate. In return, many of them save lives every day in the British hospitals. We realize how extraordinary people they are only when we are in a difficult medical condition. To them and to the British NHS, I pay my deep respect.


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