In February, 2002, my family traveled from Chicago to visit our daughter in London where she was studying abroad for the semester.
We were hurrying to the theater when our son, then 10, was hit by a motorcycle while crossing the street.
His leg was badly broken, he went into shock, and we were taken by ambulance to St. Thomas' Hospital south of Westminster Bridge, a short walk from the Houses of Parliament. St. Thomas' is not some community hospital, but a major National Health Service center. With its sister institution Guy's, the hospitals are advertised on their NHS web page as "two of London's most well known teaching hospitals."
Our son was seen quickly, his leg was set in a cast that extended just above his knee, and he was transported to a children's ward -- a bleak room with rows of beds and little privacy. There he remained for about a week, with me sleeping at his bedside, usually on the dusty floor. For the first couple of days he was in such excruciating pain that the movement of air from anyone approaching was enough to cause him to scream out in agony.
He was vomiting and the need to change him and his bed made things worse. Clean linens were in short supply; one particularly bad night a hospital aide and I turned the bottom sheet so that the vomit was away from his face.
The public restrooms were frequently out of toilet paper, paper towels, and soap. I switched to the restrooms reserved for staff which were generally better supplied. Meals were served from a wheeled cart that stopped at the door. Relatives would ladle up what appeared to be soups and stews. No one in our family ever ventured close enough to get a clear look.
Our son's pain persisted and he and I were sent to the cast department for a consultation. The technician was a friendly young African who looked at the cast and the x-rays and instantly stopped the pain by adding a section to the existing cast. It was the first time since the accident that I saw my son smile, as the technician engaged him in talk of the 1990s Chicago Bulls and Michael Jordan.
I wrote down the tech's name and promised that when we returned home my son and I would go NikeTown and buy him the best Bulls hat in the store.
The technician's impressive skills would not have saved our son from being permanently disabled. As soon as he could travel, we got him back to Chicago's Children's Memorial Hospital and to a talented pediatric orthopedist recommended by our pediatrician.
We arrived home on a Saturday night and the next Monday morning we saw the orthopedist who studied the x-rays we brought with us from London, took his own, and told us the leg would not heal normally. That Wednesday we sat in the waiting room at Children's while our son's leg was re-broken and re-casted. Both were done so well that after the general anesthesia wore off he didn't require as much as a Tylenol. We took him home very late that night after meeting with a physical therapist, and his uneventful recovery commenced.
By the time school was out for the summer, the cast was off and, with excellent physical therapy at Children's, he regained his normal gait.
As he gets ready now to leave for his first year of college, we look at him and thank American medicine that his legs are straight and strong. (I had to ask him today which leg was broken.)
American friends who have an apartment in London and visited our son in the hospital -- the wife berated a doctor who loudly discussed with a colleague at our son's bedside the possibility of a rare complication that could require amputation of the leg -- asked us why we didn't do what people of means do there; seek medical care from a private hospital and private physicians, many of whom have offices along the same street in Central London.
We didn't know about that two-tier system, and with our son slipping into shock, we did what we would have done in America -- sat with him in the back of an ambulance that took him to the nearest hospital.
I felt gratitude to the dedicated nurses at St. Thomas' and I hugged several of them goodbye as we left. St. Thomas' has a rich history dating to the 12th century and is famous for its association with Florence Nightingale, who founded the first nursing school at the hospital in 1860. She would have been proud of these nurses. Still the doctor who set the leg did not do a competent job, and a 10-year-old with his life in front of him would have had to live with that poor technique for the rest of his life.
Once he could get around reasonably well on crutches, he and I went to the Nike store, bought the hat, gift wrapped it, and mailed it to the cast technician. I also wrote a letter to a top administrator at the hospital telling her how brilliant this young man was. She wrote me back to thank me for my letter and to tell me that the technician had been promoted because of it.
I do not mean to argue that health care reform is not needed here, but rather that the British model, in most respects, is not one to emulate.
That same first-rate children's hospital in Chicago to which we rushed so many times with our children as they suffered the usual range of fractured bones and cuts deep enough to require stitches, was always crowded with uninsured parents and their ailing children. Late at night these exhausted looking working people cradled children who seemed more likely to have a routine malady -- ear infection, strep throat, rash -- than a ligament torn playing soccer or Little League.
For them, the ER was the only option.
As we left the hospital, we were handed a bill from the NHS for around $3000, which covered everything, including the ambulance. We handed over our credit card. Our private insurance carrier eventually reimbursed us. The price would seem like a bargain, but, obviously, it would have been no bargain for our son.