Edward Paul Brown was a premature baby whose birth and death took place within minutes of each other on February 23rd 2007 in a lavatory in Queen’s Hospital, Romford.
Eighteen weeks into her pregnancy, his mother, Catherine Brown, was told that there was no amniotic fluid surrounding the baby in her womb. This meant that the baby’s chances of survival were minimal and her own life was threatened. Catherine Brown took the “devastating” decision to abort. Even those (such as I) who generally oppose abortion, will see this as a hard case – and I hope that any comments do not get sidetracked onto that issue.
So. We have a woman in hospital waiting for the procedure that will abort her baby, a child she had wanted to bear and raise. Not a pleasant situation at any time, but what followed next was disconcerting to read about even for those who have grown weary of NHS “war stories”.
I first saw this in the Times (Baby’s birth and death in lavatory of hospital with no trained staff), but there is a considerably more detailed account in This Is London (Mother forced to give birth alone in toilet of ‘flagship’ NHS hospital) (A very similar account appeared in the Daily Mail.)
Both headlines understate the peculiarly modern horror of what happened. The reader gets a picture of nurses trying to help, but out of their depth because Queen’s Hospital did not at that time have a proper maternity unit. That picture is wrong. The part of it that is wrong is the “trying to help.” The nurses declined to help.
This Is London quotes Catherine Brown’s mother, Sheila Keeling, who was present as her daughter went into labour:
“I was running around frantically trying to find gas and air for her and pleaded with nurses, who seemed very matter of fact, to assist,” she said.
“The staff I did find told me they did not have the training to help. Catherine was left to deliver the baby alone with just me for help before cleaning herself up and going back to bed. It was horrific.”
(Emphasis addded.)
Not just could not help, would not. Would not even be present, as far as I can see. Modern nursing has moved on, you know, since the days when the role of the nurse was to hold your hand and wipe the sweat from your brow. They don’t do that any more!
What caused these nurses to hang back from offering the ordinary, unskilled comfort that would once have been seen as the heart of their calling? I am tempted to simply blame it on the NHS. Certainly this case is something to set against all those stories we hear from those benighted lands where healthcare is not financed by taxation. Of course I do blame the NHS for the dreary catalogue of delays and mismanagement that Catherine Brown suffered before the birth; the wait for a scan, the further wait for pain relief, and the fact that she had to lie in a mixed sex ward and the fact that they nearly dumped Edward’s dead body. But that is old hat. Things were no different a decade and a half ago when I was in labour in another hospital in Essex and the midwife was obliged to run out into the corridor and yell “Where’s the fucking obstetrician?” And my would-be epidural man popped his head round the door and announced that he was ready to begin twenty minutes after the birth. I did not hold it against them. It was a difficult day, lots of births happening at the same time. At least they tried. In Queen’s Hospital as Catherine Brown crouched over the support bar of a disabled person’s lavatory to deliver her doomed child, they felt themselves unqualified to try. More than their jobs were worth.
No, this gutlessness is new, and although I do see it as yet another consequence of the command economy of the National Health Service, to add to the melancholy consequences we knew about already, I seek a more specific explanation as well. One major factor might well be fear of getting sued. Yet that, too, does not wholly explain it. The nurses concerned must have known that their chances of being held personally liable were tiny and they must also have known that the chances of their hospital getting sued for neglect of duty were significant. (None of the reports I have read in the press say whether this happened, although clearly some official inquisition took place and reached the verdict that press has been reporting over the last few days.)
The loss of nerve is not just seen in hospitals. One can see it in the other public services too.
Looking at the fire service, fireman Tam Brown nearly drowned saving a woman’s life in the River Tay – and was rewarded by being threatened with disciplinary action by Tayside Fire and Rescue, on the grounds that he had “broken procedure” by entering the water. He was meant to use the correct ropes and poles and since his crew did not have the correct ropes and poles he was meant to watch her die. Possibly he was meant to put the down time to good use by filling in a safety report on the incident. As it happens he not only got away with his archaic belief that that was not what he had joined the fire service to do, but was belatedly praised for it by his superiors – but, make no mistake, as Squander Two says, that will be because of the publicity.
Looking at the police – Julia Pemberton was murdered along with her son by her estranged husband. She called the police as he rampaged with a shotgun through the house. You can read the transcript of her last 999 call here. “Officers are on the way,” says the operator. That was moderately close to being true and the fact that the police could not even find the address of a woman whose house they had fitted with a panic button is not really relevant to this post. They got there in the end and saw the son, William, lying on the drive. At this point three unarmed officers vainly but creditably attempted to help him. Guess what? They were breaking procedure. In the words of Julia Drown MP,
However, the irony is that the officers who stand out as having done everything, and more, that the family could have expected from the police, were the ones who breached the police’s policy.
What Julia needed was a firearms response, but it was more than one hour after she picked up the phone before the first armed response arrived outside the grounds. Armed units did not enter the house for almost seven hours, despite the fact that no sounds from it had been heard for more than six hours. Instead of going directly to the house, armed units were sent to a remote rendezvous point, and further problems were caused by poor communication among the police. The wrong silver commander was initially called, with the correct one not called for more than an hour after the start of the 999 call. When the silver commander finally arrived, he moved the rendezvous point and did not take command until three hours and 26 minutes after the call started.
During that time, it was not known whether Julia was dead or alive. The police priority was to preserve the lives of officers rather than the lives of victims.
The police did not actually go into the house for hours. Goodness, no. There might have been a violent criminal in there! Probably it made no difference. The victims were already dead. But for all the police knew Julia Pemberton could have been alive but desperately wounded and praying for help. Time was when the ordinary village policeman, unarmed as he was, would have gone in.
Let me say (before someone says it for me) that I do not claim that I would have the courage to go into a house where a killer might lie in wait, or that I would have jumped in the bitter, fast flowing waters of the Tay to save some stupid woman who wanted to top herself. But such were the traditions that were honoured in the police and fire services. In fact, when I talk about “gutlessness” and “loss of nerve” here I am not talking about individual physical courage. Fireman Tam Brown showed great courage. At least three of the policemen in the Pemberton murders did as well and all of them showed more guts than I would. But institutional gutlessness surrounded them, was embarrassed by them, and will kill off their like eventually. Poisoned soil does not long give forth good fruit.
Going back to the Queen’s Hospital example, I do not have the personal qualities to be a good nurse, though I do think I could have bestirred myself to help in this case, when even standing around being useless because untrained would not have been useless and was clearly what the patient wanted. All the training nurses have these days appears to have trained the initiative and compassion right out.
I keep asking myself why anyone wants the new way?
Perhaps, in the case of those who will not act because unqualified in that speciality, it is a fear of finally having to be the real thing. When your whole life has been one long rehersal the raising of the curtain for the First Night is not always a welcome event. So Nurse Smith listens to the howling through the lavatory door rather than act wrongly and Constable Jones watches the stripy tape flutter around the perimeter of the silent house and waits for the Armed Response Team.
Perhaps, in the case of those who make these regulations, it is a peverted delicacy. Some are offended by the eruption of death or violence into their paper world, by the bloody evidence that not everything is covered by their rules. Below that delicacy, deeper and colder than mere personal malice, is a hatred of efficacy.
How do we get our nerve back?
For some reason I am reminded of the Eloi from H.G. Wells The Time Machine. The irony, of course, is that Wells assumed that such torpor would result from Capitalism gone haywire. While private enterprises are not immune from bureaucratic nonsense, it is the Socialistic Bureaucracy that takes it to such dizzying heights of nobility. It’s almost as if the apparatchiki are rewarded by how non-common sensical they can be.
I think there are several factors at play here.
First is the ‘quantitative management’ culture – which basically comes down to central control of organisations and companies. Procedures are distributed which are correct because they are quantitative. Statisticians show that if you get into the water to help a drowning person, the most common outcome is x+1 deaths rather than x deaths. The +1 death will inevitably be the one the statisticians focus on (because that’s ‘their man’ and they ignore the fact that several other members of the public who are more ill-equipped will probably try to help anyway) so they issue the instructions. As these are qualitative and issued either by a management advisor or a risk assessor, no individual below that level would be permitted to question them.
2. Disparate management – the management of organisations with ‘front line’ staff is now more often sourced externally, due to bogus pre-requisites such as degrees. In the fire service this leads to management being typical public-service-middle-management types who think that the above point 1 is fantastic because there’s no way at all anyone can blame them for implementing it.
3. Communication. TV, internet etc have opened up the worlds of many people who’s horizons have previously been typically restricted. Being presented with so many ‘optional lifestyles’ brings out the ‘it’s just the job I do now’ mentality amongst people. Weak management due to point 2 – most people of this caliber simply cannot control people who are both strong-willed yet competent and civil as they simply lack the personality traits because they have no experience of command – leads to some employees evaluating every request as ‘how does this benefit me.’
4. Poor resourcing leading to low staff morale – in point 3 above, a nurse in a hospital that’s badly resourced is probably already working pretty hard, stressed, and on a fairly shit wage. They know they don’t have the training, a bogus manager will probably discipline them for ‘operating in an area outside of their remit with all that this may entail’ and there is simply no benefit to them to help. Helping will create grief. It’s not _their fault_ that their employer doesn’t provide the relevant resources and expects everyone to run around to compensate. It’s a common trick that poorly resourced organisations play but most employees have seen through it now and go by the book.
Basically too many people in jobs that were traditionally viewed (alongside the military) as a ‘vocation’ are subjected to a constant barrage of evidence that everyone else is having it better and their response is a resounding ‘why should I bother?’
The solution is already presenting itself – volunteer fire corps and immigrants from countries where hard work is valued and discipline is valued. These immigrants also tend to come with a mission in mind (save a ton of money and go back home and buy ten houses) and aren’t used to a hectic and expensive social life so they just get on with it.
Ah, yes. This is the Universal Health Care that Michael Moore thinks I need.
Natalie,
That’s one of the most powerful posts I’ve seen on SD for a while. And you are absolutely right.
You are especially right about it getting much worse recently. I am soon to become the warden of a Quaker meeting house. There is hordes of legislation on Health and Safety that I have to assimilate (and presumably be assimilated by) This is not the fault of the Quakers. This is government edicts, legal and insurance matters and the like. And this is all about making tea and using such lethal devices as a strimmer or a Karcher. The fact that I have frequently used both before and that I’m not daft is irrelevant. The god-kings of elfnsafety require it.
This is not like when I was a physics undergrad in the 90s and experimenting with genuinely dangerous stuff. The university just assumed that anyone smart enough to get in was smart enough not to tinker with 6000V PSUs, put radio-isotopes in their pockets or stick a screwdriver into a 30 Tesla MRI rig without first turning it off.
My father in law does health and safety in a school. He had to do a “risk assessment” for a room that was converted into an Islamic prayer room. The risks included (he told me incredulously) banging your head on a sharp table corner when kneeling to pray.
It would appear that schoolkids facing Mecca in Cheshire or a bit of light gardening (I don’t even have to cut the grass) for a pacifist organization is now considered more dangerous than playing with high voltages when I was a teenager.
17th of December 1903, Kill Devil Hills, NC – just lucky it wasn’t 2003 we’d still be thinking the hansom cab was a pretty neat way to get around in 2103.
> How do we get our nerve back?
With the highest respect from a denizen of the colonies, gentlemen, get brutal.
I’m a blue collar boy from Jersey City, NJ, my father a fireman, my brother and uncle both policemen.
Somebody has to step up and take charge.
Three words… “Not my problem”
It is becoming policy, and dutifully enforced. Ellsworth Toohey rides on.
In a country where “institutional racism” is the most pressing problem the police have to face, “institutional gutlessness” was the only possible result.
This story is absolutely appalling. Words fail.
With the highest respect from a denizen of the colonies, gentlemen, get brutal.
I’m a blue collar boy from Jersey City, NJ, my father a fireman, my brother and uncle both policemen.
Somebody has to step up and take charge.
Please, do not re-inflict the brutality of your parents and relatives on the rest of society. Getting “nerve” does not require brutality, it requires getting rid of the illusion that we need some external force to go around regulating our attitudes and behaviors.
Second that, Nick. Excellent post, Natalie!
I’ve just being listening on the radio, here in Melbourne, to a report of a passenger on a tram who was abused and gropped by another passenger and no one on the tram rendered the young lady any assistance, or asked her, once she moved away from the abusive passanger, if she was alright. I think this and the instances you report are connected. How it is to be reversed is beyond me, apart from acting myself when confronted by a like situation, and by resisting procedures that actually curtail this sort of action.
This is the sort of opinion and commentary on the news that we should be reading in the main stream media. And aren’t. How is it that apparently intelligent and experienced journalists do not see that the direct consequence of the accrued weight of their continuous reports calling for government intervention and regulation to correct the sins of the world they report on, is a reduction in the ability of individuals to take responsibility for action to correct those problems? I know that I’m preaching to the choir , but it is refreshing to read such incisive analysis on Samizdata. But what do we do? Join the Scouts? Sack the government? Create a commune?
All I’ll say here and now is that I still hit Natalie’s own blog every single day. She doesn’t owe anyone anything, of course, but she never posts enough for my tastes.
Smashing, this one.
When a car goes off the road in front of you, call 911, lay down reflectors (not flares: gasoline and road flares are don’t mix particularly well), and render appropriate first aid as needed.
If a woman goes into labor in front of you, if all you know to do is find her a comfortable place to lay down and mop sweat off her forehead, that’s a whole hell of a lot better than nothing.
When someone falls off a bridge, reach throw row go.
When some guy on the Boston-Los Angeles red-eye (a hellish way to travel between hellholes) yells something in an un-named middle-eastern language and stabs the flight attendant with a #2 pencil, throw a blanket over his head, trip him, and dogpile him.
All you have to do, is interact with the world around you the way that you would anyway if you’re more than just a passive observer of your own life.
Britain is beyond saving. Just get out. Get out NOW. Down under, the New World, anywhere.
Harry, Australia is well down the path of the nanny state and the passive society.
I really don’t have anything to add to the analysis except to say that I share Natalie’s viewpoint.
“A hatred of efficacy”. If ever there was a phrase to keep and remember, that one is. It nails so much of what is wrong today in our culture, at least the state-run bits.
A valuable observation, certainly, but I don’t see how people putting fear of litigation above their own humanity would be any less prevalent in the capitalist system.
A chilling account of the banality of evil. It is an exceptionally fine piece. Thanks for posting it.
Johnathan Pearce writes, ‘“A hatred of efficacy”. If ever there was a phrase to keep and remember, that one is. ‘
Thanks for your kind words, though the thought is certainly not original to me. In fact I did spend some time unsuccessfully hunting for a blog post linked to by Instapundit that said something similar, in order to quote it.
Thank you too to the others who have also made kind remarks. Of course I wish the situation were such that I could be complimented on something else!
Ham writes,
‘I don’t see how people putting fear of litigation above their own humanity would be any less prevalent in the capitalist system.’
It certainly also happens in systems that are more capitalist than ours in Britain. (Though the US system, the one most often cited as an example of unbridled laissez faire, is nothing of the sort.) However, as I said in the post, I don’t think fear of litigation is a sufficient explanation for the gutless behaviour I have described. It is more to do with dependency, and that is linked to statism.
Yet I admit you do increasingly see the same thing in purely private organisations too. Possibly that is a spillover effect of the habit of dependency to the State or perhaps both are effects of a deeper cause.
Thank you Natalie, a brilliant post.
It is utterly utterly appalling!
My wifes 85 year old grandmother was admitted to the Heath hospital in Cardiff some years ago, suffering from a yeast infection that was makiing her a bit doolally in the head.
She got out of bed one evening to go to the toilet and became so confused that she wouldn’t go back in the ward and was raving up and down the corridor.
What did the nurses do? Cope with her like they were trained to do?
Nope. They rang my wife and I to come and sort her out! Fortunately we were staying at my mums house, just the other side of the park.
When we got there the 5 nurses on duty were not taking a blind bit of notice of her. They were having a nice cup of coffee, listening to the radio with a stack of snacks and magazines to hand. Well sorted for the night shift.
It took us an hour and a half to get her back to bed with no assistance whatsoever.
It runs dangerously close to Ayn Rand. (I’m being facetious with that “dangerously” bit, knowing how many people cinch-up when they see Her Dread Name.)
RAB,
Ah, the gossip at the nurses station. You do appreciate how much more important the antics in the Big Brother house are than the goings on in the ward? Surely you see that? There is so much deadwood in the NHS a cull could solve our energy crisis.
Natalie,
It is more to do with dependency, and that is linked to statism.
Yes. I don’t have any formal qualifications for my IT work. Apart from the books I’ve read and the hordes of bookmarked online reference material and two physics degrees and I’ve been programming since 1984. I know what I’m doing but I don’t have a certificate from a government regulated body to say I can do it.
And you know what – it shocks some people. They’re like… “But… how?” It simply doesn’t compute that someone can have skills without official approval. And I mean shocks. I don’t think they’d be any more shocked if I told ’em I did open heart surgery on the dining room table with the contents of the kitchen draw and a bottle of Sainsburys vodka for anaesthesia (with the odd swig for me) and say, “Yeah, it’s OK, I’ve seen a couple of episodes of ER…”
The it’s not my job attitude is becoming engrained in our society.
My aunt was the Matron at the Miners Hospital in Caerphilly in the 50s. The place ran on rails. There were no killer bugs stalking the corridors and if something got spilled or needed cleaning up, the nurses would do it insantly and without even a thought of crying its not my job.
Then some bright spark decided that nurses should have Degrees and go to college for three years.
The result of that ,is that nurses think that what their predecessors in previous generations did as a matter of course, is beneath them. “Not me! I have a degree!”
No arse wiping and floor scrubbing for them!
In the late 70’s, I dated a nursing degree student at one of the major London teaching hospitals.
Even though I was younger & dumber, the degree of feminist indoctrination was quite surpising to me. Students were taught all about the decades of male patrirachy in the medical profession and about how they would be the first generation of nurses to be the equals of (male) doctors. A lot of the pedagogical materials (from the US) were frankly incomprehensible to me, having nothing to do with nursing (that I could see) but being involved entirely with questions of gender roles and how nurses need to break out from the mold of females as passive caregivers into a new heuristical paradigm that corrects societal imbalances and empowers inerdisciplanry synergies to manifest a truth-to-power ineraction, de-dah-de-dah-de-dah. You get the idea. The ‘Nursing Times’ in those days was all about paths to management, specialist practices and innovative schemes where nurses were displacing MD’s.
I think the UK tradition of nursing as a selfless vocation that was often still operated as a cross between a paramilitary and a prison was fertile ground for this sort of thinking. I still well-recall being accosted on the grounds of Guy’s Hospital by a matron-like person – straight out of a ‘Carry On’ film – who seemed to think that she could bark orders at me like she did her staff. I could see young women with broader horizons than that seeing the ‘new’ thinking about nursing as a way out of that ’50’s starightjacket.
Might be inheriting that wind now, it seems. Plenty of managers, not enough people to change the bedpans and check whether the patent is still alive.
Frightening story.
llater,
llamas
…about how they would be the first generation of nurses to be the equals of (male) doctors Why didn’t they just go and study medicine to become doctors then?
Perhaps it’s just a matter of the Nock-esque Remnant being overwhelmed, finally, in Britain?
I certainly prefer institutions that tolerate “not on my watch” rather than “not my job” (as Natalie said, a goodly number of individuals still operate on the former, even in institutions devoted to the latter).
Yes Alisa. Quite.
I had a neighbour about my age when I was growing up, who didn’t quite get the A level grades she needed.You wern’t allowed to re-take them forever till you got a result.
She despirately wanted to be a doctor but the best she could find that would accept her, was Dentistry school.
So she did the course and passed with flying colours. She still wanted to be a doctor though and kept taking exams and studying.
To cut a long story short, she is now a Consultant Surgeon.
That was hard graft and determination.
How hard is it to pass the current Nurses exams are I wonder? Bit like our current A levels perhaps?
We get our nerve back by honoring those who kept theirs, like fireman Tam Brown, or Rick Rescorla–British by birth, American by choice–and one of my personal heroes. We honor them and we tell their stories to our children, so that they will know how honorable men and women behave.
http://en.wikipedia.org/wiki/Rick_Rescorla
Natalie –
Fear of personal responsibility is primarily caused by fear of personal loss – when the lawyers can steal everything you ever had, or will have, by making YOU look like a total IDIOT, when you were trying desperately to save a life, you may well stop saving lives.
So much for the Good Samaritan Laws.
As for myself, when I see a woman in labor, I will do whatever I can to help her until fully-qualified medical help can take over – and I mean take over in a positive manner. When I see a fire, I’ll call 911 and go see if I can get anyone OUT – or if all else fails, pee on the flames! If I see a holdup going down, the first cop that drops his 9mm, I’ll pick it up and start shooting at bad guys – while standing NEXT to the other cops (no sense in giveng them a reason to shoot at ME)! Any rapist that I see will sing soprano all the way to the gallows – if I have to build them myself.
NO, I refuse to perform open-heart surgery; I have no desire to kill people who don’t need it. I will be happy to perform a transplant on murderers and other capital criminals.
the thought of my great nation turning into what Britain is rapidly becoming…… oy. Ultimate nightmare scenario right there.
Stuff like this is why you should have a revolution.
Do not be too hard on Australia.
Taxes (overall – as a percentage of G.D.P.) are rather lower than in Britain – and so is government spending (indeed government spending, local, State and Federal, is a lot lower than in the Britain).
Unemployment and inflation are lower to.
As for regulations – at least Australian regulations are not imposed to fit the fancies of the E.U. (the elected government decides on them – not good, but not as bad as here).
Almost needless to say the left are aware of all the above and are planning to destroy it.
For example last week’s “New Statesman” (the leading magazine of the left in Britain) was dominated by a big feature on Australia – on how it was not statist enough, but how the comming election would fix that.
It seems there is not “investment in social capital” (i.e. Welfare State spending). And there are not enough regulations – especially in the labour market (i.e. the left wish unemployment to be higher).
I could go on, but the plans of the left were so vile I could not bring myself to carry on reading.
No doubt pushing censorship still further (of un P.C. books and other such) was in the plan somewhere. I am told that the left in Australia are very keen on such things.
I do not believe that the plans of the left reflect errors of reasoning, they have ignored too much argument and experience for that to be the case. They are evil and if they are to be driven back that must be understood.
It’s more than a bit depressing that nursing care in Russia seems to now be better than it is in the UK. True, the hospitals are falling to bits, the equipment decrepit, and the expertise limited, but the nurses actually do traditional nursing and the places are spotlessly clean where it matters (and reeking of disinfectant).
I just found this.
Un-f***ing believable.
I’m sorry that my choice of a word, “brutal,” wounded your fluttering heart, but the choice remains.
The civilized world is going to have to get tough, or it will be swamped.
dover_beach: We’ve had our similar tragedies here. Sometime in the 1950s, a young woman named Kitty Genovese was brutally murdered on a street in front of an apartment house. There were many witnesses, but no-one called the police. The mantra then was – and still is – “I don’t want to get involved”.
Not entirely unreasonable. Sometimes, getting involved can get you killed. Or worse – it can get you sued.
The sad story of Ms Brown should convince us that a single approach to abortion – either “never” or “whenever” doesn’t help. And we on this side of the pond should pray mightily that Universal Health Care doesn’t rear its woeful head here. Our system has many flaws, which must be fixed, but looking to England or Canada is not the way out.
Tom: Thanks for the Rescorla link. He should not be forgotten.
Clint Calls Us ‘Generation Pussy’
(Newser) – “We live in more of a pussy generation now,” Clint Eastwood tells Esquire upon the release of his new film Gran Torino. “Everybody’s become used to saying, ‘Well, how do we handle it psychologically?’ ” Eastwood, who grew up having to duke it out with bullies, looks back to a more stoic time: “My father had a couple of kids at the beginning of the Depression. There was not much employment. Not much welfare. People barely got by. People were tougher then.”
But stoicism didn’t mean a lack of sentiment, Clint adds. “Look how fast—seven years—people have been able to forget 9/11. Maybe you remember if you lost a relative or a loved one. But the public can get pretty blasé about stuff like that. Nobody got blasé about Pearl Harbor.”
http://www.newser.com/story/45398/clint-calls-us-generation-pussy.html