WARNING: If you are squeamish you might not want to read this, and especially not look at the photo’s.
This is the tale of the removal of two lumps from my body by the NHS.
I am fully aware, as a good social scientist, it is a completely idiosyncratic story from which no general lessons can be drawn. But given the debates about having a “GP driven” NHS and the desirability of more locally provided services, it might be interesting as a bit of ‘participant observation’ research?
I had two lumps on my body that had grown over the last few years. One, which was about 3cm across and maybe raised about 0.75cm, was in full view on the back of my neck. The other was much larger, 8cm across and at least 1.5cm raised, on my lower back.
Both were unsightly, and both had been growing at steady and slightly alarming rate. I was reassured by my GP that they were almost certainly medically harmless ‘lipomas’. I was however worried about how fast they were growing, and the lower, larger, one was causing me physical problems. When I lent back in a solid chair for any length of time (an occupational hazard for an academic conference goer) it was digging into my back and pushing on my spine.
My (very good) GP said I could have them looked at by another GP who did minor surgery at our health center. I did, and he offered to remove the smaller one but said that I’d have to see a surgeon to get the other one done.
Within a couple of weeks I went back and had the first one done. I also got an appointment a hospital and the surgeon there said they’d remove the other one, but it was routine elective surgery and I’d probably have to wait a bit (which turned out to be 4 months).
Now, first of all let me say I am extremely grateful for our (mostly) free at the point of delivery NHS. I have had some small experience of the US health “system” and it is not good. The NHS has saved my life, for free. I would not give up the NHS in a million years
My experience of ‘GP led’ local provision was not, in this case, a wholly positive one. It was quick, that is true. But the operation itself was, in my opinion, clumsily carried out and resulted in far more trauma than was necessary. I got an infection in the wound and 5 months later it is still badly scarred.
My hospital experience wholly positive either, but in different ways. I had to wait a longish time (but in this case wasn’t worried) and on the day I was kept waiting for four hours in a dressing gown. As usual, no-one seemed to be in charge. But once I got into theatre I had excellent care and although the operation was a bit more uncomfortable, that was mainly because of the relative sizes of the lumps.
You can judge the comparative results for yourself by looking at the two photographs below, taken at approximately the same time after my two ops.
So the GP service was quick, but crude and with a poorer outcome. The Hospital service was organizationally poor, but excellent clinically and with (so far) a much better outcome. Personally, I’d take the latter any time. Though like a good social scientist, I am willing to look at contrary evidence. but I’ll take some convincing.
A few days after removal of a 3cm lipoma by GP
A few days after removal of 8cm lipoma by Surgeon