Happy Christmas 2023

 

A very merry Christmas to all my brother and sister hospital porters, serving or retired, our civilian allies and everybody else who reads the HPWA or listens to The Gas Spanner. Hope you all have a wonderful day; especially if you are on duty, giving up your time to keep everybody else safe while they enjoy their Christmas... And remember! It's just 154 days to St Theo's Day!

Telephone Dignity Statements

 

This kind of dignity statement is a variation of third party one, see background links below, but it is actually much easier because your stooge is not present. The way to carry out this dignity statement is purely opportunistic; it's not really possible to plan it beforehand. Also not all porters have the role where they are in the right position because they don't often talk on the telephone in front of civilian staff. Primarily it's the providence of the departmental porter rather than somebody from the lodge. If you happen to take a phone call or make one in a public place, for instance at a nurses station, and somebody happens to turn up who would make an appropriate dignity statement target; then if it feels right, as always, this is what you do. During the conversation on the phone, slip in words like: "Yes, but we are porters with a lot of porters' pride and dignity which nobody can take away from us. A lot of them try, but they fail and it drives them nuts..." As with the dignity statement where your stooge is present, do not look at your target. Only ever keep your gaze in the position you normally do when addressing somebody on the phone. If the call is a video communication, keep your eyes on the stooge where his or her image appears on the monitor screen. Even after the stooge has ended the call and you have not yet made a dignity statement; if you are holding the receiver and those around you don't know the call is over, you can pretend you are still on the call and deliver the dignity statement followed by: "...Anyway. Thanks for the call. Bye bye." and put down the phone. ("Stooge" is a term I use for the third party in a third party dignity statement.) After your call is over, act normally. Return to your normal duties by walking away, keeping your eyes averted from your target. If you are lucky you might catch his or her richly-deserved wince of humiliation in your peripheral vision.
See here for background: https://hpanwo-tv.blogspot.com/2013/07/physical-dignity-statements.html.
And: https://hpanwo-radio.blogspot.com/2020/08/the-gas-spanner-programme-2.html.

Wokies Hate HP's!

 

This is a topic I more normally cover on the other HPANWO sites, but in this case it is relevant to hospital portering. I've hesitated to tell this story before because I suppose I feel a little embarrassed about my own behaviour during this encounter. A few years ago, due to social circumstances I will not reveal, I found myself in a group of people in a cafe sitting opposite a woman who would today be called a "wokie", "wokeist" or "woke person". In those days that terminology didn't exist and her kinds of people were known as "SJW's- social justice warriors". It was immediately very obvious by her appearance and style of speech what her beliefs were and so I braced myself. Conversations with SJW's can only go in one direction. When the usual subject of professions came up I said: "I'm a hospital porter". (Of course, I was technically an ex-hospital porter, but I tend not to divulge that part to strangers; it requires too much explanation.) When I told her this I saw her flinch and look away, as I expected. She was already being very frosty with me because I'm a white male and had not yet made the usual mandatory virtue signalling noises, but to know that I'm a working class white male deepened her antipathy even further. There's a common myth that snobbery is something the upper classes feel for the lower classes; the lord of the manor for his butler. This is false. Firstly, there is such a thing as inverted snobbery, in which the lower classes hate those above them; but that is too big a subject to explore in detail here. However, the worst and most common kind of snobbery is experienced by the working class, but it doesn't come from the top; it comes from the middle. Leftwing middle class people are the ones who really hate the working class; or to be precise, the white working class. During this conversation I was aware that I had to watch my words very carefully so as to prevent her locating the entry point she was desperately searching for, but it didn't work. Eventually and inevitably she found the excuse to say to me: "Yes, but you're a privileged white male!" I groaned inwardly. There are so many responses to that chestnut. What she was hoping for was for me to wince and bow my head with shame as the white male guilt washed over me and memories of slavery, rape and the Holocaust passed through my self-hating soul. Alternatively I could retort and try to justify my existence, allowing her to dismiss my concerns as "white fragility!" I could also have brought up false rape allegations, diversity hiring, South African farm murders etc; which she would have discarded with the same scorn and lack of compassion. I could explain how absurd it was for her to think I had any privilege when she was manifestly much wealthier than I was; but she would say: "but I'm a 'Woman!' which means I'm a victim of sexism which you are not!". Alternatively I could remain silent or say "no comment" which is probably the best defence when dealing with people like her. Despite this, my diplomacy armour failed at that point and I chose to wind her up.
 
This was not something I planned; it just occurred to me spontaneously. "So," I began. "What do you mean by 'white male privilege'? Are you saying that my demographic enjoys a higher standard of living because our exploitation of women and non-white people?"
    "Yes!" she hissed with a glare.
    "Then why would I want it to end?"
    She gasped. "What!?"
    I repeated my question, but she was speechless. I continued: "In an equitable world, white males would have to get in line with everybody else. We would no longer experience the life of luxury we currently do. So, why would I want an equitable world? I enjoy my pampered existence."
    My interlocutor was dumbfounded. Her face was a portrait! Just like "Miss Stuck Up Little Bitch Nurse" when I strike back at her with a well delivered Dignity Statement. She was not used to this response. Of course wokies always accuse white men of secretly wanting white male privilege to continue for the reasons I stated, no matter how much they protest; but they are accustomed only to dealing with white males who "try to deny it!" What she couldn't cope with was a white male who openly admits it and is unapologetic.
    I can't quite remember the next few exchanges verbatim, but it was along the lines of her saying that white male privilege was immoral and it made other people suffer, and me replying with comments supporting moral nihilism and social Darwinism. Finally she stood up and stormed off with the words: "You are truly evil scum!"
    I chuckled and yelled after her: "Yeah, winners tend to be!"
    I felt ashamed of myself. Those who know me will realize straight away that I didn't actually mean what I said to her, for example see: https://hpanwo-tv.blogspot.com/2020/11/nice-guys-reply-to-stefan-molyneux.html. The thing is, I find people like her exhausting and infuriating. I avoid their company whenever possible, which luckily is almost all the time in my personal social circles. I know for a fact that had I tried to be honest and reasonable with her she would not have returned my good faith, a bit like this other example: https://hpanwo-voice.blogspot.com/2023/07/payback.html. Get used to the fact that I'm not a saint and I have my limits.
See here for more background: http://hpanwo.blogspot.com/2021/08/political-correctness-portal.html.

HP's and Psychos

 

I've always taken a keen interest in ponerology, the study of psychopathy, see background links below, and it is a well-known fact that certain personality types are drawn to certain occupations. According to the psychologist and clinical ponerologist Prof. Kevin Dutton, psychopaths gravitate towards certain career paths and he has compiled a list of the top ten. Number one, no surprise, is finance. However I was surprised to see that number two is medicine. Doctors, especially surgeons, have among them a far high proportion of psychopaths than the average of six percent; or higher, depending on the source. You might think: "But doctors need to care to do their jobs!" No they don't; in fact a doctor who doesn't care has a huge advantage over those who do because they don't experience the emotional trauma that comes from witnessing the everlasting parade of pain, death and dismemberment doctors have to deal with. That kind of character is skilfully reproduced in the fictional film Malice, see: https://www.youtube.com/watch?v=LqeC3BPYTmE. I then wondered if there are any professions that naturally repel psychopaths. My first instinct was to assume that the professions empaths are drawn to repel psychos because of the contradiction, such as community caring jobs and charity work; but this does not necessarily follow. A psycho who is a sexual predator might get involved in a children's charity or nursery school because it would allow them easy access to victims; a perfect example being the Oxfam Haiti scandal, see: https://www.bbc.co.uk/news/uk-43112200. Psychos lack an understanding of many concepts which to non-psychos are obvious; not just the empathy but a sense of time, regret for the past or fear of the future. This is why genuine psychos never apologize to their victims nor do they fear punishment by the law or revenge from their victims' loved ones. One thing psychopaths have an acute awareness of is social status. They crave dominance over others and in a social situation this means eminence within the group. For this reason a psycho will find any job which has low conventional status unbearable... You can probably guess where I'm going with this. Yes, hospital portering is a natural filter to weed out psychopaths. There is literally nothing for them here. I can think of a perfect example, a porter I served with in the early '90's. He was, I believe, a clinical psychopath. He exhibited all the red flags. He was obsessed with leaving portering and joining security. The John Radcliffe has always had its own separate security corps, whereas in smaller hospitals this is very often a portering discipline. Nevertheless JRH porters are often required to assist security in various roles; I did so myself many times. This psycho porter volunteered for every security assist task he could get, sometimes bolting from the lodge the moment the attack alarm went off before anybody else could get to their feet.
 
This psycho porter was never given a job in hospital security; I think they saw through him. His zeal was a bit overplayed, in my view. However, obviously he could not remain in hospital portering. He used to seethe with agonized frustration and suppressed rage at situations where I found a solution through the dignity statement. He eventually managed to get onto a security team at a shopping centre. The last I heard about him he had become a prison warder... makes sense. So, that's another advantage of being a HP; you exist in a naturally psychopath-free bubble. Psychos rarely join HPing and those that do don't last very long. One more reason to love being a HP.
See here for background: https://hpanwo-hpwa.blogspot.com/2015/12/nhs-nurses-destroy-patients-doll.html.
And: http://hpanwo-voice.blogspot.com/2013/12/channel-4s-psychopath-night.html.
And: https://hpanwo-voice.blogspot.com/2019/12/the-empath-test_11.html.

Acute Care Vehicles 2- Second Generation

 

I consider the second generation of acute care vehicles a golden age of engineering; this was from the late 1990's to the mid 2000's. The hero of this boom was undoubtedly Egerton, a company based in Poland. There were three general bed designs that made up the backbone of the JRH fleet. I can't remember their official names, but we nicknamed them the "blue" and "grey" because of their colours. The blue Egerton was a pleasure to handle. It was by far the most manoeuvrable bed I have ever used. It had a folding handle at the foot for the sit-up mechanism and a separate squeeze handle for the pitch. Level was raised and lowered by a pair of smooth pedals at the side which needed very little pressure to operate. The top level was about five feet which added to the vehicle's portability. The grey Egerton came in three models. There was one with a lift-and-pull headboard that was mostly used to replace the original fleet maternity beds. The second design was more like the blue, but had slightly different controls. The pitch was altered by two black squeeze handles at the foot. It was also slightly heavier. The third variant was basically the grey with electric posture controls. I have always considered electric power an extravagance and a typical example of over-engineering for its own sake. Early electric vehicles had to be plugged in whenever they were in use and had backup manual handles and pedals. They can also actuate by accident when, for example, somebody leans against the control paddle. They grey had no manual backup. It had a battery which very quickly ran flat because staff usually didn't bother to plug it in, sometimes because the ward bed-spaces didn't have enough electric sockets. Another problem was that very few staff used the proper storage hook for the flex and plug. Some developed a bad habit of wrapping it around the rear corner fenders. This not only made it easy for it to fall off, but when the bed was raised it sometimes ripped the flex out of its fitting. (One theatre porter in particular was very irritating because he would do this on purpose when I told him about the wrong method just to wind me up; because that's the kind of person he was.) The second generation was not all a bed of roses though, if you'll excuse the pun. I'm thinking of the Hill Rom. Only a handful of these awful contraptions ever made it into the John Radcliffe fleet, but I used to groan whenever I had to use one. They had a feeble plastic footboard that usually broke and without it, as I said in the background link below, it was like a car without a steering wheel. We often kept a secret store of spare footboards in the lodge and a Hill Rom one was like gold dust. It also had a nasty static sting problem, sometimes producing an audible crack and visible spark... Good job anaesthetics no longer use ether! There was one bed that was a real bummer; it lost one of its footboard mountings meaning it could only be used without a footboard. Whenever I saw it unoccupied I used to wheel it to the "cage", a store in the industrial block for vehicles needing repair. I stuck a note on it explaining that it was not safe to use, but the maintenance team always returned it to service without replacing the mounting. I was tempted to sabotage that bed quietly in secret so they had to take it off the wards. All the second generation beds have a centralized footbrake; the blue Egertons' were the best; they were easy to apply, like the level pedals, and the lever was unobtrusive. The Egerton's were also the first full-size beds to have a function previously reserved for trolleys; optional steering lock. By raising the brake pedal to a third position, usually at the top, the foot wheels would lock into a north-south position rather than the usual free caster. This made the bed very easy to manoeuvre and it could even be pushed with a single porter, but only when empty. We hardly ever used to wheel lock with a patient, but then we were never alone with a bed patient anyway.

The second generation also provided one of the best wheelchairs ever, the Bristol Maid. This was a nifty rear wheel steered chair with an excellent sliding footplate and retractable telescopic arms. Its small size made it ideal for cramped passages in corridors, wards and departments. It had a unique storage compartment at the back for patient notes folders, but I learned quickly not to use it because it was too easy to lose the notes, something that would get you into terrible trouble. If you get one of these chairs I recommend asking the patients if they can hold them, if they are able, or put them behind their back.

The second generation was the first to deliver what I regard as specially designed bariatric beds. Bariatric is a politically correct way of saying "very big and fat". These were sometimes based on standard designs but were bigger and stronger. There were some other models specialized for bariatric cases from the wheels up. Along with bariatric beds we were given equivalent wheelchairs, operating tables and even mortuary slabs. Together with these innovations were far better intensive care beds with inflatable soft mattresses to reduce pressure sores for patients who were stuck in them a long time. The largest and heaviest of these we called "the Beast" and it needed at least three porters to move it. I wondered where technology would take us in the future, to better or worse machines. The answer was both.

See here for background: http://hpanwo-hpwa.blogspot.com/2023/09/acute-care-vehicles-1-original-fleet.html.

Being Human

 

Being Human is a TV series by the BBC and it's one of the few by the Beeb in recent years I would say is any good. It is described as a "supernatural comedy drama"; but, although it has its droll moments, it's not very funny. Actually it's pretty grim. It follows the lives of three young urbanites who superficially appear to be ordinary people, but they are not. They're not even human, they're only trying to be like humans; hence the title. One is called Mitchell and he is a vampire, the second is called George who is a werewolf and the third is Annie, the ghost of a woman who was murdered. All three of them face different challenges. Mitchell is trying to get by eating normal food and giving up his lust for human blood. George is trying to manage his condition by hiding himself away every full moon; and Annie is haunting the man who killed her, her ex-boyfriend. Despite being completely different denizens of the undead, George and Mitchell share a very important common destiny; they are both HP's. My two brother porters, if I can call a werewolf and a vampire my brothers... Of course I can, they're HP's for goodness sake!... Anyway, George and Mitchell serve in the same hospital and appear to be in the same section, but they deal with the challenges of the profession differently. George maintains a light-hearted attitude and he has a part-time job teaching English as a foreign language. However, Mitchell is bitter and exhibits a lot of self-pity. In one scene where his partner is mourning the death of her goldfish, he says to her: "I wade through blood and shit from dawn till dusk for the minimum wage, so don't whinge to me about some bloody goldfish!" As I've explained before, that might be true, but the victimhood mentality is not helpful. It breeds an inner darkness and cynicism that becomes a goal in itself; almost an addiction. HP's can easily fall into that trap and we must avoid it at all costs. George manages to find a girlfriend of his own at one point. Of course this means he has to make up some excuse to explain why he goes away on his own once a lunar month. At one point he tells her: "I have to go off on a training course." She replies: "Training? You're only a hospital porter, George!" I'd dump her on the spot if she said that to me! There are some pretty horrific scenes and storylines in the series, making it more of a horror than a comedy. At one point, the protagonists are kidnapped by a religious cult who do sadistic experiments on them. Despite this, and its sometimes patronizing anti-HP-ism, it is very well done in terms of writing, acting and plot; so it's worth watching. Since the original BBC seasons it has been picked up by an American network that have produced their own version, as Americans tend to. See here for the trailer: https://www.youtube.com/watch?v=YWjZ2QU999o.

Stop Expecting Better

 

I keep hearing complaints like this from my fellow HP's.
"Why do civilians talk down to me all the time?"
"Why does the head porter never take my side in a dispute?"
"Why do people have a go at me when I've done nothing wrong to them?"
"Why do senior staff lie about me or twist things?"
You might have noticed that I have made similar complaints about my own career, legitimately. The invention of the Dignity Statement is for the purpose of undoing and eliminating this situation, for example: https://hpanwo-radio.blogspot.com/2020/08/the-gas-spanner-programme-2.html. It can't make the head take your side in a dispute, but it will work in all the other examples I gave. The first step to overcoming this bleak state of affairs is actually not learning the Dignity Statements, it is expecting these things to happen. I used to be like that too. Whenever one of the above scenarios unfolded I would storm around the lodge lamenting "That was so unfair!"... "Why did she do that!?"... "I can't believe he just told such a blatant and shameless lie about me!" I was not alone; nearly all my brothers and sisters did the very same, in fact hardly a shift passed without it. I only found a way to integrate these very unpleasant experiences when I realized that I should stop expecting better. We're part of a massive, heartless, mindless, gutless government bureaucracy. The NHS is the world's third biggest employer (after the People's Liberation Army of China and India Railways). It is a purebred mutant baby of the state. 1.27 million servicemen have to be organized into an effective healthcare provision unit with no natural incentives at all for justice, diligence, conscience and duty. More than that, these sentiments are actually discouraged, to say the least, by management. The unspoken truth very quickly sinks in that there are no rewards for honest hardworking service, quite the opposite in fact. Corruption waxes, discipline wanes. Is it any wonder people within it are so spiteful and backbiting? Battery hens peck at each other not the farmer. This realization is actually an incredible liberation. When you stop expecting better from your colleagues, including your brother porters sometimes, you can face the world for what it is rather than what it should be. That is when the Dignity Statements come in. That is the first step to creating a world that is as it should be.

Gaza Hospital Attacked

 

See here for essential background: http://hpanwo-hpwa.blogspot.com/2023/10/gaza-hospital-evacuation.html.
The news is reporting that the Al Ahli Hospital in Gaza City has suffered a gigantic explosion. It is reported that "hundreds" have been killed. The IDF says that this hospital was not one of its targets, but to me it is incredibly unlikely that this was not the result of Israeli offensive action. (EDIT: This is now seriously been called into question.) They have claimed that Hamas terrorists have established makeshift bases in Gaza hospitals. It is not the purpose of the HPWA blog to discuss the rights and wrongs of what's going on politically in Israel and Gaza now; we're going to focus on the HP's and their duties. The background link below has a wider scope. A spokesman for the Palestinian National Authority has stated that the Gaza hospital infrastructure has now totally collapsed. Water and fuel for emergency generators has run out. A surgeon, Professor Ghassan Abu Sittah, said: "Parts of the hospital are on fire. I don't know whether that is the emergency department. But it's certainly the operating suite, part of the roof has fallen. There is broken glass everywhere." Source: https://www.youtube.com/watch?v=oUxZFxwwp-Y. From what I've seen, at this point the situation at the damaged hospital is one for the fire brigade, and indeed I have seen videos of firemen entering the premises. Some casualties have been moved to waiting ambulances, but right now the ambulances are the only places they can be treated. There is nothing more we HP's can do at this point. With the breakdown of the infrastructure and the attack on the campuses, probably personnel discipline will also weaken. The surviving staff have their own families and loved ones who need them. I'm afraid I don't fancy the chances much of any patient still left in the hospital. If they were too sick to be evacuated a few days ago, they are unlikely to survive now. The focus must shift to those who have a fighting chance. An Egyptian spokesman claims that the border at Rafah is not closed, but this makes no sense because the bottlenecks of refugees on one side and aid lorries on the other are not moving in either direction. My heart goes out to all those affected by this, in Gaza and Israel.
See here for more information: http://hpanwo-tv.blogspot.com/2023/10/israel-war-livestream.html.

Gaza Hospital Evacuation

 

There is an ongoing evacuation operation underway in hospitals all over the Gaza Strip. This Palestinian enclave has a population of over half a million in an area of 141 square miles, about the size of the Isle of Wight. The enclave is therefore highly urbanized. The hospitals there are already overcapacity because of retaliatory strikes against Hamas by Israel (as are Israeli hospitals because of initial Hamas attacks). As a former hospital porter I can understand exactly how dire a situation these hospitals are in. Yesterday, the Israeli government warned Gaza hospitals that they had two hours to evacuate all their patients because the buildings risked being targeted by strike missiles and aerial bombardment. The reason is that Israel suspects Hamas has set up headquarters in some hospitals. At my hospital, the John Radcliffe in Oxford, we often did evacuation drills, but this was moving patients quickly from one part of the hospital to the other in case one area was struck by fire, flood or explosion etc. At no time did we think of a contingency involving the evacuation of the entire hospital. The noble welfare group Médecins Sans Frontières, French for "doctors without borders", protested saying that two hours is not nearly long enough to evacuate all the patients. Israel relented and increased the grace period to eight hours. Source: https://www.timesofisrael.com/liveblog_entry/israel-warns-hospital-in-northern-gaza-to-evacuate-by-6-a-m-rights-group/. However, is this long enough? The difficulty in evacuating a patient is primarily dependent on how serious their condition is. The walking wounded can move themselves; somebody with a minor fracture, burns or lacerations can be transported by trolley or wheelchair, but what about somebody in intensive care? How about somebody undergoing major surgery? What's more, where do they go afterwards? When evacuating seriously ill patients there is really nowhere you can evacuate them to except another hospital. If all the hospitals in Gaza have to be emptied, where do the staff take the patients? It is obvious Israel is preparing for a full-scale invasion of Gaza which will probably happen in the next couple of days. The only way out is through the border with Egypt which is currently tightly controlled. There are large hospitals on the far side of the border that will be able to help, such as the Rafah Central Hospital. Obviously Egypt does not want Hamas terrorists in its midst anymore than anybody else does, but if they don't help then there will be carnage in Gaza and 99% of the people killed will be innocent. I salute my Extremely Proud and Dignified Brother and Sister Porters in both Gaza and Israel; as well as the brave civilian healthcare providers. May this crisis end soon and without further atrocity.

Platelet Hand Agitation

 

What is it about HP's that when we do our job we might have to do it well, but not too well? I have been challenged several times in the course of my career, not because I wasn't being a good enough porter, but because I was too good a porter. One of these examples involves platelets. Platelets are blood cells whose function is to cause coagulation when a blood vessel is breached. They clump together at the rupture site and form a gelatinous blockage which eventually hardens into a scab. This is essential for stopping bleeding; without it we could not live. Platelets are extracted when blood components are separated in the transfusion laboratory before being given to patients. They look like opaque yellow fluid and are stored in a plastic bag, illustrated above. Unlike red corpuscles and plasma which have to be chilled, platelets have to be stored at a warm room temperature, twenty to twenty-four degrees. They also have to be continuously "agitated", this means kept in constant motion otherwise coagulation initiates and they set into a solid lump of jelly; making them useless. In the storage cabinet they are put on a machine that constantly lurches and rotates. Now, when I was being trained in the late '80's the porters who trained me told me that when I'm carrying the platelet units to where they are needed I have to do something called "hand agitation". This means simply imitating the action of the storage machine with our hands. I did this for my entire career when delivering platelets. Newer porters didn't do this because that part of our training was discontinued, like so much else in our traditional skill-set. Welcome to a result of the casualization that I have described elsewhere, for example: https://hpanwo-hpwa.blogspot.com/2011/09/why-do-we-need-hpwa.html.
 
One day I was delivering platelets and was accompanied by a "boy wonder", a young and well-connected individual with "one foot in the lodge", as we used to say. Basically they all had ambitions to be trust directors and were doing their standard six months in portering for three words on their CV. I can't recall why this boy wonder was with me, but we were standing in a lift together while I did the hand agitation and he frowned and said "Why are you doing that?" I explained why and he immediately replied: "Don't do it please." I asked: "Why?" He said: "It looks unprofessional." I asked him to explain and he made a chopping motion with his hands and said: "I'm not going to have this conversation with you here and now; I am a senior member of staff and I am just asking you not to do that with the platelets." I refused and continued, calmly and politely, to demand some clarity and he said: "Very well, Ben; if you're refusing to obey my order I will have to report you to the office." He looked almost as agitated as the platelets I was holding. I shrugged and said: "Go ahead." He never did. Actually I was never really worried that he would. Despite this, I was dismayed and baffled at his actions, and his insistence that I do not do the hand agitation. What difference does it make? Where's the harm? It is almost as if he had been given instructions to pull the porters up if they did their jobs too well. Are the original skills of hospital portering not merely being accidentally forgotten, they are being deliberately outlawed? Is the enforcement of mediocrity a policy? Is porters' Pride and Dignity a threat? Is expertise and commitment in the Hospital Portering Service a detriment to today's NHS? If so, why is that? I can think of other examples and I will describe them in future articles. Something to think about, isn't it?

Acute Care Vehicles 1- Original Fleet

 

A few years ago, while I was still serving, I wrote to all the manufacturers of hospital acute care vehicles offering my services as a consultant, free of charge. No false modesty here; I am one of the most highly qualified people in the world, having used these vehicles every day for over twenty-three years as a hospital porter. Throughout my long career I watched technology advance to improve these vehicles... mostly... and it is important for you, if you are a HP, that you learn about these tools of our trade and their history. When I started at the John Radcliffe, almost the entire fleet consisted of vehicles deployed to the hospital when it first opened in 1973 for the JRI Maternity unit and 1977 for JRII general side. The maternity beds were all equipped with "lift-and-pull" heads. There was a flat piece attached to the headboards which could be pulled out at an angle to allow the patient to sit up, with a few pillows behind her of course. This was considered sufficient for maternity patients long after these beds became obsolete. They were of fixed height, which was extremely awkward especially as Caesarean patients were put on them immediately post-op to recover, even if they'd had general anaesthetics. They had single wheel footbrakes on the front right and back left leg; again, not very user-friendly because to secure the bed the porter had to walk all the way round it. The footboard was a wooden one, but these were upgraded to metal handled ones in the 1990's. One golden rule for HP's, a footboard is absolutely essential. Without one your bed is like a car without a steering wheel. I've seen porters struggling to manoeuvre beds by clinging onto the corners of the mattress, sometimes grasping the woollen blankets with their fingernails. Also, without a footboard the mattress tends to slip off the stead as well. I've seen them half hanging off, threatening to dump the patient onto the floor. (A possible exception to this rule is the Blue Egerton, but I'll cover that in a future article.)
 
On general side these lift-and-pull beds were agreed on as being inadequate for general patients and so we had beds with a sit-up mechanism that raised the head section of the stead up at an angle. This was operated by a handle under the footpiece which could be folded away. There was also a hand-cranked system for raising and lowering the bed's level on the left-hand side of the stead, but the handle was detachable; big mistake! It was stowed on a pair of hooks beside the turning connector, and the designer naively assumed everybody who used it would always kindly return it to the hooks afterwards. No way! Anything in a hospital not tied down or nailed down grows legs and walks. (This incidentally is why the AWARE study was doomed to failure, see: https://hpanwo-voice.blogspot.com/2014/10/proof-of-life-after-death.html.) Pitch was altered by a lever surrounding the level crank. It had three positions, foot-up, head-up or both together, which was the actual leveling. An awful piece of engineering. Another problem the original general fleet had was static shock. The motion of its wheels would build up static in the metal frame that would sting badly when it discharged to earth. This was an even bigger problem with other designs such as the original Hill-Roms, but I'll cover that in a future article. Happily the old rust buckets of the original general fleet have now been scrapped.

Hospital wheelchairs vary considerably in design, but they fall into two basic categories; front wheel steering and rear wheel steering. They all have four wheels, one at each corner with one pair fixed along the north-south axis. The other pair are casters. Different HP's have different preferences and, in my experience, there are advantages and disadvantages with both formats. The original fleet were all rear wheel steered. In the case of wheelchairs single wheel brakes are by far the best. In fact a later, supposedly more advanced, design had a single footbrake, but it was operated by a long pedal that stuck obtrusively out from the back right into the space where the porters' legs have to move while pushing. It meant that the only way to push the chair was to stand much further back and lean forward; which is actually a back care hazard. What anti-genius came up with that quantum leap? You see why it's a good idea to consult with HP's when designing these vehicles? I'll describe more modern wheelchair designs in future articles. You may wonder what the difference is between a hospital wheelchair and one made for use outside in the normal world. Wheelchairs for disabled people in everyday life and designed to traverse streets, pavements and other public places. They usually have pneumatic tyres and suspension, and sometimes a large rear wheel with handle-rims if the person is able to use their arms and hands to propel themselves. They often have to be used for many hours at a time so they are cushioned to be comfortable. Hospitals wheelchairs are designed only to be sat in for a few minutes to an hour or so at a time so they have a straight seat and back without any angling and minimal padding. Their wheels are solid and the hub is fixed to the axle without shock absorbers or suspension. The tyres are usually solid rubber.

I like the word "gurney" because it is uniquely descriptive, but it is only used in American English. We Brits still call the narrow waist-high vehicles for supine patients "trolleys", which of course means you have to add the word "hospital" in front of it if there is any ambiguity of context, otherwise you might end up putting your groceries on one in Sainsbury's. The original trolley fleet were used in A and E, X-ray and a few other places. They were only designed to be lain on for a few hours at the most; but, as is more and more often the case as waiting times increase, some patients end up lying on them for too long. Beds should always be used for stays of more than a few hours. The original fleet, amazingly were also all fixed height. Their side-rails only had two positions, up and down; and they were lowered or raised by rotating away from the frame. This meant you had to do this while the trolley was at least the height of the side-rail's distance from the receiving vehicle. We did lose a few patients down that gap. The only difference with the resuscitation trolleys was that they had an F-size oxygen tank holder underneath, and I once got into trouble for putting one in the general trolley pool by the major side entrance instead of in the resus room where it belongs. The mattress was foam coated by heavy-duty plastic and we had to take it off the vehicle to wash it. The stead and legs were bare steel and they used to rust after a while. This is the first part of a series of articles about acute care hospital vehicles and in the next one we will discuss the next generation of designs. This series is also intended to be just one part of a larger project, the formation of a hospital portering guild, see here for background: https://hpanwo.blogspot.com/2009/09/guilds.html. Oh... and one last thing; to clear up the eternal confusion once and for all, the rule for entering a lift with a vehicle is: bed and trolley feet first, wheelchair head first.

Diathermy and Ego

 

As I've said many times before, my Brother Porters mean everything to me. That does not mean that I like all of them or consider them all friends. As HP's we share a common destiny and that is the sole basis of my sentiment. I dislike many; and among those I don't actively dislike there are more I am wary of, because, like us all, they are so often tempted to do the conventional thing in their interactions with others. One individual is a man I will call Abbas. He was a Delivery Suite porter who was one of the culprits in my story about "helping each other out", see the background link below. This was not the first time Abbas tried to pull one over on me thinking he could get away with it. He was actually the instigator of the whole "let's help each other out" hoax. I remember him chasing me out of the hospital's main entrance one morning demanding to know why the topping up had not being done. I explained that I was on nights, not lates, and so it was not my responsibility. I'm taking a risk here because only a handful of porters end up being trained for DS and those on the inside who are old enough will be able to identify Abbas from my report, but I can't avoid that. As I've said before, we represent a crack contingent. Abbas was a middle aged Moroccan who helped train me for the JRI (the original name for the "Women's' Centre") lodge when I started in 1988. He later followed me into DS. Once he did, he began to grate somewhat on the nerves of the other porters. Abbas was always criticizing his departmental team-mates, so much so that we began to dread it when he relieved us. He lambasted us to the point of perfectionism; yet, ironically, his own quality of service was mediocre at best. He had a habit of turning up for duty and just before handing over, when his relieved was heading for the changing room, he would find some piece of minutiae he thought they did wrong and tackle them before they could get away. He did this many times to me and I did my best to defend myself in those situations; but the diamond of those occasions revealed something about Abbas' personality that is also revealing about human nature in general.
 
I was on two-to-ten and he was on nights. As per normal practice, he turned up at 9.50 PM to clock in, change into DS whites and be ready for duty; he was always punctual, I'll give him that. He disappeared into the theatres like he always did when he came on duty and I knew exactly what he was doing. I bolted for the changing rooms, but I was too late. "Ben, come with me!" he ordered in his high-pitched nasal accented voice. I followed him back into the department, rolling my eyes. What was it this time? Had he found a speck of dust on top of the operating lamp or a scrap of limescale of the scrub sink? He pointed at the diathermy machine. One of our jobs after cases was to replace the diathermy plate. A diathermy is a surgical tool that uses electrical current to generate heat, usually for cauterizing arteries during a caesarean section to stop bleeding. It consists of a metal probe, held by the obstetrician, and an earthing plate that is stuck onto the patient's thigh. The plate is connected to the machine by a wire and it has a strip onto which the wire is fixed with a lever clip. Abbas held up the fresh unused plate. "Ben, you've attached this the wrong way... again!" He scolded. "You keep doing this! Every time I relieve you, I have to switch it round." I asked: "What do you mean?" He explained that the lever clip has to be closed with the handle turned outwards. I wondered why this was such a big deal to him seeing as it didn't alter the function of the device at all. In a way it made sense because, as you can see in the illustration above, when the clip is facing inwards it leaves an air gap. This is probably why Abbas conjectured that the opposite was the right way to do it. However, the diathermy machine has a laminated instruction book attached to it with a chain which gives basic instructions for its operation. He had not read it whereas I had. The book clearly showed that, for whatever reason, the plate has to be attached to the clip with the handle inwards. You can see this in the illustration; the grey surface is actually the peel-off covering of a sticky surface which fixes it to the patient's skin. I opened the book and showed it to Abbas. HHis face fell. "No!" he said. "That's the clip turned outward!" "What are you talking about, Abbas?" I asked. "The clip is meant to turn inward which is why I did it that way; as it shows very clearly here." I pointed at the very simple and comprehensive diagram in the manual. The pointless debate went on for a few minutes. In the end Abbas physically pushed the book away and stormed out of the theatre with a scornful laugh. What had just happened was that I had just proved Abbas wrong and he couldn't admit it; he refused to back down even in the face of obvious facts. Sadly, this is all too common in human nature. Ego is an essential part of our personality. Without it we self-annihilate and become zombies, soulless objects. Everybody needs an ego; but for some people they do not so much have an ego as their ego has them. This flaw is definitely not reserved for HP's; but as a new HP, please do not assume your fellow porters will be immune to egocentrism. Watch out for the signs; and refusing to change one's position when proved wrong beyond all doubt is one of the worst. I lost contact with Abbas when I left Delivery Suite in 1999; shortly afterwards he retired. Then, just a few months ago, I bumped into a midwife who had been in DS when we had, and she informed me that Abbas was living in a care home for the elderly just a mile from where I live. He is very old now, but still alive. I considered going there to visit him, and I'm still doing so...
See here for background: https://hpanwo-hpwa.blogspot.com/2022/02/lets-just-help-each-other-out.html.

The NHS is 75... Who Gives?

 

The Oxford Mail has published a special sixteen-page supplement in its daily journal celebrating the seventy-fifth anniversary of the National Health Service. It is sixteen pages, but it is infested with ads; and it says nothing original at all. It is simply a parade of healthcare providers in their best uniforms smiling like waxworks for the camera. There is also a history lesson of how the NHS came about in 1948 as a result of tireless work by the Minister of Health at the time. I consider Aneurin Bevan a sincere person. He was from a poor mining family in south Wales and wanted genuinely to improve the lives of the working class. He said: "The collective principle asserts that... no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means." and I agree with him. The problem is that over the three quarters of a century since, his grand artwork has mutated into some kind of hideous monster like Dorian Grey's portrait. I will not repeat myself in this article, but simply refer you to the background links below. I remember the sixtieth NHS birthday fifteen years ago because I was one of the guests of honour at Oxford Town Hall, see:  https://hpanwo-hpwa.blogspot.com/2018/06/nhs-seventieth-anniversary.html. There's nothing more really I can add except to say I don't care about this anniversary timestamp and I don't think we have anything to celebrate.
See here for background: https://hpanwo-hpwa.blogspot.com/2014/07/allyson-pollock-at-tedx.html.
And: https://hpanwo-hpwa.blogspot.com/2016/03/national-health-singers-yours.html.
And: https://hpanwo-hpwa.blogspot.com/2023/01/nhs-winter-crisis-2023.html.
And: https://hpanwo-radio.blogspot.com/2023/07/the-gas-spanner-programme-49.html.

Happy St Theo's Day 2023!

 

On behalf of every serving hospital porter, every former hospital porter, and everybody else who loves, appreciates and supports us, with all the Pride and Dignity of my Extremely Proud and Dignified Brother and Sister Porters, I'd like to wish all my friends and readers, a very happy St Theo's Day.
See here for The Gas Spanner St Theo 2023: https://hpanwo-radio.blogspot.com/2023/06/the-gas-spanner-programme-45.html.
See here for the HPANWO TV St Theo 2023 video: https://hpanwo-tv.blogspot.com/2023/05/st-theo-2023.html.

"I've Got a Posting in Thailand!"

 

A few years ago I was at work on an outdoor street when I saw somebody I recognized, a woman I shall call "Shirley"; I actually can't remember her real name. This is a lady who started work at OxRad in 2006 as an administrator for Carillion when they first arrived, making her one of the "plank-owners" of that very prestigious contract. I never liked Shirley, always finding her rather snooty and smug. She also seemed to return that same feeling to others, at least anybody who was beneath her in the hierarchy. Despite this, she greeted me warmly enough and I wondered if she had left Carillion and therefore all that corporate bitchiness had drained out of her. A minute later I realized that it had not and she had actually not left the company. In fact she boasted lavishly that she had just been offered a posting to Thailand. Carillion were contracted to build a hotel and leisure complex in that country connected to a motor racing circuit. They had a deadline to finish the job in time for the next Thai Grand Prix. "Ever since I joined Carillion I've always wanted to work in Thailand." she gushed. "I'll be over there eighteen months; big salary, all expenses covered." She went on for a few more minutes and as she did I got the distinct impression she was lauding it over me. This was confirmed when she looked down at the shopping bags I was carrying, as part of a job I do for an old lady, and said wistfully: "That could have been you, you know, Ben. You could be where I am right now. I was just a junior admin officer when I started out in the Radcliffe contract, but I worked hard and climbed the ladder. You could have done the same."
    I felt insulted and was tempted to add that along with working hard she had kissed an awful lot of arse. This woman was essentially giving me the internal Facilities equivalent of "popping the question", see: https://hpanwo-hpwa.blogspot.com/2022/10/popping-question-responses.html. However I just shrugged and said: "I have no regrets." Soon afterwards our conversation ended. We wished each other goodbye and I never saw her again. I don't how she got on in Thailand, but I imagine it was not the luxury adventure she hoped it would be because a couple of years later Carillion folded amidst an enormous scandal, see: https://hpanwo-hpwa.blogspot.com/2018/01/carillion-collapse-update.html. The reason I never achieved the conventional success Shirley did was nothing to do with a lack of abilities or ambition on my part; it was because I know how the management promotion structure of a public sector contractor works and to ascend that stinking stairway you have to be the "right kind of person", meaning somebody who talks like a robot and looks like a waxwork. You have to be able to stomp on your rivals and smile sweetly at your superiors in order to advance to the next stage. Eccentricity and uniqueness are not tolerated, let alone having an independent set of principles and the willingness to act in accordance with them. No, I was a basic grade porter for twenty-three years. Occasionally I acted up as a working senior or even full senior, but only to cover leave. I was never considered for promotion, never got that quiet word in the ear advising that I would do well to apply for this post or that post. It took me a while to realize that I was being paid an enormous compliment.

St Theo's Day 2023 Fliers

The fliers for this year's St Theo's Day are finished. Pretty soon I shall print and distribute them. This year, as with last year, I have produced two different fliers, one for the Oxfordshire hospitals on my doorstep; and another to be distributed to other institutions around the country. I will send the second national flier by post, addressed to the porters in those institutions.

NB: The venue and time have changed for the Oxford event. It is now at the Swan and Castle, Castle Street, Oxford, starting at 5 PM.

St Theo's Flyer 2023 (JR) by Ben Emlyn-Jones on Scribd

St Theo's Flyer 2023 (National) by Ben Emlyn-Jones on Scribd

I Lied to Jack

 

One of the most infamous figures in my long struggle to maintain my Hospital Porters' Pride and Dignity is a man I call "Jack Shaw". I've mentioned Jack several times before, see the background links below. Over the course of my twenty-three year HPing career dozens of people "popped the question", but most of them did it just once and then let the matter go; Jack was different. I don't know why he took such an extreme and obsessive attitude to my little answer of "no", but he really did. This is despite the fact, or maybe because of it, he had himself been a porter for five years before "going up the ladder" to get a nursing diploma and qualifying as an ODP- Operating Department Practitioner. His insistence got worse as the years went by. He said things like: "You're nuts for not doing your training, Ben! Nuts!" Luckily I was only in the same department with him for a few months and so saw little of him on duty. My interactions with him were mostly in the social club and other hospital hangouts. I found his manner very abrasive. These days I would have forced him to back off a lot sooner; but in those days I suffered from a hyper-agreeable disorder (totally self-inflicted though, see: https://hpanwo-tv.blogspot.com/2020/11/nice-guys-reply-to-stefan-molyneux.html). Despite this he eventually pushed me too far. We were in The Britannia Inn talking to one of my brother porters who had just left to become a theatre nursing auxiliary (He was back as a HP within a month!) and I gave him my best wishes. Jack went berserk. He hurled abuse at me in from of my brother porter and everybody in the pub. I retaliated with equally aggressive words and stormed off. As well as being angry I was baffled. How dare he try to tell me what to do with my own life; yet, I wondered if he ever looked in the mirror and asked himself why he suffered from this mania. I only saw Jack a few times after that and he was more subdued. He popped the question one last time in a light-hearted tone to indicate he was only joking. He left Oxford Radcliffe Hospitals Trust a few years before I did. Last time I heard he was at a hospital in Southampton... Until about two months ago when I bumped into him again.
 
I was in a cafe near the area of Oxford where I work when Jack walked in. Despite not having seen him for only about fifteen years he looked about thirty years older than how I remember him, but I still recognized him. I instinctively turned my head away, but it was too late. Our gazes met; he smiled and said. "Ben!"
    I returned his smile, but inwardly I was bracing myself. Since my dismissal I've been imagining how Jack must have reacted to the news. For him this was a vindication and a just punishment for my crime; the crime of being different to him, the crime of refusing to obey the commands that he had passed over my life. I knew he would have been overjoyed and must have longed for the opportunity to meet me so he could gloat. We exchanged greetings. I asked him what he was doing and he told me about his current employment in an orthopaedic theatre suite. He was in the area visiting old friends who were still at OxRad. Then came the moment I had been dreading. I'm not sure if I'm being paranoid, but I saw a very subtle smug smile break out on his face. "So, Ben... I heard you'd been sacked. What are you doing with yourself these days?"
    I hadn't planned what came next. It was instinctive. I lied: "I'm at a private hospital in London, Harley Street actually." I'm still astonished at how automatic and elaborate my deception was.
    Jack flushed slightly. "Hey? How did you get that job? How come they took you on after your discharge from the NHS?"
    "I won my appeal. Despite that, my life there was tainted and I decided to leave."
    Jack paused and frowned dejectedly. This was supposed to have been his moment of glory, but it had all gone terribly wrong. "Which hospital?"
    "The Plastic Surgery Group." Luckily I had spoken recently online to somebody who worked there so knew some of the details of the London private medical scene, enough to bluff Jack anyway.
    "What's your job there?"
    I gave a haughty chuckle. "You know the answer to that question, Jack."
    He paused and looked down. "So you're a porter?"
    "Yup."
    Our conversation ended quickly after that. Jack seemed to be in a hurry to get away from me. He drained his coffee and left.
    I know I'm taking a risk writing this article because if he sees it he will recognize himself and know that I had fooled him. However, I'm pretty confident he doesn't know about the HPWA and certainly does not read it. Also, I've waited two months before publishing this experience. I know some of you will be very critical of me for lying to him. It is disrespectful to tell false tales about one's own life; but then again, how much respect did he ever show me? He tried to dictate to me what I can and cannot do with my own life, as if I were a misguided child instead of a fellow grown man. He grossly violated my boundaries. He put pressure on me persistently and insultingly not to be my own person. He tried desperately to turn me into a Jack Shaw Mark II. I do not owe everybody the truth. I will not give people the truth when all they will do with my honesty is exploit it. My honesty, in this situation, would be nothing more than me handing Jack stick to beat me with. He has not earned the right to the truth. He deserves what he got, to be tricked. I'm not ashamed; in fact I'm glad I did it.
See here for background: https://hpanwo-hpwa.blogspot.com/2022/10/popping-question-responses.html.
And: https://hpanwo-hpwa.blogspot.com/2022/01/ten-years-on.html.

Simon Le Bon was a HP

 

Readers much younger than me may not know what I'm talking about, but for 80's kids Duran Duran was a name on everybody's lips. For me it brings up memories of school discos, mullet hairstyles and girls in leg-warmers squealing with excitement. Duran Duran was probably the leading act in the New Romantic musical scene of the early 1980's and were renowned for their stunning videos, abstract lyrics and for the band members' status as sex symbols. They were formed by four young men from Birmingham in 1978 and quickly became enormously successful. Some music journalists were even predicting that they could be the new Beatles. As the lead vocalist, Le Bon was the focus of Duran Duran's fame. When he married a girl from Oxford called Yasmin, she received death threats from Simon's jealous female fans. Simon joined the band in 1980 just before they reached the hit parade. Before that he had sung in a punk band called Dog Days and had a go at being an actor. However, most importantly of all, he was a hospital porter. He joined the crew at Northwick Park Hospital in the London Borough of Brent and served as a theatre porter as well as an A&E porter during the 70's before taking up singing fulltime. There is an interesting article about this by another HP, Rupert Loydell. Rupert and Simon were never friends, but they were sometimes shift partners. Rupert left portering in 1980 to teach sailing and art in Michigan USA. He returned to Britain and signed on for a second period at the hospital. When he asked the other porters where Simon was they just pointed at the TV set. There was their brother porter Simon Le Bon singing to a crowd of thousands. Of course, the majority of people will describe this transformation as something along the lines of: "he started from humble beginnings and went up in the world." Rupert himself describes his feelings thus: "Anyone who works in the arts and lives long enough, comes across others who become famous, make it big, appear on the TV or have successful exhibitions. It helps make one feel you stand a chance." I, as you know, regard the situation very differently. Source: https://internationaltimes.it/duran-duran/. I salute MEP&DBP Simon. He kept me entertained as a child, but little did I know I would soon follow in his illustrious footsteps.

Serial Releavers

 

Of all the stereotypical hospital portering characters that I have identified, the serial releaver is the only one I really cannot understand. A serial releaver is a HP who basically spends his entire working life in HPing, but every so often, usually two or three times a decade, he will leave portering for another job, most often outside healthcare entirely; and then return after anything from a few weeks to a couple of months. This behaviour makes no sense to me. They gain nothing from it. Leaving the NHS can sometimes be a one-way ticket, even if you don't get dismissed like I was. It is something that should never be taken on lightly. You run the risk of not being allowed back in. You might think "but I'm a good worker; they'll always take me back." That is a very naive thing to say. The NHS does not care how good or bad you are at your job, as I have explained before, see: https://hpanwo-hpwa.blogspot.com/2016/12/nurse-sacked-for-praying.html. If you are turned down for recruitment after reapplying then it will probably be because you have made a personal enemy of somebody in authority; and who doesn't ever do that? I have known a few serial releavers who were blocked from rejoining because of this. Another disadvantage is that you break your service and therefore lose all your long service benefits and pay increments. You have to start again at the bottom from scratch. So why are so many porters serial releavers? I suspect it may simply be virtue signalling at convention. Peer pressure is one of the most powerful forces in most people's lives. Because HP's are not supposed to love our work, some of us feel obliged to make gestures to show other people we do not... even if we do. I notice that serial releavers also engineer other persona displays along these lines. They say things to me like "a job's just a job, mate"; and they also tell everybody all the time that they are going to leave and that they are looking for other work, even right in the middle of the HPing phase of their releaving cycle. One Delivery Suite porter I remember used to leave a newspaper on the lodge table open at the jobs ads page whenever he went off duty. He clearly wanted to drop hints to the next shift about what his intentions were, or supposed intentions. That is frustrating and tragic. If they are attached to the Hospital Portering Service then why not just admit it, like I do, and stay in it permanently?

Posters for The Gas Spanner

I have created a series of posters for The Gas Spanner. Listening figures for the show have been dropping lately and that is my own fault for not promoting it enough and also not doing enough shows. I'm up to Programme 34, but that's after two and a half years. I intend to give The Spanner a permanent weekly slot, Sunday evening, and I am distributing the notices more widely. I'll do the same with these posters. One of them is in Welsh. I'm in the process of designing some more.

Paper Mask- The Book

 

See here for essential background: https://hpanwo-hpwa.blogspot.com/2022/08/cabal-on-paper-mask.html.
I occasionally go through phases in which I feel totally masochistic. This time, in order to stop myself beating my own forehead with a cricket bat I decided to do something I've been plucking up courage to do for a very long time, I've read the book of Paper Mask. The novel A Paper Mask was published in 1987 and penned by the film's screenwriter, a Scotsman called John Collee. The author is surprisingly mainstream, having been behind far superior productions such as Happy Feet and Star Cops. He comes from Edinburgh and graduated in medicine from its university. He practiced in Cambridge, probably Addenbrooke's, also Bath and Bristol. This may be why the Harris/Hennessey character flees to Bristol under his fake identity. Matthew Harris is very like Ripley, the antihero of a series of books by Patricia Highsmith. As I've said before, he is not a likeable or admirable central character. He is a ruthless liar and exploiter; and a coward whose only emotion is fear, and he only feels it when his own welfare is threatened. As a doctor, Collee was in the perfect place to do research for his story. It is quite a short book just 224 pages in the edition I have, see illustration, and I read it in a couple of days. Of course the most interesting element of the book for me was how it portrays the hospital porters so I paid special attention to the first couple of chapters, before Matthew Harris assumes the identity of Dr Simon Hennessey.
 
The fictional hospital where the story starts is called West Harwood. In the opening scene Matthew and Alec are waiting to transfer a patient from a ward and the former laments about how half of a hospital porter's life is waiting for other people. The narrative is in Matthew's first person. He and Alec place bets on what is wrong with the patient. This first glimpse of portering life, especially the dry humour, is quite accurate, although it's an exaggeration to say half our time is spent waiting for others; maybe twenty percent. However, in the next scene I read: "There's not much pleasure to be derived from endlessly transferring patients from ward to ward." Firstly, that is not the only role played by a HP and secondly, most people who expressed a preference said that they did find that duty enjoyable. I was even once told that by an obs and gynae consultant who had portered during his holidays from medical school for two months. "I'll never forget it." he said. "It's changed my life." Harris is a very observant man and during his aforementioned downtime, he watches the doctors and nurses at work, suturing wounds, inserting drips, changing dressings and the myriad of other medical tasks; and he begins to see doctors as "a pretty ordinary bunch" and that medicine was "ridiculously straightforward". This is a deluded judgement. Doctors and nurses have to train for years and continuously study hard to learn to do what they do. Experts always make things look easy to a layman. Harris and the real Simon Hennessey become acquaintances and Harris feels bitter envy towards him. When Hennessey dies Harris feels a "rush of pleasure". One thing psychopaths are acutely aware of is social status. This is why psychopaths cannot usually endure the HP life; it is too lowly and there are too many people above them. I have known at least once psycho in my own HPing career, but he did indeed soon leave portering to go "up the ladder!", albeit by a more conventional and lawful route than Harris. Harris is unwilling to get too close to his brother porters because "I'd be infected by their hopelessness." He notices how in the pubs near hospitals where the staff congregate (the West Harwood appears to have no social club), there is subconscious social segregation. The doctors and nurses crowd round each other in the lounge while the porters congregate by the dartboard. This is an accurate observation, but, unlike Harris, I never saw it as a bad thing. Alec is a more developed character in the book than he is in the film. He actually expresses some of the same sentiments I do: "We're a crucial part of the system, Matthew. We inject a bit of humour, a bit of goodwill. You can't put a price on that." Alec is actually a proud and dignified HP! Harris dismisses his friend's ideals with cold cynicism. "Any fool can wheel trolleys about." Not true; it takes a special kind of person to do that task well and stick to it. Harris scornfully rejects Alec's positivity, believing that it is nothing more than the false aggrandizement of menial labour that is characteristic of "the Scottish working class." He also refers to Alec as "a blundering Celtic oaf." Matthew is different to his brother porters in that his parents were quite middle class. You can tell that by the accent of the character in the movie. His mother ran a shop and his sister is a hotel manager in Hong Kong. His mother cannot "hide her disappointment in me." Harris considers himself a washout; but he is also, paradoxically, a snob. The plot of the book is more or less the same as the film, which you would expect seeing as John Collee adapted the script himself. There are a few deviations though; for example, Christine gets her own voice in the form of letters to a friend at the start of each chapter. Harris also first tries to kill Alec by running him over in a car, not pushing him off a cliff. The finale of the book is far more open-ended. There is a hint, on the very last page, that Matthew Harris is not going to get away with his chicanery after all. See: https://www.johncollee.com/novels.
 
Because the novel is a first person narration, it is difficult to grasp the author's own opinions on hospital portering. All we know is the derogatory attitude the Matthew Harris character feels towards us. The book portrays HP's in a manner that is equally patronizing and insulting; however I got the impression that this attitude might after all be an essential element of the theme rather than the author's personal derision. I feel far more well-disposed towards John Collee now I have read his original novel. Generally, my opinion of both the book and film is the same, but my feelings towards the story itself have mellowed slightly.
See here for more background: http://hpanwo-hpwa.blogspot.com/2012/11/paper-mask-online.html.