Chapter Thirty-Two
Apologies for sporadic updates! This chapter is quite heavy- lots of technical words here. Apologies for any errors. Although the reactions of the characters to the epilepsy diagnosis are rather negative, Ethan's experience and every experience are different, and I do not wish to paint it as an extremely negative or drastic condition, although of course some with epilepsy do have this experience.
'I've got our set of files,' Cal said, gesturing to the bulging bag he was carrying. 'I think there'll be some doubles but better to cover all bases, right?'
'Absolutely,' Dylan cleared his throat, picking up a box and an index file from the desk. 'I had some time last night. These should be in chronological order. The red is linked to the spinal TB and initial admission, the green is the haemorrhage. We should be covered.'
Dylan locked the door as they left the office. 'It'll be fine, Cal.' It still felt odd calling him by that. Caleb was more acceptable. 'It's not like we're on trial.'
Cal gave a wry grin. 'We're defending Ethan, right?'
'I suppose. I just think Menai sounds wrong. It's too far. But who knows? There might be a closer placement.'
'He could be eligible here. I'm sure he'll get the place.'
Dylan didn't respond, choosing instead to ensure the catch on one of the files was shut properly.
They were heading to a panel to discuss Ethan's case, and decide with a team of specialists on the next best steps. It was also likely that the epilepsy diagnosis they'd all known already would be brought up. Cal had booked a session with Ben Harding for straight after. He knew without a shadow of a doubt that this would be challenging for everybody. This was deciding their future.
'Good morning,' Connie greeted them. She was dressed immaculately, as usual, but there was a slight edge of anxiety to her appearance overall. 'We're early. That's good.'
'Any updates?' Cal demanded. He was bouncing on the tips of his shoes, ever so slightly. The second coffee before 9 was a mistake.
Connie sighed, pushing a strand of hair into place. 'Guy Self's apparently pushing for Menai. They've got a place there. It'll also be cheaper for the NHS.'
'Who cares? It's Ethan, he's contributed more than most people ever will. That unit is in Wales. It's four hours away with no traffic. What happens if there's another bleed?' Cal demanded.
'Right, Cal, we aren't exactly keen either.' Dylan cut in. 'Don't shoot the messenger.'
Cal stopped bouncing. 'I know. It's ridiculous though. Even if he can't get a place on the rehab unit here, there are about six closer than that.'
Connie nodded, grimly. 'It's about the best fit, though. It's rubbish for us, though, Cal, I know it is.'
It took another thirty minutes for everybody to show up. By the time everyone was sat around the cold, oak table, there were about fifteen people, including the three of them, Mr Albion, Guy Self, Mr Hanssen and other neurologists, plus a rehabilitation consultant specialising in haemorrhage recovery. Cal felt slightly unnerved by Hanssen's presence. He knew he was there to ensure that there was a good level of impartiality given Ethan's connection to the hospital, but he didn't want to lose it in front of the top dog.
'Mr Self. Would you begin by giving us an overview of Dr Hardy's condition at present?'
Guy stood, which immediately annoyed Connie. This wasn't a bloody presentation. Eventually, the message must have shown on her face, as he took his seat again.
'Dr Ethan Hardy, aged twenty-nine. Dr Hardy was admitted to the neurology department on February 20th following a serious fall linked to a previous admittance. Emergency surgery was carried out once it had been established that Dr Hardy had suffered a subarachnoid haemorrhage. Eight days later, Dr Hardy suffered a second, smaller bleed. In the five weeks since, he has made good progress developing his mobility, linked also to his spinal condition prior to the admission. Dr Hardy has shown signs of personality changes, mood swings, difficulty communicating and distress at unfamiliarity since the initial and subsequent bleed. Around two weeks after the initial haemorrhage, Dr Hardy began to suffer from generalised tonic-clonic seizures as well as migraines. While this was initially considered to be a potential temporary state due to the recent surgery, last week, the decision was made by myself and my colleague Dr Natalia Rigg, that Dr Hardy met the threshold for an epilepsy diagnosis.'
'Thank you, Mr Self.' Hanssen said. Cal glanced to his right, trying to judge Connie's reaction. It was almost a relief that Self had taken the clinical and detached route. He was reading from a bloody script. 'And your prognosis, please?'
'To the best of my ability, I believe Dr Hardy is likely to make a significant recovery. Although it is unlikely that he will be able to work exactly as before, it is likely he can practice medicine in a diagnostic capacity, although multiple assessments will be needed, and I would not currently put any definite timeline on this. Dr Hardy will require therapy prior to being able to return to his home, particularly around his motor skill and independence. Given my knowledge of the patient's current condition, I would recommend Bridgeworth as the best fit for the rehabilitation facility.'
Connie raised her hand. All eyes turned to her, and she was aware, uncomfortably, that she was the only woman in the room, despite her seniority.
'Constance Beauchamp. My relationship with Dr Hardy is primarily as his clinical lead, although I have become significantly involved with his care since the initial stage of Pott's Disease and admission to orthopaedics. It is my belief that Bridgeworth, being over four hours from Holby, isn't the ideal location. Dr Hardy can become distressed when away from those he is familiar with, and has shown accelerated progress when visiting familiar locations or seeing those he knows.'
A neurologist raised his hand, and took over. 'Tobias Fletcher, senior neurology consultant. Having read through the patient files, it is clear that in order to do our duty as professionals and give Dr Hardy the best care for him as an individual, the rehabilitation facility needed must be specialised. Bridgeworth is a smaller unit which is more likely to be able to focus on his specific profile. Dr Hardy shows better memory and recall than on average with this injury, and will be recovering alongside those with similar strengths. If he feels ostracised when in rehabilitation, studies show he is far less likely to feel motivated to reach his potential.'
Too many big words. Caleb scribbled it on a card, and shoved it towards Dylan, who gave the slightest indication with his head that he agreed.
The meeting continued. Every time one of them tried to counter the decision, the neurology team smoothly pushed it aside. Even Cal started to feel defeated. Eventually, Hanssen spread his hands onto the table and silence fell.
'I believe that there has been a strong case made by your team, Mr Self, and that there is a place available that is suitable. Waiting for another place to potentially come up could take time, limiting progress for Dr Hardy and occurring a level of cost to the NHS that can't be well justified given our present situation. It is my belief that the place at Bridgeworth Rehabilitation Centre be accepted on Dr Hardy's behalf. Every attempt will be made to ensure he can make regular contact with his brother, and given the circumstances, compassionate leave made readily available so that visits are possible. I'm sure everybody here will agree, regardless of their opinion, we owe it to him that his care is the very best that can be offered.'
