An inspiration of breath.
HYWEL, a porter, watches the dawn from
a third-floor window
in Nevill Hall hospital, Abergavenny.
An empty bed stands beside him.
Hywel
Here’s a thing.
How, exactly, would you say
does an idea begin? Where does it all start?
In one woman’s brain? One man’s heart?
Doesn’t seem likely, does it?
I mean, all of us are fuelled
by the thoughts of others,
by what we’ve read, gleaned or seen.
Take all this – health care, medicine,
didn’t just rise from nowhere, did it?
Someone, somewhere, I always think,
back across the millennia, must have been the first –
to lay a hand on the wound of a stranger.
In a cave maybe, ice at its mouth,
a fire beside. Or perhaps later, in a hut or a shelter.
Wherever, whenever it was,
someone must have been the first –
to offer comfort beyond their tribe
not because they had to or should,
but because they could.
He takes up the empty bed
and pushes it on down the corridor.
Someone else again would have seen that,
watched, learnt how to do the same –
what staunched the blood, eased the pain.
And so it must have begun within us,
not so much an idea as an offering –
a caring chain of practice and knowledge;
a refusal as a species to just lie down and take it
but rather, through attention,
intelligence, care, foster a belief
in our agency in life –
our ability to pit our empathy and wit
against sickness, disease and death,
the trials of the body and the brain.
To say, when our health goes south,
‘No, not this.’
As he follows his route through the hospital
it begins to come to life around him.
Nurses doing handovers, radiographers preparing,
domestics delivering meals, doctors reading notes.
Ever since then, I’d say, all of us
who work in medicine,
well, we’re all, however tangential,
descendants aren’t we?
Of that offering, that first intimate action.
Here in Wales, by all accounts, we started early.
Around 1000BC, before Hippocrates, mind,
that’s whenMeddyginiaeth – medicine,
or the language of doctors, literally –
was first recorded as a rural art,
practised by theCymro before they had much
of anything else – cities, sovereignty.
By 430BC it lay even closer
to the civic heart, protected and encouraged
as one of three civil arts.
YVONNE, a domestic,
is buffing the corridor between two wards.
Yvonne
It was, fair dos – but what were the other two?
Navigation, that was one and Commerce the other.
Oh yeah, right from the start
money and medicine were close, like brothers.
Just look at the laws of Hywel Dda,
in what, 930AD? There it is in black and white,
‘the offices of the court physician’.
But what else did those laws enshrine? That’s right. His fees.
‘Four pence for the letting of blood
Nine score and his food for a dangerous wound –
a stroke on the head unto the brain,
a stroke on the body unto the bowels,
a broken limb put right –
Four pence again for herbs to ease a pain.
Twelve pence for an ointment of red.
One legal penny for his light every night
and one and a half for his daily bread.’
HYWEL has collected
an elderly patient, ALICE.
As he wheels her back to her ward—
Hywel
She’s right of course. There’s no denying,
the ideas that make us meet in us too,
conjoin, get all wrapped up in each other,
until to imagine them apart, pulled asunder,
well, would be more vision than thought.
I mean, time, knowledge, skill,
none has ever come for nothing has it?
So how might you do it? Where would you begin?
To unwrap the money from the medicine?
Make individual care a communal concern?
How might you surgically remove
financial transaction from the consulting room?
Make treatments free at the point of care,
available to all, no matter who they are?
Would it even be possible?
HYWEL rolls ALICE into her ward,
handing over to VALERIA, a nurse.
As he leaves—
Good questions, all,
but before you can solve them
you need someone to ask them
and that, I’d argue, is when sometimes
one person can be the difference.
Not tohave the idea as such, but yes,
to change its direction, maybe, who knows,
even where it lands, the final destination.
Someone who doesn’t just see the vision
but who can raise it too,
beyond the orbit of the eye
towards the doing of the hand
and the believing of the brain.
YVONNE is storing her buffer in a storage cupboard.
As she emerges—
Yvonne
It can happen.
Look at Churchill during the war.
Everyone knew what had to be done,
but to get us there?
That took a certain sort of man,
someone who could imagine the journey
and in that imagining make it happen.
Which he did. But after war comes peace,
a very different proposition.
And harder too, perhaps,
to win your victories not on the field of battle
but in the day-to-day lives of your people.
Hywel
But that can be done too, can’t it?
And that’s the tale, if you’ll listen, we’ll tell.
The story of how, in the wake...
