The day began with P and I jogging to the Tube station. Penny is convinced that if we are so much as a minute late for our appointment God will punish us by ensuring that the treatment doesn’t work. I am convinced that if we are on time the ACU unit staff will punish us by ensuring that we are left sitting the waiting room forever reading 34 year old copies of the Readers’ Digest.

By the time I had digested the article I had been reading about whether Nixon could cling to power, a nurse appeared calling out a name which was similar to P’s. As we were the only people in the waiting room we deduced that she wanted us. 

As I have come to see NHWD as the start of a familiar slide down the frothing flume of despair, it would be fair to say that the artifical jollity of the nurse’s mood did not match the funereal blackness of my own. Chirpily she directed me to the “sample room”. To my initial relief the sticky sofa had been removed. It had been replaced instead with a vinyl covered reclinable office chair. But that was not the only change. The NHS’s porn operation has gone digital. In the corner of the room was a television and a DVD player. The tray was open and lodged in it was a copy of “Happy Slappers” (Eisenstein’s rather disappointing sequel to “Battleship Potemkin”). Next to the player was a stack of forms indicating that one of the members of the clinical staff was conducting a study into whether the new chair and the prospect of watching breasts jiggle in colour made sample collection “more efficient”. I decided to skip watching the movie and participation in the survey. To be honest I wasn’t sure what counted as “efficiency” for the NHS’s purposes. I had a horrible feeling that there had been a meeting at which a written proposal had undergone careful consideration. A young doctor had opined that for a minimal increase in the hospital’s pornography budget they could speed up the rate of ejaculation and double efficiency. Once one goes down that route, the next stop is setting targets for patients to meet.

Emerging having done my bounden duty I went to join P who had been wheeled into a treatment room for egg retrieval.

Jolly Nurse: You can’t go in there Mr Moobs. Oh no! So sorry!

Storm cloud in form of Moobs: Why?

JN: There’s no room for you. Oh no! None at all!

SCM: Have they shrunk the room?

JN: No no. I certainly don’t think so.

SCM: Well there was room for me the last five times.

JN: Really? Ever since I’ve been here no-one has been allowed in.

SCM: How long have you been here?

JN: Two weeks.

It was not a point worth pursuing. There had clearly been a change in policy and rather than explain it, the line adopted to be adopted was that the policy had always been as it now was.

I sat and waited until P reappeared. As usual, the sedative had knocked her out. The usual pattern has been for her to sleep for a couple of hours, have some tea and then we go home. There appeared to have been another change in policy as the nursing staff were determined to wake her.

JN: P are you awake?

P (rousing): Er … y … yes

JN: How do you feel?

P: Tired

JN: Good good I wanted to tell you that you should sleep for a bit.

P is very fit and has a very low resting heart rate. Under sedation it drops to around 45 – 50 bpm. There was some fuss about this as the machine to which she was connected sounded an alarm at any rate under 50. I told the nurse that P’s pulse rate was often low but did not normally hit 42 which was the rate she appeared to have settled at. The staff did not seem worried so I took that as a comfort. By 11:15 P was up, scoffing down a paracetemol and completing discharge paperwork. P wanted to know how many eggs they had retrieved (16) and what quality they were. The nurse said that, if we would like her to, she would go and ask the embryologist. P, her Britishness showing, said that she would rather not bother the embryologist. The nurse said she would ask anyway. 5 minutes later we were joined a tall Asian lady in a bad mood.

TALBM: I’m the embryologist. You want to know about your eggs.

P: Er … please

TALBM: We are not normally interrupted during dissection.

P:  …

TALBM: 16 eggs. Four are no good.

P: So 12 good eggs?

TALBM: Some are better than others.

P: Are there any good ones?

TALBM: Maybe … maybe not.

You can imagine what a reassuring experience this had been.

P: Well thank you for coming to speak to us.

TALBM: That is alright. We would not normally do it but I understand that some patients like to be reassured.

I sat quietly, imagining myself beating her unconscious with her file of medical notes.

Once outside the hospital P and I had our usual row. She tells me that she feels fit enough to take the Tube home. I tell her that if she passes out it will be easier to deal with in a cab than in a tube train. I win the row but she is grumpy the whole way home. We get stuck in traffic and she begins to hand out death sentences to anyone she considers in any way responsible for her delay in getting home (myself included). Then, once in South London we are in the world of the speed bump. Each time we pass over one, the stage coach suspension of the cab we are in throws P into the air and she lands with a bump that aggravates the soreness of her nethers. We enter a cycle repeated every 20 secs or so: BUMP, P rises, P falls, P winces, P gives husband death stare.

Once home She lies on the sofa and, having been given paracetemol and a cup of tea she settles down to have her brain-addled by daytime television. I make myself a coffee and attack the fiendish SuDoku in the Times feeling very grown up and bourgeois.

Half an hour later the puzzle page of the newspaper is awash with scribbles, clumps of hair I have pulled from my scalp and ground up bits of teeth. I hear P calling:

“Moobs come here”

I assume that she has seen someone purchase a particularly horrifying piece of bric-a-brac on “Bargain Hunt” so I take my time, shouting: “Coming Love.”

When I go into the sitting room I find P trying, unsuccessfully to stand. She is grey and sweat is running down her forehead and chest in rivulets. She is having trouble speaking.

“I’m  … dizzy, hurts when I breathe”.

I begin to feel myself slipping into panic.

P: “I think it might be Hyper Ovulation Syndrome”.

M: I’m calling the unit.

I charge back to the kitchen, grab the ACU’s number and dial. My fingers suddenly feel twice their normal size; dialling feels like mending watches with sausages for digits. A very long recorded message informs me that as it is now past 4pm everyone has gone home. At the end of the message I am invited to call back the next day. Next door I hear P cry out in pain. I look for the number of my GP and can’t find it. Upstairs I run and google it. I find myself once again listening to a recorded message which tells me that if it is after 6 pm (it isn’t) I will be put through to an emergency out of hours doctors service. There then follows a detailed explanation of the process for booking appointments and then finally a long list of “options”. Wife apparently dying does not appear on the list so I select “other”. The phone rings and rings and rings and rings. Moving downstairs I can hear P gasping for breath and moaning. Finally, the receptionist answers and tells me that she will inform the duty doctor what is going on. She assures me that he will, at some indeterminate point in the future, call me back.

I run back into the sitting room to tell P that the duty doctor will call. “I think I need an ambulance” she says. This terrifies me. P comes from a family in which no medical emergency is sufficiently grave that it justifies troubling a doctor let alone an ambulance. P has a 6 inch scar on her arm from when she pushed her hand through a plate glass window as a child. Her mother simply wrapped the wound in a tea towel, replacing it every 20 minutes or so when it filled with blood.

I dial 999 and ask for an ambulance. I then hear a recorded message telling me that the Ambulance Service is very busy and that all their operators are enaged on other calls but that if I would like to stay on the line they will get to me shortly. P is now lying silently on the sofa; paler than milk. I am jumping from foot to foot, one fist clenched in impotent rage, the other waving the phone around in the air. Once I had got through to the operator things happened very quickly. An estate car with a flashing light pulled up within a couple of minutes and two men rushed into the house. One of them set about asking P questions and festooning her in wires. The other stood next to me and spoke:

Other Paramedic: “Hello, I am Danish”

M: “I’m Sorry?”

OP: “I am from Denmark”

M: “Er … welcome”.

As P answered questions the principal paramedic wrote the answers on his latex glove. He decided to put in a cannula and attached a drip to it. He was concerned about P’s blood pressure which meant that I was terrified. I hopped about the room like a sparrow trying to think of things I could do that would help. As I saw P lying there in distress I found I just want to cry. I could not bear to see her hurting.

Two minutes later an ambulance arrived and before long we had arrived at the A&E department (the “ER”) of St George’s Hospital. By this time, though her stomach was distended and breathing painful, P had slipped down below the agony threshhold and began to announce that she felt much better. She seemed to be concerned that she had put everyone to “trouble”. She was wheeled into a room and a young doctor came to see us.

Young Doctor: “I hear you are feeling better”

P: Yes

YD: Some people are recovered by the time the ambulance arrives haha

P: Haha ow ow ow haha

YD: Well I’m sure you’ll be ok.

As his pen was hovering over what I thought was probably her discharge papers, I pointed out that she was still in pain, still having trouble breathing, had low blood pressure and a bpm of under 50. I then pointed out that her symptoms matched those on a list given to us by the ACU immediately beneath which was a warning to contact a hospital urgently if they were experienced. I had with me a short description of Hyper Stimulation Syndrome which identified the attendant risks of heart attack, thrombosis and stroke. The Young Doctor stayed his pen and thought for a bit.

YD: Hmm. I don’t really know anything about this stuff.

Again with the reassurance. We settled down to wait until someone from gynae could come along. In the meantime a steady stream of medical personnel visited to ask the same question over and over again: “Is that your normal blood pressure?”. Occasionally they would poke her with a needle or alter her sitting position. Sometimes they would scare us by saying worryingly incompetent things:

Worrying Incompetent: “Yeah she has low blood pressure, but no need to worry because the body compensates by raising the heart rate”

M: “Her heart rate is 42 bpm. Are you saying it would ordinarily be lower?”

WI: “No, that is very low”

M: “So should I be worrying?”

WI: “No”

Eventually it became clear that gynae wasn’t going to come to us so we went to them. There we were dealt with by a charming nurse called Erica and a consultant called Dr Tan. I name them because despite my worry-induced grumpiness and my patent unwillingness to give people who do a difficult job credit, they were marvellous. They decided P should be admitted for observation. It was, by that time 10:30 at night. P shuffled painfully into the bed and I set off for home to get her nightclothes and washkit. I walked down the polished lino corridor away from her room, I looked back to see her lying in her bed and thought wistfully that some people get to conceive by making love.

PS. P is home from hospital today. She is still a little tender and anaemic but her blood pressure and pulse rate are up and the doctors believe we should still be able to do the embryo transfer. We have 9 embryos and will be updated on Sunday.