Why is the waiting time for A&E the same as a flight to Gothenburg?

The adventures of a broken toe.

When your luck runs out, it runs out all at once. I muse on this as I enter the third hour of my wait in A & E. The day before, I had banged my little toe against the door frame so hard that it is still too sensitive to touch a day later and the configuration of the pain strongly suggests that a bone might have been broken.

I suppose there’s nothing much they can do with a broken little toe, except tell you not to use it, which I think I could work out all by myself, so what I was really after in St Mary’s was information and validation of my own suffering. Which, after the rather painful journey to the hospital – it’s a 15-minute stroll from the Hovel but a rather longer hobble – was fairly acute.

Still, what the hell is this, my waiting here with a possibly broken toe (I did it while rushing to get the clothes out of the machine, which makes me one of the few people in the modern age to have hurt themselves while doing the laundry) when there are people around me visibly suffering? As I write, my friend Leyla Sanai is contemplating the amputation of her leg because of her scleroderma, and is bearing her sufferings with a fortitude that is beyond comprehension. There is a young Spanish man sitting next to me who appears to have something terrible going on with his arm. “Joan,” calls a nurse from a consulting room. He looks up and there is a silence. Of all the people in this room, none is prepared to answer to the name Joan.

“Joan Estevez,” says the nurse. The young Spaniard lifts his head. “Juan,” he says.

“It says ‘Joan’ here,” replies the nurse, in tones which suggest that the name “Juan”, which this young man seems to be claiming as his own, is an imposture and an affectation. Eventually, though, as no one else seems to be claiming the surname “Estevez”, she lets him go into the room.

The quarter hours go by. A nurse had offered me a couple of co-codamol on turning up and I had accepted more out of politeness than need; in rest, the toe was quite docile, but the nurse had charmed me by calling me “sweet pea” and I had a hunch that a couple of these on an empty stomach would have a rather soothing effect. They do but I recognise another pain bubbling up: that of the end of a brief interlude of domestic happiness.

The Beloved, you see, has been offered a job in Gothenburg for something approaching twice the salary she is bringing in here. The offer was made some time ago and she has been putting off making a decision for as long as she can. I have been to Gothenburg and wouldn’t go back there if you paid me, but she is for some reason enamoured of the country and the language; so it’s rather as if someone had offered me a job in Verona.

Is that right? In my campaign to dissuade her from going, I have been doing a spot of research, both on the internet and the internot (ie, books) and have come up with some killer facts about this country, for which I am beginning to nurture a dislike – as you would a rival in love.

“There are 12 people in Sweden,” I tell her, only slightly massaging the facts to suit my purpose. “In the summer, three of them are eaten alive by giant mutant mosquitoes. In the autumn, feral moose, pissed out of their minds on decaying windfalls, account for about four more. Those that remain blow their brains out in winter, which lasts for nine months.

You can only buy alcohol from a small corrugated-iron shed in Malmö, and when you do your name is put on a criminal register, right next to the paedophiles and heroin traffickers. A bottle of beer costs 6,000 kronor and tastes of moose piss, for the very good reason that that is what it is made from.”

I reinforce my point by demonstrating that when you type the words “bad things about Sweden” into Google you get 36,200,000 results (try it). But it’s a jump up in terms of her career and if I was the one to hold her back by having a crying fit, I’d feel guilty for the rest of my life. So, I know that all I can do is try to ignore my own very strong feelings for once and think of what is best for her.

Hence, perhaps, my concentration on my toe. Which, as it turns out, is not broken (but a week later is still painful and impossible to touch). It took four hours to learn that; as long as a return flight to Gothenburg, I reflect.

Turn up with a broken toe at A&E, and be prepared for a wait. Image: Getty

Nicholas Lezard is a literary critic for the Guardian and also writes for the Independent. He writes the Down and Out in London column for the New Statesman.

This article first appeared in the 06 November 2013 issue of the New Statesman, Are cities getting too big?

Show Hide image

Leader: The angry middle

As a sense of victimhood extends even to the middle classes, it makes Western democracies much more difficult to govern.

Two months after the United Kingdom’s vote to leave the European Union, it remains conventional wisdom that the referendum result was largely a revolt by the so-called left behind. Yet this is not the full picture. Many of the 52 per cent who voted Leave were relatively prosperous and well educated, yet still angry and determined to deliver a shock to the political system. We should ask ourselves why the English middle class, for so long presumed to be placid and risk-averse, was prepared to gamble on Brexit.

Populism has long appealed to those excluded from political systems, or from a share in prosperity. In recent years, however, its appeal has broadened to young graduates and those on above-average incomes who also feel that they have not benefited from globalisation. The sense of middle-class victimhood has become a major strand in Western politics.

In the United States, middle-class anger has powered support for Bernie Sanders and Donald Trump. The former drew his activist base mostly from young liberals. And while Mr Trump’s success in the Republican primaries was often attributed to a working-class insurrection against “the elites”, exit poll data showed that the median yearly income of a Trump voter was $72,000, compared with a national average of $56,000. (For supporters of Hillary Clinton, the figure was roughly $61,000.) It is not the have-nots who have powered Mr Trump’s rise, but the have-a-bits.

In the UK, similar forces can be seen in the rise of Jeremy Corbyn. Indeed, research shows that three-quarters of Labour Party members are from the top social grades, known as ABC1. About 57 per cent have a degree.

Mr Sanders, Mr Trump and Mr Corbyn have very different policies, ideologies and strategies, but they are united by an ability to tap into middle-class dissatisfaction with the present order. Some of that anger flows from politicians’ failure to convey the ways in which society has improved in recent years, or to speak truthfully to electorates. In the UK and much of the West, there have been huge gains – life expectancy has risen, absolute poverty has decreased, teenage pregnancy has fallen to a record low, crime rates have fallen, and huge strides have been made in curbing gender, sexual and racial discrimination. Yet we hear too little of these successes.

Perhaps that is why so many who are doing comparatively well seem the most keen to upset the status quo. For instance, pensioners voted strongly to leave the EU and are the demographic from which Ukip attracts most support. Yet the over-65s are enjoying an era of unprecedented growth in their real incomes. Since 2010, the basic state pension has risen by over four times the increase in average earnings. 

Among young people, much of their anger is directed towards tuition fees and the iniquities of the housing market. Yet, by definition, tuition fees are paid only by those who go into higher education – and these people receive a “graduate bonus” for the rest of their lives. Half of school-leavers do not attend university and, in a globalised world, it is their wages that are most likely to be undercut by immigration.

However, we should not be complacent about the concerns of the “angry middle”. The resentment exploited by Donald Trump is the result of 40 years of stagnant median wages in the United States. In Japan and Germany, median wages have not increased in the past two decades. In the UK, meanwhile, the median income for those aged 31-59 is no greater than it was in 2007, and those aged 22-30 are 7 per cent worse off, according to the Institute for Fiscal Studies.

To compound the problem, the wealthy keep getting wealthier. In 1980, American CEOs were paid 42 times the wage of the average worker. They are now paid 400 times as much. In the UK, the share of household income going to the top 1 per cent has more than doubled since 1979. Because of our hyperconnected, globalised media culture, we see more of the super-rich, fuelling feelings of resentment.

As a sense of victimhood extends even to the middle classes, it makes Western democracies much more difficult to govern, with voters oscillating between populists of the left and the right. The political centre is hollowing out. Rather than pander to the populists, we must do more to quell the politics of victimhood by addressing the root of this corrosive sense of grievance: entrenched inequality. 

This article first appeared in the 25 August 2016 issue of the New Statesman, Cameron: the legacy of a loser