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?

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How should Labour's disgruntled moderates behave?

The price for loyalty looks like being long-term opposition. Sometimes exiting can be brave.

When Albert O. Hirschman was writing Exit, Voice, Loyalty: Responses to decline in Firms, Organizations, and States he wasn’t thinking of the British Labour Party.  That doesn’t mean, though, that one of the world’s seminal applications of economics to politics can’t help us clarify the options open to the 80 to 90 per cent of Labour MPs who, after another week of utter chaos, are in total despair at what’s happening under Jeremy Corbyn.

According to Hirschman, people in their situation have essentially three choices – all of which stand some chance, although there are no guarantees, of turning things around sooner or later.

The first option is simply to get the hell out: exit, after all, can send a pretty powerful, market-style signal to those at the top that things are going wrong and that something has to change.

The second option is to speak up and shout out: if the leadership’s not listening then complaining loudly might mean they get the message.

The third option is to sit tight and shut up, believing that if the boat isn’t rocked it will somehow eventually make it safely to port.

Most Labour MPs have so far plumped for the third course of action.  They’ve battened down the hatches and are waiting for the storm to pass.  In some ways, that makes sense.  For one thing, Labour’s rules and Corbyn’s famous ‘mandate’ make him difficult to dislodge, and anyone seen to move against him risks deselection by angry activists.

For another, there will be a reckoning – a general election defeat so bad that it will be difficult even for diehards to deny there’s a problem: maybe Labour has to do ‘déjà vu all over again’ and lose like it did in 1983 in order to come to its senses. The problem, however, is that this scenario could still see it stuck in opposition for at least a decade. And that’s presuming that the left hasn’t so effectively consolidated its grip on the party that it can’t get out from under.

That’s presumably why a handful of Labour MPs have gone for option two – voice.  Michael Dugher, John Woodcock, Kevan Jones, Wes Streeting and, of course, John Mann have made it pretty clear they think the whole thing’s a mess and that something – ideally Jeremy Corbyn and those around him – has to give.  They’re joined by others – most recently Stephen Kinnock, who’s talked about the party having to take ‘remedial action’ if its performance in local elections turns out to be as woeful as some are suggesting.  And then of course there are potential leadership challengers making none-too-coded keynote speeches and public appearances (both virtual and real), as well as a whole host of back and frontbenchers prepared to criticise Corbyn and those around him, but only off the record.

So far, however, we’ve seen no-one prepared to take the exit option – or at least to go the whole hog. Admittedly, some, like Emma Reynolds, Chuka Umunna, Dan Jarvis, Yvette Cooper, and Rachel Reeves, have gone halfway by pointedly refusing to serve in Corbyn’s Shadow Cabinet.  But nobody has so far declared their intention to leave politics altogether or to quit the party, either to become an independent or to try to set up something else.

The latter is easily dismissed as a pipe-dream, especially in the light of what happened when Labour moderates tried to do it with the SDP in the eighties.  But maybe it’s time to think again.  After all, in order to refuse even to contemplate it you have to believe that the pendulum will naturally swing back to Labour at a time when, all over Europe, the centre-left looks like being left behind by the march of time and when, in the UK, there seems precious little chance of a now shrunken, predominantly public-sector union movement urging the party back to the centre ground in the same way that its more powerful predecessors did back in the fifties and the late-eighties and nineties. 

Maybe it’s also worth wondering whether those Labour MPs who left for the SDP could and should have done things differently.  Instead of simply jumping ship in relatively small numbers and then staying in parliament, something much bolder and much more dramatic is needed.  What if over one hundred current Labour MPs simultaneously declared they were setting up ‘Real Labour’?  What if they simultaneously resigned from the Commons and then simultaneously fought scores of by-elections under that banner?

To many, even to ask the question is to answer it. The obstacles – political, procedural, and financial – are formidable and forbidding.  The risks are huge and the pay-off massively uncertain.  Indeed, the whole idea can be swiftly written off as a thought-experiment explicitly designed to demonstrate that nothing like it will ever come to pass.

On the other hand, Labour MPs, whether we use Hirschman’s three-way schema or not, are fast running out of options.  The price for loyalty looks like being long-term opposition.  Voice can only do so much when those you’re complaining about seem – in both senses of the word – immovable.  Exit, of course, can easily be made to seem like the coward’s way out. Sometimes, however, it really is the bravest and the best thing to do.

Tim Bale is professor of politics at QMUL. His latest book, Five Year Mission, chronicles Ed Miliband's leadership of the Labour party.