For Lillian Beecher, who suffers agonising chronic pain, there are times when suicide seems a logical escape. Her feelings of hopelessness have not been eased by the negative responses which five politicians have given her written entreaties for help.
She is on a waiting list at St Vincent's Hospital, Dublin, for a spinal cord stimulator which could ease her pain and transform her life at a cost of £7,000, plus theatre and nursing costs. The stimulator, which is implanted in the abdominal wall and attached to leads implanted in the spine, produces a tingling sensation which masks the pain, reducing it by more than 50 per cent. There is a three-year waiting list of 94 desperate patients in need of this high-tech solution to chronic pain.
"I believe that politicians don't really care. If they did care they would give money to hospitals instead of the GAA. I have considered suicide to escape the pain because really, if I was a dog I would be put down on compassionate grounds," says Lillian from Killiney in Co Dublin.
The three-year waiting list is public: the stimulators are not available privately and are not covered by health insurance. Three years is too long an endurance test for distressed patients whose tortured existence is almost like that of concentration camp inmates, believes Dr Declan O'Keefe, consultant anaesthetist and pain management specialist at St Vincent's. But up to this week the situation looked even worse. Dr O'Keefe told The Irish Times on Monday night that it would be the year 2005 before the waiting list could be cleared. However, following inquiries by The Irish Times to the Department of Health and St Vincent's Hospital, the hospital's chief executive officer, Nicky Jermyn, said on Tuesday that in fact he had been able to juggle the budget to increase the number of operations, reducing the waiting period to three years.
However, that can still seem an interminable wait for people in constant pain. One person on the waiting list is believed to have committed suicide.
"It is quite common for people to feel so very distressed by their pain that at times it is questionable whether it is worth going on," says Dr O'Keefe. "To think of suicide is a logical thing if you have so much pain all day, every day and no prospect of it being reduced." The excruciating pain which tortures Lillian 24 hours a day, 365 days a year is, in her experience, far worse than the pain of childbirth. It began four years ago after traumatic chest surgery aimed at easing a problem she had with swallowing. She has tried everything to relieve the pain - including addictive, morphine-based drugs, further surgery, acupuncture and faith-healing. Like the other patients awaiting spinal cord stimulators, Lillian has had to be assessed by a multi-disciplinary committee of pain specialists, a psychologist and a physiotherapist who are convinced that only a spinal cord stimulator can help them.
"I'm in heaven," says Tommy Ellis (45), from Dublin, who went home from St Vincent's hospital earlier this week after having a spinal cord stimulator implanted. He was on the waiting list for five years and this week is the first time in eight years that he has been without the unbearable abdominal pain which destroyed his life, making him unemployed and preventing him and his wife of 15 years from having a family.
Last July, Dr O'Keefe told a group of patients the devastating news that the waiting list was by his reckoning seven years long. Since then there has been intense anger from patients and their families, with some patients even threatening suicide. The hospital's CEO, Nicky Jermyn, has lobbied the Department of Health and juggled hospital finances in order to fund more spinal cord stimulators.
Jermyn told The Irish Times that the 1998 quota of spinal cord stimulators has been boosted in the past eight weeks from 12-14 to 18-20 cases, increasing to 25 cases in 1999 - a pace which Mr Jermyn hopes to maintain with the support of the Department of Health and Children.
To help these patients, the Government's options are: to grant a capital cash injection of about £500,000 to pay for the stimulators, letting the hospital absorb surgical costs; to place spinal cord stimulators on the designated waiting list, thus justifying additional funding; or to ask health boards to contribute to the cost of their patients treated at St Vincent's. More pain management centres are urgently needed around the Republic.
The plight of patients awaiting spinal cord stimulators can be matched in many other areas of the health service, where the budget-balancers are forced to play God by developing some programmes at the expense of others in a State where the per capita spending on health is relatively low. The fundamental question is do these financial planners want to keep the health services trim at the expense of quality of life, if not life itself? It's a question that waiting-list patients like Lillian hope will be on the Government's conscience as it finalises next month's Budget.
