Returning to work

Five patients (Sanjay, Eddie, David, Graham and Jose) had been in full time paid employment prior to their current illness and this section details the thoughts of those within this group who presented their return to work as a significant recovery milestone. The anxieties conveyed about returning to work were placed on a number of levels, by all four of the study participants who were of conventional working age.

In the transcription below Jose expressed a clear desire to not only return to work, but felt as though he could do so almost immediately, feeling as he did, in good health both physically and mentally. He did however express caution in this regard, recognising that for someone recovering from a heart attack such a move would be viewed as unconventional and unlikely to be permitted by those overseeing his medical care and advising his employers.

KS: Do you feel able to go to work?

Jose: Yes, I mean...I...I...right now I think I could go and have a shower and go to my office to-die...today...I feel...like that […]

Jose: I know I am...I am not allowed and I shouldn’t do it (laughs)...I know that... KS: mmm

Jose: Err...that’s maybe the most difficult part because I feel well […]

When considering his return home, Jose continued to appear slightly frustrated with the lack of forthcoming information from the healthcare team, which had limited his preparations for his impending discharge from hospital, a point which Jose had

repeatedly identified, being that it was also covered in the first section of this chapter.

Graham, who was self-employed, was similarly pragmatic and took a seemingly sensible position about restarting work.

KS: Do you...is that what...what...what...I'm interested in why you're keen to go home, is it so that you can just get back to being normal?

Graham: Yeah, I mean, I don't anticipate doing much work because my work is quite heavy...

KS: Are you...do you do the physical work or are you on the managerial side... Graham: No, I...I just work for myself. I've got a workshop in the garden.

Despite being repeatedly contacted by clients whilst he was recovering in hospital, Graham had been largely compliant with his wife’s request that he should refrain from any type of work during this time. She had eventually found it necessary to confiscate her husband’s mobile telephone.

Graham: One bloke who...who's waiting for some work off me, rang up at nine o'clock Sunday night and it wasn't only just to see how I was it was to see... KS: yeah

Graham: well...how he was going to get some work and my wife said 'you're not having the phone in there 'cos your not going to talk to anybody', 'you're stressed enough as it is'

David framed his recovery around two key milestones, the first being a return to work and second being a return home in time for Christmas. During the interview it had become clear that David had enjoyed his job and he took an ambitious view towards an early return to work, but his recovery progress, at the time of the interview, had

indicated to him that he might have been looking at this from an idealistic perspective.

KS: Have you got a view about when you might go back to work?

David: Well, no I haven't, erm...I was thinking next week, but I don't think that's going to happen […]

David went on to consider whether his illness had affected his ability to perform his conventional work role and in doing so had raised the question of on-going biographical disruption, which will be discussed in chapter 7.

David: I do wonder what's going to happen at work as well, 'cos I'm going to be behaving slightly differently...

KS: are you, why do you say that?

David: Well I won't be racing around like before, you know, I'd get a queue of students and it'll be a case of dealing with them as quickly as possible and quite often I'd do the job for them just to get them out the way and you know...

David: and I do wonder, whether, you know, I probably won't be capable of doing that.

KS: why do you think that?

David: well, I...I'm going to be a lot slower I think.

The above transcription was taken from a later point in the interview and here David demonstrated his awareness of the potential reduction in his functional delivery of his job role. Whilst he might have been thinking about his job security, he did not

verbalise any concerns that his job may be under threat at any point in the interview.

The issue of work was of concern for Sanjay who was the remaining participant amongst the study cohort who commented on returning to work. Sanjay’s heart had stopped during a yoga class and during the previous year he had required a pacemaker to be inserted. Sanjay had found it necessary to conduct organisational work whilst recuperating in his hospital bed. In the interview he had been careful to justify his decision to conduct this work. As the owner of his business he felt that he had needed to ensure that everything was under control, which had enabled him to take a step back to concentrate on achieving a full medical recovery.

Sanjay: It is niggling in the back, because if I didn't have those things I could just say 'right, I'm gonna stay here until I get hundred per cent better, everything’s fine, nothing to worry about, OK?'. What I can do is work from here and fix all those problems so I don't have to worry about anything, so maybe tomorrow, day after tomorrow, get my wife to bring some stuff I need to do, I quickly do it and that’s it with that and I'm fine...err...its something that I nee...I need to do, that no-one else can do...I'm not worried about err...the business because I've got staff that are looking after it so...I'm...I'm not...I'm not that...and It’s not...it’s not, it’s a slow time of the year, so it’s not like undue pressure on my staff...OK, so, I'm quite capable of staying here till...till...till I get better […]

During the course of the interview Sanjay demonstrated a determination to fully recover, he appeared to be well informed and cognisant of his situation. He also alluded to his responsibilities towards his extended family, which under-pinned his strategic approach to that recovery.

The complexities of the individual patient recovery journeys that have thus far been revealed through scholarly inquiry indicated that healthcare professionals have found it challenging to adopt a genuinely patient-centred holistic approach to care. Healthcare professionals appeared oblivious to the individual physiological needs of the patient that might have been helpful in assisting them (and their families and friends). By providing more effective support and better quality information, the search for coherence is likely to be enhanced, which may also help patients to determine realistic, positive and encouraging milestones along the tortuous route of recovery.

The third and final findings chapter will consider how the influence of the medical gaze, viewed through a Foucauldian lens that saw the hospital as failed panopticon, affected the recovery experiences of the patients.

Chapter 6 Illness and recovery – encounters with the medical gaze