It started in a wine-shop one November, one of those where, come lunchtime, they find some tables, rustle up some charcuterie and charge you corkage. The sort of place where you pair the food with the wine, not vice versa.
My host had bought a decent bottle. I think. I couldn’t drink it. Even the smell was turning my stomach. I couldn’t eat anything either. I was sweating, shaking. The nausea came. I made my excuses and headed for the Tube. Fortunately it wasn’t that many stops from wine-shop to home. I walked through the door, said hello to my then fiance and projectile vomited across the bedroom.
She sent me to the doctor. I had stopped sweating and shaking when I saw him. I had food poisoning, he decided. Come back if you’re not better next week.
I was better, but not better. Over the next few weeks, going to the loo became uncomfortable – both versions. Then the acid came, intense after every meal. I went back to the doctor. Gastric reflux, he decided. Take these pills. They worked, then they didn’t. I went back. That’s quite common, take these instead. They worked, then they didn’t.
The stomach cramps started. Jets of white-hot pain shooting up my digestive tract. The only relief was sitting in a hot bath – not a viable solution for the office. The vomiting started again. Particularly after alcohol, and not just in the quantities after which some form of judgement would be understandable. A single glass was all it took for me to start the next morning bent over the loo.
It was October now. I went back to the doctor. Go and see a specialist. I did. We’ll stick a tube down you and have a look, he decided. He did. Nothing to see. We’ll stick a tube up you and have a look, he decided (not quite as keen on this idea).
Sedated beyond the ability to complain, I heard “I can’t get it up, give me the thinner one.” Couldn’t we have started with that, I thought. “I can’t get it up, see if the scanner’s free,” I heard. Couldn’t we have started with that, I thought.
A couple of hours later, sedation worn off, I was given the good news and the bad news. My appendix had burst. My body had been quite clever and produced a putty-like substance to set the surrounding tissue hard. Bad news was you can have too much of a good thing – it was starting to choke off the tube from my kidney. When it did, he said, it would swell and probably explode. That would be lights out. I had about a month.
Fortunately, the doctor in the next-door office was the finest bowel surgeon in London. Equally fortunately, he had an afternoon free the next week to spend elbows-deep in my abdomen. You can judge the outcome of his labours by the fact you’re reading this.
It’s coming up to the 25th anniversary of that lunch. I can’t prove that was when my appendix burst, but it was the only time my body behaved like a body whose appendix was bursting and all the subsequent symptoms can be explained by the way it reacted to the hole it unexpectedly acquired.
Other people’s medical histories are about as interesting as other people’s holidays, so if you’re still reading, thank you. But the Henry Nowak affair has brought the episode back to my mind.
As you know, he was a student, walking home after a night out who was stabbed several times. As he lay on the ground, his assailant called the Police alleging racial abuse. They turned up and, despite Nowak telling them several times that he had been stabbed and couldn’t breathe, they handcuffed him. And he died.
There has been outrage over his death, understandably so. It shouldn’t have happened. We can all agree on that. In an ideal world.
In an ideal world, the doctor would have sent me to the hospital the first time he saw me. He didn’t. He made a mistake, as people do. And it was an understandable mistake for him to make. Food poisoning cases are more common, even in London, than bursting appendices. I didn’t have the agonising pain which is usually diagnostic. I was a little bit older than the normal age for the condition. Based on everything he knew, he made the reasonable diagnosis.
When the Police arrived, they knew there had been an accusation of racial abuse. They were primed to look for it. For what we know colours what we look for. You may remember the Invisible Gorilla video from a while back. People were told to watch it and count the number of times a basketball was passed. Few if any noticed the man in a gorilla suit walking through the shot.
This is not to defend the police officers involved. They may have done wrong. An Inquiry is underway which will tell us. But to be fair, it has to take account of how they were primed when they arrived on the scene, and how quickly they adapted to the new information they found. “I don’t think you have, mate” – an officer’s reply to Nowak telling him he had been stabbed will live on in infamy, but which of us really knows how accused assailants behave when the police are called in the wee hours? The “noble” villain who puts his hands up and says, “It’s a fair cop, guv,” exists only in stories.
The tragedy is that, even had the Police acted perfectly, the outcome would probably have been the same. The coroner determined that Nowak’s wounds were fatal. His death could not have been prevented once help arrived, its circumstances could only be altered.
The outcome, I think, matters. I can look back on my burst appendix with a degree of amusement. By luck, a fatal episode turned into an amusing (to me, at least) anecdote. Nowak does not have that luxury. It is easy for me to shrug off my doctor’s mistakes and take the long view. To err is human…
But had the chain of history played out differently, nothing of what had gone before would have changed. The NHS thinks it gets the right diagnosis 95% of the time. I was, that day, in the 5%. As I would have been had I keeled over in agony one morning on the Tube and never got up. Had the police taken Nowak to hospital as soon as they found him, his story might have made it into the Southampton press, it wouldn’t be in the New York Times.
But he would still have died.
The philosopher Bernard Williams coined the term “moral luck” – that we use outcomes to decide what we think about the events which led up to them. We revise the beginning and middle of a story in the light of the end. But those outcomes are often less in our control than we like to think – had I not had a slightly strange physiology or been referred to the specialist at the right time, you wouldn’t be reading this. Had Nowak been stabbed in slightly different locations, you wouldn’t be reading it either.
We can try to reduce the impact of luck, but we can never entirely eliminate it. When things go wrong, we should review them to try to prevent them going wrong in the same way in the future. But there is a danger in thinking that because few things go wrong, nothing should and it is a failure when they do. The first time we meet perfection will be when we get to Heaven. Blaming is just as human as erring and just as understandable, but not always as reasonable.
That’s easy for me to say, of course. My appendix may no longer be here, but I am.
Stewart Slater works in Finance. He is now also on Substack, where you are welcome to follow him.
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With respect to Stewart, I think he completely misses the “lesson” of Henry Nowak’s death despite penning the following sentences:
“When the Police arrived, they knew there had been an accusation of racial abuse. They were primed to look for it.”
If I could work out how to do so, I’d have put that second sentence in bold type, underlined and italicised. That the police were “primed to look for [racism]” when called to an assault/stabbing, is THE major problem. And it’s not just the police who’ve been primed to place alleged racism in the “absolute truth” category – it’s now established in the culture of the UK that white people are racist and if there is an issue of any kind, with people of colour on one side and whites on the other, the whites are automatically in the wrong and should plead guilty as a matter of course.
Stewart’s entire article is based on the false belief that the issue of Henry’s death is nothing more than the fact that the police, like the rest of us, like Stewart’s doctor, make mistakes. That is NOT the issue.
The police didn’t make a mistake. They enacted policy. And just like that other crackpot policy – that if a woman accuses a man of sexual assault, she must be believed – this policy of assuming white people are murderous racists is what brought about Henry’s death.
The policy is unlikely to change because this belief has been deliberately embedded in minds and hearts by those in positions of political and psychological power. It’s shameful.