I took this picture of myself and couldn’t manage a smile.

One cheek was slightly swollen. My eyes were heavy. The pain had taken over.

That morning, I had an emergency dental appointment as a private patient, because as an NHS patient, my options would have been to wait weeks, call 111, or end up in A&E, one of my least favourite places to visit. I have currently been waiting over four months for an urgent dental procedure caused by my wisdom tooth. The procedure must be done in a hospital setting due to my complex health issues. The wisdom tooth, in its isolation, decided to cut off the blood supply to its neighbouring tooth, which is now decaying and infected.

The issue wasn’t resolved, only temporarily soothed. The decayed tooth, which had been chipping away and slicing my inner cheek and tongue, was filed down. There were a few hours of relief, at the cost of a reduced bank balance. The swelling, bleeding, wounds, and persistent pain remained all on top of the chronic pain I already live with.

When I took this selfie, the local anaesthetic was wearing off and I was exhausted. I couldn’t get my GP to prescribe the antibiotics I needed. The dentist couldn’t issue a prescription because I was seen privately. The GP couldn’t prescribe them either, because the recommendation came from a private clinician. Before I forget, the dentist wanted to file my infected and decayed tooth without local anaesthetic. If you had seen the bombastic side-eye I gave him. I told him, “Absolutely not.”

Back to the antibiotics request, I was told to go back to the dentist or call 111. I wanted to cry, and I did. I do not understand why the system expects me to pay for this prescription when I already have a prescription certificate due to the cocktail of medications I take regularly.

I was in pain, I was tired and my to-do list didn’t stop: unanswered emails, board papers to read, and decisions to prepare for. I felt overwhelmed. 

And I kept thinking: if I, a patient advocate who understands how to navigate this system, feel this crushed by it, what happens to those who don’t?

What happens to someone who:

• can’t afford private care?

• doesn’t speak English fluently?

• lives with disabilities that make communication difficult?

• has no one to advocate for them?

• is in too much pain to advocate for themself?

The system is disjointed. The emotional, physical, and financial costs are always paid by the most vulnerable.

We say the NHS is for everyone. But access is not equity. Navigation should not require privilege.

I carry my lived experience into every boardroom. But that morning, I carried it in my body, swollen, aching, and unseen.