I'm not really sure when or why it became a normal practice to take your family and friends with you when you needed to seek emergency medical attention in the ER .
I admit that there have been a few occasions when I have had to phone a friend to fetch me from hospital ,after a night out with my good friends Johnny , Jack and Jim ,when I have found myself unexpectedly having to use crutches.
I suppose that I can understand why a teenager requesting the Morning-After-Pill would want a gaggle of her girlfriends with her if her greasy,pimply boyfriend didn't have the courage to keep her company when he had sobered up the following morning...and I understand that if you're playing a contact sport and get injured that your teammates will want to accompany you to provide moral support and to make sure that you don't cry...and to laugh at you if you do.
But why would you get your mummy and daddy to bring you to hospital if you're 25 and your girlfriend has just punched you in the face and broken your nose because she has found out that you are cheating on her?
Why would you insist that your 16 year old daughter stay with you when I am trying to take a history and examine you after your drunk abusive "boyfriend" has, -yet again-, beaten you?
And so...our waiting area is often packed to bursting,looking like a casting call for Britain's Got No Talent-Welcome to the Dole...and it used to be very disheartening until we realised that most of the people were simply supporters, and not actual patients.
Looking out into the waiting room on Sunday,I saw that a group of nine adults and four children had colonised one end of the room and appeared to be having a picnic...there were sandwiches,packets of crisps,bars of chocolate and bottles of Coke !
Now our waiting area is very clean and tastefully appointed with posters advertising the clap clinic and abortion services...but really...there is a park just around the corner and the beach is only a mile away...our Unit looks out onto a soulless concrete parking lot with a grave-yard across the road...its not as if they are going to see a herd of wildebeest sweeping majestically across some African Savannah...
The adults were in their late teens and early twenties...all of them had clearly shopped at the 'Cheap Chinese Clothes for Ugly People Sweat Shop' ...and they only possessed 27 teeth between the nine of them. At a guess...correct as it transpired...only one of them actually had a job...the rest were on benefits of one sort or another.
The first member of the group I saw was a pretty young woman,with a tight little vacant smile, who was accompanied by the ubiquitous loud-mouthed and opinionated single fat girl of the group,who was bulging out of her tiny (sweaty and grubby) tank top and shorts...
(Note to self: reconsider the whole vegetarian thing!)
"Good afternoon...what can I do for you today then?"
The vacant girl looked at me and then at her friend.
The friend looked back at her.
Then they both just stared at me as if they were on a school field trip to the zoo and had just caught sight of a blue bottomed baboon for the first time in their life
"I'm sorry...but do you speak English?"
Julian stuck his head through the door...looked at the patient and her friend...looked at me and rolled his eyes...'Yes Lucien...what do you want now?'
"Well...you know that Language Line telephone interpreter service we have...can you please check if they translate 'stupid' ?"
'I'll be right back with a cup of tea and your tablets...alright?'
I looked at the friend..."Do you know why this lady has come here today?"
Its my ear...innit, the patient suddenly replied.It hurts...
"Right...how long has it been hurting you then?"
Two weeks I think...its wet and it smells and I've been sticking cotton wool in it but its not working...
"Uh huh...have you been swimming at all?"
Yes you have , chimed in the friend. You was on holiday in Spain and you said you was swimming in the sea.
Oh...yes...I was swimming in the sea...but not in a swimming pool...just the sea...so that's cleaner isn't it?
She had a straightforward outer ear infection called an otitis externa and I dispensed the appropriate ear drops...
Is that all I'm getting?
"Pretty much...what else did you want?"
Well...its painful...that's why I came in...can't you give me any thing for the pain?
"Well ma'am...you could do with some ibuprofen...which you can get at any shop for about 50 pence...you don't need a prescription...
But I'm a single mum on benefits...and I've just spent all my money in Spain haven't I...how do you expect me to feed my baby?
"Well I'm not sure how much milk you can actually get for 50 pence...but here's an idea...try breastfeeding...or...let me think about this...I could phone the chaplain..."
Its all right for you isn't it...sitting there in your fancy chair....I know my rights...
(Take me now Lord)
Yes dear reader...I gave her the ibuprofen...it was that or face a long and complex interview with a policeman
About an hour later I saw a young man of 21 with an obviously broken right hand,swollen almost to twice the size of his left hand,with marked bruising...and his ring finger was in an unnaturally bent position.
He was polite and co-operative,and self employed as a window cleaner.He told me that he had been on holiday in Spain and that last Sunday...a week ago...in the bar...that he had tried his hand on a punch-bag machine but that he was so drunk that he missed the bag and hit the metal machine casing instead...his girlfriend didn't think that it was broken...he did...but he couldn't afford to go to hospital because he hadn't taken out any insurance.
And a previous girlfriend had stolen his European Health card...
And of course he hadn't come directly to hospital when he got home because he was scared.
Oh...and his girlfriend didn't think that it was broken.
I duly x-rayed his hand and he had a nasty angluated and displaced fracture of his 4th meta-carpal...he was also unable to straighten his ring finger having clearly damaged the extensor tendon.
I emailed the x-rays to St Vulvas where a tired and defeated-sounding hand surgeon agreed to see him later that same evening.
"Right then Sir...my colleague Julian is just going to strap your fingers together,pop you in a sling and we will send you up to St Vulvas where the hand guys will look at you and probably operate tonight or tomorrow morning."
Operate...? Operate...? What do you mean?
"Well...that's a bad fracture...its a week old...you've damaged the tendon and its your dominant hand...so you need to get it sorted out asap..."
So when will I be able to go back to work?
"I'm not sure...but probably not for a week or two at the earliest...it depends on what the surgeons do...you'll need to talk to them...I'm sorry."
Can I bring my partner in...can you tell her as well?
Two minutes later he returned accompanied by his partner...otitis externa girl!!!
She looked at me...I looked at her...
"Here's some free advice Sir...don't buy any lottery tickets."