A patient said to to me the other day that he liked the relaxed, informal and yet thorough approach that we strive for in the Unit...I reassured him that whilst we were friendly and tried to be approachable and non-patronising, we were never complacent or smug...virtually every day I have to go home and read up on something new...or something I have forgotten!!
We work within a post-modern model of care , in which the patient is asked to 'narrate' the story of their illness or injury...in their own words and within the context of their understanding of the world...without interruption...well...thats the theory anyway.
Of course,since we are a Minor Illness and Injury Unit,we should seldom need to do more than find out out much our patients had to drink before they fell over and broke their wrists!!
But in fact we often get complex and difficult cases...about which I know nothing...nothing I tell you !! Nothing !!
So...sunday then...a warm morning and ten patients were waiting before we even opened for business...
The first patient was a middle aged woman who had hemorrhoids for 20 years and wanted them checked...for rust I suppose...
The second patient had a weird fungal rash on his foreskin...which he had had for six years...
The third patient had an outer ear infection...'swimmers ear'...that had started when he was on holiday in Greece the week before...but of course he hadn't wanted to go to a Greek hospital because it was full of foreigners...as you would expect I suppose...and so he waited...in pain...until he got safely home where he saw a foreigner anyway!
The fourth patient was a PFO with a wrist injury who in fairness asked for a referral to the alcohol intervention team...
And then it got interesting...
The next patient was a baby with a straight forward viral infection but who has a Möbius disorder.Lovely baby,lovely but stressed parents.
(It is an extremely rare congenital neurological disorder which is characterized by facial paralysis and an inability to move the eyes from side to side. Most people with Möbius syndrome are born with complete facial paralysis, which means they cannot close their eyes or form facial expressions.)
And then it got even more interesting...
My next patient was a five month old baby who I had heard crying in the waiting room with that high pitched two-tone keen so often associated with odd children.
He had been brought in by his foster mother,-he had been abandoned at birth-,because he had been crying continually for 24 hours...and wasn't taking any feeds.
He had a shock of thick black hair ...like he was wearing a Beatles wig...and looked like a little wizened man.
His foster mother had only had him for a few days and hadn't yet got hooked up with a paediatrician...
She told me that he had a Trisomy 4P disorder...and she has been told that there are only 70 children in the world with this disorder...
Its so rare that even Wikipedia doesn't have an entry for it!!
( Symptoms and physical findings may vary greatly in range and severity from case to case,but many affected infants may have feeding and breathing difficulties, characteristic malformations of the head and facial area, and abnormalities of the hands and feet. Additional features may include other skeletal defects, genital abnormalities in affected males, or heart defects and is also characterized by severe mental retardation.)
I had never heard of this disorder but thankfully Google had...and I didn't really know what to do...but I know how to use a telephone and page a paediatrician and get an urgent referral...which is what I did...
So much for working in a Minor Injuries Unit then...
never a dull moment hey? if a parent came in telling me their child had mobius disorder, i would have to quietly excuse myself for about 10 minutes to go and google it! anyway, at least it makes life interesting. nice photo by the way, of the swine flu mask. very stylish...
ReplyDeletealamp cannot burn wiithout oil
ReplyDeleteAny juicy stories from your days in joburg??/
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