The last patient on Sunday evening is always a killer...and 14 hours into a shift with the Unholy Trinity of colleagues...all energy-vampires,all loafers...all ugly...I had really just lost the will to live.
It was just one of those days where the volume of patients wasn't particularly taxing and I had faced no real intellectual challenges apart from that of how to heat-up my M&S 'Goan Prawn curry' in a 600W microwave when it only came with directions for a 750W and 800W machine.
So the last patient of the day was a 13 year old boy,overweight and dressed in an ill-fitting football strip who was accompanied by his mother. A dermatologist had removed a suspect mole ,using a wide excision, to his left forearm about 10 days ago ; but the wound had dehisced and was clearly infected, and his temperature was 37.6C.
The pair of them looked poor and truculent which is pretty much the default setting for most of the patients we see in this little corner of heaven on earth...and I was not a little irritated that they had chosen to come into the Unit at 21H25 on a Sunday night.
I introduced myself to the boy...Wayne...and his mother, started the consultation and immediately became aware that the young boy was answering all the questions...including those that were directed to his mother...and that when he didn't know the answer to a question...such as when I asked if his vaccinations were up to date...was speaking loudly...indeed...actually shouting at his mother.
"Really? I thought to myself.As his mother you're happy to sit there and let this kid shout at you and ignore you?"
"And actually...you cant be bothered to get involved in your child's' care?"
As we came to the end of the consultation he was also started to repeat my instructions for further care and management of his wound.
I decided to start him on a course of Flucloxacillin and dress the wound with a mepitel-and-inadine dressing.
I was really irritated by this point and asked 'Sweet Caroline', -(the Health Care Support Worker)-,to do the dressing whilst I finished my notes and dispensed the antibiotics.
Walking back into my room I handed him the Fluclox and asked him if he had any final questions.
He asked me again how often he needed to take the tablets...and repeated the answer to himself.Twice.
In one last attempt to engage with his mother,I asked her if she had any questions...about any aspect of the treatment plan.
Excuse me Nurse...my mum is really deaf...and we can't afford a hearing aid...can you please just face her and speak loudly to her so she can hear you?
And then he patted her on the hand...she looked at him...and smiled...
The Nurse wants to know if you want to ask him anything?
No...she smiled at me. Thank you.I can see you've been very thorough with my boy.
So that's an extra-large helping of humble-pie with the decaff-latte for the nurse in the corner then!!