Friday 30 March 2012

I need to start taking life with a pinch of salt and a shot of tequila


The patient was a middle-aged woman,with a thin lipped,sun burnt face, nicotine-stained fingers, and was dressed in several layers of clothes, some formal and clearly expensive,some casual and clearly cheap, some clean, some dirty;she had a pashmina draped around her thin hunched shoulders, and a bright silk scarf wrapped around her head.She had over 20 metal bangles on her right wrist and her left arm was in an improvised sling.
She had moved around the waiting room ,picking up discarded newspapers ,talking to-, and generally annoying-,other patients whilst waiting to see me.

She came in complaining of pain and reduced movement to her left shoulder...she said that she had been taking her doberman for a walk and that he got excited and pulled her over.
She was however unsure as to exactly when the accident had happened although she thought it was probably this year...
...if it was still 2001...
...looking at the bruising on her shoulder I guessed it was about 3 days before she came to see me...

There is a phrase we write in the notes which says..."patient is 'unable/unwilling' to take her shoulder through ANY Range of Movement" which other health professionals knows is code for "take a deep breath...this patient is going to jerk you around...waste your time...like she wasted mine...and she is unwilling to take any responsibility for anything to do with her current or future health."

After a full and frustrating consultation with the ever vigilant Julian patting the sweat off of my fevered forehead,I decided to simply x-ray her shoulder and save myself a heart attack...
...in fairness , it was swollen and bruised and warm to the touch and she screamed when I tried to passively take her shoulder through its range-of-movement.

About an hour later I noticed that she still hadn't returned from the radiology department...
...and eating only my fifth bar of chocolate of the day I wandered down to see if she was still alive or if she had perhaps absconded...
...when I bumped into 'Samhuael-from-radiology-MSc', the duty radiographer.

Apart from the fact that he seems to subside on a diet of carrots, black tea and loud gospel music, he is best known for being officially the worlds slowest radiographer...there is always that 'heartsink' moment when you get to work and find he is covering the floor that evening.

His films are of an excellent quality...but in fairness they should be because it can take him 30 minutes to shoot one plain view of an ankle.
It would be quicker if he painted the picture!

(What I do need to say , for the purposes of the story ,is that he is Nigerian...)

So I found him in the little processing booth adjacent to the radiology waiting room, where my patient was terrorising a student with a potentially broken wrist...
...still...the student had irritated me so much with his stupid haircut that I wasn't too bothered...

"Samhuael...whats happening...have you been able to do that shoulder for me?"

Yes Lucien...Eish...it was difficult...that woman, she was not co-operating you know....

"Jah...I know...tell me...did you see anything interesting?"

No....I think it is okay...

"Good...thank you Samhuael"

I turned and looked at the patient

"Okay Ma'am...if you'd like to come back with me , we'll go and have a look at your shoulder on my x-ray viewer..."

She stood up slowly, painfully, gathered her bags and papers and started to follow me down the passage...

She stopped opposite Samhuael and held out her hand to shake his...
...he looked surprised...

Muchas gracias she said, shaking his hand vigorously

Samhuael looked at her...
I looked at her...

"I beg your pardon Ma'am...what did you just say?"

Muchas gracias....she looked at me like I was mad.

"Ummm...why are you speaking Spanish?"

Well...I'm just being polite and talking to the Mexican man in his own language...

"What 'Mexican' man?"

She pointed at Samhuael...Him...

Samhuael looked both nonplussed and offended but had the sense to retreat into the developing booth and close the curtain...

"Ummh...he's not Mexican Ma'am...he's from Nigeria..."

Don't be stupid...I heard you talking to him in Mexican...I was sitting right there...

"Ummm...no...you heard me say 'thank you' in English to him..."

You think I'm stupid don't you...I heard you speaking to the Mexican man in Mexican...I'm not stupid you know...

"Honestly...he's from Nigeria and we were speaking English..."

You're just a quack you are...

(No argument from me there...)

And I'm going to sue you for every penny you have...

Her shoulder wasn't broken.
I phoned the RSPCA about her dog.



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