Upstairs , Downstairs.

Monday morning...a 'Public Holiday' here in the UK...the third day of a long weekend...

...and because our core customer base is poor , most of the town seems to have chosen our waiting room, with its free cold water dispenser, and Sky News, as the place they want to spend their holiday.

I've been thinking of selling postcards and candy floss but our esteemed leader,Blodwyn-from-Wales thought that might be against the spirit of the NHS.

Just before lunch, Granny the Triage Nurse asked me to see a young man who only wanted to be seen by a male nurse.

My heart sank.

Really Granny?

Just before I'm about to eat my 'fuller/longer' spaghetti-and-meatballs ready-meal you saw me pop in the microwave?

Really??

He was 22 years old, with piercings to every visible surface...

...and to some invisible surfaces as I was unfortunately about to discover.

He was pale and spotty with a few scattered hairs on his pale chinny chin chin.

And he was wearing one of those stupid knitted tube hats so beloved of Coldplay devotees.

"Right Sir...what can I do for you today? What great emergency...what catastrophic event...what overwhelming health calamity... brings you to my Unit then?"

Well what it is...obviously...is that my right ball is swollen.

*sigh*

"Uh huh...when did it start to swell?"

Well what it is...obviously...is since when I went through my  puberty at nine, is that every month, for about a week, my right ball swells up....

(Puberty at nine....I don't think soooooooooooo....I'm South African and mine only started at 11!)

"Right...so let me get this correct...every year for the past ,-what-,13 years, your right testicle has swollen up for a week and then settled back to its normal size?"

Yerss...

"Uh huh...and why have you chosen to come to see me today then?"

Well I'm worried about what it could be....

"Uh huh..."

My girlfriend thinks it may be cancer....

"Uh huh..."

So can you do an x-ray or something...?

"No...Alas...What I can do...and legally must do I suppose...is to examine your testicles..."

*sigh*

Wot...now?

"Jah...now"

*oh happy day*

He stood up and dropped his already low-hanging jeans and displayed 'Mickey Mouse' fake silk boxers...

I sat there in front of him, put on a surgical mask, sighed, slapped on two pairs of gloves and stared to examine him.

Really...this is what my life is reduced too...?

Here I am in my early forties sitting in downtown Armpit , England handling the testicles of a complete stranger...

...okay...in my late forties...

...okay...in my early fifties...

...okay...at 56!!!

There was nothing to find.

"Okay...have you ever had a sexually transmitted disease?"

No...

"Are you in a monogamous relationship?"

What does that mean...?

"Are you only having sex with your girlfriend?"

Oh....yes

"Okay...I need to check your temperature and then I need you to give me a urine sample so that I can test it...Okay?"

I gave him the container and showed him the toilet , which is about 10 meters from my office.

"Okay....I just need a few millilitres...just come back to my office when you're finished."

He nodded and walked to the toilet.

I sat  and sipped my coffee and caught up on some notes.

I had some more coffee and finished a second set of notes.

I rooted around in the disaster cupboard for some digestive biscuits and dunked a few in the remains of my coffee.

I finished a third set of notes.

Fifteen minutes had elapsed.

I walked down to the toilet and knocked on the door...

"Yo...buddy...is everything okay in there...?"

Yerss...I'm okay

He sounded breathless .

"You've been in there for 15 minutes...how long does it take you to have a pee? I only need a little bit of urine to test..."

Urine....?

"Jah...urine...what did you think I said?"

Hummmm...sperm...?

*take me now Lord, take me now*

I referred him to the urologist...

...and the audiologist.

In which I proudly unveil a new syndrome....

The patient was a middle aged man with no teeth , thinning hair, big ears , a squint and an inexplicably attractive wife.

He came in complaining of neck-, and back-pain and stiffness.

He reported that he had tried to get out of his car quickly because he was excited to see his wife (go figure!!) and that in doing so, as he levered himself up and out of the front seat, that he had "heard something go 'crack' in his back".

He came walking in like C3PO from Star Wars....head erect and not moving on his neck...his upper arms tucked in  and braced against his ribs...forearms and hands stuck out at right angles...and was turning his whole body around to talk to me.

He was also walking like he had a carrot up his bottom.

A large carrot.

A small bottom.

He sat down holding his upper body absolutely still.

His wife had to take his shoes and socks off as he told me that he couldn't bend forward.

As I asked him questions he swivelled on his seat to talk to me....and then swivelled back to face his wife...all the while keeping his upper body immobile.

I very  quickly established that there was nothing seriously wrong with him.

And of course he had not taken any analgesia...and had refused Shuffling Bob's kind offer of mega doses of codeine.

"Right Sir...well...I'm afraid that you have a positive 'Star Wars' sign...."

Is that bad...?

"Well...your C3PO test was positive so we need to be careful..."

Orright...what do you mean...?

"Your are an arse Sir..."

Did you just call me an arse...?

Yerrr....did you just call him an arse...?

"No....I said...'you have ARSS...Sir..."

Oh...what does that mean...?

" 'Acute Robotic Stance Syndrome'"

Is it bad...?

"No...it just  means that you longer you walk around like C3PO did in Star Wars...holding your body all stiff and tense...then the longer you will have pain in your neck and shoulders and back..."

Oh...but its painful to move....

"I know...but it could be worse."

How could it be worse...?

"It could be my back..."

So what can I do for the pain...?

"Well...for a start...'don't underestimate the power of the force' ...of the pain killers!"

And the winner of the 'Sunday "say what?" ' prize is...

In third place was the 19 year old unemployed man who had punched a wall...in anger...he thinks...

"So...do you have any medical problems at all?"

No

"Do you take any medicines on a daily basis, for any reason, medical or otherwise?"

Just the marijuana...

"Oh...okay...what do you take that for...pain management? Glaucoma?"

No medical reason mate...I just like it...

And in second place was a charming old chap with a head injury...well he started off charming...

"Right Sir...do you know the name of the Prime Minister?"

Which one...?

"The current Prime Minister?"

Yes...

"Well who is it...?"

You asked me if I knew who it was....you didn't ask me to tell you who it was...!

I couldn't argue with him.

And the winner is the 23 year old woman who had injured her back getting out of bed....she thought...and who told Shuffling Bob that she couldn't walk....had no sensation in her legs...but that her legs were painful.

She had of course walked completely unaided into my room....and every time I touched her she complained of pain to her 'numb' legs which 'had lost all feeling'

"Right....there are just some 'red flag' questions I need to ask you then....I need to know if you have any 'saddle anaesthesia'...

Okay....

"So....are you experiencing any numbness or tingling to your perineum?"

Yerss....its completely numb but sometimes its tingling....

"Really....numb and tingling?"

Yerss...numb and tingling....

( The next step would be to check her anal tone...by sticking my finger where it didn't really want to go for all sorts of reasons but not least though because ChakalakaCindy's mother is visiting her and she had brought some vetkoek with curry mince in for my lunch.)

"Are you absolutely sure that your perineum is numb?"

Yerss...

*sigh*

By the way....where is my perineum...?

Its right next to the sign that says 'Exit'.

In which life truly does imitate art...

It had been a very pleasant day...

Good staff mix, some interesting cases, some funny children.

Just before 5, 'Granny' the Triage Nurse came into my room and asked if I could see a patient immediately.

The admissions clerk had apparently mislaid the patients paperwork and he had been sitting in the waiting room for 2 hours watching other patients being taken in and treated ahead of him...although he hadn't complained.

Mind you he was snoring gently when I went to call him.

I walked to the door and called out his name...

"Mr Royale? Mr Kir Royale?"

A dishevelled looking man , with a sun burnt face and a happy smile stood up...he was holding his left shoulder very still with his right hand...

Here doc...

A wave of stale beer, pickled eggs, and baked beans with just a tiny hint of urine wafted towards me.

He followed me through to my room as I apologised for the delay in treating him.

"Right Sir...again, apologies for the delay in seeing you...what can i do for you today then?"

Well what it is...obviously...is that we were pulling a big TV through a door and I heard something go 'crack' / 'crack / 'crack' in my arm .

"Uh huh..."

Well...its too painful to move now...

"Have you taken anything for the pain?"

No...I thought I should just come straight here...

"Okay....would you like something for the pain?"

Nah mate....I'm orright...

"Okay...can you move your arm or shoulder at all?"

No...I can"t move it and it hurts a lot...

"Uh huh...okay...well I need to examine you...could you please just take your t-shirt off?"

Orright mate...

...and he stood up , raised both of his hands above his head and easily pulled  it up and over his head.

So...full range of movement then...and with no apparent pain or discomfort!

"Okay...pop your t-shirt back on and have a seat....i just need to scribble some notes..."

Orright mate...

"So...what work do you do then?"

Work?...I don't work mate...

"Okay...are you married? Do you live with anyone?"

Nah...I 'm divorced....I live alone...

"Okay..."

Mind you, she stills shags me....

I raised an eyebrow...

...and started to scribble my notes.

Boerewors...

"I beg your pardon...?"

Boerewors...that's what you South Africans eat isn't it...?

"Jah...amongst other things of course..."

Yeh...I had a friend who was from Durban and he used to talk about boerewors...

"Uh huh..."

I continued to scribble....

Yeh....that's why me ex-wife still shags me...he grinned.

"I beg your pardon?"

Well you should see the size of my boerewors...he laughed, pointing at his groin, just in case I had missed his delicate and flowery literary allusion.

"Oy!!"

I rested my head against on my desk.

"Julian....JULIAN!!"

Yes Lucien?

"Please get me a double espresso and a large kit-kat before I kill myself!"

Oh...are "we" having 'one of those days' then?

"'We'?...no...'me'....I'm having one of those careers!".

The patient was still laughing at his Wildean wit.

(And yes dear reader, its all true...)

(Alas!!)

I can see clearly now...

A typical British summer Sunday evening...cold, dark and raining...

...and so I was irritated to see a man sitting in the waiting room wearing sunglasses...

...of the many,  many,-indeed many-,things that irritate me, wearing hats and sunglasses inside a building are two of my worst things...

But I was busy with a sick child and the next time I saw him he was lying on a bed in a treatment room with my lovely son , aka "The Monkey King", who was doing a shift as a Health Care Support Worker, and who was cleaning some grazes to the patients knees.

Being nosey, I stuck my head in the door...

"Hey Rowan...whats happening?"

'Yo Lucien...('cos he doesn't call me 'dad' at work)...this gentleman fell off of his bicycle after hitting something in the road...and he has lots of grazes to his knees and hands and elbows...I'm just cleaning them and picking out the biggest bits of gravel...'

"Sweet..."

I looked at the patient more closely.

"Can I ask you... (because I am soooooooooooo irritated that you are wearing sunglasses at 21h20 inside a room with no windows )...why are you wearing sunglasses? Do you have an eye infection?"

Well what it is,  piped up his girlfriend, is that he is partially sighted...that's why he wears the sunglasses...

Rowan looked at me...

I looked back at him...

We both looked at the patient.

I couldn't see if he was looking back at us because the sunglasses were really dark.

"Right.....So....you're partially sighted and you usually wear sunglasses?"

Yerss...

"And you were riding a bicycle wearing the sunglasses?"

Yerss...

"In the dark and in the rain?"

Yerss...

"So you're partially sighted...and wear sunglasses...in the dark and the rain...?"

Well he's not allowed to drive a car is he...!!! He can't see properly!!!

"Right"

"Did you see what it was that you hit in the road?"

No...it was too dark...

Rowan looked at me...

I looked back at him...

We both looked at the patient.

I couldn't see if he was looking back at us because the sunglasses were really dark.

Really dark.

"Excuse me..."

I went to my room and printed off some forms.

"I wonder if you can just sign this form please Sir..."

Whats it for...?

"Your application to be considered for the Darwin Awards..."

London Pride

I have to be honest and say that I am very glad that the Olympics are over....

I think they are a waste of money and have become (in the words of AA Gill) "a quadrennial television series, that have grown as television has grown.Before the 1960's, they were sports meetings you read about or might have seen on a bit of flickering newsreel a month later."

Really - who cares?

However...it would be petty and small minded of me not to acknowledge and pay homage to-, the soldiers, sailors, airmen and marines who,-as always-, just stepped up and quietly and efficiently got on with their work.

And also , a word of thanks to all the volunteers...

I.M.H.O., this  is the song that should have ended the games...

(And if you have no idea of who The Master is, or you have never heard this song,then I hope you enjoy it...actually I don't really care....I enjoy his music)