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apatientdoctor

Cornish Pasty

The next part of our "dream vacation" was a trip to Cornwall to meet up with my side of the family including my delightful brand new nephew. After sweating my way through another EasyJet budget flight from Pisa to Luton with some of the worst turbulence I can remember and a transfer through London that completed the holy trinity of planes, trains and automobiles, we were on the road through the green and pleasant countryside. On the trajectory we were on, however, the latest blessing was an extra few hours to appreciate said scenery. Google cheerily predicted a journey time of 3hrs 46 minutes and, as is my wont, I was determined to beat that time. I knew it was optimistic - having studied in London whilst my parents lived next door to Cornwall in Devon I had travelled this route often. Some context for readers. Home is Alberta, Canada - 661,800 km2 (255,522 sq miles), population 4.3 million. The entire United Kingdom is 242,500 km2 (93,630 sq miles), population 66 million. So, averaged out, in each square kilometer in Alberta there are 6 people. In each square kilometer in the UK, there are 274 people, so the population density in the UK is more than 45 times that of Alberta. Despite this, people here in Alberta complain bitterly about the traffic on the Deerfoot highway through Calgary. I always laugh, when I'm in a good mood.

It was August 2nd, and school holidays were in full swing. Ancient British feudal law states that, on the 3 days per year it isn't raining, that everyone must pack their cars and spend the day in bumper to bumper traffic so that they can spend the next one hundred days or so before the next break in the clouds complaining about that time they tried to get to the beach. Being British, we couldn't feign ignorance of this law and this Friday was indeed sunny, so we spent 10, yes one zero, ten hours in this...


On the plus side, however, we did spend more time viewing Stonehenge from the road than when we actually visited it a few years ago.


Becoming Unhenged

We finally arrived in beautiful Cornwall late on Friday evening, needing to sit down after a long day of sitting down. Wonderful as it was to meet up with family we hadn't seen in quite some time, my lower abdomen was telling me that it was determined to take the role of black sheep and ruin the family gathering with its pent up anger and bitterness. I tried to shepherd the sheep according to our long established family tradition of pretending nothing is wrong. The pain, intermittent fever and recurrent rapid heart rate and fatigue were telling me a different story however. We were staying in a holiday complex just outside of the town of Looe, ironic given that I was to spend the next two days mostly in the loo. I had no strong compulsion to visit another A&E (accident and emergency) department given my previous experience and by Sunday afternoon had researched which general practice I could present myself to on Monday morning. By this stage of most vacations I have had in the past, my thoughts have turned to getting home, usually from the perspective of how I can possibly put it off, or dreading the desk full of paperwork that inevitably awaits me after a couple of weeks away. This time my thoughts turned to the fact that if I was at home, I probably would be able to pull at least some strings with long term colleagues and maybe be seen and treated a little sooner. I was without those privileges here, thousands of miles from home. Being able to explain things succinctly and in medical-speak with the GP in Looe, along with a quick confirmation that I had a fever, tachycardia and a very tender abdomen did grease the wheels somewhat and in short order, my wife was driving me to Plymouth - the nearest city with a hospital - to the surgical assessment unit.


So far, the plan to avoid A&E was working, but hope soon turned to despair as we found standing room only in the unit and several waiting patients in just as bad or worse shape than me. Several colourful local characters were present but there was no comic relief like in Belfast and the hours dragged by. Waiting, though is made somewhat easier when it is in-your-face-obvious that there are others suffering more than you are. I found myself again with the natural bent of my vocation wanting to do something for the vomiting teenager in the left hand corner curled up in one of three beds moaning and clutching at her right iliac fossa whom I decided had a likely appendicitis and the "fat, female and forty" year old in the opposite corner whom almost certainly had gallstone trouble. Of course I knew there was nothing I could do and instead turned my attention to keeping the conversation with my wife away from medical matters, in case I uttered something that might give away my secret identity and lead to people asking me questions I didn't want to answer.


Eventually though, my turn rolled around and after some more questions, prodding, poking and scanning, another IV cannula was placed in my arm and a bed was found. I was quickly discovering that being a patient-doctor (or is it doctor-patient?) was walking a fine line between knowing what I needed and how I felt, and doing what I was told. Nothing happened as quickly as I would have liked and so I was forced to be, well, patient!

Everything in hospital happens on a schedule. The meal trolley rolls around exactly half an hour after you start considering the nutritional merits of intravenous tubing. By the quality of the food, it also ran on a schedule that meant it took at least three days for the trolley to travel from the kitchen to the surgical unit. The drug trolley appears 5 minutes after you black out from pain, and then you have to wait another 4 hrs after you wake up before the next chance to score some painkillers. The deafening buzzer attached to the wall of your room which abuts the nurses station goes off 30 seconds after you get back to sleep after being woken by the last buzzer. Years of carrying a pager, including several years on the crash team have made me a ridiculously light sleeper and so my sleep routine in Derriford hospital became

1. Fall into deep sleep brought on by exhaustion and stronger-than-paracetamolo-painkillers.

2.Buzzer

3.Wide awake, heart racing, adrenaline pumping

4.Repeat


On the second night however, the routine was interrupted at 4 am with an added feature at step three.

1. Fall into deep sleep brought on by exhaustion and stronger-than-paracetamolo-painkillers.

2.Buzzer

3.Wide awake, heart racing, adrenaline pumping, notice that bedsheets no longer starched and crunchy but wet and sticky.

4.Turn light on to find the following.


5.Spend 5 minutes in drug/fatigue-fuelled consideration of likelihood of menarche at the age of 45, vs necessity of hanging sheets from the hospital window to prove my virginity..

6.Notice, with some relief that underwear is dry and (relatively) clean.

7.Observe that not all the moisture is blood but some clear fluid

8.Finally tumble to realisation that IV cannula is no longer in my arm, but on the floor, along with half a litre of normal saline.

9.Buzzer (this time initiated by me)


As has been my experience through all of my, lets call them adventures, the nursing and medical staff were excellent and my bed and I were cleaned up, showered and recanulated in short order (although those last two were exclusively for me, not my bed) and I was able to restart version one of the sleep routine.

By day 2, I could feel the antibiotics start to work and gradually reached the point where I was able to decline the painkillers I was offered. By 5 o'clock on day 3 I was ready for discharge on oral antibiotics again. However there was a little paperwork to complete. The ubiquitous customer survey had reached Derriford Hospital.



The thought of another night with the buzzer spurred me on to put aside thoughts of hiding the questionnaire in the laundry hamper with the sheets from last night. If this was the deal breaker in the decision to let me out then it was at least worth the ink to fill it out. That didn't mean I had to treat it with anything but the amount of respect that the questions demanded.


And so , still with some pain, and looking a little pale and pasty, I was able to leave the hospital and spend the last few days of vacation with my family, before returning home to Alberta, rested, relaxed and ready to get back to work., or at least that was the plan.

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