Yesterday was my last day on the Orthophaedic service. Today I begin four months of Surgery.
The little girl cried while the nurse removed her dressings so that we could inspect her wound. Hidden underneath a hip spica cast, her skin graft donor site had gone horribly septic, and we were trying to remedy it.
When I was asked by Figure 1 which one piece of medical equipment I valued above all others, I said “my hearing”. We were taught from the very beginning that a good history was our first step to an accurate diagnosis, and I have always valued a physician who LISTENS: to their patients, their students, their allies, and their contemporaries.
Remember the game we always played? – “If you had to lose one sense, which would it be?”
I thought of my dad, who is blind: when he applied to do an honours degree in Psychology, his application was denied based on the fact that he would not be able to see his client’s faces (ridiculous, really. That was nearly 30 years ago). It had me thinking: what about a blind physician? We have many blind physiotherapists, but surely doctors must SEE… a quick Google search proved me wrong.
Here’s one way I didn’t expect my first day back at work to go:
“Go home! You’re going to make the patients sick!”
Which I suppose makes sense since in the Orthopaedics wards, very few of our patients are actually SICK. They’re mostly just broken. And if they become sick we can’t discharge them and that spells disaster given our already-high patient load.
So here I am, in bed, drugged up on flu meds.
My break in Cape Town was wonderful. I spent time with my little sister and with GeekBoy. We watched West Side Story and ate wonderful food. On two separate occasions I managed to catch up with friends (one from school, another who emigrated to Australia) whom I hadn’t seen in over FIVE YEARS. I also met up with the lovely Lily from Lily Does Medschool.
“Uyagoduka namhlanje!” I say with the biggest smile. You can go home today! It’s one of my favourite things to tell patients. Sometimes I think it’s the only time they ever like me.
And she does smile. The physiotherapist discharged her day one post-op and she wanted to go home so badly, but I felt day one was a bit soon. What can I say: I’m an intern, I’m too careful.
Then she asks, “So what thing did you put in my leg?”
She injured herself playing contact sports and sustained a mean distal femur fracture. I tell her the basics: we put some hardware in her leg to keep the bone together.
And her neighbour, a middle-aged woman, says, “So that means she can get a disability grant.”
Despite my love of clinic days, Orthopaedic Clinic Days are proving extremely demotivating.
On a clinic day we see more than 200 patients. We are an extremely stretched department but we try extremely hard to keep our patients functional. By far the majority of South Africans are reliant on their hands and feet for their daily work, and so it is important that we preserve their ability to make a living. And we make a massive effort to do so.
And yet on clinic days every second patient tells me that they want a Disability Grant. A measly grant that brings 1,1 million South Africans at the most ZAR1,400 (USD112) per month. Hardly a worthy income. Continue reading “Land of the Disability Grant”
GeekBoy is really good at foot massages. You know that good-painful type where one squeezes all the knots from a persons feet.
I discovered this because I needed a foot massage after work today. For some reason I thought it wise to work in heels for close on ten hours.
1. Write neat patient notes (my OT-sister says that means my pencil grip isn’t great. But it is functional. When I have a functioning hand.)
2. Draw blood on a neonate (because of the crab-grip required. Those little premies can be quite powerful when you bring a needle their way.)
3. Carry a heavy textbook with one hand. Then try to catch it. Ouch.
One thing you can (still) do with a broken middle finger: tell people where to get off.
Allow me to just rant about this AGAIN. Different story, same outcome. (I’ve been meaning to write about this for a while, but I wanted to be sure that I passed my exams first. Hah.)
I’m really just looking for an excuse to post this awesome picture. This giraffe is an educational model. It’s big and fluffy and beautiful – I have an affinity for giraffes in part due to my great-grandmother – and also it has a real spine that the orthopods used to teach the students on rotation and also to educate their spine patients.
I kind of hoped that I would be an ortho queen. I just loved the idea of being a tiny woman in a male-dominated specialty (at least, it is in South Africa) and kicking ass at it. I’m sure I’m not the only person with those kinds of bad-ass dreams. Continue reading “Reflections on Orthopaedics”