But I Don’t Want To Have Surgery | On Children and Consent

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.

h9991427_001 Continue reading “But I Don’t Want To Have Surgery | On Children and Consent”

How To Run A Clinic Without A Voice

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.

Blind doctor Albert A. Nast holding his ear to the back of a 3 month old instead of using a stethoscope.
Blind doctor Albert A. Nast holding his ear to the back of a 3 month old instead of using a stethoscope. Image: Time Life. Click for link.

Continue reading “How To Run A Clinic Without A Voice”

I Left My Voice In Cape Town

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.

IMG_5702
Sister, GeekBoy and I at Vovo Telo (awesome bakery!)

Continue reading “I Left My Voice In Cape Town”

Another Disability Grant Request

“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.”

Copyright Faheema Patel 2010, “Human Inside” | Click image for link.

NO. Continue reading “Another Disability Grant Request”

Land of the 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.

Susan Dorothea White, "Right Hand" 2010
Susan Dorothea White, “Right Hand” 2010

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”

Three Things You Can’t Do With A Broken Middle Finger

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.

xray r mid finger Continue reading “Three Things You Can’t Do With A Broken Middle Finger”

Reflections on Orthopaedics

ortho giraffeI’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”