Tuesday, 21 February 2012

Thumbs, nails and hospitals

Wed Feb 15, late afternoon. Ouch. My right thumb is stinging a little. But it looks fine.

The ouch lengthens along with the evening.

More throbbing than sleeping through the night.

7.25 the alarm fulfils its purpose what seems like minutes after I fall asleep.

The thumb hurts. and looks a little red. Shirt buttons become a challenge.

I resolve to visit a doctor if it’s no better at the end of the day. But i don’t want to because tonight I’m out for a meal with Tina.

Early afternoon and still throbbing. Redder. A thin white line appearing around the bottom of the nail.

No answer on Tina’s phone so I send a text to say that I can’t make the evening out. Little knowing what is about to unfold.

A lunchtime walk and I phone my daughter Katie.

Low battery bleeps the phone as we chat.

My thumb’s a bit sore. Maybe I should visit a & e (accident & emergency in UK national health service speak.

What? with a sore thumb? I sense her grinning.

I buy a snack. Partly because I am hungry. Partly to get change for the hospital car park. just in case.

Mid afternoon a text from Tina ... let me know how you are when you get back

17.45 and it’s very red. And the thin white line is no longer so thin.

A&E seems over the top, but I drive close by the NHS walk-in centre at Upton park hospital. An earlier few minutes with Google told me it’s open until 20.00.

Left at the lights instead of the usual straight on.

The pay and display meter says parking is free after 18.00 and it’s past 18.15. small mercies.

The doors open and in I walk.

OMG ... there are loads and loads of people here.

I multiply the number of people by an optimistic 10 minutes and come up with something later than 20.00.

I wave my thumb at the receptionist.

We aren’t making any new appointments tonight. But the triage nurse will see you and offer advice.

Sitting I look around at the people.

All ages and races.

18.35 or so and the triage nurse is looking at my thumb.

That must be painful.

I nod.

name. Date of birth. GP (family doctor). What happened?

I think you should go to A&E tonight.

And so ... Wexham park hospital it is.

A ten minute drive.

The car park isn’t free at any time. But at least there are spaces.

The door opens. Not many people.

I tell the receptionist my date of birth and name. She can work out the rest.

Any existing medical conditions? Taking any medication? Any allergies?

Please take a seat.


You can see the doctor in the urgent care centre. Out the door and left.

I take the folder with me and hunt out the urgent care centre.

About 9 people in the waiting room.

Now there are ten.

But some are together so maybe not really so many.

Almost 19.15 and the nurse at reception calls me over. Takes the red folder. Runs through the litany and confirms everything.

There are four patients ahead of you, so you may need to wait a while.

In my head I’m thinking ... well ... maybe 20.00?

The doctor calls people out. They come back and sit around again.

Two young guys and a girl. One of the guys goes with the doctor.

A few minutes later he gets back ... has to go for an x-ray and come back.

They disappear.

I wait.

Thumb quietly throbs.

Redder. Whiter.

They arrive back.

19.45 and there are still 4 people ahead of me.

Everyone looks well happy says the x-rayed man.

Everyone smiles and looks well happy for a few seconds.

The hand on the wall clock moves ever onwards.

The girl sitting across to the left has nicely painted red nails and nice black heeled shoes. I notice things like that these days.

Two middle aged people arrive.

Then two younger people. She has nails that are a lovely shade of pink. Flat shoes. Nice black lace ribbon near the toes.

The nurse calls them each in turn.

The sign reads patients might not be seen in the same order that they arrive.

20.40 ...  and my name is called. I wasn’t expecting to be called before the red-nailed lady.

The doctor shakes hands and then notices I was actually offering my thumb as an exhibit.

The litany again. Name, date of birth ....

That looks painful.

I nod.

Smiling to myself ... maybe I could be a doctor?

It needs cleaning out and antibiotics.

Will it stop hurting after that? I ask.

He reassures me.

Follow me.

I follow him.

Retracing steps back to A&E.

The place is crowded.

Take a seat.


Minutes later he comes back in and takes me to the inner sanctum.

I sit in a cubicle. No need for the curtains to be drawn.

He gets a nurse and exhibits my thumb. And explains what is needed.

They disappear.

I wait.

The cubicle has seen better days.

The floor needs sweeping.

MIAMI patients only says the sign on the wall.

I have no idea what a MIAMI means. Except I’m sure it has nothing to do with Miami.

I sit and wait.

Opposite a man laying on a bed asks no one in particular why he is being ignored and calls at passing nurses.

Once in a while someone asks him what he wants.

A drink.

But he is categorised as nil by mouth. So he gets no water.

But keeps on asking.

I look at the signs.

Everyone should have a GP.

Curtain closed? Think! Privacy and dignity.

A twenty-something  girl in another cubicle has blonde, green and brown hair.

The nurse visits with another nurse and exhibits my thumb. They smile but say nothing to me.

It feels like being a Franz Kafka kind of character.

A doctor arrives.

We repeat the litany.

He look as at my exhibit.

And mentions infection. Intravenous antibiotics. Overnight stay. Plastics. Drainage. Thumb nail removal. X-rays. Bone infection.

I take the yellow sheet of paper and follow the blue squares in the floor.

Another receptionist. I hand over the sheet and confirm my identity.

I take a seat and wait.

The thirsty man is wheeled in to the x-ray room.

Moments later he reappears.

A young guy takes his turn.

Then, just a few minutes later it’s me.

I make a ducks head sort of shape with mu hand. The red light lines up on my thumb.


Reshape my hand. Line up.


I follow the blue squares back towards A&E.

The thirsty man seems to be no longer nil by mouth.

I take a seat.

21.08 my phone rings. It’ Katie.

Low battery beeps.

I explain where I am.  We talk.

The doctor arrives so I have to say goodbye.

He escorts me back to MIAMI.

Spreads paper towelling onto the trolley bed and asks me to lie down.

The girl with the coloured hair is still opposite.

The no longer thirsty man.

An elderly lady who cries out occasionally.

I wait.

Receiving health care involves patience.

A single strand of cobweb dangles loosely from the ceiling.

There’s a hole in the wall blocked up with some temporary filler.

Time passes.

I phone Katie.

my phone tells  me it needs feeding.

I think of the cats at home.

The doctor returns.

Sweater comes off. Right shirt sleeve rolls up.

I know that the sight of my own blood leaking from my body makes my blood pressure drop ... quite dramatically.

I look the other way and hardly feel a thing as the needle penetrates just below the elbow joint.

Moments later he has a phial of red fluid and I have a cannula and intravenous saline.

A nurse comes and mentions ward 3 and then goes.

Another nurse arrives with antibiotics.

Do you have a pen and some paper?

Of course.

Please could you write down a phone number for me?

Before the phone expires on me I read out Sarah’s number so I can at least try from a landline later.

The antibiotics make their way into my vein and I’m asked to sit in a wheelchair and await transportation to Ward 3.

I phone Sarah ... battery needs charging ... she says that she’ll phone A&E.

I sit and wait.

A phone rings. And rings. And rings.

Nurses and doctors busily move around.

The phone rings. And rings. And rings.

And rings. And rings.

And no one answers.

I’m wheeled along to Ward 3, though I would have been happy to walk.

Ward 3 is fairly quiet at this time of night. A bed is being prepared for me as I wait in the chair.

Name ... date of birth ...

Can I use the phone?

Well ...

A patient says I’m welcome to use his mobile ... but there’s no signal.

I use the landline.

Sarah phones back and I explain what’s happening.

The bed is ready so I’m escorted to bed 11 in Ward 2 SS (short stay).

The man in bed 10 nods hello. Everyone else is asleep.

Actually there are only 4 beds on this side of the ward and one of them is empty.

The thought of car parking fees crosses my mind ... but I’ll worry about that tomorrow.

Pyjamas. The nurse disappears a moment and hands me some. The bottoms and tops don’t match ... but I’m not too worried about that ... if I’d had a handbag with me though who knows J

The curtains close and I begin to get changed.

My toe nails are polished red. And the floor is cold.

I’m not worried about the red nails. If people ask questions then I’m happy to share the answers. Having said that ... I’m also aware that my red nails might cause people heartache ... so I keep my socks on ... if asked to take them off then people will get to see my nails without me forcing the sight upon them.

The nurse arrives back. Katie’s on the phone. We chat a while then back to the bed.

Some pain killers. A wrist band with my name, NHS number, hospital number, date of birth ... A sling so I can have my arm up in the air while I sleep.

Sleep ... a little restless but not bad.

5:30 or so and lights go on.

Antibiotics time.

The nurse wonders why on earth the cannula is on the same arm as the infected thumb. It would have been a lot easier to not have to unhook the sling and take it off.

A new patient arrives in bed 9.

Bed 10 chats a bit with bed 12 as medications are passed round the ward.

6:30 and breakfast orders. I opt for toast and coffee. Bed 11 wonders about a full English, but settles for cereal.

It arrives at about 7:00 with marmalade.

The beds are made.

How are you today? says one nurse to the other.

Comme ci comme ça.

Ahh .. Parlez vous Français

Well ... no.

A man from plastic surgery comes to say hello.

The nail’s going to have to go. It’ll happen in the operating theatre. Local anaesthetic ... injections here and here. An arrow is drawn in my arm ... thick black ink ... pointing towards the problem thumb. Makes me smile. Only an idiot would take of the wrong thumb nail. And I’ll be awake as well. I might need to stay the night in hospital.

8:55 ... can I use the phone to call work? No problem.

A colleague of the man from plastics looks at my thumb. Probably won’t need to stay the night in hospital.

Sitting in the chair at the side of the bed.

Chatting a little.

Bed 10 thinks the sling looks a little like a piece of armour from a star wars storm trooper.

One of the nurses is from Mauritius and does parlez Français. He explains that about half the people in Mauritius support Manchester United. The other half go for Liverpool.

The other patients on the ward are older than I am, and all I have is a sore thumb.

I know that if left untreated the thumb could develop into a debilitating thing and could get quite serious. But I expect it to get better. And I don’t have a problem in getting out of bed, or walking, or passing urine.

Hospitals are sobering places. Especially with age. Sometimes the passing of time brings good things. But in the shadows lurk things that aren’t so good.

Time passes.

Consent forms to sign with an explanation of risks and benefits.

A nurse arrives with a 2 nighties ... can’t wear PJ’s in the operating theatre. I put one on the front and another at the back so my modesty can be preserved J

11: 20 and the trolley bed arrives.

Can I manage it by myself? I do.

The porter pushes the trolley and we’re accompanied by the nurse from Mauritius who admires my sling ... its purple ... wow .. if you don’t like the surgeon ... wow ... especially if he’s a Liverpool supporter. As well as being purple it’s also made of foam ... so I decide not to use it as a weapon.

The sign on the door says we can’t get through ... so we take a detour.

At the entrance to the theatre ... name ... date of birth ... do I have a black arrow?

I need a pee ... and I’m escorted to the loo.

Back onto the trolley.

The surgeon arrives and tells me all about me.

And explains what he’s going to do and why.

Maybe I’ll have to spend the night in hospital.

The anaesthetist arrives.

I look the other way as the needle does it’s work.

The trolley is wheeled in.

Paperwork is checked and corrected.

They wonder why the cannula isn’t on the other arm. And also the wrist identity strap.

The cannula stays. The strap is cut off and fastened to my other wrist.

Stuff is painted on my hand.

I look the other way.

The anaesthetist offers to distract me and we chat as the work begins.

Let us know if it hurts.

I promise to let them know.

It’s an odd feeling ... I can feel pulling and cutting ... but it doesn’t hurt.

We talk about Frankfurt, skiing, snowboarding and the fact that we’ve both fainted at the sight of our own blood.

It’s done ... and I’m invited ... recommended ... to look at the results.

Thumb ... no nail.

Raw and red. But surreal. It looks as though it should be hurting.

The infection was at the point where the nail grows. They expect it to grow again ... but maybe not quite the way it used to. I’ll have to wait and see on that one.

Bandages and sticking plaster.

I don’t need to stay the night ... but need to call in on Monday to get it checked out.

If I feel feverish or it hurts a lot over the weekend I need to get back to the A&E department. The surgeon is on call and says he’ll head straight back to check it out.

Wheeled to the recovery room.

The nurse there says I look familiar.

Another chats. We talk about the thumb and how it might have got infected. He mentions that computer keyboards can harbour a lot of nasty things. And that some research had discovered nastier things lurking on the top of cans of soft drinks than are found in the average toilets.

The first nurse goes hunting for the paperwork.

In the background I hear her phoning ward 3 asking if they are expecting me back.

I hope they are. They’ve got my clothes. And my wallet.

I lay on the trolley. Legs crossed.

Sorry ... I’ll have to ask you to uncross your legs whilst your here. Blood clots.

I uncross my legs.

Another porter and another nurse to accompany me back to Ward 3 SS.

The door is closed. The porter manages to open it. The sign ... visible only from the other side ... says the door isn’t working and to take a detour.

Which bed? Asks the porter.

Probably the empty one smiles the nurse.

That’s the one I came from say I.

Lunch is a baked potato, cheese and baked beans. Ice cream. Coffee.

More antibiotics.

Visiting time ... and I’m pleasantly surprised when Katie walks in. I had no idea she’d be visiting.

The cannula is removed and strip of gauze taped over where it was.

I’m good to go ... with my pack of antibiotics and pain killers and appointment card for Monday.

The nurse says that security will let me out of the car park for free.

And there we go.

I haven’t needed the pain killers. Still taking the antibiotics. And on Monday things were looking good.

All in all ...

The waiting was sometimes tedious ... but never very long really.

Everyone was helpful and courteous.

Lots of people were friendly.

Everyone helpful.

Some people need to be better at answering telephones.

It’s interesting how difficult it is to know what might happen next ... it changes as time passes. But I guess that’s actually a good thing.

It’s nice that at no time did I have to think about insurance or costs.

People seemed efficient ... and the process actually went quickly and smoothly all things considered.

The food is unexciting. But ... I have no complaints.

The nail ... I’ll let you know about that.

And finally, some possibilities for the meaning of MIAMI:

  • MIAMI Money Is A Major Issue (music CD) 
  • MIAMI Metoprolol in Acute Myocardial Infarction 
  • MIAMI Marrow Isolated Adult Multilineage Inducible (biology; cells) 
  • MIAMI Microwave Ice Accretion Measurement Instrument 
  • MIAMI Modem-Based Internet for Amiga (TCP/IP implementation for Amiga) 
  • MIAMI Mafia Is After Me! I...

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