Saturday 24 November 2007

Foot Notes (and the Joys of Exploring the NHS)

I recently had the joy of experiencing a hospital as an outpatient, pleased that I only had to worry about problems with my feet, which would involve no embarrassing stripping or awkward exposure. It didn’t occur to me that I should be a lot more worried since we tend to depend on our feet a fair bit to get around, particularly if, like me, you live in a city, don’t have a car, and walking everywhere is the exercise that prevents you from being the 50-stone person you probably deserve to be.

After a rare visit to my doctor, which in itself seemed like a videogame victory as I managed to get past the complicated appointment booking system and the gatekeeper/receptionist, I was able to choose whether I wanted to attend the MRSA-ridden hospital they’re threatening to close that is regularly on the “worst hospital” lists with reports in local papers of disgusting deposits often found on the floor, or the other hospital they’re threatening to close (I expect our “local” will soon be in South Africa). As you can imagine, I thought long and hard about this tough decision before opting for the latter.

As an American who rarely gets sick, I felt like a lost new kid in school being scolded for wandering in the wrong direction as I was shuffled from clinic to clinic, and my presence was barely acknowledged by people who spoke gobbledygook to me and shoved various forms at me to complete before prodding or scanning me. I quickly realised I was a mere cog on an assembly line, just one of a thousand that would pass before them that day as they busied themselves chatting to each other as colleagues do, and though I was slightly worried about what was going on, they were too busy to adjust their jargon for a layman or be less than frustrated by my inability to know the ropes. I’m not actually criticising the hospital or the NHS; I quickly realised the fault lay with my expectations. Although things weren’t like this when my mother was in hospital in the States, one pays (or one’s insurance pays) a bazillion pounds for those niceties, and frankly my current financial state would have left me unable to investigate this extreme pain if I'd had to cough up a few thousand pounds for the privilege.

My humanity was better recognised once I was pushed into the room where The Actual Consultant, who was treated by all like Deity, was seated, although I wasn’t allowed to approach him directly and was initially shuffled into a nearby cubicle set off by curtains. I was left alone without any instructions and was wondering whether I should be disrobing, but fortunately before I did, I was retrieved as that was merely a holding cell. The nurses and receptionists flurried around HRH The Actual Consultant whilst practically doubled over and retreating backwards, but I’d had no protocol instructions so merely walked toward him in hopes I would not be shot for this disrespect. He had a medical student with him cowering near the floor throughout our interview.

To be fair, HRH The AC was delightful, a rare kind soul in the setting, and had already made a diagnosis from my X-Rays that were displayed on his desk. Unfortunately, he then bombarded me with what seemed to be an entire encyclopaedia’s worth of news spoken in medical lingo about my various problems within all of about two minutes, which seemed to be the maximum time one is allowed with Actual Consultants. It didn’t help that I’m easily distracted, that I was desperately trying to remember the points I’d told myself I must mention, and that he had a thick accent of some sort. Then, as he pointed vaguely to my feet that had been stripped naked, I looked down and was horrified to find them covered with black residue left by my socks that looked like filth spread around my feet and, horribly, lingering in between some toes.

I rarely dress casually but had realised that a skirt/tights arrangement would have involved more embarrassing undressing than whipping off just socks, and I also wanted to wear casual supportive shoes that suggested that I treated my feet better than I do. I did not realise that wearing new black socks would leave my feet looking like a feature in a Cajun recipe, as though I hadn’t washed them for weeks, when honestly I’d scrubbed them as I knew they’d be centre stage (and feet are rather disgusting generally, aren’t they?). So I spent much of my time trying to reach down subtly and brush them off before The AC and student became too judgemental, and I wondered how I could casually work into the conversation an explanation that the black on my feet was cloth residue and I wasn’t Pigpen from Peanuts.

When I returned my focus to HRH The Actual Consultant, I found I had missed loads of important information, just catching the occasional scary bit about having worn down one of my bones, which he pointed out on the X-ray as though it were obvious. I seem to have a disability when interpreting X-rays; I recognised that we were looking at feet, but could tell little more than that. I sensed his frustration at my failure so I nodded encouragingly, which was stupid when discussing my health, as were my misguided attempts to claim that I bravely coped fine with the pain as though it was nothing to worry about.

Somewhere amidst his forays into blaming spinal discs for other problems, HRH used an additional flurry of medical terms whilst pointing vaguely towards my black spotted feet, and I could swear I heard him use the terms “metamorphosis” and “dorsal fin”. Naturally, rather than query this, I disappeared into my mind to ponder that quandary until I found myself being led back into reception by his minders. I was at least relieved that I had not been taken to an operating theatre to have my feet removed, though when the problem gets sufficiently worse, perhaps that will be an option open to HRH the Actual Consultant.

Note to self for next time: take a tape recorder with you, even if you have to secrete it in your handbag like a bootlegger at a concert, but then I could later go through the tremendous amount of important information poured through my ears in such a condensed slot of time and digest it slowly, though that wouldn’t solve the fact that I later thought up a hundred sensible questions I should have asked whilst there (eg, “Do you intend one day to chop off my feet, as your answer will dictate how soon I return to see you.”).

Back at work, my colleagues helped established that what I’d heard as “metamorphosis/dorsal fin” was actually a reference to my worn first metatarsal, which impressed some football fans as it meant I had something in common with Wayne Rooney. Another colleague pointed out that my feet were about three times the age of the rest of me since I’m notorious for walking at such speed that I’m normally just a blur on the horizon.

I have since had time to worry that my “metamorphosis dorsal fin” troubles might mean I can no longer jazz/tap dance on stage, go rock climbing, or sprint around a track at great speed as I did when I was younger. Okay, so I’ve not done those things for about 30 years, but that’s not the point….what if I suddenly wanted to again tomorrow? Right now, I’m busy eating and sitting on the sofa whilst watching Jools Holland on the telly (oh God, is that James Blunt?!? Why must we listen to that unpleasantness and can’t someone drag him to a barber or sheep shearer? Next I expect Jools will introduce Katie Melua and my compounded reaction will be a method of losing weight without troubling my metatarsals to walk, one tried and tested by bulimics though hard on the oesophagus. Sorry, that was unkind; I guess I’m just bitter because I can’t go tap dancing up Ben Nevis tonight as I might have done if I didn’t have such ancient metamorphosising dorsal fins for feet.). Sigh.

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