Wednesday, December 12, 2007


A multi-post. I had several good ideas on the way home, again; once again, I appear to have left them on the motorway.

Last night was an odd one. Most Docs and Nurses were living it up at the ED Xmas do. Not me, obviously. The gremlins seemed determined to make the most of our discomfort, and so, for reasons I still do not understand, the temperature in the Dept fell steadily to a nice round 16 degrees (Celsius); or maybe it was 14. The corridors were lovely, toasty warm. But the treatment areas? Cold enough to freeze the balls off a brass monkey.

(Bonus points for any of my dear readers who can suggest the origin of this expression...)

I also began to suspect someone was playing silly buggers with the nitrous, as everyone spent more time than usual giggling. Or maybe I just had something on my face...

The evening ended on a sour note. Another failure.

Young patient. Extensive forensic history, IVDU, epilepsy. Attended as he was having frequent, multiple fits.

But he didn't want treatment; and refused even basic blood tests. He said he had a needle "fixation". I guess he meant that to mean phobia? I'm not sure, but I was cynical enough to note the multiple tattoos, and history of iv drug use.

What he did want was us to "sort my meds out". Not without blood for levels, I countered. No blood he assured me; he was fairly certain I wouldn't find a vein anyway. "I don't even want to be here", he mumbled.

And so I failed him. If I was a better physician, we could, I'm sure, have discussed his fears and desires rationally. Maybe I could have helped. Instead, I got annoyed. Don't wanna be here? Fine. Thanks for stopping, and we'll see you later.

This made him very angry, and he described, among other things as a "no-mark, toffee-nosed prick, who thinks he knows it all just cos he's got a degree off the back of a Cornflakes box."

I'm afraid this made me a little more annoyed. I am well used to people judging me on the strength of my accent. It is particularly... plummy, shall we say. Posh, even. This is not my fault. It is the way I am. I am well spoken, and proud of it. But if you aren't, or your accent doesn't sound like mine? I don't care. It is not who you are. It is how you sound. But to have a go at me, because I am the very thing you have come to see - a well educated, well spoken medical professional? This seems pointless, and despite being used to being the posh boy, I increasingly resent it being used as an insult. After all, I choose not to describe my patient as a "no-mark guttersnipe junkie, who can barely read the back of a Cornflakes box".

So, despite my attempt to reason with him, which probably made things worse - he clearly didn't want to be reminded that to a certain extent, I do know it all, that's why I have my four degrees from Kellogg Uni - our therapeutic relationship was irrevocably soured. And he left.

He did not come back.

But I should have done better by him.


Anonymous said...

don't be too hard on yourself shroom, live and learn eh?

Still, loved the dry wit of your retort (bit of a shame not to have used it, but professional none the less)

Faith Walker said...

Freezing the balls off a brass monkey:

Not sure if its true, but popular folk law says its an old navy term (I know you love that shit), for when the racks that held the cannon balls, which were called "monkeys" would get so cold they would break or crack and the cannon balls would fall off.

But that might be a more recent one, I think the references made were usually to "tails off a brass monkey".

I didnt even have to look that up either!

DrShroom said...

Not sure about tails, but my understanding was as you gave it. The monkey was a triangle, in which cannon balls were stacked, in a pyramid stylee. When made of brass it would contract in cold climes, causing the balls to fall off.


DrShroom said...

Tho actually I suspect it might be a naval urban myth; but they did have powder monkeys, so who knows? I like it anyway...