You Need A Licence To Own A Dog, Right?

There may be ranting following. It may well paint me in an unfavourable light. I apologise.

Some housekeeping first. I have been following my track-backs. So welcome to the fella that found me by searching for "Small Breasts" on Google. And it was on page 6 - so a dedicated pervert?

Also to any of my new occasional readers - those who funk, and those who do not. All are welcome. And to my dedicated core, all 10 of you, I love you too.

For today's random thought: I cannot understand why some drivers, when stopped at traffic lights, make as if to pull away quickly. They creep over the stop line; they edge forward a little at a time. Then the lights change, and they pootle forward at geriatric pace. WHY? If you wanna be Charlie Big-Bollocks (Carlos Grandes-Cojones for the Spanish out there), fair enough. But why show blitz, and then weiner out? I don't get it. Obviously, because I am mature and drive a car that should in no way be construed as a Penis extension, simply pull up at the lights, wait calmly and then burn away as soon as there's a hint of lights changing.

And to tonight. I was called to see a patient, a young girl, who had been discharged, and was unhappy about it. This is often the way. No-one likes being discharged at one in the morning, and indeed we often keep people overnight for that very reason; but they are the elderly, the infirm, those who live alone. In fact the definition of 'too late to send home' gets looser daily. Today we admitted a medically fit 80-something at 6 pm, because it was "too late" to send her home.

But this patient was in her late teens. It transpired that she was mostly unhappy because of her blood results. She had come to us complaining of vague, non-specific abdominal pain. Of most significance in her history was her suspicion that she was 8 weeks pregnant. Urine testing corroborated her theory. A thorough work up by one of our new juniors did not appreciate anything sinister in her pain, or other symptoms. Follow up at an early pregnancy clinic was aranged for 48 hours. Personally, I think this is too late to wait for an ultrasound to confir viability, but there you go. If Mum is stable, she gets to wait.

This, however was not the problem. She wanted a copy of her blood results, specifically the one that showed that the baby was 'ok'. No such test exists, I explained gently. She protested that she had been told that that was what we were testing for. I'm fairly certain that no-one told her any such thing, but sometimes our communication ain't what it should be; sometimes patiets just hear what they want to...

I apologised, but re-iterated that, although her bloods were essentially normal, none of them guaranteed that the baby would be 'ok'. Then she demande pfoof that she was pregnant. This struck me as odd. I've never had this request before. I double checked the notes, and hand wrote a letter, on hospital stationary (no expense spared) explaining that, as far as we could tell, the patient was indeed pregnant, but that ultrasound evaluation would follow to confirm gestation and viability.

She regarded the letter with some contempt. The written word evidently does not carry much wieght in her world. I explained what I had written. At the mention of the ultrasound, she looked blankly at me. 'What's that?', she enquired. More communication breakdown; I guess no-one had explained follow up to her. Explaining what an ultrasound was proved beyond me. I'm embarrassed to say I resorted to saying: 'Y'know, the scans you see pregnant ladies having, on the telly.'

'Yeah, well my boyfriend's just gonna say this is my handwritin'.' I did not know where to go with this. It seems highly unlikely that our handwriting is all that similar, but maybe... It also seemed to me, unlikely that someone who was 2 months pregnant and did not know what an ultrasound was would be unlikely to use words like 'gestation', 'foetus' or 'viability', or for that matter hit upon the right combination of letters I string after my name - to show off, you understand.

But, who knows. Next she asked for the print out of her urine sample. I explained that there was no print out, that it was a dipstick test. She assured me that someone had promised her the printout. I'm fairly certain she could not have misunderstood this. There is no 'print out' to have. Bad communicators we may be, but we tend not to offer non-existant documentation to our patients.

I confess to being a bit frustrated by now. I gave her a pregnancy test to take home, including instructions, in case 'pee on the stick, if it turns blue, you're pregnant' was beyond her. I showed her my name at the bottom of the letter, and the direct ED line. If trusting boyf still thinks it's all a scam, he can call me. Somehow this still isn't enough. I am by now, thoroughly hacked off with this woman, who, it appears has come to the ED solely to obtain proof of her pregnancy. I am beginning to feel my Right wing side emerging, and can hear my inner Fascist grinding his teeth. Malthus, eat your heart out.

As she finally leaves, still unhappy with my attempts at providing her with copper-bottomed proof of pregnancy, I re-visit her notes. It seems that her boyf doesn't believe that she is pregnant, and has left her.

Suddenly I see why it was so important for her.

But I cant help but feel proof of insemination will bring boyf back. If he wanted her to be pregnant, why wasn't he here, now, waiting for the tests, pushing for a scan?

I don't think I've helped her at all tonight.