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Sunday 7 September 2008

It helps if the doctor actually looks at the X-ray

James Hughes-Onslow reports on the wretchedness of breaking an ankle and then having to persuade the man in A&E that his agony was caused by more than a sprain

My foot was by now increasingly painful and swollen and, after about an hour’s wait at A&E, a doctor said it was probably sprained but I ought to have an X-ray. The X-ray operative told me she was not allowed to disclose what she could see on her machine but that I’d have to wait for a doctor’s analysis. Then there was another hour’s wait before a doctor appeared. He asked about other problems I had had, medication for asthma, operations for cancer, that sort of thing, before telling me I had sprained my ankle. I told him I knew I hadn’t twisted my foot, only squashed it between the bike and the cobbles, and I knew what a bone injury felt like as a result of the previous episode. But had he looked at the X-ray? No, he hadn’t, but he promised to do so and, after disappearing for a while, he came back to confirm that I had sprained my ankle. From my prone position I was unable to see what his name was.

On the way home I apologised to my wife for wasting everyone’s time but said it was just as well we’d gone to the hospital because I would otherwise have been convinced that I had broken it. But as the days went by and the pain and swelling got worse, I became more convinced it was a fracture. After ten days I went to see my GP, the excellent Dr Sunanda Wickremesinghe, who came to England as a medical student from Ceylon but now rather wishes he had gone to America or Australia where the medical profession is in better health. After much painful probing Dr Wickers, as he is known to his patients in Stockwell, pronounced that I had cracked a bone and, with a fine fountain pen, wrote a two-page letter to King’s College Hospital requesting another X-ray.

Hospital staff were not too pleased to see me again when I turned up ten minutes later, as it was Christmas Eve. They dug up my records and pointed out that I had already had an X-ray and it indicated there was no injury to the bone. I suggested they should read Dr Wickers’s letter and telephone him if necessary, which they promised to do. But they’d need to do that quickly, I explained, because he was about to go home for the Christmas holiday. Reluctantly, a nurse rang him up and I heard her telling him he ought to have given me some painkillers. I couldn’t hear what the good doctor was saying on the other end of the line but I gather from secondary sources that his spectacles were steaming up as he spoke.

Whatever he said, it worked. A second X-ray was ordered and it revealed quite clearly — even I could see it — that there was a crack in the bone. The second doctor, Mr Hamilton, told me the crack was also visible in the first X-ray. So my leg was put in plaster and I was given crutches but no apologies were offered. These days they might be legally expensive, after all. Three days later I was provided with a magnificent plastic boot with inflatable air-cushioning, enabling me to walk without crutches. I would need to come back in a month.

More articles from: James Hughes-Onslow | this section

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