On Tuesday night I swallowed a lump of exquisitely prepared Beef Ragu and that was it. It failed to move anywhere other than my oesophagus. Given that it was still firmly lodged there at 4am, my partner, Lance, decided it was high time to get me to our local hospital emergency department.
4.30AM saw us in the reception area of the Royal Prince Alfred hospital, one of Sydney’s major medical teaching institutions. It was done out in early vomit-prone violent junkie – fixed plastic seating, lino floors, harsh lights and a small gruff admissions clerk locked and barred away behind bullet proof glass. We were the only people there – predawn Wednesday morning, freezing cold – the crazy crowd obviously had other engagements.
“It’s cold” Lance offered to the clerk in the way of small talk as I hiccoughed my way through the interminable paperwork.
“It’s not.” She replied. I counselled against further attempts at intimacy in case she called security.
After triage and then second triage by two separate nurses who asked me exactly the same questions – which I’d already addressed in the admissions stuff – I was popped in to the Plaster Room, “the only room available, sorry” with a young Resident Doc who was clearly aspiring to a specialist career in naturopathy – “elderberry oil (or somesuch) is supposed to be really good for hiccoughs.” She was a very lovely person, keen to know why I was hiccoughing and vomitting every sip of water back up, but at a loss to bring down a definitive diagnosis. They gave me pills which rapidly re-emerged, pondered some more, then sent for the opinion of the Registrar, who advised that I be put to bed, after a shot to control the throwing up. It didn’t work.
I lay in a cubicle until about 9.00am when a gastro-enterologist arrived and told me he thought I probably had something stuck. I agreed. Avidly.
“What’s this?” He said peering at two forlornly melting yellow capsules floating in my sick bowl. I told him they were pills to stop reflux which I’d instantly regurgitated. “It’s almost a metaphor for diagnostic failure,” he said gloomily.
“It seems to me that if someone comes in unable to swallow and throwing up everything offered you’d pretty much conclude they had an obstruction.”
“Especially if the patient suggests that’s probably what happened” I added supportively.
“It’s the hiccoughs,” he said. “They can’t see past the bloody hiccoughs”.
‘We’ll give you an endoscopy. Sign the consent form.” I did so while he counselled me as to the many horrors – albeit very lowrisk – that could potentially arise from hurling a small camera down my throat. To be frank, I couldn’t have given a rat’s. I just wanted it over.
So I was whisked off, in my bed, to endoscopy, by a jolly Fijian orderly via what seemed an interminable journey through the labyrinth of underground corridors that connect the vast hospital campus.
Shortly thereafter someone slipped me a magic mouthpiece and I woke up 3 hours later surrounded by my co-partnered tertiary health care team.
“We’ve cleared it,” said my Gastro main man. “You should be fine but we’ll keep you in overnight just to make sure. There’s apparently Chicken ravioli for dinner,” he concluded merrily.
Next instalment: an inside scoop on RPA gastrointestinal ward cultural dynamics and the lowdown on nursing. Bet you can’t wait.
Geoff,
sounds nasty. Here’s a news report to amuse you while you convalesce.
A DANISH amusement park has banned the sale of lollipops moulded in the shape of male genitalia.
The 10-cm multicoloured lollipops were sold for 20 kroner ($A4.50) under the name Dillermaend, Danish slang for the male organ.
The Bakken amusement park, 15 km north of Copenhagen, ordered Flemming Barfod, the maker of candy, to stop producing and selling the sweets.
“We considered it tasteless,” said Tina Baungaard-Jensen, a spokeswoman for Bakken, which was founded in 1853 and claims to the world’s oldest amusement park.
The lollipops sparked harsh reactions in Denmark, a usually tolerant Scandinavian country of 5.3 million that was the first in the world to legalise pornography in 1969.
The chairman of the Danish Family Planning Association, Dr Christian Graugaard, said the lollipop could be considered “pornographic” and was unsuitable for children.
Some 2.5 million people visit Bakken every year.
Doesn’t sound like a great experience, Geoff. Pity you don’t live on the upper North Shore or Northern Districts where Lance could have driven you to the Sydney Adventist Hospital Wahroonga (The “San”), where they have an excellent private emergency department for the non-indigent – cost $120 non claimable, but great for those whose immediate health concerns outweigh their concerns about their next fortnight’s beer money by a considerable margin.
We’ve used it three times in the wee small hours for members of our family and have been more than happy with the service provided.
Ron, are you one of these Seventh Day Adventist Types? Do they have pictures of Lindy Chamberlin in the emergency ward?
The San is a very large private hospital servicing the large area centred on Wahroonga and Hornsby. There is some Adventist influence there, particularly in the non-availability of cafeine products in the cafeteria on the reception level.
Otherwise it’s no more Adventist than say St Vincent’s is Catholic these days. The level of care and the standing of the various specialists operating from there is very high.
Delighted to hear it. Tell me, Ron, for your $120, is it first in first served in casualty or do you have to wait around for hours while cases deemed more urgent get treated first?
The interesting thing here, Ron, is that you’re probably only paying for the probability of being seen sooner – and with more politesse – than you would at RPA. Australian medical training is conducted entirely within the public system and the docs you’re likely to encounter in a non-specialist sense at the San are the same ones you’re going to encounter at, say, Royal North Shore – probably doing more hours than they should be, to make money.
With few exceptions, the specialists will also be public system-based. Plastic surgery is the only medical specialism I can think of, offhand, that might claim a substantial private-only presence.
To be utterly simplistic, at a tertiary health level we pay a premium for superior hotel services provided almost entirely by publicly-provided medical personnel.
I should add that I see nothing whatsoever wrong with superior hotel services.
Geoff,
The earlier attention at the “San” Emergency (at least in the early hours) is more than just probable – more like highly likely. You hear terrible horror stories about long waits in public hospitals for emergency service. If you can afford it the $120 is terrific value insofar as better and quicker attention is concerned. I can think of much worse ways of spending 120 bucks!
Another example of why Australia’s Public hospital is so highly rated.
Ken, Do you know if the cookies for this site are working? I click on the Yes for “Remember personal info” on the “Post a comment” section each time but my name and email address isn’t carried forward.
Geoff,
I was wondering why you hadn’t blogged for a couple of days. Was it one of those damn Pommie chefs, I wonder? Anyway, you weren’t actually choking to death as such. Why couldn’t you have taken the laptop with you to hospital, you wuz!?
Ron,
If you’d read my own whinges over the last couple of days, you would have noticed that this periodic deletion of personal details cookies seems to have something to do with the database problems Scott is having. They in turn arise from Scott’s having been so generous to so many bloggers like me that he’s overloaded his database. He’s going to start fixing it over the weekend, I understand, so in the meantime we’ll all have to be patient.
Good point Ken. I could have logged on to Medline and come up with a preferred diagnosis and recommended treatment plan, on the spot.
aw, Geoff, if I’d known you were choking to death just up the road from my place, I would’ve come by and given you the Heimlich manouevre for free.
I agree with Ron. A couple of years ago I suffered a particularly severe attack of kidney stones. I went to the Royal Darwin Hospital at 3 am where I was put in the triage line, with only one patient before me. I asked the nurse for some pain treatment but was told that I couldn’t have anything until a doctor could assess the situation. When would that be? She couldn’t say, I would just have to grin and bear it.
I don’t know if any of you have had kidney stones but the pain is excrutiating – and also the favourite scam played by junkies wanting a hit of morphine.
So there I was with my bare arse hanging out of the hospital shift, vomiting into a bucket for half an hour until I could tolerate the pain no longer and asked my wife to drive me to the Private hospital. Once there (it’s only about 500 metres from the RDH) I flashed the Mastercard and was injected with morphine in five minutes. If I ever get stones again, it’s straight off to the Private for me!
And the moral of all this seems to be that good doctors are unwilling to work at three O’Clock in the morning unless they are paid extra money for it. This isn’t surprising, but it is the sort of reality that public health bureacracies have difficulty dealing with. Geoff, I hope you are feeling better.