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.