“Number 328 to Consultant Room 12 Blue”
I spun around in my chair and stood up, opening the door. My partner sat at the only place available-the bed. We were sitting in our own consult room at fracture clinic, taking in turns to see patients. The one we had just called in was a woman in her 60s, with what seemed to be a minor fracture on the calcaneus. A man approached, pushing a woman-my patient-in a wheelchair. I greeted them, and whilst the man seemed quite engaged, the woman merely smiled, and already I was beginning to question the lady’s cognition.
Don’t be so judgmental, I told myself. Perhaps she just isn’t in the mood to visit clinics and get questioned, poked and prodded.
I began to ask her questions, to establish her history of presenting complaint. I’d already read most of her story from the correspondence and outpatient notes however we had always been taught to learn the story firsthand. Despite my best efforts she would look at me blankly every time I directed a question at her, and eventually the man would respond. I found myself directing more and more questions to him before catching myself and returning to the patient. From the consult I had determined that although she was wheelchair bound due to the fracture (which resulted from a fall), there was a number of other co-morbidities, the most limiting to the issue we were addressing being her weight.
“I’m basically her caregiver, you know,” the man was saying. “Like I cook and help her and take her around and everything, I look after her.” I nodded and glanced at her for a reaction. Nothing much. I decided to move on to the examination.
I examined her foot, which seemed tense and leg attached a little swollen. She indicated there was some tenderness over the area where her fracture was on the X-Ray however she didn’t seem completely certain that that was the case.
“So before the fall, how much were you able to walk around?” She gazed at me, with no indication that she intended to respond. “She hasn’t done much walking for years,” the man answered for her. I nodded. “I had a walker. “ She interjected. I repeated the last word inquisitively, hoping she would provide me with more information without me needing to ask directly. “Yeah I used to go shopping, with my walker. I could go for hours, I just took a seat when I was tired.” I tried to delve further, to ask how long she had been on the walker, but when she didn’t seem to comprehend my questions I turned to the man. “So before the fall, what was your mum’s mobility like?
The man nodded and smiled. “Well she hasn’t been properly walking for years, and then she got a walker you know, because of her legs and her weight you know, and then the fall and now this. She hasn’t been walking for years. I’m her husband by the way.”
The seconds for which I was rendered speechless seemed to last forever.
Did I just?
I thought he said mum?
Oh God no, he said caregiver.
I could almost sense the amusement emanating off my partner. I made a conscious effort to not glance in her direction.
“Oh my gosh I am so sorry!” I gasped. Thankfully they seemed amused. “For some reason I thought you mentioned that you were his mum.” He laughed “Oh really, no no, we’re married.” The woman looked at me and sighed in jest. “Yeah.”
I shook my head and laughed at myself. “Wow, I am so sorry. What I’ll do now is I’ll have a chat to the bosses and we’ll have a look at your X-Rays and work out where to go from there, how does that sound?” They nodded and said no worries, and as I stood up I had to apologise once more. “Again, I’m so sorry, we’ve had a few kids come in with their mums so I must be in that mindset, sorry!” They smiled again and told me not to worry.
Alright Priscilla, you haven’t dug a ditch, you’ve dug a ravine, time to back out and recompose.
The management was simple: the X-Ray had shown complete healing of the fracture, and so it was recommended that she weight bear as tolerated. The husband thanked me as the patient smiled. “Great, we’ll try to get her back on her walker. Thank you so much.” I nodded and smiled. “No worries, hope it all goes well. It was lovely to see you, sorry again for my slip-up before!”
They left the room and I turned to my partner.