“ADVENTURES IN MEDICINE” by H. Kuhn (shared at the Nov. 14th magazine release event)

My doctor looked puzzled by what he observed at my naval. He said it might be infected, as I had been told at the walk in clinic two days earlier, but the solid bump resembled a hernia protrusion. He decided to have me come back the following week but in the meantime would send me to a specialist and have an ultra sound done.

I felt a bit uneasy at the mention of a hernia. A hernia problem equaled surgery  in my mind and I dreaded the prospect. Living alone on the second floor of a building without an elevator brought an assortment of problems to mind for the time of recovery after surgery.

It was warm and sunny as I left the health centre. The usual faces of homeless people were there at the outreach half of the centre and a steady flow of cars, trucks and buses moved along Dundas Street. Many of the people who frequent that part of town were familiar to me after eleven years as a volunteer and part-time help at the nearby drop in coffee house. Most I did not know by name but sight only. Now and then a head would nod in my direction or I heard a quick ‘How’s it goin’?’ from a passer by as I walked west toward my next appointment.

Once settled in for my meeting at Queens Avenue and William Street my cell phone rang. It was my doctor himself calling, not his nurse or receptionist. He wanted me to return to the centre, pick up an envelope of forms and go to emergency at Victoria Hospital. I felt a little knot forming in the pit of my stomach.  He had never personally phoned me in the seventeen or so years I had been his patient. He said he was concerned he may have missed something in his examination and wanted the doctors at the hospital to check me over. Securing a ride, I said I would do that and the meeting ended almost before it began.

On the trip to the hospital I stayed talkative and joked often with my driver. At the emergency entrance, as I stepped out of the car, she asked me to let her know how it turned out.

The waiting room seemed smaller than I expected but a dozen or so people, some obviously in pain, were seated there and a good number of seats remained available. Roughly square with a separate area for masked patients and a side aisle with seats leading into the hospital, the waiting room was dominated by a large, semi-circular reception desk that was sealed off with sheets of plexi glass.You spoke to the nurse through several slots in the front panel.

I was taken in immediately to the triage area through secured doors beside the reception desk. There seemed to not be a lot of room in this area but it was not crowded. Work was being done here and nurses would come and go as well as the occasional paramedic or policeman. A row of several padded chairs marked for triage patients was to my left, two clerk stations to the right and two small rooms for triage nurses to check you were beside those. Behind the clerk stations the large reception booth was open. Double doors led further into the emergency department and a hallway ran off to the left just beyond  the padded chairs.

Processing in the small nurses room, blood pressure, pulse and temperature, was done quickly by the experienced triage nurse. I began to think that perhaps this would not be so bad after all. With a handful of completed documents and my health card I was sent to the nearest clerk’s desk. Here my identity and personal information were verified and I was relieved of the paperwork. The clerk returned my health card and instructed me to take a seat in the waiting room. I asked how long, approximately, the wait might be. The young woman looked at her computer screen for a moment, then said it would be about five hours for the type of examination I was there for. Despite myself I could feel the frown on my face. The thought that this would not be too bad left quickly. Not really wanting to complain but not able to resist speaking I replied that I would be there all evening then.

Back in the waiting room, I studied the people who were already dug in for the long haul. On one bench, made of three chairs built into one piece, a woman was sleeping with her head pillowed on the arm of the bench at one end. She was covered with a blanket. How long had she been there?

Others held an arm awkwardly across their chests or were missing a shoe. Some were quite composed and using their cell phones to text. I assumed that they were waiting for people already taken in. A few were in wheelchairs. One man in a wheelchair I recognized and could smell the Listerine he had been drinking. He was in rough shape at the best of times.

So this would be home for the next five hours. I decided that the next time my family doctor suggested I go there to be checked over I might want to debate the idea with him a little. Walking outside I found it was still sunny and warm. It was roughly 4:30 pm. The driveway to emergency was long and downhill into a loop to turn around at the hospital doors. Sheltered parking for ambulances was on one side of the loop with a separate entrance for the people they wheeled in on stretchers. On the north side of the loop, not far from the entrance, was a bench and open sidewalk. The sidewalk led back up the hill.

A man and woman sat on the bench smoking and a second man with a cigarette leaned against the red brick wall about forty feet toward the hill. I saw the no smoking sign behind the seated couple but also numerous cigarette butts on the concrete in front of them. A security guard walked across the loop in front of the bench and disappeared into a small door further up the sidewalk. He had not seemed too concerned about the smokers. There were a few signs along that wall directing smokers to the top of the hill.

My assessment  of the situation suggested that smoking was not allowed anywhere near the entrance but the rule was not being enforced. I decided the arrangement worked for me and lit up.

Within minutes the bench was free and I sat down. A face I recognized but whose name I could not remember sat down beside me. He had been a regular at the coffee house. As we began to chat he gave me directions to the Timmies inside the hospital and warned me of the steep prices on some of the foods. I thanked him for the information and he left soon after.

The familiar man in the wheelchair with the Listerine aroma was pushed up the sidewalk beside me next to the bench by a good Samaritan. In his gravelly voice he began to tell me how the police had broken up a gathering he had been at and one officer had punched him on the jaw. He made no mention of what he had said or done to get that reaction from the policeman but I assumed it wasn’t pleasant. It was possible he was the innocent victim he claimed to be as street people are often not treated as well as your average citizen by police, but the Listerine scent suggested he was inebriated and had probably been belligerent.

He asked me if I had any spare change and I said no. He asked two people who walked by us the same question. Having no success he became conversational again and offered me a vending machine sandwich he had. I thanked him but said no. He offered me a can of pop that was still chilled. Thanking him I took it.  A minute later he asked me if I was sure I didn’t have any change. I began to smile as I realized how smoothly he had switched from panhandling to salesmanship despite his intoxication. Apologizing for not having much I handed him about eighty cents in loose change. He thanked me and began to wheel himself back toward the emergency entrance.  A short time later a taxi arrived and the driver helped him out of the chair and into the front seat before taking him away.

It was quiet at the bench then and my thoughts turned back to my own situation. I began to feel a bit of anxiety about the prospect of needing treatment for a hernia. I decided it would be best to just let the doctors tell me what the problem was first and think about it then.

Next on my agenda  was to locate the Tim Horton’s. Following the directions I had been given, I arrived at the third floor food court. Not only was Timmies there but a few other food outlets as well and a number of glass fronted coolers with fruit salads and cold drinks. It was a large area including the seating with only a few customers at that time. I ate two slices of pizza and drank a bottle of coke before returning to the waiting room.

Finding a seat in the side aisle I took a book of short stories from my back pack and settled in. The story I chose was written by Charles Lindbergh and described the last half of his flight across the Atlantic and the vividly real hallucinations he experienced due to a lack of sleep.

As I put the book away I looked at my watch. Still a few hours to go most likely. Feeling the urge again, I exited the waiting room to the no smoking bench and lit a cigarette. I began to chat with a fellow leper, as smokers seem to be these days. He seemed familiar to me but I could not place where I knew him from. His manner suggested he knew me as well but neither of us used names during  our conversation. I commented on the no smoking signs with the arrows pointing up the driveway. He said yes, that the actual smoking area was at the top of the hill. We agreed that neither of us would like to be there with a foot or leg injury for five hours and need to climb that hill when we wanted a cigarette. The conversation was pleasant.

Finally I said I was going back inside. I seated myself in the main waiting room this time and pulled out my trusty book of short stories. This time I chose one which was a series of journal entries made by Lewis and  Clark when they crossed the Rocky Mountains in the early 1800s. This too was an entertaining read.

Putting the book in my back pack, I sat back and attempted to stay relaxed without falling asleep. A young girl in a wheelchair, with a Toronto Maple Leafs blanket over her, was in tears telling her father seated beside her about the pain in her hip area.  A neatly dressed , middle aged woman who obviously was used to be being in charge, was giving orders to her much larger male companion. Appearing to be at ease, he was ignoring her and sitting where he liked. The woman who had been sleeping under the blanket when I first arrived was gone and there were some new faces in the room.

A nurse came through the double doors beside reception and called my name. I looked at my watch as I stood up. It was almost 10:00 pm. She directed me through the triage area to a large room of beds, each with a curtain. Most of the beds were occupied. She asked me to change into a hospital gown and despite it being much too small for me, I did. She returned and took two tubes of blood from my right arm. Saying the doctor would be right in, she closed the curtain and left.

On the other side of the curtain beside my bed a young man was telling his mother how he had been riding his bike and collided with a parked truck. He began to weep as he told her the doctors had said his jaw was broken and they were going to wire it shut.

A tall youthful looking doctor in hospital scrubs came through the curtain at the foot of the bed. He was very friendly and asked me to lay back. While poking and prodding the swelling around my naval he asked numerous questions. Finally, he said he would be right back with his boss. A few minutes later a doctor several years older, the original doctor who had examined me and a young female intern entered.  Again I answered all the questions pertaining to how I felt and what I was experiencing. The senior doctor instructed the woman to touch the lump on my stomach also. He told me there could be a few things inside my abdomen causing the bump but he was very sure it was not caused by a hernia. The only way to know for certain what it was would be to do an ultra sound. Looking me in the eye he said that the ultra sound department was closed at that time of night except for emergencies.

I allowed myself one slow breath before answering that of course it was. He said the nurse would make the arrangements for me to come back the following morning to have it done. Once they left I put my clothes on.

Yes, I told myself, the next time my doctor wanted to send me there to be checked over I definitely would want to debate the idea with him a little.

 

                                                                               H. Kuhn

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