Mind Your Words, Doctor

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Mind Your Words, Doctor

Since the audit meeting, Dr Braver had added more rules for us. We were now supposed to put anything we needed to inform him in writing and pass it to him. That was what he wanted. His rule. The unalterable law that must be obeyed.

The new rules had caused a long wait as I had to write lengthy notes and pass them through the auxiliary nurse to Dr Braver. He would then write instructions in the note to be sent back to me. Sometimes his instructions were not clear but I wasn’t allowed to go into his room for clarification. I had to reason out what I thought he meant. For instance, WL meant I should put the patient on the waiting list. But he had not specified its urgency. I would have to decide whether to put on routine or urgent waiting list. TCI meant To Come In. It was unclear if the patient should be admitted straight from the clinic or to book an admission for him. That was a clinical decision. And it was up to me to make that clinical judgment. I have always understood “A.S.A.P” as, “As soon as possible.” But when Dr Braver wrote it in the patient’s note he meant, “And See Anna Please.”

Whilst waiting for the next set of notes to be sent to me, I heard a knock on my door. I thought that was the auxiliary nurse bringing my notes. But it wasn’t her. Sister Bamforth sneaked in, smiling suspiciously.

“I saw you were not happy when you went to report to him.

“Oh! That’s alright.” I said, dismissively.

“Is it about the man on the ward?” She walked closer to me.

“The man?” I pretended not to know that she was referring to the patient with perforated colon.

“Oh yes, the colonoscopy man that had a perforated colon.” She was frighteningly emphatic and direct. I wondered how she came by such an accurate information. But I really didn’t want to know. Knowing the type of person she was, it wasn’t surprising that she knew about the case.

“So you know about him?” I tried to show some interest.

“Of course, I know about him. Walls have got ears, you know.” She rose up preparing to leave my room.

“And they listen to every conversation?” I said, now wanting to hear more about what they had been gossiping about.

“This is the Infirmary, you know. And the walls have eyes too.” She lowered her voice again and after checking that the door was jammed, she asked, “Have you heard about the incident this morning?”

I scratched my head, couldn’t figure out what incident she was referring to. I knew there was some argument between a couple and the receptionist but that didn’t go far, I believed.

“You’ve lost me there, sister,” I said, as I sat straight and leant forward, eager to have more volumes of the gossips. I now no more cared about whether Dr Braver came or not. It would be unusual for him to come to my room, anyway. Besides, he had not sent any more case notes to me and I was getting bored. Not a bad way to occupy my time, I reckoned.

“He nearly got his nose punched.” She said.

“Really?” I encouraged her. I knew her too well. Hilary Bamforth was that person who would start a conversation but never carried it to the end. She would gossip about something but leave you to guess the rest of the story or make it up.

“Oh yes,” she continued, “Did you not hear all the noise?”

Truly I didn’t know what had happened. The OPD reception was full to its capacity with spillage to the corridor. And with all the talking going on I couldn’t hear any particular one that she was referring to.

“No.” I replied. “Well, except that I heard a man shouting at the receptionist.”

“That’s it, my boy.” She became excited and really ready to pour out everything she knew. Every secret lodged in her mouth. And every story her tongue had told a million times. That was Hilary Bamforth, ready to tell it all. So, I leaned back in my chair and simply tuned my ears to her story.

“The girl has just got the result of her biopsy. Poor girl. And she is only twenty eight, bless her. Imagine how you would feel if you were her husband.”

“Very disturbed. Oh my God. To have breast cancer at that age. That’s bad news.” I replied.

“Indeed.” She continued, “Her husband had wanted to come in with her. But you know the rule. His Lordship would not let him in.”

“Oh no!” I exclaimed and urged her to continue.

“The girl broke down when he told her that her breast lump was cancerous. So the husband forced himself into the consulting room to support his wife. Dr Braver told him to get out as he did not invite him. But the man insisted on staying.”

“I don’t blame him. Who would not do that?” I further encouraged her.

“And you know what?” She cleared her throat and continued, “His Lordship told her point blank, that he would cut off her breast and use part of it on the other woman who also had breast cancer. The woman would be having partial mastectomy but she had small breasts which her husband did not like.”

“No. Never,” I said.

“Her husband did not like the way Dr Braver had spoken to her. He got up and held him by his collar. Oh I liked that. I really wanted him to break his nose. But I had to do something. I put my hand on the young man’s shoulder and told him that he was not helping his wife by doing that. And I quietly took him and his wife out of the room.”

“So what’s going to happen now?” I asked.

“Don’t know.” She said. “I guess they would make official complaint.”

“That’s serious. Isn’t it?” I reasoned.

“I think your boss is in for a big trouble. Well, you didn’t hear that from me.” She concluded.

“Good luck to him,” I said.

“He needs more than that. A miracle, perhaps.” She said. “I better go and see what he is up to before he starts looking for my whereabouts.”

I heaved a sigh of relief as she closed the door behind her. Part of me hated the fact that I had been gossiping about my surgical colleague, my consultant. But another part of me was really angry with the unprofessional way Dr Braver had behaved. We were taught in the medical school to be sensitive to patient’s emotion. Cancer is an emotive subject. Every doctor dealing with cancer needs to know how to break bad news. He should be sympathetic and empathetic when discussing cancer treatment. The thought of Dr Braver telling that young woman that he would cut her breast off and use it to patch another woman’s breast was absolutely disgusting. And I really hoped that the couple would not let the issue be swept under the carpet.

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