A n article by Rob Walters 

Copyright 2006

Getting into the system took some time. The lone lady in reception was clearly flustered. She glared at me briefly and then said, "There's only me here, you'll have to wait. Just sit over there, next to that gentleman - he's waiting too. We will call you." She then continued pounding away at her keyboard. An ageing lady under pressure and well aware of her power - the gatekeeper.

The seat faced the reception desks so I thought that I would be OK. Out of sight, out of mind, surely the opposite must follow - in sight, in mind. Unfortunately the gatekeeper did have a screen (bulletproof?) covering roughly two-thirds of her kiosk, presumably to dissuade that fraction of the walking wounded who might attack - there were notices warning us against violence to the staff hung at strategic positions around the walls. But at least I was seated to the left of the entrance doors and should be able to spot, and neutralise, queue jumpers as they entered.

The other patient waiter was clearly in pain and probably now was not the time for a conversation - but it was too early to take out the book that I had been forewarned to bring, so I ventured the obvious question whilst keeping a wary eye on the reception desk and the entrance doors.

"What happened to you," I asked,

"Gearbox fell on me leg," he said, wincing.

"Are you a mechanic then," I said, as if a gearbox could fall on any old person's leg.

He didn't seem to notice the superfluity of this remark and gave me all the details: type of vehicle, support given to the gearbox, how the support failed and the heavy crash onto his knee! Fortunately a new lady had now entered the reception area and was directed to this poor chap by the gatekeeper. The new lady, a dumpy woman with a fixed smile, came towards us leaving the gatekeeper alone again; I looked hopefully at her but was ignored.

The mechanic was interrogated and his details recorded. He was then directed to Minor Injuries - yes Minor Injuries! I would have thought that a gearbox falling on one's leg was fairly major. Just what did you have to do to get into Major Injuries? Have the whole motor car fall on your leg? The dumpy lady returned to reception and set up home in an empty cubicle. This is it, I though, when she has finished punching the mechanic's detail into a computer, she will call me. I will then be interrogated and entered into the system. I was nervously aware that I was not in the system at present. The only person I had talked to was the mechanic and he, naturally, was more interested in the injuries that the gearbox had inflicted than in me and my problems.

Then, my worst fears were realised, a couple swept through the doors and walked straight up to dumpy lady's cubicle - and she started processing them! I had been queue jumped. I could be here forever, never entering the system, shunned and ignored. This was the time for action. I bravely approached the reception kiosks. The gatekeeper did not look up and second lady was busy processing the queue jumpers, innocent queue jumpers I admit, but queue jumpers all the same!

"Have you forgotten me?" I asked, reasonably loudly and hopefully not too plaintively.

Everyone looked at me, the two receptionists and the two queue jumpers. I detected a fleeting look of annoyance in the face of the gatekeeper, then guilt, and then officialdom.

"Please sit down sir. You will be seen once these two have been admitted. We are under pressure here you know."

Thankfully the couples' admission didn't take long - and, when finally called, I got a little apology, not an effusive one - just enough to recognise that I had been unfairly jumped over, though finely balanced by the pressure that these two were under. That dealt with dumpy lady was then briskly friendly, whilst the gatekeeper carried on doing whatever it was that took up so much of her time that she couldn't deal with people. I too was sent to Minor Injuries! I was quite proud to retrace the steps of the badly injured mechanic - well treads actually, he had been pushed there in a wheel chair by a workmate.

At Minor Injuries I found a nurse, as instructed. She quickly decided what was wrong with my injured hand and I quickly learned not to scream when tortured, she wasn't unkind but she certainly knew where to press to find the pain. I was given a piece of paper and directed to the X-ray department. Things were going well. This is where I wanted to be. Another wait at another reception desk, once again there was one lady playing with a computer and another overstressed receptionist dealing with us - the patient patients. I was told to just sit in the waiting area, I would be called. The mechanic and his mate were at one end. He now had his shoe and sock off and I could see that the injured leg was tattooed, though the exact nature of the tattoo was not clear. Opposite was an ancient lady who was without her dentures - a sadly humorous sight. She was lying on a trolley, her head supported by a raised rest and her frail body barely making an indent on the sheet. But she was vocal; she was most certainly that. A smart young Indian lady had been sent to find her- certain people who are in the system seemed to have minders who track their progress, though I certainly didn't warrant this premier treatment. The Indian lady smiled and asked questions, noting the answers on a form. The old lady complained bitterly that she had been left in various places. Everyone told her that they would be back for her in half an hour, she said - but didn't come. At one point she swore, even without her teeth the word was quite clear - and the temperature in that X-ray waiting room definitely seemed to drop a few degrees. The Indian lady smiled and said that she would be back in half and hour, then left. The corrosive old lady swept her beady bird eyes around the room -everyone studied the walls, their feet or the notices advising us not to attack the staff. But the lady next to me faltered; she met the old lady's eyes for just a second and was immediately trapped into a hypnotic monologue.

At last my name was called. A man, who was obviously an accountant pathetically disguised in a white coat, took me to the enormous X-ray room. Why is it so big? Do they do group X-rays? Like family portraits but more revealing. Do they X-ray elephants who have been involved with collisions with other elephants? He was efficient and more generous with words than the usual accountant. He frightened me by saying that scaphoid fractures are difficult to detect and can be dangerous because a major blood supply passes through the bone. My hand was X-rayed in four different poses, whilst the accountant hid behind a small screen. I obediently returned to just sit in the waiting room. The impossibly old lady was still there but she did not capture me. I was happy. I read my book and waited for the big brown envelope - the reward for successfully passing through the X-ray department.

Then my name was called again, the accountant was back. He led me back to the X-ray ballroom saying that something had gone wrong. Was he going to confess that he was really a chartered accountant and not an X-ray expert at all? Was he going to announce that my scaphoid was shattered and that I might loose the use of my hand? As we entered his shining white domain he immediately confessed that the computer had gone wrong. My X-rays were no good. He had to do them all over again. It didn't take long and I was then told to just sit in the waiting area. After some time my name was called again. And this time I was given the large brown envelope. I was so proud and excited. The accountant did not reveal the content in any way. He merely told me to return to Minor Injuries. I couldn't wait to set out.

Walking along the corridor I did a one handed inspection of my X-ray, just as I had seen Harrison Ford do in The Fugitive. There were no fractures visible; the scaphoid seemed to be intact. I was both disappointed and pleased. On the one hand I had come here for nothing, on the other I should soon be out and away. I found a nurse at Minor Injuries quite easily. Sadly she showed no interest in the contents of my brown envelope, she merely stuck it into a rack and told me to just sit outside in the corridor until a doctor was available. And so I joined the long line of walking wounded in the thin corridor with its constant flow of trolleys - some empty, some with a sad human cargo, and its slow passage of injured walkers.

Time passed. I did some Spanish practice. More time passed, I studied a book on Turkey, a country that I hope to visit in a few months time. Hours went by. People came and went. I observed that children got priority attention - why not? I just hoped that there wouldn't be too many more of them. A young woman and her friend came in, she was hardly able to walk, but they brought with them a lightness - the joy of youth. After their first visit to Minor Injuries they happened to sit next to me. Then the uninjured one went off to make the inevitable calls on her mobile. Now thoroughly bored by reading and studying, I asked my neighbour what had happened to her. She was, I guess, about twenty years old, well-built, quite attractive, if you like big girls, with an open and smiling face.

"I fell down the stairs," she said, almost proudly.

It transpired that she had been, with her friend, to look at rooms available for rental in a shared house. Somehow she got her foot stuck in the stairway and fell - twisting the big toe very badly, as I could now see. She was waiting to go to X-ray.

"I really hope it's broken," she laughed, "It's the first time that I've been to hospital so I want to leave with something to show for it."

She certainly helped to dispel the gloom of the place, but then her friend returned and they began an intense conversation, so I returned to my books.

I had now gone through various phases in the waiting game. Uncaring at first, I was pleased to have the time to study and read. Later I thought it was quite interesting to watch the comings and goings of the injured. My mechanic smiled as he awkwardly moved up the corridor towards the exit on the crutches that he had been given, others came by in wheelchairs - leg and foot injuries seemed to be the most popular. Then I began to think that I had been forgotten. The thought grew as I saw more people come in, get processed through Minor Injuries and then take their leave - repaired. Then I became obsessed by the possibility of neglect. I could be here forever. Perhaps my brown envelope had fallen off the rack and had been accidentally kicked into a side room. Maybe they had called my name and I had been dozing and had missed it. Perhaps they thought that I had just done a runner, left the place in disgust. No, I told myself, it's none of that, it's just that everyone is more seriously injured than I am.

At long last, after many hours I decided not to "just sit." I determined to enter the inner reaches of Minor Injuries and put the question to them, "have I been passed over?"

Then, almost exactly on cue, my name was called. The nurse, doctor, assistant or whatever was young, dressed in a green uniform and clearly agitated.

"I'm very sorry," she gushed, " we missed you. I don't know why. But why didn't you say something?"

"I assumed there were more urgent cases than mine. So I…."

"You should have said something. Anyway we cannot see a fracture, your X-ray looks fine."

"Yes I know, I looked at……"

"Why didn't you say something? I don't know how it happened. Now, we have to wait for the swelling to go down. It's no good going to Trauma just yet."

"I did it eight days ago, the swelling has gone."

"It will still be swollen. You should have said something, not just sit there."

"What is Trauma?"

"You must go to Trauma tomorrow. They will take a more detailed look. The scaphoid is a difficult bone - they have more time. Now I'm going to fit a wrist support. Which hand is it."

"Left."

She raced off and returned with a polythene bag which she expertly rips open. Inside was a strange blue and black thing - like a glove with no fingers or thumb and lots of straps. She talks incessantly whilst fitting it to my hand.

"I can't come back tomorrow," I managed to interject I have to be on the streets, collecting money for charity."

"People will give you more now that you have this on. Now take this form to reception, they will make an appointment for you - ask for an early one. You should have said something."

"I thought….."

"Bye."

"Thanks, bye."

Off I go, past the fresh line of walking wounded. At reception I try to find out what "Trauma" is - but they just make the appointments. I am due to reappear, at the Trauma Department at 9.30 the next day. I am part of the system. This is becoming part of my life. This is becoming my life!

Still at least I have something to show for my sitting - I have a very noticeable wrist support. We spend the night together, really get to know one another. And then it's back again for the 9.30 appointment. Trauma is much further into the limitless building than Minor Injuries. I suppose that makes sense. Nonetheless I am early. The receptionist here has not yet had time to become ensnared by the computer so I quickly learn that there are no papers for me - the brown envelope is lost. Aargh - does this mean I have to go back to the start? Apparently not, this lady seems to have more initiative than the others. She looks at me suspiciously, as if I might be getting into Trauma under false pretences - but an examination of my appointment card soon convinces her that I'm genuine. Without even telling me to just sit in the worrying large, enormously capacious, waiting area, she makes a call.

"Hullo, it's me. I've got one here without notes." She does not look at me

"Yes I know." She looks at her nails.

"Are you going to the…" She taps the computer screen with her pen.

"Yes, well it isn't the first time and it won't be the last." She looks despairing.

"Thanks, yes, see you soon." She replaces the phone and says to me. "Just sit over there. Someone will call you."

Chastened by yesterday's marathon, I venture. "Will it take long? Will I have to wait long?"

She looks puzzled, genuinely puzzled, "There's no one here yet. Just sit over there, you will be called."

I had pretty much got the message and slide out of the entrance doors to make a call.

"Its Rob. I'm at the hospital. The way things look I doubt that I'll be there by eleven. Just carry on and I'll find you or phone you. Heaven knows when. I might be here forever."

Just sitting in the Trauma waiting area isn't so bad. It could be used as a theatre; it's so big. The doctors and nurses could stage reviews in the blank area next to the reception desk. Perhaps they do - it would certainly pass the time. Forewarned by yesterday's experience I have brought a fascinating book along this time - it records a motorcycle journey around the world that takes the rider four years to complete. And he completed it without a visit to Trauma.

Things are hotting up. A couple of people have had their name called and have vanished into some inner sanctuary. Then it's me. Wow, this is much better. In the inner sanctuary I am shown to one of the many cubicles that are ranged around the periphery and told to just sit - someone will be with me soon. In the centre is a very long bench-table - like a breakfast bar but fitted with computers and X-ray viewing screens, and lined with high stools. A balding man with glasses is sitting opposite my cubicle, he is talking to a younger woman - they both wear white coats. He is looking important and she is looking respectful. He is lecturing her about the state of the National Health Service. He understands all of the problems, and has all of the answers. She listens and nods. Then there is a short silence - her eyes wander around the room. Then he starts up again, "If the people who run this place were in industry, they wouldn't last a week." She flicks her attention back to the boss and smiles in feigned agreement. It is doubtful that she listens to his words at all, maybe she's heard it all before. He seems to be the God of Trauma, she an acolyte picking up the pearls of wisdom that he seem all too willing to drop. Someone brings a brown envelope. God picks it up languidly and flicks an X-ray onto the viewing screens. He begins his diagnosis immediately, glancing at the notes and running his finger over the bones of someone's leg. He strokes the tibia and comments on a small fracture at the upper end, the acolyte has his full attention now. His diagnosis is rapid, confident, very much an aside to the diatribe against his employer.

Then I received a visitor, an Australian I think. A handsome, polite young man, he examined my hand, much more gently than the nurse in Minor Injuries did, maybe she was used to more exciting injuries. He is attentive and confidence inspiring, I think that he must be a junior doctor. He tells me to just sit whilst he confirms the diagnosis. As he leaves he draws the curtain of my cubicle, cutting me off from the world of Trauma which itself is cut from the outside world by the insulating layers of the hospital and its administration. I can just see God through a split in the curtain. His finger waves over the interior view of my hand, now placed on the X-ray screen - it gives me an odd feeling, like someone peering into your soul.

Junior returns and tells me that all is well, they do not think that my scaphoid is fractured - but you can never be sure and it does have blood vessels flowing through it. I am becoming an expert on the bleeding scaphoid. He tells me to wear the wrist support for two weeks and then to try doing without it. In four weeks I should be back to normal.

"But, I have to fit a new kitchen and……."

He listens politely but I know it is hopeless to protest, I am in the system now.

"Just sit here and I will arrange for the physiotherapist to see you."

Oh no, not more expert attention. Now they have me, will they ever let me go!

"Just sit here?" I asked - thinking that I should return to the vast waiting area - there might be a show!

"Yes, someone will find you."

I settled down with my book. After some time I thought I heard someone call my name - but it was soft, coming from a long way away. I couldn't be sure, and I had no idea of where it was coming from. The curtain was now partly drawn, I could see movement in the Trauma workshop, but no one came my way. God was still dispensing his wisdom, nurses moved silently around. I went back to my book. Then I heard it again. Surely not though. Perhaps it was someone with a similar name being called in that grand theatre of a waiting room. And Junior had been quite definite - just sit and someone will find you.

Finally I acted, I was not going to be left in that cubicle forever, overlooked and ignored. I sallied forth and accosted a nurse, explained that I was waiting for the physiotherapist and…

The nurse raised her eyes to the ceiling, Junior passed by but didn't seem to notice or recognise me.

"Follow me," she said. And led me to the far end of huge waiting room, next to an extensive area furnished as a children's play ground - with slides, rocking toys, even a huge computer games terminal.

"Just sit there, the physio will be out soon."

"Oh dear God, here we go again," I inwardly scream, "I've been missed and now I've dropped out of the system." But at least there was no one else waiting. Then, an elderly couple came along. They wisely sat closer to the physio's door than me. Soon after that the physio popped out saying "Mrs Farginson." The lady got painfully to her feet. But what about me? I fearlessly rushed up to the white-coated physiotherapist.

"Uh, I think I heard my name called. I was in a cubical over there. I wasn't sure. My name is Robert Walters."

The physiotherapist looked a trifle annoyed, I thought.

"Just sit there," she said, "I must see this lady first."

"But," I thought as I sank back into the chair," it's so unfair. Junior told me to wait in the cubicle, I couldn't hear you, it's not my fault. Don't leave me here." Meanwhile the words "you should have said something" echoed around my skull.

She did see me after the lady had left, and was delightfully friendly. I was given thumb exercises and told not to wear the wrist restraint unless I went out, "so that other people would know that I had an injured hand." Then she started to make another appointment! Aargh - no more please, no more. We came to a deal. No further appointments but, if the wrist was no better in two weeks then I must call in to make one. I promised that I would do so and was released - free at last! But for how long?

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