By Anne Biccard
The medical profession in South Africa has been rocked today by the apparent assassination of a colleague. He was shot six times and died on the scene, just a few blocks from our hospital. He was the anaesthetist in a case that went wrong about six months ago. Tragically, a child died shortly after surgery and both the anaesthetist and the paediatric surgeon faced charges. I heard, informally, that the postmortem revealed that neither was to blame for the child’s death, but perhaps someone decided to take the law into their own hands. What is the world coming to, doctors ask each other in the corridors? If a patient dies whilst under your care, is it murder? Did either of those doctors go to work that morning with evil or wrongful intent? Maybe it was a coincidence, I hear in the tearoom.
Maybe he was secretly a drug lord or owed money to the mafia. I shake my head. Crime is so rife in our country that people are routinely gunned down. But there was no robbery here; his mobile phone and wallet were untouched. And I am pretty sure, having met him a few times, that he was not a member of the mafia. As a group, the medical profession is divided on everything from politics and religion to a simple diagnosis. Doctors like to think for themselves, but this makes us unable to stand together on any one issue. The assassination of a colleague is a case in point. Trying to get any kind of protest going is like trying to herd a group of cats. It all feels so wrong and yet it seems that there is not much that I, personally, can do about it. I feel like rebelling; sitting on the shirking wall and refusing to see any patients until the murder is solved. But that would leave a lot of innocent people badly affected, so I feel stuck and angry. Regardless of how I feel, the files keep coming through. The administration lady has an infuriating way of flinging them into the tray from a few metres away, like paper frisbees. They land with a whoosh and slap, one on top of the other. I grit my teeth and stop myself from intercepting them. I want to seize them, mid-air, and fling them out of the window. I try to keep my head down and get through the shift, but I am just not in the mood today.
As if sensing my discontent, the sisters seem to be on a ‘go-slow’ and patients are presenting with the strangest ailments. The physician is annoyed with me for sending one of his patients home yesterday, although he refused to accept her, and he complains loudly to everyone who will listen. I want to throw him out of the window too. I am sure that there is a correlation between laziness and casting blame. There is also an inverse correlation between the length of a radiology report and how uncertain the radiologist is of the diagnosis. If there is something simple, and obvious, the report will be a few lines. But today I am getting three-page reports telling me that ‘there is an impression’ and ‘clinical correlation is advised’. I want to call downstairs and tell them to stop sitting on the fence.
I am just grumpy, and I have pain in my back to add to my irritable mood. Mostly I just want to go home and have a long walk on the farm with the snoopies, but there are still another four hours to go.It feels interminable.
The sisters bring through a dapper man. He is about eighty but in excellent shape with a fine head of silver hair and freshly veneered teeth. He has a little handkerchief folded in his shirt pocket that matches his belt and shoes. He perches expectantly on the bed. I greet him and open the front cover of the file, ready to take the history. ‘Doctor,’ he says earnestly, ‘I hope that you know CPR.’ I look up. ‘Because you take my breath away.’ He gives me a charming flash of teeth and I am speechless for a second. I doubt that he can even see me, behind all my layers of PPE, and I am certainly no oil painting. ‘Please tell me that you are not married,’ he continues, and he seems to be serious. This guy, who is old enough to be my father, is flirting outrageously with me and I am not sure how to respond. I don’t want to be rude, but I need to put a stop to it. ‘Yes, I am married,’ I lie, ‘and what can I do for you today?’ He looks genuinely disappointed, but we get on with the consultation. As I escort him out of the ED, he tells me that I really am his type. It is an uncomfortable moment, and it gets worse when a huge bouquet of flowers arrives at the front desk.
Mr Dapper appears every day thereafter in the ED. From being quaint, he is taking on the role of a proper stalker. He tells the sister at the front desk that he is here to visit me. I refuse to see him unless he is actually sick and so he opens a file. He makes up a few complaints and it becomes more and more awkward. Eventually, I must confront him. ‘I am really flattered by your attention, but I need to be clear that I am not interested at all in any kind of relationship. I am very happy with my partner. I am concerned that, if you keep opening files to see me, you are going to run out of medical savings.’ He looks down and becomes suddenly tearful. It turns out that he was bereaved a few months ago and is desperately lonely. He shows me a few photographs of his wife on his mobile. She was a truly beautiful woman. He also shows me a video clip of him playing the saxophone and he is an excellent musician. He takes out his little colour-coded handkerchief and wipes his eyes. He thanks me for my time and slowly makes his way out of the ED. I feel terrible and resist the impulse to run after him and agree to coffee. That is not the answer, I tell myself sternly. It would be unethical and counterproductive. But still, he is lonely and means no harm.
I slump down on the shirking wall and stare at the shimmering green canopy over the parking area. A light breeze shuffles the leaves, and they sound like water running. I look at the smokers, back on the job after the ban on cigarettes was lifted, haze rising from their noses and mouths like steaming dragons. A few days later, I hear from the sisters that Mr Dapper passed away. I start feeling guilty all over again. Maybe he died of a broken heart. Maybe I should have gone to have coffee with him. ‘Stop it,’ I tell myself firmly. ‘Get a grip.
.This is an extract from Holding My Breath : Further exploits of an ER doctor by Anne Biccard, published by Jacana Media. Available online and in all good bookstores. RRP: R260.00