Anti-natal
I'm not saying I am, per se. I'm just curious as to how different mothers can be when they walk into my consulting room this clinic.
The first looks stressed from the moment she scowls her way into the room, blanking my smile and invitation to use my first name (and suddenly I realise why Nikki hates giving patients that degree of famliarity.) She has a clinically impalpable inguinal hernia and wants to know what I am going to do about it. I'm relieved it's a surgical problem rather than a difficult obstetric one.
I explain the limited options as carefully as I can, and I have to admit I'm pleased by my own forthrightness and lucidity. Maybe this is the slow release of carbohydrates from my cheesy potato waffles this morning; but I'm not sure.
"So are you going to fob me off with paracetamol?"
"Primum Non Nocere" I tell her. Anything else would cause harm to her and her unborn child, so I accept it may not seem like much, but it's what's best. "It's a fantastic drug" I confide, just stopping short of telling her that I actually think it's one of the world's unsung miracles. I don't think she'd care anyway.
"It's not an anti-inflammatory" she scoffs.
"It's a COX-3 selective inhibitor" I tell her, and the rest of the spiel. I'm puzzled why she should want to out-opinion me, like it's some sort of silly competition. But wowed by this bit of science, she seems to deflate a little.
I try and explain exactly why there is no simple solution to this for the next five weeks. And as I reflect woefully that the whole service has become a demand-led service provision for the pushy, I hear her demand the registrar's opinion as well. A little sigh and trickle onto my next patient. (For the record, the registrar backs me up entirely. But there you go.)
I have been describing to N over the weekend how beautiful and otherworldly expectant mothers seem - that sort of purity of purpose missing from the rest of us mere mortals. The next patient walks in with a furrowed brow as well, but she looks absolutely radiant with it, and I feel a little more Quakerly again.
She wants to know about IOL; suffering with SPD. Suffering horribly with SPD, actually. This is one patient where a sympathetic ear does help slightly, and we chat through prostin, and ARM, and the one hour wait, before I work out with Miss Street's help that the risk of C-section is about 30%. I advise her against the IOL and actually, she's happy with that.
Pain seems that much more endurable with that inimitable purity of purpose. She smiles as she leaves, and I feel a whole lot better for it.
The first looks stressed from the moment she scowls her way into the room, blanking my smile and invitation to use my first name (and suddenly I realise why Nikki hates giving patients that degree of famliarity.) She has a clinically impalpable inguinal hernia and wants to know what I am going to do about it. I'm relieved it's a surgical problem rather than a difficult obstetric one.
I explain the limited options as carefully as I can, and I have to admit I'm pleased by my own forthrightness and lucidity. Maybe this is the slow release of carbohydrates from my cheesy potato waffles this morning; but I'm not sure.
"So are you going to fob me off with paracetamol?"
"Primum Non Nocere" I tell her. Anything else would cause harm to her and her unborn child, so I accept it may not seem like much, but it's what's best. "It's a fantastic drug" I confide, just stopping short of telling her that I actually think it's one of the world's unsung miracles. I don't think she'd care anyway.
"It's not an anti-inflammatory" she scoffs.
"It's a COX-3 selective inhibitor" I tell her, and the rest of the spiel. I'm puzzled why she should want to out-opinion me, like it's some sort of silly competition. But wowed by this bit of science, she seems to deflate a little.
I try and explain exactly why there is no simple solution to this for the next five weeks. And as I reflect woefully that the whole service has become a demand-led service provision for the pushy, I hear her demand the registrar's opinion as well. A little sigh and trickle onto my next patient. (For the record, the registrar backs me up entirely. But there you go.)
I have been describing to N over the weekend how beautiful and otherworldly expectant mothers seem - that sort of purity of purpose missing from the rest of us mere mortals. The next patient walks in with a furrowed brow as well, but she looks absolutely radiant with it, and I feel a little more Quakerly again.
She wants to know about IOL; suffering with SPD. Suffering horribly with SPD, actually. This is one patient where a sympathetic ear does help slightly, and we chat through prostin, and ARM, and the one hour wait, before I work out with Miss Street's help that the risk of C-section is about 30%. I advise her against the IOL and actually, she's happy with that.
Pain seems that much more endurable with that inimitable purity of purpose. She smiles as she leaves, and I feel a whole lot better for it.
posted by Bas at 3:46 AM
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