Who Wants To Get Sick And Go To Hospital

A few weeks back I was pushing the lawn mower for the first time this summer around the back yard. The backyard has two areas; the back section is separated from the lower front area by a raked, sloping incline. The late spring morning had ushered in bright sunshine and blue skies, and grass moist and damp with condensation. I was wearing my thongs, as I’m known to do through spring, summer, and autumn; the rubber sole footwear with a strip of rubber anchored in a Y formation at three places to the sole. In the US and Europe they’re called flip flops, but Australians insist on calling them thongs; they’re as much a part of everyday life to an Aussie as Vegemite, meat pies, and beetroot. And you’re not a true blue Aussie unless you’ve put your foot on the back of your mate’s thong when they’re walking in front of you.

image source:jmcadam

I knew the raked, sloping incline was going to be a test of motor mower handling, balance, and precision thong placement. I angled the mower down the incline, and pulled back on the handle with both hands in an attempt to have some control over the careening, belching, machine; with every step my thongs slid and slipped on the moist grass of the incline. My legs twisted and contorted at the knees as I pulled and pushed the mower across, and down the incline; and then I was sitting on a leg on the moist incline. My foot had slid out of it’s thong, and my leg had arched up and under and behind me. I sat on my knee wondering if a needed a stretcher; or maybe I could limp off over the boundary without any help. I decided that when the trainers came out with a wet towel to wipe my face down, and said a few encouraging words to me, I’d just get up and pretend I’m OK. The longer I sat there the more I started to think about how I ended up sitting on my leg; did I come down the wrong way on my knee after taking a specky, or did my foot really slip out of it’s thong. I thought I heard the roar of the crowd; I shook off the ache in my knee, grabbed the mower and tackled what was left of the long grass on the moist, raked, sloping incline.

image source:thesaturdaypaper.com.au

Over the next few days I found it painful to put any type of pressure on my knee and so I started to wear a brace; the ache didn’t subside. I gave into the knee discomfort and contacted my health provider’s orthopaedic clinic; the earliest they could schedule an appointment was in six weeks. I already had a previously scheduled visit with my doctor so I thought he could check out my knee for any serious damage. Maybe the remedy the footie trainers used in the seventies had some merit; wrap it in a wet towel and pretend it’s OK.

My general doctor practices at a teaching hospital so whenever I have an appointment a medical student gets to practice their interview and basic examination skills with me. The examination room has a small institutional desk in one corner with a computer monitor and keyboard on it; two uncomfortable plastic chairs sit alongside the desk. In another corner there’s an examination table covered with a white paper sheet. It has a fold out step at one end that becomes a foot rest when the doctor feels around your ankles. The room could be taken straight from a hospital examination room design catalogue. Every time I’m left alone in the examination room waiting for a light knock on the door I think back to my time in Springfield Illinois.

image source:jmcadam

After arriving in the US, and living just short of five years in Lincoln and Omaha, Nebraska, I moved to Springfield, Illinois. I thought Springfield was going to be similar to Lincoln; both being state capitals and college towns. Springfield was smaller than Lincoln, and had none of the attributes of a college town; but it have a lot of Lincoln in it. It was hard to walk two minutes without reading something about, or seeing somewhere Abe Lincoln had been.

Springfield didn’t offer many opportunities for an Instructional Designer. I suppose I could have waited tables at the nearby Big Boy restaurant, or been a shelf stocker at the neighbourhood grocery and deli. But I was an Instructional Designer, committed to advancing the latest strategies for infusing technology into the redesign and delivery of learning. It’s said that one person alone can’t make a difference, and that you should accept the course you’re on; but I believed in America being the land of opportunity, where everyone can go and do anything, be anything, and make any dreams come true. I would come to be the best Instructional Designer in Springfield, Illinois. Within a few months I was collecting food stamps and unemployment benefits. If only Abe Lincoln had decided on a career in Instructional Design instead of law.

I think one of the best ways to introduce yourself to a new place is to join a community club, a special interest group, or and an organisation; it introduces you to a communities resources and surrounds you with persons with shared interests.

image source:jmcadam

I auditioned for an upcoming production at the Springfield Community Theatre and was offered a role; the start of my involvement in the Springfield theatre scene. Before long an acquaintance from the theatre asked if I was interested in part time work. Was this the end of the empty endless days of searching for an Instructional Designer position, and a goodbye to the anguish of collecting food stamps? And so I became a patient simulator.

The University of Illinois had a residency program at one of Springfield’s hospitals. Back then an innovative component of the program was first and final year medical students having proctored interviews and examinations with simulated patients. You became a patient by role playing scenarios based on actual patient cases. You were given a medical history, personality, emotional temperament, response patterns during interviews and examinations, and symptoms for a condition such as depression, a common cold, appendix about to burst, anxiety, irritability. The students were given the results from test that could include X Rays, blood tests, or Diabetes screening. A flair for improvisational acting was a plus.

image source:medicaldaily.com

Most of my simulations were considered as moderately invasive; and included looking into my eyes, ear, nose, and throat, taking my blood pressure and pulse, listening with a stethoscope to my heart and lungs, testing reflexes, and an abdomen examination. Simulations that included a breast exam, pelvic exam, or a rectal exam were considered invasive and if you volunteered for these you were handsomely rewarded. Some might say that being a patient simulator is only a part time acting job. But an Instructional Designer knows simulations as instructional scenarios; a learner is placed in a world defined by a teacher, and the experience is a student centred constructivist experiential learning activity. I was a patient simulator Instructional Designer. Food stamps were becoming a fading memory.

I’d finished reading Good Housekeeping and was still waiting in the hospital examination room design catalogue. My doctor, instead of a medical student, walked in from the light knock on the door; summer had given the students a breather from learning. He dutifully reviewed my past colonoscopy results, and reminded me of my upcoming colonoscopy appointment. I gestured to my knee and recounted the saga of the mower. He pushed and poked at my knee, suggested a possible sprained ligament or tendon, and ordered an X Ray and appointment with the orthopaedic clinic. Maybe the remedy the footie trainers used in the seventies had some merit; wrap it in a wet towel and pretend it’s OK.

image source:jmcadam

When I went to check in for my knee X-Ray I was stopped dead in my tracks by the sign between me and the check in desk; “Self Service Check In” with an arrow pointing to three computers set up on a table to the side, and away from the check you in humans. I waited for a check you in human.

Me: (with a smile on my voice) G’day, certainly a brilliant decision to have self service check in at an orthopaedic clinic; I would have thought a lot of people may have sprained and broken wrists and limited mobility of their arms.
Check You In Human: Good morning; name?
Me: (with an insightful tone) Sort of like getting your boarding pass at the airport; must save a lot of queuing
Check You In Human: And you’re here to see Doctor?
Me: (with a knowing what’s what inflection)There’s been a lot of interest lately in autonomous intelligent control and robotic technology
Check You In Human: Are you still at the same address?
Me: (with a sense of wonder) Every time I come for an appointment there’s something new; technology is transforming the health care experience. Before you know it we’ll be getting digital health care coupons with our self service check in
Check You In Human: And you still have the same health care plans?
Me: (in an approving manner) Sometimes I get really annoyed standing in queues; I think I’ll use self check in for my next colonoscopy procedure.
Check You In Human: If you would just take a seat; we’ll call you soon

With the way things are going the next time I go for my twice a year check up I’ll probably check in at a photo collection and signature capture kiosk and then have to use an interactive navigation app to get step by step directions to my assigned examination room. I wonder if I should take my doctor’s visit back to a human experience and roll play a patient with a psychedelic optimism about new medical technologies when the medical student comes into the room to practice their interview and basic examination skills.

Medical Student: And how are we feeling today?
Me:(in a low and articulate voice) Computer cybernetics, are going to take us to interesting places and may work the way psychedelics do without the idea of substance. And I think I’ve swallowed a small brass key, a bottle cap, a pipe screen, and a mascara brush

Jerry Garcia – Autopsy

Standardized Patient Program – Johns Hopkins Medicine

What You Need to Know About Knee Sprain Injuries

2 thoughts on “Who Wants To Get Sick And Go To Hospital

    • Good point Mr Royster, but I can think of a couple of non sloping inclines.
      • incline flat bench. Doing 12 ounce press reps on an incline flat bench is what gave me incredible chest muscles.
      • inclining her head sideways. I remember a hot summer day in Melbourne; she beckoned me to the cold ones sitting in the Esky on the verandah by crooking her finger and inclining her head sideways.


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