Thursday, 21 April 2016

The fracture clinic.

One of the boys is calling me from another part of the house. “Mummy!” he calls, because that’s what boys do, what all children do.

“Here!” I call back, because that’s what all parents do, too.

“This is so weird,” he calls again.

“What?” I call back.

“This thing on me.”

“What on you? Don't shout. Come here and explain.”

He does. He comes into the kitchen. It's Youngest.

“You should look at this,” he says, peeling his top off.

It’s a weird lump - a growth of some sort - right on the centre of his collar bone where he broke it last Autumn. It's big.

The growth on Youngest's collar bone.

‘That doesn’t look right,” I say. “When did you first notice that?”

“In France,” he says. “I fell over. At least I think it happened there.”

“Really?” I say. “Are you sure about that?”

“I’m not, actually,” he admits.

I ring for a doctor’s appointment as soon as I can, which is first thing next morning. You have to ring first thing in order to have a hope of getting an appointment that same day because like most NHS doctors' surgeries in London, ours is overrun with sick people.

At the surgery the GP takes one look at the lump and pronounces the bone broken, again.

“Broken?” I say, “but he can move his arms and shoulders and he’s not in any pain.”

“I am in a bit of pain,” says Youngest.

“Ok,” I say, because he hasn’t mentioned this before. “But he can dress himself and feed himself and he’s been going to school and he didn't tell me about it when it happened. He’s been functioning completely normally.”

“Not completely normally,” says Youngest.

“Ok," I say, "but to all intents and purposes.”

The doctor says we should go to A&E so we do, again.

“It’s broken,” says the doctor in A&E, studying the x-ray.

It does indeed look broken on the x-ray, snapped in two. But how can it be? A broken collar bone is painful. I know this because I’ve already lived through three of them, vicariously. If it is broken it’s his fifth fracture, while the other two boys haven't broken a thing.

I look at the doctor, who looks right back at me. “Don’t panic,” says the doctor, reading my mind. “It’s still perfectly normal for a child his age to have suffered so many breaks. I’ll refer him to the fracture clinic.” 

“How did it happen?” asks the third doctor, on Wednesday morning at the fracture clinic.

“It’s a lump,” Youngest replies, rubbing it.

“That’s not how it happened,” says the doctor, “that’s a diagnosis.”

“Oh, yeah,” says Youngest. “I slipped over, in France.”

The doctor frowns: “It's not broken, at least not recently, and something about this story doesn’t stack up. Growths can form over time but not straightaway. It could be a non-union fracture but that would take weeks to form.”

I write this down because I’ve never heard of a non-union fracture before. The doctor stops talking and looks at me, intently. I look right back.

I’m not very good with silences, I tend to fill them with inane chatter but for once I’m lost for words. This is my child - my baby - sitting in St George’s Hospital fracture clinic with a doctor who doesn’t know what’s the matter with him. Something bad happening to one of my children is my worst nightmare, of course.

“I’ll just go and talk to a colleague,” says the doctor, and Youngest and I are left alone in the consulting room, with nothing but the thoughts in our heads.

“What’s happening?” says Youngest.

“Nothing,” I say. “The doctor’s just gone to get a second opinion.”

“Why?” says Youngest.

“Because,” I say, “it’s important not to get it wrong.”

The doctor returns and sits directly opposite us and begins to explain, but now there's a white noise in my head making it hard to follow the thread. I make a determined effort to tune the white noise out, and the doctor in.

“I’m not sure,” the doctor is saying, “because I haven’t seen anything quite like this before, so I’m going to refer him for a CAT scan.”

A CAT scan. No one in the family has had a CAT scan before; we like to keep well away from hospitals. Despite having three children I only ever gave birth in hospital once, when I had Eldest, and even then I was out within 24 hours.

“I’m going to fast track this,” the doctor tells me.

“Thank you,” I say.

The doctor smiles, and asks if I'd mind filling in a form to rate the service we've just received. I don't mind - of course not - because the service has been exemplary, as ever. All NHS doctors I've ever encountered have been exemplary: friendly, kind, attentive, while also appearing to work incredibly long hours. 

I tick all the boxes on the left side of the form for 'extremely good', then at the main reception desk we’re told the fast track appointment will be in three weeks time, which doesn’t seem very fast track to me. I drive home.

“Will I have to have an operation?” Youngest asks anxiously from the back of the car, “to have the lump removed?”

“I shouldn't think so,” I say, although in all honesty I have no idea. “But don't worry because if you do you’ll be asleep the whole time, like when you had your appendix out, so you won't feel a thing.”

Love E x


P.S. I'm hoping it's just calcified. And did I mention that all three doctors were women?