Way back in July, on a fine summer evening, biking back from a lovely night of comedy and beer, my bike decided that it was fundamentally done with supporting me and thought it would be great laugh to instead opt for horizontal positioning.
This was while I was happily cruising down the street, dreaming of a soft bed and restful sleep before waking for work in the morning. My dreams were interrupted by my head bouncing along the ground, luckily well wrapped in a helmet. My shoulder bore the brunt of the impact; I distinctly remember it skidding and grinding along the pavement, bringing my forward progress to a halt.
From my prone position on the (luckily deserted) street, I looked around for what might have caused my sudden fall from grace, and saw no obvious culprit. It was close to midnight and I picked myself off the ground, saw that my bike was more or less fine (it was the one, after all, that had opted for this change in the scheduled programming), and decided that I would just have to walk the rest of the way, pushing my traitorous steed along.
I limped, cursed, thanked everyone who has ever admonished me to wear a helmet when biking, and tried to feel-out where I was damaged. Doing quick math in my head, I figured I had about four miles yet to go, which at my hobbling pace would get me home after 1am, and since I had to wake up for work at 6:30, this just would not do.
So I remounted my untrustworthy ride. Upon doing so my shoulder informed me that it was distinctly unwilling to perform any requested duties, and was in fact really quite angry with me.
No matter, I gritted my teeth and attempted to lean as much as possible on my right side, only using that arm for small steering help and braking.
I arrived home without further incident, collapsed in bed, and found that sleeping on my side was something that I just would no longer be doing.
The next week involved me complaining loudly about my damaged shoulder to anyone who seemed to have some sympathy to spare. Unfortunately the fact that this incident happened after the afore-mentioned comedy show where beer was consumed reflected the blame squarely on me. The accusations that I must have been drunk felt all the more unjust since I clearly remember having a mere three beers over the course of the night. Math of three beers divided by three hours yields sober, yeah? Sometimes math lies, I’m told.
Regardless, eventually both Firefly and a co-worker talked me into going to a doctor. I am normally of the opinion that one’s body will heal itself unless part of it is unexpectedly detached or otherwise performing unnatural activities. The fact that my shoulder was not healing rapidly was easily chalked up to the fact that I have become old (much to my dissatisfaction).
However, here was a chance to fully experience how British Health Care works. Years ago (June 2013 to exact) I had a brush with the system as a traveler. I remember being quite pleasantly shocked that a bill for setting me up with a walking boot, xrays, and doctor visits came to less than $300 back then. Now I had a chance to experience this as a local. It was in this spirit that I embarked on this next journey.
So here is a quick inventory of state of things around a week after I was betrayed by my own bike:
My shoulder had a lump poking up at the top. Like someone had decided to build an extension up by my left ear and had started to erect some scaffolding.
Moving my arm was generally fine, except for a few motions. Any pushing motion was excruciating. Raising above chest level: similar. This made writing on white boards at work a comical exercise of grimacing and propping up with my other hand. It also made activities such as donning or removing my shirt to be a ten minute charade each morning and night.
Sleeping was problematic due of the previous note that laying on my side generated a wild array of bodily complaints. Any attempt to lay on my damaged shoulder would elicit fire alarms, air raid sirens, and screaming children. Laying on my right side was initially without pain, but within minutes my left shoulder would start to ache as gravity pulled it in a position it did not want to go in.
Still: I’ll just heal, yeah?
First neat discovery: there’s a hotline that people in England call to help one decide how to proceed with a medical quandary. Here you speak to a real-life person who will ask a battery of questions to help diagnose how severe your situation is and whether you should make a physician appointment, go to the A&E (accident and Emergency) for urgent treatment, or if you just need to rub some dirt on it and grow a pair ya pansy. Below is a partial recreation of this conversation:
her: What is your trouble?
Me: My left shoulder hurts.
Did you have recent trauma to it?
Yes, bike accident.
Are you able to move it?
How severe is the pain?
Depends on the motion.
Can you lift your arm vertically without pain?
I mean, isn’t all lifting vertical?
Are you being purposely obtuse?
Don’t British people respect this and basically practice it as a religion?
Do you really think you should be asking me questions when you have a potentially terrible medical problem?
Look, I’m just doing this so my girl and a random co-worker will know that I’m right; I don’t need a doctor, I just need some time to heal.
Let me guess, you searched online and have diagnosed yourself expertly.
God no! the Internet told me I have cancer.
So what is the basis of your belief that you don’t need a doctor?
Ignorance and optimism. This is how I live my life.
I see. Your nearest A&E is a half mile away. Go there now.
It’s 7pm! On a Tuesday!
We know your kind. Go. Now.
(note: I may have short-cut the actual diagnostic questions that led the nice lady to direct me to the A&E. I feel the mood, however, is representative)
So I went. My coworker direly intoned that he hoped the wait would be less than a couple hours. Dry British wit, I presumed; if this was to be multiple hours I wouldn’t be getting home until midnight. Sleep deprivation had become a force in my life and I was eager to not exacerbate it.
At the A&E, you are greeted at reception where you complete an intake form and wait for someone to take a quick measure of how urgent you problem is. My turn came quickly, and after answering a few questions about my situation and filling in a meager form, I was told to go wait in the waiting room.
It was here that the reality of my situation set in:
So apparently Tuesday night is a hot night for A&E. Who knew? I silently hoped this monitor was displaying for some other waiting lines. Majors, for example could mean there was a waiting queue for military leaders. Urgent might be a euphemism for people with toe nail fungus that really, desperately needed some treatment. Children were getting preferential treatment, obviously. I pondered whether dying the gray out of my hair might help me pass for twelve.
So I wandered around the waiting room, feeling ridiculous amid a sea of people with bandages on the heads, makeshift splints, crutches and other obvious ailments. I had no obvious malady; I just looked like a guy loitering in the waiting room, hands in my pockets (helped keep weight off my shoulder). I came to wish for an openly gushing wound or other such visible damage.
Eight pm came and went.
Nine o’clock barely touched it’s toe on the stage before it too was rushed to the exit.
Ten o’clock slid by grudgingly, unwilling to give up the limelight to it’s later brother.
Eleven o’clock chimed in cheerily and I fumed in the corner. What if I really was gushing blood? What if I had a life threatening problem? Well, the answer there was obvious: All the people I saw with head bandages and splints and such seemed to be getting attention before me. I began to suspect I was a victim of some sort of able-ist prejudice.
During these hours, I cleared out my backlog of podcasts, read every news item on my phone, paced for 6,000 steps, and made up backgrounds for my fellow waiting room patrons. I also seethed about this waste of my night when ultimately I knew the doctor would tell me to ice my injury, keep it elevated, take ibuprofen for swelling and pain, and take it easy.
It’s not my first time to the injury rodeo. I know how this goes.
Eventually my name was called by a large, efficient nurse. She introduced me to the baby-faced trainee that was shadowing her, took me behind a curtain, asked a few questions, helped me remove my shirt (when assisted this activity is much easier, I found), prodded me a few times, then sent me for x-rays.
I returned with the following results:
Turns out the gap is not supposed to be there. This is what is called a “separated shoulder”. The nurse explained quickly but compassionately that this is an injury that will require a fair amount of Physical Therapy, and they usually do not recommend surgery for this as you can strengthen the surrounding muscles to restore full mobility and functionality.
The trainee fitted me with a sling. The nurse gave me a number to call to set up a PT appointment. A tube ride home, and a restless sleep found me in the morning looking at my shoulder in the mirror, accusingly. Why just a week ago I had been doing fifty pushups in the mornings, and now trying to push open a door stabbed a knife through my shoulder. This situation seemed monstrously unfair.
Not to mention I had to endure the fact that Firefly and the co-worker had been right.
Through July, August, and September I attended a few physical therapy sessions where an intimidatingly good looking Australian man gave me exercise advice, workout bands, and told me stories of his own rehab of a similar injury from a surfing accident. I diligently grimaced and sweat at home, and by the second appointment I had nearly full range of motion. By the last appointment he pronounced me as “recovering really well” and instructed me to get into a gym where I could start adding weight to my movements instead of just the bands.
And so it is that I now go to a local gym and grimace through light weight movements, telling my shoulder to quit it’s complaining. But it is still a fine time to recollect on what we have learned about British Health Care:
- The A&E could really do with a little more staff on a Tuesday night. I don’t know how it is the rest of the nights, but given my co-worker’s hints, this might happen more often than ideal.
- The nurse, Physical Therapist, and all other people who treated me were very attentive, knowledgeable, and compassionate. This is worth pointing out because it is subtle until contrasting with the business-like brusqueness of most doctor visits I experienced in the states.
- The total bill for my A&E visit, sling fitting, PT appointments, exercise bands, comes to (Drum roll please): a clean zero. Donut. Nada. Zilch.
I simply walked in, announced that I required medical help, and was given requested help.
It’s almost like there is compassion and healing built into the entire system, instead of a business model.
I don’t know what has gotten into these people. Obviously nobody has informed them that the only reason to get into the medical practice is to get rich.
So now my shoulder and I are on relatively better terms. I am able to lay on my side and sleep is once again something to be enjoyed like a fine wine. Pushups are still somewhat elusive in that I can do a few but soon my shoulder advises me that it would rather I didn’t.
And I have a much deeper appreciation for the security the British populace must feel, knowing that if something catastrophic befalls them, they only have to worry about dealing with that problem and not extra financial destruction and horror.
I’m also aware that I can purchase “premium” insurance (one of the perks of my job), which will give me access to private health care. Perhaps this allows one to skip the wait? I can’t imagine needing better care than I have gotten thus far, only quicker. Hopefully I don’t have another opportunity to explore this further.