As he smoothed the plaster on the gleaming white cast, the orthopedist smiled at his latest sculpture. The patient’s story was that because he had a little too much to drink, he found himself on someone’s plantation picking a banana, thinking it his own banana tree. The plantation security team dealt their justice swiftly without testimony. Not that the pieces of the banana juiced man’s story fit properly, but then neither did his left humerus bone and 4th metacarpal, with jagged edges meeting jagged edges at right angles instead of end to end. And what in the end needed to get straightened out were the bones more than the man’s story; the police would handle that intervention.
When he was brought in to Naggalama, the bone-setter Kevin felt it was best for the banana man to sober up before consenting to care, but in the meantime sent him to the cashier to pay for the necessary x-rays. Clearly the left humerus was snapped, that was obvious by the patient appearing to have two elbows on the left arm, one in the usual spot, and one 5 inches above the one he was born with. The left foot was puffed out more than the right, and both hands were hugely swollen like boxing mitts. So the patient was sent for 2 views of the upper arm, both feet and both hands to be x-rayed.
A few hours later, when hangover was overlapping inebriation, Kevin was smoothing the sculpted cast on the left arm from left shoulder to elbow, and another from elbow to the left boxing mitt, the alleged thief snoring from banana liquor anesthesia. But what about the right hand? The feet? I asked. Dr. Kevin finished smoothing, almost polishing, the plaster and explained matter-of-factly that the because of the cost of all the x-rays, the patient chose one view of the upper arm and a view of the left hand and left foot because that’s what was hurting him the most. I picked up the x-ray again and held it up to the window. The severe humerus fracture was obvious as was a left hand fracture. The left foot x-ray was normal.
“But couldn’t the right hand be broken as well?” I asked, recalling that it had looked like he had had equal sized boxing mitts on? Dr. Kevin ran his hands down the cast one last time, now smooth and cleaner white than anything else in the small procedure room. He nodded, removed his gloves and apron, said something to the patient, and said, “This is a problem we have in Uganda. People don’t have money to pay, and hospitals can’t survive giving free care. The patient has to make choices.” Obamacare patient directed care taken to an extreme.
When he was brought in to Naggalama, the bone-setter Kevin felt it was best for the banana man to sober up before consenting to care, but in the meantime sent him to the cashier to pay for the necessary x-rays. Clearly the left humerus was snapped, that was obvious by the patient appearing to have two elbows on the left arm, one in the usual spot, and one 5 inches above the one he was born with. The left foot was puffed out more than the right, and both hands were hugely swollen like boxing mitts. So the patient was sent for 2 views of the upper arm, both feet and both hands to be x-rayed.
A few hours later, when hangover was overlapping inebriation, Kevin was smoothing the sculpted cast on the left arm from left shoulder to elbow, and another from elbow to the left boxing mitt, the alleged thief snoring from banana liquor anesthesia. But what about the right hand? The feet? I asked. Dr. Kevin finished smoothing, almost polishing, the plaster and explained matter-of-factly that the because of the cost of all the x-rays, the patient chose one view of the upper arm and a view of the left hand and left foot because that’s what was hurting him the most. I picked up the x-ray again and held it up to the window. The severe humerus fracture was obvious as was a left hand fracture. The left foot x-ray was normal.
“But couldn’t the right hand be broken as well?” I asked, recalling that it had looked like he had had equal sized boxing mitts on? Dr. Kevin ran his hands down the cast one last time, now smooth and cleaner white than anything else in the small procedure room. He nodded, removed his gloves and apron, said something to the patient, and said, “This is a problem we have in Uganda. People don’t have money to pay, and hospitals can’t survive giving free care. The patient has to make choices.” Obamacare patient directed care taken to an extreme.
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