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These are the breaks

By Dermot - 17th Oct 2016

<p class=”p1″><span class=”s1″>I me</span>t a man recently who had fractured his scaphoid bone. He is a finished scholar; an elderly, learned man with an academic’s view of the world. “I learned three things,” he said. “Firstly, I learned where the bone was. I never really knew. Secondly, I learned that it is pronounced ‘skayphoid’, not ‘skaaphoid’. Thirdly, it is spelt with a ‘ph’, and not an ‘f’.”

<p class=”p3″><span class=”s1″>These are the things that doctors learned so long ago that they cannot remember learning them. Of course, the scaphoid was a great one to remember for exams, it being partial to a bit of avascular necrosis and so on. It was also known as the ‘Chancer’s Fracture’. In the days when a civil servant who haunted the pubs of Dublin would fall among medical students (as a Joycean biographer once put it), these merry lads passed on a secret: if you x-ray a scaphoid fracture, it can take up to 10 days to show on a fracture. So your civil servant who had wasted his summer holidays helping out with lambing down home in Roscommon knew just what to do. </span>

<blockquote> <p class=”p1″><span class=”s1″>‘The scaphoid has not felt right since. It hurts a bit after a night playing guitar and I cannot arm-wrestle any more. That does not matter now, but I had been good at it and had made a nice few bob arm-wrestling’</span>

</blockquote> <p class=”p3″><span class=”s1″>He learned the location of the anatomical snuffbox in the back of the Palace Bar, stood the medical student a few pints and presented to the emergency department (ED). </span>

<p class=”p3″><span class=”s1″>He was duly plastered, if he wasn’t already, and he presented his right arm, ironically frozen in the shape of a pint glass, to the boss the next morning. A sick note that would do for the entire Galway races was clutched piteously in his other hand. </span>

<p class=”p3″><span class=”s1″>When he was x-rayed again, and of course had no break, he expressed relief and returned to do whatever civil servants did. It wouldn’t work now, what with keyboards and all. Of course, I genuinely broke my scaphoid when I was a student. My hand-writing was bad at the best of times and I had no chance at all with my hand locked in the shape of a civil servant’s pint, and furthermore I had to sit an exam in forensic medicine. It doesn’t seem long ago to me, but a computer was an exotic yoke then, so they found me a typist. She was a postgrad in history with a department word processor. She was also extremely squeamish. I did my best, despite her turning white at every paragraph and green at the really sordid bits. She finished and I went out into the quadrangle air for a smoke. </span>

<p class=”p3″><span class=”s1″>The plaster came off a few weeks later and we were called back to the orals. The extern was a famous man. “This is the student who fractured his wrist,” hissed a waspish pathologist when I was ushered in, glaring at me as if I had done it to make his life more difficult. </span>

<p class=”p3″><span class=”s1″>“Ah yes,” murmured the extern. “You obviously dictated it to somebody who has no medical training. You did read over it at the end?” Did I heckers like, not with a Marlboro Light and the college bar waiting for me. I passed anyway. </span>

<p class=”p3″><span class=”s1″>The scaphoid has not felt right since. It hurts a bit after a night playing guitar and I cannot arm-wrestle any more. That does not matter now, but I had been good at it and had made a nice few bob arm-wrestling. I suppose it will come back and bite me when I am at a low ebb, but there is not much I can do about it now. As Tony Soprano used to remark: “Whatcha gonna do about it?” If the weather changes, it aches in harmony with my broken toes. </span>

<p class=”p3″><span class=”s1″>I broke my toe one morning when I dropped a dumbbell on my foot. I was a casualty officer in Northern Ireland at the time so I presented to work, had my foot x-rayed, confirmed the fracture and worked on. That was the kind of eejit medical training bred in those days. </span>

<p class=”p3″><span class=”s1″>As I hobbled about that evening, a policeman (there were always policemen hanging about the ED in those days, I never knew why) asked me what was wrong. “Broken toe,” I told him. A smile slowly grew beneath his regulation moustache. “I broke my toe last year,” he said. “It was marvellous. Eight weeks I knocked out of it. Spent a month doing up the house and a month on holidays.” </span>

<p class=”p3″>At the time of writing, the medical profession are tired and low. The civil servants seem to be in splendid fettle. You can learn a lot from a scaphoid fracture alright.

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