A couple of weeks ago, in avoiding a the close attentions of a 25 bus on the Vogue Gyratory, one of my panniers clipped my rear wheel and was sent spiralling backwards towards Sainsbury’s. As this particular bag held my Macbook and all original interview material, it is precious and costly to think about replacing, and though the bike was leaning in towards the curb, my instinctive response was to ‘sling on the anchors’ as The Sweeney would have it, and I braked hard. The bike, now lighter than usual, rocked forward, flipping over the axis of the front wheel, and I was sent sprawling on to the road’s surface hands first. The second instinct was yelling ‘Not the face!’, but my arms broke my fall, before I slid into the curb on my left side and knee. Blood and panic washed everywhere as the blue transit van, that had been following me round the exit back onto the Lewes Road stopped and the passenger checked to see if I was ok. Being busy collecting my things from up and down the near side lane of the road, I mumbled a shocked Yes, I’m fine, and moved by bike, bags and grazed self onto the pavement.
So far, so unfortunate; should have fitted the panniers so they don’t foal the wheels, and would have avoided putting my knee through my jeans and bruising a rib. Or so I thought. Later that day, as I attempted to cycle home (I had continued on to University as I had meetings and a teaching commitment to attend to) I realised I couldn’t hold the handlebars with my thumb of my right hand. Broken wrist was my amateur diagnosis, and so the x-ray at A&E appeared to confirm, when I was speedily seen at the Royal Sussex later that evening. Suspected fracture to the end of the ulna. Common in any trauma where you land on the flat of you hand, palm open and perpendicular to your arm. I have done this before, twice; once resulting in a fractured scaphoid requiring long term plaster, once similar to now, caused by landing heavily while playing football, and resulting in wearing a splint for a month. An appointment was made for the Fracture Clinic for a hand specialist to confirm the original diagnosis and to clarify the follow-up care. Come back Tuesday morning.
Hating hospitals with the clarity of any healthy, non-health-professional human, I make sure I was being seen early, so I could avoid all the sick and infirm. My own frailties are embarrassing enough, without the demand that I am exposed to other peoples frailties and the concerns of their caring relatives. See me first please, and 08:30, first appointment in the book. I arrived nice and early, prompt meaning I am 10 minutes in advance of my appointment time, and take a seat in the comfortable but worryingly large waiting area. How many people do these people have to cater for? Is there an epidemic of brittle boned cyclists in Brighton? In hindsight, I why they have such nicely padded chairs in the waiting room; don’t really want anyone to cause any further damage to a broken skeleton do we, but my main concern was getting seen and walking back to North Laine and a cup of tea.
My appointment duly arrived and was swiftly aborted. The x-ray server was down. Now, for those of you who are too pre-cautious to cycle to work of a morning, or more likely too sensible to fall off regularly, you may not know but x-rays are no longer printed. The examination of you bones is now carried out digitally, with the results being stored electronically and served to a web browser for inspection. This is a national service, enabling the rapid recall of x-ray material as part of your medical notes and allowing the speedy transfer of material between departments and institutions. Sadly on this morning, the server was down and no x-rays were retrievable. The consultant who explained the situation, mentioned that the clinic has 80 patients due to visit today, all of which would have x-rays that would need to be inspected. Could I return to the waiting area until the software was working? Upon further investigation, it was discovered that the issue was not a local network connection problem, but that the national service was being restarted. No x-rays were currently available for inspection.
My predicament was soon remedied and the arm is mending happily, if slightly smelly, with the support of the splint. However, the failure of an x-ray server bears long consideration. If the x-rays were taken in preparation for surgery and they were required to confirm the status of a patient prior to any procedure, or worse, during the operation itself, how would the care of the patient be guaranteed? Does the theatre nurse have to go back and check a cached copy? Is there a hospital policy about making sure that the browser history is retained for future reference? What sort of server is used for this delicate information? Is it sitting on virtual machine servers, with data redundancy to ensure that a seamless service is maintained? Well obviously not that tuesday morning. Who specifies this stuff.
As an academic who is interested in the continual creep of the digital and virtual into the realm of the physical object, this is fascinating. How are the roles of the consultant and nurses responsible for first line diagnosis and clinic support affected by the digitalisation of records and test materials, and how often is the service failing to deliver for the patients? I suspect that no one is counting, no one is asking how the staff are reacting to these changes, and this is worrying me far more than this itchy splint.