Loose Cannon
Loose Cannon is an excerpt from my medical memoir. This is a work in progress. The genre is creative non fiction. It is based on real life events. All names have been changed to protect the identity of the individuals involved.
Chapter Three
November, 2013
Her name was Daisy. She had Crohn’s Disease. She was desperately thin, and she walked around the ward with a feeder tube in her nose. Daisy groaned and vomited through the night. By day, though, she went shopping, and returned to the ward with bags full of Adidas clothing. I admired her determination to carry on living her life. I envied her, not because I wanted a degenerative disease, but because she had a diagnosed condition, for which she received treatment. She was believed.
Professor Wong
Meet the Loose Cannon. I was under the care of The Clinical Lead of Ophthalmology, Professor Wong, at an NHS Teaching Hospital. Professor Wong specialised in ocular plastics, which is the medical and surgical treatment affecting the eyelids, the lacrimal, tear system, the bone around the eye, adjacent periocular (around the eyes), and the facial structures, including the forehead and cheeks.
He wore thin silver spectacles, and exerted a dictatorship style authority. From day one, our relationship was combative. My tone was exasperated. His was brusque. He started me on the oral antibiotic Doxycycline, for my orbital pain. He also took two blood tests. Both blood tests showed that I had raised neutrophils, a high white blood count, (WBC)and a raised Erythrocyte Sedimentation Rate (ESR). He wrote to my GP, and said that ‘the clinical evidence, points to infection as the cause,’ but he refused to acknowledge this to me.
IV Antibiotics
Professor Wong agreed to admit me on a for 48 hours of intravenous antibiotics. Once I was on the ward, I was contacted by a wonderful microbiologist. He was called Dr Penrose. ‘I will work with you for six months to find the right antibiotic,’ he said. He told me that he would administer Ciprofloxacin, intravenously, and that he would give me the strongest antibiotic that there is, for soft tissue infections, orally. This is the Super Daddy of antibiotics, called Linezolid. It penetrates muscle and soft tissue better than other antibiotics.
Over that weekend, kind-hearted nurses came and went to change my IV bag and to flush out my Cannula. I felt more energised from the treatment, but I still had the stabbing pain behind my eye and a swollen cheek. On the Sunday evening, I heard a kafuffle out on the corridor. The nurses were speaking to each other in hushed tones. I could hear them saying that Professor Wong wanted me gone by the end of the next day. I smelt trouble.
The Eclipsed Truth
It has always been difficult for me express myself truthfully to those in authority. I was raised by a middle-class family, who knew better than most, how to put on a show that ‘everything was fine,’ when in fact it was not. My mother was abusive toward me mentally and physically for most of my childhood and adolescence. She was also a secret alcoholic. No one knew that she drank. Not even me. It was at thirty years old, when I found a black binbag full of empty Whisky bottles under her bed, that I joined the dots, and realised that her weird behaviour was because of the alcohol.
My mother would hurl abuse at me most days, until I was so worn out, that I could not defend myself. After this, I would make her a cup of tea and tell that I loved her. I did that because I had no one else. I was frightened of losing her. That wasn’t the truth though. For the most part, I hated her, but my truth was eclipsed.
The Truth Gap
There was abuse from my father as well, but I did not realise that it had happened until I was in my early forties. That gap of thirty years between the trauma and the realisation that it had happened, means that when trauma or confrontation occurs now, I have a delayed reaction. I am unable to respond in the moment. I freeze, and then days or weeks later, I become furious. That is when I am able to say something, but by then, it is too late. The other person has moved on.
Keeping quiet is my default position. If I experience pain, I try to vocalise it, but my words get stuck. It is like my mind and my mouth are not connected. I know what I want to say, but when I speak, my words deflect and I become quiet and accommodating instead. My hope, is that the truth gap will lessen over time.
During child sexual abuse, the freeze response keeps us safe by keeping us still. It prevents something worse happening. It allows us to survive in the moment. But it manifests in the long-term as a learned helplessness, as an all-pervading sense of our powerlessness in our lives.
www.carolynspring.com
Angry Man
The sun shone through the sealed windows on the ward. I was sitting up in bed, eating a bowl of cornflakes, and I heard Professor Wong pacing up and down on the corridor.
‘I want her gone by the end of the day!’ he cursed.
‘Yes, Professor Wong,’ the ward sister replied.
I felt my throat constrict and my eyes prickle. He appeared, standing at the end of my bed. He was wearing a long raincoat, the kind you imagine a flasher, who is lurking in the bushes, would wear. ‘This is your last day of antibiotics,’ he said. ‘We will be discharging you today.’
‘But my face is still swollen, and my eye is still sore,’ I squealed.
‘My colleagues and I would like to speak with you.’ His eyes were stern. ‘We will see you in half an hour.’ He marched out of the ward, with his coat-tails flapping behind him.
Mr Andrews
Professor Wong reminded me of my headmaster at primary school, Mr Andrews. He would give the class a warning, before returning with the punishment. He once dropped a boy called Mark Sawyer onto his knees during an assembly, in front of the entire school, as a punishment for swearing. It was a wooden floor. We heard a thud, and then Mark’s long-drawn-out squeal. I thought of Mr Andrews when Professor Wong stormed off. I knew that he was coming back soon with my punishment. The ward sister agreed to accompany me to the meeting and Daisy took some photographs of my small eye and puffy face on my Blackberry.
‘Can you see my swollen face?’ I asked Daisy.
‘The left side of your face is completely different from your right side. Your face is lopsided,’ she replied.
The Meeting
It was a stuffy room. There was poor natural light, and horrible plastic chairs around the sides. The room smelt of cheesy feet and cold plaster. I was wearing my Snoopy pyjamas and trainers, and the cannula was still inserted into my vein. I laid my phone on the seat next to me, and sat with my hands pressed tightly under my bum. Professor Wong entered. Two consultants trailed behind him, both with short hair and grey suits. Professor Wong sat down next to me, reeking of boiled spinach.
‘You’ve had your 48 hours of antibiotics. My team and I have agreed that there is nothing more we can do for you here,’ he said.
‘But I feeling an improvement from the IV antibiotics,’ I pleaded. My voice was small. I could feel that familiar freeze within me setting in.
‘But the improvement is not significant enough to justify us continuing your treatment,’ he said. The scan was normal.’
I felt a jab in my heart. ‘But the blood tests showed infection.’ I looked up at the nurse for help, but she glanced down at the floor. ‘Look, Professor Wong. My eye is small and my cheek is swollen.’ I swiped the screen on my phone to show him the sequence of photos.
He flicked his hand at my face, like he was shooing away a stray cat. ‘I cannot see anything wrong,’ he said, pushing away my phone. ‘You are irrational.’
‘I am not irrational!’ I said. I dug to find force in my voice. ‘You don’t want to see that something is wrong. I am still in pain. Please do not stop my treatment, Professor Wong.’
‘There is nothing more we can do for you here. We’re done.’
Ouch!
The jab in my heart turned into a transforming sting. I looked up at the other two consultants. They looked like military officers on standby; quiet, but condescending in their poise. One of them was reading my notes, the other was looking down, with a pinched face.
My back was dripping wet. I could hear ringing in my ears. ‘The antibiotics are helping. The microbiologist said he would work with me for six months. Is that offer still open?’ I asked.
‘No, it isn’t,’ he replied.
That was it. The loose cannon was washing his hands of me.
The Fight
I refused to leave. I told the nurses that I wanted to see the Chief Executive, (CEO). There were phone calls back and forth from the ward to the CEO’s office. Later in the day, a nurse from the Chief Executive’s Office agreed to meet me in the main foyer. I ran down the stairs, still wearing my Snoopy Pyjamas, and carrying an Egg Mayonnaise sandwich in my hand. Families were milling around in the foyer. I found the nurse. She was podgy and wearing blue scrubs. She introduced herself as Rosie. We sat on the brown cushioned chairs, and I collapsed into her arms and fell into a paroxysm of weeping.
Rosie
‘Professor Wong is kicking me off the ward!’ I cried. ‘Can you help?’
‘I am aware, Felicia. I have little power. He is the consultant, and he has the last word.’
Rosie handed me a packet of tissues. I blew my nose. A lady with swollen ankles sat down next to us. Her husband was chomping on a Dime bar. I clung to Rosie, and nestled my head into her fat rolls around her tummy. ‘How can he just kick me off the ward, mid treatment?’
She said she would speak to him, but that she ‘could not promise anything.’ She got me a cup of cold water from the water machine. I drank the water, while my tears quietened.
Marching Orders
I got to stay one further night on the ward, after seeing Rosie. The next morning, Professor Wong marched into the ward, still wearing the same raincoat. ‘My colleague, Mr Sanders up at a nearby Hospital is willing to see you today,’ he said. His manner was milder, ‘but he is likely to say the same thing same as me.’
Professor Wong knew as well as I did, that his colleague would back up his opinion.
‘Who is he?’ I asked.
‘He was my mentor. He trained me,’ he replied. ‘We will send you up there in a taxi, but don’t expect a different opinion.’
‘OK, I’ll go and see him,’ I replied. I thought that something was better than nothing.
My Medication
My God! Then he really did shock me. He wasn’t just kicking me off the ward. He told me that he was stopping all of my medication as well. ‘I will be writing to your GP,’ he continued, ‘I will be advising that all antibiotics should be stopped after this final week’s course of oral Linezolid and Ciprofloxacin.’
A lump of tears rose in my throat. He wasn’t just kicking me off the ward. He was cutting my prescriptions dead without doing a blood test first. ‘But you haven’t done a blood test, to see if my infection markers are normal,’ I replied.
He squinted. ‘The medication that we give you will be your last lot.’ He started to walk away.
‘Professor Wong!’ I cried. ‘Please will you do a blood test, to check that everything is normal first?’
He ignored me and stormed off the ward.
Shock
I was winded. A lump of tears were stuck in my throat. He had admitted me for intravenous antibiotics, because of clinical evidence, that there was an infection in my system. He was now ordering that no further medication should be prescribed, without checking that my Neutrophil and White Blood Count were normal. Did he skip medical school when they taught about compassion? I looked up at Daisy, who was plaiting her hair.
‘Is he a doctor?’ Daisy asked.
‘Yep,’ I replied.
‘He doesn’t act like one,’ she said.
I was glad that Daisy saw the loose cannon for what he was. A nurse bought me my one week’s course of antibiotics in a stapled bag. While I waited for my taxi, Daisy came over and handed me a wooden doll. ‘This will bring you luck,’ she said and kissed me on the cheek. ‘Bye, Felicia.’
Two nurses escorted me down to the hospital entrance, where a taxi was waiting for me. I knew that this trip, to see the loose cannon’s colleague was a waste of time. Professor Wong was the most senior oculoplastic surgeon in the UK. If his clinical opinion was that I am irrational, then no other Ophthalmologist would contradict him.
‘Don’t worry, love. Everything always works out in the end,’ the taxi driver said. His name was Sunny.
The Taxi
As the taxi sped up the A64, I watched birds out of the window, spiralling in the sky. This was going from bad to worse. A collective opinion was forming around me, and about me, which was not positive. Something I once read at university came back to me. I took a course in my final year, called Comparative Epistemologies, which is the study of different knowledge systems. My tutor gave me a book called The Structure of Scientific Revolutions by Thomas Kuhn. Thomas Kuhn speaks about the emergence of paradigms and theories in science. He says that paradigms or theories emerge when there is enough agreement between people.
I gripped onto a bag of Skip crisps. Professor Wong was a medical consultant with enormous prestige. He had set in motion a theory that I was ‘irrational.’ If one or two more Consultants agreed with him, then a paradigm would emerge that I am irrational, and that there was nothing wrong with me. This theory would grow, and it would make getting a diagnosis and treatment impossible. I was slipping down a dangerous ravine, and there was nobody at the top to help me back up.
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