Thumbs up

I baked sticky date pudding with butterscotch sauce according to MasterChef and it's sooo good. Except for my almond praline which turned out bitter because I burnt the caramel. It's so simple, I wonder why I didn't baked this before!

We have an awesome consultant at the moment who rocks up in high heeled knee-length boots, the colour of which matches her long red hair. Pretty funky. Our team - made up of 5 young, female doctors tend to startle some of our older male patients. I wonder what patients would say if we all came to work with knee-length boots. Here comes the Spice Girls with their stethoscopes. Oh yeah.

I was once explaining to a patient's husband about his wife's multiple sclerosis and the investigations that were going to be ordered. Throughout the whole conversation, he listened to me and I asked questions and he answered hesitantly. His hesistance should have warned me that something was amiss. Finally I closed the conversation by asking whether he had any more questions of which he answered he didn't and I left.

Later the speech pathologist came to find me and ask me whether I could speak to this patient's husband as he wanted to speak to a doctor. Perplexed, I told her I just did. She too was surprised because the husband said that he hadn't seen a doctor all morning.

Sighing, I left my station to speak to him. "Sorry, you wanted to speak to a doctor?"

"Yes if that's allright. When is the doctor coming?" At this point I was thinking - seriously who did he think I was - some nosy busybody who had nothing else better to do than ask him questions about his wife's multiple sclerosis and previous treatments and write up investigation slips and run down to radiology for fun??

I calmly replied, "I'm a doctor."

"Oh." I stared at him, waiting for him to say more, waiting for him to put two and two together. Still nothing from him.

"Did you have any questions?" I finally relented.

"Erm no, that's fine," he answered defensively. Later I returned to visit the patient again with my registar and consultant and my consultant back then was a tall, male doctor with grey hair, the typical look all doctors should carry in order to get the label 'doctor'. He immediately perked up and asked the consultant questions about the results of the investigations and what we thought was happening.

My consultant then turned to me, giving me the opportunity to answer his questions. I didn't look at the husband. I looked at the patient giving her a warm smile and told her what the MRI showed. I was still smarting from earlier and refused to look at the husband.

Many days passed as I continued to interact with this patient and her husband. Throughout the whole admission, he remained very brusque and defensive to me. I tried not to let that bother me, reminding myself that his wife was the patient and she was a lovely, courageous person.

Another morning came, and the team came round to visit again. She was trying to tell the team something. As the consultant and registrar tried to work out what she was trying to say, I entered and immediately she turned to me. As interns, we spend the most amount of time with patients apart from nurses and I had worked out a simple way of communicating with her. Thumbs up means 'Yes' and thumbs down means 'No'. Is is the breathing? Thumbs down. Is it the neck? Thumbs down. Is it pain? I gave her paper and she scribbled something illegible. Her lips were trying to say something but no sound came out. It looked like she was saying food and she was pointing to her neck. Finally I worked out that she wanted us to know that the textured food she was having was too dry and that was making swallowing difficult. Thumbs up.

I left to inform the dietician. As the team reassembled outside her room, the husband went to find us and said the wife wanted to say something. My consultant went in and then came out saying that she wanted to speak to someone else. My registrar popped in and again she came out. Puzzled, I went into the room and she saw me and she smiled a lopsided smile. She pointed to me and gave me a thumbs up. I returned the same gesture to her thinking she was telling me she felt better. She then pointed to me again and repeated the same gesture.

My consultant said, "She's saying thank you. She likes you."

I was very touched and I couldn't help but feel very satisfied that day. Her husband remained aloof to me until her discharge but the patient made up for all of that. Thumbs up.