Butter Doctor 

Despite the pain I knew would be involved, I could not get to this morning’s appointment fast enough. If nothing else, this was evidenced by the fact that although I run late for every meeting, I was in the waiting room and ready to go for a 9.15 am appointment at 8.45am sharp.

Maybe I should have let my Dr finish her cup of coffee, but given the size of her – very slim and immaculately dressed, she did not look like the sort of person who would arrive for her day at work and start sinking extra cups of beverage. She was a lovely lady and greeted me warmly as I lay on the bench, knee popped up by a triangular cushion.

We talked briefly about my knee and how it had once again brought me to this place. I knew the procedure: local anaesthic, quite painful but very localized in the pain. This would effectively sink the needle that was going to do all the work into my knee cavity. The hopper atop the needle would then be replaced with an empty container and fluid drawn out under guided ultrasound, which meant the Dr had to manage the ultrasound head and the needle plunger (hopefully a slightly easier time for me as the numbing agent kicked in). Finally, the hopper would be replaced one last time with one full of cortisone which would be delivered to the site to work its magic, maybe calm down my angry joint and reduce the amount of fluid its lining is currently pumping out in its desperate pursuit of I don’t know what.

I feel kind of sorry for my skeletal system. It is furiously responding to the site of an injury, which it had no way of knowing  was booked and paid for by health insurance and managed by the brain, and doing its best to make a bad situation better. Maybe it is. Maybe the fact that I can not walk properly is a good thing, but I have had five months of this good thing and it shows no sign of giving up its tenancy. I watched TV last night in dismay as a program aired about how to stay young while growing older. They asked the 71 year old presenter of the program to try a simple test: could she stand with her legs loosely crossed and sit down on the spot without using any other part of her body for stability or strength. Not only did she do this, but she completed part two as well: to stand up with the same limitations from a crossed leg seating position on the floor. I lay on the couch and knew without even trying that if I tried only the first part of that test, I would have more than a bung knee to worry about, I would also have a broken coccyx.

The doctor prepared her trolley with the attending nurse, who handed her lines, hoppers and partially ripped open sterile needle packets so she could assemble the three pieces of kit for the procedure. A needle was filled with solution, a line was attached to a hopper, then she reached for the other vessel and it kind of flew out of the packet and across the trolley.

‘Whoops!’ Said the Dr.  ‘Another one, please nurse.’

The nurse handed her another packet and threw the other compromised equipment into the large sharps box.

‘And another, please,’ said the doctor. This one was in her hands for a matter of seconds before it flew up in the air, ricocheted off a sink and landed across the room.

‘Oh goodness!’ she said, no doubt wishing to God that these procedures were conducted with the patient under general anaesthetic, ‘I don’t know what is wrong with me today. I am sorry – you must think we are like the Keystone Cops in here.’

‘No problem,’ I said, wondering if perhaps that second cup of coffee might have been a good idea for her after all.

‘Right,’ she said, needle poised above my knee, ‘sharp scratch.’

Not so much of a scratch, I thought, more the feeling that a two inch length needle is being plunged through your skin towards a target some distance away. I felt my shoulders tighten. I knew the numbing effect would kick in and then there would be little or no more pain. It was just a matter of time.

Nope, no time to waste here. Without waiting at all, the Dr, with an alarming efficiency replaced the hopper and dug in a little deeper to begin drawing out the fluid.

I felt my shoulder blades meet in the middle of my back as I looked desperately at the ceiling. There were no answers there.

‘I am surprised you have not squawked,’ said the Dr. ‘People normally squawk at this bit.’

‘No shit?’ I thought, but said ‘Oh trust me, I have been wanting to squawk for a while now.’

‘Ok,’ she said, ‘That is 50 mls of fluid out of your knee. Now we will just pop the cortisone in.’

She picked up the final hopper with the thick, white fluid, and deftly dropped it on the bed beside me as she failed to screw it to the needle.

‘Goodness me! Not again.’ She cried out. ‘Can we get another shot please nurse?’ She turned to me and said, ‘I am so sorry, it is just that I don’t want to risk even the tiniest bit of infection.’ She turned back to the trolley.

‘Agreed, ‘ I replied through gritted teeth, because she was still holding the needle and everytime she turned to me and then to the nurse, it caused the needle to move too, and that is how I know the local still had not quite kicked in. My aim was to engage her in no more conversation so she would not turn to look at me again.

‘All done!’ She cried a few minutes later. ‘Sorry about all the butter fingers stuff – I just do not know what is up with me today.’

I knew. I knew because it reminded me of something from many years ago as I watched from a seventh floor window someone trying to reverse a car into a bay in the carpark below. The carpark was not busy and the bay was much wider than the car, but the driver executed something like a fifteen point turn to get the small hatchback in and straight.

It took so long that a few of us started watching the spectacle and then were doubly rewarded when the driver got out and was revealed as our manager, Sharon.

Sharon arrived in the office a few minute later to a volley of applause.

‘How did you guys know?’ she asked.

‘Know what?’ we said.

‘That I’m pregnant’ she answered.

I limped carefully out of the consulting room, wishing the Dr goodbye. Who was I to discuss my impromptu diagnosis with her? If I am right, I am sure she will get to experience more pain than I did as she gives birth.

I could have been wrong though. I got to reception.

‘Okay’, said the receptionist looking at the slip I had been told to give her, ‘so today we are charging you for an aspiration and injection to your LEFT knee.’ She put emphasis on the left.

‘It was the right knee,’ I answered.

‘Oh,’ she said, ‘so it was!’

I paid the bill and left the medical centre.

Fingers, as they say, crossed.


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