Lets Take a Trip to A and E

See Amanda. Amanda lives in London. Amanda and her husband get to spend a night away from the children in a fancy hotel. Yay for Amanda!

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Amanda and her husband watch a nice show. Amanda is happy.

Amanda and her husband go to look for dessert. Yummy!

Oh no, it is after midnight, no one will sell dessert. Amanda is sad.

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Amanda and her husband decide to return to the hotel. See Amanda cross the street.

Oh no, Amanda has tripped and fallen down! Poor Amanda! She is having trouble walking to the hotel.

See Amanda look at the cut on her knee. She thinks she can see bone. Oh no! Amanda must go to the Accident and Emergency department.

See hotel security call for an ambulance. See Amanda and her husband wait, and wait, and wait.

See hotel security call for the ambulance again. See Amanda and her husband wait and wait and wait. See more than an hour go by.

See the ambulance arrive. See Amanda walk S-L-O-W-L-Y to the ambulance. Amanda is puzzled and confused that she was not put in a wheel chair.

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See the ambulance arrive at the A and E department. See Amanda and her husband sit and wait and wait and wait.

Amanda watches the other people who are waiting. Amanda thinks many of these people are very drunk.

Amanda sees one young man with glass in his hand try to pick up a girl who looks very drunk. It does not work. It is funny to watch. Amanda sees the drunk boy with the glass in his hand and his friends pose for selfies with the man in the corner who is snoring very loudly. Then they throw food at the man. Amanda feels tired and bored and annoyed.

See the clock strike 4:30 in the morning.

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See a doctor come out and call Amanda’s name. See Amanda struggle to walk to the examining room. Amanda is surprised that she has not been checked by a nurse before she sees the doctor. How odd.

Amanda is scared. She must have an x-ray to be sure she has not broken a bone.

Yay for Amanda! She has no broken bones! She can avoid immediate surgery!

See the doctor put 5 stitches in Amanda’s knee. See the doctor tell Amanda to stop by any clinic to have her stitches removed in 5 days. 5 Days! Wow! Amanda does not think that is very much time.

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See the doctor tell Amanda she can go. Perhaps Amanda has misunderstood. She has not been given any discharge instructions or papers, or any prescriptions for antibiotics.

See Amanda go home and go to bed. She did not sleep in the fancy hotel.

It is 5 days later. See Amanda call the surgery where she is registered. In the United States we would call it a “primary care physician.” See the surgery tell Amanda she can not be seen until next week. Amanda feels angry and confused. She feels that having stitches removed must be a priority. See the receptionist squeeze Amanda in on Monday. It is only three days late.

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See Amanda have her stitches removed by the nurse. See Amanda expecting a follow up appointment. See Amanda expecting some home-care instructions, exercises or stretches. See Amanda receive none of these. Amanda feels astonished.

Amanda knows about wound care. Amanda knows she must be very careful to take very good care of her wound so it heals well. Amanda asks what she should do to heal well. The nurse tells Amanda to “take it easy” for a few days. The nurse says good bye.

Amanda never sees a doctor again for her knee. It is 5 months since Amanda fell down and hurt her knee. Amanda feels that her knee is getting back to normal. Amanda thinks it is funny that her knee cap now has a dent in it. Amanda’s knee hurts when she sits curled up on the couch or when it is damp and cold outside. It is always damp and cold in London. Amanda continues to be surprised at the lack of follow-up care for her knee. She is also very surprised at the lack of after-care instructions for her knee.

Amanda is lucky. She was seeing a physio for her foot when she hurt her knee. In the United States we would call it a “physical therapist”. The physio has helped Amanda with her knee a little bit. Also, Amanda’s mother is a nurse. Amanda can get advice from her mother. Amanda feels happy that she is so lucky.

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Amanda wonders about the people who are not as lucky as she is. Amanda wonders who tells them how to take care of their injuries? Amanda acknowledges that she never had to pay any money to see the doctor at A and E. She also never had to pay to have her stitches taken out three days late. Amanda thinks she might be willing to pay a co-pay if it meant she would receive more complete care.

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(Amanda acknowledges that this may represent a simplistic view of the issues involved in acquiring good health care. S-I-M-P-L-I-S-T-I-C is a big word which here means “It is easier for the purposes of this blog not to have to consider the ramifications of a multifaceted socioeconomically diverse society and the costs and benefits of state run versus privatized health care.”)