Excerpt From Actual Conversation Today

Last Saturday night, I injured my wrist trying to do something by myself that I had no business trying to do by myself. Last Sunday, I went to the Emergency Room, where ER staff promptly blew off the immobilize-everything protocol and sent me home with a velcro wrist splint on full duty. Wednesday, I followed up with my Primary Care Manager, who was LIVID at the botched-up ER procedures and referred me to Orthopedics, after completely taking me off duty and prohibiting any use of my left arm whatsoever.

When Orthopedics called me on Friday, they told me that my appointment was for January 21, 2010. I asked to speak to the Charge Nurse, and advised her that the injury is 1) acute, and 2) not immobilized. Magically, an appointment for this morning appeared in the schedule.

When I appeared at Ortho, a cursory clinical evaluation was done on the joint. However, NONE of the newly touted exam methods for diagnosing torn and ruptured ligaments were performed. When I performed one of these on myself to demonstrate, the clinical significance was ignored. One Physician's Assistant looked at the other Physician's Assistant and said, "sounds like a strained muscle." Please keep in mind that I am and have been complaining of ulnar-sided wrist pain, ulnar-sided pain upon any kind of forearm rotation, ulnar displacement, wrist and forearm bone "clicking," and limited range of motion (without pain) on the ulnar side. And in one week of partial immobilization, there has been no improvement.

The following brief-but-stupid conversation ensued:

Me: “So, you think it’s a muscle strain. Wouldn’t I be having less pain at this point if that were the case?”

Them: “No. Strains take a long time to heal. Have you ever strained a hamstring? They take forever.”

Me: “This isn’t a hamstring. It’s not even remotely comparable.”

Them: ::::exchanged looks as if to say ‘stupid civilian’::::

Me after awkward silence: “Okay, then, what next?”

Them: “Wear the splint you were given at the ER for about a week. Then back to normal.”

Me: “The splint hurts to wear. My arm aches at the end of the day. If I go without the splint, I still have pain, but nothing like the pain wearing the splint causes.”

Them: “Oh, that’s because it’s pulling your hand back slightly. We’ll just make you another one.”

Me: “Ok, but am I going to be able to see a surgeon any time soon?”

Them: “Why would you need to do that?”

Me: “Because with rotational movement, my bones are rubbing against each other. Because my symptoms indicate there may be a TFCC rupture/avulsion and/or a UT lateral tear. You can’t see any of this on x-rays and sometimes not even on MRI imaging. Because I’m telling you that my arm doesn’t look right, it doesn’t feel right, and it doesn’t work right.”

Them: “Well, what do YOU want to do?”

Me: “I want an MRI and an appointment with the surgeon.”

Them: “That’s not necessary.”

Me: “Then why did you ask me what I wanted?”

Them: :::::glaring:::::

Me after awkward silence: “Ok, so what about work?”

Them: “Just be careful.”

Me: “Careful? Right now I’m pulled off of full duty with a chit that says “NO LEFT ARM USE.” Are you modifying that to “Just be careful?”

Them: “Do you want a note for work?"

Me: “No, unless you are putting me back on full duty I already have a note. Are you putting me back on full duty?”

Them: “Sure.”

Me: “So it’s okay if I get in a fight or have to take someone down or have to lift heavy files?”

Them: “Well, no. So I guess light duty. Or whatever you call it.”


When I return next week, I will come fully armed and prepared for the battle which will inevitably ensue. Sigh.