My child’s arm is broken, but is our health system?

Jennifer O’Connell learns some life lessons from a trip to A&E

Photograph: Alan Betson
Photograph: Alan Betson

“Why do they call it ‘Casualty’?” my daughter asked on the way to Casualty. “That’s terrible advertising. They should call it Survivor. Or Purple Teddy Bear Cuddles. Anything but Casualty.”

It was one of those things. A fall in the playground. She crossed her arms in front of her chest and insisted she was fine. On closer inspection a few hours later, it was clear she really wasn’t fine.

And so we joined the circuit of the minorly injured. GP’s surgery. Casualty. Minor Injuries Unit. X-ray. Back to Minor Injuries. Back for another X-ray. Finally, we ended up at that place where every journey through the Irish health system, however brief and unremarkable, goes in the end: a trolley on a corridor. We waited there, surrounded by the properly sick – people with drips and dead eyes – for orthopaedics to tell her she could go home and come back at 7am for surgery.

The worst thing about the Irish health system is the system. The best thing is the people you meet within it

It’s true what they say. The worst thing about the Irish health system is the system. The best thing is the people you meet within it. People like the nurses in the paediatric ward who had to somehow fit 13 children into six beds. “I can’t knit beds, you know,” one of them said. “Any day now they’re going to bring in bunks,” another sighed. But they kept monitoring and smiling, checking and helping, reassuring and smiling, fetching and caring, wiping and smiling, and they’d be doing it long after we went home.

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And the doctor who, when my girl finally gave into pain and exhaustion, got her a cup of milk and some toast and some tissues to wipe her eyes. Or the one who promised that, when they had to put her to sleep so they could fix her arm, she could choose her own dream.

As we completed our Casualty-X-ray-Minor Injuries circuit, we kept seeing the same faces. There was a lady who had fallen when she was out walking the dog. She came in with her husband and daughter. “It’s the second time I broke it. And I was only out for an hour,” she was shaking her head at the unlikeliness of it all. “Brave little girl,” she’d say to my daughter whenever we met.

Then there was the man in the wheelchair with the painfully swollen foot, whose two young friends, both called Mikey, kept up an enthusiastic speculation about how much compo he'd be up for. "Fortnight in Spain. Easy," the first Mikey said. The other Mikey knew someone who'd got 150 grand "and not a mark on him".

“Price of a house, no bother,” the first Mikey said.

“And an apartment in Spain,” the other Mikey added.

Another man had fallen in the bath on Saturday; he’d kept going and it was now Wednesday and he hadn’t slept a wink with the pain but he’d still gone into work and he’d spent the day lifting crates of fruit and veg because that’s the way he was. He wasn’t a skivver. He gazed across the room at the Mikeys, their attention now turned to an apparently hilarious leaflet on sexually transmitted infections.

Then there were the worried parents, trying to stay out of the way so that the medics would know they weren't <em>those </em> parents

“I can’t stand it anymore,” he said. It wasn’t clear if he meant the pain or the Mikeys.

Then there were the worried parents, trying to stay out of the way so that the medics would know they weren't those parents; they weren't parents who hovered or questioned or demanded. There was the couple with the lovely young daughter who was quietly but determinedly having none of the prodding or the testing or the hospital gown, and who certainly wasn't taking out her hairslides for anybody, until her Dad read her a Mister Men book, and all was right with the world. Her favourite one was Little Miss Sunshine, she said, all sunshine herself.

There was one other couple we kept bumping into, a mother and son. He was here so often he should have a loyalty card, she said. Falls off horses. Kicks from cows. Blows on the GAA pitch. Crashes off his bike. Other bits and pieces, she said wearily. You know yourself.

When he went off for another X-ray, she elaborated on the “other bits and pieces”. He sometimes got pains in his chest from anxiety. Bad pains. He had to get his heart checked out, but she knew it was just anxiety. It ran in families, she said. I know, I said. It worried her a bit, even though she tried not to let it. I know, I said, I know.

She looked at me gently, in a way that told me I really didn’t know. We met again, later in the evening, outside the X-ray department. “I had another son,” she said simply. “It got too much for him. I lost him to it, to the anxiety.”

She took a deep breath. “He committed suicide when he was 19.”

“Hold your daughter close,” she said, and just like that, a trip to Casualty with a broken arm was nothing at all. An interlude. A heartbeat.

“Keep an eye on her,” she said, and I promised I would.

joconnell@irishtimes.com