Sunday, July 15, 2007

ER in Cairo

I was out riding with a few friends yesterday, just an hour jog in the countryside, training for two of them who want to improve their riding skills and training for my 5 year old gelding Figgy who is just now joining the working horse string. My mobile phone rang in my fanny pack attached to the front of my saddle and I slowed everyone to answer. Two of my neighbours and a friend had ridden down to Dahshur early that morning and it was one of them on the line to tell me that another had fallen from her horse and needed a pick up with a jeep. The four of us hastened back to the farm to go rescue Janie. Two of the friends went on home while one came with me after we collected cold water, a frozen jug of water, some arnica and some Rescue Remedy.

I ride in the Dahshur area quite frequently. The desert there is beautiful and the pyramids are easily as interesting and beautiful as Giza, although not as big. They are older though. The directions given would probably have stumped an ambulance driver, and even most of the local people around here wouldn't have had a good idea of the best way in to pick up our invalid. So horseback riding does have its rewards. We zipped off down the Mariouteya to the Dahshur turn, and then turned onto a dirt road before the entrance to the pyramid area. About a couple of kilometres down the road a turn over the canal into the tomb area of Dahshur gave us an entry into the desert close to the point where Janie's horse had fallen through a fox den with the result of her rolling over his shoulder and landing on her own on the sand breaking her collarbone.

The other riders collected horses, a groom that I'd brought would ride her horse home, and we packed Janie up into the jeep for the ride to the hospital. We'd only gone a few kilometres on the main road when a nasty floppy sound was the signal that I had a flat tire. Wonderful. And what a flat. The entire side of the tire was cut open, by what I have no idea. A quick call to Janie's daughter arranged a ride for my driver out to our parking place and a new car to continue to the hospital. While we were waiting, three different vehicles stopped by to offer assistance with the problem, but we told them we had someone coming. That's one of the things I really love about Egypt. When you have a problem, someone is going to help.

After a nice traffic jam on the Moneeb bridge we finally made it to Al Salam hospital on the Corniche in Maadi, our emergency room of choice...although that may change. About a year ago I'd taken another neighbour in there after a fall from a horse that broke her arm just below the shoulder, and a month or so ago Janie had taken a friend in late at night after a fall from a horse broke her tailbone. Yes, horseback riding can be dangerous, no question. In both of those cases, the doctors examined the women, made an x-ray, and sent them home with appropriate treatment, so we were expecting to be in the hospital for only an hour and a half or so, as long as the break in the collarbone wasn't too complicated. Something had changed, however, in the ER. A doctor first came and insisted that Janie had to lie on a back board, an object that looks like a surfboard with handles and is supposed to protect the spine in case of injury. Well, that's fine but where was it when we were collecting her in the desert, driving the jeep down the country roads, changing to the daughter's car and walking into the hospital? Seemed a bit like overkill to us but we humoured them. They very nicely gave Janie some pain killer IV and then hit us with a list of x-rays and diagnostic tests that were apparently "procedure". Must have new procedures, I guess. Despite our protests that a) she hadn't hit her head, lost consciousness, been confused or drowsy they wanted a CT scan on the brain. Ok, a bit much but reasonable. They wanted a bunch of x-rays on her back and pelvis as well as sonography on the pelvis and abdomen. Whoa Nelly! Janie had rolled off a horse that was also on the ground, hit the corner of her shoulder on the sand breaking her collarbone, but there had been no impact on her lower back, pelvis, head or even the other shoulder. The problem was very localised.

I was elected the official arguer because I'm very well-known to be stubborn and inflexible when necessary and I have a good understanding of medical procedures for basic first aid. We finally whittled the list down to something we felt was reasonable and would yield some actual information rather than a bunch of "You're fine"'s and a huge hospital bill. Six x-rays and a CT scan later we were told that she'd broken her collarbone (Well, duh. What did we tell you had happened?) but that it was a nice clean break that would have to heal in a sling. We'd walked into the ER at about 12 noon and it was 4:30 pm by the time we could leave. Janie hadn't even had coffee before going riding, her daughter hadn't had any breakfast before picking us up, and none of us had any lunch, so it was a pretty crabby group of women who left the hospital. That probably explains the vehemence of the final argument with the internal medicine guy who still wanted to have a sonography on the pelvic area. Fortunately for us, we already knew that the sonography man had gone home for dinner, so we told the doctor that if anything at all looked bad we would get back to them.

Both Janie and I are old hands here and remember when you had to walk into a hospital and tell the nurses and residents what kind of tests and treatments you needed rather than having some administrator tell us that "procedure" dictates what tests are performed. It's nice that they have all the new equipment and I'm sure that the procedures are useful, but it was so hard to get away from the idea that the driving force for the "procedures" was the balance sheet. I'm quite sure that the income for Al Salam will be rising in the near future because most people are neither as sure of what is wrong as we were, nor as determined in insisting on signing off on things that are unnecessary. I guess that progress has its price.

Oh, and by the way, the photos are just there for the viewing. They are pictures of the Dahshur area where they were riding. Pretty.

copyright 2007 Maryanne Stroud Gabbani