Who You Gonna Call?

The following episode takes place between 9am and 10am on the day we were hoping to leave Manado.

INT: A surprisingly posh hotel room. Z is lying on the bed, contentedly re-reading his latest Da-Vinci-Code-ripoff for about the fifteenth time. I am shouting into a Mac in the corner, where a nurse from the travel insurance helpline is trying to understand me.

Nurse: “Can’t you take him to the family doctor?”

Me: “Err… No. We’re in Indonesia.”

Nurse: “When do you get home?”

Me: “About fourteen months from now.”

Nurse: “Ah. So what’s the problem?”

Me (adopting confident voice of experienced mother who basically knows what she’s doing and has been through this conjunctivitis schtick before): “Well, there was an eye infection going round. I got it before him. I treated it with Visine then picked up some antibiotics…”

Nurse (disapproving): “You shouldn’t do that, you know.”

Me (startled): “Do what?”

Nurse: “You shouldn’t treat him with over the counter medicines. He needs to go to a hospital. Have swabs so they can establish what the infection is. Then they can treat him for that infection.”

Now, I’m going to digress a little at this point.

Conjunctivitis, or pinkeye, spreads like wildfire through British nurseries, schools and afterschool clubs: anywhere, in fact, where small people with zero sense of hygiene stick fingers into body parts with the abandon of patrons in a San Francisco bath house.

To your average British GP, or British nurse, “Child has conjunctivitis” is not front page news.

And certainly not swabbable.

I’m just guessing, here, but I’d imagine that your average health professional, just like the rest of us, doesn’t want to poke a swab into the eyes of a howling, wriggling child unless they really, really, really have to.

In fact, the only time ANYONE in Z’s school got swabbed for anything was a friend of his, the first in school with swine flu. And his father, a GP, only got the swab down his throat by promising him a fortnight off school if he tested positive…

Anywise. Back to conjunctivitis.

The first time your child gets conjunctivitis (which, in toddlers, can go from “oh, he’s rubbing his eyes” to “OMFG his eyes are white with pus” in a matter of hours), you run to the doctor’s in a flat panic.

Your doctor looks at the child. Says, “He’s got conjunctivitis,”; pulls out the torch; checks the eyes; sends you away with something you could buy over the counter and says, “Come back if it hasn’t cleared in four days.”

The second time, you take your suppurating spawn to the pharmacist and say “He’s got conjunctivitis”. He or she looks at them, sells you something over the counter and says, “See your doctor if it hasn’t cleared in two days.”

The third time, you leave the spawn behind, trot down to the chemists and just buy the bleeding stuff over the counter.

Clearly, however, this nurse does not.

Nurse: “So, can you describe the symptoms?”

Me: “Well, like I said. He had conjunctivitis. I’ve been using antibiotics, so the infection seems to have cleared. But he’s got red marks on one of his eyes as if he’s scratched the surface of his eye or burst a blood vessel and I’m wondering whether he needs to see someone.”

Witch Nurse: “So, what you are saying is, you think he may have lesions on his cornea? You think he has an open wound on the surface of his eye?”

Me: “Erm…”

Evil Witch Nurse: “That’s very dangerous, you know. There’s a risk of ulceration and sepsis.”

Now, that wasn’t, actually, what I was thinking, or saying.

What I was thinking was that his eye looked suspiciously red and he might have done it some minor injury in the course of rubbing his eyes or perfecting his zombie impression.

The magic words “corneal ulceration”, however, have me thinking that the healthy, happy, if rather red-eyed child might be on the verge of infection, death, *blindness*… And from a *tropical* disease, at that.

The paradigm shift took me right back to my first (and last) encounter with NHS Direct, the telephone advice line set up by our last government (ironically enough, in the light of what follows) to dissuade people from bothering their doctor with minor ailments.

Z was five weeks old. He had a cold.

I don’t know why. But I looked up “cold” in a baby book.

Big mistake.

It said, “Whenever your baby has their first cold, especially if they are under six weeks old, you should ring the doctor.”

OK, I think to myself. I’m not bothering the doctor. She’s got enough to do.

I’ll ring NHS Direct.

Really big mistake.

The nurse on the other end ran me through a series of questions:

“Is he drowsy?” (Well, erm, he’s five weeks old. He’s asleep.)

“Is he his usual self?” (Well, I guess so. I don’t know, though. He’s asleep.)

“Trouble breathing?” (A bit snuffly.)

“Fever?” (Nope.)

“Fits?” (Nope.)

“Red spots?” (Nope.)

Etc.

By the end of our call, I was feeling quite relaxed.

That is, until she said: “Given what you’ve told me, and Z’s age, I have to ask you to go straight to A&E at your nearest hospital immediately. Do not wait. Go straight away. And if his condition deteriorates on the way, don’t hesitate. Call an ambulance at once.”

So H, my dear friend whose role in his life Z explains to friends at school as “stepfather”, and I sat staring at the baby. Transformed, in a second, from little, warm, slightly snuffly, creature snoozing in a basket to fragile Dickensian waif at death’s door from neglect.

Back in Manado, nigh-on ten years later, with a sturdy, if scrawny nine year old perfectly capable of talking for himself, I am less concerned about imminent death. More sort of guilt-ridden.

Me: “OK. So what do I need to do?”

Nurse: “Take him to an ophthalmologist.”

Me: “Do you know an ophthalmologist in Manado, Indonesia?”

[pregnant pause]

Nurse: “Well, take him to the doctor. The doctor will take swabs and be able to inform you whether you need to see an ophthalmologist.”

Off we trot to the hospital.

This is no less clean than a British hospital. There are many fewer facilities (I wouldn’t want to get a head injury here, let’s put it that way) but no queues. The building is pretty shabby but there are lots of staff around and everyone is quite phenomenally helpful.

The doctor takes one look at Z. His verdict? “He has conjunctivitis.” He shoves a (camping) torch in his eyes; prescribes some stronger eye drops; and sends us home.

Back in London, H, I and our precious burden are processed with phenomenal rapidity at A&E, the emergency unit, and brought through to a weary-looking junior doctor, probably some way into a 48-hour shift.

To give him credit, confronted with what is manifestly not a very sick baby, he does not immediately ask the obvious question: “Is it your first baby?”

He runs dutifully through Z’s “symptoms”. (Snotty nose, snuffly, erm, sorry to bother you, but NHS Direct said we should come…)

I undress his sleeping form. The doctor drapes him over his forearm to best inspect him.

At which point Z wakes up, turns and looks at the doctor (for any non-parents still reading, that’s the 5-week-old equivalent of a backflip with triple sukahara) and beams, broadly.

“He’s got good head control,” says the doctor, drily. “Was that a smile?”

“Erm,” I say, embarrassed. “Yes. I think it was.”

“First baby, is it?” says the doctor.

“Yes,” I say.

“He has an Upper Respiratory Tract Infection,” says the doctor. “That’s an infection of the upper respiratory airways. Otherwise known as a cold.”

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