Reading the Results

It's not easy to see an orthopedic surgeon.

You make a call and in 3-4 weeks you can get in for an initial visit, xrays and a series of twists and pushes and pulls with your arm and shoulder to convince the physician's assistant that your arm is weak. This is the first mention of the multisyllabics: supraspiniti, infraspinitis, ________ There's a map of muscles and tendons and bones in your shoulder, a geography, a topography that makes a car's transmission seem simple.  There's a mysterious architecture here displayed in the light and shadows of the xray. Displayed on the light box, nothing seems particularly complex or broken or out of place. The PA and later the orthopedist points a pencil as a white abstract shadowy area.  THat looks like a tear. That coud be a tear. See this bridge of darkness here? That shouldn;t be there. Thata a birth defect. Bones didn't close. Nothiong to do about that now.

This is not an interview or an exchange.  It's a monologue, complete with the darting pencil, the general circular motions near some light or shadow.  See?

We're meant to follow the anatomy and the didactic pointing above the xray, as if writing on it, marking it, would somehow mar the sacred surface. The result is obfuscation. general motions that replace what could be pinpoint accuracy.  Which is not how we read a map, especially whern we're trying to locate where we are. We trace our finger across the surface of roads and arteries and junctions. The sliding of the finger and halting on sites verifies our location.  We trust maps better than we trust verbal directions at a gas station: go down south about a mile or two, take your second right after the bridge, past the dirt road, then turn left onto the old highway. 

You are assigned 6 weeks of physical therapy, and then a follow-up with the orthopedist, and then, based on your status, you'll get more therapy, or a shot of cortisone, or arthroscopic surgery.

The follow-up lead to theneed for an MRI to confirm what was know during the first visit. Insurance compies requir this protocol, so you schedule an MRI and then another follow-up with the surgeon and by this time you're three months out from your first visit. 

Once the MRI results are loaded on the screen the PA examines them, explains what they might mean, and then the surgeon comes in and dials into the results with alarming speed. You have two complete tears, here and here. You have a sliver of arthristis here. We can scrape that out. You have a tear in your biceps tendon here, we'll just cut that and let the musle slip down a bit, and you still have a tenderness in your elbow, we'll give you a shot.  It's like the ditrections a baseball manager gives to pitcher when visiting the mound.  We'll pitch to the lefty, nothing hittable, but challenge him high. If we walk hom then the bases are loaded and we have a double play set up everywhere.