A collection of articles and thoughts by Dr Chris Ellis
DESPATCHES FROM THE LAST OUTPOST
The second printing of this book is now sold out except for some copies at Bookworld, which can be ordered
At : cascadesbookshop@lantic.net
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Communicating with the
African Patient
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This book is filled with useful and practical language learning strategies designed to help doctors, nurses and other healthcare workers (who do not speak an indigenous language) to learn an African language through their daily contact with patients.
More than this, it gives advice on ways to reach some understanding of the culture, health beliefs and world views of the patient in a medical consultation. Although English/Zulu and the Zulu medical culture are used as the examples, the underlying themes are applicable to any culture.
The book has retained the humour and wit of its predecessor, Learning Language and Culture in the Medical Consultation, but it has been considerable revised and expanded to include more material on the cross-cultural consultation, the Aids pandemic, as well as appendices of vocabulary and ‘survival phrases’ designed to facilitate communication and understanding in a medical context.
Chris Ellis is a General Practitioner in Pietermaritzburg, and an honorary Senior Lecturer in family medicine at the Nelson R. Mandela Medical School, Durban
His post-doctoral studies involve language and communication in the medical consultation.
Private Bag X01, Scottsville 3209, South Africa Tel: +27 (33) 260 5226 Fax: +27 (33) 260 5801
E-mail: books@ukzn.ac.za http://www.ukznpress.co.za
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I have recently been down to watch Maritzburg College play at their rugby fields called Goldstones. It really is an amazingly enjoyable afternoon. There are the hurrahs of the supporting boys and the braying of unweaned old boys. In fact, one can eavesdrop on old boys meeting up with each other and pick up pieces of conversation such as "in my day, old Codger would never have allowed . . ." and remarks between very old boys along the lines of "was it you or your brother who died in the war?"
Apart from the enjoyment of the game, it is reminiscing time. I last played rugger as a medical student in London in the sixties. I was at the smallest school, called Charing Cross Hospital Medical School, and I played for their bottom team, the thirds. Our scrum was a group of misfits, most of whom were blind because we couldn't afford contact lenses and had to take our glasses off. Those who weren't blind suffered from Adult Co-ordination Deficit Disorder. As the bottom team, we rarely fielded 15 players and often had to ask to borrow a player or two from the opposition and play 13 or 14 aside. Our captain was a wing forward called Blod Weekes, who weighed about 45 kg, and our wing, Spider Coleman, had amazingly thin arms and legs, and was selected for his ability to recite all 42 verses of Eskimo Nell in the bar afterwards. I remember us once losing 75 points to nil and that was in the days when a try was only three points. Playing in the rain and mud in the cold English winter we slithered around and, after 10 minutes, everyone was covered in mud and it was difficult to tell who was on whose side. It must have been a nightmare to referee. Actually, thinking about it, I don't think we often had a referee.
They were very interesting games because, as everyone was covered in brown, wet mud, you couldn't tell who was an enemy and who was a friend. Consequently, no one really wanted the ball because as soon as someone threw you the sodden, slippery thing the other 29 players on the field descended on you, so you immediately threw it up in the air and made a dive for cover.
One of our favourite matches was against a team called HMS Chrysanthemum, who were a team of Royal Naval Volunteers, who we could nearly beat. HMS Chrysanthemum was a retired training frigate that was moored on the Thames at the Embankment. Consequently, they did not have a home field and had to play all their matches as away fixtures. To make up for this, they had a Wednesday evening once a month when they invited, to their mess, the teams that they had played the previous month. Once you crossed the gangplank and were on board, you were officially on a Royal Naval boat at sea and there was no duty on the drinks. Gin was four pence a tot, which to a medical student was as near heaven as you could get. I only went once. I was about 19 years of age at the time and was not used to drinking gin in such quantities. There was a lot of singing and then someone asked us to go into the boardroom for a movie. I sat down and they turned the lights out and I immediately went to sleep. I missed out on a blue movie and that is the nearest I have got to one ever since.
In our school or student days we all had a moment of glory in rugby or sport, however small. It was when we actually caught the ball and fell over the line or accidentally stopped them getting a goal. My moment of glory started on a Friday night in the Lemon Tree in Covent Garden, which was the hospital pub. It was the sixties and we were all trying to live up to John Lennon's famous dictum that if you remembered the sixties then you weren't really there. The sixties, in retrospect, seemed to be a decade of great optimism and innocence, although that may be a ubiquitous feeling of the youth of every decade. We all seemed to be on a high. This Friday night we were trying to get high on Watney's Red Barrel draught bitter.
So, in walks Charlie Burton, who was the rugby correspondent for the Irish Times, which doesn't really sound like a full-time job, does it? And it wasn't. His main occupation was running a rugby team called the Public School Wanderers. Now, myself and a friend called Dave John, who was also a member of the third team unco-ordinateds, were having a quiet pint when Charlie joined us and asked if we would like to play in his team as he was two players short for tomorrow's game. We explained that it was September and the beginning of the season and we were both hopelessly unfit. He then cunningly offered to buy us a round of Watneys as he knew that we also suffered from the Alcohol-Medical Student Mutual Attraction Syndrome. It must have been many free rounds of beer later that we had agreed to play because Dave and I found ourselves, with crashing hangovers, at St Pancras Street Station at midday as arranged the previous night. Dave was asking the train driver to go easy on the whistle.
Charlie was in his tatty old brown macintosh, unshaven and also avoiding the light of day and had obviously tried to trim his moustache with his right hand because the left part was short and the right side was still droopy.
As we boarded the train Dave casually asked Charlie what team we were playing and Charlie, equally casually, replied we were playing the Cambridge University First team. It was their first match of the season and they would all be out to prove themselves. I was appalled and then decided to go off and be sick. There was no ways Dave and I could last even one half against their eighth team. So it was with a reasonable amount of nausea, dizziness and fear that we got off the train in Cambridge.
Dave managed to stop me getting straight back on the next train to London and we were driven to the grounds, where, to my horror, people were sitting down in the stands. We were actually going to be watched as well as humiliated.
In our changing room we were given a shirt and I sat down, feeling miserable, to dress when I began to realise that the other members of our team were enormous and seem very confident and fit. This was not like Blod Weekes's team of no-hopers at all. I asked Charlie who they all were and it turned out that Dave and I were the only ones who were not either an International or a British Lion. There was a South African on the team called Tommy Bedford as well as the English and Welsh captains.
It turned out to be the most wonderful game. I had not realised before that you could catch the ball and run forwards. I had spent my dubious rugby career trying to catch a ball thrown at my feet and then running backwards being pursued by giants. In this game, the giants were all on my side. They hadn't just come for the shower and the drinks afterwards. Our scrum actually moved forwards. It was the most exhilarating feeling. My moment of glory had come.
· Chris Ellis is a city doctor and author.
Publish Date: 22 July 2004
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