Reconstructions!

Walking our smallest grandchild in her elegant red baby buggy one day last week, I fell into conversation with an elderly man walking in the same direction. He remarked on the smartness of the baby buggy, the steepness of the slope we were descending and the cleverness of the strap attaching the buggy to my wrist, so that it could not slip my grasp and run away down the hill. He informed me that HE was in no condition to run away anywhere. Indeed, a year ago he had been in no condition to walk anywhere. Like the ancient mariner in the poem, he had a glint in his eye that suggested that thereby hung a tale.

So I obliged him by asking him to explain.

Fifty years ago he was involved in an accident. The details of the accident were clearly irrelevant as he gave me none. The important fact was that as a result of the accident his left ankle was smashed. Not just broken but smashed. Back then, he told me, Oldham hospital barely had an X-ray machine. Scans were a thing of the future. However, the equipment available was enough to show that his ankle was a mess. Beyond repair. The best 1960s solution they could propose was to amputate just below the knee. Fancy prosthetic limbs were also a thing of the future and so he declined the offer and walked away.

Yes, he walked away, on his ruined ankle and for fifty years continued to walk on his ruined ankle. He never learnt to drive, lacking the necessary flexibility in his ruined ankle. How was walking even possible? That was what I wanted to know. He promised to come back to that point. The tale was clearly going to be told at his pace.

Fifty years on he received a letter one day, from a doctor he had never heard of. The doctor had seen his records and wanted to meet him. Aware that the elderly gent might not be too mobile, instead of asking the patient to visit him, he proposed to visit the patient. Or at any rate meet half way at the big health centre in Oldham, at a time when the health centre is usually closed. "I think you will find it stays open for me," he commented. Clearly a medical chap with some clout! And so the old chap went along, with his ruined ankle, and the doctor poked and prodded and declared that he believed he could do something to sort it out. First, though, he wanted some scans of the ruined ankle. Before you could say "waiting list" the old chap had an appointment at Oldham hospital, once again at an unusual hour, and scans were taken from every conceivable angle.

Called once more into the presence of the mystery doctor, the old chap viewed these 3-d pictures. Ouch! What a mess! Crunched up bits of broken bone, mangled and out of place. And the doctor proposed to put this right? Well, yes! He even showed him before and after scans of the ankle of a lady involved rather less than fifty years ago in a car accident. The before scans were remarkably similar to his own ruined ankle. The lady in question was now walking around perfectly well once more. The doctor had put the ankle back together rather like a complicated three-dimensional jigsaw. 

It was time for the first big question: if his ankle was such a mishmash of bits of broken bone, how had the old chap been walking around on it for fifty years? How come he had not been in agony? The doctor had a couple of theories.

It was highly likely that the old chap had a very high pain threshold. Yes, the old chap confirmed, that seemed to be so. On more than one occasion he had burnt himself without realising and once he had only become aware of having cut himself badly when he saw blood on the floor. Good grief, it was a wonder he was still alive!

The second factor was that his brain had kind of excommunicated his foot. All the nerve ending were in such a mess that his brain had decided that his foot was no longer there. The human body is an amazing thing! Who knew that your brian could do that?

But the good doctor sorted him out. Once more there was no mention of waiting lists before the old gent was whistled off for a two-month stay in hospital where the good doctor took apart the ruined ankle, reshaped bits of bones and put it all back together again. A work of art! And there the old chap was, not exactly running marathons but off to his allotment to dig for potatoes. And all this on the National Health!

Time for the second big question: why had all this happened? Well, the doctor finally explained, he and his professional companions have been doing hip replacements and knee replacements for a good while now and they would like to be able to the same with wonky ankles. However, the ankle is a much more complex joint and needs a lot of detailed study. Every time he does a reconstruction he learns a little more about how the ankle works.

Another question springs to mind: perhaps more important than the other two: if the government keeps selling off the National Health Service to Richard Branson and others, will this kind of story be able to be repeated in the future?