‘And are her immunisations up to date?’

Its one of life’s universal rules: Emergency Departments are situated in the basement. No matter the city, the country, the healthcare system, the age of the building itself: Emergency Departments are almost wholly subterranean. One unfortunate upshot of this is that, when you’re working in one of these EDs, you generally have no idea what the weather’s like outdoors: that is, until the broken bones roll in. This is the fourth patient with a nasty fracture I’ve seen in as many hours, which pretty much narrows it down, weather-wise, to treacherous snow and hail, or glorious sunshine. It’s July. Even in England, my suspicions are that, up in the outside world, this would be a lovely afternoon to while away an hour or two in a beer garden.

Sitting in front of me, the four year old girl being cradled close to her mother has started to calm down. The intranasal diamorphine has kicked in. She has spent the afternoon performing acrobatics on her cousin’s trampoline and now she has a very bendy arm. Before we get round to fixing that I just need a little more information.

‘And are her immunisations up to date?’

‘No. She hasn’t had any of her immunisations.’ Breathe, I tell myself, just breathe. Poker face. Do I challenge this?

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