Tell them they can kiss my Aspergers

Hail,
Back again, just a quick note. By the way, I'm not sure I come out of this post looking entirely good.

Anyway, tomorrow I go back to the prisons. Normally I look forward to this. But tomorrow, what is normally a joy and a delight will be dust and ashes in my mouth.

Because tomorrow I have Dr Zhu.

Let me explain.

At Hogarth House I have junior doctors under me. I get one every three months or so, they are sent out from Florey or the Royal. They are sent to learn to do community medicine and to learn about dealing with adolescent medicine. First was Doctor Bill, the amiable, well-meaning, sensitive-to-the-point-of-nervous-breakdown from Florey. He went back to palliative care and was replaced by Doctor Rebecca: slim, blonde, enviably bright, and one of those people you feel you can't assess job-wise because personality-wise they are so pleasant to have around.

And now there is Zhu.

I first sensed a grave disturbance in the force around Dr Zhu when I mentioned him to Rebecca, his predecessor.

"I've found out who your replacement is" I said. "It's a Dr Zhu."

She stared. "Not Jacky Zhu?"

I looked down at the email. "Dr J Zhu. Looks like it. Why?"

"Oh my God" she murmured, looking off into the distance. "Jacky Zhu coming here. Oh my God."

"Why?"

Suddenly she snapped back to attention. "What? Oh, no reason. Nothing at all. He's very keen. Very hardworking. Anyway, did we get the blood result on..." and she continued*.

A few days later I was in a resus at Florey, and the entire team (emerge, medicine, surgery, anaesthetics and ICU) were down in the tiny resuscitation room blundering around the body of Unknown Male, Mid Forties, Polysubstance Overdose as he twitched his way into a coma. I was trying to put a line in one of his ropy but highly mobile veins and Doctor Bill (now the Intensive Care RMO) sidled over to help.

"I hear you've got Jacky Zhu coming to Hogarth" he said.

"Yep" I admitted.

He laughed.

"What's so funny?" I asked.

"Nothing" he said, shaking his head. "Nothing at all." Then he laughed again, drawing concerned glances from some of the nurses, and shook his head, and laughed some more, and as they wheeled Unknown Male out, I heard his guffawing echo down the corridor.

A few days later Dr Zhu arrived. Clean. Neat. Clutching a briefcase, wearing a tie. Earnest, enthusiastic, punctual. I showed him around the building.

"This will be your office" I said, showing him the small, sparsely furnished room.

"Ahhh...My own office!" he said.

I must shamefacedly confess that at this point I noticed how much he talked like one of those ghastly "Chinamen" you see in nineteen forties movies. You could close your eyes when he talked and you would be irresistibly compelled to imagine hands sliding into voluminous sleeves, thin Manchu beards and inscrutable utterances. I hate being reminded of that kind of thing, and it's not his fault, it's not logical or sensible or helpful, but the image just juts into my head. I know I would look askance at a black guy eating watermelon and plucking a banjo while toting a bale of cotton (not just because he'd have to have around four arms).

I showed Dr Zhu the tea-room.

"Aaah! A tea-room!" he said. I am not making this up.

"Yes" I admitted. "Here are the coffee cups"

"Aah! Cups for coffee!" And so on.

And so the pattern was set. Initially I thought he had only two emotions; number one was a kind of perplexed delight, grading into delighted perplexity. Number two was perplexed horror, with flashes of horrified perplexity. He showed this one on the second day.

I was telling him about a patient. "At ten thirty we had a fifteen year old girl who presented alone for the emergency contraceptive pill..." I began, but stopped and stared in alarm, because before I could go on he covered his face with his hands, let out a long, sibilant exhalation and rocked back in the chair, shaking his head.

I stared. Had he perhaps misheard me? Had he thought I had said "The cancer has spread to your brain and you have only fifteen minutes to live... hold on, my watch is slow"?

After a full minute he emerged and spoke softly. "So young! How is it possible?"

I opened my mouth to say that it was quite possible that a fifteen year old girl in South Mordor was sexually active. In fact, it was pretty much the local mixed doubles sport.

Then I mentioned the three shallow scars on her forearm, and he asked if I had detained her under the mental health act (i.e.: called up the ambulance and if necessary, the police to take her away to a psychiatric ward against her will). I admitted that I had not performed this basic clinical intervention.

Anyway, it's a difficult thing to delineate. I can't say exactly what is wrong. It might be something that comes good with a bit of practice and a bit of education, it might be nothing. I don't know that I can say it's nothing. But I reckon it might be a while, possibly a considerable while, before I leave Dr Zhu sitting alone in a room in Hogarth with a fifteen year old girl who wants emergency contraception.

John

Oh, and one more thing. After almost a fortnight, he still laughs uncontrollably when someone mentions sexually transmitted diseases. No, I lie, the last few times he managed to get it down to a brief, high pitched giggle, only about a minute in duration. Because, you know, there's nothing as funny as acute chlamydial urethritis. And teenagers really want the doctor giggling as they outline their sexual history.

And this is a thirty seven year old (single) man who has lived in Australia for eight years and the US before that. Not a mujahadiin, a monk or a Martian.

But he's a nice guy, and his knowledge of clinical medicine is certainly adequate, and he is keen, and he dresses well. And I reckon he'll make a top radiologist or anaesthesiologist ... or something. Especially if he starts soon. Like today.

John

* Apparently you don't speak ill of the dud