True stories: ROSE ROUSE; Etiquette rules in casualty

Waiting is just part of the misery of a visit to hospital
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The Independent Culture
Two ambulances are unloading outside the stretcher-case door as I struggle through the other, walkers-only (in my case, hoppers) entrance. Weary faces look up in anticipation. The words "So what's wrong with her?" silently circle the room.

This is St Mary's casualty department, Paddington, on a Friday at 5pm, and I've just experienced the "once-over". I'm a disappointing candidate because my injury is so obvious. Where's the mystery in a leg injury? Others who come later are more intriguing: the platinum blonde in platforms clutching her stomach; the ginger-haired lad holding his head in his hands; and the Bengali woman vomiting quietly in the corner. Dwelling mentally on people's possible illnesses is an integral part of the casualty wait.

Dragging my overnight bag across the white lino, I queue at reception, only to be told that I need to see the nurse in the corner first. No one offers to help me cross the room. In casualty, the etiquette of suffering rules.

Having taken a numbered ticket and talked to the nurse, I return to reception to be registered. Reluctant to move far, I plonk myself down on the nearby red seats. A mistake. "You can't sit there," announces a man with a ponytail and red ribbon. "You're confusing everyone. This is where people queue for the nurse." Suitably chastised, I hobble out of the way.

An elderly man who seems confused is dabbing his bleeding nose. "Please sit down," says his wife. "It's no good wandering around." A girl with a burn on her arm is given a bag of ice to cool it down, and a young Spanish boy is holding his wrist. He has obviously fallen off the skateboard he is carrying under his other arm. More worryingly, a man with an intense, unnerving stare prowls the room like a panther waiting to be fed. It is his way of dealing with the wait.

A deadly gloom settles over the room. No one speaks. Everyone is clearly over-conscious of the wait. "I've been here for two hours already," says a man with no discernible illness.

"Sybil Wolf," calls out for a nurse. No one comes forward. I covet that name. There is a system of priority at work here, but sometimes it seems to defy logic. "He's 90, you know," the lady looking after her husband says to the nurse, but it doesn't seem to make any difference.

Just as I am sinking into the communal melancholy, a large, grey-haired woman sits down next to me. A casualty habitue, she refuses to be sucked into this deadpan club. She talks loudly, blackly and hilariously. Naturally, her best friend had had an operation on a damaged Achilles tendon, which is what my doctor suspected might have happened to me. "It's a serious operation, you know," she says, obviously revelling in my reaction, "you'll be on crutches for two months."

I laugh hysterically at the implications. Four flights of stairs, shopping, driving, looking after my son - how will I manage? However, Jean, a drama teacher (which seems appropriate), has reached maximum volubility. Surveying the available patients, she begins a series of dark prognoses. "A miscarriage, I expect," she says, pointing to an agonised Indian lady with glee. Then, yanking her head to the right, she spots a young girl in her clubbing outfit. "Slit wrists, I'll wager you."

Jean, it transpires, is a veteran hospital-goer. Once, after a car crash that had left her paralysed, she'd done a six-month stretch. What's more, she enjoys hospitals. "I just hope I've got at least a broken foot," she says, trying to look optimistic. Ironically, Jean fell over when she was on the way to her doctor to make an appointment. "Typical of me," she says, almost falling off her seat with raucous laughter.

I finally get to see a doctor after three hours and 10 minutes. It isn't a snapped Achilles tendon after all, it's a ruptured muscle. Relieved, I hop out with my new fashion accoutrement - a support stocking. "Bad luck," mutters Jean - and she means it.