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Many years ago my father had to go into hospital for an operation. During this he had a massive allergic reaction to an anaesthetic called scoline. For a time it was touch and go. Because I was my father’s son, it was decreed that I should be tested to see if I had inherited the allergy. I donated the usual armful of blood and it vanished into the nether regions of the medical laboratory. A week later the verdict was delivered.
"We don’t know."
My test results were inconclusive and the only way of finding out for sure appeared to be to feed me the drug and see if I died. While it would certainly settle the question, it was an experiment I was less than keen to undertake and so nothing more was said or done. For the next ten years I contented myself with informing any doctors with whom I came into contact that I was probably allergic to scoline and could they avoid using it please? It seemed to work.
And then one day, quite out of the blue, my GP said, "They’ve got a new test for scoline allergy. Shall we try it out?"
And thus began an adventure…
Since the test is a new one and since it is very rarely asked for anyway, it doesn’t appear on the standard list printed on the medical laboratory form. So my doctor had to write out by hand the details of what she wanted done. It turned out that there were three separate tests required. There’s a medical laboratory collection point just up the road from my office, so I went there the next day and presented the form. The nice nurse frowned at it.
"I wonder what it says?" she mused. She adjusted the angle so that the sunshine coming in through the window illuminated it more clearly, and she squinted hard. But it did no good. My doctor's squiggles remained illegible.
The nurse phoned my doctor’s surgery and explained her predicament. I could feel the blushes travelling down the telephone lines. I’ll swear the handset turned red. The nurse printed the details carefully and legibly on the form and sniffed audibly. She hung up the phone.
"They ought to send all the doctors back to school," she muttered. "Teach them to write properly. My three year old daughter writes more clearly than most doctors, and she uses an unsharpened crayon and hasn’t been taught her alphabet yet."
She looked closely at what she had written on the form. "I wonder what these tests are?" she mused. "I wonder what kind of blood sample I have to take, what tubes to store it in? Hmmm…"
She bustled about with various reference books and master lists of tests correlated with columns of data about exactly what kind of chemical needed to be mixed with the blood in order to present it properly to the master technicians for them to perform their arcane rites and rituals upon it. She found two of the tests documented, but could find no trace of the third anywhere. "One hep, one plain," she muttered. "But what on earth do they need in order to test your dibucaine number?"
"I don’t know," I confessed. "I’ve never heard of a dibucaine number."
She returned to the phone and rang the testing centre itself. She engaged in a muttered dialogue with the person at the other end. There were long silences as various reference works were consulted at both ends. Eventually she rang off.
"They’ve never heard of a dibucaine number test either," she said. "They’re going to ask the chief pathologist when he comes in. Do you want a cup of coffee while we wait?"
I had a cup of coffee, and then another and we chatted about this and that. Every so often she’d break off the conversation to go and take blood from a new customer. These were all straightforward bread and butter stuff – liver enzymes, ESR, cholesterol. She emptied their arms of blood with brisk efficiency and squirted it into the appropriate tubes.
Eventually the chief pathologist rang back and the nurse went into a huddle with the telephone. She came back to me smiling.
"Right," she said. "One hep, two plain."
She sat me down in the chair and tied a pressure strap around my upper arm. "Just clench your fist for me, please," she requested.
I clenched my fist. "Oooh! What lovely veins you’ve got," she said, which has to be one of the oddest compliments I have ever received. She collected the blood and prepared the tubes. One hep, two plain; it sounded like a knitting pattern.
The blood was sent to the appropriate testing centre and a week later they delivered their verdict on my scoline allergy.
"We don’t know."
My doctor was hopping mad.
"What do they mean they don’t know?" she raved. "They only did two of the tests anyway. They completely omitted the dibucaine number. And that’s the most important one."
She rang the laboratory and tore them off a strip. Paint flaked from the walls. "Why didn’t you do the dibucaine number test?"
She listened closely to the reply. "You didn’t notice it on the form," she said flatly. She looked at me. "They didn’t notice it written down on the form," she explained to me. She raised her eyes eloquently to heaven as she hung up the phone.
"Reading lessons," she said. "They all need reading lessons. My three year old daughter reads better than they do at that place. And she can only read her own secret squiggles that she draws with an unsharpened crayon because she hasn’t been taught her alphabet yet."
She fixed me with a gimlet glare. "I’m sorry Alan," she said, "but you are going to have to have the test done again."
She filled out the medical laboratory form for me. She wrote the tests down very carefully and slowly and legibly. Then she numbered them; one, two, three. On the last line of the form she printed THREE TESTS IN TOTAL. She looked closely at it for a moment then she inserted a couple of exclamation marks and underlined it for good measure. "Now let’s see them ignore the dibucaine number test," she muttered triumphantly.
I took the form and went to give blood again. It was a different nurse this time. "Gosh," she said, somewhat predictably, "I’ve never taken samples for these tests before. I wonder what tubes they need?"
"One hep, two plain," I told her. "Purl one". She was not convinced and bustled off to her reference books. This was followed by the usual phone call to the chief pathologist and the usual long wait. She offered me coffee and conversation.
"Have you got a three year old daughter?" I enquired.
"As a matter of fact, I have," she said. "A most unusually talented child…"
Eventually it was decided that the tests did indeed require one hep and two plain and she took the blood from my arm. It disappeared off to the medical laboratory and a week later they delivered their final, definitive verdict on my scoline allergy.
"We don’t know."
My doctor glared fiercely at the dibucaine number result. "It doesn’t prove anything one way or the other," she admitted. "You’re right on the borderline."
Since three separate tests have now come back with inconclusive results we decided that enough was enough and we will err on the side of caution. The next time you see me I will be wearing a nifty piece of jewellery on my wrist. The Medic-Alert bracelet will be engraved with the words scoline allergy and on my file it says not to be given scoline as an anaesthetic.
My next door neighbour’s three year old daughter thinks it’s neat.
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