BMJ 2001;322:1373 ( 2 June )

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My months as a hatstand

In our encounters with strangers we follow protocols that are rooted in our cultural identity. These codes characterise countless fragments of our daily lives, which although mundane are no less dear to us. Living in Gambia I have once or twice astonished myself with a feeling of nostalgia for the blank anonymity of the London underground, where a lone commuter can almost be the only passenger in a carriage which is in fact crowded with others. The same void of interaction must encapsulate, to Gambians in Britain, all that separates them from the poetic greeting that accompanies every encounter between strangers back home.


If the problem is not permanent it is not tragic; if not tragic then it is okay to ask

Some months ago a less than dramatic surfing accident left me with an odontoid fracture and an abrupt suspension of my life as a research paediatrician in the Gambia. In Bristol five days later, wearing a halothoracic brace and with all the elegance of an ambulant hatstand, I left hospital. In the ensuing weeks, dislocated temporarily from my family and working life, I had plenty of time to walk, look around, and be looked at, enjoying the comfortable familiarity of shops, pavements, and the British public.

However, for the first time in my life I have seemed to passers by as something manifestly not "a stranger like us" but something different, and I have been intrigued by the experience. I anticipated, and have received, glances from adults and long stares from children, but beyond that I expected the same conspiracy of disinterest that exists between facing passengers on a train. To my surprise, however, I have experienced quite the opposite reaction from a large number of people. I am by nature reticent in public. I never crack jokes in elevators, and although I enjoy pub or shop banter, it is rarely me who starts it. It is, therefore, all the more surprising that at least a hundred strangers now have a new knowledge of neck fractures and their management.


"Now then, you're not going to cause any trouble are you?"

Admittedly, the information sought typically focuses on the key issue: "How do you sleep at night?" This matter in particular has propelled individuals across crowded cafes in their quest for the truth, and I have been happy to spare no detail in my reply. To the more obvious question, "What did you do to yourself?" I reply "surfing accident," and leave the inquirer with a (false) image of spectacular manoeuvres on huge glassy waves in the tropics.

Had I found myself in a wheelchair---and in grimmer moments of reflection I remind myself that I came rather too close to this or something worse---would I now be facing a similar line of questioning? I try to picture the encounters in the High Street: "Now that looks awkward, whatever did you do to yourself?" or "How do you get into bed at night?" I don't think so.

So where does the difference lie? My predicament is much more trivial than many, but I am as conspicuous and bizarre as a walking scaffold. Why don't people exhibit the familiar embarrassed reserve? Perhaps there is no such thing---after all, I have mercifully never spent time in a wheelchair. Perhaps many people are seduced by the sheer novelty or comedy of my appearance. Few will ever have seen such a contraption bobbing along the road, and for some people curiosity must win the day. However, I think the crucial issue is lack of permanence. So far everyone who has quizzed me has assumed, correctly, that I have sustained an injury and the metal contraption is temporary. If the problem is not permanent it is not tragic; if not tragic then it is okay to ask.

Three months later I am still in the halo, and the frequent inquiries have worn somewhat thin. I look forward to regaining the anonymity of an inconspicuous appearance, something that is denied to many of the permanently disabled. Fortunately, I expect to be relieved of my own encumbrance within weeks, with little more than stories to show for it.

Of course, there is no great revelation in these reflections, but my months as a hatstand have reminded me of the fresh perspectives that can accompany unexpected personal experiences. One comment still puzzles me. In a crowded greengrocer's recently, the shopkeeper took one look at me and called out, "Now then, you're not going to cause any trouble, are you?" I was momentarily flummoxed. Was the shopkeeper expressing relief that among the jostling vegetable buyers, here at least was one who would not lash out with the nearest marrow, or was she alerting the other shoppers to possible danger? I decided to assume the latter. "Well I'm not sure," I replied, "I haven't yet decided."

Andrew Collinson, specialist registrar in paediatrics

Gambia


© BMJ 2001

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