From Zero to Hero and back again

In the space of 1 month I’ve had the privilege of visiting Cape Town twice J  I surprised my splendid sister for her birthday on my first visit and my second visit was over the Easter weekend. Both visits to the fair Cape have been fantastical, the journey home on the other hand has been interesting to say the least.

Getting back to Cape Town or any other form of civilisation is no joke. It’s a 2 hour flight preceded by a 4.5 hour drive along the N2 with no lights, many trucks and sprinkle of my favourite Gauteng and Mpumalanga drivers (hope you can feel the sarcasm radiating through your screen). However, there are a few aspects you can look forward…let’s re-phrase that, there’s one aspect...being able to play Need for Speed for reals! You can drive at 120km for 4.5 hours and not worry about getting a fine. In addition to this you get the perfect opportunity to test just how mad your driving skills are whilst enjoying the view of God’s awesome creation.

These trips to civilisation may be a burden or a breeze. It’s a breeze when you like your car, it's light on petrol, you have an epic playlist and you have a GPS to get you around town. It’s a burden when none of the above happens. My last trip to Cape Town was by far the most memorable, as I got 2 for the price of one…it was what I like to call a “breezy burden”. 


The Breezy Burden:
It was my first solo mission to Cape Town for 2 Oceans so I woke up super early to get a head start before the Easter weekend traffic madness began. It was all good - I had Adele, Bassment Jaxx and Kings of Leon keeping me company, the sun was out and Janet (my GPS) was leading the way. I had completed ¾ of my journey before tea time and there was even time for me to head to the shops. Lets just say I was feeling like a champion.

Me feeling like a hero after 3/4 of my journey...well done, you beat a cow and a rock

This heroic feeling was short lived, as I hit Durban city my dearest Janet (the GPS) cut out. Every time I tried to plot my route I got a message saying  “lost signal”, Janet failed in the area I needed her the most. This would be fine if Janet was joking and I actually knew Durban , however this was not the case. I feverishly tried to resuscitate her, but nothing worked. I tired following the signage, but I kept taking the wrong turn. Since I couldn't get to a shopping mall or garage to ask for directions I ended up driving around Durban like a forlorn frazzled fart for a total of 2 hours. It took the kindness of a cuddly oom at the Sasol station to get me out of this pickle. He was gracious enough to escort me from the hustle and bustle of Durban CBD to Pavillion shopping mall. 

The road from Zero to Hero is but 2 words away...Signal Lost

The Hero face versus the Zero face...see, my eye's twitching

After 5 hours of driving, 2 hours of freak out and 2 hours of attempted retail therapy I boarded a plane where I had the “privilege” of being wedged between 2 gentlemen. One was drunk pensioner, the other a charming young man. The pensioner insisted on lecturing me regarding my dreams and aspirations as well as giving advice regarding the upcoming race; the charming young man delighted in watching me squirm and dodge the Pensioner as he invaded my personal space and sprayed saliva on me with every word.

My flight at a glance: Charming young man laughing on the left, drunk pensioner on the right and me looking as awkward as a turtle in the middle.

Though the journey to get home was a boarder line trauma case, it was by no means a predictor for my stay in the city. I successfully managed to complete 2 Oceans by running the first 10km and swimming the last 11km (thanks to the rain). In addition to this, I finally bought a camera and I have been trigger happy ever since-"real pictures" will follow shortly!

Whilst at home I have found that living in the sticks has made me appreciate the finer things in life. I find myself marvelling at robots, funneling and downing tap water, gazing at shower head as the water gushes out at the right pressure for a Type 1 shower all day everyday. I have also noted a strong urge to embrace anyone and everyone who speaks English and Afrikaans, it's like we have a bond that they are not aware of. If you catch me at the right moment you may find me laughing and smiling at nothing and no one in particular and if you are very lucky you might witness/hear me sing the “Wena” song. The Wena song was written and composed by me in a moment of sheer joy and is performed when words do not suffice. 

City things that make me do the Wena dance-namely robots, bright lights, tap water, cars and people. 

Lost in Translation

Treating patients in a newly found language has been an interesting ride. It’s been the source of much frustration, many laughs and far too many marathon treatment sessions.

The 3 Zulu phrases I learnt on my first day was “Hello”, “How are you?” and “What are you here for?”. The first 2 phrases are fine-they have generic answers-the universal response to “hello” is “hello/hi/yo/*grunt*” and most people respond to “how are you?” with “I am fine”…the last phrase on the other hand opens Pandora’s Box. It marks the beginning of an adventure that generally consists of me frantically searching for remotely familiar Zulu words, running between colleagues  to relay + translate unknown phrases that keep coming up and to ask follow-on questions - all of this activity to START the physical evaluation in order to identify and treat the cause of the problem.

The "Universal" section of the treatment session, where respective greetings are exchanged. Hello. How are you? I am fine, How are you?

Upethwe yini? Translated into English "what are you here for?" aka The calm before the storm

The course of events between me asking "what are you here for?" and the patient giving me a long answer in Zulu. My brain responds to this verbal outflow by embarking on a frantic search for familiar words. This search inevitably ends in my brain short circuiting, frazzling and atrophying.  

Up until 3 months ago I found myself feeling overwhelmed, lost and forlorn every time a patient walked through the therapy doors into my cubicle as my Zulu vocabulary is “limited” and gesticulating only gets you so far (try gesturing “3 point touch weight bearing” to a patient with a fracture and you’ll get a taste of a typical therapy session). One of the teachers who attend our church came to save the day. The Chrin and I were advised to contact two local lads who have subsequently become our super-hero translators. 

Super C fist pumping on the left in blue and Tenacious Tutu on the right in green. 

Super C and Tenacious Tutu sit in on treatment sessions relaying my questions to the patients and their answers to me. This has been an answer to prayer as patients receive optimal treatment and rehab programmes and I no longer run the risk of treating the “wrong” problem – one stormy afternoon I worked out an elaborate strengthening home programme for a patient with a degenerative condition…one hour later I learnt via translation that all he wanted was a wheelchair-wheelchairs take 5 minutes to measure 10 minutes to adjust and 3 minutes to do the paper work. Super C and Tenacious Tutu are super-star translators, the patients; on the other hand have a tendency to try ones patience with their long winded and sometimes irrelevant answers. The patient type determines whether the session will occur in 2 parts or 4 phases.

Type 1 Patient

Definition: These patients are generally young –> middle aged. They have been referred to physio for fractures, sprains or pain of a specific cause. They generally have a good baseline health level. Their sessions are straight forward and occur in 2 parts.

Part 1: They come in, greet, tell you the problem

Part 2: They answer the questions and receive treatment.

Portion of population: These patients make up ±10% of my patient population.

Average treatment time: 45min to 1 hour

General vibe post treatment: Happy patient, happy therapist – therapist was challenged but felt productive

Type 2 Patient

Definition: These patients are generally middle aged –> old. They have their primary problem + 10000000000000000 other ones (eg. Fractured leg, but they have had a stroke and they have had arthritis for the past 10 years) alternatively they have 1000000000000000000 problems with 1 primary cause which they don’t acknowledge (this may be by choice or default). For example their WHOLE body aches because they have arthritis, in addition to this they get crazy head aches but this is caused by their arthritis and their legs and arms swell after they’ve had a busy day….but you guessed it-it’s from the arthritis.

Due to the nature of these cases these patients give long-winded and many times irrelevant answers. These patients have 4 phase treatment sessions which can be marked by varying levels of frustration.

Phase 1 - Bright Eyed and Bushy Tailed: The universal greeting and establishing the main problem.

Phase 2 - Hopeful : Asking 1 of the 5 "clearance questions" which determine the severity of the problem. The patient usually responds with a long winded answer.

Phase 3 - Frustration: The question is posed a second time in a different manner. The patient responds with yet another long winded answer.

Phase 4 - Desperation: The question is posed for the third time in the form of an ultimatum "yes/no" question.

Patient Scenario: Gogo comes to physio with a 2 year history of headaches and neck pain

Phase 1: Bright Eyed and Bushy Tailed - With the help of the translators the physio executes the Universal greeting and the dreaded Upethwe yini with grace and ease.

Phase 2:Hopeful - The clearance question is asked "Do you ever see double?" The patients answer is verbose, but the physios bright eyes indicate that she is listening intently-hopeful that the answer will be hidden somewhere between the patient telling you about her cat and the colour and shape of her 9 different tablets.

Phase 3: Frustration - The question is repeated in a different form. The patient responds with another slightly off course answer. Note, the physio's tail and eyes droop as frustration kicks in, the number if patients in the waiting room increases and the time ticks on.

Phase 4: Desperation - The same question is posed for the third time in a closed form. "Gogo, you are only allowed to answer yes or no...do you EVER see double?" To which the gogo finally responds..."No"

Portion of population: These patients make up ±80% of my patient population.

Average treatment time: minimum of 1 hour

General vibe post treatment: Patient happy/annoyed depending on the perceived outcome. Therapist….on the verge of tears-and we haven’t even started on the physical evaluation.

Type 3 Patient

Definition: These patients are generally children, middle aged or old. They are in-patients (ie patients who have been admitted to the hospital and chill in the ward) and have been referred to physio for a number of different causes. These patients are the source of colourful treatment sessions which generally involve me making a fool of myself as I try to win their co-operation, most times my effort is in vain! Their session also occurs in 4 phases.

Phase 1: I come in, greet, give an instruction.

Phase 2: They patient looks at me like I fell out of a tree.

Phase 3: I recruit a translator in the form of a Nurse/Super C/Tenacious Tutu.

Phase 4: The patient grunts/blinks/ looks at me + the recruit as if we have fallen out of the tree together.

Patient Scenario: Gogo with pneumonia referred for chest physio, gogo is required to take deep breaths as part of treatment and evaluation.

Phase 1: Universal greeting, physio tries to explain in broken Zulu/with gestures the aim of treatment as well as the exercise to be done. 
Example: Gogo, I need to listen to your chest so please take a deep breath (pefumla kakhulu) 

Phase 1: Physio demonstrating a deep breath. Note the exaggerated facial expression-massive eyes, flared nostrils and shoulder shrugging to elicit a breath. 

Phase 2: Patient blinks...twice

Phase 3: Nurse is recruited to supervise-check that the physio is pronouncing the word correctly and to reinforce the instruction.

Phase 4: Patient response: Patient politely goes moves from sitting to lying and pretends to sleep. 

Portion of population: These patients make up ±10% of my patient population.

Average treatment time: 15 to 30 min

General vibe post treatment: Therapist: Hysterical, humiliated, defeated or manic. Patient: indifferent, amused or victorious