The Nation's Health

You just never know

"73 year old male, chest pain"

It was an average weekday morning, bright blue sky, chill in the air, sat outside Starbucks getting the early morning caffeine fix. The MDT made an unwelcome noise. The job was only a few miles away so with the roof lit up, the squeal of the sirens and the groans of a semi-willing crew we headed off. We had no details, just an address but that wasn't unusual. As we pulled up to the house we found out what we were going into to. An old guy with chest pains. Pretty nondescript but it could be a good job. It was a bungalow we had pulled up outside of. Set back from the road it was preceded by a very well kept garden. A small fish pond in the middle of the lawn, flower beds immaculately kept with well pruned roses providing an array of colour. All the lower windows had window boxes of flowers and there was ivy climbing up the exterior walls. A grand oak door with a huge knocker awaited us at the end of the crazy paved pathway. As we approached the door it opened, a well dressed elderly lady greeted us with a smile and invited us it. She directed us to the lounge. As I made my way through the foyer and down the hallway I admired the black and white photos and military memorabilia that lined the walls, it was a real homely home, the smell of freshly baked bread filled the air. I entered the room and our patient was sat in his armchair. He too was well dressed, shirt and tie, trousers and slippers. An equally infectious smile greeted me.

"Good morning sir, what's the problem today?"

"I'm awfully sorry to bother you, I don't want to go to hospital really but I've had this niggling pain all morning ever since I got. It's under my right arm on my ribs and hurts every time I move. I just wanted to ask someone about it so a called NHS Direct and they told me an ambulance was on its way. It seems such a fuss for something so trivial. I'm awfully sorry"

I assured him there was nothing to be sorry for and that I'd give him an MOT and take it from there. I did the full battery of tests on him, every box ticked. He was fit and well, his mobility excellent. His vision spot on, all his observations perfect. His secret was 2 hours gardening a day and it showed. My crew mate had vanished to get the Lifepack 12 to do an ECG. He was telling me about his military career and the amazing life he had led. I was fixated on him. He was such an interesting guy. With every word he muttered his perfectly groomed moustache moved up and down. He was was so well kept and so well spoken. He pointed out his military photos and his medals. He was so animated and enthused to be able to share his experiences. I saw through the window my crew mate returning.

"If it's OK with you sir, we'd like to do a quick ECG and then we can leave you in peace."

"Is that totally necessary?"

"Well, because you had chest pain, albeit, apparently non-cardiac because of your age and the fact you don't want to go to hospital I'd be happier leaving you if we did one."

His wife, Margaret, interjected....

"Harry, you are having one, end of story, either that or you are going to hospital"

Well, that showed him. Clearly the key to their 53 year marriage was a him doing exactly what he was told, when he was told to do so! The Lifepack arrived and my crew mate began to attach the electrodes to wires. As he did so, I began to unbutton Harry's shirt. Under the shirt was a vest, firmly tucked into the belt. I explained we'd need to un-tuck the vest. At that point Margaret walked out of the room and closed the door. With a sigh he undid his belt and slowly pulled the vest up to his neck. It was in this moment that his reluctance to have an ECG became obvious, it was in this moment I realised why Margaret had left the room and it was in this moment I didn't know where to look, what to do or what to say. He was wearing a black, laced bra. No padding, just the Bra. He was red faced, I was red faced, my crew mate was frozen to the spot and a deftly silence engulfed the room. Never have I wanted the ground to open me up and swallow me whole so much!

I did the ECG in silence, no questions asked, no explanations given, he redressed himself and Margaret returned with a plate of biscuits quizzing us about shift patterns in a vain attempt to restore normality. I certainly wasn't expecting that. A cross dresser! It didn't fit with the man, his life, his home. It's amazing, you really just never know what goes on behind closed doors. Maybe that was the key to a 53 year marriage. A bra!