The Independence of Sally Anne

Sally Anne (please note, no hyphen – it’s very important!) was frustrated. Not in a sexual context…God forbid, she was normally too busy for that kind of thing, but because of the delay she was experiencing in getting the plaster cast removed from her arm.  She’d fallen from one of her horses on the 5^th March, just a couple of days before lockdown started, breaking her left arm.

Thankfully, it was a clean break and A & E were able to sort everything out relatively simply. If it had been her other arm, then who knows how she’d have coped! As it happens, the cast had caused no problems day to day (she’d read that some people had developed itchiness they couldn’t scratch, whilst others complained the cast was tight on them), but the obvious inconvenience she faced doing all those things you don’t realise involve your left arm until it’s out of commission were starting to wear her down a bit.

She lived alone, in a small cottage close to the stables. Her mother had offered Sally Anne the use of her place to recuperate after the fall, but Sally Anne (not Sally, or SA, just Sally Anne) stoically rejected the offer, saying she’d be able to manage. The unexpected lockdown announcement put a block on any change of mind she may have had a few days later anyway, given her mother lived 40 miles away. In any event, how on earth would she be able to survive without seeing her beloved horses?

Sally Anne soldiered on person-fully by herself. There was no partner to help her at home. She’d had a few flings over the years, but the horses were more important to her than a packed social life and occasional weekends away, irrespective of the opportunity to take a break from her self-imposed equine responsibilities. It didn’t bother her in the slightest. She loved her life and, anyway, so far she’d never found anyone who was as much fun as the horses. The stables were a 5-minute walk from where she lived.

She was 29 years of age and an only child. Her parents doted on her to the extent she had never needed to get a job. They provided a monthly allowance and the cottage in which she currently lived. That’s not to say she was the archetypal ‘hooray Harriet’ individual. She was well-liked by the people she knew at the stables and was happy to muck in when necessary. She thought she understood how lucky she was – she never, ever talked about her privileged background and went out of her way to be seen to be one of the girls. If someone needed a lift somewhere, she was usually the first one to offer.

Her attitude was generally positive, but the bloody cast was beginning to get on her nerves. If the hospital didn’t get its act together soon she was going to speak to the blacksmith based at the stables to see if he would be prepared to attempt to remove it. She understood the reasons why everything was being delayed – she’d been reading only that morning about the knock-on effects the pandemic was causing with the treatment of other illnesses – and her view was if she could get it sorted out herself then she wouldn’t be clogging up the system. It was her general rule of thumb. Other people should be prioritised if her problem was minor in comparison to theirs.

The stables were continuing to function despite the lockdown. Admittedly, it was running at a reduced level but at least Sally Anne and the others were able to visit their beloved horses, subject to social distancing rules being observed. Feeding of animals wasn’t on the list of exclusions. Additionally, the stables were involved in some aspects of rural life, which is why the blacksmith based himself there. Local farms availed themselves of his services. You need to be aware of all this.

A few days passed. Sally Anne continued her life as best she could. She tried to contact the hospital to get an update, but it took ages to get her call answered, and when she did get through the receptionist was unable to transfer her call to Outpatients. With Easter approaching she realised it was unlikely anything was going to happen soon, so she approached George, the blacksmith at the stables.

George rated people according to how well they looked after their horses. Sally Anne was therefore near the top of his league table. She explained her predicament carefully, mentally preparing herself for rejection. George, however, surprised her by saying he loved a challenge and would be happy to give it a go if she could wait half an hour or so whilst he prepared a variety of tools he thought would do the job efficiently, quickly and, most importantly, safely.

She had some looser clothing with her, so she went off to change. Half an hour would probably be just enough time for her, given the problems she was experiencing getting dressed effectively one-handed. When she returned, George inspected the cast carefully and decided to use a circular saw to cut most of the plaster from top to bottom. He proposed leaving the part of the cast nearest to Sally Anne’s skin intact, with the intention of using an as yet unspecified sharp instrument to complete the separation. Sally Anne was scared, but absolutely determined the cast was coming off today no matter what.

Amongst other jobs at the stables, George shoed horses that, if provoked, could seriously injure or even kill him. His gentility in doing this was testament to the fact he’d never experienced any problems of that nature. It didn’t make him less circumspect in his planning and operation, but he was confident in his abilities. From his viewpoint, the only difference in treating Sally Anne would be she would talk to him rather than strike out in his direction. That had to be an improvement.

Sally Anne put her left arm out in front of her and laid it on the table as flat as she could make it, whilst George started the saw. He carefully, almost tentatively, began to cut into the plaster. It was slow progress, and he took his time to ensure no mistakes or slips occurred. Quite a lot of dust was thrown up, but George managed to complete the task in about 20 minutes without injuring the patient. Sally Anne looked on with a steely expression in her face.

George experimented with a number of sharp instruments to complete the job, before deciding on some tin snips. There was some give in the cast, particularly now the vertical cut had been made, and the gap between it and Sally Anne’s skin was sufficient to allow the blades to gently force their way in. Within a few seconds, the cast came apart and her left arm was now free.

From her investigations on the internet, Sally Anne knew one of the reasons the cast removal was usually undertaken in Outpatients was so the medical staff could check the bone had healed properly and ensure there was a full range of movement. She carefully lifted her left arm off the table and began to gently rotate it, before bending her elbow and bringing her arm to her face. No obvious discomfort was noted. She gave George £20, thanked him for his help and left the stables in a much improved humour.

The Easter break passed. Sally Anne’s arm was working perfectly in her opinion. All its usual activities – assisting with dressing and undressing, holding and pulling things, scratching her nose (this list is in no way exhaustive) – were completed so simply and painlessly Sally Anne soon forgot it had recently been broken. She would email Outpatients in a few days to tell them what she’d done but, in the meantime, she wanted to enjoy the feeling of normality.

The email had been sent. No reply had as yet been received. Sally Anne was lying in her bed reading. It was 11.15 at night. The phone rang. Perhaps in other stories the subject under scrutiny at such a moment would leap up or gasp in shock or surprise, but this is Sally Anne we’re talking about and her phone ringing at such a late hour is not such an unusual occurrence. It was bound to be the stables to advise her that something had happened or was about to happen she needed to know about. Inevitably, it would be nothing particularly serious, but the people at the stables worked in the unique time zones familiar to horsey people the world over. If they were awake, so was everyone else they knew.

Sally Anne rolled over and answered the phone. Sure enough, it was Gail from the stables. Her tone was bordering on frantic. She was all over the place. It was serious.

“Just to let you know, Sally Anne, we’ve had to get the vet out tonight,” she said. “He wasn’t very happy and when he got here you could hardly recognise him with the amount of PPE he was wearing. Anyway, it wasn’t one of your horses he saw, you’ll be glad to know, but it was Barney. You know, the one owned by Mrs Cartwright. The vet thinks it’s got symptoms of equine flu.”

“How can that be?” asked Sally Anne. All our horses were vaccinated after the outbreak last year.”

“I don’t know, but the vet is quarantining the yard immediately. I’m letting all the owners of horses at the stables know so they can start to make plans.”

Sally Anne couldn’t think what plans could be put into place at such a time in the evening, but she let it pass for now. She recalled equine flu was extremely contagious, but didn’t pass from horses to humans. How it had arrived at the stables was anyone’s guess, but it was there and, as far as she was concerned, had no right to be. She needed to check the vaccination certificates at the stables to make sure her horses had received jabs and, more importantly, that the certificates were in date.

“I’m coming down to the stables now,” she told Gail. “I have PPE and it is an emergency, so if I get stopped by the police I have a valid reason.” Normally, Sally Anne would walk there. Indeed, she hadn’t driven since breaking her arm. Certainly, when her arm was in plaster she had no choice. But it was late at night, and the plaster had been removed a few days ago. Not a problem.

She got dressed quickly (she’s already forgotten how long it took when using less than two arms), found her car keys and located the PPE. Then she left the cottage, and jumped into the car she hadn’t been able to use for a while. She was grateful it started first time.

She woke up three days later. There was a PPE-wearing nurse writing something on a piece of paper attached to a clip-board at the end of her bed. Sally Anne couldn’t remember anything about what had happened, and was appalled to discover her left arm was once again in plaster. There were no other signs of injury, but her head was aching a bit now she came to think about it. She waved her right arm feebly to attract attention.

From what she was told subsequently, it would appear that she was driving towards the stables when she lost control of her car. It veered off the road, clipped a kerb and then overturned before and landing in a ditch. Thank goodness she had been wearing her seat-belt. The people in the house nearby had heard the squealing of the tyres and gone to investigate. Police and an ambulance were called. She was found unconscious in her car, with her left arm in an unnatural position. The car was a write-off.

A doctor came to see her. She was a nice lady with sad eyes. Covid-19 had knocked much of the stuffing out of her. “How are you feeling?” she asked Sally Anne.

“I’m OK I think,” replied Sally Anne. “Apart from the left arm.” She pointed at it with her other arm.

“Yes. From your notes I see it’s the second time you’ve broken it this year, and it’s only April now. I also note that when you were found in your car the plaster cast placed on your arm following the first fracture was missing. Can you explain why?”

Sally Anne told her the story, stressing that given the pandemic crisis she was trying to avoid making unnecessary work for Outpatients. The doctor nodded in understanding.

“When you researched how to remove the plaster cast, did you consider how weak your arm would be until it was exercised back to full fitness? I ask because it seems you were trying to steer round a right hand bend when you lost control of your car. Clearly, the stress you placed on your left arm in doing this was more than it was used to, especially following its period of immobilisation.”

“You really shouldn’t have been driving until passed fit to do so by someone like me. I know it’s not what you want to hear, but impatience and misplaced initiative have conspired to endanger your life. Blaming the pandemic is, unfortunately, no justification. I’m afraid there will be consequences. Insurers, the police, even the local authority I think. Sorry.”

Indeed there were consequences. As her insurers hadn’t been advised about the first broken arm, and Sally Anne hadn’t obtained medical clearance before driving again, they were refusing to indemnify. The police summonsed her for driving without due care and attention, and the local authority wanted the cost of the damaged street furniture recovering from her.

The horses were fine though. They had been vaccinated and the certificates were all valid. Gail could have located them herself if Sally Anne hadn’t decided to get involved. Sadly, Mrs Cartwright’s horse hadn’t been vaccinated. It died a few days later.

An avoidable tragedy?