A woman waves to us from the entrance to a partially grassed alleyway, then turns and hurries back along it. We follow her halfway up to where her partner Craig is lying flat on his back, groaning and clutching his arm, his dispatch bike lying on its side nearby.
‘Don’t move your head at all, Craig,’ I say as I crouch down beside him. ‘Tell me what’s happened.’
Between strangled gasps of pain he describes how he was coming out from the garage at the back, riding the bike at a walking pace; how a cat had jumped down off a fence in front of him; how he’d touched the front brake, the wheel had slid out into a deep furrow, pitching him over onto his side, and his left arm.
‘I think I’ve broken it,’ he says.
The villain of the piece, a rough, square cut, ginger and white tom cat, sits on top of a low wall to our right, innocently licking a paw.
The arm seems to be Craig’s only injury; everything else checks out. We give him Entonox to dull the pain, then set about helping him up. It takes all three of us. With Craig bulked out in all his biker gear - t-shirt, sweat shirt, wax jacket, fluorescent jerkin, leather trousers, buckled boots – we’re like three feeble villagers struggling to right a statue that’s fallen off its plinth. Once he’s upright, Craig pauses for a moment to take a few more trembling intakes of gas, then with a series of groans and swearwords, staggers between us to the ambulance. We sit him on the trolley.
‘I have to cut your jacket off.’
He starts to laugh, the gas making the intensity of his predicament – the grinding pain, the sickeningly disjointed sensation in his upper arm, the confined space of the ambulance and who knows what else - profoundly unsettling. He closes his eyes and clenches his face, to ride out the laugh, to escape the pain.
‘Jesus God it hurts,’ he says.
‘Keep going with the gas.’
We cut the jacket off and the layers beneath it, exposing the site of the injury. Gross mobility in the centre of his upper arm; the skin bulging dangerously when he repositions himself on the trolley. We immobilise his arm as best we can with a vacuum splint, then set off.
Back at the nurse’s station later that day a doctor obliges us by tapping Craig’s name into the computer and bringing up his x-ray.
‘That’s the fellow. Ouch.’
Through the translucent ghost of Craig’s flesh the outline of his fractured humerus, the central section neatly punched out in a ragged, trapezoid shape.
‘Is that what you’d call a comminuted fracture, then?’
‘Yep. That’s it.’
Another doctor who’d been standing alongside him at the counter writing up a report looks up, leans across, and taps the screen with his pen.
‘Actually, no. Not anymore. We’re supposed to call them multi-fragmentary fractures these days.’
‘Multi-fragmentary? Since when?’
‘Since – forever.’
‘Why did they change it?’
‘I don’t know,’ he says, going back to his report. ‘Maybe they thought comminuted was too obscure.’
‘It took me ages to remember comminuted.’
‘Multi-fragmentary’s more descriptive.’
‘Well, hello! Welcome to the world of medicine! The whole thing’s founded on obscure words no-one can remember.’
The other doctor shrugs again.
The first one looks back at the screen.
After studying the screen for a second or two more he sighs, shuts the window down and says: ‘It’s going to hurt, whatever you call it.’