“Oh great - you’re here early” my boss says, as I put down my bag on the desk five minutes early for my first shift after some time away “It’s been a maggot day” I love her language, especially when she’s stressed “there is an old bird on an ambulance trolley out front who’s been there about an hour and a half. Can you sort her out?” Sort her out, I will that octogenarian mandarin lady who can’t speak english. No worries. there is no translator. Her daughter’s english is broken but she tells me “mum’s not well” there’s nothing specifically wrong, but her blood pressure is up and she feels "a little off" so they thought they’d call an ambulance for a check-up. I roll my minds eye, but take care to not roll my eyes. A thousand assumptions flood my mind. call an ambulance for a checkup. On taxpayer money, she’s just spent. A couple of hundred for the ambulance ride. A couple of hours of my time and the nurses time. And I’ll order a couple of hundred dollars worth of tests she probably doesn’t need. It’s how the system works. Or doesn’t. I give up on taking a history. I examine her. Chest clear. Belly soft. Breathings fine. She looks pretty comfortable. I take blood tests and walk away. “another life saved” I whisper in a joke born of my self-important contempt, with a wink of camaraderie at the triage nurse who smiles back This isn’t why either of us got into emergency medicine. why couldn’t a young person have crashed his car just before my shift? Instead of this old bird feeling a bit off. But then the lab technician leaves an urgent message for me to ring. Flustered he tells me that her salt level is low. very low. For us in the know - it’s scary low. she left hospital a week ago and she was given a letter that, down at the bottom of the page in size nine font told her she has an issue in her kidneys and not to drink more than a litre of water a day but she did. “didn’t you know?” I ask “know what?” her daughter replies, anxious and confused, translating for her mother into mandarin. “mum can’t read.” her daughter says. “I’ve been making sure she keeps her fluids up!” her daughter says “I’ve been making her soup and broth!” she nearly killed her mum because no one told her soup and broth could kill. A salt specialist is called. An Intensive care specialist is called. She needs blood tests every three hours. if her salt level stays low she will have a seizure. If it gets lower she could go into a coma or die but if we fix it too fast she could die too. This little old bird. almost dead because no one told her daughter not to make her soup and broth.