You can get a free meal if you give your self to Jesus. But only on the odd Saturday night.
Twelve emergency calls (more than 4,000 Service wide). Six required assistance only, one was a false alarm and the rest needed an ambulance.
Saturday nights are a chore for every emergency service but when the streets begin to clear of the merry and colourful people of London, there is a hard core of stragglers that draw attention to themselves. They aren’t noticeable because they cause trouble; they stand out because they behave abnormally. I don’t know if they are always there when other people disappear or if they come out in the wee small hours just to wander the town. London’s mentally ill make up a small but fairly significant number of the individuals I watch as I sit on stand-by. Some of them are drunk as well as disturbed. Some of them are dangerous. Some are my patients.
I went up to the fourth floor of a grubby block of flats to lift a drunken ex-boxer to his feet. He had fallen and his care worker couldn’t, wouldn’t or wasn’t allowed to pick him up. He had been told to stay at home because he is normally ‘unsteady’ on his feet. The reality is that he will never be steady on his feet because he is an alcoholic.
I remonstrated with him to begin with because he was aggressive. He didn’t like my tone (to be honest I can sometimes be a little abrasive when I am dealing with people who just don’t want me there) but we settled on a compromise and agreed to work with one another to get him into his flat. He didn’t want to go to hospital, so at least he wasn’t going to need an ambulance and he wouldn’t be wasting some nurse’s time.
I picked him up after checking that he had no injuries. His nose gave his past profession away; it was flattened and spread across his face. He looked like he had been handy in his youth, so I was being careful not to antagonise him too much – even an alcoholic ex-pugilist could take a fairly accurate swing.
We staggered into his flat (so now I looked drunk too, we could have been buddies) and I sat him in his chair. The home he lived in was a war zone. I can’t fathom how some people survive in the squalid conditions they live in – brought about by their own hand I should add.
I chatted with him and he gave me an uneven, gappy smile as I left the place. His care worker stuck around for a few more minutes then I watched her escape to a social life as I sat in the car doing my paperwork. All was well with his world again. He had fags and booze.
From that place I went into Theatreland to rescue a woman who had fainted as a result of the heat. The older theatres can become stifling when the weather is warm and the woman, who was 50 years-old, collapsed during a show. I walked into the bar area where she was recovering and there was a bunch of 'animals' standing in a circle rehearsing their next scene. It was bizarre. You can go ahead and guess the show if you like, my patient won't mind.
The woman was recovering well but it was still hot where she sat, so I took her into the fresh air, along with her two daughters and a member of staff who had initially come to her aid. The cooler evening air did her a world of good and she got her colour back. Her obs were normal (and had been since I arrived) and she didn’t want (or need) to go to hospital. I let her get better and chatted to them all until she was ready to get a cab back to her hotel. She signed my magic form and off she went.
Control dragged me 3.5 miles south for a 19 year-old female who was fitting. The journey seemed to take a long time and I realised I had no idea where I was after ten minutes. I ended up in a large estate of grey-brick blocks of flats, crammed full of newly housed immigrants and the less fortunate of society. I worked my way up to the zillionth floor (I’ve used millionth before and I don’t want to be seen to exaggerate) and into a horrible little flat. I was shown in by a dark skinned woman and led to a bedroom where another dark-skinned woman was lying on a filthy mattress on the floor. She wouldn’t look at me when I spoke and was doing the dramatic act. I have seen this many times and I have no patience for it, I have never pretended to have time for it.
All her obs were normal and I wasn’t in the least surprised. As soon as I told her this and asked her why she thought she needed an ambulance she began to ‘convulse’. She was faking it big time. Her movements were so controlled and violent that she nearly injured me as I tried to hold her down. I told her to stop the act and she did. Then she asked me why I was even there if I thought she was alright. Good question. She became rude and annoying and I left, telling her many, many female friends (what was this place?) that she was being emotional and that there was nothing medically wrong with her. I considered her mental state and left the scene. I could hear shouting all the way out but I don't know if any of it was directed at me.
On my way back to my own area I was asked to attend another fitting female. This one was only 15 years-old and had been drinking, according to her friends. I never got to speak to her directly because when I showed up, along with the police and an ambulance, she had run off. Apparently she was scared that her parents might find out about the alcohol. We looked around for her but none of us, including and especially the police, were fussed about pinning down some stupid teenager who wanted to waste our collective time, so we left her to it, wherever she was hiding.
Some call descriptions make me look twice at the screen. This one, ’23 year-old female, can’t stand up, ? cause’ and located right outside a bar nearly had me in stitches. I rolled towards it thinking that someone was joking. It wasn’t until the update appeared informing me that it was ‘not related to alcohol’ that my smirk was wiped off. I couldn’t say it was EOC’s fault then.
The young Italian woman had collapsed (fainted) whilst having a drink or two with her friends. They were all quite pleasant and I had nothing to do but obs. She was fully recovered and a little embarrassed and I know that’s not fatal. When I left, the bar manager asked me if I wanted a drink, which was considerate of him. He got me a coke and I stood there drinking it but I felt too awkward, so I left it on a table. I was the only one dressed in unfashionable green.
A few minutes later I was at the scene of a 40 year-old Polish, homeless alcoholic who had fallen onto steps as he made his way to his usual bed for the night. His nose was pulped and there was a bit of blood around. He had been sleeping with a bloody face and another homeless alcoholic had spotted him and called us. He will be okay and the ambulance crew took him off to get cleaned up but I felt sorry for the people who were going to arrive for work on Monday to a blood-stained entrance.
I went back into the West End and immediately got caught in heavy traffic. I was trapped and I got a call (of course) so had to book a delay because I was going nowhere. It was 1am.
The journey took ten minutes, the distance was one mile and the patient was hyperventilating. She was asthmatic and had taken her ventolin inhaler but with no relief. That was because she wasn’t having an asthma attack.
I sat with her and her boyfriend and a rather over-friendly female friend while she recovered. It took a mere ten minutes to work that trick and she was quite happy when I left her.
I got my break about now but I can’t remember that one either!
A drunken Polish man on a bus (what is going on?) in Trafalgar Square next. He was easy to wake up. I just walked onto the bus – the bendy variety – shook him hard, shouted and he opened his eyes. He smiled and nodded. The bus driver didn’t even know I had arrived.
The man had a very heavy bag with him and when the police arrived, after I had walked him off the bus, they had a look inside. He was carrying large books and cans of deodorant. He was a nice smelling, Polish bookworm. He probably had a degree. Or he was a library thief.
My next stop was a local club where I found my patient, a 24 year-old female, lying unconscious with her huge boyfriend crying and wailing over her. He was holding her like she was dead. I thought the whole thing was rather over the top but I didn’t know him and he may well have just been the emotional type. In any case, his girlfriend was very much alive, very drunk and very unconscious as a result. The ambulance was delayed on this call, so I started fluids on scene. A voice in my ear asked if I needed any help and I looked up to see a young Asian woman who announced that she was a qualified dentist. She was also drunk, so I wasn’t about to let her get near my patient’s teeth – that’s what she meant, right?
After a long wait, during which the unconscious girl recovered a little, the crew arrived to take her away. The boyfirend had resumed his crying.
Back to base for a cup of coffee and then on to a stabbing at a club in Victoria. Actually, the patient, a 32 year-old female hadn’t been stabbed at all and I was being diverted to her from a fight which had taken place around the corner. An ambulance crew were already sorting that one out and I found myself sitting at a bus stop with a crying Eritrean woman, a police officer and three students who just wanted to know that she was alright. I thanked them for their help and they had a group hug before leaving. Strange.
The woman was homeless and very sad about her situation. She was very meek and to me she seemed too vulnerable to be out on the streets. I agreed to take her back to the hospital that she had been in earlier today (when she claimed she had been stabbed) and I could only think of ‘vulnerable adult’ as a reasonable excuse for doing this. I couldn’t just leave her where she was and the police officer was hoping I’d make a decision – so I did.
I took her back to hospital myself but the reception for her wasn’t warm. The nurse wasn’t too pleased to see her again because there was nothing wrong with her. I told her that I felt she was vulnerable and that this was a place of safety for her. I also pointed out that we bring plenty of drunken frequent flyers in and that she, at least, wasn’t drunk...or smelly.
She got a cubicle and a bed.
While I was there I saw that armed police had set up guard points at the entrance and exit to resus. This usually means that someone has been shot. I was told later that there had been a double shooting in south London and that one of the victims had died. There was the usual gang of friends hanging around outside, waiting to hear the prognosis for their injured mate. This has become a sick routine now.
My next call was to a petrol station where a 35 year-old man had been assaulted. He had a head injury and was quite aggressive. His little gang of mates were also a bit rowdy and they jostled the police as they tried to argue their point, whatever that was. All of these men were Somali and this appeared to be some kind of inside fight but I was told later that he had been hit over the head with an iron bar and a litter bin after telling another driver off for not having car insurance. It mattered that much to him apparently. Nobody believed this story of course, least of all the police.
My last call was to a night club where a 22 year-old female had collapsed. This was given as a Red1, with ‘life status questionable’ stuck on the screen. This produces a long sigh.
She was, of course, drunk as a skunk. She was also not very helpful and didn’t appreciate the pain I produced to get her to sit up and pay attention. She was far too heavy for me to consider playing ‘carry the rag doll’ with. She came to her senses (what little she had), stood up, with support from two of the door staff and wobbled her way to the exit with her stunned (and sober) friend. A taxi was hailed but he tried to escape when he saw what he was being asked to deliver home – mini-cab drivers are too fussy these days, don’t you think?
The door staff collared the driver before he could make good his U-turn and bundled the ungrateful woman into the back seat. Poured is the word I’m looking for.
Saturday nights are a chore for every emergency service but when the streets begin to clear of the merry and colourful people of London, there is a hard core of stragglers that draw attention to themselves. They aren’t noticeable because they cause trouble; they stand out because they behave abnormally. I don’t know if they are always there when other people disappear or if they come out in the wee small hours just to wander the town. London’s mentally ill make up a small but fairly significant number of the individuals I watch as I sit on stand-by. Some of them are drunk as well as disturbed. Some of them are dangerous. Some are my patients.
I went up to the fourth floor of a grubby block of flats to lift a drunken ex-boxer to his feet. He had fallen and his care worker couldn’t, wouldn’t or wasn’t allowed to pick him up. He had been told to stay at home because he is normally ‘unsteady’ on his feet. The reality is that he will never be steady on his feet because he is an alcoholic.
I remonstrated with him to begin with because he was aggressive. He didn’t like my tone (to be honest I can sometimes be a little abrasive when I am dealing with people who just don’t want me there) but we settled on a compromise and agreed to work with one another to get him into his flat. He didn’t want to go to hospital, so at least he wasn’t going to need an ambulance and he wouldn’t be wasting some nurse’s time.
I picked him up after checking that he had no injuries. His nose gave his past profession away; it was flattened and spread across his face. He looked like he had been handy in his youth, so I was being careful not to antagonise him too much – even an alcoholic ex-pugilist could take a fairly accurate swing.
We staggered into his flat (so now I looked drunk too, we could have been buddies) and I sat him in his chair. The home he lived in was a war zone. I can’t fathom how some people survive in the squalid conditions they live in – brought about by their own hand I should add.
I chatted with him and he gave me an uneven, gappy smile as I left the place. His care worker stuck around for a few more minutes then I watched her escape to a social life as I sat in the car doing my paperwork. All was well with his world again. He had fags and booze.
From that place I went into Theatreland to rescue a woman who had fainted as a result of the heat. The older theatres can become stifling when the weather is warm and the woman, who was 50 years-old, collapsed during a show. I walked into the bar area where she was recovering and there was a bunch of 'animals' standing in a circle rehearsing their next scene. It was bizarre. You can go ahead and guess the show if you like, my patient won't mind.
The woman was recovering well but it was still hot where she sat, so I took her into the fresh air, along with her two daughters and a member of staff who had initially come to her aid. The cooler evening air did her a world of good and she got her colour back. Her obs were normal (and had been since I arrived) and she didn’t want (or need) to go to hospital. I let her get better and chatted to them all until she was ready to get a cab back to her hotel. She signed my magic form and off she went.
Control dragged me 3.5 miles south for a 19 year-old female who was fitting. The journey seemed to take a long time and I realised I had no idea where I was after ten minutes. I ended up in a large estate of grey-brick blocks of flats, crammed full of newly housed immigrants and the less fortunate of society. I worked my way up to the zillionth floor (I’ve used millionth before and I don’t want to be seen to exaggerate) and into a horrible little flat. I was shown in by a dark skinned woman and led to a bedroom where another dark-skinned woman was lying on a filthy mattress on the floor. She wouldn’t look at me when I spoke and was doing the dramatic act. I have seen this many times and I have no patience for it, I have never pretended to have time for it.
All her obs were normal and I wasn’t in the least surprised. As soon as I told her this and asked her why she thought she needed an ambulance she began to ‘convulse’. She was faking it big time. Her movements were so controlled and violent that she nearly injured me as I tried to hold her down. I told her to stop the act and she did. Then she asked me why I was even there if I thought she was alright. Good question. She became rude and annoying and I left, telling her many, many female friends (what was this place?) that she was being emotional and that there was nothing medically wrong with her. I considered her mental state and left the scene. I could hear shouting all the way out but I don't know if any of it was directed at me.
On my way back to my own area I was asked to attend another fitting female. This one was only 15 years-old and had been drinking, according to her friends. I never got to speak to her directly because when I showed up, along with the police and an ambulance, she had run off. Apparently she was scared that her parents might find out about the alcohol. We looked around for her but none of us, including and especially the police, were fussed about pinning down some stupid teenager who wanted to waste our collective time, so we left her to it, wherever she was hiding.
Some call descriptions make me look twice at the screen. This one, ’23 year-old female, can’t stand up, ? cause’ and located right outside a bar nearly had me in stitches. I rolled towards it thinking that someone was joking. It wasn’t until the update appeared informing me that it was ‘not related to alcohol’ that my smirk was wiped off. I couldn’t say it was EOC’s fault then.
The young Italian woman had collapsed (fainted) whilst having a drink or two with her friends. They were all quite pleasant and I had nothing to do but obs. She was fully recovered and a little embarrassed and I know that’s not fatal. When I left, the bar manager asked me if I wanted a drink, which was considerate of him. He got me a coke and I stood there drinking it but I felt too awkward, so I left it on a table. I was the only one dressed in unfashionable green.
A few minutes later I was at the scene of a 40 year-old Polish, homeless alcoholic who had fallen onto steps as he made his way to his usual bed for the night. His nose was pulped and there was a bit of blood around. He had been sleeping with a bloody face and another homeless alcoholic had spotted him and called us. He will be okay and the ambulance crew took him off to get cleaned up but I felt sorry for the people who were going to arrive for work on Monday to a blood-stained entrance.
I went back into the West End and immediately got caught in heavy traffic. I was trapped and I got a call (of course) so had to book a delay because I was going nowhere. It was 1am.
The journey took ten minutes, the distance was one mile and the patient was hyperventilating. She was asthmatic and had taken her ventolin inhaler but with no relief. That was because she wasn’t having an asthma attack.
I sat with her and her boyfriend and a rather over-friendly female friend while she recovered. It took a mere ten minutes to work that trick and she was quite happy when I left her.
I got my break about now but I can’t remember that one either!
A drunken Polish man on a bus (what is going on?) in Trafalgar Square next. He was easy to wake up. I just walked onto the bus – the bendy variety – shook him hard, shouted and he opened his eyes. He smiled and nodded. The bus driver didn’t even know I had arrived.
The man had a very heavy bag with him and when the police arrived, after I had walked him off the bus, they had a look inside. He was carrying large books and cans of deodorant. He was a nice smelling, Polish bookworm. He probably had a degree. Or he was a library thief.
My next stop was a local club where I found my patient, a 24 year-old female, lying unconscious with her huge boyfriend crying and wailing over her. He was holding her like she was dead. I thought the whole thing was rather over the top but I didn’t know him and he may well have just been the emotional type. In any case, his girlfriend was very much alive, very drunk and very unconscious as a result. The ambulance was delayed on this call, so I started fluids on scene. A voice in my ear asked if I needed any help and I looked up to see a young Asian woman who announced that she was a qualified dentist. She was also drunk, so I wasn’t about to let her get near my patient’s teeth – that’s what she meant, right?
After a long wait, during which the unconscious girl recovered a little, the crew arrived to take her away. The boyfirend had resumed his crying.
Back to base for a cup of coffee and then on to a stabbing at a club in Victoria. Actually, the patient, a 32 year-old female hadn’t been stabbed at all and I was being diverted to her from a fight which had taken place around the corner. An ambulance crew were already sorting that one out and I found myself sitting at a bus stop with a crying Eritrean woman, a police officer and three students who just wanted to know that she was alright. I thanked them for their help and they had a group hug before leaving. Strange.
The woman was homeless and very sad about her situation. She was very meek and to me she seemed too vulnerable to be out on the streets. I agreed to take her back to the hospital that she had been in earlier today (when she claimed she had been stabbed) and I could only think of ‘vulnerable adult’ as a reasonable excuse for doing this. I couldn’t just leave her where she was and the police officer was hoping I’d make a decision – so I did.
I took her back to hospital myself but the reception for her wasn’t warm. The nurse wasn’t too pleased to see her again because there was nothing wrong with her. I told her that I felt she was vulnerable and that this was a place of safety for her. I also pointed out that we bring plenty of drunken frequent flyers in and that she, at least, wasn’t drunk...or smelly.
She got a cubicle and a bed.
While I was there I saw that armed police had set up guard points at the entrance and exit to resus. This usually means that someone has been shot. I was told later that there had been a double shooting in south London and that one of the victims had died. There was the usual gang of friends hanging around outside, waiting to hear the prognosis for their injured mate. This has become a sick routine now.
My next call was to a petrol station where a 35 year-old man had been assaulted. He had a head injury and was quite aggressive. His little gang of mates were also a bit rowdy and they jostled the police as they tried to argue their point, whatever that was. All of these men were Somali and this appeared to be some kind of inside fight but I was told later that he had been hit over the head with an iron bar and a litter bin after telling another driver off for not having car insurance. It mattered that much to him apparently. Nobody believed this story of course, least of all the police.
My last call was to a night club where a 22 year-old female had collapsed. This was given as a Red1, with ‘life status questionable’ stuck on the screen. This produces a long sigh.
She was, of course, drunk as a skunk. She was also not very helpful and didn’t appreciate the pain I produced to get her to sit up and pay attention. She was far too heavy for me to consider playing ‘carry the rag doll’ with. She came to her senses (what little she had), stood up, with support from two of the door staff and wobbled her way to the exit with her stunned (and sober) friend. A taxi was hailed but he tried to escape when he saw what he was being asked to deliver home – mini-cab drivers are too fussy these days, don’t you think?
The door staff collared the driver before he could make good his U-turn and bundled the ungrateful woman into the back seat. Poured is the word I’m looking for.
Be safe.
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4 comments:
Wondered if you were whizzing through Parliament Square about ten to five today? Always wonder when I see an FRU if it's you or not!
sue
No, that wouldn't have been me. I am on my rest week now - not back on til the weekend.
I do whizz around though - as long as my brakes work!
xf
Concerning the 51 year old woman who fainted. If she did not need to go to hospital, why did you require her to sign your "magic" form, which I take to mean the patient report form? What happens if a patient does not want to sign that form?
Concerning the 22 year old drunk woman. What kind of pain did you "produce" to get her to sit up and pay attention?
anonymous
The PRF should be signed wherever possible if I have explained anything or given advice (such as "if it happens again, call us"). If the patient refuses, I simply write 'refused' and hope for the best but I usually have witnesses to the refusal.
We produce tolerable pain by pinching earlobes or, as is my usual habit, pinching the fleshy part of the shoulder muscle. This will usually wake a person up. I should stress that we use these techniques for suspected drunks or drug O/D's and start with gentler methods, including voice, loud voice, louder voice and a good old shake.
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