Monday, 26 November 2007

Hemingway and Heroin

Five emergencies – one treated on scene, four taken by ambulance.

I did a lot of research into childhood obesity when I was at University. My dissertation concluded that the current trend would lead to much younger people, perhaps even kids at high school, having heart attacks and strokes as a result of their ludicrous eating habits. I wrote about this in 2004 when the obesity ‘epidemic’ wasn’t even vogue and Jamie Oliver was just touching on the subject of healthier school dinners (he has since been screwed over by the Government) but now the subject has become one of the biggest talking points in the UK.

Today I heard a story on the radio of a woman who became impaled through the buttocks on a railing which penetrated so deep it should have severed major arteries and damaged vital organs. However, this didn’t happen because she was so fat the mass of her buttock actually saved her life. Her boyfriend, who is obviously happy that she survived, wrote to her favourite fast food chain, KFC, thanking them and offering to work for them for free as a reward for ‘saving her life’.

I should have laughed but I was too shocked. This isn’t about being fat any more, it’s about being too ignorant to realise the damage that is being done. I’ve even seen a report in which new research suggests that being fat means you might live longer! Give me a break!

What next, someone who deliberately gets fat for the sake of art? ‘I’m expressing myself through the medium of pizza’.

First off, a 22 year-old pregnant woman with abdominal pain. Sometimes the pain is normal, sometimes it’s sinister, so we always take it seriously. An ambulance was already on scene when I arrived, so I was surplus.

Then a 43 year-old solicitor described as ‘not fully conscious’. He was on the floor of his little office when I arrived but he got himself up as soon as he saw me. His mum had called the ambulance because she was concerned about him. He had recently started drinking heavily and was generally depressed. He was on a slippery slope and didn’t seem to want to help himself.

‘Have you been drinking today?’ I asked, looking around at the empty bottles lying on his desk.

‘Yes. I’ll drink anything I can get my hands on’, he replied.

I think the doctors, who have diagnosed him as having ‘anxiety syndrome’ have only scratched the surface. The man is falling apart.

A call to the City for a 38 year-old man with chest pain later on in the day. He was with his two friends, both doctors (one medical, one not) and a report of ‘diminished breath sounds’ on his right side was given when I met them. He had been playing football and fell on top of someone’s knee. His chest had taken the brunt of the force, so a rib could have cracked and penetrated a lung. If he had a pneumothorax, it may develop and become potentially life-threatening, so he was taken to hospital quickly.

I treated my next patient where he lay, on the bedroom floor of a hostel. He was a 59 year-old man who had just taken more than his fair share of heroin. He was unconscious when I found him and his breathing had become very slow and shallow. He was on his way out. This was the second overdose I had treated at these premises and no doubt one day, I will find one of the residents dead.

I injected narcan into the man’s vein and waited a few minutes for him to recover. I ‘bagged’ him to support his breathing and he began to come out of his little coma. Within ten minutes of arriving, he was sitting up and talking.

‘That’s the last time I do that’, he said.

I wanted to believe him but I had more chance of seeing Santa. He refused to go to hospital, which is fairly normal for this kind of call and he related his life story to me while I took his details, re-checked his obs (heroin has a nasty habit of kicking in again after the narcan has done its job) and waited for evidence that he was stable.

He had lost his wife of 20-odd years recently. She had died violently, by his account and he had never recovered from watching her go. I felt sorry for him but I also knew that where he was, in the depths of drugs and alcohol, might be impossible to escape from.

I looked around his little room; he shared it with one other. He had a crisp clean shirt ready on the bed, almost as if he had an interview to attend and his clothes were generally tidy. It was his reading material that attracted my attention most, however – among the books on his shelf were a couple of Hemingways.

My last call of the shift was to a 55 year-old male, ‘collapsed’. He was very pale when I arrived and he vomited as soon as he was sat up from his slumped position on the floor. The crew were already on scene when I got there, but only by a few seconds. There were no access ramps (this was a university building) at all and we had to take the trolley bed up to the 4th floor and put him on it. When we got back to the ground floor, we discovered that the only lift big enough to take the bed, the goods lift, was out of order. Now we had no way of getting him out of the building without lifting him up steps. The trolley beds are extremely heavy and not designed for lifting, so the prospect of injuring our backs to get him to the ambulance did not appeal to us.

Luckily, he recovered enough to transfer from the bed to the chair and we got him out that way. I still had to lift the trolley bed out of the building but at least it was lighter without the patient. I was very surprised to see that the place, which is fairly modern, had no disabled access. I thought it was illegal these days.

On my way home I saw a cyclist cross my path wearing a hi-vis tabard upon which was printed one word – POLITE.

One smile for the day then.

Be safe.

4 comments:

JJ said...

I'd like to know how the authorities define obese? I am overweight and take my excess weight seriously having lost almost two stone within the last year but am now stuck at just over 10stone. I had a giggle a few months back when I was on my scooter and saw a man wearing a tshirt that read I am a lesbian aren't some folk strange?

Andy Carr said...

It'd be interesting to hear your views on the BBC News article (http://news.bbc.co.uk/1/hi/health/7110078.stm) I read today.

Xf said...

JJ

10 stone? How old are you?

The World Health Organisation defines obesity. A Body Mass Index (BMI) of over 25 is 'overweight' and one that is more than 30 is 'obese'.

The current argument is that those children who are heading toward or are on a BMI of 25 will become obese before adulthood, thus presenting a growing trend in health issues such as diabetes, heart disease and stroke.

Xf said...

andy

I agree. My service introduced 'make ready' a few yaers ago and that usually means the vehicles are deep cleaned and sanitised. The problem, however, is when the same vehicle is being worked on one shift after another. Bacteria and viruses can build up inside an ambulance and absolutely no time is given to us for cleaning.

Remember that this pressure to get out there and deliver is brought about by ORCON and the Government's obsession with targets.

Personally, I always wipe my hands and the steering wheel of the car before starting my shift. The steering wheel is where most of the bugs are going to be.