Monday, 3 March 2008

Diamond geezer

Ten calls; one assisted-only and nine by ambulance.

If you don’t fancy worrying about your life or giving your wife stress and you don’t relish having seizures on your front room carpet then don’t become an alcoholic with a cocaine habit. That’s my advice anyway. Take it or leave it.

He is 45 years-old and he had a fit tonight. His wife cradled a can of lager as I attempted to get details but their nosey neighbour (also an alcoholic) kept coming in to offer nuggets of wisdom.

‘Listen to the ambulance man, he knows what to do. Don’t give him a hard time!’ he’d say, over and over again.

The patient wasn’t giving me a hard time, he was too busy crying and stressing out about his predicament. Don’t do drugs (and alcohol) then, I felt like saying. I did say this, however…

‘One day, you won’t stop fitting and one of us will be trying to save your life’.

I have no idea whether that approach will work with a hardened drinker but I feel I have a duty (and the right) to tell him what his future may be. Tough love, kinda.

I stayed in rainy south London for my next call to a 25 year-old woman who mistakenly took antibiotics, which had previously been prescribed for her but she had reacted to. Now she was having a widespread reaction again. She agreed that it was silly to have kept them in a little patterned box by her bedside. She had reached for it and taken out the first pill she found, popping it into her mouth to resolve a headache. She got more than she bargained for but her crisis wasn’t life-threatening – she just thought it was. She was itching and had a sore throat.

Back into the north and a call for a 41 year-old woman who claimed to have DIB as the result of food poisoning caused by eating trifles. I love trifle.

When I got to the address, which I had recognised, I found myself at a local hostel for alcoholics, drug addicts and people with mental health issues. We get regular calls to this place, usually for nothing much…as was the case now.

The woman was sitting on the stairs looking sad, the way people who want to look ill look – that kind of sad. She told me she was reacting to trifles she had eaten…wait for it…a week ago! She had no difficulty breathing and she had no pain, although she claimed to have vomited. No amount of persuasion was going to convince her that those trifles were long gone from her system, so I left her with the bemused crew and she went to hospital.

I spent almost two hours with my next patient, an 83 year-old man with a cardiac history and DIB. Initially I spent about an hour with him at his little home in north London and then I continued his care, along with the crew, all the way to hospital.

He used to be a jeweller by trade and he knew a lot about diamonds (if you are interested in just how much we are being ripped off, he is a mine - excuse the pun - of information). He still dabbles, despite his age, but only to keep a living coming in. We chatted for ages as I monitored his condition (he improved on oxygen).

As the crew and I took him to the ambulance, I noticed how badly damaged his front door was. There was evidence of several break-in attempts. He told us that the local drug addicts had been trying to burgle him. His house is in a quiet alleyway and I am concerned that one day these scumbags will break in when he is at home. They won’t stop to chat to him, that’s for sure and tall as he is, he’s no longer strong enough to protect himself.

He was one of the nicest patients I’ve spent time with in years and we got on immediately, like old friends.

‘We’ll have to go for a drink and a meal sometime’, he said as I left him in his hospital cubicle. Hopefully, he’ll get better and be well enough to go anywhere soon.

I rushed off to a call for a 51 year-old male with chest pain and had to descend into a public toilet (never pleasant) to get to him. He was the cleaner and his female friend was busily flushing the last of the vomit he’d thrown up, down the sink. It stank in there.

He didn’t have chest pain either – he had a boil on his chest! He showed me it when I asked him about his current problem. It looked like he was suffering from food poisoning but somehow this had translated to chest pain during the call to the ambulance service. Whether this came about as a result of a communication error or the language barrier (both were African with strong accents), I don’t know. Whenever I asked him about it he rolled up his shirt and displayed his pus-filled friend. Being in that stinking public toilet was injurious but having to look at his boil time and time again like it was a prized possession, was the insult.

To make matters worse, I found his BM to be quite high and I asked him if he was a diabetic. He told me he wasn’t but when he went to the ambulance with the crew, he told them he was. Every now and again a patient will do that to me. His hyperglycaemia was probably the reason for his sickly state.

I didn’t wait too long for the crew on my next call, to an 85 year-old man with chest pain and shortness of breath who was also very pale. His recent cardiac history meant that he could well be having his next heart attack, so he was taken to hospital very quickly.

Drunk on a bus time. The bus driver was waiting for me like a wife at the entrance to his vehicle. The drunk was sound asleep at the back and all I had to do, as usual, was wake him up.

'I didn't want to touch him after the last time when I got attacked', said the driver.

Oh, so it's fine that I take the risk instead, is it?, I thought.

My new sleepy-drunken Polish friend walked off with me and I got a disposable blanket, wrapped him up in it and guided him to a bench across the road. There, he settled down and went back to sleep. He had nowhere else to go.

An unconscious 25 year-old drunken male probably sustained a head injury when his very irritating mate stepped in to ‘help’ us out as we tried to rouse him. He lifted his buddy’s head, shook it and shouted ‘Come on mate, wake up!’ Then he dropped it like a hot brick onto the pavement. The thud was quite sickening.

When a call comes in for a teenager with chest pain, we have one of several possible options: (1) they have no chest pain; (2) they are one of the rare few with cardiac problems; (3) they have another medical problem which has produced chest pain or (3) they have taken drugs.

This 18 year-old student stood in the street and denied taking anything, even though I repeated the question and added the all too famous line, ‘I’m not the police’. She had all the signs and symptoms of recent drug abuse and only when the crew showed up and my female colleague asked her again in the ambulance, did she admit to taking MDMA earlier. I hope when she grows up and gets her degree, she has more sense than this.

I was cancelled on the last call of the shift but I was already on my way, so I pulled up on scene to see if I could assist. A motorcyclist was lying in the middle of the road with a head injury after having been hit by a car at speed. Another FRU was on scene and a crew had just arrived but it was clear another pair of hands would be useful. I forgot to call Control and tell them what I was doing but they ‘phoned me anyway because they could see where I was, so I was given the job again.

I helped my colleagues to stabilise the man in the road before he was packed off to the ambulance. He was hurt but not in a life-threatening or life-changing way; he will survive.

I trundled back to the station, just around the corner, and prepared myself for the countdown to going home time. This moment is always sweeter than on earlies; I don’t know why but going home after a night-shift feels like a reward.

Be safe.


Anonymous said...

When a call comes in for a teenager with chest pain, we have one of several possible options: (1) they have no chest pain; (2) they are one of the rare few with cardiac problems; (3) they have another medical problem which has produced chest pain or (3) they have taken drugs.

And dont automatically assume that they're making it up! 3/4 ambulances did that (The 1/4 that didnt was the first one that was called for me, did an ecg, nothing wrong, and we went to my GP instead of sitting in A+E), the other 2/4 didn't even put me on an ECG, and the last one that i had didn't want to put me on an ECG, i insisted, and I ended up being blued into hospital with O2, GTN, etc.

Xf said...


Not quite sure of your point. I think my statement clearly indicates that I presume nothing and everything. And I can tell you that persuading an 18 year old girl to have a chest-exposing 12 lead ECG done when you are a male crew, is nigh on impossible.

I've seen young people in cardiac arrest...none of my colleagues presume one way or the other.

Tabitha said...

Hospital, for trifle poisoning??

Dammit, I want trifle now...