Wednesday, 12 March 2008

Out with the Times

Ten emergency calls – one hoax, one assisted-only, one declined and seven by ambulance.

I had the company of the Press tonight. A reporter and photographer from the Sunday Times were with me for most of the shift and they hoped to catch a glimpse of the world of drunks and timewasters out on the streets. What they got, however, was mostly a routine night of genuine medical emergencies. Mostly.

A 66 year-old female collapsed in a theatre – this was given as ‘fitting’ but she wasn’t; she had a history of TIA and looked to be having a neurological event. She was very pale and slightly confused. It soon got rather crowded where we were because the interval started just as I was completing my obs. and crowds poured out of every exit of the auditorium, surrounding us like the so-called ‘Red Indians’ of old – we were akin to Custer and his men. The crew quickly collected her in the chair and off she went to hospital.

Another ‘fitting’ call; this time for an 18 moth-old baby girl. Again, she wasn’t fitting in the conventional sense; she had suffered a febrile convulsion, which, by the time I arrived, had finished. Another FRU was already on scene and the crew soon followed so I had nothing to do.

Then a sinister encounter in a dodgy estate in SW London. I was called to a 22 year-old male with DIB and when I arrived, the MRU was on scene. At first we couldn’t locate the patient, who was supposed to be outside, so the MRU paramedic went inside the estate to have a look and I followed a few moments later, after getting out and checking on foot.

I found the paramedic with a young man who was crumpled in a heap against a wall, quite deep into the estate. Nothing looked right about this job from the start – he was a fit, young man but he was behaving like a big baby and hyperventilating all over the place. He had a history of asthma but this wasn’t his current problem.

A few minutes into the call and we were joined by a small group of young men – they had that ‘gangsta’ look about them and they weren’t impressed with their friend’s behaviour. I asked them if they needed to be there and realised my mistake as soon as the sentence finished.

‘What do you mean we don’t need to be here?’ one of them retorted.

I am smart enough to recognise the tone of a potential challenge, so I left it and softened the phrase to an enquiry.

‘Do you know this guy?’ I asked.

They nodded but nobody said anything; they just stared at him with zero compassion. If they had been a pack of dogs, I would consider the possibility that they wanted to put him down for being a weakling.

Then my Press companions decided to alight from the car and the photographer tentatively began to take pictures (of myself and the other paramedic at work, not the patient). This did not go down well with the posse around us and a few of them began to move to different positions – one of them demanded to know why the photographer was taking pictures. The atmosphere was a wee bit charged now and I asked my friends to go back into the car, which they did. Both of my observers had stab vests on, at the behest of my superiors - just as well.

The ambulance arrived and I asked the crew if they could take this guy straight on board; it was getting uncomfortable in that closed environment and the locals weren’t being friendly – they weren’t being directly threatening either – they were just standing there, inches away from us, weighing us up.

The crew had to semi-drag this young guy into the ambulance. He put on such a show of being too weak to walk that I suspected he felt he had to. Maybe he needed to convince these guys that he was genuinely ill. I don’t know but I left the scene as soon as it was prudent to do so and I sat just outside the estate waiting for the ambulance to appear…but after a while it didn’t. This worried me because I couldn’t be sure the crew were safe in there, so I called Control and asked them to give them a discreet buzz. They did and the crew were fine apparently.

I left after waiting another ten minutes without sight of the ambulance but I figured they must have let the man go or were busy getting a thorough examination completed. One of those I hoped.

My first call to a pub and I thought the 25 year-old female who had passed out inside must surely be intoxicated. At least the Times men would get something to write about. Unfortunately, she wasn’t drunk. She had a low BP and had fainted. The hot, noisy atmosphere in the little pub room didn’t help, so she was taken out to the fresh air by the ambulance crew.

I’ve never treated a patient from the travelling community before, so this was a first. A call to a 60 year-old man with chest pains. The address was a traveller’s static home site. He was lying in bed and almost as soon as I asked him his name, he began to vomit violently all over his bedroom floor. I heard it coming before I saw it.

'Can someone grab a bucket for me please?' I asked of the family gathered in the front room.

'Phwerggggh!!'

'Too late', I said.

I tried not to take this personally.

He denied chest pain and he denied everything his family claimed was wrong with him, despite the evidence in front of me and his weeping daughter and distraught wife and son. His mother, the grandma, wandered around saying stuff I couldn’t understand, so I’m not sure where she was in the scheme of things.

When the crew arrived we managed, after a long drawn-out debate, to convince him to get on the chair (he was a big fella) and be wheeled to the ambulance. On the way, he pulled himself up, got out of the chair and disappeared around the back of his home to have a pee. No amount of arguing could stop him and at 6 foot something, nobody dared. This wasn’t the time to be clinically clever – at least he was compliant to some degree.

Oh and here’s an irony…travellers are often berated and put down but the fact that I have rarely had to treat one of them and that his family told me he never went to the doctors, even when he felt ill, throws a spanner in the works of the narrow-minded and high-and-mighty, does it not? Most of our timewasters are non-tax paying individuals who don’t belong to a particularly targeted sector.

Anyway, his ECG wasn’t good and we ‘blued’ him in. He got a cannula in his vein and some Metoclopramide to stop him vomiting. He was having some kind of cardiac event and, despite his continuing denial, he probably had chest pain to go with it.

A 61 year-old female with Parkinson’s disease next. The City police were on scene because they knew the lady and had received several calls from her earlier on. There’s nothing medically wrong with the patient (apart from her predisposing condition) and all she seemed to want me to do was sit with her. When the crew arrived, she wanted them to sit with her too. Her husband (long-suffering from all accounts) wasn’t invited to sit with her at all. It was a bizarre and slightly complicated situation but none of us could help. She didn’t want, or need, to go to hospital, so she was left in the care of her husband.

After a short break at the station, I was called to attend a stabbing in Leicester Square. According to the call info, a 30 year-old male had been stabbed in the chest and stomach. Unfortunately, and I don’t mean that in a heartless, cruel way, the victim didn’t exist. We sped all the way down there and my Press mates were a bit apprehensive I think, but when we got on scene, another FRU was patrolling around looking for him. I joined the search and so did the police, who started piling in, as expected.

It was a hoax call and we were stood down after twenty minutes of looking stupid.

A call to a 44 year-old female whose English was non-existent and who presented me with a difficult language barrier, wanted treatment on scene for hyperventilation, according to her translator. She wasn’t even breathing fast enough to warrant it, so the crew left her at home in the care of her family.

That’s about when my Times buddies left me and went home. They had stuck it out for about eight hours, so I think they did well. I’m sure the shift had interested them but I don’t think it was the material they were looking for. You just can’t predict the job unfortunately. Ironically, my colleagues were up against drunk after drunk. Maybe Control thought it best to steer me away from those jobs tonight.

My next call was to a 30 year-old female with DIB and fainting spells. I found her in a small room at the top of the stairs inside a grotty little hotel which had the audacity to display an Egon Ronay award plaque (from the 80's) outside the front door. She let me in and walked all the way back to her sanctuary. She’d been ill for the past two weeks, she said, but now she was convinced she had a fever and needed an ambulance.

Her temperature was normal. The crew took her anyway because she insisted.

The job that made me late was the 33 year-old female with DIB and a cough. She was with her boyfriend and she told me she had been bringing up thick green phlegm recently. Her main complaint was of a sharp pain in the right side of her chest. She had suffered this on and off for a year and nobody had done anything about it, allegedly, even though she had seen her GP a number of times.

Her BP was low and she definitely didn’t look well. She also looked like something else, although I was careful not to pass judgment (still, I needed to know).

‘Do you use drugs?’ I asked.

‘Yeah’

‘What drugs?’

‘Heroin’.

They were both drug addicts but that didn't sway me from my intention of getting her some decent treatment. She needed to be in hospital. She was completely out of breath every time she tried to walk a few steps and I figured she may well have a PE. Drug users develop this problem sometimes and abcesses can form in their lung tissue if the embolus becomes septic, so I advised the crew of her habit when they came to collect her.

They lived, courtesy of the council, in a flat which directly overlooked the river Thames. I come across lots of free housing that is situated right in the heart of it all in London and, although I have no bitterness about it, I feel annoyed that the Government can't do more to provide us, the essential workers, with centrally-located accomodation. It would cost me upwards of half a million quid to afford to live in a flat located where this couple were and that is ridiculous. No wonder we and our colleagues in the health professions have to live out in the sticks.


Be safe.

5 comments:

Sam Tyler said...

Good post Xf. And thanks for the link

Tabitha said...

I agree about the riverside flats. I am amazed at how many buildings in London are prime for conversion into affordable homes, and yet they are all knocked down to make way for ugly 'luxury' flats! This situation can't go on forever... I hope.

Poor old Sunday Times, not getting the right stuff for the article. I hope it's a good read anyhow.

gjmoomin said...

Interesting post. Thanks for your comments the other day, much appreciated. Just wondered if your Parkinsons lady had the associated Lewy body dementia and her poor husband was suffering the consequences. Just a thought as he wasn't invited to sit.
Take care Gill

Dani said...

well, thats just muphys law that the Times people didnt get to see any 'dead' people on buses ;)

very weird about the call to the estate.

Anonymous said...

"I come across lots of free housing that is situated right in the heart of it all in London and, although I have no bitterness about it, I feel annoyed that the Government can't do more to provide us, the essential workers, with centrally-located accomodation."
Why aren't you bitter ?
Why just essential workers ?
Why should heroin addicts or other wasters receive free, what most workers can not afford. It is crazy that workers with good jobs nowdays dream of living in housing that is given free to people who do not work. Why work ?

David