Day shift: Nine calls; all by ambulance (funnily enough).
Stats: 1 Anal pain (no jokes please); 2 Unconscious, ?O/D; 2 Abdo pain; 1 CVA; 1 Fracture; 1 Fit and 1 Generally unwell.
The powers that be have decided to pull all of the FRU’s off the road. The motorcycles will be replacing us on the basis that they are faster and better looking – leather has always been more popular than cotton. I will be back on my old line and back on an ambulance with a new crew mate for a stint until something changes again (and it will). I’ve been running around Central London in that little yellow car for three years now and I will miss it (I think). I’ve been on a couple of ambulance shifts, one of which I write about here and have two more shifts on the FRU before I hang up my badge and gun, either for the last time or for a hiatus – who knows?
So, a 61 year-old bowel cancer patient with a painful anus requires our attention and we discover she hasn’t been taking her pain killers properly – she’s been taking four a day instead of two, four times a day. No surprise then that she had a bit of discomfort. She walks out to the ambulance with us and we chat all the way to hospital. She’s Italian and quite funny, considering her predicament.
The first of two unconscious drug overdoses next. The 24 year-old man is inside a popular gay club and he’s not responding to anything, so he gets ‘Narc’d’ and I give him fluids too but still nothing. Of course Narcan won’t help a GHB overdose, if that’s what he’s had but we have to cover all the bases. By the time we get to hospital, he’s stable but still unconscious, so we leave him in the hands of the Resus team, who intubate him and cart him off to Critical Care for his own good.
A regular caller with abdominal pain (of which he complains a lot) and I’m chatting to a fellow Glaswegian who doesn’t care about anything and tells us which hospital he’d prefer to go to because the other one ‘doesn’t understand my problem’, he claims. They are probably just fed up with him. He’s known to be abusive but I forgave him on the basis that a) he might have genuine pain and b) he’s a Glaswegian alcoholic from the good old days.
‘I thought I was going to die’, said my next patient as she described her abdominal pain and near-faint experience. The 40 year-old had obviously never been exposed to anything more lethal than cotton wool in her life. Her crying Italian mum was making things worse by demonstrating how serious she thought her daughter’s condition was. Both had to be consoled. Both were very lovely people but neither had a sense of the real world.
An 89 year-old woman who fell earlier in the day and was now ‘making no sense’, according to her daughter, was probably suffering the effects of a UTI. The smell was powerfully strong and she had all the classic signs.
A short trip down to The London Eye for a 14 year-old boy with a broken collar bone next. We arrived to find him among hundreds of youngsters who were jumping from heights and somersaulting to the ground – urban free-running it’s called. He’d done a forward jump with a backward flip and landed awkwardly and heavily onto his shoulder, breaking the thin collar bone in the process. The fracture was immediately obvious and it looked serious enough to warrant a couple of stabilising pins in surgery but the x-ray would confirm the severity of it when he got to hospital.
His father and brother were with him; the boy had been wearing absolutely no protective gear when he came crashing down and I could see his father squirming uncomfortably in his seat in the back of the ambulance as I lectured the young lad about how ‘lucky’ he had been considering he’d only damaged his shoulder and not his head or neck. Dad would have to explain this to estranged mum and I didn’t fancy his chances at all.
The last time I dealt with a patient in a taxi he was the driver. He’d had a stroke and was slumped at the wheel on Parliament Square, right outside the House of Commons. Nervous armed cops had approached in case he was a terrorist. He was a Cockney but I don’t think a couple of cops with guns was going to change that. Anyway, my next patient was the passenger of a cab and he had his two young sons with him. He had just been discharged from hospital after having an epileptic fit and had another in the taxi on the way home. His very switched on and amazingly calm sons took care of him and waited for the ambulance to arrive. A FRU was on scene and we took over when the details of his fit were given. He was post ictal and it took another twenty minutes for him to realise what had happened. He was bitterly disappointed to be heading straight back to hospital.
Cirrhosis of the liver is common in alcoholics and my 52 year-old patient had a long history of alcoholism. Now he was suffering generally as his liver began the road to self-destruction. He was unwell – Hep C was exacerbating his malaise.
A strange unconscious call next. A 20 year-old man had been found slumped on Oxford Street. He was completely unrousable, even to deep pain. A solo cyclist was waiting for us when we arrived (although the road works down almost the entire length of one side of the road didn’t help to speed our journey - I had to keep jumping out to chuck cones away) and he explained that the man had been found in this condition by a passer-by who’d bothered to check on him. The patient’s pupils were pinpoint and his blood glucose level was low, so he was given Glucagon and Narcan (for good measure). There was no sensory evidence of alcohol but his possessions gave us something to ponder. He had a bag on him and inside the bag was another bag...a feminine looking bag. Inside that was a store card with a name on it. We presumed that it was his name, of course and proceeded to call him by it all the way to hospital. It was a foreign name and although I didn’t recognise it for gender my brain was telling me it wasn’t a male name. I even asked the attending doctor what he thought of it while the patient was examined in Resus. Everyone was a bit confused about the man’s name and his bag...and the cheap make-up that was inside it.
Now, before you all say ‘it’s obvious’, nothing is in London these days. It could easily have been his make-up and he may well have taken GHB (a popular recreational drug for the gay community) and he may have been on his way home but collapsed as a result of taking the drug. Contrarily, and I began to suspect this and suggest it after looking through more of his possessions – he could have been a bag thief.
Inside the outer bag was another form of ID – a travel pass. This bore a completely different name and a photo, which matched our unconscious patient. Now it was fairly obvious. He had stolen this bag from some unsuspecting lady with bad taste in make-up and had probably intended to get rid of it but had become unconscious in the street – for what reason we still don’t know, unless he had taken heroin earlier on.
If there’s one thing about this city that never ceases to amaze me, it’s the possibility of coming across the most bizarre jobs on a regular basis. I would miss that if everyone became normal.
Oh and the decision to take the FRU's off the road was suddenly reversed soon after I wrote this. Nobody knows why.