Wednesday, 6 May 2009

Self abuse

Night shift: Nine calls; one conveyed, two assisted-only, one false alarm and the others by ambulance.

Stats: 2 Chest pain; 1 DOAB; 4 Etoh; 1 Drug o/d.

Back on nights - I’ve had a few stints of annual leave to help me avoid these long, busy dark shifts but now I have to face them again.

And so off to a 28 year-old man with chest pain – not likely to be cardiac but you never know. He was sitting behind the counter of an off-licence (where he works) and his colleagues were on scene to help me understand his problem because he didn’t speak much English. I was told he had a familial history of irregular heart beat; his father and grandfather had suffered from it – the latter had died as a result.

I was surrounded by booze and sweets as I examined him and noticed that he was quite pale. Otherwise his pulse felt regular and steady and his other signs were normal but the crew took him out to the ambulance by chair, as is required for chest pain. I was quite peckish for a Twix after being in there.

My DOAB was on the top deck and at the back of the bus (as usual), where he slumbered with a can of extra strength lager still in his hand – a dead giveaway for the driver who’d called it in as ‘unconscious’. He might have added ‘possibly drunk’ but he didn’t and my assumption that he was, based on years of dealing with such patients, proved correct after I’d asked Control not to bother sending an ambulance for this one until I’d checked it out.

I woke him up in a few seconds (I’ve become very good at it) and asked him to leave the bus after uttering the famous have-to-ask question ‘do you need an ambulance?’ He didn’t and he slurred his way through an unintelligible response to confirm it.

As he raised his heavy drunken head and body from the seat I noticed a large suitcase beside him. ‘Don’t forget to take your case’, I said. ‘You bring it down for me’, he replied. ‘No, you brought it up, so you can take it down’ I responded. This made him unhappy and no doubt a letter of complaint against me will wing its way to ambulance HQ in the next day or two, providing he remembers where he was, who I was, what happened and what year it happened in. Of course, he might just mail a can of lager in by mistake.

He staggered down the stairs with me behind him and his case fell apart at the bottom of the steps. The contents of his life fell out onto the floor – two further cans of special. The original, hand-held can was in his inside pocket, he’d placed it there gingerly when he was asked to leave. As he bent down to pick up the beer he said ‘aw, my two babies’ and the liquid from his opened can spilled out from inside his pocket, like it was bleeding – or urinating. Now he had a mad juggling routine going on; should he save his babies or his obviously fatally injured other kid (by another marriage)?

I helped him get his case back together and led him out into the London night. Now, I’m not one for kicking babies at all but I had to use my boot to help the cans back into their home. I didn’t want to touch them and it was easier than bending down with him and letting my guard go. Drunks can get very tetchy around their children.

The next drunk I encountered was leaning on a fence but I only knew he was my prospective patient because, of the two drunks to choose from in the same street, both of whom could have been the candidate for the call that simply stated ‘laying in street, appears drunk’, the other was on some steps and chatting into his mobile phone – real or imaginary, I couldn’t tell (I’ve never seen a street drunk on a mobile). So, I chose the fine fellow who was propping up the fence and stopped to ask if he needed any help. The crew was arriving too, so eventually the three of us stood around him asking him to go away before someone else panicked and called an ambulance for what might seem to be totally unnatural public behaviour (i.e. staggering, swaying, lying down and sleeping).

He refused and we all took that as a sign from above that he didn’t want to go to hospital. He was left where he stood and he re-propped himself for the night. He’s probably still there.

A cancellation half-way to a ‘man whose been strangled, police on scene’ meant that I wasn’t going to see the person who’d been brutally assaulted. To tell you the truth I couldn’t imagine it being an exciting adventure.

NPC for the 56 year-old Casino cook who suddenly developed chest pain at work. A crew was on scene and I didn’t do anything except carry their bag as they left with the patient strapped into the chair.

Two MOPS, a man and a woman, probably on their way to an exciting night out, called 999 when their evening (and path) were obstructed by the body of a man lying on the pavement. Well, they couldn’t just walk on by and leave him there, could they? This was Central London and such human obstacles are quite normal but it is entirely understandable that people should occasionally show concern. I figured they must be out-of-towners.

The man on the deck was in the recovery position, placed that way by the gentleman who was now waving at me to stop as I arrived on scene – on his face was etched a mixture of concern and resignation; he already knew what I was going to tell him.

As for the laterally-laid man, he could have put himself into the recovery position because he wasn’t unconscious and he sat up when asked to. I thanked the MOPS and they wandered off into the night and to a better form of entertainment than I was going to have.

‘I’ve been drinking’, the groggy, slow-eyed man said. He’d also been taking something much more potent and I suggested a cocktail of drugs may have been on the menu recently. He agreed and told me he’d taken Valium and Rohypnol; an unusual combination out of clubland but it accounted perfectly for his slow-motion behaviour and frequent relapses into compete brain stand-still while I was talking to him.

He was homeless and not at all aggressive – not that he could be with that lot on board. He told me he had Hep C and then warned me not to go into his bag, which had fallen onto the pavement just as he had. ‘There’s jar of pins in there without a lid’, he informed me, ‘please be careful’.

Now, I know I’m not the softest heart you’ll ever have read (or meet) but I felt some gratitude for having been warned not to stick my mittens into a container full of exposed used needles, so from that moment on I remained very nice to him. He was incapable of getting up and walking off, which is what he should have been doing, so the ambulance crew took him away and he got himself a warm bed for a few hours. I do hope he hadn't taken the 'Roofies' so that he could molest himself as he slept.

My next port of call was to a phone box not too far away from Leicester Square, where a 32 year-old man who should have known better was slumped on the floor with the phone still in his hand and the display flashing ‘999 emergency’. I took the phone from him and told the person at the other end who I was, then I hung up and asked him what was wrong.

‘I’ve had cocaine and ecstasy’, he said. One drug just isn’t enough for some people and now he was suffering from tremors, paranoia and cold sweats. He’d used the stuff before but this time he didn’t know the supplier and that’s always risky for a user; very often drugs like this are cut with other, less than exotic substances, like baking soda but sometimes more harmful adulterants are used.

I waited and waited for an ambulance but relented and took him to hospital myself in the car, something I’d rather not do with a druggy. He told me this was the first time he’d been ill as a result of his habit but when I got him into A&E I noticed a plaster mark and puncture on the back of his hand, where a needle or cannula had probably been. When I drew his attention to it, he told me that he'd had a heart attack after using cocaine recently. I didn't know whether this was true or not but it blew my 'he's normally fit and well' statement, which I'd just given in my handover, out of the water.

Young vomiting women are very common when the weather improves and the weekend is heralded by the mid-week (yes, I know, Friday used to be the weekend’s herald, then it was Thursday but now its Wednesday – soon we’ll be starting our next weekend before the current one is finished, getting drunk on a Sunday before sobering up for an hour and starting all over again).

So, a 25 year-old girl with no dignity left and very little clothing on, lay on the floor of a small, noisy club, throwing up the entire contents of her stomach (and a little more for good measure). The sick flowed like a little river down the incline of the floor, heading towards my boots but I’m wise to sneaky vomit-floods and none of it made contact with me. Instead, her hair and face got covered and now she epitomised the advert that has been aired over and over – you know, the one where the girl is getting ready for a night out but she is plastering her hair in sick. It’s good to know that these multi-million quid television ads are having an effect.

I waited for the crew to arrive and we scraped her up and poured her into a chair. Of course, as always, claims of drink spiking were thrown around by her friends but I think she’d just had fifteen too many...

...As had my Irish patient on the next call. Control phoned me to advise that there were no ambulances available for the 21 year-old male who’d fallen and sustained a head injury at a club. He was drunk and boisterous, so I was asked if I could go and check it out but if I didn’t want to, they’d understand. I frequently get sent into dark estates in the middle of gangland south London without any cautionary advice but for a young hard-drinking Irishman with a loud voice I was being offered the opportunity to wait for backup?

I trundled off and found him sitting with club security and a mate. They’d been waiting half an hour. The patient was noisy, drunk but friendly and there was no threat here at all, especially as I had three very large men watching over me. The worst I got out of this encounter was a cheeky remark from his friend when he saw my watch and said how cheap it looked. I told him I only wear this one at work because if I lose it I won’t care (and it has a little light so that I can see the time when it’s dark). I also considered asking him if he could possibly tell the difference between a £20 timepiece and a Rolex (that wasn’t knocked off) but he may have been a jeweller by trade, so I didn’t.

My patient had fallen backwards and cracked his head on the bar. Now he had a decent gash in the back of his scalp – nothing life-threatening but it would have to be closed up. I dressed it and waited a short time before the crew came and took him away. On the way out, he pulled my perfectly good dressing off his head. I don't know why I bother sometimes.

I went home after a false alarm for an ‘unconscious’ 25 year-old led me to a bar that was closing, with people spilling out onto the pavement. The woman who’d called came up to me and apologised. ‘I thought she was in trouble’, she said. Then she pointed out my ‘patient’. A tall girl was getting into a taxi with a man. I asked if she was okay and was told that she’d initially fallen down drunk but had been helped up and was now being taken home by a friend (at least I presume he knew her). The emergency was over before it had begun. I just wish someone had called us back and cancelled it.

Be safe.

1 comment:

Dark Side said...

Good to have you back, it seemed strange you not being around, hope you had a good break too..xx