Sunday, 2 August 2009

Plinth life

Night shift: Six calls; one by car, one treated on scene and four by ambulance.

Stats: 1 EP fit; 1 Chest pain; 1 Asthma; 1 Abdo pain; 1 Head injury.

The Student Paramedic (SP) is with me again tonight and we start off with a call to a 28 year-old woman who’s had two fits in the street. One of my MRU colleagues is already there and he explains that she usually only has one seizure. She has a cut to her chin but no other injury. She seems lucid enough and because there are no ambulances available, I decide to take her in the car. If she’d been confused or the least bit unstable, I would have waited with her but Control has sent me for this reason.

We get her to hospital quickly with her friend as Chaperone.

Not long after this I was asked to attend a 70 year-old lady who was unwell. I was told that she just needed a ‘welfare check’ (and for my American friends that means a health check; not a Government handout). We got to the large flat in a well-off part of town and she was sitting in the front room with her sister. They live on their own and have done so all their lives – never been married, never been apart. There used to be three of them (I was shown a picture of them all in their youth) but one of them died recently. It was a poignant tale to hear.

The unwell lady had a ‘heavy chest’, which she had been coping with for a few days – she’d had a cold too and complained about pain down one side of her face every now and again. This sounded like trigeminal neuralgia to me; possibly associated with pressure in her skull, so I dropped the idea of leaving her to it and cancelling the ambulance.

They had apologised profusely for calling us, citing our need to be with ‘genuinely ill people’. I had to smile at the irony of it – here we were with two hard-working, tax-paying people who’d probably never dialled 999 before in their lives and they were feeling guilty about their ‘abuse’ of it when I’ll bet not a mile away from them, someone is making demands of us purely because they can, and not for any truly medical reason.

As the lady was taken out to the ambulance, I noticed a Euro-Millions lottery ticket on a table. I guess even the well-lived have aspirations of more luxury.

Her ECG was abnormal and I was invited, by her sister, to talk to their private GP. I’m always a little wary of doing this because some of them tend to adopt an immediately haughty air about them when they realise they are speaking with a mere ‘ambulance driver’. Fortunately, this one treated me like a fellow professional and we exchanged information about his patient like colleagues.

They were two of the loveliest people I have met in a while and their little history, which adorned the walls and tables of their flat, set in picture frames and trinkets, reminded me of how honoured we are to be invited into the lives of others because we are trusted and appreciated by them. I think much of the harm done by the masses who abuse us and whose lives, forgive me, are just not worth knowing about, is repaired when we deal with genuinely nice people.

Unfortunately, it was back to ‘normal’ on the next call, for a 46 year-old man who had chest pain. In fact, he was in bed, drunk and in no pain whatsoever. His concerned neighbour had called us on his behalf and he lay there refusing to keep his eyes open as the alcohol-induced stupor overtook him. He was just another sleepy drunk, with a long history of being just that and there was no reason for us to be there. We left him to the crew and they did what they had to do. He went to hospital to sleep some more.

A running call in Leicester Square when we got back on stand-by; a Birmingham man, out with his wife on their first anniversary, was feeling a bit wheezy and tight-chested. He is asthmatic and had forgotten to bring his inhaler with him when they left the hotel. He’d approached the car and asked if we could help, so the SP got busy and nebulised him until he felt ‘much better thanks’ and the couple continued their evening (via the hotel and collection of an inhaler).

A 55 year-old female with abdominal pain next. She’d claimed chest pain when the call was made, as many do, and she really over-milked the pain she said she was in. Her retching seemed deliberate and she only referenced her agony when there was someone watching her. Once again, this seemingly cultural behaviour, for the benefit of their families, exhausts me and makes me feel depressed about the mind-set of grown-ups in some sectors of society. She may or may not have had abdominal pain but, for a woman who has children, to claim 10 out of 10 for it, stating that it was worse than giving birth, even though all her vital signs said the opposite (breathing, pulse and BP changes occur in pain), she was definitely going for the sympathy vote from her extended crowd at home.

At 3.30am, we received a call to a market, where someone had been run over by a fork-lift truck. When we arrived, we found an ambulance already on scene. The patient was inside and he had a head injury, caused when he hit the ground after the reversing fork-lift had apparently ‘glanced’ him. The spritely 85 year-old man had been buying flowers (presumably to be sold from a stall) when he was hit.

At first the story seemed to make sense and the fork-lift driver certainly agreed with it all (well, he would – he was the one that had supplied the story in the first place) but the old man couldn’t really remember exactly what had happened and his head injury wasn’t the only problem he had. When he was moved, he complained about leg pain and I found a significant sprain, possibly a fracture, to his ankle and a very swollen, discoloured foot. He could only have sustained that injury if he’d been violently twisted during the fall, or his foot had been run over by the truck. I suspected the latter.

He was put on entonox for the pain and went to hospital giggling and joking with the crew. He was still under the influence of the gas when I saw him next, lying on his bed in a cubicle in the Majors Department, flirting outrageously with the nurses.

During the shift, we wandered across to Trafalgar Square several times and watched the people up on the fourth plinth. To be honest, I’ve seen little up there to inspire me to think of it as a work of art. Most of them seem to just stand and chat on their mobiles, ignoring everyone and everything around them. We watched a representative of the Monster Raving Loony Party bouncing on a Space Hopper while drinking beer, spinning around a post and using a bullhorn to deliver pointless ‘political’ lectures to three people gathered below at small o’clock in the morning.

Earlier on, we’d watched a boring individual do nothing of any interest as a family had a picnic underneath and an artist painted images of the scene which, ironically would now qualify as art outside of the reality of the situation. At night, a shadow is cast on the National Gallery wall by the lights shining on the people on the plinth. It’s often much more entertaining to watch the shadow than it is to watch the ‘art’.

So, what would you do if you were up on that plinth for an hour? Let’s see what kind of imagination you have. Have fun but keep it clean if possible... remember that kids read this!

Be safe.


Fee said...

I'd go for a "sponsored pogo stick jump" to add in that element of danger. And possible raise some funds before requiring the service of you or a colleague!

Uncle J said...

//what would you do if you were up on that plinth //

I might emulate Hertfordshire St John Ambulance member Alan Poppelwell, who spent his hour (on July 14th) demonstrating CPR whilst members of the public practiced on manikins laid out in the Square nearby.

MarkUK said...

Well said Uncle J. (Hey, you're not the Uncle Joe of the Mint Balls are you? "Keep you all aglow" and all that.)

I really like Alan Popplewell's style.

Sewmouse said...

I am such a boring individual...

Never having seen said plinth - if it was not high enough to cause vertigo-induced vomiting, I suspect I'd just be sitting down looking around at all the "LONDON" going on around me and taking photos.

Darn boring 'merkans...

Tassiegal said...

I'd make shadow puppets on teh wall of the national gallery!

Tom said...

Good for Alan Poppelwell. I don't think I could do a follow-up, but perhaps a rant at time wasters for an hour might be a fraction of my life well spent.

I mourn the loss of the patient base, who would call 999 as a very last resort. Your mentioning of the two ladies reminded me of a call received in the early hours one Monday morning.

My mate and I attended a collapse call. I had the 'board', and while my mate prepped the motor I knocked gently on the door. The elderly lady explained that her husband had gone to bed complaining of chest pain, and she had tried to call a doctor. This was several long hours after he had retired.

Leaving the distraught woman with my oppo, I entered the room, and was met with the waxen skin, and putty texture of the recently dead.
I was overwhelmed with a sense of loss, and my heart went out to this lady.

Her family lived some distance away, and I was at a loss of what to do for her. I had resolved to call my wife, and was wandering how to transport her to my home when a timid enquiry from a neighbour soon settled the problem.

My compassion was never sorely tested, as it is the norm these days. Once again I have to salute the 'guardians' who are our emergency services.

Anonymous said...

well I was asked to go on it, but at 3 in the morning, so I declined! but I had been planning on either knitting a sock, doing some kind of first aid demo or singing really really bad kareoke....

James said...

I once dropped my entire PC on my big toe - it ripped the front of my toe open and there was blood all over the place. I only realised when my foot felt wet, I looked down and there was a small pool of blood.

I called for an ambulance and they called me back and asked if I could make my own way to the hospital as they were busy with road traffic accidents and the like - I happily obliged them, wrapping my toe up with towels and hopping to the street to get a taxi.

Was I wrong to call the ambulance in the first place?

Xf said...


The fact that you are asking if it was wrong to call says a lot about how we now think as a society. There is no right or wrong about it; common sense and experience should help one decide about the seriousness (or not) of an injury and whether a flashing blue lights and sirens emergency response is appropriate.

In your case, it wasn't and confirmation of that came via the 999 service you called.

Everyone is entitled to dial 999 if they feel they need emergency help but we must do this with care and use common sense so that we don't overload it and the whole concept becomes a nonesense.

Don't you agree?

James said...

I most certainly do agree, thanks for replying.