Thursday, 29 October 2009


Carved this one myself.

Night shift: Seven calls; one treated on scene - the rest by ambulance.

Stats: 2 Head injuries; 1 Cut finger; 1 eTOH; 1 NPC; 1 Chest pain; 1 Asthma; 1 Labour; 1 Suicidal.

This was my second night shift since taking leave over a month ago and as soon as I hit the streets I got a bad feeling about it. Sometimes that happens; I get a sense of something not quite right and I keep an eye on myself, so to speak.

The first call took me to Leicester Square and the remnants of a fight that had broken out amid the crowds. One Asian man had allegedly set upon two Chinese men, laying into them with a broken bottle and smashing their heads. There was no evidence of a bottle at all, except for glass fragments in the hair of one of the assaulted men but all three had injuries – the assailant had a nasty cut to his finger and the other two had cuts to their heads and the cops were trying to figure out just what had taken place. It seemed that the bottle had cut the assailant when it broke but, as I said, there was absolutely no sign of the bottle fragment or glass in the area. I guess the actual assault took place elsewhere.

I asked for two ambulances because the assailant would have to go to a separate hospital, as is standard practice and while I waited, after treating all three for their wounds, the cops discovered a large knife on one of the men. ‘That’s not mine’, said the man sheepishly and quite unbelievably. I asked that the other two be searched because I had been in close contact with the guy with the demon blade and I didn’t fancy exposing myself or my colleagues to that risk again.

After the men had been removed and things were being cleared up, I chatted to one of the cops about what had happened and we discussed whether the injuries were life-threatening or not. As we talked, an angry white van man demanded that the police move their vehicle so that he could enter the square to make a delivery. Normally I get the brunt of such impatience but I couldn’t believe that he was confronting a police officer who was busy at a taped-off scene of a crime. Absolutely nothing is respected these days.

As I completed the paperwork for that call another came through as a General Broadcast. It was behind me, a little way down the road, so I took it and headed the hundred metres or so to the location. In a theatre doorway a man had settled down on the ground, causing the door staff to call us because they thought he was ill. He had told them he was ill. A police officer was with him and I was soon told that he had said he was passing out all the time for no known reason. Right at the outset I knew there was something not quite straight with him. He refused to get up until the police officer insisted and helped him to his feet and when he went to my car to wait for the ambulance, he became abusive towards us (the cop and me). A quick radio check on him (by the cop of course) revealed a long history of aggression and violent behavior and when the crew arrived, having been pre-warned of the nature of this man, the EMT was given a bruised arm when he grabbed at her as he left the car.

No patient contact for the French man who cut his leg on broken glass in a club. The crew was already on scene.

On two occasions tonight, as I blued my way to calls in the West End, I had to avoid colliding with police Armed Response Units on their way, in the opposite direction, to calls. Even driving to calls was going to sharpen my attention on this shift. And when I arrived back at my station for a cuppa, I was greeted with a fight which was going on at the bottom of the road. I walked down to see if I could slow it down or stop it and watched as another man got in the middle of three teenage boys and a teenage girl as they argued and hit out at each other with belt buckles (the new weapon of the streets). To be honest, the girl was doing a lot of screeching and mixing it up but when the man who tried to stop it became the victim of their combined violence, she got in there with feet and fists, just like the boys.

I had shouted for the man to get away from them because even I wasn’t going to get in the middle of it – these young kids weren’t even aware of me or anyone else, such was their red mist for each other. The consequences for the man who tried to help were fairly predictable – he got rounded on and beaten up right in front of me. I had already called the police and they arrived just as the fight broke and all parties wandered off but they were able to get a hold of two of the assailants and the girl, as well as the man who’d tried to stop them.

I was the only witness to this violence (other bystanders had cleared off) and as I stood with the cops, waiting to give them any information they might need, the girl walked over to the assaulted man and threatened him. ‘I know where you live’, she said. She did this twice, in front of the police. Then she flicked her cigarette across my face after I’d offered to get an ambulance for one of the young lads who’d suffered a fractured cheek. He’d refused and she was showing her contempt for anyone but her own. Somebody, somewhere actually loves this vicious, disrespectful little girl.

A call to Soho for a 43 year-old man who’d collapsed with chest pain in the street next and a passer-by told me that he’d called an ambulance because the man was in a lot of pain. The ex-crack-cocaine addict had been smoking cannabis earlier and now he had central chest pain and felt weak. When the crew arrived a woman appeared in front of us and listened intently to what we were discussing as I handed the patient over. I assumed she was an observer with the crew and they assumed she was with me but she wasn’t.

‘Can I help you?’ I asked.

‘I’m a doctor’, she said with an accent that could have been German or Dutch.

Once again, the phenomenon of helpful-foreign-doctor types rears its head for the night.

A crew joined me minutes after I’d arrived at the home of a large woman with asthma who was suffering DIB because she couldn’t get to her medicines. She was sitting on her bed, struggling to reach her inhalers, all of which were a mere two feet from her on a table. Her little dog was deeply concerned for her (you can always tell when a dog is worried) but her husband, who is her paid registered carer, was in bed asleep in the next room. ‘Why didn’t he come and help you?’ I asked. ‘He doesn’t give a damn’, she replied sadly.

We nebulised her until she felt better and then left her with advice on keeping her meds nearby; she could reach the phone to call us but she couldn’t get to the medicine she needed and that was a dangerous paradox we had to bring to her attention.

I thought I might be delivering a child in the early hours of the morning. The call stated that the woman was 41 weeks and her contractions were two minutes apart. In fact her contractions were five minutes apart and she was nowhere near dropping a sprog just yet. However, this lady had given birth to three children before this one and that always changes the timing, so I asked for an ambulance and prepared my Matpack just in case. I’m still in paternal mode clearly! She should have taken a taxi.

My last patient of the shift was described as ‘violent’ for some reason and I asked for the police to join me, believing that Control obviously knew something I didn’t. When I got on scene the suicidal 32 year-old was waiting for me and signalled to me with a meek wave. He stood outside a phone box and introduced himself, explaining that he had tried to cut his wrists with broken glass and had taken 12 paracetamol in a bid to end his life because he had lost everything and was at the end of his tether.

His wrists bore superficial evidence of his attempt, which was nowhere near a vein or artery and a dozen paracetamol isn’t likely to cause him great harm, so I reasoned that this guy was looking for help.

As he sat in the back of my car (I had cancelled the police because he was as gentle as a lamb) I listened to his story. He’d lost his business and gone downhill via alcohol. He had no living family except distant relatives in the north and he felt he had no prospects because nobody was willing to give him a start. There was probably a lot more to it – there usually is but I could see how easy it must be to lose it all and then find it impossible to climb back out of the hole. No bank is going to finance you, no employer will look at you and benefits can be a trap that you simply can’t get away from. I couldn’t believe that a man with such intelligence and character couldn’t find some way of getting help though – there are lots of wonderful organizations out there and the support is around if you want it. It still left me feeling sad.

I watched him walk away with the crew and wondered if he’d get his life sorted out now or if I’d meet him again in a less healthy state.

Be safe.


lightsandsirens said...

I was told that that kind of quantity of paracetamol at one time is enough to cause fatal liver damage if untreated?

lightsandsirens said...

I was told that that kind of quantity of paracetamol at one time is enough to cause fatal liver damage if untreated?

Xf said...

Depending on your size, weight, medical history and other factors, even a few paracetamol could cause some harm but generally you need to have taken more than 6g on board, which is what he had done.

Anonymous said...

Your last patient was in a public place and had admitted self harming with broken glass that would have been flagged as a weapon. Perhaps that is why the police were called?


I agree on the paracetamol, ten panadol can kill a person, although it takes about 3 days or so to die from liver failure.

Give a cat one paracetamol and its dead.

People need to know the dangers of paracetamol because if someone is dicking around and possibly attention seeking thinking paracetamol doesn't kill, it does and can.