Thursday, 1 July 2010

Life changes

Night shift: Five calls; two assisted-only; one treated on scene; two by ambulance

Stats: 1 MS pt; 1 ? Fit; 1 ?# Leg; 1 panic attack; 1 taxi fare dodger.

The car is no longer controlled by human beings with medical knowledge and therefore the ability to intelligently send the appropriate response to a call. Now, as before in the bad old days, a computer is tasking me on every call, regardless of how suitable (or not) it may be. This didn’t work before and I doubt it will work again but I am only a minion, like the others who want to do the best job in the safest way, so what I think is irrelevant.

The first call was simply an assist-only; the 53 year-old woman with Multiple Sclerosis had travelled on the baking hot tube to get to an evening out with friends but failed to complete her mission when her legs, predictably, stopped working. Two police officers helped her up to the station booking hall and I arranged for an ambulance crew (SJA) to bring a chair so that we could get her to street level and into a taxi for the homeward journey. Her friend arrived to travel with her and all was good – her night was ruined but she is struggling to come to terms with her new deteriorating condition; she won’t be travelling on the underground again and probably never will. She told me herself that it was a ‘hard learned lesson’.

Up in Leicester Square, the vampire lovers gathered for the premiere showing of that vamp movie and one of them, a 30 year-old female had a seizure on the ground that she’d spent more than 24 hours sitting/lying and crouching on as she and the other fans waited for a glimpse of their favourite stars. She had no history of epilepsy but she had definitely fitted and was post ictal. She’d lost bladder control and was slowly coming round but still very confused.

A private paramedic team was on scene helping out when I arrived and an ambulance arrived within ten minutes to take her away. By that time, she was more lucid and co-operative. It’s possible the heat had got to her – swelling her brain and causing her seizure. It’s also possible she is epileptic now.

I was sent back to the same location for a 31 year-old man who jumped from the back of a lorry and possibly broke his leg. His mates told me they heard the crack as the bone split when he landed. Sometimes ligaments tearing will sound like that, so there was the possibility of a bad sprain, although when I palpated the swollen mass that was his ankle, I thought I could detect crepitus. He had good pulses and colour in the foot, so apart from the pain, this was a simple job.

I asked for an ambulance and got one thirty minutes later – by that time I had given him entonox and morphine and put his injured leg into a ‘blanket splint’ which looked comfortable but was no match for a proper rigid box splint or vacuum splint, neither of which I carry on the car.

The ambulance had got lost around the area because the Square was blocked off and full of people so I went to help the driver get in but the vehicle wouldn’t start and it took a good few turns of the key before it behaved itself; by that time the audience at the local pub who’d been watching, cheered their approval. Then we nearly crashed through the film premier as crowds swamped us on the drive into the Square. Eventually we got to where we needed to be and the poor guy, who by now had been lying there for an hour, was taken to hospital.

Outside a pub, a 19 year-old man was having a major panic attack in front of his girlfriend and other people who were milling about smoking. He was kind of hyperventilating but not the real kind because he was perfectly able to speak in unbroken, unhurried sentences as he flapped his hands and complained about the ‘tingly’ feeling he had.

I know some of you feel I am a bit harsh on the panic attack afflicted but I don’t mean to be... I suppose it could happen to me and then I’d be told, but come on, there’s panic attack and there’s mostly doing it for show.

He was treated on scene (30 minutes of talking, checking and re-checking) and left in the care of his girlfriend. Paper was left with him and he got advice – the usual stuff.

A complete waste of time next as I motored on a Red2 and found police with a 22 year-old Filipino woman who had refused to pay a taxi fare. She was feigning unconsciousness and I woke her up immediately with some medical persuasion. She didn’t like it and spat out abuse in broken English.

The taxi driver told me he'd been hailed by her and she’d pleaded with him to take her home. She was drunk and the driver, who has a daughter the same age, felt duty bound to take her. When she refused to pay the fare and became abusive with him, he drove her to a police station and the cops came out to deal with it. That’s when she ‘passed out’.

After a few minutes and another wake up pinch from me, she crawled out of the cab and was sent on her way but then, as I was chatting to the officers, there was a screech from around the corner. She’d fallen on her face. She was uninjured and as soon as we arrived to help her she started up with the abuse again. She really was a nasty piece of work and I think I can safely say whoever she lives with must be getting a lot of tender loving care from her. She didn’t get an ambulance; she was sent away to find herself another taxi. The poor cabbie that she ripped off got nothing for his trip.

A lull followed and I got a break for a few hours. I made my way into Leicester Square in the lightening hours and watched as dancing teenagers gave end-of-shift cops verbal abuse and drug addicts scooted around looking for change and a quick fix. Once the police officers had dealt with the nuisance, one of them asked me to look at a man they’d just woken up. They thought he might be too drunk to stay there but, after chatting to him I realised he was just very tired. The 28 year-old man had travelled from Luxembourg yesterday and spent the night on the streets. He had nowhere to go, no food and one set of clothes; the set he was wearing. He stank of stale everything and he looked like he’d given up. He told me he’d left home – left everything, so I guess he’s had some kind of domestic problem.

He looked intelligent enough to work out what a risk he was taking and he acknowledged this when I told him how dangerous London could be but I had a problem; he couldn’t be left there and he had no need of hospital. The police couldn’t take him anywhere and so we seemed stuck.

I drove him to the nearest hostel and left him outside. I told him that the residents would be out soon, gathering as they did every morning for their breakfast, provided by a charity group who visit the Strand. I advised him to ask for help because he was surely going to need it.

Be safe.


Anonymous said...

Nah, don't think you're harsh about panic attacks particularly, but I do think it can be genuinely impossible for sufferers to know they're having one - even after years of bitter experience but certainly in the case of a 19-yr-old it could be a recent and unknown affliction to the sufferer.

I've had CBT, read extensively on the subject and all sorts but I have still been caught out, and it's always humiliating :( Luckily the two paramedics I've dealt with were completely understanding.

Japhia said...

Hopefully the crowd of vampire lovers were well behaved, I've heard a few stories of fights that had been breaking out when chosing edward or jacob... What's the world heading to heh. Used to be Batman or spiderman, now it's a wolf or a vampire heh.

Anonymous said...

I do love reading this blog and have immense respect for the work you do but the one thing that spoils it for me is the harshness towards panic attack sufferers. As a previous poster pointed out it can be genuinely impossible to know that you're having one and your brain and thoughts are telling you you're going to die, right this second. Until you've experienced it, and I hope to god you never do, I hope you can become less harsh.

Xf said...


Point taken but I have to clarify a few things. First of all, the diary reflects how I feel at that moment, rather than my overall perspective; some patients just over-do it and that's a fact I'm afraid.

Secondly, I have suffered from hyperventilation after a nocturnal apnoeic event in which I stopped breathing. It is a very distressing thing but I remember telling myself to stay calm and control it or I would probably die. I know not everyone is like that but they should be because there is no other way to resolve it.

I do have immense sympathy for those who suffer unexpectedly - they need our reassurance and support. It's the people who play on this stuff and overact it because they want a day off work that annoy me. While they play this game, someone else (probably someone like you)who is genuine, is getting no help.

I hope you understand. I'm not harsh; I'm Glaswegian.