Wednesday, 10 February 2010

Threats and laughs

Night shift: Five calls; one false alarm; four by car; none by ambulance.

Stats: 1 Alcoholic in pain; 1 Faint; 1 Head injury; 1 Sleeping person; 1 eTOH.

And here comes the snow again. It’s freezing out there and my second night with my Uni Student starts with a call to a less-than-beloved hostel for alcoholics and drug addicts. An abusive male has been calling for an ambulance on behalf of a female that is having chest pains, so it goes Red and I am sent to check it out because (and I don’t blame them) nobody on the desk is sure if this is a genuine call. When we arrive the staff has no idea what’s going on and we are shown up to the room where the call originated. That’s when the staff member decides to tell us that the guy inside has brandished a knife before and has a bit of a temper.

The door isn’t answered for nearly three minutes as we stand outside and the staff member shouts through it ‘Open up, the ambulance is here’. The man takes his sweet time to open up (remember this was a 999 call) and almost as soon as I step forward I am treated to verbal abuse and attitude. All I did was ask if the girl, who can clearly be seen in the room with another man, could put her cigarette out before we went in – that request sparked a spittle-loaded response.

I went in and asked what the problem was but the loud-mouthed man wouldn’t stop shouting and swearing, so it was difficult to get any sense out of the situation. The girl looked as if she was clucking for lack of booze or drugs, I didn’t know for sure which, and she was writhing around and yelling that her whole body hurt. She too became abusive after I informed them that I wasn’t going to take her anywhere under these circumstances. I needed them to calm down and let us do our job but this unleashed an even more personal and poisonous attack on me and I had noticed where his knife was, so I was keeping a corner of my eye on it. The student was behind me – this wasn’t really a suitable job for her to learn how to get attacked. We left the room to a rising melee of anti-Scottish, anti-ambulance abuse which had now been joined by the complete choir in the room and went back to the reception office with the staff member, who seemed embarrassed by this behaviour.

I asked for police and requested that no ambulance should be sent to this call. I knew the man upstairs would call 999 again and he did, several times. So we waited for the cops and when they arrived we all went back up and the two men were asked to leave the room so that we could assess the young woman who was in pain. The resident of the room, who had until then been fairly quiet, started shouting and swearing, telling us that he was not leaving his own room. Despite the fact that he was not this woman’s kin, he couldn’t see why she needed privacy during a clinical examination. But he caved in when I suggested the woman could walk out of the room instead (she’d told us that she couldn’t walk).

She was an alcoholic but denied taking drugs, even though she was a known Methadone user. Her body was a mess and the main problem affecting her health, which could never be fixed, was that her Liver was failing. She had generalised pain but it was the pain of a person who had inflicted it upon herself in a short lifetime of self-abuse. I will be surprised if she reaches the age of 30 - she's 23 now.

I can honestly say that this was one of the most menacing, threatening calls I've been on for a while and I would normally be working alone. This man was quite capable of taking that knife of his and sending me to the morgue. Why we, as a society, continue to put up with the evil that lives with us I will never know.

A 33 year-old American lady fainted outside a pub and we arrived to find her being tended by her husband and a few of the customers. Broken shards from a dropped glass lay around her as she recovered. She had a history of stomach problems but had never fainted before. We found her BP to be high, so we took her to hospital so that she could be assessed more thoroughly – rather that than miss something important. She was a very emotional person and I think this had a lot to do with current condition.

As the night ground into the late hours a 23 year-old woman fell down the stairs at an underground station and cracked her head on the floor when she landed. Her friend was with her and they’d both been drinking but not enough to be described as drunk. There was a good size bump on the crown of the falling girl’s head but she hadn’t been knocked out and she simply complained about how painful it was. It was a straight-forward transfer in the car – again because she’d been drinking, it was better safe than sorry.

A false alarm for a male ‘collapsed’ inside an office turned out to be one of the workers who’d decided to kip down on the floor for the night, either because he’d been drinking and couldn’t get home or because his wife had chucked him out. Whatever the reason, he was quite embarrassed when two police officers, the staff from an office above him and London Ambulance turned up.

Another embarrassed person; an Irish lady who fell onto her face and broke her tooth after being out with her daughter on a drinking marathon, will wake up in the morning and completely forget how she lost it. The ‘almost 50 year-old’ as she reminded me repeatedly, was conscious but unable to get up from the sitting position she’d been found in by PCSO’s when they arrived to help. Her daughter was a little worse for wear too and asked me to marry her a few times before finally understanding that I already was. They both went in the car and they kept us entertained all the way to hospital.

To be honest, I don’t mind a funny, well-meaning drunken person. I much prefer them to hard-nosed aggressive alcoholics or drug addicts who actually hate us because we spoil their party when it all goes wrong for them. This mother and daughter duo were funny and sincere. All the while the patient complained about losing a perfectly good tooth, her daughter laughed, like it was Ireland’s best joke. The young lady’s swearing was a bit too much to start with but I realised that was how she spoke and she meant no harm by it. I doubted the hospital staff could see that point of view on behalf of the other patients.

And the night ends with quite possibly the first slip and fall of the new day when a 40 year-old female slid on black ice at a crossing, falling onto her back. She was in some distress when we arrived and a MOP was taking care of her as best she could but a lot of the tears she was crying were in consequence of the event, rather than the pain I think.

My student almost came down just as hard when she too slipped on the treacherous surface as I tried to warn her. I had tested it when I got out of the car and what looked like surface water was in fact an ice rink – not funny for anyone and I could see how this day was going to develop unless the council got its act together and start gritting the pedestrian areas. We have only had a week’s warning about these conditions after all.

Be safe.


CrazyNewt said...

...and, just after I open my mouth and post a criticism on one post, I get an answer here. Guess it's not just scottish drunks that are okay... the irish are okay in your book too. ;)

Actually, I can see your point regarding the silly drunks. They definitely are a lot more fun. I had a whole gang of them surround me last year and when one of them found out we share the same tattoo, I was instantly his best friend. Which was kind of funny.

JB102 said...

I hope you were wearing your stab vest at the time mate, although that doesn't cover your neck god forbid he came at you.
It is such a shame that you have to waste time dealing with these morons before you can even get to your patient.

Harry said...

Heya there, I started reading your website back in october and have finally caught up (slow, I know) with present time.

Thank you for your insight :)

Anonymous said...

I've finally read your book, it made great reading! I've been following the blog for ages but just never got around to reading the book! It was well worth the read and a good eye opener into the work you do!

Jack said...

I always enjoy your posts! What I do find amazing though is how much you are allowed to think for yourselves with regard to medical decisions.

Over here in North America, we take full spinal precautions and immobilize nearly everyone who falls and complains of any type of soft tissue pain - under the protocols' assumption there is the small chance they 'could' have spinal injury. Many departments allow us to rule out spinal under certain conditions, but I believe the very real fear of litigation often causes us to err on the side of immobilization. Patients who are drunk had better watch out, especially... That altered mental status combined with a slip/trip/fall nearly always justifies an automatic ED trip strapped to a board! (Especially if they get mouthy) :p

Stay safe!

Xf said...


I'm with you on the strapping down of drunks for mouthing off but I wonder, in reality, if you are just as open to litigation if one of them aspirates on vomit whilst strapped down and unable to move to clear their own airway. I know what a nightmare this is when I have had to immobilise drunken, injured (potentially spinal) patients. Doing it as routine would just be a worry...

The Woftam Awards said...

I'm not a big fan of drunks and they don't get a lot of sympathy but I agree, they can be good fun on an otherwise boring night shift! As for the lot who call an ambulance and then give you mouthfuls of abuse when you're only trying to help by doing your job, waiting for them to tell you to 'go away' works for me!