Drama Queen?

A whole big dramatic chain-reaction took place on a call for a cyclist versus pedestrian. He was pedalling at a pace the wrong way up a cycle lane and she was minding her own business and crossing the lane, looking in the direction of normal traffic flow. It was clear, so she proceeded.

Maybe she should have taken a second to look the other way, but she didn’t and she was thumped by the cyclist. She was thrown onto the pavement, hurting her arm on landing, and he was chucked from the bike and dropped onto the road with some force.

The whole thing was witnessed, so when I arrived I was frantically guided in by a windmill with distress on his face. The reason for this became clear when I parked up and exited the car. The cyclist was howling and screaming in pain.

He told me he’d damaged his pelvis before, after a previous cycling accident in which he was, in his own words, ‘left for dead’. He said his pain was 10/10 and screamed out when any suggestion of examining his hip and pelvis was made.

‘I need to have a look to assess the extent of any injury’, I said.

‘Don’t touch me! I don’t want you to look at it!’ he shouted back.

Now, there are times when it is clear when someone is over-cooking their pain and there are times when it is doubtful that any injury of significance exists. This, however, was one of those borderline cases. His actions, demeanour and language suggested more going on behind the scenes than this possible injury, but his physical appearance (one leg shorter than the other and some rotation), hinted at something else. Of course, anyone can make one leg shorter than the other by appearance, if they so desire... but who am I to judge?

His pelvis or femur may well have been damaged by the catapulted landing but some of the things he came out with were outlandish and illogical for someone who needed immediate medical attention. I felt it was a combination of over-doing it and a reluctance to acknowledge the means to an end. He was like a petulant child refusing a tissue for a runny nose.

He relented when we got him into the ambulance and, even with the initial rotated, shortened look, his hips and pelvis seemed fine, sturdy and in position. The poor woman standing on the pavement, however, was left to worry herself grey about what she might have done to this guy. She thought he was dying.

I attended to her soon after leaving the crew with our screaming (now morphine controlled) cyclist and had a look at the woman’s arm. She had a significant bruise there and swelling had developed, so I took her to A&E to have it x-rayed. I suspected that, ironically, she’d be found to have much more wrong with her physically than our speeding patient. She made quite a point of ensuring she was led away and out of his sight when she arrived at the department and he was still waiting, apparently pain-free now, on the trolley bed in triage.

I know a few people like this and I'm sorry to sound arrogant and judgemental, because I'm sure there is an excuse for them somewhere. But they think that someone like me... and my colleagues, are so easily fooled... are so inexperienced and gullible, as to believe they have an injury that has the potential to kill, and yet underneath it, they are dramatic. There is no drama in real pain, there is only pain.

In the wee hours, just before going home and when the strangest cases surface, I was asked to investigate a man who was fitting outside a Casino. ‘Door staff on scene’ I was told.

I arrived to find the door staff doing their job... staffing the doors, whilst my patient lay flat on his back on the pavement. They had given him a wide berth and I treated him to a closer inspection.

‘He just dropped down and started fitting or something’, the tall, wide, door staff men said.

The young man was bleeding from the head and this made me cautious about what was happening here.

‘So where did the blood come from?’ I asked.

I thought I was being diplomatic but I must have sounded accusatory, because their reaction to the question was immediately defensive and highly unlikely.

‘Mate’, they chimed. ‘He just fell down and had some kind of fit. The blood just appeared.’

Hmm, I thought. Just appeared, did it? To be honest with you, my first thought was that he’d been a bit mouthy with them and they’d given him a push. I know that’s not fair but it’s happened before and wouldn’t be an unrealistic scenario given the time of day, the place, and the wild, drugged look of the man on the ground.

I had to struggle with him a few times to keep him under control and his arms flailed in my general direction as I did so, but it was clear early on that he wasn’t going to remain calm and my initial thoughts were that he’d sustained a significant head injury, or he’d taken something to cause this behaviour. Of course the logical pathway is followed routinely but it also takes into account the possibility that he was just like that normally; that is was in his genes.

I asked the doormen a few times about the man’s injury but they kept their distance and stuck to their story. The patient was going on about people coming after him and seemed highly agitated about the prospect that he was going to be attacked. So, he started ranting at me, as if I was the threat. This made me a little uneasy about my prospects of staying safe, even with the two large gentlemen standing at the Casino door. I tried to call in for backup and got no response. Then I called in again... and again. I pressed the priority button on my radio and got zilch back. Then, as a last resort, and because I really needed a cop or two to help me out, I activated the crew emergency alarm. This is used when we are under attack or need urgent, urgent, police attendance. To be fair, all I needed was urgent police attendance. Just one urgent... not two.

Pressing my ‘I’m in real trouble, come and help me quickly’ button made no difference and I heard nothing back. I must have been in a blind spot.

The ranting patient was on his feet and pushing at me to get past. The two doormen looked on nervously, which I found chillingly confidence-busting. Did they know something about him that I didn’t? Did he have an Uzi in his pocket? I was inspired by the knowledge that his pockets were far too small to conceal such a weapon. I’d just have to avoid his fists instead... or the world's smallest Uzi.

An ambulance rolled up as I managed to get the man to lie down again. I had to keep a little distance from him because he was still convinced he was about to be mobbed by a gang.

He said that he’d run 3 miles to escape a mob of youths that had attacked him and who ‘hated’ him. He had come a long way across London, just to collapse in a heap on the pavement.

There was no sign of any gang, so we got him onto the ambulance and the crew called for police on my behalf. It was too late for physical protection but we still needed this matter cleared up.

When the cops turned up, they knew the man and said he had a long history with them. That history included drug use and violence, so I hadn’t been over-reacting after all. His story about being assaulted and chased for miles may well have been true but, from what I was hearing, he’d more than likely brought it on himself.

And so another weekend night ends with a sunrise and a spatter of someone else’s blood on my sleeve. It’s crazy.


Be safe.