Том Рейнолдс – The Complete Blood, Sweat and Tea (страница 21)
Should have been a nice easy removal, even with the weight of the patient and reduced ability to walk. We had our carry-chair and after struggling a little to get the patient on it, we didn’t expect any trouble.
Heh …
It turned out that the patient was an agoraphobic and hadn’t left her house in 20 years …
Sweating profusely, the patient fought us the entire way out of the house; she grabbed at anything tied down, at door-frames and at the handrail she had installed in her house. Trying to get a sweaty 20-stone patient out of a house is tough enough without them fighting you the whole way.
We had explained that she needed to go to hospital, and she had logically agreed, but this didn’t stop her panicking when we started to move her. When we finally managed to get her into the open air her panic rose to a dangerous level.
She was shaking, her eyes rolled back into her skull, sweat was pouring off of her and her thrashing about in the carry-chair got worse (if such a thing was possible). Both my crewmate and myself thought that she was going to have a heart attack; in fact, she had all the classic symptoms of a massive myocardial infarction (posh medical term for a heart attack). Then she started a strange screaming/moaning call that sounded completely unearthly. I could just see the next day’s newspaper headline, ‘Ambulance Crew Scare Patient To Death!’
All I could think about was to try and calm her down, so I tried using some hypnosis techniques that I just happen to know, which helped a little, but by then she was in such an agitated state that horse tranquillisers probably wouldn’t have affected her.
We managed to get her into the ambulance, where we shut the doors very quickly and made as smooth a transport to hospital as possible. During the transport my crewmate and the patient’s family worked constantly to calm the patient down, but they were only having a fairly limited success; every so often I would hear her moan in that alien fashion and my crewmate babbling at her to calm down.
When we got to the hospital, we nearly threw her off the ambulance into the A&E department; actually, she was so slicked with sweat we could have slid her off the trolley. She calmed down a bit once she was in hospital, which only made our exhausted faces seem over-dramatic to the nursing staff.
You never know what you are going to get in this job, but nine times out of ten it isn’t the illness that surprises you, but the circumstances around the job.
I can’t drive past that address without thinking about the trouble we had with that call.
We got called as a ‘second crew’ to an address. Sometimes, when a situation is beyond the capability of one crew to deal with, they will request another crew; normally this is because they have two patients, or the one patient that they have is too heavy for one crew to lift on their own.
We got the job as ‘female giving apple to 7-day-old baby’, which had us wondering …
As we turned up we saw the other ambulance and a police car. On entering the flat we saw two policemen standing in the corner, with a 5-foot 2-inch tall female paramedic sitting on a young woman (Patient Number 1); her crewmate was dealing with a male who had a nasty bite on his arm (Patient Number 2). The police were talking between themselves deciding what to do, as we got a quick briefing from the crew who was sitting on the woman.
It turned out that the woman (who had a previous mental illness episode), had given birth by Caesarean section 7 days earlier, and today had tried to feed the baby apple pie; she had then ‘freaked’ (note the professional medical terminology), shouting that the man wasn’t her husband, and had attacked him. The ambulance crew had been called and, as they arrived, the woman had sunk her teeth into her husband’s arm. The crew had fought the woman to – ahem – disengage her teeth, and this is why they were sitting on her. The police had been called, but were reluctant to do anything (I got the impression that they were a rather crap pair of coppers) and the second crew (us) had been called to deal with the husband (with new teeth-mark wound) and baby.
This woman was (brace yourself for more medical terms) ‘completely bonkers’, she had the rolling eyes, the delusional thoughts and the inability to communicate that separates the mildly strange from those who need immediate medication. It was actually quite sad to see this family come apart at the seams; the husband was shell-shocked, the wife was completely detached from reality and the police weren’t being very helpful (which is unusual).
We got the husband and baby out of the house and into the back of our ambulance, and then returned to see the police (finally) manhandling the woman out of the house and into the back of the first ambulance. She was securely strapped down (although we don’t have restraints, so she could have easily gotten free if she so desired); we had to lend the first crew a belt-strap as the one on their trolley was broken. The first crew then forewarned the hospital about what they were bringing in (violent schizophrenic female) and we all set off for the hospital.
We got there first and advised the nurse in charge that this was a ‘real’ warning and that security guards would be needed, along with the private ‘psychiatric’ room. It took her 20 minutes to arrange both, while the ambulance took less than 5 minutes to get to the hospital. So, while the secure room and security was being arranged this very disturbed woman was lying on the ambulance trolley … Not a good situation, and it made the job a lot harder than it should have been.
The husband was completely stunned; he had no idea how to look after a baby and quite simply couldn’t cope. Social services were informed, and the child was admitted to the paediatric ward for a while, until the husband could be taught how to look after a baby. The woman was sent to the local psychiatric unit for assessment and treatment; hopefully, this is a temporary condition brought on by childbirth (puerperal psychosis). The husband had his wound treated, and was sent home.
Oh, and the baby is a hermaphrodite.
There are jobs that you can recount around a dinner table (or at the pub) when people ask you what your job is like. This is one of those jobs, although for some reason people seem to prefer hearing about me being injured by little old ladies.
The London Ambulance Service doesn’t just deal with emergency calls to people’s houses, we also do hospital transfers – patients who go from hospital to hospital because the original hospital hasn’t the expertise to deal with that person’s medical problems. An example of this would be the transfer I recently did from Newham to the Royal London because Newham’s CT scanner was broken, and the patient needed an emergency scan.
One of the regular places that we find ourselves transferring people to is St Joseph’s Hospice, or as we call it Holy Joe’s. Sometimes we will be picking up patients from one of the nearby hospitals, sometimes from the patient’s own home. Its one of those jobs most of us don’t mind doing. The patients are, by definition of needing hospice treatment, actually sick, and we are not so hard-hearted that we would begrudge an ambulance to someone who is ill. Then there is Holy Joe’s itself …
Holy Joe’s is a religious place, it used to be run by nuns, but now they are a bit few and far between. To be honest, I saw my first nun there yesterday, and she was picking her nose … But, you walk into the place and it just seems nice, it is clean, the staff are all friendly, the patients all seem happy and there is a really good social atmosphere there. I don’t know if it is because of its ties to the religious orders (I hate all religions, but the best nursing homes always seem to have nuns running the place), but the hospice just seems to exude calm.
My crewmate and I had just transferred a terminally ill patient into Holy Joe’s and were having a cup of tea in their tea bar (hot drinks are free to the LAS – another reason to love Holy Joe’s). Sitting in this clean, comfortable area, we were watching the patients chat with relatives, staff and other patients, giving the place a real friendly atmosphere quite unlike anywhere in the NHS. It is very rare to see a doctor sitting down with a patient, chatting about nothing in particular and having a cup of tea with them. We both agreed that this has got to be one of the better places to see out the end of your days, and that it is a real shame that there are not more places like this.
It is a shame that in this increasingly ‘technical/evidence-based/audit/professional development/governmental targets’ style of health service, we seem to have forgotten that sometimes we simply, and honestly, need to care.
I went back there for the first time in 18 months. It’s even better now. I’m thinking that the NHS should poach the board of directors and point them at some of our local hospitals.