Friday, July 18, 2014

Make like Bender


 Bender / Futurama
Futurama
I won’t be posting for a couple of weeks as we’re off on holiday. So just a quick note to say thanks for reading & commenting. I hope you all manage to get away somewhere this summer and have a very well-deserved break.


Okay? Right? So... Cheese it!

the storm

Martha insists on buttoning up the dressing gown herself, a slow and difficult operation with ninety-six-year-old hands.
‘Jes’ a minute,’ she says. ‘Last two.’
She hardly needs it. The night is so oppressively hot it’s exhausting just to breathe. In Martha’s airless kitchen even the mantelpiece clock has given up. It sits there, sweating the time.
We’ve been trying to hurry things along, conscious of the storm that’s been brewing through the night, a series of wild and hectic flashes growing in ferocity, and like monstrous footsteps heading our way, the whumps and thumps of thunder so low you feel it in your chest.
‘We ought to get a move on, Martha. We don’t want to get caught in the rain.’
‘Jes’ a minute.’
Her cottage is set back down a rocky lane. Getting her out to the ambulance on our carry chair is going to be difficult; in the pouring rain, it’ll be worse.
The dimly lit kitchen is suddenly illuminated by a pulse of silvery white light, so intense every detail holds its image for a moment after.
‘One and two and three and four and ...’
A monstrous tearing sound low overhead.
‘Let’s get you comfy in our seat,’ I tell her.
It’s a delicate process. She shuffle-turns with difficulty, and like anyone who’s suffered falls in the past, finds it difficult to trust that the same thing won’t happen again. But our desire to be out and on the truck before the rain comes makes us even more positive than normal. We actively sit her down, apply the straps, and hurry outside.
Another crack of lightning, this one so close all my hairs line up in one direction. I try to remember what I read about lightning; nothing I can think of is reassuring: how it branches out from the strike point, how it’s attracted to tall objects (like these trees, like that lamppost); how susceptible you are on high ground (Martha’s road, for instance).
 ‘One and two and three and ..’
Another dreadful rack of thunder.
 ‘Almost there.’
We’re almost running with her now, lifting the wheels of the chair clear of all the ruts and stones. Despite all the frantic jiggling, Martha is perfectly composed.
 ‘Okay?’ I ask her.
 ‘Fine,’ she says. ‘Don’t drop me’
By the time we’ve reached the ambulance, risen up on the tail lift, settle her comfortably on the trolley and packed everything away, the first of the rain has started to fall – fat, warm drops that feel good in the heat.
We shelter in the ambulance just as the storm hits, watching through the slats of the cabin window as terrifying blasts of electricity arc from sky to earth, leaping down in vertical rivers of energy, or drift off across the sky like demonic hair.
‘Jesus Christ!’
‘Oh my God!’
‘Are you okay, Martha?’ says Rae, shouting above the sound of the rain as it cannonades across the roof of the ambulance. She reaches out to the old woman and holds her hand. ‘I hope you’re not scared of the storm’
‘No dear,’ says Martha, laying her free hand on top, and resting her head back on the cushion. ‘No. I’m not scared of the storm.’


Wednesday, July 16, 2014

high stakes

The transfer team are perfectly nice about it. They make encouraging comments, useful suggestions, jokes to ease the tension. But there’s an increasingly steely undercurrent to the banter that grows as horribly as the delay until the anaesthetist is driven to say: If this doesn’t work, I think we should take the patient off again and into resus.
It doesn’t work. For whatever reason, the trolley clamping mechanism just will not engage. Five millimetres would do it, but nothing, no creative cheating of the angle, no subtle variations on force downwards, upwards or any-wards – nothing we can think of makes any difference. I’m down on all fours trying to figure out what’s wrong, but everything seems okay, and I’m completely stumped.
Reluctantly, we set about off-loading the patient. We unplug everything, swap the ventilator oxygen back onto cylinder, untangle all the leads and drains and drips, re-organise the blankets, and then carefully begin manoeuvring the whole unwieldy package back out of the cabin, onto the tail-lift, and, mindful of the snag risks, the closing gaps, the tight spaces and every other hazard, we move the patient in through the A&E doors and into resus.
‘So what shall we do?’ says the anaesthetist, smiling pleasantly but red in the face. ‘Order another truck?’
‘Give us a few minutes to have one last look, then if that doesn’t work we’ll get you another.’
‘Fine.’
I’m mindful of the fact that if we stand down from this job, our friends who’ve just this moment cleared in front of us will almost certainly have to do it, and as they finish in half an hour, it would mean a significant over-run.
They’re more than happy to lend us their trolley so we can check the clamping mechanism again. It clicks in smoothly – as it has done all day. There’s nothing bent out of shape, and no other signs of damage or failure to account for the difficulty. We can only think that the patient load is affecting the trolley balance. Maybe if we take off all the apparatus just before we push the trolley fully home, it’ll work.
I explain the theory to the Anaesthetist.
‘If you think that’s it,’ he says. ‘I’m happy to give it another go.’
His smile is a little less certain, though. The patient needs to be with the vascular team right away, and we’re all conscious of time passing. The beeps of all the life support machinery couldn’t measure out the stress of the scene any more emphatically.
‘If you’re absolutely sure,’ he says.
‘It’s going to work.’
‘Let’s do it.’
We unplug the patient, set him up for the short trip back out of A&E and onto the truck again. Once we’ve risen up on the lift and moved into position, we take off as much of the equipment as we can, getting as many hands on board to hold it all and keep the trolley clear. Then I manoeuvre more fully into position, introducing the trolley bar into the mouth of the clamping mechanism.
One millimetre only, and it still doesn’t work.
In desperation, I sit on the floor, put the heel of my boot onto the bar, and push as hard as I can.
Click.
‘Excellent!’ says the Anaesthetist. ‘Phew! Thank God for that!’
The ODP bends down and slaps me on the shoulder.
‘Well done,’ he says. ‘I never doubted you for a second.’

Tuesday, July 15, 2014

humpty numpty

Geoff couldn’t be lying any more precisely than if he’d stretched himself out on his back on a large sheet of paper and asked someone to draw round him with a crayon. Title at the top: Man on Carpet. Except no doubt he’d want the title changed, to Man who woke up unexpectedly on the floor after just four cans of beer, now with pain in his neck.
‘I got hit by a car twelve years ago, and it left me with an unstable fracture,’ he says. ‘No. Can’t feel that. No. Nor that. I’ve got pins and needles in my right hand. Can you move it for me, Rae? Yeah? And my leg, too. That’s gone numb. No – wait. I mean the left one.’
There’s something unconvincing about Geoff. He chatters on about his ailments and accidents, his drinking and his unreliable friends, his fights outside the courthouse and his troubles with the police, in the same way that he talks about his jacket or his fags – like a man standing in for someone else, versed in all the details, but lacking connection.
‘I’m first-aid trained,’ he says, smacking his lips. ‘So I knew exactly what to do. As soon as I woke up on the floor I knew not to move a muscle, but stay still and leave it to the experts. Luckily I had my phone in my pocket and could call for help, which I did straight away, knowing the damage I could do if I tried anything else. So here we are. I’m in your hands. I’ll be guided by you.’
There’s no sign of trauma, and no sign of any disturbance in the flat. But he’s complaining of central neck pain and neurological deficit, and we’re duty bound to fully immobilise. We’re a few flights up, with a narrow, sharply turning staircase to complicate things, so I call for a second crew to help.
‘Has this ever happened to you before, Geoff?’
‘Yes. A year or so back.’
‘Tell us about that.’
‘It was exactly the same. I woke up on the floor. Pain in the neck. Got parcelled up. Carried out. Taken to hospital.’
‘And what did they find?’
‘Nothing. Sent me home with pain killers.’
‘Any follow up?’
‘Nah. I don’t like hospitals. I try to stay out of ‘em.’
He laces his fingers contentedly across his belly.
‘So you’re getting some movement back in your hand, then?’
‘Not really. I just wanted to get it out of your way when you slide the scoop under. I’m first aid trained. I like to help where I can.’

When the second crew arrives we log roll Geoff onto the scoop and then strap him into the vacuum mattress.
‘Hey – this is a bit kinky!’ he says. ‘Tell you what. Why don’t we all just go to bed?’ he says. ‘Maybe not you. But you and you. That’d be more fun, wouldn’t it?’
‘Let’s keep comments like that out of it, shall we, Geoff?’
‘Yeah – no worries. Don’t mind me. I’m just trying to lighten the situation. You do an amazing job. Not as good as the last crew, but not bad. A close second. I’m sorry to be such a bother. At least I’m not fat.’
We carry him out of the sitting room.
There’s a notice sellotaped to the front door, crudely written with black marker pen on a scrap of torn cardboard: Do not forget U keys UR numpty.
‘Have you got your keys, Geoff?’
‘They’re on a chain on my belt’ he says. Then smirks up at Rae as she reaches over to unclip them. ‘Don’t tug too hard,’ he says, ‘you might do me a mischief.’

Monday, July 14, 2014

third time unlucky

The first thing you notice about Colin’s flat is the smell, a rank and cloying cheesiness that immediately has you panting through your mouth like a dog. The second are the many squares of paper stuck over the walls and cupboard doors – crudely handwritten slogans: You don’t have to be mad to work here but it helps and I’m about to go nuckin’ futs and The floggings will continue until morale improves, and so on. In one alcove is a tall, black bookcase, each shelf given over to a fussy collection of figurines: the first two, native Americans, the next, witches and warlocks, the next elves and faeries, the very top shelf taken up by three wax skulls, one of them horned. Each shelf has a handwritten notice: You can look but do NOT touch. Each time Colin has written it, he’s made some kind of mistake and crossed it out furiously, until the very last notice on the top shelf beneath the skulls which, from here at least, looks relatively neat and clean.
Colin is rocking backwards and forwards in an old rocking chair, his filthy white towelling robe gaping open across a distended, waxy white abdomen, the scar of an old laparotomy straining like the zip on an overstuffed bag. Colin is talking as we come into the room, an excitable jabbering that would be surprising at any time of day; at three o’clock in the morning, in this stinking, airless room, it’s quite overwhelming.
‘Six point three it was! Six point three! So I checked it again and blow me, it was down a point! I’ve kept a record of the tests for the past few weeks – look! Here! That’s me, there! It’s never usually that up and down, so I was very confused by that. I’d just finished watching my DVD and I thought – hey! I don’t feel right. So I got my kit out and gave it a bash, and look – see? How it’s up and down? I’ve had some food and something to drink. I’ve done my injections exactly as I’m supposed to. So how d’you account for it? Or is it just me? Have I got completely the wrong end of the stick? I ‘spect you think I’m I right old duffer. Hey? Hey?’
Luckily, Rae’s attending. She drops straight in to get-out-quick mode, each question direct and sharply illuminating, like an emergency beacon that starts to flash as soon as it hits the water.
We’re out of the flat in five minutes. Even the lift smells sweet.

*

Nerys the pat nurse looks at me and shakes her head as I’m cleaning up in the triage area.
‘That’s the third dreadful patient you’ve brought me tonight,’ she says. ‘What did I ever do to you?’
She’s right. I do feel bad.
The first was a disruptive mental health patient, who ended up charging round the department knocking things over, or standing stock-still and freaking everyone out with a weird smile; the second was a creepy drunk guy with neck pain who made inappropriate comments from where he lay immobilised on his trolley.
‘They gave us grief, too,’  I tell her. ‘Don’t forget, that first patient tried to throw herself out of the ambulance and I spent the whole time wrestling with her in the back. And neck pain guy, we had to immobilise him in his dodgy flat, listen to him for an hour whilst we waited for back-up, then carry him down four flights of stairs. And he wasn’t light.’
‘Yeah? Am I supposed to feel sorry for you? At least you get to drop them off and walk out. We have to sit with them for hours.’
She’s got a point. That’s one benefit of working on the ambulance. You get limited exposure to the difficult patients.
‘I’ll make it up to you,’ I tell her.
‘How exactly?’
‘I’ll think of something.’
‘Yeah? I can’t wait to hear it.’
At four o’clock in the morning, she may be waiting a while.

Friday, July 11, 2014

unorthodox therapies

‘I’ve been around lurchers all me life’, says Thomas. ‘Greyhounds, lurchers.’
He hands me back my phone, and while I scroll back out of the gallery pics to the home page, he leans forward and starts coughing, a darkly churning noise, like someone trying to start an old car with a handle.
‘Maybe you’d better not talk for a bit, Thomas.’
‘Jes’ give me a minute. I’ll be all right. I find it takes me mind off of it.’
After a lot of hawking and gargling he leans forward and spits into the vomit bowl, then wipes his mouth with the bundle of tissue he has in his other hand, and rests his head back.
‘I should never have smoked,’ he gasps, closing his eyes. ‘Good job I stopped when I did, though. And all without them patches and whatnot. Jes’ will power and the love of a good woman.’
I replace the bowl and tissues with fresh.
The ambulance rocks along.
When Thomas has found the energy again, he continues.
‘Ye-es. Smashing dogs, lurchers. But like all them long-legged dogs, they are prone to yer sprains and strains.’
‘This is the third Lola’s had this year.’
‘I’m not surprised. No doubt going after rabbits a bit too enthoosiastic?’
‘Yep.’
‘But there’s a trick to getting them over it. Know what it is?’
‘No.’
‘You give ‘em a good ol’ rub down. Really work your fingers in, from the shoulder down to the paw. The moment you see they’re brewing up a bit of a limp, you get in there with your fingers. And when you’ve had a good ol’ prod and a poke, you know what you do next?’
‘What?’
‘You throw them in the air! Not a huge amount, ‘course. Jes’ enough so’s when they land they land paws down running. And the limp’ll have gone, I guarantee it!’
‘I might try that then.’
‘Oh ye-es. I’ve had lurchers all me life. And you know the trick to getting a good one?’
‘No. What’s that?’
‘Let the dog pick you. You don’t pick the dog. And see it with its mum.’
He nods emphatically.
‘You’ll know when the dog knows, not a moment sooner.’

*

Later that day, we’re sitting in Sheila’s front room. Sheila is ninety-four, thoroughly independent. Her neighbours pop round most days, help keep the little garden tidy, the odd dinner and bake, and she has someone come in and clean the house once a week. But apart from that, she still goes to the local shop every day for her TV Quick and her groceries, and manages quite well enough, thank you very much.
Only she does suffer with a touch of arthritis, and it was playing up so much through the day that she got worried something else might be wrong and she pushed her red button.
‘I’m so sorry to call you out. I know you’ve got better things to do.’
‘Absolutely not. You should always call us if you’re worried. It keeps us in a job.’
‘Still. I don’t like to make a fuss.’
Everything seems fine. We decide to make a call to her GP, though, as she hasn’t seen her for a while and could do with a review.
I sit back down on the sofa next to her to explain what’s going to happen next.
‘You couldn’t rub my arm, could you?’ she says.
‘Sure.’
I start to massage her arm, working my way down from shoulder to fingers.
‘Ooh – that’s better,’ she says.
‘Good’ I say – gauging the distance from the sofa to the middle of the room.

Tuesday, July 08, 2014

in the unit

Harry reminds me of a Rock ‘Em! Sock ‘Em! robot. He’s got the grimace, the crouch, the crooked arms, the bunched fists. He’s also got a significant skin flap on the top of his head from where he toppled forward half an hour ago. The carer has done her best to tidy him up, but Harry is an aggressive dementia patient at the best of times and his head injury has only made him worse. Without plenty of hands to help it’s impossible to get anything done. The crevices of his ancient face are stained with drying blood, in contrast with the dull, milky white hostility of his eyes.
‘I’ll muckin’ do you,’ he says, swinging his arms backwards and forwards. ‘I’ll knock yer muckin’ lights aht.’
If it wasn’t for the wound, it would be tempting to rest a hand on the top of his head and keep him at arm’s length; as it is, we have to inveigle him into our chair, swaddle him tightly in blankets, and strap him in securely. When the carer bends down to put his shoes on, Harry tries to kick her.
‘Gerd aht’avit’ he says.
We strap his legs, too.
It’s a shame we can’t treat the head wound here, but it’s just too deep, and aside from the stitches and sedation, he’ll need a close watch for any developing head injury.
‘Will you be able to spare a member of staff to come with Harry?’ I ask the carer.
Just at that moment, there’s a crash from the room next door, followed by a high-pitched scream and anguished shouts for help.
For a moment I think the carer might cry. She pushes her hair away from her face with the back of a gloved hand, then takes a steadying breath.
‘No,’ she says after a moment. ‘Sorry.’
And hurries out to see what’s happened.

Sunday, July 06, 2014

super

‘I don’t keep bulbs in the sockets. I’m saving on the electric.’
A doughy man in his early thirties, there’s an unsettling aura about David, something beyond the smell of stale sweat and self-neglect, something that the three flies buzzing overhead are probably trying to spell out. He stands quite neutrally in the middle of the room, his arms down by his sides, waiting for our next question.
We have to make do with what natural light there is, coming in through the yellowing net curtains, illuminating an orderly but airless and foul-smelling room, comprising a sofa, table, bookcase of DVDs, a glass cabinet filled with porcelain tortoises, and on every wall, a different superhero: The Incredible Hulk, Captain America, Wonder Woman, Batman.
‘Great posters,’ I say.
He turns his eyes on me and smiles unexpectedly. His gum-line is so low, his teeth so angled and rotten, I feel like taking a step back, like Roy Schneider in Jaws, chumming over the side of the boat and the shark suddenly rearing up.
‘Do you? Do you like my posters?’
‘Yep,’ I say. ‘They’re erm…’ And for the moment I can’t think of a word.
David stares at me.
‘Super.’