Friday, May 30, 2008

what's out there

‘I’ve got three accountancy exams next week,’ Paul says, moving his eyes up to look at me. The eyes are about the only things he can move, trussed-up as he is on our spinal board. His head is between two blocks, strapped across the forehead and chin; his neck is in a cervical collar; his torso is held crossways over both shoulders and over the hips, and his legs by a loop around the ankles.
‘That sounds tough,’ I say.
Paul had been round at a friend’s house until the early hours, when he’d accepted a lift home. Within two minutes of finishing the last round of Grand Theft Auto he was sprinting outside through a sudden downpour to the front passenger seat; within five he was spinning out of control into a flint wall on the main coast road.
Paul wriggles his toes on the board. His Timberlands have been cut through the laces, taken off and placed backwards on top of his legs. It’s like the street version of the cavalry officer’s funeral, reversing the empty boots in the stirrups, but I keep that one to myself. Instead I ask Paul what he remembers about the accident.
‘We were going round and round and round and I was holding on thinking “I’m dead” – then there was this crunching mess – and everything closed right in – and slowed – and then silence. I really thought that was it. But after a bit of just hanging there thinking “shit, shit, shit” I kind of checked everything off mentally, and it all seemed to work. And I looked Sye over, and he seemed worse, but alive at least. Then I climbed out, and some people were there saying the fire brigade were on their way. And that was that.’
The car was such a beaten wreck, it seemed inconceivable anyone could climb out unaided. But apart from a bloody nose and some lower leg pain, Paul seems remarkably intact. Sye has suffered more, though. Cut out of the car and taken on ahead by the first crew on scene, he is being assessed by the trauma team in resus whilst we wait our turn in the corridor outside.

Three o’clock in the morning and it’s the busiest the department has been all night. First up ahead of us, cued up on the runway for inspection, is an old man in such an advanced state of decrepitude the son who stands by him at the trolley is himself a livery retiree. He stands clutching a plastic bag and a jacket, nodding and smiling around him like some benign school inspector having a lucid dream. Next to them on a trolley is a woman with her face buried in a vomit bowl. She gives a cat like heave every once in a while, but is otherwise silent in her misery.
Some of the crews here I haven’t seen in a long while. In between glib interactions with our clients, circus performers spinning the plate once in a while, we catch up with the latest. Richard’s industrial goth punk sado-metal band is doing well – they’ve just finished another recording session. He’s also a paramedic now, but it took months for his registration to come through. Mike seems unusually quiet, and it’s only when I ask him how Maria is he tells me he wouldn’t know, she kicked him out two weeks ago.
‘Taxi for Mr Kennedy,’ says Richard, jamming his hand into his mouth, the clown.
Another crew arrive. Their patient, a woman in her forties, is screaming in pain as they come through the doors. It is the kind of excoriating howl that rips through everything, that stops up all normal activity for a second and lays everything completely still. They go to the front of the queue, and are taken off to a cubicle. Rae goes to help them with the transfer. I chat to Paul some more to take his mind off her screams. I can guess how awful it must be to hear something like that without being able to turn your head and look.
‘So – is that what you want to go into? Accountancy?’
‘I don’t know. Maybe. Maybe not. I’m also doing Business Studies. But I think after these exams I’ll take a couple of years off. Do some travelling. See what’s out there.’
‘Good idea. There’s plenty of time.’
The doors to the resus room swing open, and a nurse gives us a nod.
‘RTC?’ she smiles. ‘This way.’
‘Come on then, Paul,’ I say, as we wheel him in. ‘Try not to worry.’
The team close round him with their scissors and their needles and their questions.


cogidubnus said...

Wonderful description of the subdued, but perhaps mildly expectant, atmosphere in an A&E department at long as it's not Friday or Saturday, which are presumably a good deal more manic!

I particularly liked the exchanges of news between crews and the "in-house" gossip, without which no profession would properly function...

Strange how a potentially grey accountant should figure in a slightly more colourful accident of this nature...was this why you picked him?

Spence Kennedy said...

Thanks, C.
I must admit I was surprised when he told me what he was studying. You would never have guessed, either from the way he was dressed, or the circumstances.
I didn't choose him for that reason, though. It just struck me as an interesting snapshot of A&E at that time - the different routes that people took to get there, both crews and patients.

loveinvienna said...

Once again, wonderfully written. Did you find out what the problem with the screaming lady was? Appendicitus (sp?) or something equally painful? Hope everyone turned out to be curable in the end.
Liv xxx

uphilldowndale said...

There is something in that post that makes me shudder,I think it's the parental thing, you've guided your child, intact through the perils of childhood and adolescence and there they are on the cusp of the adult world; and it's all so fragile and it's not a game that they can play again another day, if they lose tonight.

Spence Kennedy said...

LiV - unfortunately the woman who was screaming had bone cancer. She'd just suffered a pathological fracture of the femur, and was in such pain that the 20mg of morphine the crew had given her hadn't touched it.
UHD - I know what you mean about that sense of fragility. I think it's good to be reminded of it from time to time (but not so much that you get overly scared). BTW - talking of being overly scared - still haven't decided whether to do the tag thing. Hope you don't mind! May yet, tho.

loveinvienna said...

Poor lady. I shudder to think about the kind of pain she must have been in if 20mg of morphine didn't even take the edge off.
Liv xxx

uphilldowndale said...

No problem, sometime being 'tagged' feels like you have got 'home work you must do.' hanging over you and that's no fun.