Thursday, October 09, 2008


This modern quadrangle of glass and red brick could easily be a Halls of Residence in the grounds of a university. The shock would come, though – a lurch forward in time – when instead of a surge of teenagers running out into the yard you saw a derelict shuffle of elderly people, not text books but prescriptions in their hands, not jumping onto bikes with baskets on the front, but tentatively raising specialist footwear onto the running boards of mobility scooters (with baskets on the front).
With my colleague Frank next to me, zipping up his jacket against the cold, I press the flat number we need to visit the patient who is sick, unspecified. After a long pause towards the end of which I’m reaching for my mobile, the intercom crackles on. It’s almost impossible to understand what the voice is saying, distorted by dodgy electrics, accent and – is that whisky I can smell through the little aluminium grille? As far as I can make out the voice is saying, at top volume: It’s me you want. It’s me you’ve come for.
‘Could you buzz us in please?’
It’s me. It’s me you want.
‘Yes - could you let us in please?’
Nothing. Then, just before I buzz again we hear a door slamming and the sound of two maybe three voices from an interior stairwell.
Eventually, a grizzled man – intense, wild, like a backwoodsman who’s been trapped in his cabin all winter – hauls himself up the stairs and reaches for the door. He’s being pursued by a large middle-aged woman in a seedy black raincoat with markedly less drive than the man, and a young woman who looks like a scaled down version of her. He flings back the door and they all start talking at once.
‘That’s it. Go. Take me.’
‘I’m a nurse. He’s not well.’
‘Fucking hell it stinks. I’ve got better things to do than this.’
And a verbal dump of other stuff, none of which makes sense. I talk over them, as calmly and clearly as I can.
‘Could we just go back inside please and sit down? I need to find out what’s going on, then we can take it from there. It won’t take long. Bear with me. Inside, please. Inside. Thank you.’
They all turn around and clump back down the stairs, the elderly man flinging his arms out from time to time at furious spots in his continuing monologue. The young woman reaches the flat door first. She stands aside and holds her nose.
‘I ain’t going back in there. It stinks,’ she says.
We leave her by the door and follow the other two in. Wild man throws himself down in a knackered armchair, the woman in the raincoat sits on the edge of a nearby sofa. He blows furiously through his nostrils and glares at me, for all the world like James Finlayson in a Laurel & Hardy short.
‘So. Now. Let’s start this properly. My name’s Spence and …’
‘If you’re not going to do anything then fuck you, fuck you all for wasting my time. Look at this.’
He suddenly raises his left leg up and crashes the foot down on the table.
‘What are you going to do about that?’
I look over at Frank and he raises his eyebrows. I look back at Ian and lower mine.
‘Please don’t swear at me. We’ve come here to help, but if you start, we’ll simply walk away. Do you understand?’
He squints up at me.
‘I mean it.’
The woman starts undoing his filthy trainer shoe.
‘I’m a nurse,’ she says. ‘Ian’s foot has oedema.’
‘Are you here professionally?’
‘No. I’m – erm – a friend. I used to be a nurse. I know about all this stuff.’ She gives his foot a poke. ‘Look at that. Look at all that oedema.’
A dodgy relish to the word, like a bent lawyer using Latin.
‘And I’m guessing this is not normal for you, Ian?’
He sits up as if someone’s jabbed him in the back through the chair.
‘What did he say? What do you mean, I’m not normal? What the fuck do you mean?’
He stands up and hops around dangerously as he tries to snatch the trainer back from the friendly ex-nurse.
The young woman has decided to come into the lounge now. She stands next to Frank, smirking and rubbing her nose.
‘What’s your connection to all of this?’ I ask her.
‘Me? I’m his niece. For my sins. God it smells in here. How do you bear it?’
I’m about to tell her that – as these things go – this one isn’t too bad, when Ian stamps his trainer back into place and then comes at me.
‘Are you going to take me to the fucking hospital or not?’
He’s working up a head of steam, as if the next word I see will be the one he has tattooed on the knuckles of his right hand.
‘Ian, don’t!’ says the nurse. Then to me, in a curiously happy tone, as if she’s telling me something cute about a pet of hers: ‘I don’t think he’s had his diazepam today.’
‘That’s it’, I say. ‘Make your own way to hospital. There’s no way I’m having you on the ambulance with an attitude like that, foot or no foot. And even if we did take you, the nurses at A&E would throw you out in a second.’
‘Fuck you! Fuck you! You don’t care!’
‘We do care, Ian – but we’re not here to be abused. Make your own way.’
We walk back out of the flat, the niece lapping the scene up, the former nurse sitting helplessly on the sofa and Ian flexing and unflexing his hands as if he wants to grab hold of something or someone but can’t for the moment think what.


loveinvienna said...

I feel sorry for the guy (sounds as if it isn't really his fault, what with the diazapam etc) but I'm glad you didn't do what he demanded. It's not in your contract, I'd guess!

Some people WITHOUT medication are just as bad or worse - out of interest, how do you deal professionally with someone who demands (amid a stream of abuse) you take them to hospital and who, if you say you're not there to be shouted at and ordered about, is compos mentis enough to start throwing a royal hissy fit?

Liv xxx

Spence Kennedy said...

Hi Liv
I think that the diazepam was part of his psych/alcoholism-related medication. The ex-nurse struck me as a drinker, too (don't ask!) I did feel sorry for him, but he wasn't helping his cause any.
The way we deal with abusive patients is that we tell them quite plainly they won't be transported if they carry on with their behaviour. Sometimes there can be a good medical reason why someone is aggressive/combative/uncooperative (hypo, cerebrally irritated &c): it's down to us at the time to make a judgement and act accordingly. In this case, he was drunk / aggressive, which isn't a good combination if you want a lift down the hospital. Maybe if we thought his condition was very serious we may have cut him more slack; as it was, he could be left at home safely.

But having said that - I've seen A&E staff throw people out with fractures before who were aggressive & abusive. Quite right too!

Hope you're well
LoL Sx

loveinvienna said...

I completely agree - quite right that A&E staff should throw people out of the department if they're abusive or aggressive (unless there is a medical reason behind it as you say). No one deserves to be treated like something you'd scrape off the bottom of your shoe, no matter how ill or in pain you are. People should just be thankful for the NHS - creaky old cart that it is...

One of my flatmates here is from the Netherlands and she has to pay 100 Euros a month for pretty basic medical insurance and even then it doesn't cover serious road accidents and so on. Also, their ambulances take up to half an hour to reach a patient sometimes... makes out 8 minute targets look rather good, I think!

The Great British Public don't realise how lucky they are!

I'm doing ok thanks, a bit worn out and frustrated at my lack of language skills (feel like I've hit a lingual brick wall at the moment) but I still love Vienna :) Hope you're doing ok yourself!

Liv xxx