Monday, March 08, 2010

grippy boots

A woman waves to us from between some parked cars. She smiles as I draw level and wind the window down, but then she puts her hand up to cover her mouth and nose, and cries.
‘Let me just park up and we’ll be with you’ I say to her.
She steps back as I pull as close over to the side as I can and put the hazards on.
It’s midnight. The night is sharp, balanced on a point between a good night out and something wilder, louder, more ragged. A tsunami of girls comes crashing along the pavement, a Hen party, all dressed in St Trinian’s outfits. We climb out and take cover with the woman behind the ambulance just as they wash past, shouting and singing; one of them flicks her skirt up, moons us in a thong. The woman nods and smiles at them, and eventually they pass away, their cat-calls echoing off the house fronts and cars and frosted paving slabs.
‘What’s going on?’ Rae says.
‘My sister isn’t very well – here,’ she whispers, leaning in to us, tapping the side of her head. ‘She’s had a lot of personal problems, difficult things. But this? This is something else. It’s been going on for a year now. I looked up the symptoms on-line and she ticks all the boxes. I’m really scared she’s becoming a paranoid schizophrenic.’
‘So what happened tonight?’
‘It’s my mum’s birthday. We went out to celebrate, to a restaurant. On the way there she was saying how she’s been hearing voices whispering from the walls, and how when she’s out running strange people have been jumping out at her. It was so painful to hear her talk like that. When we got to the restaurant she was quiet and edgy. We ordered starters, she had a rocket salad with parmesan, and we drank some wine. When she put a forkful in her mouth she started gagging and making a horrible noise, pulling it out and spitting it all over the table. She said the waiter had put poison in it. I can’t tell you how awful it was. We had to leave. And then when we got back here, she’s just been crying constantly, saying how she’s not going to be around much longer to worry us. We really didn’t know what to do. She doesn’t know I’ve called you. I’m scared she’s really going to flip out.’
‘You did the right thing.’
‘Did I?’
‘Definitely. Let’s go in and say hello. Who’s with her now?’
‘My mum and my husband.’
‘Lead on.’
She takes us down some steep basement steps and along a narrow corridor set with heavy brown doors and neatly lit with porthole sidelamps like the passageway of a thirties cruise liner. The mother, a woman as neatly constructed as the house, stands at the far end, smoking. She smiles warmly as we approach, moves to one side to give us room.
‘She’s calmed down a bit now,’ she says. ‘She’s doing all right.’
The woman stops with one hand on the sitting room door.
‘I’d better go on ahead and announce you,’ she says. ‘I don’t want it to be too much of a shock.’
‘Of course.’
She opens the door just enough to slip through; we hear her call her sister’s name. There’s no reply, but after a second or two I hear the husband say: ‘You’re joking.’
We wait in the hallway with the mother.

‘So it’s your birthday today?’
‘Yep. For my sins.’
‘Happy Birthday.’
‘Thanks very much.’
‘How did you do with your presents?’
‘Pretty good. I got some great stuff, actually. I got these beautiful, grippy boots.’
She leans back slightly and raises her left foot, turning it from side to side in its new grey fabric boot.
‘That’s nice. You can’t beat a nice pair of boots.’
‘You certainly can’t. Especially with it being so cold out, so treacherous.’
She takes another drag of her cigarette. The smoke rises off into the cool white light along the top of the corridor.
We hear raised voices behind the door.
‘Oh. Time to go,’ says the mother.
We follow Rae in.


ViatorT said...

When I was being interviewed for my paramedic course I asked about the position of the amublance service with mental health and the answers I got were very interesting, what sort of action can you take from here? How do you treat (in the broadest sense) mental illnesses in a out of hospital setting if that makes sense?

Cheers, VT

Spence Kennedy said...

MH is a difficult area, no question. The best we can do is to make sure the patient - and the public - is safe, working in conjunction with the police and OOH as much as anyone. A&E is not an ideal environment for the pt with MH issues. They're not really set up for it, especially at those hours that the problems often occur (late at night). You do the best you can - often frustratingly little!

ViatorT said...

Tis very true,
I think MH is difficult, because maybe treatments the wrong word?yes some conditions you can, but its more support in a way?
Interesting post spence!


lulu's missives said...

Hi Spence,
MH is so difficult to deal with when you're not trained to, either as a paramedic or as a family member. It has so many unexpected twists and turns that you don't really know what might happen next.
What did happen next?
I always seem to want the next chapter of your posts.
xx jo

Spence Kennedy said...

Hi Jo
It's absolutely fraught! (can be). In this case, the family on scene were v supportive, the OOH was to make contact, then the pt start on the road to a psych r/v via her GP on the next working day. We really didn't want to take her to A&E if we could avoid it, esp on a w/end night! Not a great place if you're emotionally volatile.