Monday, March 25, 2013

no-one knows

‘Have a read of that. Go on. It’ll tell you everything you need to know. It’s the God’s honest truth – why would I lie?’
Gus hands me a bundle of notepaper, each page closely covered on both sides in shaky handwriting. But it’s not the right time. We’ve already been here half an hour, trying to make sense of his rambling speech, trying to organise some kind of logical response, whilst his sister Bel sobs in the doorway.
‘He needs help,’ she says. ‘You can see how he is. The family can’t take it no more.’ She blows her nose. ‘You know you’re not well, Gus,’ she says. ‘All last night, howling and screaming and slapping yourself in the face like you did.’
‘I just wanted you to see I can take pain. Normal pain. But this is different. I can’t take this.’
‘Gus – you’ve got to get some help.’
‘I want help. Do you think I don’t? Do you think I haven’t been trying? You don’t know what it’s like. No-one does – not you, not the specialists. Look what they said. They’re completely stumped. They’ve never seen nothing like it. All them tests and still no wiser.’
‘I don’t mean your back,’ says Bel. ‘It’s not your back we’re worried about.’
‘No-one understands,’ he says, looking at me. His face is thin and pale, his eyes so raw with sleeplessness you’d think they were smudged with red paint, like a forty year old clown who’d had enough and roughly wiped his face on his sleeve.
‘What am I gonna do?’ he says. ‘I don’t know what to do.’
‘The way I see it, Gus, there are two things going on here. On the one hand you’ve got this on-going problem with your back, and on the other, you’ve got the way you’re coping with it. On an emotional level.’
I use the word emotional as lightly as I can, but no-one can be in any doubt what I really mean.
Gus fixes me with his red eyes a moment or two, then looks down at his hands.
‘You don’t know what it’s like,’ he says. ‘No-one does.’
‘He said he was going to kill himself,’ says Bel. ‘He wrote out his will and said he was going to take all his medication at once. You know you did, Gus. Didn’t you?’
He starts crying.
‘You don’t know what it’s like. Everybody’s supposed to be all caring and medical and the rest of it, but it’s really just like in medieval times, when they put your legs in a vice and smashed all the bones to jelly. It’s just like that – like walking on broken bits of old bones. I can’t stand up. I can’t lie down. I can’t do nothing or go nowhere.’
He reaches down and pulls one of his trouser legs up, revealing a healthy, muscled calf. ‘Look at that,’ he says, slapping it with his hand. ‘The flesh just hanging off.’
‘Please don’t let them discharge him back home like this,’ says Bel. ‘It’s not fair. He needs help.’
‘I’ll see what I can do.’
‘Promise me you’ll tell them what’s been going on? Because if he just gets sent straight back, I don’t know what’ll happen.’
‘I’ll do my best. Come on, Gus. I’ll have a read of your notes when we’re en route to the hospital.’
He gets up, his powerful frame dwarfing me.
We walk out to the truck.


He hands me the notes.
Each page is dated and signed at the bottom: These are the official last words of what really happened to me, Gus, a truthful man. Signed Gus
‘Have a read.’

“I told them all about my back and when I hurt it. The vertibrays all squashed out of line and then I got pain all up from the top of my bottom to my neck. ASK MR CROPREDY HES GOT ALL THE NOTES. I done a lot of jobs in my life carrying heavy things a lot of climbing and lifting and going up ladders even digging a trench was agony, no-one understands what it’s like. They tried all sorts of pills and nothing worked not even the really heavy stuff what made me sick anyway I didn’t get on with it. Theres a problem down there AND ITS GETTING WORSE but there not giving me the MRYs or the Xraze to see whats really going on either that or they wont tell me. I got prostrate problems too I know I have and that hasn’t helped. My balls are all smoove and shrunk back to nothing and my penus is just a stub with a slit in it when I drink anything it goes straight through me and runs down my leg which isn’t nice no one should have to put up with that. But then when I see the nurse she just stuck her fingers up my bottom and felt around and said everything was all right down there, but she doesn’t know. Then they dipped my urin which is nothing but a kind of PASTE and they said that was allright as well. So if everything’s allright, why when I look in the mirror does MY BELLY BUTTUN SHIFT OVER TO THE LEFT? Because my spines pulling all my guts to the right and all my organs are moving where they shoudnt thats why. I know I’m going to die soon which is why I’m writing these notes to let you know the true story of my agony, and what no one did to help not even when I told them the flesh was hanging off my bones and MY NAILS HAVE STOPPED GROING. I cant eat or drink I cant sleep and I know Im driving my family mad but theres nothing to do but write these notes and explane to my lovely girls who I love more than life itself that there dad tryed hard but it wasnt enough to stop him dying a horrible and lonely diseese. Yesterday was the same. I cant eat much at all I’m so bunged up with big toilet I tried putting seppositries up there but they werent no good so now I have to put my fingers up my bum to get it all out its agony no man should have to do this but no one cares which is why I’m writing this now please belive me this is the truth after all WHY WOULD I LIE”

I hand it back to him.
‘What do you think?’ he says, and leans in.


tpals said...

What on earth did you say???

Ellie said...

First things first I just have to say I have spent the last week or so reading through your blog after having it recommended to me through another blog and I'm just amazed by your writing skill. It felt like I was right there with you in most of them and I could feel the emotions I could only guess you did as well. Your writing truly amazes me.

Any who now that I'm fully caught up on the years of blog posts here I finally feel justified in commenting. This post makes me sad, it's clear this man has some serious mental issues but I can only presume he probably has some physical ailments as well. Dealing with a whole list of physical problems myself I can in some ways understand the seemingly helpless feeling he has, perhaps thats what drove him to the somewhat unstable state he is in now. I hope he finally does get the help he needs sometime soon. Seeing what was once a vibrant young man turn into this is rather saddening.

Spence Kennedy said...

tpals - I told him I thought it was a really interesting document. I said I thought it was a good idea to write all this stuff down, to keep a record of how he was feeling, because sometimes that can help clarify things and put them into some kind of context. I tried to be as honest and open with him as I could - which wasn't all that easy, considering his volatile state of mind.

Ellie - Thanks v much for reading(and all that way back, too!) I feel like I ought to send you a t-shirt or something (that might be an idea - although I shudder to think what the picture on the front would be...) Anyway, cheers for sticking with it.

I did really feel for Gus. Life's difficult enough without years of chronic pain to contend with. I hope he gets help to bring him back on the level. Because of course it wasn't just Gus who was suffering - the whole family was under terrible strain.

Thanks for your comments. Hope you're both well. :)

jacksofbuxton said...

Goodness me Spence,how can a man get so low and yet not receive the help he needs?

I realise these are just snapshots of the things you do,and obviously the most interesting ones make the cut.So I know you're not dealing with 10 of these a day,but have people like Gus become more common recently or have there always been a few that fall through the cracks?

Look Away Now said...

Another corker of a post. One of my all-time favourite blogs. Keep it up, Spence!

Spence Kennedy said...

Well, Jacks, I must admit I don't know. Gus had already seen the GP, consultants and various other people a few times, but I didn't get the impression he'd seen any psych professionals - so maybe this was an acute manifestation. Whatever the reason, he def needed some urgent intervention. His poor family were in meltdown because of it. These jobs are the most difficult to take into hospital, esp. when it's so busy. The duty psych team would see him pretty soon (particularly as he hadn't taken any alcohol), but there was still a period of time when he'd have to wait in the hectic A&E environment - difficult for anyone, but particularly someone so emotionally volatile.

I think psych cases have become more common (of course, that's purely anecdotal). Probably due to increased pressure of life out there, and a reduction in psych beds.

Look Away Now - Thanks very much!

Anonymous said...

All your posts are great Spence. I love your writing and also your care and diplomacy in dealing with the patients 'I told him I thought it was an interesting document'. That is wonderful.

This story I particularly appreciated because it shows how limited the options are for some people. This guy clearly needs help, yet his problems don't seem like they are going to be easy to solve. No easy answers sometimes.

All the best,

Spence Kennedy said...

Cheers H!

One aspect I left out of this story - another really difficult one - is what happens when we get to A&E. A department that's so overcrowded, there's scarcely room to get in the door. You can imagine how that goes down with our patient! I have to take the 'pat' nurse aside, describe the situation to her with sufficient impact (because of course she hasn't seen the situation at the man's home, hasn't read his letter, hasn't talked to him), whilst a hundred other demands are being made on her attention, and persuade her that among all the chaos of the department, all the demands that are being made of her and the staff there, that man anxiously standing with my partner over in that corner deserves a quiet place to be seen. Something as basic as that, but as challenging as that.

Like you say, no easy answers :/

Thanks very much for the comment, H.