Monday, June 03, 2013

pellets - a tragedy in one act

An EMT single-responder
Mrs Taylor, seventy-four
Mr Taylor, eighty-two
Benjamin, their middle-aged son
Lilly, sixty-seven, neighbour to the Taylors


Scene: A suburban street.
Half-past seven in the morning.
An ambulance car turns in to the top of the street with its blue lights on. It slows as it makes its way down, coming to a stop outside the house where Benjamin Taylor is standing, waving. The EMT gets out, opens the boot and begins pulling out the bags he needs. Benjamin goes over, talking the whole time, his fleshy hands resting one on top of the other in front of him, like the paws of a giant, solicitous rabbit.

Benjamin: Thanks for coming so quickly. Thank you. I know how busy you are. I’ve been reading about all this trouble at the A and E. So thank you for coming to see Mum. I really appreciate it. She’s not been herself since she had her shoulder done. The operation was a success, don’t get me wrong. We’ve had all the physio, all the home care you could wish for and we’re grateful for everything. But the thing is, as I say, Mum’s not been quite right since they sent her home five days ago. She...

EMT: Shall we go in and see her?

 Benjamin: Yes, of course. Sorry. Thank you. Thanks. This way.

EMT: The call was for chest pain, palpitations...

Benjamin: Just through here. Thank you.

A sitting room as bright and tidy as the front garden. Magazine supplements – the Queen’s Diamond Jubilee. Watercolours of country scenes. A dish of toffees. Mrs Taylor is sitting surrounded by cushions on a scallop-backed armchair, her head resting back, her mouth a deeply carved, downward curving arc. Mr Taylor is asleep in the armchair next to her. Breakfast news is running quietly in the background.
The EMT puts his bags on the floor at her feet, draws up a stool and touches her lightly on the hand.

EMT: Hello, Mrs Taylor? It’s the ambulance. What’s happened today?

Mrs T: (Speaking in a measured way, as if she were describing a particularly disappointing caravan holiday where it rained the whole time). Oh. You’re here. Thank you for coming. I didn’t want to call you but I had such a restless night and I wasn’t sure what to do.

EMT: Do you have any pain at the moment?

Mrs T: Only in my shoulder, but it’s not too bad.

EMT: Chest pain?

Mrs T: No, no chest pain. Thank goodness.

EMT: Shortness of breath? Dizziness, nausea, that kind of thing?

Mrs T: No, nothing like that. I’m pretty good, really.

EMT: Okay. So what seems to be the problem?

Mrs T: I don’t like to make a fuss. I know how busy you are what with one thing and another. I like to cope with these things by myself.

Benjamin: Mum doesn’t like to cause a fuss. You soldier on, don’t you, mum? Would you like me to move any furniture whilst you carry out your examinations? Would you like to see Mum’s medications?

Mrs T: I don’t take much. I’m not one for popping pills. I like to cope with things naturally, if I can. I don’t hold with all this medical razzmatazz.

EMT: So let’s start from the beginning. How were you when you went to bed last night?

Mrs T: Not good.

EMT: In what way, not good?

Mrs T: Restless, you know. I couldn’t get comfortable. Half my problem is I’m bunged up. I’m taking these codeine pills for the pain, and they’ve pretty much stopped me going. I’m taking Lactulose, I’m drinking glasses of water, eating fruit, you know, but it’s still all – pellety. Do you know what I mean? Little round hard things.  I manage to go a bit, but there’s always some left in there. And I don’t want to strain too hard in case I give myself a stroke. I mean, I eat a healthy diet, don’t I, Benjamin? They’ve always said I had a touch of anaemia, so I try to eat as well as I can. Liver, watercress, broccoli. They’re all good, aren’t they? Broccoli. Oh, I’ve said broccoli, haven’t I? Oranges I like. Figs. Now figs are definitely good for you.

Benjamin: Mum loves her figs. And prunes. You like prunes, too, don’t you Mum?

Mrs T: They’re all right.

EMT: So you had a restless night. You’re a bit constipated. Anything else out of the ordinary?

Mrs T: The physiotherapist has been coming round a lot. A little Chinese girl, you know. Very quiet. Big hands. She said she’s happy with the way the operation’s gone. I’ve almost got full movement back, it’s just that last little bit. It’s quite sore when she shoves it about, but she says if we don’t it might not knit properly or sit properly or something. Anyway, I might have to have it done again and I don’t think I could. I’m regretting it as it is. I sit here thinking bloody shoulder. I wish I’d never agreed to have it done.

Benjamin: Oh Mum! She’s never normally like this. She never normally complains. Do you Mum?

Mrs T: I don’t like to make a fuss. I know you’re busy.

(The EMT carries out a thorough set of obs, including a twelve lead ECG. He explains that the dots need to go across Mrs T’s chest, and would Benjamin like to step out of the room? He stays put, though, hugging his knee and rocking backwards and forwards a little. Mrs T doesn’t seem to care, so the EMT carries on. Mr T remains asleep in the armchair next to her.)
Benjamin: It’s incredible, all the equipment you have these days. Isn’t it, Mum? Just amazing. We’re so lucky. Thank you. Thanks for all you’ve done.
Mrs T:  Funnily enough we were just watching one of those casualty programmes on the telly last night. Now this.
Benjamin: I know you’re very busy. You must get a lot of aggravation, what with the drunks and everything. Do you get attacked much? I don’t know why people have to be so unpleasant. You’re only doing your job.
Mrs T:  People are animals. Especially when they’ve had a drink. I stick to orange juice. That’s good for you, isn’t it? Vitamins and so on. Almost as good as spinach.
EMT: (covering her chest back up with her dressing gown). No talking for the ECG, now.
Mrs T: Right you are.
Benjamin: Thanks.

(Suddenly there’s a knock on the door. Benjamin gets up to answer it. In comes Lilly the next door neighbour, a bird-like woman in her sixties with spiky hair, tiny eyes and a short beak.)

Lilly: Coo-ee! Only me! I saw the ambulance. I thought gosh! What’s wrong? Can I help?

(Mrs T adopts the same tragic face she was wearing when the EMT first came in. She waves feebly at Lilly)

Mrs T: I can’t talk now, Lilly. I’m being examined. I’ll see you later.

(Lilly makes no sign that she understands or is prepared to leave.)

Lilly: I’ve only just got out of hospital. A big heart attack. Out of the blue. Two months ago. Stent fitted. A serious operation, but it did the trick. I’m completely back to normal.

Benjamin: Mum can’t really talk now, Lilly. She’s had a difficult night and the paramedic’s just assessing her to see whether she needs hospital or not. Shall we see you later?

Lilly: If there’s anything I can do. You know! Just next door...

Mrs T: (feebly) Thank you, Lilly. Maybe later.

Benjamin: (standing and ushering her to the door) Thanks Lilly. See you in a little while. (Shutting the door firmly behind her). A wonderful woman, Lilly. We’ve got the best neighbours in the world. We’re very thankful.

Mrs T:  What do you think’s wrong with me?

EMT: Well I’m not sure, Mrs Taylor. All your observations are normal. It had come through as a chest pain for some reason...

Mrs T: (putting her hand on her chest) I just didn’t feel right in myself. Do they still do suppositories, do you know? I just think if I could have a suppository, I could have a really good clear out. Because at the moment it’s just pellets, and it always feels as if there’s one or two left. And as I say, if I strain too hard I might have a stroke.

EMT: Codeine can bung you up a bit. I think it’s really a balancing act between pain relief and managing the side-effects.

Mrs T: Maybe I shouldn’t take the codeine, then. Is that what you think?

EMT: I think it’s something you need to talk to your GP about. Maybe you should go and see your GP for a general review of your meds and how things are going.

Mrs T: I don’t like to bother him.

EMT: But you were worried enough to call an ambulance...

Mrs T: Do you think he’ll give me a suppository?

EMT: See what he says.

Benjamin: Thanks for all you’ve done. Marvellous!

EMT: I’ve just got to complete my paperwork.

Benjamin: It’s all paperwork nowadays.  I suppose you must get used to it.

EMT: Who shall I put down as next of kin?

(Mr Taylor suddenly opens his eyes and sits forward, raising his hand in the air. Mrs Taylor glances at him, then sighs.)

Mrs T: No. Best put Benjamin down.

(Benjamin leans over the EMT and spells out his name, slowly, like he was writing it out with crayon).

EMT: I don’t think you need to go to the hospital, Mrs Taylor.

Mrs T: The hospital? No thanks. I’d rather try to cope here at home where I’m comfortable. If there’s no need for me to go, I won’t. I like to do as much for myself as possible.

Benjamin: Thank you so much for coming. Can I get you a cup of tea or something?

EMT: No – Actually I’ve pretty much finished now. Thanks all the same.

Benjamin: It’s no trouble at all. You’re very welcome. We’re just grateful you’ve come out to us this morning. Thanks for all you’ve done.

(The EMT struggles out of the door with all his bags.
Lilly the neighbour is standing waiting for him by the car.)

Lilly: I had a proper ambulance when I had my heart attack. ECG. X-Ray. Blood tests. You name it. I had a stent fitted. You know what that is, don’t you? And it worked! I’m one hundred per cent back to normal. So – Mrs Taylor? Is she, erm...?

EMT: She’s fine. She’s going to see her doctor.

Lilly: Her doctor? Nothing serious, then?

EMT: (Closing the boot and moving past Lilly to the driver’s door. He hesitates before getting in the car, then smiles at her.) You could go back inside and have a chat about it.

(She raises her eyebrows, turns round and hurries back through the Taylor’s gate. The EMT hears her knocking on the door as he drives quickly away. Just round the corner, he parks up, turns the engine off, rests his elbows on the rim of the steering wheel, plants the heels of both hands firmly in each eye socket, and stays like that, breathing quietly, rapping his fingers on his forehead, little finger through to index, one-two-three-four, followed by a quick rattle-tat, and then on again, just like that. Over and over. About a minute.)


Jane said...

sheesh, and I thought I'd had a tricky frustrating day.... I prescribe a nice dose of Stan Freburg to counteract the Taylors...

Hope the rest of your shift was less hair tearing....

Sabine said...

How about having the EMT break into song now (a lament maybe) or better still, a long low moaning or wailing? Just as a dramatic climax to counteract the disappointment of hard little pellets? No enema was involved I guess.

Spence Kennedy said...

Jane - That Stan Freberg sketch is brilliant! It makes me want to re-write the whole blog post in a similar style.

Sabine - Or... maybe I could do it as a modern opera, like Les Miserables (which would've been a good title for the ambulance service generally) with an especially heart-rending solo entitled 'Stools Out' or maybe 'The codeine, my motions and Me' - it's a work in progress.

jacksofbuxton said...

She could have been prescribed raw chicken.

Wouldn't have been pellet like then.

More like the great pouring of the Niagra.

Spence Kennedy said...

It sounds like you speak from experience, Jacks. Bad barbecue? Bad Voodoo?
(BTW - I'm glad all our jobs aren't this exciting. How could I possibly cope?)