Monday, October 21, 2013

back in kansas

There was a plague of drunks that night. Everyone did their share. We had three – one of them, a guy of twenty or so, was sprawled face down on the pavement outside a fast food place, so covered in vomit it looked like he himself must have been eaten by a larger species of clubber and vomited whole a while later. There’s an art to moving patients like this. You swaddle them in blankets before you even think of getting them up, then after a few essential obs, postural adjustments, tactical placing of bowls and inco pads, you transport them to hospital and roll them onto a trolley in A&E. And there they lie, a collection of noxious pupae, waiting for the alcoholic tide in their blood to recede so they can be re-born. You’ll see them later in the morning, tentatively unfolding the stinking wings that will carry them home.

Our third drunk doesn’t even have the decency to be soiled.
A young guy in pipe jeans, denim shirt and punky, sugar paste hair as sad and folded as he is now.
Two friends stand over him.
‘What’s happened?’ I ask them.
‘Dave drank too much and says he can’t go on.’
‘I can’t,’ says Dave. ‘I’ve puked my guts up and it really hurts.’
‘Was it just alcohol tonight, Dave?’
Just’ says the other friend. ‘Look – how long’s this going to take?’
I ignore her.
‘Have you had any recreational drugs tonight, Dave?’
His friends laugh; I look up and repeat the worn old line that we’re not the police, we don’t care if you do or don’t take drugs, but as health care professionals we need to know so we can treat you appropriately.
‘I don’t do drugs,’ says Dave, spitting on the pavement, and the groaning some more.
‘What’s your medical history? Any problems – heart, breathing, that kind of thing?’
He shakes his head.
‘On any meds?’
‘Allergic to any?’
‘What are you going to do with him?’ says the girl, checking the time on her phone. ‘We’re sorry to have called you but we didn’t know what else to do. The taxi said no.’
‘Take me home,’ says Dave. ‘Please take me home.’
Then groans as another bout of nausea rolls through him.
‘The only thing we can offer is a trip up the hospital. You can sober up there and get a cab home later.’
‘Why can’t you take me?’ he says, looking up. ‘Please? I just want to go home.’
‘Just run him home’ says the girl. ‘It won’t take long.’
I shake my head.
‘It’s not going to happen.’
Rae sighs.
‘How do you think that’ll play? When people hear the ambulance is giving free rides home when the taxis refuse?’
‘I know, but couldn’t you make an exception in this case? We promise we won’t tell.’
‘No,’ I tell them. ‘Absolutely not.’
Dave retches, then spits.
‘But he’s only had a bit too much to drink. He doesn’t need the hospital,’ says the girl.
‘I agree with you. And the hospital certainly doesn’t need him. Look. I’ll tell you what I’ll do. I’ll give you a blanket. You can wear that round your shoulders to keep warm, and here you are –have a vomit bowl, too, just in case. I think if you make a big effort and stand up straight, you’ll look well enough to go in a taxi. What do you think?’
He groans.
‘Just take me home,’ he says. ‘I want to go home.’
‘No – Forget it. It’s just not going to happen, Dave. You’ve got to be realistic.’
‘Open your eyes, Dorothy,’ says Rae, pulling off her gloves. ‘You’re back in Kansas now.’


tpals said...

Too much to ask that these people could arrange a designated driver before getting wasted?

Although this could be the answer to the NHS budget troubles...too drunk for the taxi? We can take you home for 200 quid cash. :)

Spence Kennedy said...

It's so tempting to push for some kind of charge for ambulance use as a result of intoxication. I know it's fraught with problems, but the stress it causes the system is immense.

There's been a strange drift in things, that the ambulance has come to be the transport option of many people's night out.

jacksofbuxton said...

Perhaps Dave thought he had room for one wafer thin biscuit.

Spence Kennedy said...

And another thing... *rant alert* .... what about the crime of Drunk & Disorderly? Surely if someone's sprawled on the pavement, intoxicated, that should mean a fine? Couldn't A&E have some kind of relationship with the police, so that any drunks we have to scoop up get their details processed? Some kind of disincentive is needed.

petrolhead said...

I've been having this exact conversation on Twitter - if you end up in a cell, you expect to leave custody with a fine. So surely it should follow that if you end up in A&E (through drink/drugs) you should expect to leave with a fine/bill?

English Magistrate said...

Drawn out of my lurking corner by your rant …

From your description, Dave wasn’t being disorderly – which would normally be expected to involve shouting and/or causing a disturbance, rather than being a flippin’ nuisance to the ambulance service.

There is an offence of being drunk in a public place, for which the penalty is a fine; however, I have to say that I’ve never come across it being used. Perhaps it should be (otherwise there seems to be little point in keeping it on the statute book).

(Returns to lurking corner.)

Spence Kennedy said...

PH - I think so. The whole thing's just getting untenable. It wouldn't be a money-making idea (I'm sure the cost of administration would outweigh any profit) - but more a dampener / disincentive.

EM - Ve-ery interesting! I think it's probably time to shake the dust off that 'drunk in a public place' offence. I mean, I like a drink - but even I draw the line at laying myself out on the pavement for a ride to the hospital to sober up. There should be a charge for that.

* * *

Thanks for the comments!

MrTomVee said...

Hey Spence!

I wonder how often every Friday/Saturday night you have to turn down that request.

I live in Germany, and here usually the police turns up as well when an ambulance is called for an incident around alcohol. While there isn't a fine, when the drunkard isn't drunk enough for hospital the police may just decide that in their drunk state they are a threat to themselves and make them sleep it off in one of their VERY austere cells, minus belt and shoes - and the next mornig they make them pay handsomely for it. We are talking four-star hotel price range here.
So calling emergency services on drunks here can go either way for them, it's sometimes even a matter of who finds you first.
This set-up was never intended as a deterrent, at least I don't think so, but it certainly works like one :-)

Spence Kennedy said...

Hi Tom
Over a w/end (which actually starts Thurs pretty much) every crew will have to deal with at least 2 intox. Mostly they're so drunk they need taking somewhere safe. It's not uncommon to be asked for a lift home (because the taxi won't take them), and also not uncommon for the person or, more usually, the people with them, to get annoyed / aggressive when you refuse.

Over here the police don't have the capacity or the inclination to take on the role. There was talk of private companies setting up recovery centres - and charging for them - which I think's an interesting idea. Like you say, a deterrent is certainly needed. It's one burden on the NHS that could be eased fairly quickly - something that needs doing as we head into winter and the extra demands that brings.

Thanks for the comment!