It’s John’s birthday today but it doesn’t look like he’ll be celebrating.
He was woken in the early hours by a crashing noise in the bathroom. When he went to investigate he found his twenty-five year old son, Alex, unconscious on the floor, so he put him on his side and called the ambulance.
When I squeeze into the bathroom Alex is conscious but sweating profusely, his eyes wide, his pupils wider. He has a lump on his head where it struck the pedestal of the hand basin. When I talk to him, he doesn’t reply, but thrashes around like a man in a waking nightmare.
John is too upset to tell us much, other than the fact that Alex uses heroin and other drugs, and a few years ago was beaten half to death with a fence post.
‘Did that leave him with any speech problems or weakness anywhere?’
John shakes his head and retreats into the kitchen.
I put a SATS probe on Alex’s finger; he immediately puts it in his mouth and bites down on it.
Whilst I’m scrabbling around to pick up the pieces, Alex hauls himself to his feet and staggers around, knocking bottles and cups and toothbrushes off the shelf above the sink, and tearing a bathrobe off the back of the door.
Our best guess is that it’s the effect of some drug he’s taken, maybe GHB. But the head injury is a worry, so we’ll have to take him in. Getting him out to the ambulance is going to be difficult, so we call for a second crew.
Whilst we wait for them to turn up we try to guide Alex so he doesn’t hurt himself, but it’s dangerous work. Despite his condition – or maybe because of it – he’s wild and strong and difficult to control. We try to balance the risk of getting punched or head-butted with the job of keeping him safe. He staggers out of the bathroom across the landing into his bedroom, lowing like a bull. I try to guide him onto the bed where he’ll do less harm to himself and certainly less damage to the room. On the way over to the bed he grabs a lava lamp and makes as if to smash it, but we manage to get it off him. He knocks everything off the dressing table and yanks a wall covering down on top of himself. He falls across the bed, kicking and moaning incoherently.
The second crew arrive.
Between us we manage to coax Alex down the stairs, holding him by the wrists so he doesn’t lash out or pitch down head-first.
On the ambulance he becomes even wilder, screaming in terror, struggling to get away. We restrain him as humanely as we can with the straps on the trolley. There’s no point in trying to get any obs, so we run as we are and phone ahead.
At the hospital we’re met by security who take over the job of restraint. We wheel him through the department into resus, where a team is ready for us. I leave the room to book him in just as they’re drawing up a syringe of something to chill him out.
* * *
Later that morning I run into one of the doctors who dealt with Alex.
‘How was our man this morning?’
‘Alex? Bat-shit crazy,’ she says. ‘But I’ve had the pleasure a couple of times before. Once when he came in after an argument with a fence post. One of our more select customers.’
‘I felt so sorry for his dad. It’s his birthday today.’
She takes a sip of coffee then pulls a face and reaches for the sugar.
‘So what do you reckon it was?’ I ask, as I get myself a cup.
‘Alex? Crack and smack, no doubt, but we won’t be doing a tox-screen. We did a CT, though, just to make sure. And it confirmed our suspicion.’
‘What’s that?’‘He’s a wanker.’