Sunday, April 19, 2015


Cara, Jake’s support worker, is waiting for us in the lobby of the health centre. As soon as she sees us walking up the path she brings him out to meet us. They’re a curious pair, both middle-aged, but whilst Cara is neatly dressed, bright and sharp, clipping along in a hacking jacket, ethnic scarf and pixie boots, Jake is rolling beside her, morbidly obese, covered rather than dressed, everything black – black t-shirt, black tracksuit bottoms, black anorak, the striking blackness of it all emphasising the pallor of his face.  
‘I can’t go there,’ says Jake. ‘It’ll be ten o’clock soon. I have to have my cup of tea at ten o’clock. How am I going to get back in time?’
‘Don’t worry about it,’ I tell him. ‘They’ve got plenty of tea at the hospital. They’re good for that.’
‘I’ve got OCD,’ says Jake. ‘Anxiety and panic attacks. I’m going to need a Diazepam or I’ll lose it, I know I will,’
‘One step at a time,’ says Cara. ‘We’ve really got to get your leg sorted out.’
‘I don’t care about my leg,’ says Jake. ‘I want to go home.’
Jake seldom goes outside his flat, or even out of his chair. On top of all his other health problems he’s suffered a DVT. The doctor has ordered him straight into hospital for a scan, but even though Jake’s left calf is as tight as a red balloon, covered in a pruritic rash he’s scratched into a scabby mess, he’s still reluctant to come with us. We have to tempt him onto the ambulance with a string of blandishments, keeping him talking whilst we quietly put on his seatbelt and gently pull away. With me one side and Cara the other, we keep him in a cross-fire of reassurance for the short journey in.
‘How long will I be up there?’
‘It’s hard to say. It’s not too bad at the moment so it’s a good time to go.’
‘I can’t sit around and wait for hours. Will they see me straight away?’
‘They’ll certainly do their best to sort you out as quickly as they can. They need the space!’
‘I can’t be waiting for hours and hours. It’s too much for me. I want to go home. Why can’t you take me home?’
‘You’ve done really well getting this far, Jake. Just try and take it a little step at a time. You made it to the doctor’s, which was brilliant. And now you’re on the ambulance going to the hospital, which is fantastic. One step at a time.’
‘I think you’re doing brilliantly, Jake.’
‘Yeah but I don’t want to go to the hospital. Take me home.’
‘We can’t take you home, Jake.’
‘Why not?’
‘Because your leg’s in a pretty bad way. If you don’t get it treated today you could suffer complications.’
‘What do you mean, complications?’
‘A clot could go up into your lungs and stop you breathing.’
‘I don’t care if it does.’
‘But we do, Jake.’
‘Just take me home.’
‘We’re not allowed to.’
‘Okay. Drive me to a cliff and throw me over.’
‘We care about you too much to do that.’
‘I don’t, and I don’t care about my leg. Why would I care about my leg when I don’t want to live?’
‘I’m sorry you feel like that, Jake. I know this is difficult for you. But if you come to the hospital we can get your leg sorted and then find you someone to talk to about your low mood and how things are generally.’
‘I don’t care about any of that. Just take me to a cliff, throw me off and be done.’
‘We’re not going to do that.’
‘Why not?’
‘Jake. Try not to worry. Look – I’ll make you a nice cup of tea when you get to the hospital. How about that?’
‘It’s not the same. I need my special cup. I need to be home.’
‘Getting your leg sorted isn’t something we can do at home, though.’
‘Why not?’
‘Because of all the special machinery, the ultrasound scanners and what have you. All the specialist staff that are involved.’
The ambulance rocks violently as we turn up the ramp into the A&E car park.
‘We’re here!’ I tell him. ‘Well done!’
‘But I don’t want to be here,’ he says.
‘Come on, Jake,’ says Cara, holding out her hand to him at the bottom of the steps.
Eventually he gets up and moves to the back of the ambulance. He stands in the doorway with his hands either side, staring out, massive, bloodless white, taking in the horrifying activity of the ambulance bays, the fuss and clamour of it all, like an albino Orang-utan being coaxed out of the forest into the city.
‘I want my tea,’ he says. 


jacksofbuxton said...

I know it would be easy to laugh and say pull yourself together,but I'm sure Jake would be a lot calmer after his cup of tea from his special mug.

Spence Kennedy said...

It's a shame he didn't bring it along. Nothing wrong with having your own special mug. Not that I have one particular mug. I'm not mugnonomous. Er-hem.

Lynda Halliger Otvos (Lynda M O) said...

You made me laugh with that one Spence. I miss having a wordsmith about the place; I left my favorite jokester when I moved cross country.

Spence Kennedy said...

Who was the jokester? I'm intrigued...
And cross country? From where to where?
(I'm so nosey).

Anonymous said...

I have severe anxiety and OCD of various types, and while I do see the care in this, and that the intent is good? It terrifies me to not be allowed to say "no, stop, I am leaving". It has kept me away from shrinks, doctors, and any other form of help for decades. It will, sooner or later, kill me.

The system can't be changed, I know that. I just wanted to offer a glimpse into how it is on the other side.

Spence Kennedy said...

Hi Anon - thanks for commenting. Sorry to hear about your anxiety & OCD. It must make life incredibly difficult. Of course, you always do have the right to say no. If you don't want something to happen, you should stick to your guns and stay put. So long as you're deemed to have mental capacity, and understand the consequences of refusing treatment, there's no reason in the world why you should have it. I think most health care professionals are sympathetic & genuinely keen to help. They wouldn't stay long in the job otherwise! So if they see that you need treatment, they'll always try really hard to persuade you to have it. When you add to that the 'murky waters' of the legal side of Duty of Care, it often makes it impossible to simply walk away. At the very least you'd have to refer up the chain, and get other people involved. And if the treatment is for something serious or potentially life-threatening, that referral could be very positive indeed! Whatever the outcome, though, your understanding & active participation in your treatment options should always be paramount.

I hope you're getting all the support you need, Anon. Please don't be put off by anything you might have read here.

Best wishes

Jim (SK as used to be, until I 'came out'!)