Friday, January 11, 2008

deus ex machina

Act One: We take a call to a man collapsed in the street. The location is given as o/s Co-op beside bench – and this is enough to tell me that Michael has made it up town again.

Michael is in the Top Ten of our regular callers. I know all his details off by heart; I hardly need ask him any questions at all these days. Fifty-seven years old. Suffers from Motor Neurone Disease and alcoholism, is (approximately) mobile with a zimmer. Once a week he will buy a packet of sandwiches, some crisps and a bottle of vodka, drag himself either to the bench in front of the Co-op or a bus stop outside the railway station, drink the bottle of vodka, eat the sandwiches and fall to the floor. His difficulty in speaking is made worse by the alcohol, of course, and by the vast, twiggy hedge of a beard that obscures the lower half of his face and the top half of his body. He can be aggressive, but the punches, should he be in a bad mood and throw one, are like his words – without focus or real intent. He tries his best to insult you. The swear words come spittling out through his crooked yellow teeth, and his eyes flicker from side to side.

A teenager waves us over to the bench and I can see – yes – it is Michael lying there. Today he is wearing pyjamas under his ex-army greatcoat, which is a variation. I thank the boy for calling us, and then we set to picking Michael up and on to the bench. Rae fetches a blanket from the vehicle and drapes it over his shoulders. He sits Rae like a doomed prophet, white robed and bearded on the bench, grinding out his profane prayers to anyone close enough to listen.

And so we face the usual problem. This is not a medical emergency. This is really a matter for the police – drunk and disorderly. But we know that if we request the police via Control, we could be waiting here for a long time. And if Control let the police know who the patient is, we could be waiting here for ever. But the other option of a trip to hospital and a seat in the waiting room until such time as the patient sobers up and makes his own way home – well, this has been done so many times in the past, I’m worried that the A&E charge nurse will have security throw us all out. However, if we leave Michael here as he is, he will only fall over again, someone else will call for an ambulance, and resources will be tied up even more. So, making the best of a rather tedious job, we decide to take him in. When we get to hospital I talk up the fact that Michael was borderline hypothermic. The charge nurse gives me a look that even the most optimistic interpretation would be: ‘I’m watching you’. But they accept him. What else can they do? Michael has a social worker, and various carers have tried their hand and left in tears soon after, but short of a miracle, or a ball and chain, this expensive routine looks set to play over and over without relief for years.

Act Two: A week later we take a call to a man collapsed in the street. The location is given as o/s Railway station, bus stop. Rae says it’s Michael, but I say I’m not so sure. I say I have a feeling that this will be a resus in the street. I snap my gloves heroically. The station comes into view. It is Michael. Two off-duty nurses have called the ambulance. One of them even works in A&E. ‘What else could I do?’ she says, helplessly. And this is, of course, the problem. We take him in without even considering the police, as he seems less responsive than normal. But all his observations are fine. We pass him on a corridor trolley throughout the day as we come and go in the hospital, snoring.

Act Three: Two months later we take a call to a man collapsed at home. The call has originated from social services, and the address seems familiar. Neither Rae nor I have been there before, but it just seems to ring a bell. As we turn into the courtyard of the block of flats, Rae says: Michael. Of course – and then I think: This is a first, collapsing at home. We jump out of the vehicle and go over to the two people standing by the door. One is a carer, and the other is a manager from Social Services.

‘The last contact we have with Michael is two weeks ago,’ says the manager, fiddling with a knob on her radio. ‘I’m just waiting for someone to get back to me about key holders. But the police should be here soon.’

The carer tells us this is her first day. She says she knocked on the door, looked through the window, but then wasn’t sure what to do. She bites the quick of her thumb. ‘He’s supposed to be here.’

Rae gets on the radio and tells Control the situation. I have a look through the window but a filthy set of curtains hides everything. Rae comes over and says that Control have given the go-ahead to break in, and confirms that the police will be here in about five minutes.

I love pushing doors in. It’s a perk of the job. I draw myself up and back, and then give it a good kick. It bows impressively. On the second kick it flies backwards in a satisfying crack of splintering wood, and we go in. The smell wraps around us along the filthy hallway before we see the legs just poking around the side of the bedroom door. He is lying on his side on the floor. He has been dead for some time – at least for the two weeks the manager mentioned. If the flat had been properly heated the smell would have been a lot worse, but as it is, Michael has been doggedly pursuing the various stages of decay, as slowly but inevitably as his shuffling walk up town with the vodka and sandwiches. The social services manager has followed us in with her radio crackling loudly, but she about turns and strides back out with an ‘Urph’. We follow her. Back outside in the yard the carer asks me: ‘Is he all right?’ and I tell her that unfortunately, no, he’s died. A police car turns into the yard. The carer says: ‘What do I do now? This is all new to me.’

I tell her, I’m as surprised as she is.


Unknown said...

I've just found your blog from New Naw and I must say it's great reading.

Spence Kennedy said...

Thanks v much, Greg. It's great to have feedback. I'm glad you like it!

Ben said...

Wow! Seriously impressed by your posts! Nee Naw pointed the way here and im glad he did. Im a student Paramedic so love reading about the profession, and hearing about the things I've to look forward to :)

pandop said...

What Greg said.

Situations like that are so difficult, as sometimes there are so few options available.

Spence Kennedy said...

Thanks, Ben. Good luck with the paramedic studies. I'm looking forward to re-training sometime in the next couple of years (it'll give me time to really settle into the job, plus allow for the management to sort out courses - at the moment all the training seems a bit ad hoc in the south east!)
Hazel - we've got at least twenty people we see regularly, a combination of drink, drugs, OD attempts, social/psych problems and a combination of the above. Some of them are flagged, and control only allow them one call a day (unless it sounds v out of the ordinary), but lots of them aren't. It's difficult for control to triage/psiam them, so all we can do is go out and see if we can dissuade them from travelling. But it's incredibly frustrating. Thanks for reading the blog, btw.

Steve said...

Good blog - I'm amazed I haven't been pointed to it before. Like the others, came here from NeeNaw.

I'll add a link to you from my blog.

Spence Kennedy said...

Thanks, Steve. Ever since Mark put a link to Siren Voices on nee naw, I've had loads of new people coming to the blog. It's great! What's your blog, btw? S.

Shade said...

Another one linked from NeeNaw. Read a number of your posts - brilliant writing, do keep it up!

I have a friend who's a student paramedic and various family members in various medical professions and I do a bit of voluntary first aid myslf but I am always endlessly impressed at how ambulance workers deal with the massive range of situations they come across - respect to you for doing a job that so many need and so few appreciate!

Spence Kennedy said...

Thanks, Emily.
Sometimes when I'm doing the job it feels like I've got one of those 'Access all areas' backstage passes swinging round my neck! One minute you're dealing with a collapse in the boardroom, the next, you're mediating in a domestic dispute in an S&M club. The variety is fantastic. I've worked in lots of different situations, and for a long time I wondered if I'd ever find anything that would last me more than a couple of years. But this is great! (Perhaps it's just a sign that I'm nosier than I realised).

Thanks for reading blog.
Best wishes, S.

Unknown said...

Another one over from Neenaw. Absolutely fantastic stuff. Read the whole lot in one sitting (perhaps I need to get out more?). Keep up the good work.

Spence Kennedy said...

Thanks, v much, K. For quite a while I've been keeping up this blog more for writing practice than anything - but now I've started getting feedback, it's given me a whole new perspective on the thing!
And I really feel like I owe Mark (nee naw) big time for linking to me! Anyway - thanks again. Regards, S.

BenefitScroungingScum said...

I'm another one who's found you via NeeNaw. Your writing is excellent. Bendy Girl

Spence Kennedy said...

Thanks, BG! And at the risk of this sounding like a love-in - I read your blog and really enjoyed it, too! It's lovely, warm and funny, so I hope you don't mind if I put a link to it on my site. BTW - about your accident last August: you needn't have worried about calling the ambulance. You definitely qualified that time - what we'd call a 'genuine job'. Hope youre fully recovered now. S.

BenefitScroungingScum said...

Thank you Spence, I'm blushing now! I'm always so pleased when people say they like my blog, it's funny isn't it the way we all feel about our writing?!
I'm all recovered now thanks..well, until the next lunatic accident anyway! TY for the link to, I'm going to put one up to your blog on mine. BG

Anonymous said...

Hi Spence,

You're a smashing writer. If you don't have a book deal yet, give it a minute or two. So many blogs ride on the inherent interest value of their content, but I think you could make a haunting post out of drying paint. Consider yourself bookmarked and loudly spruiked to anyone who'll listen.


Spence Kennedy said...

Thanks v much Nicole! It's really kind of you to make such an encouraging comment. I owe you!

BTW - had to look up 'spruiked' - what a great word!


Anonymous said...

guys and gals you do a fantastic job and as a nurse i know its never easy really get a good laugh from your blogs so keep it up.