Wednesday, March 12, 2008

the voluntary visitor

The door opens a crack and a wizened old face peers round.
‘Ye-es? Who is it?’
‘It’s the ambulance.’
‘Oh. I suppose you’d better come in. She’s in the front room.’
There are three of us; Eric pulled up on scene in the car at exactly the same time, so we are two paramedics and a technician – the ideal team for a resus. We busy in with all our bags like champion shoppers home from the sales.
‘I’m afraid I’m no use to you,’ the old man says. ‘I’m blind, you see.’
I ask him to take a seat in the kitchen whilst the other two dump their bags around a female figure prone on the carpet.
I help the man sit on a wooden yellow chair. I ask him what happened.
‘Absolutely no idea. One minute she’s talking about roses or something – could have been box – no, definitely roses, because I remember…’
‘Sorry to interrupt, but I just need to know what happened to your friend.’
‘She is not my friend. She’s a voluntary visitor. I had nothing to do with it.’
‘Okay. Whoever she is. Did she complain of feeling unwell? Did she cry out? What happened?’
‘As I was just explaining to you – we were talking – she stopped – I asked her what she was doing – she fell out of the chair. I couldn’t do anything as I’m blind, you see. So I called you. And there you are.’
He places his left hand on the melamine tabletop and touches a wristwatch with his right.
‘You won’t be long, will you? She was only supposed to be here for half an hour and it’s already a quarter to.’
‘We’ll certainly be as quick as we can.’
‘Do I just sit here then?’
I tell him I’ll be back with an update in a few minutes. He sighs as I hurry out.

Back in the sitting room, Eric and Rae have turned the woman over, cut her top off, stuck defib pads on; Eric is cannulating whilst Rae compresses her chest. I join in, prepping drugs, helping Eric intubate, taking over the compressions. The woman is only about sixty, fit and trim. She has no health bracelets or anything on her that suggests any kind of illness.
After ten minutes of The Works – fantastically – we have plumped her up into a shockable heart rhythm. Two zaps later and her heart is beating again, and she is making some respiratory effort. Whilst Eric and Rae continue treating the woman, I set to making ready our escape.
The front room is tiny and cluttered with years of accumulated junk. There is barely room for us to work around the patient, but getting her out horizontally – to maintain what feeble blood pressure she has at the moment – is going to be a challenge. I clear as much of a space as I can, dumping an antique rocking-chair onto a settee, nests of tables and footstools onto the sofa, pushing the magazine racks, piles of books and the television as far as I can into a corner. Eric and Rae are already zipping up the resus and drugs bags; I pick them up and haul them out to the ambulance, which I prepare for take-off. I unload the trolley and make it ready just in the street by the front gate, then come back into the house with the orthopedic stretcher. The plan is to scoop her up on that, manoeuvre her through the sitting room door and tiny hallway out to the trolley.
It all goes to plan, although it is a struggle in such a confined space. We have her out on the vehicle pretty quickly. She still has an output, and I hurry back inside to gather the last of the bags and to tell the man what’s happening.
He’s still sitting at the kitchen table.
‘I’m afraid we’re going to have to hurry away now. Your – er – the woman – is very unwell and needs to go to hospital right away.’
He turns his face up to me, rucked up and livery with discontent.
‘First you must put my room back exactly how it was.’
‘Sorry,’ I say, ‘We really have to go.’
I can feel his outrage boring holes in my back as I shut the front door.


BenefitScroungingScum said...

Oh dear. So much badness on so many levels! BG

Anonymous said...

If he was blind wouldnt moving all his possessions around make it the equivalent of dropping him into a brand new house, where he didnt know where anything was, and then leaving him to walk and fall over/hit into things? I would imagine that it would be very distressing for him. I understand that the woman needs to be admitted asap, but I think you may have missed the point about why he said that. There are 2 people in need of 'duty of care' in this scenario, just because he sounds like he overcompensates for his disability through arrogance doesnt mean he doesnt require some help as well.

Spence Kennedy said...

I accept what you're saying, Anon, and in retrospect I think there was a lot more I could have done for him. If I'd have been thinking more clearly after we'd cleared up at the hospital and the excitement had eased off, I could've mentioned his dilemma to someone - maybe contacted social services and made sure that someone could go round and sort him out. But that's hindsight. At the time, we were 100% focused on the woman who'd arrested. I mean, to be blunt, she'd just died, and we were her last chance of life. So whatever else presented itself to us, she was our priority. We certainly didn't have time for anyone to stay on scene and put his room back together.

If I'm brutally honest - which is always a dangerous thing, especially with people you don't know - I'd say that the guy didn't strike me as particularly likeable (subjective, I know, but there you are). And it's often the case that you do more to go out of your way to help people if they're just polite, or reasonable, regardless of their circumstance.
But I appreciate your comment - and thanks for reading the blog (warts and all)

Canadian Girl said...

While I understand that moving the furniture in a blind man's room makes life difficult for him, I'm astounded by how self-centred that blind man is. How can you witness someone's cardiac arrest and resuscitation and still care about the location of your rocking chair?

michaell said...

I was going to say something similar to anon... I can certainly see your point - your job is to try and save the life of the person you have been called to. On the other hand, it should be somebody's job to look after him as well - probably social services, as you say, but they'd probably claim it should be someone else's job as well, if they could get away with it...

Anonymous said...

Tough call.
But probably the right one.
She had a good chance, and needed you all (and quickly!)if she was to maximise on that chance. He'll get a few knocked knees and a voyage of discovery in his own home - but he'll be ok.

Some people learn their helplessness - and its fairly common. Its quite amazing to witness.

Mart said...

I agree your priority is the resus, however, there were 3 of you, a crew and a car. Now to me that says that either 3 of you are going to travel in the ambo (1 driving, 2 in the back - ideal for a 'big sick' patient)so therefore after you have handed over and cleared up the mess at the hospital you are going to have to drop the responder off back at scene to reunite with their car and could quickly rearrange the furniture then, I'm sure a quick word with control and they'd be happy with that.

Or, if only the crew travelled in with the patient then the responder could spend a few mins rearranging things.

Like you say easy to do with hindsight.

Is it a possibility that the blind chap hadn't realised how serious the situation was?

uphilldowndale said...

Being disabled doesn't preclude any one from being a grumpy old fart, nor does it excuse them, that said it must have been pretty disorientating for him, having witnessed something similar, I am trying to think what it would be like if I couldn't see what was going on and its not a nice thought. As time was the very thing that was needed most and least available it's a no win situation.
You just have to hope some was available to help him afterwards, but by the sounds of things, it would need to be paid help, he doesn't sound the sort of guy you'd go out of your way to help

Spence Kennedy said...

To be honest, we were so focused on the woman we didn't pay the guy much attention. He wasn't sick, he wasn't vulnerable or in danger, he seemed emotionally 'contained' - so we devoted all our attention to the woman who'd arrested. It’s probably true that when we got a viable output from her, we became rather ‘blinkered’, and focused entirely on getting her to hospital alive.

I suppose it's worth pointing out that she was visiting in a social capacity. The blind guy seemed to be entirely self-caring, fully mobile etc. It looked like he'd been taking care of himself and coping at home for some time; she was there in a 'befriending' capacity.

I know it all sounds like an excuse, and I suppose in many ways it is. In retrospect we could have spared Eric on the car to stay on scene and tidy up, but it didn't occur to us to do that. He followed us back to hospital in the car and helped us carry on into resus.

The old guy was curiously detached from proceedings, and it seemed something more than a confused kind of remoteness - more a kind of extreme self-interest. But often it's the case that we're surprised by people's behaviour and never know the reason.

I’ll try harder in future to see the bigger picture, but I know that I’m as influenced as anyone by appearances, perceptions, the things that are said or not said. It’s quite a task, to stay objective when there are so many distractions, but that’s all part of the job and part of the challenge of learning from each experience. One of the reasons I like writing the blog is that I can pick out different experiences and think about them in other ways than simply another anecdote: ‘…and then the guy turned round and said…’ Real voices in real situations, for better or worse!

Thanks for all your comments.


uphilldowndale said...

'a kind of extreme self-interest' some conditions on the Autistic spectrum can appear like that, maybe he had more than one disability.

Thanks for sharing your writing, you've got a gift for showing the nuance

Anonymous said...

I am finding it difficult to believe that you'd prefer a paramedic to spend time rearranging someone's rocking chair, rather than assisting during a resus.

I think a sense of perspective is needed here - a diagnosed cardiac arrest against some possible knocked knees. I know where I'd rather the help.

Anonymous said...

Rather late to comment I guess - just found the blog!! BUT - if he was totally blind but coping it was probably entirely due to the fact he knew exactly where everything was and could navigate from piece of furniture to piece of furniture. And not knowing where something was could actually have led to another call for an ambulance because he'd fallen and damaged himself to some degree or other. Try closing your eyes tightly and walking around and see how you feel. I imagine, too, that blindness and total deafness both may result in a withdrawal from interaction with the outside world eventually - and result in the "me" focus. And he couldn't have seen what was going on, missing the urgency of the situation for her.
You said he wasn't vulnerable - he was even if not in the "vulnerable adult", fill in the form sense. I'm not saying your action in making her the priority was wrong, no way. BUT ...