Tuesday, April 08, 2008

man on the verge

The man on verge of collapse is sitting on the steps leading up to the block entranceway, taking contemplative draws on a cigarette beneath the harsh utilitarian lighting. He is dressed in a little black leather jacket, white shirt undone half-way, smart black trousers and leather shoes. He looks about fifty, a squashy, sagging melon of a face, hair as black and slick as his jacket. He looks like Walter Matthau after some bad news.
‘Ambulance,’ I say as we approach, although presumably he can tell by the logos and writing on our jackets. Drag on the cigarette. ‘My name’s Spence, this is Frank. Can I ask your name?’
When I ask him what the problem is, he makes a vague, open-handed gesture around his middle and his chest, and grimaces.
‘When did this all come on?’
‘Three month. One month. I collapse this morning. At the centre. They took me to the hospital. I wait hours and hours. This, then that. I see fifteen doctors.’
‘Fifteen doctors. Paper and paper and paper. No good.’ He mimes tossing paper aside, then takes advantage of this unexpected momentum to reach for a bottle of Gaviscon, which he tries to drink, but finding it empty, lobs into the rhododendrons. ‘No good.’
Seeing the Gaviscon wakes us both up a bit. It’s been the silent witness at too many heart attacks to ignore. But speaking to José it seems clear that he is not symptomatic, and that his problems are more alcohol related.
‘How much have you had to drink tonight, José?’
He shrugs. ‘Two litre? Not so, anyway.’
‘And tell me what happened at the hospital? How come you ended up back here? Did you discharge yourself?’
He shrugs again. ‘Fifteen doctors.’
‘Do you want to go to hospital now?’ I ask him.
‘Yes. I don’t want collapse on my own.’
‘Well let’s go, then.’

On the vehicle we both give up trying to spell his name; he pulls out a wallet as big and squashy as its owner. Behind a laminate screen on the inside of the wallet is an old, full length photo of José, dressed exactly as he is now. He tugs out his EU driving licence from underneath it to show me his name.
‘Are you working at the moment, José?’ I say, sounding more like an immigration official than an ambulance man, but only making conversation whilst I write down all the patronyms.
Again the José shrug. ‘A little. Some week yes, some no.’
‘And you’re going to a centre for help. Is this a place to get help for your drinking?’
‘Yes,’ he says. He leans forward, and looks around the ambulance. ‘I see eh-spiders.’

At the hospital I’m describing my patient to the Charge Nurse when the ward clerk comes over. She says that José was in this morning, caused havoc, falling off trolleys, arguing with staff, wandering off. Eventually he disappeared altogether. But they didn’t think there was anything wrong with him much, apart from stomach ulcers, and a little … she taps her head.

We help him onto a trolley in good view of the nurses’ station. He thanks us for our trouble, and settles down.

Fifteen minutes later, when we’ve had a coffee and are getting ready to go again, Frank comes back out to the ambulance to say that José’s already fallen off the trolley.


Two and half hours later we get details of another emergency call. José’s address. We query it on the radio. Control says that it sounds like the same man but they can’t be sure as he’s difficult to understand. This time he’s presenting with a stroke. We’re duty bound to attend.

At least we don’t see him smoking a fag when we turn into the block courtyard. He buzzes us up to see him. There is no recognition when he answers the door. The only difference to his appearance is maybe one button more undone on his shirt, and his shoes are off.
‘José,’ says Frank. ‘Why are we here again?’
José makes the open-handed sign of sickness over the same area, vaguely his stomach and chest. ‘No good,’ he says.
‘They told us on the radio that you were having a stroke.’
‘Yes. Yes. Eh-stroke.’ He makes the same gesture over his stomach.
‘José – you are not having a stroke,’ says Frank, in the steely tone of a stage hypnotist. ‘I know what a stroke looks like. You are not it.’
‘No. In fact, I have to say José, you look really well.’
José brightens. ‘Really?’
‘Really. So please. Don’t call us out again tonight. It’s busy, we’re tired, and there are genuinely sick people out there who need us. Do us all a favour. Go to bed, get some rest. In the morning, go and see your Doctor.’
‘No stroke?’
‘No stroke. And José?’
‘If you call us out again it won’t be so funny. We’ll call the police.’
‘Oh. Okay.’
‘Goodnight, José.’
As he closes the door I notice the phone in his other hand, and wonder how long before he taps the golden numbers again.


Judith said...

Honestly Spence, I don't know how you do it! Much admiration. Onya, as we say over here ("Good on you"). JB

Unknown said...

"He looks like Walter Matthau after some bad news".


Wren said...

I love your stories about the people you run across in the course of your work. You're an excellent writer; your descriptions are sometimes just breathtaking in their clarity and imagery. Thank you for sharing your talent and your work with us.

Spence Kennedy said...

Thank you so much for all your lovely comments. I really appreciate it.

I started this blog as a writing exercise, but it's had a number of unexpected spin-offs. One is that it helps me cope at work. If I have stressful jobs, I find it helps me stay objective if I'm actively looking for detail. If I'm really tired, and we get a late job that's bound to make us overrun, it helps wake me up if I think 'Well I wonder if this will be one to write up'. For some of the time I think it helps keep me sane. And then another great spin-off is the thought that there are people out there - way out there, in far away places - who are reading what I write and telling me what they think. It certainly is a motivator, feeling that you have an audience.

So thanks again!

Anonymous said...

Another wonderful post. The Walter Matthau description really made sense. I feel that I know exactly what José looks like.

Anonymous said...

We have several 'patients' like this in the area, its like a sixth sense when an address shows up. I don't know about where you work but up here there is a feeling of:

"I don't want to be the Tech/Para who left the drunk at home who was really hvaing a heart attack"

So even though we're encouraged to use our 'clinical judgement' to decide if a patient should go, we take most of them in to fall off trolleys in A&E.

Love the blog!