Wednesday, April 23, 2008

a slow drive out

‘Apparently you’ve got a transfer to Southview for us. A patient Beauregard?’
The charge nurse suddenly looks up at me with a thousand watts of attention. Worryingly, she stands, walks around the desk, grabs me by both shoulders and holds me at arms length.
‘God. Jesus. Yes. Thank you so much. Now then. She’ll tell you she’s injured but she’s not. She’ll tell you she’s been in umpteen traffic accidents but she hasn’t. She says she can’t move, but even though she’s perfectly mobile, please, please, please treat her as if she can’t and pat slide her slowly onto your trolley. She’ll throw herself on the floor if you don’t. She’s had all her medication – don’t listen to her. Her brother Ken’s with her and he’s okay, so follow what he says. She’s taken everyone’s name in here, threatened us all with the police, so don’t worry about that. She’s very volatile and she may well try to pinch or slap you, but I don’t think she needs a police escort. Ken seems to have things in hand. Follow him. Strap her into the trolley. Drive slowly. God. Thank you so much for taking her off our hands.’
‘Is this a compulsory section?’
‘No – it’s voluntary. But best not talk about it overmuch.’
The charge nurse leads us to a cubicle with all its curtains drawn. She gives me a preparatory over-the-shoulder look – one part showman, two parts executioner – then draws the curtain back.
‘Ah. There you are. Look. I’m really not at all comfortable. My legs are swelling up. I have dangerous sensations in my arms and my back is an utter nightmare. Why aren’t you giving me the medication I need? Why are you torturing me like this? I don’t think you can be aware of the extent of my condition.’
Mrs Beauregard reminds me of one of my primary school teachers. She has the same high manner, the same great jowls of indignation, but behind the lenses of Mrs B’s thick glasses, her eyes seem painted and flat.
‘This is the ambulance crew who have come to take you to the other hospital we talked about.’
Mrs Beauregard scans us vaguely, then plucks at her blankets.
‘That’s all very well – and I’m happy to meet you – but this isn’t addressing the central question. I am suffering. I am in considerable pain. And you don’t seem in the least bit interested to do anything about it. I know what your name is and I know what you’re up to. I’ve taken note of everything that’s happened here today, and I shall be contacting the police, my MP, the papers. It pains me to say it but your career is effectively over.’
‘Obviously you are entitled to say whatever you like about the treatment you’ve had from us today. I’m confident that it will show a proper level of care.’
The charge nurse introduces me to Ken, who is sitting surrounded by bags on a hospital chair. As he stands up, it seems inconceivable that he is related to the woman in the bed. The vigour of his handshake, the warmth in his eyes, even the care evident in his closely-trimmed white beard – whilst her illness has leached something intangibly connected from Mrs Beauregard, her brother looks at us with a grounded smile.
‘Hello,’ he says. ‘Thanks for coming so quickly.’

Despite taking as much care in the transfer from the hospital bed to our trolley as we would for a critically injured patient, Mrs Beauregard provides an awful soundtrack of yelps, shrieks, urgent instruction, threats and pleadings.
‘My back! My back! Good God Alive! You’ll paralyse me! Don’t you care? Can you be so cruel?’
Once we have her on the ambulance trolley, and Ken collects all the bags together ready to go, Mrs B gives us some more information.
‘I don’t know if you’ve been made aware,’ she says, placing her hand on my arm, ‘about my eye condition? As a result of the last road accident, my retinas have become detached, and pressure has built up dangerously behind the eye. It’ll be in my notes. Is it in my notes?’
I look across to Ken and he raises his eyebrows.
‘Let’s have a look at that on the vehicle,’ I say to her. ‘The sooner we make a start, the sooner we’ll be there and you can have a rest.’
‘No. You don’t understand. Why should you? The nursing standards here are execrable. No. Listen to me – and do not move until you have this perfectly understood. My eyes are in a fragile state. The slightest wrong move and I will be plunged into darkness. I cannot be subject to any untoward movement. I cannot be driven above twenty miles an hour. Any faster and I will jump out of the vehicle. Do you understand? I shall go blind.’
Ken puts the bags back down and steps over to his sister.
‘Dorothy,’ he says, stroking her forehead. ‘Dorothy. Try to relax. This is an experienced crew. They know what they’re doing. Let’s just get going and make the best of it.’
‘I hope they do know what they’re doing,’ she says, releasing my arm. ‘If they do, it’ll be a first.’

The journey to Southview is an extended version of the transfer from bed to trolley. Mrs Beauregard instructs and screams and threatens and reaches across to slap me, whilst Ken does what he can to pacify his sister. At one point, in an effort to introduce some rational understanding of her situation, I decide to see if Mrs B knows where she is going; this is supposed to be a voluntary admission, after all.
‘Dorothy? Do you know much about Southview?’ But when I glance at Ken, he shakes his head discretely. I decide not to pursue that particular line, and settle back into my seat.
‘How can you be so cruel?’ says Dorothy, fixing me with a watery stare. ‘When I first saw you I thought you seemed kind, but now I see you for what you are. A cruel and petty man.’

At Southview we are faced with a practical dilemma. The trolley will not fit into the lift, and there are no chairs. Mrs Beauregard can barely interrupt her monologue of threats to think about the problem, so I leave her with Rae and Ken and set off to muster some help from the ward.
The psychiatric nurse who comes down with me listens to my description of Mrs Beauregard with a battle worn air of detachment.
‘We don’t need a chair,’ she says. ‘Come on. We’ll do this quickly.’
I’m encouraged; she seems a formidable ally, with her pile of henna red hair and her orange lipstick, a vivid specialist who’ll know how to trot this one out.
Unfortunately, back down in the lobby, it appears she has no magic formula. We’re left to wrap Mrs Beauregard in blankets, slide her onto the ambulance carry chair, and wheel her up to her bare little room, all within a storm of sound that echoes about the resoundingly empty corridors.

Whilst the psychiatric nurse and an orderly settle Mrs Beauregard into her room, Ken steps outside and thanks us for our help.
‘Don’t worry about anything she said to you. It doesn’t mean anything. It’s just her illness.’
For the only time that night I’m able to ask him a little about the situation. He tells me that he has two sisters. The eldest sister is already in a special unit; Dorothy started showing similar symptoms about a year ago, but this is an acute deterioration. In neither case can the doctors pinpoint an organic cause, and there’s no history of it in their parents or other relatives. Ken lives abroad, and flew back yesterday to oversee things.
‘Good luck with everything,’ I say to him as we gather up our chair and blankets. ‘I hope it all works out.’
He waves to us from outside the room, steps back inside, and the door closes on Dorothy’s booming complaint.

We wait by the security door to be buzzed out.


Anonymous said...

How absolutely horrible. I wonder is it "monkey see, monkey do?" - or some bizarre genetic quirk that only affects the sisters?

Really horribly creepy, whatever the reason

Unknown said...

you seem to get all the "interesting" transfers

from an ex-psychi nurse.

Spence Kennedy said...

Thanks for your comments.

Deborah - Of course, you only ever get to see a small part of the overall story, so you never know enough to really tell - but I would have thought that there must be an organic reason for her illness. It certainly presented as some form of dementia.

Ian - At one point I used to look forward to psych jobs. I used to think I was quite good at them, and made the patient feel calmer. Now I'm not so sure. I seem to have had a run over the past few months of patients looking into my eyes and saying I was evil, or producing blades unexpectedly. One case recently insisted I leave the room. I think respect is due to you for working in the field. I know it's an area I would struggle in.

Anonymous said...

You're a brave man Spence! I work on an IT helpdesk, and strangely that lady's endless tirade sounds exactly like two of my regular callers!
Been reading for a number of months now, I really like your style, it's riveting stuff. Good work chap.

mumof4 said...

Wow - I don't envy you that transfer but nor do I envy the brother having to witness the illness for a second time around. I hope the poor woman gets the help she needs.

Judith said...

I love the part about the charge nurse clasping you by the shoulders, I'm surprised she didn't kiss you! But OMG, poor Ken. And poor Mrs B & her sister -- yes, horrible and creepy.

uphilldowndale said...

Sad, you just wonder, how much they themselves, understand/know about what is happening to them.

Anonymous said...

How utterly sad. Imagine being absolutely convinced you're physically falling apart and nobody around you seems to care. It must be so frightening.

McNoddy said...

Got to you via uphilldowndale. You might want to comment on this and link to me - you are on my sidebar!