Friday, September 12, 2008

the jacket with the bible in it

We don’t need satnav on this one. I used to live in this part of town and I know the street well, an early Victorian terrace with brightly coloured houses packed together like fancy cakes on a shelf. The street has managed to hang on to some cute period details, stretches of raised pavements, cobbles, and intricate patterns of bricks dividing up the road, the nineteenth century equivalent of speed humps. And still determinedly flying its pub sign, a tiny drinking den squeezed into the middle of the row, last serving survivor of a dozen or so in this stretch alone.

The job is given as a forty nine year old male with haemorrhage/lacerations. The follow-up notes tell us that the guy has started bleeding from a burst blood vessel in his groin. The lighting in this street is poor, but we still make out a man flagging us down a little way ahead. He stands waiting by the kerb, and as we draw level with him he pulls out his iPod earphone with a sigh as audible as the electric window Rae puts down.

‘He’s over on that wall’, he whispers, but looks the other way down the street. ‘I guess he’s been doing something he shouldn’t.’
‘Sorry? I didn’t … what did you say?’
‘Who knows? Drugs, maybe? Anyway – he’s on the wall and he’s bleeding a fair bit. That’s it.’
‘Okay. Thanks for your help.’
He nods without commitment, reattaches himself to the iPod. It seems to steer him away into the gloom.

I grab a dressings bag and we walk over to a man who is sitting on a low brick wall with his trousers down by his ankles, one hand pressing a towel into his groin and the other keeping him propped upright. There is a substantial course of blood running from underneath his boxer shorts, across the pavement to the gutter.

‘I injected into a femoral vein yesterday and it’s just gone on me,’ he gasps. ‘Don’t forget my jacket. It’s got my bible in it.’

In a few minutes we have him on the truck, his legs raised, three dressings binding his leg, oxygen flowing, connected to various monitors. I hand Rae a cannula.

‘You’ll not find a vein,’ he tells her with a ghastly smile beneath the oxygen mask, but says ‘Fair play’ when she does. We set a bag of Hartmann’s running.

He watches everything with a grim, glistening detachment.

‘Don’t think bad of me. I’ve got titanium plates in my back. Five, six, seven and eight. I can’t bend my knee. I could tell you a few things about pain, mate. I quit the smack but, fuck it – things, you know? Beyond my control. I was clean for years. But then – don’t ask – it’s big, big, unreal. Another time, mate.’

He pulls off the finger probe and produces a packet of tobacco.

‘I need a smoke, mate.’

We stop him from smoking.

He absorbs that.

Rae takes the clipboard, jumps out and slams the door behind her. I hear her give the ASHICE in the cab.

‘Have you got my jacket?’, he says, raising his head up, pulling the mask aside and looking around the bloodied compartment like a man suddenly conscious in the middle of a dream set in a butcher’s shop.

‘I can’t lose that, mate. It’s got my bible.’

I hold up his jacket, a dirty brown corduroy sack, heavy with stuff. He sighs and replaces the mask. Rae passes the board back through to me. We set off in a rattle of blue.


Anonymous said...

Yes mate I do work in LAS control, you sort of got me the job, I used a piece of work you helped me with during my interview.

It's a shame about this guy, he must still be clinging to hope if he carries the bible, I'm not a believer but I really hope it pays off for him eventually.

Mary said...

Was it actually a bible? Or was it a stash book?

Spence Kennedy said...

It would've been interesting to find out - but those were pockets you'd really hesitate to look in!

Anonymous said...

I didn't think of that. Another bruise to my faith in humanity.

Patrick said...

It's been years since I heard the term "Hartmanns solution". Do you really use Hartmanns, or is it Lactated Ringers?

Spence Kennedy said...

Hi Patrick
Yep - still use it. I'm not an expert on fluid replacement, other than the basic crystalloid / colloid difference. I thought Hartmanns was pretty much the same as Lactated Ringers?

With this guy, we were only about 5 mins from the hospital, so we thought a brisk 500ml challenge of Hartmann's was good enough to start with.

Where do you work?

Thanks for your comment!

Caroline said...

I hope it was a bible - not my thing as such but he sounds as if a bit of hope in his life wouldn't go amiss

loveinvienna said...

Poor guys, he must have somehow got lost along the way :( Horrid as it sounds my sister and her colleagues avoid touching addicts when they come into the MAU as they never know what they might find. Sad, isn't it?

Just letting you know I'm still alive and in love with Vienna :D Im on a friend's laptop as mine will be arriving in about 2 weeks :)

Liv xxx

Spence Kennedy said...

Hi Liv,
You're right - you have to be so careful when you're handling IVDUs. A friend of mine got a needlestick injury the other day and is now in the middle of his PEP treatment... Hideous.

Glad everything's fine with you and you're finding your feet in Vienna.