Wednesday, October 01, 2008


A young man with a fussy beard and chunky media specs waves us over to the entrance. We park just down from it; I follow him into the foyer. He seems upset, which I translate into degrees of seriousness.

The elderly patient is sitting slumped against the wall, his left arm up on a plain wooden chair. He has the lumpish torso and receding forehead of a great silverback gorilla, white-haired and washed out, incongruously dressed in a Hawaiian shirt and nut brown slacks. He opens his eyes and looks up at me when I crouch down to him. I can smell alcohol, but the guy who flagged us down is standing watching over by the facing wall and he still seems very upset, which is puzzling, and makes me question whether this is just alcohol. But then – maybe he’s an unreliable witness and has issues of his own.

‘This is how I found him,’ he says, biting the quick of his finger, his eyes flicking from side to side. ‘Is he going to be all right?’

Another man comes into the lobby, a solid-seeming guy with more to tell us. Our patient’s name is David, and – yes - this is unusual for him. He tells us that David has heart problems.
‘David? Are you in pain? Do you hurt anywhere?’
The massive head pivots slowly on his neck, and his rheumy eyes seem to slide down the inclination. He is definitely very drunk.

‘Why are you people bothering?’ he says. And suddenly a tear runs down his pock-marked nose. ‘Why now? I don’t get it.’

We help David into the ambulance. At one point – alarmingly - he produces a GTN spray and squirts himself under the tongue. But the ECG doesn’t show cardiac distress other than some ongoing problems. He has a bulge under the skin of his left breast, just above the head of a big-breasted tattoo, but he isn’t able to tell us if it is a pacemaker or ICD. He wants to tell us instead about his long life in the construction industry.

‘I ended up in demolition,’ he says, almost falling off the trolley as tries to pull a vast chequered handkerchief from his pocket. ‘I could knock a building down with these arms.’

David seems to brighten up a little with all the attention, but keeps refusing to go to hospital.

‘The last time I went in one of these here fucking ambliences, with one of you lot, I went over boom and didn’t come up for a week,’ he says, almost rubbing his nose off with the handkerchief. ‘I should be dead now. Dead and gone and no bother to anyone.’ Then he stops absolutely still and studies us, frowning hard, as if we were ghosts he’d just shaken out of his handkerchief. ‘What the hell do you want with me?’

We tell him we’re worried about him and want him to be well. We tell him we want him to come to the hospital for a check-up.

He thinks about this, then seems utterly to lose interest. He settles back into the trolley, which creaks horribly.

‘Go on then,’ he says. ‘I’m past caring now. I just want to go to sleep and never wake up.’


Caroline said...

Doesn't it drive you MAD when you only get half a story? Or am I just too nosy for my own good...I want to know what was going on apart from the drink *stamp*

Spence Kennedy said...

Hi Caroline. Sorry to drive you mad. I suppose it's a measure of the job, though. Now and again I'll manage to do a follow-up on the patients we take in, but quite often - because of the presure of numbers / pressure of working nights etc - I forget to find out what was actually wrong with them, and so never do know.

With David, we got him on to the ambulance so we could give him a thorough going over and try to talk to him out of the public eye about what was going on. We only decided to take him in to H when he produced his GTN and took some puffs. Even though he wasn't symptomatic of a heart attack (or much else, to be honest), his PMH was cause for concern, as was the fact that this was unusual behaviour for him - and of course he was too drunk to really say what the problem was. So we took him as a precautionary measure. I'd guess he passed their assessments at hospital, slept off the booze and made his way home in the morning (cursing us). We try not to take people in, but sometimes you have to just to be safe.

I supppose these little vignettes could well drive you nuts! No real endings...

Did feel v sorry for him, though. (But he was living in a nice place, so it wasn't all bad).

loveinvienna said...

Poor guy :( Makes me sad when people just want to give up on life, especially when you can't work out why.

And I'm fine thanks, Spence :) I know what you mean about the paperwork etc getting you down but I bet saving that woman has really put you on the up-and-up :)

Liv xxx