Friday, October 17, 2008

stop the world I want to get off

From the outside, the shelter for homeless people still carries itself with the architectural politesse of the few remaining Georgian houses in this part of town. The elegant windows in the front, the fan-shaped stained glass panels above the door, the simple white columns either side, and the three stone steps – worn in the middle by two hundred years of boots - lead us up into a tougher environment than the architects could possibly have imagined.

The great hall is now partitioned by security-glassed fire doors controlled by buzzers from a grilled and gated office. The walls are white, without decoration. There is strip lighting, fire exit signs, extinguishers. Easy-clean lino with non-slip grips at the danger points. The grand old staircase, still wide enough for a brocaded Georgian day dress, proves just wide enough for a key worker, two ambulance men, a chair and a bag.

‘So what’s the story with this guy?’

‘His name’s Brad but we don’t know too much more about him. IV user, drinker. Came to us late yesterday. Got into a fight outside – in fact, he got a right kicking by all accounts. Had the ambulance out but didn’t go in. Found him this morning incoherent, difficult to rouse. Acting like he’s taken something, but then his pulse is banging away. We were due to evict him for his aggressive attitude.’
‘Is he likely to be aggressive now?’
‘Not in the state he’s in.’
The key worker leads us up the stairs, up past landings that diverge into corridors so numerous it’s like she’s taking us into the heart of a grim metropolitan hive. Brad’s room is right at the very top of the building. I swap a pained look with my partner, Clive.
‘I think we’re going to need the oxygen, at this rate,’ he says.
But we’ve reached the door, guarded by another key worker.
‘Hi,’ she says, pushing it open. ‘Thanks for coming.’
She lets us in to a plain, boxy room with the morning sun blazing in through the sash window opposite.
‘This is Brad.’
Brad is sprawled on a low bed. He has an arm crooked over his face to shield it from the sun, his legs drawn up to his stomach. A blockish, crudely tattooed man in his late twenties, he breaths heavily, and only vaguely bats my hand away when I go to wake him.
‘Brad? Brad? Sit up and talk to us, Brad.’
He grunts and snorts like a tranquilised horse. I lift up an eyelid. His pupil is small, but not pinpoint. His pulse thumps away beneath my fingers.
‘What’s he taken this morning?’
‘We don’t know. Maybe some drugs. We wondered if he’d taken more than he should of his quetiapine. We found some empty packets.’
‘And he was in a fight, you say? Do you know if he was knocked out?’
‘No. Don’t know.’
I study his face. He has some scuff marks on his head and a graze to the side of his mouth, just visible beneath the stubble. He opens his eyes to look at me, but it is the abstracted focus of a sleepwalker.
‘We need to take him to hospital, all things considered,’ I tell them. They seem relieved. The key worker by the bed mimes a little cheer. The one that led us up here says: ‘How are you going to do that, then?’
‘Main strength,’ I say, but without much conviction. ‘Come on, Brad.’
Clive helps me sit him up. I use my body to keep him on the edge of the bed whilst they all make ready for the chair.

Brad has a crude tattoo on his left bicep: Stop the world I want to get off. Both of his forearms are striped with great waxy scars. I can’t decide what would be better: having him conscious enough to walk down but at risk of being violent, or sedated but needing a carry chair. I think the first option would have been better. At least then we could have withdrawn for safety reasons. But Clive has the chair up and ready, so we load him on to it, wrap him in the blanket, strap him securely, and set off on the long haul back down the stairs. The key workers follow, carrying our bag and clipboard.

A couple of times they say they owe us big time as we struggle downwards one step after another; by about the second landing we could tell them the exact weight of that obligation. But we battle on, and make it down to the foyer. They open the doors wide, keep a few early risers away, and then cheerfully walk along with us to the ambulance as we wheel Brad out into the bright and busy morning.


loveinvienna said...

And then you spent the rest of the day with a back which rattled like a set of castanets every time you bent over to do something... know that feeling! I'm not impressed by the other workers, couldn't they have given you a hand with the chair?! I suppose they did carry your bags...

Hope Brad (and you two) turned out the be ok :)

Liv xxx

Spence Kennedy said...

We had quite a few heavy patients that shift. We felt quite punch drunk - & crook-backed - by the end of it.

Don't know what happened to Brad (nothing unusual there!) It was probably an OD on quetiapine - which can give you a tachycardia as well as sedating, apparently.

I think the key workers would've helped with the lift, but it's quite a tricky thing, carrying someone down stairs, especially if they're heavy, so we wouldn't have risked it even if they'd offered. The only time I've accepted lots of help with a lift was getting an unco patient from off a yacht! Eech!



loveinvienna said...

Sounds like quite a story, lifting a patient off a yacht! A future post perhaps? :) Evidently heavy patients are like many things, including buses, you don't see any of *insertthinghere* for ages and then 4 come along at once...

Might want to get off to a physio or osteopath... I'm sure you know that the damage isn't always immediately noticeable but three weeks down the line you'll bend over, something with go *crunch-click* in a most distressing manner and you'll start lurching around like Frankenstein's monster... amusing as this is for various family members, it's rather painful (and embarrassing when you have to go up the stairs backwards) :P Comments such as 'Strike up number two, love' abound...

Liv xxx

Spence Kennedy said...

Yeah - maybe I'll do that one next week! The last couple of shifts have been dominated by drunken assaults, and they blur after a while.

I did see an osteopath last year. It was great, but I used up my 3 free sessions pa, and I'm too tight to fund any more (Headline: Credit Crunch wins over Back Crunch). I love it when they crack your back. It makes me laugh. Nerves, probably.



loveinvienna said...

You're on nights then? :| Poor you. I can see why drunken assaults would blend into one another. A blur of blood and shouts of 'Leev' it, Wayne, 'tain't wurf it!' I'd guess.

I like the headline *snigger* You only get three 3 sessions pa? That's harsh - evidently those who create such rules don't have to lift 21 stone drunks off the floor every shift. Mind you, there is only so much money to go around I suppose.

I uploaded a few photos from my Viennese wanderings a few days ago if you want to have a look :) No pressure, I know you're busy!

Liv xxx
PS. I also like it when osteos crack your back. *crrrrrunch* *blood rushes back to creaky joints* *sigh of relief*. Is a bit nerve-wracking though, especially around the next area.