Wednesday, February 23, 2011


This housing estate is as real as a theme park, verges efficiently lain in squares, saplings with their labels showing, sleek, low mileage cars parked according to contract in sleek, low mileage bays. The map book is way out of date, but even the Sat Nav does not recognise the place; according to the screen I’m floating in a grey zone. I slowly drive the ambulance four by four towards the chequered flag around an intricate network of roads, cul-de-sacs and roundabouts so confusingly run together that you can probably only get the picture and sense of it all from the air - a giant chameleon, with its tongue extended. All the houses are dark and sleeping except for a few solar garden lights at jaunty angles in the grass carpeting out front, and the occasional stab of yellow behind an upstairs window. But here is a house with its uPVC door ajar and an elderly man raising a hand. I park up, grab a bag out of the back and head over.

Mr Muir is as carefully put together as the estate. His scarlet woollen jersey is shop-sharp, two neatly pressed shirt cuffs at his wrist, the crease of his linen slacks aligned with the centre of the crosses of his laces, his silver moustache clipped to the lip and his hair as buffed as the silver top on an antique box.
‘I took her pulse, which felt rather light and fast to me. But see what you think,’ he says, quietly closing the door behind me. ‘This way.’

He seems to move without making contact with anything, leading me up a pale carpeted staircase to a landing plumped out in creams and whites, past a Japanese bamboo print and a tall white biscuit vase filled with cracked willow spray painted silver, to a small and superheated bedroom.

Valerie, his middle-aged daughter, is lying on her side on the bed. She raises her head and smiles thinly as I put my bag and board down and introduce myself. Over in the corner, Lisa, her twenty year old daughter, shifts palely on a black velvet dressing stool. Mr Muir follows me in, then rests against a white veneer chest of drawers and examines his cuticles as I ask the woman what the matter is.
‘I’ve been getting this pain,’ she says, ‘all over. My neck, shoulders, into my arms and hands. My legs.’
Mr Muir clears his throat.
‘What would it take to get a scan done?’ he says. ‘We’ve had an x-ray but the doctors said it didn’t show anything.’
‘Tell him about the faint,’ says Lisa, chewing her lip. ‘Tell him what happened.’
‘Did you faint then?’ I ask, kneeling down and feeling her pulse.
‘I went dizzy, yes. There were these white spots, moving around.’
‘But did you actually pass out?’
‘No. I didn’t pass out as such.’
‘And this pain. How long have you had it?’
‘About three years. I wish I knew what it was. The doctors don’t seem to have an idea. I think they think I’m just some hypochondriac and they wish I’d leave them alone.’
‘So have you had any new pain tonight?’
‘Well it’s been getting worse and worse. I can’t do anything.’
‘Over what period?’
‘Three weeks or so.’
‘And does your doctor know about that?’
‘I don’t think he cares.’
‘You can’t go on like this, mum,’ says Lisa, sitting on her hands and chewing her lip. ‘You just can’t.’
Mr Muir stands more upright.
‘How is her blood pressure? Would you be able to find that out for us?’
‘Of course. I’ll run through the usual checks and see where we are.’
‘Because I wouldn’t mind betting it’s low. What do you think about her pulse? I thought it was dangerously thready.’
‘No. It feels pretty good to me. Regular, not too fast. Pretty good.’
‘Really? I am surprised. You’re sure about that? It definitely felt off to me. But I suppose you know best.’
‘Let’s do the checks and see what’s what.’
Mr Muir and his grand-daughter watch me carefully. I ask question after question, as much to lighten the atmosphere as anything else, but my efforts sound thin and unconvincing even to me, the soft furnishings absorbing my bonhomie as ruthlessly as the acoustics.
‘It all looks fine,’ I say, curling up and stowing the stethoscope, wishing I could follow it into the bag. ‘So now we need to think about what to do next.’
‘This can’t go on,’ says Lisa. ‘You’re not well.’
Valerie props herself up on one arm and flashes her daughter a look. ‘What can I do? No one seems to believe that I’m ill.’
‘Are you sure you wouldn’t be able to get her a scan? Wouldn’t that show if a nerve was being impinged in the neck? Or anything else? I mean – what can be causing all this?’
‘As far as the faint goes, it’s not uncommon for someone to be sitting down in a hot room then feel light headed when they get up. You didn’t pass out, you haven’t had any new pain – and you’ve recently started some strong pain killers, which might be making you drowsier and more susceptible to this kind of thing. I think it would be as well if you went back to see your doctor about how you’re feeling, but I don’t think you need to go rushing off to hospital tonight. I don’t think they’re in the best position to help.’
She lies back down and drapes a hand across her forehead.
‘It just goes on and on.’
‘If you’re not happy with your doctor, you could always change.’
She glances at me from beneath her hand.
‘Really? Do you think? How?’
‘I’m not sure. But you’re perfectly entitled to see someone else.’
‘And have him ring up the new chap and say: “Watch out for this one. She’s a waste of time.”’
‘I’m sure that wouldn’t happen.’
‘Are you?’
‘It shouldn’t happen.’
‘Well, there.’
Lisa sighs. ‘Go to hospital and get a scan.’
‘They won’t be doing any scans tonight,’ I say to her, as pleasantly as I can. ‘Your doctor will refer you if he thinks it’s called for.’
‘But it takes ages. Months and months.’
‘Not so long as that. And if they think it’s urgent, they’ll work one up right away.’
Mr Muir clears his throat.
‘My wife went to the doctor with shooting pains in her leg. He said it was muscle strain and sent her off with pain killers. Three months later she was dead. Riddled with cancer. If they’d taken action sooner, she might have lived.’
‘I’m sorry to hear that.’
‘”Just muscle strain”, he said. “Take these”. Three months later she was gone.’
‘How awful.’
‘You must get this sorted, mum,’ says Lisa. ‘Please.’
The room is silent for a moment. Valerie almost seems to fall asleep. But then suddenly she opens her eyes again, and as the brightly enamelled radiators quietly click and the night presses up against the window, she studies me from where she lies, glittering darkly against the pillow.


Salty Letters said...

Again, a great story.

Crosby Kenyon said...

I enjoy the detail you provide. It's fun being taken into the scene. This piece points out the sometimes nebulous nature of "illness." Also, as a writer, I can't help let my imagination run a bit: "The Ghost and Mrs. Muir" comes to mind, only here it's Mr. Muir and in the end his wife, Valerie, glitters "darkly against the pillow." I really don't mean to make light of the poor family's concerns--it was very real to them. Nice post.

BB said...

It absolutely amazes me how some people accept what they are told and don't think to find another doctor. I wouldn't stop till I find an answer.

Unknown said...

It seems as though a physician and a therapist might be in order on this one. Valerie may be suffering symptoms based on the facts leading up to her mother's death.

I hope, if the cause is psychological rather than physical, that the tendency doesn't move from Valerie to Lisa. Illneses of the mind are probably easier to contract than the physical ones.

jacksofbuxton said...

I can understand Mr Muir being so very protective(and possibly dangerously so.It seems the power of suggestion isn't helping Valerie here)but that doesn't mean every head ache is a tumour.

Hopefully you'll have put their minds at ease,but I doubt it.

Slightly flippant again,but seeing the name Muir reminded me of a magnificent opening line from Frank Muir.He was speaking at a charity dinner when his opening line was...

"I've just spent the last six months in the South of France finishing my book.

I'm a very slow reader...."

Ali_Q said...

Hmmm.... Sometimes I wonder what must be harder for you, the ones that don't want to go and really need to or the ones that really don't need to but everyone else thinks they should! Your descriptions of the scene are fantastic as always!

Spence Kennedy said...

SL - Thanks v much!

CK - Sometimes illness is incredibly difficult to identify. I think GPs have a tremendously difficult job screening patients for signs of serious illness hidden away amongst the more usual aches and pains. It's frustrating that sometimes when patients aren't happy with their doctor they look to the ambulance & A&E to sort it out.

BB - I'm not entirely sure they were accepting what they were told, though. Mr Muir seemed fixated on having a scan, as if it's some magic tool for finding out the truth.

It's strange too these days when you rarely get to see the same GP twice at your local medical centre. But I know I'd switch to another practice if I was uneasy.

Nari - It was a hot house in more ways than one. I was v uneasy (as you can prob tell). Treating Valerie would need to be a holistic approach taking in the whole family - but how likely is that?

JoB - Absolutely. Their level of anxiety was understandable, given the horrible circumstances of Mrs Muir's death, but it makes them into difficult patients. I absolutely did not put their minds at rest. I'm not sure if anyone could.

Love the Frank Muir anecdote. I can just hear him saying it. I must admit I did get the name from 'The Ghost and Mrs Muir', though. I remember the TV series (just!) - I had a crush on Hope Lange... :/

Alison - You're right - the ones where everyone thinks they should go to hospital and you really don't are the most tricky. Obviously you make it clear that they can go in if they want (but it was a busy night, I was out in the middle of nowhere, on the car, and it would've been a long wait for a truck - you try to ease the pressure on the service by cutting down on unnecessary journeys). Plus I would've found it difficult waiting with them for an hour.


Thanks v much for all your comments! :)

Steve said...

I worked as an ambulance technician a few years ago and saw quite a bit of this. Most patients think they can short-circuit the system and get taken to hospital where they will immediately get the tests they think they should have, which is so far from the truth it's laughable. What they'll get is a long wait in A & E, followed by 5 minutes with a stressed and overworked registrar, then make their own way home with a letter for the GP.

Spence Kennedy said...

Absolutely. The other misconception goes something like: 'if I go in to hospital by ambulance, my GP will see I'm really ill and start taking me seriously'. Same outcome though - long wait, minimal tests, referred back to GP. But if a patient insists on going to hospital, we're not allowed to refuse. At least in this case they were persuaded, if not comforted particularly.

Anonymous said...

Having had someone call 999 against my wishes and the resulting fuss concluding with a trip to hospital I'd like to just say that I can sort of understand the man hitting panic in this way.

But, my shame at being picked up and treated so kindly by the paramedics was compounded when I got to A+E and saw people there on various trolleys and states of illness.

I've never called 999 for myself because I've never seen any need. The time it was called against my will was due to becoming unwell in a public place. I wanted to get a taxi home and go to bed, the 1st aider had other ideas.

I felt and still feel exactly like the people you & your other colleagues in the blog circle describe when they've totally wasted your time and taken a crew away from someone elderly/dying/unconscious/child................

Guilty as hell.