The estate rises around us in the darkness like a ruthlessly illuminated housing machine. Layer upon layer of regularly spaced squares fitfully lit by plasma screens, measured out in a grid of walkways. But despite the scale of the place there’s no-one around, not even a dog walker or a posse from the clubs; no sign of life at all, just a skin of frost over the parked cars and the grass, and here and there faint wisps of steam rising from vents.
Ellie is waiting for us in one of the entrance halls, staring out at us through the scratched Perspex of the front door. Her eyes are so wide and dark they make the hall lights flicker.
‘Can we come in?’
She doesn’t answer, but relaxes her hold on the door and turns to walk back inside.
Her flat is clean and warm, the laminate floor clear of anything but a pair of dog slippers and a scattering of empty pill packets. Ellie goes over to turn off the TV – a cooking competition - and puts her feet into the slippers.
‘My name’s Spence. This is Frank. We were told you might have taken an overdose tonight. Is that right, Ellie?’
She nods, gathers the lapels of her pink towelling robe around her, knots the belt more tightly.
‘Are these the tablets you took?’ pointing to the packets on the floor.
She nods again, and goes to pick them up.
‘It’s all right, Ellie. I’ll get them. Were these all full when you started?’
‘There’s quite a few here. I’ll do the counting up on the ambulance. What we need to do now is take you to hospital for some treatment. Is that okay?’
‘I’ll get my bag.’
‘And your keys? Good. Okay – let’s go.’
She lies back on the trolley, folds her hands neatly across her stomach and closes her eyes. She’s only twenty one; her face is as clear and unmarked as a sleeping alabaster angel in a church.
I calculate the number and size of the pills she’s taken, dropping the counted packets into a spare vomit bowl. The tally is dreadful, a shopping list for the damned. I put everything aside and feel the pulse at her wrist.
‘Did you take any alcohol with these pills, Ellie?’
She opens her eyes.
‘A glass of wine.’
I picture her alone in the flat, sitting on the edge of the sofa, taking little sips with each mouthful, tipping her head back, watching the chefs battle it out on the TV.
‘How long ago?’
‘Half an hour.’
‘Good. And how are you feeling now?’
She rests her head back on the pillow and closes her eyes again.
‘My tummy hurts,’ she says.
We turn up the slope to the department.
The Charge Nurse looks at the name on my sheet and then glances down the corridor to where Frank is waiting with Ellie.
‘Oh yeah. Yep. She was in about a month ago. What’s she taken this time? Whoah!’
She signs the board, hands it back to me, then asks one of the other nurses to come over.
‘Best crack on with this,’ she says. ‘Although why the hell she’s still got all these meds hanging around is beyond me.’
I go back to the trolley to help push her into a cubicle. Her dog slippers are poking out of the bottom of the blanket, so I pull it down a little to cover them.
‘The nurse will be with you very shortly,’ I say to Ellie as we move along. But I can see the nurse is already there waiting for us, smiling, a bottle of charcoal in her hand, shaking it.
What happens after treatment? Is there real help available?
She sounds so young to take that route.
There is help - and Ellie was getting some. But it feels patchy and under pressure, just like plenty of other services. They've just closed 12 beds at our local MH facility.
I was like the nurse - I didn't understand how just a few weeks after her first o/d she still had lots of scrip drugs at home (although the paracetamol was bought over the counter).
Twenty-one is v young - but I've been to much younger...
On one hand, she seems determined. But, if that's true, why call for help at all? Just attention-seeking?
I know what you mean, Jean. It is really difficult to understand. Sometimes I wonder if a person under terrible stress fractures into two parts - one that wants to live, and one that wants to die. So maybe the dark part forces down the drugs, and the lighter part makes the phone call. But that's obviously a gross simplification and I've really no idea. I just wish they could be spared such suffering.
Spence, your explanation of the fracture into two parts during a suicide attempt makes such sense. You have such an intuitive empathy for your patients and a wonderful way of expressing it. Thank you.
Thanks Karen. It's a difficult area, no question, and I'm full of admiration for the people who work in mental health. As far as the ambulance goes, it's frustrating that our input is so minimal. We often find ourselves making the best of a bad situation. But it's all you can do, really!
I am an avid reader of your blog but don't comment, but felt compelled to after reading this entry.
I commend you for your empathy and gentle treatment of this patient. As someone who has taken more overdoses and been in more ambulances than I care to remember it is herat warming and relieving to know there are people like you in the service.
A kind word and a lack of rudeness or unhelpful comments can make all the difference and may provide the person with enough comfort and securityto be able to call when in need in the future.
At the end of the day we are still people, we may be going through an awful time in our lives and be doing things others do not understand but yelling at us or refusing to treat us isn't going to help the situation.
Thats a lot longer than I anticipated! Thank you.
At least Ellie had the sense to realise what she'd done.Very sad to see someone so young have to take such a route.
It seems you and Frank dealt with Ellie very well Spence.Admiration for you both as always.
Thanks v much Anon. I suppose everyone in the ambulance has their weak spot - the patient that you really can't understand or have much sympathy for. I'm no different. There are plenty of times I've been snippy or tough-talking or just downright mean - but I've always been okay with mental health issues, prob because there's a family history of it and I've struggled off and on myself (which you might have guessed from the way I write sometimes!). I do recognise that bleak, self-destructive impulse, because it's one I feel every now and again. It's just the way it is, and so I suppose I'm sympathetic when I see something similar in others.
Thanks for the comment, and for reading all this time, Anon.
Cheers, Jacks. It's a sad story, no question, and we do see quite a lot of it. I thought Ellie was v impressive, actually. Despite the incredible strain she was under, she managed to keep things pretty much together. You could tell she was a good person.
fractures into two parts - that is a perfect explanation/understanding and I can relate because I've been too close too often myself. It's the struggle within that is much more difficult than the stressors from outside.
I think you're right about the internal struggle being the most difficult, Jean. It's an absolute curse, and all the more difficult for being irrational and hard to pin down. It's quite noticeable that circumstances can be pretty much the same, but interpreted either well or badly according to your state of mind. :/
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