Tuesday, September 11, 2012

a world of signs

The sea is a glittering expanse of greens and blues, almost too bright to look at. Some early boats are out on the water, far off out on the cut of it, shavings of light moving in slow lines.
Rae takes us to the scene – a cafe down on the front. The staff have sprinkled water over the paving slabs to freshen the place up for the breakfast crowd, but the day is already so warm it’s burned off most of it. A couple of chairs and a table have been moved aside at one point, leaving room for our patient, her husband and a community responder.
Carol is sitting on the pavement leaning back against the railings, her hands resting in her lap, staring down at her union jack flip-flops. Carol is a heavy woman in her fifties, her body a sinus wave of flesh formed by the pinch-points of skirt, t-shirt, blouse, jewellery. There is a streak of red in her bobbed blonde hair, and her blue mascara has run. Her husband Barry is patiently waiting on the periphery of it all behind a pair of seventies-style, Reactolite sunglasses.
‘I can’t believe this,’ she says as we introduce ourselves. ‘I’m so embarrassed.’
‘What’s happened then?’
‘Well, look around. There’s nothing, is there? No sign, nothing. How stupid can you get? Spraying water everywhere and not telling anyone about it. They should have a sign up. Get a photo with your phone, Barry. I’m going to sue them for everything they’ve got.’
‘So you fell over?’
‘Yes, I fell over. And I cracked the side of my head on this concrete ledge as I went down. It don’t half hurt.’
I check her over. Apart from a small abrasion on the side of her head, there’s nothing to suggest Carol has suffered anything other than a minor head injury.
‘Let’s get you up and do the rest of our checks on the ambulance,’ I say. ‘Shall we help you up?’
‘No – thank you. I don’t mean to be rude, but I know how I need to do this.’
She struggles, but every time we step in to offer a hand she refuses.
When she’s finally upright she bats her skirt clean and says: ‘You can see where I fell, can’t you? Honestly, those Serbo-Croats. They’re absolutely useless. Have you made a note of all this, Barry? We’re definitely going to sue.’
I offer Carol my arm but she refuses that, too. We make our way slowly across the promenade and up the steps to the ambulance.


After a thorough examination the only thing I can find wrong is a minor abrasion.
‘I don’t think you need to go to hospital, Carol,’ I tell her. ‘What I suggest is you go back to the hotel with Barry, take some paracetamol and rest up. You’ll be fine.’
She dabs at her eyes with some tissue, and sniffs.
‘What about Natasha Richardson?’ she says.
‘Oh. Well. Yep. That was a surprising case.’
‘Natasha Richardson went over and banged her head when she was skiing. On the nursery slopes. They all said she’d be fine. She didn’t go to hospital – and look what happened. Dead in a few hours.’
‘I know. That was pretty shocking.’
‘How do you know that won’t happen to me?’
‘I can’t guarantee it. I don’t know enough about Natasha Richardson, but in your case, you don’t have any of the predisposing signs of a serious head injury. You didn’t bang your head with a lot of force, you weren’t knocked out...’
‘She weren’t knocked out.’
‘Was she wearing a helmet, do you know?’
‘No – and neither was I.’
‘No. But you don’t have any of what they call neurological deficit – numbness, blurred vision, dizziness and whatnot.’
‘Neither did she.’
‘Didn’t she?’
She sniffs again and dabs at her nose with the tissue. Then she crumples it up and looks across at Barry.
‘What do you think I should do, pet?’
He shrugs, but says nothing.
‘Did you get the pictures?’
He waves his phone in the air.


Back in the cab outside the hospital, I throw the clipboard onto the dash and lean back in the chair.
‘Jesus! It makes you wonder how the human race ever made it out of the swamp. How do people survive when every little thing’s a hazard?’
‘It’s insurance, Spence. Where there’s a blame and all that...’
‘And because everyone’s terrified of being sued, they have to put signs up for everything. Pretty soon there’ll be signs all over the place. Every tree, pond, and hill. And then they’ll put up a massive fence along the coast, with signs to warn you about the sea, and signs to warn you about the fence, probably. It’ll be one vast world of signs, and even then it won’t be enough. In the end they’ll have to clear everything away. There’ll be nothing left, completely flat – like Cambridgeshire, only without the dykes - with maybe a scattering of cushions, big enough so you can’t choke on them, but not so big you can’t accidentally smother yourself.’
‘Yeah,’ says Rae, stretching. ‘Great. Then I can sue for emotional cruelty.’


jacksofbuxton said...

Aaaaargh.It's people like this bloody drama queen that mean we're all paying far more in insurance than is necessary.

It does get my goat.

Again,I'd recommend a firm smacking noise as the rubber gloves go on and a full examination of every orifice you can find "just to be sure".

Spence Kennedy said...

My goat's been got so many times recently I think I may as well just shrug and hand over the keys to the goat shed.

I do wonder just how far these current levels of litigation will affect the way we see ourselves in the world - our ability to sum things up, take risks etc. Not to mention rising insurance premiums.

I like the full examination treatment, Jacks. Especially if you get to put on one of those old fashioned head torches, the big silver disc with the light bulb in the middle. And a mask... eeuch.


Philip Dodd said...

Ha! Beautifully done. But..... What about Natasha Richardson?!

Spence Kennedy said...

Cheers Philip

I don't know what to make of that whole Natasha Richardson thing. From what I can glean from different newspaper reports, she wasn't wearing a helmet, refused the ambulance/hospital but fell ill soon after. I don't know if she had any underlying condition or not. I must admit the whole story did shake up my idea of what constituted a 'safe' head injury - but if you took everyone into hospital who fell over and banged their head, the place would be completely overrun (more than usual levels, anyway).

I suppose the bottom line is - wear a helmet when you go skiing, even if it's the nursery slope!


Anonymous said...


Your not wrong a hotel here got sued when someone fell over the wet floor sign.

The sharks said the hotel should of had a sign warning about the sign.

Chris said...

Ah, I'm here in America, and the litigation climate is so bad (and I'm a legal assistant, ha) that there is no way a paramedic/EMT (is that the proper term?) in this country could say what you did - they would have to take her in, lights and sirens all the way, and she would have gotten her CT and probably a ton of other unnecessary garbage. It's horrible here - there is no mistaking why our health care system is a disaster: the legal system that allows it. Common sense (like you dispensed to her), is gone in the U.S. The UK seems to have a teeny bit left. Keep up the good work!

Spence Kennedy said...

Anon - That's v funny! I'm always tripping over those 'Wet floor' signs when I come into A&E. Def a hazard.

But I can't see any end to these signs, though. And eventually every sign will need a sign... until there's an unbroken chain of signs all the way round the world. :/

Chris - We really want to use common sense, but I think it might be a losing battle. Esp. as it seems that most claims are settled out of court these days (more cost effective, apparently).

The frustrating thing is that medicine is not the same as mechanics. It's much more interpretive. You can only go on what's most likely to be happening, given the facts. So a person without any predisposing factors who's suffered a low-impact head injury and who isn't showing any signs/symptoms of concern, will more than likely be okay. That should be enough to cover you legally. So long as you took all reasonable precautions, you'd think you'd be in the clear. But if it's true that you're not, it means that hospitals will be even more swamped than they already are. And it's the general public who'll pay for that (and higher insurance premiums, too). B'ah.

Thanks for the comments! :)