Tuesday, January 29, 2013

a quiet night in

The A&E entrance has been changed.The good news is that the foyer is much bigger than it used to be; the bad news is we’ve lost a side room, one of the most useful rooms in the building.
Side Room One was the Crazy Cubicle, the Isolation Suite, the room we’d discreetly hurry in to with the disruptive patients – the psychotics, the wild drug casualties, the hostile drunks, the acute onset dementias. It was accessible immediately you came in. You could go straight through, shut the doors and effectively insulate the rest of A&E from the shouting and swearing and the distress of witnessing the level of restraint that’s needed sometimes.

But now Side Room One has gone, and instead we have an open plan foyer.

‘Can everyone just move down as far as possible?’ says Ellis, the charge nurse. ‘A bit more. That’s good. It’s just we need to make as much room as we can for something coming in. Guys – if you could put the mattress down there for me, that’d be great.’
Two porters drag over a double mattress and lie it on the floor in the space we’ve made. They grin knowingly, then walk away.
‘Just make sure you give the crew plenty of room,’ says Ellis. ‘There’s police with them, too.’
‘So what’s this for, Ellis?’
‘Oh - some kid kicking off on something or other. Apparently he’s quite a handful. Are you guys all right there? Good.’
He looks across at Enid, our patient, an elderly woman comfortably blanketed on the ambulance trolley, clutching on her lap a paisley print carpet bag and a green plastic carrier full of drugs. She nods and smiles and gives him a queenly wave.
‘We’ll get you a space as soon as we can,’ he says, then hurries away.

The following minutes drag with expectation. We try to chat about this and that, but it’s noticeable that everyone’s attention is really on the automatic doors. We hear another ambulance backing into the parking lot, but when the crew come through they’re pushing a middle-aged guy hunched over a vomit bowl in a wheelchair,. The crew stop short when they see the mattress on the floor.
‘Times really are hard,’ says one.
‘There’s a mad druggie coming in,’ someone tells him.
They tuck themselves as far away from the mattress as they can, even braving the space by the pathology tube that everyone’s scared of, because it whisks specimens up a vacuum run and then spits empties out onto the floor like the shell casings from a howitzer.

Time passes.

‘Shouldn’t be too much longer,’ I tell Enid. I meant the handover, but no sooner as I’ve said it then there’s the sound of more vehicles outside, shouting, doors banging, a confusion of instructions, the scuffles and commands of a big team effort – then the automatic doors swish aside and four policemen stagger in carrying a person whose arms are handcuffed behind their back and their feet zippered up with flex.
‘Here we go!’
‘Easy now!’
‘Almost there, fella.’
But their package – a hefty kid in his late teens – writhes and thrashes between them like some monstrous landed cod. A hang of drool trails beneath him as he bellows.
‘Is that mattress for us?’ says one of the policemen.
‘Oh yes.’
‘Jolly good.’
They land the beast, and then kneel around him puffing and sweating, hands on their catch to keep him in place.
‘If you calm down, we can loosen these restraints, Eddie.’
Ellis comes over with Mark, an A&E Consultant whose simple and open expression would make him the casting director’s choice either for the spiritual head of a monastery or a hit man.
‘Hello, Eddie. How’s it going?’ he says softly, crouching in front of him. ‘I understand you’ve taken something tonight?’
Eddie howls.
‘What have you taken? Can you tell us? Hmm?’
Suddenly Eddie seems to relax completely. He mumbles something, but it’s hard to hear because his great mop of curly hair is sticking to his face.
‘Let’s try and sit you up and talk to you properly,’ says Mark. ‘Is that all right, guys? Can we sit him up?’
The police officers adjust their position, and cautiously set him into a sideways kind of sit. Mark clears the hair from Eddie’s face and smiles at him.
‘I love you,’ Eddie says.
‘That’s nice,’ says Mark. ‘That’s what I like to hear. Now then, Eddie. Tell us what’s happened to you tonight.’
But the sudden calm is broken by another bout of wrestling and shrieking. Mark’s expression doesn’t change, but he shuffles backwards a little as the police officers move in to take a stronger hold. This is the pattern Eddie falls into for the next half an hour: periods of calm, periods of mania.
During a lull Mark manages to check his pulse.
‘We need to give you something to calm everything down,’ he says, releasing Eddie’s wrist. ‘Here. Will you take this tablet for me and a little sip of water? Okay? Eddie?’
Eddie looks up.
‘I love you,’ he says.
‘I love you too, Eddie. Now, how about taking this pill? It’ll really help make you feel better.’
What follows is a nightmarish stream of unconnected thoughts.
‘Do we have any idea what he’s taken?’ says Mark after a while, lowering his hand.
‘There was definitely some mephedrone floating around. Meow Meow or Hello Kitty,  or whatever you want to call it. Plus some LSD – quite retro, but there you go. Who knows? I don’t suppose he’s the last casualty we’ll see from that particular party tonight. The seeds of it are blowing all over town as we speak.’
Eddie slowly lifts his head again and smiles at Mark.
‘You’re all so beautiful,’ he says.
‘So are you,’ says Mark. ‘Now – how about taking this pill for me?’
‘I’ll take it if he won’t,’ says one of the police officers.

I’ve been trying to shield Enid from all this, but actually she seems to be enjoying the spectacle.
‘Poor boy,’ she says with a delicious shrug of her shoulders. ‘Trussed up like a chicken. Is that what happens when you take drugs?’
‘Sometimes. Depends what drugs. And then you can’t always trust your dealer, so you never really know what you’re getting. I imagine.’
She clutches her medication bag more tightly to her.
‘I’ve got plenty of my own without taking any more,’ she says. Especially if that’s what happens.’
‘It’s not good.’
‘What did he say it was called?’
‘Meow Meow. But they’ve got lots of weird names. My favourite so far’s Gorilla Rage.
Gorilla rage?’
‘Yeah! I know! Gorilla Rage. I don’t suppose you take that if you want a quiet night in.’
‘I don’t think I’d like Gorilla Rage.’
She watches as Mark carries on trying to persuade Eddie to take the pill.
‘But Meow Meow sounds nice,’ she says.


tpals said...

I wonder if Eddie would learn anything if someone showed him a video of that night.

Wonderful write-up as usual.

Spence Kennedy said...

Thanks tpals.

I reckon he'd be amazed to see a video of how he was. His behaviour was so wild and out of character - a real Jekyll & Hyde moment. I wonder if it would change things, though. Anyway, he was lucky to get picked up when he did. In that state you'd have to wonder how long he'd have lasted without something awful happening. :/

Anonymous said...

Funniest last line ever!

Spence Kennedy said...

She's right - it does sound nice. (Nicer than Gorilla Rage, at least) :0)

northern stretcher monkey said...

Gorilla rage!! Quality, Some of the regular "service users" that I have the pleasure of helping are currently spending their hard earned benefits on a delightful little product called annihilation. They do pull some quality faces and are always surprised that they end up coming for a ride to the ED. YOU'VE TAKEN SOMETHING CALLED ANNIHILATION YOU HALF WIT!!

petrolhead said...

An ambulance service somewhere is trialling an idea of recording footage of drunk/drugged up 'patients' in an effort to kick them into touch and seek help, before they do themselves serious harm or becoming hooked onto harder drugs.

Spence Kennedy said...


You've got to love these product names. There's one called 'Bounce', which is actually quite cute - more like a fabric softener. 'Annihilation' is great, pretty graphic. Maybe we should bring out our own brands: 'Arrhythmia' (exotic); 'Psychosis' (oooh - dark); 'Aspiration' (actually sounds quite positive). :/

Hey PH

I like that! But then again, maybe it might end up being a kind of badge of honour, and encourage a kind of competitive edge to it all. But something needs to be done. It's an unnecessary burden - and one that only seems to be growing. There's definitely a sense now that you can go out, get wasted, sleep it off in A&E and get a cab / picked up by family from there. Grim.

Cheers for the comments.

jacksofbuxton said...

I thought Gorilla Rage was what happened when David Attenborough arrived at the wrong time.

Spence Kennedy said...

That makes me think of the Not the Nine O'clock News sketch with Gerald the gorilla. 'Mad? I was absolutely livid!' :)

Anonymous said...

Hi Spence,
a few years ago I was the reception supervisor at a Social Security office. Much of my day was spent dealing with the poor unfortunate crazies of society. I'm a 5ft girly yet was still expected to box well outside my weight. A handily placed mattress would have been ideal, if only to give me something to hide behind.

I still work for the "Social" but these days they are mostly contact centres. I often wonder where all my crazy buddies went - seems they are rolling about on the floor in your hospital.

Sadly I'm not allowed to tell any tales although there are many.One day I might be able to describe the "lady" who changed into a wedding dress in front of me, then demanded money as she needed to get back to intensive care (she had indeed got a canula in place and was swinging a bag of whatever was being fed into her veins).When asked to leave, she swung for me with the aforementioned bag.

Happy days.

I love your writing. It's always a good day when there's a new chapter.

Mort's Mom

Spence Kennedy said...

Hey Mort's Mom!

Well that sounds like a colourful kind of job. I remember a friend of mine used to work in a Social Security office, in the days when they didn't have perspex screens. He said they had to wear clip-on ties to stop them being dragged across the desk.

Love the story about the woman and the wedding dress. Miss Havisham of the ER. You should definitely write these things up - I'm sure with a little bit of anonymising it could pass through the censors okay. Anyway, I think it's important to get a few dispatches from the front out there.

Thanks for the comment, MM. Hope everything's good with you today.

Unknown said...

What I really liked, Spence, was the way we cut from the foreground (Edith waiting patiently on her trolley), to what was happening on the mattress, and then back to the foreground characters observing and commenting on events. Very nice, very clever.

Spence Kennedy said...

Thanks, Jane. I think it helps that the raw material is naturally dramatic. Some of these situations are a real gift!

Thanks very much for the comment, JP!