a misunderstanding

Henry is sitting on the path leaning back against the wall, his face pale, his eyes closed, his breath coming fast.

‘Jesus fackin’ Christ I’ve never felt like this before,’ he gasps. ‘Fack me.’

His work colleagues are gathered round. They describe how he came staggering downstairs, one hand on the balustrade, the other bunched in the middle of his chest.

I take what history and obs I can whilst Rae fetches the trolley down.

‘One, two, three… h’up!’

‘I just can’t do it,’ he says.

‘Do what you can.’

‘I can’t.’

We haul Henry to his feet and settle him on to the trolley.

‘Just try to slow your breathing down, Henry. I know it’s upsetting, but your oxygen levels are better than normal, so that’s good.’

‘I’m dying of a fackin’ heart attack. Never mind slow your fackin’ breathing.’

Once he’s on board we work around him, putting on the BP cuff, the SATS probe, the ECG dots. He keeps his eyes closed throughout, resting his left elbow on the side shelf, the fingers of that hand trembling and trailing over his face, then his neck, then back to his face again.

‘What’s your past medical history?’ I ask him, fixing on the last of the dots.

‘I’ve been investigated for chest pains before – but it’s never gone on so long or as bad as this – they said it was costochondritis or samink – they don’t fackin’ know – I’ve had all kinds of tests – when I was nineteen I was in a car accident – had to be cut from the wreckage – I went through a bad patch – anxiety attacks – but that was twenty years ago – I know things have got a bit stressful lately …’

‘Just hold still for a second whilst we take the ECG,’ I tell him.

‘Well you asked me what my medical history was…’

‘I know. And I want to hear. But we need you to be still so we can take the snapshot. Just for a second or two.’

His fluttering hand covers his face.

We get the readout.

Rae tears it off then hands it to me with a wry smile.

‘See what I mean?’ she says.

I know exactly what she means. When we’d both come striding down the alley and seen Henry sitting there, seen how pale and sweaty he was, how he clutched at the centre of his chest, we’d glanced at each other and acknowledged what we both immediately thought: MI. Some old-timers still talk about the ONF, the overall nick factor, that first impression of the serious job that increases the pace and urgency of everything you do. Just that morning Rae had been talking about how she’d been getting things wrong lately, thinking things were serious when they weren’t, and vice versa.

Now that we had Henry on the ambulance and had spent a little more time with him, seen his observations in context, and had the ECG in our hands as further evidence, it was looking increasingly as if Henry was suffering from anxiety and hyperventilation – unpleasant, but not life-threatening.

‘See what I mean?’

But if I do, Henry doesn’t.

‘You fackin’ people, you make me sick!’ he says, tugging the leads off his chest and making as if to swing his legs off the trolley. ‘You fackin’ think you know it all. Yeah – yeah! So you think it’s just anxiety, mate. Well fack you. Fack the lot of you. I don’t have to sit here and take this shit. You can kiss my arse you fackin’ kant. Fack’s sake. Un-fackin’-believable. I’ll be putting in a complaint, you can fackin’ count on it.’

‘No, no! Henry! Seriously – it’s a misunderstanding!’

He shuts his eyes and rests his head back.

‘No. I don’t want to fackin’ hear your excuses. Just shut it. If you’re taking me to hospital then just do it  and don’t say another fackin’ word. I’m sick of you and all your snap judgements. Fack sake.’

Rae quietly withdraws.

After a brief pause I try to start winning Henry back again, but every attempt is slapped down.

‘I’m not answering any of your questions,’ he says. ‘Just shut up and drive.’

‘I’ve listened to you, Henry, so I think it’s only fair you listen to me. There’s a simple explanation for what happened just now and it’s not what you think. Will you let me tell you?’

‘No. I don’t want to hear your lame attempts at a cover-up. I know what you think of me. You think I’m a waste of time who’s just having a panic attack. Well fack you, I don’t want to know.’

‘You’re wrong, Henry. But if you don’t want to talk any more, that’s fine. I’m glad you’re coming to hospital. I think there are aspects of your condition that need looking at there.’

‘There are, are there?’

‘Yes.’

‘Really?’

‘Yes. Now. Can I ask you a few very basic questions, like your surname and date of birth?’

‘I was telling you all that earlier and you completely fackin’ ignored me so what’s the fackin point? You couldn’t be bothered to listen to what I was saying. You were too busy swapping snidey comments with your friend.’

‘Sometimes we have to multi-task, Henry. I was listening to what you were saying – about the car crash and everything – but I was trying to do some other stuff at the same time.’

‘Well…’ he says. ‘It looked to me like you didn’t give a shit.’

‘I’m sorry if you feel like that, Henry.’

‘I do fackin’ feel like that. And I will be putting in a fackin’ complaint.’

‘That’s absolutely your right.’

‘Too fackin’ right.’

We pass most of the rest of the journey in silence.

Nearing the hospital, I tell Henry the story of a friend of mine who had an anxiety attack on a petrol forecourt and was so convinced he was having a heart attack he got out of the car and lay down between the pumps.

Henry opens his eyes and squints at me.

‘Un-fackin-believable,’ he says.