Wednesday, January 15, 2014

a mess

If this is a test, I’m failing.

We’d been lucky up to that point. The last hour of the night shift snoozing on standby. We had just been debating whether it was a good time to call Control and start lobbying for a return to base when the radio pre-empted any discussion: a fall, the other side of town. Still, if we were quick and the job was as straightforward as it sounded, we’d still be able to finish on time.

But then the added details. Fallen just behind the door. And some complicated instructions on how to locate the key.

‘I’ve got a bad feeling about this.’

When we get to the block of flats, it’s hard enough just to find the entrance, set back as it is behind a high laurel hedge. The first thing we do is buzz the flat we want, but there’s no reply, even though the notes had said the patient’s wife was on scene. Looking at the liberal spread of Key Safes across the left hand wall, the instructions we’ve been sent – second from left on bottom row – might be helpful if the boxes were actually in rows, but they’ve spread out over the bricks like a colony of mussels on a harbour wall. We’re driven in desperation to flip the lid and try the code on each one starting from the bottom. Finally, one drops open and we let ourselves in.

As soon as we crack the door open the smell hits us.

Mr Samuels is lying on his side in the hallway, naked, covered with faeces.
‘Can you help me?’ he says. ‘Oh. Oh. Are you there?’

He’s been on the floor several hours. Mr and Mrs Samuels sleep in separate beds. When he got up in the middle of the night to go to the bathroom and fell in the hall, Mrs Samuels hadn’t heard anything. It was only after several hours she realised something was wrong and picked up the phone.
‘She’s got flu,’ he says. But I begin to wonder what else.

Mr Samuel’s in such a mess it’s hard to know where to start. He’s breathing, has a radial pulse, he’s only complaining of abdo pain, so at least it looks as if we might have a little time.
Rae goes back downstairs to fetch a chair, inco pads and blankets.
I fill a washing up bowl with warm soapy water and using a dishcloth make a rudimentary start at cleaning him up.
‘We’ll have to take you to hospital, Mr Samuels,’ I say as I slop him down. ‘Will your wife be okay on her own till the carers get here?’
‘I look after her.’
‘I know, but will she be all right for half an hour or so?’
He doesn’t seem sure. She has mobility problems, but self-mobilises with a frame. Nothing else diagnosed. They’re quite young to be needing care at home – both in their early seventies – but it’s impossible to know without studying the folder. I think that when Rae gets back I’ll have a quick scout around.

I’ve used another bowl of suds by the time Rae struggles in with the chair. I tip the foetid water down the toilet; the hospital will have to see to the rest.

With some difficulty we manage to lift Mr Samuels off the floor, wrapping him in several blankets. Once he’s up, the margin of time we have has shrunk. His breathing is more laboured, and he looks dreadful. There’s just time for me to stick my head round the bedroom door.
Mrs Samuels is lying in bed, staring up at the ceiling.
‘Hello,’ I say. ‘How are you doing?’
She turns her head to look at me but doesn’t say anything.
‘Your husband’s had a fall this morning. He’s not very well, so we’re going to take him to the hospital. We’ll just pop him down to the ambulance, then I’ll come back up and see you’re okay.’

She turns her head back, slowly, like she dreamed the whole thing.

I’m tempted to take them both in, just in case. But that would mean one of us coming back with the chair to deal with Mrs Samuels on her own, which is unthinkable, given all the obstacles. I consider calling out a second vehicle, but I delay making that decision until we’ve got Mr Samuels on the vehicle and started on some therapy. We struggle out of the flat around the mess.


Mr Samuels blood pressure has dropped. With his high temperature and tachycardia, it looks like he’s septic – so we set about correcting what we can. Once he’s relatively stable, I hurry back inside to make a final decision about his wife.
I knock and go in, picking my way around the mess.
But Mrs Samuels isn’t in bed. She’s got up, negotiated the hallway, made herself a cup of tea and is sitting watching breakfast news in the living room, smoking a cigarette.
‘All right?’ I say.
She turns to look at me with exactly the same expression as before.
‘Will you be okay until the carer gets here? They won’t be long.’
She stubs out her fag.

I have a quick glance around for a care folder, but if they have one it’s not immediately apparent. I’m conscious of the fact that Mr Samuels is very unwell down in the truck, so I can’t be long. I decide that as she’s been able to get herself out of bed, make some tea and smoke a cigarette, she’ll probably be all right on her own until the carer gets here. Surely if things were more serious, the care package would be more comprehensive, more obvious? I’ll report it to Control and hope for the best.
‘Just tell the carer your husband had to go to hospital,’ I tell her. ‘I’m sure they’ll be able to sort things out.’
She nods, picks up her tea, and turns back to the TV.

I see myself out.


After we’ve handed Mr Samuels over at the hospital, I mention the situation with his wife to one of the nurses. I don’t think she’s convinced there’s a problem, and saying it, neither am I. Mrs Samuels seemed quite self-sufficient. She’d managed to get out of bed, get herself some tea, put the TV on. A carer was due. The whole story sounds thin even to me. Maybe it’s just a function of my exhaustion, the fourth of four nights, the end of it all, a mess.

‘Anyway. Just thought I’d say.’

I hand in the paperwork, say goodbye.

We finish late.

The rush hour is in full flow. I don’t so much drive home as drift there on a river of metal.


jacksofbuxton said...

I don't know what to make of this one Spence.

Obviously Mr Samuels is unwell,had a fall and required assistance.Surely any wife would,upon discovering a stricken husband,at least show some emotion other than brew,tv,fag.

You never know what goes on behind net curtains I suppose.

I suspect Mr Samuels might be better off with the carer than Mrs S.

Spence Kennedy said...

I didn't know, either! Her reaction was so disconnected I thought she might have something like Alzheimer's, or maybe a mental illness of some description. But as I say, it was a minimal care package, just a kind of morning look-in, so I assumed she was okay to be left alone for a half hour or so until the carer came by (given what we all know about the word 'assume'). It's a given that not every job leaves you with a warm glow - or much of anything other than exhaustion, come to that. At the very least we took care of the basics - helped him off the floor, cleaned him up some, got him to hospital. :)

TomVee said...

Hey Spence!

What I find strange is how she barely acknowledged you but was, earlier on, apparently able to call 999 and give correct instructions for an ambulance - what happened, where, that sort of thing.
I'd go with mental illness. But who knows.

Greets tomvee

Spence Kennedy said...

The whole thing was odd. I mean, it definitely wasn't Mr S who called, and I'm pretty sure they didn't have an emergency button. Quite why she'd be able to phone, and yet be so uncommunicative when I spoke to her, is hard to understand. There was a dreamlike / nightmarish aspect to the whole job, come to think of it!