real life

There are three other ambulance crews waiting to handover in the triage area, so we take our place in the queue, tucking ourselves in as best we can, somewhere between CT and the exit. It’s only when we’ve settled in that I notice Richard, the lead consultant, standing by a patient on a stripped-down ambulance trolley. The patient is wearing a collar, lying in a strange position on a vac-mat, but although it strikes me as odd that he’s not fully immobilised, I assume he’s been semi-cleared, waiting to go off for x-ray or something.

‘Now don’t move,’ says Richard. ‘You’ve got a fractured femur, remember?’

‘I can’t believe this is my second go.’

‘And you’ve got a lot of alcohol on board. Okay? Happy?’

‘Delirious.’

‘Good.’

Richard goes over to the other crews but I can’t quite hear what he asks them. It all seems very odd, but still, I take it at face value. I make sure our patient is as comfortable as possible, then look over my paperwork to see if there’s anything else I want to add.

Suddenly, Richard is standing in front of me.

‘Could you come in and hand my patient over for me, Spence?’ he says. Before I can say anything, he takes me by the shoulder and leads me over.

‘This is Luke. Twenty-four years old. Luke’s been drinking alcohol today. He jumped over a wall and fell twenty feet onto concrete. Landed on his left side. A period of unconsciousness. Reduced air entry on the left, query left femur. Okay? They’ll be ready for you in a minute. I’ve just got to go in and set up.’

And he hurries off through the resus doors.

Intensely odd.

‘Hi Luke,’ I say, looking down at the patient. And then: ‘Oh! Luke!’

Luke is a nurse who works at A&E.

He wriggles around on the vac-mat.

‘Just hold still,’ I tell him. ‘It’s important you don’t move your head.’

There are no straps on him, no tape securing the blocks. Why isn’t he fully immobilised? Reduced air entry? Fracture femur? Where’s the oxygen? The Kendrick? And why aren’t there any poles on this trolley? Why is it in the down position?  And any moment now I’m supposed  to handover to the resus team.

Why?

I’m utterly confused.

Luke sits up.

‘I can’t bear this fucking collar,’ he says, turning his head from side to side. ‘Is it on straight?’

‘Luke! Luke! You must keep still and lie flat. You’ve had a long fall and you might have hurt your neck.’

He lies down again.

‘Yes, but is it on straight? I can’t believe I put it on myself. This is fucking ridiculous.’

‘I hardly think you put this collar on yourself,’ I tell him, holding his head still between the blocks. The head injury is making him combative, I think.

But there’s no blood. He doesn’t smell of alcohol. His tracksuit and t-shirt are immaculate.

‘Where did you fall?’ I ask him.

‘I don’t know,’ he says, staring up at me. ‘The beach? You decide.’

‘You don’t remember?’

He stares at me.

Richard pushes the resus doors open.

‘Come on. Ready for you now. Bring the patient through.’

Not only is the trolley in the down position and without any poles to steer, but there’s something wrong with the wheels. They’re locked into the in-line position, and the red button that normally releases them won’t respond to my kicks. It’s difficult to do that, anyway, as two nurses are hurriedly dragging us forward and not stopping to do anything about it, even though they’re forced to lift the trolley a couple of times to make the turns.

The team is standing around a resus bed ahead of us.

‘Let’s get the patient across and take the story once he’s over,’ says Richard, running the show from a white metal trolley off to the side. ‘Ben? Airway and primary survey please.’

‘Is he on a scoop?’ says another consultant.

‘Er – no. Apparently not.’

‘Why’s the trolley so low?’

‘I don’t know. Battery’s flat.’

‘How are we supposed to get him over?’

‘Someone could get a replacement battery from another trolley.’

‘Just lift him up on the mattress for now.’

‘It’ll sag in the middle.’

‘We’ll pretend it doesn’t.’

‘No, no. Let’s do this properly. Nurse, fetch the scoop.’

There’s a lot of unconvincing fussing around.

Ben starts his assessment, leaning over me in the cramped conditions beside the trolley.

None of it makes sense.  

And then suddenly I understand. And all the facts and scraps of information that should’ve tipped me off, crowd in:

The sheepish crews.

The strange trolley.

Richard, loitering outside resus with a seriously injured patient.

Luke.

‘I can’t believe I put this collar on myself’

‘Where did you fall?’

‘You decide.’

This isn’t real life.

Nor is it a waking dream.

This is a scenario.

‘Let me tell you the story now,’ I say, speaking across the team. ‘ We’ve got Luke. Twenty-four years old. Alcohol. Fell twenty feet onto concrete. Unco for a time. Query reduced air entry on left; query left femur. Richard? Would you mind if someone else took the head? Only I ought to be attending to my patient outside.’

‘Of course. Thanks for your help.’

I’m blushing so much as I exit the doors, when I peel my blue gloves off and throw them in the bin I want to jump head-first after them.