Sunday, April 13, 2014

guess what

‘You’ll need a back board,’ says Paul. Then he lets go of the door, turns round and heads back inside, where he resumes his position, spooning with Cariad on the bed in the sitting room. It’s a double-sized frame with two single mattresses, a high one for Cariad, and a lower one with a spread of all her necessaries – two laptops, a pile of inco pads, a box of tissues, an assortment of treats, a landline, mobile phone and walkie talkie, all charging in a nest of cables.
‘I’m not going to hospital,’ she says, pushing her wig back to get a better look.
‘The bloody doctor needs to get off her fat arse and get down here now,’ says Paul.
He’s as bulky as Cariad is fragile. The bed dips alarmingly in his direction, and she has to bunch up her knees and cheat her weight forward to avoid being drawn back and the two of them roll off onto the floor. But even if they did they wouldn’t hurt themselves. The bed is surrounded by a clutter of soft toys, coats, cushions and assorted bric-a-brac.
‘So what’s the problem?’ I say, adding a little pathetically ‘We haven’t been told much.’
‘What’s happening,’ says Paul, shifting his bulk into a sitting position, ‘What’s happening is that Cariad has been choking to death, turning blue and everything and the doctor won’t do a thing about it. She just told us to call you lot.’
The way he says lot. A candy-coating on something bitter.
‘Well if you were turning blue it’s no wonder he said dial 999.’ I put my bag down. ‘So how are you feeling now?’
‘Like I’m going to die, that’s how I’m feeling now,’ says Cariad. ‘I can’t breathe properly. My inhalers don’t work. I’m going to choke to death and no-one cares.’
Her voice is sharp and short as a paring knife.
‘The good news is that you’re able to talk to me now,’ I say. ‘So your breathing is okay for the moment.’
‘Oh? It’s okay, is it? Well I’m sorry if you think I’m wasting your time.’
‘No, no. That’s not what I meant. I can tell even without listening to your chest that you’ve probably got a bit of a chest infection.’
‘A bit of a chest infection? Is that what he said? A bit of a chest infection?’
Paul stands up and stomps out of the room, muttering.
I have a sudden, empty feeling, like a mountaineer who’s stepped confidently out onto a slope only to find it’s really a bridge of snow over a crevasse, doomed whether he goes back or carries on.
‘Anyway, it doesn’t matter,’ she says. ‘I’m not going to hospital. How will I get home?’
‘Why don’t we check your SATS, blood pressure and the rest and then take it from there?’ I say, opening my bag. ‘One step at a time.’
Paul comes back into the room, red in the face, like he’d only nipped out to shoot steroids in his neck.
‘What’re you doing now?’ he says. ‘I’m her carer. You should ask me first.’
‘Cariad’s the one who has to decide about her treatment,’ Rae says. ‘But obviously we won’t do anything that everyone’s not happy about.’
‘I’m not happy about it, ‘ he says. ‘Not happy at all. First the doctor, now this.’
Rae takes some observations, I write them down, asking questions that Cariad answers reluctantly.
‘Everything’s looking pretty good,’ I say at last. ‘It sounds as if you do have a chest infection, Cariad. Lying down like this makes it difficult to clear your lungs. Are you able to sit up? Only I saw your wheelchair in the hall and I thought maybe...’
‘No! I have to lie flat.‘
‘Okay. Well. Given that you went blue a little while ago, and it’s obviously been distressing for you...’
Paul snorts.
‘...the safest thing would be to take you to hospital. Even though it might be difficult to get you there.’
‘Like I said,’ snaps Paul, ‘You’re going to need a back board. Why does no-one ever listen?’
‘I can’t go to hospital. Not after last time.’
‘What happened last time?’
‘No-one would take me home, so I had to lie on the floor of a taxi, screaming in agony the whole way. I won’t do it, Paul! I can’t!’
‘If she goes to hospital, are you going to bring her back?’ he says.
‘It won’t be us, and I can’t even say it’ll be a frontline crew. But this should be the last of your worries given the problems you’ve had with your breathing. You’ll just have to cross that bridge when you come to it.’
‘I’m not coming home like that again,’ wails Cariad. ‘I’d rather die here.’
‘I’ll protect you,’ says Paul, plucking up a teddy bear by the face and looking at me.
‘If we do decide to go in,’ I say, trying to keep my voice as low and steady as I can, ‘it’ll be a little difficult getting out. We’ll have to clear all this stuff off the bed to get to you.’
‘No! Not my stuff!’
‘We’ll put it aside somewhere safe.’
‘Then what?’
‘Then we’ll have a think what’s the best way to get you out.’
‘A backboard. Christ, how many more times have I got to tell you.’
‘Try to keep your temper, Paul’ I say to him. ‘We’re doing our best.’
‘The last crew dropped her.’
‘I’m sorry to hear it.’
‘Yeah. Well. You’re sorry.’
He throws the bear off to the side, snatches up a box of tissues, tosses them after it.
‘We’re definitely going in then, are we?’ he says to Cariad.
‘I don’t know!’ she shouts. ‘Why can’t the doctor come out?’
‘We could certainly call the doctor and see what they say,’ I suggest.
‘Do it,’ says Paul.
‘I’m not speaking to her,’ says Cariad. ‘Useless piece of shit.’

Rae calls the doctor. After a while she hands to phone to Paul.
‘She wants a word.’
Paul grips the phone, holding it a little way off from his ear, like he’s wary of infection. After a short series of grunts and sighs he hands it back, then leaves the room again.
Rae finishes the call, and hangs up.
‘She wants you to go in for a chest X-ray, Cariad. Just to rule out the possibility of pneumonia or other complications.’
‘But how am I going to get back?’ says Cariad.
‘They can’t do an X-ray at home.’
Cariad buries her face in a pillow.

We call for another crew to help. Even though Cariad isn’t heavy, the fact that she has to be kept flat makes things tricky. The front room is cramped, we can’t get the trolley in the front door, and the only way out is through the kitchen and down a short flight of concrete steps into the garden. It’s no wonder the other crew struggled.

Ordinarily – perversely – I quite like these difficult extrications. Three-dimensional puzzles that demand a creative use of kit, teamwork and a flair for cheating angles. But Paul changes the dynamic. He masses darkly behind us all  like a thunderhead storm cloud, flashes of disapproval, spots of anger.

Just before the second crew arrives I offer to help clear the second mattress.
‘You’ve fucking asked me that already,’ he shouts. ‘I’m doing it, aren’t I?’
‘Please don’t swear at us, Paul. Okay?’
He keeps his back to me as he unplugs the laptops. I’m increasingly mindful of striking distances. 

The second crew gets here. Between us we discuss how best to get her out, at the same time struggling to contain Cariad’s rising levels of anxiety. She won’t even let us look at her meds. She clutches them to her chest like she’s terrified we’re going to steal them.
Despite everything we manage to get ourselves into position, ready to slide Cariad from the furthest mattress onto the backboard.
Ready, set – slide!
She screams, even though I’m certain we haven’t done anything to cause her any pain.
‘That’s it! Stop! That’s it!’ shouts Paul, storming forwards. ‘You can fuck off, the lot of you! I’m not having this. Put her back. You put her back how she was! Now!’
‘Please don’t swear at us,’ I tell him, wishing I could think of something else. ‘We’re doing our best.’
‘Well it’s not good enough. Put her back, now.’
‘Is that what you want, Cariad?’ asks Rae, in a steady voice. ‘We can carry on and take you to hospital if that’s what you’d like us to do.’
But Cariad is just crying and shaking her head, so we slide her back, pack up our things and leave.

We rendezvous back at base to put in an untoward incident form, and to alert any other crews who might have to attend in future. Whilst we’re there, Control ring. They want me to tell them what happened. ‘Because we’ve got Paul on the phone,’ says the dispatcher. ‘Guess what? He says you refused to take her to hospital.’


TomVee said...

I bet on the life of my dead grandmother that Cariad could have walked out the door and to the hospital at any time. Paul, however, seems to believe he's in charge, that he's the one steering things... sorry Paul.

Cassandra said...

Oh dear god… it's people like that that make chronic illness patients like us look bad. The kind that make every. single. thing. a catastrophe and a mountain to climb in and of itself and of COURSE they know best and all the *trained* health care professionals are incompetent idiots and they know best and… hold on. I have to finish reading it. I just needed to stop and rant. I'm at "back board! we need a back board! why won't anyone listen? don't worry! I'll protect you! *squeezes teddy bear* no! not my stuff!!!!"

Okay, I'm back. I finished it. And all I've got to say is.. oh. dear. god.

You've got to be fucking KIDDING me.

I'm done.

I can't even…

No. Just no.

Go fuck yourself, Paul. You make it difficult for people like us to get legitimate help, Paul and Cariad. I'm a million times done with you.


*stalks off, tail lashing angrily.*

Spence Kennedy said...

TV - I must admit I wasn't convinced, either, but what can you do? (Other than struggle to remember all those mindfulness techniques I thought I'd got off by heart...)

Cass - I must admit my tail was equally agitated when we lit out of there for the sanctuary of the ambulance. It was a situation sent to try us - and I'm not altogether convinced we passed. But hey - no-one died, so it wasn't that bad.

I have to say that experiences like that don't change how we feel / deal with chronically ill patients generally, so don't worry. And people like P&C are very much in the minority. In the cause of balance, it's probably worth saying that long-term stress can wreak terrible damage. I know it must be tough on both of them. (I just wish they wouldn't take it out on us).

Cheers for the comments! :)

tpals said...

I'm all tensed up just from reading it, can't imagine experiencing it.

Lynda Halliger Otvos (Lynda M O) said...

Yowza !~! Interesting how folks live, isn't it ?~! You must see so much of life in your job, Spence. I so appreciate all who serve others.

Anonymous said...

Paul needs to pull his head out of his backside! My sympathies having to deal with that twit.

Spence Kennedy said...

tpals - It was pretty tense. Even a second crew didn't seem to dissipate his fury any, which is a measure of how deep it ran, I suppose.

Lynda - You certainly do get to see all sorts. I should point out that most of the people we go to are absolutely fine, though. The very next day we had wall-to-wall lovely people (another note to self: write about them more!)

anon - Definitely! I don't mind helping him with that (he said bravely, from a safe distance away...)


Thanks for all your supportive comments! Very much appreciated :)

jacksofbuxton said...

Don't know where to start with that one Spence.I suppose that address now has a red flag alongside it."Requires armed guard and tranquiliser darts" and they're just for Paul....

Spence Kennedy said...

I wonder if it will get any kind of warning on it, Jack. The thing about flagging addresses is that unless there's been an actual use of violence, they're reluctant to put any notes on. From our point of view, we'd certainly be unhappy with a single responder attending. But all this stuff seems to get done after the event rather than before - very frustrating! Esp. when you can see he's ready to blow! :/

Blair Ivey said...

Which is why I couldn't be an EMT in the UK, anyway. My overwhelming thought would have been to tell Paul to step right the f*** off. Kudos for keeping you temper.

Spence Kennedy said...

It is a struggle, Blair! In fact, I was so wound up by the whole business that I went online to read as much as I could about how to deal with angry people! We'll see how effective it's been when I get the next one... :/