This is just another part of the job that I like – that sometimes I have to out-think problems. I can’t see me doing this in an office job.
There is something that I’ve learned over many years of health-care work. When you are lifting little old ladies with senile dementia, they will sometimes grab you by the testicles.
And squeeze …
This hurts.
I swear, the greater the degree of dementia, the greater the accuracy and the stronger the grip.
And for the love of all that is holy …
Don’t drop them.
That hurts even more …
When I went to the Clap Clinic for my HIV test, I was referred to a ‘Health Adviser’, which is a new name for Counsellor. I am, as regular readers may appreciate, a fairly simple, pragmatic person: within hours of my HIV exposure I was aware of transmission rates, odds of infection and the rates of death caused by electrocution (1 in 5 000) and shooting in America (1 in 2 500). So, to be honest, counselling was the last thing I needed.
I did a counselling course when I was a nurse, and it did nothing to disabuse me of the notion that all counsellors are hippies who consider themselves ‘worthy’.
She asked me a load of questions about how I would cope if I were to be found HIV positive (answer: get over it), and cautioned me not to tell anyone I was testing, unless I was happy for them to know the result (answer: the whole world could know – if they read this site). There was some other stuff that is just too dull for words, and definitely too dull to read.
The thing that amused me the most, however, was not that the ‘Advice Room’ had the only comfy chairs in the place but that the counsellor was wearing a sari (the Indian dress). In and of itself not unusual, except that the woman wearing it was ‘whiter’ than me.
I’m well used to ‘white’ women wearing various Muslim dresses – it’s a religion after all – but as far as I’m aware a sari is a cultural thing. I’m guessing that in her ‘equal-opportunities, worthy, multicultural’ world that she is proving how non-racist she is. This is handy because to be honest out of the 20 or more people at the clinic I was in a race/culture minority of one. Not a problem, I know Newham well … it’s very diverse, but I wonder if Asian people would be impressed or nonplussed by her wearing a traditional Indian dress?
Maybe I should start wearing nothing but a Papuan penis sheath?
The HIV test result should be received by the 28th …
I’ve tried as hard as possible to make this sound as non-racist as possible – at no point have I meant to cause offence. I hate no ‘race’ more than another – I hate them all.
‘I hate them all’ – a philosophy to live by.
Our second call of the day was to an address where the elderly woman who lived there was believed deceased – the neighbours had called the police, and the police had called us. What this often turns into is us struggling to gain entry to the house, normally resulting in an injury to me, only to find someone who has been dead for some time.
We rolled up to the house and met with the neighbours who led us around to the back garden where, peering through the rear window, we could see the old woman sitting in her chair looking pale, still … and very dead.
Simultaneously, my crewmate and I jumped back in shock as we saw her take a breath!
She was breathing about six times a minute, and surely didn’t have much longer left to live – I rushed around the front and kicked in the front door (in one hit – something I’ve never managed before) and we got her out to the ambulance in double-time. We quickly decided that it would be wrong to ‘stay and play’, instead opting to ventilate her via ‘Ambubag’ and to monitor her cardiac rhythm and her pulse (which was strong and regular).
The hospital had a team standing by, as we had notified them of the patient on leaving the scene. The transport time to hospital was about 2 minutes, and on arrival the A&E team leaped into action, intubating and ventilating her, gaining venous access and running the various blood tests. Family members were contacted and plans for her treatment were drawn up. At no time did I feel that this 88-year-old woman was receiving anything other than the best treatment possible.
We cleaned the ambulance and restocked before going onto our next job; each time we returned to the hospital we popped our head into the Resus’ room to check how she was doing; there were plans to CT scan her head and to move her to ITU (intensive treatment unit). The family arrived and after some discussion it was decided that the best care for her was going to be palliative (that is to make her comfortable, but not to do any invasive procedures and to allow her to die). This was, I feel, the right course of action – the lack of oxygen would make any survival short and probably result in serious brain damage.
It has been a very long time since I’ve felt a great deal of sympathy towards someone, but this was one patient that I did actually care about, and not just because I’m soft on ‘little old ladies’. She had little chance of recovery, but we hoped for it anyway. She fought for her life, and had probably been doing that for the whole of the night. Because of our actions, and the actions of the hospital team, she wasn’t going to die alone, and she wasn’t going to die without her family saying a final goodbye to her.
It’s a small victory, but sometimes those are the only ones you get.
Yesterday we got a call to a 27-year-old male, diabetic having a fit. It was only 4–5 miles away, but travelling through Newham on a Saturday afternoon is always slow business – this was compounded by one of the roads which we use as a shortcut being closed for resurfacing. It took us 14 minutes to travel those 4 miles. Then it was up 5 flights of stairs into a flat where the first thing we could hear was hysterical sobbing. As I’ve mentioned before it’s one of those sounds you know means trouble.
Squeezing past a large bed we entered the bedroom to find a First Responder ‘bagging’ the young man, who was lying motionless on the floor. Sitting on the bed wailing, was a young woman who we discovered later to be his fiancée. The patient was connected to one of our cardiac monitors and it was showing sinus rhythm. Kneeling on the floor I did a quick pulse check – beat, beat, beat … then nothing, no pulse for 10 seconds. During the pulse check I was getting a history. Apparently the patient was an insulin-dependent diabetic, who had possibly been neglecting to take his insulin injections. He had become more agitated during the morning until he collapsed and started fitting after having an argument with his fiancée.
With a monitor showing an apparent sinus rhythm the patient was in ‘pulseless electrical activity’ – we can’t ‘shock’ this rhythm so I started CPR. From out of his mouth flew some bloody saliva, straight towards my face, luckily impacting on my forehead rather than ending up being swallowed (I don’t want to make that a habit).
One round of CPR (3 minutes later) and we got a pulse – the patient started ‘cramping up’, all his muscles had gone into spasm. A very quick blood sugar measurement reading showed ‘HI’ (a reading of