Tom Reynolds - More Blood, More Sweat and Another Cup of Tea

I had a similar job the day before, another job where I ended up wrestling with a mentally disturbed patient.

What struck me as amusing was that on consecutive days the first job of the shift was to someone with an altered mental state who was blaming their God and the Devil, and who would later go on to show us their genitals.

I wonder if it’s something in the water?

I also sometimes wonder what the mentally disturbed would rant and rave about if we hadn’t thought up the idea of religion.

After two days of struggling with people, it was nice to go back to the simple jobs that are a joy to do. It’s also good to see a sense of community.

In this case it was a little old lady who had tripped over a wobbly pavement in one of our local markets. She was surrounded by people of all backgrounds. There was a black market warden who had put cones over the offending paving stones. A Bangladeshi man was chatting to her and two Greek-looking men met me at the ambulance and led me to the patient. A Sikh stall keeper also pointed me in her direction.

The patient herself was one of the dying breed of ‘traditional’ English east Londoner. Normally an extremely healthy 80-year-old, she had a graze to her nose that refused to stop oozing blood. A real pleasure to talk to, we chatted about how the east of London has changed in her lifetime and how she still enjoyed living here.

‘I’m an ethnic minority now,’ she told me, ‘but there are still a lot of people around who’ll help you out.’

And she was right—as an ambulance person I tend only to see the worst of people. I go to the assaults and the arguments. I hear about the murders and the abuse, the neglect and the trouble. Just as this woman was, for me, an unusual patient in that she was a healthy 80-year-old, so it was that I saw the unusual event of people helping someone in distress.

It was one of those jobs that leaves you with a smile on your face for the rest of the day.

Here is the thing—I’m a pretty poor liar. I don’t get much practice, I don’t like doing it and as part of my personality flaws I love sharing things that I know with anyone who’ll listen. Unfortunately, in this business you need to try to keep some things to yourself.

I was called to a place of work where a 55-year-old woman was complaining of constant headaches. When I arrived on the scene a work colleague was comforting her as she had obviously just been crying.

I got a verbal history from the patient—the headache had been coming and going for two weeks and normal painkillers weren’t touching the pain. There was no other history of ill health, she hadn’t been to the doctor for years and she had no allergies. She told me that on that morning she had woken up with the headache and also a feeling of ‘not being connected to the world’. Once more, her painkillers hadn’t even touched the pain.

A quick ‘n’ dirty neurological examination didn’t reveal anything particularly scary and her observations were all normal apart from a moderately raised blood pressure. I discounted the blood pressure as her being scared and sitting in the back of an ambulance looking at my ugly face.

So we had a drive over to the hospital.

All through the trip I could see that her main fear was that she had grown a brain tumour. The words were never mentioned but her fear was of such intensity and direction that I knew that this is what she was thinking. I would have loved to lie to her. I would have given a lot to be able to put my arm around her and tell her that there was no chance of the headaches being caused by a brain tumour.

But I couldn’t.

I had to sit there and explain about all my ‘negative findings’. I could tell her that her pulse was fine, that she hadn’t had a stroke, that her blood sugar was better than mine and that her short neurological exam didn’t show anything unusual.

But I couldn’t tell her what she wanted to hear.

We reached the hospital, and while I handed over to the nurse one side of her face started to become numb…

A little later, while returning to the hospital with another patient, I saw our woman in the resuscitation room. She was sitting up and talking to her work colleague who had accompanied her in the ambulance. I wondered why she was in there but was too busy to ask the resuscitation nurse.

Towards the end of my shift I saw our patient walking back from the toilet (with colleague still in tow). I asked her what the doctors had found.

‘They are keeping me in,’ she told me and my heart sank, ‘apparently I have a really high blood pressure, and that’s what’s been causing it.’

‘Oh superb!’ I said. ‘They can cure that!’

You could see that she was a lot more relaxed, and that her main concern was that she was now going to be in hospital while the doctors treated her blood pressure.

Hardly a concern at all.

The thing that I didn’t tell her was that her blood pressure had been so high, our machine for recording it hadn’t been able to measure it correctly. Which is a little troubling.

Let’s imagine that you are old and need a bit of care in your home—simple stuff, nothing too taxing, just a bit of a hand to help you wash when you wake up. Maybe you need help with some of the fiddly little tablets you have to take. Perhaps you just need someone who’ll help you keep your flat tidy.

Then, for the sake of argument, let’s say you’ve had a bit of a fall—nothing too serious, it’s just that your legs are starting to get a bit weak, and you don’t want to use the walking frame the hospital has given you. You are lying by your front door. You press the community alarm button you are wearing and when your carer arrives she lets herself in and then the ambulance people.

The ambulance people quickly check you over while you are on the floor—they let you know that they don’t want to pick you up if you’ve broken your leg. So you let them examine you, and when they find nothing, you ask them if they can just put you in your normal chair by the television. You wonder why the ambulance crew are tutting at your carer for not at least putting a pillow behind your head while you were stuck on the floor.

The ambulance crew help you up and put you into your favourite chair. As you aren’t hurt by the fall you don’t want to go to the hospital—you’ll only sit in the department for several hours before some young doctor tells you that you should be using your walking frame. It’s easier to sit in your own flat. The ambulance people seem pretty nice, though, and they want to give you a full physical check-up to make sure that there is nothing obvious that would cause you to fall.

You tell the ambulance people that you’ve been having a few falls as your legs have been getting a bit weaker recently, but that you get around all right and that you have the community alarm button around your neck should you get into any trouble. The ambulance people try to persuade you to go to hospital, but you refuse again. One of the ambulance people checks various pulses and pressures and sugars and heart tracings before agreeing that you can refuse to go with them.

The ambulance man is looking around your flat and tutting at the carer again. He doesn’t like it that as he walks around he is making a crunching noise as he crushes your tablets which are strewn all over the carpet. It’s not your fault that you sometimes drop them. It’s not the carer’s job to make sure that you can take your pills.

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