Michael Alexander: Confessions of a Male Nurse

Russell really seemed to be doing a good job. The calm and correct way he was dealing with things was putting not just me at ease, but the patient as well.

‘I’ll leave you to it,’ I said to Russell, having got the equipment he needed to perform the procedure. ‘But I’ll be at the bed opposite if you need me. Just sing out and I’ll be right there.’

Ten minutes passed and Russell hadn’t reached out for help. All must have gone well. I poked my head through the curtain.

‘You shouldn’t be feeling a thing,’ Russell was saying to Miss Hope while gently touching her left foot.

I couldn’t believe what I was hearing.

‘I can’t feel a thing,’ she replied, ‘but my right leg is still bloody agony.’

Russell looked up at me, an expression of horror on his face.

‘When will it help my right leg? It had better be bloody well soon. It’s unbearable.’

How would Russell charm his way out of this one?

‘I think you need a bit more,’ Russell began, ‘just another small injection, and then you’ll be fine.’

I couldn’t speak up in front of the patient. The damage had been done but at least with another injection the patient would still get some relief. But in the interests of future patient safety and my own liability, I had to do something.

Once Miss Hope was wheeled off to theatre, Russell approached me, a big, albeit forced, smile on his face. But there was no Russell wink, and he wouldn’t look me in the eye.

‘Fookin’ great,’ he said. ‘Have ya told the boss yet?’

I didn’t like to be the one to turn my friend in, but this was serious.

‘Sorry, Russ, but you really messed up. At least he doesn’t know about the finger episode. It’s your first screw-up as far as he is concerned,’ I said, trying to look on the bright side.

‘Well, thanks anyway.’

Russell was taking this better than I expected.

‘I can’t believe I got the wrong leg. What is wrong with me?’

I didn’t say anything; we both knew that this could be the end of his time in the emergency room.

The senior doctor of the emergency room reacted reasonably well, with only a little shouting, and some mild threats to end Russell’s career.

Nevertheless, the following week, Russell went to work in the medical ward where he would be in familiar territory. The emergency room is not for everyone, and it’s not a place where you can bluff your way through. The emergency room is often the home of the most experienced doctors and nurses, who have spent plenty of time in the core areas of medicine. People like this don’t accept egos or incompetence. They can’t afford to when people’s lives are at stake.

‘Where’re my boots? You’ve stolen my bloody boots,’ Mr Crump shouted as he was wheeled past. ‘Did you hear me? Where’re my fucking boots?’

Tom the paramedic stood at the head of the trolley. He’d heard it all before and was now impervious to Mr Crump’s tirades. In fact, as an experienced paramedic, he’d heard a lot worse. Mr Crump was just being his normal self, a miserable old drunken sod.

‘Let me guess, the garden again?’ I asked Tom as we transferred Mr Crump from the trolley to the bed.

‘How’d you guess? Oh, that’s right it’s raining. This is the third time in two months, isn’t it, Mr Crump?’ Tom replied, with a wry smile.

‘I didn’t bloody well ask to come here. You’ve no bloody right. Where’s my boots, ya thief?’

‘Just doing my job.’ Tom shrugged his shoulders, and turned to me. ‘His neighbours found him unconscious in the garden; said they could hear him partying all night. At around eight o’clock next morning, he headed out to the garden and began digging.’

Mr Crump was freezing to touch; he was lucky to be alive. It may have been late summer, but there was a nip in the air and the rain coming down outside was torrential.

‘Mr Crump, your neighbours probably saved your life. If they hadn’t kept an eye on you, you’d probably be dead on your lawn.’ I paused briefly, wondering why I bothered to explain, but it was my nature to give Mr Crump a chance to redeem himself.

‘Bah! What bullshit. I’m not soft like you. I’ve been doing this for 50 years and I’m as tough as nails. A little rain won’t hurt me. Just get me my boots and I’ll be outta here,’ Mr Crump said in disgust.

‘The only reason you’re still here, is because every time you’ve passed out in the garden, in bad weather, your neighbours have called the ambulance. It’s not our fault you can’t handle your booze.’

Of course, I was well aware the old boy could outdrink any of us. He had all the visible signs of a serious long-term drinker: rheumy eyes that could still see, but no longer cared what they saw; a huge, red, bulbous mass that once was a nose; a wiry body, grotesquely distorted by his protruding beer belly; and worst of all, the overwhelming smell of rotten teeth, mixed with blood from his bleeding gums, combined again with spirits and beer. When people regularly drink too much the alcohol affects every organ in the body. At the levels Mr Crump drank, he was constantly poisoning himself, from his brain to the tiniest blood vessel. Long-term heavy drinkers develop swollen noses due to the damage caused by and dilatory effect of alcohol on the blood vessels. Over time, it’s the liver that takes the brunt of alcohol abuse. It keeps on getting bigger, as it has to work overtime to remove the toxins from the body. It’s not unusual to see people with a liver twice the size of a normal one, hence the swollen stomach.

Then, of course, there is the effect on the brain. I’ve seen some middle-aged men showing signs of dementia. It’s not reversible.

Mr Crump sat up in bed and looked at me expectantly.

‘Well, I’m here now so you might as well make yourself useful.’

His tone had softened a little. I felt the corners of my mouth forming a smile – I knew the routine well.

‘One or two sugars?’ I asked.

‘Two, and don’t forget the sandwiches; I’m starving.’

Tom looked at me and rolled his eyes. He too was familiar with the process.

Mr Crump inhaled the sandwiches.

‘Any more?’ he asked, picking crumbs off the plate.

Four ham and cheese sandwiches, four slices of toast dripping with butter and honey, and a cup of coffee later, Mr Crump sat back on his bed rubbing his belly, a contented look on his face.

‘Where’s me boots? Be a good lad and get me boots would ya, I’d better be on my way.’

I half-heartedly tried to dissuade Mr Crump from leaving, as he technically needed to see a doctor.

‘I don’t need to see a flaming doctor. I need to get home, back to me garden. I’m as fit as a fiddle,’ he protested.

From past experience, I knew the battle was never going to be won and I made sure that Mr Crump signed the self-discharge form, just in case he dropped dead when he walked out the door.

Sometimes it felt like nearly all my time and energy was spent dealing with the consequences of alcohol misuse. From Thursday through to Sunday night, I would have been willing to bet my monthly salary that every shift would bring in an alcohol-related patient, whether they were drunk themselves, or the victim of someone else’s drunkenness. Maybe they were all victims in one way or another, they just didn’t know it.

My experiences were sometimes amusing, tragic, horrible, or even scary, but never boring. The people affected by alcohol came from all walks of life, and from all corners of the world.

Whether it is the Mr Crumps of the world, or a first-time drinker, I’ve found patients come in two main categories: there are your nice drunks and then there are your mean drunks.