Norma

Norma is usually a bundle of laughs, a handful, and was a real joy to meet. Bed-bound she may be, but her physical restraint had left her mind sharp. At least that was the case the last time we met. That first time, she was trying to escape the nursing home that had become her prison. She knew she would never make it past the bed guard. She'd never really recovered from the faint that led to her falling and breaking both hips. No longer able to walk unaided, she'd been forced out of her lifelong house and into the care of the nursing home.

She sat on the floor, refusing to accept in her heart that which her head was already telling her.

"I'll get up and walk. You ain't taking me to no hospital!" That before I'd even opened my mouth to greet her. Something told me that this battle of wits would be good natured rather than nasty, but it looked like it may well be protracted. As we checked Norma's injuries, it was difficult to know whether what we were seeing, and hearing for that matter, was from the previous fall or this one.

"I'm a war veteran y'know!" she said at one point.

"Which war was that then, Norma?"

"The Forty Year War!"

I had to admit that I'd not heard of it, which was a little surprising. You'd think that something that went on for that long would have registered somewhere in my brain during history lessons.

"Enlighten me", was the best I could come up with.

"Forty years it took me to realise that I wanted shot of that man! In the end, I took him for everything he was worth! Now he's got the kids, the grandkids and our house, and all I've got is a prison warden for a nurse!" She laughed the sort of infectious laugh that you can't help joining in.

I looked back on the information sheet that gave all Norma's details and saw that her next of kin was her husband.

"How come it says here that you're married then?"

"I didn't say I got divorced, did I? I just kind of moved out!" Another burst of laughter, but this time it hurt her hip when she moved. I just raised an eyebrow in her direction, and didn't dare say another word for a second or two.

"Alright", she growled, half joking, half serious, "you can take me to hospital. I promise to behave now!"

And behave she did. Before we moved her, I decided that it might be an idea to give her some morphine to help with the pain, and explained about putting a needle in her arm to be able to give her the medication.

"You miss this vein", she threatened, "and I'll pull the needle out myself and jab it in your eye!"

No pressure then.

Soon the needle was in, the morphine coursed through her veins and provided the much needed relief enabling us to get her to hospital as comfortably as possible. After we'd moved her onto the hospital bed, Norma even managed a thank you, put out her hand to shake ours, and gave each of us a kiss on our fingers as if we were each the Pope. At least. "You lot should be treated like royalty, not like bloody cab drivers!"

I smiled and wished her good luck. We left Norma at the hospital, and by the time we came back, she'd already been moved to a ward.

Now, Norma and I were meeting for a second time, this time I was alone, at least initially. There was none of her wit, no sharp tongue to contend with, none of the feistiness that made her such a pain in neck, yet a pleasure to help.

Norma was unconscious. The nursing home staff told me that she was diabetic. They checked her blood sugar which they found to be dangerously low, and so decided to force feed her a sugary drink to try to help.

Not such a great idea with an unconscious patient.

The rest of her basic observations weren't so good either. A pulse and blood pressure so low that they were barely readable, with an ECG that confirmed what I already knew - her heart was really struggling. She was hypothermic as well, her body temperature dangerously cold despite being in a room that was so hot I was sweating from the moment I stepped in.

The crew backing me up turned up after a few minutes. I'd made sure they were updated before they arrived as to what was really happening, and the fact that it wasn't exactly as the call had originally been sent. In fact, it wasn't even close. "Diabetic problems, patient conscious and dizzy" was what I had initially expected, although I'd learnt long ago that not everything the call-taker is told is what is really happening. The patient calling for an ambulance because their own heart had stopped is a real, if a little far-fetched example.

As they came in with the stretcher, Norma's breathing became erratic, the oxygen in the mask now needing some external assistance to make its way into her lungs. We moved her across from the nursing home bed to ours, with the staff complaining that we'd taken their sheet with the patient. If it had been some sort of expensive bedding, I might have had some sympathy, but it was nothing but a regular hospital sheet. We were followed out to the ambulance by two members of staff, one carrying an envelope with the photocopies of Norma's details and drugs, the other empty handed.

"Is one of you coming with Norma? If so, we'll be going in a couple of minutes."

"No. We're not coming. We don't usually send anyone, just the letter."

We load the trolley into the ambulance, and as the hydraulic ramp closes, a voice calls out.

"Can you please make sure you bring that sheet back?"

Incredulous, just as I'm about to shut the other door, I look out the back at the two people charged with the care of so many, but couldn't muster an ounce of understanding between them.

I open the cupboard at the rear of the ambulance, find a spare sheet, and throw it out at them, leaving them fumbling over the cascading linen.

Looking back at Norma, I'm left wondering what her sharp tongue would have replied. I'm sure she'd have found the words at a time when I was fuming, but completely speechless.