English Lesson

Blotchy eyed and with a tear-stained face, Claire meets us at the door holding a small child in her arms. His chubby face is flushed with colour and steam comes off him where the cold compress is applied to his back. A quick check with the thermometer only confirms the fever and gives it a number: 40.9 degrees Celsius, or 105 and a little bit in old (and American) money. It's the highest I've ever seen.

"I only went out for five minutes, just to get some milk from the shop. I left him with Liana - the nanny."

She whispered the next bit.

"By the time I got back you were already on the way. Sounds like he's had a febrile convulsion. She was terrified, thought she'd done something wrong, and I can't convince her it wasn't her fault - we both ended up crying. Will you have a word with her? It's just that Andy's never had a fit before."

"No problem. Lets deal with little one first. I have to say, you seem quite calm about it all!"

"I'm a paediatric nurse in the A&E down the road, actually due on shift in an hour. Obviously it's a little different when it's your own, but at least I know what I'm dealing with. We've thrown everything at him, he'd only just had paracetamol just before I went out. Poor Liana's completely freaked out by it all."

Quiet, muffled footsteps shuffled towards us, and I could see Liana tentatively head back into the lounge.

"He's OK?" A slight accent gave away her foreign origins, but I couldn't at first place the country.

"He's absolutely fine. He has a fever, and babies sometimes do that when they can't bring the fever down. He needs some medicine, but he should be just fine."

"So I shouldn't called the ambulance?"

"It was good to call the ambulance. If a baby has a fit then he needs help - so don't worry."

"I'm sorry. I don't want you tell me off, I don't want you think I hurt Andy." Her look darted between Claire and me. "I love Andy - he's like my own baby - I never hurting him!"

Claire handed Andy over to me and went to put her arms around Liana. "You did everything right. I know you would never do anything to harm him." Then she turned to me. "Liana's been here for nine months, since he was five months old and I went back to work. She's like gold dust - I don't know how I'd ever manage without her! I'm helping her with English, and she's trying to teach me Greek - although she's a much better student than I'll ever be."

At last, Liana smiled.

"I can hold Andy?" she asked Claire.

"Of course you can."

"Efxaristo!" she said as she took Andy from me and held him tight. 

"I presume that means thank you?" I asked Claire.

"You're a quicker student than I am!"

"But now," laughed Liana, "you have to say it!"

"Forget it. My language-student days are over. I'm sticking to what I know."

As we walked in to the department, Claire was met with some quizzical looks, one in particular from the nurse in charge.

"I know it's a bit rough in here these days, but now you bring your own security detail?"

"Well, you know, these paramedics, they're always hassling us, interrupting our peace and quiet. I thought it was time we hassled them instead."

"Sorry," interrupted Liana, "this word hassle, it means to look after somebody?"

We left them in the department and went to find someone else to hassle.

Can't Cure Stupid

I think, that rather than preventing my kids from leaving the car at the wrong time, I need to child-lock myself in my car sometimes. 

On route to work, I was followed for almost ten minutes by another car with a small child on the front seat. Then on the back seat. Then back to the front. 

In uniform, out of sorts, and stopped at a set of traffic lights, I could bear it no more. 

I got out of my car, knocked on the window, and was about to suggest to driver that an unrestrained child is not only illegal, but it's damned stupid, and that I didn't much fancy the idea of being the medic at the scene of an accident who had to break the news that her child's dead. Because she's stupid.

Stupid wasn't the half of it. 

On the back seat, secured by not one but two seat belts, was a brand new television. 

"Your TV is strapped in, and your child isn't? What's wrong with you?" I didn't mean to yell, but my red-headed temper got the better of me.

As luck would have it, a passing police car saw the altercation and came to tell me off, assuming another road rage incident (they were only partially wrong), only to see the real problem.

I left them to it. 

Trademark

As predicted, there was no answer when I rang the doorbell. Patients calling and claiming to be unconscious tend to be a little like the outer door I was facing - unhinged. I stopped the car one house up from the address leaving room for the ambulance to park up right outside, and left my trademark orange beacon flashing on the roof. A light was switched off in a front room confirming that the patient wasn't unconscious as they'd tried to tell the call-taker. Instead, they were probably drunk and up to mischief. 

The crew, a very friendly Little and Large, arrived a few minutes later.

"We knew it was you!" It's always nice to be greeted with a smiling pair of faces, especially in the dead of night.

"What gave it away?"

"First, the orange beacon. Secondly, this call sounds a bit crazy. It's got you written all over it!"

"Yeah, can't argue that one..."

We stood by the porch door, eventually working out that we could open that one and get to the front door itself. Just in case the patient hadn't already heard us, we knocked on that door too, shouting through the letter box for good measure. The upstairs light had stayed off for some time, so we had no option but to ask for the police. It took them a few minutes before they screeched up the road like a scene from a movie. 

"You know you've left that orange beacon on, don't you?" Asked one of the officers as they stepped out. 

"Ye-e-e-s-s-s...?" 

"You'll end up with a flat battery, you know!" They seemed to find the whole thing amusing. 

"Never happened yet. Anyway, it's my trademark. Warns the crews that they're about to face the madness..." 

Little explained the situation, whilst Large and I each tried to shift the blame for the call onto the other by giving each other's call signs to the police. After a few attempts at the traditional knock-at-the-door-ring-the-doorbell-shout-through-the-letter-box methods, they opted for the big red door key. One gentle tap later with the weighty battering ram and we were in. 

Our patient was sitting at the top of the stairs, a cocktail of drink and drugs making him unsteady both of body and mind. It took the combined efforts of police and ambulance to coax him downstairs and into the truck. Whether he'd overdosed was difficult to tell, but he was certainly drunk and very incapable, so leaving him at home was not an option. Lacking the energy to fight, he finally crumpled in a heap onto the trolley bed and the police left us and returned to their duties. 

It took us a few more minutes to check vital signs and make sure our patient co-operated. Just as the ambulance was about to leave, there was a knock at the door. A sheepish looking police officer stood there. 

"Errr, g-u-u-u-y-y-y-s..."

"Y-e-e-e-s-s-s..." 

"You know your trademark orange light that we laughed at?"

"Y-e-e-e-s-s-s..."

"Well, we take it back."

"Y-e-e-e-s-s-s..."

"Do you, just by chance, have any jump leads?" 

The Other Look

It's the look. The look of someone totally unaware of their surroundings. The room is filthy, a pile of dirty clothes here, cat litter-tray there, drug paraphernalia everywhere. Rena, his girlfriend pretended to be concerned but at the same time seemed totally disinterested. On the floor of the back room, in amongst the filth and grime, lying unconscious on the sticky carpet, we found Dan. 

Dan's face was pale, the colour drained totally from his face. His breathing was slow, shallow, barely enough to sustain his life. 

"What have you been doing today?" I asked Rena.

"Dunno." She shrugged her shoulders for good measure.

"Where have you been?" 

"Here. Didn't go nowhere." 

"Has he had anything to drink?"

"Maybe." 

"Has he taken anything else?" 

"Dunno. Don't care."

Her acting as the concerned girlfriend didn't last very long. 

"I only called you lot 'cos I didn't want no cops coming round." 

Too bad, I thought, they came with us anyway. 

Dan's pupils were tiny, pinpoint sized, leading us, alongside all the other evidence, to an obvious conclusion. We'd guessed it anyway, for once jumping to the right conclusion as soon as we'd walked into the flat. When we asked Rena if she's had the same stuff, she denied knowing what "stuff" we were talking about. In the meantime a bag and mask were helping his breathing as we prepared the injection that would reverse the effects of the heroin and bring him back to life. 

Moments later, already strapped in to the wheelchair, Dan started coming round. The look in his eyes changed, the life returned, and as we wheeled him to the ambulance, he began to respond in earnest. 

"What're you doin'?" 

"Taking you to the hospital. You overdosed and nearly stopped breathing. They need to keep an eye on you for a while." 

"Did you give me that damn injection again?" 

"If by damn injection you mean the drug that saved your life, then yes. We did. "

"I hate you. That gear cost me money!"

"Well, no money in the world would have helped you if you were dead!" 

"I don't give a damn. I might not be dead - but I hope you die instead!"

That look in his eyes, the one so recently changed from death to life, turned suddenly from life to hate. 

The Look

It's that look. The look of someone who knows they're going to die, and very soon. The room is a hive of activity, several people buzzing around trying to help but becoming more of a hindrance, and in the corner, almost hidden from view, is Glenn. His hands clasped at the back of his head, whilst Jana, his girlfriend, tries to comfort him through her own tears.

Glenn's face is tinged with blue, his lips are almost purple. He's breathing, but hardly moving any air. It seems as though his body is going through the motions, the reflex action of the diaphragm shifting up and down to allow the lungs to expand, but the area created turns into a vacuum instead of a lung full of air. The supply to his extremities has practically stopped, the brain electing to feed his core organs first on a starvation diet of rapidly diminishing oxygen. It leaves his finger-nails a deathly shade of white, whilst his pupils are dilated seas of black. The fear in his eyes radiates from head to toe. 

"He's so healthy normally," Jana tells me. "He doesn't take any medicines, not even for a headache!"

She goes on to explain that they'd been out for the evening and had no more than a glass of wine each alongside a meal at a favourite restaurant, one where they had eaten many times before. A minute or two from home, they stopped at a set of lights.

"A friend of ours stopped next to us at the lights, just by chance, and we chatted and waited for the red light to change to green. Then, he threw a piece of chocolate at us, just as a joke. It flew through the window, straight into Glenn's lap. He picked it up, popped it in his mouth, and then we drove off laughing."

The half mile home was uneventful, but as they walked through the front door, Glenn felt his throat starting to tighten.

Jana, worried that Glenn was choking, woke their housemates not knowing what else to do. One of them called for the ambulance, and five or so minutes later I arrived. Glenn is unable to speak, but the signs are classic enough. Textbook cases of anything are rare, but this one was just that. Anaphylaxis kills, and it kills quickly. Glenn's oxygen levels were low, his blood pressure dropping, and the unknown chocolate the final giveaway when Jana remembers he's allergic to nuts. He's carried an Epipen for years, but had never had to use it. The only one he had was ten years out of date.

As I prepare an injection of adrenaline, I place a mask on his face forcing oxygen laced with salbutamol into his lungs, hoping to prise open his airway. He's rapidly becoming less responsive, fighting to keep his eyes open, struggling to stay conscious. The injection into his upper arm is a last gasp attempt, but within seconds it's clear to see that it's working.

Two minutes later, the crew arrive, and as they walk in, Glenn greets them.

"Hey guys, I'm alright now!" His breathing is still a little laboured, and a loud, audible wheeze rasps across the room. It's a much better sound than the total silence of only minutes earlier.

"Don't you EVER do that to me again!" Jana slaps him on the shoulder, and then crumples sobbing into his arms.

Glenn's wheeled out to the ambulance, his oxygen levels vastly improved and his cheeks a flushed rosy colour.   In the ambulance, his blood pressure is up, the wheeze is slowly being replaced by clear breaths, and he's almost able to complete a whole sentence without becoming breathless.

Most importantly, the look in Glenn's eyes has changed. Now he no longer thinks he's going to die - he knows he's going to live. 

Two Feet

The rain is pouring down and I can't help but step across some muddy grass to get to the front door. I ring the doorbell and am thankful when it only takes a few seconds for Wendy to open the door - a torrential downpour is not my favourite choice of climate. As she pushes the door outwards, she looks back into the house and shouts. 

"They're here!" 

I wipe my feet and as I walk in I accidentally catch the strap of the bag on the door handle. 

"Can't your mate help you carry any of that?" 

"It's just me for now. There'll be another ambulance along soon enough." 

"Well, I don't know how you're going to get him off the floor on your own! I mean, he's been there for hours, and I've tried all I can do. He just keeps shouting at me that it hurts!" 

"Let's have a look and see. If I can help him on my own, then we'll do that. If not, I'll make sure he's comfortable, and we'll wait for a couple more pairs of hands." 

Clive's lying flat on his back, his legs in the kitchen, whilst his head and torso are out in the narrow corridor. It's rarely that these falls occur somewhere simple, and I have no choice but to step over him repeatedly, assessing for injuries and vital signs. 

"As long as I lie still," Clive's voice has a sing-song quality to it, "I really don't feel that ill. But if I try to get up or move, well, that's a different kettle of fish altogether." 

"Where's the pain?"

"In my left hip. I've already had the right one replaced, and I expect I've got the same treatment coming up now on the other side." There's no way I can move him on my own, and I've just been helpfully advised that the nearest crew may as well be in France. 

"The boss tells me you've been down here for hours. What time did you fall?"

"Oh, no. I only fell about ten minutes before she called you. She gets a little confused at times." He whispers the last bit, hoping not to upset his wife of more than fifty years. 

"I heard that!" She yells, out of sight, but clearly not out of earshot. "I don't get confused, thank you. Just forgetful!" 

Clive beckons me nearer. "Forgetful then, but selectively good hearing too."

"OY!"

"Told you!"

The crew arrive over half an hour later. In the meantime Clive's had all the pain relief I can safely give him, any minor wounds have been bandaged and I've strapped his legs together to try to take some of the strain off his hips. It takes about the same time again to manoeuvre a scoop stretcher into place to try to get him out the house. 

We split the scoop in two, separating the hinges at each end and gently move each side underneath him. We need to keep him as straight as possible to avoid moving his hip, but there's no way the now rigid stretcher will make the turn around the tight corner and into the narrow corridor. We try moving further into the kitchen to get a different angle, then try again to move in the opposite direction. The only success we have is in leaving dark footprints on the cream carpet. 

"I'm sorry, Clive, but there's nothing for it. We're going to have to stand you up. But don't worry, we'll keep you on this stretcher, strapped in, so you won't actually be standing at all. Is that all alright with you?" 

"No problem. Just do what you have to do." 

We add some extra straps for support, forming a "figure-8" around his feet and the bottom of the scoop, ensuring that when we stand him up, he won't move anywhere. 

"You can close your eyes if you like, it's probably a bit of weird sensation rising like a zombie." 

"With all that stuff you've given me, I feel like a zombie anyway!"

"Ah. That'll be the morphine. Told you it was good stuff." 

"You weren't kidding!"

After more to-ing and fro-ing, furniture moving and a few more wet, muddy footprints on the carpet, we finally manage to get Clive out to the ambulance and make sure he's as comfortable as possible for the journey. His wife joins him, and just before I shut the doors, I apologise. 

"Sorry about the footprints. If there's a next time, which I hope there isn't, I'll come in barefoot. Failing that, you could try calling when it's sunny instead." 

"Don't worry about it," says Clive. "Hopefully the next set of mucky footprints on there will be when I'm back on my own two feet." 

Head Injury

Barely a cupboard under the stairs, the tiny top-floor room in the residential care home had no more than a bed, a two-door bedside cabinet and a tiny sink. The floor space was almost entirely taken up by Jasmine, and she was no bigger than a ten-year-old. As I walked in through the door, the sloped ceiling made me tilt my head to the right a little, just to make sure I walked in unscathed. 

From the look of her, Jasmine looked like she weighed no more than a wet tea-bag, and even then after the water had been squeezed out. Her skin was dry and fragile, veins spidering up arms so thin they seemed as though they would snap like sun-dried twigs. The red tinge to her thinning white hair gave away a secret, as yet unseen, cut to her head. She lay there confused and a little disorientated, but a winning smile crossed her face. 

"I'm not too sure how I ended up here, but I think I'm alright. Just get me up and I'll get right back on that gin that must have floored me in the first place!" 

"Now, Jasmine, if you'd have said whisky, I'm your man, but not gin. Might have to leave you on the floor until you can choose a proper drink."

The care home staff looked horrified, but Jasmine saw the funny side. 

"You'll do as you're told, young man! Now get me up so I can see exactly who I'm telling off." 

With the help of one of the carers, Jasmine was lifted off the floor and helped to a chair. It was the first we saw of the damage she'd done to her head. 

"You're going to need a trip up the hospital, I'm afraid. That's quite a nasty cut you've got on your head." 

"I'm not going anywhere, but back to bed." 

"Jasmine, your scalp looks like you've put a cat-flap in it - it needs sticking back together again. It's that impressive, that I can almost read your thoughts!" 

"I'm NOT going to hospital!" 

"See! I knew you were going to say that!" Jasmine eyed me suspiciously, a small, half-smile giving away her amusement. 

I tried to replace the flap of skin back in place and hold it all together with some bandaging. The carer who helped me lift Jasmine off the floor started to feel faint at the sight of the injury, so I sent him to get something completely irrelevant, allowing him to get some fresh air and maintain some dignity. 

As he left, the ambulance crew arrived, the two-wheeled carry-chair in hand. Having spent a few minutes explaining, cajoling and joking with Jasmine about her injury and the need to have it treated, she finally agreed. We helped her into the wheelchair, wrapped her in a blanket and secured her with the belt.

"At least I managed to arrange a blanket that matches your new hair colour. Anyway, I'll leave you with the  friendly ambulance crew, I'm sure they'll be nicer to you than I was." 

As they turned the chair around, Jasmine said a polite "Thank you", and I turned back to sort out all my bags. 

"I'll check on you a bit later at the hospital if I get the chance, make sure you're behaving yourself." 

"You do that. I look forward to it. And make sure you don't forget that gin!" 

"Whisky!"

"Oh. Alright then. Make it a whisky." 

With that, Jasmine was wheeled into the lift and taken down to the ambulance for the short journey to the hospital. I tidied up the mess of packaging, wrapped some of the blood-stained bandages in an inside-out glove, picked up all my luggage, turned to leave the room, and without looking up properly, walked head-first into the low sloped ceiling.

Milk Bottle

Two bottles of milk by the front door,

A neighbour sensed something was wrong.

"She has one bottle delivered each and every day!"

A light was on,

The television flickered through a sliver of open curtain,

But there was no answer to our calls.

A kick, another kick, and the door splintered open.

In the kitchen, by the table and an upturned chair,

She lay where she fell.

A bowl of dry cereal sat waiting,

For an unopened bottle of milk.

Sppel Chekking

I admit, I'm a pedant. I don't claim to be perfect at it, but to me, spelling matters. 

I have an editor and a sub-editor for this blog who regularly pick up on mistakes I make, as well as using the sppel chekking fasility, because grammatical errors aren't picked up. 

So, in a begging open letter to our call takers, I ask you to please check your spelling. 

I know that if the message on the screen tells me the patient has "palpertayshuns", I can understand what it means. 

I know that if the patient apparently has narrowed "artoreys", he's at risk of heart problems, and not, as would seem at first glance, that he's a high-risk attorney. 

Vomiting. It has one 'T'. Lots of carrots and a dreadful smell, but - Only. One. T. 

Assmah. Really? Or are you just sending coded messages as to what you think of me? 

Stares. As in "The patient fell down the stares." Into my deep, dark, bloodshot eyes? 

And many, many others. Some amusing, some confusing. 

So please, dear call takers. I know it all happens in a hurry, I know the callers aren't always calm, clear and concise. And believe me, I know, that for all the tea in China, I couldn't do your job. But I beg of you; please, please, check your spelling before sending it down the computer to the often baffled crew... 

Anyone else out there got some good ones to share? Feel free to add your comments!