Mood Swings

The gesture is so unexpected, coming from someone clearly suffering as much as Leah is. Lying in her makeshift bed as she has been for two days, a look of pain etched on her face, silently spelling out the words that she refuses to say. Instead, all she does is smile and tell us that everything is alright. 

"It's just a little painful when I move," Leah tells us, except that she can't move at all. The tell-tale sign of one leg appearing shorter than the other leads us to the quick conclusion that she probably has a broken hip - fractured NOF - or neck of femur. I remember wondering in the very early days of my career what a "nekkafeema" was, only summoning up the courage to ask after I could no longer hide my embarrassment at not understanding yet another medical term. 

Leah's son, a tall, sickly looking man of fifty, appears almost as old as his mother and at first I mistook him for her husband. He tells us that she had fallen almost a week ago. Since then, the pain has gradually increased, her mobility slowly becoming more and more limited until eventually she could move no more. 

"It's taken us days to convince her that she needs help!" Leah's son explains. "Every time I've picked up the phone to call you, she screams at me that she'll die if she goes to hospital." 

The smile on Leah's face cracks a little, like an ice-cube in a glass of water, still present but a little changed, and the polished facade she has paraded for her family and initially for us no longer holds strong. "It does hurt, but not too bad. Are you sure I need to go to hospital?" I explain that there may be, in fact probably is, a fracture, but the only way to tell for sure is to have an X-ray done. The old, well-worn joke that I left my X-ray glasses in the other ambulance rejuvenates her smile a little. 

We're lucky. Leah is lying on a strong sheet that we can use to manoeuvre her. She has cushions for support all around and we use all of these to help move her as gently as possible onto the trolley bed. The first couple of attempts catch her off guard, despite my warning that she would feel a little pain when we helped her across. It makes her grab hold of the bed railing and prevents us from carrying her from her bed to ours. On the third attempt, I make her promise that she keeps her hands still and if necessary grabs hold of my arms. That way, at least we'll still be able to keep moving in the right direction. It's a successful move. We're grateful for the lift that means we only have to transfer her once, rather than into a chair and only then on to the bed. Fewer moves means less pain. 

At the hospital, Leah withdraws a little, showing the apprehension that her son had warned us about. "Are you leaving me here now?" 

"As soon as we make sure that you're as comfortable as possible on a hospital bed, then yes. It's the hospital's turn to take care of you." She doesn't seem too keen on the idea, but resigns herself to it nonetheless.

"I have to tell you something," she says once she's calmly lying on the hospital bed. She motions me to stand a little closer, as if she has some state secret to sell. Suddenly, Leah grabs my face and gives me a kiss on the cheek, loud enough for what seemed like the entire department to hear. My crewmate laughs hysterically, sensing and seeing my embarrassment as my face glows a warm shade of red. 

As the first call of the morning, I feel that that one moment sets me up for the day and set off out of the emergency department with a smile firmly planted on my face. 

On our second call, a man dies in front of us with his family all around, and there's nothing we can do.