by Wharton, Kit
He has his own bedroom in the flat, and lately if we arrive he sometimes doesn’t even come out of it. Whether it’s embarrassment, exhaustion or despair, who knows?
Tonight, as often, she’s called us because she’s having difficulty breathing. This is almost a chronic complaint – her lungs are being crushed by all the fat and don’t function that well any more. She wants to go into hospital to be looked after. We bring our stretcher in and position it by her chair, but we have no training in how to use the hoist, and she would be simply impossible to lift, so we ask her to get up out of the chair and sit down on the stretcher. With enormous difficulty she manages it. Her backside has been crushed into the chair for so long it’s become completely square, moulded by the leather. It’s also covered in excrement from when she hasn’t managed – or bothered – to get out and on to the commode.
Her son stays in his room – who would want to see this?
It’s off to hospital we go.
Ambulance people, the NHS, the country as a whole, sometimes have slightly mixed feelings about people like this. There’s confusion about the correct amount of sympathy in a situation that is sometimes, only sometimes, self-inflicted. The service has brought in special ambulances to deal with obese people – they were called bariatric trucks until somebody decided that was offensive, and now they’re called something else. Crews often just call them fat trucks or the like now. And the stretcher on it – especially big – is called the ‘Megasus’ – it’s written underneath it in large letters – which probably doesn’t make the patients feel any better.
But it’s the relatives I feel sorry for, especially the young girl looking after her mum and losing her childhood in the process.
Nobody seems to give a shit about offending her.
9
Mental Illness
My parents weren’t monsters, they had their own problems. My father’s parents died when he was young, and then he’d had to go through the war, killing people and nearly killed himself. My mother grew up a triplet in a large family, stabbed in the head as a child by her own brother (no doubt accidentally) and neglected by her parents. Where does it ever end?
I suppose the beauty of it is – like in the Larkin poem – it never does. Your parents fuck you up but they were fucked up by theirs in turn. That’s life, baby.
We do a lot of psychiatric calls. It’s not something the NHS handles well, because it’s so complicated and time-consuming – not like fixing a broken leg. From the ambulance point of view we’re not much more than a taxi service. Maybe with a bit of amateur counselling thrown in.
But one thing the job teaches you is mental illness is just as bad as physical illness.
Alison
Called to a female, forties, cutting herself and generally having a meltdown. She has some history of self-harm and mental illness, and is staying with two friends in their flat. She’s locked herself in the bathroom with the razor blades and is screaming and crying because her boyfriend’s having an affair or left, I think. Worried friends have dialled 999.
Control comes over the radio.
—Police are towards but haven’t given an ETA. Are you happy to approach with caution?
We are. Control does its best to shield us and assess whether a violent situation is dangerous, but sometimes it’s difficult. Sometimes all the call-taker can do is ask the caller: are you dangerous? The caller doesn’t often say: well funnily enough, yes – I’m a homicidal maniac, actually.
Anyway, we get to the address, which is the back entrance to a block of flats with shops round the front on the high street. One of the flatmates comes out to find us. The patient has gone ballistic and is screaming dire threats she’ll kill them, herself, and everyone else besides if they call 999. Even though she’s now sliced herself up with a razor blade and there’s blood all over the floor of the flat. The flatmate’s understandably nervous and upset. We’re just getting a bit of info off her when out comes the patient.
She’s about forty, with bare feet and weirdly bright green hair. Nice.
She’s cut her wrists and ankles. All the cuts are a good three or four inches and deep, and now she’s covered in blood. She’s tried to cover the cuts with a rudimentary collection of tea towels and handkerchiefs, which aren’t doing anything to stop the bleeding.
Quite a sight.
—Fuck you. I told you not to call!
She marches straight past us and her flatmate, screaming abuse, and out onto the main street with the traffic whizzing past. A bloke about her age has appeared from somewhere and tries to remonstrate with her a bit – the boyfriend – but when she approaches him he just runs away. We don’t see him again.
She walks on up the hill, leaving a trail of blood behind her. I’m not too worried about her, more about what the sight of her would do to any young children passing by. She’s lost a lot of blood, but she’s still conscious and a good colour – she can’t have cut anything fatal.
We follow her up the road, trying to persuade her to get in the ambulance, but she just screams at us to fuck off and carries on the threats against all and sundry. Then ahead of us the police turn up.
A PC and a WPC. They get out of the car a few yards ahead of her. It’s pretty obvious, but I look at them and point out our patient just walking past them, covered in blood. The WPC reaches out to grab her arm and the patient goes mental.
She starts struggling, then whacking the WPC with all her strength, right in the face, again and again. We’re all a bit surprised, to say the least. The PC and me jump towards the patient to pull her off the WPC, who has taken a couple of hefty blows in the face, and the PC sweeps her legs away and dumps her on the ground with her arms behind her back and kneels on her. She’s still struggling as he tries to get the cuffs on her and the WPC leans in to spray her in the face with a pepper spray, but most of it misses because the WPC is crying with the shock and the fact she’s taken a punch on the nose and can’t see.
Eventually she’s subdued, still screaming out threats and insults. The WPC is still sobbing slightly with the shock of it all, and motorists on the high street are staring at us sitting on this woman covered in blood and probably wondering why we all seem to be attacking her. Their eyes are about to pop out of their heads.
I think we need to get off the street somehow. Quickly.
The ambulance is around the corner, where I left it, so I run around to get it, then scream on blue lights the wrong way round the corner so we can get her on board and off the street.
Things begin to calm down, but only a bit. The PC’s still kneeling on the patient’s back, while we try to get some proper dressings on the horrendous cuts. She looks at the PC venomously.
—You fucking pervert. You’re enjoying this, aren’t you? Touching me up! Do you like it? Does it get you excited?
The PC looks anything but excited, kneeling on her back.
—Shut up.
He looks more concerned for his colleague, whose eyes are still watering from the punch on the nose. I lead her gently over to the ambulance and help her into it so she can sit somewhere quiet and out of the public gaze, and eventually more coppers turn up who help her colleague get the patient to her feet and into the ambulance onto the stretcher. One of them takes the WPC away.
All the way into hospital she keeps up a running commentary of filthy insults and accusations at the copper, calling him a rapist and paedophile and abuser, while he writes in his notebook and ignores her.
Only as we arrive at A&E does she relent, and collapses sobbing.
—I’m sorry. I didn’t mean any of that. I’m sorry.
The PC still just looks bored.
—Whatever, darling. Whatever.
Barry
Hooray, we’re off to the seaside.
But there’s probably not going to be any deckchairs or ice cream on this trip. For a start, it’s gone three in the morning. We’ve got a transfer of a patient from the local cardiac unit down to the coast where the
big cardiology hospital is, going for an emergency procedure. The patient’s nice and stable, no chest pain, it’s a comfortable journey. No problem.
Or rather, none getting down there.
The problem isn’t getting to this town. It’s getting out of it. Even at five in the morning. At some point we’ve got to press the button on our truck telling control we’re available, then hightail it out of town for the ninety-minute drive back to base, praying we’re not spotted on the way. It’s a bit like being a big juicy, tasty mouse, painted bright green and yellow, with a load of hungry eagles flying around.
We press the button and drive off out of the hospital, trying not to even breathe. Control pounces.
Male, forties, drowning incident, now fitting.
Fuck. And then fuck again. Drowning and fitting? What the hell does that mean? Surely if you’re dead from drowning you can’t be fitting? And if you’re fitting you can’t have drowned? Both jobs sound complicated. Together they sound like a nightmare.
Anyway, off we go. Apparently the patient’s been fished out of the water by the coastguard and we’re to meet their boat down on the beach. So access is going to be difficult, and we’re going to need practically every bit of kit on the truck. Bollocks.
As always, life’s a bit more complicated than that.
We scream down to the seafront, and take the obs kit, oxygen, drugs and the defibrillator with us. We’ll have to come back for suction, the carry chair, stretcher and scoop, immobilisation stuff, a cuddly toy and the kitchen sink and anything else we might need.
I can see the coastguard rubber dinghy coming in the distance. Then as it draws near I see the worried-looking faces of the coastguard people, dressed in their red suits. They’re staring at us as if to say: help! All I can see of the patient is a big pair of hairy white buttocks sticking up, thrashing around in the boat, as the patient’s jeans have fallen down. Val stares horrified.
—What the fuck?
Behind us the critical-care paramedic is dragging another mountain of equipment down the beach as the dinghy hits the stones. Then the buttocks disappear and a face appears out of the bottom of the boat.
Barry.
It’s not a face you’d forget easily. Barry’s completely bald, and a lifetime of self-harming and dragging razor blades across his scalp has given him a whole series of ridge lines right across. Some of these have opened up and are pouring blood out down his face. He has wide staring eyes practically swivelling around, and the reason he has these is because Barry is, in non-medical parlance, raving fucking mad.
Nuts. Bonkers. Cuckoo. He’s in the hospital several times a week, self-harming, overdosing, or just drinking himself unconscious. God knows what an actual diagnosis would say. Everything, probably.
He screams out to us, grinning.
—All right mate? Fucking great!
He steps straight out over the side of the boat and falls straight into the water in a heap of arms and legs and buttocks, then somehow manages to right himself and stagger out of the waves and on up the beach past us and towards the ambulance.
The critical-care paramedic knows him well.
—All right Barry? Why were you in the sea?
Barry marches straight past him too.
—Some cunt bet me I couldn’t swim to France! I’ll show him.
Barry’s been drinking all night, indeed all decade, is not in the best of shape, and France is a good hundred miles away. But obviously in his crazy world, it seemed like a good idea at the time.
He marches on up to the ambulance and falls into it and onto the stretcher. We stagger after him with all our equipment, do some basic obs and put a dressing on his bleeding head, then take him up to the hospital. He’s soaked to the skin and hypothermic, but otherwise seems untouched by his adventure. The critical-care paramedic smiles at us and gets back in his car and drives off, the coastguard boys just stare at us, before turning round and heading back out to sea.
Up at the hospital – practically Barry’s second home – we get him on a bed and get some of his clothes off and cover him with blankets to warm him up. Within ten minutes he’s bored with this and throws them off.
—Fuck it, I’m off.
—Barry, you really should stay here until you’ve warmed up a bit.
—Nah, fuck it.
And off he goes into the bright new day, staggering all over the shop with his jeans practically round his ankles. Legally I don’t think we can stop him and I wouldn’t like to try. I say a silent prayer no mother with her little children comes across him and his buttocks before he gets to wherever he’s going. It’s no sight for the faint-hearted.
10
Unsafe Discharges
Some people say their jobs are the best in the world, and George Clooney or David Beckham may have a point. But the ambulance service has a lot going for it. It’s a varied life. Like a box of chocolates, you never know what you’re going to get. I like working odd hours, with odd people. I love shift work, driving round town when everyone else is asleep and there’s no traffic. I like being able to pick the kids up from school, and there’s no better feeling than driving home on Monday morning knowing every other bugger is just starting their day. It’s nice having a job where people are pleased to see you – I wouldn’t want to be a tax inspector. It’s nice being out and about, not pushing pieces of paper around a desk or something.
There are downsides to the job, obviously.
A Frenchman once said: hell is other people.
Wrong.
It’s what comes out of them that’s the problem.
We have a hamster at home. He’s called Abdul, because he’s a Syrian hamster and that sounded like a good Syrian name. (Bear with me a moment.)
He’s very nice is Abdul. He sleeps all day and is up all night, making his wheel spin round or looking round his cage. He really likes peanuts as a special treat. He has some rather strange toilet habits though. He’s very fastidious about where he urinates. We’ve bought him a special plastic box which he uses as a toilet, and he always pees in that, never anywhere else. And once he’s peed he buries it in little granules, so it doesn’t smell. All this is odd because his behaviour’s very different when he opens his bowels. He does that in bed, keeping the stools in the bed with him and eating them again when he feels like it. All very strange, but he’s a hamster after all. The reason I mention him is the other day we went out to a woman whose toilet habits are almost a mirror image of this.
Lisa
Called to a female, fifties, abdominal pain.
I haven’t been out to this lady before, but many people have. She’s an alcoholic and a frequent caller, with a variety of ailments and complaints. The flat is in a new development, and there’s a sea of flowers in the front garden.
Unfortunately, the front room is a sea of empty wine bottles and overflowing ashtrays. The patient’s slumped on the sofa while her lodger, looking slightly disgusted by the whole thing, is sitting halfway up the stairs.
Lisa tells me her stomach hurts, and so I sit down to ask some questions and take her pulse and blood pressure and suchlike. Judging by the evidence of drinking I have a fair idea of why her stomach might hurt, but I need to rule out other causes just in case.
—Does the pain go into your chest? (Could be a heart attack.)
—No.
—Does it go round to your kidneys? (Could be a kidney stone.)
—No.
—Does it go up into the right side of your chest under the ribs? (Could be gall bladder.)
—No.
—Have you opened your bowels recently? (Could be impaction.)
—Yes.
She has a slight temperature. Could be a urinary infection.
—Have you noticed your pee is very dark or smelly?
The patient stares at me blankly. Instead the lodger answers from halfway up the stairs.
—She wouldn’t know.
—Eh?
—She wouldn’t know. She doesn’t
go to the loo to pee. She just pees into the sofa. It sinks in.
—Oh. Right.
Oh dear. The same sofa I’m sitting on. It’s a big, thick yellowy-brown affair, none too clean. Very absorbent. Could probably swallow gallons of the stuff.
Without making too much of a production of it, I get up and continue the assessment standing up. My bum doesn’t feel dry for a long time. Val has to ‘go out to the ambulance to collect something’ quickly, doubled up with laughter.
And we take the patient into hospital, where she stays for only about an hour until she starts to sober up and decides to go home because that’s where the wine is.
Ho hum.
This is the perennial problem with alcoholics. When they’re ill and drunk, they want to go to hospital, but then when they sober up life’s better again and they want out. And the alcohol’s waiting. Everywhere.
The job was years ago now, just after we’d got Abdul. Then a couple of years after that, he got sick and began to swell up to an enormous size, the size of a cricket ball. Bilateral cysts in the stomach, the vet said, charging me three times what it cost to get him for the privilege. A few months after that he never woke up at all one morning, stayed lying in his bed, dead. I buried him in the front garden.
You should’ve let the children see his body, Jo said. It introduces them to death.
Fuck that, I thought. I didn’t want to see it myself.
(Odd to see dead bodies nearly every week but end up crying over a hamster.)
If all human life is here, all human anatomy’s coming up on the rails. You get to see people in the raw, and they’re always fascinating. Sometimes seeing them in a rather more literal sense than God, or whoever is in charge of this mess, intended.
