More Blood, More Sweat and Another Cup of Tea

The child was (almost certainly) an undiagnosed diabetic.

In my ‘big book of how to tell what might be wrong with someone’ there are six probable causes for severe long-term weight loss. They are Malignancy, Depression, Thyrotoxicosis, Uncontrolled Diabetes, Infection and Addison’s Disease. Within minutes of meeting this child for the first time, we had a provisional diagnosis.

It’s not hard to do a blood sugar test in a GP surgery; it takes less than 30 seconds.

So why did the GP tell the parent to go away? Was it because the GP was so busy trying to fill the government’s targets? Or was it the case that the GP considers severe weight loss in six-year-old girls a ‘phase’ that they will grow out of?

However, now I realise why the ambulance service is doing diabetes screening.

Small Observation (#ulink_e6d856bb-ef90-5564-b34d-f9ea7b5649fd)

When the weather is nice, a polite 90-year-old woman who has drunk a bit too much wine and has fallen over can be a very endearing patient.

(Another) Nan Down (#ulink_cdfc3ce0-fd48-5b89-8be9-0fc9b8afe9cf)

Since I am feeling (and to be more honest looking) fat I’ve decided to take up cycling again. I’m sure that I gave a great amount of joy to anyone who saw this particular tubby man puffing and panting against the wind while cycling along at 1 mph. Still, if I want to stop from looking six months pregnant I need to start some exercise. Another reason is a job I did yesterday.

We were sent to a strange call. It was given as ‘Elderly woman lying on the green as you enter Kellett Road. Woman may have got up.’

Rushing to the green we found it empty. So we decamped from the ambulance, grabbed our bags and went for a little wander to see if the patient was hiding in a dip in the ground. Across the green, near some houses, some people started waving at us so we trotted over.

The patient was a very elderly woman. She was wearing a nightdress, a threadbare cardigan and nothing on her legs. She was also barefoot—I was surprised that the thin skin on her feet hadn’t been torn apart by the pavement.

The temperature, not taking into account the strong windchill factor, was around 1° Celsius.

She was—unsurprisingly—a bit blue and she felt like a block of ice.

We only had our medical equipment with us; we didn’t have a blanket so I took off my fleece and wrapped it around her before running back to the ambulance to bring it closer to the patient.

I was shocked by how out of breath I was after jogging about 150 yards. Twenty-four hours later and my ankles were still in pain.

I brought the ambulance closer and we bundled the patient into the back, turned the heating on full and wrapped her in our blankets. The patient was one of those little old ladies that you would want to give a good cuddle to if she were your gran. We had a short and uneventful trip to the hospital where she was soon receiving the attention of the nursing staff.

My crewmate filled in a ‘vulnerable adult’ form, which means that the social services will get involved so that the patient will (hopefully) get any long-term care that she needs.

I managed to get my fleece back.

It now smells of granny wee.

It’s in the washing machine as I type this.

More Madness in East London (#ulink_09168721-2ffc-5210-b02d-4378c92a2002)

We were called to a fourth-floor flat in one of the many housing blocks in the east of London where we found an unkempt man in his forties pacing back and forth along the access balcony to his flat.

He wasn’t wearing any shoes, socks or a shirt, and his trousers and pants were falling off him.

While he paced he was muttering about God and the Devil.

The patient obviously had mental health issues, but we also suspected something else was causing this behaviour. At one point he made to throw himself over the balcony. We stood in his way to prevent him doing this, and more importantly to stop him making us go through the, frankly hard, work of trying to save his life in the face of major trauma.

As we led him back into his flat to get some shoes/clothes we realised that the reason why he was behaving so strangely might have been exacerbated by drug use. We nearly tripped over an empty bottle of methadone.

The flat was—as I’ve mentioned before—exactly how you would expect a drug den to look. There was drug paraphernalia strewn around the place, mattresses on the floor and the heavy curtains looked like they had never been drawn.

The patient continued to pace around while occasionally becoming quite agitated. While we didn’t think that he would become violent we were still rather wary of getting too close to him or letting our guard down.

After half an hour we had managed to get him dressed and were able to lead him downstairs where we ‘ahem’ ‘gently’ got him into the ambulance.

While I drove us to the hospital my crewmate did his best to keep the patient calm. We pre-warned the hospital that they would need security and the secure room ready for us. Unfortunately, the hospital switchboard wasn’t picking up the phone so there was no one there to meet us when we rolled up outside the A&E doors.

At one point he exposed his genitals to my crewmate.

A bit of a struggle began where the patient wanted to jump off the ambulance and run away, so my crewmate and I ended up restraining him until security arrived to help drag him into the department’s ‘padded room’.

I had a similar job the day before, another job where I ended up wrestling with a mentally disturbed patient.

What struck me as amusing was that on consecutive days the first job of the shift was to someone with an altered mental state who was blaming their God and the Devil, and who would later go on to show us their genitals.

I wonder if it’s something in the water?

I also sometimes wonder what the mentally disturbed would rant and rave about if we hadn’t thought up the idea of religion.

Ethnic Relations (#ulink_0f80dd32-e594-5b53-bcc6-fbc9a722c959)

After two days of struggling with people, it was nice to go back to the simple jobs that are a joy to do. It’s also good to see a sense of community.

In this case it was a little old lady who had tripped over a wobbly pavement in one of our local markets. She was surrounded by people of all backgrounds. There was a black market warden who had put cones over the offending paving stones. A Bangladeshi man was chatting to her and two Greek-looking men met me at the ambulance and led me to the patient. A Sikh stall keeper also pointed me in her direction.

The patient herself was one of the dying breed of ‘traditional’ English east Londoner. Normally an extremely healthy 80-year-old, she had a graze to her nose that refused to stop oozing blood. A real pleasure to talk to, we chatted about how the east of London has changed in her lifetime and how she still enjoyed living here.

‘I’m an ethnic minority now,’ she told me, ‘but there are still a lot of people around who’ll help you out.’

And she was right—as an ambulance person I tend only to see the worst of people. I go to the assaults and the arguments. I hear about the murders and the abuse, the neglect and the trouble. Just as this woman was, for me, an unusual patient in that she was a healthy 80-year-old, so it was that I saw the unusual event of people helping someone in distress.

It was one of those jobs that leaves you with a smile on your face for the rest of the day.

Lying to Patients (#ulink_2c0f05ad-39d0-541c-a66c-d07d423cb9e4)

Here is the thing—I’m a pretty poor liar. I don’t get much practice, I don’t like doing it and as part of my personality flaws I love sharing things that I know with anyone who’ll listen. Unfortunately, in this business you need to try to keep some things to yourself.

I was called to a place of work where a 55-year-old woman was complaining of constant headaches. When I arrived on the scene a work colleague was comforting her as she had obviously just been crying.

I got a verbal history from the patient—the headache had been coming and going for two weeks and normal painkillers weren’t touching the pain. There was no other history of ill health, she hadn’t been to the doctor for years and she had no allergies. She told me that on that morning she had woken up with the headache and also a feeling of ‘not being connected to the world’. Once more, her painkillers hadn’t even touched the pain.

A quick ‘n’ dirty neurological examination didn’t reveal anything particularly scary and her observations were all normal apart from a moderately raised blood pressure. I discounted the blood pressure as her being scared and sitting in the back of an ambulance looking at my ugly face.

So we had a drive over to the hospital.