Magwitch arrives for the day shift
I may have got out of the wrong side of the bed this morning, or perhaps it was just the result of a busy party weekend. Either way every job today seemed to be a “load of crap”. How do I define a crap job? Well, anything I’m not in the mood for probably sums it up. Today, most of the calls seemed to be for “patient unwell”. Now what the heck is that supposed to mean? Can’t the patient be a little more specific? Got a headache, chest pain, trouble breathing, foot fallen off, stake through the heart? I had a rather alcoholic weekend and by yesterday I was feeling, erm… ah… unwell. Last week I had a couple of days with a dodgy tummy and felt – unwell. And when I have a migraine a feel, just a touch, unwell. I know I’m “under the weather” and deal with it accordingly. What I don’t do is dial 999 for an emergency ambulance.
It was in this frame of mind that I drove round to see Mrs Sourberry; she was feeling unwell. She looked fine; well perfused, sparkling eyes, clear tongue. She just seemed to be feigning illness for a bit of attention.
“Can you explain what unwell means to you?”
“Aaahhh, I just feel rotten,” she panted.
“Can you be a bit more specific? Have you got a [insert anything you can think of] ?”
Mrs Sourberry’s been like this for a week now. She’s seen her GP, saying it was her chronic back pain “playing up again” -he gave her some diclofenac to help out. Three days ago she pitched up at A&E because she felt ‘unwell’; back pain still much in evidence and some vomiting to boot. They ran tests and excluded a triple-A and pancreatitis, amongst other things, apparently. They took bloods but found nothing of note. They sent her home with instructions to carry on with the diclofenac and her existing analgesia.
“Is your back pain better today”
“Yes it’s a bit better”.
“Are you still vomiting?”
“All the time” pipped up Mr Sourberry junior – though in all the time I was at the house she didn’t so much as retch.
“And she can’t walk.” he continued.
We covered the usual scenarios of getting to the toilet, climbing the stairs etc. Yes, as expected, she can walk but just feels weak.
“Could it be the tablets?
‘It’s possible but I don’t know.”
“Could it be a reaction to the back pain?’
“Might be but I don’t know.”
“Could it be…[a hundred and one other ideas he had come up with]” All of which I had to honestly reply that “I don’t know.”
“Not very helpful are you!”
My initial inclination at this point was to shake him very warmly by the throat or see what a mess his head would make if it came into collision with a brick wall. I was, of course, as professional as usual, and explained that “I am only a paramedic and not a doctor and that I’m unable to answer any of the questions posed”.
ECP 1 – Annoying relative 0
After chatting to the patient’s GP and the med reg at the assessment unit, I arranged for her to go in. Maybe it was just my mood but I’m sure the GP gave the impression that this was one of his ‘awkward’ patients.
Back on station my colleagues said I seemed a touch aggressive today. OK, so I gave the weatherman on the TV a piece of my mind and told him to “piss off with your cold weather and more rain.” Later, the channel ran a trailer for a programe about a woman who knows she’s fat, had just been told she was clinically obese, but “that was ok because its a lifestyle choice and makes me feel sexy”. Wrong! You’re a fat bitch who’s going to suffer from hypertension, cardiac problems, diabetes and all sorts of other life threatening diseases and, in a few years, some ambulance staff are going to have to break their backs humping your bloated carcass down the stairs while your fat, lethargic children look on while munching a large bag of crisps.
Ok, ok, I know, I’m fattist.
I bumped into the crew that conveyed Mrs Sourberry later in the shift. They did the handover to the MAU sister based on the notes I’d written in my clinical report. Now, I make a point of running through the notes I make with the patient, to see if there are any errors or omissions. I did this with Mrs Sourberry and she was in agreement with my history. At the hosptial, while my colleague was handing over, she apparently kept saying “no that’s not it. It’s not like that at all.”
“Yes doctor, I’ll double my medication immediately and wear my straight jacket tomorrow.”
Picture from Monkeys with Hats