It's the busiest night of the year for us, as evryone goes out and gets drunk at their work Christmas party. I don't know what's going on at the moment, but it's barely 21:00 and already we are at 3,500+ calls.

We normally do 3,500 calls in a day, so how many more will we squeeze in over the next three hours?

My first job was to and alcoholic having had a fit. A common symptom of being an alcoholic is having fits, I'd say that of the two types of fits that we go to, I tend to see more alcoholic fits, that epileptic fits. I don't have any numbers to prove it, but it just seems right in my experience.

This job was typical. I had to step over the detritus on the carpet, the packets of tobacco, the trainers, the half eaten takeaway container. I saw my patient sitting on a chair, being sick. He was vomiting directly onto the living room floor, his wife didn't see fit to put a bucket under the stream of vomit.

Lovely.

Like a lot of our regular alcoholic customers, he was topless, while his tracksuit bottoms were stained with...well I wouldn't like to guess, but they were stained with something. Homemade tattoos covered his chest, arms and hands, and inbetween bouts of vomiting he would continue making a roll-up cigarette.

"Can I turn the living room light on?", I asked the wife.

"Don't work", she said back to me in a voice that I guessed had been arguing with her husband just before I'd arrived.

I guessed this because she then started arguing with him again.

While the living room had a nice stereo, a reasonable televison (satellite included) and a gaming console, they didn't have a lightbulb.

He didn't want to go to hospital, but I always think of the potential headlines in the paper the next day "Ambulance leave patient to die", so the crew and I persuaded him to go to hospital for a 'check up'.

You know why? No one ever lost their job by taking a patient to hospital.

"I don't want to waste their time", he mumbled, "I'm just an alcoholic".

"It's alright mate", I'd reply, "We look after everyone, even alcoholics".

I’ve been nominated for two awards in the 2005 Medgadget Medical Blog awards.  Go figure.  So the other nominees in the Literary award decided that we should all write something interesting.  My arm was twisted and I agreed.  We were given the first section of the story, and had to continue it in under 999 words, and had to contain at least one lyric from a Christmas song.

I wrote my story, counted my words and found that I’d brought the word count up to 1,425.  A bit too long.  So what you see here is the edited version.  I’ll stick my first draft in the comments of this post.

Other nominees, who will probably show me up for the hack I am can be found at Barbados Butterfly, Bloodletting, The Cheerful Oncologist, The Examining Room Of Dr Charles, Simonscapes and Intueri.

And no, I have no idea what I’m doing in a Literary award either.

——–

It was a dark and stormy night.

 

I struck the match and the flame burst into bright orange-blue life. It danced on the end of the matchstick as it neared the ragged edge of the cigarette dangling between my chapped lips. Soon, the smoke that lazily trailed from the glowing end of the cancer stick filled the entire elevator. My fingers plucked it from my mouth and I exhaled, mindlessly watching the plume of wispy grey ash travel towards the cylindrical fluorescent bulb that poured antiseptic yellow light onto us.

 

The elevator ungracefully jolted to a halt and the doors swished open. The man with a goatee in a long white coat and black patent leather shoes shot me a dirty look as he stepped off.

 

“We’re in an elevator in a hospital,” he derisively muttered, enunciating “hospital” as if he was introducing a new word into my vocabulary. “What kind of idiot smokes in the hospital?”

 

The elevator doors swished shut, but not before he noticed the solitary third finger of my right hand poised in the air. At him.

 

He looked offended. I didn’t care.

 

The elevator lurched back into motion as I chuckled to myself. His expression was certainly more amusing than the duties that awaited me.

Reluctant to acknowledge that I was near my destination, my tired fingers apathetically dropped the cigarette and I watched the sole of my left shoe squash it, along with its orange flame.

 

The elevators doors swished open. I then looked up.

 

Before me was one of those hospital signs, arrows pointing in different directions, leading the sick, the dying and the hopeful to their often final places of rest.  Turning left I stalked towards the intensive care unit.

 

My quarry had led me on a merry dance this year, I'd chased him through Tokyo, but he'd given me the slip in the Odaiba district.  I'd traced him to Toronto where I saw him descending in a glass lift, unfortunately I was rising in the adjacent lift.

 

I’d finally nailed him tonight in New York.  I’d hit him with the car I was driving, but the crowd of people who appeared seemingly from nowhere stopped me from finishing the job.  He was wounded, probably soon to be dead, but I needed to be sure.

 

So I found myself in the hospital, charming the receptionist into telling me that their only trauma case was indeed still alive, and had been taken to intensive care.  It was nearly midnight, so gaining access to ITU would be a little trickier than I would have hoped.  Sometimes my job is just an absolute nightmare, I mean, what kind of psycho enjoys killing things?  Still it would be nice if just for once my target didn't make such a fuss.  That’s the problem, none of them want to 'go gentle into that good night'.  But they all die, eventually.

 

I pushed open the door to the ITU, ignoring the 'All visitors must remove their coats' sign with '...even doctors' scrawled underneath it.  The lights were dim, and I could see two people in scrubs sitting at the nurses station, faces cast in sickly screen from the numerous monitors positioned there.  Somewhere a radio quietly droned, "Silent night, Holy night. All was still, all was quiet...".

 

"Detective Alan Trophos", I whispered putting on my best 'I'm the authority figure here' expression, "I understand you have a patient hit by a car tonight?".

 

"Bed four", replied the plump woman reading a frayed paperback book, "but he's sedated and intubated, you won't be able to talk to him".

 

"The body", I replied with a grin, "can give evidence without speaking".  I lifted up what I hoped looked like the sort of suitcase that detectives use to gather forensic evidence. 

 

"I'll just need a few moments alone with him.  Nail scrapings, that sort of thing", I smiled what I hoped was my best attempt at flirting.

 

"Go right ahead", the other woman said, "He won't mind, and he'll probably be dead by tomorrow".

 

I crept past the two women, the ITU seemed to inspire me into the same silent reverence that churches do.  The desire to speak only in a whisper and to walk softly was a strong one.  I pulled the curtains around bed floor and finally took a long look at my quarry.  I pulled over a plastic chair and took hold of his hand.

 

"I know you can't hear me", I whispered, barely above the sound of the machine that was breathing for him, "but I'm hoping you can <i>feel</i> me".

 

Was that a flicker under the taped closed eyes?

 

"Your time is limited", I continued, "we can't leave you floating around like a loose end.  You are put here to do your job, and then leave.  Much like me".

 

The machine kept up the steady rhythm, breathing in, breathing out, keeping the oxygen passing into the lungs, keeping the body alive.

 

"That's why they have me, someone to make sure that you don't run on past your time.  In a year I'll come for your successor, and the year after, and the year after that, as I have since they started worshipping you".

 

I turned off the monitoring machine, I didn't need any alarms going off.

 

"Imagine what would happen if the Spirit of Christmas continued throughout the year?  Imagine humans being nice to each other all year round?  The Gods of Strife would have a fit.  A couple of days a year, that’s the deal".

 

I slipped the dagger under his breastbone into the heart.

 

"I wish that goodwill for all men could last forever, but that's not what The Rules say".

 

I felt for a pulse, so weak...

 

The pulse stopped.

 

Suddenly the tinsel around the bed seemed to lose the glitter, the radio started playing an R&B number, and far away I heard a clock strike midnight.  Midnight of Christmas day.

 

Christmas was over.

 

——–

Yes, I know, I’m sorry, but I don’t ‘do’ fiction.

“Warning : Assailant may still be on scene, wait for police” had apparently flashed up on my computer screen.  Unfortunately it had done so silently, so the first I saw it I was pulling up outside the house.  Luckily, I was pulling up to the house which had the police car outside it.

I entered a house that was full of four generations of Bangladeshi people who were mainly shouting at each other and the two beleaguered police officers.  Quite rightly so I thought, as I looked at the fifteen your old boy i had been called to treat.  He had been hit around the head with a metal bar.  Thankfully his injuries were fairly minor, although there was a possibility that he had broken his elbow.

Unfortunately this was one of those nights where ambulances were a bit thin on the ground, so I was waiting for sometime.  At least this meant I was able to get the reasoning behind what had been happening.

There were two families, one with a daughter, the other had a son (my patient).  He had apparently offered her a place to sleep after she had been in an argument with her family.  This had then turned into a feud that had dragged on via school bullying.  The police had just told everyone present that they would be going around the other family’s house to arrest people when the father of this family turned up.

To say there was a lot of shouting would be an understatement.  There was also a procession of stern young men into the garden for a bit of a war council, mobile phones clamped to ears as they called in reinforcements.  The atmosphere was getting a trifle warm for my liking.

Luckily the police were able to calm the situation down somewhat, a bit tricky when the father was shouting about how he was going to burn the other family’s house down if they didn’t do anything.  Meanwhile large numbers of youths were appearing and disappearing into the night.  I thought that there was a real chance for things to turn nasty.

“Sir”, said one of the policemen, “I don’t wish to insult, or cause offence, but normally with this kind of trouble it is one cultural group against another, but in this case both parties are Bangladeshi.  Could you explain that to me?”

One of the calmer young men replied, “That’s how it used to be, now everyone is fighting everyone else, and race don’t matter”.

By now I had the real impression of angry villagers with pitchforks and flaming torches gathering, thankfully I was rescued by both police backup and an ambulance to take the injured party away to hospital.

“Control”, I called up on my radio, “Just to make you aware, if there is any assaults in this part of my patch, don’t let crews go in without police escort, because it might kick of big time”.

“Roger that EC50, I’ll make a note”.

I don’t think that there was any trouble that night, but it is a little hard to lynch someone if you’ve been arrested…

No time for a ‘proper’ post until perhaps the small hours of the morning.  (A question, how is it possible that my body clock is on ‘normal’ hours, and then decides to screw it all up by sleeping for 15 hours straight?)

So until then I give you the gift of a slideshow of transparent computer screens.

You may have seen this before, but I read it for the first time last night, and my ribs are still hurting because I was laughing so much.  As I’m not working for the next couple of days you are going to have to put up with whatever I can think of.  If you behave yourself I may do some live posting on my Friday nightshift.

Enjoy…

HOW TO GIVE A CAT A PILL

1. Pick up cat and cradle it in the crook of your left arm as if holding a baby. Position right forefinger and thumb on either side of cat's mouth and gently apply pressure to cheeks while holding pill in right hand. As cat opens mouth pop pill into mouth. Allow cat to close mouth and swallow.

2. Retrieve pill from floor and cat from behind sofa. Cradle cat in left arm and repeat process.

3. Retrieve cat from bedroom, and throw soggy pill away.

4. Take new pill from foil wrap, cradle cat in left arm holding rear paws tightly with left hand. Force jaws open and push pill to back of mouth with right fore-finger. Hold mouth shut for a count of ten.

5. Retrieve pill from goldfish bowl and cat from top of wardrobe. Call spouse in from garden.

6. Kneel on floor with cat wedged firmly between knees, hold front and rear paws. Ignore low growls emitted by cat. Get spouse to hold head firmly with one hand while forcing wooden ruler into mouth. Drop pill down ruler and rub cat's throat vigorously.

7. Retrieve cat from curtain rail, get another pill from foil wrap. Make note to buy new ruler and repair curtains. Carefully sweep shattered figurines and vases from hearth and set to one side for gluing later.

8. Wrap cat in large towel and get spouse to lie on cat with head just visible from below armpit. Put pill in end of drinking straw, force mouth open with pencil and blow down the straw.

9. Check label to make sure pill not harmful to humans, drink glass of water to take taste away. Apply band-aid to spouse's forearm and remove blood from carpet with cold water and soap.

10. Retrieve cat from neighbor's shed. Get another pill. Place cat in cupboard and close door onto neck to leave head showing. Force mouth open with dessert spoon. Flick pill down throat with elastic band.

11. Fetch screwdriver from garage and put cupboard door back on hinges. Apply cold compress to cheek and check records for date of last tetanus jab. Throw Tee-shirt away and fetch new one from bedroom.

12. Ring fire brigade to retrieve cat from tree across road. Apologize to neighbor who crashed into fence while swerving to avoid cat. Take last pill from foil wrap.

13. Tie cat's front paws to rear paws with garden twine and bind tightly to leg of dining table, find heavy duty pruning gloves from shed. Push pill into mouth followed by large piece of fillet steak. Hold head vertically and pour two pints of water down throat to wash pill down.

14. Get spouse to drive you to the emergency room, sit quietly while doctor stitches fingers and forearm and remove pill remnants from right eye. Call furniture shop on way home to order new table.

15. Arrange for RSPCA to collect cat and ring local pet shop to see if they have any hamsters.

HOW TO GIVE A DOG A PILL

1. Wrap it in bacon.

While we deal with a lot of crap jobs on a day to day basis, but when we are really needed I think we do a bloody good job.

One of the people injured in the London bombings is getting married this weekend.

The thing that gets me is this quote.

“As well as losing both feet in the bombing, Ms Hicks lost 75 per cent of her blood and her heart stopped twice on the way to the hospital.”

That means that an ambulance crew successfully resuscitated her twice, long enough to get her to hospital and that because of that unnamed crew, she is now alive and getting married.  It’s stories like that which makes me happy to do the work that I do, that sometimes we can make a difference.

(Via: Going Underground)

Did you know that the Meteorological Office offers ‘health forecasts’?  We got a memo from them (via our office) about a predicted increase in paediatric respiratory infections.

No kidding!  For two days all I attended were patients with chest infections.

Then on Friday all but two of my thirteen calls were faints, or epileptic fits.  I’m left wondering if it is something in the weather that caused that little spike.

Oh, I also attended three schools on Friday (one epileptic and two fainters), while normally I wouldn’t see that many schools in on month.

A strange day.

I’ve checked with my sources, and the story is true.

At Poplar ambulance station there is no room to park.  The station itself is tiny, barely bigger than a portacabin.  There is a big metal fence and electric gate around it.  There is minimal parking.

So the ambulances park out on the street – if they didn’t then every emergency call would be delayed by minutes as the crews wait for the gate to open and then maneuver the ambulances out.  This would be very bad for the patients (and more importantly, extremely bad for our ORCON times).

There is nowhere else to park.

So…a couple of days ago the ambulances all got parking tickets.

Apparently there is a man who lives in one of the nearby tower blocks who keeps complaining because his daughter nearly had an accident pulling out of the turning.

So a nice man from the council (or a parking warden) came around and put tickets on the ambulances.  In his defence he did try to not ticket them by telling the crews to drive around the block…

The ambulance crews find this all very amusing.

(We are, by our driving exemptions allowed to park where we like as long as it’s not ‘dangerous’, we are guessing that this man has complained so much the council has been spurred into action).

40 stone patient.

On the floor.

-----

3 hours on scene.

Tears, swearing, pain and blood.

Up to 9 staff on scene at once.

-----

I am F******g knackered. Maybe a more detailed post tomorrow, maybe not.

Gah...

I was miles out of my area, but this was not a worry, as the sun was shining, the scenery was pretty (well...prettier than Newham, not that that is hard to do) and there was some nice music on the radio.

Then the call came down my terminal. 'male ?suspended in car'. I consider it a personal strength that I was thinking 'excellent! I can use my big trauma shears to break a window'. I soon reached the car and was dismayed to find the passenger door open, and two bystanders watching the man intently.

"He's breathing", they said.

I tried to hide the disappointment that I wouldn't be smashing any windows.

Checking the patient, who was slumped over the passenger seat drooling like a baby I immediately thought that it would be one of three things. He was either having a diabetic crisis, had just had a stroke, or was just incredibly drunk.

A quick test of his blood sugar showed that he wasn't diabetic, a neurological assessment showed that he probably hadn't had a stroke (he was also younger than me, so a stroke would have been rather surprising). This left the last option. He was drunk.

Once more I found myself cursing my own particular disability - that I can't smell alcohol. Thankfully the ambulance crew turned up and let me know that he did indeed stink of booze.

The crew loaded him onto the ambulance, which was tricky as he could hardly walk, while I turned off the engine to his car,amazed that he had driven as far as he had without crashing into something. He was also lucky he'd stopped when he did, as less than 100 meters away was a main road with a speed limit of 50mph...

We called the police, who duly arrested him. Meanwhile he kept saying that all he wanted to do was die...

...I would think that his desire to die would only increase as his hangover hits him in the police cell. I got the impression that the reason he was drunk was because he had had an argument with his family.

Somehow I don't think that getting arrested for drink driving (oh, and his tax disc was out of date as well) will do him any good with his family.

See, I keep telling people that getting pissed solves nothing. But do they listen to me? Do they buggery...

I had to do a police statement, before going back to work, returning just in time to get called to a Bed and Breakfast where an alcoholic was having a panic attack.

I have a hilarious story to tell you later, but before I write about it I need to check my sources...