As a follow up to my last post, I thought I would post up some events in my St. John Ambulance career which stick out in my memory. Most, if not all of them, aren't particularly clinically interesting but they have made a lasting impression on me for reasons I will try and explain. Obviously, no names will be given and details are deliberately vague to protect the anonymity of those involved.
I'm going to start with a heart-warming case. I was treating a young boy. While I was treating him, my colleague was taking a history from his father. I immediately kicked into "kid" mode, smiling and making bad jokes (it generally helps distract the kid from any pain and keeps the situation calm. If parent/child sees you are relaxed, they are unlikely to panic making everyone's life easier. And I have a store of dreadful jokes to roll out!). While I was doing my usual routine of explaining what I was doing to the child, I overheard the father tell my colleague that the child was autistic. He then turned to me and told me not to be offended if I didn't get a response. I continued to treat him while giving a commentary on what I was doing and getting him to help me. What makes this case stick in my mind is that I did manage to develop a rapport with this kid. He was making eye contact and responding to my attempts at conversation. I know autism has a spectrum of severity but when his father was surprised at how much he was interacting I really felt like I had achieved something.
The second case I'm going to relate is a surprising one. I was treating a patient who had fallen off his bike at high speed, fracturing his collar bone and dislocating his shoulder (his shoulder was down at about the level of his nipple). So far, so ouch! He needed the arm immobilised and shipped to hospital fairly smartish. What was surprising was that he refused all forms of pain relief even when I took three attempts to get one of the new issue paper slings on him. For a bit of background, first aiders can dish out gas and air and paracetamol. The former might have had a short term effect, the latter wouldn't have touched it. Therefore we called in a paramedic in case more powerful pain relief was required. The patient hadn't hit his head, nor was he showing signs of shock and freely admitted being in agony (in a calm, level manner) he just had an extraordinarily high pain threshold.
A happy case I dealt with recently was a young child who had been stung by a bee for the first time. The child's mother brought him to me because this was the first bee sting and she was concerned about anaphylaxis. Fortunately the child was as good as gold and went from being a bit subdued when in acute pain to bored of having to sit still. In the mean time, I had a long chat with the mother explaining a bit about anaphylaxis; describing what happened in the body and how it is likely to manifest its self. This was gratifying on two levels. Firstly, I was pleased to reassure the mother and ease her concern as well as giving her the confidence to recognise a serious reaction when it happened.. Secondly, as a human biology graduate, I find physiological processes fascinating and I was pleased not only to put my hours spent in the library to good use but to dust off the old subject knowledge in the first place.
A couple of sad ones next... for different reasons:
Firstly was a gentleman that came up to us on a small duty complaining of feeling dizzy. We ascertained that he was diabetic but since we can't take blood sugar readings or blood pressure we had to content ourselves by giving him fluids and a place to sit down. When we talked to him in more detail we found out that he had advanced and diffuse cancer and the diabetes was a side-effect of his medication. This situation is tragic for anyone to be in but it was somehow compounded by the fact that he was comparatively young. We spent quite a while talking to him as we observed him and he turned out to be a trained chef. Naturally, this led to him and me swapping recipe ideas before the conversation turned to malt. It seems such a shame for such a warm and vital man to be so gravely ill. I will never be able to follow him up but I hope for the very best for him.
Another sad one (for different reasons) was a girl I treated on my first Notting Hill Carnival. She was poured (well mopped) onto our treatment centre where I was allocated to treat her. I placed her on a stretcher near a drain to let her get it out of her system. To gain an idea of what she had consumed in terms of drink (or worse) and to distract her mates from the fact that she was freely and voluminously peeing herself I started chatting to them. It turns out they were celebrating their exam results. When I asked how their A levels went, they told me they had just finished their GCSEs. As a product of the Scottish education system I have no idea how old one is when one sits these exams but I'm guessing around 15 or 16. To make matters worse, her friends told me they had been accepting cocktails from a strange bloke in a pub. At this point I struggled to stop my jaw hitting the floor. It may have been paternalistic and condescending but I spend the next couple of minutes explaining that accepting drinks from strangers is a bad idea at the best of times and even worse at Notting Hill (when all bets are off) and even big, ugly Scotsmen like me are wary of accepting freebies. They were insistent that they had drunk before (I don't doubt it) but given they were uniformly very well dressed and very well spoken I am willing to bet that the drinking was done at house parties with the parents upstairs or neighbours keeping a fairly close eye on proceedings.
And finally...
It's always entertaining when we get silly requests. As hinted at in the previous post, it is not unusual to be asked for condoms. Neither is it unusual to be asked for transport when transport is really not appropriate.
The funniest thing that happened to me involved no patient contact. It was my first duty (Notting Hill again) and due to a problem with the supply chain, I didn't have any uniform shirts. One of the others in the division kindly lent me one of theirs. Unfortunately I didn't get it until the morning of the duty. As I was changing into the shirt the call, "Brass" went up to indicate approaching senior officers. Not wanting to be caught half-naked by said officers, I make an attempt to dash into the back of the treatment centre with it's tinted windows... straight into the commissioner! Fortunately, she saw the funny side and even complimented me on my uniform presentation later in the day!
These are a small portion of the people I have met and treated. I hope it shows that treatment doesn't have to be dramatic to be rewarding and reflects the gratitude I feel towards the people that tell me their story and allow me into their lives.
JR
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