It is funny how you find yourself going to the same people, I'm sure that some form of 'Power Law' applies to patients as much as everything else. while sometimes you can get seeming 'clumps', other times the reasons for the repeat calls are easy to understand.
Take, for instance, a twelve year old boy. He had a history of collapsing at home and at school and previous medical tests had been performed to see if there was some cause for this. When I first met him he was waiting for an MRI scan.
He had collapsed at home – my immediate sense was that this is a family that cares for him very much, nothing tripped my 'spider sense' that there was anything wrong. My own examination of him didn't show anything unusual, his behaviour didn't lead me to think that he had had a seizure. His blood sugar was normal which ruled out him being an undiagnosed diabetic and everything else I did drew a blank.
He'd been to hospital a day earlier and, after a battery of tests, they had discharged him. The tests had shown nothing. I was more than happy to take the boy to hospital, his family were nice and I've developed a 'risk adverse' attitude to leaving children at home.
I later talked to the unit and they told me that, although they could find nothing wrong, the paediatric team were going to admit him overnight for observation.
It was only a day or two later when I got called to him, he had collapsed on a public green on his way to school. One of his teachers was next to him. This time he wasn't moving or talking but a quick assessment told me that he wasn't really unconscious. So I got him up and took him to the ambulance. One teacher went to phone his parents, the other stayed to talk to my crewmate.
Once more all his vital signs were normal and once his father turned up we took him to hospital.
It was only after we put him to the paediatric waiting room that my crewmate turned to me and told me what I had suspected from the first time I saw him. The teachers suspected that he was being bullied although the child would not say anything to them about it. We passed this information on to the hospital and, after checking with the notes of his last visit, the hospital let us know that the paediatric consultant was thinking along the same lines. Various meetings were going to be planned with the school and the social services to fix this problem.
I'm glad that the hospital were taking things seriously, we've all heard of schoolchildren who commit suicide over bullying, so it is important to have support services like this. This isn't the first time that I've seen a child become physically ill due to bullying, I suspect that unfortunately it also won't be the last.
For my part I'm glad that I could provide a safe and reassuring environment for the time he was with us – He might not be physically hurt, but that didn't mean that we would ignore his mental health. It's not all about bandages in this work, and sometimes it's the stuff like this that makes you feel that you are doing the right job.