On The Possible Causes For A Collapse

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.

20 thoughts on “On The Possible Causes For A Collapse”

  1. I can relate with this. When I was at school, I became a victim of 'bullying'. It got to the point were I could see no way out. On various occasions I comtemplated self harm and sometimes more extreme things. LoL I still have the memory of trying to convince my mum who had been a nurse for over 25 years that I was to ill to go to school, by sticking my fingers down my throat. Its partly one of the reasons why I want to go into Health care and do what i do with SJA. Hopefully in this case they've catched it in time.

  2. I hope so too, poor kid. I was psychologically bullied right through secondary school, and it's wonderful that people take this much more seriously now and don't fall so much for the “character building” b****cks that was a popular cop-out back then.

  3. I dont think this would of ever crossed my mind. i, honestly , would of thought “little shit”.i read your blog because I like it, and because I learn. Thank you.

  4. And nowadays you have so much more pressure in schools, kids have to live up to the expectations of the parents, the teachers, and still fit in with their peer groups.I have heard in the news where physical bullying has gone out of control in some cases but I feel the payload of non-physical violence leaves more lasting damage (psychological bullying (psychological is a much too fancy word for it I think)), and is harder to spot and fix unless you are alert to the signs.

  5. Psychological is EXACTLY what it is and it's been going on (either unnoticed or disregarded) for decades……..it leaves psychological scars on the victims and is a recognised trigger for a wide variety of psychological disorders, many of which create difficulties in social situations…..which is sadly ironic since it's a “social situation” which is the breeding ground………But I'd hesitate to lay the blame at the feet of teachers who miss it happening, since they're probably so bloody stressed out, underpaid and overstretched in state schools at least that it's hardly surprising really.

    God, I'm glad I emigrated, to a place which takes things like this seriously enough to help me overcome my own “psychological bullying” from school and family in spite of the effects not being diagnosed until the age of 35……

  6. No blame being assigned to to teachers but to the people who put the huge workload on them, and restrict them with regulations which if they fart the could be sued by a student (not that I know of any rules about this particular example that I use). Not wishing to have a go at teaching profession but those that decide what the curriculum should be but I think that excellent mental arithmetic, and the ability to read big words (other than on a bag of crisps), and being able to spell without a computer / mobile phone (but perhaps use a dictionary), is far better than being able to make a folder full of clippings from newspaper articles and printout from web sites look pretty and get given marks in an examination for as project work.My apology to all for having a verbal excretion here – I do not know all the answers, and I have had four cups of very strong coffee in the last hour…

  7. Weird. I just transported a 12 year old yesterday for a syncopal episode of unknown origin. He'd hit his head on the floor and had neck pain, so ended up with full spinal precautions and a long hard ride on a backboard. I spent the rest of the day wondering what the cause was. Sometimes we have the bad habit of ruling things out because we don't even want to think they are possible – like drug abuse in a 12 year old. Bullying wouldn't even have crossed my mind.

  8. I have to say the first thing I thought about was whether some kind of abuse was going on.My (4 yo) nephew was recently having uncharacteristic episodes of enuresis and urinary incontinence which seemed to be related to attendance a local nursery. Mother spoke to the nursery manager who denied any bullying could be taking place, we decided to keep monitoring the situation. Over Christmas, he was completely dry including waking up at night to relieve himself.

    Second day back at nursery… wet bed and immediately before leaving, wet trousers. He told his mum that two boys at the nursery were hitting him and taking the toys he was playing with. Mother again spoke to the manager, who said she was sure it wasn't happening (“Does he have the names right?”). When picking him up, the manager said they'd caught exactly what was described happening, and “dealth with it”. He's been dry since.

    He's lucky to have such an aware mum.

    (A colleague also recently attended a collapse ?not breathing which didn't seem right, unresponsive but unexpected reaction to pupillary reaction test. Amazing how fast they come round when you start putting in an OP tube…)

  9. I went from a reasonably polite private school on the US East Coast to an English school for one semester. I was appalled at the bullying. Horrified. It's amateur torture that goes on there. Much as I like and admire many things about the Brits, I think it's a real flaw that such a level of bullying is not just tolerated, it's condoned. I don't know what would have happened to me if I hadn't been tall and strong for my age, because I'm not much good at the whole top-dog-underdog thing. But it was bad enough as it was. One of the most picked-on kids stuck to me like glue because she was safe there, and–remember, I was twelve–I was mortified at being associated with a loser.

  10. Well done for picking up on this problem. My daughter went through hell at her local primary school with both physical (bad enough to require hospitalisation) and mental bullying. She ended up with all sorts of physical manifestations of the stress she was under, and thankfully we had an aware GP and Paediatrician who helped to deal with this. Sadly the school was not entirely interested (until a new head teacher was appointed – by which time it was too late for my daughter) in dealing with the problem, and so we ended up changing schools. She is now happy and has loads of friends, but there is a lot of mental scarring, and probably always will be. The agony caused by bullying often goes unnoticed, and children will often hide it from their parents so any help and/or recognition comes as a great morale boost for the child. Your and the hospital's intervention will make a huge difference to this boy, one that will probably never be forgotten by him!

  11. Well said guys. Things have improved, but I believe that the indiviual schools have alot to do with the out come.

  12. the poor lad…The thing that many teachers etc foget is that the mental marks of bullying will stay with you for life, normaly more so then the physical scars…..bolloks to “sticks and stones may break my bones but words could never hurt me”….i can still remember what plp said to me years ago….people dont take this kind of bullying serously untill it gets to out of hand…

    h x

  13. I never told my mum, in fact I worked to conceal it – I was too ashamed. Plus it'd got into my head to the point I sort of thought I deserved it, or at least, it was “just the way things are.”So well done for helping your daughter there, and well done her for being able to get help.

    With regards to mental scarring, yes that does happen, I don't want to get into it too much except to say that I found studying a lot of psychology/personal development stuff has helped me move on and be a person no longer defined by any of that, and free to choose my own reactions when situations crop up that echo the past.

  14. I count myself lucky – although I was bullied as a child, due to my poor memory, I've forgotten it all.It's not all bad having a bad memory.

  15. Im seeing a pattern here. Maybe theres some deep cycological affect that makes peopel want to become Health Care workers when there bullied (justa theory).

  16. I'd jsut like to say a big “hear hear” to your final paragraph. Injurys and illnesses aren't always physical. There is “first aid of the mind” too (as it was put by a Salvation Army lady a few years ago)

  17. Wow..very interesting blog here. I'm not sure about others out there but i find it difficult to chance upon blogs that's actually very meaningful and deep. This one is a fabulous one. Gives insights into what goes on within the health professionals; things that you never hear about or learn about. Keep it up. Enjoyed reading it. Hope you don't mind if i link u…

  18. I was bullied at my first secondary school.My sister and I, being twins, were at the same primary school, in the same class and she stuck up for me a lot. I was very lucky.

    It all changed at secondary school.

    I was horrendously psychologocially bullied, to the point I could not take it any more and moved schools. I got on much better at my new school and I believe, to this day if i had remained at that school I would never have got as far as i have today.

    Sometimes things happen for mysterious reasons- this, although terrible for me, worked out for the best!

    Thanks for all your help the other day tom- you are a star!

  19. I moved from California to Bristol, England when I was 13. The bullying was almost unbearable, they made fun of my accent, made snide comments, called me names, stole my stuff, ruined my painting in art class, physically assaulted me. A 13 year old boy punched me in the face! I punched him back, and my only friend berated him for hitting a girl! My parents complained to the head mistress. It did no good, and when the offending kids were confronted, it just made them angry, and the bullying got worse. I wanted to die! We moved back to California 2 years later. By this time, I'd developed an English accent, and I was really scared about another new school. But the kids LOVED my accent, and wanted to hear all about where I was from! What a diffence! It is a cultural thing?

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