Ten Deep Breaths

19 year old male – Patient has lump on ribs – difficulty in breathing”.

I’d just been to the Christmas Crisis run homeless shelter at the London Arena three times on the trot (I’d be back there once more later that night).  I’d never seen so many alcoholics in one place.  The people running the shelter were all nice in a worthy sort of way.  This is good, we need more people like this, and less people like me…

But I digress.

Halfway to the address, a private house, my screen was updated.

Patient has taken cocaine”.

I was met at the front door by a young male, stripped to the waist and obviously agitated.

“Comein, myribsfeelfunny, andmyshoulderbladeedon’tfeelright”.

“Slow down”, I said, taking his pulse – 110, a bit on the high side, but he was bouncing off the walls.

“My ribs man!  They don’t feel right!  Have a feel”, he then started running his hands up and down his chest.

“Have you fallen over?  Been hit?  Anything unusual happened?”, I asked.

“No man – just feel them…FEEL THEM!”

“Look you need to calm down”, I replied, “I can’t do anything while you are hopping all over the place”.

He started shouting, “FEEL THEM!  JUST FUCKIN’ FEEL THEM!”

He turned his back to me, indicating that I should feel his normal looking ribs.

I sudden wave of anger passed over me – it was all I could do to not punch him in the back.

“There”, I said, “Your ribs are fine”.

“What about my shoulderblades man!?”

“Look, you’ve taken cocaine right?  You are feeling paranoid, it’s normal, just try to relax a little”


He turned his back on me again.  I grit my teeth and grabbed his shoulderblades, “They are fine, Now. Sit. Down.”.

He sat down.  Then he stood up, then he paced around the kitchen.  I noted that there were no knives on the washtop, but even so I kept close to the door. (Mum didn’t raise me to be a fool).

“Look”, I said trying to calm him, and me, down, “Is this the first time you’ve taken cocaine?”

“No man!”

“OK, well if you want we can take you to the hospital, get you checked out if you’d like?”

“NO!”, he shouted, “I’m not going to hospital”.

Fine, I thought, not that the hospital will thank me…

“Ok mate, then are you alone in the house?”

“Nah, my dads asleep upstairs”

“Well I’d like to have a chat with him, so he can keep an eye on you”.

“NO!  Get out of my house”, he started advancing towards me, “No hospital, no waking my dad up, just get the fuck out of my house!”.

I left the house, while a fight with the patient would have done absolute wonders for my stress levels, it wasn’t worth the hassle.

But what now?  Should I post my patient report through the letterbox (if the patient isn’t transported then we should leave a copy with them).  The problem being, that if his father saw the report I’d be breaching patient confidentiality.  I’m guessing that they police wouldn’t be too interested in paying him a visit either.  So I left it – there was little else I could do for him, as he didn’t want help.

I sat in my car, filled out my forms and took a couple of deep breaths.  It would be a long Christmas…


5 thoughts on “Ten Deep Breaths”

  1. If you put the report in an envelope, seal it, mark it confidential, and address it to the patient (if you don't know his name call him “patient”) – shouldn't that take care of the confidentiality dilemma (always assuming you have an envelope…).

  2. I'd staple it to his forehead he'll not loose it then! – Had a client who was stuck in plasti-cuffs after playing cops and robbers (at 20somthing years old) He became distressed that we needded to validate the use of our time with a form “Your not sending that in are you” he exclaimed drunkenly.

  3. Hi, I've been reading your blog for ages. Only just plucked up courage to post a comment – I love your blog but sometimes get the impression you're not too impressed by my profession (GP)…..! I've got one like this. Utterly paranoid and developing all sorts of mental health issues even when not completely high but try to even mention that coke might be a factor and all you get is “You have no idea, coke is the only thing that keeps me sane”. Yeah right. I wouldn't care if it didn't take up so much of my time – which is valuable to me if to no-one else…

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