Big Mouth

Well, no sooner than I post about how there is no-one who is ill, I end up 'blueing' into hospital a 44 year old with a severe asthma attack coupled with an Addisonian crisis. As an almost exact opposite to the rest of the people today, the patient is well known to the local ambulance crews as someone who won't call an ambulance until she is exceptionally ill.
We then went to a nursing home to transfer a patient with Alzheimers disease to hospital so that she could receive intravenous fluids to rehydrate her. She had been treated with antibiotics for a leg infection, and it had upset her stomach, so the patient had stopped eating and drinking. Why this job sticks in my mind is that the patient has been suffering from Alzheimers disease for the last 12 years, and that for every day that she was in the nursing home, her husband had visited her. She was very confused, and could hardly recognise her husband, she was doubly incontinent and unable to have a conversation, yet her husband doted on her. He came with us in the ambulance and spent the trip holding his wife's hand, and talking to her to keep her calm. He seemed very happy to talk to my crewmate, I doubt that the nurses in the nursing time have enough time (or perhaps the inclination) to spend some time talking to him, and it meant that he could talk to someone and have a decent conversation.

It was both touching and sad, the utterly confused state his wife was in, and yet the tenderness which he still showed towards her.

Another 12 hours tomorrow.

13 thoughts on “Big Mouth”

  1. I saw that program too. Very good.As someone who used to have the LAS as a client, I got quite close to the service over a period of time, doing shifts with paramedics to see what it's really like, etc. It's good to see someone writing such a frank and honest account of what it is to be a paramedic in London. It's probably the most honourable job in my opinion, and one I don't think I could do. By the end of my time working with the LAS I had nothing but respect for service and everyone in it. Especially the crews!

  2. I don't know how the recipe for love has changed, but something tells me that the contemporary variety isn't quite as tenacious as the old one. That's a touching anecdote – humbling too.
    On another note, I don't suppose you saw Tonight with Trevor McDonald? – the programme was about how the government's 4-hour target is impacting on the availability of ambulances as crews are tied up at hospitals awaiting A&E Departments taking over responsibility for patients. Be interested in your own experiences in this regard.

    Keep up the good work, Tom – your blog is always a refreshing read.


  3. Greetings from downunder! Fascinating reading from my perspective of a soon to be paramedic or nurse (to be decided over the upcoming month). I think many of the issues you touch on are familiar to Australian readers – particularly overstretched ambos and A&E departments. In addition, there appears to be a growing shortage of GP's/Doctors in Australia at present which is not helping.You write very well by the way- thanks for your insight.

  4. Andy – I have spent two years studying to be a nurse with the intention of crossing straight over to Paramedic. Luckily Queensland has just this year started a uni course in Paramedic and I have been successful in being amoungst the first intake. Had I known that it was possible to study in other states I would have moved to do it. I will finish my BN but later. From my observations on Prac all a nurse is is a lackey to the Doctors. You are told at uni how autonomous and important you are but on prac you see nurses treated like dogs. F that. I wasn't going to spend 3 years, incur a student debt, to do that. Been an observer with an ambulance crew and it rocks. Hope it works out for you mate.

  5. My grandad had alzheimers, and it is one of those horrible situations where the 'person' dies long before the body does. But because the body is all that one has left, one keeps looking for sense in the words that come in the familiar voice, looking for coherence in the responses and actions. Hoping that they don't understand what is happening to them, as it is so terribly undignified and often intrusive. But for the little that they do understand, talking to them and staying with them and doing anything that you possibly can for them. It is just what happens when you care about someone. Caring, supportive, interested and respectful medical staff (like you) make it possible. Keep up the good work.

  6. I know!Take it from someone who worked in Nursing Homes, Now in A&E at weekends, and training to be a Nurse, (with the intention of getting a degree and going straight to the Ambo Service for Tech Training)

    Luckily Ambulance crews have a one to one relationship with their patients (2 – 1 some of the time) in my nuring homes it was oftern 12 / (20 in some) to ONE! (or two)

    There simply isnt the time to spent talking to people like this man sad as it is. I have also been told off in AE for sitting holding the hand of a dying woman (wasting my time apparently) !!!!!!!

  7. I think out of all the things that can occur in old age, Alzheimers and the like are the worst. I saw my Nan deteriorate with Parkinsons and a little while before she died, my Mum and I went to visit her. This previously strong, mischievous and insightful woman didn't recognised me until Mum told her who I was … and even then I wasn't sure.I guess you never know how you'd react until you were in that situation. I would hope that I had that man's strength of love and commitment but, selfishly, I sincerely hope that neither my husband nor myself will ever be in such a situation.

  8. thanks for the links to expand Knowledge. “tis why i scribble on the internet to try and keep the cells weaving Dungbeetle.

  9. Thanks for the comments- yes, I hear the same comments about nursing; pretty disappointing isnt it? I had my interview today with Metropolitan Ambulance Service (Victoria) and it went well- I've passed all the exams/tests to date so if I pass the interview its just a medical/physical/referee check and I'm there (standard entry)! Fingers crossed.

  10. I think what you touch on here about the old couple, commitment, and changes within a relationship is particularly poignant. Quite beautifully written too – like the understatement.

  11. That's funny, I think I may know that couple- or at least, they sound very much like a couple I do know. I don't want to say any more in case you get done for patient confidentiality. But with the couple I know, anyway, it is very touching and sad, and also amazing. It's hard to say whether it's a good thing or a bad thing though, to some extent. For him, I mean.-PP

  12. And, in addition to your lovely sensitive writing in this one post about the difficulties in old age which I much appreciate, I learnt from you far more than I ever knew before about Addison's Diseas and its seriousness.Please tell that to the hostile Bob/Paul bloke on your recent radio interview panel !

    If you can't contact him, maybe you can pass our collective responses to the BBC Scotland host.

    david, Londoner in Chicago.

  13. I was so taken by the phrase “the person dies before the body does” and made the point to my wife that it SO well describes what one percieves to be Alzheimer'sThank you.

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