Hello sir, what’s happened today?

I am now FRU trained.  This means I can go out on the car as a solo responder and attempt to arrive at Category A calls within the 8 minute [tippy title=”ORCON” URL=””] ORCON (Operational Research CONsultancy) These are the timelines set out by the government for us to reach patients from the moment the call starts.  8 minutes is our deadline for Cat A Red calls (“immediately life threatening” . . . but oddly are not when we arrive).  So, taking into account that the person calling rarely speaks English and that this has to be translated, Ambulance crews are tied up dealing with someone who’s called us for a broken finger nail, the route to the patient is full of pot holes, speed bumps, trendies on single speed bikes, black cab drivers “surfing the blue wave”, general idiots in cars and the en-masse population occupying the road – it is no wonder that these targets are hard to meet!. [/tippy] time limit.

I had my official ride-out yesterday and finished the shift on my own.  To be honest, I enjoyed it and think I will enjoy it in the future.  There is clearly no difference in the clientèle we go to its just I would be aiming to get there first.

I went to one job yesterday – ’70 year old male fallen, hit head – Consc: No’.  I arrived outside a busy shop in the city to find several bystanders crowding round an old gentleman sat on the floor.  He was dressed smartly and had a posh appearance.  He looked like he was smiling.

Good, I thought, he’s alive and going to be a happy chap.  This should be a nice easy job.

Stepping nearer I did a quick primary survey – ie did he look like he was about to die?  No he didn’t – and then knelt down beside him asking folk if they’d seen what had happened.  Only one person had seen it saying the old man had teetered a little before falling backward and smacking his head hard on the concrete floor.

I looked down at the gentleman and smiled.  Nonchalantly, he stared back.

Binder:       Hello sir, how are you and what’s happened today?

Nothing but the stare.  Hmmmm, I thought, perhaps he’s concussed.

Binder:       Hello sir, what’s your name?  Do you know what’s happened?

Without changing his expression and without taking his eyes from mine the gentleman started to speak.  Posh, slowly and precisely and in just the same way Cary Grant spoke to Ann Sheridan in the film ‘I Was a Male War Bride’.

Patient:       Fuck off you utter idiot!
Binder:       . . . . um . . .

I didn’t see that one coming.

Binder:       Well, I guess we can at least say you’re ‘alert’ then
Patient:       Who the fuck do you think you are!  You retard – get off me and kindly fuck off!
Binder:       Sir, what’s your name please?
Patient:       I’m not telling you
Binder:       Ok I’ll just call you sir then
Patient:       Too fucking right you will.  Now fuck off!
Binder:       Have you been drinking sir?
Patient:       No I fucking haven’t!  Get stuffed!
Binder:       There we are then*.

And so it went on, until an ambulance crew and a police unit arrived, where our patient continued to be of interesting character to them.  However, the police eventually put him in his place and ‘assisted’ him onto the ambulance.  They said the gentleman reeked of alcohol but neither the ambulance crew or myself could smell anything . . . guess that’s years of ‘odour conditioning’.

The police soon left us and the patient quickly became delightful again and eventually opted to leave on his own accord.  But not before offering more abusive expletives and spitting disdain at our efforts to help him.

This was a shame as we would have very much liked to have conveyed this man to hospital as his temperament could well have been masking underlying problems.  We are only too aware that sometimes, an individual’s behaviour can show dramatic changes if they are suffering bleeding into the sub arachnoid space after a head injury.  Whereas other times, an individual’s behaviour can appear like they are drunk should they be suffering from a low blood sugar count . . . . but then sometimes, just sometimes, an individual’s behaviour can simply be the result of them being nothing more than . . . . . . . . . a complete arsehole.

I’d like to think, and hope that our patient was the latter


*take the first letter of each of those words . . .