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Tuesday, July 26, 2016

Making of a Child Psychiatrist: (44) Work, if you want to call it that(3)

The reception area was a cosy hangout when there were few patients, although we got turfed out quickly enough when things got busy. There was a piece of machinery tucked into a corner of a high level desk that intrigued me (as electronic bits and pieces often have). It was a primitive facsimile machine attached to a telephone line that used a wire to apply heat to sensitized paper in a roll. I had never seen such a thing, and we were not allowed near it (of course), until we had been trained in changing the roll (often necessary late at night). It was a bit limited given you needed some sort of similar device the other end to be able to send notes or letters. It was also frustrating given the quality of the information which came was often blurred, or the paper had found a way to ruckle up. But it was intriguing, and once in a while proved its value.
I was attempting to change a roll of paper one night when there was a screech of tyres outside down the ramp, a thump followed by slamming car doors, and then the squeal of tyres as a car sped off. As we went to investigate, a man crawled towards us announcing he had ben shot in the head. He had indeed. When we lifted him onto a trolley, we could see the entry wounds; it was remarkable that he was still conscious in terms of the head injury, and the loss of blood. An emergency call went out for the Neurosurgeons, and in the meantime, blood was drawn for cross-matching, a drip line was set up, and head Xrays were organised. Within about 20 minutes he was wheeled away, and we were left looking at each other and shaking our heads at how violent South London seemed to have become.
There were interviews with police when they arrived, but none of us could identify the car. I understand our patient went straight into surgery to remove the two bullets. The report ultimately was that he had lost part of his eyesight in one eye, but remarkably little else. I guess he was able eventually to provide reasonable information to the police on the sequence of events. But as I noted earlier, you never hear much in terms of outcomes. Casualty is simply a passing show of a wide array of problems and trauma; as medical staff, we have a very temporary set of responsibilities.
My stories make it sound as if it may have been a violent place in itself. And when you hear a story like the one I have just recounted, you wonder whether staff themselves may ever be in danger. Certainly Friday and Saturday nights were often rowdy, and occasionally a staff member would be injured in a minor way by accident. There were some hefty male security staff who provided protection to the whole hospital and were available within minutes to subdue a stroppy customer. I don’t remember them being called in often, though I do have a memory of one particular night.
It was late, and Casualty customers were beginning to thin out, when some young male drunks came to the desk with a friend who had taken a solid blow to the jaw. We were busy; so they had to wait. They were rowdy, and began to be really belligerent. At first it was a polite enquiry to nursing staff as to how long they might have to wait; they were not happy with the answer, but everyone was tied up. I finished with a case and went to reception to get the notes for my next patient. As I emerged, I was confronted by one of the young men, about my height and build but a few years younger. He demanded I see his friend immediately. When I said I already had a case to see, he got really stroppy, grabbed the front of my white coat with two hands bringing my face close to his he began to abuse me and the department, spraying bits of beer-loaded spittle. When I repeated, very calmly, that I already had a case to see who was just as urgent as his friend, he almost exploded and lifted a fist to hit me. I am afraid my right knee rose rather swiftly into his groin. It was a reflex action; I did not learn it from anyone nor had I had time to plan it or even think it through. It just happened. He doubled over, letting go of my white coat. Groaning, he was led away by one of the other abusive young men. From the waiting benches, having recovered his poise a bit, he abused me, telling me he would make it his business to get me. If not tonight, then one night he would get me!
My heart was pounding, and I was both recovering from my violent act, but also very embarrassed. I had probably made the whole situation worse. As it happened, the group became much quieter, restless but with no verbal abuse. A couple of them looked daggers at me as I collected my young patient and his mother and took them to a cubicle. Once behind the curtain, the mother sympathised with the department having to cope with angry young men; I shrugged my shoulders and began to clean up a very nasty cut on a knee that required several sutures.
Several hours later, at the end of the shift I found myself quite anxious as I left Casualty and walked down Denmark Hill to our flat. I am not sure what I expected, but found myself with my right hand in the pocket of my Mackintosh, with my keys slotted uncomfortably between my fingers. I have no idea which B grade movie such an idea came from. I have no idea what I thought I might have to deal with, or what I was going to do if I had to. In fact, I reasoned I was likely to severely damage my hand from the keys as much as damaging someone else. It made no difference. For the next two weeks I found my keys creeping into my loose fist on my short walks home.
With a regular salary finding its way into the bank account from both Jan and I, we began to have ideas above our station. Perhaps we should begin to think about buying a house or a flat. No, it was much too early for that. It was still summer, and a whole year since our last holiday. Given we were both quite exhausted from our work days, and finding it difficult to get sufficient quality time together, perhaps we should have another holiday. A decision was made. We would not be having a holiday that demanded hours and hours on a Vespa scooter. We had loved our time in France and Spain, but during the past winter had found the icy cold of riding down to Thanet almost too much. In addition, Jan had never really come to terms with driving the bike even though she had made several attempts the previous year. We decided that if we were to have a holiday, perhaps we should look out for a cheap car. Jan would be much more comfortable in a car (and they usually had heaters), and she might want to complete her driving licence.
I began to look on notice boards in the hospital and medical school, bought some newspapers looking through the ‘For Sale’ lists, and talked with my friend on Coldharbour Lane who had contacts in the car trade. Eventually we found a 1962 bright red Mini for £120; it had done close to 50,000 miles, but looked in good shape. I asked a garage I had worked for to have a look at it; they said it was a good buy, the engine appeared to be running well, the tyres and brakes were good. It only had two doors, but then there were only two of us. So we decided. Despite the fact I had to sell the Vespa that had served us so well, we were excited.
My first job in Casualty did allow a one week holiday, and mine had been rostered about two-thirds the way through; I was ready for it. Jan had made some tentative enquiries in her Biochemistry Department and they were prepared to let her go. She, too, was ready for a break. So instead of just sitting around, or perhaps going to our old haunts in Thanet and staying with family, we planned a proper week off and went down to Cornwall, staying in Bed and Breakfast hotels, and getting lunches and dinners as and when we could. We dug out our old movie camera and bought a couple of reels of 8mm film intending to take silly movies like we had done with our old friends Bob and Chris.
We headed due west, staying overnight in Bath. The next morning we did the tourist thing and had a look at Cheddar Gorge. Then, being a couple of romantics, we headed for Tintagel on the West Coast; reputed to be the site of Camelot. The next day we headed further down the coast to St Ives and Penzance. The following day we came back via the New Forest, staying overnight and then heading home.
The most spectacular memory is being deep in the woods, and finding a quiet spot to make a small film on one reel of 8mm. The fantasy was of a wolf dreaming of and being seduced by red riding hood, chasing her through the woods and eventually catching her. Jan did the bits of filming of the wolf, and I filmed the bits of red riding hood – part reality and part in a fantasy world. The whole idea was to have a brief silent movie which could be played with Sam the Sham and the Pharaohs’ version of “Little Red Riding Hood” (which had been released on a 45rpm black vinyl record in 1966). We still have these romantic little treasures, and a projector that still seems to work every four or five years when we drag both out of a box.

More tomorrow….

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