Diary

Casualty: 3am; and my heart racing


I’m sitting here, I think, on this computer, and it’s about nine one Friday night.

My heart starts hammering furiously in my chest, like a child that’s been ignored far too long and is having to make more and more noise to have attention paid her.

Time to stop.

So I go downstairs to rest, and pick up the blood pressure monitor, just to see.

It tells me my heart is beating at 139 beats a minute.

I feel a bit shocked and numb and try to lie down to rest, but rest is impossible because the minute my head touches the pillow my heart beats louder than ever.

Lie up then, and try to breathe deeply, and meditate.

Impossible to meditate. Impossible to focus on anything but the unimaginably rapid beating of my heart.

Turn on the radio then, there’s a discussion about the end of design, post-design, fascinating.

And then it’s composer of the week, and this soothes me.

Besides, I’m frightened of casualty at 10pm on a Friday night.

Perhaps it’ll pass, this beating, perhaps it’ll go away. Perhaps if I settle down it’ll settle down.

So it’s back to breathing, and focusing on the little spot between my eyes and time passes, somehow.

Until some time after 3am, and it’s not getting better, it’s just not, and I phone for help.

I want a doctor, but I get an ambulance.

It’s hard to get down the stairs to open the door, and the main ambulance man seems to disapprove of me, “Is it you?”, he asks as if he thinks I might be faking, and he disapproves of the blood pressure monitor, “A little knowledge is a dangerous thing”, he says loftily, struggling to get the portable ECG wired up correctly, and he asks, “Is that a CPAP machine” and seems to disapprove of that also.

He just says: “The Infirmary”, and that’s it, no choice in the matter, and tells me I should have phoned hours ago.

I throw some stuff randomly into a bag, and we’re off.

The driver gets lost, and the road is bumpy, and the ambulance man spends the whole journey writing figures down into a form.

But there’s a volounteer come along, and he has a gentle way with him, and that’s comforting.

At the door of A & E there’s a woman screaming. Inside there’s police everywhere.

I get parked in a chair for a while, and sit there a bit stranded until I’m asked to move into a vacant booth and wait for my trolley.

And just then a man appears out of nowhere, running at top speed, and there’s a policeman behind him.

The policeman brings him down and they’re sprawling among the trolleys, and someone says “That’s enough to start my heart off into atrial fibrillation” and we all laugh as the man is sullenly led away.

But it’s lucky I’d moved, or he would have landed on top of me.

The woman’s stopped screaming, she’s in the booth opposite me, I recognise her from her boyfriend, still stolid, still eating crisps in a conspicuously disinterested kind of way, and she’s out of control, she’s staggering, and there’s a nurse gone over to manage her.

And then there’s another falling over with a clatter, and another with blod all over his face, and a group of girls with hardly any cloths on and their tights all ladders.

And so it goes on, and the nurses and the doctor, there must be more than one, but the only I recognise is the one dealing with me, just get on with their business as if nothing unusual is happening.

I like my doctor, he’s got a nice way with him, and he explains things in a clear and gentle way that really contradicts his somewhat sinister appearance - heavily unshaven and with something wrong with one eye that keeps it half open, half closed.

And perhaps nothing unusual is happening, this totally insane procession of self-destructive is, in fact, part of the routine.

And we’re teasing one of the x ray attendants, it’s her first night shift, ever, and she’s half dead with fatigue, and all the young people wandering about with their torn clothes and their laddered tights and their impossible shoes all have the air of people for whom this is, in fact, normal. Some of them even look quite pleased with themselves, as if getting so smashed as to end up in casualty is some kind of badge of honour.

And round about six they’re thinning out, and there’s me and the other old people, and we’re suddenly joined by a truculent old man who demands checking over. And the nurse is indignant, he’s just come off the first bus and walked straight in without even bothering to go through reception, and anyway he should get this done through his GP.

“I’m diabetic” the old man says, it’s his trump card, he knows the game, and he lets itself be chased off to reception and the nurse turns away in the hope that surly gatekeeper will turn the disagreeable old man away completely.

But he’s son back, and he’s clutching a piece of paper he’s extracted from the reception and waves it at the nurse in surly triumph and she leads him off to sort him.

Meantime I’ve really lost interest. Something remarkable is happening to me.

The doctor has located a vein, set up a drip, and just injected a beta blocker into it.
And then he’s gone off somewhere.

And I’m alone, waiting, Listening to the rapid beep beep beep of my heart monitor, still at 138, and wondering if anything will happen.

Nothing happens. I’m just giving up when the sound alerts me: the monitor slowing, and I can turn round and see the rate going down, down. 90. 80. 70 60.

My chest expands in the hugest relief, the tension is gone, that terrible inner pressure, and I can breathe easy again.

And soon the doctor re-appears, all smiles, and suddenly there’s a cup of tea and congealed white buttered toast, as if to celebrate.

For a brief delirious moment it looks like I’m going to escape... but I’m caught in the hospital machinery now and there’s no way out of it.

It’s the combined assessment ward, even though I’ve been assessed, and I get the extra privilege of cornflakes, more cold toast, and an extra cup of tea.

Also I snatch a brief moment of freedom and go to the loo, before I’m tethered to the monitor again.

Hospital, I’ve discovered in the past, is not too bad a place to be, and the people can be very clever and very kind. But you have to keep alert, and keep your wits about yo: because you have to look out for yourself.

Which makes it a really awful place to be ill.

Illness has this major inconvenience in that it frightens you, it preoccupies you, and so it distracts you so you can’t take the best care of yourself.

Luckily, I’m not ill now, I’m in full possession of my faculties, and so I know to ask the doctor if I still need to be on the monitor, and I know to tell the nurse that the doctor says I’m not to be on the monitor, and that means I can get off it, and take that hideous hospital gown off and start to dress like a human being again.

And that matters, because you can act like a human being, with strength and freedom and even a bit of self-determination, and stop being a helpless cog in an over-loaded and hopeless slow moving machine.

I start o look around me and identify the faces that go with the voices I’ve been hearing.

There’s a surly young man, diabetic, who’s about to discharge himself, and various nondescripts in pyjamas, and there’s Bill.

Bill’s been pouring out an endless tale of woe to the doctor about a long list of intractable problems, and there he is looking lost and bewildered, and he’s been asking the nurse to phone his wife so she remembers his paddi-pants, and it’s somehow just his luck that he’s taken off for a scan just as his breakfast arrives.

When he’s wheeled back the porter with the wheeled chair is busy with an incontinence pad, and then there’s Bill standing in the middle of the ward like a naughty school boy, his legs all cold and wet, and he’s asking the nurse for another pair of pyjama bottoms, and the nurse is off looking through all the linen cupboards, leaving Bill still standing, a bit unsteady on his feet now, and I can see the nurse searching down the corridor, until he comes back with a pair, really bright green and incongruous, and after some business behind the closed screens Bill can at last sit down again.

Meantime there was a woman's voice earlier, sobbing, sobbing, and a female nurse telling her “You’ve got a tube in and it does the peeing for you. You’ve no need to go to the toilet”.
Again and again. And the old woman sobbing, “Will no-one help me? Will no-one help me?”

And nobody can.

And the voice subsiding into silence.

I want to see who it belongs to, but I can’t see until much later and all the wearisome business is completed, and the cardiologist has come round, and the discharge letter has been typed, and they’ve taken off the tube in the vein on my wrist and removed my armband, and my lovely daughter and her lovely man have come to take me home.

I see her on the way out: mass of straggly hair, curled up inside the cot sides, staring blankly at a woman’s magazine.

Shockingly young.

Labels: casualty; too fast a beating heart