Saturday, October 27, 2007

Frequent Flier

Most people in EMS can tell stories about a 'frequent flier', a patient that regularly calls for help, whether warranted or not. At the football games we cover, we have one such patient, a young women who works in the concession stand. More often then not, we get a call at the beginning of the 4th quarter, consisting of any variety of complaint, from an injury to chest pain to dizziness. I have helped out with her treatment before, assisting in splinting a 'broken' arm that most certainly was not, but have never been the primary responder. At the last game, Roy and I were the closest when the call came through, so we got the dubious honour of treating her.

It has been raining almost all evening, we have gotten soaked, as we were posted throughout the stands. The rain didn't seem to matter as Roy and I were talking to the man in charge, casually chatting as the rain poured down, dripping down our faces and soaking through our uniforms. Sometimes you just have to suck it up and ignore the weather, we don't usually work in ideal conditions. We were happy to get back to the warm and dry truck, however, and jumped in the front to chat and will the clock to wind down more quickly. Our team always loses anyways, so the dying minutes of every game are rather pathetic, this one is no exception.

As we stare out the rain-spattered windshield, a girl runs over to the security guard at the gate and we hear her ask, "Is the ambulance here, are they in there?" The man nods and Roy rolls down his window as she ducks beneath the barrier and beelines it for the truck. She is very excited, "At the concession stand, a girl fainted, she collapsed, she might have epilepsy, she needs help!" Roy and I exchange knowing glances as we hop out of the truck into the ever-falling rain. We grab our gear as Roy radios the call and our ensuing response into control. I can practically hear the laughter of John and the others echoing throughout the stadium, every one of them knows who the patient is.

We follow the excited girl through the crowd and behind the counter of the now-closed concession. Carefully maneuvering past the giant deep-fryers with our gear, we round the corner to see her slumped against a shelving unit, head buried in her arms. Roy has treated her for several years now, he knows her history and takes the call. "Hi, Caitlin." He says as he crouches beside her. "What seems to be the problem today?" She mumbles something about being dizzy and lightheaded as he checks her pulse. She refuses to make eye contact, keeping her head buried and eyes averted as he talks to her. "Why don't we go over to the truck, do you think you can walk over if we help you? You usually feel better after you rest in the truck for a while." She likes that idea, but is unsure if she can make it. We help her up and start her walking, we just need to get her to the truck, a warm, safe controlled environment is what she needs. As we emerge from the close quarters of the concession booth into the rain, she starts to falter. "We're almost there, almost to the truck, just a bit farther" I encourage as I take her arm. I feel pity for this poor girl, she obviously has issues, and nothing we can do for her in the truck is going to come close to fixing them. Nevertheless, we need to get her inside, she like creating a scene, so we need to get her out of the crowds.

Once in the truck, she starts to shiver violently, now complaining of shortness of breath, dizziness, severe light-headedness and a variety of other symptoms that sound good to her at the time. Roy talks her through all the symptoms, and soon, all but the light-headedness has disappeared. She now feels the need to go for a walk, perhaps that will make it go away. We try to change the subject and convince her to stay lying down, but she adamantly insists on going for "just a little walk, it'll make my head feel better." Roy looks at me and shrugs, we both know what will happen as soon as she gets back into the crowd, but we may as well get it over with.

I step out of the truck and help her down, leaving the back doors open so Roy can hear me when I call. She immediately heads around the side of the truck - rather quickly for somebody so ill - and out of Roy's line of vision. She asks if we can go 'down there', pointing down the aisle under the stands. I don't want to get far from the truck, but I agree for a very short walk and we duck under the barrier. I hold her arm lightly, I want to know what she's planning. We take no more then 2 steps and I feel her about to go. A slight pressure increase on my arm, and as soon as she confirms I have her, she does a perfect swan-dive, the back of her hand pressed to her forehead, down to the dirty wet concrete. I knew that was what was going to happen, so as soon as I sensed the change in her demeanor, I stepped behind her, grabbed her other shoulder and controlled her fall, exactly as she knew I would. The crowd seems rather concerned as I shout, "Roy!" and kneel down beside her, supporting her in a sitting position. Roy sticks his head out of the back of the truck and sees us on the ground. Without surprise and with very little concern, he steps down and heads over. I get in her face and try to make eye contact with her, "Caitlin, can you hear me? Are you ok?". She jerks her head away and says "Yes!" in a rather forceful tone for somebody who is supposed to be semi-conscious. Roy leans over us, the question in his eyes obvious, and I shake my head, bringing my hand up to my forehead and mouthing "Swan-dive". He nods and I see the humour return to his eyes as I continue to talk to her. "Caitlin, we need to get back to the truck. We are going to help you back, now take my arm. Ok, up we go." Roy helps lift as I force her to stand, she leans on me heavily as we walk her back. She glibly hops into the ambulance, then loses all her strength as she swoons back down onto the stretcher.

We get her to call her mother, who is coming to pick her up anyways, and learn she is 'just a minute away'. Her mother arrives with a knock on the back of the truck, I open the doors and help her in. She looks at her daughter with loving exasperation but very little real concern. She is tired of this scene, that is obvious, but she doesn't yell or berate her daughter, I am impressed by the patience and love this woman shows. She does not put up with it though, she very quickly states, "Ok, we're going home, you're fine, now let's go." Caitlin insists she cannot possibly walk to the outer gate where Mom is parked, and Roy says we'll wheel her out. The crowd parts with drunken interest as we wheel her through. We lower the stretcher and she swings her feet down as her mother takes her arm, leading her to the car. I step forward to take her other arm, but Roy indicates not to bother. He leans over the stretcher and whispers, "She won't faint with her mother watching." She doesn't, and we head back to the truck without incident.

The game has ended by now, and the others have begun to return to the truck. We lift the stretcher in as they all laugh at us. We lost, we had to treat Caitlin. I am not comfortable with that prevailing attitude. I realize she is an annoyance to them, she regularly ties up at least 2 responders with her BS complaints, and I agree that is not right. I appreciate Roy's attitude towards her and the entire call though. Although he knew, we both knew, that there was nothing wrong with her, we treated her with professional respect and dignity. Regardless of her past history or what we think of her, she deserves nothing less, no patient does. We are there to treat all people, all illnesses and all issues. We need to treat everyone with the same respect, it doesn't matter if they are drunk, mean, annoying or 'frequent fliers', they all deserve our best care.


Jill Pole said...

My but you're a fantastic read! I love your descriptions. Thanks for sharing...I'll keep an eye on this. :D And now you know my secret identity too. :P

ceppault said...

A wonderful read.

'Frequent fliers' are so very much a part of 'our flock.' We become shepherds of these folks; watching over them for years. We even miss them when one is lost to us.