The Nation's Health

Playing Cards

"24 year old female, chest pain, DIB"

I tend to be very cynical about young people with chest pain. It is very, very rare that the chest pain is anything sinister at that age. However, I'd reserve judgement until I met the patient and oh what a treat I was in for!

The door was ajar when we arrived, so pushing it tentatively open I shouted a speculative 'Hello?!' as I entered. We were summoned through to the living room where our patient was sitting on the sofa, smoking and watching TV.

"Hello there, what's the problem today?"

"I got a cough innit."

"OK, how long have you had it for? What has your GP said?"

I always ask that question knowing full well that 99% of people haven't bothered with their GP, but it's my way of subtly making a point!

"Bout 2 days, I ain't bovvered wit ma GP coz they are useless innit."

She said that while exhaling smoke into my face.

"Can you put that out please?"

*kisses teeth* "Ya can't tell me what to do in my OWN house, ya get me."

"Firstly I asked you, I didn't tell you, and secondly can you also refrain from kissing your teeth at me."

*kisses teeth* "Whatevs man."

There is nothing I hate more than teeth kissing. It winds me up something chronic. We don't ask to go to people's houses, they ask us to come to them. Show us some respect and courtesy. In this case, that means no teeth kissing and no smoke in the face. It really isn't asking much!

We checked her over, did an ECG etc and decided that she should go to hospital. The reason for this, she didn't know who her GP was so we couldn't refer her on. She was also complaining of pain in her chest and although it was most likely to be caused by the excess coughing, without a blood test we can't rule out cardiac problems as the cause. As we were getting ready to go to the ambulance she said:

"I can't walk, I feel dizzy."

She wasn't about to be carried. We explained there is no medical reason she can't walk. Her legs are fine all she has is a cough. Cue farther teeth kissing. We assisted her to standing and started walking her to the truck. She then took it upon herself to throw herself on the floor and pretend to faint. I've seen enough people actually faint and plenty that fake it to know the difference. After a few stern words she magically came round, of course, with selected amnesia and no memory of dropping to the ground. Miraculously, she made it to the ambulance. As she climbed up the steps I told her to take the second seat on the left. She laid down on the bed. Brilliant!

The journey to hospital was uneventful and lacking conversation. Her dying swan routine was in full swing and she didn't seem in the mood to answer questions. When we arrived she wouldn't get off the bed, so rather than arguing, we took her in on the bed. I handed her over to the nurse in charge who promptly directed us to 'the lounge! (The waiting room!)

*kisses teeth* "I ain't goin' to da waiting room, truss me bruvs." she said to the nurse.

He looked at her, looked at me and simply said "waiting room"! I love the power nurses have! We started wheeling her back down the corridor as her expletives and mood began to worsen. She had certainly found her voice again! We largely ignored her rant. It was nothing to do with us, it was the hospitals choice where she waited!

The waiting room was packed. We wheeled the bed up to the chair and asked her take a seat. After a slight delay and a little fuss she clambered onto a chair. My crew mate took the bed back to the ambulance whilst I booked the patient in at reception. Suddenly there was a commotion from the waiting room. I cast my eye over and my beloved patient was lying on the floor, half faking a faint and half faking a seizure. Her movements were not involuntary. It was was one of the worst fakes I'd seen, but the waiting room was in uproar, demanding help and a bed. As people were looking at me to do something, I wandered over.

"Up we get, sit on the bench, this won't get you seen quicker."

*keeps up charade*

"Come on, you're embarrassing yourself." (and me).

At this point another patient of similar age decided she'd seen enough. Not of the patient faking illness to get seen quicker, oh no. Of me and my failure to treat her!

"You're a disgrace, how can you stand there and not do anything, it's well out of order."

"She is faking it. I know it, and she knows it."

"If she was white she'd have a bed and you wouldn't leave her on the floor."

Ahhhh, the race card. If at first you don't succeed, accuse someone of being racist! At that point, I decided to walk away. I wasn't going to get drawn into a race row in a crowded waiting room. I never discuss the colour of my patients in my blogs or in real life unless it's relevant. It very rarely is. Today it wasn't. It makes absolutely no difference to me. I don't see a difference, race doesn't even register on my radar. Yet here I am, stood in front of 40 odd people, being publicly labelled a racist.

I could have informed her that I have siblings that are black. I do. I could have listed to her my Indian, Chinese, Egyptian, Polish, Romanian and Nigerian friends. I could have told her about my black gay friend who I shared a flat with. But I didn't. I don't need to defend myself. I don't need to acknowledge her ignorance. I don't need to feed her desire for an argument. If anything, my being white was an issue to her. I left the department with my patient pretending to fit on the floor and her new found guardian shouting obscenities at me!

Living the dream.....