The Nation's Health

"32 year old male, head injury post RTC, Car vs Lamppost"

First job of the shift; one minute in, typical start to the day. We put on our hi-vis jackets, threw our stuff on the truck and headed out for the day. The location was a residential road but quite a high speed one. It was just after 7am so the traffic was starting to pick up. When we arrived on scene, at the same time as the police, our patient was still in the car, the bonnet of which was wrapped around a lamp post. The airbags had been deployed and he had a nasty looking gash on his head. We fully assessed him and after the wound was cleaned slightly it wasn't as bad as it first looked. He had no neck pain at all so we slowly helped him out of the car, onto the trolley bed and onto the truck. He said he'd been driving to work and a cat had run out in front of him. He'd swerved to miss it, lost control and ended up well acquainted with the lamp post. As is standard practise the police came on board to take a statement and breathalyse him. Up to this point he had been very chatty but failing the breathalyser changed that.

Although guilty of drink driving, I believed he had done so without intention. It is all too common to still be over the legal limit following a night's sleep and a breakfast. Regardless of his intentions though, the law is there for a reason. That reason is to stop people getting killed; simple as that. The costs to our patient, of not baring that in mind were huge. What made this job interesting though was watching how he dealt with being arrested. There was a striking similarity to that of the 5 stages of grief and mourning. Obviously, he wasn't suffering grief or mourning in the traditional sense but he did follow the pattern first described in Elsabeth Kubler-Ross' 1969 book 'On
Death and Dying' that says a distinct pattern of emotions is followed.

1. Denial

His first reaction to learning of being arrested was to deny the reality of the situation. He simply would not accept what was happening or what the officer was saying to him.

"Are you serious? No way. This is not happening, you're kidding right?"

"I don't kid about drink driving"

"But I stopped drinking last night... I didn't have that much, it can't be right"

Explaining that it was indeed correct and he would now be arrested changed his mood somewhat.

2. Anger

As the masking effects of denial began to wear thin the reality and severity of the situation re-emerged. His intense emotion was deflected from his apparent vulnerability and was redirected and expressed instead as anger. He started shouting abuse at the cops and us for that matter.

"You lot should be out catching real criminals" Blah Blah Blah....

"What the f@$k are you looking at?"

He then proceeded to jump off of the bed and make a bee line for the back door, kicking out and swinging wildly. Needless to say, he was promptly subdued and put in the back on the bed, this time in handcuffs. He continued his abuse for a few minutes until he realised it was getting him nowhere.

3. Bargaining

It didn't take him long to realise that anger was not working so he tried begging and pleading to not be arrested.

"Please mate, come on, you don't have to do this. There must be something I can do. Please. I'll do anything, honest"

"Sorry fella, you've been drink driving, there's no excuse and nothing you can say to change the facts"

"Seriously, I'll do anything, I'll pay a fine, community service, whatever you want"

Like the anger, this went on for a while. My crew mate was dressing the cut on his head while I did paperwork and he just continued to beg and plead for redemption.

4. Depression

Two types of depression are associated with mourning. Obviously he wasn't mourning in the traditional sense but he was certainly realising the gravity of the situation. The first one was the reaction to practical implications relating his arrest. His sadness and regret were obvious and as he spoke I kind of felt sorry for him. I'm passionate about my hatred for drink drivers, but when you hear someone list the implications of the careless mistake they have made made, it's hard not to feel for them a bit.

"I'm gonna lose my licence and my job aren't I?"

It was a rhetorical question; he knew the answer as did we.

"What am I gonna tell my wife? She can't drive, how am I gonna pay the bills? Oh my god, what have I done?"

He had a point but as the old adage goes, if you can't do the time, don't do the crime. The second type of depression was more subtle and, in a sense, perhaps more private. He just lay their on our bed, staring at the ceiling. He then put his head in his hands and cried. It was an awkward moment really. What do you say? You can't really say 'serves you right', although it does, but it's human nature to have compassion. Then again, if his drink driving had killed a little kid there would be no questions that he should get everything that's coming to him. The fact that he got lucky doesn't negate that.

5. Acceptance

By the time we got to hospital he had a quiet acceptance about what was going to happen. He was apologetic to everyone for what he had done and how he behaved. I'm sure in the coming days he will be dipping back into anger and depression, and only once he's had his day in court and learns to live with the consequences of his actions, will he truly accept what has happened. It's easy to point the finger and equally easy to find compassion for the guilty, but there are people who may never find the acceptance they need. These people are the victims of drink driving; the people behind the statistics, the people who will never forget the consequences of someone's stupidity.

• On average 3,000 people are killed or seriously injured each year in drink drive collisions.

• Nearly one in six of all deaths on the road involve drivers who are over the legal alcohol limit.

• The latest figures show that some 590 people were killed in crashes in which a driver was over the legal limit; 2,350 were seriously injured and 14,050 were slightly injured in the last year.

• Car crashes are the leading cause of death for teens and one out of three of those are alcohol related.