"32 year old male, fainted, DIB"
This was the first job of the day and amazingly we had been at work for a good two hours by the time we got it! We'd managed a relaxing Costa and a non-rushed breakfast so we were in high spirits. The address given was a gym so we were fully expecting a non-complicated faint in someone who had not eaten and been pushing themselves too hard. We pulled up outside and it was obvious from the name what kind of gym it was. There would be no treadmills, no cross-trainers and no pool. There would also be no middle-aged slightly tubby woman, or any women for that matter. It was a weights-only gym and appeared to be aimed at bodybuilders only. We walked in and were met by the manager; arms bulging, veins in neck pulsating and wearing a vest meant for a 10 year old. With his chest puffed out and his arms resembling a two-handled mug he led us up the stairs and to the patient.
Our guy was lying on the floor, unconscious, sweating and snoring. He was squashed up against some dumbbells so we pulled him into some open space. He was showing all the signs and symptoms of being hypoglycaemic (low blood sugar) but having no working kit to test it, we had to guess! We treated it as such and gave him an injection to raise his sugar levels. While waiting for him to regain consciousness I looked around; it was such a bizarre place. There were a good 25 or so blokes pumping iron, growling, grimacing and then starring at themselves in the mirror! The mirrors stretched around most of the walls allowing them to stare to their hearts content. Scattered around the place were hundreds of photos and posters, some signed, of male body builders all who looked like they'd been tango'd! In a setting where people are trying to act as manly as possible it all seemed very homoerotic! There was a long oak bar, about 25ft long like in old social clubs, the difference being no pint of lager and some pork scratchings; just protein shakes! I found the whole ethos of it bizarre!
Anyway, back the patient! He started coming round after about 3-4 minutes. He was very groggy and confused. Confused in his vocal response but also in his eyes! He clearly didn't have a clue where he was or what was going on! We gave him a Lucozade to up his sugars as when he came round he said 'yes' when I asked if he was a diabetic. It became apparent pretty quickly by the odour in the air that he had been incontinent, and not just a No. 1! We led him to the toilet and as every minute went by became more and more coercive. We got him a change of clothes while he cleaned himself up in the cubicle. I went back in and he was by the sink.
"Any chance you could give me some privacy while I wash at the sink."
"Of course, we'll be just outside."
We waited and chatted, and sniggered at some of the characters we could see in this testosterone filled cauldron of vanity. The FRU arrived with the kit needed to test his blood sugar and we explained what was going on. We asked the manager if there was any chance he'd been taking any under-the-counter steroids or anything like that.
"No, definitely not, he's not the type."
To be fair, he didn't look the type. He wasn't that well-built and didn't seem to have the obsession many of the others appeared to. After a few minutes of waiting I heard a bang. We burst into the toilet to find our patient naked and in a cubicle, upright and fitting. We got him on to the floor, got the oxygen on him and let him fit. We took his blood sugar and to our surprise it was relatively high. Clearly our initial diagnosis was wrong and he had been unconscious post a seizure. After a few minutes he stopped but then vomited; we rolled him into the recovery position whilst this was going on. Unfortunately, the use of all the muscles needed for the body to vomit had another undesirable effect. Like the eruption of Mount Vesuvius out came an explosion of poo. I've never been so close to vomiting. It went everywhere, and as he came round he rolled in it. It got on his hands which he then kindly transfered to us in the post-ictal melee. We eventually got him wrapped in a blanket, into a chair and down to the ambulance. I should have been concentrating more on what was causing his fits but all I would think of was:
"I have sh*t in my hair"
"I have sh*t in my fuc*ing"
"I have sh*t in my mother fuc*ing hair"
"I have fuc*ing shit in my mother fuc*ing hair"
It really is a panic stricken moment when you get bodily fluids on you. You want it off but often you don't get a chance. Often you know it's there but try and ignore it but once it starts seeping through your uniform you feel the damp on your skin. Sometimes it's spit in your face or blood all over you. It is just an unnerving experience and one I will never get used to. Surely I should get paid more than £9 an hour to get sh*t in my hair?!
Once on the ambulance our patient came round again. This time he said he wasn't diabetic! In fact, he said he had no medical problems at all. No history of seizures and on no medication.
"Have you taken any illegal, under-the-counter drugs to help you bulk up? You won't be in any trouble, we are not the police, but we need to know. It's really important."
After a brief pause he nodded. "Yes"
"Are they amphetamine based?"
"Yes"
"How long have you been using them for?"
"2 days. I bought them off the gym manager, he said I'd lose weight and bulk up quicker."
I couldn't be bothered to go back in to give the lying rat a dressing down. We needed to get our patient to hospital, ideally before another seizure. My crewmate got some IV access, I did an ECG and we left on blue lights. On route he had another seizure. He was still seizing when we arrived. He was still seizing when we left resus. It did eventually stop, we checked in on him a few hours later. He had been for brain scans and we were told by the doctor that the drugs he'd been given had raised his blood pressure significantly. This had caused the seizures and had probably triggered epilepsy. All for what?
This guy felt the need to take drugs to improve himself. He wasn't happy with the body he was in. Who really is though? Models often have eating disorders in their pursuit of a size 0. I don't think anyone is ever really content. The skinny amongst us often wish they could bulk out a bit or get even slimmer and the fat want to be skinny. People complain about needing to lose weight and I often look at them and think 'No you don't!' but it's personal. The people who are physically fit want to be fitter and the dedicated athletes want to get better. Will a body builder ever think they have reached perfection? Will a diet ever get anyone to where they want to be? I don't think so. If I set myself an ideal weight to get to, I am pretty sure that if I got there I wouldn't be happy. There would still be a bit that needs improvement. It's not just about weight, I know plenty of people who are happy with their size but there is always something. There would still be something to strive for, but for the vast majority of people the need for improvement is balanced with the enjoyment of the nicer things in life and we tend to find a middle ground. We want to improve and will occasionally do something about it, but deep down we want that Chinese takeaway and binge at the weekend. Basically, we don't care enough to do something about it. The other side of the coin is people who care too much; they will do anything to reach a goal that cannot be reached, and as I saw today that often comes at a cost. It is amazing the lengths people will go to in the pursuit of happiness that I don't think is ever truly obtainable. You tell me, is it?