Tuesday, 22 September 2009

Cen-Tree

I have an ex-crewmate, Jim, who, when frustrated with the job and its ensuing politics, would threaten to go and work for the council as a lawn-mower. No, not as the machine, but as the operator of one. No grief, out in the open air, music blaring. What more could you ask for?
*****
Al, a local-council gardener for several years, loved his job. It wasn't taxing, he loved the open air, loved working at his own pace, loved listening to his music. No managers, no hassles, never home late. Just him, and the flora and fauna of the local area. Today was his turn on Daisy, the industrial-sized ride-on lawn mower. Daisy was used when the big jobs needed doing. Parks, large verges, anywhere that a normal sized machine would take days to complete, Daisy could do the job in a fraction of the time. Daisy's twin, Belle, was also sent out on the mission, piloted by Sue.
The weather forecast had promised a bright sunny day and for once had delivered on its promise. Al and Sue were thrilled. They moved from place to place, leaving behind them the scent of freshly cut grass whenever they journeyed on. Daisy and Belle were in their element. With Sue and Al chatting throughout, the morning flew by, and as the midday sun began beating down, they found a shady area that needed cutting too. A wide grass verge with several large trees dotted around.
Sue went left, and Al, right. He'd just remembered a funny story he was going to tell her and turned round to call out. Two seconds. That's all it took. Two seconds looking in the wrong direction. Sue barely had the time to scream: "AL! LOOK OUT!!!!"
Al turned round to face the front again, just in time to see the huge branch. Most trees would be proud to have that branch as their trunk, but on this tree it was just a branch. Perpendicular to the tree-trunk, parallel to the ground, and about six feet above it. Daisy was about four foot high. Al sitting down another two. He took the full impact straight in the face. Ten miles an hour isn't fast when you're surrounded by a tonne and a half of metal, but it's lightning speed if your face meets a tree and has no protection at all.
When we arrive, Daisy is the other side of the tree, with Al a crumpled heap on the floor. There's blood everywhere. I take a few seconds to assess and work out what's going on, in which time, Jim, my crewmate suggests that immobilisation may be a good idea. I wholeheartedly agree, and curse myself for not thinking of it immediately too. Right, brain back into gear. Trauma. ABCs.
Airway - clear at the moment, but some bleeding in the mouth. Unknown source. Regular reassessment required.
Breathing - yes. At the moment. Clear chest, no funny noises, no missing sounds.
Circulation - yes. At the moment. Several areas of blood loss, none that are obviously too heavy.
Disability - Sue's unsure if he lost consciousness, but thinks that he did. At the moment, he's conscious but very confused and a little agitated.
I'm still worried about Al's airway. We need to immobilise him on a board, with a neck brace, on his back. And there's something bleeding in his mouth. Not at all ideal. Ideally I'd like to have the patient knocked out and intubated. That would ensure that his airway and breathing are secure and I could deal with the other problems.
I ask for HEMS. They're unavailable. (Not once, in my whole career so far, have they come when I've called them. I've done calls with HEMS, when other people have asked for them, but never when I have. Either they've been busy, had no helicopter, or a myriad of other excuses. Once, they even crashed when they were on route to me. Before you scan old newspapers for news of a HEMS chopper crash, they were coming in the car. But still, it must be some sort of conspiracy...)
I ask for a BASICS doctor. The nearest one is at least 40 minutes away.
We're ten minutes at most from the nearest A&E, not one known for its trauma care. The nearest Trauma Centre is an extra twenty minutes drive away. Al has an airway problem, so we don't really have a choice. We package Al, load him into the ambulance, warn the local A&E that we're on the way, and apply diesel. Jim's driving, which is a good thing, as he's a much faster and smoother driver than I am. On route I constantly suction the blood from Al's oral cavity. I have flashbacks to the dental surgery. Not a good thing.
His observations remain stable. A quick look shows that he's lost several teeth, probably fractured his jaw and eye-socket, possibly fractured his skull. As his face took the full force whilst Daisy kept going, we had to suspect a serious spinal injury too. When we arrive at the hospital, there's a full trauma team to meet us. I'm impressed. They obviously understood the significance of the injuries that we'd tried to relate over the radio. Al's handed over to the team, and I never find out what happened to him after that.
Whilst we're cleaning all the blood, mud, and carnage we'd left in the ambulance, Jim mentions that he's not so sure about his alternative career path after all. I'm not surprised.
*****
PS. This is my 100th blog post. My century entry. What started out as a little bit of a trial run, has turned into something that has taken over my life! I'm shocked I've made it this far, and honoured that I seem to have captured the interest of so many people. I hope I keep going for a long while yet, and I hope you keep coming back. But in the meantime - thank you.

8 comments:

slmiller72 said...

Congratulations Ben on your 100th entry!!! And what a good one it is!

Your posts seem to go from strength to strength as does the support for your blog.

Don't give up - you clearly have a talent, a hobby if you like, at which you exel.

Btw - just because your crewmate helpfully suggests a course of action doesn't mean you should berate yourself. You work as a team. We can't be 100% on the ball 100% of the time... :)

911 and the Randomness.. said...

As long as you are wrinting, I will keep coming back! Your stroies are very well written.

Anonymous said...

Congrats! Here's to the next 100 fantastic human interest stories, and looking forward to the book that is clearly hiding in you.

Tom said...

Good on you Ben. I hope to see many more posts.

I have to say that it was only the relentless cajouling of my 'rug rats' that led me to overcome my technophobia, and explore the land of blog.

I am amazed at the quality of writing, and fondly recall my own service. However unlike yourself and other gifted medi-blog writers, I am bereft of your talent.

RapidResponseDoc said...

Hi Ben, where was this? Anywhere near my neck of the woods (pun not intended), because I find I'm not used nearly enough, even for jobs close by...

Great post, and well done on number 100 (I'm just over half way there...)

Ben Yatzbaz said...

Thanks again one and all. :-)
RRD - it was indeed not far from you at all. I even asked for you by name, but apparently you had the audacity to be away that day... Oh well. Don't worry - I still keep an eye out for jobs where I could put you to good use... :)

RapidResponseDoc said...

Ah yes, my trip to Surrey to see my brother and sister-in law and my new niece. Sorry. Won't happen again!!! You should have my number. PM me and I'll let you have it...

medicblog999 said...

Congratulations Ben!

I'm enjoying them all! Here's to the next 100 and what that may bring.