Monday, 30 August 2010

After-Dinner Mint

A midsummer's night, a cool breeze shakes off the last of the day's stifling heat. The trees wave a silent farewell to the day, and usher in the perfect evening. The streets are still aglow in the last moments of the red sunset, and as darkness falls, they step into the restaurant for a quiet birthday dinner. It's still their favourite eatery, the place where they first met, he a waiter in his parents' business, putting his teenage years to good use and saving some money. She was the shy daughter of regular diners. When they married, they took over the business.

They had sold the restaurant several years ago, but it had retained its character under the new ownership, and as it still felt like home, they would always go back for special occasions, and were always treated as royalty each time they did. Her birthday was one of those special occasions.

They sat at their usual table, hidden away in a corner behind a screen. It had been their own private hideaway when they were teenagers, and it remained so well into their adult life. The service was, as always, excellent, the food was top grade, and, most importantly, the company was intimate and loving. They sat and talked about their lives, their jobs, their futures. Their kids, babysat at home by their grandparents, were central to their plans. They talked about school achievements, nursery drawings, friends coming to play, and how they were growing up so fast.

"We have everything we wanted, and everything to live for", he said.

"I know. But if I don't go to the bathroom now, I may explode, and that might ruin our plans!"

They laughed, and as she left the table after their dessert bowls were emptied, she picked up a striped mint sweet and popped it in her mouth.

Less than ten minutes later, there were four of us crowded into that bathroom, as well as her frantic, distraught husband and the restaurant manager looking lost and scared. She lay on the floor, her breathing stopped, her heart firing a useless, chaotic attempt at a rhythm, she was a vision of suspended animation.

Equipment flew in all directions, instructions given, actions undertaken. We would breathe for her, we'd pump her heart for her, forcing the oxygen and the blood to fulfil their duty against their will. The air from the mask was going nowhere. Her lungs wouldn't move, declining the offer of the oxygen that was being forced into them. Something must be sitting in the way and fighting our actions. After another round trying to beat and shock the heart into action, someone took another look at the airway.

It wasn't there the first time we looked, I could swear to it, but now it sat staring innocently back at us, just out of reach. It was the round mint, all along, that had lodged itself in the airway, trying to complete her circle of life, and kill her on her birthday. Five seconds later, a pair of forceps flew across the bathroom and were used to fish the mint out of her throat. We breathed a few more breaths for her, whilst all the while her heart was being operated remotely, from the outside-in.

In the ambulance, it finally happened.

She took a breath.

We all stopped to watch her, to check the monitors, to make sure that our imagination wasn't playing tricks on us.

There were no tricks. She was pulling through.

By the time we reached the hospital, there was nothing left for us to do but hope and pray.

As the adrenaline wore off and the ambulance was being returned to its normal state, I had a weird thought.

Crazily, I wondered what had happened to the mint.


Lynda Halliger-Otvos said...

Well done, mates.

Anonymous said...

Well done, that's one towards the complex ROSC target ;)

Anonymous said...

You're an incredibly odd person, as most of the readers will know all too well. But, even for you, that is extremely odd! And by 'that' I'm talking about where the sweet is. However, another excellent blog! Dr Abuse :)

oneunder said...

Always an interesting perspective and a pleasure to read.

Anonymous said...

How much of that is actually true? How did you arrive on scene, assess the patient and successfully resuscitate them whilst getting the life history of the patient and their family? This is my problem with blogs, if you were to put the whole truth down (eg, we got called to a cardiac arrest, the patient had a sweet stuck in their mouth, we removed it with some forceps and then the patient had ROSC but is probably a vegetable) then it wouldn't be that interesting to the public. Instead bloggers insist on elaborating on the truth to make either the situation, themselves or both seem more interesting. You've got a great writing style and this is not aimed at you in particular but I just wish blogs were more fact than fiction.

Anonymous said...

Does it not occur to you (Anonymous timed at 20:46)that the initial details in this blog could have been gleaned after the event! You have a pretty low regard for someone who is overworked and under extreme pressure to think that this is merely a work of fiction.

Anonymous said...

Actually, I'm a London Paramedic as well so I know full well how overworked and under pressure we all are and I certainly don't have a low regard for this individual. It is because of the pressures such as turning round quickly that I am not convinced by all the facts of the post. I am sure that the blog is based on fact but I am sceptical about the reality of ambulance blogs in general. This is after I found a blog posting (not from this author) about a job that I attended which was so far from the truth that I struggled to recognise the job that I was present at. This may well be the complete 100% truth but I remain unconvinced. Like I said, the writing style of insomniac medic is fantastic and their blog posts convey a real sense that they enjoy the job so well done, but my question was how much of this particular blog post is 100% fact? I don't expect insomniac medic would say this blog was 100% truth (more like 90% at most) but readers should be aware that no matter how entertaining and enlightenining this and other blogs are, it does not fully reflect the reality.

Rachael said...

Anonymous @20:46, I find that in my job as a student radiographer, patients and their families do everything within their power to tell me the whole of their life story in the time it takes me to do a hand x-ray (ie. not very long) Getting them to stop is an art-form that I am still in the process of mastering.
However, in this case, UNOHOO has probably hit the nail on the head, and this information was gleaned after the main event. Please think before you are rude about another's work. I've always been taught that if I can't say anything nice, then I shouldn't say anything at all.

Rachael said...
This comment has been removed by the author.
Anonymous said...

Actually, I had said something nice I think "the writing style of insomniac medic is fantastic and their blog posts convey a real sense that they enjoy the job so well done". I'm not trying to be rude (I apologise if that is how it seems), just raising the point that I don't think the blog (and other blogs) is 100% fact. Patients/relative do indeed try to tell you everything about their life but I feel that the level of detail in this post suggests that there has been some elaboration to the original story. Besides this, the blog is very entertaining and well written. Just my opinion!

InsomniacMedic said...

Ok, anonymous (I wish you'd at least give yourself a pseudonym). Lets bring this to a conclusion. This whole blog is to an extent, a work of fiction, closely based on fact. It has to be fiction in order to maintain confidentiality. If a patient was to look at a post and think it was about them, I'd be able to point them in the direction of a dozen other calls that were the same. I change details every time, the sex, age, family status, location, background, names if I ever use them. Sometimes the story I tell is actually two or more stories combined into one.
I have never once claimed that the tales I tell are 100% fact. They can't be. Confidentiality rules and common sense forbid it. The idea of this blog was to give an idea of what we face as paramedics, and how it affects me, not to give a call by call list of every day's activities. There are other blogs that do that and you're more than welcome to read them too!
So yes, sometimes it's dressed up. Other times it's all dressed down. I don't mean to make me sound more important. If I wanted self importance, I'd become a politician - not a paramedic... I want to show our job for what it is and what it can aspire to be.
Thank you for being honest and for complimenting my writing. I hope you'll still come back for more. If we ever meet on a call - assuming you know who I am - let me know! Because if I write about it, chances are you won't know it's you that I'm writing about...

nickopotamus said...

I can see your point Anonymous, but also why people initially took offence!

When I write, I can promise you that nothing I say regarding patients is 100% fact. The reasoning?

Firstly, details are changed to protect the innocent, and more importantly, my career. Can't have those patients being written about personally identifiable now, can we. Any healthcare blogger who was actually 100% would be out of a job exceptionally quickly.

Secondly, there is poetic license in there. You romanticise the stories, try and put more of the emotion that you and those around you are feeling in. The stories aren't as good to tell or to listen to without the feelings of those involved.

I don't think any blogger claims, or can claim even if they wanted, to be 100% reliable (not least because who on earth would want our jobs if we portrayed it realistically!), but you could argue that this still doesn't mean the stories are "made up". The characters, events and locations are based in reality; and the feelings and reflections are very much real. Isn't that why people read the stories rather than watch a Five TV show - more for the feelings of the characters than for the cold, hard facts?

Anonymous said...

To Anon 20.46:

As a Paramedic in the LAS myself, I'm always interested on other peoples opinions of ambulance blogs. Your comments intrigued me in that you have answered your own point. If the events weren't elaborated upon it would not be interesting to read thus no one would want to read it!

The fact that you then go on to say how much you like the authors writing style makes you look daft. May I respectfully
suggest if you feel that this or indeed any other blog you read is so far removedfrom the truth that you read The LAS news for that dose of "reality" you crave and leave the creative writing based on true events to those that clearly excel at doing so....


Anonymous said...

Thanks for your response insomniac medic. I could have written the initial comment more politely so I apologise. I think it's important that people realise that blogs aren't 100% reality but unfortunately (in my opinion) too many people think that they are gospel.

Anonymous said...

To MM1. I wasn't actually trying to find out why blogs aren't 100% true so there wasn't really a point for me to answer. Also, is it not possible that I can like somebody's writing style but not agree with what is written?

Anonymous said...

Great story as usual mate. I must admit though, it does sound a bit Mills and Boon... Until the cardiac arrest but obviously!!! AH-D4

oneunder said...

I have to say that I like the scene setting. It creates an emotional link and you find yourself caring about the patient (most of the time).
As an ambo bod I find it hard to empathise with a lot of our patients but this blog helps to remind me what it is that we actually do. At the end of each drunk or cardiac arrest there is another human being, I sometimes forget.

Thanks for reminding me.

Pie said...

It's all about the patient confidentiality... The details have to be changed beyond recognition to protect patient, and also to protect paramedic in question from getting fired!
All the paramedic/ambo blogs I read have got clear statements saying that they are basically fiction loosely based around fact, and that this is because of patient confidentiality.
I haven't come across any paramedic bloggers who have given readers the impression that what they are reading is the truth.

RapidResponseDoc said...

As a blogger myself, and one who has worked with IM on a number of occasions, I find the comment that one of the readers wished that the blogs were more fact than fiction is interesting. It brings to question why people read blogs, and why people write them.

People read them to be entertained, and to be educated. There is a sense of voyerism in reading about someone else's life - the most intimate details of their life and death. It can't all be true, as has been said so often in these comments. But, it has to have a grain of truth, and basis in truth. If IM were to tell us about how he grabbed his trusty bic biro, thrust it one-handedly into this woman's neck and, amidst a spray of arterial blood, breathed down the pen barrel all the way to hospital, thereby saving her life, well, most of us would have turned away in disbelief.

And why do we write? Because we can.

I read some blogs, and don't read others. Some, such as IM's and Spence's, I return to again and again. That is the best bit about blogs for the reader - they cost nothing, and if you don't like it, you don't have to come back. I for one will be back!!

Anonymous said...

I will be back too!!
I loved it!
Well done & Thanks for the entertainment


burned-out medic said...

how does one question the veracity of events chronicled that one was not a party to?

InsomniacMedic said...

All - MM1, RRD, Pie, oneunder, the anons, burned-out medic, everyone. Thanks for taking the time to comment.
As to the initial anon (to be known as 20:46 for all eternity now...) I thank you too, and hope you don't feel under attack from an army I didn't realise I had.... I hope you don't feel misled any more. I don't just write cold hard facts, other than the obvious other reasons mentioned above, as that would fail on two fronts.
1 - It wouldn't be the release for me that I need, and
2 - no-one else would bother to read it either.
I hope I continue to showcase our job in the positive light that I have tried to do so until now, whilst at the same time giving a slightly different perspective on things as we see them.
It isn't gospel, and should never be treated as such.
I hope you'll come back too.