Sep 30 2008
…and a young man enters.
Part II of “We open on a room…”
“25YOM, septicaemia, will need a stretcher”,
25 year old males rarely find themselves so acutely ill that they can’t walk.
It happens, granted, but it’s rare.
We’re growling, hackles sky ward, at the direction from whoever’s booked this call that he’ll “need a stretcher”.
I have five ways of moving prone people: two stretchers, a trolley, a canvas and a vacuum mattress, not to mention a bewildering series of bondage-esque lifting and moving harnesses, sheets, handles and cushions.
He’ll need a stretcher to get out of the house will he?
Jolly dee.
Which one would you recommend?
At the front door of a well kept Georgian town house, we’re met by a woman in her sixties, slate grey hair brushed time and again out of her eyes, no make up this morning, one earring swings at a lopsided angle, shoved in any old way.
“He’s through there.”
Unshaved and apparently wearing the clothes he slept in, the young man sways across the floor towards us. His gait so languid and deviant his hips seem to climb to his shoulders with each spastic, shuffling stride. I wouldn’t startle to hear him mumble about my braaaains
Instead he has his own lines.
“Ohhhh….fffffuck…..fuckfuckfuckfuck.”
Whatever’s going on, he certainly looks uncomfortable, but the swearing seems to be for our benefit. Like a kid with a new toy, insistently shaking it in the face of a visitor to the house.
His mother sighs as he hirples past us through the front door, glancing at my partner to see if we’re impressed by his spectacle.
He’s clearly not interested in talking, just as long as we all see how terribly ill he is.
His mum, my partner and I follow him down the house steps to the back of the vehicle, where he loiters like a fart in a lift.
My frustrations at his total absence of manners aside, I’m pleased to see that he’s alert and pink, breathing and walking with ease (“needs a stretcher” my ass).
In the grossly septic patient I’d be concerned about shock or at least dehydration, with a casual eye for rocketing temperatures that send people a wee bit loopy.
He has none of these.
In fact, other than being a little shabby and gasping like a steam kettle at climax whenever he walks, he doesn’t appear all that unwell.
I get him settled in a seat.
“So what’s the problem, Mark?”
He stands upright, pulls down his trousers and underwear.
“It’s this, mate.”
So it is, by the way.
His scrotum and thighs are howling red, an abcess the size of my fist snuggles at the top of one of his legs, the skin strained and tight. Pus and plasma seep from the edges; it is, in short, everything you hope your tackle will never be.
“How long’s it been like that, then?”
He fills his lungs and launches into his story, clearly a tale he’s told before and, like the stories of fights told in the pub the next night. The highs and lows are escalated, the near misses, punishing defeats and shining victories are more dramatic and exuberant than Bollywood, without the choreography.
Regardless of the tides of his past, his opening line catches me and won’t let go, the rest of his chat fades into soft focus.
“I started shooting up 13 years ago…”
I recycle the maths in my head over and over, but the answer always comes out the same.
He first took smack when he was twelve.
Twelve.
And I may be speaking out of turn, I may be presumptuous, I may be coming to conclusions that have no foundation.
But it showed.
It wasn’t his glowingly visibly clavicle or sunken ribs or concave cheeks.
It wasn’t his matte eyes or sulking skin or open sores
It wasn’t the shadows in the cleft of his elbows or the screaming livid pink foliage that climbed up his wrist (“I got a hit that was mixed with rosin, it melted fine but solidified in my veins, I had to cut the lumps out with a Stanley knife”).
It showed in his personality, which had hung at twelve years old.
He was pubescent, brash and rude, evident in his inflated accounts of heroic injustices.
Between the two of us, his mother and I had to guide his conversation as with a teenager.
It was clear that his mother was stupid and understood nothing of his life, that I was an idiot meddling in issues of which I had no comprehension.
He idly made phone calls in the middle of my asking him questions, his mother twisting him back into an appropriate social response - “Mark, the gentleman was asking you something…can you listen to him, please?”
Where he differed from an adolescent was in his knowledge of the world. He was armed with opinions, facts, figures and concepts; current affairs, politics and social challenges. He just lacked the maturity to apply them; like giving a sugar-rushing eight year old a Kalashnikov in a party bag, lethal, excited and totally misguided.
The addiction therapy services in the UK were “completely fucking stupid” and would be better supplying their patients with street heroin “Because we know what’s good and what’s not”.
Methadone was a government conspiracy to keep “people like me” down.
He would “fucking kill” his mother if she went into his room while he was at hospital because he “had stuff that she had no business dealing with”.
By the end of the journey his Mum and I were sharing glances, agreeing with each other without words, conspiring against him to manage his conduct and treatment.
It was immediately clear that my skills with Mark paled in the shadow of her’s. She obviously had years of ambulance rides, discussions with doctors and patient management of his behaviour.
Her love as a parent stretched her tolerance far beyond the point at which mere mortals would have stepped aside and let her son fall.
Astonishing and far beyond my comprehension…but it certainly gave me some perspective as regards my own problems.
