The job itself sounds straight forward, 69 year old man fallen, with a head injury. It’s in a house, rather than the street so is potentially less likely to have alcohol at its root, despite it being past midnight on a Friday.
The front door is closed, but opens when I try the handle. Nobody meets us in the corridor but a woman’s voice answers me when I shout my arrival.
In the bedroom a well dressed woman in her sixties stands in front of her husband, his face is caked in dark red blood, it congeals and hardens in his wrinkles, drips from his chin. His entire shirt front is rigid where it’s clotted and it seeps, bright red, from the split across his forehead.
A simple enough job, confirm no C-spine injury, clean and dress the wound, assess for skull fracture and/or neurological deficit and transport.
But the patient is on his feet, his face twisted with rage and as I step across the threshold he lifts his left hand to point a finger in my face.
“You can get out! Get out of my house!”
I rock back on my heels. The patient’s right hand is wrapped tightly around his wife’s wrist, her skin puckered and convoluted as it bulges between his fingers.
“Please, Ronnie…” she begins and he stops pointing at me to lift his hand up and back. I catch his wrist as I step inside the room.
“Just calm down, sir.”
“Let go of me.”
“No sir. Calm down and take a seat. Let go of the lady.”
“You can’t do this! Get out of my house! Shirley! Get them out! I’m your husband!”
Shirley pulls back from him, trying to tug her arm from his grip.
“Ronnie, you’re hurting me…”
“Ronnie, let go of her now or we’ll call the police…”
“Call them then, call the bloody police!”
He twists her wrist a little harder, she glances between her husband and I
I don’t have a problem with aggression, it’s a relatively common feature of the job, to some degree or another. Fear, pain, embarassment, drink, drugs and metabolic discrepancies can all cause a normally placid person to respond to our presence with anger and threats of violence.
I have no desire to get involved in a ruck and will, given the opportunity, get back in my motor and drive away. Verbal threats roll off my back, angry people shout and bluster, but when it comes to attempted or actual violence towards me or a third party on scene, I have no qualms about engaging someone physically.
On the other side, this is no swaggering drunk with a bottle in his hand and a belly full of bravado, no shrieking, cat-fighting woman pulling hair and scratching at her friends. He’s a pensioner, one half of a pleasant couple in a nice house in a nice part of town. He’s shorter and slighter than me with a potentially serious head injury.
I’d happily leave this guy to it, call for police back up and let him blunder around the room, bleeding from his punctured head until they arrive and we can take him up to A&E in cuffs.
But he’s threatening his wife and her eyes plead with me to deal with the situation she finds herself in. She’s begging and placating her husband, promising him that the police won’t come, that everything will be fine as long as he lets her go.
I hear her words and it strikes me that she’s not just calming her husband down, there’s a part of her that’s genuinely frightened this hulking, uninformed brute in the door will go fighting with the man she loves.
Stuck between protecting herself and her husband she again begs with him to let her go and this time he does, releasing her from his right hand and turning towards me, pulling his fist back. I put my hands on his shoulders and push him backwards, he sits heavily on the bed behind him and I, momentarily, lose my rag, raising my voice and hollering.
“You try that again, pal? I’ll put you on the floor, you understand me?”
He sulks back.
“I’ll put you on the floor.”
Aye, and so’s yer maw.
But now things have changed. He’s sat down, we all back off and he resorts to sniping and blustering at us all. We are all bastards, all three of us, his wife is a bitch and should obey him, he’s her husband. He wants us to leave, to get out of his house. It’s his house and he wants us out.
“I can’t leave, sir.”
“Yes you can.”
“No, sir…you’ve had a drink and you’ve…”
“Shut up! Shut up and get out.”
“There’s no need for that, Ronnie. You’re a gentleman, let’s have a conversation like gentlemen, shall we?”
He glares at me.
“You’ve had a drink and you’ve hit your head. I can’t leave you behind, I’d be in dereliction of duty if I did.”
His shoulders slump.
“Right. Fine. Do what you have to do.”
My partner fetches a basin of warm water and a flannel and I put one knee on the ground beside him, keeping my other foot flat. Body sideways, my leg protecting my groin, tucking my chin in over my throat, watching his hands. He relents to my care, lets me clean the blood from his face, mopping and wiping, bathing and scrubbing while he stare straight ahead like a kid who’s been caught playing in the coal bunker.
An awkward silence.
“So….Ronnie…you were at the bowling club tonight?”
“Do you play?”
I recognise a chance for him to regain his dignity and play it.
“I can’t understand that game. I watch it on TV, the way they curl the bowls? I couldn’t do that, never had a head for that sort of thing.”
He is, immediately, engaged and starts telling me at length about the weights of different bowls, how you’ve got to pitch them just so to reach the jack. How golf players make good bowlers because they understand the contours of a green.
Five minutes later we’re laughing together, he tells me he watches “all they programmes” on daytime TV and how “it’s disgusting the way folk get drunk and waste your time.”
“Oh, it’s terrible, Ronnie. It really is. Just tonight I was dealing with this drunken old goat who was wanting to go fighting with me…”
His eyes widen and he begins to commiserate before recognition kicks in.
“Old goat! You cheeky wee bugger!”
We shake hands, make friends, he apologises for his behaviour and I for mine. By the time we get to hospital he’s making sweeping statements that, once he’s out, he’ll take me and “your wife, girlfriend, whatever” out for dinner. He sits forward every few minutes to clasp my hands in his.
I leave him in Immediate Care, Shirley in the waiting room with a cup of tea, her wrist bruised, her hands gently trembling the tan liquid in the plastic cup.