I’m just draining my second espresso and scraping up the remains of the apple kaflouti we shared when there’s a scream from down the street.
We ignore it, concentrating mainly on teachin Louis to play Carcassone on an Ipad (he’s not great at the strategy bit, but rather enjoys making roads and laying little men down on them. He also makes a handy-dandy “semi-smart” random opponent to mix things up. Still, enough about toddlers and their capabilities vis a vis French medieval empires – do you see the ridiculous sideways garden paths we skip down on Trauma Queen?
The screaming continues. It’s interspersed with some yelling as well and as a group we continue to ignore the noise, it sounds good-natured, maybe a group of students horsing around in the evening sunshine. The street we’re sitting on seems a lot like the Grassmarket back home, all pavement pubs and buskers.
A few minutes later when people are starting to stand in the road and look into the distance, Kate casually mentions,
“Is it weird that we’re the only people who don’t seem bothered by the noise?”
“Nah. I’m sure it’s fine…”
But because I’m curious, I hop up from the table and look down the street.
“Guys? One on the deck. I’m going to go.”
They nod the indulgent nods of friends and families of emergency workers everywhere – yeah, we know you’re going….bye…- and I set off jogging down the pavement, running thoughts through my head.
“The woman on the floor isn’t moving, is flat on her back, one guy standing over her waving a jersey in her face…could be airway problems…could be an arrest…big crowd to the right…lots of shouting still…no actual violence….everyone seems upset rather than angry, but then I can’t understand what they’re saying…no services on scene…”
In reply there’s a wail and a police car swings past me, disgorging its passengers into the melee. I breathe a little easier… things always seems so much better when there are people on your side with guns.
Jog into the middle of the crowd, stay just outside flailing distance of any of the shoutier ones, eyes and ears open.
I approach one of the cops – “Hey, you speak English?”
He’s distracted by the shouting, trying to measure up the situation, waves me away. I’m more insistent.
“I’m a paramedic – can I help?”
That gets his attention; seems like cops in Maastricht are just as keen to pass off the medical aspect of any injury case as the ones back home, he bangs on the shoulder of the guy standing over the patient and speaks to him in Dutch.
They both step back and let me in.
She’s a large woman, lying still but breathing and well perfused, a little blood at her lips and a bruise rising on one cheek. She doesn’t respond when I yell at her, nor when I pinch her shoulder. When I flip her eyelids back her pupils focus briefly then roll upwards into her skull, but her eyelashes flicker when I brush them with my fingers.
I’m not clear where I stand legally using ‘noxious stimuli’ over here, so I hold back from deploying some of the more unpleasant pressure points to assess someone’s neurological status, settling for feeling the weight of her chin, measuring how readily she holds her jaw forwards from the back of her throat.
A cop is standing over me (and I quickly start to think of him as “my cop”).
“Do you know what’s happened to her?”
“I just arrived.”
I have to stifle explosive laughter, it’s a cliched line from back home. When you rock up at a job on an RRU and haven’t done much in preparation by the time the ambulance arrives it’s traditional to shrug – “I’m just here ahead of you boys…”
It’s also used sarcastically by the ambulance crews – “You just here ahead of us, I take it?”
Anyway, turns out it’s the same across here too.
My cop listens to his colleagues and his eyes widen with alarm.
“They’re saying she’s been stabbed.”
He hollers something in Dutch to his mate, who runs to their van and brings me a pair of gloves which I gratefully pull over my hands. I hadn’t wanted to body check this woman too thoroughly, since I wasn’t able to communicate my intentions in Dutch, but if she’s got a knife wound somewhere I want to find it.
I plunge my hands under her shirt, rubbing my palms over her skin, feeling for hot blood under my fingers. I cover her belly and chest, her armpits, the parts of her back I can reach, her thighs and buttocks.
If she has been stabbed it’s not somewhere that’ll kill her too shortly…
In any case I’m distracted by a gurgling at the back of her throat. Tongue bobbing and spittle and phlegm boiling in her mouth, she chokes and splutters.
I grab her far shoulder and hip and roll her towards me to drain the crap out of her airway.
She fights back, struggling to stay on her back.
Oh-ho. It’s like that, is it?
There’s a hierarchy to nervous responses in your body, with the most vital (thankfully) being some of the last to disappear under the waves of unconsciousness when it washes over you.
Gag and cough responses are tenacious buggers and stick around for ages, even when the rest of your body and brain are effectively turned off.
I’ve never met someone who was unable to spit up phlegm but still sufficiently with it to coordinate their gross motor responses and roll from the recovery position directly back to supine.
She’s at it, perhaps not entirely, but certainly over egging the “unconscious” line
beyond medical authenticity.
I settle for immobiliising her head and holding her airway in a jaw thrust, not because she particularly needs it, but because it’s a neat non-verbal way of saying to arriving back-up that you’re not just some shmuck who read a first aid book once.
An ambulance arrives and two guys in the *brightest* flouroescent poloshirts hop out. Seriously, I thought our uniforms were garish (”Irish” green rather than the “Bottle” green the rest of the UK wears) but these guys look like they’ve just rolled out of a UV disco. They’re friendly and polite, laughing at my question – “Do you speak english?”
I bring them up to speed quickly, their English being so great that we can communicate just as I would at home, explaining that I’m confident she’s laying it all on a bit thick without letting the patient know we know.
We agree that while she’s probably just fine, we can’t risk not collaring her (it turns out that our Scottish “Bring the lot” translates into Dutch as “somethingsomething planken…alles.”)
Suddenly there’s a cop and the para of the two stands up and walks away into a nearby shop. The technician explains:
“There’s another patient…a woman with her neck cut.”
He draws a finger across his throat.
I nod at our patient – “I’m ok here…you want to go back him up?”
But he’s cool as can be, murmuring into his radio and nodding.
“He says she’s fine.”
We sit with our woman on the floor.
“I think we can’t roll her without my partner.”
“We’ll just wait?”
“Yes…did you have a nice dinner?”
“What course were you on when this happened”?
“I’d finished my coffee.”
“Ahhh. Not a spoiled evening then?”
“Nope. Good coffee, too.”
“That’s lucky…you shouldn’t spoil dinner for shit like this…how long are you on vacation for?”
And then, with just a hint of cynical glare….
“You always carry gloves on vacation?”
“Hah! No, the police officer gave them to me.”
“Thank God for that…”
Check it out – I’ve found Dutch North Cunts
The para rejoins us, laughing a little and shaking his head.
“The woman with her throat cut?”
“I think she was shaving…I’ve done worse myself.”
We prepare to roll the patient onto the spinal board and realise we need an extra person.
And it’s then that I spot Kate hovering at the police tape that’s been stretched around the whole incident; I wave her over and we all learn something about the Dutch police.
If you LOOK like you know what you’re doing, the Dutch police will let you do whatever you fancy. Kate nonchalantly lifts tape and wanders over to us.
“My colleague, from Scotland…”
They smile at her and gesture towards the patient’s feet – I don’t bother trying to explain the whole Red Cross vs statutory services thing, I just trust Kate to get on with helping us log roll.
The patient firmly on the board and onto a bewildering yellow stretcher we’re left with handshakes and thanks.
We’re about to return to Sean and Louis when a cop stops us –
“Before you go…can I have your names and telephone numbers?”
We comply and he only winces a little when he realises we’re giving him international codes for our mobile phone numbers.
I still haven’t heard from them.
Somethings just don’t change, no matter where you’re working.