It was around 10:30 in the morning as I pulled up outside the patients address. I was working on a car and had been dispatched to reports of an elderly lady who had a fall. She had managed to get up with the help of her husband. However, now had considerable hip pain.
I got out of the car and put on my Level 2 PPE – a mask, goggles, apron and gloves. Although necessary during the COVID pandemic this feels as though you are placing more than just a barrier to infection on – there is an element of removing the element of humanity and ridding the patient of the ability to read expression; a vital part in communication.
I walked to the boot of the car and collected my equipment: Monitor, primary response bag and oxygen as well as my tablet computer. I ensured I was well balanced as I carried the equipment to the front door. As I approached it swung open. Stood in the doorway was an elderly gentlemen. His aged face wrought with worry. I quickly introduced myself and he told me his name was Stan.
Stan wobbled back through the hallway – grabbing onto anything he could find as he showed me the way to his wife. He introduced me to her on the way. Her name was Betty, like him she was 86 and had tripped on a piece of post that had been dropped on the floor by a carer causing her to fall backwards onto her bottom.
I walked into their living room – and there on a bed was Betty. Betty looked a little less frail than Stan. Although, was obviously in pain. I quickly gained her details and past medical history while I obtained a quick set of observations. Betty explained that she had osteoporosis and felt as though she may have broken something.
Betty was describing groin pain and inability to lift her right leg. She was in severe pain and given her medical history and the mechanism of injury I was suspecting that she had a fractured neck of femur. This type of fracture is relatively common in our frailer patients. It is the bone that connects the femur to the ball joint that sits in the hip. In my experience of seeing many of these – they are extremely painful.
With this in mind I called for backup on a priority 2 – I wanted an ambulance to run on emergency conditions (lights and sirens) to back me up.
While we waited for my backup to arrive I got Betty ready for her trip to hospital. I put a cannula in and gave her some pain relief – which made her a lot more comfortable and in turn, more chatty.
Betty told me how she met Stan. It was at a train station. He was the guard and she was travelling to London to meet family. This was 10 years after the end of World War 2, and travelling to London was quite a depressing task. Betty said that the evidence of bombing remained in the landscape as the train approached the city.
Stan came and sat with Betty for the last half an hour of the journey. He admitted then that he couldn’t take his eyes off of her. However, at the time he told her he was due a break and didn’t want to sit in the smoking car.
For the next month or so, Betty would be on that train on a weekly basis – and every time she travelled Stan took his break with her. Eventually, she started bringing him bacon sandwiches. Which; he says, won him over.
For the last 50 years, they had been inseparable. Stan loved her. Really loved her. You could sense it, from the way he spoke about her and also the way he spoke to her.
Eventually, talk turned to the pandemic. Betty explained that she was worried about this – and that she had been isolating away from it all with Stan. They had only had carers in and they had been in full PPE. Something that stood in the way of Betty communicating with them as she felt it made them less human – I agreed that the masks were a bit of a barrier.
I explained that currently, the hospital was not allowed visitors. There was silence apart from Stan shuffling from side to side nervously.
“I have to go love, this needs sorting. I will be back before you know it and causing you all sorts of mischief” Betty said to Stan.
I couldn’t help but notice the wobble in her voice. Stan noticed too. He came over and sat on the bed next to her. I moved my monitor to give him some room. For the next couple of minutes nothing was said as he held her hand and mopped her hair out of her eyes.
Nothing was said, but at the same time. In that moment, Stan said so much.
I excused my self to give them some time together. As I started getting my things packed up in the hallway the ambulance arrived. I led the crew into the room and handed over. The crew were tender and caring and had Betty smiling in no time.
I watched with Stan as Betty was wheeled out on a stretcher to the ambulance. I saw a familiar look on Stan’s face. It was the same worried expression I had seen as I approached the front door.
“They will look after her” I said out loud. I’m not sure if it was for me or for Stan.
As the crew were loading Betty on board she stopped them. She wanted to give Stan a kiss.
“Ill be back soon, make sure you eat properly” Betty said to Stan, and they shared a kiss.
With that, the doors to the ambulance closed and Stan shuffled towards the front door. I helped him into the house and watched to make sure he got in okay.
He walked to the window – and watched for a while before the crew left. With that, he pulled the curtains across and disappeared into the house.
It is widely known that patients who suffer from Neck of Femur fractures who are elderly spend longer in hospital. They also have a higher risk of death whilst there. During the COVID-19 pandemic Betty would not have been allowed visitors at all.
I do not know the outcome for Betty, but I hope she was reunited with Stan again and they got the chance to spend longer together. While I stood watching Betty tenderly kiss her husband, I couldn’t help but think this was more than just a quick goodbye.