“78 YOF, Unconcious, Noisy Breathing” Came up on the MDT. We had just finished ordering our coffee and I was sat absent mindedly stirring it and watching the world go by. It was remembrance Sunday, we were on an early. I was doing an overtime shift out of area and so far; 3 hours in. This was our first job.
The location was in public; in the town centre. The town I worked in had a war memorial in the town centre and I knew the roads would be closed off. We headed towards the job – anticipating that we would have to fight with some traffic cones.
As we approached – the pedestrian traffic increased. There was a marching band, lots of service people and onlookers. On one of the benches to the side of the high street there was a crowd of people with a member of a well known voluntary aid organisation furiously wind milling in our direction.
Windmilling – the form a bystander takes when waving furiously at an approaching emergency vehicle.
I pulled out up in the road; next to a line of soldiers who looked ready to march and went to grab the bags.
“Which one are you here for!?” A shout came from the crowd.
I span around – there was a gentlemen who was dressed in the uniform of an army officer. He must have sensed the look of confusion on my face as he soon followed with: “You do know there is 3 of them!?”
As I walked towards the bench – there in a row were three very pale looking elderly people – two ladies dressed in black and a gentlemen in the middle wearing a trench coat. The colour of their poppies and his medals at a contrast to the black and white of their skin and clothing.
As it transpired all three were veterans. They had all been stood still waiting to move off with the parade when like dominoes they fell over. Luckily, there were no injuries.
My crewmate and I set up a little triage system. I would wheel them one by one to the ambulance; we would do an ECG, take a history and do a postural blood pressure. We would rule out the red flags before settling on the prodromal symptoms and a diagnosis of syncope.
Prodromal symptoms – the horrible symptoms you get prior to a syncope (feint) – usually sweating, feeling hot, nausea, collapse, fast recovery time and sometimes a tunnelling of vision.
Finally, we wheeled the last patient on – the gentleman; and, he was a gentlemen. He had let the ladies go first and ensured that they were all happy and heading off with family before he would even talk to us.
We introduced ourselves to the patient, who said his name was Bill. As I gained a history I systemically went through – his presenting complaint, the history of the event, his past medical history and medication. I then went on to ask “Who do you live with”.
This question is usually an easy answer. However, Bill found it really difficult. He shuffled on the trolley; looked down at his feet. “I live alone”.
Those three words were heavy with sadness. Bill reached for his coat and pulled out a handkerchief. He blew his nose and then reached for his wallet. It was worn, leather and had his initials etched into it. He pulled out a photo. It was fairly recent, it showed Bill stood next to an elderly lady – they were at a wedding.
He handed it to me – hands shaking, voice thick with emotion.
“That’s my wife, Elizabeth”. He explained.
They had met just prior to the onset of WW2. Bill had been in the army, and had been deployed abroad and they had married when he had got back.
“She was my thing to fight for – I always had her to come home too” He said tearfully.
She had died in the past year, it was obviously still really painful. Bill had come to the remembrance parade as they had done every year. For him, it was usually bitter sweet as it reminded him of the war – but also of his marriage. However, this year had been massively different and he had struggled. We took him home.
On the way back I sat with him and we chatted. Mostly about the war and his wife. When we got him home I arranged for the local social prescriber to get in touch with some befriending support and bereavement counselling. Bills family all arrived and we left them too it – they were massively supportive. However, I couldn’t help but feel that Bill’s fight had gone – his anchor and steady was gone and he was left floating in an ocean of sadness with nothing but his family keeping him afloat.