Friday, 6 November 2009

'Cafe coronary' certification

There is an endless stream of serial and annual certification that you have to endure to work in the NHS,that ranges from the ubiquitous 'Health & Safety' absolutely-blindingly-obvious rubbish...usually a lecture from some retired Naval petty officer on the need to wash your hands before using a fire extinguisher which you should only activate if your back is in the safe more prosaic subjects like "infection control",ie,wash your hands before, during and after sex...actually...maybe that's just what they tell me!

My personal bete noire is "Basic Life Support".

Now there are occasional seismic changes to the rate and rhythm of life support but the truth is that if you work in Emergency Medicine in any capacity then you probably know about it already.

So you typically have the bizarre situation where some self-proclaimed 'Resuscitation Officer' who has long ago forgotten what an actual patient looks like,teaching basic CPR to a group such as I was in last week that included two ER consultant surgeons all of this on a daily basis for real!

Also...I am currently ALS and ATLS and even APLS qualified...but despite that,I still have to do the basic course...because everyone has to do it!

And of course,its fair to say that if you're South African,then you probably have seen all the weird stuff anyway...certainly I have yet to face any scenario that is worse than the quietest night ever was in the Jo'burg Trauma Unit.


Anyway...there I was trying to look interested as we moved on to the 'choking scenario'...and a demonstration of the 'abdominal thrust' technique...what used to be called the 'Heimlich' maneuver

Has anyone here ever had too do this?

I raised my hand again...well...would you like to share your story with us?

Many years ago then,in the early 1990's I was for about 15 months the 'Night Superintendent' of a very prestigious and very private Johannesburg hospital.

I used to utilise a small office space behind the main reception area which was shared with a part time driver and telephonist and the full time Night Receptionist.

Her name was Jean and she was evil.

She had the compassion on Lucrezia Borgia and had all the charm of Myra Hindley.
Evil I tell you.

One of the perks of the job was that the kitchen would frequently leave me cheese-and-fruit platters...or smoked salmon...or some such edible delicacy which would help get me through the night.

Which she would steal.
All the time.

Typically I would return to the office with our meals and then get called out to one of the wards...and when I got back the salmon or slice of cheese-cake would have miraculously been stolen from under her very nose.

This one particular hot Saturday December evening I had been left a fresh fruit platter...strawberries,grapes, I sat down to eat it I got paged to ICU to sort out a problem.

On my return both my dessert and the fruit platter had disappeared...and Jean denied any knowledge of its disappearance...

So I made a cup of tea and sat at my desk, opened the Star to read the obituaries...

As I read and sipped my tea,I became aware of a hoarse guttural "cough" coming from the general direction of Jean's desk.

I lowered my paper and saw that she was making the classical sign of someone who is choking...both hands at her neck...protuberant tongue...and was a fetching shade of blue.

I raised my paper and read my horoscope.

She coughed again.

I lowered my paper and saw that she was quite blue at this point.

Decisions , decisions...if I let her choke and die I would be rid of a very irritating person.
I would however then have to fill in an incident report...and book all the patients in as well.

Sighing,I folded my paper,picked up my pager,switched off the light and locked the door and walked over to where she was sitting collapsed in the chair.

Evil. Did I mention she was evil.

I picked her up...and in the approved manner gave her two almighty thrusts...and after the second a grape flew out of her mouth ...closely followed by her upper denture...and shot about 4 meters across the room...

She sat back down and composed herself.

"So Jean...still have no idea of what happened to my fruit platter then?"

Looking me straight in the eye, she replied : That was a grape I brought in from home!

I knew I should have let her choke!


  1. was that the same clinic where a child got a gold tracheostomy instead of a silver negus?

  2. if you cant be bothered to blog........i will have to go else where. it is a pity, i enjoyed this blog and its links. you are a good and amusing writer. anyhow you have obviously moved onwards and hopefully upwards