Mothers Day always has a familiar script...dads/husbands who decide to "help" their children cook lunch and who slice off assorted parts of various bits of their anatomy because they actually only prepare vegetables twice a year...
...young children with thermal burns to their hands and chests,from spilt cups-of-tea that they have attempted to carry up a flight of stairs for a breakfast-in-bed treat for their mum...
...older ,well-preserved women, smelling of lavender and mothballs and depend pads, brought in by red-faced sons and sour-faced bottle-blonds daughters-in-law,because they drink too much at lunch and fall going to the toilet and break their wrists and ankles...
In truth its not much different from most Sundays except some of the patients have had a bath in the recent past...
So there we were...a busy but pleasant day,and I was just back from lunch...an M&S SpagBoll... when TheGranny called me to the Resus Room to see a man with a rash.
He was 42,looked 52 and had been dressed by the Salvation Army.
He had a florid urticarial rash and was short of breath.
"When did the rash start Sir?"
Well....we had been out doing some shopping...and I felt a little short of breath...so we went home and then my daughter told me that I had a rash...that was about 3 hours ago...
His daughter , about 12 years old,was sitting quietly in the corner looking scared, clutching a cheap bag, dressed cleanly but as cheaply as her father.
"Okay....why did it take you so long to come to hospital?"
Well....I was trying to find someone to look after Imogen,my daughter...and I couldn't find anyone...my mum didn't answer her phone...and then we had to wait for the bus...I'm sorry...
"That's okay....you don't have anything to be sorry about...I was just wondering why you waited so long...Okay then...how are you feeling ?"
Well...the rash is really hot and itchy...but I feel really short of breath....and I have this pain in my chest...
I had been taking his pulse whilst talking to him...it was thin and thready and slow.
"Julian...please lets get this man on some monitoring...and do an ECG please!"
"Granny...please give him a stat dose of Piriton sublingually...and then start him on some oxygen ..."
His daughter just sat there,big eyed,listening and watching.
I quickly squatted down next to her and smiled...
"Hi...my name is Lucien...we're just getting your dad sorted out...don't worry...he's going to be just fine..."
Julian gave me the ECG...the patient had just had a heart attack...a very large,very scary heart attack...his blood pressure was 210/140,with a pulse of 43.
We sprayed some GTN under his tongue stuck a big freaking needle in his arm and called for an ambulance.
Imogen sat in the corner,tears running slowly down her cheeks.
"Okay Sir....you're having a heart attack....I'm not sure what the rash is all about and it doesn't really matter right now...we're going to get you up to St Vulvas as quickly as possible...I'll phone the cath lab when you leave and the paramedics will take you straight there..."
What about Imogen ? he gasped.
"Well...umhh...she can go up to St Vulvas with you...but it might be better if you can get someone fetch her ....or who can meet you there....is there anyone you can call....like your daughters mother...?"
No....her mum walked out on us 5 years ago when I lost my job....and its just been Immy and me since....we do all right...don't we darlin'...
Imogen smiled shyly.
We can try my mum...she only lives 2 miles away...can I phone her...?
"Sure...use your cell phone....she'll be less worried talking to you than to me..."
Ummhh....I don't have any credit on my phone...
"Okay...give me the number...you can use our phone..."
I called his mother and he spoke to her and she agreed to come to the Unit to take Imogen home.
Julian was sitting hugging Imogen at this point.
The paramedics arrived about 8 minutes later and quickly packaged up the patient.
"How long is your mum going to be Sir...ummh...we're not really allowed to have an unaccompanied child in the department...?"
Not long....she lives just 2 miles away...
(I took a command decision to keep Imogen in the department until her grandmother arrived,thereby contravening a large number of laws...what are you going to do?)
He pulled the oxygen mask off and kissed his daughter goodbye.
Julian took Imogen to his office and gave her some of my Coca Cola and some of Chakalaka's cake.
She sat there quietly ,shredding tissues and smiling bravely anytime one of us looked in on her.
Thirty minutes passed...an hour...an hour and a half...and still the grandmother hadn't arrived.
My decision to let Imogen stay was looking a bit dodgy.
Two hours later I got called to reception and found an old and overweight lady,breathless and anxious, sitting gasping in a chair.
"Can I help you Ma'am?"
Yes....my grand-daughter....Imogen... is waiting here for me ?
"Right...well...thats good...shes going to be pleased to see you...come through..."
I turned away and held the doors open.
The lady clambered to her feet....and using 2 crutches...shuffled into the Unit.
"may I ask why it took you so long to get here ma'am...?"
Well....I have arthritis...and I don't walk too well...
"You mean you walked here...? I'm sorry....I just assumed that you had transport of some kind...?"
No...I don't have a car...
"What about a taxi...?"
No...I don't have any money for a taxi....or for bus fare...so I just walked here...
She came running out of Julian's room and threw herself at her gran...they hugged and cried.
"Okay...its time you two got home..."
Well just give me a minute to rest young man...its a long walk home again...
"No...its not...we will get you a taxi that the hospital will pay for..."
I don't need charity....she said stiffly.
"I know...but Imogen is tired...and I don't want her walking home in the dark...so maybe...if its okay with you....you can let us send her home in a taxi....and you can just go with her...?"
"Julian....is there any more of Chakalaka's cake left...I need a big piece..."