It’s lonely in the ER

Last night when my friend Kate went to bed her heart decided to start skipping beats. Lots of them. For around 20 minutes. Unsurprisingly, she found this a little unnerving, so although she didn’t feel particularly unwell in any other way, and she wasn’t in pain,  Kate decided to call 000. She felt a little bit of a fraud by the time the ambulance arrived, because of course the skipping had stopped, so there was nothing for them to record on their portable ECG, or to hear with a stethoscope.

The paramedics were amazing. Alex walked in, introduced himself, and shook Kate’s hand. He smiled into her eyes and asked her what was up. He made a fast and incredibly effective effort to build a personal connection, and Kate felt immediately reassured. As she told him what had happened, he asked lots of questions, and collected information very calmly, while his partner, Sharon, hooked Kate up to the ECG machine.

There was no rush, no sense at all that she was wasting their time, or that they had more important cases to attend to. They were calm, they were competent, and they were immensely reassuring. When Alex said he thought they should take her in to hospital, Kate was surprised, but not at all scared, because of the compassionate and matter of fact way he handled the whole situation. He explained all of the possibilities clearly and eloquently, and left her feeling that she was in the best of hands.

On the ride in to the hospital Kate was still hooked up to the ECG, but Alex made sure she was warm and comfortable, and then talked to her all the way, about her job, about her kids, about anything and everything – laughing, joking, and connecting, with the result that by the time they got to the hospital she was quite relaxed. In fact her blood pressure was textbook normal, which for a stress bunny like Kate is all but miraculous!

Kate commented to Sharon while waiting in reception that she felt rather silly, since the abnormal heart beat had disappeared, and Sharon warmly reassured her that it was much better to get it checked out and find that it was nothing, than to ignore it when it was serious. Both Sharon and Alex kept assuring Kate that she had done the right thing. Here she was, in the ER with heart problems, and she was feeling relaxed and happy. That speaks volumes about the incredible skill and compassion with which those paramedics did their jobs.

Then Kate asked Sharon what time she was due to finish, and she said 7am. They had started at 5pm. And they’d done the same the day before. 14 hour shifts, not as a once off, but a regular occurrence! It amazes me that even though they must have been feeling exhausted, stressed, and massively under-appreciated as the government makes it clear that they do not believe ambos deserve a pay rise or better conditions, Alex and Sharon still made Kate feel far better than any medication could ever manage.

As they left they wished Kate well, shaking her hand and smiling at her in a way that both reassured her and made her want to beg them to stay – she had felt so comforted and protected by their competent, compassionate professionalism. For around 5 minutes Kate lay on the bed in the Emergency ward, wondering what was coming next, until a staff member appeared. Relieved, Kate assumed that things would start happening now. But no, this was a matter of fees and forms to be sorted out. Still, it relieved the monotony, so it was welcome. A nurse dashed in and made grumpy comments about the location of the chart, which she snatched from the administrator before dashing out again. Kate was not looking forward to having this nurse look after her!

Nonetheless, when the nurse did show up she was brisk but kind, as she told Kate to get out of her nighty and into the hospital gown. I know it has been said before, but do hospital staff really understand how humiliating these gowns are? They are cold, they are drafty, and they are impossible to tie up secure enough not to show your naked vulnerability, and indeed your knickers, to the world.

Fortunately Kate was allowed to keep her pyjama pants on, so she did not feel quite so exposed, but the curious thing is that these gowns open at the back – and Kate needed to have a huge array of sensors stuck to her chest. So her nighty with the convenient buttons down the front would have allowed much easier access. As it was, when the cable was uplugged so that Kate could go to the loo, vainly trying to clutch her gown closed behind her, the orderly (male, of course), had to rummage around inside the gown to try to reattach it. In the front of the gown. Around her breasts.

Luckily Kate is not a particularly shy person. In fact she has strong views about the naturalness of the human body, and how there is nothing embarrassing about the naked human form, but even so this stranger rummaging around in her top, and peering at her breasts, left her feeling incredibly vulnerable and exposed. In fact the entire ER experience made it clear that Kate was completely powerless.

She had to ask permission (and help, for unplugging all of the cables) to go to the toilet.  She had to ask to be allowed a cup of water. She was hesitant to bother the staff, because she did not want to distract them from all of the other patients, who she was sure were in much greater need than she was, but for the first half an hour she could not even reach the buzzer, and she fretted about how she would alert them if her erratic heartbeat returned. They had even taken her handbag and placed it on a bench at the side of the room, out of her reach, so she could not reach her phone.

Kate was lucky that she had a book in her pocket and was able to read to while away the time. She was also lucky that she had private health insurance and could afford the out of pocket expenses to choose to go to the local private hospital, rather than the invariably crowded and busy public hospital that would have been the default. In the end she was only in there for 4 hours, with a battery of clear tests showing that there was no immediate danger, and a fistful of forms for follow up tests to confirm the initial diagnosis of a benign, if disconcerting condition.

The staff at the hospital were kind and attentive, given that Kate’s case was not particularly urgent. But in a hundred little ways her dignity was stripped from her and left at the door.

What struck me, though, as Kate told me her story, was that her overwhelming impression of last night is the warmth of Alex’s hand, and his smile, as he shook hands to say goodbye. Alex and Sharon held Kate’s life in their hands last night, but she felt secure and protected from the moment they walked in her front door. Lonely and vulnerable though she was when she arrived in the ER, Kate coped with it all, because of the support and strength those paramedics left behind them. Those overworked, under-appreciated paramedics on their 14 hour shift. I don’t know what we pay Alex & Sharon, but it’s not enough.

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