Monthly Archives: May 2016

A broken wrist . . . (episode 88)

mole

10 Forsythia Grove
Outer Hamlet
CORSETTSHIRE ZY6 4GT

May 22 2000

Hello Pets

I have become hors de combat and it is painful even to cough or waggle a finger or two around. Honestly, after so many – injury-free – years as a horticulturalist, I fear I may have become blase even during manoeuvres around the house (which is where I managed to fall, stepping down from a table on to a chair).

I was up on the table, indeed I was up on a window ledge, during the course of siting something called a mobile wireless device as high up in the room as possible. But, as I stepped down on to the chair, I must have been a trifle incautious and the whole thing tipped to the left. I crashed to the ground dears, whacking my head and rib cage on the floor, and bearing a considerable amount of impact on my left wrist. I don’t think I was knocked out, but the word “concussion” has taken on a whole new meaning since that moment.

When I finally had the electromotive force to get up off the floor, I fortunately recalled the phone number of my chum Lord Sloth of Denbigh Dale (a.k.a. the Cosy Old Sock) and gave vent to some considerable importunings to come round forthwith. When he arrived, I said,

“Have you changed the registration plate on your car? It does not look quite the same as usual.”

Lord Sloth gave me a strange look and said, “What have you done to yourself Lady Beaver? You have a large bruise to the left of your eye.”

“Yes,” I said. I seem to have hit my head and the writing on my wall calendar looks a bit fuzzy.” I expect I will be alright in a minute.”

Round at Lord Sloth’s demesne, I said, “I’m sure I’m doing an afternoon shift for the care company this afternoon. The thing is, I can’t actually remember the name of the care company or the time I usually start it.”

“Oh,” said Lord Sloth, who started to turn the page of any number of old-fashioned paper directories and reading out the names of local care companies.

And finally we came across it or, eventually, I remembered it.

“Why don’t you give them a call?” said Lord Sloth. “You could ask them what time you usually start.”

“How can I phone up and ask them that?” I hissed. “It would look most odd.”

“Well, don’t you know Eloise’s number,” he said. “You could phone up and ask her.”

“Who?” I said. “Never heard of her. Who is she?”

“The person you normally work with,” rejoined Lord Sloth.

“Oh,” I said.

Eventually, and after one or two hours had elapsed, I decided that, actually, I probably shouldn’t go at all as my left arm, by then, was nearly-completely unusable and my rib cage felt like it had been crushed under a train.

“Why don’t you go to A&E and ask for an X-ray?” remarked the ever-reasonable Lord Sloth.

“Certainly not,” I rejoined. It is only a little strain. And, anyway, it is a trip on the bus, followed by a long walk up the hill to the hospital.”

“I will take you,” said Lord Sloth.

“Hmmph,” I replied.

Well, the long and the short of it pets, was that – two days later – on Saturday – I had a conversation with a citizen called Claude in the High street. Claude said that, when something similar had happened to him some years ago, he too had not thought he had broken anything.

“Oh?” I said. “What happened?”

“Well,” he said. “They X-rayed my wrist and said I’d broken it. They then informed me that they had to put a torniquet round my upper arm (to prevent the drug they were using ever reaching my heart and potentially stopping it). And when they did that my arm started to jump around uncontrollably. They then summoned an ‘ape’ to pull on the hand and get the bones back in the right position.”

I stared dubiously at Claude and said, “Perhaps times have moved on since then. Who knows.”

Anyway. This conversation had the effect of getting me to the bus stop. And at the bus stop (with shelter) was the local alcoholic with the long brown hair and strange white face. I wished I’d phoned Lord Sloth at this juncture. And then another unusual lady also turned up, followed up by somebody slightly more normal.

The bus arrived some 20 minutes later and I accelerated towards it, leaped on board, and asked for my ticket. The driver, however, was looking through the window in rather a distracted manner and then started to shout:

“HE’S NOT GETTING ON THE BUS. HE’S NOT GETTING ON THE BUS.” We all looked at the man with long brown hair. And then the driver started to shout, “GET ON THE BUS. GET ON THE BUS” to the other two ladies who were waiting. They, of course, froze before finally struggling in together and getting jammed in the door as it closed.

Phew pets. This whole thing was turning into a bit of a strain.

At the hospital – having spilled a cup of Mocha all over the waiting room floor – I was summoned by a nurse into the treatment room. She looked at my Michelin tyre-size hand, all blue and black, and said,

“Hmmm. It is the amount of bruising descending the inside of your wrist that I am worried about.”

And, indeed, the bruising did seem to have seeped for a whole 7.5cm down the inside of my wrist.

“However,” she went on. “It is Saturday and X-ray is closed. You will have to come back on Monday.”

And this, dears, is where matters have rested – apart from the unfortunate incident with the young men in baseball caps whom I encountered in the over-ground tunnel en route to the bus stop. Always be wary of young men clad in caps which read something like, “F . . . O . . . OR I’LL NUT YOU” when visibly incapacitated in an arm sling, toute seule and out of sight of the rest of the world.

Your loving relative

Evangeline Tankful (DBE)

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Morpheus . . . (episode 87)

mole

10 Forsythia Grove
Outer Hamlet
CORSETTSHIRE ZY6 4GT

May 7 2000

My Dear Ralph and Harriet

My apologies, dears, for sending this to you via carbon copy. I know it is months since I last penned a missive – owing to prostrating endeavours on both the horticultural, and home care, fronts (albeit in different ways) – and so I have inserted an inked-blue ‘leaf’ beneath my writing page. I do feel faintly guilty about the duplicate method of correspondence, I must say, owing to feelings of boundless irritation when someone sends me a Christmas ’round robin.’ I myself always bin these . . .

It is some of my recent experiences with home care that I feel moved to discuss here. There are occasions when one is called upon to care for critically ill people in the community. These are not necessarily individuals with cancer; sometimes they are people with progressive, long-term, conditions who may experience a crisis in their conditions. They may spend time in hospital and then, for one reason or another, spend some months in bed. They may live or they may die. No-one knows and I feel that no-one should presume: either way.

There is still, to my mind, a far too hasty tendency to assign such people to the ‘palliative care’ mode of treatment and care. They may, after all, recover given time – and a chance! But, no, should a doctor attend and comment that the person has ‘end stage’ disease, a whole destructive steamroller of ‘care’ actions can be set into motion. The principal one is that community nurses may arrive and suggest that morphine – either as a liquid cordial or via syringe driver – be given “for the pain.” What pain? It is admittedly true that someone who has spent months in bed is going to be excruciatingly sore and stiff – when rolled from side to side – but this is an entirely different to the grinding, boring into you, sort of pain that accompanies toothache or bone cancer. Morphine – even at a dosage of 5mg/2.5ml – delivers a blow to consciousness equivalent to being hit over the head with a heavy lead cosh – and puts the unfortunate person into a state where they are simply unable to even ask for food and drink. And who can recover when food and drink is denied in this way?

I feel that insufficient thinking is going on in the heads of all concerned here. And I have recently felt prompted to make remonstrations on behalf of individuals in receipt of what appears to be ‘check list’ care. I hope that, in the future, a clause will be inserted into ‘end-of-life care’ regulations which protects such people and which states, in effect, that ‘where the outcome – life or death – is unknown, then all decisions should be made which follow the direction of Life.’

I have heard that the formation of a body called NICE (National Institute for Care Excellence) has been mooted. Maybe, by the end of 2015, they will have published new ‘end-of-life care’ regulations which will put such protection into place. But – even then – will the doctors, nurses, physios, OT’s, and care staff out in the community even read them?

In a way pets, this wasn’t even what I sat down to write about. I was going to talk about what a privilege it is to touch the skin – and perform the most intimate of tasks – for the person who is cared for in bed. And how one’s own skin sings with the compassion that such work requires. The work of a community health care assistant is skilled, responsible, and difficult. We not only perform the care of intact skin, we wash and feed and administer drinks and medicines. We handle all manner of excreted fluids. We regulate a person’s body temperature – opening windows/fitting bed socks. We occupy them with the radio and read them poems and stories. We act as advocates, representing what seem to be their needs and best interests to our employers.

And when, at night, they shout ‘help – help – help -‘ continuously, in their distress, we are the ones who soothe and distract them. We hold their hands and kiss their foreheads as we leave.

This work merits all our respect.

With Love

Evangeline