A&E

ae

On Sunday B noticed something weird – he had a bad headache, his left eyelid was a bit droopy and his left pupil was unresponsive. Here we go again, I thought. Tumour problems. On Monday I went with him to his GP who sent him to A&E.

We arrived at King’s College Hospital at 4pm. This won’t be so bad, I thought. Weekday afternoon, should be pretty quiet. How wrong I was.

In case you’re unaware of the regimented procedure at modern accident and emergency departments, I had plenty of time to observe it for you.

Stage 1: Reception

What you should do: Give a concise verbal summary of your symptoms.
What most people do: Huff and puff and be visually agitated if there is anyone ahead of you. Complain about the man in the wheelchair who’s had 8 partial seizures in the past 6 hours blocking your way. Say you were just in here last week so you shouldn’t need to queue. Remove your disgusting sock and swing your mangy foot up onto the desk to display the problem. If you are accompanying an ill family member try to get your hayfever problem addressed, since you’re already here.

The reception nurse was a saint. I didn’t see her roll her eyes, hardly at all.

Stage 2: Registration

What you should do: Stand near the white sign and wait to be registered.
What most people do: Anything but stand near the white sign. Wander outside and back in again. Sit down, then stand up again. Pace.

Stage 3: Triage

What you should do: Rate the level of pain you’re experiencing on a scale from 1-10. Provide a detailed description of your symptoms and medical history.
What most people do: Mumble vaguely about your symptoms. Relate your life story. Complete any paperwork partially or not at all. “So you’re not taking that anymore? Oh, you are. You haven’t written it down here?”

At triage you are assigned to a queue. There’s Major and Minor, with 3 separate queues within Minor. B was assigned to Major and we settled in to wait.

Stage 4: Consultation

There’s an incredible sense of victory when you reach this stage and see an actual doctor. B’s eyes were examined, his reactions and reflexes were tested and he answered a lot of questions. He was then referred for a CT scan. More waiting.

Luckily our cubicle was right near the little mobile station where paramedics admit their patients and describe their condition. It was like watching 24 Hours in A&E (which has been filmed at Kings in the past, but sadly not on our night). During the time we were waiting the following were admitted:

  • An elderly lady who’d been knocked over on a bus by some rowdy youngsters and broken her leg
  • A young man who was playing football when a fight broke out between the teams and he was punched in the head (“What kind of football game is that?” asked the nurse)
  • A pregnant woman who’d been vomiting blood
  • An elderly diabetic man with chest pains
  • A drunk man with grazes on his head
  • A woman with severe abdominal pain

Eventually B had a scan that was inconclusive. More waiting. He was referred for a second scan, at which they injected the contrast dye at the same time as scanning. He was diagnosed with a dissected carotid artery, injected with an anticoagulant and admitted.

It only occurred to me later that our attitude to the whole thing was pretty casual, when he could have had a stroke at any second.

All of the above took 12 hours. We entered A&E at 4pm and I got a taxi home at 4am.

The burst artery lining has nothing to do with the tumour at all! How unlucky can one guy be? But there was more to come. To Be Continued…

 

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