At Least He’s Breathing!
I was sat in a park near Brixton Underground a few days ago, scribbling away, when a man started having a seizure.
He was in his mid-forties, I’d say, and was in the park, lying in the sun, with two of his friends. We’ll call him John. John had been there with woman – Jenny – before I arrived, resting on one side, occasionally drinking beer. His second friend, Joe, had arrived roughly at the same time I was – when he entered the park, he was talking to himself, chiding something no one else could see, but on seeing his companions they all embraced merrily and settled down to play a bit of drums and sleep in the sun.
There are certain assumptions you make as a Londoner, looking on this gathering. Skin old before its time, dirt on face, hands, clothes, much alcohol consumed by noon, voices that only one of them could hear, strong body smells, a dragging in the voice – sure, yes, obviously, you leap straight to a question mark on whether there’s addiction at play here. It’s not a hugely important question really, as they’re just guys sat in the sunshine drinking a few beers and not bothering anyone, but it’s a thing which you clock, and yes, rightly or wrongly, I’d clocked it.
Then John started having seizures. They’d come for a few seconds as he lay on his side, body shaking head to toe, then they’d stop for a few seconds, then start, then stop, then start, then stop. After a couple of these short cycles, in which the seizures are getting longer, I’m beginning to pay attention, though Jenny, lying next to him, hasn’t even noticed. As I begin to pick up my bag in order to go over there, Joe, by now sat on a bench a little way off, has also noticed, and gets up from his bench to tap the woman on the shoulder and inform her.
She sits up, sees John having a seizure. Pokes him on the side, “Hey, stop that!” He does not stop. “Stop that!”
By now I’m on my way over, and so is another passer-by who’s already – wisely – reaching for his phone. By the time I arrive, Jenny has adjusted her position and is tightly holding John’s head close to her, pulling it down into her chest like you’d comfort a crying child.
“Has he had seizures before?” I ask, “Is he epileptic?” I don’t hear her first answer – there’s a thick accent to work through – so I ask again. “Yes, yes, I said!” she snaps, furiously, still holding his head.
Now. I’ve got very little medical knowledge, but every drama school and every major theatre is very keen on having its technicians do regular first aid courses. My last is about four years out of date, but it was also the third one I’d taken after doing one at school and another at uni, and it’s something I’ve always vaguely kept up with on the basis that it’s more life-important than my ability to program pixel maps. And I have this vague yet firm memory that one of the first rules of seizures is that you don’t tightly hold the body down – and don’t restrain the neck unless there’s serious danger of injury. Instead your primary objective should be to make the area around the body as comfortable as possible, and to cushion – not grip – but cushion the head with your hands to limit injury. I try very gently explaining this and, as I come within about two feet of Jenny and John, she raises her head and snaps, “Don’t touch my stuff!”
It’s an angry, biting, aggressive sound, and makes it pretty clear that my presence is not welcome. By now about four or five people have gathered – two are on mobile phones, and when I check the nearest guy confirms that he’s already through to the ambulance service. Fine, good – given the lack of medical knowledge in the area right now, that’s clearly the best thing to be done.
What’s not the best thing to be doing is what’s now happening in front of me. The woman starts putting her fingers into John’s mouth. It’s hard to tell what she’s trying to achieve – he’s still breathing, his tongue doesn’t appear to be lodged, there’s no vomitting happening which is a relief, but there she is, sticking her fingers between his teeth and having a gentle rummage around the inside of his mouth. Someone mutters that maybe this isn’t a great idea, but she glowers and in response to this instead, with John still fitting, attempts to tip some beer into his mouth.
Now: this definitely strikes even the most medically ignorant of us as not a good idea. One guy even tries, very gently and still leaving her loads of space, to move the can of beer outside both her reach, and the patient’s radius of motion.
“Don’t touch my stuff!” she screams. “Fuck off! All of you fuck off!”
John’s till seizing though, and so we’ve made a wide circle and aren’t hounding at all, the guys who are on phones to the ambulances have enough civic decency to not be going anywhere while a seizure is still in progress.
At this point the other friend, Joe, comes over with a helpful idea. He’s picked a broken twig, about six inches long, up from the ground, and holds it out to Jenny with a smile on his face. “Thank you!” she says, and moves to put it between John’s teeth.
Before she can do so, the seizures stop, which is a source of huge relief to everyone gathered there, as, let’s face it, the beer was bad, the twig might be a step too far even for the polite detachment of this very English crowd. Slowly, John opens his eyes, looks around bewildered, sees a small crowd, smiles in the slightly child-like manner of someone who hasn’t worked out where he is and, as one arm is still slightly doing its own thing and has flung itself above his head, barks, “Heil Hitler!”
The crowd drift away. My eyes meet the eyes of a woman who had come over to help. “What the fuck was that?” she mutters as we drift by each other. “I’m a nurse, and I’ve never seen anything like… I mean what the fuck were they trying to…? But you know what, he’s still breathing, that’s all that I think I need to care about.”
We exchange the mutual nods of could-have been good Samaritans everywhere who find themselves relieved not to have to put their better natures to the test, and went our separate ways.
I’m a big believer in the idea that you can have too many chefs to a pot. The last time I saw a situation where a first aider would come in handy was in Holborn, when a guy fell off his motorbike. He wasn’t hit by anything, just took a very nasty fall, and the bike fell on top of him. I saw it happen, went straight out into the middle of the street, saw several other people approaching, saw a woman on her mobile phone. Checked that she was calling the paramedics and, given that she was and that others were already removing the bike and starting to engage with the biker and control the traffic, I went away again pretty damn fast. Like I said – my first aid training is four years old, and when the gathered crowd seems calm, competent and already on the phone to the paramedics, I’m pretty quick to get out of the way on the basis that I’m probably an unnecessary spectator.
Brixton, however, was something else. If Jenny, as she looked after John, had known what she was doing, then I would have been fine with her telling us all to fuck off – we were spectators to someone else’s pain. But as the observing nurse pointed out, bloody hell! On the basic 101 list of what not to do when someone’s having a seizure, I think the answers given were flatly outside the realm of rational probability. Beer, teeth, restraint and a twig? At least he’s breathing, said the nurse. You know what: at least he’s breathing.
My medic mate deals with difficult patients all the time. She deals with difficult families, with difficult colleagues, with difficult cases and with a large number of cases where half the time the answer is that social services have let someone down, and here they are now, in hospital. It doesn’t seem to get easier for her.
In Brixton park, watching Jenny, John and Joe, lots of thoughts came to mind. I thought that there’s a great deal of decent human concern and common sense around, in that people were willing and quick to come to a stranger’s aid, quick to phone for help, careful to give some space and calm, not imposing but not walking away either from the situation, even when Jenny was hostile.
I thought that first aid is a barely adequate qualification for anyone in society at all, and that there are probably interesting statistics to be found about first aiders who make things worse, rather than better, by perhaps thinking that there is something pro-active to be done, rather than by simply calling 999 and doing their best to control the space and calm the patient. I say again: at least he’s still breathing. There are probably plenty of circumstances where that’s the thing to focus on, and the rest is unwise intervention.
I also came away thinking that first aid training is something that everyone should damn well do at some point ever, if only to provide a set of reactions which are ingrained as well as surprise and fear, neither of which are any use. I think of a party my Mum was at a few months ago, where a friend had a heart attack – the calm and the CPR training of a couple of people in that room, saved his life. It’s not very often that CPR does that (the movies all lie) but even a low percentage of success equates to many, many lives saved.
Finally, I came away thinking more than ever that our society has a duty – a moral and a political duty – to give a damn about the desperate. And I do feel that what I saw in Brixton counted as desperate. The solution to a seizure was beer; the help of others was seen as a vicious attack that threatened to steal Jenny’s stuff. A few minutes of light contemplation will reason your way into just what kind of daily life would breed that sort of thinking, and how strong it must be to manifest even as your friend is seizing, and it’s not pretty.
As readers of this blog will know, I feckin’ hate this government. I hate everything they stand for and everything they do, and their recent cunning moves to cut disability welfare, to slice at the independent living allowance, to cut back funding for social programs and welfare support, are frankly, shit. Yes, there are those who exploit the system, but the vast majority of the welfare budget goes on State Pensions. The savings being made by slashing at welfare funding that serves the most disadvantaged of society is a drop in the ocean, that causes disproportionate harm. I feckin’ hate paying my taxes, but if they are the price for a world where ambulances arrive quickly, where anti-addiction programs are available in city streets, for buses that run and air I can breathe, for schools that can teach their students basic first aid, then raise my damn taxes, please. Because the opposite just doesn’t seem to work.
As a first aider on the scene, I think it’s fair to ask ‘is he breathing?’ As a society, I think we fail too many people if we just leave the question at that.
