Things I Know

I know where the intercom to gain access to the ward is hidden, tucked away behind an oxygen cylinder, and I know to step sharply backwards after pressing it, to avoid being temporarily deafened when it squawks into life.  This little ward is hidden away, a sort of outpost of accident and emergency, not officially part of the great system of wards and clinics that make up the rest of the general hospital.  This is a limbo area, for patients who cannot be simply patched up in the hurly burly of a&e and sent on their way.  Some of the patients are waiting, in various states of impatience, to be admitted to the hospital proper.  Some of them, like Julie, just need a bed for the night while they finish their treatment and are then sent home.  This is the ward where Julie goes when she takes an overdose and needs treatment.  I have got to know this poky little ward fairly well over the last few years.

I know Julie is usually in the same bed on the same side ward, positioned so that the staff can keep an eye on her from the desk.  I know when she has been misbehaving because there will be a bored looking young nurse sitting slumped beside her on the visitors chair, assigned to “mind” her.

Today it seems Julie has been behaving herself because she is sitting alone, not in her usual bed but tucked into a dark corner, screened from the rest of the ward by a thin curtain.  “I smell.” She says lugubriously when I bend to hug her.  She glowers at the drip looming over her with its plastic bag of life-saving antidote still half full.  There are no showers on this ward, and the drip would get in the way.  “How long have I got?” I squint at the control panel, “Another four and a half hours.” This is always the low point in the procedure: Julie has already been on the drip for sixteen hours.  I know not to expect Julie to be in a good mood at this point.

I know that after taking an overdose, Julie must always go to a&e.  Four hours after the overdose they will take a blood test, and the results take between one and two hours to come back from the lab.  It is a long wait in a busy waiting room, and she goes armed with a book and games.  These days, as the number of pills she swallows has gone up, Julie’s results nearly always come back positive: she needs the drip to try to avoid damage to her liver.  I don’t believe she really has the slightest idea what liver damage would mean, despite the many attempts to explain it to her.  I know that once her bloods come back positive, staff will transfer her to this little ward, put her in a bed for the night, and give her three drips in sequence – one hour, four hours, sixteen hours.  The first and the second will make her extremely sick.  After the final drip has finished, usually some time the following evening, they then repeat the blood tests.  So far the second round of blood tests has always come back negative.  I don’t know what happens if they come back positive – I haven’t tried to find out because I hope and pray they never will.

I know not to worry too much what Julie says during this treatment.  It is always a very low point.  If she talks obsessively about safety and a return to the mental hospital, I can usually guess she has been seen by a “psych on duty” that afternoon.  This sort of talk doesn’t necessarily translate into a readmission to the mental hospital: it just seems to be the result of a certain kind of consultation.  Take one nervous psychiatrist, worried about suicide risks and ending up in court, and one susceptible young woman. Julie usually comes straight home after her treatment, and we manage fine.  I know now not to start getting upset by anything she says when she is in the middle of treatment.

I know that Julie hates the treatment.  By the time I visit on the second day she has spent nearly 24 hours in hospital, most of it alone.  Sometimes she finds camaraderie with the staff, but usually they are just too busy to even talk to her.  The other patients are often very sick and anxious and not interested in her.  On the whole people are not judgemental about her behaviour, but nor are they particularly sympathetic. She cannot contact her friends because there is no phone signal or internet.  She has been very sick, and she is short of sleep.  Until I arrive she tries to occupy herself but is usually very miserable, often bizarre and sometimes paranoid.

Fortunately I know that the suggestibility works both ways.  I turn up with a bag of chocolates, and a puzzle magazine.  We try to solve the prize crossword, and talk about what we would do with the money if we won.  Suddenly the mood lifts and there is no further talk of going into mental hospital.  Julie begins making plans for her weekend; she teases me about sneaking an extra chocolate from the bag when I thought she wasn’t looking. Suddenly there are only two more hours left of the drip and I have to go, leaving her the money to catch a taxi home when she is discharged later on that night.  Assuming the treatment has worked, I know she will be alright for a bit now.

But I also know it is a sad and dangerous way to waste your days, sitting in a hospital attached to a drip.