Fighting For Your Life. Lysa Walder
hasn’t been able to get out very much.
‘My neighbours help me,’ he tells us.
‘But does anyone else come in to help you?’
‘No,’ he wheezes. ‘I don’t go to the doctor and I don’t take medication. I don’t want anyone coming here. I can manage.’
How many times have I heard those three little words? Frail, elderly people living alone who want to cling to their independence say that to us time and time again – when the evidence is so clearly the opposite. They say it to concerned relatives too, usually the ones that ring up but, for whatever reason, usually distance, never actually get to see them. So it goes on and on for years. Technically they’re ‘managing’, ‘getting by’. In reality, it’s all out of control. But this really is the worst chaos I’ve seen for a long time.
Luckily the fire service have turned up so we can organise his departure. It’s a real struggle but four of us manage to strap him on to a board and we form a small chain so we can easily pass him along to each other. The fire service have decided our best bet is to get him out via a sash window in the bedroom which I manage to open with some difficulty; it hasn’t been opened for years. Outside there are more firefighters to help carry him into the ambulance.
‘What about my cats?’ he asks me. ‘Who’ll feed them?’
I suggest I ask the next-door neighbour who might be willing to put some food out for them. He nods. ‘Yes, but as long as they put it on the front doorstep,’ he warns me. Clearly he doesn’t want even the neighbours to step inside. So before we drive off, I jump out to knock at the house next door. The neighbour, a pleasant-faced, plump, blonde woman, fills me in. They’ve been worried about him for quite some time. In fact they’d called the ambulance; they’d seen lights on in the house but hadn’t heard anything of him for several days.
‘He won’t have a phone,’ she tells me. But they’re fine about the cats. ‘He won’t let anyone help him. Apart from us, he’s got no one,’ the woman says sadly. But they’d worked out a little routine: they’d been regularly collecting basic foodstuffs for him for ages.
At the hospital he is taken to the emergency department. Part of our work is to alert hospital staff to his living conditions. The fire service also report the house as a fire hazard. In due course social services will get involved and liaise with environmental services to clear the house. But I keep wondering about him. A few weeks later I manage to pop into the ward. A nurse told me the house has been cleared – and he’s gone home. Apparently he’s accepting a bit of help from social services too. So while it was probably the worst example of domestic neglect I’d ever seen, at least it didn’t all end in total disaster.
Sadly our job involves seeing quite a lot of this kind of neglect. Often the call-out itself is for a relatively minor thing. But when you talk to the elderly person you discover that they might only see another human being for an hour or two once a week. And the rest of the time they just sit there, in a chair, often in silence. If you’re very old with impaired vision or hearing, even the simple pleasures of life, such as listening to the radio or reading, might be impossible. If you don’t go out at all, no one visits, you can’t walk much, you struggle to heat a can of soup or make a sandwich, what is left? Life just drizzles away from you. Yes, you’re still alive. If you can see, you’ve got the TV. But in another way you’re not really living, are you?
Yet it’s not the dirt and the chaos that are the problem. The heart of it all is sheer loneliness. You can live alone in a spotless environment with everything you need around you. But you can still be totally isolated. I don’t know the answer to that kind of loneliness, I really don’t.
He was 26. He died where he stood, absolutely upright, his body leaning against the bathroom wall. I’ve seen hundreds of dead bodies. But not many standing up like this, almost as if he’s got a broom stuck up the back of him. It’s a ghastly picture. His lower limbs are a mottled, purple colour because of the position he’s died in and the natural effect of gravity. There’s a name for it: it’s called post-mortem staining. His face, shoulders and upper body are completely devoid of any colour.
I go through the motions, put a heart monitor on – flat line. Nothing. He’s gone.
This is one of the dirtiest, most squalid council flats I’ve ever seen on any estate. Blood and excrement on the walls, floors sticky with heaven knows what. Disgusting. Empty cans of Stella everywhere, empty vodka bottles and ciggy butts wherever you look. Tobacco-coloured walls. The home of someone who’s given up – and does nothing but drink, day in, day out. It’s also cold and dark. The electricity’s been cut off, making it even more sinister and murky.
‘Is this a natural end?’ the copper asks me.
Not really. This call had came through to me an hour before as ‘male collapsed behind locked doors’. It’s quite a common call-out and usually comes after a home help turns up and can’t get any response from an older person. Tonight there were a couple of neighbours waiting for me outside the block. They called 999 because they know this guy. They led me to his flat on the ground floor. One neighbour had walked past this morning and noticed the man’s head resting against the opaque glass of the bathroom window. When she came back in the afternoon the head was still there. ‘He’s a heavy drinker, he doesn’t work – but he’s not a troublemaker,’ she tells me.
‘Yeah, but you do get a lot of ambulance and police cars turning up,’ chips in the other. I’m getting the picture.
Call-outs involving drunks are routine for any paramedic. Crews may even know the person, sometimes by first name. But I’ve never been called out to this guy. First, I bang really hard on the glass to rouse him. Nothing. I try again: bang bang. No response.
Now the neighbours are getting the message. ‘Oh no, is he dead, dear?’
‘I don’t know,’ I tell them – but I think I do. If he’s been there since morning and my banging doesn’t make him stir, it doesn’t look good. But I can’t get into the flat. I’ve arrived before the police but, as hard as I try, I can’t manage kick the door in. Getting in windows is easy, but breaking down doors is something else. I try and try – but I keep bouncing off it.
I try a final, hip-busting kick – but it still doesn’t work. Technically we’re not supposed to try to kick doors in – that’s the police’s job. When you think it’s a worst-case scenario, though, you have some justification. You just have to remember that for every door that gets kicked in in London – and there are many – someone has to pay for it. So it’s not something a paramedic does willy-nilly. Later we will discover five different bolts in the door. Clearly guests weren’t welcome, though a ground-floor flat in a pretty rough estate is unlikely to be as safe as Fort Knox whatever you do.
Just as I’m starting to get really frustrated, three police turn up. One young officer starts to try to kick the door down in his size 12s. The door still won’t budge. Another bigger one has a go – door kicking’s a real macho sport – but nothing. On cue, a man suddenly comes out of another ground-floor flat, locks his door and – magic – he’s carrying a tool kit. ‘Excuse me, mate, but you wouldn’t happen to have a crowbar in that bag, would you?’ asks one copper. Hmm. The response isn’t enthusiastic, though it’s quite obvious what we’re trying to do.
‘Yeah, but I need it for work,’ he grumbles.
‘Never mind that, we need to get into this flat,’ says the copper tartly.
Reluctantly the man opens his bag and hands over the crowbar, standing there wordless as the copper manages to jemmy the door open. He isn’t the least bit curious or concerned about the fate of his neighbour. He just wants his crowbar back.
By now an ambulance crew has arrived. And inside the flat, once we’ve established that the occupant is dead, we try to figure out what has happened.
There’s