I'm not dead yet

The day before yesterday I had chest pain, and went to hospital.

It started as a backache, then sort of expanded forward and upward as I worked my way through the three most recent episodes of Torchwood. Then, when I was no longer distracted by slow-moving Mid-Atlantic sci-fi, I noticed the pain was only getting worse.

I was alone in the house, so I decided to strike some sort of balance between actually calling the ambulance as soon as I noticed central chest pains with a feeling of pressure, and the traditional male alternative of being found dead next to your laptop, which is still displaying a Web page about what killed you.

(At least I wasn't dumb enough to take any painkillers. It is not a good idea to mask pain that may indicate something very bad.)

I've been in hospitals before, but only as an onlooker. I'd never previously been in an ambulance at all. Hell, I'd never even called 000 before. So this experience included a number of firsts for me.

Lots of leads stuck to my chest and other, whimsically selected locations, with three different kinds of mildly epilatory adhesive pad. My very own PVC. One of those idiotic gowns which may or may not give you more personal dignity than just being naked. (I got to keep my pants on, thank heaven.) The curious burning sensation you get when you put a nitroglycerine pill under your tongue. (A pill that creates that sensation without any other effects would be a fantastic placebo.)

While the ambulance blokes fed me aspirin and nitro and hooked me up to the machine that goes "ping", I seized the opportunity to compare and contrast what I've gleaned from UK ambo-blogs (the defunct Random Acts of Reality and Nee Naw, and the still-extant Trauma Queen) with the experiences of the local ambos.

("Ambos", plural of "ambo". Pronounced "am" as in "ham", "bo" as in the thing that shoots arrows.)

It turns out that Aussie ambos share their British colleagues' superstitious terror of "the Q-word". But the ambos seemed honestly puzzled when I pledged not to bite them, turn out to be completely faking my illness, or defecate in their ambulance.

I'm sure all of these things have happened to them at some point, but Australian ambulance crews seem to have to deal with less pointless bullshit from patients than British paramedics. The reason for this only dawned on me when I was a bit less concerned about maybe being about to die.

Here in Australia, you see, the public hospitals are free, but the ambulances, generally, aren't.

So Aussie ambulance crews don't have to put up with nearly as many patients who could definitely safely be driven to hospital by a family member, or could definitely safely drive themselves there, or in some cases could definitely get to the hospital on a pogo stick and stop for a picnic lunch on the way without in any way worsening their illness, if they have an illness at all.

[EDIT: I just remembered that I have been to the emergency room as a patient before, years ago when in a fit of pique I punched a door and broke my hand. I drove myself there, and asked the triage nurse to make sure I was seen after anybody whose injury was less stupid than mine.]

"Maternataxi" calls (healthy, complication-free pregnant women in labour who do not actually need to get to the hospital particularly quickly), for instance, don't seem to be a big problem for Aussie ambulances.

The ambos asked me to rate my pain on a scale from one to ten. I observed that this penalises the imaginative. When pressed, I said about a five.

Shortly after this, they put an oxygen mask on me. I'm pretty sure they just wanted me to shut up.

I've been to our local hospital in the dead of night a few times now, though only this once as the patient. I've developed a strange liking for the emergency room at three in the morning. The experience is basically tedious, of course - I get plenty of use out of my OLPC XO-1 with a shelfload of books on it (though this time the level-five pain, which hung around for several hours, kept distracting me).

But there's a sort of direct human... realness... in the emergency room that I, in my everyday life of sitting in my little office staring at a monitor, don't normally encounter.

The stories being played out around you in an emergency room often aren't very happy ones, of course. But if anything, that makes them more interesting.

This time, there was the little kid oscillating from cheerful (several adults, some in important-looking uniforms, were clearly deeply impressed when he successfully did a wee in a bottle) to inconsolable (when he discovered he wasn't going home any time soon).

And there was the bloke who'd gotten himself on the outside of rather a lot of pills, and was now disinclined to open his eyes no matter how often, and how loudly, the nice nurse requested he do so.

And then there was the old lady in the bed next to mine, whose house had caught fire, adding some unrequested particulates to her lungs, but sparing the pets.

And there was someone referred to by the staff, not unkindly, as "toothache man", whose malady did not appear to be a very high treatment priority.

(Have the Satanic atheist Muslim socialist US health care reforms reduced the number of people with chronic and otherwise non-emergency health problems who go to the emergency room because it's the only way they can afford any sort of treatment? God, I hope so.)

Anyway, it turned out my heart is fine. It was probably something I ate.

I had some pretty solid suffering time in the hospital, though, as the pain tired of living in my chest and referred itself to some other desirable residences in my torso. After I was introduced to the diverting short-term side effects of intravenous butylscopolamine (instant farsightedness, and a very dry mouth; butylscopolamine is the time-limited downloadable demo version of plain scopolamine), my overenthusiastic bowel muscles calmed down and, at dawn, I was sent on my way.

Just to annoy Anne (who'd gone home to get at least a little sleep when it became clear that my name did not need to be taken off the joint bank account), I would have walked home. Except I was wearing ugg boots, which are (a) not actually cool in any way, you American lunatics and (b) unsuitable for a four-kilometre walk.

So I got a taxi, and talked to the old bloke driving it about the numerous ways in which we'd each courted death by not seeking medical care.

Next time, I'll see if I can come down with something more interesting.

21 Responses to “I'm not dead yet”

  1. Patrick Says:

    I would have gotten to #7 on that chart had I found it last week when I went to the ER with sudden chest pain. Fortunately it wasn't a pneumothorax, it was just a pulled muscle along my ribcage. But even though I came in with OH GOD CHEST PAIN CAN'T BREATHE, they just hooked me up to an EKG and rolled me back into a little room where a nurse fitted me with an IV before getting my chest xrayed after drawing some blood.

    It sounds like you got to have more fun, on the whole.

  2. n17ikh Says:

    Glad to hear you're OK, Dan. If that little adventure had happened here in the US you'd probably be $15k poorer right now. Damn commie Australian doctors, just giving medical treatment to anyone who asks!

  3. Alex Whiteside Says:

    Super-glad that Dan's in one piece. Although I like to think that in a good universe, if he did pop his clogs he'd still somehow update the blog to discuss the experience. (Not in the fashion of Peter Atkins' disturbingly specific firstperson account of his own decomposition.)

    I think that most public spaces become endlessly fascinating after midnight. I've found my rest stops at service stations to feel like I've stepped into some sort of secret, magical place, outside of the normal flow of life, perhaps a layover at an asteroid halfway to Jupiter. Where the soup costs £4.

    Oh BTW Ugg boots were popular in the UK last year. A surprising number of fashionable women seemed to believe they'd be effective in early 2011's uncharacteristic snows which I don't think is a mistake they'll repeat.

  4. Joachim Says:

    Fortunately it was only indigestion.

    You know what is also funny? Finding out the, contrary to its depiction in movies and television, hyperventilation feels almost exactly like a heart attack and because the rising oxygen levels inhibt your higher brain functions, you are absolutely sure that you are not breathing to fast.

    Regarding the Nitro, in my case it was Nitro-Spray under the tongue and the words "You might experience a strange headache". True.

  5. Daniel Rutter Says:

    hyperventilation feels almost exactly like a heart attack

    I was successfully, consciously, not doing that. It's impossible to avoid a bit of adrenaline release when you think you may be Very Ill, though, and that spikes your heart rate and makes you sweat, giving you ticks in more boxes of the Yep, That's A Heart Attack All Right checklist.

    At least I knew it wasn't just heartburn. I'm blessed with a very lazy lower esophageal sphincter, so I am vividly familiar with every way in which stomach contents can come back up my throat, including the especially magical moments when the liquid then takes a sightseeing tour of my lungs.

    (If you have an overeating problem, allow me to strongly recommend midnight reflux as aversion therapy.)

  6. rhy7s Says:

    If your looking to avoid the real thing, consider listening to this interview.

  7. Anne Says:

    Glad to hear you're okay! I have not had to deal with chest pains, thankfully, and unfortunately I don't remember very much from any of my visits to the emergency room. But I can say that I am rather unnerved when I take the hospital elevator with fellows carrying what appear to be picnic coolers whose labels make it clear that what they actually contain is living organs.

  8. Bern Says:

    Actually, I think the organ-carrying esky is one of the coolest things to be seen. While it means (usually) bad things for the donor, it also means (usually) good news for the recipient. And, you know, while I hope I live to an age where nobody *wants* my organs any more, if I don't, I sincerely hope they can be put to good use. It's not like I'll need them any more!

    I've never been to the ER for myself, though I did get to ride in an ambulance once when I tore some ligaments in my ankle playing footy at lunchtime back in the high school days. The most interesting time was when the missus dislocated a finger playing gaelic footy. Even the ER nurses were impressed when they saw the x-ray! (finger now healed, almost as good as knew thanks to some great physio)

    Re the heart attack thing - haven't been there, thankfully, though my cholesterol levels were getting a bit high a few years back. Cardiologist suggested I change my diet a bit, which worked wonders. Incentive to do so was provided by having him tell me I had a 1% chance of having a heart attack in the next 5 years. Serious wake-up call, that.

  9. ChrisGoodall Says:

    Congrats on not being dead! My body does this to me. Pain in the chest-ish area that radiates 'round to my back. It's my gall bladder. Ugh...

  10. ChrisGoodall Says:

    Also, my wife has a weak esophageal sphincter, too. I think it's HOT!

  11. RichVR Says:

    I have a reasonably bad hiatal hernia. So once a month or so I get pain which on a scale of 1 to 10 I consider an eleven. I went to the emergency room twice for it. Once before I knew what it was. The second time more recently when the endoscopy that diagnosed it caused an attack. The worse ever. The second time I checked myself out after the morphine injection. They wanted to give me tests. I wanted to get home and go to sleep before the drugs wore off.

    Later my doctor said something like that could get me marked as a drug seeker. But he also told me that any time I ever had pain that bad and went to the ER for medication, to have them call him (any time, day or night) and he would okay the morphine. Nice guy, eh?

    Anyway, glad to hear that you're okay Dan.

  12. MorganGT Says:

    Some months ago I had a similar experience when the pain got bad enough to worry my wife, she rang the 'nurse-on-call' service, then after getting some advice from them rang an ambulance for me. When it turned out to not be heart related, but just severe stomach pain, the ambos offered me the option of going to hospital or staying in bed and seeing if it got worse or better. I opted for bed.
    A few hours later the problem made its way all the way through my bowels, and after suffering the indignity of beginning to projectile vomit while sitting hunched on the toilet with severe stomach cramps and projectile diarrhoea (probably the most unpleasant experience of my life!) I found myself vomiting copiously into the sink. When globs of dark blood started to appear my wife called the ambulance again and this time they took me to hospital, although they did seem happy to wait until the vomiting had stopped, to save themselves the job of hosing out the ambulance.......
    A few hours of rest and some anti-nausea medication and I was OK to go home.
    I fgelt pretty bad, but I also felt bad for my wife who was left with the job of cleaning up the mess I left......

  13. moetop Says:

    I'll have to admit, I was a bit more worried when I reached the 1/2 way point in the story, and didnt see mention of Anne yet. Glad your ok..

  14. TwoHedWlf Says:

    The only time I'd seriously thought I might need an ambulance was the first time I got a migraine. I didn't know what it was or what the symptoms were at the time. In hindsight when you start losing chunks of your vision and your face and hands start to go numb, "Shit am I having a stroke?" it's probably a bad idea to just sit and feel miserable.

  15. Joachim Says:

    hyperventilation feels almost exactly like a heart attack

    I was successfully, consciously, not doing that.

    Didn't say you were. I was.
    I was lying on the ground on a tram station because I could not remain standing. I felt extremly nauseous and experienced chest pain. My lower arms and legs started to feel like something was putting pressure on them and I felt a "band of iron" around my chest. A young man was attending me at the time (who turned out to be an assistant doctor from the hospital right around the corner), told the emergency operator that I was tachycardic and in immediate need of an ambulance.

    After a short while the symptoms got worse and my hands started to turn towards my chest (In German this is called "Pfoetchenhaltung" which tranlates to something like "small paw position"). This, as I now know is a sure sign of hypervantilation and, if left untreated, I would soon have passed out and (funny fact) would have started to breathe normally again!

    Another proof of un-Intelligent Design: The breathing reflex is controlled by (among other factors) the CO2 level in your brain. The rising oxygen levels not only inhibit your brains reasoning functions but also lead to rising CO2 Levels which bring the brain to instruct your lungs to breathe faster and deeper to get rid of the CO2 buildup. The faster breathing raises the oxygen level even higher and bingO: Hyperventilation.

  16. Joachim Says:

    BTW For future experiments in interesting body sensations, from personal experience, I would suggest a) a good migraine as the aura beforehand is a very interesting experiment on how your brain processes visual information (the first few times I walked against stuff, because it took me some time to realize that to me the "left" side of the world did not exist anymore.)
    or
    b) anice billiary colic. This will give you a resounding 10 on the pain scale. Always nice to know how that feels like.

  17. Fallingwater Says:

    Glad you're OK. I could go on about just HOW glad I am (can you imagine a world without Dan's rants?), but we're all nerds here, so: more information about the OLPC XO-1, please :P

    As for normal places during the night, I know *exactly* how you people feel. The only thing I hate about it is that everything's closed, and that prevents me from living as a proper night owl, which is what I'd truly want. *sigh*

  18. MorganGT Says:

    I spent 10 years working mainly afternoon and night shifts as a security guard, so I too know how 'different' the world appears late at night. Especially in the inner city, where in the brief period after most people have headed home, but the rubbish trucks and delivery trucks have yet to do their early morning runs, the city streets are virtually deserted - no pedestrians, no traffic. At one point I was doing vehicle patrols in the Melbourne CBD, back before it became more of a 24hour world, when everything was shut at night. Belting around the city streets flat out in my patrol car and not seeing a single person anywhere, it often felt like a scene from the movie 'The Quiet Earth'.

  19. TwoHedWlf Says:

    Haha, Morgan I thought of Quiet Earth at the second line of your post.:) Especially appropriate since it was made here in NZ. Nights in the city are surreal, but the most I've found is christmas day. I've finished work a few times christmas morning. Head home driving through the central city at 7am, it's nice and sunny...Not a person, car or sound anywhere. Just the occasional scrap of paper blowing across the road tumbleweed style.

  20. AndrewPrime Says:

    I also had the dubious privilege of taking my first ambulance ride in January this year. Fortunately in my case there was no doubt that the hospital required - I slipped, tangled up my legs trying to recover, and managed to fracture my ankle in 3 places and dislocate it in the ensuing fall. When your foot is sideways, this is a pretty good indication that medical attention is warranted. Here in BC, Canada, ambulance fees are pretty minimal ($80 for residents under the provincial medical insurance, waived for people who are on premium assistance), so that wasn't a concern.

    I learned that hospital staff really doesn't want you to feel any pain - at one point while awaiting surgery I was being given IV morphine *&* Tylenol 3. Between that, conscious sedation while they were resetting the dislocation in the ER, & a Percoset prescription post-surgery, it was an interesting time. I've made a good start towards having a bionic ankle, with the plate & 13 screws in there, but it's nearly back to normal... definitely not an adventure I'd care to repeat, though.

  21. RichVR Says:

    I'm still not dead. At least so far. Although I'll feel like it when the hangover kicks in.


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