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Emergency doctoring on demand

I never relished the obligation to deal with an emergency medical situation in a public place; I kept my personae separated, like Jekyll and Hyde (maybe not a good analogy).

It is good when things work out satisfactorily, however.  An anaesthetist colleague was able to save a man’s life in a road traffic accident by a simple manoeuvre that opened his airway. My episodes were less dramatic.  Once, when travelling on a train with my two young children, a request came over the intercom for a doctor to come and assist a passenger.

Telling the boys not to move on pain of something dire, I went along the crowded passage to find a young woman who had fainted.  Deathly pale and woozy, she was being propped upright by well-meaning co-travellers.

In bossyboots mode, I used my authority to clear a space, which was not easy, on the dirty floor so that she could lie flat.  The response was instant, of course.  A male medical student also on the scene felt it was his duty to ply her with questions, and, once it was clear she was fine, I left him to it; I often wonder if this was the start of something good.

On another occasion in Hungary, while walking with friends in some public gardens, we saw an older man in a party of Germans vomit, then keel over and crack his head.

When I went over, and in spite of the language barriers, it was clear to me that they all had varying degrees of post-party hangovers, which was perhaps enough to explain the event.

However, it was difficult to resist pressure and expectations, and I found myself asking some rather personal questions with an interpreter in attendance, an audience all agog and a most reluctant patient. I soon bowed out.

As students, my generation was inculcated with a sense of moral obligation, almost of missionary zeal, to carry good medical practice to all, whether they wanted it or not.

To me a person’s right to autonomy is sacrosanct even if it means odd choices.

One other memorable emergency happened at an open day at a dockyard, where I was with my family. We became aware of a commotion some distance away, with a crowd gathering.  When I went along, I found that a woman lying on the ground had had an epileptic fit, and was being attended by a most efficient nurse who happened to be close by.  She had done all that was needed, and an ambulance was on its way.

The only contribution I made — but arguably a most important one — was to see that the patient’s dentures, removed by the nurse and popped into a bystander’s handbag in error, were transferred to the correct one. 

Margaret Cook, retired consultant haematologist from Edinburgh

Posted in:  Communication skills

Tags:  Emergency treatment