Is that better?
Retention of urine is a common condition, primarily affecting male patients. As men grow older, the prostate gland continues to enlarge, and often constricts the urethra. This can result in inability to pass water at all, or in frequent, unsatisfying urination. Other causes might include physical obstructions, such as a tumour, though this is less likely. So, this condition is considered a run-of-the-mill job by ambulance crews, and is normally already diagnosed by a G.P. The ambulance is summoned to take the affected person to hospital, for a pre-arranged examination by a urologist, and it is not considered to be an emergency. In many cases, the man will make his own way to hospital, though if he has another condition already, such as a heart problem, difficulty in walking, or breathing problems, it is likely that his doctor will request transport by ambulance.
One late afternoon shift, we were summoned to just such a call.
On a small, neat estate, about two miles from our base, we were met at the door by a lady, dressed in clothes much too fine for attending a hospital. She was immaculately coiffured, and carried herself with the air of a disdainful aristocrat. She handed me a brown envelope, containing the letter from the G.P., and told me to wait for her husband, who was putting on his shoes. Her attitude did not bode well, but I chose to ignore it, and smiled pleasantly, shuffling my feet in the doorway of the tiny terraced house. When her husband appeared, he was a small, bespectacled man, aged about 70. He too was well-dressed, and he nodded congenially to me, before they both walked up the two steps into the back of the ambulance. After making them both comfortable, I sat directly opposite the man, and read the letter from the doctor. We started to make our way, and though we were less than three miles from the destination hospital, the traffic was at a rush-hour standstill.
I tried to make conversation, as there was the usual awkward silence needing to be dispelled. The man’s wife answered all the questions, leaving him to nod in affirmation, as she relayed the history of his various illnesses, and gave me a comprehensive list of all her husband’s current medicines. She spoke without opening her mouth, the sound coming through pursed, disapproving lips, that were covered by a thick swathe of bright red lipstick, which would have been envied by many a circus clown. This strange style of talking resulted in a nasal whine, which together with the affected upper-class accent, provided a really unique sound, which was extremely unpleasant to the ears. I looked at the downtrodden man, feeling sympathy for a life spent with this unappealing member of the opposite sex.
I decided to involve him directly, and asked him for his date of birth. I didn’t need to, as it was clearly stated on the doctor’s letter, but I wanted him to say something. I looked down at my folder of paperwork, preparing to write down his answer. What happened next, was completely unexpected; and I felt as if he had thrown a bucket of water over my head. He had, in fact, vomited over me, in a projectile display worthy of the infamous scene from The Exorcist. His entire stomach contents had been discharged over the top of my head as I glanced down, completely soaking my hair, face, paperwork, and going inside my green uniform coverall, with sufficient force to also wet my T shirt, front and back.
There had been no indication that he had felt unwell. The vehicle had not been moving with enough momentum to induce motion sickness, and he had as much time as he could have needed, to tell me he felt nauseous. Instead, he thought it was completely acceptable to throw up two day’s worth of stale urine, and whatever else was in there, all over a person sitting inches away. His wife turned to him and patted his leg, adding the comment ‘Is that better?’ I was appalled at this behaviour, and would liked to have punched the fool unconscious, but of course, I could do nothing, except towel myself down, and ask the man why he hadn’t told me he felt sick, and asked for help. ‘I thought I could make it to the hospital’, was his lame reply.
Neither the patient, nor his sneering wife, made any vestige of apology, no matter how shallow and insincere it might have been. I had to escort them into the hospital, reeking of this man’s urine and vomit, and hand over to the staff. To the nurse in charge, his wife offered, ‘He was sick a while ago, but I don’t think he’s got anything left now.’ I walked away, unable to even glance in their direction, as I climbed back into the vehicle, to return to base, to shower and change. In the London Ambulance Service, you are used to many things. Assaults and threats, mad people, abuse and swearing, all of this is commonplace. But you don’t expect a respectable, elderly, middle-class man, to think that it is OK to knowingly, and deliberately, vomit all over the person that has arrived to help him.