Dedication

Dedicated to Intensive Care nurses everywhere

Saturday, May 23, 2015

The Rabbit hole opens - Part two


Continues...






Two paramedics treated Carolie immediately on arrival.  One of them came to tell me she had experienced a seizure but was still alive.  I was still prevented from seeing her, which is an understandable protocol given the automatic tendency to rush to a loved one.  I would have been in the way.  The paramedics organized breathing assistance and brought her out on an ambulance trolley. 

She was a pallid colour and appeared barely alive.  I held her hand as they put her into the ambulance.  She managed to say something – I think it was “Grade 5”.  My guess is the last thing she was doing was a roster or a schedule connected with that grade.  She was found near the staff photocopier.  Something as prosaic as a class roster was the last thing on her mind as she slipped into a bewildering dimension of continuous light, beeping machines and prodding hands. 

Intensive care professionals have told me that every minute lost in treatment of a brain bleed is crucial to the outcome - a matter of life and death and a possible determinant of extent of brain damage.  I estimate it took the police well over an hour to enable paramedics to start treatment. Possibly their default reaction to an anxious person claiming their wife is on the floor behind a locked door is studied scepticism.  They certainly took little heed of my obvious anxiety. 

Had the police reacted immediately and forced entry, her treatment would have started within 15 minutes.  Clearly the emergency was only obvious to me.  What does this tell us about ‘standard operating procedures’ in these circumstances?  Why not force entry to the building?  Why was an ambulance not rung until Carolie was found?  Why did they ignore my pleas? I am haunted by my failure to convey the gravity of the situation.  My warnings were treated as something else. 

I recall one of the constables coming up to me just before I left to follow the ambulance.  He said, “Sorry”.  I do not know whether he was sorry about their general tardiness or just sorry for us in the circumstances.  Probably the latter but it has stuck with me.  

As a postscript, one of the attending police rang me a couple of weeks later, when Carolie was in the Neurological Intensive Care Unit in Sydney.  He informed me as part of a “duty of care” he was following up what had happened and how we were.  The irony was not lost on me and I did not let him down gently, letting him know that I would be following up my concerns with Police management - I might just encourage them to read this.

On leaving the school, I trailed the ambulance through the wet Canberra night.  Everything was eerily still.  The city is easy to move around after business hours, as the roads are wide and relatively empty.  They did not hurry or put their lights on.  I wondered about that but I imagine there were practical operational reasons. 

My mind was in a fever.  What had happened?  How bad was it?  Would she live?  The awful surrealism had intensified – acute fear had subsided, replaced by a creeping, almost detached, dread.  Everything was in slow motion, colours and sounds intensified; I was mindful of my thought processes – observing my reactions to the situation distractedly from a distance as if in a cinema. A rabbit hole had opened and we were tumbling downwards together in the dark.  Carroll captures it brilliantly:

          Either the well was very deep, or she fell very slowly, for she had plenty of time as she went down to look about her, and to wonder what was going to happen next.  First, she tried to look down and make out what she was coming to, but it was too dark to see anything; then she looked at the sides of the well, and noticed that they were filled with cupboards and book-shelves:  here and there she saw maps and pictures hung upon pegs.*

It was that sense of everything reduced to slow motion in response to acute shock.  Violent energy appears to be funneled through a transducer that projects a three dimensional cinematic event in slow motion.  I had experienced something similar in a car accident, where I became an observer of, rather than a participant in, the extreme action.  One can write a poem, have a smoke, and take a coffee, whilst action taking split seconds hurtles around you. The ‘bubble’ is calming in a weird way.  




I do not know the exact metabolic processes at work in such situations, but it provides a protective sheet under duress, and doubtless involves adrenalin triggering other built-in hormones and neurotransmitters - an innate coping mechanism.  Jefferson Airplane¥ was spot on - Alice was off her head via in-built neurotransmitters:

          ‘Dear, dear!  How queer everything is today!  And yesterday things went on just as usual.  I wonder if I’ve been changed in the night?  Let me think:  was I the same when I got up this morning?  I almost think I can remember feeling a little different.  But if I’m not the same, the next question is, Who in the world am I?  Ah, that’s the great puzzle!’*



*              Lewis Carroll, Alice’s Adventures in Wonderland, The Folio Society, London, 1961, p.4
¥             Jefferson Airplane, “White Rabbit”, 1967
*              Carroll, op. cit, p13

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