Another time, someone came in with chest pain. He was wearing a pristine suit. As I took his trousers off, I saw he had fishnet stockings on with painted red toenails. ‘Oh,’ I said. ‘I like your nail varnish!’ I thought it was brilliant. It was the fishnet stockings that got me. There was nothing about him that said ‘I dress up like a woman on Thursdays.’ I’ve learnt never to judge by appearances or to take things at face value.
There are the classic stories of people getting things stuck in orifices, of which every A&E professional has hundreds. One man I saw had a carving fork stuck up his anus. He was in his eighties and said he had been experimenting with his wife. I loved his honesty. ‘Good on you,’ I thought.
Usually you get teenage boys that say: ‘I fell on [insert object here].’ No one falls at the exact angle and with enough force to get a deodorant can, for example, stuck up their ass. I say deodorant cans, because they are often used – so much so that we once had a discussion trying to guess from the X-ray what brand it was. Vibrators are also popular; once I asked someone how they knew it was still there. He said he could feel it vibrating. This was eight hours later. I was impressed by the long battery life. Sometimes people put animals up there which is a form of cruelty – they usually die.
I love working in A&E. It’s a constant sprint, but a marathon at the same time. You’re always busy, no one sits down and rests. You’re kept on your toes.
The sense of teamwork is amazing. We work as one and there isn’t the hierarchy you can sometimes get in other areas. There’s no divide between doctors and nurses. It’s respectful and everyone trusts one another. When I’ve got through a shift, I think: ‘I’ve achieved that with a great team.’ I go to work for the team. I don’t want to let them down and that keeps me going too.
The stuff we see is insane and it’s impossible to get bored.
I look back at my career trajectory. Eight years ago, I was a newly qualified nurse, new to the hospital and the city. The opportunities to progress are incredible. You can follow whatever takes your fancy, whether it’s clinical advancement, teaching, management or research. I don’t think other professions are quite the same.
If you’ve worked in A&E, you can work almost anywhere. And that’s been made even more apparent since this pandemic began. You see the whole range of humanity in the emergency department and I’ve noticed even more acutely the best and worst parts of human nature in all its raw glory.
2
It’s Just in Wuhan
I first heard about coronavirus on the news and from my husband’s brother. He was living in China with his wife and used to update us daily on a group chat. He was really blasé about it. ‘It’s just scaremongering,’ he would say. ‘They’re overreacting.’ Every day there’d be more restrictions on his life as they gradually shut down the country until it was total lockdown. ‘This is overkill,’ he insisted. ‘Not many people have died.’
We kept hearing about his life as the changes took hold. Only one member of the household was allowed out once a day. There were security guards who checked their temperatures when they left the apartment complex. They had a pass to get in and out of their home. They told us they had fostered loads of animals because people were dumping them in the street to get killed.
I started seeing the images of overcrowded hospitals in Wuhan on TV and thought, ‘Oh wow, that looks hectic.’ It was terrible for them, but I was glad it wasn’t in the UK. It was so far away and I never thought that we would be affected. I thought it would spread beyond Wuhan a bit but not to the extent that it ended up blanketing what seemed like the whole world. Perhaps that was me being naive, or perhaps it was a lack of understanding about this new disease.
Although news of the virus was drip-fed into my work and personal worlds, life carried on largely as normal in December and January. I had Christmas off – a rare treat – so spent it with my family. I was working days over the end of December and didn’t dare stay up to see the new year in because I liked to be as rested as possible for each shift. Before becoming an ACP I’d found the work had become second nature. It was easy and that’s why I wanted to become an ACP. I craved a challenge and to be a better nurse with more time for patients.
When I began in the role, in October 2019, I was as nervous as when I first started in the NHS. Every day was so mentally exhausting. I was constantly on high alert and double checking everything I did while making sure I documented it correctly. I got so worried that if I didn’t get enough sleep, it would impact on my work the next day and my ability to care for patients. So I made sure I got at least six, ideally eight, hours’ sleep.
Alongside work, everyday life continued. The weather at the beginning of the year was miserable; there were floods, the days were short, the dogs always rolled around in the vast quantities of mud on their walks, and I was feeling more exhausted than usual. Life in A&E is unrelenting.
My dogs mean the world to me. We got Lexie because I wanted company during my days off when Ed was at work. She was a rescue dog, a Labrador cross, and had obviously been abused by a past owner because, when we first got her, she was very nervous and barked at every stranger that came into the house. She still makes a racket when the postman delivers anything. We adopted Max, a Parson terrier, a couple of years later when his owner couldn’t look after him anymore. He is a rascal. Leave any food anywhere within his reach and he’ll inhale it in seconds. He once destroyed a packet of pistachios my sister had brought and spent the next day pooping whole ones out. He hadn’t even chewed them. He also mauled a friend’s phone because it smelt of coconut butter handcream.
When I get time off, Ed and I like to go running, especially with the dogs. One Saturday morning, I was driving to a cross country race my running club had asked me to take part in. I hate cross country running but find it hard to say no, so there I was, on my way to what would turn out to be hours of trudging through mud that was so deep and sticky that my left shoe came off.
In the car, a message came through from my sister. It read: ‘Are you there?’ She was in Brazil for work. She is a journalist and was on a month-long reporting assignment. My sister rarely gets in touch, especially when she is thousands of miles away, and so I knew it was something important. I called her back with the hands-free set in the car. She picked up immediately.
‘Hi, Louise. I need some advice,’ she said sheepishly.
‘Oh, OK. What’s up? How was your new year?’
‘I’ll tell you about that later. Am I on speakerphone?’
‘Yes.’
‘Is Ed there?’
‘Yes, we’re on our way to a race.’
‘Can you take me off speakerphone please?’
‘I can’t, I’m driving.’
‘Ugh, this is awkward,’ she said, addressing the both of us. ‘Well, you’re my brother-in-law now, so I guess I can tell you.’
Already, worst-case scenarios had started forming in my mind. To give you a brief insight into my sister, she is, what I would describe as, a shit magnet. Bad things happen to her. I say bad, but what I mean is that some of the situations she gets herself into are ridiculous and provide endless entertainment at family get-togethers.