Further Confessions of a GP

Because David didn’t fit my stereotype of a drug addict, I hadn’t even considered drug overdose as a possibility. Whereas, even before my other patient Kenny introduced himself as Crackhead Kenny, it wouldn’t have taken a genius to suspect that he might be a user: his clothes, his hair, his tattoos and even his smell… everything fitted the stereotype of the archetypal drug addict. David had a young daughter and a wife who was a nurse working at this very hospital. He lived in one of the nicer parts of town, and this was a Tuesday afternoon, not a Saturday night. He couldn’t have been taking drugs, could he?

Barry was never one to turn down the opportunity to get one over on me. He grabbed a pen torch and shone it into David’s eyes. Both pupils were tiny. Next he grabbed David’s left arm and pointed out to me the needle prick mark on his forearm. We had taken blood and put in a cannula in his right arm, so the needle prick must have already been there when David arrived at hospital. Without saying a word, Barry went to the cupboard, pulled out some naloxone and injected it into David’s cannula. Naloxone is an antidote to morphine and heroin. It reverses the effects almost instantly. Within a minute David was awake, pulling off his oxygen mask and asking where he was.

Barry was trying to catch my eye so that I would notice his smug smirk, but I was too preoccupied with David and his wife. Her relief at his recovery was very quickly replaced with tears of hurt and anger. As a nurse she knew the significance of his sudden improvement following the naloxone. Through her tears she kept asking him why. David only seemed to be able to answer, ‘I don’t know.’ It turned out that he had spent a period of time injecting heroin regularly in his early 20s but had kept away from it for years. For some reason, today his previous addiction had got the better of him and he’d tried to inject himself with the quantity of heroin that he used to take as a regular user. After such a long break, his body was naive to the drug and he accidentally overdosed.

Russell Brand talks very eloquently about the power drugs have over an addict even after years of staying clean. For some people the pull of that ‘high’ is something that hangs over them for ever, however settled and happy their drug-free life might seem on the outside. I learned that day that I had to leave my stupid stereotypes behind. Clearly, anyone can suffer from drug addiction.

The hardest part of the day was telling them that I was going to have to contact social services. I’m sure David was a great dad, but he had taken drugs when he was responsible for looking after his young daughter. Despite David’s pleas, I just couldn’t ignore that. I spent a lot of time with David and his wife, and we talked about getting help and support for them both. David had beaten drugs before, and there was no reason why he couldn’t again. He had so much to stay clean for.

Hospital deaths

There have been a fair few doctors and nurses over the years who haven’t exactly covered our profession in glory. It’s understandable that medics who have either deliberately or accidentally killed their patients make headline news. However, just occasionally, there are hospital deaths that aren’t solely the fault of the medical staff.

One medical team in a hospital in South Africa started noticing that each Saturday morning a patient who occupied a certain bed on the intensive care ward would be found dead with no apparent cause. Initially it was considered a morose coincidence, but soon staff realised that there must be some reason for the patients in this specific bed to all die within a week of arrival on the ward. The doctors feared the bed was contaminated with some sort of killer bug that was infecting the patients. Appropriate investigations were undertaken, but no bug was found. Presumably because of a lack of beds, or an unwillingness to give in to superstition, the killer bed was always refilled with a new patient each week, but the mysterious deaths continued.

Until, one day, somebody took notice of the cleaning lady as she did her weekly Friday-evening deep clean. The cleaner entered the ward, unplugged the life-support system beside the bed, and plugged in her floor polisher, before spending half an hour cleaning the ward. The staff finally realised what had been happening. Over the noise of her polishing machine, no one would have heard the gasps for breath and the death rattle from the desperate inhabitant of the ‘killer bed’. The cleaner would then plug back in the life-support, leaving a lovely clean floor and a dead patient. Labelled in the press as the ‘South African Floor Polisher Massacre’, the exact numbers of people who died still isn’t known!