The seriousness of most illnesses can be determined by the global demeanour of those gathered round the patient. When you enter someone’s home and are greeted by a smiley happy chirpy face of a relative mid throws in the process of making a pot of tea, I think it’s a safe bet that the patient you’ve come to see will not be dead or dying.
I stood at the foot of a bed where my patient lay and unperturbed, repeated his proclamation.
“You can’t move”
The patient’s wife stood in the kitchen. A smiley happy chirpy face befit her as she made a pot of tea.
“No. At all. And I can’t breathe.”
“You can’t breathe?”
“Ok. So you can’t move and you can’t breathe?”
“Right . . .”
I paused for thought.
“. . . any chest pain?”
I know, I thought, I’ll try the old ‘drop the arm on face’ technique. We’ll soon see if you can’t move. So, I took a gentle hold of his wrist and went to lift his arm.
I furrowed my eyebrows and glanced at him out the corner of my eye. He then stopped resisting and allowed me to lift his arm above his face. I then let go.
He kept his arm where it was.
“Right,” I said apathetically, “there you go. You can move”
“No I can’t.”
“Yes you can.”
“I really can’t.”
“Look. You are voluntarily holding your arm above your head. You are consciously doing this. You can move.”
I then went to push his arm back down beside him.
I slowly and obviously turned my expression of disinterest to him and as if on cue, he stopped resisting. Within a few seconds he started wiggling his fingers, followed by his hands and then by his arms.
“There. Brilliant. That’s good eh. Now, what about your legs then”
“I can’t move them.”
“Oh? Would you mind if I did little test?”
I then performed the ‘Babinski’ planter-reflex test on the soles of his feet. Both feet were as negative as they could possibly be. And to top it off, both feet were jerked back when the test was done.
I stood back and gave my patient a sidewards smile.
“You gonna sit up for me now?”
My patient sat up. And at that moment the wife stepped in with a cup of tea in her hand. She looked pleased with the result.
“Yey!” I cheered, “We have a winner. Well done. It’s a miracle. Come on, let’s have some high fives . . . ”
I then proceeded to get my victory high fives from the patient and his wife. And, eventually, after a full set of obs and a little ‘discussion’ on appropriate us of the Ambulance Service, I went to leave.
The wife held the front door open for me, “Thank you” she smiled.
“Just doing my job ma’am,” I gave my best effort in a look of cheesy nonchalance, “. . . just doing my job”.