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Impending Sense of Doom

Posted Jan 11 2009 4:23pm
I've been meaning to write about this call for ages but there always seemed to be something else to do and it got pushed to one side. Now that I've started blogging properly again I thought it was about time to pull it out of the "pending" file and share it with you. I really think it's a quite extraordinary call.

A few months ago (I believe it was around October), I was doing overtime and I was down on the 9's. I'd forgotten how much I enjoy it down there and after I'd got back into the swing of things was having a great day. I get the all too familiar ping in my ear and confronted with a guy who sounds a bit embarrassed (I'll call him Stanley) starts talking. This transcript is not word for word by any stretch of the imagination but it is what actually happened.

Me: What's the problem. Tell me exactly what's happened.
Stanley: I'm really sorry to bother you. I don't really think this is an emergency but I just don't know who else to call.
Here we go I think - a cut finger, man flu - something rubbish that he should really go to the GP about
Me: Can you tell me what's actually happened?
Stanley: It just sounds so stupid. I don't know how to describe it. I'm not in any pain, I've not hurt myself, I'm not ill
Then why are bloody ringing me? Is he going to tell me he's got his privates stuck in something?
Me: Sir. What's actually the problem?
Stanley: I'm sorry. I just feel like something bad is going to happen. I can't explain it. I just have this overwhelming feeling that something is going to happen. It's unbearable and I feel so stupid ringing you. I mean what can you do about it? The only way I can describe it ... well it's ... It's like I have a complete and utter impending sense of doom.
Oh my god! Alarm bells start ringing. I've heard those words before. Somewhere back in training school. That's a rare but valid symptom of a heart attack.
Me: It's not a problem ringing Sir. That's what we're here for. Are you sure you don't have any pain anywhere?
Stanley: No none whatsoever.
Me: Ok I'm going to ask you a few questions and we'll get some help to you.
I type into the Diagnosis Field "Patients states he has an impending sense of doom". That's it. I hope the crew will understand why I've gone for the chest pain card.
Me: Are you breathing normally?
Stanley: Absolutely fine
Me: Are you clammy?
Stanley: Nope not at all
Me: Are you nausea or vomiting?
Stanley: Nope
Me: Have you any history of heart problems?
Stanley: Nope. I'm fit and healthy
Me: Have you taken any medication in the last 12 hours
Stanley: Not so much as a paracetamol. This all sounds so stupid. I'm so sorry for bothering you. It's probably just me being paranoid. I shouldn't be wasting your time.
Me: Sir, you are not wasting my time in the slightest. We've got an ambulance on the way to you at the moment.
Stanley: You know what. Don't worry about it. It's silly for me to have an ambulance when there are people out there who really need them
YOU may really need one I'm thinking. If this is a true symptom then you may be about to have a heart attack!! Of course I don't want to scare the poor chap and have him collapse whilst on the phone
Me: Sir, let the crew just come and check you over. They're not going to force you to hospital but they can give you the once over and then you won't have to worry about anything.
Stanley: I suppose you're right. A quick check over to put my mind at rest. Thank you very much and sorry again for bothering you.

I give the rest of the information we have to give and put the phone down, jotting down the CAD number so I can see what happens next.

What happened next? ... Stanley gets blued into the Cath lab having an MI! I couldn't believe it. I mean I thought maybe he'd get taken in for a thorough check up. I never expected it to be an actual MI. Thank God I took him seriously and ran it through the chest pain card. Thank God it didn't go up to CTA for a ring back. Thank God the crew were there quickly.

It was certainly one of those calls that I won't forget and one that I tell lots of people who want to know the symptoms of a heart attack. As I've put on a previous post, there are some random symptoms for very serious illnesses that don't seem to make any sense. I always thought that one was quite amusing but not anymore. I'm now waiting to diagnose a stroke when a patients only complaint is that they can smell burnt toast!!
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