Ranting to follow...
Previously on 'The Knifeman'... I contemplated giving up the drink, and smoked a cigarette.
This weekend, I got royally plastered, and smoked a cigarette. This might be a worrying trend. My dismay was tempered, however, by a very dear friend of mine who gave me a t-shirt for my birthday; it celebrates a triple birthday - mine, hers and another friend of ours, all within a few days of one and other - with a collage of amusing pictures. Only after a while did I realise that one of these photos was of my genitals... still it's not every fella who can boast he owns a t shirt like that.
Today, I find myself marvelling at how quickly someone gets sick in front of you. I know that sounds obvious... ill people will go off if you just look at them - that's what they do. But sometimes people become more ill in retrospect as you begin to realise the enormity of how unwell they truly are.
The only analogy that makes sense was one I heard used by soldiers in Vietnam. They talked about VC snipers getting older after they had died. They would convince themselves that the 12 year old gunman couldn't be that young. Small for his age, sure. And youthful, 'cos of his race, sure. So that by the time they got back to camp, the 12 year old kid was 18, maybe even 20.
Anyway- I know what I mean.
Here's how it happened today...
---The young man is brought to us, welcomed into our warm embrace. The call came ahead of him. 'Known alcoholic, post EP fit'. Right now, he's not too unwell. We've all seen this before.
---He's post ictal now, sluggishly unco-operative as we slide needles into his veins, push and prod and probe him. 'Mother says he's done this a lot... always fits when he comes off the booze'... he's still not too bad. Obs are stable (-ish)... another withdrawal fitter...
---Then: actually, maybe he hit his head, as he went down... maybe. Mum says she thinks he's normally come round by now... obs still ok, sugar fine... but maybe his pupils don't look quite right... shit. Maybe he's bled. (Bleeding inside your skull is bad. It should be right up there on your list of places not to bleed from)
---Next: he wakes up, rambling, all over the place, hallucinating, gibbering. Struggling. Shit. Delirium tremens?
Lots of people pick up the habit of casually describing withdrawing, tremulous alcoholics as having the 'DTs'. They're usually wrong. I've seen a lot of alcoholics in withdrawal. I've seen a lot of tremens... but the DTs is a different kettle of fish altogether.
---Shit. He really is sick, isn't he. And his temperature's what? Shit... 39? Shit.
---Finally: as if adding insult to injury, his blood results come back. The final hurrah underlining quite how fully I had underestimated this guy's condition. Sodium 102; Potassium 2.2. Balls. Time to admit defeat, and call the fellas from Expensive Care. My 'routine' withdrawal fit evolved in front of me, into an unstable, head injured, encephalopathic metabolic nightmare. With the DTs. He won 24 cm of rigid plastic, and at least one night on a ventilator.