fire risk

‘Hi, Jim. Doctor Solway. Is this a good time to talk?
‘Absolutely.’
‘It’s about Bill Mason. D’you remember? We talked about him last week.’
‘Bill. Yes. How can I help?’
‘I take it you heard?’
‘No?’
‘I’m afraid he died.’
‘He died? Blimey! I’m sorry to hear that.’
‘I thought you knew. Sorry to break it to you like that.’
‘It’s okay. Poor Bill. He was in a pretty bad way, though.’
‘Apparently when they broke in they found him with his oxygen mask still on.’
‘Oh. I thought they were supposed to be taking the oxygen away, what with him smoking.’
‘I know! It’s sad he died, but at least it wasn’t in a ball of fire along with half the block.’
‘Who found him?’
‘The respiratory team, when they called round to collect the cylinder. I just wanted to ask you a few questions, seeing as you were the last clinician to see him alive.’
‘Sure. Fire away.’

*

Bill has the intercom buzzer by his bed so he doesn’t have to move to let me in the main entrance. His flat door is on the latch, so I let myself in. His Jack Russell, Sniffy, comes gambolling along the hallway to see me, his paws madly clicking and snickering on the laminate floor.
‘Hey there, Sniffy!’ I say, scroffling his head and ears. He immediately rolls onto his back for a more comprehensive fuss – a hazardous gambit, the poor thing being so fat he’s in danger of getting stuck. But with an ingenious flick of his spine and some frantic waving of his paws, he manages to find traction enough to turn himself right way up again as I straighten and make my way into Bill’s bedroom.
‘Hi Bill! How’re you doing?’ I say, putting my bag down.
Bill is slumped across the bed at an angle, so exhausted he can barely find the energy to wave.
Sniffy makes it up onto the bed via a graded and circuitous route, scrabbling over boxes and chairs, eventually wrestling himself across the duvet to put himself between me and Bill. I give Sniffy a good stroking as I chat.

Bill has been on our books many times before, variations on a theme of self-neglect and non-compliance: not taking his medication, not adjusting his diet despite his obesity and diabetes, smoking despite his breathing problems, and in this particular instance, discharging himself from hospital despite a pernicious chest infection and a recent MI. It’s something of a miracle he’s talking to me now, given his SATS.

Bill is wearing a pair of nasal specs, linked by a coiling line of clear plastic to a large cylinder of oxygen standing by the bedside cabinet. Bill has made some attempt to disguise the fact he’s still smoking, but it’s like one of those photo set-ups where you’re asked to look for clues, and the clues are so obvious it’s embarrassing: a new packet of fags resting in the open bedside drawer, one temptingly half-drawn; a cigarette resting in an ashtray, the tip recently and carefully extinguished (I would guess in the half an hour it’s been since I phoned him to say I was on my way); a few strands of smoke hanging on the air despite the opened window.
‘You really mustn’t smoke with oxygen in the room,’ I tell him, patting the cylinder and earning a jealous look from Sniffy. ‘You’ll blow yourself up and the flat next door.’
‘I’m not smoking, Jim. Honest,’ he says, struggling to push himself up in the bed. ‘I’m too whacked to smoke.’
‘Seriously, Bill. You’ll put Sniffy into orbit.’
‘I’m not going to smoke.’
‘I’m just saying. It’s a huge risk.’
I feel his pulse. In fact, none of his observations are good.
‘You should go back to hospital,’ I tell him, writing it all down. ‘Your SATS are terrible, and that’s with the oxygen…’
‘I’m not going back to that place. Never again. No.’
He’s signed all the paperwork, and he does seem to have capacity, even taking into account the low SATS.
‘We’ll check on you a bit later,’ I say, shaking his hand.
‘Thanks,’ he says. ‘Thanks a lot. But don’t even think about calling an ambulance, Jim. I’m not going nowhere. Sorry. It’s just how it is.’
Sniffy rolls off the bed with a thump, recovers himself, sees me to the door.

Outside in the car I manage to get through to Doctor Solway, to report what I’d found and to come up with a plan of action.
‘First thing I’m going to do is see the respiratory team and ask they visit. We need to get that oxygen away. I feel mean about it, but it’s such a fire hazard I don’t know what else to suggest.’
‘It’s annoying,’ says Doctor Solway. ‘He gave me his word. Anyway, on a cruel to be kind basis, maybe Bill will change his mind about going back to hospital when he’s off the pop and starting to struggle. The man’s his own worst enemy. And his neighbour’s, come to that.’
‘I wonder what’ll happen to Sniffy?’
‘The cute little dog? I don’t know. Someone’ll take him in. He always seems to land on his paws.’

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