Clinical Group arrived at Canal Walk (nice mall in Cape Town) at 21:00. We were going to have baklava (which I had been craving) and seafood. Ocean Basket was full; so onto the list went our names and a-walking we went.
At about 21:30 we were heading back towards the restaurant when we passed a little corridor and saw a young lady fall to the ground. She was seizing.
I once heard a definition for a coward: one who, in perilous emergency, thinks with his legs. [Ambrose Bierce]
I think that for a second, we considered walking on. The boys claim that we kind of stared at each other and sighed. Girl and I went to her. I checked her pulse, Girl checked airways (which I forgot. Brilliant). Her pulse was ridiculously low, probably about 65 BPM – normal-ish for a healthy person, but I think not when you’re in the throes of a seizure.
We called the ambulance and almost couldn’t remember the number. The national call centre in Johannesburg kept asking me for an address for Canal Walk. An address, I ask you! I eventually told him to tell the paramedics and they will know where it is. Everyone in Cape Town knows Canal Walk… right? I hung up at 21:35.
At this point, her seizure had subsided and a crowd had congregated. Some guy pushed to the front and pushed her into (what he considered to be) recovery position. Unfortunately he did it way too quickly/brusquely and she started seizing all over again. Girl shouted at him – that bit was kind of funny.
Lady M (she needs a name) did not lose consciousness while she was fitting. She was crying and I asked us to take the people away. She also said, “I just want my daddy now” and asked us to call him. There was no urinary or faecal incontinence and no frothing at the mouth. The muscle-jerking was bilateral though, and involved her whole body.
Keeping the above in mind, I’m struggling to classify her seizure. It has characteristics of both generalised tonic-clonic seizures and simple seizures. Take note that this case happens to involve one of the few bodily systems with which we have not yet dealt in class, so Clinical Groups knowledge of seizures is a conglomerate of common sense, intuition, random facts and the Kumar&Clarke. [Neurosciences are only dealt with at the beginning of our third year.]
Canal Walk’s on-duty medics go off-duty at 21:00, “because that’s when the shops close.” Never mind the fact that restaurants and movies continue until as late as 01:00.
As mentioned before, the ambulance was called just before 21:35. Sadly they dismally failed at their seven-minute response time – but a seizure-case with adequate airways, breathing and circulation is not on top of the priority list.
We were worried because Lady M was drowsy to a point of non-responsiveness and seemed to need oxygen.
We waited for the paramedics. A guy who said he was a doctor came and did a general check. I hope he felt for fever and asked about neck stiffness, because I forgot. Lady M’s father arrived. He was really sweet and reminded me of Ugly Betty’s dad.
A gentleman came up to me and told me that she had had a panic attack. “She suffers from anxiety and she didn’t take her calming medicine in time.” Really. I may only be a second year, but I think I know what a seizure looks like. Maybe she felt panicky beforehand because she felt the aura of the seizure. I acknowledge that I do make mistakes, so I did some reading-up on the topic. Nowhere does it mention tonic-clonic convulsing as a panic attack.
But even better – and eventually a cause for laughter – was a young man who walked by, looked really worried and asked us, “Is she having a miscarriage?” I still don’t know where that comes from, bless.
The paramedics arrived 40 minutes later. They had spent ten minutes looking for us in the mall, though we had given clear directions. The mall is not that big, by the way. I won’t judge because I don’t know the circumstances of their evening, but we weren’t pleased.
Unbelievably, everything happened in about 45 minutes and we left for the restaurant at 22:15. One of my friends said well done as I sat down, and we laughed. And in the laughter there were a few tears, because I felt useless and overwhelmed.
I have done courses on Emergency Medicine before and have practised certain procedures, but this was my first run-in with an unexpected emergency. It was scary, but it was practise. It felt terrible and it felt good.
It was a blessing to be there with Clinical Group: It is like our first joint battle scar. Hopefully next time we can act better and quicker, more confidently. I hope that Lady M will be fine.
En passant: I want the teddy at Build-a-Bear Workshop with the surgical scrubs. I saw it before the incident. Look: