Pissed Stick

As usual, while engaging the grey matter, I get distracted. This time, I’m trying desperately not to curse every other word, while tearing apart the inane drivel that is a belief in Psychological Safety. Which by the way, is bloody dangerous!

Anyway, while picking the brains of some lovely people, I told a true story about how not feeling safe, recognising danger and taking a definite risk to act on that feeling, can do wonderful things. I’m not telling you where this was or who was involved, because they’d be reprimanded for breaking about a 1000 school rules. In truth, I can’t quite believe I’ve not posted this one already, so I’ll do some of it in first person to disguise a few recognisable details.

Dodgy old Bob…

That was the first thing I heard before meeting this old boy for the first time. A regular at the emergency department, he was sometimes pleasant, smart and flirty, but had a bit of Jekyll and Hyde about him. The police often brought him in, for little other than he only had the one leg. He was drunk most of the time we’d met him. Polite and grateful for help on the inside, but on the outside, pissed and everyone who said “hello my name is” typically got cut short with a “fuck off”.

Bob was an independent old ‘valley commando’ as we say in Cardiff. Born up the far end of a run down valley dead end, he was the salt of the earth, hard as nails and a proper geezer, who’d somehow survived into his 70s, having lost a leg, in the 70s. Trouble is, he’d now been in the ED four times in as many months and everyone who laid a hand on Bob said he was gorgeous, but a bit cantankerous when he was not allowed to just, go home!

There were many corridor conversations and several more expletives about Bob, but a fair number of people and professions ended up tinkering around the edges of his regular visits. Kate and Donna, enter the affray!

I had listed Bob in a multidisciplinary meeting which started with the Consultant announcing, “poor old bugger is going to kill himself” and the girls immediately screwed up their noses! Bob was becoming increasingly frail every time he turned up, which was typically with a left wrist fracture, broken bits of his face and usually a cracked head or rib or both. It’s not difficult to work out the mechanics of what he was experiencing: getting drunker and getting older and living with a left, above-knee amputation. Bob was trapped in a vicious circle.

So later that day, in the car together, half way home from a long tough shift, they looked at each other and with nothing more than a knowing nod, turned off and instigated a bing-bong. That is with no referral, no signed bits of paper, no real plan and certainly no consent, two beautiful people chose to act and upon arrival at Bob’s door, were suitably greeted.

“Fuck Off”

Bob was fed up with bloody do-gooders banging his door. Apparently one day “some dopey old twats” turned up and handed him a second hand jumper and some leaflets about art classes. They both got chased out of the front gate, dodging a selection of flying crockery.

But on this day, Kate was having none of it. She spun Bob around by the shoulders and marched him back into the living room, physically by the seat of his pants. Donna set to work in the kitchen, with a soapy cloth, a kettle and a bloody good nose around, while Kate took both barrels, or so she thought. On this occasion however, Bob was sober and quite clearly carrying the weight of a world of trouble, way beyond that which could be generated by an unannounced visit, from do-gooders, on a Thursday afternoon. A brew or two later and all was revealed.

Bob had lost the 60 year love of his life the winter before last, had lost touch with his family and couldn’t give a shit if he lived or died. He had enough money and a nice little house, on a nice street, at the end of which was a proper old school corner pub. Bob was like one of the fixtures and fittings. More than once Phil Mawr (Welsh for Big Phil) the Landlord, had gone to find Bob when he didn’t appear and ended up taking him to hospital.

Donna recognised a man surrounded by people and intensely lonely. A long conversation with Phil Mawr – as Bob was not forthcoming – and Donna learned all about the routine. On a Friday, Bob would be at the door at opening, have lunch a few beers, tea and a few more beers and Saturday and Sunday and was often the life and soul of the place. We’ve a cultural thing in Wales, where we really enjoy taking the piss out of each other and Bob “has been around long enough to know some shit about everyone”. Then typically, being in a bit of a state by Monday, if he’d managed to avoid hospital, Bob would just sit in his house and rot… until Friday.

Kate asked Bob about the stick. A rickety old piece of willow that had belonged to his father and the only walking aid he was willing to use. He had a wheelchair, it was out the back, covered in weeds. Bob was not a weak man, he got around on one leg balancing between his dad’s stick and a carefully planned out route of various handles, shelves, cupboards, fences and posts between his front door and the pub. It turned out that most of the time, Bob fell down in his own house, while navigating a broken front gate, a dodgy step, the stairs, the landing, the sodding bog and all his wife’s paraphernalia.

Despite their best attempts Kate and Donna were getting nowhere on their first visit. Bob didn’t want them there, couldn’t give a shit about Kate’s mobility nonsense – where were you 40 years ago – and Donna could stick all her faffing where the sun don’t shine. “It’s my bloody house” and Bob was utterly unwilling to do anything differently.

So Donna went all Welsh-Mam on his arse. The most fearsome thing you’ll ever witness is a Welsh-Mam in full flight. Small, dark, fearless, 500 words a minute at 200 decibels, they have nuclear powered hearts of gold and a stare that can reduce massive rugby players to rubble… as they hear their full name echoing across a packed clubhouse.

She went up stairs, got his pillows and blankets and issued an instruction: “if you are going to go out and get pissed again tomorrow, at least sleep downstairs, you dopey old bastard”. Or words to that effect.

Monday Morning

Kate tried again. This time with a brand new stick, a posh one, that clipped onto the forearm for extra leverage. Donna then had a breakthrough, having spotted a MacBook under the TV – who’d have thought?

During the rot between Monday and Friday, Bob had little if any food in the house and couldn’t be bothered with the shops. Five minutes of Donna style instructions later, and Bob had an account set up, address plumbed in and a schedule of Monday afternoon deliveries, all planned.

“What would your wife think of you? Look after yourself during the week and you won’t be in such a bloody mess come Sunday”. I’ve a feeling that he probably saluted at that instruction.

One Friday afternoon, Donna gets a call from Phil Mawr. Bob’s been entertaining the whole place telling everyone about ‘the mad witch’ who turns up and keeps tidying his house and the ‘pretty little thing’ that has given him a “pissed stick”. A special walking stick just for getting pissed. Kate’s going to kill me for that reference – anyhow, Kate and Donna weren’t entirely sure the right messages were getting across but they were now in full: cunning plan mode!

Like all the best OTs, Donna was on first name terms with half a dozen odd-job men. Within a week or two the notorious fall-over gate was replaced, various handles and rails reinforced and a reclining chair in the back kitchen, next to a newly installed downstairs sodding bog. I still can’t fathom how she managed to get that done!

Meanwhile Bob had some even better stories to tell in the pub as the ‘pretty little thing’, had been teaching him how to fall over properly. Without breaking anything. Quite possibly the most important bit of Physio that we could all do with learning.

I’m sure, I don’t have to explain the beginnings of a virtuous circle.

Fast Forward

According to Donna, Bob is now 90 something, doesn’t drink as much, but is still on good form with the locals. He’s got a lodger called Dai Top – as he lives upstairs now that Bob has a bedroom downstairs – a good lad, who works in the pub and walks him back and forth. Bob has only been to the Hospital once in all the intervening years. He turned up to show off his new prosthetic leg and to say thank you, as he never thought that he’d get to walk his granddaughter down the aisle.

No self-righteous assumptions about aging. No pompous stop drinking, no admissions, no drugs, no referrals, no shared goals, no pity plans, no daft arsed waiting lists and best of all according to Kate and Donna, no crappy paperwork. Just some love and some trust and two bloody brilliant therapists.

And the perfectly timed intervention of a Pissed Stick.