Posted by: medicblog999 | July 1, 2009

True Asylum

behind_barsIn the area that I work in, we have a large immigrant population, many of which are asylum seekers. I would imagine that this is common in many town across the country, and what we find is that we become one of the first ports of calls for any illness or injury that these families may have.

Over the years I have come to recognise that there is a big education need in these communities to teach families the appropriate pathways to the appropriate type of care they need. There was however one man who I will remember for the rest of my days. This man was truly in need of asylum from our country. His story is one that may well affect you a little, but as I sit here typing it down, I clearly remember the chill down my spine and the feeling of utter helplessness that I felt when I heard his story.

I wanted so much to scoop him up and take him to a ‘magical place’ where all problems can be solved and people can move on with thier lives no matter what traumas they have been exposed to but we all know that isn’t possible.

I know many of you are used to tough stuff, but I feel I should warn that this story is graffic, so please dont read on if you think that may bother you.

I was working on the rapid response car one day when I was sent to a local GP surgery for a patient who was ? short of breath. I arrived and was shown through to one of the consultation rooms where I was met by a man of middle eastern looks (we will call him Rahim), he was breathing fine and looked a good colour, but was obviously upset by something.

I will be honest here and tell you all that initially I thought, ‘Here we go, another minor problem with an emergency response’, but we were there now, so off we went with our questions and assessment. At this point in time there was no GP present only a practice nurse who had just been sitting with him whilst they were waiting for our arrival.

The nurse informed us that he had been in a few days earlier complaining of not being able to sleep and had requested some sleeping tablets, she also told us that he suffered with depression and had been in the country only a matter of weeks. All of this information had been gained during the earlier consultation with a GP and an interpreter from language line (a phone based interpretation service). It quickly became evident that Rahim had no English language abilities what so ever and it looked impossible to gain a good history of what was going on now.

Rahim was a young man, in his early twenties, handsome and physically imposing but with a gentle character. He was obviously upset about something and despite his best efforts we could not understand what his problems were. All of his observations were fine and there was nothing apparently physically wrong with him.

I discussed what to do next with the nurse and suggested getting language line on the phone again, which she duly went off and organised. About 15 minutes later there was a phone call put through to our room and the nurse came dashing in and answered it. I was a little surprised that as soon as she had given the patients details and ethnic origin, she passed the phone to me for the remainder of the conversation.

M999: Hello there, my name is Mark Glencorse and I am a paramedic with the ambulance service, I have a gentleman here called Rahim, who seems very upset about something and in apparent need of some help. I just need to know what his concerns are and what he wants doing so that I can tell if its something that can be handled by the GP or not (I was fully expecting this to be a GP job, with no need for transport anywhere)

Language Line (LL): Okay, if you pass the phone to him, Ill have a chat and see what I can find out.

I pass the phone over to Rahim, and listen while he speaks in his own language to the interpreter, the conversation lasts about 5 minutes with mostly Rahim speaking. I imagine all sorts of minor problems that can hopefully be sorted out by the GP so that we can clear and move onto our next job. We had already been on scene for 30-40 minutes by this time. Rahim slowly passes the phone back to me…

M999: Hiya, its Mark again. So, whats the story then?

LL: It appears that Rahim is having difficulty sleeping, he has some new sleeping tablets, but he has really noisy neighbours and he still cant get to sleep. All he wants is some quiet so that he can try to rest and think about some personal things. He wants me to ask you if you want to know what happened to him?

M999: Errr…..I suppose if he wants to tell me, then I can let the GP know so that he gets a better picture of what problems Rahim is having.

LL: Okay, if you pass the phone back to Rahim, I will find out for you.

(It feels really weird writing this down. I have got the butterflys back in my stomach and I can feel the exact same anxious feeling that I had that day. Some of you may find that this seems a little dramatic on my behalf, but im just trying to share the emotion of the day. Ive talked about it alot, but writing it down forces you to remember the really intricate details of the moment. I can remember the next part word for word…)

Whilst Rahim is speaking on the phone, he starts to weep. His muscular frame suddenly crumples and he seems far from the strong and imposing man that I saw when I walk into the room. He is talking through his sobs and stops and takes the phone away from his mouth a couple of time to compose himself before carrying on. I am sitting in a chair two feet away, and I start to feel really apprehensive about what I am going to be told. He finishes talking to the interpreter and hands me the phone, making eye contact with me, with the knowledge that we are about to have a connection which I hadn’t thought possible 45 minutes ago.

M999:  (Deep breath)……Hello, its Mark…

LL: Ok, this is a tough one………. Rahim was a police man in ……….. he came home from work one day to find a group of rebels in his house with his family. They beat him to the ground, tied him up and then made him watch whilst they took his wife and mother and cut their heads off with a short knife in front of him. He was powerless, he begged for them to kill him too, but they just left him there lying next to their decapitated bodies……….

I look up from the phone into the eyes of Rahim, I know I should be professional but I cant hold it in. The tears start running down my face…..the tears are running down his. He knows that I understand.

The nurse looks at me in surprise seems hesitant to ask what has been said.

M999: Jesus Christ…..what am I meant to say to that?…..

LL: I know, its a bad one, but you would be surprised how many times I have heard similar…wives, mothers, daughters, sons. I’m sorry that I have burdened you with this, but he really needs your help.

M999: I know, thank you for your help…Goodbye.

I put the phone down and take a moment to compose myself. I cant take my eyes of Rahim, I dont want to. I want him to know that I want to help him as much as I can, but I know that there is so little I can actually do. Without looking away, I repeat the story to the nurse who gasps, then also starts sobbing.

I keep thinking that this isn’t professional, we should be composed and ‘clinical’, but maybe this will show Rahim that we truly understand the horror that he has been through. The nurse leaves and returns with the GP who tells us that we can leave. Before I go I ask him what he is going to do. I know its not my place to question but I want to know that something will be done to help Rahim. We need to look after him, we need to help him and protect him from any further harm.

The doctor tells me that he will do whatever he can to get him into some sort of care whether that be community or hospital based, but we all know how difficult that is.

I turn to leave, but I feel as though I am abandoning him, I really dont want to go…everything in my being is saying that I want to do more for him…..but there is nothing more to do. I go over and shake his hand, tell him I am sorry, sorry for what he has been through, and sorry I cannot make things better for him. I know he cant understand me, but I tell him that I hope he finds peace soon, and I hope that the doctor can do something to help him. I turn my back on him and walk out of the room. I walk silently back to the car, put my patient report form board on the passanger seat and stare out of the front window, watching families go about their day to day business.

It all feels wrong…….

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Responses

  1. Unfortuanlly this has happened to a lot of the immigrants into this area of the country. I have a good friend who runs a community centre for them with native speaks and councillors for them to talk to. If you like I can email you the contact details then you have them, if your unfortunate to experience anything thing like this again. Sorry don’t want to post his details on here as im not sure just how public he makes it but I do know its open to everyone.
    Hope you can move on and in future letting them know you care is great, a lot of these people arrive from countries where not even the police care and will often not even bother to investigate the crime, so coming over here to someone who cares is the 1st step in a long process back to some normality.

  2. Mark, it has taken me most of the day to gather my thoughts on this post. I can only imagine the images that haunt this man’s nightmares. I don’t think it’s the neighbors keeping him awake.

    Dealing with these folks isn’t in the job description, too many in our line of work forget that.

    A bit of compassion and thought can make all the difference in someone’s life, as you shared.

    Thank you,
    HM

  3. I had a lady from Cambodia once who lived through the Pol Pot regime. She was 10, then, in her thirties when she died of complications from chronic alcoholism. I took her to the hospital nyumerous times before learning about her past. I wrote about it on my blog, I think the post is called “Chickens” because she told me through an interperter that she watched soldiers cut the heads off of her father, mother, brothers and sisters while she hid in the woods…like chickens.

  4. Wow…. really nothing else that can be said. Thank you for telling his story.

  5. […] recently cared for a patient whose story affected him deeply, as well as the nurse who was present. True Asylum, while not directly about nursing, is included here. It is not an easy story to read, and it will […]

  6. […] This is True Asylum. […]

  7. I have done hospital chaplaincy work and pastoral care, and what you did here – just listening, normalizing for him that his distress was a normal and healthy reaction, showing that it was a sad and affecting story – that was very good care indeed. We call it “ministry of presence”: the incredible effect that one can have by simply being really present with the person in their grief/sorrow/pain.

  8. This made me cry… how terrible that not only he carries such pain, but is for the most part unable to communicate it to other people.

    I hope that just your being there, and taking your time to make a real, human connection with him, gave him a measure of comfort. And I hope that the GP found him some sort of care…

  9. thanks for that Parodie, that means alot coming from someone with your expertise.


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