BMJ 08 April 2000 Cite this as: BMJ 2000;320:1017
I was called recently to a patient who had collapsed in church.
At church is a good place to collapse, implying a previous life of probity and devotion. The bystanders are likely to be helpful. Collapsing outside a bar late at night, by contrast, you are unlikely to get a lift home from a friendly drug dealer; a better class of people attend church, although they may be more fastidious about mouth to mouth—perhaps not a bad thing. The doctor also feels more obliged to attend; there is something deserving about a church carpark. This collapse, we infer, is unrelated to debauchery.
I drove out at once, but some do-gooder had already taken the patient to the surgery. And, returning to the surgery, I found, with a certain fatal satisfaction, that the entourage had inevitably returned to the church.
Eventually, a few laps later, I hounded the patient to earth. Invigorated by the chase, she was at first unwilling to accept cardiac pulmonary resuscitation, but a crowd had gathered and, as Pierre said in War and Peace, the common good is the only kind there is. Pleasing the mob always comes first, and saying all was fine would have been inconsiderately detumescent; doing nothing was too hard a proposition, the power was intoxicating, put a beggar on horseback and he’ll ride to hell.
So, instead a symphony; excited oohs as I whip out the shock blanket like a magician’s rabbit; somebody shouting, “Don’t move her!” (because the conventions must be observed); the triumphant clash of the defib paddles as I flourish them theatrically on high; the patient’s futile protests, “I’m fine, no really I am, really”; the crowd moaning and crooning and swaying with pleasure until the ambulance arrives, rabbits transfixed by the weasel’s dance.
I accepted the plaudits modestly, mindful of La Rochefoucauld’s maxim, “To refuse praise is to be praised twice.” And as I led her up the steps into the ambulance, its interior lambent like a little piece of heaven, a ghostly Roman slave appeared at my elbow, whispering, “Et tu fili recordare…..”