Castle Pillock's Guide To Emergency Departments

    Castle Pillock is a bit of a connoisseur of hospital emergency departments.  I am always incredulous to hear that some people, people who have reached a fine age and who have had children, and parents, have never seen the inside of A&E.  On the one hand I envy them.  On the other – when you do end up in one, there’s nothing like knowing your way around.

     I have an inbuilt advantage at our local hospital, because I also used to work there.  In those days social services kept an Advice and Information office in a dusty corridor round the corner from the loos, for whom we were often mistaken.  I loved my duty days there.  No-one wanting advice and information could ever find us (unless they happened to want the loo as well) so there was sod all to do, and it was great for catching up on vital tasks like writing your Christmas cards or reading a good book.   It was also useful for taking the occasional amble round other dusty corridors and finding the quick ways to departments.  Ways the public know nothing about.  I can still go from anywhere in the hospital to anywhere else in half the time it would take you.

    My first visit to A&E doesn’t really count.  I was eight years old, half drowned, full of filthy water, and all I really recall is screaming blue murder while assorted tubes were inserted into assorted orifices.   It was also abroad, where they do things differently, so not helpful in the long term.

    My next trip was on 4th May 1977.  I was twenty-two.  It was the day the Queen went to the Palace of Westminster to receive a loyal address from both houses of Parliament on the occasion of her Silver Jubilee.  It was also the day I got knocked down by a motorbike in Great George Street, just a little way along from Palace of Westminster, about half an hour before she was due to arrive. 

    I suppose these days they’d cordon off all the streets, but they didn’t then, which was bad luck for me and the motorcyclist.  I was late for a job interview.  I contemplated crossing the road at the traffic lights, but that would have meant going half way up the street and then belting back down again.  Both lines of traffic on my side of the road were stationary, so I legged it towards the island in the middle.  The motorcyclist was illegally roaring up outside the lines of traffic.  Oops. 

    As I spat my front teeth out onto the tarmac, I looked up to find a coachload of tourists peering down at me as though as I were part of the day’s entertainment.  Then I realised that everywhere hurt and you could see bone through my knee and my foot, and I started screaming blue murder again. 

    I had competition when we got to A&E.  In the next cubicle there was a guardsman who’d been thrown off his horse and trampled.

    Some months later, when most of me had been repaired, I went back and got the job.

    There were a couple of other trips in my own right, like when I stopped breathing due to an allergic reaction to spray tan, and when I sneezed and apparently burst every blood vessel in one of my eyes, but then I had kids and the focus of my A&E visits shifted.  The Scion swallowed a five pence piece when he was six.  (Medical advice:  It’ll come out eventually.)  A few years later he got into a fight and had his head stamped on.  At three years old the Princess fell down the stairs and was unconscious for all of thirty seconds.  The Scion was beaten up again, but not as badly as his friend who had the better mobile phone.  The Princess was on a bus that crashed.  The Scion announced he was dying of earache on Christmas Day.  The Princess got whiplash when the brakes failed on a fairground ride.

    Enter first parent.  That’s when it starts getting really regular.  At least the second parent waited until the first had gone to the great waiting room in the sky before taking out her own season ticket. 

    Then the Princess was diagnosed with epilepsy and my main goal in life was to manage three months without a trip to A&E.  Not so far.  On one occasion last spring, on a particularly busy day, they shoved us in a room off a corridor even I had never seen before.  Opposite the door was a painting of the Titanic.  I suppose, in A&E, it might be heartening to reflect that, most times, the heart does go on. 

    In light of all this, I do have some advice to offer those summoned to A&E as supporter rather than patient:

Go to the loo before you leave home.  Otherwise you’ll be busting and you either won’t want to leave your patient in the waiting area in case they get called, or you won’t want to leave them in the cubicle in case they die while you’re having a wee.

Take a flask.  OK, if your patient has had a heart attack and it’s flashing lights time this might not be possible, but otherwise, boil the kettle as soon as you’ve made up your mind you’re going, and make the beverage of your choice.  A sprained ankle or a bloodshot eye or a foreign object where it shouldn’t be will not be affected by the time it takes to pop a couple of tea bags in a flask.  Hospital drinks machines are as expensive and horrible as all other drinks machines, and even more prone to breaking down. 

Take something to eat.  For you, not your patient.  Your patient should not eat or drink anything until they’ve seen the doctor.  You should not feel guilty about taking your own snack.  You’re the one who’ll be sitting on a hard chair, not lying on a trolley, and if anyone does come by with a cup of tea and a biscuit, it won’t be for you.

Take something to read/listen to/watch on your phone, for both you and your patient.  You will be there for hours.  If your patient is not unconscious, they will start getting fractious.  Especially as you’re eating and drinking from your handy provisions, and they’re not.

If it’s winter, wear clothing you can discard easily.  A&E departments are warm verging on tropical.  As a woman, I have found it inadvisable to wear a heavy jumper with just a bra underneath.

Hospital phrase book 

Shortly:  a couple of hours

I’ll pop back in a minute:  one hour. 

As soon as we can:  you’ll be seeing the sun rise. 

When a bed’s available:  a week next Tuesday

We’re referring you urgently to the outpatients’ clinic:  six weeks next Tuesday

If you see someone you know in another cubicle, it’s bad form to yell, ‘Mavis!  What are you in for?’  However, I personally feel that if people choose to have a domestic in the middle of A&E, it’s perfectly permissible to stare. 

Don’t stare at the one who’s come in handcuffed to the police officer.  They might remember your face.

Smile and say please and thank you to any member of staff who comes near you.  This is unusual and they will remember it and there is a chance, just the remotest chance, that when your flask is empty and your snack eaten, and you’re still on that bloody hard chair, and you’ve followed your patient’s trolley round to X-ray and back, and your patient is now snoring away while you’re so tired you can’t recall what day it was when you first arrived – there is just the faintest chance they might find a cup of tea and a digestive for you too. 








Useful info. I expect some of it works for visiting friends and relatives who have planned ops too. Boyfriend is getting half a titanium knee this autumn. I shall take my flask.

Oooh, that sounds a bit bionic.  Hope it goes well for him!

Yeh, should be ok. RD and E is world famous for hip and knee replacement surgery, in fact one of the surgeons goes to India to train surgeons there. Pete is glad to have op in Autumn as his allottment and garden will be past the growing season and he can rest for a couple of months. And it's Devon Partnership Trust (NHS) so it does not cost anything. Although some of our health service has become threadbare, hospitals which have a medical school eg RD &E in Exeter and Derriford in Plymouth still have some money. Other places eg North Devon and Cornwall are truly struggling.

enjoyed reading this. all good advice comes from experience. 


Thank you Celtic!  

My first visit to A & E was when I was a stonking young man. I slit the small finger on my left hand from top to bottom with a dough knife (long story). The nurse that looked after me was quite possibly the most gorgeous creature ever to put on a nurse's uniform. I was besotted beyond belief. After she'd sorted my finger, I obviously asked her for a date. She declined, which left me not only with a slit finger, but also a far-more damaged and broken heart. 

I've since had many visits to A & E accompanying various small children with miscellaneous maladies, but only ever encountered matron-like nurses. This is probably a good thing... saved me many a further broken heart.


One of my daughter's greatest regrets is that when she was sharing a house with friends and they had to call an ambulance for one of her seizures, they said the all male crew were like something out of a Hollywood movie, literally stop, gasp, look again gorgeous, and my poor lass was unconscious the whole time.

Thank you for reading!