Nee Naw - Brain Malfunction

Brain Malfunction

I say the stupidest things sometimes. An elderly gentleman came on the line; there was something peculiar about his voice and he wasn’t listening to what I said at all — he just repeated the same thing three times, which was:

“My wife has had an accident and she is injured. My address is 6 Wisteria Drive, Edgware. My wife has had an accident and she is injured…”

I tried to interject and ask what sort of accident, how is she injured, etc, but he wasn’t having any of it and carried on repeating himself as if I hadn’t spoken. Then he said:

“I’m completely deaf, but my wife will tell me when you are the door and I’ll come and let you in. I hope you can help us…”

“Ah!” I said, the penny dropping. “I see, you’re deaf and you can’t hear me. Well, don’t worry, we’ll be there soon!”

And then I realised there was no point in my saying that, because HE WAS DEAF and HE COULDN’T HEAR ME.

I hope Quality Assurance weren’t marking me on that one. I need more sleep…

Published Jan 03, 2006 -

Comments on “Brain Malfunction”

Becca Says:
January 3rd, 2006 at 10:00 pm

I’m curious, do you have a protocol for dealing with that kind of situation? Because it seems to me that the caller wouldn’t know they’d been heard, and you don’t have a way of getting more information than they give you. Do you have any phones that are TDD or TTY compatible?
Mark Myers Says:
January 3rd, 2006 at 10:15 pm

We use a service called Type Talk where the deaf person types and someone rings us and reads it out, then we talk and the person types it back to the deaf person. But I’ve never had a call from them myself and this is the first time I’ve ever had a call from someone *completely* deaf (although I often get hard-of-hearing old people and end up bellowing things loudly at them, so loudly that everyone in the room can hear). In this case, it all worked out okay — I triaged the call as “unknown problem”, it got an amber response, which is probably what it would have got if it had been triaged properly, the crew got in okay and everything was straightforward. Which was fortunate.
The Hitman Says:
January 4th, 2006 at 9:29 am

Brilliant!
Newbie Says:
January 4th, 2006 at 12:27 pm

I had a type talk call the other day and it’s pretty much the same as a language line call. You just have to wait for the operator to say “over” at the end of each section - took me a while to get used to it - kept trying to jump in with the next question! The operator was really good and started the call with “are you familiar with how this operates” to which i said no and then they quickly explain it. It’s a great service. I hear the have even trialled video phones with a signer in some counties.
mary p Says:
January 4th, 2006 at 1:04 pm

Hi - re bellowing at hard of hearing old people - my husband is seriously deaf as well as being elderly and unwell and I know how embarrassing it to be on the phone - say on the train - repeating the same thing over and over again. However I have noticed that when soemone shouts he becomes more anxious and confused - what he needs is for you to speak very clearly and slowly - i.e with spaces between the words. And if neccesary for sentences to be broken down. I hope this helps - this is not meant as a criticism - as I very much appreciate the way you apporach the work. Mary
smileykarl Says:
January 4th, 2006 at 1:55 pm

Should you be publishing PT’s address?
Mark Myers Says:
January 4th, 2006 at 2:31 pm

smileykarl — all addresses and other personal details in this post (and any other) are completely made up. See disclaimer on “about Nee Naw page”!

mary p — thanks for that, tips on how to work better are always appreciated and I will give it a go your way next time I get a hard-of-hearing caller, which I’m sure will be soon!
Lauren Says:
January 4th, 2006 at 8:19 pm

When I was an operator I used to do that all the time with automatic fire alarms. The alarm would be saying ‘There is a fire at…’ and I’d be interrupting trying to get it to answer my question.

I used to get several Type Talk calls a shift and they always scared me, just because the procedure was different and required some actual thinking to deal with. Out of all the calls I only ever had 1 where the person actually typed anything and none where an emergency service was actually required.
Aginoth Says:
January 4th, 2006 at 9:20 pm

Well done to that chap I say…
Spike Says:
January 5th, 2006 at 6:15 am

With my Terminally Bewildered Nana I find putting the subject at the beginning of the sentence helps her comprehension considerably. Eg, ‘The train, when does it go?’ Might help for the hard-of-hearing as well. With the totally deaf, you’re on yer own.

LOL Lauren.
barakta Says:
January 5th, 2006 at 7:02 am

I’m severely deaf and have recently switched my phone usage from voice to a textphone because I can’t reliably hear about 50% of the population on a phone. I’ve never had to call 999 via typetalk, in fact I need to find out what to dial and stick it on the textphone itself for emergencies - cos I know I won’t remember.

I have made one 999 call by voice about 2 years ago. I was fortunately able to hear the female dispatcher and I explained that I am severely deaf and may mishear or not hear things. The dispatcher was very quiet (the nature of the phone at her end I think) so she had to shout quite loudly at me (poor thing) but she was very good and repeated things without getting cross with me. I have ‘almost normal’ speech so speaking into a phone isn’t a problem for me, so I could say what i needed on a repeat a few times explaining that and as much as I knew about the incident.

Do you know anything about what deaf people should do if they need to call 999 but have very poor or no speech and no access to a textphone. I’ve heard people mention something about dialling 999 and tapping the speaker which will apparently mean an ambulance is automatically sent to that address/location or something. Oh and are there any areas where deaf people can use SMS to provide 999 call info that you know about?

If you want to ask me any questions about deafness then I’m happy to answer them. These ‘from the other side’ blogs are great for getting a different and helpful perspective.
P Says:
January 5th, 2006 at 1:20 pm

My 2p as a hard of hearing soul. If, after repeating something a couple of times, we don’t get it, try saying the same thing in a different way - that way there’s a good chance we can put the pieces of the puzzle together and make overall sense of what you are trying to tell us.
Lauren Says:
January 5th, 2006 at 2:38 pm

barakta,
Someone else can probably answer you more fully but I wanted to comment on what you said about tapping the handset for an ambulance. If the operator gets a silent 999 call, they’ll go through a series of questions/statements, one of which is ‘if you are unable to speak but need an emergency service please tap the handset’. If tapping is heard then (or probably if it’s heard at any point in the call) it will be transferred to the police, who decide what to do (and normally they said they’d phone the number back). I’d guess that the best case scenario with that situation is that the police would call round at your house. It’s obviously not the quickest way to get help if you need it. The only way we were trained on taking calls from people who couldn’t speak was through Type Talk. It might be different depending on your telephone provider (I worked for BT).
Noesis Says:
January 5th, 2006 at 10:57 pm

Accessing the ambulance service

Nee Naw has a post about a call from a Deaf person calling the ambulance service. Worth a read to get an operator’s viewpoint….
Alison Says:
January 5th, 2006 at 11:19 pm

As a Deaf person, this is exactly what I would do. Typetalk at the best of times is utter rubbish, and thus I don’t use it. Don’t even have a minicom plugged in. I’ve not got around to using any of the BSL relay services to date.

My mother has epilepsy, and has needed to be hospitalised twice in the past year, and twice an ambulance has needed to be called. Both times I’ve got someone else to call, but if I was on my own the operator would get exactly the above. Perhaps its something that should be included in training, not just the bog standard relay service.
Mark Myers Says:
January 6th, 2006 at 12:28 am

I wrote this post as an example of how my brain sometimes doesn’t engage properly, but it’s been really interesting to read the replies from deaf people and I’ll be using all your tips next time rather than just increasing my volume.

I’ve never heard this thing about tapping the receiver but we would send on a call if someone appeared to be trying to communicate with us through taps, or if they were trying to talk but their speech wasn’t clear enough for us to understand. We sometimes come across this with stroke/diabetic/breathing problems patients (and very drunk ones!) and if we try and fail to get any sense out of the caller, the call goes through as a medium priority “unknown problem” call. I think the man whom I mentioned in the post had a pretty good idea, actually… although I wish he’d started off by telling me he was deaf as I was beginning to think he was just weird!

I’ve heard of a text messaging system but we don’t have one in place. I think it’d be a prime target for hoaxers so they’d have to make sure it was only assessible to people who can’t make voice calls. Do you know common is it for deaf people not to be able to speak?

I did wonder why no-one ever used Type Talk!
Alison Says:
January 6th, 2006 at 3:18 am

If a Deaf person called 999, and said nothing on the phone, what happens? You wouldn’t get the call and I assume it would be directed to the police?

There are some police forces that have implemented sms, eg Hampshire, Westminster. I’ve not come across am ambulance service yet. However, there is some reluctance in that sms isn’t reliable in terms of delivery, thus discouraged in emergencies. Hoax calls for smses, would there be an increase to voice phone calls? The other thing with sms, you couldn’t ask the standard questions well, due to its limitations. All that said, personally I would like to see the introduction of sms, and perhaps an immediate reply to acknowledge receipt.

The AA (supposedly that last emergency service!), now also employs sms. Off the subject a bit, I know the days before sms, breaking down on motorways Deaf people were told to take the receiver off the motorway phone, and just wait out for the police to go and investigate. However, this didn’t really work, and I’ve been known to run across a motorway in order to get help. (Not a bright idea I know).
barakta Says:
January 6th, 2006 at 5:18 am

Thanks for the interesting responses regarding tapping and SMS. Interesting that dispatchers only seem to be trained via typetalk and nothing else especially as typetalk use is declining rapidly amongst deaf people that I know because it’s so annoying and crap. I’m not sure if Alison means she would do what I suggested in tapping, or would just talk in a loop as the OP said - threading confusion in comments.

Being out and about a deaf person doesn’t have access to a textphone, just a mobile phone. Neither SMS or GPRS/G3 data is reliable enough for something there and I’ll get a dig in about IP authenticated access to ‘typetalk’ is a good 10 years behind the USA *grr*. They also have those funky textphone-like public telephones in lots of public places, which we certainly don’t have here in the UK.

One wonders instead of tapping whether DTMF (those tones what phone keys generate) could be useful as a slightly more information loaded ‘I can’t speak but I can give you basic requirement’ type stuff. You have at least 10 different digits which could be mapped to different services… Or Morse Code? If I was tapping and unable to speak I’d probably try and do SOS + Police/Fire/Ambulance or something… Of course I only know SOS currently - which I ought to change.
Mark Myers Says:
January 6th, 2006 at 10:38 am

If someone was just tapping, they’d get the police. The police would turn up at whatever address the phone was registered and if they needed an ambulance the police would get one for them. Not the quickest way to go about it, of course. Your idea about pressing the keys for certain services is a good one. I don’t think any of the dispatchers know morse code though!

It would, of course, be no use if a non-speaking person called us from a mobile phone whilst out and about. Their only hope in that situation would be to find someone who can speak, or a phone box. And they’d have to do their best to speak to the phone box — a silent call from a box is likely to be dismissed as a hoax. Most of our hoaxes come from phone boxes.
Lauren Says:
January 6th, 2006 at 8:31 pm

Calls from mobiles where there’s speech in the background but no direct speech are put through to an automated service where callers are asked to press 55 if they need an emergency service and anyone who does this is put through to the police. I guess it would be a good idea if this could be expanded somehow for people who aren’t able to speak so more information could be passed on.
Margaret Says:
January 19th, 2006 at 4:35 pm

I’ve just been told about this conversation … and hope you don’t mind me joining in. I thought you might be interested to know that the Patient & Public Involvement (PPI) Committee at the LAS is commencing a project on this very topic.

The main part of this work will be about access to the service for deaf people (especially if they don’t have Type Talk) - this will include looking at technological soluitions which might be preferable to tapping the receiver! There are concerns about SMS messages, as at the moment you can’t be sure they’ve been received. Anyway, all these things are going to be looked at - we’ll be working with the deaf members of our Patients’ Forum and the RNID on this.

The other aspect is how we can best communicate with deaf people once we’ve got there; the deaf people on the Forum are keen to develop the use of Visual Translator Cards, where you point to the relevant picture to describe your pain / symptoms / the animal that has bitten you (!) etc. Again, we will be working with the Patients’ Forum and RNID on this.

Sorry for the long message but I’m especially interested in the comments made by the deaf people who have contributed to the conversation and would be very happy to have your views / involvement in this work.
Mark Myers Says:
January 19th, 2006 at 5:29 pm

Thank you for that, Margaret. Us down in “the pit” never seem to know what’s going on upstairs until we have to start doing it, so it’s always interesting to hear from you. I’d be interested to hear what you decide. I hadn’t really thought of the problems faced by deaf people until I made this post, and it’s clear that TypeTalk alone isn’t enough for them, so I hope your project yields some good solutions!
Joe Clark Says:
February 9th, 2006 at 5:47 pm

In Toronto, we have no trouble at all just dialling 911 with a TTY. There is no technical reason why British emergency authorities could not answer textphone emergency calls directly.
Allan Says:
March 14th, 2006 at 1:09 am

I’m catching up on this blog, so excuse the late reply.

Rather than SMS which is not real time. Instant Messaging should be considered. The major mobile phone companies globally have all agreed to roll out an interconnected Instant Messaging system see: http://www.gsmworld.com/news/press_2006/press06_12.shtml

This will provide a messaging service that is real time, interactive - so triage questions can be asked and as traceable as any other mobile phone contact - it is tied to the phone number of the mobile, although a name can be aliased to the number.

Additionally as contacts are only allowed on Personal IM between “buddies” it is possible to register users i.e. add an “emergency buddie” to thier contact list and the registered person to a list at the contact centre.

This surely must have some potenial for this sort of circumstance?

If anyone with the power to investigate this as a possibility this wants more information then contact me via Mark, I have added my work email address when posting this.

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Nee Naw is a blog about life in the London Ambulance Service control room. It is written by Suzi Brent.

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