Bread and Butter

There's no such thing in the Ambulance world as a routine call. Every time you dare to entertain the thought of "I've seen it all", something will jump up and bite you.

This time it was a Green call. No lights and sirens. No dire emergency. Just a 90-something year old who's "On the floor, unable to get up. No apparent injuries. Grandson on scene for access". These calls are our bread-and-butter jobs. Something we do, on average, at least once a shift. Normally, we turn up, make sure the patient is uninjured, help them back into either their favourite chair, the loo or into bed. Sometimes we'll make sure they have a cup of tea and a natter before we leave. Maybe check their fridge and ensure they have some food. They may not see anyone again for a day or two. And then we leave. Easy. Straightforward. Uncomplicated. So without putting my brain into gear, we trundle off to see the young man on the floor.

The first knock at the door yields no response. Neither does ringing the doorbell. Quick look through the windows and a knock on them too. Finally, just as I'm about to go and ask control to phone back, the door opens.

As promised, the grandson opens the door, and in an instant my brain jumps into gear.

The grandson is standing at the door with a clean 10" knife pressed against his own neck. If it's clean, he hasn't used it yet, so Grandpa is probably safe. He's probably in his late 20's, shaking like a leaf and has a terrified look in his bloodshot eyes.

"They've done it to me again!" he screams. "This time I've had enough! I'm gonna do it!!"

My crewmate backs away very slowly to the ambulance to summon urgent police help. I (probably stupidly) stand and try to talk to him. His name's Mike. He's always being left to look after his grandfather who's asleep upstairs. And he doesn't want to do it anymore. But nobody listens, so this time he has to do it.

"I'm not allowed to work, I'm not allowed to go out, I'm not allowed to do anything!" By now the neighbours are twitching their curtains to see what all the shouting's about. Some are even brave enough to come out of their front doors. Mike looks serious, but he also looks scared. I get the feeling that this isn't really a suicide attempt, but just a cry for help. A man at the end of his wits who has no idea what else to do.

Slowly, Mike tells me that he has the job of looking after his grandfather, and has done for years, because his parents work and there are no other family members to help. I also observe, and have confirmation from one of the neighbours, that Mike has learning difficulties. He still has a knife to his own neck, which has already made a mark. Somehow I eventually gain his trust, and at about the fourth time of asking he throws the knife into the garden, far enough away from both of us. 30 seconds later the police arrive.

I ask the police to talk to Mike, to keep him calm, while my crewmate and I go to check on his grandfather. He's fast asleep in bed, unaware of the drama that was unfolding on his own doorstep. One of the officers calls Mike's dad and asks him to come home.

Mike is no longer left in charge. He's now finally getting the care that he needs too.

Bread-and-butter calls? Only if you expect the unexpected...