White Van

Downtime is a rare commodity on the ambulances these days. Socialising with colleagues is limited to snatched moments in between handing over patients at the hospital and the next call. Rarely is that time more than a few brief minutes. More often than not, the second a crew is ready to go, there's a call already waiting for them. The same is true from shift's start to shift's end. I try to arrive for my shift about half an hour before the official start time. It gives me a chance to get all my equipment ready and catch up on the news, whilst not having the stress of having to go out on call the second the clock ticks over at the start of my shift. 

The evenings are getting cooler, and darkness seems to fall in the middle of the afternoon. Standing out the front of the station, I start to get the car ready for my shift. Checking the stock, changing the oxygen cylinders and making sure that all the lights are working, whilst at the same time catching up with the oncoming night shift crew. One of them is a brand new trainee, in only their second week on the road, the other with only a year's worth of experience, having a new probationer to look after for the first time. 

"You guys make sure you hurry to my rescue tonight, won't you?" I know that at night, sometimes waiting for the ambulance to back me up can take some time. 

"More like you're going to rescue us!"

The chit-chat continues, some along professional lines, some less so. A bit of good, off-the-record banter can work wonders sometimes, giving the time to replay calls that we're unsure of, seeking backup for good decisions, learning from others about things we don't know or understand. With ten minutes to go, we all finish our checks, the crew head inside and I'm only a step behind, hoping for a quick cup of coffee. Just then, a white van pulls up outside the station and the driver steps out.

"Excuse me, I don't feel very well."

He looked pale, and the sweat was dripping off him. He walked up to the car and as he came within touching distance, collapsed to the floor. Practically tasting their coffee, the crew turned round and came straight back outside. Within a few seconds of hitting the floor, our unnamed patient started to come round.

"Stay there a second," I tell him, as he tries to get up. "We'll get you in the ambulance and check you out." A check of his blood pressure confirmed our suspicions - it was so low that it was barely readable and his pulse was much slower than it should be, at less than forty beats a minute. We get the trolley from the back of the ambulance, and lift him gently from the floor,.

"What's your name, sir?"

"Mani."

"How old are you?"

"Thirty." One of the crew, the new probationer, looks shocked. Mani looked probably double the age he claimed to be, but confirmed his date of birth without having to stop and think about it. The maths adds up. He really is as young as he says. As usual, several things need to happen at once. Observations, an ECG, cannulating a vein ready for any drugs he may need. It's always a good indication of the seriousness of an illness when a patient's reaction to the threat of being stabbed in the arm with a large needle is almost no reaction at all. He managed to give us various other details, including his home address, only one street away from the ambulance station. He'd decided when he started feeling unwell that it was quicker for him to drive to us, rather than the other way round. By the end of the call, we would all realise that he was lucky to drive that far.

Despite raising Mani's legs on the stretcher, giving him drugs and some fluids, his blood pressure fails to rise. We have difficulty attaching the sticky dots to his chest because he's so clammy, but eventually we succeed and the machine complies, printing out the tracing of his heart. His heart was sick.

At thirty years old, Mani was having a heart attack, the part of the heart that affects his pulse and blood pressure blocked and dying. It was no wonder that he wasn't responding to any treatment we were giving him. I abandon my car at the station before I'd even had the chance to turn the wheel, and travel with Mani and the crew to hospital, hoping to get there before his heart gave up altogether. With a twenty-five minute journey, there were no guarantees, and there was little more we could do to help improve the odds.

Mani listened anxiously as we explained what was happening, but accepted it. His greatest worry after his health was getting a parking ticket on his van. or worse, having it towed, having left it in front of the ambulance station with the keys still in the ignition. I promised to do what I could to make sure that wouldn't happen.

He was lucky. Still conscious when we got him to hospital, and amazingly calm as the team did their work. As we stood watching what is effectively a plumbing procedure on the heart, the response was almost instantaneous. Blood began to flow back around his heart, feeding oxygen to the parts of it that had been starved for some time. His pulse improved, as did his blood pressure, and the hospital team seemed pleased with their work and Mani's response.

"We'll keep him here for a few days," the consultant tells us through the lead-lined window, "then if all's well, he'll be sent home to restart his life. Good work guys!"

"Don't forget my van, will you?"

"Don't worry, Mani. We'll sort it out for you. You concentrate on getting better. I'll leave a message with the hospital when we work out what to do."

"Thank you. Thank you for everything." He waved at us, a relieved smile on his face, and then rested his head back on the trolley that had been brought to wheel him to the ward.

Having tidied up the ambulance, we drove all the way back to station, and I discussed with control what would be the best plan for Mani's van. Having made all the arrangements and received agreement from on high, I called the hospital and asked them to let Mani know that his van was parked outside his house, and the keys had been put through the letter box.

"You know," said one of the crew as I walked back into station, "you've got a new career ahead of you if you give up on ambulance work!"

"Oh yeah? What's that then?"

"Well, the world always needs more white-van men..."

"Yeah, thanks for that guys. Should we start our shifts now?"