Wednesday, 29 February 2012


Elaine stood over my shoulder, watching my every move. She'd been there from the second I knelt down beside her husband Carl. She watched every chest compression, heard every rib as it cracked loudly beneath my hands. And as she watched and listened, she told Carl's life story. 

"He lost his leg last year. Diabetes, you know. Awful disease. But he didn't really look after himself. It was probably his own fault in the end." 

She watched as two more crews entered and made a little room for them and their equipment. Then, as we worked in streamlined silence, she continued her story. 

"We're a rare couple we are. Carl from Jamaica and me, a working-class white girl from the East End. When we got married, back in the sixties, my parents swore to write me out of their lives. They never visited, we never visited them, and eventually we didn't even speak. There was no such thing as racism back then. It was just black and white. And no mixing."

She watched as someone stuck a needle in his arm and started to give him fluids and drugs. 

"When the grand-kids came along, suddenly they wanted to visit. But only if Carl wasn't home. So I told them they could choose. They either accepted our family as it was, or they couldn't be a part of it. It was the toughest decision of my life." 

She watched as a tube went down Carl's throat, allowing us to help him breathe a little more. 

"Our friends stopped being our friends. Blacks and whites each going their own separate ways, all of them turning outwards, away from us, instead of rallying around us and learning from each other. We were left with no family, no friends. It was just us. Carl and me and the kids." 

She watched as the first of the shocks jolted Carl's lifeless body off the floor, the unnatural jerk phasing her just a little, throwing her narrative into a brief silence.

"Is he going to be OK?" 

"We're doing everything we can for him, but at the moment the signs aren't good." 

"He's a fighter you know. He'd have to be, putting up with what we have. We've had to fight for everything. Over the last few years, though, we've finally been winning that fight. Mixed couples are all normal now, aren't they?" 

She watched another shock violently wrack his body and begged him to keep fighting.

"I love seeing them. Walking through the park, doing the shopping, wherever. And those beautiful children. Remind me of my own kids when they were little. Not that my kids aren't beautiful any more!" 

She watched as half an hour later, we stopped. Carl lay where he fell and Elaine knelt next to his head, her story told, muttering in silent prayer.

"Maybe," Elaine said after watching us clear up, "I'll write our story one day. Be good to have it written down once I've gone too, then someone else can tell our story." 

Monday, 27 February 2012

The Corridor

Four of them, maybe brothers, maybe cousins, maybe friends, stand in the corridor. Flat-peaked baseball caps with hoods over the top and trousers hanging low revealing their underwear. Just their mere presence intimidated all who walked past or saw them there. Security moved them along a little, away from the doors, allowing more patients in without fear or impression of running a gauntlet on the way in to the emergency department.

Crew after crew came in, offloaded their patient and left to find yet another. As the night wore on, some crews ended their shifts and headed home, as the group of boys stood their ground, marking their territory in the hospital passageway.

They caused no problems, never raised their voices, never tried to upset a single person. But try as they might, they remained conspicuous and inviting to suspicious looks. If they'd been walking down a dark street, anyone seeing them would cross to the other side, or even turn round and head the other way.

Heavy gold chains rattle around one of their necks as he moves, pacing up and down as if hunting for prey. As I head for the doors with the trolley they make a path, two stand either side of the corridor, all in silence. Their staring gaze follows me out the door, accusing me of an unknown crime, blaming me for an unknown misdemeanor. Outside, I tidy the ambulance, put away the kit used on our last call and realise that I've forgotten to pick up a clean sheet to replace the one I'd just put in the laundry. 

The boys are still there, but as I pass by and head for the double doors, a doctor steps out of the resuscitation room. The boys gather round her. I watch from a few metres away as she says something inaudible, accompanied by a sad shake of the head. 

The brothers, or cousins, or friends, collapse as one to the floor and leave me to think. 

Even tough guys are human. 

Thursday, 23 February 2012

Homework - The Old Trunk

As an incentive / threat / reward for my eldest to write a good story for her English homework, I told her that if I liked the story, I would publish it here. Being her father, of course I liked it. And a promise is a promise. So now - unassisted, unedited and untouched, I present - "The Old Trunk": 

Stepping out into the black eerie night, I stopped and I stared as a black blurry shadow towers upon me. Broken bricks, cracked, cobwebbed windows, a damaged roof and a battered door. Suddenly, the door swung open. 

"Hello?" My voice echoed throughout the house. Should I go in or should I stay outside? Do I explore or stand under the black blanket? Is it safe or should I turn around and go home? It reminds me of a film I watched last night, but surely ghosts don't exist? 

Step by step, I cautiously crept into the house. Every movement I made, every breath I took was heard in every dusty corner of the room. My nose was feeling itchy, there was dust everywhere. The mould felt damp and I thought that the house would collapse on top of me! 

Out of the corner of my eye, down the long dark hallway, I saw a large, brown, dusty, trunk covered in cobwebs and hairy tarantulas. I wonder what is in there? Could there be gold and silver, or could there be evil ghosts inside, trapped, waiting for someone to set them free from the old abandoned trunk. 

Slowly and steadily, I nervously walk up to the trunk. Half of me was saying to open it, the other half was saying don't. What if something happens when I open it? On the other hand, it could be to my benefit. I placed my hand on the top of the trunk. 


What was that? 

Is anyone there? 

I slowly got up. I was shaking. I headed towards the door. 

I left. 

I left and never looked back. 

Monday, 20 February 2012


Asthma had plagued Leanne's life for the past three years. Now, at only five years old, she was having yet another bad attack and as always, it was at bed time. The local crews know her well. They also know that her parents aren't the panicking type. They only call when they've tried to control everything on their own, but failing to do so always means a trip up to the hospital and an inevitable stay for a day or two.

Her little lungs struggle to cope with the narrowed airways, breathing in all the good stuff, but not breathing out the bad. Her shoulders move up and down with each breath, her stomach moves in and out, her chest muscles hurt with every move. Leanne's face is pale and tired, yet she still tries to force a feeble smile. 

We attach the mask with the misting medicine, willing it into her lungs, hoping it will work quicker than we know it really will. 

"You know what happens now Leanne, don't you?" 

She nods a silent reply, conserving her energy for more important things. 

"Good. Who's going to carry you down the stairs this time? It was Daddy last time, wasn't it?" 

Again she nods. She looks around the room at the four adults, two parents and two green giants, finally makes her choice, and points. 

"Well, I'm honoured!" I say, picking up Leanne as if she were one of my own. I hold her up to my shoulder and we can see eye to eye. Each time she breathes out, a little of the mist blows out the sides of the mask and onto my face, making her laugh a little. A strained giggle at best, but at least it's something. 

We double the dose as we settle her on the trolley and get ready to make our way to hospital. 

"Now, you know the drill. We're going straight in to see the nurses and doctors, and they might want to do all the tests they did last time. Do you remember?" 

Finally, she manages just a single word. "Yes." 

"And you know you have to show Mummy and Daddy how you're much braver than they are!" 

Each smile from Leanne paints a slightly brighter picture, her face has a little more colour, her shoulders  and lungs struggle a little less. Each small effort is rewarded with a small step forward and by the time we've slalomed our way through the early evening traffic, parting the cars with sirens and lights, Leanne is able to say a few words at a time. 

Leanne asks me to carry her back out of the ambulance again, but we decide that it might be more fun if she was wheeled in on the trolley. The familiar sliding doors won't open as we approach and she is confused. 

"Why don't the magic doors open?" 

I show her the numbered keypad and explain. "We need to tell it the password. Only special people are allowed through!" 

"Am I special?" 

"Of course you are." All four adults said it at the same time, causing Leanne to laugh again. 

"Do you think you can you guess the password?" 

She thinks for a few seconds and then talks loudly, straight at the keypad. 


Tuesday, 7 February 2012

Eight Miles

The radio vibrates against my shirt, the phone beeps in my pocket and I run back to the car to see the screen flash up a new call. Eight miles isn't all that far, particularly at night, but even at an average of sixty miles an hour, it will take eight minutes to get there. To average sixty, I need to be going ninety for at least some of it. In London, even at night, it's barely possible and for the most part unsafe. Unsafe for me, unsafe for pedestrians, unsafe for other motorists, unsafe for my patient if I never make it to where they are.

Eight minutes is a long time to wait for an ambulance. I know. I've been there. I've had to make that call, had to wait that wait, watching and worrying. I understand. And I want you to know that when I have to travel that far with the screen shouting at me that someone isn't breathing, or someone is seriously injured, I feel the same as you do.

The trepidation that ninety miles an hour just isn't quick enough. The worry that eight miles is just one mile too far. The feeling that each and every speed bump in the road that's meant to slow me down and as I encounter it makes the patient's chance just a little worse. If I could somehow jump over those bumps, skip around the width restrictions, fly over the cars that block my path, I would. But I can't.

The address is eight miles away, 8.2 to be exact. The junction of two suburban streets is also the meeting point for a car and the bicycle carrying Hayley on her early-morning paper round. At six in the morning, traffic is starting to build and people city-wide are starting to consider their commute to work, just as I start to see the light at the end of the shift.

The caller is the car driver, distraught, distressed, disturbed. Scared not so much of the long term consequences, but more of the immediate danger to Hayley as she lies unconscious in the road. The call-taker gives some basic instructions, to check the airway, the breathing. Not to move the patient, but to wait for the crews to turn up.

We arrive on scene together, two of them in the ambulance and me in the car. 

"Six miles we've had to run for this!" says the frustrated attendant as he grabs another bag out of the side cupboard.

"Tell me about it. I ran eight."

One look at Hayley tells us we're going to need some extra help. She's starting to come round, moaning in pain and confusion. A large, dark patch is slowly spreading across her jeans from just above her knee. Her femur, the thigh bone, is clearly broken, the angle of her leg telling us more than we needed to know.

"I'll get HEMS running. I think we're going to need more pain relief than we can give her."

"Good idea. Bet they have further to run than we did."

During the hours of darkness, HEMS teams travel by car, leaving the helicopter to a better night's rest than most of the people who work on it during the day. It takes them some time to get to us, by which time we've tried to stabilise Hayley as much as possible. I give her a strong dose of Morphine, hoping to reduce the pain at least a little, at least enough to let us straighten her leg. It's not enough. Even doubling the dose to the maximum we're allowed to give doesn't allow us to move Hayley's shattered leg at all. HEMS arrive and the doctor on board gives Hayley some ketamine, finally relaxing her into a state where we can pull the jigsaw-puzzle femur straight enough.

We finally settle her on the stretcher, the minimal warmth of the blood-soaked blankets now assisted by the heater in the back of the ambulance. Hayley is well looked after - a couple of paramedics, a doctor, a mother who ran frantically to the scene when she finally heard what had happened. It leaves me with nothing to do but to clear up the scene as much as I can without upsetting the police.

I sit in the car and watch the clock tick over to the end of the shift. The tail-lift is raised and the back door is shut, the blue lights start to flash and the ambulance pulls away with its injured cargo, leaving me to wonder if we had done all we could, if it would be enough. I start the engine and begin my journey back. 

It's a lonely, subdued eight miles. 

Friday, 3 February 2012


Elves. It must be elves.

We have ECG leads, blood pressure tubing, oxygen piping. We have an oxygen saturation monitor on an electrical lead, charging leads for the machines and a suction unit with a hose that works like a vacuum cleaner.

And no matter how tidy you leave them, no matter how neatly you put them away, no matter which bag, or holder, or drawer you put them in ready for next time, the elves always get in there.

Because the very next time you take out the leads to do an ECG, or whenever you take an oxygen mask out of the packaging, or if you need to check someone's blood pressure, it's all back in a tangled mess. Again.

I keep looking for those elves, but have never spotted them. Somehow, these stowaway menaces appear on every shift, on every vehicle, for every patient. The solution is simple, but probably years away.

Wireless everything - that'll fox the blighters.

Until then, the hunt for the tanglers goes on.

Thursday, 2 February 2012

Football Pictures

A young father meets me at the door, his face wracked with worry. He ushers me up the stairs and in a rare gesture even offers to carry one of the bags for me.

"He's just not stopping!"

"What's his name?"

"Harry. He's only five."

A quick look into the room allows me to take in my surroundings and looking at the posters and t-shirts, I see that we support the same football team. Maybe a little later it'll be a good conversation piece, but right now, this little boy needs help. The seizure that's taken hold of him is relentless and, according to his dad, has been going for almost fifteen minutes. It's the first time he's ever had a fit.

"I wish his mum was here, she'd have known what to do! She's a doctor. She's on her way back, so she'll be more help."

Great. A doctor. Just a little bit of added pressure - as if treating sick kids isn't bad enough. As promised, she walks in less than a minute later, after I'd given Harry oxygen and some other medications and just as I'm about to cannulate. The needle and tiny plastic tube need to pierce his skin and a vein, giving me access to his blood stream and the ability to give him some more medications to help stop the fit. It's not a skill I use often on children.

I turn round to see mum as she walks in and realise that she's a doctor I know. She used to work in one of the local A&E departments and was one of the more positive when it came to attitudes to ambulance crews. She would always take the time to listen to handovers, talk through a call if we needed to, show us x-rays and blood results and generally involve us more in a patient's continued treatment.

"Hey Doc." I tell her what's been happening, what I'd already done, what I was planning to do. "You're welcome to do the cannula if you want." She declines and I have to say that I agree. I'm not sure that if it was my child that I'd want to play any role other than the parenting one. With a little skill, a little help and a little luck, the cannula goes in first time. The drugs hit his system moments later and after seconds that seemed to stretch for hours, the seizure finally stopped. 

Harry's breathing needed a little support on the way to hospital, but by the time we arrived, he was starting to come round a little. Mum came in with us, blending into the crowd as just another parent until one of the nurses recognised her. 

"You been helping out the paramedics again?"  

"Not this time. Just been trying to stay out their way for a change."

Harry starts to notice his surroundings, the unfamiliar faces, sterile walls and disposable curtains leave him confused and scared, but a familiar voice and the gentle, welcome hand across his face do something to allay his fears.

"Mummy, is this where you go to work?" 

"Sometimes it is. Do you like it?" 


"Why not?" 

"Because there's no football pictures!" 

"But is it OK that I come to work here?" 

"Yes, but only if you're my mummy first. Then you can be a doctor too."