Monologue

An all too familiar scene awaits us as we swing open the door to the doctors' surgery. A waiting room full of coughing, spluttering children, parents losing the battle between enforced immobility and a pile of old toys that have all seen better days. A receptionist pretending to work sits at the front desk playing Spider Solitaire on the computer.

"One of your doctors has called for an ambulance?"

In one swift movement and a click of the mouse the green, card-bearing screen disappears and a computerised table of doctors and appointments appears in its place.

"One of the doctors, eh? The doctors don't do anything here without my say so. Who called you do you think? The doctor, or me? They can't dial anything on their phones without it going through me. First they dial 'zero' to get an outside line and only if I approve it can they make a call."

She barely takes a breath and any attempt to stem the flow is like the little boy with his finger in the dam.

"You know what, they probably don't even need you, they're forever calling ambulances these doctors. They've got no idea what they're doing half the time. Covering their own backsides just to be a pain in mine. I mean, it's not as if they actually make the calls themselves or have to sit watching all these people come in and out, day in - day out, with their coughs and colds and ear aches and ingrowing toe nails. Do you even know what an ingrowing toenail looks like? Have you ever seen one? They're gross, I tell you, but they don't really need a doctor, do they? Just pull it out themselves."

Just for a second, she stops, but before answering the question of where the patient is, the engine starts up again and heads straight into top gear.

"And this one, the one you're here for, do you know what's wrong with them? Nothing! Nothing, I tell you. Came in feeling dizzy, pretending he can't stand up, leaning on their friend, or wife, or girlfriend or whatever that slummy looking woman was. Torn jeans and a see through white t-shirt with a fluorescent pink bra. Who goes out like that? And to a doctor's surgery, no less! I'm surprised she was strong enough to hold him up anyway. He's about six foot, she's only about five. He's probably just faking it for the attention."

She pauses and picks up the phone, pressing just a single button.

"Did you call an ambulance?" From our side, the answer is inaudible, but obvious.

"Well why didn't you tell me? I should have placed the call, not you. How was I supposed to know where to send them?" Yet more one sided silence.

"Next time, make sure you let me do the ambulance arranging." Then, looking back at us, she finally gives us directions.

"Room eight. Down the corridor, second door on the right. It says Dr. Craig on the door, but actually it's Dr. Iain that you're seeing. And don't let the patient give you any sob stories, alright? I know what they're like round here."

We were already half way down the corridor as she finished her last sentence, but still she made sure it was heard. The door opened before we even had the chance to knock and the tall, balding doctor introduced himself and the patient.

"Hi guys, I'm Dr. Iain. This young man is Adam. He came in complaining of severe dizziness. I've called you because he really can't walk unaided, and I've referred him to hospital. It looks like he's got two ruptured ear-drums."

"Both ear-drums?"

"Certainly looks like it. Some accident at work. He's a little bit coy about it all."

"I doubt it was work related. I reckon he must have just been talking to your receptionist."

Five Words

Stepping into the office with an envelope in my hand, I was about to take one of the biggest steps in almost a decade.

"Need my signature on an application form, do you?"

It was an obvious question for my boss to ask considering the fact that once again, the coveted places on the air ambulance had been advertised. That, and the fact that he had no idea of my real motives.

"Not quite!" I answered, handing him one of the copies of the letter. He looked down at the piece of paper, the cheap and nasty stuff that the ambulance service has started to use recently in yet another cost-cutting exercise. The confusion on his face said it all.

"You're sure about this are you?"

"Quite sure."

"Can we do anything to change your mind?"

"Not unless you're packing the LAS into a suitcase and sending it with me."

Handing in my notice was a great deal more traumatic than I had ever anticipated. I have loved my job. If not every minute of it, certainly as a career, as a way of life, I have loved it. But the time had come for a change that MrsInsomniac and I had been planning for some time. I'll write more about the change we're making in another post.

I've already had my final shift. It was initially scheduled to be a lonely solo shift on a rapid response unit, but luck had it that there was a student who needed a few extra hours out and about, so she joined me, hoping that my reputation for attracting "real" jobs would prove itself in reality. It didn't, but it gave us time to talk. Time for me to pass on a little of my questionable wisdom and for her to ask questions, question my answers and answer my challenges too.

Towards the end of the shift, she threw me a curve-ball.

"If you had to sum up your career in four words, how would you do it?"

"Four words? I'm not sure I can. Am I allowed five?"

"You can have five. It's my leaving present."

It took me some time. We attended another call, handed another patient to yet another crew and still my mind's rusty cogs whined and creaked to come up with some cohesive thought. Eventually, in a dull flash of panicked inspiration, I had it.

"Tried to make a difference." It really does some it all up.

It speaks of the patients who had no-one else to care for them, it speaks of the families suddenly bereaved, it speaks of the babies brought into the world.

It speaks of the children who were left battered and bruised by their very own flesh and blood, and others who were nothing if not heroes to their families.

It speaks of the people who just needed to hear a voice tell them that help is at hand, and it speaks of those pleading for help for their loved ones.

I hope it speaks of the students I worked with, studied with, taught and learned from.

I hope it speaks of the people who read this blog, those in the know and those who hope that they will become more in the know by reading it.

I tried. Sometimes I succeeded, sometimes I failed, but I tried. In most cases, I'll never really know.

My move takes me away from the London Ambulance Service, but not away from the world of the ambulance. The blog will continue (considering the accolade it has just received, it couldn't really not). For some time it'll be based on the scribbled notes that already sit in my diary, and soon stories will be told from new notes, new patients, whilst looking out over new horizons.

And if nothing else works out, I'm still proud of who I've become, what I've achieved, and the experience that I've gained. I'm proud of this blog. I'm proud to call some of the best ambulance staff out there my friends. And I'm still proud of those five words.

WINNER!

Maybe I should go away more often. I take some time out, a couple of days away from anything interweb-ish, and lo and behold, the miraculous happens. Whilst I'm away, the results of the EMS Blog of the Year Award are announced.

And there, in black-and-white-and-colours-all-over, is the name of this blog. Winner of the Readers' Choice category.

You're an amazing bunch of people, dear readers, you really are.

Thank you.

Thank you for reading the ramblings of a sleep-deprived paramedic, thank you for joining me for the ride, and thank you for voting too.

Stand by now, for there are exciting developments afoot over the coming days and weeks. You may be in for some surprises...

You've made a simple, if somewhat crazy man very happy.

Jimmy

One two seven High Street, Suburbia.

I know that address. I know that it's not where we're actually needed. It's the centre where emergency calls made by mainly elderly patients hitting a panic button are received. The computer instantly recognises the address from the phone number and dispatches us anyway. Two miles down the road, the address updates and sends us three miles in the other direction.

The call is given as a possible collapse. Someone has pressed the panic button and then contact was lost. All attempts to reach the ninety-four year old, either through the emergency call box or by phone, failed. There was even a mobile phone number on the records, a rarity for someone of that age, but it appeared to be switched off.

With no other options, we were sent. The next of kin, a great niece who lived somewhere in the middle of nowhere, had been woken up and informed of the problem, but even at top speed couldn't get there in under two hours. The police, as is so often the case, had sunk under a tidal wave of their own calls and had no units to send. If there was any need to break in to the house, we'd have to do it ourselves.

As we pull up outside the house, the computer updates with the latest message - there's a key safe hidden behind a pot plant - so no need to break down any doors. As I punch in the four digit code and push open the lock, a bunch of four keys falls onto the floor. There's only one door and one lock, so the need for four keys is unknown, but on the third guess, the key moves the lock and allows us inside.

The house is in total darkness. There's no sound either. Initially I use a torch to find our way round, but feeling too much like a burglar, we opt to switch on the lights. We search the downstairs and find nothing, except for the reason for the other keys. Each door, one to the kitchen, one to the lounge and one into a dining room that looked as if it had been accidentally left behind in the 1800's, was locked. On closer examination of each room, we find them uninhabited.

There were three rooms upstairs too - a bathroom and two bedrooms. In the second bedroom, oblivious to the two strangers wandering around his house calling his name, was Jimmy.

A gentle, almost inaudible snore emanates from the sleeping man and his breathing is calm and restful. Strapped to his wrist, unmoved by the commotion, is his panic button and next to him on a small bedside table is a barrier between between Jimmy and the outside world.

A pair of hearing aids.

We creep back down the stairs, turn off all the lights, lock the door and replace the key in the safe box. As it clicks gently back into place, we both, almost subconsciously, mutter the same three words.

"Good night Jimmy."

Seven Months

We approach only as far as the police tape allows.

"You'll have to wait here with us, just until we know what's going on."

On the screen in front of us, the special instructions fill us in on the latest details as they emerge. Caller states his girlfriend has a gun and is threatening to kill herself. The call is from a mobile phone, the mobile mast locating it two hundred miles from the address we've been given. Instead of playing Chinese whispers, I ask for the mobile number and hand it to one of the police officers. In a swift flip of his radio, he unbuckles it from his bullet-proof vest and with the radio on loud speaker dials the number.

There's no answer the first time and the call rings straight through to the answer phone.

"Hello, you've reached Michael's phone. Please leave a message after the tone, and if I remember, I'll call you back some time."

The officer doesn't leave a message, but tries to call again only a minute later. This time, a sleepy voice answers.

"Hello?"

"Hello Michael. This is PC Ryan from the Met Police. You called to tell us about your girlfriend?"

"Yeah. Natalie! She's at home, she phoned to say she had a gun and she was going to kill herself."

"Has she ever owned a gun?"

"Never. She probably doesn't even know how to use it."

In the distance, we can see other officers dressing as if for battle. Full body armour, helmets, gloves and semi-automatic weapons at the ready give an impression more of a unit preparing for war than a group of people attempting to save a life.

"Has she ever threatened suicide before?"

"Loads of times. She's taken tablets, slashed her wrists, all sorts, but never anything like this!"

"What's her name again?"

"Natalie."

Seconds later, a negotiator calls through a megaphone.

"Natalie - this is the police. Open the door." For some time, nothing happens. No lights are switched on, no curtains move, no doors open. He calls for a second time, but this time, as soon as he calls her name, light suddenly appears through a tiny gap in the curtain of a first floor window.

The face that eventually appears looks confused, perhaps even scared at the sight of a small invading army standing outside the front door. Slowly, reluctantly, she opens a window.

"What's wrong?"

"Put the gun down!" Screams the police team's sergeant.

"Gun? What gun?"

"Put your hands where we can see them!"

Natalie places both her hands very deliberately on the window sill. "I really don't have a gun. What's this all about?"

"Did you tell someone you wanted to hurt yourself tonight?"

Immediately, a note of understanding registers on her face. "You've had a call from Michael, haven't you?"

He puts down the megaphone and the rest of the conversation takes place at a more civilized volume, particularly as it's the middle of the night. Faces appear at various windows and curtains twitch up and down the street.

"We have. He's told us you have a gun and were threatening to kill yourself."

"Wait there. I'm coming to open the door."

Thirty seconds later, Natalie appeared at the front door, adorned in a pair of pink pyjamas for which she apologises.

"It's a hoax. It's the best one he's pulled yet. He can't get over the fact that we split up, seven months ago already."

She goes on to tell the officers about all the other problems he's caused, sending the fire brigade, calling out doctors and mental health teams, even getting the Samaritans to give her a call. Just as a formality, one of the armed response team searched the house and, as expected, found no gun.

"I told you everything was alright. I'm not suicidal, I'm not depressed, I'm just trying to get on with my life." She stared suddenly at the stars, then looked all around her and laughed. "I'll tell you one thing for free; it's been a long seven months." 

The armed response team packed away their kit, other police removed the tape that had cordoned off the street, and we could finally remove the heavy ballistic vests that we'd been asked to wear. As we sit back in the ambulance and watch all the other teams leave, life in the suburban road returns to what should be a normal night, especially in Natalie's life.

Quiet and undisturbed. 

VOTING NOW OPEN!!!

 

Right then, loyal readers, the voting is now open for the EMS Blog of the Year. 

I have, miraculously, been shortlisted. You now have seven days of nagging to look forward to. 

Therefore, GO VOTE! 

Subtle, ain't I? Or maybe, Subtle ain't me. Anyway, I'm up against some serious competition, most of whom I read regularly, and two of them I even nominated in the first place, so I really, REALLY need your votes. You get one vote each - so make 'em count! 

Thanks to all those who nominated me in the first place - I'm honoured to be on a list with some great bloggers. 

Playing Dead

Saturday night. 

In fact, it's worse. 

It's a post pay-day Saturday night. 

The calls are coming in faster than the customers can spend their hard-earned cash. Call after call is alcohol related, leading either to faints or fights, pass-outs or punch-ups. Suddenly, in the middle of it all, a genuine call. 

In fact, it's worse. 

It's a genuine call made by a child. 

The call comes in as a mother who isn't breathing. The child is barely able to contain their emotion as they  follow instructions from the call-taker. Luckily, I'm less than a mile away. Under a minute later, as I step across the threshold, a bag on my back and another two balanced on my arms, a young child grabs me by the hand and practically drags me off my feet. 

I walk into the room to see a sight that worries me even more; it's not just one child who's distraught, but four. The oldest is ten years old. All are crying, worried, scared. One begs me to help their mother. 

"She's not breathing! Do something!" 

Another asks me the awful question. "Is she dead?"

All it takes is one look at the mother. Her eyelids flicker like no dead person's can. As I call her name loudly, she jumps a little, but tries to stifle it to keep up the pretence. As a crew arrives, I usher the children out of the room, asking them to let me treat their mother whilst reassuring them that she'll be absolutely fine in a few minutes. 

"Right," I say, "the kids have gone, and it's just us. Now do you want to tell me what this is all about?" It's  rare for me to lose my temper with patients, but I'm close. She opens one eye, then the other and after a moment or two, decides to pretend that she remembers nothing and that she doesn't know where she is.

Leaving the crew to treat the so-called patient, I go to speak to the children. One of them tells me that the two oldest siblings were fighting, their mum shouted at them to stop and when they didn't, she collapsed and stopped breathing.

"She just dropped to the floor?"

"No. She sat on the couch with a bit of a bump, shouted again, and then fell back with her head on the cushions."

"I understand. Just so you know, your mum's going to be absolutely fine. We'll let you in soon so you can see her and talk to her."

"You mean she isn't dead?"

"No, she's not. She's just a little upset."

Back in the room with our now alert patient, I could bite my tongue no more.

"You realise what you've done to your children, don't you?"

"It's their fault. They know how to behave. I just wanted to show them what it would be like if their mother wasn't here. When they fight, they pretend like I'm not here anyway, so I thought I'd show them what it would be really like."

Speechless and angry, we invite the children back into the room. As the youngest runs into her mother's arms, I leave the house, wondering what would force a parent to be so cruel to their own child. 

Intact

As luck would have it,

we were on the way to a patient and not transporting at the time.

As luck would have it,

they were stood at the side of the road and not above it.

As luck would have it,

the brick shattered the glass in the back, not the front.

As luck would have it,

the trolley caught the brunt of the hit and not us.

Stupid kids.

Stupid games.

Lucky break.

But our patient had to wait for an ambulance that had all of its windows intact.

Bad Weather

Heading through the terrible weather towards the scene at right angles to the accident, the level of carnage looks all the more brutal. We're the third ambulance to arrive, adding to the sea of flashing lights. Rain drops look like tiny blue specks of light, reflecting the LEDs from all the emergency vehicles. Police cordon off each end of the street as fire crews start to cut through the mangled remains of what used to be a private car. The two occupants of the first car have managed to escape their wrecked former mode of transport and walked away with nothing but scratched arms and, for the driver at least, a bruised ego.

The other driver wasn't so lucky. Trapped in his seat by the crumpled front of the car, his head pinned back by the first paramedic on scene, all Terry wanted to do was move. One quick glance and I realised that it wasn't going to be a simple question of taking the roof off and dragging him out. There would have to be pieces of metal bent against their natural direction, some cut away all together, before we could even begin to think about getting him out of the car. 

And all the while, the rain continues to fall. 

"You must be getting soaked out there!" said Terry, talking through a misty oxygen mask. 

"Drenched to my core, but I'll worry about that later." 

At least he was in fairly good spirits. 

"Have you got any pain anywhere?" 

"Just my legs, but that's probably because they're wearing part of the engine." 

"No pins and needles, no pain anywhere else?"

"Nope. Nothing at all." 

"That's good. Can you move your toes for me?" 

Terry tells me that he's following my instructions, but his toes don't seem to move. Maybe I just can't see properly, but in any case, there's not much I can do about it.

"OK, we'll check on you a bit more once we've got you out of there." 

It took almost two hours of the fire brigade cutting, stretching and bending metal to get Terry free. In the meantime, we did what we could; gave him fluids and pain relief to keep him stable and comfortable. He finally appeared, borne out of his car on a flat, rigid rescue board. One look at his legs was all it took to see that they were both broken below the knee. 

"Can I just see the car before you take me away?" 

"Well, not really. It's the other side of the ambulance and you're now joining the wet-suit brigade. Besides, I think you need to get to hospital." 

Terry looked disappointed. 

"I'll tell you what - let's get you inside and out of this tropical downpour, and I'll go and take a photo for you on my phone." 

"Sounds like a plan to me!" 

We moved the trolley inside, turn the heating onto the highest level and my crew mate checked him out from top to toe again. I ran outside into the pouring rain, took a photograph as promised, and ran back inside into the dry.

"So, you sure you want to see this?" 

"You bet. Might as well have nightmares about something I've seen, rather than something I've imagined." 

"Alright then, here you go." 

With his head strapped to the board and stuck between two head-blocks, only his eyes moved. 

"Well, it's taken me twenty years!"

"First accident in twenty years?" 

"No. Third actually." 

"So what's taken you twenty years?" 

"Well, I've always wanted a convertible. I just thought I'd pick better weather to put the roof down." 

AHEM!!!

So, the nominations for the Fire and EMS Blog of the Year have opened.

Know anyone you want to nominate? Well, do you?

Go on. You know you want to. Click here to nominate.