Sunday, 21 July 2013


Progress report: Situation normal.

Well, as normal as it can get in the world of EMS. Several months into my new adventure, treating patients from right to left, filling in electronic patient reports instead of paper ones, on a system that is a combination of awkward, clever, helpful and frustrating all at once, and generally getting back into the swing of things, I have discovered that even if the systems are totally different, the end result is the same. 

The patients don't change. 

There are calls for all the same reasons, some genuine, some not. 

There are drunks. There are assaults. 

There are those who are dying to live and those who are living to die. 

And there is everything in between.

I have been working at a number of different stations, in different towns, separated by distances that in London are probably the equivalent of boroughs and in Australia or the USA I guess it would be just popping by to the neighbours. Still, the people are all the same. 

The arrival of a new baby still brings joy to the parents. 

The passing of an elderly relative brings sadness, grief; sometimes relief. 

The feeling of impending doom of a critically ill cardiac patient is just the same, whatever language may be used to express that feeling. Often, words aren't required; the mere look in the eyes conveys the message all too clearly. 
Just a few short years ago, In her early thirties, Leah had a cardiac arrest. She was one of the lucky ones. The stars aligned and she collapsed whilst visiting a relative in hospital. The ward staff reached her in seconds and she was resuscitated, waking up in unfamiliar surrounding a few days later. She heard talk of her heart stopping. She heard talk of having a funny rhythm and could think of nothing but a set of drums, but then talk of electricity in the heart confused her even more. Nothing made sense. 

She heard something about a defibrillator to shock her heart each time it happened. Something about it being there for the rest of her life. A life that had been taken away, returned, and now seemed once again to be slipping through her fingers. 

Leah's deathly pale, beads of sweat covering her face and arms. The fear in her eyes, as if we couldn't see it, was reflecting in her voice, in her pleading. 

"Don't let me die. Not here. Not with my children in the next room." 

The voices of cartoon characters fill the background, muffled by a doorway that separates the innocence of childhood and the harsh reality of life. That reality was monitors, needles, drugs. A battle against time and an unruly heart, beating to its own chaotic rhythm, rather than the regular spike on a screen and the audible lub-dub in the stethoscope. 

A few tense minutes later, Leah's face eases a little. As drugs course through her veins, sending orders to the heart to regroup, we see the rhythm take on a semblance of order. Finally steady enough to move, we carry her down the four flights of stairs to the ambulance and start to head to hospital. A few minutes into the journey, she lifts the oxygen mask from her face and asks a simple question. 

"Do you think it would help if I stopped smoking?"  

"I'm sure you've been told several times prior to today to stop." 

"But I only smoke about five a day." 

"Even those five aren't helping your heart, are they?" 

Leah didn't answer, choosing to sit in silence for the rest of the journey. We wheel her in to the hospital, to be met by an all-hands-on-deck medical team. Leah is transferred to the hospital bed, a nurse detaches our cables so that she could reattach theirs, as all the while Leah appeared deep in thought. 

"They'll take good care of you now," I said as I started to walk away, "just make sure that you do the same."  

Leah called after me. 

"Wait. Just wait a second. I have something for you." She reaches into her handbag, pulls out a box of cigarettes and a lighter, and places them firmly in my hands. 

"Take them. Throw them away. I never want to see them again."