Angels

Some days I feel like the Angel of Death's right hand man. It's almost as if he's sitting on my shoulder, bidding me to do his work, waiting for me to feed him another soul.

The shift starts with a family member or a carer discovering that their relative or ward has died peacefully during the night. We march in, carrying equipment that we know will be totally redundant. Oxygen, where the tap will remain unopened. A box full of drugs that will number the same when we leave as they did when we entered. A monitor that will do nothing but paint a long, straight, lifeless line on a strip of paper, telling us and the family what we already know. All too often we are still there as the reality of loss strikes home. Sometimes slowly, gently creeping into the minds of those around; sometimes it hits with the full force of a tsunami wave. Before we leave, we comfort the bereaved, we mutter words, platitudes, practicalities, and then go back into the world outside that just carries on as if nothing has happened - unlike the four walls that we have just left, within which the world has suddenly stopped. The Angel has won.

Then there's a call for someone who's dizzy.

Yet another for someone in pain.

And we treat them with care, give them attention, tend to their needs, transport them to the hospital. In the short time it takes me to walk back from the emergency department to the ambulance, all too often I have forgotten their basic details, like a name, or age, or chief complaint. By the end of the day I barely remember these calls at all. And the Angel lurks bored in the background.

And then again there's a call: to someone who has stopped breathing. But this time, someone was watching as they took their last breath. We drive fast, arrive into the confusion and chaos and panic and fright. This time we have a chance. We open the oxygen, we give them the drugs, we beat hard on their chest, we breathe for them, pump blood around the body for them. Try our damndest for them as all around people are crying or screaming or praying or silent. But after a while, twenty minutes, forty minutes, an hour, we are defeated. Death has beaten life, as if the Angel is ironing out the last of the ups and downs on the monitor, leaving that long, flat, lifeless line again.

Then there's a call for someone short of breath. They have nothing more than a cold.

Then there's a call for someone whose blood sugar has fallen so low that they're unconscious, or confused, or violent. We fill their blood stream with dextrose which brings them out of their stupor. All too often they are embarrassed and apologetic. Nine times out of ten we leave on the best of terms, but every so often we need to force a trip to the hospital. All the while, the Angel slumbers.

Then there's a call for someone who's fallen and can't get up. We help them up, dust them down, sometimes make them a tea or coffee. We look at pictures of their grandchildren, or take an interest in their books, or listen to an abridged life story. Often we leave with a smile and a smirk at the Angel. Sometimes, that smile fades in the blink of an eye.

There's a baby turning blue. Can't breathe. Floppy. And we're miles away.

These sorts of journeys happen in an eerie sort of silence. No words are spoken, no thoughts-out-loud. Only the wail of the siren permeates the air, helping us push through traffic as fast as we can, but it never seems quite fast enough. Yet, when we arrive, with the Angel looking over our shoulders, we take hold of the baby.

She's breathing. Shallow, struggling breaths, her shoulders and ribs working twice as hard as they should be, trying to expand her lungs and feed them the oxygen they crave. And the Angel stares, prepares, dares us as he heats his iron, yet all the while we beat him back. We feed her oxygen, drugs, put up defensible borders, give her a fighting chance. We carve our way through the traffic again, to hospital, hand her over to the staff and breathe a sigh of relief when we hear a beautiful noise.

She's crying.

We clear up, tidy the back of the ambulance and prepare it for the next call, and finish the paperwork. Just before we leave, we go back to check on the baby, whose cries have subsided as she finally catches her breath and her face slowly breaks into a wary smile. As we step into the room, her mother finally sees us, as if for the first time, even though she was with us all along. 

"Do you know what you people are?" she asks, as she gently strokes her baby's face. "You're angels. Nothing short of angels."

I look over my shoulder, see no-one there,  and smile. 

Tammy

A crescent moon hangs in the sky, fighting for supremacy over the scattered clouds. Street lights and unnecessarily illuminated buildings pollute the atmosphere and hide the stars, but the blue lights twinkle in their stead. The night is drawing to an end, the last night. The last shift. As it heads to a close, I think back to my first day, my first call, my first patient and wonder if my last call is going to be quite as bizarre.

The calls all night have been routine. No major trauma, no critically ill patients.

"What would you like your last call to be?" My observer for the shift had been quizzing me all night on all aspects of my years on the front line. What had I seen, what had I missed, how had I coped with the mundane, the bizarre and the upsetting.

"I'd love to deliver a baby. Bring one more life into the world. I think that would round everything off very nicely."

It's a far cry from my early years. Maternity calls used to terrify me, even the simple transports. The thought that a routine call could go so horribly wrong, the thought that I could suddenly be thrown from caring for a straightforward pregnant woman to suddenly fighting for two lives at once, used to scare me more than any other call.

A healthy dose of reality, six months on the Baby Bus and delivering almost a dozen babies in just one year (I wonder if that's some sort of record?) put paid to that fear. In total, over the years, I delivered sixteen, but none in the last year. Just one more would be a nice way to end.

"I guess it'll be nicer than a resus!"

"Pretty much anything would be nicer than a resus."

The address appeared on the screen but there were still no other details. A minute later, an update gave the patient's age and gender. Forty-eight year old female. There was still some hope that it would be what I'd asked for, although the chances were slim. Eventually, the call was completed and categorised. Red 2, Breathing problems. Delay as caller very distressed. Caller is patient's mother.

It could be anything from a panic attack to an asthma attack, from back pain to a head ache. It might, just might, even be the wished for maternity. Approaching the address in the early hours of the morning whilst watching the horizon start to brighten, the two of us travel the last mile in silence, trying to prepare mentally for what we could be about to see and the fact that at least for one of us, it'll be for the last time.

An elderly lady, presumably the caller, stands outside the property, one hand on a walking stick and the other using a car bonnet for balance.

"Quick, quick! She's just in the lounge. She won't talk to me!"

Between the two of us, we grab all the bags we're likely to need, at least to start with, to deal with anything from a simple faint to a cardiac arrest. At least five decades younger than our host, we overtake her on the way to the patient and find Tammy sitting in an armchair, eyes wide open but unable to speak. Her mum had finally caught up with us, automatically accepting the two strangers in her front room as if she had known and trusted them for years.

"There's been nothing wrong with her. She's always in and out of here making sure that I'm alright, but she doesn't even take paracetamol!"

Tammy's blood pressure is high and her pulse slower than normal. Her speech is slurred and confused, and she seems troubled by her lost faculties. One arm is strong, the other has no power at all. She can move her head with no problems, so we ask questions with yes or no answers. She understands some, appears confused by others, but keeps trying to answer.

The ambulance arrives, a crew I recognise and who both immediately understand two things; the seriousness of the patient's condition and the fact that this will be my last patient. One unfolds the carry chair, the safety rings clattering into place as they rattle metal on metal. Tammy is helped into the chair, wrapped in a blanket to keep her warm and secured with a strap to keep her safe.

Loaded once more with the bags on our backs, my observer and I walk out behind Tammy and the crew and watch as she's loaded into the ambulance. The tail-lift shuts into place with a thump, the hydraulic whine easing as the pressure is taken off. Moments later, the back door closes too, the blue lights are switched on and Tammy is rushed to hospital.

The return journey to station is almost silent. Traffic is starting to build as the world begins to go about its daily business. A thousand thoughts run through my head. A thousand faces, a thousand places, a thousand cases. But as we finally pull in, driving into the garage for one final time, only one face remains. Tammy looking back at me through the open ambulance door and nodding a wordless thank you. 

Due Date

"Hello, ambulance service, what's the emergency?"

"Quick, my baby is coming!"

"Is the baby coming now?"

"Yes! Quick!"

A rapid response unit is dispatched from the nearest ambulance station, its driver preparing in his mind to add another delivery to his tally. Arriving no more than three minutes later, and rushing with multiple items to the front door, I am met by the lady in question and stupidly, ask the obvious.

"Is the ambulance for you?"

"Yes! Quick! The baby is coming."

The young lady in question is in no distress, and is having no contractions.

"When's the baby due?"

"NOW!"

The calls to ambulance control are numbered, resetting to call number 1 at midnight. This is call number 3. The call start time is only a few seconds after the witching hour. 

"I understand that you think the baby is coming now, but why do you think that? Are you having contractions? Have your waters broken? Do you feel like you need to push?"

"I don't understand what you're asking me. Talk to him. I just need to get to the hospital!"

"Is he your partner?" 

"No. He's my babyfather." Babyfather. I never get used to hearing that. 

He doesn't utter a word, just hands over the yellow book, it's corners dog-eared and cover stained, and the expected delivery date hand-written in the top corner. He points repeatedly to the date as he shoves the book into my hands. Through gritted teeth and a look of disdain he mutters the only words he would say. 

"The book says it's today, so it's today. Now just take her to the damn hospital." 

"Is this your first baby?"

"Mine, yes. Him, not. He's got four. Well, will have today." 

"You do realise that just because the due date is today, doesn't automatically mean that that's when the baby will be born? It's just an estimated due date!" 

"Really?" 

"Really." 

"Oh. But that's why I waited 'til midnight to call!"

"As it happens, most babies aren't born on their due date at all. You need to go into labour first. You know, contractions and stuff." 

"Oh. But it's the due date. So can you take me to the hospital?" 

English Lesson

Blotchy eyed and with a tear-stained face, Claire meets us at the door holding a small child in her arms. His chubby face is flushed with colour and steam comes off him where the cold compress is applied to his back. A quick check with the thermometer only confirms the fever and gives it a number: 40.9 degrees Celsius, or 105 and a little bit in old (and American) money. It's the highest I've ever seen.

"I only went out for five minutes, just to get some milk from the shop. I left him with Liana - the nanny."

She whispered the next bit.

"By the time I got back you were already on the way. Sounds like he's had a febrile convulsion. She was terrified, thought she'd done something wrong, and I can't convince her it wasn't her fault - we both ended up crying. Will you have a word with her? It's just that Andy's never had a fit before."

"No problem. Lets deal with little one first. I have to say, you seem quite calm about it all!"

"I'm a paediatric nurse in the A&E down the road, actually due on shift in an hour. Obviously it's a little different when it's your own, but at least I know what I'm dealing with. We've thrown everything at him, he'd only just had paracetamol just before I went out. Poor Liana's completely freaked out by it all."

Quiet, muffled footsteps shuffled towards us, and I could see Liana tentatively head back into the lounge.

"He's OK?" A slight accent gave away her foreign origins, but I couldn't at first place the country.

"He's absolutely fine. He has a fever, and babies sometimes do that when they can't bring the fever down. He needs some medicine, but he should be just fine."

"So I shouldn't called the ambulance?"

"It was good to call the ambulance. If a baby has a fit then he needs help - so don't worry."

"I'm sorry. I don't want you tell me off, I don't want you think I hurt Andy." Her look darted between Claire and me. "I love Andy - he's like my own baby - I never hurting him!"

Claire handed Andy over to me and went to put her arms around Liana. "You did everything right. I know you would never do anything to harm him." Then she turned to me. "Liana's been here for nine months, since he was five months old and I went back to work. She's like gold dust - I don't know how I'd ever manage without her! I'm helping her with English, and she's trying to teach me Greek - although she's a much better student than I'll ever be."

At last, Liana smiled.

"I can hold Andy?" she asked Claire.

"Of course you can."

"Efxaristo!" she said as she took Andy from me and held him tight. 

"I presume that means thank you?" I asked Claire.

"You're a quicker student than I am!"

"But now," laughed Liana, "you have to say it!"

"Forget it. My language-student days are over. I'm sticking to what I know."

As we walked in to the department, Claire was met with some quizzical looks, one in particular from the nurse in charge.

"I know it's a bit rough in here these days, but now you bring your own security detail?"

"Well, you know, these paramedics, they're always hassling us, interrupting our peace and quiet. I thought it was time we hassled them instead."

"Sorry," interrupted Liana, "this word hassle, it means to look after somebody?"

We left them in the department and went to find someone else to hassle.

Coping

Eyes glazed and bloodshot, he stands in a corner at the side of the building trying to hide his tears, but to no avail. His colleagues avoid his eyes, fearing that they'll make things worse. Last time him and I met on a call, it was after a man had been shot in the head. He sat holding a bandage over the bleeding wound whilst we worked to save the man's life, none of us fazed by the scene or its consequences. 

"It's never the big things that get you. It's always the ones you least expect!" A word at a time, sobbing through a simple sentence, he managed to verbalise what we all felt. 

His police uniform, bullet-proof vest and all might shield his exterior, but his insides were in turmoil. We all were. He was just brave enough to show it, even with his colleagues and superiors around. I'm not that brave.

At the scene, blood trailed around the house. 

There were no screams. 

No shouts. 

No reaction at all. 

And just for once, I wish there were. It might have made things seem less surreal, and maybe we'd have had less time to think. 

When it was all over, the scene was cleared, the ambulance had taken the patient away, and I was left with my car and a dozen police officers. I tidied up outside and went to talk to him, trying to rationalise the medical side of what we'd just seen. 

But a dead baby can't be explained. 

It can't be rationalised. 

It can't be forgotten. 

Our uniform makes people think that we can deal with anything, sometimes we think the same too. Sometimes we believe that we can see anything and just go home at the end of the day as if we've had just another day at the office.

But we're as human as a bank clerk, a teacher, a garbage collector. Each of us finds a way to cope, because we have to, just so we can go back to work each day and do it all again. 

And for now, at least for me, coping means that I travel to and from work using a different route, just so I don't drive past the scene every day and see those vacant eyes. The eyes that stared back at me from the blood-soaked crib. 

Hysterics

As I mind my own business walking around the local supermarket someone I've never met starts a conversation. 

"You don't remember me, do you?" 

I get nervous when I hear things like that. She'd walked past me down one of the aisles a few minutes earlier, and gave me a funny look that I just shrugged off. Her daughter, probably three-years-old, was sat in the half-trolley, half-car, trying to grab anything off the shelves that took her fancy. I recognised the constant struggle with a toddler, and was pleased that I no longer have to deal with it. Having said that, bigger kids, sometimes bigger problems.

"Sorry, I don't remember." 

"Well, do you remember my daughter?" 

"Also not. I'm sorry. " I'd put the idea that she could have been a patient out my head, as I live and shop some distance from where I work. 

"Well, really, you should remember her more than me, as you met her first!"

"Pardon?"

"Well," she said, clearly enjoying the exchange as much as I was confused by it, "this is Aleesha, and you and your colleague brought her into the world!" 

A few seconds passed as I regained my composure. 

"Oh! Wow! I've never met anyone I've delivered before!"

"Well, now you have!" She turns to Aleesha, just as the toddler's about to take some chocolate from the shelf.

"What do you say to the nice man?" 

Aleesha quickly hides the chocolate in her car, looks sheepishly down at her feet and mumbles a barely audible word. 

"Sorry..." she says, as mum and a very strange man burst into hysterics. 

Shortlist

It all seemed so simple. We turned up at the house for what appeared to be yet another "maternataxi". An ambulance being called to a woman in early labour for simple transport, where after nine months of preparation, buying clothes, painting nurseries, and building cots, no-one had thought about how to get to the hospital. Either that, or it's just that we're the cheapest option. Taxis cost money, as does parking, so an ambulance that will deliver you (sorry) to the front door and not cost a penny is a very attractive proposition.

Zara had two days to go according to her notes, but babies rarely arrive exactly when expected unless it's by planned Caesarean. Whoever called the ambulance told the call taker that the contractions were two minutes apart, whereas in reality it was nearly five. Her waters hadn't broken, this was her first pregnancy, and she wasn't too troubled by the contractions even when they did occur. Her husband said he'd make his own way in the car. He could have taken Zara too, but probably feared the mess if she delivered on route. Either that or he panicked. I gave him the benefit of the doubt as it was their first baby.

"Which hospital are you booked into?"

"Faraway hospital," she answered. Not the answer we'd hoped for. There were at least five other maternity units that were nearer in all directions, but if that's where she was booked, that's where we were taking her. It was over half an hour away, if the traffic was bad it could be double that, and the only reason she wanted to go there was because she had heard from friends that it was a good place to go. She never quite took into account the fact that she actually had to get there, and possibly in a hurry.

"Lucky you're not booked into Edinburgh hospital!" I commented, only half joking, trying to hide the nervousness I felt at a long trek with a labouring mother-to-be. Zara's husband stuck his head back in and asked if we would take the luggage as well and then he'd follow us to hospital.

"I'll be right behind you. Don't have the baby without me!" I hoped Zara's husband was right. We told him that if the traffic was particularly bad, we'd cheat and use the lights, and he had to make sure that he got there safely, even if it meant a slight delay.

I was fairly new, with only one delivery under my belt, an easy home birth where the midwife turned up less than five minutes too late. I was working with a partner who'd long ago lost interest in treating patients. He was working out the years until his retirement and spent most of his time driving the ambulance, ignoring both patients and crew mates alike.

"She'll be fine," he said, "we'll make it there with enough time for us to grow the coffee beans and still drink them before she has this baby." With that, he shut me and the patient in the back, and started gently trundling to hospital. Half way there, something about the way she was contracting changed. The look on her face was more anguished, the mix of gas-and-air in the bottle with the chipped blue paint no longer worked its magic quite so effectively. I called through to the front and explained what was happening. My crew mate looked up briefly in the mirror, switched on the lights and pushed the engine a little harder. The engine roared a response, but the actual change in speed was barely perceptible. Zara certainly didn't seem to notice the difference. I placed a maternity kit on the trolley, just by her feet, hoping the clear plastic case would remain sealed.

We called ahead to the hospital and asked them to make sure we were met by the front door, as it was notoriously difficult to get into the unit in a hurry. It involved two doors that required remote access, and a lift in between the floors where the doors were located. Waiting at each stage could easily add ten minutes to the journey. The lights and sirens had no real effect on the speed, but at least we could weave a little easier through the daytime traffic. Fifteen minutes and six or seven sets of strengthening contractions later, we pulled up outside the hospital. As expected, despite our prior warning and plea, there was no one there to meet us.

Zara screamed. She yelled about needing to go to the toilet. Desperately. There are two sets of patients who tell us that. One set is those having some sort of cardiac event, who if allowed to go will probably collapse, or worse. The other set is mothers in labour who are about to deliver their babies. As we lowered the trolley out of the ambulance, I was in a way glad of Zara's panic. It was doing a great job of masking mine. We pressed the button and waited for what seemed like an eternity until someone answered. We didn't need to identify ourselves, Zara once again did it for us.

"Get the lift down here, and get these doors open!" yelled my crew mate. It was the first time I'd seen any sense of urgency about the man.

Dragging the trolley up a slight ramp into the building, I prayed for the lift doors to open, and a midwife to be standing inside. Neither happened. I pressed to call the lift, and the square button lit up, its dim red light stopping us from proceeding. As the lift arrived, the light went off and a bell chimed to announce the blindingly obvious. Another chrome button, this time with a large "2" embossed both as a regular numeral and in braille. Once again I cursed hospitals everywhere for not having all maternity units on the ground floor.

We stopped on the first floor, a frightened looking mother and child taking one look inside and deciding to wait for the next time round. Another delay, another contraction, another scream. I frantically looked for the button that closed the doors again, only to find that there wasn't one. Instead I pressed the number 2 again, willing the lift to move. Zara had practically finished the entonox, and I promised her that there was more on the unit. All she had to do was hold on another minute.

I timed it. Forty-five seconds from when we stopped on the first floor, until we starting rising again, another thirty for the doors to open on the second door. As we landed, Zara contracted once again, and begged us not to move until it was over. We stood, waited, and prayed.

"It's coming!" She yelled. "Now!"

My crew mate got out the lift and pressed the buzzer to ask the staff to let us in. A distance of no more than five metres. As he got out and pushed the button, Zara pushed the baby.

There was a gush of water as the amniotic fluid escaped from the sac, and a scream as the baby's head appeared an instant later. The scream was Zara's, but it might as well have been mine. In the meantime, the unit's doors remained firmly shut, the magnets holding them in place still secured by an electrical circuit. Finally, training took over from panic, and I gently held the babies head as it turned. The next contraction didn't move anything, and in between the pains my crew mate resorted to bashing on the ward doors instead of pressing on the buzzer. But it was too late.

One more contraction, and Zara was able to hold her beautiful baby girl.

"Time of delivery - 13:14. Born in a lift."

She seemed, from my limited experience at the time, to be quite a big baby. Thirty seconds after she made an appearance, a midwife finally came to open the doors.

"What gives you the right to make such a noise? We're very busy in there, and if we don't answer the door, you'll just have to wait!" She emphasised each of the last four words through gritted teeth.

"Unfortunately," I said, somewhat cooler than I'd imagined possible given the circumstances, "this young lady couldn't wait any longer." I pointed to Zara and the little bundle she was cuddling, each wrapped in an appropriately sized ambulance issue blanket.

Instantly, the attitude changed. We were led inside, shown into a delivery room, and assisted Zara to move across from our narrow and uncomfortable trolley onto the hospital bed. There was the small issue of the cord and placenta to deal with, of which the midwives now took charge. The baby was taken to be cleaned and weighed, a shout from across the room announcing that what I'd guessed at being 'quite big' turned out to be well over four kilos, some nine-and-a-half pounds.

Zara was given an injection in her thigh, and with that chemical encouragement, the placenta too was delivered. She was free to hold her baby again now she'd been cleaned, and at that point her husband appeared. He was puffing and panting as if he'd been through the labour himself.

"I thought I told you to wait for me!" he gasped, leaning over to kiss both his girls.

"Have you got a name for her yet?" asked the midwife who'd initially let us in, now suddenly full of smiles.

"Not yet," they answered in unison.

"We've got a shortlist," Zara added, "but we hadn't definitely decided. We had a definite name for a boy, but this little one will have to wait a little while."

"How about Ellie?" I ventured. Zara looked offended.

"You mean short for elephant? Just because she's a big baby?"

"Actually, I meant Ellie as in short for elevator. I didn't think about the weight!"

"She was born in the lift?" asked the new dad, his voice an octave higher than it should have been. "How did I miss out on all that action? I can't believe it!" He sank into the armchair next to the bed, gently stroking his little girl's wispy hair. "What do you think Zara?" he added after a few moments. "It's quite a nice name? And what with all the circumstances, it really fits too..."

"I'm too tired to think about it right now." Zara replied. Single tears from each eye took a gentle stroll down both her cheeks as she gazed lovingly at her newborn daughter. "Why don't we just add it to the shortlist?"

Sleeping Partner

The bed is covered in blood. The floor is too. Apparently there's loads of the stuff in the bathroom as well.

"We left it there, unflushed, just in case you wanted to see it!" I'd seen enough already, without having to go snooping in someone else's toilet bowl.

Another one of my return customers, Greg and I had met on a previous similar occasion, and probably about a year had passed since then. Maybe eighteen months. The alcohol he'd taken on board over years, slowly destroying him from the inside out. He looked pale, gray even, and was sweating as though he'd just run a marathon in the Sahara Desert.

"I'm gonna die, aren't I?" Greg asks. The fear in his voice is only too real. "Not in my ambulance you're not". I think it, but don't say it. Patients who genuinely fear it, and voice that fear, often know.

"No, Greg, you're not. We're going to get you up to the hospital as quick as we can, and get you sorted."

"We? You're the only one here!" And he's right.

"Another ambulance is on its way. They'll be here soon enough!" I hope my prediction is a self-fulfilling one. I need them in a hurry. In the meantime, I start getting some fluids into him. It's another case of salty water replacing blood, but at least it gives the heart something to work with until we can get him the real stuff he needs. The blood that's left inside him will have to work extra hard to pump round the oxygen that's free-flowing into him through the mask on his face. At least he's stopped vomiting for a while. I don't know how much he's lost internally, but just from what I can see in front of me, he must have expelled a third of his blood volume. By the time the crew arrive, he's had about a litre of fluid back in through a thankfully large vein in his arm.

I hear them downstairs and yell: "Bring a chair up with you!" Often crews backing up first responders will come in to see what's going on, and only then decide what extra things they'll need. Usually it works just fine. Luckily the crew recognised my voice, and the urgency in it, to know not to ask questions.

"Last time I needed surgery. And they gave me nearly twenty bags of blood apparently. But I don't really remember anything. They told me if it happened again, if I didn't stop drinking, that I'd probably kill myself."

He started sobbing.

"I have, haven't I? I've killed myself! And now, two days before my son's due to be born!"

A neighbour was with Greg the whole time we were there, but no-one pregnant.

"Where is she Greg? Where's your partner?" I thought that a friendly face might help calm him a little.

"She went up to her mum's last night, up north somewhere. I've got her mobile number, but I don't want to call her now. It's too early!" Barely in control of his own body, he was still worried enough about his partner and unborn child. "I didn't mean to drink so much. I shouldn't have had anything at all. It's the first time in months!"

We moved Greg to the ambulance, a creaking flight of wooden steps leading down to the front door and out into the cold night's air. Dawn was breaking across the horizon, and the traffic was just starting to build as normal people started another working day. Leaving my car on scene, I travelled with Greg, an extra pair of hands always helpful with a particularly ill patient. The siren blared its way, ensuring the cars cleared the way for us to make a smooth but rapid journey to hospital.

"I don't want to hear the sirens! I don't..." He wept again. "I just want to hear my baby cry..."

We arrived at the hospital, a team ready to meet us was standing round the designated bed.

A doctor listened to the handover and asked for some blood almost immediately, as a student nurse hooked him up to the machines. A nurse thanked his luck for finding a decent vein and put a second needle in the arm I'd left alone.

Greg's tears flowed, and he was barely able to catch his breath between sobs. "Just help me see my baby! Just once! Please... Please..."
Another nurse left the cubicle without a word, and hurried to wake his partner.

Loco Parentis

The door is opened by a middle aged woman, cigarette hanging off her lips, her attitude delighting us almost as much as the smoke in our faces.

"You take this bag, and I'll bring her out in a minute!" She dumps a pink hold-all in my surprised arms, and shuts the door almost completely, leaving us in the pouring rain. The inch of artificial light shining between the door and the frame means the gap is just wide enough for us to hear our patient and her cries of pain. Our requests to be allowed in to at least see and start to assess the patient are met with defiance.

"You stay out there. I don't want your muddy boots in my house. I told you she'll be down in a minute."

The tirade changes direction and is re-aimed at the patient.

"Come on already. They're here. And you make sure that you don't have any of that gas stuff they're gonna offer you. You don't need it!"

A minute or so later, Mina appears. 18-years-old and a week overdue with her first baby, she looks just about ready to pop. She has a look about her that's a mix of excitement and anticipation, as well as fear of the unknown.

We invite Mina into the back of the ambulance, and ask her whether she'd be more comfortable sitting on the chair or lying on the trolley. She chooses the chair, and as she sits down, another contraction begins. I write the exact time down on my glove, ready to time the frequency and length of each contraction.

Her pregnancy notes suggest that all has been well for the duration, that the health of mother and baby is satisfactory, and even, from just the day before, that the baby was head down and ready to be born. Her vital signs are normal, and contractions now two minutes apart. She seems to be at the stage of labour that makes most ambulance staff nervous about a BBA, a baby Born Before Arrival at hospital, and start to think about the mess they're going to have to clean up.

I offer Mina some entonox, the magic pain relieving gas. She takes the equipment in her hand, only for her mother to snatch it away.

"I told you, you don't need that rubbish. I never had any when you were born, and you're certainly not going to have any with your baby either!"

Mina looks downtrodden.

"I'm sorry", I say to her mother, "but you're not the patient in this case. If Mina decides she wants the gas, then she is more than welcome to use it".

"You. Are not. Her mother", she spits through gritted teeth, "And you're not going to make the decisions. She's MY daughter, MY responsibility, and it's MY decision!"

"You're absolutely right, it's not my decision. But it's not yours either. It's Mina's. She's old enough to make her own decisions. If she wants to use the entonox she uses it. I understand you're almost as anxious as she is, but right now you're not the patient. Mina, would you like the gas?"

She's terrified, struggling with the conflict between the pain she's in and her mother's overbearing presence. She nods an almost imperceptible "yes", and I hand her the entonox once again, just as another contraction starts.

"Well, if she keeps using the gas, then I'm not going with her to the hospital!"

Shocked looks are exchanged between Mina, her mother, and the crew.

"That's your choice! You decide! Yes gas, no mother!"

Another contraction starts, and I tell them both that we're leaving, as this baby wants to make an entrance, sooner rather than later. Mina screams with the contraction, takes another few lungs-full of entonox, and her mother storms out the back door and back into the house.

"You do it on your own then!" she screams, as she slams the door behind her.

Mina's resolute, and tells us to go, as her partner should be at the hospital within the hour anyway.

The transport is relatively uneventful, other than the contractions strengthening and becoming more frequent, causing us to move Mina onto the trolley. Just in case. We arrive at hospital, and Mina moves across onto the delivery suite's bed. As she does so, her waters break, and a baby's head appears.

"Stay with me", she begs the two of us. We do.

A minute later, her baby boy is born, and in loco parentis we witness her joy.

"Thank you, both of you. And don't worry about my mother. She'll be up here apologising soon enough. Stubborn cow that she is."

We congratulate Mina, refuse to have our photo taken with her and the baby, and head back to the ambulance to pack away the trolley.

As we sit back in the front completing the call, a car races into the car park, its driver rushes straight past us and into the department, begging to be allowed to see her daughter.

Sleep

"Have you ever seen something at work that you wish you'd never seen, or that you'll never see again?"

"Sure there is."

"Was it a bad crash or something?"

"No, it wasn't. There are much worse things to see than that."

"Such as?"

"Well, if I never ever again see another neglected, abused child, it'll be too soon."

"So you've actually seen it? Bad child abuse I mean?"

"Yes. I've seen it."

"How did you cope?"

"I called the police, looked after the child, took them to hospital, and made sure they were cared for."

"And then what?"

"Then, I saw another dozen patients in the shift, and carried on as normal."

"And that's it?!"

"Nope. Come the morning I went home, hugged my kids, had some breakfast, and cried myself to sleep."

Noise

Opening the door of the ambulance, there's a noise.

An almost feral scream.

Entering the house, there's a noise.

An accusatory shout, querying the delay.

As the kit is prepared, there's a noise.

A low groan, panting, pushing.

As it's being born, there's a noise.

A parent's question, checking the baby's welfare.

Once the baby makes a full appearance, there's no noise.

No noise at all.

As it arrives, it's blue, lifeless. Silent.

We warm it, dry it, breathe for it.

After a few forced breaths, there's a noise.

The noise of a newborn's cry.

As the lungs open up and greet the world, there's a noise.

A loud, high-pitched, life-saving noise.

The most beautiful noise in the world.

Nosey Neighbours

"40 West St, East Area, Baby crying constantly for last hour".

It's a call that's come directly from the police.

That's an emergency? That's what I spent all that time training for? You need parenting classes, not an emergency ambulance! Nevertheless, it's off to the address to see what's probably a teething baby and convey it needlessly to hospital. One of the residents of number 40 is standing on the doorstep, and we head over towards them. It's about one in the morning, the street's quiet, and other than our voices, there are no other sounds. Not even a crying baby.

"You managed to calm the baby down then?"

"No, the baby's still crying. Follow me please."

We walk up a flight of stairs, and I still don't hear any crying. We're shown into a back room, and finally, a faint cry can be heard. Except that there's no baby in the room, and it's almost as though, judging by the direction of the noise, that the baby's been hidden in the cupboard.

"Where's the baby?"

"We think it's next door. There are no babies in this house, and it's been crying for nearly two hours now."

"If the baby's next door, why did you bring us here?" I can't help thinking that this is a case of nosey-neighbouritis.

"We've tried knocking on the door, ringing the doorbell, and nothing. No-one's answering. They're a really nice couple. He works some weird hours, think he's a copper or detective or something, and she's always home with the little one. Only seems to go out for shopping."

We go back out the house and try to look through the front door and windows. There's a light shining through from the back of the house, and some flickering that suggests the television is on too. Someone's definitely home. An adult. Just like the neighbours, we try the doorbell, we try banging on the door and the windows. When there's still no response, we ask the police to turn up. Just to tug a little harder on the heartstrings in the police control room, and hopefully ensure a more swift response, we tell them that there's possibly an infant in danger.

It works. Less than five minutes later there are two units on scene.

One of the officers goes back into number 40, into the back garden, and scales the fence to see if he can find anyone or anything. A few seconds later, there's a yell.

"She's here, on the ground. The doors are locked, someone get the enforcer!"

The enforcer is affectionately known as the big red door key. It's a single-operator battering ram, made of metal and painted red, weighing several kilos. It opens most front doors with just a few well-placed blows. Hence the key reference. It's not carried in all police vehicles, and sometimes has to be specially requested to scene.

Whilst we wait, and feeling a little more athletic than normal, I decide to scale the fence myself to have a look.

She's lying on the floor of the kitchen, face down and looking away from the door. The only movement is her slow, rhythmical breathing. The television is showing some shopping channel, trying to sell an item for thousands that is probably only worth its weight in paper. As I'm standing next to the police officer, his radio blares back that the enforcer is on its way, but it'll take 15 minutes or so to get there. At a rough estimate, and looking from a distance through the patio door, our patient was breathing no more than 6 times a minute, barely enough to sustain life for any length of time. Back over the fence and through the neighbours' front door, I call out to Kim.

"I need the oxygen bag and a blanket!" My crew mate looks at me confused.

"Have you found a way in?"

"Not yet, but we're about to!"

I take the items round the back of the house, and grab another pair of hands in the form of a tall police officer. The officers take one top corner each of the blanket, and place it over the double-glazed door.

"Wish me luck!" The first tentative strike at the glass meets with stubborn resistance.

The second is more successful. The shattered glass cascades downwards like a shower of hail, the blanket protecting the officers and me from getting covered. The patient is far enough from the door not to be at any risk.

One step into the house and the smell gives away its secret. One officer goes to the front door and opens it. He yells to everyone not to touch any light switches.

I go to the unconscious patient and using a bag and mask, help to pump oxygen into her starved lungs.

The second officer goes straight to the gas hob and turns off the ring that had blown out.

Kim runs upstairs and grabs a baby, no more than six months old.

A torrent of instructions are yelled in all directions, from needing more oxygen and opening all the windows, to getting the carry chair, alerting the fire-brigade, the need to get us all out and both mother and baby to hospital in a hurry. No other crew is available, so we're taking them both. with a 2 metre tall policeman playing nursemaid to the baby, she looks like a miniature doll in his arms.

At hospital, when they're no longer our patients, it's a little easier to reflect. To ask all the what ifs.

What if we'd have been a little longer?

What if the baby hadn't cried so loudly?

What, despite my initial cynicism, if the neighbours hadn't been so nosey?

Luckily, we never found out.

At Home

And so, with no pomp or circumstance whatsoever, it came to an end. A mundane call just before six o'clock in the morning, a simple handover to the crew, and a slightly solemn and very lonely drive back to station. I don't know what I was expecting or hoping for.

Almost five years ago, I started it for the first time. It lasted 6 months, and I hated almost every minute of it. I stuck at it because it was challenging and different, but I still couldn't stand it. At the end of the allocated half-dozen moons, you couldn't see me for dust in my haste to get away. Maybe I was just too young and inexperienced, maybe I was just lacking in confidence. Whatever it was, I was pleased it was over.

Almost two years ago, through lack of choice and with fear and trepidation, I went back to it. Last week it came to a halt, again through no choice of my own. My time on the FRU, the single-manned (personed) Fast Response Unit, has ended. All the things I hated about it the first time round, I loved this time, and I will sorely miss. I guess I'd grown up a little in the interim, and eventually started to feel at home in the FRU.

The most appealing is the challenge of having to think on your own, often for extended periods of time, and sometimes with very ill patients.

Starting a resus on your own and having to carry it out with no back-up for quarter of an hour.

Managing the asthmatic patient who's deteriorating before your very eyes.

Relieving the pain in the elderly patient who's fallen and fractured their hip.

And being unable to transport any of them.

Delivering a baby and praying for it to take its first breath.

Supporting the dislocated shoulder of a brave kid and watching them get drunk on entonox.

Sticking a plaster, or a band-aid, depending on where you are, on an adult who's behaving like a spoilt child.

And telling him so.

Being the first at the scene of a suicide attempt, working hard to save a life, only to see the patient whisked off in the ambulance or the helicopter, and staying at the scene filling in paperwork.

Being the first at the scene of a fatal accident, and having to call it before anyone else even turns up.

Being the first at the scene of a cardiac arrest, a terminally ill cancer patient, and grieving with the family.

And being left alone with your thoughts and a cup of coffee.

Travelling with a crew and them hating you for pulling rank.

Travelling with a crew and them loving you for pulling rank.

Travelling with a crew and the patient thanking you all. Together.

And having to justify it all. To control, to the crew, to the patient, to yourself.

Now, it's back to a mix of real ambulances and a few FRU shifts, but it won't be my car.

It'll be nice to have someone to share with, someone who I can look at over my shoulder when I'm unsure, and hopefully vice versa, someone to sing along to the radio with between and on the way to calls.

They say, whoever they are, that a change is as good as a holiday. Truth is, I could really do with one right now. It's just that I'll miss being at home.

Who'd have thought it?

Possibly, Probably

I had to be honest. "Possibly not", was the best answer I could come up with.

How do they do it? How do kids always know to pick that one moment? The split second sometimes when the adult's gaze is averted, their attention diverted, is the exact moment that their child decides to do something dangerous.

*

A year and a half is a long time in the life of a toddler. Long enough to fill them with a sense of adventure, a love of excitement, a curious wonder, and no fear of danger whatsoever. Milly was a typical 18-month-old girl, waddling and toddling from one new find to the next. This time, the next find happened to be a marble. Well, a bag of marbles, but one marble in particular was to be the cause of all the excitement over the next few minutes.

The bedtime routine was more or less adhered to. Milly and her big brother Dan, had dinner at six, bath time at half past, story at seven, lights out at quarter past. Their parents split their nights, taking it in turns to make sure that both of them read to each of their elder children on different nights. Milly and Dan's baby sister, only two months old, didn't yet believe in timekeeping and routines, and during this one bedtime decided to scream, just after bath time. Milly was left in pyjamas and ready for bed, whilst mum went to tend to her sister. Her dad was just sorting Dan out upstairs. It was a perfect time for Milly to go discovering her big brother's collection of marbles.

As mum was dealing with baby and dad was settling Dan, Milly started to cough. A strange cough, one like Milly's mum and her intuition had never heard before. She rushed back in, baby in arms, and saw Milly struggling to breath.

"Tony! Tony, get in here now!"

Dad ran downstairs, saw what was happening, picked Milly up and looked in her mouth, hooked a finger in to see what he could find, and then tipped her upside down to see if he could dislodge whatever it was.

Mum was on the phone to the Ambulance Service.

Milly continued to struggle for breath.

Parents were frantic, Dan was scared to the point of tears, when all of a sudden, after a lifetime of being held upside down and patted harshly on her back, Milly coughed once more, screamed, and cried.

At that point, we walked in. Ninety-nine times out of a hundred, when called to a choking, the call will downgrade whilst we're on the way. What will start as a call to a non-breathing patient will often, through the wonders of the human body and its capacity to fix itself, turn into a post-choking, now breathing normally call. This time, it didn't happen, and until the second we walked into the house, we were on the way to a child still choking. Five minutes from the start of the call until the second we clambered over the building site of a driveway and into the house.

As I stepped across the threshold, I heard her scream, and breathed a sigh of relief. You can't choke and scream at the same time. It's physically impossible, so I knew Milly was no longer choking. The look in Milly's parents' eyes told the story. There was a mix of fear and panic, along with tears of relief welling up, threatening to burst their banks.

"She must have picked up a marble when we weren't looking. That's all I can guess, because they weren't all over the floor before".

I left Milly in dad's hands whilst I listened to her lungs, and checked that her breathing was completely back to normal.

Dad started to tell me what he did. "I just picked her up and stuck my finger in her mouth to see if I could find anything, but there was nothing there!"

Alarm bells rang. "I don't mean to tell you off, and I certainly don't want to scare you, but please don't do that again. If you blindly put your finger in, you could push whatever is there in the wrong direction, which could be the worst thing to do". He looked shocked.

"And then I tipped her upside down, and patted her on the back, and then you came in and saw what happened." Now, that's a better idea.

"Can I ask you a question?" said mum. Questions always welcomed, I just hoped I had the answer.

"If she'd have kept choking, and you'd have been another couple of minutes, would you have been here in time?"

I had to be honest. "Possibly not", was the best answer I could come up with. "But that's where you come in. That's why control give you the instructions, to give us the extra time to get here. You need to be able to help us to help you".

On the way to hospital, we talked about how kids are there to scare us as parents, how, even with all my training as a paramedic, I still hate it when it's one of my kids that's unwell or injured, and how MrsInsomniac has the luxury of panicking whilst I deal with whatever crisis may arise. Except, obviously, when I'm not there.

"So what can I do?" Milly's mum asked.

"Well, a first aid course would be a great start". It's something I strongly believe every parent should be offered and something I recommend regularly to all parents I meet in the line of duty.

It's true. First aid courses can't prepare you for every eventuality, but they can give you the confidence to know that what you're doing is definitely going to help, at least until the ambulance arrives. Whether it be CPR, how to deal with burns, with injuries, or, just like in this case, with a choking baby. Those few minutes of immediate care can make all the difference. They could change the outcome, they could improve survival chances, and they could even change my answer to Milly's mum's question, and in fact, the question itself.

Instead of saying "probably not" to the question she asked, she could ask a different one, a question with a very different answer.

"Could I be the one to make the difference?"

With just a little bit of training, even of the very basic kind, very probably.

Two Hours

Jen's been a little overweight almost all of her life, enough to give the kids at junior school the excuse to tease and bully her, but never really badly enough for her to want to do something drastic about it. Sure, she'd tried diets, fads, exercise, everything, but always ended up back where she'd started. Her parents had, maybe a little tactlessly, nick-named her YoYo thanks to her eternally fluctuating weight. Eventually, at almost 18 years old, she'd learnt to accept who she was and what she looked like and live her life the best way she knew how. She went to a good school, had friends, many of whom had been her tormentors in earlier years, and now saw Jen for who she really was, rather than how she appeared. And she had a boyfriend, Ian, a childhood sweetheart who'd been her partner now for almost four years.

It was Ian who'd called the ambulance. An 18 year old female with abdo pain doesn't fill any ambulance crew with the joys of spring. It's another routine, mundane call, often leading to mutterings of "waste of time", "taxi run", and "bet they haven't taken any pain-killers". Nevertheless, the way the call comes in, we have to run on lights-and-sirens.

As we walk in, Jen looks a little embarrassed, apologises for calling us out, and says that the pain has passed. "He panicked a bit", she starts, "the pain was really bad, and it came back a couple of times, but it's gone now. Really, guys, I don't need an ambulance. I'm sorry".

She's pleasant enough, too nice to be mad at, and clearly concerned as to how ridiculous she seems.

"We'll just do a couple of quick checks, make sure you're really ok, then we'll leave you alone. But if the pain was as bad as Ian described it, maybe you should come with us anyway, just to be on the safe side".

Abdo pain is such a minefield. It can be everything and nothing. Anything from uncomfortable food poisoning from last night's drunken take-away, all the way to a deadly ruptured aorta, the body's trunk-route for blood distribution.

She sat comfortably on the couch, hand on her lower abdomen, the memory of the pain still there, the brain trying to do its usual trick of erasing it. We check her basic observations, her pulse is a little quick, her blood pressure normal. We take her temperature, placing the tympanic thermometer in her ear - a quick and painless way of doing what used to take 3 minutes of sitting still with a piece of glass stuck under your tongue.

Jen suddenly screams. A piercing, terrifying scream that made me jump back, wondering how I could have inflicted such pain by just taking a temperature. She arches her back, holds on to the couch as though she was clutching at life. The pain lasts for no more than 30 seconds, and is gone as if nothing had happened. She looks down at the floor, suddenly refusing to make eye-contact and mutters, barely audibly, "I think I've wet myself".

A minute later, the pain returns again, and it finally dawns on us.

"Jen, how many months pregnant are you?"

"I'M NOT PREGNANT! WHAT ARE YOU TALKING ABOUT?"

"Jen, these pains are contractions. You're about to have a baby! How many months are you?"

Ian and Jen stare at each other.

"I can't be pregnant! I'd know if I was! I've only put on a bit of weight. I'm NOT PREGNANT"

Much as she tried, much as she wanted to, there was no denying it. Jen was in labour. Her waters had just broken, she was having contractions every minute. The baby was about to be born. We asked for a midwife, and another crew, and started preparing for the birth. We have no idea how developed the baby will be, so have to prepare for every eventuality, from a normal delivery to the horrendous thought of having to resuscitate a tiny newborn. There was hardly the time to think.

The baby's head appeared in the very next contraction, and by the one after that, a newborn baby's cry filled the room. The baby girl seemed a good size, a good colour, and there was clearly nothing wrong with her lungs as her voice made her surprise appearance clear to all. We cut the umbilical cord, cleaned her up, and I handed her to the new mum.

"Here she is! Your beautiful baby girl!"

Jen looked away, kept her arms folded, and through stifled tears whispered "I don't want it".

"It", she said. not "her". I was shocked and saddened, trying to understand the turmoil that Jen was going through. An hour ago she had some tummy ache, now she had a daughter. I couldn't get my head round it any more than she could. She couldn't, wouldn't, accept that this baby was hers. To her, the little girl was an "it".

The second crew turned up just after she was born. The midwife was still miles away. We decided to send mother and baby to hospital in separate ambulances, and not wait in the midst of the anger, the confusion and the rejection. Jen came with us, a few minutes after her baby had gone. A few minutes to gather her belongings, gather her lost dignity, and gather her muddled thoughts.

At the hospital, we're shown into a room, and as we walk in, Jen having refused to travel on the trolley bed. There's a small cot already there, and in it a sleeping baby, swaddled in a pink blanket. Jen gets onto the bed and says nothing. One of the midwives asks us for the story, we take her aside and explain all that has happened. Slowly and quietly, the cot is moved nearer and nearer to Jen's bed as she has her blood pressure checked and a midwife reels off a seemingly never-ending list of questions.

Absentmindedly, as she answers the queries about her health, about the pregnancy she never knew she had, and about her personal life, Jen's hand moves to the cot. She sits there, a tiny smile slowly creeping onto her face, as she strokes her daughter's soft, downy hair.

"I want her". As the words escape her lips, she grins, then bursts into tears. "I want to keep her. I want her to be mine".

She seems hardly to believe her own thoughts, as if someone else had spoken them. But she was exceptionally proud of them.

"She is yours, Jen", says one of the midwives. "And there's nothing you can do about it".

She just sits there, uncomfortable on the ancient hospital bed, the initial shock on her face and sadness in her eyes, turned now to relief and happiness like she has never experienced.
Two hours earlier, it had all been so very different.

Except

Came in to find that all the shifts are changing, and not for the better. Would love to stay doing what I'm doing after they change.

Except I can't. So onwards and upwards.

*

Well, at least the vehicle works. It stinks of cigarettes, but at least it works.

Except it doesn't - not to the extent I need it to.

*

It starts OK, but the flashing lights and computer screens on it don't. But at least I can get it to the people who can supposedly fix it.

Except they can't.

*

So I then spend the next five hours being told to drive from pillar to post to find a working car. Apparently you have the supposedly "bigger picture".

Except you don't. You have a severe case of LeftHandRightHandItis.

*

After driving from pillar number 4 to post number 5, you then phone me up, tell me off for not being back at point number 1, and that I'm shirking my duties.

Except I'm not. I'm doing anything but.

*

So I arrive at work almost an hour early, try to solve the problems, follow your instructions to the letter, and still get told off.

Except that you don't do it yourself - you send someone else to tell me off. Cowards.

*

Finally, despite risking being sectioned and put away for temporary insanity by screaming out loud, I have a working vehicle. I can do my job.

And just as an aside, I'm sure you felt good about getting the vehicle on the road. I'm sure you felt good about bullying one of your loyal members of staff. I'm sure you felt good that all the numbers tallied up.

Except that, despite your best efforts, I win.

*

How many of you up there went home knowing that they'd come to work and helped a mum deliver her baby? No hands up?

Oh well.

I know that I did.

Footwell

Even if you put the seat belt around you both.
Even if you hold on to her as tightly as you can.
Even if you think you're only driving down the road.
It's a stupid thing to do.
*
When we come to get you out of your car.
When we have to cut the roof off, and you out of it.
When we think that a five-seat car only has five passengers.
It's a horrible thing to be proved wrong.
*
As the noise of the cutters finally stops.
As the chaos of the rescue comes to an end.
As the ambulances start to take you all away.
It's a dreadful thing to hear your scream.
*
Just when we thought that you were all safe.
Just when we thought it was time to leave.
Just when we thought that all the harm was already done.
It's a moment of horror as we find there's one more.
*
And she lies there, in the foot well, as if she's asleep.
And she lies there, in the foot well, no lap keeping her still.
And she lies there, in the foot well, killed by the one sworn to protect her.
It's then that you realise. But by then it's too late.

Taxi!

Normal thought process:

Pregnant.

9 months.

Got a twinge.

I know.

I'll call an ambulance.

*****

Really?

Had a strange experience recently. Someone I know very well was pregnant. Overdue even. She's young, never been pregnant before, except for the last nine months, so didn't really know what to expect.

She did the strangest thing. She asked her family, several of whom have been through the same thing over the past few years for help, advice, guidance, tips. Anything that may assist her in this weird new world.

Then, finally, what seemed like 2 months late, she went into labour. She wasn't sure it was labour, so she called her family again. They said it sounded very much like she was in labour. So she called the hospital. They said she should come in. It was time.

Except that she has no car.

So she did something even stranger. In the middle of the night, she phoned her nearest relative and asked for a ride to the hospital. She didn't call an ambulance! Can you believe it? What sort of odd behaviour is that?

Said relative took her and remarkably calm hubby to hospital, dropped them off, and waited for news.

Several hours later, still in the middle of the night, the news arrived. As had the baby. And all was well.

And not a maternataxi ambulance in sight!

Amazing.

Who knew???

PS - Congratulations!

GD

Chaos.
Smashed glass.
Fuel all over the place.
Unconscious, probably drunk driver.
Lots and lots of bystanders who all come rushing out.

*****
I'm always amused by the fact that when attending the scene of a serious RTA, as this one was, there are people who still insist on waving frantically to show the ambulance where to go. I mean, do you really think I can't see the upside down car with the steam pouring out of it? I know, I know they're only trying to help, so I shouldn't really complain, but still. It's weird.
One of the bystanders, we'll call him GD (the reasons will become clear shortly), comes over to tell me proudly that he and one other person dragged / assisted the driver out of the upside-down car, and after a few seconds of drunken yelling and thrashing about, he collapsed into an unconscious heap, where I found him.

GD then stands watching me and talking to me as if I'm his best friend. I complete an initial assessment, sort out a collar, some oxygen, do some basic obs, and assess for any immediately life-threatening injuries. None are apparent. Had he not have been drunk, this would never have happened, but the fact that he was, probably saved his life. Ironic really.

The whole of the local fire department turn up, and look sorely disappointed when the car wasn't on fire as had been originally reported. Apparently. They're closely followed by the ambulance. We package our drunk friend, who's starting to come round a little. Frankly, it was easier when he was unconscious and wasn't claiming to be one of several Hollywood heroes whilst fighting everybody off.

The ambulance leaves, and as I start my paperwork, I'm left watching the fire brigade turn the car back onto its wheels and then sweep up the mess. A voice behind me startles me a little, and I turn round to see GD standing there, proud as a peacock. "You don't remember me, do you?," he says. "You were at my house six weeks ago!"

I search the recesses of my brain but in the chaos can't place him at all. He must have seen the blank look on my face. "You were at my house", he adds, "for something completely different. Just as messy, though. Don't you remember? You delivered my... "

"Grandson!" we both said, simultaneously.

I'd delivered his grandson not two months previous, in the house right by the scene of the crash. I knew the house looked familiar.

"Don't you remember? I floated round the house yelling to everyone on the street: I'm a GrandDad! I'm a GrandDad!"

Cue huge grin.

Oh yes, GD. I do remember.

Ever Before

She holds her eldest child close.

Closer than ever before.

Her sobs are pained and silent.

Quieter than ever before.

She needs him as he needs her.

More than ever before.

They've said goodbye to the baby.

They'd not said it ever before.