Footprints

Bright red footprints, like they'd been painted in a playground, appeared on the steps that we were hurriedly climbing. Not every step, only some. Every second or third stair was marked by a print hastily left by whomever it was that had either caused this horror or, at the very least, discovered it. We would never know whose prints they were, but a clue had been left for the police to use in their hunt. Each mark, no more than half the sole of a shoe or a boot, was as red as the next, each as incriminating as the next, each as foreboding as the next. As we ascended three flights of stairs, the footprints descended at speed. 

The floor and the walls are awash with red; pools and clots and smears and streaks. And footprints. And in the middle of it all, she lies, barely breathing, barely conscious, barely alive. Two police officers search the house as we start to treat her. The scene is no better in the tiny bedroom or bathroom. She had tried to escape and was cornered, prevented from fleeing by the force of a knife, and by her lifeblood draining away. Eventually, she fell by the front door and there she lay, waiting, in a motionless race against time. 

It took time to get her out, as we stepped out of the sea of red, time she didn't have. We couldn't bandage each wound; they were too many, and the minutes too few. We could barely stem the bleeding, although, ominously, it seemed to be slowing of its own accord. Four pairs of hands carried her on the backboard down the stairs, following the footprints and leaving some more, but this time each step was marked. Prints of different sizes, different shapes, but each dipped in the same red paint. 

At the hospital, they're ready for her. Bags of fluids and blood hang at the ready the instant we set foot in the resuscitation room. Oxygen can already be heard hissing out of the tap. Nurses and doctors take over the treatment. Orders are barked, instructions carried out, messages relayed. She's still breathing, still conscious, still alive. 

Outside, as we start to clean up, the police are waiting for us. They want the prints from all our boots. One by one, each police officer who had entered the scene, each paramedic who took part in the call, steps somberly on and off shoe-shaped pieces of card. Each leaving a pair of gruesome footprints - the imprints that would rule them out of the investigation - but would leave a mark in their minds. 

Inside, in the meantime, as the footprints dry, she dies.  

Meant To Be

It's so easy to be dismissive, so easy to drive along, thinking that this is just going to be yet another one of those calls. A young girl, in her twenties, complaining of the ambulance service's number one call. Abdo pain. Another twenty-something, self-entitled, all-deserving, all-demanding twenty-something who can't be bothered to take any pain killers and like most people, wait for the pain to go away. 

It's so easy just to assume another late night out, another curry gone bad, another Chinese take-away with more after-effects than the alcohol it was meant to be soaking up, another case of food-poisoning victim seeking a non-existent magic cure. 

But with only half a story, it's so easy to be wrong. 

The tear-stained face, the look of real pain, the blood-soaked trousers, the shocked and saddened eyes, tell the other half of the story. 

A story, a history, of broken hearts and shattered dreams, of hopes raised and dashed time and time again. Through sobs and tears, she looks at him, she shrugs, she says We'll try again, neither of them really knowing if they have the strength.

Twenty two weeks, the furthest she'd ever got. But once again, for the fifth time in as many years, it just wasn't meant to be.

The Night After

It was one of those nights. I only saw five patients. 

1) Drunk, fallen asleep in the street. Told me to get lost. Not quite as politely as that, however. Then proceeded to walk straight into a wall.

2) Drunk, fallen over in the street. Told me I need a shave, which I do, and that I speak good English for a Chinaman, which I'm not. Also, I need to go back to China, where I come from, "'cos we don't need no more foreigners in the country." Nice.

3) Drunk, fallen over at home, slightly apologetic. Slightly better natured than the previous two. Things were looking up. But not for long.

4) Drunk, violent and nasty, high on drugs to boot. I got covered in his blood as well as mine as I tried to stop him killing both himself and me, before the police turned up and looked after him. Things were looking grim again. 

5) Drunk, unconscious and very seriously injured after a high speed impact with the road. Definitely grim. Grim for me, as it was pouring with rain, but that's nothing. It's much more grim for him. He's probably going to die, assuming he hasn't already.

I'm back at work in a few hours. The night after the night before. I hope it's a better one. For everyone.

Sisters

At the risk of having posts on my blog that are better than my own, this is a guest post from PenguinEMT - one of the people at the top of my list of friends whom I've never met. Yet.

_____________________

She lay in a barren field, the blood from her face and knees mixing with the dirt and grime to hold her together as a sheath of discolored glue. I heard no sound, save that of the vehicles racing by. As I came closer, I heard some slight gurgling and moaning. The officers stood back as we surveyed what has become a scene that haunts my dreams.

I spoke to her softly, trying to encourage a response. Nothing. Once in the ambulance she roused, shielding her face with her hands, screaming in absolute terror. My voice calm, I assured her we were there to help. With every procedure, every move we made, she recoiled and screamed, her voice hoarse. 

We weren't to touch her, she said. She belonged to her husband. Only he could touch her. 

We couldn't. 

He would be angry. 

*****

He lay curled up on the basement floor, the blood soaking the carpet. A crimson mist coated the walls. From upstairs I could hear the sounds of anger. Downstairs, however, it was eerily quiet. 

A faint pulse, but no response. Four occlusive dressings and two packs of gauze. I spoke loudly, attempting to garner a reaction. Any reaction. Finally, at the hospital, I heard a faint whisper. 

"Thank you," he mouthed, eyes still closed. 

*****

She stood in the kitchen, a mere wisp of a thing. The anger was palpable, her face mottled with tears. The knife block was empty, its contents scattered on the counter-tops and in the sink. All of them covered in blood. 

My exhausted mind traveled back in time, just an hour. 

Sisters. 

Central Locking

Before the old ambulances could be completely replaced, we were treated to a smattering of new vehicles. Shiny yellow, with a trendy battenberg design all the way round, and as an extra confusion, diesel engines rather than the lawn-mower type petrol ones. Many a medic would be caught out in the first few months by feeding the engines with the wrong fuel.

They were hardly loved, those old LDV's. Nothing more than vans that had been given blue flashing lights for the roof and the front grill. Meat wagons. Loud, growling engines that would wake an entire street at three in the morning, but which you had no choice sometimes but to leave running, just to make sure that you still had some battery power by the time the patient had been recovered from the scene and placed on board. The three battery lights on the front would give the cab a disco feeling as they would all start off a tired red, change through slumbering amber and on their way to eager green, each individually, each moving backwards and forwards through the sequences depending on what the driver tried to get out of the engine.

At least the temperature control was reliable. The heating would completely fail in the winter, and work whether you liked it or not on the hottest days of summer. The air-conditioning never worked - there simply wasn't any. Anything that broke, fell apart or went missing was fixed with tape, a staple of any medic's armoury, along with all the medical stuff, and in fact probably higher on the priority list than most of the real kit.

In their final days, as they sensed the day of judgement and their own demise, they mounted a rebellion. They had a knack for trying to poison the occupants by filling the cab with noxious gases that would leave crews needing oxygen therapy themselves. Finally, not so long ago, and at least five years past their best, the last of the old fleet were mothballed.

In the early days of the new Mercedes ambulances there would be fights as to which crew would have the privilege of owning it for the shift. Those on the longest shift thought they were entitled to it, or those who were taking the longest transfer. The lure of the softer suspension, gentler ride, and most importantly the ability to control the internal temperature were cause for more than one disagreement. Yet, as the younger members of staff would argue over the newest, shiniest ambulances, the old guard would reminisce about the wondrous days of sliding doors, scoop-and-run, and were often mocked about their memories of the horse-and-cart. Finally, after several weeks of watching others enjoy the pleasures of the new arrival, it was my turn, and as I tried to climb in the passenger side door, I discovered one more novelty that the old trucks lacked - central locking.

Dean took the keys and control of the vehicle for the day, I never even got a look-in, not that I minded particularly. Even from the earliest days in this job I've preferred to attend rather than drive. Dean, however, was like a kid in a sweet shop who'd been given free run of the shelves, and loved every minute of finally driving a vehicle that responded as an emergency ambulance should. After a few routine calls, we were tasked to a call given as a man with a serious laceration to his arm caused by broken glass.

Arriving at the call a few minutes later, we took out the normal bags, as well as an extra bag of bandages. A trail of blood stretched across the pavement by where we'd parked, down the paved driveway and into the house that was about thirty metres away. Dean locked the ambulance. We started to walk towards the house and as we opened the porch door, a figure started to run towards us and stopped us in our tracks. As he came nearer, we saw that he wasn't alone, but carrying what looked to be a knife behind his back. We could just see the handle and a glint of metal, but that was enough. 

We stepped back out, backpedalling at speed, and Dean had the presence of mind to slide the porch door shut in a hurry. Still carrying all our kit, we ran back to the ambulance, and tried to climb back in, only to find that the doors, for the first time ever, were locked. Our "patient" had almost caught up with us, and now all I saw was the knife, which turned out to be a samurai sword being waved menacingly above his head and coming ever closer. I dropped the bags.

"Open the doors!" I screamed to Dean. 

"I can't! The bloody things won't open!"

"IT'S THE CENTRAL LOCKING!!! USE THE KEY!!!" 

Dean fumbled in his pocket for the unfamiliar key, whilst we both ran round and round the ambulance trying to avoid being sliced in half. Dean yelled to a neighbour to call the police, as this was before the days when we had personal radios, and our only means of communication were, like our safe haven, locked inside the ambulance. Eventually there was a standoff, where we stood at 180 degrees to each other - us on one side - and a sword wielding maniac on the other, but all three of us standing by doors. If we unlocked the ambulance, he could get inside just as quickly as we could. We worked out a plan where we could hold him away from an access for just long enough to unlock the doors, climb inside and re-lock the ambulance before he'd climb in. Another couple of circuits of the ambulance and we'd finally positioned ourselves as per the plan, and miraculously managed to pull it off. 

"Control, this is Z321, we need urgent police assistance!"

"Z321, received. Can you tell us what's happening?" 

As I tried to catch my breath, I told them in half sentences what had happened and they promised to arrange for the police to attend. Our sword-swinging friend had finally realised he couldn't get in, and instead took to trying to smash the windscreen, which thankfully held fast. Any interested bystanders had quickly seen sense and fled back into the safety of their own homes, and as he turned away to pick up one of our discarded pieces of kit, we had just enough time for Dean to beat a hasty retreat, far enough to be safe, but close enough to still see the scene. Ninety seconds later, the first of the police units arrived, closely followed by several more. 

We watched from afar as our patient was quickly bundled to the ground by half a dozen officers, the sword wrenched from his grip, and he was placed in the back of a police car. Not without a struggle, but it wasn't a very long one. Slowly, Dean turned the ambulance round and we headed back to the scene, safe in the knowledge that neither assailant nor weapon were now of any threat. Stopping alongside one of the officers, I wound down the window and briefly explained again what had happened. 

"We'll need a full statement," said the officer, "we can do it here or back at the nick." 

"Might as well do it here. At least we've got air-conditioning." I climbed through the door between the cab and the back of the ambulance as the officer tried to open the back door from the outside. 

"Can't open it!" he said, "Must be jammed!" 

"Oh. Yeah. That'll be the central locking..." 

Dean pressed the button that magically unlocked every door to the ambulance. 

"Must remember not to lock these in future, especially on samurai-sword calls. Too bloody dangerous!" 

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. 

Matching Description

Disused, misused, abused.

Once a proud London family home, now a squat for all and sundry.

A solitary ray of light fights its way through the boarded-up windows.

Tiny flecks of floating dust flicker as they pass through the beam,

Disappearing as quickly as they came to life.

The call came from a mobile.

Gave an address, "I think she's dead!" the only scream,

before cutting off the call and turning off the phone.

We arrive, police and ambulance, and all step tentatively into the house.

Not a sound, not a soul, no response to our calls.

Glass breaks underfoot, floorboards creak,

needles shimmer in the torchlight.

Two flights of stairs, rooms on every floor,

each deserted,

dark,

cold,  

unloved.

In the furthest room, in the darkest part of the house,

surrounded by filth, and blood, and human waste, we find her.

Curled up in a corner.

Deserted.

Dark.

Cold.

Unloved.  

And matching exactly the caller's description.

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.