The Best

As we march quickly into the resuscitation room, wading through the sea of people currently waiting for their turn in triage, one face looks directly at us. Most mumble amongst themselves, wondering what trauma had befallen our patient with his face a mangled, bloody mess, made all the more grotesque by the tube sticking out of his mouth. People stare. Human nature seems to render all those around unable to look away from the macabre scene. All except for her. Her gaze held for just long enough. Enough for me to realise that she recognised me, remembered me from some event in the past. Whether that past was recent or not was beyond me and in all honesty I was too busy with the patient we had right now. 

The chaos in the resus room was as organised as usual. Doctors waiting for a handover, nurses anxious to begin treatment, paramedics eager to deliver their patient to the next link in the chain fighting for his survival. His chances were slim - we knew that. Falling, perhaps jumping off a bridge onto the road below should have been lethal. Being hit by the car after he fell should have sealed his fate. Somehow, however, against all the odds, he was still alive when we reached him. Somewhere, the stars combined. The calls came in fast, we were nearby, the hospital was only a few minutes away. We treated him on the move, leaving us on scene for as short a time as possible. We had done our best. 

We spent some time cleaning our equipment in the resus room, keeping out of the way while trying to stay in the loop. As always, we knew that as soon as we left the department, chances were high that we would never know what happened next, so we took our time to grab more snippets of information. Anything from the results of an x-ray to the positing of a professor who happened to be in the area. Eventually, however, we had no choice but to head back out into the heat of the day, through the throng of people still hovering around the waiting room. Still, she sat there, a bandage wound round her head, with a small patch of blood showing through just above her left eye. 

Outside, by the ambulance that looked inside as though full-scale war had just taken place, we started to take stock of what we had seen and done just as one of the nurses who was in the resus room came out, cigarette in one hand and a lighter in the other. 

"They've done their best, but they've called the organ donations team," he said, as he flicked the lighter into life. I couldn't help but grimly wonder if one day he too would need a new set of lungs. 

We tidied up in silence, clearing the floor of the bags of fluids, of the empty wrappers from the kit we'd used, of the blood. The next link in the chain of survival meant that he wouldn't survive, but perhaps others would. It would be a tough call to make. They needed to find his family fast, give them the impossible task to make an impossible decision in an impossible situation - to do what's best. 

Suddenly, she stepped into the sunlight, bandage still in place with its crimson spot and walked straight over to us, stopping only very briefly. "You don't remember me, do you?" 

"No. I'm sorry, I don't." 

"I'm glad. It's probably for the best." 

A Life Worth Living?

Life is difficult, I get that.

There are financial troubles,

family conflicts.

Friends who fall out, 

failed relationships,

failed studies.

A home barely suitable for

human habitation.

You can't cope,

you want out.  

You want to die,

you understand what that means,

clearly comprehend the closure,

the finality.

So you try, not once,

but twice.

You fail, and I'm glad.

Glad,

not because you've failed at life,

but because you've failed at death.

I'm glad,

mainly,

because you're only

ten years old.

You have a whole life yet

to live.

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. 

Picture on the Wall

A smiling face adorns the walls,
in frames all shapes and sizes,
Holding trophies, hugging dad,
bringing home surprises.

A quick look round the house again,
whilst clearing up the mess,
Certificates of excellence,
no signs of any stress.

Yet here we are, police are too,
looking at the rope.
That piece of ragged, torn up towel
that's stolen all your hope.

Your smiling face, a child so proud,
watched us as we tried.
Tried to save your dying dad,
'Til that silent face then cried.

I never met you, little one,
but know one thing for sure.
We tried our hardest, tried it all,
until there was no more.

All that pride there in your eyes,
as you stand with your team.
Your face will stay there, in my mind,

play havoc in my dreams.

I'd hate to see those eyes go dim,
I'd hate to see those tears.
Just to imagine your heart break,
brings out my deepest fears.

Your smiling face adorns the walls,
despite the sight so grim.
I'm sorry we weren't good enough,
to give you back to him.

Sad or Depressed?

It's so easy to overlook, to underestimate. "Cheer up, it might never happen." It's easy to say. Often easy to do, too. Sometimes, however, suggesting that a smile will cure all ills, only shows a lack of understanding. Sometimes it takes a big name, a celebrity, a high-flying politician to be affected enough by something that whatever that something is, suddenly hits the news. 

Gary Speed, a well known footballer and football manager, took his own life. The news only broke today so one can only assume, at this very early stage, that Gary was trying to cope with some unenviable hardship. He was a man who seemingly had everything to live for, a loving family, a place in the history books of both national and international football, a career and direction in life envied by many. And yet, somewhere in the deep recesses of his mind and soul, a dark, endless depression loomed. 

It's a tough one, depression. I see patients practically daily on anti-depression medications. Depression is the only illness named and described with the same word. Diabetes is an illness where a person's sugars are out of control. Hypertension is when blood pressure is too high. Asthma is when the lungs aren't working properly. 

Depression is when a person is depressed. 

The other problem is that depression is a word that is bandied about all too freely. People are depressed when they miss out on a good night out, they're depressed when their boss tells them off, they're depressed when their football team loses. But depression isn't sadness or upset. It's a state of mind caused by one of many factors and triggers, some physical, some chemical, some emotional, where a person can appear happy and content with their lives, and yet not be able to cope with all that is happening around them. 

Often, in the depths of these depressions there is only one viable option, and that's the option that Gary Speed seems to have taken. Some will claim that this is a selfish option, but to be honest, my uneducated mind tells me that for something to be selfish, there needs to be conscious and coherent thought. Depression allows for neither. The mind's inability to cope, to rationalise, to comprehend, leads the body down a path of self-destruction. 

It's also not something that we can solve in a twenty minute meeting in the back of an ambulance. Sometimes, however, just being able to spot the first signs, may be the trigger that leads a patient to treatment and save them and their families heartbreak in the long term. Most of the knowledge I have about depression isn't from books or classrooms, it's from witnessing it first hand. It's not something we're taught as paramedics to really deal with, because most of the time we're dealing with the consequences, not the disease itself. 

We can bandage wounds, or we can pronounce death. Understanding that there's a stage before this, a stage that we should be able to spot, may be the most life-saving action we can perform out on the front line. 

Street Lights

The street lights off,

the normal orange glow replaced 

by the flashing blue lights of the police. 

They wave, the officers,

an unnecessary, well-meaning gesture 

to show me the way. 

They turn both their torches downwards

towards the floor,  

and look down, their heads bent 

as if in prayer.

She lies there, a mass of displaced, 

broken bones, 

a mangled, tangled mess, 

limbs misshapen, 

arms and legs scarred,

outstretched. 

She stares, in silence, directly upwards,

past the darkened street lights,

past the trees, 

past the broken, open window, 

past the clouds. 

The sky responds, sheds tears of its own, 

and washes away the blood, the hurt, 

the pain. 

S'pose

"I know you," he says, his knock on the window jolting me out of my nocturnal daydream. "You picked me up when them cops came to my house! S'pose you don't remember." 

"Craig?" 

"Good memory you've got there." 

"What are you doing here at four in the morning?" 

"Oh, you know. This and that. Just hanging around." 

"Outside a hospital?"

"S'pose this is where I live now. Under section, in the nut house round the back. They just let me out for a smoke, but I ran off to get a better spot." 

Craig was dragged away from home a couple of weeks earlier by the police after destroying every piece of furniture in his house and threatening to set fire to the damaged remains. His mother begged us to let him stay at home, claiming it had never happened before, that he was just drunk, and that she'd look after him now. Two facts prevented that from happening. The first was the fact that it was taking the full force of several police officers to restrain him, and the second was the arterial bleed from his arm. 

Craig went back to sitting on the wall where he must have been perched before scaring the life out of me. It was three storeys up from the ground, with nothing between him and the concrete below. 

"You know, I'm pleased you're here. You can be my witness." 

"Witness for what, Craig?" 

"For me jumping off here. You can tell them that I meant it, that I didn't just fall." 

"Jumping? What do you want to do that for?" I sat there, frantically wracking my brain for a way to get some help without alerting him to the idea, but in the meantime I was happy that he just kept talking. 

He took a crumpled cigarette out of his pocket. "I 'spose you don't smoke, do you?"

"Nope. Never have done. Why?"

"Smoked since I was fourteen. Ten years that is. S'pose I knew then already that I wasn't going to have a long life. Twenty a day normally, sometimes thirty, forty. Even had a hundred once in one day, thought it would kill me there and then, but it didn't. Still here, aren't I? Still need my smokes. Still need some fresh air to smoke 'em. Pollute the air with smoke like they tried to pollute my mind. I know what they were doing to me in there!"

"In where, Craig?"

"There! The nut house!"

Craig pulled a lighter out that was tucked into his watch strap, made himself a little more comfortable on the edge of the wall and after a few attempts finally managed to light the cigarette. Two long drags later, he kept talking.

"I'm gonna finish the pack of twenty that I've got, and then that's it. I'm getting out. I've got this one and one more. That's it. No more smokes, no more police, no more hospitals, no more nothing. Glad you're here, anyway. I already told you that, didn't I?"

"You did. But I might be gone in a minute, if I get a call."

"S'pose I'll wait 'til you get back then."

As if on cue, the computer rang and sent me out into the night, heading in the vague direction of a jumbled set of coordinates on a map. Someone had called in from a mobile phone, and before the exact details are confirmed, the system works out which mast the call is routed through, and starts sending me there. The little red triangle on the map showed a point less than a mile away. Now that I finally had the chance, I called up control and let them know about Craig, where he was sitting, and that they need to send someone, anyone, to stop him from carrying out his threat.

A minute or so down the road, the details of the call finally came through.

Location: Nearby Hospital, by the A&E entrance. 


Details: Male, unknown age, threatening to jump off high wall. Ambulance car was on scene, now left. 


By the time I'd turned round and got back to where I started, two members of staff from the Mental Health unit were talking to Craig, as a police officer helped him off the wall. He looks up at me, perhaps confused by my swift return, perhaps amused by it.

"You know what," he says, as a pair of handcuffs are applied, "I'll do it one day, whether you're there, or anyone's there. Or not. S'pose it's back to the nut house. S'pose I'd better get another packet of smokes, though."

Zapped

The alleyway's smell would linger for a long time. It seemed to cling to my uniform, my boots, the ambulance, and in particular, my nostrils. Boxes of discarded food, bags of waste, animal waste, probably human waste too. And in amongst it all stood Larry.

"Come one step nearer, and I'll kill you. Then I'll kill myself!"

The machete in his hand proved the seriousness of his threat. I'd met Larry before, only once, at a nearby bus garage. Just another homeless man in the sea of misery and despair that still shocks me in a first-world city such as ours. Looking twenty years older than the early forties he really was, all he wanted then was somewhere warm and dry to spend the night, and we obliged. Much to the disgust but resigned acceptance of the local hospital. They placed him in the waiting room where he slept the night away, awkwardly perched on one of the wooden seats.

This time was different. He was angry, frustrated by the cards that life had dealt him. He was desparate.

"I just want to end it all. You can't help me, and I don't want you to try!"

I didn't dare open my mouth yet. There was a line of police officers between Larry and us, each carrying a shield and covered in body armour. The absurdity that the only people who regularly carry weapons in this country are the criminals, seemed all the more frightening as we waited for the armed response unit to arrive. One of the officers, taking on the role of negotiator tried to talk to Larry, eliciting nothing more than threats that were becoming more real by the minute. We heard more sirens in the distance, the distinctive sound of the armed unit's cars speeding their way through the streets, and as they arrived, there was a definite change in the atmosphere around us.

We had no idea he was armed until we turned up on scene. All we had was a call to a distressed male threatening passers by. No one bothered to tell us that the threats were more than just verbal, and when we were told that the police were on scene, we expected nothing more than a panda car and a couple of local officers.

The police seemed to have a little more information, but it never reached us, and as we pulled up to see several vehicles and a dozen officers dressed ready for battle, we realised that the call was a little more than the initial disturbance we'd assumed. As he started swinging his arms at the cordon, we finally saw what we were dealing with. The alleyway was a dead end, but humans when frightened and cornered, just like animals, will try to battle their way out. Larry could only see one way out, and he seemed determined enough to take it.

He took one swing with the machete towards the line of officers, more a threatening gesture than a real attempt at causing harm. The entire line shuffled a step backwards and erupted into loud calls to put the knife down. Larry laughed. A manic, full-bodied laugh that turned unexpectedly to tears.

"Go away," he sobbed, "and leave me alone to get on with it! I don't want to hurt anybody. I just want to die!"

Two armed officers had joined the ranks, with several others a row behind, using the shields already present for their protection. The standoff tensed, and the sight of a dozen armoured personnel standing over a lone, tormented soul, protected by nothing more than a t-shirt and frenzied arm-waving, turned almost surreal. Negotiations continued, Larry shouted some of his replies, whispered others, and intermittently threatened to put the knife to its intended use.

We stood there for over an hour, a dozen or so paces behind the front line. Crowds of people had gathered at all the police tapes, trying to catch a voyeuristic glimpse of the drama unfolding on their streets. Dozens of police cars and vans were both inside and on the edges of the cordon, along with a solitary ambulance. The presence of the large yellow box on wheels looked almost symbolic rather than functional in the sea of silvery-blue.

In an instant, the mood changed. A chorus of voices yelled at Larry, and two red laser dots appeared on his chest. Over the top of the line of officers, a glint of steel reflected the blue LED lights from the police cars and seemed to come a little nearer. Larry screamed back, frantically flailing and warning the police to stay back. A combination of stupidity and curiosity made us take a few steps forwards, just in time to hear more warnings in both directions, hear a crackle through the air, and see Larry's torso get hit by two spikes. 

The moment he was hit, Larry let out an almost primeval shriek, his body stiffened, the machete fell one way, and he the other. Seconds later, it was all over. Half a dozen officers were on top of Larry, securing him, ensuring his safety and theirs. The knife was removed and placed in a large plastic tube, and Larry was carried face down onto the back of the ambulance. I'd only had the training two days earlier on how to remove Taser barbs, and was probably inappropriately pleased to get the chance to use the training so soon after.  

Larry was sat up on the trolley bed, restraints in place around his legs, handcuffs holding his wrists behind his back. He was no threat to anyone now, least of all and most importantly to himself. We removed the barbs from his chest, at which he flinched but hardly made a sound. Two officers were stood by the top of the bed, ready to pounce in case he made an unlikely and frankly impossible dash for freedom. Once the barbs had been removed, we lowered the head of the bed down a little, allowing Larry to lay on there a little more comfortably, on his side facing us, easing the pressure off his cuffed hands.

As we took Larry to hospital with what seemed like a battalion of police officers accompanying us, there was an eerie quiet, each of us mulling over everything that had just happened. I was writing notes, the officers were standing guard. Only the noise of the sirens made any impression on the surroundings. Finally, Larry broke the silence, as he turned to one of the officers.

"Are you the guy that zapped me with that thing?"

The reply was gruff, pointed, matter of fact. "Yeah, it was me. What of it?"

He broke down again. "Thank you for saving my life."

And I thought that was our job.

Head for Heights

The message comes down the MDT from the police. "Please approach with caution - no lights or sirens. Patient threatening to jump".

Out of area as usual, we don't really know the names of the buildings, but this one has its name on a sign that can, for a change, be seen from a couple of blocks away. As requested, we make a silent approach, as much as is possible in an almost 5-ton truck with a large diesel engine, and await further instructions from the police officers on scene.

In front of us, still about 100 metres away, looms a large apartment block, and I count at least 12 storeys. If she jumps from there, our presence will be superfluous. In contrast to our orders, the police seem to be turning up in force, blue lights bouncing off the surrounding buildings, giving the street a look of a club on a Saturday night, the staccato lighting beating in time to the music. The street is cordoned off at both ends preventing traffic from approaching, and any pedestrians, though very few at this time of the day, are shepherded away from the scene on a long detour. A chorus of complaints comes from one group of bystanders who want to see the action, as they are firmly removed and asked not to return. A police Inspector approaches us, his two-pipped shoulders confirming his command, and explains the situation.

"At the moment, we're talking to her on the phone. She says she's in flat 55, and threatening to jump from the balcony. It sounds like she's had a lot to drink too, so anything could happen. There are, we believe, six flats on each floor, so she's probably on the 10th. We're just trying to see exactly where she is and what she's doing, and then we'll decide what we're going to do about it. You two just hang back and wait." He ends abruptly and walks off, retaking his position in control of the out-of-control situation.

Only once before have I been involved in something similar. Back then, when I was still only in my probationary year, we sat waiting for four hours. We drank tea, read books, snoozed and generally sat still as nothing continued to happen. At the end of it all, despite negotiations and attempts to get into the building, he jumped, and there was still nothing that we could do.

So once again, we sat. I don't tend to take a book with me to work any more - there's never really any time to read it - this time, my phone would have to suffice for entertainment. A police officer was sent over to us and informed us that she was our liaison. As soon as it was safe for us to approach, she'd get the message on her radio, and advise us to advance. We made ourselves comfortable for what could be a long stay.

The message arrived after less than fifteen minutes.

"Suspect detained indoors, advise ambulance safe to attend."

We drive the short distance to the block, and find that it's split into three separate entrances. Several more officers walk out of the middle of the three. Some are smiling, some are laughing, some just walk by silently. We take out our equipment, and advance on the entrance.

"I hope there's a lift. Don't fancy a walk up 10 flights of stairs."

"Wouldn't worry about that", chimes in an officer, a mischievous grin on his face. "The lift's working, tells you which floor you need just outside the door".

We look at the sign stuck on the wall by the lift. Graffiti is sprayed and scrawled all over it, some of it legible and unrepeatable, some of it just looks like streaks of dirt. Through it all, a list of floors and it's corresponding flat numbers is just about distinguishable. All the while, officers are streaming down the stairs next to us. You've had a long walk down.

Eventually, we actually pay attention to the sign.

Ground floor - Entrance

First floor - 53 - 56

Second floor - 57 - 60

Third floor - 61 - 64...

And so it goes on. Up to the twelfth floor, and flat number 96, four flats per floor, not six.

"What number did we want?" I ask my partner.

"55".

"Are you telling me that all this was for someone who was going to jump from the first floor?"

"Apparently so..."

We don't bother with the lift, and walk the dozen or so steps up onto the first floor and into flat number 55. The room is littered with empty bottles of vodka and ashtrays filled to the brim. The patient looks up at us and before we even get the chance to say a word, starts yelling.

"I would have jumped you know! If it wasn't for these coppers I'd have done it! There wouldn't be nothing left of me except bits of brains on the floor, and it'd all be your fault!" She points randomly at one particular officer, who'd only just entered the room, and was forced to respond as the patient was being clasped in handcuffs.

"You might, if you were really unlucky, have broken your leg. There'd be no brains anywhere!" "Especially in your head", he adds, just loud enough for us to hear.

"Well I'd have jumped from the top floor", she bites back, "but I might've hurt myself. And anyway", she rasps, years of smoke having damaged her vocal cords, "I've got no head for heights".

Tuxedo

Tuxedo hanging on the cupboard door.

Burgundy bow tie hanging off the jacket pocket.

A rose, poking out of the button hole, its colour matching the tie.

The corner of the best man's speech peeks out from under the pillow.

On the floor, right next to the perfectly polished black patent shoes,

and the crimson blood,

lies an empty bottle of pills, with a story to tell,

but there was no-one there to listen.

Something

Last night I met one of the HEMS team that was on a recent call I attended.

The one where I performed my first needle-thoracocentesis.

It kept the lungs breathing.

It kept the heart pumping.

It kept the patient alive.

I knew at the time that the patient's chances of survival were very slim.

At last night's chance meeting my fears were confirmed.

The patient died about two days later.

Stabbing them in the chest didn't save their life.

But it did give the family the chance to come and say a final farewell.

And I guess that's something.

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?

Everyday Decisions

Everyday decisions.


What to have for breakfast.

What to pack for lunch.

What to wear for work, and how to get there.

Whether not to bother going at all.

*

Everyday decisions.

Cook dinner, or take-away.

Football or soap on TV.

Early to bed, or a late night out.

*

Everyday decisions.

Bridge.

Or Building.

Or Drugs.

Or a combination thereof.

*

Everyday decisions.

To Jump.

Or not.

*

He did.

And no-one will ever know why.

No-one will ever understand.

Nor explain his tragic, irreversible,

Everyday Decision.

Piece of Paper

The red and blue lights of the police illuminate the street and point to the house that I've been sent to. I'm not sure how they got there before me, as it took all of 90 seconds for me to arrive, but I'm glad of their presence nonetheless. This doesn't sound like the type of call I'd like to be at on my own for too long.

*****

She sits downstairs, clutching an innocent looking piece of paper as if her life depended on it. The chair squeaks as she rocks backwards and forwards, fighting the rising tide of tears that are about to break the dam. I'm directed upstairs by one of the police officers, whilst another helps carry one of the bags that I've dragged hurriedly out of the car. The initial sight of tears and pale shock tells me that the bags are going to be redundant.

*****

The piece of paper was stuck to the fridge, oblivious to the pain it was about to unleash. She saw it on the fridge door, but didn't register at first that it was a new note amongst all the others stuck there by a multitude of colourful magnets. She'd been in and out of the kitchen a few times before finally taking a proper look. Then her world collapsed around her.

*****

Too afraid to go upstairs herself, she called the police. They had turned up, looked at the piece of paper, and ran around every room in the house. His room was the last they checked. When they found him, one of their number called for the ambulance. He lay there motionless, cold and blue. The blood on the walls and the floor had long since dried and turned from crimson red to dark brown. Next to him lay the weapon that had ended his life, destroyed his future and shattered his parents' world.

*****

She clutched it and begged for answers that she knew would never come. "I'm sorry. There is really no other way."

A silent, innocent, clean piece of paper.