Three Young Guys

Stood outside the station, five minutes pre-shift.
Checking the car, the equipment, the spares.
I feel their car before I even see it.
The booming bass from the stereo pulsates shock waves ahead.
They practically fly by, three young guys, in a suped-up car.
Must be doing sixty in a thirty zone.
"I'll see you guys later" comes to mind.
Along with the hope that I'm wrong.
I'm not. "Later" turns out to be only five minutes.
Three young guys, with one simple need.
The need? Speed.
Three young guys, with one inevitable end.
The end? The end.

Squashed

He lies flat on his stomach in the road, holding her head as still as possible. His dark blue uniform, ballistic vest, highly polished boots and all, normally radiates authority, control and discipline. Right now it portrays none of these, but gives him the courage to see through the job that he's trying to do, and helps him hide his anxiety.

I race to the scene of another RTC. A pedestrian hit by a van. Police on scene requesting urgent attendance of an ambulance. I arrive to see the police vehicle blocking the road, blue lights turning angrily and illuminating the dark surroundings as they spin. It shields the patient on one side, and I drive round to the other, effectively blocking the road completely, and ensuring the further safety of the patient as she lies sprawled and barely conscious in the middle of the road.

As I step out into the road, a smell that hangs in the air almost makes me vomit.

*****

The police officer who was holding the lady's head was shaking as he gave a garbled handover.

"She walked out without looking and got hit. I think she's got a bad head injury".

I ask if he knows if anyone else was involved, and he points to the pavement, where she's sitting, swamped by the same blue, authoritarian uniform, bawling her eyes out. At least she doesn't seem injured. After a few seconds of confusion, I finally grasp the reason the police were there so fast.

They'd hit the patient. Theirs was the van that had hit the pedestrian.

No wonder he was shaking. No surprise that she was crying.

That smell still lingered in the air.

*****

They were on their way to an immediate response call to an ambulance crew calling for police aid after being attacked. Travelling at 60mph, with lights and sirens, they had no chance of stopping as the lady didn't even bother to look or listen before stepping out in front of them. They'd caught her with the wing-mirror.

I leave the officer holding the head whilst I do some basic checks, connect some oxygen, and hope that the ambulance turns up quickly. He's doing a good job of immobilisation, and it helps calm his nerves if he feels he's being useful. Two birds, one stone.

I wish I could find the source of that smell.

*****

The crew turns up, as does an ambulance officer, who I send to check on the sobbing police officer. She's hysterical, but unhurt. It seems she was driving at the time of the accident, and couldn't calm down. Can't say I blame her.

The patient seems to be regaining a little of the awareness that had deserted her since she'd been hit. We move her bags of supermarket shopping away so that we can bring in the bed, the board and other bits and pieces. We've already decided that she has to go to a trauma centre that specialises in head injuries, which is a little further than the nearest hospital, but it's best for the patient. We think she has a fractured skull and she's been unconscious. A bad combination.

As we lift her off the floor, the smell becomes almost unbearable, and I physically heave, but just, and only just, avoid throwing up.

*****

Once she's packaged and in the ambulance, we reassess her, recheck that nothing has changed for the worse, and the crew then get ready to leave. As I jump out, they start the engine, switch on the blue lights, and start moving away. Other police officers are looking after their colleagues, trying to comfort and reassure them. One of them hands me the patient's bags of shopping, including the one that was underneath the patient.

The smell returns.

*****

I look through the bags for anything that will reveal some details on the patient, but all I find is her shopping, a week's worth of groceries. In amongst it all, looking as innocuous as fruit can, was a bunch of over-ripe and very squashed bananas.

I hate bananas.

Lost and Found

Nothing to do with ambulances at all, and unashamedly stolen from my friend over at Jumblerant. Don't worry. I've already warned him... You choose how you look at your life and how you run it. No one else can do it for you. Watch it. All the way through.

Dear Doctor

Dear Dr G Practice,

Despite my seemingly, at least in your eyes, lowly position in the world of patient care, I would nevertheless like to raise the following points. This is due to the fact that recently I have repeatedly been met by an attitude which I would not wish on a rabid dog.

1) We are not your get-out-of-the-surgery-on-time assessment, referral, or taxi service. If I get called to a patient two minutes before the end of my day (or more usually, night), I still have to see them, assess them, refer or treat them, transport them too, if necessary. I can't, don't and wouldn't pass them onto somebody else just because I couldn't be bothered, especially without having seen them at all.

2) Just because you have seen your patient and called for an ambulance, does not discharge you of your responsibility towards them. It should not give you the right to dump them back in the waiting room, letter in hand, waiting for the ambulance to turn up. At best, it's unprofessional. At worst, detrimental to the patient. Especially, just as an example, when they are asthmatic, struggling for breath, hypoxic, O2 levels of 68% instead of nearly 100%, and literally climbing the walls, desperately near death.

3) I and all my colleagues, much to your chagrin, are not mere stretcher-monkeys any more. We are emergency medicine experts. We spend years studying, improving on and perfecting our craft. Much as you do with yours. As such, to have the professional courtesy towards a fellow medical professional and to give us a clinical handover would be greatly appreciated. Not to show that courtesy says much more about you than it does about us.

4) I'm fully aware that not ALL GPs are the same. I'm aware that there are plenty who do understand, comprehend and appreciate our role in patient care. I'm aware that there are many who are even pro-active in their dealings with paramedics. But I'm equally, and acutely, aware that there are those who hold us in disdain. So, even though I've said this before, I'll say it again. If what you think about the Ambulance Service and Paramedics hasn't changed in the last 10, 15, even 20 years, then come and spend a shift, maybe two on an ambulance. Relearn all that you thought you knew about us, but has changed so much since your early days as a doctor. You may be pleasantly surprised.

Show us the respect we're due, and once again I can guarantee we'll return the favour.

Ask the Audience

There are many ways, and many places to fall. For some reason however, fallers often manage to find the MOST awkward of them. I have had patients fall behind toilets, in shop windows, half-in and half-out of truck cabs.

They have fallen on ice, tripped over street furniture, even the apocryphal slipped on a banana skin. With the vast majority of these fallers, whatever their injuries, and sometimes after a little bit of thinking, it's been possible to get to them, treat them, help them up. Transport them if necessary.

What was I supposed to do, however, with the man who fell down a flight of stairs and landed, unconscious, pinned against the front door? The family were trapped inside, having been told, quite rightly, by control not to move him. I was trapped outside.

There was a flight of stairs 3 feet from the front door, the patient had his legs up the first couple of steps - so no room for manoeuvre there. Ground floor windows were only of the very small version, able to fit an underweight supermodel at best. The only part of me that's that thin, is my hairline...

*****

So what would you do?

Scaredy Cat

Oh, for the sake of all that is holy! Man up, man!

Category A.

Immediately Life Threatening.

Lights and Sirens.

16 year old male.

Difficulty in Breathing.

"Do you have asthma?"

"No."

"Do you have any medical conditions?"

"No."

"Do you know why you're breathing quite so quickly?"

"Um, yes..."

Normally, people with breathing problems who are struggling for oxygen have a habit of turning grey, or even blue. They don't tend to turn a tomato-like shade of red, especially their cheeks and ears. I wait until he decides he wants to tell me what happened. His mates are all trying to suppress their laughter. One is laughing so hard, he has tears running down his cheek.

Now, I know that as human beings we have a very nasty (but irresistible) tendency to mock the afflicted, but, other than the fact he was having a panic attack, I couldn't quite work out what he was afflicted by. Eventually, he manages to control his breathing enough to tell me what had really happened. He handed me the box that the latest horror DVD had come in, and with the most embarrassed look, and just the hint of a resigned smile, just said:

"It scared the hell out of me..."

I was glad that just at that point, the ambulance crew turned up. I had to leave the room in a hurry, just before he'd see me join his friends in the fits of laughter.

I really couldn't help it. Sorry.

Switched Off

It's always the little things. The small, almost invisible details, that are most strongly etched in the memory. The daily sights and routines that just blend into the background, and yet give life its real meaning.

*****

Their wedding anniversary was coming up in a couple of months, and since the day they married, he'd gone through the same daily ritual. Every night before he went to bed, he'd set his alarm, place a small chocolate on her pillow, and get the old-fashioned teas-maid machine ready so that the tea would be freshly brewed for the minute they wake up. It'd been exactly the same for more than forty years.

Last night, he'd set the alarm, prepared the tea, and left the chocolate. This morning, his alarm never even had a chance. He was awake a full hour before it was due to go off, woken by a crushing pain in his chest and a desperate inability to catch his breath. When we arrived, he was blue. His face was blue. His hands were blue. His oxygen levels 40% lower than they should have been. His breathing laboured, hardly moving any air at all. He was fighting to stay alive.

She stood there, helpless, terrified, lost. Silently sobbing and wiping away the tears that were flooding her cheeks. We rushed around treating him, willing the oxygen into his body faster than the cylinder could push it in. IV lines were inserted, drugs administered, chairs brought up to the third floor apartment. Everything seemed to her to be happening in a blur. We were hurrying out the flat, when she stopped to take one last look at the room.

She walked back in, stood by his side of the bed, and shedding another tear, turned off the teas-maid.

Resolutions

I couldn't leave this auspicious (suspicious?) date, without at least disturbing your day for a short while, so first, allow me to wish you a happy, healthy, successful and prosperous New Year. And if by prosperous it means that you win a huge amount on the lottery, then please remember who your friends are.

*****

In the days leading up to the end of the year, the London Ambulance Service has been doing one of the things it does best. Counting numbers. Specifically, a very large number. One Million to be precise.

That was the magic number we hit at just after 3am on the last day of the year. One million calls dealt with in a single year. It's a significant rise on the year before, and the year before that, and the ... well, you get the picture. The thing is, I'm not so sure that it's a number to be proud of.

There are no more ambulances out there than there were a year ago.

No more man- (or woman-) hours. There are boasts that there have been hundreds of new recruits, but there have been probably an equal number of people leaving. The front line staff, as well as those in control, are being pushed ever harder to meet targets that are at best dubious and ill-conceived, and at worst downright dangerous. Patient care targets are nothing compared to the national time-based targets set by the government, and this is where we have the danger of falling flat on our faces.

Patients don't want to see just an FRU outside, single-staffed, with no ability to convey a sick patient. They want to see it backed up quickly by an ambulance. More than that, they want those staffing the FRU and the ambulance to be at the top of their game. Well-informed, well-trained, professional staff will do a great deal more for not only our patients, but our image too. Demoralised, despondent and harassed staff will do the opposite.

Partly, the blame needs to be placed on the fact that we are, in a way, victims of our own success. We are too good sometimes. We provide too much for too little, and do not do enough in the way of public education. We provide paramedics with extra training who now do the house-calls that used to be done by GPs. We provide ambulances especially geared for non-life threatening calls. We still attend calls that any level-headed person would look at with disbelief. Stubbed toes, broken finger-nails, a three-week runny nose, and many more of the same ilk. We even provide transport, every weekend of the year, so that the public can drink as much alcohol as possible, take the booze bus, and not face up to their social responsibility. Or their cab fare.

This year, I'd like to see the trend reversed. I'd like to see fewer calls. Not because I'm lazy, but because I think that the priorities need rethinking.

I think we need to educate ourselves and the public. I think we need to concentrate on what's important, and not necessarily what's arbitrary.

I think we need to worry more about serving those who really need us, and ensure that we are always prepared for them.

I think we need to go back to the days where ambulances are waiting for calls, and not calls waiting for ambulances.

I love my job. I am passionate and idealistic about it, probably to a fault. I'm one of those crazy people who actually loves getting up in the morning and going to work (ok, ok, so I work nights and go to bed in the mornings). If I have more than two or three days off, I start getting withdrawal symptoms. I'm inspired by my job, my colleagues, even my patients. I know, it's worrying, but this is why I want to see positive changes.

We all have our New Year's resolutions. The Service's should include more public education, higher expectation of their staff, whilst maintaining high levels of morale. It's a tricky balance.

My resolutions are little changed from last year. Always be ready to learn something new every single day. I owe it to my career, to myself, to the Service. Most of all, I owe it to my patients. I hope I can stick to it, and I hope, whether you're a colleague, a manager, or a patient, that you can help me do that. I promise to return the favour.

*****

Happy New Year to you all.

Holiday Handover

Due to an incapacitated MrsInsomniac, and an overworked and ever more underslept Insomniac, I have been extremely lax in promoting the latest Handover Carnival. It has been expertly and brilliantly hosted over at Ambulance Driver's site, and I thank him for including one of my posts along with so many other terrific pieces. In the spirit of AD's musings, I wish you all a happy, healthy and peaceful holiday season.

There's plenty of reading to keep you busy...

Prayers Answered?

Conversations with patients and their relatives often turn to the weird and wonderful whilst waiting, ever longer, on scene for an ambulance. Ambulances are scarce at the best of times, but especially at this time of the year.

There's an absurd fascination in this wintry weather with attempting to stand on that frozen stuff on the ground and see if it really is slippery, and really does make you fall over, and really makes you break your arm/leg/hip. Let me help. It is. It does. It will do. So unless you absolutely have to - don't. Enjoy the view from the window, hot chocolate in hand, heating all around. Don't get me wrong - I fully understand, appreciate and endorse the need for building snowmen. And snowwomen, if you prefer. But stay off the ice! (The publication of this blog has been delayed due to MrsInsomniac doing precisely the opposite...)

Anyway - I digress.

Marik was one of those I'd term the "Worried well". He bought himself a blood pressure machine, just in case. And he had an hour-long head-ache, so he checked his blood pressure, which was fine.

Which worried him. So he took it again. And it went up.

Which worried him more.

So he took it again, and up it went, and he panicked. A little.

He spoke to the doctor on the phone who told him he was having a CVA, or stroke. Thanks Doc.

Well, that was it. Full scale panic. The FRU (aka clock-stopper), was sent, with the promise of an ambulance as soon as one became available. It may be a while. A history was taken, observations checked and found to be in perfect order, advice was given, and a request to be taken to hospital made. For various reasons I was unhappy about taking him in the FRU, so we'd have to wait for the snow/ice/leaves-on-the-track delayed ambulance to arrive and convey.

Whilst passing the time of day, I have a good look around the room and check out all the books. I have a bad habit of doing that, as it gives me a very good clue as to who the people in front of me are. I find that you can learn a lot from books, and not necessarily just by reading them. I see books on all the sciences, especially physics and maths. Books about stars, planets, discovery, the world, and its place in the universe.

Then I see bibles. Dozens of them, in a dozen languages. Shelves of them, 3 books deep, each shelf holding one of the languages. I'm a little surprised. Not at the fact that there is a bible in the house, but at the sheer volume and variety. I'm forced into a corner. I try not to show my curiosity/nosiness or whatever you want to call it, but on the other hand, I have to ask.

"Do you sell bibles for a living?"

"Well, in a way, I guess you could call it that."

"OK. What do you mean?"

"As you ask, I have to be honest. I don't like to tell everyone, but I'm a Prophet of the Lord!"

Now, how do you respond to such a statement? I want to say "A What???" or "Are you sure???" or, probably less appropriately, I want to shout "What the hell are you on about???" I didn't say any of them. I was much more profound.

"Oh", I said. For good measure, I think I even added an "I see".

Then he went on to talk about how he uses his knowledge of science to help him spread the word of God, help him understand, help him make the world a better place. He told me how he received his information, how he knew what to teach. He told me about the messages he received. They were the equivalent of the Twitter Direct Messages. @Prophet. @God. Cool. Wish I had that sort of inside information.

I also wondered if he'd been sent to help out an old friend of mine. I wonder if his prayers have finally been answered.

Someone, Somewhere...

...has been paying attention to what the workforce on the frontline has been saying for ages. You never know, we may actually have been right!

I know, it's not all as straightforward and simple as we'd like, but there has to be talk about the system. It isn't some sort of sacred cow that can't be criticised, and should be open to debate, investigation, and change.

Here's hoping.

Shock Tactics

It's a change in behaviour that we need to aim at the younger, grass-roots members of society.

Before they start exhibiting that behaviour.

Maybe, just maybe, this is one way of doing it.

Good Luck.

Anonymous

Dear All,

I have been toying for some time with the idea of blocking anonymous comments on the blog. Whilst I want to encourage conversation, I find it difficult to respond when, for example on the last post, there are FIVE anonymous comments. And then debate begins between them. So, in order to not turn away those who wish to hide, I haven't blocked them. Yet. But...

I'm now starting to moderate every comment that comes in, and every comment that doesn't arrive with at least initials at the bottom of it, be they real or even fake initials, will be rejected. You can use nicknames, daft names, real names, whatever (within reason please), but you must use at least some form of identification.

In the meantime, please keep reading, commenting, and debating.

Thank you!

Sim's Card

All around, festive lights are flickering. On trees, in windows, in truck cabs and shops. Some windows have candles alight. It seems that everyone needs some extra light at such a dark time of the year. The short days bring only temporary respite from the long nights. Even then they're merely a dim glimmer of hope, the cloudy skies preventing the sun from breaking through and showering some of its warmth. For so many, this time of year, far from being a time of joy and family gatherings, is a time of loneliness, fear, and heartbreak.

Having never before had the need to break into a house, I found it a difficult decision to make. It had always been the police's job to break doors down. This time they had no units to send, and the report I'd been given was one of a child, possibly a baby, crying continuously. The call had come from a concerned neighbour, who'd heard crying when they went out for the evening, and had returned hours later to still hear the same noise. There were no lights on in the house.

As we arrived (I was in the FRU (fast response unit), but had an observer -a nurse turned medical student- with me for the night), we could hear the whimpers through the letter box. We called, yelled, banged on the door, rang the bell, all to no avail. No lights came on, no curtains twitched, no movement. Throwing caution to the wind and cursing Health and Safety rules, I looked at Beth, my observer, told her she never saw a thing, and broke the door down with two swings of an oxygen cylinder. Note for future reference - they make damned good battering rams.

The first light switch clicked ominously like an empty rifle. No flash of light, just an echoing click. The second did the same. As did the third. I went back to the car and found a torch, and carried that and the newly redefined oxygen cylinder as self-defence. Just in case. I had a quick look up and saw that none of the light fittings had any bulbs in them. We searched every room, and tried to follow the sound of the cries. It was like trying to find the end of a rainbow. Every time we thought we'd pinpointed it, it seemed to move, and we started wondering if we were actually chasing a cat rather than a baby. Ominously, after a few minutes, the noise stopped.

Having found nothing downstairs, other than a framed photograph of a soldier standing proudly in dress uniform, we started up the stairs, a double flight, with a small landing half way up. The darkness seemed even heavier here, the torchlight making minimal difference. In the dull glare of the torch I checked the first set of stairs, skipped the landing, and looked directly upwards. My heart rate doubled and I could feel the sweat starting to build as the adrenaline pumped itself round my slightly terrified system. I still don't know why I kept going, rather than waiting for back up, either in the form of another ambulance or the police. Stupidity rather than bravery, I assure you. Reaching the top of the first flight, and stepping on to the landing, I tripped over a boot, and yelled in fright. The boot was attached to Sim.

Sim looked like a ghost, a pale, almost skeletal ghost, hands nothing but skin and bone, terrified, wild, bloodshot eyes sunk deep into his head. He was cowering in the corner, legs folded up into his chest. Then the tears streamed, and the all-too-familiar cry that we'd heard from outside returned. Sim was no baby, or child. He was a fully grown man, looking decades older than the mid-30s that he was, a shadow of what he probably used to be.

He wouldn't, maybe couldn't, talk for a long while. I'd informed control that we'd found him, that there was no child involved, and they in return told me that they had no ambulance to send, and that the police would be at least an hour as well. Beth and I were ready for a long stay, unsure of what to expect. We asked questions, made statements, promised help, if only he would talk to us. Beth tried to put an arm around his shoulders, a gesture that at first he repelled, horrified, but then accepted with a look of desperation. Sim cried into her shoulder for a full ten minutes, before at last regaining some composure, and whispering a barely audible "Sorry".

We talked some more, Beth and I, while Sim would only answer by nodding or shaking his head. There were intermittent sobs, long silences while we searched for the right questions to give us the answers we needed. The photo downstairs eventually registered in the recesses of my mind, and I realised that this shadow was once that same proud soldier.

"Is that you? In the photo downstairs?"

A nod of the head confirmed my suspicions.

"I was a soldier once. Miss it too! Miss the friends, the closeness, the action. Would go back tomorrow if I could." I told him a little of where I was, what I'd done, what I'd seen, and what it meant to me. Slowly, the tears dried.

For the first time, Sim looked me in the eye. I'd found it. The connection we needed. And then he talked. For the next 20 minutes, uninterrupted, he talked, and we listened. About the Army, about his life without it, about the injury he'd received that meant he could no longer serve his country. He spoke of the nightmares he has, the flashbacks, the friends he'd lost. He told us that the Army was not only his life, but his friends, his family, his support. He cried about being jealous of his friends who were still serving, how they couldn't visit him while they were away on a deployment. How he was left all alone, now that they'd been away for three months. He had no food, no electricity, no money, and not a soul in the world to turn to. He couldn't bring himself to leave the house, the thought of the outside world terrifying him. Tonight was the night he was going to end it all, but he couldn't bring himself to do it. He sat on the landing and cried for hours, until we arrived.

We talked some more about how we could get him some help, and reluctantly he'd agreed to try. He'd come to the hospital, talk to the doctors, the crisis team, the social workers. He made no promises about succeeding, but at least he'd give it a go. "At least I'll try to get to see one more Christmas."

Weeks later, and after a few days off, I returned to station for my next shift to find a card and an almost empty box of chocolates, just sat on the table. I looked in the card, expecting to see another "Merry Christmas" or "Happy New Year" message from a grateful member of the public, or maybe even from our management. Happens sometimes. Instead, it had two sentences inside.

"Thank You for understanding and saving my life. From one ex-soldier to another".

Sim's chocolates were gone.

Sim's card is still safe.

Hopefully, Sim is too.

Bricks and Stones

So, if we catch them, what do we do with them?

Unfortunately, probably nothing.

Gotcha!

Well done to all those involved in stopping this idiot BEFORE someone was killed.

Wonder if the book they threw made any impression to his numbed brain?

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.

Used and Abused

With apologies to, well, everyone. You really probably shouldn't read this either on a full stomach or an empty one. It's 3 in the morning, and I can't sleep. Again. And I can't use work as my excuse this time. The news is showing endless loops of drunks in public places, private parties, and excruciatingly humiliating themselves. It's led to some sort of worrying muse. However - I have to say, hats off to the boys and girls who man (sorry) the Booze Bus. I don't know how you do it.

*****

The Season has begun.
You know what must be done.
You must go to the office do,
And start off at a run.

To drink all that you can,
Will show you're such a man.
It's just the greatest thing to do,
From pint, to glass to can.

You'll vomit like a tap,
Wake up and feel crap.
Won't remember a single thing,
Was it worth it, dear chap?

No connection - brain to feet,
You'll fall down in the street.
They'll call for you an ambulance,
That has someone else to treat.

You really couldn't care,
Whether it should be there.
The ambulance is there for you,
So your vomit you can share.

We'll cart you in the back,
You'll shower us with flack.
Both words and stomach contents,
A hurtling attack.

You'll wake in A&E,
Desperate for a wee,
And do it in the cubicle,
"The bog's too far for me!"

That's how you'll end your night,
In bright fluorescent light.
A black mark on your record,
And your friends nowhere in sight.

And the crew that you abused?
They're feeling somewhat bruised.
We really have much better things,
For which we should be used.

Swings

I like swings.

And roundabouts.

And slides.

But I don't like swings.

So please don't take one at me. I won't take to it kindly.

Thank you.