Behind Closed Doors

Midnight. The normally quiet residential street is a hive of activity, as busy and bustling as a midday marketplace. People have gathered from all over; neighbours, friends, relatives, all standing outside trying to make sense of the unfolding drama. We can see it all, hear it all from the bedroom, each of us taking turns to peek out to the street a dozen floors below as we rotate over and over again, each of us briefly the centre of the chaos, standing pumping his heart, then taking a break, a breath of fresh air and a glimpse out the window. 

The bedroom is tiny, the furniture within taking up the vast majority of the space, leaving us with very little room to work, yet somehow we all fit in. Through the closed door we can hear the sounds from the lounge. It too is packed full of people, some who heard the initial shrieks and screams for help, some who received the panicked phone-call. Some were further along the communication tree, receiving word as the news branched out exponentially. 

We know how much this means, how much is riding on our success or failure. Every call means the world to someone. Every patient needs our help equally at their time of distress, even if we don't always see it that way. It's hard for us to think that the patient who's had backache for a fortnight ranks as highly as our patient now. Sometimes we show our frustration, but mostly we treat what we see and who we are seeing as the centre of our attention, as though nothing else in the world matters now. 

Right now, however, we really feel it. Nothing else matters. In that tiny, closed room is the entire universe and all that's important within. We are fighting for a life in one room, as in the other they can only wait. Every few minutes someone goes out to update them on what is happening behind the ominously closed doors. 

It's all so different from the time before, when we worked in the lounge, watched throughout by a partner who knew she was saying goodbye to her lifelong companion. There was no noise, barely a sound uttered. Every few minutes she'd hover behind our backs and ask us if there was any change. At the third time of asking, when there was none, she calmly sat down and asked us to stop. 

This time we stopped when we saw that all our efforts were futile. We fought for over an hour, far longer than we should have done, far longer than the protocol requires of us. We fought because it felt as though we couldn't afford to lose, even when we knew we were losing. We fought until we lost. 

We sit silently behind the closed doors of the ambulance, tidying, cleaning, preparing the inevitable, intrusive paperwork. We are not quite hidden, more cocooned, yet unavoidably touched by the tragedy all around. More friends and family turn up at the scene, each showing grief in their own way. Some cry, some wail, some are silent and sombre. Some are more stoic, lending shoulders and strength to those who need it most. 

Back upstairs, behind closed doors, a mother and her young children sit stunned as the building in which they reside remains upright but the entire world around them collapses. 

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.

Silence

Two faces in the dead of night, staring out of the front windscreen of a destroyed car. One's talking to me,  bragging, apologising, part regaling in their achievements, part regretting their actions. He tells me of their drink fuelled night, how they argued over who would drive, how they agreed that they'd have one go each at making the car fly over the bridge. His friend is quiet, eyes staring into the distance.

They succeeded. The police estimated that they must have been driving at over a hundred miles an hour when they hit the brow of the hill. The car's front was unrecognisable, make and model only clear from the back, airbags deployed all around. As we strap him down to a board, hoping to prevent any further injury, he tells us that once they'd left the road, the car just seemed to fly sideways instead of straight, and there was nothing they could do. In the meantime, the police dealt with his friend.

He kept saying that he wasn't brave enough to drive that fast, and when they failed the first time, they turned around, lined up again, changed seats, and had another go. He talked to us all the way to hospital, barely noticing any checks we did, any treatments we provided, just boasting about their tricks, about how impressed he was with his friend, the one we'd left on scene.

"Car's a write-off, isn't it?"

"I'd guess so."

"How come you guys got me out first? Is it because I was making so much noise?"

"Something like that, yeah."

"Well, my leg is smashed, isn't it?" It was. 

"Guess my mate's OK then, he didn't seem too hurt, just sitting back like that in his chair." 

A police officer travelling with us shuffles uncomfortably in his seat, and gives me a quick look. He makes a few more notes in his pocket book, checks once more for our call sign, and asks the passenger again what happened. He goes through the stories again, tells how they took a longer run up the second time round, makes sure that we know that he wasn't driving, that his friend was.

"I was in the driver's seat first time, but we didn't take off. So he took over. Called me all sorts of things for chickening out. But he did it! It was so cool! Shame we hit that fence though, won't be able to do it in that car again!"

It wasn't the fence that was the problem. It was the street light after the fence, the one that had smashed through the roof and the windscreen of the car. On the driver's side. The passenger, our patient, notices the looks, senses the unease. 

"Is my friend OK? Is there another ambulance looking after him? How come you didn't get him out too?" His world crashes in around him as the reality dawns, and he shouts. "I asked you, is he OK?"

I look across at the officer, who gives me an almost imperceptible nod of the head. 

"No. He's not OK. He's dead." 

Suddenly, silence engulfs the ambulance. 

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. 

Traffic Stop

Knowing that police are on scene and knowing that the scene is safe are two very different things. Once we know that the latter is true, we approach at speed. 

A bystander runs up to us and practically pushes me off my feet. 

"What the hell took you so long? The police have been here for ages." 

I push him off, lift the police tape that marks the outer cordon, and head into the neutralised area.

One of the officers signals to us to head towards the idling car, the headlights of a police van on full beam illuminating our approach. Sitting in the front passenger seat of the car is yet another officer, looking pale and wearing a blood-soaked shirt. A crowd stand around the cordon, some hurling abuse at the police, some at us, some at each other. The atmosphere is on a knife-edge, teetering on the brink of an all-out riot. In the driver's seat, unconscious and bloodied, sits London's latest gun-crime statistic. 

Two holes through the windscreen, almost perfect circles, the rest of the glass undisturbed. 

To the police, he's a victim; to us, a patient. The work we do could mean the difference between attempted and actual murder, between a life-threatening injury and a fatal one, between life and death. We move him out of the car, looking for injuries, and finding them too. 

Two holes in his chest, almost perfect circles, the rest of his body untouched. 

Entry wounds only, leading to only one conclusion: the bullets are still lodged within him. The visible damage is only a small part of the story. It's impossible to know what damage was caused after those tiny projectiles entered the body, where they veered off to, what organs they hit, what arteries they missed, how much blood has been lost. 

"Are you gonna just sit there looking at him all day?" 

The call comes from one of the irate crowd, someone who doesn't understand that just moving the patient could be the wrong thing to do. We need to have an idea of what we're dealing with, whether his lungs will hold out for long enough, whether we think his heart's been hit, whether there's anything we could possibly do to give him a better chance. 

There's no one else to send to help us out so we package him up into the ambulance, give a report over the radio and head to the trauma unit. Luckily, for a change, we're not too far away. On route to the hospital his breathing becomes more noisy, more erratic, and then silent. His heart changes from a rapid beat to a slow beat, to no beat at all.

The officer in the bloodied shirt meets us at the hospital and asks how the victim is doing. We tell him. 

"Damn. I only pulled him over because he had no headlights on, I had no idea that anyone else was watching him too." He shakes his head. "Can I go and see him?" 

We walk with him in the direction of the resuscitation room, and he knocks gently on the door. A nurse peeks through to see who's disturbing their work, sees the blood on his shirt and lets him in immediately. It takes a minute for him to convince her that he's not injured, that he just wants to see the victim. 

The third cubicle along has the curtains drawn. Monitors all around ping with electronic bells, whine with wavering warnings, but the monitor in cubicle three is silent. The officer steps in, the nurse follows and we stand by the curtains. The victim's face is already covered, and the nurse slowly, gently, mournfully pulls the cover back. The officer takes one final look, shakes his head again and turns to leave. 

"A traffic stop. Just a simple, damned traffic stop." 

Windows

Tiny drops trickle down, zigzagging along

the inside of the steamy window, 

leaving streaks,

like tears, 

on a pockmarked face. 

Inside, they lie, 

side by side. 

He watches her, holds her, 

caresses her lifeless, cooling hand,

begs her to stay, despite knowing,

knowing she's gone. 

We step inside and take one look. 

Inside, the image in the window is mirrored, 

as tears stream down his gentle, pockmarked face. 

Cycles

A children's channel shows quietly in the background. A young boy sits in a corner of the entrance hall trying his hardest to keep his eye on the television, as all around him chaos reigns. Dozens of people are in the house, men in one room, women in another. Children wonder between the two, the younger ones chasing each other, playing happily, their childhood seemingly unaffected by the grown-up reality all around them. 

A middle-aged, grey-haired man meets me at the door and guides me towards a side room. The house suddenly becomes silent as they see, hear and sense the intrusion of an unknown guest. Dozens of eyes follow me through the narrow corridor. Another man, of similar age and strikingly similar features to my guide joins us. He puts his hand on the handle, and just before we enter, he stops to explain.

"My name is Deepesh, and this", he says, pointing to the other man, "is my brother. I'm sorry you were called. There is nothing for you to do, but they said this was the only way." 

Deepesh opens the door, and motions me in. Two women are sitting at the other end of the room, their chairs angled gently towards each other. One wipes tears away as the other sits reading prayers from a book. Between them, lying on the floor and covered up to his face in a white sheet, is an elderly man. 

"He died a few hours ago," said Deepesh. "We called the family just before, when we knew he was in his last moments. Many of them have been here since then, many have joined us in the meantime. It is how we help his soul on its way. My sister and aunt, his sister, are the ladies in the room." 

It was the aunt who was crying. 

"We called the doctor to tell him that my father had died, but it was after hours, so they said we had to call for you. All we need is the certificate so we can prepare the funeral."

The call had been dispatched as a cardiac arrest. That would mean at least another three pairs of hands were on the way, possibly even four. I'd left the car and headed for the house with several bags full of kit and ready for a resuscitation. As soon as I had reached the front door, I knew that the equipment was surplus, and that any efforts would be futile. The calm, sad acceptance written on Deepesh's face told me all that I needed to know. As soon as I had seen his father, I called off the reinforcements. Distant sirens fell silent moments later. 

"We knew he was dying. A year ago, he was given three months, but he fought on. He wanted to see his first great grandchild. She was born last week, and he held her yesterday for the first and last time." 

Deepesh called to one of the children, and following an apology to me, asked them something in a language I don't understand. The child, a young girl of six or seven, her long dark hair tied in a plait, looked at him as if he was crazy. He, in turn just confirmed his request with a gentle nod of the head. A minute later she returned holding a digital camera, and handed it to him. He pressed a couple of buttons, and showed me the screen. Sitting there, a broad smile across his face and cuddling a tiny baby, was the same man who lay lifeless on the floor only one day later. 

"He knew it was his time." Deepesh wiped away the hint of a tear and stopped for a few seconds. "Only yesterday he sat holding the baby, and all he kept talking about was the cycle of life." 

Movies

The feet appeared first, his legs skewed apart

mimicking the lines they draw in the movies.

His upper body hidden from view, the suspense building, 

following a plot like the movies.

Climbing over a table to see blood spattered walls,

and a gun lying spent on the floor. 

Finding him there, motionless, lifeless. 

Faceless.

Looking for some way to help. 

Finding none. 

Realising that this isn't the movies. 

And knowing, again, that happily-ever-after 

is often nothing more than a movie, a wish, a dream. 

Milk Bottle

Two bottles of milk by the front door,

A neighbour sensed something was wrong.

"She has one bottle delivered each and every day!"

A light was on,

The television flickered through a sliver of open curtain,

But there was no answer to our calls.

A kick, another kick, and the door splintered open.

In the kitchen, by the table and an upturned chair,

She lay where she fell.

A bowl of dry cereal sat waiting,

For an unopened bottle of milk.

Scriptwriting

Just as I'd started to get over the trauma of the call itself, a reminder arrived through the internal mail. 

The Coroner was requesting a report. 

As I sat for the next two hours typing out everything as I remembered it, or as a copy of my paperwork reminded me, I wondered how much I would have changed given the chance to press a delete button and rewrite the script just as I was doing to ensure the accuracy of my report. 

Thinking back to the call, I wouldn't have changed a thing. The team worked well, the skills were flawless, the professionalism without blemish. 

But as I typed out the last line of the conclusion, I realised that there was one thing that needed to be crossed out and rewritten, one thing, that if given the chance I'd never have sent in to the editors for printing. 

The final page of the script. 

Sometimes we don't write the scripts. Sometimes we're merely characters within it. 

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. 

Scars

We're both going to be left with scars, but mine seem unfair. Unfair to you, not to me. I don't have the right to feel this way, to feel the anger, the frustration, the sadness and injustice of it all. After all, he wasn't my child.

My children were safely at home, sharing popcorn and a movie with friends.

Your child was being roughly manhandled by ambulance crews desperately trying and miserably failing to save his life.

We must have seemed so cold to you, so callous, calculated, so damned professional. Sticking tubes down his throat, needles in his scrawny arms, pounding on his delicate, fragile chest. But we're human too. 

At the hospital, after we'd walked back out of your lives, we shed a tear, shared a tear. Some of us outwardly, some torn from the inside out, some showing a passive face, hiding the emotion that was battling to break through the dam. 

As we worked to save his life, nothing else mattered. But afterwards, there are questions, doubts, replays of every single thing that happened go through my mind. Could we have done something differently? Could we have worked faster, better, harder? Would it have made a difference? 

The team at the hospital told us that we did everything that we could. They came out to the ambulance to find a saloon full of sombre faces in green uniforms. They said what they said, and left to go back to talk to you, a conversation so much worse. I know we did all we could. I know that we couldn't have done anything better. I know that nothing we could have done would have saved his life. I don't expect you to feel the same. 

It's never right for a child to die. Not through illness or trauma, neither by accident nor malice. You know that better than I, as you sit and try to come to terms with a tragedy so deep that the scars will never entirely fade, whilst I go home and hold my children closer. 

At home, I tried to leave your child behind. "Just another day at the office," I'd tell myself. I failed at that too. 

Instead, I sat and cried as I polished my boots clean of all the scars of that call, feeling guilty that I'm erasing any physical memory I have of your son. 

I know that you can't erase the memory. Won't erase it. All I can hope is that the memories that linger aren't the ones I have, of a lifeless child, bereft of hope. I can only pray that the memories you keep are the good ones, the happy times, the playful child full of life.

And that in time, your scars heal, if only a little. 

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.

Often, Sometimes

Dozens of times, each time different, yet each time the same.

"I'm sorry. There's nothing else we can do."

Often at home,

Sometimes at hospital.

Often, there are tears,

Sometimes screams.

Often silence.

Sometimes hugs.

Often phone calls.

Sometimes, oddly, smiles.

Often confusion.

Yet always, as we leave, we leave nothing but an empty, dark void.

And questions. Always questions.

Each time may be different, yet each time is the same.

And each time, I'm sorry.

Survivor

Today is International Holocaust Memorial Day. This repost is my attempt at keeping one story alive, honouring one memory, and teaching just one extra person, in the hope that if we remember our history and learn from it, we are unlikely to repeat it. 
__________________________________

Like a herd of elephants, we charge into the sanctuary that has been their home for the last forty years, maybe more. Eyes withered with age and a hand crippled by arthritis, a tattooed number just visible below the three-quarter length sleeve, pointed us in the direction of the upstairs rear bedroom. She lay there, exactly as she had done for probably several hours, a peaceful look on her immobile face. There was nothing left for us to do. Back downstairs, waiting for confirmation of the inevitable, was the person who had lived with her and cared for her for the best part of seventy years. 

As soon as we broke the news, the lifelong protector broke down in tears, and after a minute or two, composed herself, and began a breathtaking monologue.

"She's my baby sister, younger than me by three years. She was five years old when our parents were dragged out of our house, along with our six other siblings, and machine-gunned. I saw it, couldn't help but watch in warped and terrified fascination, through a darkened window in the cellar of a neighbour's house. Eva was still hiding in a drain when they marched off. To this day I don't know how she ended up there."

Rosa's perfect English is betrayed every so often by a Germanic twang to some of her words, labeling her for all eternity with a past she'd rather forget.

"When it was all done, they were dumped into large wheelbarrows, taken just past the tree line not fifty paces away, and thrown into a mass grave. As a parting gesture, the soldiers fired on them again, silencing the few voices still calling for help. Or praying for the end. Whichever would cease their suffering quicker.

"After they disappeared to look for more fun, I ran out of my hiding place and went to find Eva. We had seen death around us, heard it, tasted it, but this was the first time it hit us directly, and we knew we had no-one left. For a few days we hid where we could, and once a day I left Eva and went to steal any food I could. One day, when we heard more soldiers coming, we ran into the woods, and never looked back. 

"For over a year that forest was our home. We even hid in the graves, where we learnt to play dead if we heard anyone coming. Bodies were dumped on top of us, and we'd have to dig our way out. We slept in barns when we could sneak in, found abandoned houses where they at least had a roof, even if no windows. We stole food, ate dead animals that we found, every so often a friendly home owner would give us something small, but they'd never let us stay. The fear in their heads ruled the compassion in their hearts. 

"About two years later, we were finally caught. It was a blessing in disguise. We were taken to a camp and forced into different jobs. The Kommandant's wife took a liking to Eva, and decided she'd take her in as a maid. It saved her life. All other children her age were taken away, often literally snatched out of the arms of screaming mothers, and never seen again. I was put to work in the camp itself, anything from scrubbing floors to sewing uniforms and repairing soldiers' socks. Beatings were a regular part of life, but so was a daily slice of bread and clear soup. No more fighting for food, or stealing it. I saw Eva every few days, when one or other of us managed to sneak across the camp.

"We survived so much that others didn't. We were the lucky ones. At the end of the war, after we were liberated, we eventually found our way to London. I was fourteen, and Eva eleven, but our life up until that point gave us a look of several years older. We were taken in by a children's charity and cared for until we decided we'd never again trust anyone else. We worked hard, saved some money, with it we bought our own home, and have lived here ever since.  I don't know how I'll live without her here."

Once again, the tears flowed. Rosa's mainly, but we weren't doing a great job of hiding ours either. I sat, pen and paper in hand to fill in the necessary forms, but as Rosa's sobs ended her story, I found that I'd not written a single word.

"I'm sorry", she said, wiping her face dry. "I have more than sixty years worth of crying to do. This is the first time since."

At her request, we contacted a friend who arrived within minutes of our call. We left the room to allow them to talk and grieve together. To comfort each other. To shed those reluctant tears. Whilst they did, we reloaded the ambulance with our equipment, sat in silence as I completed the paperwork that I'd struggled to fill in while in the house, and fought to comprehend all that we'd heard. After writing the empty words that described all that had clinically occurred, we returned to the house one last time to explain to Rosa what would now be happening.

Once we'd finished and offered our condolences, Rosa got up and saw us to the door.

"Don't worry about me", she started. "I've got my friends and neighbours. They'll help look after me".

And as we stepped back out over the threshold, as a farewell comfort from her to us, she called us back again.

"I'll be fine", she said. "I'm a survivor".

I know she is. I just hope I've done her story justice.

For Sale

For Sale: 

Brand new car.

100 miles on the clock.

Good for spare parts and scrap metal,

also some empty beer cans.

One previous owner.

Now deceased.

Street Escalator

A misunderstanding that led to an argument.

An argument that develops into a fight.

A fight escalates into acts of revenge.

Revenge takes form as a bullet.

The bullet takes a life.

A life, so young.

A waste.

At the top of the escalator, flat on the floor, lies the misunderstanding.

Purple

The streets are lined with market stalls, selling flags, scarves, team-branded items of all sorts. Blues to the right, Reds to the left. Home team advantage to the Blues, but it's a local derby, so feelings are running high, the tension in the air is palpable and threatens to erupt at any moment.

Thousands of fans on the streets walk, talk, shout and sing their way to the match. Some are sucked in by the stall-holders, but most have come prepared. The seasoned professionals in this game are the supporters, not the players. Years, even generations of loyal, unwavering support. The traditions remain strong, even when the reasons behind them can no longer be recalled. The sea of people converge on the ground, Reds from the left, Blues from the right, meeting to create a purple haze as they mingle at the gates.

It's a daunting sight, all the more so if you're trying to find one needle-like patient in a haystack of raucous colour. At least we know he's a Red. Eventually, thanks to the police, stewards and several drunken antics, he's found. Lying face down on a bench, his scarf loosely dangling from around his neck, the back of his shirt proudly displaying the coveted number 10.

Around us are more stalls, this time each plying their trade with an added bonus of advertising by aroma. Food and drink on sale at extortionate prices, yet being bought by hundreds of fans, each allowing themselves one more luxury to complete the day. All the while, there's an added smell in the mix, lavender-like, seemingly, almost impossibly, coming from the comatose patient.

Under the bench we see the can. Lavender air freshener. An officer picks it up and with one shake announces that it's empty. He hands us the can as he reads the warning printed boldly, menacingly on the back.

"Solvent abuse can kill instantly".

A Red fan amongst his own, away at the home of the Blues, gone in a self-inflicted haze of purple.

Eating Habits

The famous adage, "You learn something new every day", is especially true if you have kids, or spend any length of time with them. Kids have a way of saying things, seeing things, questioning things, that we as adults seem to lose. It's a kind of honesty and direct approach that where an adult would think twice about the ramifications of what they are about to say, children just want to know. Their inquisitive nature is their no-holds-barred method to a greater understanding of the world around them.

This week, one of my kids found out that in a previous life I used to be a soldier. It's not a fact I hide, neither is it something I'm ashamed of. It's just never come up in conversation. She found a photo of me in greens, carrying a semi-automatic, and looking every part the soldier. She looked, digested, dissected, and then came out with the question that I could clearly see was troubling her 6-year-old mind.

"Did you kill anyone?"

Woah.

I didn't see that one coming. I thought about it for a minute, and told her about people not joining the army to kill people. Soldiers are in the army to care for other people. To secure their land. To safeguard their way of life. Forget the politics. Six-year-olds don't care about it. If she did, she'd have asked about the legal ramifications for the Iraq War, the troops being in Afghanistan, and what the new coalition government plans to do about it all. Clearly not very likely.

She wanted to know about her dad, and I answered her intended question.

All my kids know what I do now. Obviously. They're proud to say that their dad's a paramedic, and if you were to ask any of them what my job description is, they'd each tell you, in their own inimitable style, that I save people's lives, or I go and help the sick and injured, or something along the same sorts of lines. Sometimes, if I come home looking particularly harassed, said 6-year-old will ask if I saved anybody at work, or how many people did I look after, but she has never yet asked me if anybody died. Her question about the army taught me a little about how the little people around us perceive the confusing world around them. To my six-year-old, the following is her view of the world:

Soldiers kill, Paramedics save.

As adults, on the other hand, we look at the world through completely different eyes. Our vision is blurred by stereotype, cynicism, media portrayal, politics, and a small dose of reality. After the "army question", I was left thinking about perception in general, and of the ambulance service in particular. I sent out a tweet to my followers asking a very simple question: "What is the first question/reaction you get as a paramedic/EMT when being introduced to someone new?" A simple question, but the answer to which is probably reduced to a bare half-dozen similar answers.

"Wow, that's interesting", or "How cool", or "You must see some horrible things".

Of course there are the silly ones, like "Do you drive on lights and sirens just to get back for a cup of coffee?" I'd love to say yes to that one, but no. Unfortunately not.

I find that there's one more. Often not the first question or reaction, but is asked on a very frequent basis.

"What's the worst thing you've ever seen?"

I refuse to answer that one honestly. The adult in me forbids it. Anyone asking that question doesn't really want to hear what the worst things are to see, and I know they don't. I know because once upon a time when I was much newer, I'd answer with the truth. Except that after the first three words they'd cover their ears and yell for me to stop. "Stop! No more! I can't understand how you do it!" Now my answer tends to be about the latest delivery I assisted with, and the mess all over the place. It's enough for most.

There's an element in all of us that wants to hear the gory story, to hear about the trauma. It's what makes any person driving past the scene of an accident drive slower in order to take a look, but drive much quicker if there's any risk of actually finding out. The childlike curiosity that is in all of us often makes way for the cynicism of an adult's view of the universe. We really want to know, but not at any cost.

Children have a thirst for knowledge that we as adults have quenched by reality.

Children are on a quest, a treasure-hunt searching for understanding, whilst we as adults we want to rest at the starting line, ignoring all the clues and helpful hints.

As adults we always have much to learn, but not always the hunger to do so. We'd do well to look at the children around us, and learn a little from their hunger. And from their eating habits.

That's what helps them grow.

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.