Bragging Rights

Sometimes, I look at the career I've chosen,

and think back to my biology teacher. And laugh.

(No more than the most basic grasp of the subject.)

Sometimes, I look at the blog I write,

and think back to my English teacher. And laugh.

(Poor writing style, no imagination, little effort.)

Sometimes, I look at the job I do,

and think back to my careers adviser. And laugh. 

(Back-office job, contact with the public ill-advised.)

I laugh at how wrong they were. 

I laugh at how I believed everything they said. 

I laugh at how, despite the fact that I believed them at the time, I proved them all wrong. 

A very good friend of mine recently told me that he used to read my blog, but stopped because it was too self-centred, sounded too much like a self-portrait of a hero in the making. Initially, I was a little troubled by his comments, well, actually, more than just a little troubled. I didn't perceive that this is what this blog is all about. However, thinking about it, I guess he was at least partially right. It is very self-centred. But that's only because I can only write what I feel. I can't express the feelings of the people I meet, although I can often have a good guess. And for anyone who's known me for any length of time knows, expressing what I feel is a very new (and exceptionally frightening) concept that I still fail at doing in a face-to-face situation. It's precisely why I took to writing. 

As for heroics? Pah. Anyone who does the same job I do is as much a hero as I am, although I am almost totally certain that none of us looks inwards and sees anything suchlike. We see a person who may have a special skill, maybe even a special connection with people we've never met before and may never meet again. We may even be opportunists who are presented with a statistically skewed number of chances to help preserve a human life. But heroes? Soldiers who save their comrades whilst under heavy fire are heroes. Random members of the public who jump into a raging sea to save a drowning child are heroes. We have a job to do, a special job maybe, but we wear uniforms, not capes. 

All of that doesn't mean that I'm not proud of who I am and what I do - alongside my colleagues. I may have recently had some second thoughts, well, more of a crisis of confidence really, but hopefully I'm back to  what passes as almost normal. I'm still pleased that I chose the path I did, even if it did take me some time to realise what that path should be. And if that comes across in this blog as being too self-centred - well, good. Because, whether my friend likes it or not (and yes, we're still friends), I've still got much to brag about. Even if it is self-centred. 

London's Burning

We're a privileged lot, us ambulance people. We knock on people's doors, people we have never met before and in all likelihood will never see again, and they just let us in. In fact, not only do they allow us in, they invite us into their homes. Any time of the day or night, we knock on the door, strangers in every sense of the word, and step into somebody else's world, usually without any fear. And in these worlds, these homes, we see lives laid bare. Emotion at its most raw, sadness and anger in equal measure, happiness rarely, but for just a brief period we're allowed a quick peek into lives that not only do we not live, but often couldn't imagine. 

From beautiful homes, some bigger than my street, fenced off, gated properties with the rich and sometimes famous, to squalid apartments, crawling with rats and bearing a gut-wrenching smell that needs to be experienced to be understood, we see them all. 

We see happy families, smiling photos beaming down from the walls, and families torn apart by an unknown, unloved past. There are single parents, adopting and adopted families, children who grow up with everything they could wish for, and children who grow up with nothing. 

This country is the same as any other, the people here too. Most of us strive to make the best with what we have, to live our lives to our fullest potential, to be a member who contributes to a society in order to make it more livable, more comfortable for both ourselves and everyone else. These are the basics of human life, of being part of normal society. 

These last few days, starting in London and spreading around the country, have shown another side to our first world society. An ugly side, a threatening side, a destructive side. We've seen society at its worst. 

There's a sense of entitlement that exists amongst too many. It starts with people expecting to have everything handed to them on a plate. People don't want to have to think for themselves any more, so that where once, many years ago, ambulances would only be called in the most dire of circumstances, now a mere six hour old case of sinusitis is cause for a deferment of responsibilities onto somebody else. 

Let someone else tell me what to do, it's too hard to think for myself. 

I'm not a member of society, I'm me. And I'm the most important. 

What I want, I will have. 

The longer it goes on, the more it becomes ingrained as a norm. It's culminated over these past few days by several hundred people deciding that normal society just isn't for them. They don't want to be a part of it, and don't care about any other members of it. 

If I want a television, I'll just go and get one. 

If I want the latest trend in sportswear, I'll just smash my way into a shop and take it. 

That's not my house, or shop, so who cares if I set fire to it? 

This isn't a democratic exhibition of freedom. Freedom isn't expressed by attacking public and private property; homes, cars, even ambulances.

This isn't a political protest, aimed at changing any one of many government strategies or some perceived unfairness. 

This isn't the underprivileged minority, or a certain race, or only young men. The pictures tell a different story altogether. There's a huge mix. The demographics can't be narrowed down in any way, but the thought process can:

What's mine is mine, and what's yours is also mine. 

It starts with disregard for society as a whole and its rules; it's a disregard for private belongings, a disregard for public provisions, and eventually leads to a disregard for human life in general. We can consider ourselves lucky if all we do is count the cost in the number of human lives lost. But that is not all we've lost. People have lost their homes, their businesses, their streets. 

They have lost financially and physically. They have lost their pasts, their presents, their futures. But we, as a society, have lost a great deal more. 

We have lost our dignity. 

Now's the time to fight to get it back, and maybe, just maybe, by showing these criminal thugs and hoodlums that we care, by teaching them that there is another way, they might decide to rejoin society as valued members rather than self-proclaimed outcasts. 

And as I watch London burn, I can only hope. 

Making Friends

Michael Morse, one of the best EMS bloggers out there, has written a humbling, haunting, heartfelt post as he hits twenty years on the front line, both in Fire and EMS. In it he speaks of the sights, sounds and smells of all those years, the ghosts and how he thought he could face them all, and how they have affected him over the years. Follow the link and read the post.

Dozens of people commented, offering support, strength and reassurance. Some even expressed their gratitude.

One response in particular stood out for me. This one from Ambulance Driver - another one of the big hitters in the EMS blogging world.

"You will never, ever be able to banish all the faces.

But you can, with a little time and perspective, make friends with the ghosts."

I'm nowhere near twenty years in. But I know exactly what they mean. Both of them.

And I'm still making friends.

Vote Now Open!

The voting for the "Blog of the Year" has kicked off in earnest over at FireCritic's blog. There are two categories - one for EMS blogs, and one for Fire blogs. 

Although I was nominated, an honour in itself, I wasn't included in the shortlist of finalists, so luckily for you, dear reader, no begging letters from here. 

I do, however, know how much effort goes into writing these blogs, and understand that recognition is an important part of keeping these blogs alive. 

I think I know who I'm voting for. Since you can vote once every twelve hours, I'm probably going to split my vote two ways in the EMS category, and another one for Fire. 

So, please, head over to the Voting Page, and show your support. It will truly be appreciated! 

Cul-de-Sac

The cold temperature in the dingy basement flat matched the frost-bitten air outside. Small icicles surrounded the windows, the only light was that of a lone candle, battling to break through the dark of another winter's night. The kitchen, bathroom, living room, even the bedroom, all crammed into a flat no bigger than an average family car.

*

The fire-call seemed straight forward. A ground floor apartment, probably a kitchen fire. There was smoke billowing from the broken windows, but the Fire Brigade seemed to be in control now. The ambulance's occupants enjoying the respite that these types of calls often bring. We're only there "just in case". In case one of the Brigade are hurt, or in case any occupants are found and need treatment.

*

In the middle of it all, surrounded by the barest of bare essentials and wrapped in layers of blankets, sat Ray, looking almost double his middle-aged years. Hardly more than a skeleton wearing a thin layer of skin, with sunken cheeks and saddened eyes, he was clearly embarrassed to let us in. "I don't know where to turn any more", he started. It was tough to work out if his speech was shaky because of the cold, his fear, or a medical condition. "My family have either died or left me to do the same. I have no help. No gas. No electricity. I steal or beg to eat, and only keep warm by wrapping up in layers. I have no light and no heating. I just need to be somewhere warm".

*

The white-helmeted Station Officer had come over to let us know that they didn't think that there were any occupants, but that they'd still like us to stand by. "Hang fire", he says, his grin indicating clearly an intentional pun. "We've still got guys in breathing apparatus. Once they're all out and OK, we'll let you go." We're in no rush. We have chocolate. We have drinks. We have hours left of our shift, and now we have a break. The music's turned up just a little more.

*

Cases such as these are rare, but not as rare as I'd like to think, or hope. In a country famed for its welfare, cases like these have no right to exist, and where they do, they should be easily and quickly solved. Many, too many of them are unknown, shame and fear preventing those suffering from doing anything about it. Ray had had no heating or light for several months. The utility companies seemed just to give up on getting their money, cut off the supplies, and never bothered to check if anyone was still living there. There was wax everywhere from where he'd lit the candles, bags full of rubbish that he said he still had to go through to see if he could find anything worth salvaging for food, and filth all over the space that hardly qualified as a kitchen.

*

One more update from the Station Officer. The last of his crews was now going into the building, to ensure that it was well ventilated and assess when it would be safe for the other residents in the vicinity to return back to their own homes. "A few more minutes guys", he says, talking over the noise of the generators, the pumps and our radio. It's all now a matter of minutes before we'll be back on our way to the reality of ambulance work.
*
One thing was for certain. Ray couldn't stay here any longer. Irrelevant of any medical need - he was going to hospital. At least there he'd be warm, fed, showered possibly, and most importantly there would be time to get the system in place for him to be cared for long-term. It wasn't an ideal solution - just the start of one. He was unsurprisingly hypothermic, his pulse was low, his blood pressure too. It was surprising he was still sat up. We brought the chair in for him, but he refused it, wanting to salvage his last vestige of pride, and chose to walk to the ambulance. He got as far as the door and caved in.

*

Then came the shout. "There's someone here! He's not breathing! Get the paramedics!" We both hear the Brigade's radio over the music channel we're listening to in the ambulance, and jump out of our seats. A Fireman's Lift is given a whole new meaning when you actually see a lifeless body being carried out by a fireman.

*

The journey to hospital was uneventful, we left him in their care, filled in the multitude of forms to get social services involved as quickly as possible. Something must have worked somewhere. Not long after that, I had a call to the same building, to see an estate agent's To Let sign outside. I had a peek through the window and saw that the place had been cleaned up, was brightly painted, and now just waiting for a new resident. Ray was nowhere to be seen.

*

He was placed on our trolley bed, and the resus started in earnest. His face was covered in soot, his skin cracked, his eyes glazed over. Someone started on compressing his chest, trying to beat a rhythm into his arrested heart, whilst I was in charge of using the bag and mask, to breath some oxygen into his burnt lungs. I removed the mask from his face and prepared to intubate him, so that the oxygen we were pushing in to him at random with a mask hit exactly the right spot via a tube.

*

I spoke to the sister in charge to find out what had happened in the interim. She told me that he'd been moved to a ward and would probably spend a few days in hospital. Social services had been contacted and the system's cogs were turning, trying to find the most suitable answer to his problems. For some reason this call bugged me, so I followed up again a few days later to find that he'd been rehoused. I hoped it was clean, warm, and had 1st world utilities, instead of 3rd world conditions. I hoped he was on the road to recovery.

*

One of the bystanders, forced out of their neighbouring apartment by the fire, told us that he'd only moved in a couple of weeks previously, that he seemed pleasant, but kept himself to himself. She didn't really know any more about him. As I took the mask away, I saw a face I couldn't forget. I hadn't noticed in the first moments he'd been thrown at us. Ray's face, covered in smoke and contorted in pain, his eyes, once saddened, now looked back at me again, this time glazed and lifeless. His chance at finding a road to recovery reaching no more than a cul-de-sac.

Spitting Distance

One of the disadvantages of working solo on the FRU is that I don't have the luxury of being able to walk out of the room if I get a fit of the giggles. And it happens. All the professionalism in the world doesn't prepare you for some of the funniest moments that we have.

The 30 year old woman who stripped off in the middle of the street telling us we should do an ECG as she thought she was having a heart attack.

The lady who uses a phrase that we always laugh about on station, but nobody really says, or do they?

The elderly gentleman who called an ambulance to tell them that his phone wasn't working.

The elderly lady who was spotted in a phone box, playing a violin, topless.

The teenager who challenged his young siblings that he could beat them in a running race if he was running backwards, then tried, then fell and cracked his head open.

Sometimes, patients say and do the funniest things. Sometimes you can laugh along with them, and the joke is appreciated all round. Sometimes you have to wait until later to laugh. Sometimes, for no apparent reason whatsoever, you just get a fit of the giggles, and have to walk away.

And very rarely, you get to go back to the same patient, and have a laugh about the last time you had a laugh.

*****

Mr and Mrs Oapsky are an elderly couple who live on the top floor of a 3-storey apartment block. At the moment they are sitting on a bench outside their flat, watching the fire brigade tackle a fire in the place they've called home for the last 15 years. They got out before the fire really took hold, and as per all the rules, stopped for nothing. Except Mrs O's make-up box and comb. Can't go anywhere without them. They're uninjured, having only inhaled a very small amount of smoke, if a little concerned for all their belonging, but are stoic in a way only the older generation tends to be these days. The smoke billows out of the windows, and one of the firefighters comes over to tell the couple that although the fire is out, the flat is heavily smoke damaged, but most of their belongings were still intact. They seem relieved, and decide that for now, as it's about 2am, they won't wake their relatives, but will go to the hospital and make all the arrangements in the daytime.

Mr and Mrs Oapsky seem familiar, but I can't place why I seem to know them, until, just before they leave in the ambulance I need their details for my paperwork and ask for their first names. "Oh, I'm Gillian, and this," she says, nodding her head in her husband's direction, "is Jacob. But everyone calls us Jack and Jill." I can't help it. I laugh out loud, and my memory is finally jogged to the call a few months earlier, when I was on a proper ambulance.

*****

The call comes in for an elderly gentleman, confused and talking nonsense. Sounds like my kinda guy. We're greeted on our arrival by Gillian "Please call me Jill" Oapsky, who's looking mildly confused herself.

"He keeps saying the strangest things! First he wanted to know where the cat was, when we've never had a cat, and then he started picking up the telephone and telling it off as if it were a small child!"

"What's his name?" I ask.

"Jacob, but everyone calls him Jack." The corners of my mouth turn up ever so slightly. Reena, my crewmate, gives me the "don't-you-dare-on-pain-of-death" stare. I can't help it. The giggles are lurking. Somehow I regain my composure, and approach Jack to ask him how he feels.

"I'm alright. Nothing wrong with me. Don't know what she's making all this fuss for." He denies having any pain, knows his name, date of birth, who the prime minister is, and can count backwards from 100 in sevens. I can't do that under normal circumstances.

Then, all of a sudden, he yells.

"PASS ME THAT PHONE. I'M THROWING IT OUT THE WINDOW. IT KEEPS SPITTING AT ME!"

Well, that does it. My composure is destroyed. I look at Reena, look at Jill, look at Jack, and finally I look at the phone. It's the phone's innocence, just sitting there placidly, not even ringing, that does for me. I crumble into giggles. I'm given the threatened death-stare, but it's a lost cause. Jill tries to look disapprovingly, but eventually gives in to the giggles too. Through all the laughter we check Jack's observations and ask Jill what medical problems he has. Apparently, for a 70-something year old, he's as fit as a fiddle.

"The doctor's just started him on some new medicine, but I'm not sure what it's for." We have a look and find that it's a tablet for diabetes. Having just checked his blood sugar and found that it's very low, we're not at all surprised. Most people I've met with the level he had were unconscious, but Jack was just talking to us as if nothing was wrong, except for intermittent bursts of phone-rage.

"WILL YOU STOP SPITTING! DIDN'T YOUR MOTHER EVER TELL YOU IT WAS RUDE TO SPIT? COME HERE! I'M THROWING YOU OUT THE WINDOW!"

On and on he went about throwing this phone out the window. How it kept spitting and swearing at him. The more he continued, the more raucous the laughter became. We tried to give him some oral glucose as well as a glucagon injection to bring his sugar levels up, but neither seemed to help. Eventually we decide that the only choice we have is to give him IV dextrose. It's not an ideal solution, as it tends to mess up the sugar levels for the next few days, but it is a miracle cure.

Jack lets Reena cannulate him and give him the IV, and within no more than about 2 minutes he looks up at us with a very confused look. "Who are you two? What are you doing in my house?"

"Welcome back Jack! We're from the ambulance service and we're here because your blood sugar was very low. Your wife was worried because as well as not being your normal self, you also threatened serious violence against your phone." Once again, Reena, Jill and I all collapse in hysterics. The treatment has done the trick. Jack is back to normal. A little bemused at all the merriment around him, but it's soon explained, and he laughs along too. We take him to hospital just so that he can have a check-up and make sure that his new medication is the right one for him. I've just about managed to calm down by the time we have to hand him over to the staff.

*****

Several months later, back at the scene of the fire, Jack takes one final look out of the ambulance, and just as I'm about to close the doors he calls after me.

"Oy! Make sure they don't throw my phone out the window! I still need to tell it off about all that spitting!"