Friday, 21 March 2008

Sudden death

Ten emergency calls; four assisted-only, one declined aid, one declared dead at scene and the rest went by ambulance.

A horrible shift and one that is still bothering me so much that I have hardly slept properly since. I’m currently in a harsh and frank mood. I’m not someone you want to get on the wrong side of at the moment but on-duty, as always, I will keep my mood in check.

My first call, a Red1, ? cardiac arrest on a bus was a sleeping drunk and nothing more. I know people are scared of seemingly lifeless bodies but a ten second check for breathing, even from a distance, would confirm, in most cases, that they are not dead. I woke him up and escorted him from the bus. I’m doing this more and more frequently these days and I feel like a hi-vis clad usher. In fact, we are nothing more than security for bus drivers in such instances, not that I blame them wholly but a little common sense is required at times.

A 48 year-old homeless drunken man was sitting on the pavement with his suitcase some distance from him when I pulled up to see if he was alright. The local tenant who called us made a point of coming out to tell me that she was worried about him because he wasn’t moving and was lying on the pavement. Now, she said, he seemed to be just drunk and she was sorry I had been bothered for nothing. I thanked her and said I would check him out anyway.

‘F**k off. I don’t need to go to fu**ing hospital!’ he ranted after I asked him if he needed any help.

The crew turned up and the paramedic gently backed off after receiving the same verbal assault. This was later changed to a slurred conversation about where he was going and what he was going to do for shelter. He clearly knew his mind and that was fine with us. I reunited him with his estranged suitcase and left the scene, followed immediately by the ambulance.

We all know when someone is faking unconsciousness - every time. The 35 year-old female that I encountered on my next call didn’t know this and she flopped and flailed on the floor of a ladies public toilet at a train station. The police had been called to her when she was discovered and it became clear to me after a few seconds that she had issues and was trying to deal with them by pretending to be somewhere else. I convinced her of my ability to overturn her game and she eventually opened her eyes and communicated...a little. She told me she had taken ‘some pills’. Her problem wasn’t medical but she had to go to hospital now because I didn’t know what she had taken or how much. The crew arrived to a more able patient, even though she dragged her feet during the walk to the ambulance.

Another woman with issues was found in a callbox after a fruitless search by the police after my call for a 42 year-old female with chest pain led me to a riverside hotel. She wasn’t there and I suggested we try the phone box because I could see someone lingering inside. Sure enough, it was the patient but she wasn’t pleased to see the cops. She told me she had mental health problems but wouldn’t specify what they were until after the police left and I led her into the ambulance when the crew arrived. She was schizophrenic. You can see that in their eyes; it’s like looking at two people at once, each with a different personality.

‘Just leave me here’, she said after attempts were made to conduct the simplest of tests. She was very suspicious of the ECG and we had to explain at length the reason for doing it. In the end, we settled for a 4-lead and she was taken to hospital. Her chest pain may have been real but her behaviour made it impossible to get any impression of sincerity.

I got my next call from the station and the crew were sent just after I left. A 35 year-old woman was having severe DIB and her inhaler wasn’t working, so I sped off towards the Euston Road, where I would have to make the dangerous transition from one side to the other using my lights and sirens to create a safe pathway. Tonight I nearly got killed in the process. All of the traffic had stopped on one side and I crawled across so that heavy traffic in the other lanes could see me and slow down, which they did. A large articulated lorry seemed to be slowing too, so I continued to move across the road but I was being a lot more cautious this time and I don’t know if I had sensed it or I was just being the world’s slowest emergency driver tonight but if I had continued and increased my speed as I normally did, that thing would have smashed right through my car, through me and rolled over me like a bowling ball on a fly. The driver didn’t stop. I could swear I saw him slowing down; it was almost an invite for me to continue but instead he hurtled across my path, feet from the front of the car, as if I didn’t exist. I could see the look on some of the other drivers faces. They were shocked. I was shocked.

The patient I had almost been killed for was hyperventilating and needed nothing more than the sympathy and care of the ambulance crew for twenty minutes while I composed myself in the car outside.

The lorry wasn’t what destroyed my shift and left me feeling numb to this moment. It was something more tragic and less to do with me than you’d think.

I was on station with a technician crew when I received another call. I went to the car knowing that the crew had also been called to the same job. I read the description when I pressed my ‘amber to scene’ button. It read '39 year-old male, jumped off building'. I started moving fast towards the scene and an update on my screen informed me that ‘the caller believes he is dead’. No CPR was being performed because the caller had refused to do it. Instead, when we arrived, the police were there and one of their officers was busily jumping up and down on the chest of a man who was lying on the pavement below a high building. I got out and went over to the patient. He had head injuries and there was blood around his eyes and mouth; he was in cardiac arrest and the ECG monitor showed asystole when it was attached. The crew began to work on him and I prepared everything I’d need to continue resuscitation efforts before conveying him directly to hospital...that was the plan.

Unfortunately other events dictated what I could and could not do for this dying man. I can’t detail them here because there are sensitive issues I mustn’t discuss on a public space but I will say this – the conclusion of this particular call left me feeling hollow and useless for the rest of the shift and even into today. The one thing I remember most of all - the thing that burned into my mind as I left him there to die was the gold wedding ring on his perfectly manicured finger.

And so I carried on with my routine and attended a 45 year-old man who walked from his house to make a phone call about his chest pain. He was still sitting near the phone box when I arrived in the early hours of the morning – he windmilled me as I approached. He has had three MI’s in the past and a long history of angina, so his complaint had to be taken seriously. His BP was high and I started him on O2 until the ambulance arrived and the crew took over.

Then off to see a 47 year-old man who claimed he was vomiting blood but wasn’t. He was lying on the floor of his flat when I got there and wouldn’t move or communicate at first. There was no blood on his tongue or around his mouth and that familiar metallic smell wasn’t in the air, so I persuaded him to tell me what was really wrong and he gave in. ‘Just put me back in bed’, he said. The crew knew him – he had psychiatric issues and was usually drunk when they dealt with him. He’s known to be aggressive but I just happened to find him on a good night. I found that suggestion ironic after the events of earlier. He didn’t want to go to hospital now and even though the crew spent almost half an hour persuading him, he made an excuse to go into his bedroom before diving into his bed like a naughty child who doesn’t want to go to school. He was left there and I went back to the car.

Another unconscious drunk on a bus outside Australia House and I had my hand shaken this time by the culprit. He was a 26 year-old man and he seemed grateful that I had woken him and apologetic for the inconvenience caused.

Finally, a 29 year-old female with chest pain and a fast heart rate. She was in a private clinic, in their critical care unit and I was hardly needed. What they wanted was an ambulance crew to transfer her for NHS treatment, so I felt a bit useless. On my way out I stopped to look in on one of their patients – a premature baby on life support. It broke my heart to see it.

Be safe.


Anonymous said...

forgive me if im wrong, it seems the fatal incident at the building got to you more than it might normally, due to reasons you cant discuss, while curious as to what happened i genuinely hope that you will be alright, and that not too much ill has come of that tragic incident. much respect

Anonymous said...

Some jobs do that to us, especially if we can see ourselves in the patient. I'm sure this man had something deeply wrong in his life that he thought he could not fix, so he ended it, to be in a better place.
You couldn't have helped him, no matter how much you wanted to. He probably didn't want you to save him either, I'm just glad he can rest in peace.
You'll be okay =]

miss emma said...

so sorry to hear that you had a bad shift. hopefuly the weekend wil bring some better things! i wil look out for you tomorrow as im off to mayfair to buy the scrubs i need for my paramedic costume for the party! thanks for the help with that!

Anonymous said...

I find it amazing that individuals like yourself choose to do this for a living. Admirable career.

That said, my husband is a firefighter and myself an aide to the disabled.

But responding daily to such scenes must make you an incredibly giving and caring person. Not to mention the horrific scenes you must visit and the deaths you witness.

My hat is off to you. Be good to yourself.

Fiona - Premmie Mum said...

I came across your blog today because you spoke of a premature baby.
Firstly I just wanted to say What a fantastic job ambos do. I am from Australia and luckily have only ever had to use them once when being transfered from a level 2 hospital to a level 3 hospital so my daughter had to be born @ 27 weeks due to me suffering PE and HELLPS. The ambos were great people and helped me get there safe and sound.
Secondly I wanted to commend you on a great job. I hear the frustration in your words and I am sure it can be really trying sometimes but just know that there are many out there who appreciate your work. Those who are rude or those who make calls without checking the true nature of the person I think would be due to being scared of getting involved. For me I don't really consider that and find myself helping before I actually realize but for others its just something they are not willing to do.

Keep up the great work and look forward to reading your blog more.

Fiona from Australia

Xf said...


Thank you.

Xf said...


Thanks for your support. The job itself didn't get to me...other events caused me significant concern and it was those events that are now eating into me.

Nevertheless, as in all of these cases, I'll get over it.

Again, thanks for your comment.

Xf said...


I think your husband and you both do equally admirable jobs and we all choose our vocations. Its the nature of this job that keeps me going, even through the rough.

Xf said...


thanks...keep reading :-)

Anonymous said...


I was to read you had a bad shift. I know you feel lousy just now, but it'll get better. I may have failed to mention this before, but I have a deep admiration for the work you do and I didn't properly comprehend the complexities of of the job until I started reading this blog (and later, the book).

You did everything you could, and thats all anyone can ever ask.

Hang in there. I've give you a call on Wednesday.

~ C

Airy Fairie said...

Sorry you had a rough day. Often reader/never commenter here, wanted to shout out today that I hope you are finding a way to deal with the aftermath of this shift, and to thank you for blogging so much.

Anonymous said...

I'm reading between the lines and won't begin to presume why the caller refused to do CPR, although only a certain nationality of males have perfectly manicured nails.
I'm sorry that you feel so bad after that shift, but I hope it hasn't completely destroyed your faith in humanity.
You, at least are a true gentleman with a big heart who appears incredibly selfless, especially when you can continue on to the next job after feeling soul destroyed. Thankyou for all you do for all of us.x

Fiz said...

Thank God you are safe, XF! Bloody lorry drivers! And then the case you can't discuss. That all amounts to a horrendous shift. I'm thinking of you.

Tabitha said...

Goodness, what a shift for mental health, yours and that of others. How do you deal with it? Are coping methods covered in your training, or is it up to you to get your head round it?

(P.S. I'm sure you already know, but just in case anyone reading isn't aware, schizophrenia and multiple personality disorder aren't the same thing.)

Thanks for your and your colleagues hard work.

Anonymous said...

As a potential future paramedic/tech/eca this has made me go over why i want to join the force and do this job. After reading, i still do, and i hope thats a good sign i want to be on the job.

Sorry you had to see that, like a similar story on Tom Reynolds blog.

Hope you don't see anything too nasty for a while.

Heather said...

Sorry you had a lousy shift. Thanks for making a difference every time you go to work though.

And as an aside, while it's unlikely it was you, thanks to you fellows who checked on me multiple times when I was waddling around London 36 weeks pregnant dragging laptops behind me. It was nice to know that if it ever decided to be labor rather than me being utterly fed up, you all were obviously near by!

Staff Nurse M said...

Hope that your feeling a bit better after the fall-from-height case.

Never a nice job, I myself have both parents in the ambulance service, I'm a St John member (as well as a Nurse) and work as an executive comittee officer to an national ambulance society. I certainly hear tales like yours every now and agin when the bad calls come in. I suggest you think of the more positive calls, like that ex-Jewler you had a few weeks back, and of the high esteem that the public hold the ambulance service in. It really helps!

As for the lorry drive. W%*@£r! Not the first time your intuition has helped you at junctions!

Keep up your great blog!

Xf said...


sorry...too lazy to reply to individual comments at the moment.

Thank you for your supportive comments re the jumper but it wasn't the job itself that got to me; it's far more complicated than that and is more to do with the actions of another individual than anything else.

If I didn't blog, I don't think I'd ever have been aware of how many people appreciate what we do and I'm thankful to have that to bolster me when I get down about a job.

Anonymous said...

Hope you get to do some 'debrief' if the issues are still chipping away at you.

Anonymous said...

still a little concerned about your description of a person with schizophrenia... :) A lot of people reading this will not know the truth of mental health issues, it is easy to unconsiously promote stereotypes and misconceptions!! xx

Xf said...


My description of the schizophrenic lady (she told us she was) is broadly brushed and my own perception entirely; it's not supposed to describe the condition - that is why I linked it to a defintion, so that people could read exactly what it was about.

I understand that my description may mislead people into thinking that she had a split personality but if read carefully and in context, it should be clear that I was only interpreting what I saw.

I'll try to be a bit less ambiguous though in future.