Wednesday, 7 May 2008

Life extinct

Eleven calls; two dead, one assisted-only and eight to hospital by ambulance.

It’s rare to face more than one death in a single shift, unless you are called to a multiple car crash or a terrorist incident – it’s rare when you are working a ‘routine’ sort of night.

Neither death was traumatic – both were elderly ladies and both had died suddenly at home. The first, a 92 year-old hadn’t answered her phone for days, so her neighbours eventually decided to call an ambulance after gaining entry to the flat themselves and finding her lying in the hallway. She was obviously dead and had been for at least a day, I should think. There was no drama about her demise, she’d probably just been walking between rooms and collapsed – no pain existed on her face; she went quickly.

The second lady, a 90 year-old, had last been heard from this afternoon, when she spoke to a relative on the phone at lunchtime. The same relative now waited outside the flat after calling an ambulance because she wasn’t answering the door and the television could be heard in the front room. The police had been requested in case forced entry had to be made and there was also a crew and a MRU on scene with me.

There was a delay in getting to the address because the name of the building was given incorrectly – even the police were at a loss. Then we got the updated information we needed to locate the premises. A worried looking woman and her husband were waiting outside the door as we reached the flat. I listened through the letter box and could only hear the television, nothing else, despite calling the old lady’s name repeatedly.

The police broke the door down and we poured into the little flat, searching every room. She was found in the living room, sitting in front of the TV in her chair. She had died there sometime that day. She looked very peaceful – she must have gone to sleep.

What made the shift unusual wasn’t just the fact that I had two deaths to go to – it was the fact that they were one after the other and they were the first two calls I got tonight. It made me quite depressed when I knew I was still facing another ten hours of calls.

Just so that a point could be proven, my next call was also a Red1, for a 55 year-old ‘life status questionable’. Now, usually that means no information has been given about breathing and an assumption has been made that the person may be in cardiac arrest – however, this is almost never the case and what I find is a sleeping drunk or a drugged up person in an alley. Tonight, I expected to be given another corpse, judging by the trend so far.

A hotel guest was crouching face down on the floor when I got on scene – he was indeed breathing, so why this information was so difficult to obtain I’ll never know. He was drunk and had fallen backwards, smashing his skull on the hard tiling near the lift. His scalp had split and he had a long gash across it. There was a decent amount of blood on the floor and a towel (where are the first aiders in these places?) had been pressed onto the wound.

I dressed the injury and sat the man up as the crew arrived to take him to hospital. At least he was alive.

Another panic attack and another twenty minutes of calming someone down. The 42 year-old woman had a history of hyperventilating spontaneously and was on anti-depressants. She had a paper bag over her mouth when I arrived and her boyfriend explained the situation to me. She was already half-way to getting better and I knew an ambulance wouldn’t be needed, so I cancelled it with her consent.

We chatted and discussed how best to handle these attacks in the future and within a short time she was back to normal, although she complained of having problems swallowing. I told her that would settle down in due course but to call us back if she was at all concerned. They literally lived a couple of hundred yards from the hospital, so I expected them to make their own way there if they felt they had to go.

A crew was already on scene for the 71 year-old chest pain patient I had made my way to, so I wasn’t required and the same applied to a 34 year-old sickle cell crisis patient at the same estate when I was turned around to go back. A crew was already there. It seemed they were sending me to calls and not seeing the ambulances there. This meant I wasn’t covering my own area any more.

A drunken 20 year-old was lying in a doorway, doing a starfish impersonation and worrying the local passers-by, some of whom called an ambulance in panic. The man insisted on going to hospital, even though he couldn’t be specific about what illness or injury he might have to warrant the trip. He was exercising his non-tax payer right to be seen by a doctor for absolutely no reason. What a soft touch we are as a nation.

Yet again, I was sent to a call – a 36 year-old vomiting diabetic - where an ambulance crew had arrived and were already dealing. I had made the trip from north to south for nothing.

We routinely see people who simply don’t care about the NHS and the state its in – they just want attention and they will use and abuse us as much as they like, even though they will never pay for us. My next patient, a 46 year-old woman, was slumped on her sofa refusing to look at me, speak to me or even acknowledge my presence. Her attitude reeked of ‘do your job but don’t hassle me’ and I found it very annoying. She was a large woman with asthma and probably a dozen other problems. She lived with a thin man who didn’t seem bothered about me being there or her need for me to be there.

She had called two ambulances today; I was her third visit. Each time, she claimed she was having an asthma attack and each time she refused to go to hospital, ultimately wasting everyone’s time. I read both PRFs, left by the previous crews and both clearly stated that she was offered treatment and a hospital trip but declined without reason. So, what was the point of calling 999? Selfish need, that’s all.

Her breathing was fine; she wasn’t having an asthma attack and she lolled on her sofa as I talked to her and asked her questions she wouldn’t answer. She is the type of patient that makes me wonder why I do this job at all.

When the crew arrived, we managed to get her to go to the ambulance. She gathered her mobile phone and her fags and shuffled her way down the stairs, complaining about a pain in her side. I had one in my neck.

Someone thought that a 20 year-old man had been knocked down by a car in Oxford Street in the early hours but when I arrived with the crew and witnesses told the story of what happened, it became clear that he’d allegedly been set upon by four men who’d jumped from a car as it drove past. The vehicle had mounted the pavement as the man walked along, the men had jumped out and beaten him unconscious. There was a clear pattern on his skull, probably made by a boot as a foot stamped on his head.

My last job was also an assault, only this time the victim seemed less innocent. Apparently, he ran the local crack house and was bottled in the face by one of his angry clients. He stood in the street like an ordinary citizen and received the same care and attention from both the police and ambulance services that you and I would expect, except that we don’t sell death and we have to fork out a huge proportion of what we honestly gain to pay for the justice and treatment he’ll receive. He’ll probably get compensation for his trouble. At least in the ‘old days’ criminals sorted their own problems out among themselves, without too much cost to others.

I didn't feel sorry for him as he mopped his bloody face and I left the scene. I felt sorry for the families of two women who died after living respectable lives. When he's found, he won't have died of old age and I very much doubt there will be too many mourning relatives at his door.

Be safe.


miss emma said...

interesting that you mentioned a sickle cell patient as i found out today that one of my friends at sixth form has sickle cell. she was off yesterday (first day off since september so we were all slightly concerned) and she described it as a 'bone crisis' and then admitted she had sickle cell. she said she hadnt told us before because she didnt want to be treated differently by any of us. well we assured her that we wouldnt and she is one of the strongest, most comfident people i know and wants to pursue a career in politics! good luck to her is all i can say!

oh and ive just been accepted to do some volunteering work/work experience for HEMS during my sumemr hols so i dont get bored! :D

Matthew Henson said...

After reading about your all-too-frequent need to wake drunks on buses I was pleased to see that mayor Boris has decided to ban drinking on public transport. Sounded good.

However, it seems he has not consulted seriously about enforcing the ban, so this is a potentially useless measure.

Very much enjoy the blog (and the book), though it's wearying to read about the drunks and time-wasters - must be hard to cope some times.

Matthew Henson

Xf said...

miss emma

Good luck with HEMS, I'm sure you'll enjoy it.

Xf said...


Trust me, no matter what Boris does, the drunks of eastern europe won't give a toss.

Oliver Smith said...

Tough start to the shift!

Interesting read as always.

miss emma said...

thought of a medical related question for you today! is it a good idea (and one that would work) to have a number stored in your mobile phone under ICE (in case of emergency)? is it worth doing this and would people actually check to see if it was there?
enjoy the weekend!

Fiz said...

I've actually got it on my phone(ICE). I hope you have a less stressful weekend, xf, and that you don't have all the usual drunks and drug brigade. It seems such a waste and a misuse of your time and public funds. I hope the two elderly ladies died in peace. It's so sad they died alone.

Petrolhead said...

When you said 'where are the first aiders in these places?' about the towel being placedon the drunk man's head wound, I was surprised. In Control, we actually tell the caller to press down hard on the wound with a clean dry cloth or towel to stop the bleeding. I think the caller was just doing what the call-taker told them to do.

Xf said...


Yeah, I know I've debated this before and I know that the system tells call-takers to advise the use of a clean towel. This is because it's unlikely a dressing will be available.

The issue is that hotels and the like have a specific duty of care and, although not necessarily with respect to first aid for guests, they are bound by law to provide a first aider for their other words, someone with a proper first aid kit.

Towels are NEVER properly clean...and if anywhere on the body can contract an infection easily as the result of a wound, its the scalp.

I fully understand the use of whatever you can lay your hands on for the shor term but a proper dressing should be applied ASAP. It was clear when I arrived that they had no first aider at that place.

Anonymous said...

Xf - off topic I know but was that you I saw interviewed on p55 of todays Independent? It's the vox pop article about ages...


(Long time lurker, Indy reader, and first time commenter!!)

Louise said...

Hi there,

Just wanted to leave a quick message, I read you blog regularly and covered your book in a day in the sunshine this week!

You help remind me why I love this job, even though I'm new to it!

Xf said...


Yep! I got caught on Trafalgar Square and they asked me to take part...I thought, 'what the hell'. Thing is, they refused to believe my true age and insisted I was only 37...that made me smile, considering what the article was about.

Xf said...


Thank you. Maybe I should write a bigger book next time...everyone seems to be finishing it off in a day!