Sunday, 28 June 2009

Park life

Night shift: Seven calls; two assisted-only, five by ambulance.

Stats: 1 DIB; 3 eTOH; 1 EP fit; 1 Chest injury; 1 Chest pain.

The last night of the tour and its busy and business as usual in Dodge. It kicked off with a 95 year-old lady with shortness of breath (SOB). She’s a CHF sufferer and at her age things are going to start deteriorating unfortunately. Her Californian-dwelling family were over to visit and they told me she is always ill when they see her and that she gets worse each time. The poor old lady’s ECG showed a possible heart block and so she was ‘blued in’. She will probably survive this with good care but is unlikely to see many more years… or months.

The 31 year-old who was ‘fitting’ wasn’t when we arrived. The crew was on scene and the alcoholic man was suffering from nothing but withdrawal symptoms; something he ought to expect, given his habit.

This call was followed by a similar patient who decided to go to sleep on the floor of a shop. Strangely, the owners weren’t happy to have him there, so we were tasked with his removal, although the police would have been more appropriate since all he was doing was trespassing and being a public nuisance.

The crew arrived as I pulled up at the store and we all piled in to find our ‘patient’ flat on the floor and unwilling to raise his head to acknowledge us when we spoke. One of the crew was a trainee and she was trying her best, with a gentle manner and quiet voice, to rouse this experienced drunk. I gave her a few minutes before grabbing the man’s collars and hauling him up into a sitting position. Once moved like this, they tend not to sleep any more and one of two things will occur; compliance and a satisfactory completion to the job, or aggression and possibly violence. Unfortunately, he chose the latter path and, like it or not, this risk is inherent in the removal of offending alcoholic trouble-makers. He was lying on that floor just to show that he could and that he would create problems for others if he did. He was right on both counts… until we arrived.

He swung his arms around and his clenched fists threatened us more than once, so I pinned his arms against his chest until he was less willing to wave menacingly. At one point poor Lottie had her arm pinched when the guy held onto her in a drunken faux-friendly way – she’s learning fast.

‘I’m a Marine’, the drunken man said as he staggered to his feet, ‘I’ve killed eight people’. I was very impressed by his statement and wanted to be his friend for the rest of my life. I have no doubt that other servicemen and women are proud to be connected with this kind of person, regardless of where he served and what he allegedly killed. I don’t think so, somehow. The majority of them manage to get their lives together without reaching such lows, even if the Government stiffs them after they’ve done their duty.

He became verbally abusive and a tall, skinny alcoholic buddy wandered into the shop to ‘have a word’ with him and sort him out. ‘These people are here to f***ing help you, stop being such a pratt!’, he told the aggressor, who had now decided to start trashing the shops hanging sweet display. It was a bloodbath, with jelly tots and wine gums flying all over the place and the threat of harder sweets getting involved. To help the man make his mind up and perhaps pacify him, the tall guy decided to grab him by the neck and ram his head into the sweet rack, so that his eyes were immediately in danger of being pierced by the holding spikes protruding from every level – including eye level. I felt this was probably not the best tactic and so asked the shop owner to call the police (I had to ask him twice because his brain seemed to stop working when he witnessed this display of madness - or he was upset at the death of so many innocent sweeties).

Meanwhile, people were still coming and going with their cigarettes, sweets (if they could pick them off the floor) and small grocery items. They had to veer around us as we stood with the noisy Marine. He threatened us and other people a few more times before settling into a quieter tirade of generalised abuse. The cops arrived, dragged him out and sat him on the ground outside, where he continued to be an arse for their benefit.

The crew left the scene and Lottie and I hung around, just in case. The skinny tall man was still being a pest in general and had to be shooed away more than once as the officers tried to get the drunken man to move on. They weren’t going to arrest him and now they had a problem – could I arrange for an ambulance to take him to hospital, they asked. Uh-oh! I’d just sent the one that was here away. Now I had to call another one and explain to the crew why they had to taxi this obnoxious man to A&E.

It took another twenty minutes of waiting before the crew showed up. They weren’t impressed and I apologised profusely, as if it was my fault and I’d thrown alcohol down this guy’s throat just for the hell of it. I couldn’t blame my colleagues; he was a complete waste of time and would probably be thrown out of the hospital two minutes after arriving. He couldn’t walk but he couldn’t be arrested – so A&E.

Off to Hyde Park later on, where a gig staff member had become so drunk, she’d fallen and bumped her head. A St. John Ambulance bod was on scene, as was Paul, the man in charge, who would soon become a friend of mine. The girl was just drunk – her head was fine and as soon as I spoke to her, she responded. She flashed a white Californian smile as I went through the process of checking her brain was working properly (so I accused her of killing Michael Jackson) and generally wound her up for fifteen minutes. Paul was chuckling away in the corner. I don’t think he realised that we, of the LAS, take great pride in our professional duty to produce sobriety through mirth.

The crew arrived before I could cancel them and they didn’t need to do anything because the girl decided she was fine, got up and went to join her equally drunken sister (who had virtually no sense of humour from what I could gather).

Speaking of lacking humour; a call to Trafalgar Square had us sitting on the steps as I tended to the hurting chest of a 21 year-old man who ran, full pelt, into one of the metal posts around the lions. He had intended to jump it but his brain had forgotten to tell his legs what to do, so his upper mid-body took the full force of the impact. The potential for a serious injury was there, given the mechanisms but as I chatted to him, I realised he’d survive – probably with bruises (chest and pride).

There were a few other teens around him, including one girl (south London gangsta-girl type), who had told me what he’d done. She asked if he was going to be okay when he was taken into the ambulance and I attempted banter with her about the possibility of having to do an operation there and then, where we’d take each lung out and examine them for injury. I put on my most sincere face and serious voice but she blanked me until she’d had enough and then put her hand up, looked me in the eye and said ‘you’re gas’.

Finally, a 53 year-old drug addict with a recent history of pneumonia, sat in the reception area of her hostel with chest pain, localised in her lower left side. I could hear crackles in there and she was very uncomfortable, repeatedly asking for pain relief. She got entonox, which helped a little but IV morphine was out of the question because her veins were non-existent. She was in a mess. Her BP and sats were low and physically, she just wasn’t stable.

She was blued in and it’s possible she had a recurrent pneumonia, although I couldn’t rule out a PE or other significant problem, associated directly with her lifestyle and habits no doubt. People make their own choices – the outcome of them is often very predictable and unavoidable.

This tour of nights ended Charlotte’s adventures into my world and hopefully inspired her to write a bit for her medical publication – it will probably be titled ‘Paramedics have a rubbish sense of humour’ or something like that. I was glad of her company and she kept me in check when I forgot I had female company (no swearing allowed). She may decide to venture out again to expand on her project, who knows? Between now and then, I will have a few more people on board with me because I will be supervising a number of students over the next few months. At least I won’t be alone on those long, busy nights. You know how lonely I get :-)

Be safe.

Saturday, 27 June 2009


Night shift: Seven calls; all by ambulance.

Stats: 1 EP fit; 2 Head injury; 3 eTOH; 1 Chest pain.

On a pavement in the West End a 16 year-old boy had his first ever seizure after complaining of headache for a short time before collapsing. An off-duty doctor was on scene rendering aid when I arrived and he was post ictal and recovering. His parents were with him and he was understandably confused about what had happened, denying the episode – this is quite normal after a fit, especially the first one of your life. He was taken by ambulance to hospital for further checks.

A running call next, for a male who was allegedly assaulted by at least three people; he was punched and kicked to the ground, sustaining a cut to his head. He was quite aggressive verbally but posed no threat to us as we attempted to find out if he had been knocked out during the attack. Police were on scene and he too was taken to hospital.

Some drunks are ashamed of themselves when we appear; they usually don’t call ambulances for themselves – others do that and in this case, a 24 year-old man, who couldn’t even walk because he was so inebriated, displayed appropriate embarrassment that we’d been asked to see to him. He could have gone home if his legs were working but they refused to comply and alcohol ruled his balance and co-ordination, so it was up to the NHS to assume responsibility for his health and welfare… as usual.

I made friends with the father of my next patient, a 26 year-old alcoholic woman with major life issues, as I sat on the sofa with her, trying to reason out her problems. Lottie sat there too, absorbing the conversation and no doubt wondering why someone so young could end up so far away from reality. The patient’s father was clearly at his wit’s end and made several remarks about being fed up, causing a few outbursts from the woman – it was clear that they didn’t get along.

The father had cancer and was struggling with his own life crisis – the man had lived thus far without a blemish to his character, as far as I could tell. His fridge was adorned with magnets depicting every country he had visited over the years with his family. His wife was also very unwell and lay upstairs in bed, away from the problems unfolding in the living room.

The woman had called us because of a widespread erythemic rash that had appeared just after she’d downed yet another beer. She had no allergies as far as she knew and this, above all else, seemed to concern her, as if the appearance of red, blotchy skin was her main problem. There was no ambulance available and so I decided we’d take her in the car but on the way out, in full view of her father, who she’d kissed goodbye and told how much she loved, she began to stagger and falter on her legs before collapsing at the car and ‘fitting’ violently on the pavement. She went on to play out these seizures five times more as I struggled to keep her head from hitting the concrete. I knew I was dealing with a pseudo and that she wasn’t in any danger but assumption is one thing and getting caught out by arrogance is another, so I asked for an ambulance on the hurry up, just in case I had miscalculated it.

She settled down after a chat and lit up a cigarette as we waited for the ambulance to arrive. I wasn’t prepared, no matter how much I felt she was faking it, to take her in the car now. She’d go in the back of an ambulance and she could roll about on the bed if she wanted.

We went to the hospital where she was taken when I discovered she’d left her precious ciggies in the back of my car and when we walked into A&E, she was chatting and smiling, as bright as a pin, with the crew and nurses. A miraculous recovery had taken place. In fact, she had exactly what she craved – attention. If she spent more time thinking about the misery her parents were going through, maybe she could glean more love from them and perhaps, give a little back.

Everyone who comes out on observation shifts is warned to expect violence from our patients and those around at times and when we arrived at the scene of a fight, where a 21 year-old man had been kicked and punched unconscious, Lottie had to make use of me and the only police officer there, to protect her from potential aggression. There was a large crowd around the man and one of the protagonists was a tall (over six feet), strong looking man with no intention of allowing us to do our jobs peacefully and safely. He threatened everyone, including the cop and at one point was prodding the poor officer and shouting into his face.

This single cop did everything he could to keep us out of harm’s way but the tension in the air was palpable and as soon as the crew arrived I asked them to grab the head-injured patient and put him on a trolley bed. We’d be dealing with him in the relative safety of the ambulance – there was no time to risk a full assessment. He was conscious and talking, so I felt this was a sound decision, given the circumstances.

As we took him into the vehicle, I saw other cops arriving, just in time to rugby tackle the tall aggressive man to the ground – he landed with a thud. He was cuffed and held down. Prior to that he had been up close and personal with us as we moved his mate away. His fingers jabbed and his voice screamed but his eyes did not make contact with any of us, even when I asked him, as politely as possible, to back off.

That was one of the most hostile calls I’d gone into ‘alone’ and it reminded me of the possibility of future incidents where my safety could be compromised for the sake of alcohol-fuelled, testosterone-accelerated hysteria.

In Soho later on, an 18 year-old drunken girl lay near a pool of her own vomit in a doorway. Her friend was with her and she acknowledged the stupidity of the situation she was in. ‘I can’t feel my legs’, her mate moaned. ‘Yes you can’, I replied, sure that she wasn’t suddenly paralysed, unless temporarily by booze.

The call had been given as a Red1 because some idiot had dialled 999 on her behalf, stating that she wasn’t breathing and was blue around the lips. This person didn’t even know who the drunken girl and her friend were, so I assume the call was made for dramatic reasons. It was possibly a slow night for the caller.

The girl’s drink could have been spiked because she had accepted freebies from strangers and that is most unwise. Nevertheless, she was able to drag herself, with assistance, into the ambulance.

Our last call was to a callbox where a 69 year-old man suffering chest pain waited patiently after trying to walk to hospital himself. He shuffled towards me and I recognised him as one of our fairly regular customers. Perhaps he had tried to get to A&E on his own or perhaps he knew to soften the blow of repetitive calling by saying this. He may even have been suffering genuine chest pain…

Be safe.

Friday, 26 June 2009


Bar Italia, where the night can be calmed by a free cup of coffee and the friendly staff. We love them really. (free ad) :-) - taken by LottieCAM!

Day shift: Ten calls; two refused; one left at home; the others by ambulance.

Stats: 3 Chest pain; 3 eTOH; 1 Asleep; 1 Throat infection; 1 Drug o/d; 1 Stabbed.

A crazily busy weekend of nights and I didn’t meet a single crew that was entirely happy to be out and about on the frontline (a word that sums up more and more the work we do).

Charlotte continues her research into what we do and why on Earth we do it, so she was keeping me company for these shifts. We found a pizza place that perfectly matched the night requirements for eating on the go – quick, cheap and always open, with the best fresh made pizza I’ve had in ages. So we made that our haunt as we crashed and burned through several shifts of ridiculous calls and violent encounters.

A horrible estate first and a call to a 73 year-old man with chest pain, who really didn’t have anything wrong with him except a history of various old-age illnesses and a son (who wasn’t on the premises) who attacks ambulance crews. The police were on scene as we headed upstairs to the flat with the crew.

Meanwhile, down below in the little parking area, a 7 year-old kid guarded the vehicles for me and it cost me a quid not to lose my wheels – a fair deal I think. However, word must have got round that there was a soft-touch paramedic on scene and I forked out another two pounds for his brother (who is six) and mate, both of whom felt the need to reinforce the security around our vehicles. The boys were well mannered, if a little hyperactive and I saw no harm in helping them earn extra pocket money. A relative of the patient told me that they regularly looked out for traffic wardens when residents parked illegally. Entrepreneurs in the making.

A call, given as an epileptic fit turned out to be an alcoholic with withdrawal problems. The area is well known to us for harbouring East European drinkers and so I wasn’t a bit surprised to be windmilled to the man by one of his associates. I knew his face, so I must have treated him before but he denied ever having been in hospital before. There was nothing wrong with him except a need for alcohol in his blood and when he got to A&E I have no doubt that he’d source something for his appetite.

A lot of chest pain calls were coming in and I seemed to be copping them one by one. Everything seemed to be Red3 on my screen. My next patient, a 50 year-old woman with a history of angina and anaemia, was genuine and had been waiting a long time for an ambulance – ironic really. We spent about 20 minutes chatting to her and I kept an eye on her condition, which had improved since she’d taken her own GTN. Her worried husband explained that she ‘wasn’t the complaining type’ and I felt annoyed on her behalf because she is a candidate for immediate service from her NHS, unlike our last patient, for example.

The next chest pain was typical of the nonsense we are struggling to cope with when it is very busy. The man actually waved at us from his front door before plonking himself back onto his sofa and throwing his hands up to his head in dramatic fashion, most likely to show us that his condition was life-threatening and he could die at any moment. He’d been seen by his GP earlier – he had a chest infection.

Not only were these calls blindingly stupid in terms of their response categories but they tended to be nowhere near where I actually work. I was being thrown all over London in a radius that seemed limitless to the system. Travelling 5 miles on blue lights isn’t unusual for a lot of services, I know and I appreciate that but others would agree that the more distance you have to cover like that, especially in heavy traffic, the more likely it is that you can make a mistake in judgment with your driving, It is extremely tiring mentally. The possibility of making it to the patient within our Government obsessed target times is also smaller, so there seems little point. On the calls I received in between the ones I am writing about, I was either cancelled half way to the scene or another ambulance showed up on my nose or my tail. Statistically, we are doing at least 30% more in terms of call volume per shift – you just don’t see it because I don’t write about it.

A Red1, cardiac arrest call in Soho late at night had me frowning all the way there because I knew the street and the likelihood of a young woman actually being in cardiac arrest outside so many clubs and pubs was lower than me going to Mars next year. She had fallen down drunk and she refused help when I got to her, while pawing at Charlotte’s face and making good eye contact (so I think she was in there). The crew arrived fully prepared to shock and go until they too realised there was no emergency here.

Another Red1 soon followed with ‘life status questionable’ on the ticket. Yeah, yeah, right. 'Lying on floor outside house', it stated.

It took a while to get to this potentially dead person because it was miles away of course but I found him and he was exactly as I’d have described him on the tin, if you’d bothered to ask me. Drunk and asleep on the pavement.

People just love calling ambulances when there is a human lump lying near their pricey properties. They don’t have the common sense, or balls, to go and see if the person they are dragging us out and away from genuine cases for is actually breathing. You don’t have to touch the person, you just have to go and look! Shout at them, wake them up and tell them to go away because they are bringing down the value of your home. They will understand, I’m sure.

The drunken Scouser smiled at me and was obnoxious, as usual but I walked up to him and had a quiet word. There is something I do that I will never divulge; it’s not offensive and it’s not illegal but I have a special quiet word with certain people and I get an instant result – always. He stood up, apologised and staggered away – influenced by the magic of certain words strung in a certain way.

A large 8-year-old boy was dragged across the bed by his equally large and very doting mum as she presented him to me for examination after her 999 call for a throat infection. Yes, he had a high temperature and yes, they were very nice people and accepted the fact that all he needed was bed rest, fluids and paracetamol but why couldn’t they figure this out for themselves? She had other kids, so she was an experienced parent and the older son got it straight away. They wanted reassurance and I accept that but really, honestly, what is happening to us all?

In the early hours of the morning, a drug addict decided to top himself with 200 valium (where’d he get them from?), heroin and booze...or so the caller had stated. So, the police were arranged and we sped south for a LOT of miles (thus ensuring that he had little or no chance of survival had he actually been so stupid) out of area to get to him. We arrived in a dark street with the police pulling up ahead of us. The crew turned up a few seconds later and we tried to gain access to the grubby, paint-shy front door without initial success.

Through an open window, high above the basement flat below, I could see a pair of feet sticking up from a sofa. I shone my torch inside the room and saw no movement. The feet were kind of black and this was a white-skinned man, so I thought we might be looking at a long dead body. There were certainly a few flies around, so my colleague and I climbed along the precarious window ledge and into the room. He landed safe and dry and I landed straight in the cat’s water bowl (at least I hope it was the water bowl), soaking my trousers leg to the back of my knee.

The Spider-man super-hero impression was lost on our captive audience however, because they had all just sauntered in through the front door after it had been opened by the further-ahead-than-me colleague, who'd gone through the room and unlocked it. Even Lottie thought it was a bizarrely risky and badly-timed option. She just doesn’t understand – we do it all for the accolade; a broken neck is nothing compared to a shiny medal.

Inside was a sleeping druggie with very dirty feet and the worst fungal infection of the toes I’ve seen for some time; rancid is the only word I could use to describe it and there you go, I have. He was a nice enough person, in terms of not abusing us, shouting at us, spitting, vomiting, peeing or punching, so that was good but he had taken a lot of something and we suspected it was heroin, so he was jabbed with narcan for good measure. His sleepy-eyed reaction and sloth-like movement justified the precaution – as did the paraphernalia covering his floor, the full-to-the-brim sharps bin and the numerous fresh injection points and tracks on his arms.

But he was a rubbish suicidal person because he knew nothing of 200 Valium and even less about the 999 call. He thought it might have been a woman he knew that had done it to cause trouble. I agreed that it might have been ‘whatsherface’ and he (for whatever reason) took me seriously.

‘Oh, do you know her?’

‘Errr, yep, I do...’ I lied.

I also suggested that the cat – a little skinny black thing that wandered in to investigate who the hell had upset it’s drinking bowl and then went to attack a dried up, age-old slice of pizza that sat on a plate on the floor as the man leaned down to snatch it up and munch on it himself (the pizza, not the cat) – might own a mobile phone and had made the call for help. He agreed with this in principle and giggled at the thought but his mushed brain had no concept of irony or sarcasm and many who know me feel that this is all I have left with which to play this silly game. Drug addicts and alcoholics will actually take me seriously on many things, including UFO appearances and the scandal of a healthy lifestyle.

The man recovered enough sense to be left at home. He refused to go to hospital, despite several warnings about the risk he was taking. He had capacity to make a decision and the cops couldn’t agree more because they were getting bored now. I’d given them something interesting to do earlier when I suggested there might be a dead body hidden somewhere – the large number of flies alluded to the possibility. I was half-joking but they felt obliged to force in the door to another room in the flat just to be on the safe side. They had, to be fair, given the drug addict plenty of opportunity to tell them what was behind the door and he had simply vanished into his own cranium with nothingness each time. They had no option and there was no need to stand and stare at it any more.

There was no corpse on the premises. The cat would have eaten it anyway.

A stabbing in Soho led us to a young man who’d been knifed in the shoulder and back. He was still standing and talking when we got there, so I wasn’t too concerned but penetrating wounds to the back are potentially life-threatening, so an ambulance quickly took him to hospital. His mate had been bottled and there were still fragments of glass in his hair and around his ear. The bump on his skull was small but he’d been knocked out, so he also went to hospital. I was left with blood on my hands and a reason to say I was worth calling out.

So, to end the shift I got a reminder that those ‘sexy’ stabbing calls were rare and not my business for the most part. I was gifted with a 21 year-old crying, drunken girl who collapsed outside a club after drinking way too much and reasoning, by proxy, that she couldn’t possibly be drunk and that she’d been spiked or something.

What concerned me about this call was the number of guys that were hanging around. A few of them were hugging, holding and pawing at her, telling me that they knew her. One of them had the cheek to tell me he was her boyfriend but she denied this, crying out ‘tell him to leave me alone!’ when she got enough breath in her lungs. Drunk or not, she was vulnerable and prey to these young animals who just want an easy lay after a night out searching for the weakest of the pack. Her tall, loud friend was with her and she eventually stepped in to block those men as they tried to drag her away God knows where for ‘treatment’. I asked for police assistance but they wouldn’t be arriving – everyone was busy tonight and this wasn’t an emergency really.

The crew got her into the ambulance and I helped them with the protestations of the patient’s friend and the patient herself until all calmed down. It turns out this young woman has cancer and is struggling with that fact. She got blind drunk to find an escape and I couldn’t help loaning my heart to her as the pain swept her inebriated, tearful, mascara streaked face. ‘Please don’t judge me’, she sobbed and shame throttled the expression I must have had on my face until I reassured her that nobody on board was doing that.

Outside, the small, weasel person who told me he was the girl’s boyfriend, persistently badgered us, opened the back door and knocked again and again until I’d had enough and I flew out at him and threatened him with the police if he didn’t back off and leave us to treat our patient, who was now screaming ‘go away!’ as another voice, that of a very drunken 50 year-old woman, drifted in from the front window of the vehicle at the same time as weasel-boy’s annoyances. The woman had introduced herself to Lottie. She held a bottle of wine in her hand and again, I think Charlotte pulled – the slurring lady insisted on tracking her for a bit and reminding her of how old she was. She said 48 but I am saying 50. Drink will do that.

Michael Jackson died and Trafalgar Square became a shrine for him. The walls of the National Gallery were covered in goodbye graffiti and candles burned at the gates. The connection eludes me, quite frankly. Was he known for his great paintings?

I want to make it quite clear that my Control colleagues are not the enemy of frontline 'grunts' like me - they too are under extreme pressure and I feel very sorry for them as they try to bring order to the chaos that is London's demand on its emergency healthcare system. None of us are paid enough for the mental stress it causes and this post, and the ones to follow, are written in tribute to my colleagues out there and to all Control staff, few of whom have a forum to air their views on. I hope my writing (including the cutting sarcasm) does them justice.

Be safe.

At risk

We are taking an average of 5,000 calls a day now; the weekend weather hasn’t helped and the spike in ‘Swine Flu’ callers, real or imagined (mostly imagined) has created a problem. Our system works in an osmotic way – vehicles can be taken from any complex and ‘loaned’ to any other complex and resources can be used for calls in any part of London – we are not community based; we are medical whores for all of London, so theoretically, I could be sent from Waterloo to a call in Croydon, or Sutton, or wherever they damn well please, just as long as someone is running. Then I’ll be cancelled eight miles in because they now have a ‘nearer vehicle’.

There seems to be no simple answer and I am in no way critical of my Control colleagues, who are simply doing as they are told by a mostly automated system that doesn’t give a toss, but when it comes down to the safety of crews who continually run on blue lights, dangerously increasing the risk of collision with traffic or human beings on the road, only to be cancelled and have to pull over, switch everything off and reset their buzzing brains for the next (and almost inevitable) wasted journey somewhere else – probably in the direction that they’ve already come from – something is seriously wrong.

We could just tell most of our callers (more than 80% of them I would guess) to get well soon and leave it at that because a Red2 for ‘chest pain’ and ‘can’t speak between breaths’ in an 18-year-old, is probably...more than likely, hyperventilation or absolutely nothing. The chances of it being a cardiac event are so slim that it is worth the risk so that we can send something to that poor 83-year-old woman who’s collapsed in her own faeces on the sofa at home because she’s had a stroke.

My colleagues and I spent tonight running to and fro in every direction, covering everyone else’s sectors but our own and there was something different about the way I was being utilised on the FRU. For a start, it seemed like every call I got was for chest pain and every one of them was under the age of twenty five. I was also being asked to drive well out of my own area, leaving it uncovered as far as I was concerned, to deal with these stupid calls. I didn’t make it to most of them of course, because I was just stopping the bloody clock and had no clinical value whatsoever.

My stress level rose suddenly and I became irritable and angry because I was risking life and limb to get to these calls – not driving like an idiot, but still moving through red lights at busy junctions and weaving around thick traffic where people and objects lurked. The more I do this without a purpose, the more I feel aggrieved about the risk I’m taking. If I have an accident, I may be killed or injured for some teenager who doesn’t know the difference between an MI and a sore throat, and a system that lacks the balls to say no when it is clear from the way the caller is speaking that he/she has plenty to say between breaths!

I worked on the Clinical Support Desk a few weeks ago and spent a couple of hours clearing the amber calls that had stacked up. I called back these patients and all of them, without exception, could be dealt with there and then – no ambulance required. One of them was just depressed because he had moved house recently! Now, if he’d added that he had ‘chest pain’ (anxiety induced), this call would have gone Red and I wouldn’t have seen it because a crew would have been sent on blue lights to find him crying into his tea at home. On behalf of everyone who is genuinely ill out there – people with real life-threatening problems, I apologise for people like this. Unfortunately, there are thousands of them and they just won’t stop dialling 999 when they can’t cope.

We do not have the resources to continue like this. If a major incident occurs while we are mopping the brows of the weakest people in society, many may die because we might fall short of supplying enough ambulances. It’s as simple as that. Not our fault because we are very well trained and are ready for large-scale incidents...and the people who will criticise us the most are the very people who have created the monster that we are dealing with every day - the upper echelons and the Government.

So, Mr and Mrs Londoner...the weather’s nice and it’s the weekend – here’s my advice. Go and enjoy yourself. Have a drink but don’t drink too fast or too much (don’t be an idiot all your life). Avoid drugs if you can and have a meal with your friends. Then go home and have a sleep – you’ve earned it.

DONT get pre-planned-pissed out of your head. Don’t take drinks or tablets from absolute strangers (yes, YOU girls, don’t be dumb cos he doesn’t like you, he just wants to get into your knickers). Try to eat before you start drinking and STOP drinking when you feel a little drunk – don’t wait until you can’t feel anything at all.

If you have depression or life issues, don’t even bother drinking unless you are clever enough to know what’s coming.

DONT even think about abusing me or my colleagues – we are sick of it and we aren’t there to pick up the pieces of your life. Let us get on with our job, which is to care for your mum or dad or granny when they become properly ill. We really are concerned about that and we’d rather not listen to your pathetic excuses for having vomit in your hair, or how your toothache has manifested into DIB when we could be treating a grown up.

I love what I do but I don't love most of the people I meet because they represent stress and possible physical danger to me and my colleagues. You'll see what I mean when you read the coming posts.

Be safe.


Have a read at this.... a letter to drunks from a hard working and pissed off ECA.

I'm not the only one saying it like it is.


Tuesday, 23 June 2009

Hiatus (again)

Day shift: Four calls; all by ambulance.

Stats: 1 Collapse; 1 RTC; 1 EP Fit; 1 Asthma.

I’ve been on training courses and generally running around the country doing other things, so there has been a shortfall in the number of words I can string together for the blog. The next book, however, is underway and I’m hoping to get serious with it in the next few months; I have more than 100,000 words to string together for the novel and I really need to develop the characters or you simply won’t want to read it and I wouldn’t want that.

So, another day shift and the sun shone from the start. The new radio system was being used ‘live’ for the first time and, inevitably, there were teething problems. Not that they presented more than a hiccup to the team I work with, so calls were still being answered and lives were still being salvaged. This is the season for elderly cardiac arrest it seems, so a lot of calls were being generated to those. None were mine.

I started with a 26 year-old man who flopped around on the floor at work, crying his eyes out and telling me that he didn’t know what his problem was. I’ve seen this many times before and it still surprises me that an ambulance gets called for a so-called ‘collapse’ when it is patently obvious that the person is having an emotional crisis and that the term ‘Accident & Emergency’ is redundant. In fact we need a special ‘crisis wagon’ for such cases. Maybe we can expand the ‘Booze Bus’ idea to cope with the large number of calls we receive regularly for people who just can’t keep it together. In defence of my scathing criticism, I am old enough to have the right to judge what is and is not an emergency deserved of dragging a resource (ambulance) away from someone who may well be dying and have to wait an extra few minutes while we dry the eyes of a grown man with issues...

...Like the 20 year-old cyclist who was hit by a car and knocked unconscious in the road. He was bleeding from the head and an off-duty (well Canadian) doctor was helping out when I arrived. Another FRU was on scene and an ambulance arrived soon after I’d started cutting the man’s clothes away in search of hidden injuries. He was almost face-down and nobody had dared to move him, which is fine, but he had to be pulled onto his back so that a better assessment could be made and his airway could be managed, if necessary.

He was conscious by the time we’d got on scene and the damage to the offending car was slight but he hadn’t been wearing a protective helmet, so his head injury had to be treated as potentially serious, especially when he retched and almost vomited in the ambulance. This, coupled with his concussion and confusion, meant that bleeding may well be taking place under his skull and that had to be treated quickly.

It wasn’t long before I got a call that summed up the day – a 40 year-old supposedly reformed alcoholic was found collapsed on the pavement by two PCSOs. He had a fit in front of them and they called an ambulance because he told them (during his seizure) that he’d had one a minute earlier. This made him a very lucid epileptic, if that was his problem at all.

A can of lager fell from his pocket and that clue alone made his story worth less in terms of blue lights and sirens. A crew was on scene when I pulled up and I could tell by their calm demeanour that they weren’t worried about this man. Neither was I but the game he played meant that he’d go to hospital and his ‘condition’ would be treated by something or someone. The bottom line is that he is and always will be an alcoholic – he will have withdrawal seizures and that’s part of it all. Plenty of reformed alcoholics go on to do well but this man seemed lost in the mire of his habit and, although I felt sorry for his difficulties, I could not see parity with it in terms of us running around to pick him up every time he caved in to his weakness.

At a hotel, where the barbecue caused problems for us when we tried to gain entry after an emergency call for a 70 year-old asthmatic was made, I found the patient sitting on the reception bench inside. The crew followed me and as soon as he saw the female Tech, he brightened up and his asthma all but disappeared. Miracles happen when you are otherwise engaged, I guess.

The hotel staff had closed off one of the main entry points to the reception area because tables and chairs had been put outside in the sunshine for guests to imbibe and eat as much sausage and burger as they could manage. All very lovely and I wouldn’t have minded a bite and a drink myself but coming to a halt on blue lights at the only entrance I knew, when there should have been access made after the call, left me speechless and not inclined to join in with their party. The ambulance crew made the same mistake and we all U-turned our way back to the other end of the street as munching guests carried on regardless. I love London, don’t you?

Be safe.

Friday, 19 June 2009


Okay...The lovely Lottie has persuaded me to get into Social Networking for the benefit of the blog and the books. I have to start 'whoring' myself out a bit more, she says. I guess she's right; I can't afford to be publicity shy (even though everyone knows my real name) if I'm going to take my writing seriously (which I do).

So, if any of you are Twittering, find me - thexfileman.


Random stuff from readers and friends...

These workmen are installing bollards to stop nurses from parking on the pavement outside the Aberdeen Royal Infirmary . They are cleaning up at the end of the day.How long do you think it will be before they realize that they can't go home?

Thanks to Roz for the above!

Thanks to Richard for this BBC news item

Says it all about how we stand with some people, doesn't it?

And my friend Katie sent this link to her blog...there is a stunning photograph of Loch Shiel at the bottom of her page (oh and a few of her dodgy ankle, post fall!)

BBC Three Counties Radio interviewed me yesterday. You can download the recording here if you're interested (the interview's about half way in).

I've just finished a training course for the new digital (all singing and dancing) radio system we are introducing and I've been doing other duties away from the frontline but I will be back with the car next week. meanwhile, I'm off to Edinburgh. Ta ta!


Friday, 12 June 2009

The Great Pretenders

Night shift: Thirteen calls; two assisted-only; one long dead at scene; one conveyed in the car; one with an unknown outcome and the rest by ambulance.

Stats: 2 ? EP Fit; 3 eTOH; 2 RTC; 1 Unwell adult; 2 Drug o/d; 1 Vomiting; 1 Asleep; 1 Alleged rape.

A medical student (Lottie) joined me tonight, so I had company and a witness to the ridiculous nature of this job at weekends. She’s intelligent, shy and quiet but not scared of anything that was thrown at her tonight – luckily that’s one of the important qualities she needs if she’s to make it in medicine.

The first call to a 6 year-old boy who was ‘unconscious’ took us to a very nice (and large) house in a more affluent part of the town. The boy was in his father’s lap and I couldn’t decide which one I should give more attention to – the boy or dad because both looked a bit shaken up (especially dad). The boy had been at the dinner table when he suddenly cried out ‘Oh no, oh no, oh no!’ according to his mum. Then he fell down and fitted for a short time before recovering as if nothing had happened.

It sounded like he’d had an epileptic seizure but that could be decided when he got to hospital. He’d wet himself during the process but seemed blissfully unaware of that fact as he sat soaking his father’s lap.

The crew arrived as a confused and highly emotional argument broke out between man and wife about the son going to get changed into something drier. The stress of the situation had clearly pressed hard on this relationship.

A drunken man fell down the steps of a very posh restaurant and cut his head open. The laceration would need closing but the man didn’t regard his injury as bothersome at all – he shrugged a lot. He clearly wasn’t all there (in terms of lucidity of mind) and that would be the fault of the large amount of alcohol in his blood. Walking down steep steps would have been a real challenge in this state and so I respectfully suggest that the restaurant installs special pulleys and lifts for such customers to avoid future embarrassment.

I asked for a free meal and was offered one if I cared to return in the future. I decided not to take them up on the offer because I was trying my luck and didn’t expect to be taken up on the request. Anyway, I don't have a fancy enough suit at home.

Sometimes old calls are sent to us when they have long been dealt with. A ‘glitch’ in the system they say. If you don’t look closely at the origin time, you can get caught out but who among us has the time to keep looking at that? So, I proceeded with haste to a RTC that had the words ‘cardiac arrest’ stuck on the descriptor line. The roads were blocked off (to be expected) and I was waved in through the police tape (also to be expected). Then I was greeted by the sight of a forensic tent in the middle of the road and a windmilling police officer who looked startled at the appearance of my car (not expected at all).

‘I was sent this call’ I bleated as I slowly realised what was going on and clocked the origin time (an hour ago).

‘Right, well, they’ve gone about an hour ago. You’re not needed here’, the annoyed officer said. ‘When you leave, can you please drive slowly and carefully, without too much steering?’

So, I had my car tuck it’s tail in and we carried out the world’s slowest and most carefully manoeuvred three-point, before dragging our sorry arses out of a potentially ruined forensic area. Luckily, when I initially arrived, I didn’t put on a spectacular skidding display as I stopped. I normally do that of course and not only for serious accidents; I’ll screech to a halt for abdo pain and hiccups. If you are a service driving instructor, don’t listen to a word of that – I’m lying.

Then I met a very pleasant Scotsman who was lying on the floor of his little flat after collapsing in the kitchen. He’d crawled out from under everything that had fallen on top of him (including an ironing board) and made his way a few feet to relative safety. He felt very weak and unwell.

He told me he was a retired ear, nose and throat specialist, which I found interesting because he was having problems hearing me. As soft classical music played in the background, I managed to sit him up and he explained that he’d been suffering from ‘Flu for a while and now he felt ‘knocked out’ by it. He was 94 years-old, so I wasn’t at all surprised. His age made him vulnerable of course but I detected a stoical and strong man underneath the misery.

A self-proclaimed epileptic man approached police in Leicester Square and told them he was ‘having a fit’ but he wasn’t. He claimed that he’d been struck down by a ‘petit mal’ attack and that he couldn’t remember what happened. ‘One minute I was over there and the next I was here’, he said. I was neither here nor there with a diagnosis, especially when he became overly sensitive to the flashing blue lights of the ambulance when it arrived. He may well have had some kind of event but his dramatic manner made me suspect otherwise.

Off to Oxford Street and again to the aid of a couple of PCSO’s who’d been left in charge of a woman with obvious mental health issues. She claimed to have taken 28 aspirins (that’s 8.4g) and that she didn’t want to live anymore (she had a less than 2% chance of topping herself like this). I asked her how long ago she’d taken them and she was vague but suggested possibly hours ago. I doubted her story and she refused to speak to me if the PCSO’s were near enough to hear. In fact, she feigned a collapse on me and decided not to go the whole way and just to prop herself up on my body, with her head lolling over my shoulder. We looked like an oddly-married couple for a minute or two and I was fairly anxious to dispel any rumours that may start about me, among the public and the crew, who were just arriving. Lottie didn’t mind at all. She thought it was hilarious. As long as I am keeping at least one person happy, I don’t mind being a trying-to-faint-but-not-quite-sure -how-to human support.

A retching 47 year-old who’d called her problem in as ‘vomiting blood’ wasn’t producing much in the way of anything, let alone red blobs. She was in a hotel room with her ‘friend’ and he was sure she was in trouble. She had been drinking a lot and its possible (I know this is the cynic in me but bear with me), just possible that the booze had something (or everything) to do with it. I hooked her up and gave her something to stop her being sick, then the crew was free to wheel her out to the ambulance. She retched violently and it looked all for show.

It wasn’t long before our next call to a drunken person who was vomiting but she at least had the honesty to admit she was wasted. The 25 year-old Italian woman was slumped on the pavement in a decent pool of watery vomit, guarded by two PCSO’s and a few of her boisterous friends. I won’t be too unkind here because they were all lovely people and gave me no trouble. Their friend was over the walking/talking limit and they knew it; no excuses, no debate.

Unfortunately, a serious RTC not far away had drawn all of the immediate resources out of my area and so I was left to connect her to fluids and hope they did their job, so that she’d be fit enough to go home. It only took ten minutes for her to come round and start being human again – her friends were excited about this and so too were the PCSO’s, who’d been held up on this call for about an hour. One of them was playing the part of my drip stand (Lottie offered and was jealously denied the opportunity), so his arm was about to give up if the Italian woman didn’t play ball.

I got a big smile when her eyes opened – probably because she was seeing someone else. She crawled and clawed her way up a few times, only to fall back down to the sound of disappointment all around. She only snapped out of it when I became a little firmer about what she needed to do – sober up, stand up and go home. A child could do it. Well, a drunken child (and let’s face it, that prospect isn’t too far off the horizon).

In the end, after one more dramatic puking feat, she was man-handled to a standing position, read the riot act and dragged off to the nearest willing taxi. Her friends did that, not me.

Outside a club in Piccadilly, another drunken 25 year-old woman staggered in front of a car and got her foot clipped as she collided with a wheel at a reasonably slow speed but because everything is in slow motion when you are drunk, she behaved as if she’d been trampled on by a herd of elephants – at a fairly rapid speed. There was a tiny little scratch on her foot, that’s all. She was collared and boarded because that’s the way we do things around here. Lots of people came up to see if she was okay and I’m not sure if any of them were her friends because they all slipped away when they saw that she wasn’t dead. So, yeah, they must have been her friends.

There was no respite and the next call invited me to Soho, where yet another 25 year-old, this time a male, was behaving erratically after taking alcohol, GHB and possibly speed. He was really wired and the risk of getting thumped accidently, incidentally or deliberately hung heavy in the early morning air. His half-naked (waist up) mate stood by him, accepting that he’d overdone it with something but not sure what that something might be. This happens a lot when drugs are involved. Nobody minds telling you that their mate is drunk but they have a problem spilling the beans when it comes to magic ones.

So, I left him to the crew when they turned up a few minutes later. I would have got nothing from him anyway; obs were unlikely until he’d come down to earth. His boyfriend showed up and asked where he'd gone, so we sat in the car after he'd gone in the general direction of my verbal directions, wondering if there was trouble afoot at A&E. His half-naked 'friend' had gone to hospital with him. There would be a bitch-fight.

In the wee small hours, I was asked to go to the aid of a 50 year-oldish Jamaican man who was high and drunk in a callbox. He had the company of two PCSO’s (they earned their money tonight) and I was tasked with the job of dispelling any rumour that he had chest pain because that’s what he claimed on the phone – obviously decided upon when his weaker story of neck pain and the further, weaker story of head pain didn’t bring about an immediate response from the non-existent ambulances.

He had no pain except in his leg in fact and I decided to take him to hospital myself, provided he promised not to throw up or attack us in the car. Lottie helped out with the obs and I rescued her from his rambling chatter because somehow she couldn’t translate it. I decided to turn it into Glaswegian and managed to get two words from him that I recognised - ‘New York’, he said after a long sentence of randomly strung words. Did you think I meant another two words? Shame on you!

He talked to himself and me and Lottie all the way to hospital, where he was deposited in a chair in reception for the night. He wore a little hat and I thought it would paint a pretty picture to place him so that his head lolled in the opposite direction to another hat-wearing, slumbering drunk, whose head just happened to be lolling towards his. It looked cute and totally in place with the ambiance of the A&E waiting room.

A Red call for two men ‘unconscious’ outside a train station came in as the light spread over the horizon. I found only one person lying on the ground; the other had either been a mirage or had skulked off on unconscious legs that could miraculously still walk. I wish his erstwhile friend could walk too because I had the unsavoury job of proving to the rail staff present that he was alive and drunk. I pulled him to his feet and he didn’t like me one bit. I was shown an aggressive finger and for a moment I thought he was going to use his lanky 6ft frame to attack me. I would stand my ground and step aside at just the right moment. He would then become a parody nightmare as he plummeted to the pavement without a hand to stop him in time.

Luckily he was too drunk to fight and too off-balance to control the direction in which his anger was directed. We all got the finger eventually; he kind of showed it around. I even saw him raise it like a football trophy to the passengers who were waiting for the bus. He’d get on with them and probably generate another 999 call somewhere in North London. Unfortunately, he wouldn’t get further than the street he lived on if he didn’t fall asleep on the bus because, despite trying to hand him his door keys mid-finger display, he declined my offer and they were thrown back onto the ground.

The last call of the night produced a police job and not one requiring an ambulance immediately, although two showed up and another FRU rolled onto the scene as I prepared to leave.

A young man windmilled us as we approached and told me that a girl had been raped by a man who’d just run off. She was still in her home in bed apparently. I called for police assistance and stayed where I was. The alleged attacker returned (as I thought he might) and started to threaten the man who’d made the complaint. Then he bolted back into the building where the girl was hiding.

I left just as police arrived - the other crews would be able to handle whatever came out of this confusing situation. I was going home. So was Lottie. To her own home, obviously.

Be safe.

Tuesday, 9 June 2009

How to ruin someone's day in one easy step

Night shift: Six calls; one dead on scene; one taken by car and the others by ambulance.

Stats: 1 Suicide; 2 Head injury; 2 eTOH; 1 Kidney pain.

The worst way to start a shift is to go to a very dead suicide. The woman had jumped in front of a tube train (one-under) and was decapitated as a result. This happened as the tube strike kicked in, so it was sadly, tragically ironic that she chose to do this at that time. She wasn’t old either; in her twenties I’m told, but there was nothing anybody could do obviously and I ended my participation soon after arriving on scene.

One-under suicides are among the most selfish I think; I wrote about them in some depth in 'A Paramedic's Diary' and I still feel strongly about it. In the wake of their act, they leave misery and horror for the train driver (and his family), the passengers on and off the train and the rest of us who have to pick up the pieces - quite literally. A single step over the edge and at the right moment, and an individual can leave this world and all their troubles behind, whilst dragging many innocent people into a nightmare that will last them for the rest of their lives. Surely pills are easier?

Then a 68 year-old man tumbled into the road and smashed his face on the pavement. He’d been drinking and was the old-soldier type, so his friends were gathered around him, checking and chatting, even when I tried to treat his head wound. I was being ignored really.

Three young girls who’d stopped to help out had bloodied hands and one of them was shaking like a leaf – she’d had a bit of a fright at the sight of a small pool of blood in the road. I told them all to get some cleansing gel and I squirted the stuff into their hands so that they could continue their night out without scaring off the boys. They looked like rubbish vampires.

A call for a man with diabetic problems turned out to be a half-naked, drunken Polish man who lay on the pavement as his friends slapped and punched him to keep him awake. His trousers were around his ankles and he lay there in his underpants for all the world (those who cared) to see.

‘He had two beers, then bang! He fell down’, said his Polish friend.

‘Just two beers?’ I asked with a raised eyebrow.

I find it unlikely that he fed himself with anything less than two hundred beers to get into his current state. He was barely conscious and because he was a very large man, I waited until the opportune moment, when he stirred enough to sit up, before grabbing his arms and, with the assistance of his mate, lift/dragging him onto the waiting stretcher that the crew (who’d arrived with me) was keeping on high alert.

I closed the ambulance doors to the sight of him flopping on the bed like a beached, Y-front wearing whale.

The cyclist who was supposed to have been hit by a car, causing a panic in MOP town and necessitating the rapid arrival of the police, had in fact just fallen off his ride and bashed his head. The HEMS desk asked for a report because the MOPS had called in to say he was ‘behaving strangely’ but when I arrived (after speeding past them on the pavement because I was looking for a RTC), he was right as rain. He had a small head wound and behaved perfectly normally with me. Maybe I cured him.

The buses hated me and the crew when they were forced to go around us into oncoming traffic but, hey, blue lights mean park anywhere, right?

Later on, I went to pick a drunken 25 year-old man off the ground because he was ‘unconscious and vomiting’. He certainly had been vomiting but he was drunk and that was that – let’s not elaborate on it. He and his mates are soldiers and he was due back at barracks (sober I would imagine) later in the day. A trip to hospital would land him in hot water, so I tried my best to persuade them all to go home. No taxi would go near them, however, so after a long discussion, I took him and one of his comrades to hospital in the car.

Now, I don’t approve of this kind of NHS-time-wasting and I’m not a fan of people who cant drink without collapsing in a heap as if they are a medical emergency but I had a lot of empathy with these guys. They were all young; early twenties, and they are about to be shipped out to Helmand Province, Afghanistan, so I didn’t mind helping them at all. These guys, whether you approve of what they do or not, will be putting their lives on the line soon and if they get stupidly drunk occasionally then I for one am happy to forgive that. You may not but I do.

As dawn rolls in to catch me by surprise, I get a call for a 22 year-old female who is ‘not alert’. The journey is fairly long and I know I’ll be beaten by an ambulance but I guess the system doesn’t care about that, just as long as somebody – anybody – is moving towards it.

I arrive to find an ambulance pulling up and we all go into the fourth floor flat (the last one in the block, surprisingly) to find a girl curled up in a ball on her knees in bed. We had been told she had kidney failure and I find out that she has only been to a Chinese herbalist for this diagnosis and she’s been given medicines that cannot be read unless you are Chinese. I should point out that the patient definitely wasn’t Chinese, so how she knew what she had been given and what it was for is anybody’s guess.

It was obvious that she was suffering kidney pain, probably as the result of infection or an obstruction. Telling her that she had failing kidneys was possibly pushing it a bit far and, not surprisingly, she made out that the pain was so severe that she couldn’t move from her current balled-up position – one that made communication and clinical observations difficult.

Eventually, we managed to persuade her to stand up, put her clothes on and walk down four flights of stairs to the ambulance. The exercise proved that she wasn’t in that much discomfort and, with all reasonable thought for her condition, we couldn’t have offered her a trip in the lift because there wasn’t one.

And then it started raining.

Be safe.

Friday, 5 June 2009

Yes, yes I know!

I haven't written anything for a while but I've been very pre-occupied with the book and getting it out there - it's been a long slog and I want to get them onto the shelves obviously, otherwise what was the point?

Now, SP Services are distributing it and they have recognised the problem that some people identified in their minimum sales price (you had to buy at least £10 worth of goods), so they've reduced it to £9.99 to accomodate the book cost. Awfully nice I think.

When you get your paws on it, please be kind enough to review it (you'll have to go to Amazon or Waterstones online to do that). In fact, review the first book (A Paramedic's Diary; Life & Death on The Streets) too if you haven't already done so because this is my best guide to how well, or badly I'm doing.

If Street Medic is successful, I will be writing another edition for next year (on top of everything else).

Enjoy the book and for those of you looking at a career as a paramedic - good luck!


Wednesday, 3 June 2009


Day shift: Three calls; all by ambulance.

Stats: 1 Unwell baby; 1 Drug o/d; 1 Suicidal.

Been a while, hasn’t it? This post is overdue because I had a little ‘incident’ in the middle of the shift and it stopped me in my tracks, so apologies for my mysterious disappearance and no need to worry (if you are); I’m okay now.

The first call of the morning went Red1 as the details changed for a baby who was ‘not breathing’. I was on my way alone (there were no other resources yet available) to one of the worst kinds of call I can imagine as a solo. The location was a large student accommodation building – I’ve been there many times and every time I go the receptionist/security person hasn’t got a clue. Calls are made directly from the hundreds of little bedsits in the building and so nobody downstairs gets told, or seems to know an ambulance is coming. This situation will fall hard on them some day and I thought this call would be the one to do it.

I spent four minutes standing in the lobby with no clue as to the room I was required in. The security guy looked at me blankly and did nothing to help. Control had no other details, apart from the building name and that it was a possibly dead baby.

‘We have lots of children in here’, the man said to me.

I thought I would narrow it down when I asked him about infants but, surprisingly for student rooms, whole families were being accommodated too apparently – what were they studying; the British Social Security system?

Eventually I got a room number from Control after a call-back and asked to be taken directly to it. I was already stressed out thinking that this baby would have no chance of survival now that I’d been unable to help for too long, even though I was standing downstairs with the skills and equipment to do so.

To my horror, the stupid security guy picked up the phone and made a call instead.

‘Hello, did you call an ambulance?’

I was angry now. I knew the room number but didn’t know how to get there fast. He could have shown me the way immediately but now he was verifying the call origin and wasting even more time!

‘Can someone just show me the way please? I said – probably out louder than I should have.

Another man, who’d been standing watching the proceedings, took me to the lift and showed me to the correct floor. Then he led me to the door of the flat. I thanked him and knocked on it.

It was opened by a man who didn’t seem worried at all. I had to ask him three times to show me where the baby was. I expected to hear crying, wailing, shouting… anything but silence. Instead I walked into a small bedroom where two women stood in the corner and a cot occupied the middle of the floor. Absolutely nothing was being said or done.

I looked into the cot where a small baby lay very still. From a distance he could have been dead but his colour disputed that and so I tried gentle stimulus by rubbing his chest and arms. He moved immediately, gurgled a bit and opened his little eyes. He was breathing and had been breathing all along. For some reason I will never understand, the parents and grandmother were nowhere near him and no attempt was, or had as far as I know, been made to establish whether he was dead or alive. They’d simply heard him breathing noisily and the 999 call had become crazily complicated after that.

None of us like being put in a position where the life of a child is at risk, especially when we work alone but the situation isn’t helped by this strange behaviour (which I think is cultural to a degree) and the obvious lack of proper communication from start to finish on the call – not necessarily a call-taker’s fault but when asked ‘is he breathing?’ I can see this father whipping up a frenzy just because he doesn’t know what the question means.

The baby was floppy, so he was unwell but his life wasn’t in the balance and he had recently been diagnosed with an infection. A crew arrived to take him away and the parents went along. Again, nothing was said and I had to ask the mother to carry her own baby. I'm sorry but sometimes I feel that, in some cultures, children are more of a commodity than anything else.

I was asked to check out a call for a 24 year-old man who was ‘bumping into things’ in the street, so I travelled up the road about a mile and found him with the police at his side. It was obvious that he’d taken something and was definitely not with it. Alcohol wasn’t in the equation; he was off his head. He couldn’t stand straight and he’d apparently walked in front of a bus when the police arrived. He had no clue where he was… or who he was. He gave his name as Brian, even though he was the most unlikely looking Brian I’d ever met. When he didn’t answer to that name later on and was reminded that he’d given us it, he simply looked at us and said ‘whatever’.

He insisted on ‘having a crap’ as he politely put it. In fact he was crouching in the street to defecate in front of us and had to be hauled up and reprimanded a couple of times by the cops.

The crew arrived after I’d originally cancelled them and then thought better of having him in the back of the car with me, so they were lumbered with the problem. I felt guilty. For a short time.

A 33 year-old homeless man threatened to throw himself into the river unless someone took him to Brighton, where his parents were. He was at his wit's end, he told me as the police stood around him, and he didn’t want to go on with his life. I asked him what he thought it would be like for me and my colleagues if we fished him out of the river. I asked him to consider how we could take such a thing home with us.

He backed down and changed his mind but I was still left with the problem of what to do with him. He had mental health problems and was bipolar. He was an alcoholic and had real health issues too but he hadn’t done anything wrong, so he wasn’t going to be arrested. Neither could he be left where he was because he would probably have seen through his threat after he’d forgotten what I’d said. There was no other option but to have him sectioned for his own safety and so I explained to him that he was going to hospital and that the police officer was going to let him know where he stood.

This decision hadn’t been made lightly and I had been on scene for almost 30 minutes before going ahead with it. He needed to be assessed and the only way to do that was to get him to hospital whether he wanted to go or not.

After that, its all a blur and, as I said, my shift ended abruptly.

Be safe.

Monday, 1 June 2009

Book latest

Thanks to everyone who voted for Scruffs - he's very happy to represent you all in the next Parliament!

The book will be out on Wednesday - it gets delivered to SP Services, who will be distributing it for me. If you haven't already ordered your copy - do it now, while they're fresh! Click on the link on the left side of this page.

I will be going up to SP's HQ to sign a limited number of them - if you wish to have one of these, please let them know when you place your order.

I will be actively promoting the new book over the next few months and then I will concentrate on the novel, which is going to take a while to complete.

In the meantime, thanks to all of you for your encouragement and support.