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.


kelly said...

When you are in the depths of despair and desperate to end the suffering you just want to be out of pain quickly and certain it will work. Pills might be easier but more prone to "failure" - you may be found and saved for starters, the last thing a truly suicidal person wants.

I agree it must be a truly awful experience for the driver, passengers and everyone else involved in the "clean up" but please spare a thought for the deceased before instantly condemning them in the way you have.

Rick said...

Ref. the Kidney Pain: I've 'been there' several times with Renal Colic and, IIRC, three times now once someone else was helping me deal with it and taking responsibility the pain receded or completely collapsed My personal little theory is that, as Renal Colic is all about a muscle spasm, just a little relaxation (knowing that someone is going to deal with this nightmare) takes the pressure off the stone a bit, which allows you to relax a bit more, etc...

You feel a right jessie and everybody thinks you were 'acting up' – then the rock in your renal system shows up on the X-Ray, or someone notices the pleasant claret colour of your urine.

Charlie2Hotel said...


Needless to say im one (maybe one of the few) who agree with you on one unders, i witnessed one as a child and still remember it to this day.

Also with the soldiers, i encountered a british soldier here one night off duty, he was after been in a fight, laceration to the forehead, oddly shaped nose the lot, the worst thing about it was he was ashamed of being a soldier, with him being irish and in the so called enemys army alot of his friends and even some of his family disowned him. All he ever wanted to be was a soldier but for whatever reason the irish army wouldnt take him so he went away to join.

He was that ashamed of it that he took off his dogtags, visable under his torn shirt and stuffed them in his pocket. Sad really, but i had no problem treating him until the fire brigade ambualance arrived to transport him to an a&e chair for oh i dunno a week or two judging by the state of hospitals here

Now, back to my/your book :p

Xf said...


try not to read to deeply into how I feel when i write; others have and get it wrong. I have every sympathy for despair and pain but I have equal sympathy for those left behind. Its a simple equation to me.

Button Ginger said...

The daft thing is, on the Tube the suicidal don't need a train.

Landing on the live rail is enough to kill someone.

The suicidal don't think of anyone else's pain and distress - hence the gruesome surprises train drivers, coppers and paramedics often have to deal with.

Uncle John said...

C2H on soldiers and drink. See "Tommy" by Rudyard Kipling - written over 100 years ago, but still valid today;

//An' if sometimes our conduck isn't all your fancy paints,
Why, single men in barricks don't grow into plaster saints;
While it's Tommy this, an' Tommy that, an` Tommy, fall be'ind,"
But it's " Please to walk in front, sir," when there's trouble in the wind //

- http://www.kipling.org.uk/poems_tommy.htm

Caroline A said...

Your book came today. It's got pictures and everything, including you on the back. Wow, you're hot!!!!
It's perfect Stuart, just what I wanted (a budding paramedic). I haven't read it properly yet but it looks quite funny and will help me on the road to my dream career. I just need to get past that bloody maths assessment!!!

Xf said...

Uncle John

Perfectly put and exactly what I mean about our forces personnel.

Xf said...


Lol! Good luck with your assessments. :-)

Stonehead said...

I'm with you on both one-unders and handling drunken service personnel.

I was on the platform at Kennington Tube Station a few years back when a man ran past me and leapt in front of an oncoming train. Not a pleasant sight for the driver, the score or so passengers waiting for the train, for the tube staff, or for the people like yourself who had to clear up in his wake. If people are going to do themselves in, they could at least have the decency to do it in private.

As for the drunken soldiers, suffice to say that there are a lot of soldiers, and a few airmen, in my family. So, I'd agree a certain amount of discretion and understanding are in order. (And if they push it, the RSM or MPs are going to be far harder on them than anything a drunken civvie faces.)

kelly said...


try not to read to deeply into how I feel when i write; others have and get it wrong. I have every sympathy for despair and pain but I have equal sympathy for those left behind. Its a simple equation to me.

Fair comment and completely understandable, especially coming from one who gets to see the aftermath first hand of one unders. As an aside, the number of times I hear about delays on a certain tube line because of "a person under a train at x station" is quite disturbing. It seems to happen very frequently :-(

8char8 said...

I agree sometimes people misread the way you write things, I know nothing about you but your style of writing and what your write about are an indication of who you are and what you deal with. I think its fair enough to have an opinion in your line of work as long as you are professional enough to not let it influence the way you treat people (which I don't think it does judging by your writings). I think if you didn't have an opinion and you weren't allowed to vent you would probably go mad, so fair play to you for being honest and not shying away from your feelings/opinion for the sake of the 'PC Brigade'. I really hope you have a nice holiday lined up this year so you can have a break away from it all!

Anonymous said...

As a passenger, I have been unlucky enough to be involved in two of these 'one under' incidents, both involving mainline trains. It's not something you can forget. My sympathies go to the train driver, & those of who who have to deal with the worst part of the aftermath.

Hugh said...

look what happens when the bus driver doesn't dial 999, they forget


Hugh said...

look what happens when the bus driver doesn't dial 999, they forget


medicblog999 said...

I have a radical idea for suicides!
I dont think that pills/hangings/cut wrists/jumpers etc are any less traumatic than one unders. The common factor is that no matter how someone decides to kill themselves, someone is going to find them!
The most selfish one I have had to deal with was a 'kneeling hanging' in a sliding door wardrobe. He was found by his wife and daughter when they were getting ready to go out!
Hows about having a place where the suicidal can go to do it. Lets face it, if someone really wants to die, they will do it, no crys for help here!
At least if there was some where they can go, the people who will find them will know what they are about to walk in on.
I know its radical and I know it will never happen, but like you, I have seen the aftermath too many times of the effects it has on those that find them or in the case of Jumpers from the Tyne Bridge in Newcastle, those in the cars who they land in front of.

Fiz said...

It's worse than you think with "one unders". The drivers lose their jobs and are downgraded due to the appalling stress caused by such an action. I know because my husband's job was interlinked with the Underground and Rail services, and the same applies to above ground drivers. It's a thoroughly selfish form of suicide. And I suffer from depression, before anyone accuses me of not understanding.

kae said...


Why spare a thought for the deceased?

They're dead. Nothing's going to touch them now, and in their dying they've hurt all the people who loved and cared for them and others who didn't even know them.

Suicide is a long-term solution for a short-term problem. It's different if you know the suicide, but if you don't it's unforgivable to involve others like that.

kelly said...


I can only feel sorry that there are so many people like you with your attitude. I doubt there is any point trying to change it so I won't waste my energy. Suffice to say, I have every sympathy for those who are in such pain they are driven to even consider taking their own lives, let alone actually doing it, and I have every sympathy for those they leave behind.

rattles said...

Hi Stewart,

You have been unusually quiet recently - I hope your ok - Presuming that your working hard on your book!!

I love reading your blog its very interesting and informative!! Well done and keep it up - Im gonna try and get a copy of your books too!!! :-)

Take care Lotsa Lv Rattles Xxxx

rattles said...


You have been very quiet recently i hope that you are ok and just finding yourself busy with your book!

I love reading your blog its funny and informative and really well written!!

Im trying to get hold of your books at the moment too.

Thanks - take care lotsa lv Rattles Xxx