Friday, 28 October 2011

Ready to go!

Use the PAYPAL button on the left hand bar to pay for your signed copy of The Station.

Remember to choose what format you want and email me to let me know your name, so that I can personalise it, otherwise I'll just scribble on it randomly.

Give me a few weeks to get them out to you (I'll try for sooner if possible).

Please write a review on Amazon and elsewhere... give me feedback!



Monday, 24 October 2011

Signed copies of the The Station

I'm getting copies ordered to sign for those of you who want one; if you want my squiggle on a hardback of the book, please drop me a comment or email me and let me know.

I'll set up a payment account soon and you can pre-order them. You've got to give it a few weeks before they get to you though.

I've noticed the prices appear a bit too high for a novel, so I am querying this with the publisher (I don't set the price, they do). I will let you know the cost of hardcover copies when I get information back.


End of life

Right now, the worst things happening around me involve children. I cope and get on with it, but I am much more sensitive than ever before. I guess that will eventually settle down.

So, calls involving pregnant women whose waters have gone, and they are only 20 weeks or so into term, make me very sad indeed. I know the woman has probably just lost her baby and I know exactly what she and her other half are about to go through.

But these calls pale into insignificance when I listen to the last moments of a child who is in Palliative Care; a child who has stopped breathing and whose nurse is carrying out CPR in a vane attempt (and contrary to the meaning of 'end of life care') to revive him.

I listened in as the call-taker processed the resuscitating nurse through the procedure, against all odds. I could hear mum in the background sobbing. "Please my darling, come on my little angel", she says. She repeats this over and over again as her child undergoes the physical punishment required to force life back into the lifeless.

I had to put my head into my hands. I was thinking I might be losing it. Or maybe I've gone soft. Or maybe the fact that children live for such a short time, just to die in medically predictable circumstances, is finally getting through to me and I'm feeling the pain of parents who are going through a hell of a lot more than I did.

If there are parents like that reading this, I want to say I can't believe you have the strength; I honestly salute your souls for loving so deeply for such short years, just to say goodbye without ever having watched your child grow old enough to earn death.

It breaks me against religion and it denies me the power to support weak and institutionalised people who think their lot is so bad that they need ambulances for every little problem they have - their drink problem, their drug problem. I wish we could drag them to see these kids. Take them all up to Great Ormond Street Hospital, or any children's hospital, so they can see what suffering with dignity looks like.

If you have the time and a little money left, give something to any Children's Hospital you know. They really need it. If I ever get Mr Tonsilpus back I will start another campaign so he can raise money for Children's Hospitals.

Be safe.

Saturday, 22 October 2011

Yellow calls and red rage

There was a dirty yellow moon sitting low on the horizon as I trundled home after this shift.

Two small women from Louisiana asked if I would allow them to have their photographs taken with me and the car. With a deep blue, sunny sky and a backdrop of the National Gallery in Trafalgar Square, I thought it would be unreasonable for me to say no.

Each in turn, they stood by me, making me feel tall for a change. They smiled and giggled and confirmed with one another that they’d taken the perfect pictures for the folks back home. “I want to show my daughters that you guys drive on the wrong side”, one of the happy ladies told me. This made me smile.

The first call came in a few hours after I’d started and I was concerned by the response category it had been given. ‘3 year old vomiting blood’ was surely more urgent than a low-amber? I queried it and my colleague in Control allowed me to continue to it, even though I’d been cancelled.

When I arrived I spent three or four valuable minutes wandering around the council estate, trying to find the building I needed. As usual there were no clear signs and the place was a mish-mash of concrete boxes, piled three storeys high. Calls to places like this increase the possibility of us getting to a life-threatening crisis later than we should. It could literally cost you your life if you live in one of these estates.

I eventually got to where I was needed, with the help of a resident and the man who made the 999 call. I was led up to a front room and met the little boy and his mother. She told me that he’d had a cough for a month and, although tests were being done to find out what was wrong with him, he seemed no better for seeing the doctor recently. This morning he’d coughed and produced ‘stringy blood’, according to his mum.

I explained that it was fairly common to produce a little bit of blood in sputum when you’ve been coughing hard and for a long period; it’s the result of small blood vessels rupturing due to the pressure. However, when I first saw this little blond-haired boy, I noticed how pale he was. He was also very lethargic; his behaviour wasn’t animated as it should be for his age.

He also had a number of bruises on his leg and I asked if he tended to mark easily. Both parents (dad had shown me in and was now in the room) confirmed that he did. Obviously I need to tell you that I wasn’t prying because I suspected any kind of abuse. This was a loved child and that was clear. The parents had become frustrated with his condition because he couldn’t sleep due to his nocturnal coughing fits. He also had less energy than normal recently and his pallor gave them real cause for concern.

I considered anaemia, particularly aplastic anaemia but there are many other conditions that could cause these signs and symptoms; some minor and transitional and some, like the one that ran through my mind, a little more significant.

I took the child and his parents to hospital and booked him into Paediatric A&E, hoping along with mum and dad, that the doctors would find nothing more wrong with him that a viral infection.

Contrast the last call with this one; my next outing was south of the river for a 30 year-old male ‘lying on the street, status unknown’. This means that somebody has called 999 and reported a man who was probably sleeping and nothing more. When asked if they’d check consciousness or breathing, the caller has declined to do so. This hints at the caller being in a building, possibly overlooking the ‘dead’ body.

I got there and found a slumbering drunk. The single pertinent clue that was next to him was the can of lager. It’s funny how that little detail escaped the caller’s interest. It would have been helpful. But I already knew this was nothing more than an eyesore-cleanup job and a MOP had tasked the good-old ambulance service to do it.

And here’s the shocking contrast. The little boy coughing blood was not as high a priority as the man I found curled up and obviously asleep in the street. This man got the highest priority response in fact, because we simply can’t afford to take the risk that he isn’t in cardiac arrest. It’s not the Service to blame; most of my colleagues in Control would see this for what it was, and act accordingly. It’s the public – the person who decided he needed an ambulance when he didn’t even look like he was unwell. That person felt it was their duty to call us, yet couldn’t go and check the man to see if he was okay.

Good Samaritans makes these calls from buses as they pass by. The fact that the street is teeming with people and that dozens, if not hundreds of individuals have walked passed this man without reporting any alarm, doesn’t seem to register. What happened to common sense in this world?

So, I tried to wake him up and got a furious tirade of abuse for my trouble. I decided he was too tricky to handle, so I asked for the police to come and move him. They responded by informing me that they had nothing available to assist and that they were watching the man on CCTV and he looked ‘asleep’, so why were they needed?

They had a point. Being drunk and asleep on the pavement is not a crime, per se, so why would they bother with it? Indeed, they’d spotted he was asleep by remote control, so it made me a bit unhappy that we couldn’t do the same. Instead of which I had to make another approach and risk getting a punch or full-blown mugging from this unpleasant person. I could have left him there but I’d have no paperwork to support his request for me to “f**k off” (which is tantamount to a refusal), and knowing Sod and his stupid law, this guy would drop dead the minute I drove off.

So I walked back over, after watching his foetal body and hating him for being able to sleep when I felt so tired. Ten or twelve people passed by... some of them were school kids. They all recognised what the hysterical 999 caller couldn’t. They knew he was drunk and asleep. They all knew he was alive and breathing; their grins and chuckles and comments of "look at that stupid effing drunk" proved this.

The twenty minutes I’d spent watching over him like a sponsor had obviously helped chill him out, because when tried for the second time to rouse him without bloodshed, he sat up and became reasonable (ish) about the whole thing. “Why the f**k can’t people leave me to sleep?” he moaned. I agreed with him; why couldn’t they just leave him to sleep?

He began to wrestle with a short, yellow cigarette that had most likely been recovered from a bin, and a lighter that refused to spark, let alone light. The ciggie and the lighter helped me muse over his life and I felt guilty about that. I saw the combination of the yellow short-end cigarrete and the useless lighter as a sum-up of who he was now.

“Oi, mate. Can you try to light this for me?” he asked, handing me the dead Bic. I wondered how this was going to look up in CCTV heaven as the eyes of the law watched me. I could almost hear them sniggering as they witnessed my fall from paramedic hero on the streets, to ciggie-lighting bitch to the great unwashed. My mental eyes rolled at the thought. But I’m not too proud to light a man’s cigarette if it gets him out of my life. If only the damned lighter would do its job!

Luckily, this drunken sleepy-head had a spare or ten on him, so he offered me another lighter and this one, thankfully, did what it was paid to do. Thus, within a few minutes, and after almost half an hour and the wasting of hundreds of pounds of tax-payers money, the blue-light emergency, potentially life-saving call, ended with me slinking back to my car and driving off with a happy, drunken idiot in my rear-view mirror - sitting on the same piece of pavement he’d slept on and been deemed dead upon. I had no doubt whatsoever that he’d simply draw out his cigarette, blacken his lungs a little more and fall back down into a pillow-less dream and that the general public would walk on by til somebody, somewhere decided he was a corpse.

Be safe.

Thursday, 20 October 2011

Drama Queen?

A whole big dramatic chain-reaction took place on a call for a cyclist versus pedestrian. He was pedalling at a pace the wrong way up a cycle lane and she was minding her own business and crossing the lane, looking in the direction of normal traffic flow. It was clear, so she proceeded.

Maybe she should have taken a second to look the other way, but she didn’t and she was thumped by the cyclist. She was thrown onto the pavement, hurting her arm on landing, and he was chucked from the bike and dropped onto the road with some force.

The whole thing was witnessed, so when I arrived I was frantically guided in by a windmill with distress on his face. The reason for this became clear when I parked up and exited the car. The cyclist was howling and screaming in pain.

He told me he’d damaged his pelvis before, after a previous cycling accident in which he was, in his own words, ‘left for dead’. He said his pain was 10/10 and screamed out when any suggestion of examining his hip and pelvis was made.

‘I need to have a look to assess the extent of any injury’, I said.

‘Don’t touch me! I don’t want you to look at it!’ he shouted back.

Now, there are times when it is clear when someone is over-cooking their pain and there are times when it is doubtful that any injury of significance exists. This, however, was one of those borderline cases. His actions, demeanour and language suggested more going on behind the scenes than this possible injury, but his physical appearance (one leg shorter than the other and some rotation), hinted at something else. Of course, anyone can make one leg shorter than the other by appearance, if they so desire... but who am I to judge?

His pelvis or femur may well have been damaged by the catapulted landing but some of the things he came out with were outlandish and illogical for someone who needed immediate medical attention. I felt it was a combination of over-doing it and a reluctance to acknowledge the means to an end. He was like a petulant child refusing a tissue for a runny nose.

He relented when we got him into the ambulance and, even with the initial rotated, shortened look, his hips and pelvis seemed fine, sturdy and in position. The poor woman standing on the pavement, however, was left to worry herself grey about what she might have done to this guy. She thought he was dying.

I attended to her soon after leaving the crew with our screaming (now morphine controlled) cyclist and had a look at the woman’s arm. She had a significant bruise there and swelling had developed, so I took her to A&E to have it x-rayed. I suspected that, ironically, she’d be found to have much more wrong with her physically than our speeding patient. She made quite a point of ensuring she was led away and out of his sight when she arrived at the department and he was still waiting, apparently pain-free now, on the trolley bed in triage.

I know a few people like this and I'm sorry to sound arrogant and judgemental, because I'm sure there is an excuse for them somewhere. But they think that someone like me... and my colleagues, are so easily fooled... are so inexperienced and gullible, as to believe they have an injury that has the potential to kill, and yet underneath it, they are dramatic. There is no drama in real pain, there is only pain.

In the wee hours, just before going home and when the strangest cases surface, I was asked to investigate a man who was fitting outside a Casino. ‘Door staff on scene’ I was told.

I arrived to find the door staff doing their job... staffing the doors, whilst my patient lay flat on his back on the pavement. They had given him a wide berth and I treated him to a closer inspection.

‘He just dropped down and started fitting or something’, the tall, wide, door staff men said.

The young man was bleeding from the head and this made me cautious about what was happening here.
‘So where did the blood come from?’ I asked.

I thought I was being diplomatic but I must have sounded accusatory, because their reaction to the question was immediately defensive and highly unlikely.

‘Mate’, they chimed. ‘He just fell down and had some kind of fit. The blood just appeared.’

Hmm, I thought. Just appeared, did it? To be honest with you, my first thought was that he’d been a bit mouthy with them and they’d given him a push. I know that’s not fair but it’s happened before and wouldn’t be an unrealistic scenario given the time of day, the place, and the wild, drugged look of the man on the ground.

I had to struggle with him a few times to keep him under control and his arms flailed in my general direction as I did so, but it was clear early on that he wasn’t going to remain calm and my initial thoughts were that he’d sustained a significant head injury, or he’d taken something to cause this behaviour. Of course the logical pathway is followed routinely but it also takes into account the possibility that he was just like that normally; that is was in his genes.

I asked the doormen a few times about the man’s injury but they kept their distance and stuck to their story. The patient was going on about people coming after him and seemed highly agitated about the prospect that he was going to be attacked. So, he started ranting at me, as if I was the threat. This made me a little uneasy about my prospects of staying safe, even with the two large gentlemen standing at the Casino door. I tried to call in for backup and got no response. Then I called in again... and again. I pressed the priority button on my radio and got zilch back. Then, as a last resort, and because I really needed a cop or two to help me out, I activated the crew emergency alarm. This is used when we are under attack or need urgent, urgent, police attendance. To be fair, all I needed was urgent police attendance. Just one urgent... not two.

Pressing my ‘I’m in real trouble, come and help me quickly’ button made no difference and I heard nothing back. I must have been in a blind spot.

The ranting patient was on his feet and pushing at me to get past. The two doormen looked on nervously, which I found chillingly confidence-busting. Did they know something about him that I didn’t? Did he have an Uzi in his pocket? I was inspired by the knowledge that his pockets were far too small to conceal such a weapon. I’d just have to avoid his fists instead... or the world's smallest Uzi.

An ambulance rolled up as I managed to get the man to lie down again. I had to keep a little distance from him because he was still convinced he was about to be mobbed by a gang.

He said that he’d run 3 miles to escape a mob of youths that had attacked him and who ‘hated’ him. He had come a long way across London, just to collapse in a heap on the pavement.

There was no sign of any gang, so we got him onto the ambulance and the crew called for police on my behalf. It was too late for physical protection but we still needed this matter cleared up.

When the cops turned up, they knew the man and said he had a long history with them. That history included drug use and violence, so I hadn’t been over-reacting after all. His story about being assaulted and chased for miles may well have been true but, from what I was hearing, he’d more than likely brought it on himself.

And so another weekend night ends with a sunrise and a spatter of someone else’s blood on my sleeve. It’s crazy.

Be safe.

Tuesday, 11 October 2011

The Station is out there...

Okay. The new book is out at last. You should see it on Amazon, etc very soon (I'm told these things take a few weeks). In the meantime, you can buy it direct from the publisher. Don't be nervous about them being an American company, charging you in dollars... they have a UK distributor, so you shouldn't be waiting for weeks and you shouldn't be paying more than the book's value to get a copy.

You can buy it in hardback or softcover - it's up to you.

Follow this link:

Please let me know what you think of it. remember it's a work of fiction and does not purport to reflect anything true or real about the ambulance service.....

Oh, and can you all please get your friends to buy it... plug it on Facebook and Twitter... give it a buzz if you like it. I want to do well with this one... it'll encourage me to write another one. I really don't care that I am blatantly plugging it. Nobody else is, so why not me?



Mickey's dead

I watched a mouse dying today. Yes... a mouse. Scruffs had caught it and was playing with it, but I took it from him and put it into a bucket so that I could chuck it into the field behind my house. I've given many a mouse a second chance by doing this. This one however, well, he was feisty and he managed to clamber up and out of the bucket before I had a chance to stop him. He obviously didn't trust my intentions.

He plopped onto the grass and ran for his life, but Scruffs was on him again and he was pawed to a stand-still. I told my cat to let him go and he did (Scruffs is generally obedient, believe it or not - he sits on command), but the mouse made a fatal mistake - he dashed away from the safety of me and my bucket. He ran straight into Scruff's path again, and this time Scruffy boy was having him. He grabbed him in his mouth and made to escape into the house with it.

I managed to get him to drop the little thing though and I picked it up and saw straight away that it was limp and weak. Scruffs hadn't pierced his body with his teeth; he rarely does that, but I guess the crush of his mouth had been enough to cause internal damage.

But I thought the little thing may also be playing dead, because they do that. I put him on the ground and watched him. His breathing was shallow and quick, and when I dropped him to the ground, his little paws jerked out, as if he was scared of the fall... or wanted to be kept out of harm's way. Then he just lay there, eyes open, and began to gasp in long, crying breaths. I recognised this. I've seen humans do it. It's called agonal breathing and it's the last thing that any breathing creature will do before they die.

I watched as he opened his little mouth and silently screamed, time and time again, over and over... and then he just stopped. His eyes never closed and he never looked in pain but he clearly was.

Why am I telling you this? I'm telling you this because as I watched him die, I felt more emotion for him than I have done recently for people.

I've had a bad year, and you all know that, but I don't deserve anything for it because there are plenty of people having bad years... and some having much, much worse. But my year has helped me focus on what's really important and it's helped me see the futility of trying to educate the public about how not to abuse their emergency ambulance service. It's hardened me against those who deliberately destroy their lives when there has never been the threat of a cat to kill them, against a backdrop of children and babies who have terminal illnesses and whose parents are living only in the shadow of inevitability for a loss that will be so great that they cannot fathom life for themselves any longer.

I'm not giving up and I'm not clinically depressed... but I am changing my mind about things.

I went out tonight. I went to a gig ('Battle of the bands') that was specially organised by my colleagues for my colleagues and in aid of charity. I spent a few hours drinking with them, laughing with them and listening to music produced and performed by them. It was great fun and a sobering reminder to me that I am not part of a company, or an organisation. I am part of a family. Every one of the people I saw tonight (the club was almost exclusively full of London Ambulance staff) do the same job as me. The fact that I write this blog and have done other things is completely irrelevant. These people also have to deal with the reality of the job, day in, day out. They know that there is no answer and never will be. Certain members of the public will always abuse their emergency services; they care not a jot that we care.

I listened-in to a call recently in which a man had dialled 999 for help because he was in pain. From the very start he was aggressive, abusive and very threatening towards the call-taker. The call-taker remained calm and professional against a tirade of swearing, animosity and direct threats. The man even threatened to punch the first medical person he saw. This was simply because he had toothache and we hadn't sent him an ambulance as a matter of priority.

Someone's 83 year-old grandmother was lying on the floor, unable to get up. She'd been there for hours waiting for us because we were tied up with other 'emergency' calls, and this guy didn't care to know, even when that was being explained to him by the polite call-taker.

I love my job. I believe my colleagues love their jobs - they must do, because they could apply to drive a train and earn a hell of a lot more and take a hell of a lot less abuse.

Christmas is coming. It's the season you all know makes my blood boil, because it's when the worst of people come out of the rotting woodwork of society. Lawyers, doctors, City bankers and a host of other 'respectable' professions will get drunker than normal, and will pile abuse, vomit and spit onto us. Please, read the mouse story again.  Try to understand what happens to people when they live the prediction of such things.

I recently noticed that someone gave me a less than flattering review for 'Life & Death on The Streets', (a professional moaner, judging by the number of other books he's also whined about) and, to be honest, I don't care because that's the name of the game. But he described me as 'just another gobby ambulance person', or something very similar. He went on to describe how I did the usual moaning about the state of things in my profession. I realised that this critic was probably not in the ambulance service, or anything at all to do with the NHS. His or her opinion is that we should all just shut up and 'do our jobs'... as many others out there think. But this isn't just a job, it's a vocation; you either love it or you don't, and for all of us... me and my colleagues, after years of abuse and violence and assaults; years of pandering to those who think they need us but do not, and a mini-lifetime of the same old faces doing the same old things to get to hospital - I think we have earned the right to be gobby.

Me, my emotions, my colleagues and one dying mouse have kicked me back into reality.

Be safe.