I'm busy over the next couple of days (a combination of Christmas parties, night shifts and *thankfully* a chance to see Laura).

As you know I love reading your comments and have learnt a lot from the discussions that go on here.

So I thought I would leave you with an ethical dilemma to chew over for the next couple of days - this situation is purely made up and hasn't happened to anyone I know. It also has nothing to do with me - it's all a fantasy to spark discussion.

You are due to work with a new crewmate on a permanent basis. The person you are to work with has been in the job for two years. While idly flicking through some websites you discover that your new crewmate is a fully paid up member of the BNP party (a UK far right political party, 'throw out immigrants, British people come first and throw out all immigrants' would be a fair summing up of their policies), It appears that management do not know this and the LAS has a strong anti-racist stance.

What would do, and could you work with them?

Talk to you all on Monday.

I'm writing this when I should be in bed, but I can't sleep. I can't sleep because you made me angry.

You could have been anything, you could have been a doctor, a teacher, a father. Your family didn't seem poor, you lived with them and now you are dead.

Twenty three years old, a heroin addict.

We tried everything we could, two ambulances were sent. You had the best treatment you can get outside of a hospital, but I guessed that you would stay dead when I saw you laying on your bedroom floor. I was pounding on your chest and all I could hear was your mother crying. I tuned out that crying because we were so busy. There was a little girl, perhaps four years old, they were crying as well. Was it your little sister? I could only ignore her as well, for we were carrying you out of the house.

I didn't have time to register the crying, we were too busy trying to start your heart.

But what did register with me? Sitting outside the hospital while my crewmate was doing his paperwork I saw your grandparents being led away in tears. They were broken. Twenty three years ago they probably thanked their God that you were born safely. Their dreams probably had you as a doctor, a teacher, a father.

Now you are dead, and why? Because you sought heroin, because you wanted that pleasure above everything else.

I don't care about you.

I care about your grandparents, your parents, your brothers and sisters. I want to go back in time and, like the ghost of Christmas present, show you where your path will lead. I want to slap you awake and show you what you have done to your family.

Was it worth that pleasure?

Yes. This job did piss me off. Sorry. And it did cause a sleepless night. I was told by someone much smarter than I that I wasn't a cynic, but that I was often disappointed by the failure of others to live up to their potential. I guess that this job hit all those buttons. The original post had more swearing in it.

We were met at the door by a man whose face was covered in blood.  The blood wasn’t his.

There were two ambulances parked outside, one of which was mine.  There was also a FRU.  We had been given the job as ‘Male, suspended’ and if the manpower is there then Control will send two ambulances.  As we were all running from our station we had followed each other down the road.

We had arrived on scene to find the man, in his 50s the only living person in the house, his mouth was covered in the blood of his childhood friend.  Standing outside were a lot of crying women.  Laying on the kitchen floor was our patient, he was surrounded by blood.  There was blood on the cupboards and the walls, there was blood on the floor.  In the sink there was blood and lumps of lung tissue.

It was obvious that we were not going to be able to do anything for him.

His friend had been doing mouth-to-mouth, but the blood that filled his lungs had rendered this best of intentions useless.

The patient had been suffering from lung cancer.  While watching the telly he had developed a coughing fit and, coughing over the sink, had showered everything with blood and then died.

So we did what we thought was best.  After talking to the relatives, we cleaned the kitchen and our patient, we took away the blood-soaked clothes.  Putting a dressing in his mouth to prevent leakage we placed our patient in a carry chair and took him upstairs and placed him in his bed.  Once there we arranged him so that he looked like he was sleeping.

By the time we were finished the kitchen was spotless, the patient was clean and looked restful.

We then helped the family get in contact with the undertaker and with the GP.  We offered them the only help that we could – they had lost their husband, their father and their friend.  We couldn’t save his life, but we could try to reduce the hurt in those who he left.

 

And you go away from a job like that thinking that you did some good, even though you didn’t save a life.

There is a problem with being sick off work when you are a 'work blogger' and that is that you will run out of interesting jobs to write about. You start looking at your shift pattern for the next couple of days hoping to eek out a few interesting posts before your seven day break. You might even consider overtime (if such a thing in the LAS existed at the moment) just in order to get some inspiration.

You also find that you have the urge to write about something, but about what you don't know. You are also aware that you don't want to dilute the 'brand' of your site with poems about puppies or some such.

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The story of the crew who ended up getting a bit lost on a 30 mile journey (and I have no idea where Mascalls Park Hospital is either, so I may well have made the same mistake) made me think of the last transfer that I did. Our patient was 20 years old, she had taken alcohol, marijuana and 'unknown brown powder' with her boyfriend. She had then fallen asleep. A couple of hours later, still asleep, her flatmates moved her to bed. A couple of hours after that they realised that she wasn't waking up and called an ambulance.

I came on shift to be told about this job by my mate who I was taking over from. The hospital were running tests for everything, even seeking to rule out meningitis due to the patient's slight fever. Little did I know that later that evening I would be transferring her from our local to another London hospital.

The patient was intubated and we were accompanied by an anaesthetist, I've done transfers with her before and she's a good doctor to do transfers with, although she can get a little travel sick. So we packaged up the patient and headed towards the hospital. I knew where the hospital was, but I didn't know where the ward was located. I was driving and it is a good job that I knew where I was going as the GPS system sends you the wrong way - into a street that has no entrance to the hospital.

There is a problem, in that there are four or five buildings to this hospital and at night some of them are closed. So I went to where I normally go, but there were no signs with directions to the ward that I needed. I considered driving around, trying to look cool, while desperately searching for the ward but instead decided to call up Control and ask them.

Control called a local crew who gave me directions over the radio.

It's a good job I'm not a typical man who is afraid of asking for directions.

I remember thinking how sad it was that some brown powder, taken in the pursuit of happiness, could lay such a young person so low. A hell of a waste.

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For something a little more fun, I'm on telly tomorrow. I was filmed some time ago for 'Imagine' and it goes on air at 10:35pm on Tuesday the 5th of December. You can follow this link to find out a bit more about the programme. I'm wondering if the bit with me in a revolving chair has been left on the cutting room floor.

I'm not working at the moment because I'm off sick. It feels like someone has been kicking me repeatedly in the kidneys and I'm hobbling around rather than walking. Still I'm alright if I'm sitting somewhere nice and warm with plenty of padding, which gives me a chance to do some writing inbetween chewing down painkillers.

Thank the Universe for Amazon in the ease of buying Christmas presents. No longer do I have to fight my way through crowds of gum chewing, slack jawed locals in the pursuit for something 'just right'. Even my mum uses Amazon (well, she tells my brother and I to buy stuff for the other and then throws the money at us. None of us are sentimental about Christmas, it's all about the swag...)

Now for an ambulance story.

I was working a late shift when I got sent to a RVP (Rendezvous Point), these are normally used when there is a suspicion that there is some violence in the offering - the last ones I have been to have been for the arrest of someone over firearms offences and for the possible stabbing of someone in a domestic violence case. Both of which were uneventful, the arrest went calmly and the 'stabbing' was actually a 'stabbing pain' with a thick accent.

This one was different, someone had smelt gas and had called the authorities. The fire service had arrived and cordoned off the road, the police were there to managed the scene and we were called in case something went *Boom*.

We were left alone with all these other services for quite some time, normally there would be a DSO (Duty Station Officer) at an event like this, but I think he was halfway across town. So I promoted myself to 'Ambulance (Non)Officer In Charge of Scene'. It's what we are supposed to do with 'major incidents', the first person on scene takes charge until someone with some pips on their epaulettes turns up.

I promise that I didn't stroll around trying to look important.

I found the fireman with the white helmet and had a chat with him, then i found the police officer in charge and chatted with him. then I updated Control, then I chatted some more with the police about the weather, our stab vests and why they make such good body warmers, and finally of the people who didn't want to be evacuated from their homes.

The man from the gas board came and went with various technical bits of equipment, then told the fire officer that he needed someone above him to declare it safe. The woman from the council's emergency planning group turned up and I had a chat with her, and managed to wrangle an offer for a cup of tea.

So we waited some more, our DSO turned up and tutted that it was me there, in his words, "Why is it always you at the centre of the chaos?"

I informed him that as I was in charge, there was no chaos...

A bit more of a wait around before the scene could be declared safe and we could all head off. I left just as they were about to dig a hole to see if the leak was worth repairing or some such.

A nice easy job, no-one was hurt, which is always nice and it managed to last me until the end of my shift so I even got off home on time.

(And yes, the title of this post highlights my inner geek).

First off, a big 'thank you' to everyone who wished me a happy birthday yesterday. You are all very kind. Also a big thank you for keeping the comments in 'Two In Two Nights' so civil. The internet is often used as a place for willy-waving and I am proud that my readers are so atypical of this.

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One of our more regular jobs is to the Newham Mental Health Unit (MHU). It is one of the more bizarre side effects of the way that the NHS is structured in that while the MHU shares a physical site with Newham hospital, they are completely different trusts.

As each trust has it's own portering staff, if a patient needs to be moved from the MHU to A&E... they call an ambulance.

So we get calls to patients who need to be moved a grand total of 400 yards down the road. I've worked in hospitals where you would need to wheel patients on trollies for longer distances just to get them to the wards. Unfortunately neither Trust will take responsibility for wheeling patients between the two buildings.

It doesn't help that I'm not enamoured of the medical care of people in the MHU...

Sometimes we will be called for something as simple as a chest infection, or that the patient needs blood tests or an x-ray. Sometimes you will go to something that sounds 'genuine', but which ends up being something simple.

Take for example the last time I went there. The patient was a young girl and her diagnosis was 'Pulmonary Embolism', now this is a serious and life-threatening illness, it is a clot on the lungs which causes severe difficulty in breathing and shock.

This patient however had none of the risk factors or symptoms for this. She was shaking like a person with Parkinsons disease but her vital signs were all normal. Without turning this post into a list of symptoms found and not found she had nothing that suggested an embolism. She had also been in this state for a couple of days.

It looked to me like a toxic amount of one of her anti-psychotics.

Oh well, 400 yards later and she was safely in A&E where they quickly ruled out an embolism and sent her back to the MHU with one of the private contract ambulances. I'd be interested to see how much that trip cost the hospital.

The cause of her illness?

A higher than normal level of anti-psychotic in her blood.

It was a bit of a 'stabby' weekend, I don't normally do 'sexy' calls but for some reason I had two stabbings on two consecutive nights.

The first was a young man who had been stabbed in the street. His main injury was a stab wound through his thigh, he'd leaked a fair bit of the red stuff, but not enough to particularly worry us. He also had a slash wound across his chest but this was fairly minor. What made the job tricky was that there was around 40 youths all milling around, all wanting to talk to their 'bruv'.
Our patient was more concerned with getting his mobile phone back from one of his friends. I'm guessing, given his demeanour, that he wanted to arrange a retaliation. Meanwhile more and more of his friends were arriving and causing trouble for the police. For some reason the people of Newham seem to enjoy ignoring 'Police:Do Not Cross' tape.
We blued him into the local A&E where he was treated (and probably discharged later that day).

The next day had another stabbing, this one somewhat different.

The patient didn't want his girlfriend to leave him, so he stabbed himself in the stomach.

(No, I have no idea either, especially as this was the third time he'd done this to himself).

What made it annoying was that the patient was pretending to be unconscious. As it was difficult to see how deep the wound went, and we had been told that it may have been three inches deep, we blued him into the local A&E. After the doctors there poked a metal probe into the wound they discovered that it was a minor injury. I left him in the A&E still pretending to be unconscious.

The police officer who came with us just wanted him to admit that it was self inflicted, then he could leave. He was only there to check that it wasn't the patient's girlfriend who had stabbed him.