The radio squawked into life, "Can anyone assist with an emergency call in Alice street?"

We were around five miles away and there were three ambulance stations between us and the call, obviously everyone else was further West than us or already busy on their own calls.

"Sod it", I said to my crewmate, "It'll be fun for you to have a decent run on blue lights..."

So we made our way there as quickly as we could in the traffic that seems to come from nowhere at 11pm in East London.

As we approached the scene we saw our FRU already on scene along with a van full of police. My heart sank, I knew that this wasn't going to be a simple job as I could see the police stringing the 'Do Not Cross' tape around where our patient was lying. The locals, as usual, were ignoring the tape, the police were getting exasperated.

Jumping from the ambulance I headed over to the patient. Our FRU paramedic was leaning over the patient's head and as he straightened to greet me I saw that the patient's head was... well... mushed.

He had huge swellings around his eyes and head, he was semi-conscious and covered with blood and vomit.

"Apparently". our FRU told me, "he's been hit once with a lump of wood".

Looking at his head I wondered why, if he'd only been hit once, it was such a strange shape.

"OK", I said, "We aren't going to hang about, lets run him to hospital".

There was some commotion as his drunk friend gave his story, in fractured English, to a police officer while more locals ignored the police tape which was cordoning off the crime scene. I needed to know how many times the patient had been hit, as it would change my treatment of him. His friend was adamant, he was only hit the once and his face normally looked misshapen. It wasn't outside the realms of possibility that our patient was just... ugly.

As we lifted the patient onto the trolley he let forth a long stream of vomit, my boots were merely splashed.

In the light of the rear of the ambulance I could take a closer look at our patient - he did have a very lumpy head along with plenty of 'soft tissue injuries' to the face. One eye was swelling up and he was still leaking blood from a large cut on his scalp. He was still semi-conscious and I made the decision to 'blue' him into hospital.

But which hospital? If I was sure he had a brain injury then I could take him a couple of extra miles to a unit with a neurology unit, but, if his drowsiness was as a result of alcohol (and we had been told that he had been drinking a lot) then the much closer local unit was a better bet. In the end I decided on the closer unit, they would be better able to assess him and if needed could easily transfer him to the hospital with the neurology unit.

So, after making sure that he hadn't been stabbed or shot (not..ahem...unknown in East London), we started towards the hospital.

The police officer who travelled with us asked if our patient's injuries were life threatening, I could only reply that it was a possibility but he'd have to wait until the hospital ran some more tests.

It was only as we were pulling into the hospital that I noticed one of his pupils was getting larger where previously they had been equal - this is not a good sign as it is an indicator of a serious head injury, it's normally quite a late sign though and he didn't look that neurologically impaired. Still it was too late to change our destination. During the transport he had turned his head to vomit on the floor (and this is the picture at the top of this post), and on arriving at the hospital did the same on the lift of the ambulance.

Straight into resus and I gave my handover to the doctor in charge - the team descended on him and, after booking the patient in, we left to begin the long, smelly and mucky task of cleaning out the back of the ambulance (and changing my now spattered uniform).

We went back to the hospital later to find out what had happened to our patient - after exhaustive tests it was found that his facial bones had been broken in
several places and he had a fractured skull - his friend had obviously been lying when he told us that he had been hit only the once. The reason why the patient's pupil had started to change was because the optic nerve had been damaged, there was a strong chance that he would lose the sight in the affected eye.

Thankfully I'd made the right decision, after CT scans it was determined that there had been no brain injury and that the reason he was so 'out of it' was because of the alcohol he had drunk over the night.

It later transpired that the beating was in part due to the 'inter-tribal' warfare that often takes to the street of London. Country 'A' hates Country 'B', and so they decide to beat each other up. The ambulance service and A&E departments along with the police are the lucky souls who get to pick up those pieces.

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OK, I have now run out of stories to write about, so I hope I get something 'interesting' in the next four days... Also I now have an empty Inbox, so if you have sent me an email and expected an answer then it's been lost somewhere.

For the first time *ever*, ambulance crews are going to have rest breaks.

For too long we have been working 12 hours a day without a break.  Sure, we may be able to sneak a cup of tea at hospital, but if you take longer than half an hour to unload patient, handover to nurse, clean and restock the ambulance and finish your paperwork so that the patient can’t sue you, then we often get asked if we could ‘green up’ for another call.  Trust me when I say that it can easily take longer than half an hour to do all the above.

We rarely get to see our station, too many people call us and we simply don’t have enough ambulances to deal with all the drunks, cut fingers and coughs and colds that we get sent to.

European legislation means that we should all get a short ‘rest break’.  If you work for 12 hours, is it really too much to ask for a half hour break at some point?

Apparently it is too much to ask for ‘The Sun’.

Some journalist, who can no doubt have plenty of cups of tea during her day, decides to attack our service for (a) following the law, and (b) treating it’s staff like human beings who need feeding and watering.

It can be hard work on an ambulance, while a lot of our work is fairly simple, there are days when, not only are you run ragged, but you also have a string of tricky jobs.  Why shouldn’t we be like everyone else and get a break.  The police have meal-breaks, nurses have meal-breaks, doctors have meal-breaks and the fire service have meal-breaks (if I were being uncharitable I say that the fire service have occasional breaks in their meals for work).

So why should we be any different?

We make enough sacrifices for this job – shift work knocks years off your life, wrecks your health and social life.  We go into dangerous situations on a daily basis, get beaten up and sit in enclosed spaces with infectious patients.  We also don’t get paid enough considering how the government keeps expecting us to hold together the tatters of the NHS.  Until we got breaks we would also be eating unhealthily, wolfing down fast food between jobs, so physical fitness is a concern for us – gym memberships are a waste of money when you work half the time they are open.

So ‘The Sun’, rag that it is, wants us to work like robots.  Instead they should ask why, despite meeting targets,despite an annual increase in calls, despite being told we should cover the shortfall in GPs and A&Es the government has taken money away from us.  Ask why we can’t have more ambulances?  Ask why we have to go to people who have stubbed their toe, got a wart on their foot or have ‘man-flu’?  Ask why, after dark, it’s us and the A&E departments against the world as all the psychiatric teams, social workers and care home staff vanish along with the sun.

Maybe that would be proper journalism.

I’m already hearing about crews getting abused due to this article, one person reports being shouted at while having a sandwich, while another received abuse from a patient with a cut finger (needing only a plaster) – all because they think we should be running around ‘saving lives’.  It only needs someone to abuse me on this subject and they would get a lecture on how you shouldn't believe everything that you read in your chip wrapper.

In reality meal-breaks won’t make much difference in responding to emergency calls, it just means that the ‘stubbed toe brigade’ will have to wait half an hour for their free taxi to hospital, while true emergency calls will be covered as well as they are at present.  Being able to have a protected break may also mean crews will  be refreshed, meaning that they will ‘green up’ that bit faster, improving our response to those genuine calls.

Everyone was ignoring the patient.

We'd picked her up after an episode of a recurrent illness, she was going to be fine but I felt sorry for her.  Hardly anyone was talking to her, they were all distracted by her partner.  I worried about how safe her partner would be in the back of our ambulance, it turned out that it wouldn’t be a problem.

When we got to the hospital the staff there were more concerned with the patient’s partner although she was a big hit with the department and she did cause a few organisational problems.  A few other patients looked a little worried by her presence.

It made me feel bad, I felt that the patient was being ignored a little with everyone paying full attention to her partner.  So I made sure that I talked to her, I’m guessing that although she was used to such reactions she would still feel upstaged.

“I bet you get ignored a lot when you are with her”, I asked our patient.

“Yes, but you have to get used to it”, she replied.

But why was all this attention being lavished on our patient’s partner?

Because our patient was blind and her partner was a guide dog.

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Sure, it’s an unusual thing to have to deal with a guide dog in an A&E department (although where I worked in A&E we had a ‘regular’), but it still surprised me that playing with the dog or talking about it seemed to be more important than putting the patient’s mind at ease.  Maybe it’s because I’ve got a mate who is registered blind, but it just seems rude to put all your attention on their dog, no matter how cute they are.

 

Blogging is a bit slow at the moment partly because I have nearly run out of interesting ambulance stories to write about.  I’m working on something (when I can motivate myself out of my current ‘funk’), that may mean more posting.  I believe that the best way to get out of a bad spell is to throw yourself into work…

Grief - a Saturday night alone on the FRU makes for a not very happy Tom.

So I'm just snuggling down for a little kip on station, it's about 3am in the morning and all seems quiet, the temperature outside is somewhere around freezing so laying on the sofa wrapped in my fleece is looking like a really good idea.

Obviously the activation phone decides to ring and I soon find myself speeding far out of my area to a 'life status questionable'.

His life status wasn't questionable, his sobriety was. One of our friends from Europe, he had been drinking and decided to have a sleep in the doorway of a shop. Granted if I hadn't gone and woken him up he may had frozen to death, as he was a nice enough bloke I couldn't be too angry. It also put me very close to 'The Log Cabin' which meant I could go and have a hot, filling 'Gob Job' before trying to catch forty winks.

Of course, halfway through the cooking of this gastronomic delight I get another job. I could tell what sort of job it was going to be - someone had dialled '999', said 'Hello', then hung up. For some reason (maybe one to ask Nee Naw), this was coded as another 'Life status questionable'.

"I'll be back in a minute", I said to the domestic goddess cooking my burger.

I dutifully screamed through the streets of Whipps Cross to find, to my utter surprise, an empty phone box.

"Hello Control", I called up on my radio, "I have a lack of any dead or dying people here, please cancel the ambulance, I'm calling it as a hoax".

It was then a quick drive back to collect and eat my burger.

The drive would have been quicker had some drunk not tried to jump into the car so I could, "just take me up the road". When I refused I was sworn at, but that didn't bother me much as I had a nice hot burger waiting for me.

The jobs I did that night were...

2 hoaxes
1 painful knee
1 hot child
1 drunk ...
and an alcoholic with liver failure.

This is not good when you need inspiration.

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.