I'd never been to the patient before although the person I was working with told me that the household was a regular place to visit. Two people lived there, an elderly man and his wife. He has diabetes and leg ulcers and finds it hard to get around the house due to Parkinson's disease. His wife has quite far reaching dementia although she is physically fitter than her husband.

Social carers come around a couple of times a day.

Apparently the normal calls to this house are for him feeling unwell with his diabetes or for her hurting herself moving around the house.

We arrived on blue lights as the morning carer had called us and told us that the husband had collapsed.

He was beyond 'collapsed', he was lying on his back in the living room, his trousers around his ankles and his entire body was shaking. When I tried talking to him all I could get out of him was incomprehensible grunts and groans. When I tried to touch him he would become combative and try to push me away.

I looked around, the carer had vanished. Unfortunately this isn't unusual and to be honest they often aren't missed.

My first thought was that he had a low blood sugar - a nice easy job, give him some sugar and wait for his gratitude as we 'cure' him.

His blood sugar was within normal limits. This wasn't going to be as simple a job as I'd hoped for.

I did a full examination and there was nothing that would suggest the reason for his collapse or for his confusion. Every time I tried to do something to him whether trying to examine or dress him he would try to strike me, so my examination wasn't perhaps the best.

His wife was alternating between pacing and sitting talking about shoes - thankfully she wasn't distressed. Actually she was quite cheery, I guess that she is used to us folk, dressed all in green, coming into her house and making things better. There was no way that we could leave her at home while we took her husband to hospital, she would have to come as well.

We made the decision that we wouldn't be able to look after both of them, I would have my hands full with my patient and there was no way that I could also keep her out of trouble. My crewmate called up Control and asked for another ambulance to take our patient's wife into hospital.

The second crew soon arrived and took control of the wife while I and my crewmate got our patient onto the trolley. Once we got him onto the back of the ambulance he immediately settled down, it was as if someone had flipped a switch in his brain. We went from wanting to 'blue light' him into hospital with me holding him down to being able to drive normally into hospital while I had a friendly chat with him.

So once more we left the patient at the hospital - the nurses there would also have to look after his wife while they investigated why he had become confused and collapsed. At the end of my shift the hospital's theory was that he had suffered a 'Transient Ischaemic Attack' or 'mini-stroke' which had resolved on it's own.

And they did take good care of his wife.

My knee still aches but I'm not as reliant on the cane, hopefully it'll soon be good enough to return to work.