It's a couple of minutes before we officially start our shift when Control phone us and ask us to go on an 'early job'. It's a cardiac arrest so we agree and jump into the ambulance.

Two FRU are already there, we are met at the door by a very calm looking elderly lady.

"He's upstairs, so are the paramedics. I'm sorry I shut the door, I didn't know anyone else was coming".

From upstairs I can hear the bump, bump, bump of the patient's head hitting the floor as one of the FRU drivers is doing CPR.

I bound up the stairs and ask the other FRU, who is currently intubating the patient, what he wants me to do.

I can hear my crewmate talking to the wife downstairs, getting a history. The FRU has finished intubating the patient so I put a pillow under the patient's head to stop the banging.

We settle into the familiar rhythm, IV access, drugs every three minutes, constant CPR, check the heart rhythm, check the pulse, repeat from start.

It's obvious that we aren't going to get him back, so I take the time to talk to the wife.

"Your husband's heart has stopped", I explain, "We are doing everything that we can for him and we need to make a decision now. Do we take him to hospital, or do we continue here and stop if there is no chance of getting him back. We are doing everything that the hospital would do for him".

"What would you like us to do?", I ask her.

And she replies, and my heart just breaks, right there on the spot.

"Well, we are both in our eighties - so we have spoken about this before especially after his heart attack. It's not a surprise and I know that he's going to stay dead. I think it's best if you continue here and stop when you think it's right".

She calmly stands there watching us working on her husband until we get a rhythm change and are forced to take him to hospital. While my colleagues work on the patient I offer to take the wife to the hospital in one of the FRUs.

I help her tidy up the bedroom, we make a mess when we are running a resus. Packaging everywhere, bloody needles*, discarded equipment. She offers to help me tidy up and gets a plastic bag for me to put the rubbish in.

Still she remains calm.

Her son arrives to take her to the hospital - he is also calm and thanks me for my help.

Driving the FRU to to hospital my eyes are damp as I think of the complete acceptance of this sudden death. The British reserve, the "we'd spoken about it in the past", the quiet thanking of everything we'd done.

Death and bad news affects everyone differently, so cry, some beat their chests, some get angry. But this quiet acceptance is one of the saddest responses I've ever seen.

*None of us had a sharps box as we'd run out on this job before we had a chance to check our motors.

Twelve Hours Ago - Cup of tea, drunk in two halves with a job in-between.

Eleven Hours Ago - Big Mac, Fillet of fish burger, medium fries.

Work without a break.

Twenty minutes from now - Pizza.

Two Hours from now - Sleep.

Nine Hours from now - Wake up and head into work again.

A very quick blogpost and you may see why once you finish reading it...

05:25 - Wake up, stumble out of bed, shave and get my clothes on.
06:45 - Arrive at work, find there is no milk, so no cup of tea.
07:00 - Discover that there are no adult oxygen masks on the ambulance or in stock.
07:03 - First job.
Job
Job
Job
Job
11:28 - First (and only) cup of tea of the day.
Job
Job
Job
etc...
18:35 - Miles from home we get our last job.
19:09 - We finally manage to get the heavy immobile (but very nice) patient into the ambulance.
19:20 - We reach the patient's hospital, miles from station.
19:40 - I find a nurse to hand over to, our patient is likely to be on our trolley for a few hours - I point out his high risk of developing pressure sores.
19:50 - Another crew come up with a cunning plan to get us away, Control agree to it.
19:55 - We start to head home.
20:17 - We arrive back on station, knackered. Due back in work in 10 hours, 15 minutes. Not counting commuting.
20:45 - Make it home - I'm too tired to cook, yet heroically managed to blog.

Oh well, at least I have a 'not a blogmeet' to look forward to with the lovely Gordon McLean. Then the day after that...ahem. A week in Florida as paid for by my lovely mum and brother.

Yeah - I'm looking forward to a week in some sort of sunshine.

A murder investigation is under way in east London after a man found stabbed in the street died in hospital.

Smack bang in the middle of my patch, yet strangely I still feel safe walking around those same streets in uniform, or in civvies.

There is a good chance that one of my mates went on that call. No doubt I'll learn the full story tomorrow - and obviously won't be able to blog about it.

Ergh. I shouldn't have drunk the wine last night. That and a too warm room has left me feeling rather grotty.

Never mind! I get to command the attention of a room full of people later today, maybe point out a few things. Who knows.

Yesterday I managed to speak to the Director General of the NHS workforce, the woman who is ultimately my boss. How could I let such an opportunity slip?

I told her that the reason that a lot of NHS staff are unhappy is because of having to chase targets, and that these targets are often clinically pointless. That because of resources being directed to hit these targets patient care is suffering and that, no matter how cynical we might be, ultimately we get annoyed when we can't give the care we would like to.

She appeared to pay attention and jotted a few things down in a notebook, although obviously I'm not hugely hopeful - she has her bosses to report to as well.

In about two hours I'll get to hear Nick Clegg talk about mental health. Perhaps I'll collar him and let him know the truth about the out of hours provision, or rather lack thereof...

Then I get my chance to present something which, contrary to tradition, starts with an insult rather than a joke. I'm not quite sure where to go after insulting everyone, but I've got two hours to work it out.

So far everyone I've met has been really nice and the Guardian are looking after me very well (as an aside, is it Guardian policy to only employ women who are lovely?) Last night during dinner I shared a table with someone who works in the cabinet office, a PR person, one of the bosses of the Guardian, someone who works with an advisory charity and Tim Campbell (and yes, I was the only person who didn't know who he was). Despite moving in these lofty circles I still found everyone to be very personable and had a nice chat with them over a very tasty dinner.

Right - time for me to get ready to hit some politicians and planners with the big stick of truth. That or stand up and make a prat of myself by not using words such as 'dynamic' or 'engage'.

One of our 'frequent flyers' died a little while ago. I realise that I haven't really written much about the people who keep calling us, our 'regular customers'.

Some are a real annoyance, others have a little smile hitting your lips when you realise that you are going to see them again. Some have medical problems, some have mental health problems. Some have, what our psychologically trained colleagues, untreatable borderline personality disorders. Many are alcoholics, or drug users.

Some become the stuff of legend, a tale to scare the new recruits with.

Freda was one of the nice ones. An elderly couple, she lived with her husband, both of them had long-standing medical problems. They looked after each other. When one of them was poorly, the other would do their best to help them before calling us out.

Freda was a diabetic, and a poorly controlled one at that. Her husband would call us out when her blood sugar dropped too low. We'd arrive to find her on the sofa, or in bed, snoring away and deeply unconscious.

"Normally I give her jam and bread", her husband would say, "but she's too far gone this time".

It's a simple job, jab her with an injection of Glucagon, wait a couple of minutes while making sure that her airway was clear, and she'd wake up and be surprised to see us standing over her.

"Did I go low again?", she'd ask, "I'm so sorry to be a nuisance".

But she wasn't a nuisance, sure we'd grumble if it was 4 a.m. in the morning, but once you arrived the thanks you'd get from the pair of them more than made up for any disturbed nap.

But now she's dead, killed in a way that could cause any of us, young or old, fit or unhealthy, to die.

I'm not sure if her husband will still live in the same house, I don't know if we'll get called back there, maybe he'll move to a warden controlled flat.

It's hard to think of him without his beloved Freda, it's hard for me to think that we'll never go there again - and leave her sitting up in bed, smiling and tucking into a jam sandwich.

So, after missing Saturday night because of a lack of boots (since resolved by me buying my own pair and the LAS promising to repay me), I finally returned to work and did a full shift.

The first thing to do is to catch up with your crewmate. She tells me about being the responder to the man who was killed by his dog. She tells me about the patient who went into cardiac arrest in the back of the ambulance. She tells me that she has had to use her extended skills more times in the past two weeks than in all the time we've been together.

It's obvious that I'm the one cursing us with non-sick patients.

As mentioned previously the first patient was a five year old with chickenpox, the mother wanted her to go to hospital and we can't refuse.

Then a patient with a mild, but long term medical problem who wanted to go to hospital.

Then a belly-ache that got better if you kept talking to the patient. Strange job because they had gone to the neighbour's house to call an ambulance. That they both looked like drug users is probably just my suspicious mind getting the better of me.

Then a maternity patient who couldn't get to her booked 'birthing centre' because no-one would pick up the phone. By the time we'd got the woman to the hospital the midwives there had managed to get in touch with the birthing centre. The birthing centre would accept the woman.

"How will I get there?", asked the patient.
"Oh", replied the midwife, "the ambulance will take you".

The midwife seemed most upset when we told her that we were for emergencies only, and that she'd have to book an ambulance just like any other hospital transfer. You'd think that they'd know better...

Then a child with a high temperature that we left at home according to the mother's wishes. She, as a lot of people want us to do, just wanted her son 'checked out'. So we do our 'mobile GP' bit and hope that the child doesn't drop dead.

A few more simple little jobs of similar seriousness - no need to carry anyone, no need to do anything other than chat to the patient and record the basic observations.

The final job was a 'frequent flyer' who I haven't seen for two years, but has apparently moved back into the area and is calling for an ambulance twice a day at least.

Oh well, nature abhors a vacuum and given the recent deaths of two of our frequent callers, it was obvious that someone would pop up to fill the gap.

So it was a nice easy night to ease me back into the swing of things. The only problem is that my foot is still as injured as it was before I went sick - but I'm getting an occupational health appointment, and it's with our new private contractors. I should give them a fair shake of the stick, but they must be cheaper than the old occupation health lot who were all NHS.

Anyhow - I'm now 23.5 hours without sleep and my brain is dripping out my ears. Perhaps something more lucid tomorrow.