Because this sort of thing happens.

And because I noticed it because Rachel 'twittered' it.

(Yes - I'm paying a bit more attention to my other blog now - there may be reasons behind this...)

We were met downstairs by a young man.

"I think she's passed away - but I couldn't bring myself to tell her mother. She's old. I thought I better call an ambulance".

We had been called to a forty year old woman - 'Drunk - ?Passed'.

I was met at the flat door by a woman in her seventies. She didn't seem distressed as she led us into the living room. Everywhere I looked there was evidence of her daughter's alcoholism. The flat was cramped and squalid. Her mother had been visiting her.

Her daughter was obviously dead, her skin was yellow and waxy, and she was in full rigor mortis. It was obvious that she had been dead for some time.

I had to tell the seemingly oblivious mother that her daughter had died.

I sat her down and explained that her daughter had passed away some hours ago and that there was nothing that we could do to help her.

I braced for tears, or a scream, or an "I thought so".

The mother didn't cry, she didn't scream, she just sat there and whispered a quiet, "oh".

The daughter had come out of her bedroom the night before and told her mother that she didn't feel too well and had laid on the sofa. Her mother had fallen asleep in the armchair. When the mother woke up she couldn't wake up her daughter.

She'd then sat with her for at least six hours before knocking on the neighbour's door to see if he could wake her up.

Talking to the mother it was obvious that she was suffering from early dementia. I'm not sure if she secretly knew that her daughter was dead, but wasn't letting herself accept it.

It was strange - no tears were shed, but several times we were treated to the mother's life story.

We had to stay around for a few hours with the police because there was a chance that the death may have been suspicious, although it was more likely to be natural causes.*

It was saddening to see the mother wandering around, her dead daughter laying on the sofa covered only with a sheet just a few feet away. Talking to her about the changes that the area has gone through, about her dead twin and about her other daughter.

Had she sat alone with the body for so long because she couldn't face up to the truth, or did she really not realise what had happened? Either was possible, and I'm not sure which one gives most comfort.

It's the sort of job that will stick with you for some time.

*There are legal and confidentiality reasons why I'm not mentioning the full details of this job.

This evening I shall be at the London CC Salon having a chat with Becky Hogge of the Open Rights Group. I'll mainly be talking about the reasons why I chose to release my book under a Creative Commons license. It should be good fun and I'm looking forward to hearing some of the other people there.

I like Dr. Crippen, I think that he writes well and with passion about the NHS. He also hates Patricia Hewitt. So he isn't all bad.

But there are two things that do annoy me somewhat about him. I thought it was only one, but I have since discovered a new annoyance.

The new annoyance would be an ad hominem attack on another blogger criticising their spelling and grammar. Disagree with the persons views, but to moan about grammar in a blogpost is the province of the forum troll, not that of reasoned debate.

And to quote,

Please feel free to criticise me in any way you like. I have but one request. Your spelling, your use of commas and apostrophes and your general grammar are embarrassing. All doctors have passed “O” level or GCSE English. Could I suggest you get one of them to glance at your copy before you publish?

Two small points - do all doctors pass "O" Level or GCSE English? Even our foreign doctors, including the ones who do not speak enough English to call for an ambulance or have not been properly tested? Secondly, there is a reason why the handwriting of doctors is traditionally seen as poor, and that is because it often is. I write my notes in the back of a moving vehicle and I would be hard-pressed to obfuscate the meaning as easily as your average doctor can.

But the one thing that I have the most problem with is the "I met a bad example of this profession, therefore all member of this profession are idiots". Take for example his recent post on grief that his partner got from an ambulance worker. When someone posts a comment that perhaps some GPs don't have much of a clue what they are doing he tells us that we shouldn't engage in 'playground insults'. Which I believe translates into "I can see more clearly than you, I am more intelligent, you are foolish and how dare you disagree with me". Or rather a shouted "Am not!"

He then goes on to call one of his commenters a fuckwit. Which obviously elevates the conversation above playground insults. He then says in reply to the 'fuckwit' commenter that he never used the phrase 'Ambulance driver'. For your entertainment I present a short excerpt,

Only yesterday we had trouble with an ambulance crew. My partner had assessed a patient, discussed him with the hospital physicians, arranged an admission and called an ambulance. The ambulance driver arrived, carried out his mickey mouse medical "assessment" and then told my partner, in front of the patient, that he did not see why an admission was necessary.

I may have accidentally bolded a word or two in that quote. I did resist putting <sic> by the uncapitalised 'Mickey Mouse'

There is a reason why ambulance crews do what they do, for most of us it is for an easy life. If we do as we are told to do then we won't get the sack, as we cost less to train than a doctor it is very much cheaper and easier for us to be sacked. A doctor has 8+ years of training to stand up in front of a coroner and explain why the patient's blood pressure wasn't measured - we ambulance crews don't.

The seeming belief that Dr. Crippen has is that the best nurse practitioner in the world is far worse than the most idiotic doctor. This is something that I do not agree with.

Take today for example, I went to a GP referral where the patient was sitting in the surgery waiting room. She was to see the psychiatrist at the local hospital. The doctor had written a letter explaining that the patient had a bottle of water with many pills dissolved in it. The patient had not only fainted in the consultation, but has also been allowed to keep the bottle. When I got her in the ambulance and took the bottle from her (handed to me when I asked for it) she told me that she had drunk half of it before entering the surgery.

The GP had taken no vital signs, had left the bottle in the patients possession and had written a referral letter that neglected to mention the faint.

If the doctor had told me that taking her observations was a waste of time and that I shouldn't bother, or that my 'Mickey Mouse' assessment of asking the patient if she had drunk from her overdose bottle would be a waste of time. If the patient died in the hospital from the unknown overdose, then you can imagine that the coroner would have some severe words for me and the LAS would probably sack me for negligence.

Finally on this post,

Ambulance crews are valuable, and have an important role at the scene of road traffic accidents but, in the domestic environment, when the problems are medical rather than truamatological, they often apply inappropriate protocols to problems they do not understand.

Which would be why GPs in my area refuse to see patients and instead tell them to 'just call for an ambulance', and this for obviously non-emergency reasons. It would also be why I have seen GPs doing CPR on patients who are feigning a fit. Why I have seen GPs taking brittle ninety year old asthmatics off oxygen because they need the examining room to see the child with a nappy rash. It's also why I've seen GPs sending people with a pulse rate of 220 walking home to wait for the ambulance and also sitting heart attack patients on the brick wall outside their surgery.

And another example from today - GPs who are unable to refer a patient to hospital in the correct manner (writing a little letter and phoning the hospital) rather than just dialling 999 and running out the house. I like Drs letters, they tell me what is wrong with the patient as I assume that they know a lot more about medicine than I do.

Uh-oh, I think I just descended into that 'playground insult' game...

There are idiots at all levels of the NHS and while the fight against the dumbing down of the NHS is an admirable one, we should perhaps stop making such sweeping generalisations.

We should concentrate more on white elephants similar to the one that he mentions in this post. And that is why I keep reading his site, because when he isn't being a arrogant twit he is being absolutely right.

I’m feeling really disconnected – I shouldn’t do, I have a metric ton of computers in my flat, even a few old laptops…

But without my Macbook which I’d set up ‘just right’, along with all my emaail settings and the like I feel like I’m missing an arm.  I think that it’s because my desktop needs me to sacrifice a small animal before it’ll start up…

What I would like to know though is why it takes ‘7–10 days’ to fix a problem which I could fix in forty minutes if I had the parts.

This is why blogging has been slight of late, and why I’ve been pretty much unable to answer any emails.

But…

There is superb news, both from my publisher.  Firstly my publisher Clare Christian won ‘Best Young Publisher’ and secondly I’ve sold the rights to my book to various people – which is fun.

Clare writes about the award here (where you can see my gap-toothed smile); and about the rights stuff here.

I've spent all day clearing my Inbox of unreplied to emails - If I ever let it get like that again, somebody shoot me. If you have been expecting an email from me and didn't get a reply, then I send my apologies and advise you to resend your email.

For those that are interested about joining the London ambulance service... We aren't recruiting. Sorry.

In a fit of 'doing things', I've signed up on Livejournal, Facebook and Myspace. I'll happily accept 'friends' from anywhere, but I would ask that you tell me a little about yourself - there is a bit more on this over here. I'm still playing around with them, as well as wondering what kind of content to put up on there, chances are that they will remain mostly unused or used for small dumps of writing.

Additionally loads of people read my Twitter feed - I'd be interested in finding out who all you lot are as well... I like finding out about people who know me because of this site.

Tomorrow is Laura's audition for X-Factor at Arsenal, I'll be with her and I may post up some pictures somewhere.

I'm curious, are there any people who work with leather reading this blog? How about blacksmiths? Preferably within a couple of hours drive of London - it's for an article that I'd like to write.

Further non-ambulance blithering will be on Mental Kipple, which I have been shamefully neglecting.

Finally two nice ambulance links sent to me by readers-

A lovely written article about the Yorkshire ambulance service following the 'Tonight' programme. (Thanks Clive).

Then a story about a 'patient' who would have suffered from a broken nose had I been sent to him. (Thanks Matt)

So it's not just St Georges day today - it is also International Pixel-Stained Technopeasants Day, go and have a look for lots of crunchy free stuff. I've included my own stuff. By coincidence I only signed up to Livejournal today.

Tip of the hat to Warren Ellis.

It's just over a week til the Open Rights Group's Support ORG (and Party!) event, at which there will be public domain DJs, free culture goodie bags and the chance to win some really cool schwag. Our special guest speaker is the wonderful Danny O'Brien, who is always fantastic value for money and well worth coming along to see. So, if that sounds like fun, come along - it's free! Well... it's sort of free - we just ask that you bring someone who might like to become a new ORG supporter.

If you can't make it, then you can still support ORG by buying a raffle ticket for just £2.50 (link to PayPal is at the bottom of that page). Prizes up for grabs include:

* a signed copy of Code 2.0 from Lawrence Lessig
* £150 in O’Reilly book vouchers
* a signed copy of the Gowers Review of Intellectual Property from Andrew Gowers
* a signed copy of Bruce Schneier's Beyond Fear
* a set of a dozen Beatpick compilations
* a signed author's galley of Cory Doctorow's next novel, Little Brother and the opportunity to be written into it
* ... and the pièce de résistance, as far as I am concerned - a 'very battered keyboard with a key missing and everything!', signed by our Patron, Neil Gaiman.

Many thanks to everyone who has donated! Buy your tickets on the night, or online via PayPal. At £2.50 each, they're a snip!

(Nicked from Suw's Blog)

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