Yesterday I had two jobs that were both dealing with someone who wasn't physically ill, but were driven to illness by their emotional state - and if they could swap places they would both be much happier.

First was 'Betty', Betty is 92 and lives in a nursing home where she feels tired and generally depressed. She wants nothing more than to go home and live independently - but her needs have been assessed and she requires nursing home care. Because of her depression she has been refusing to eat or drink and the nursing staff at the home have eventually realised that this is not good for Betty's health - so we are called and Betty is sent to hospital - all Betty wanted to tell me is that she wanted to go home as she doesn't like the nursing home.

Our next job was for 'Gladys', Gladys is 95 and lives on her own, she is partially blind, a bit deaf and craves company, because of her sight she cannot read or watch television. We were called because Gladys was having chest pain, and Gladys told me that her chest pain stops when she talks to someone and has something else to concentrate on. She was very happy when we told her that she was going to hospital, and I had a good chat with her in the back of the ambulance during which her pain disappeared, and she explained how lonely she is.

I don't know if it's because I'm tired or because the weather is bad - but I felt a great deal of sympathy for both of these patients, neither of them were happy, yet after 90 years of life shouldn't we have at least some small measure of contentment? One is surrounded by nurses, who see her as another body, few of which are of Betty's culture and she desires a more independent life. The other is isolated in her home, desperate for some human contact, whose only friend is the schizophrenic who lives next door - she would be happiest where there are other people around.

If I had a magic wand to wave, I'd swap these two women and give them, in their twilight years, a chance to be happy again.

That my trauma shears...



...have seen more 'action' wedging open the security doors to nursing homes, than they have actually cutting clothing from trauma victims.

Sometimes they are used to cut off the clothing of drunks pretending to be unconscious.

One of the jobs that we find ourselves going on (perhaps once or twice a day) is that of vaginal bleeding, in a woman who is around eight weeks pregnant. This invariably turns out being a miscarriage. Unfortunately it is normal, for foetuses which have no chance of developing into a full term baby, that the body 'rejects' the foetus. I would suppose that this stops a woman from carrying to term an infant which would not survive outside the womb.
While dealing with such patients (some of which have been trying to get pregnant for some time), I always try to be sympathetic, and explain that what is happening is not anyones 'fault', and that it is a normal happening.
Due to the amount of people who we have with this problem, and the rate at which hospitals deal with them (when working in A&E we would have about 12-18 cases of this every day) we have all become a little blasé about this. We feel some sympathy, but deep down in our hearts, we know that there is nothing we can do, and that it is a good thing that this is happening now, rather than in six months time. But none the less, we are worn down by the sheer numbers, and at the end of the day we stop caring that these women are losing babies.

I have no intention of getting into the whole abortion argument, I've seen them done, don't like them and would rather have the whole thing stay out of my worldview

I first thought that it was just me, and that as a male I wasn't best placed to pass comment - but after having a chat with some female colleagues, it seems that they feel the same way I do, that it is natural, and that it isn't worth worrying about.

But it worries me a little that I seem to have come to care so little for the little dead babies.

I got assaulted yesterday, which made me smile...

We got called to "Male collapsed outside park", which immediately set my 'drunk-o-detector' bleeping. This is the sort of call that is nine times out of ten, a drunk who has decided to have a sleep in a public place as opposed to going home. In a case like this we tend to wake them up, and get them to move on before another 'good samaritan' calls us out again.

We woke him up, so he stood up and started moaning that we had woken him up. Both my crewmate and myself we actually being quite nice towards him - mainly because it was towards the end of our shift and being nasty to people takes energy that we just didn't have.

Then he decided to take a swing at my crewmate - he then decided to have a swing at me, the next thing that I knew, I had him in an armlock up against the side of the ambulance. My mate called on the radio for urgent police assistance, and the radio controller asked if we were both alright, to which my crewmate replied "I'm alright, but my crewmate is restraining him".

The police were quick to turn up, and I had just enough time to tell them that he was drunk and had taken a swing at us before he was under arrest and carted off to the local police station. It was then I realised that he had managed to hit me in the chest, right where I've got a broken rib. It was a bit painful. It had already gotten a whack from a heavy trolley yesterday, so I'm wondering if it will ever manage to heal.

I can tell you what went through my mind as I was pinning him to the ambulance; the first thing was "Oops, I hope I haven't overeacted", the next thing (about five seconds later) was, "By the time I return to station and fill in the 'incident form' my shift will be over...Result!". I'd imagine that, by the speed that the police arrested him, that they were close to the end of their shift as well.

I'm just waiting for a team leader to read the incident form and call me into the office to ask if I need counselling...

Every day is an education for me,every day I learn more and more about my fellow man. These are some things I learned yesterday...

If I ask if someone has taken painkillers for their period pain, I should expect them to say 'no', instead I should expect them to tell me they have taken some vitamins.

Members of the public think that someone who has their eyes closed is 'unconscious', if they are talking while their eyes are closed, they are still 'unconscious'.

Patients will only be incontinent of urine if I have to lift them and I've forgotten to put on gloves.

Patients under the age of twenty have names which sound normal but are spelt strangely - e.g. 'Caryl', 'Krystyl', 'Madyline' and 'Bryon'.

If you have a serious medical emergency, or are over the age of 80, you will wait 6 hours before calling an ambulance. If you are under 40 then the longest you will wait with a minor injury is 2 minutes.

Having a sore ankle for 8 days gives you 'severe difficulty in breathing'. Grunting in pain is the same thing as 'severe difficulty in breathing'.

Patients who speak no English will not need hospital, just information. Neither you, nor your crewmate will speak the same language as the patient.

Pain in the bladder always seems to equate to 'Chest pain'.

When trying to sneak into a bank to pay a bill, the importance of the bill that needs paying is directly proportional to how many people need an ambulance during the hours of 9-5.

Infections do not disappear after taking one antibiotic tablet.

Running with a stretcher into a kerb so that it smashes into my chest is really; painful. So painful it can break a rib...

Just because a patient has an airway inserted at hospital, it doesn't mean the hospital has put in the right airway.

If I want to get out of work quickly, then the last job of the shift will be miles away, and will go to a hospital even further away. Traffic will be bad.

Like an idiot, I've taken on the role of group manager for the London web-loggers Meetup.com group. If you are a London blogger, or someone who would like to be a London blogger come along, sign up and say 'hi' to folks. There is also a forum which could prove handy...

The 'mini-blogmeet' I had recently went well, more people turned up than I was expecting, including Colin (who's link I've lost), Pixeldiva, Mozrat, and Stroppycow (who will not post any pictures of me if she knows what is good for her).

Then people from my 'real' life turned up, which was more than a little weird as in my head I have all the people I know grouped into 'Blog friends', 'Real-life friends' and 'Work friends', and it was more than a bit jarring to have these two separate groups meet up in one place. Still fun was (I think) had by all, I remained sober enough to walk, and no-one starting fighting...

So this is why I'm taking on the role of group manager - because blogmeets are a great place to make more friends, build contacts and generally relax with people who share a shared interest in blogging.

More articles in the Grand Rounds of the medical Blogsphere can be found on Galen's blog. I've got to say, some of those articles are excellent.

You really don't want to park your motor like that... Luckily both members of the crew were unhurt. Current info is that they were running on blue lights to a call, when a car in front decided to overtake another vehicle that had seen the ambulance and had (correctly) pulled over to the side of the road.
From Big White Taxi Service forums.

And in a multimedia frenzy, you can read about how a dog led nightly escapes at Battersea Dogs home, and can even watch a video of him doing it.

It's been busy today, extremely busy, so busy we didn't even manage to wave at the ambulance station as we whizzed past it to (yet another) bellyache. What makes this worse is that they are 12 hour shifts, and I'm working four of them. 7am until 7pm is a long time, you tend to get some of the busiest times of the day (pub kicking out time is perhaps a shade more busy), and there is plenty of work even if you remove the inter-hospital transfers that we find ourselves doing.

When you get a 'late job' and end up returning to station at the end of a shift late by half an hour, it is really rather disheartening to realise that you are closer to the start of your next shift than you are the beginning of the shift you are finishing.

By the time you factor in travel to and from work, you realise that you have two hours of 'free time' for that day, and that you are going to 'lather, rinse, repeat' the whole thing tomorrow... Is it any wonder it's hard to keep relationships going when they see you for less than two hours a day (and less than that if they don't live with you).

So today - because it rained, we had two people who slipped and fell; neither of which were seriously hurt. There were two people with abdominal pain (at least one of these were constipated), one little old lady with a urine infection, one transfer of an inpatient to another hospital so that they could have dialysis. Another patient had been mugged, but was essentially unharmed (we were called by worried police officers), one more had a cough while another was a 75 year old who was hyperventilating (and didn't speak English, so I couldn't calm him down). Our final job (which made us late) was a known depressive, who had told her psychiatric nurse that she was going to kill herself - which she wasn't going to do, but had managed to lock herself in her flat...

A busy day, especially when I've had the week off. Hopefully it will be a little quieter tomorrow.