This is a post that I knew I'd be writing at some point, but it is also the post that I didn't want to write.

Last night, after a long battle with illness, one of our station crew died. He was 43.

We came into work this morning to hear the news, and even though it has been expected it still shocked us, a few eyes filled with tears, and the normal jovial attitude that we have has been dampened. Thankfully the day has been very busy, so we haven't had any chance to sit down and think about it.

We all knew that the end was near, we had seen him become progressively more unwell, every day we heard from visitors how his health was getting worse.

To their credit, the firm had helped him out as much as possible, they kept him employed until the very end of his life, so that his wife will get a full pension payout, rather than the much smaller amount she would get if they had passed him 'unfit'. In the last few weeks, when he was in hospital, our Control would let crews run over to the hospital to visit him, even letting us go 'off the road', to do so.

A while ago we had a benefit night, which raised a couple of thousand pounds for him, and just before his final stay in hospital, he and his family had a holiday, thanks to the LAS benevolent society.

We deal with death regularly, but it is very different when it is one of your own. I would imagine that we will get back to normal after the funeral, but until then the mood on station is one of quiet reflection.

We got called as a 'second crew' to an address. Sometimes, when a situation is beyond the capability of one crew to deal with, they will request another crew - normally this is because they have two patients, or the one patient that they have is too heavy for one crew to lift on their own.

We got the job as "female giving apple to 7 day old baby", which had us wondering...

As we turned up we saw the other ambulance and a police car, on entering the flat we saw two policemen standing in the corner, with a 5'2" female ambulance crew sitting on a young woman (Patient Number 1), her crewmate was dealing with a male who had a nasty bite on his arm (Patient Number 2). The police were talking between themselves deciding what to do, as we got a quick briefing from the crew who was sitting on the woman.

It turned out that the woman (who had a previous mental illness episode), had given birth by Cesarean section seven days earlier, and today had tried to feed the baby apple pie, she had then 'freaked' (note the professional medical terminology) shouting that the man wasn't her husband and had attacked him. The ambulance crew had been called and as they arrived the woman had sunk her teeth into her husband's arm. The crew had fought the woman to, ahem, disengage her teeth, and this is why they were sitting on her. The police had been called, but were reluctant to do anything (I got the impression that they were a rather crap pair of coppers) and the second crew (us) had been called to deal with the husband (with new teeth-mark wound) and baby.

This woman was (brace yourself for more medical terms) 'completely bonkers', she had the rolling eyes, the delusional thoughts and the inability to communicate that separates the mildly strange from those who need immediate medication. It was actually quite sad to see this family come apart at the seams, the husband was shell-shocked, the wife was completely detached from reality and the police weren't being very helpful (which is unusual).

We got the husband and baby out of the house and into the back of our ambulance, and then returned to see the police (finally) manhandling the woman out of the house, and into the back of the first ambulance. She was securely strapped down (although we don't have restraints and so she could have easily gotten free if she so desired), and we had to lend the first crew a belt-strap as the one on their trolley was broken. The first crew then forewarned the hospital about what they were bringing in (violent schizophrenic female) and we all set off for the hospital.

We got there first and advised the nurse in charge that this was a 'real' warning, and that security guards would be needed, along with the private 'psychiatric' room. It took her twenty minutes to arrange both, while the ambulance took less than five minutes to get to the hospital. So while the secure room and security was being arranged this very disturbed woman was laying on the ambulance trolley...Not a good situation, and it made the job a lot harder than it should have been.

The husband was completely stunned, he had no idea how to look after a baby and quite simple couldn't cope. Social services were informed, and the child was admitted to the paediatric ward for a while, until the husband could be taught how to look after a baby. The woman was sent to the local psychiatric unit for assessment and treatment, hopefully this is a temporary condition brought on by childbirth (Puerperal psychosis). The husband had his wound treated, and was sent home.

Oh, and the baby is a hermaphrodite.

This is a new category where I'll stick little things that amuse me about the Ambulance Service, and the people that I treat

It amuses me that according to our dispatch system (thanks to the government) that a 18 month old child with a runny nose is of a higher priority than a 50 year old stroke.

You may remember that I've mentioned before how working day shifts are different from night shifts, in the way that I meet less drunks, and more people who may actually be ill.

Yesterday I did three jobs. "only three jobs?" I hear you ask, well it's only because of much faffing around trying to find an ambulance that not only worked, but was also stocked with some of the essential kit that we need (you know, stuff like defibulators, blood pressure machines, bandages - essential stuff like that).

So the first job of the day was a woman suffering from morning sickness, her nausea prevented her from walking or talking, in fact all she suceeded in doing was to annoy my crewmate and myself... Her 'constant vomiting' consisted of her spitting into a bowl. I don't begrudge her an ambulance, but she just couldn't get her head around the idea that lying on the floor groaning wasn't helping us get her onto the ambulance.

Then we went to a drunk, who had 'collapsed' in the street. Damn those good Samaritans who call ambulances for drunks who are having a kip after a bit of a drinking session. No problem, although she was incontinent and so smelt a bit, and piddled on the floor of the ambulance. We had to return to the ambulance station to mop out the back of the ambulance, and enjoy a cup of tea.

Our third job of the day was something that we are seeing more and more of recently - an alcoholic had been kicked out of his hostel, so he had an 'epileptic fit' on the doorstep of the hostel. Police were called to remove him, but because the hostel thought they were taking too long, they also decided to call for an ambulance. We are being called to remove more and more people being thrown out of hostels, often the reason is given as "abdominal pain", but when we turn up the 'patient' is making no such complaint.
This particular fellow was (surprise) drunk, and with my practiced eye I saw a kitchen knife sticking out of his back pocket - which using my finely tuned pickpocket skills, was soon in my possession and was handed to the police who were now on scene. There was a bit of a stand-off, but the police didn't want to arrest him because, well frankly, he smelt very bad. So we found ourselves removing the 'patient' to hospital, there was no reason for him to go to hospital, but where else could we have taken him? We aren't really allowed to take people to the homeless persons unit - but it is just a bit down the road from the hospital, so we managed to get him a bit closer to the help he needed (if only geographically).

A crew has just gone out to a job that was described on the mobile terminal in the ambulance as, "Patient confused, pulling out knives, 'going off her rocker', cannot get anymore sense from caller". What an exciting life we lead...

You voted for it...Which makes me worry a little about the type of people you are...

I think I've mentioned on more than one occasion how, when working in a hospital, the patients are often nicely 'packaged' ready for examination, this can often hide the trauma that the ambulance crew has gone through in getting the patient into hospital in such a condition.

Me and a temporary crewmate got called to a 'collapse', and we made good time getting there to be met by relatives of a 72 year old female who had vomited altered blood (probably from a stomach ulcer) and had collapsed to the ground hyperventilating. The woman was around 20 stone in weight (280 pounds to the Americans in the audience). She was in a bungalow, so we had no stairs to get in our way, and the relatives were willing to be helpful. The patient was laying on the floor and had just finished an episode of hyperventilation (a panic attack).
Should have been a nice easy removal, even with the patients weight and reduced ability to walk. We had our carry chair and after struggling a little to get the patient on it, we didn't expect any trouble.

Heh....

It turns out that the patient was an agoraphobic and hadn't left her house in 20 years...

Sweating profusely, the patient fought us the entire way out of the house, she grabbed at anything tied down, at door-frames and at the handrail she had installed in her house. Trying to get a sweaty 20st patient out of a house is tough enough without them fighting you the whole way.
We had explained that she needed to go to hospital - and she had logically agreed, but this didn't stop her panicking when we started to move her. When we finally managed to get her into the open air her panic rose to a dangerous level.

She was shaking, her eyes rolled back into her skull, sweat was pouring off of her and her thrashing about in the carry-chair got worse (if such a thing was possible). Both my crewmate and myself thought that she was going to have a heart attack, in fact she had all the classic symptoms of a massive Myocardial Infarction (posh medical term for a heart attack). Then she started a strange screaming/moaning call that sounded completely unearthly. I could just see the next days newspaper headline, "Ambulance Crew Scare Patient To Death!"

All I could think about was to try and calm her down, so I tried using some hypnosis techniques that I (just happen) to know, which helped a little - but by then she was in such an agitated state that horse tranquillisers probably wouldn't have touched her.

We managed to get her into the ambulance, where we shut the doors very quickly and made as smooth a transport to hospital as possible. During the transport my crewmate and the patients family worked constantly to calm the patient down, but they were only having a fairly limited success; every so often I would hear her moan in that alien fashion, and my crewmate start babbling at her to calm down.

When we got to the hospital, we nearly threw her off the ambulance into the A&E department; actually she was so slicked with sweat we could have slid her off the trolley. She calmed down a bit once she was in hospital, which only made our exhausted faces seem over-dramatic to the nursing staff.

You never know what you are going to get in this job, but nine times out of ten it isn't the illness that surprises you, but the circumstances around the job.

Other blogs do it, and because I have so many stories (hopefully good stories) saved up from last week, I'm going to have a little 'vote in'.
From the (cryptic?) article descriptions below, choose your favourite and leave a comment as to which one you would like to hear about first - I'll count up any/all votes to decide which entry to write next.

a) Bruised genitals in a 20 month child? More forms are needed.
b) How to nearly kill someone getting them out of their house.
c) Good press in the local paper (crew who are soft as soap).
d) Bored with the death of babies.
e) Bus on Bus action & Camouflage RTA.
f) Police check before hospital? & Baby in a bottle.
g) Please come to hospital.

I've just noticed...none of these are particularly life-affirming. Oh well, maybe I'll come across something nice tonight...

Imagine I'm working Monday, Tuesday, Wednesday and Thursday nights - I'll then have Friday, Saturday and Sunday off until I start day shifts on the following Monday. Excellent you may think, three days off. But, dear reader, this is not the case - for a start my Thursday night shift finishes on Friday morning, and moreover I need to shift my body-clock back over to 'daylight time' ready for my next run of shifts.
There are a couple of ways to do this, one way is to use chemical assistance, either stimulants to remain awake all Friday then sleep normally Friday night, or sedatives to sleep on Friday afternoon all the way through to Saturday morning. I've tried it, and chemicals are not good for me - Stimulant drinks drive me psychotic, and sedatives just don't work for some reason.
So the other option is to go 'natural'. I stay awake on Friday, with the exception of a one hours nap during the afternoon, then sleep normally on Friday night, waking up (hopefully) refreshed on a Saturday morning. Problem? Well it makes you feel as sick as a dog throughout the day. I also find myself rather 'emotional' during that time, I'll find myself crying over crap TV movies, pieces of music or even the odd book, earlier this week I told you about me crying over an RSPCA ad, that is exactly what I mean. I'm not normally fragile - but a lack of sleep does unhinge me a bit.
I try and do things during the day, sure I could sit on the computer killing evil aliens, or chasing villains online, but I'll try to do something more constructive. Normally I'll find myself paying credit card bills, standing in the queue for a cashier, having mild hallucinations, feeling sick and wondering who exactly drained the colour and joy from the world.

Then in a week or two, I get to do it all over again.

(I finish my lates on Sunday night/Monday morning, and from Wednesday I'm on seven day shifts, so further posts will be on more 'normal' subjects).

Sleep becomes very important to you, actually it becomes the most important thing in your life for a while. You become obsessed about getting enough sleep, about getting the right quality of sleep, and about your neighbours deciding that today is the day they are going to drill 1000 holes in the wall separating their home from your bedroom.
You need thick curtains, especially when it is summer - you need to keep light out. Trying to sleep when it is light, or even worse, during a heatwave is incredibly difficult. Luckily for me we tend not to have heatwaves in London, actually we don't have much light either.
Good sleep is essential - and interrupted sleep can turn you into a homicidal maniac. The times my telephone has woken me up only to be met with a recorded telesales message is beyond a joke. One day I will hunt them all down and stab them in the eyes with a sharpened pencil - I think my defence of justifiable homicide would work so long as the jurors are fellow
shift workers. If some tinker wants to ring my doorbell to try and sell me a carpet and gives me a dirty look when, bleary-eyed, I open the door at 1pm in pyjamas - then I think my ever-so-slightly sharp tone might be excused.