The black dog has risen it's ugly head and coupled with a sore throat and abdominal pain, my muse appears to have buggered off to Spain for the weekend - so I bring you a post that has been sitting in my 'potential post' file for some time. I wrote this when I was still on an ambulance, as opposed to the RRU I'm currently on.

...

We got called to a "Female - epileptic fit" in the street - this was a call that was sent to us by the police. Now, I may be accused of being overly cynical, but when the police call us to an "epileptic fit", it is normally because they are arresting someone, and in order to avoid going to the police station the person fakes a fit. There are ways and means of detecting when this is the case, some of which I have mentioned previously. Even though this was the likely explanation for this job, we still rushed down there, fully prepared for it to be genuine.

We turned up to see a car being towed away, and the police that met us had a slight smirk about them, it's the finely tuned sixth sense I have that made me suspect that the police were hiding something from me. We were led to the patient, who was laying in a darkened alleyway, with her boyfriend standing over her.

As is my normal approach, I said something along the lines of "Hello love, can you open your eyes for me", I brushed the thick, long hair from out of her eyes, and, being unable to see the patient properly pulled out my torch and shone it in her face. At first I thought it was just a very unattractive woman, then I brushed the hair back a bit further and that caused the wig to slip...

This female was born a man.

Now, I have no problem with transsexuals. I know a couple in a social situation, and apart from the time I caught one of them going to the bathroom in pink dressing gown and pink bunny slippers, their gender doesn't pay any part in what I think of them (as with gay men, I just think, "Great! More women for me!", of course it doesn't work out like that, but I live in hope).

The hardest bit is working out wether to call the patient 'he' or 'she'. So I asked the boyfriend.

It looked as if the patient had had a genuine epileptic fit, and so we got her onto the ambulance, and started our treatment. I managed to get a lot of the details off of her boyfriend. We got her into hospital, where we found out that she was not unknown to the hospital. By now she was starting to come around.

As she, and the boyfriend didn't live in the area that we found them in, I asked what she was doing there - apparently, she had parked the car on the estate, then someone had stolen the keys. Given what she was wearing (pink furry moon-boots, tight leather miniskirt, tight pink top, and a leather/furry frock jacket), and what I saw when I peeked at her previous medical historyt - I wonder if she was one of those 'ladies of the night' that we often drive past.

I mean, most of them look a bit rough, but having been born a man might explain a lot...

It is the time of year when I find myself asking the same question to people who I find collapsed.

'Are you fasting?'

For it is currently Ramadan, when observant Muslims fast during the hours of daylight. We have a lot of Muslims in Newham.

But it is not just people with low blood sugar that are affected by the fasting.

My brother has two men at his work who are fasting at the moment. They are currently in real pain from their stomach ulcers. While we spend some hours asleep without eating, our stomachs are less active at that time. If you are fasting while awake, then you are being bombarded with the sights and smells of food, and your stomach responds appropriately.

So fasting is not just a simple matter of being hungry.

Some Muslims are exempt from fasting, most notably those who are pregnant or diabetic. But not everyone takes advantage of this exemption, so for example the baby we recently delivered on a kitchen floor was born to a mother who was fasting.

So far, I've not had a fainter due to fasting, but with around 20 days left to Ramadan, I'm expecting at least one.

I only tend to see the bad nursing homes. I'm not talking about nursing homes where the patients are abused in the traditional sense, but rather where they seem to have simply been... left.

I went to one the other day, run by a large prestigious private healthcare company, it is clean and looks very pretty. But I'd rather die than spend my final days there.

The patient was 90+ years old and had been bleeding from her vagina since 9am that morning. I was called at 11am. They had left her bleeding for three hours.

I met her laying on a towel on a plastic bed, there was no sheet, and the only bedclothes she had was a single sheet across her body.

Her room was clean, but was empty of anything personal - there were no pictures, no letters, no ornaments. Nothing.

I looked at her drug chart. She was on two types of painkiller, but for the past five days, those, and her other medications were marked as having been 'spat out'. I'm guessing that this was because of her advanced dementia, rather than an informed refusal.

If she was spitting out her medicines, I wonder if she was also spitting out her food and drink. There was a bottle of drink next to her bed, but there was no way that she would be able to reach it. Looking at her skin, she did look dehydrated.

The 'nurses' all walked with the speed of arthritic turtles, and I had to struggle to find one that knew anything about the previous visit the patient had made to the hospital. Actually I struggled to find a nurse that knew much about anything.

'I don't know this drug', I said to one of the nurses testing her, 'what is it for?'

I knew what the drug was for, but the nurse didn't...

One of the care assistants sat on the end of the patient's bed. The patient seemed a bit distressed at this, but it was hard to tell as she was staring at the ceiling. The carer suddenly got off the bed, and this obviously caused the patient pain as she cried out.

The care assistant left the room, and I was left trying to comfort the patient, holding her hand and apologising.

I wondered what this woman had seen, what she had lived through. I could imagine her dancing in the 1930's, being married and having children (her daughter was on the way to the hospital already), raising her children while living through the war, maybe working as part of the Land Army. I thought about her husband, probably long dead, and the friends she had also probably outlived.

It always depresses me to think that some people end up in homes like this, where the care is slipshod, and her life is now just an accumulation of numerous small acts of omission.

So it seems that many of you are either very clever, or have been reading this blog for a long time.

Yesterday was incredibly busy, there were a lot of ambulances off the road because there was not enough staff to man them, and there were only two RRUs in the area. One of which was me, and so I was being run from one side of my patch to the other all day. I don't mind driving miles, as it's always entertaining to race through the streets on blue lights.

My last job was a maternataxi in one of the 'less exclusive' parts of town, my patch touches on both the highest and lowest income areas in London. This place was within sight of where multi-billion pound deals are made.

It was a small flat, and the family were about to prepare to break the Ramadan fast. The young patient was having contraction pains, and her waters had just broken. She was being looked after by her neighbour, and on immediate inspection there was nothing much to worry about.

'Hmmm', I thought, 'She's pretty close to giving birth though'.

Contractions were about two minutes apart, and were lasting one minute each. Still, at least she didn't have the urge to push.

Time passed...

No ambulance arrived.

More time passed...

Still no ambulance.

I phoned up my Control.

'Hi there, EC50 here on a labour. If there is a truck on the way, they might want to bring the carry chair with them', I was up in the clouds in a block of flats, so I didn't want to have them running down to get the chair when the mother was getting close to that 'I can't walk' moment.

The patient groaned and said something in her own language.

'She wants to push', translated the neighbour, but looking at the patient I didn't need that translation.

'I think we'd be better off in the bedroom...', I suggested.

But the patient didn't want to struggle up the stairs.

Now my job changed from reassuring the patient, to reassuring the patient that, should it come to it, having a baby at home wasn't going to be a problem, especially because the kitchen was fairly clean*. I mean, a kitchen is much easier than the back of a car, at night, with no streetlights.

I really wanted to examine the patient to see how near the birth was - but I'm always a bit respectful that Muslim women don't particularly want me poking around in their nether regions. If the ambulance didn't arrive soon though, I'd have no choice.

The ambulance arrived.

Luckily one of the crew was female, and so I told them what was happening, and that the female crewmember might want to have a little look at what was happening before we tried moving her out of the labyrinth of a tower block we were in.

Us men left the room. Then we heard her say that the baby was 'crowning'. Birth was going to be a few minutes away.

I opened the maternity pack that I always bring with me on calls like this, and we laid the patient down on the kitchen floor. I phoned for a midwife, while the ambulance crew delivered the baby.

They made much less of a mess than I normally do.

A perfectly happy, healthy baby girl, a happy mother, a happy neighbour and an even happier aunt.

From waters breaking to delivery in under 45 minutes. Not too shabby.

The midwife was delivered by another ambulance (traveling on a flat tyre for the last part of the journey) and I left them to check out both the baby and mother, and to deal with the delivery of the placenta. I was no longer needed.


* Cleaner than my kitchen anyway.

The back of a car down an unlit street at night.

In student digs.

In a ‘troubled teenagers’ hostel.

On the sofa in a block of flats.

In the back of an ambulance.

And now today – on a kitchen floor…

Can you guess what all these things have in common?

Answer in around 24 hours.

I was in tears last night watching the news about the earthquake victims, it's hard to imagine over 20,000 people dead and at least 46,000 people injured. I know that I would rather be out there helping people who really need help, rather than running around after people who have had a cold for the last three days...

Newham has a large Pakistani/Indian population, and I would suspect that nearly every family will have been touched by this disaster. The fasting of Ramadan (which is going on right now) is supposed to remind Muslims of those worse off than themselves - something I don't think they'll have much trouble with right now.

You can donate money to the Red Cross appeal, I have, have you?

Jeannie has now safely been packed off to Bath for the next couple of days until her return flight to Seattle.  It’s been an interesting couple of days being a tourist in my own town.  I’m hoping that I was a good enough host for Jeannie – living on my own I may have lost some of those essential social skills…

But I would just like to point out that this is my blog, and that when I ask a question I would like you to all agree with me thankyouverymuch.  I’d just like to state that I’ve learned a new definition for the word ‘sizing’, and that I’ve never had any problems with sleeping on unwashed new pillow cases.

To be honest, I reckon that my face contains more nasty stuff than any new bit of linen, and is as tough as old leather.

Back to reality/work in twenty two hours…

The answer to the previous post, barring any more moblogging bugger-ups...

Guess where we are...

I have several brand new pillow cases.

Jeannie wants to wash these *clean* pillow cases before they get used.

I think she is mad, she believes herself sane.

Votes in the comments please.

Feel free to vindicate my assessment of her mental health.

It’s strange, but given the amount of times that I’m in the Docklands area (normally picking up twenty-something traders with cocaine induced cardiac problems), I’ve never come across this rather astounding sculpture.

I think it is made from bedstead wires.

I would also suggest that everybody reading this should take a day out to play tourist in your own hometown.

Did you know that it is an impossibility for an American tourist to cross the Tower of London bridge at night in under an hour.  I think Jeannie managed to fill up the majority of her 1GB camera memory card with pictures of the tower, or corners of buildings.

London is lovely by night, so we did my favourite walk, which is along the South bank.

Today we attack Camden market…

I expect to spend most of today standing around waiting for Jeannie to finish trying on rings, while holding her coat.