I've just come from a call to one of my semi-regulars. He's alcoholic, has a stomach ulcer, and is as thin as a rake. He is sitting in a filthy kitchen surrounded by empty bottles of cheap booze.

He's 26 years old.

His friend, of the same age, is also an alcoholic. He has pancreatitis.

Asked if they want to try a rehab programme, I was told that they weren't interested.

I've got to confess, it made me angry. Two lives being washed away with bottles of cheap cider.

"So you want to die?", I asked.

They didn't have an answer.

Now I just want to hit something.

Congratulations to Kate, who was on the same training course as me, for being featured in the Independant on Sunday about what she is doing on Christmas day, and what she will be eating. (Crisps, sandwiches and a bit of fruit for those that are interested). She mentions that her Christmas dinner will be warmed up in the microwave.

Sad bit though is that she won't see her young children until much later in the day.

We get little thanks for our job, so I hereby command you, my little cult of adoring readers, to find your local ambulance station and take them something nice to eat. Packets of crisps are nice, as are boxes of chocolates. Nibbly things are good too, as they can sit on a table and be snacked on should we ever get back to station. I'm sure lots of people like mince pies.

Do the same for the Police as well.

I wouldn't worry about the Fire service though - they have lovely big kitchens and nothing to do all day...

Go forth, and spread joy to those poor bastard ambulance/police people working on Christmas.

Disclaimer: I'm working Christmas day. But I always do, not having kids and being a Godless Heathen.

The past couple of nights I've gone to calls that I've wanted to grab some parents and shake some common sense into them. Instead I have to be polite, if only for the quiet life.

Apologies - Judgemental post ahoy!

"Madam", I hear myself say, "the reason that your four children have asthma may well have something to do with the four packs of cigarettes I see sitting on the sofa. When you were at the ante natal classes, and they told you the effects of smoking on your children, did you think that they just liked to hear the sound of their own voices? Or, did you in an uncharacteristic spark of intelligence, think that they may just be the agents of some vast conspiracy financed by the companies who make nicotine patches?".

"You might also consider that the reason all your children have runny noses, is because smoking makes them less likely to fight off respiratory infections. You might not know this, but asthma kills people, and that includes your children. You are condemming them to a shortened life of ill health and hospital visits, all so that you can feed your oral fixation."

To other parents I might say...

"So, when you got an electric shock from the uninsulated wire poking from that hole in the wall, you didn't think of...I don't know...lets say protecting your children by having it fixed? Sure it might cost you a bit of money, but at least your toddler wouldn't now be in hospital to make sure that being electrocuted by mains electricity didn't do any permanent harm".

"I like that toy", I'd say to another mother of two, "I particularly like the little bite-sized bits of plastic that are strewn over the floor, yes I understand that your oldest child is a mite untidy, but when your 18 month old is choking to death on a toy soldier, you might consider it too late to tidy up. I know it's hard to teach six year olds to clean up after themselves, especially one who seems to be happier peeling your wallpaper off the wall while you shout at him to 'stop fuckin' doin' that!'. Perhaps you might try a different approach? In answer to your question, no you can't smoke in the back of the ambulance".

To one angry parent I might say...

"So your baby stopped breathing for five minutes? And I took over half an hour to come? Well, I'd like to show you the time you called, and how it took me only two minutes to get here, but I think the computer display in my car might confuse you. Besides, I'm not delivering your pizza, you don't get your money back if I'm longer than thirty minutes. Still, back to the baby - she's breathing alright now, perhaps I could interest you in employment in the ambulance service, as you seem to have a Christ-like ability to get children breathing again. Oh, sorry, baby is a 'he' not a 'she'? Sorry, I was confused at the two hoop earrings, the three necklaces, and the rings, all at under six months. Why stop there? Maybe they would like their belly button pierced as well? Still I suppose 'Shayne' is a manly name, funny way of spelling it though. Never mind, we're off to hospital now, don't forget your fags".

And don't forget those who may have strange priorities...

"JESUS CHRIST! Aren't the six foot Santa's and inflatable snowmen supposed to be outside the house? I thought I was going to get mugged by a madman in red. Nice television though, if you could just turn the volume down a little so I can hear what you are saying to me. Yes Tyler is an adorable eight year old, even if he did injure himself smashing his neighbour's windows. Why, might I ask are his hands that colour? Ah, how silly of me, paint from his self expression in the fine art of graffiti. Did you consider a taxi to take you the 400 yards to hospital. You can't afford one? Ever think of selling the TV? Or maybe the Santa?. Yes, yes, you can bring your cigarettes".

And breathe...and relax...

It was supposed to end at the first paragraph, but I just kept rolling. Oops.

I find it funny that a lot of the blogs that I read are 'winding down' a little for Christmas, either reducing posts, or taking a complete holiday. Me...I'm just getting busier and busier. Good job I'm a faithless Heathen.

When I'm at a 'job'. I don't panic, it's part of my job description to keep control of a situation and to stop other people from running around screaming like a headless chickens. Sometimes I will have to be forceful, or act quickly, but I never panic.

I got a job, '14 month child, floppy and lifeless'.

"Fuck", I thought.

It was in a part of my patch I'm not very familiar with, new buildings on the isle of dogs. The address was given as 'Flat 1, Rose house, Starling road'.

This is obviously not the address I was given, I do respect patient confidentiality after all

I rushed to Starling road, a new estate, loads of buildings, none of which seemed to be marked.

"Fuck", I thought.

If a child is floppy or lifeless, then the chances are it is either very ill, or is dead.

I sped up and down the road. I spotted some of the names of the flats in tiny writing, on little blue plaques many of them pointing away from the road. My pulse started to rise. It had taken me four minutes to reach the area, but how much longer would it take me to locate the potentially very sick child?

I found 'Lilac House', 'Lily House' and 'Tulip House', but I couldn't find 'Rose House'.

Now I was starting to panic. Was I being stupid? Had I driven past it? Was the baby dead, and if it was, was it because I couldn't find the fucking house?

I could feel the sweat soaking my back, without being able to get to the patient there was nothing I could do. I cursed the council, the builders, the architects, everyone who had thought that putting pretty, but bloody useless signs on the buildings was a good idea.

I got Control to ring the parents back, the mother came out to meet me. 'Rose House' was behind another block of flats, behind a road barrier. The name plaque had text around an inch high, pointing away from the road.

Luckily the baby only had a runny nose.

I hated it though, the utter feeling of helplessness that comes with being unable to find a patient, the sweating, the raised pulse and the vaguely sick feeling in the bottom of the stomach as you race up and down a street in the dark trying to find the right location.

Please. If any architects, builders, council planners or sign writers read this, make the signs bigger. Make them so I can read them at night. Make them so that if it is your relative that is critically ill, I can find them before it's too late.



Only 3,960 jobs today...

4,200 calls last night compared to our more normal 3,600. Yes, we were busy, and in a surprising turn-about almost all of my jobs were genuine, 'I need an ambulance' type affairs.Between midnight and six am we had 1,000 calls.At least I have things to write about for the next 10 or twelve days...

It's the busiest night of the year for us, as evryone goes out and gets drunk at their work Christmas party. I don't know what's going on at the moment, but it's barely 21:00 and already we are at 3,500+ calls.

We normally do 3,500 calls in a day, so how many more will we squeeze in over the next three hours?

My first job was to and alcoholic having had a fit. A common symptom of being an alcoholic is having fits, I'd say that of the two types of fits that we go to, I tend to see more alcoholic fits, that epileptic fits. I don't have any numbers to prove it, but it just seems right in my experience.

This job was typical. I had to step over the detritus on the carpet, the packets of tobacco, the trainers, the half eaten takeaway container. I saw my patient sitting on a chair, being sick. He was vomiting directly onto the living room floor, his wife didn't see fit to put a bucket under the stream of vomit.

Lovely.

Like a lot of our regular alcoholic customers, he was topless, while his tracksuit bottoms were stained with...well I wouldn't like to guess, but they were stained with something. Homemade tattoos covered his chest, arms and hands, and inbetween bouts of vomiting he would continue making a roll-up cigarette.

"Can I turn the living room light on?", I asked the wife.

"Don't work", she said back to me in a voice that I guessed had been arguing with her husband just before I'd arrived.

I guessed this because she then started arguing with him again.

While the living room had a nice stereo, a reasonable televison (satellite included) and a gaming console, they didn't have a lightbulb.

He didn't want to go to hospital, but I always think of the potential headlines in the paper the next day "Ambulance leave patient to die", so the crew and I persuaded him to go to hospital for a 'check up'.

You know why? No one ever lost their job by taking a patient to hospital.

"I don't want to waste their time", he mumbled, "I'm just an alcoholic".

"It's alright mate", I'd reply, "We look after everyone, even alcoholics".

I’ve been nominated for two awards in the 2005 Medgadget Medical Blog awards.  Go figure.  So the other nominees in the Literary award decided that we should all write something interesting.  My arm was twisted and I agreed.  We were given the first section of the story, and had to continue it in under 999 words, and had to contain at least one lyric from a Christmas song.

I wrote my story, counted my words and found that I’d brought the word count up to 1,425.  A bit too long.  So what you see here is the edited version.  I’ll stick my first draft in the comments of this post.

Other nominees, who will probably show me up for the hack I am can be found at Barbados Butterfly, Bloodletting, The Cheerful Oncologist, The Examining Room Of Dr Charles, Simonscapes and Intueri.

And no, I have no idea what I’m doing in a Literary award either.

——–

It was a dark and stormy night.

 

I struck the match and the flame burst into bright orange-blue life. It danced on the end of the matchstick as it neared the ragged edge of the cigarette dangling between my chapped lips. Soon, the smoke that lazily trailed from the glowing end of the cancer stick filled the entire elevator. My fingers plucked it from my mouth and I exhaled, mindlessly watching the plume of wispy grey ash travel towards the cylindrical fluorescent bulb that poured antiseptic yellow light onto us.

 

The elevator ungracefully jolted to a halt and the doors swished open. The man with a goatee in a long white coat and black patent leather shoes shot me a dirty look as he stepped off.

 

“We’re in an elevator in a hospital,” he derisively muttered, enunciating “hospital” as if he was introducing a new word into my vocabulary. “What kind of idiot smokes in the hospital?”

 

The elevator doors swished shut, but not before he noticed the solitary third finger of my right hand poised in the air. At him.

 

He looked offended. I didn’t care.

 

The elevator lurched back into motion as I chuckled to myself. His expression was certainly more amusing than the duties that awaited me.

Reluctant to acknowledge that I was near my destination, my tired fingers apathetically dropped the cigarette and I watched the sole of my left shoe squash it, along with its orange flame.

 

The elevators doors swished open. I then looked up.

 

Before me was one of those hospital signs, arrows pointing in different directions, leading the sick, the dying and the hopeful to their often final places of rest.  Turning left I stalked towards the intensive care unit.

 

My quarry had led me on a merry dance this year, I'd chased him through Tokyo, but he'd given me the slip in the Odaiba district.  I'd traced him to Toronto where I saw him descending in a glass lift, unfortunately I was rising in the adjacent lift.

 

I’d finally nailed him tonight in New York.  I’d hit him with the car I was driving, but the crowd of people who appeared seemingly from nowhere stopped me from finishing the job.  He was wounded, probably soon to be dead, but I needed to be sure.

 

So I found myself in the hospital, charming the receptionist into telling me that their only trauma case was indeed still alive, and had been taken to intensive care.  It was nearly midnight, so gaining access to ITU would be a little trickier than I would have hoped.  Sometimes my job is just an absolute nightmare, I mean, what kind of psycho enjoys killing things?  Still it would be nice if just for once my target didn't make such a fuss.  That’s the problem, none of them want to 'go gentle into that good night'.  But they all die, eventually.

 

I pushed open the door to the ITU, ignoring the 'All visitors must remove their coats' sign with '...even doctors' scrawled underneath it.  The lights were dim, and I could see two people in scrubs sitting at the nurses station, faces cast in sickly screen from the numerous monitors positioned there.  Somewhere a radio quietly droned, "Silent night, Holy night. All was still, all was quiet...".

 

"Detective Alan Trophos", I whispered putting on my best 'I'm the authority figure here' expression, "I understand you have a patient hit by a car tonight?".

 

"Bed four", replied the plump woman reading a frayed paperback book, "but he's sedated and intubated, you won't be able to talk to him".

 

"The body", I replied with a grin, "can give evidence without speaking".  I lifted up what I hoped looked like the sort of suitcase that detectives use to gather forensic evidence. 

 

"I'll just need a few moments alone with him.  Nail scrapings, that sort of thing", I smiled what I hoped was my best attempt at flirting.

 

"Go right ahead", the other woman said, "He won't mind, and he'll probably be dead by tomorrow".

 

I crept past the two women, the ITU seemed to inspire me into the same silent reverence that churches do.  The desire to speak only in a whisper and to walk softly was a strong one.  I pulled the curtains around bed floor and finally took a long look at my quarry.  I pulled over a plastic chair and took hold of his hand.

 

"I know you can't hear me", I whispered, barely above the sound of the machine that was breathing for him, "but I'm hoping you can <i>feel</i> me".

 

Was that a flicker under the taped closed eyes?

 

"Your time is limited", I continued, "we can't leave you floating around like a loose end.  You are put here to do your job, and then leave.  Much like me".

 

The machine kept up the steady rhythm, breathing in, breathing out, keeping the oxygen passing into the lungs, keeping the body alive.

 

"That's why they have me, someone to make sure that you don't run on past your time.  In a year I'll come for your successor, and the year after, and the year after that, as I have since they started worshipping you".

 

I turned off the monitoring machine, I didn't need any alarms going off.

 

"Imagine what would happen if the Spirit of Christmas continued throughout the year?  Imagine humans being nice to each other all year round?  The Gods of Strife would have a fit.  A couple of days a year, that’s the deal".

 

I slipped the dagger under his breastbone into the heart.

 

"I wish that goodwill for all men could last forever, but that's not what The Rules say".

 

I felt for a pulse, so weak...

 

The pulse stopped.

 

Suddenly the tinsel around the bed seemed to lose the glitter, the radio started playing an R&B number, and far away I heard a clock strike midnight.  Midnight of Christmas day.

 

Christmas was over.

 

——–

Yes, I know, I’m sorry, but I don’t ‘do’ fiction.

“Warning : Assailant may still be on scene, wait for police” had apparently flashed up on my computer screen.  Unfortunately it had done so silently, so the first I saw it I was pulling up outside the house.  Luckily, I was pulling up to the house which had the police car outside it.

I entered a house that was full of four generations of Bangladeshi people who were mainly shouting at each other and the two beleaguered police officers.  Quite rightly so I thought, as I looked at the fifteen your old boy i had been called to treat.  He had been hit around the head with a metal bar.  Thankfully his injuries were fairly minor, although there was a possibility that he had broken his elbow.

Unfortunately this was one of those nights where ambulances were a bit thin on the ground, so I was waiting for sometime.  At least this meant I was able to get the reasoning behind what had been happening.

There were two families, one with a daughter, the other had a son (my patient).  He had apparently offered her a place to sleep after she had been in an argument with her family.  This had then turned into a feud that had dragged on via school bullying.  The police had just told everyone present that they would be going around the other family’s house to arrest people when the father of this family turned up.

To say there was a lot of shouting would be an understatement.  There was also a procession of stern young men into the garden for a bit of a war council, mobile phones clamped to ears as they called in reinforcements.  The atmosphere was getting a trifle warm for my liking.

Luckily the police were able to calm the situation down somewhat, a bit tricky when the father was shouting about how he was going to burn the other family’s house down if they didn’t do anything.  Meanwhile large numbers of youths were appearing and disappearing into the night.  I thought that there was a real chance for things to turn nasty.

“Sir”, said one of the policemen, “I don’t wish to insult, or cause offence, but normally with this kind of trouble it is one cultural group against another, but in this case both parties are Bangladeshi.  Could you explain that to me?”

One of the calmer young men replied, “That’s how it used to be, now everyone is fighting everyone else, and race don’t matter”.

By now I had the real impression of angry villagers with pitchforks and flaming torches gathering, thankfully I was rescued by both police backup and an ambulance to take the injured party away to hospital.

“Control”, I called up on my radio, “Just to make you aware, if there is any assaults in this part of my patch, don’t let crews go in without police escort, because it might kick of big time”.

“Roger that EC50, I’ll make a note”.

I don’t think that there was any trouble that night, but it is a little hard to lynch someone if you’ve been arrested…

No time for a ‘proper’ post until perhaps the small hours of the morning.  (A question, how is it possible that my body clock is on ‘normal’ hours, and then decides to screw it all up by sleeping for 15 hours straight?)

So until then I give you the gift of a slideshow of transparent computer screens.