It could be an interesting shift today.





Of course those might be my 'famous last words'...

I've just come back from a 'Maternataxi', and it always amuses me when I turn up 5 minutes after they have called for an ambulance. Then, when I knock on the door, they look out the window, take in the uniform, the ambulance parked outside, and the big bag of medical equipment and ask...

"Who is it?"

People must be bored today, because out of three jobs, two were to drug related cases.

The first was to a GP surgery, where a man with no shoes (just socks) had walked in and thrown himself on the floor. When I got there he wasn't making any sense at all, but when asked if he had taken an illegal drug, he answered me "Yes".

It is here I feel duty bound to inform you of an occupational hazard of the job - you may have heard about the health effects of shift work (gawd knows I've made enough of it so far on this very blog), you've heard about ambulance crews being assaulted, spat at and driven off the road. Without wanting to diminish the seriousness of these problems, there is one hazard that you are never prepared for...

...halitosis.

When I first walked in the room I thought that he had left a brown, sticky 'present' for me in his trousers, it was only when I got closer to examine and talk to him that I realised that the smell was his breath. He smelt as if he had been chewing on excrement.

I can still taste that smell, even a couple of hours after the job.

It also didn't help that I had to wait 35 minutes for the ambulance, not their fault, just that it has been rather busy today. Luckily the patient was stable, and content to lay there, groan and chase imaginary butterflies. My professional opinion was that he had taken either Ketamine, or GHB and was just starting to come round.

Although I did wonder why his trousers were around his ankles when he entered the GP surgery...

The next job was a drug related patient as well. One of our regulars who decided to smoke some heroin "...and something else" before going to pick up her Methadone. She had collapsed in the chemist shop, but by the time the ambulance and I got there (only five minutes) she had made a full recovery.

Patient was taken off to hospital for a check-up.

I wonder - does Methadone actually work? I hear a rumour (I must put it on Heardsaid at some point) that more people die on Methadone than they do on Heroin.

Something to look up when I get home.

I was a good boy yesterday - I got up at 9am, trundled around and went to bed at 10pm.

Then at 11pm something woke me up.

(Some utter, utter, utter, utter *CENSORED*, who thinks that honking his horn outside my flats at that time of night is a good idea)

Now I can't sleep.

It's now 2am, and I'm wide awake - with the prospect of a 12 hour shift starting at 6:30am. I know that I'm going to be feeling extremely grotty tomorrow, perhaps it is a good thing that I spend most of the time alone in the car.

An hour's sleep will completely refresh me for a short time, but I know I'll be paying for it later.

Right at this moment I just want to kill people. Painfully.

Still, I have taken the first step on "extending my brand", more details of which will be revealed later next week.

For those that are interested in what I would suggest as a replacement for Meetup.com, there is a Yahoo group for UK Bloggers.  You can find out more about it here http://groups.yahoo.com/group/ukbloggers-social/ , while the traffic is very light at the moment, I plan to use it to set up some London based meetings.

Thanks to Tom Morris, who reminded me of the mailing list.

I spent the day in the company of two of the nicest people I know Gary Turner and Suw Charman.  Food, coffee and excellent conversation were the order of the day.  Gary is incredibly creative, and five minutes with him makes me want to steal his ideas and set up a dot.com.  Meanwhile Suw’s career motivates me purely by making me jealous of her skill and success at writing.

The council have given me the address of the flat they want to move me to.  They haven’t gotten the keys yet (I think they are cleaning out the remains of the previous occupant) but a quick look on the outside doesn’t fill me with much hope for the size of the inside.  Still it is in a quiet area, although quite a way from the nearest tube.  When I get the keys and have a look around I’ll let you know what I think.

Back to work tomorrow (Wave if you see me sitting around Stratford), so possibly some ambulance stories…

As an addendum – if free “social networks” are being deserted by people in their droves, what special sort of insanity makes Meetup.com’s owners think that charging for a social network makes good financial sense? 

Unless they are relying on the technically un-savvy to not realise that there are better software solutions out there.

I suspect that banking on the stupidity of your clients is not a good business strategy.

Do I sound like Hugh?

I was going to go to bed, but then I foolishly thought to check my email, and came across an idea so stupid, and counterproductive I just know that it’ll rattle around my head making it impossible to go to sleep.  Sure I could blog about it in the morning, but I need to get this stuff out of my head now.

There is a website called Meetup.com that exists to bring hobbyist and other communities together.  You sign up to the groups that you are interested in, tell them where your location is, and it helps you organize real-life meetings.  I belong to a couple, and I run the London Bloggers group.  We meet up for drinks in a pub occasionally and have a chat.  All well and good.

But I got an email from them telling me that they are going to start charging the group organizers for the privilege of using the facilities on their website.  The cost (not that it matters) is either $19 or $9 per month depending on the type of group you have, and how rapidly you pay.  You can see their whole release here.

The facilities that the website offers are basically; a forum, a way to email people in your group and some tools to help you plan a place to hold your meetups.

Error number one on their part is that all this is available for free using different web-services.

The second error is that they are charging the organizers for this service.  This will drive people away – once you get people used to a free service it gets really hard to persuade them to stump up cash to continue getting the same things that they were getting for free a month ago.  Meetup.com relies on their organizers to arrange the meetings, all the company does is provide the (non-essential) tools to make this task easier.

Their third, and fatal error is thinking that this is the best way to raise funds.  Don’t they realise that they have an easily sorted demographic for advertising?  People put themselves into groups (bloggers, knitters, soccer fans, Mac users, doll collectors) and arrange when to meet up.  Doesn’t this just scream as a way to get perfectly targeted advertisements out to people?  You could even go to the meetings to demonstrate your products, spread word of mouth and just generally get your ideas out there to a select few who know how to use information technology.  If I wanted to sell my knitting patterns, I’d target the knitting group in the marketplace that I wanted to enter.

Not that I own any knitting patterns – it’s just an example…

So, I’m going to step down as organizer, and I doubt if anyone else will be interested in paying to step into my shoes – instead tomorrow I’ll set up an email list so that those who want to continue a social grouping can do so in a free environment.  If people want a forum, I can set that up too.  I’m just off to tell the group this before quitting the group and going to sleep.  Details for the list will be up here later today.

As you know, I am “Soft as soap” when it comes to animals.  So when a pigeon walks into the ambulance station looking for help with his broken wing, it’s me he comes to.

The diagnosis of a broken wing is fairly easy to come to, as the wound is visible.  Unfortunately in East London there are no emergency 24 hour vet clinics, so I phoned the RSPCA who sent someone to come and collect it.

I was promptly mocked by some of my station-mates, one particularly evil woman wanted to wring it’s neck, but she doesn’t think that birds and fish are animals.

While I know that the chances of the RSPCA putting the pigeon to sleep are high, the man who collected it told me that if the break is not too near the shoulder they’ll let it rest and heal.

Either way, it’ll mean that I can face myself in the mirror, and sleep tonight.

Someone who I would like to wring their neck, is the gang of children who thought that it would be entertaining to throw a brick at our ambulance station.  They managed to crack a window, which will need replacing – and it’s likely that they will get away with this mindless act of vandalism.

Unfortunately this sort of disrespect is all too common for the emergency services, it’s what leads people to think that it is clever to shoot at firemen with air rifles, attack ambulance staff and do unspeakable things to the police.

There I am, on the 8th floor of a block of flats, a mile or two away from one of the better hospitals in the country. I'm with a 69 year old female who has suddenly developed difficulty in breathing.

This is not the normal "I've had a cough for a bit" difficulty in breathing that I find myself at all the time - no, this women is seriously struggling.

Her pulse is 130 (Not Good), her breathing rate is 40 (Not Good), her oxygen levels when I walk in the room are at 86% (Really Not Good) and she is cold and sweaty (Also Not Good).

I give her oxygen which brings her oxygen levels up to a more respectable 95%, a quick listen to her chest reveals a wheeze and crepitus, so I give her some Salbutamol medication with the oxygen to open up her airways, and she tells me that this has brought some relief.

I'm not happy with the way she looks, nor with the way she is breathing, so I phone up the RRU desk, only to be told that there are no ambulances to send, as they are all busy, and actually they are holding calls all across the sector.

Holding calls means that people want an ambulance, but there is no ambulance to send

The patient is getting some relief from the medicine I've given her, but the proper place for her is a hospital. The way she is sweating suggests that her condition is not getting any better.

Then she tells me she wants to go to the toilet, to open her bowels.

It's now my turn to break out into a cold sweat - as an A&E nurse one of the things you very quickly realise is that when people are ill, and they open their bowels, they have a nasty habit of dropping dead.

I really didn't fancy trying to resuscitate her in the toilet, so I kept persuading her that she really didn't need to go to the toilet, and I kept willing the ambulance to turn up.

Finally, I glanced out of the window of the flat, down onto the street, where I saw the sweet, sweet sight of an ambulance pulling up.

Glancing at my watch I see that I have been waiting with the patient for 35 minutes. I'm unhappy because my patient had to wait so long to get the ambulance that she needed so she could go to hospital for some essential treatment. Then I realise that without me turning up she could have died.

So sometimes it feels nice to be needed, and it is nice to see the RRU doing something more useful than just making sure our response times are up to government standards.

Just one job, during a normal nightshift.

As tonight has been rather quiet for myself, with no jobs of any note, I thought I might tell a tale that fits in with the last post. Actually my memory of this story was jogged by one of the comments left there. So I apologise for misleading you when I said in my last post that it would be the last FBUA post.

When I was much younger than I am now, probably 16 or 17, I managed through a friend to get myself on a tour of the notorious medical museum at the Royal London Hospital. This museum is not open to the public, only to medical students - I was not supposed to be there. So I had to be sneaky and pretend that not only was I interested in medicine, but that I was a first year medical student.

I think it was the first time I ever wore a tie outside of school. At that point in my life I was convinced I was going to be a System Analyst, a career in medicine was the last thing on my mind.

I was in a small group, and somehow I managed to fit right in - I suppose I had an advantage in that while these proto-doctors had spent their school life studying hard, I had spent the same time trying to con my school-mates out of their pocket money. Sure they might have better exam results, but I was better at the sneaky stuff.

We were led around the museum by an old, but very entertaining professor, who told us the tales of every exhibit. Every so often he would ask one of us a medical question - somehow he asked me something that I knew, it was then I realised the power of "trivia", which has directed my learning ever since.

We passed from the malformed foetuses and the huge tumours in glass jars to that of the two exhibits that were perhaps the centerpiece of the museum, the skeletons of John Merrick "The Elephant Man", and that of a cleaner of the hospital who had such an interestingly extensive curvature of the spine she had agreed to donate her body to the museum.

But the exhibit that sticks most in my memory was that of a cross-section of an abdomen and chest, floating in preservative, which had a white pole going from the anus to the heart.

The story was that the 'specimen' had been a male who got excitement from hanging by his hands from an overhead loft hatch, then raising and lowering himself from the same, with a broom handle inserted up his anus.

All went well until one day when his hands slipped and he fell - the broom pierced his body, coming to rest in his heart. I believe that he was found, quite dead, by his wife...

For all I know, the exhibit is still there.

Right - that is definitely the last FBUA story until I next meet a patient with that 'complaint'. Honest