This is a tricky post to write. Normally I would write something to emphasis how I feel, or to try and get my readers to understand what happened, or to highlight some point.

But I can't do that in this post.

All I can do right now is tell you what happened.

I got sent to a call near the edge of my 'patch', given to me as a "12 year old female, collapse". The navigation point wasn't accurate though, so while I could get into the right general area, it wasn't directing me right to the door. I got there fairly fast, because I always drive fast to my jobs, even if I suspect that the illness is a panic attack, a faint, or a broken fingernail.

I met up with the ambulance crew coming from the other direction while I was checking my map, and talking to Control so as to get a better location on the patient. Control called back and gave me better directions - I told the ambulance crew to follow me.

The location was down a private road, which had huge, unmarked black speedbumps. I hit the first one at about 30mph, and had to check my mirror to make sure that I hadn't left important parts of my vehicle left behind in the road.

The patient was lying in the road ahead of me, with her family standing around her - I parked my car next to her, and got out to see what was happening.

The family were quite calm, and they told me that their daughter was travelling in the family car, told her parents that she felt unwell - so they stopped, she got out, shook a bit and then fell onto the floor.

The parents had laid her into the recovery position, and while worried, weren't screaming and crying.

Examining the patient, I saw there was a small bit of vomit in her mouth.

She then grunted.

I then saw that she had stopped breathing.

I am lucky that the ambulance was right behind me.

By now the medic on the ambulance was with me, and I told him that she had stopped breathing. I threw him my bag with the ambu-bag in it (the bit of kit which we use to breathe for the patient), and while he started breathing for her, I cut off her clothes and connected our defibrillator.

She was in fine VF, which is a rhythm that is 'incompatible for life', meaning that her heart isn't pumping blood around her body. It is also a rhythm that we can 'shock' to try and bring her back.

I shocked her.

The monitor on the defibrillator showed Asystole, which is where the heart isn't moving at all - but this can be 'normal' after giving a shock.

It was about now that the parents realised that their daughter was iller than they thought. They asked us what was happening - all we could tell them was that their daughter was 'very ill'. You can't tell people that their daughter is dead while you are in the middle of the road, in case they mob you and the patient, and prevent you from doing your job.

By now I was doing CPR (pumping on her chest to keep the blood circulating), and she had vomited a large amount everywhere. Normally we care about getting vomit on our clothes - but in this case we weren't thinking of that.

By now the driver of the ambulance had gotten the trolley off the back of the ambulance, so we decided to 'load and go', this girl needed to be in hospital as quickly as possible.

Her heart changed into fine VF again - so I shocked her another two times - once more she was in Asystole.

We loaded the trolley onto the tail-lift of the ambulance - and it wouldn't lift.

We gave everything a kick (because there is sometimes a loose connection) and it still wouldn't lift, so I ran around and got the handle that we use to manually raise the lift - but then the tail-lift started up.

We got the patient, and the father on board the ambulance, I jumped on to continue chest compressions, while the medic was trying to clear the airway and continue breathing for her.

The driver then put in a priority call to the nearest hospital, and started driving.

We sometimes drive fast in this job, but if there is one thing that will have us driving like a maniac it's for a nearly dead child.

While weaving our way through traffic and high speed I was keeping up the chest compressions while telling her father what we were doing.

It is hard to stand up in the back of a Mercedes Sprinter when weaving through traffic at high speed, and it is really hard to do so when some idiot in front of you decides to brake suddenly.

The vehicle lurched, there was swearing from our driver, and I grabbed a handrail. It was then I felt something 'go' in my wrist and hip.

We reached the hospital in one piece, and a nurse took care of the father, while we wheeled the patient into the resus room, where a team of specialists were waiting for us.

The good thing about the local hospital is that they let the parents watch the resus attempt if they want. There is loads of research that shows that this is good for the family to let them know that everything was tried for their child.

I was in the reception area when the rest of the family arrived - I showed them to the relatives room, and took the mother into the resus area where they were still trying to save the patient.

I was outside in the ambulance bay when I heard the family start crying, and I knew that they were crying because they had just been told that their daughter/sister/granddaughter had died.

The ambulance crew and myself had a little de-stress in the nurses messroom, and then the crew took me back to my car.

There was a small amount of vomit and a bottle of water still on the scene.

I went back to station, filled in an injury report form, completed the rest of my paperwork, and spoke to Control and told them that I would be sick for the rest of the night, because by now my wrist and hip were really starting to hurt.

All throughout I wasn't 'feeling' anything, instead I was 'blank', and not because of 'shock'.

I think that it's because, by my fourth nightshift, the ability to care about anything leaves me.

I was contacted by a duty officer, to check on me - and he was one of the nicest officers I've spoken to. He wanted to make sure that I was psychologically alright (I was), and he told me that he would sort out the injury part with my station officers so that they would know what was happening.

I then went to bed.

This morning, while telling my mum what had happened, I started to feel sorry for the girl - so I know I'm not a monster.

Sometimes this job is really shitty - everything went right with the resus attempt, and yet the patient still died. I'm left thinking that while I will continue, and will forget about this job (until the Coroners office asks for a statement), for that family they may never recover.

I got a call at about 5:30 in the morning to a "Collapsed female" with "shouting in the background", not normally a problem, so I took advantage of the empty streets and raced there.

I narrowly avoided crashing into the ambulance also coming to the job from another direction, and so we both arrived at the house at the same time.

The patient was a middle aged woman who had been drinking with her family, and then there had been some sort of argument, and she was feigning unconsciousness.

Nothing unusual there.

Remind me to someday tell you how we recognise when people are pretending to be unconscious.

Still no problem - that the family, while concerned, were happy to agree that the patient was actually 'faking it'.

I went out to my car to pick up a bit of kit, just in order to rule out anything medically wrong with the patient, and on the way back two men in a car parked outside asked me what was going on.

"Nothing serious", I replied, and went back into the building.

It was then that the sole male of the house cried out, "Who's shouting outside my house", and went outside.

I ignored him, and we finished checking over the patient as suspected there was nothing medically wrong with her.

Then the male came storming back into the house, grabbed two kitchen knives and ran outside again.

The ambulance crew and myself thought that this would be a good time to call for the police...

We sneaked out of the house, and stood by the ambulance - meanwhile the six women who had just left the house looked as if they were (a) arguing amongst themselves, and (b) about to tear the men in the car to pieces.

The final result of the arguing, holding people back, pushing and shoving, and shrieking at the top of their lungs, was that the car drove off at high speed, missing me by about half a yard. Meanwhile the argument continued between the sisters/cousins/whoever.

The police did turn up (and to their credit, turn up very quickly), and while they went about collecting statements there was various talk about samarai swords and the like being waved around (which isn't too surprsing in this particular part of East London). We left the police dealing with what seemed to be some form of family feud.

Returning to station, we were all stood down by the duty station officer, so that we could fill in the relevant paperwork.

On reflection three things spring to mind,

1) None of us were wearing our stab vests - and probably wouldn't have felt safe even if we had.

2) Why, when I had my own mobile phone, my FRU car phone, and my work emergency phone, did I use the household landline phone when calling the police?

3) And finally, is it wrong to think "With the paperwork we now need to do, this job'll see me to the end on my shift"?


The 'phone' thing was probably because my brain saw it there, and thought 'I can dial 999 on that', rather than taking longer on wondering which pocket of many my mobile phones are in. Thus my brain was able to concentrate on the whole 'not getting stabbed' thing.

Dark street.

A man who has been beaten unconscious.

I kneel down, and use my hand to steady me.

Under my palm I find two of his teeth.

Saturday night in East London.

The first job you get after a week off tends to set the tone for the rest on the night - not tonight though.

My first job was for an eighty year old collapsed outside her front door. I turned up and sure enough, there was a clean. tidy little old lady laying under a quilt (provided by her neighbours). Completely unresponsive, I burst into action (*cough*), checked her blood sugar levels, and found that it was rather low.

(2.0 mmols, don't ask me what that is in 'American').

One injection later and by the time the ambulance crew were carrying her down the stairs, we were all having a laugh and a joke.

So a good job where I managed to "cure" someone.

But then the night has appeared to take bit of a downturn (so far...), with a 'maternataxi', a 'hot and sweaty' 20 year old (no jokes please), and a series of 'assaulted outside pub', which ended up with me calling the police because it started to 'kick off' again.

I did have another job, where I was going to a "blind 18 year old, possible broken bone, unable to walk, learning difficulties". Control asked me if I wanted to police present as the patient was apparently 'upset'.

I told them that I didn't really think I needed the police to manage the situation.

Here is hoping that the drunks of East London decide to stop beating each other up for a bit...

Some good news though - the pregnant woman I wrote about who was mugged has just given birth to a healthy baby.

Apparently an ambulance has crashed into a car in Enfield. The crew are alright, but we don't know how the people in the car are. If I find out more I'll let you know (or point to the story on a news site).

The first rule of Book Club is not to talk about Book Club.

Person #207 to use this ‘joke’ according to Google.

Some time ago I was asked by the strangely named, but very lovely, Giskin Day to come and have a chat with her medical humanities book club about Safelight by Shannon Burke.  So I read it yesterday (and finished it in the bath today) and found myself in West London in University College London with a glass of wine and some depressingly young looking medical students.

Everyone was really nice, even though I wasn’t too impressed with the book itself.  Partly technical – Eyes ‘bulging out’ after hanging for three weeks in a fly filled room when there wouldn’t be any eyes left.  And partly because of the style of the writing – lots of short vignettes written in a very detached way, nothing flowing very well, and one of the cheesiest end lines of any book I’ve read.

And I know I’m not a great writer myself, glass houses, stones, and all that notwithstanding.

So I had a nice little chat, and discovered that the department has a blog!  It’s an interesting one, I’d describe it as the ‘Boing Boing’ of medical humanities.

Go there now, and look at the comic a post or two down, for UK readers it’ll ring a few bells.

Asked what advice to give to the medical students, my reply was to find a good nurse, and listen to them, as they are the ones who have been working the job day in and day out for years.

One of them mentioned that the vignettes in the book are a bit like blog posts, and was I going to write a book?  I did a bit of hand waving on the subject…maybe if some publishing houses started knocking on my door I’d do it, otherwise it’s a lot of work for something that no one would want to publish.

So, this week I’ve spoken at OpenTech, been on the BBC website, and been a guest at a Book Club.  On Friday it all settles back to normal when I start the first of four nightshifts, and it’ll give my ego a chance to deflate as I wade through the vomit and blood of East London.

Joy.

Although there is the Great Britain Beer Festival coming up soon, and I do have that Wednesday off…

UPDATE: Actually I was at Imperial College London not UCL. At least I didn't confuse it with UCLH.

I'm on the BBC website, which makes me think two things.

1) How easy it must be to fill up column inches with blog extracts (even if they are virtual column inches).

2) I really need to change my "About me" page.

Not that I'm ungrateful for the attention mind you...

And for new readers, all the juicy stuff is in the archives.

On Saturday I went to OpenTech 2005, and not only did I get to meet some great people and listen to some very interesting talks, but they also let me try to entertain the crowd by talking about how to keep your job while blogging.

I’ve been to these sorts of talks before, and have felt a bit disappointed when people just talk about things that they have written on their blogs – but I’ve now got some sympathy for them having just done it myself.

The keynote talk by Danny O’Brien about living life in public was very good (and you can download an audio of it), basically you lot (dear readers), know much more about me, than I know about you…

Would you like to change this?  Tell me about yourself in the comments field.

He has also set up a Pledge, that I have signed up for (and I am a stingy git).

If you think that the need for someone in the UK to fight for Digital Rights is worth £5 a month, then I suggest you take a look at the pledge as well.

Ewan Spence was there, and his “Ipod Shuffle shuffle” was another highlight.  I do think that his little Lego banner needs a bit more grey in the hair now.

My talk went as well as I thought it would.  I do get the impression that blogging is “so last year”, which is only spurring me on to get my backside in gear and start podcasting.

Gia gave me one of the nicest introductions going (and she later bought me a beer, and continued to embarrass me by saying nice things).  I then got up, talked about Libel and not calling your boss a git and showed loads of cute pictures of kittens.

Personal evaluation of performance : Could have been a bit better, but could have been a lot worse.

Other talks which I saw, and was interested in were the “What should I read next” launch (which will refer you to books you might like based on previous books you have read and enjoyed), MythTV (although I may have to wait for a Windows version, because Linux gives me a headache), the Big Brother social network (I’m trying to think deep thoughts about how this technology could be used in a health setting), and Backstage BBC, which is frankly stunning in its forward thinkingness

At one point after the last talk (at the bar – naturally), I was surrounded by Stroppycow, Annie Mole, Rachel and Gia and it made me feel like a right stud.

*Cough*

The (nicest ever) picture of me is by Neil Turner (no…I’m not trying to steal the video camera)