“Today - I shall be mostly doing a clean install on my laptop”.

 

And then swearing as I realise I’ve forgotten to back up some arcane, but very important files…

Lets imagine that you are old and need a bit of care in your home – simple stuff, nothing too taxing, just a bit of a hand to help you wash when you wake up.  Maybe you need help with some of the fiddly little tablets you have to take.  Perhaps you just need someone who’ll help you keep your flat tidy.

Then, for the sake of argument, lets say you’ve had a bit of a fall – nothing too serious, it’s just that your legs are starting to get a bit weak, and you don’t want to use the walking frame the hospital has given you.  You are lying by your front door – so when you use your community alarm you are able to let your carer in and then the ambulance people.

The ambulance people quickly check you over while you are on the floor – they let you know that they don’t want to pick you up if you’ve broken your leg.  So you let them examine you, and finding nothing, you ask them if they can just put you in your normal chair by the television.  You wonder why the ambulance crew are tutting at your carer for not at least putting a pillow behind your head while you were stuck on the floor.

The ambulance crew help you up and put you into your favourite chair.  As you aren’t hurt by the fall you don’t want to go to the hospital – you’ll only sit in the department for several hours before some young doctor tells you that you should be using your walking frame.  It’s easier to sit in your own flat.  The ambulance people seem pretty nice though, and they want to give you a full physical check up to make sure that there is nothing obvious that would cause you to fall.

You tell the ambulance people that you’ve been having a few falls, as your legs have been getting a bit weaker recently, but that you get around alright and that you have the community alarm button around your neck should you get into any trouble.  The ambulance people try to persuade you to goto hospital, but you refuse again.  One of the ambulance people checks various pulses and pressures and sugars and heart tracings before agreeing that you can refuse to go with them.

The ambulance person is looking around your flat and tutting at the carer again.  He doesn’t like it that as he walks around he is making a crunching noise as he crushes your tablets which are strewn all over the carpet.  It’s not your fault that you sometimes drop them, I mean, it’s not the carers job to make sure that you can take your pills.

The ambulance man then tells you that as you don’t want to go to hospital, would you mind if we got your GP out to see you.  You agree and the ambulance man says that your GP might be able to arrange to have handrails put on your walls – it sounds like a good idea as you really don’t like using the walking frame.  You tell the ambulance man your GP’s phone number but he doesn’t want to borrow your phone.  He tells you that if his Controller phones the GP then the call is recorded so if the GP promises to come out then they darn well better.  You wonder why the ambulance man is so distrusting of GPs.

The ambulance man then disappears for a bit into the kitchen, he’s talking to the carer before she leaves.  You can’t hear what he says, but his voice seems a little forceful.

The ambulance man comes back and asks you one last time if you’d like to go to hospital, you refuse and the ambulance man reminds you to use the walking frame for getting around – and also to make sure that you have your emergency button on you at all times.  He tells you that he is only a phone call away.  He picks up his equipment and prepares to leave.

You’ve enjoyed chatting to him and his partner, so you try to keep up a conversation – the only person you regularly see is your carer, and she doesn’t talk to you much – she hasn’t said a word to you while the ambulance people have been here.  The ambulance people stay and have a chat with you, but they can only stay ten minutes.  But at least those ten minutes is ten minutes of conversation you wouldn’t have had otherwise.

The ambulance people wave goodbye to your carer as she walks out the door without saying a word.

Ten minutes later you wave goodbye to the ambulance people, and you are left on your own until the evening carer comes.

 

Downstairs in the ambulance, an EMT’s heart breaks just a little.

 

When you are writing a blog, if you want to be ‘successful’ then you need to write something everyday.  How you measure success is up to you – pagehits, number of comments left, feelings of satisfaction, or however else you like to measure it.  However, what you write has to be of a sufficient quality to get your readers feeling, or thinking about, the subject of the day.  When writing for print, I would imagine that you have a couple of days to polish whatever you write.  In this way, writing for a blog is much like how I imagine it is writing a report for a newspaper – you have a deadline, you have to write every day and you have to write on short notice.

The difference would be that while most folk speed read newspaper reports without taking much notice of who has written it - This Blog Is Me.

(Which is basically what I’m going to be talking about at the Apple store).

Some days the words just flow off the keyboard – you hardly have to edit the post before hitting ‘publish’.  The ideas come rushing at you and it’s all you can do to slow them down long enough for you to type them.  You lie in bed and blog posts run through your mind.  Every sentence comes fully formed and shining into the world – you reread it and you manage to impress yourself.

Then there are the days (like today) when every word is a struggle, where you go back over every line trying to polish it into some semblance of readability.  There are days when your muse has gone on holiday, so you read through the ‘Post ideas for a rainy day’ file for something that might spark your imagination.  And nothing does.  The blog writing feels like a chore that you’d rather not do.

So what I’m saying is that I have complete respect for those people who can turn in on a daily basis pieces of writing that consistently shine.

Rotten buggers.

For the next hour or so I’m going to be in Second Life here, watching the Turkish eclipse on live cast.

Until then, can anyone suggest a way to keep two Outlook email clients in sync, similar to the way I can have my emails shared between my home computer and my Pocket PC by using Activesync?

Preferably without spending huge sums of cash on and Exchange server.

Here is the thing – I’m a pretty poor liar.  I don’t get much practice, I don’t like doing it and as part of my personality flaws I love sharing things that I know with anyone that’ll listen.  Unfortunately in this business you need to try and keep some things to yourself.

I was called to a place of work where a fifty-five year old woman was complaining of constant headaches.  When I arrived on the scene she was being comforted by a work colleague as she had obviously just been crying.  Now – some people would be wondering why an ambulance would be called for a headache, and why I’m not moaning about the waste of resources.

The reasoning behind my not moaning are simple…

• The woman was terribly upset.  This indicated fear, and I’m very forgiving if people call an ambulance because they are scared.
• You are fifty-five years old.  you know all about headaches.  This is different, very different, to the headaches you’ve had in the past.
• I’m getting soft in my old age.

I got a verbal history from the patient – the headache had been coming and going for two weeks and normal painkillers weren’t touching the pain.  there was no other history of ill health, she hadn’t been to the doctor for years and she had no allergies.  She told me that on that morning she had woken up with the headache and also a feeling of “not being connected to the world”.  Once more, her painkillers hadn’t even touched the pain.

A quick ‘n’ dirty neurological examination didn’t reveal anything particularly scary and her observations were all normal apart from a moderately raised blood pressure.  I discounted the blood pressure as her being scared and sitting in the back of an ambulance looking at my ugly mug.

So we had a drive over to the hospital.

All through the trip I could see that her main fear was that she had grown a brain tumour.  The words were never mentioned – but her fear was of such intensity and direction that I knew that this is what she was thinking.  I would have loved to have lied to her.  I would have given a lot to be able to put my arm around her and tell her that there was no chance of the headaches being caused by a brain tumour. 

But I couldn’t.

I had to sit there and explain about all my ‘negative findings’, I could tell her that her pulse was fine, that she hadn’t had a stroke, that her blood sugar was better than mine and that her short neurological exam didn’t show anything unusual.

But I couldn’t tell her what she wanted to hear.

We reached the hospital, and while I handed over to the nurse one side of her face started to become numb…

---

A little later, while returning to the hospital with another patient, I saw our woman in the resuscitation room.  She was sitting up and talking to her work colleague who had accompanied her in the ambulance.  I wondered why she was in there – but was too busy to ask the resus nurse.

---

Towards the end of my shift I saw our patient walking back from the toilet (with colleague still in tow).  I asked her what the doctors had found.

“They are keeping me in”, she told me, my heart sank.  “Apparently I have a really high blood pressure, and that’s what’s been causing it”.

“Oh superb!”, I said, “they can cure that!”.

You could see that she was a lot more relaxed, and that her main concern was that she was now going to be in hospital while the doctors treated her blood pressure. 

Hardly a concern at all.

 

Her blood pressure had been so high, our machine for recording it hadn’t been able to measure it correctly.  Which is a little troubling. 

 

Just a few things to get you caught up on some of the things that have happened/will happen before I write a ‘proper’ ambulance post.

• I’ve had the dreaded lurgy for the past couple of days (which is why my blogging has been so light).  I could fill you with disgust about the symptoms – but I’d rather draw a veil over them and just let you know that I’m finally managing to cough up huge gobbets of green mucus at the moment.
• However – this illness comes at the right time.  My mum and brother are heading on holiday in the next few days, so I’ve taken a week of annual leave in order to housesit (or rather video record ‘Neighbours’ and ‘Doctors’ everyday for my mum).  They are having a couple of days in Toronto, a day in Niagara Falls and a couple of days in New York.  Any suggestions for must see things would be gratefully received.
• As this holiday coincides with my week of off-duty, I have a whole fortnight off work.  This will make me both happy and bored.  While I have a few ambulance stories stockpiled, you may notice me going a bit ‘off topic’ occasionally.  I’d just humour me if I were you – I bite when I get upset.
• I have new business cards.  They are a lovely shade of yellow and have one of Hugh’s cartoons on the back.  It says “This city is killing me but what a glorious death it is”.  The message just seems…right.
• This Thursday I’m meeting up with a friend for drinks and curry in the Brick Lane area.  If you want to come along you are welcome – just email me for details.
• I’ve been asked by the nice people at Londonist to take part in a multi-blogger talk.  It’s on Wednesday the 5th of April at the London Apple store starting at 7pm.  I’ll be chatting for twenty minutes or so on “Blogging as Identity – real and virtual”.  also there will be the lovely Annie Mole, the always interesting Tom Coates and the “I’ve not heard of them before – but they are the newest addition to my RSS feeder” Inky Circus.  You can get more details about it here (although I’m guessing that the Londonist chaps haven’t seen my Flickr stream…).
• I’ve just gotten the ‘blad’ of Da Book.  A ‘blad’ for those who don’t know (and I didn’t know until I was told) is a short sampler for an upcoming book.  It’s kind of rough and at a quick glance there are a couple of things that need changing, but…  It’s really weird to see things that I’ve written actually on a page, in a book, with a cover and everything.  It’s still strange to think that a jumped up taxi driver can get a book published.
• I’m currently listening to The Shortwave Set with it’s sublime “Repeat to fade” (You can get a smaller, but better quality video clip at their Myspace page).  I’m trying to get this out of my head…
• Erm…  I think that’s it.

I’ll post something else a little later today (after a bath, a spring clean, doing my shopping, paying my bills, answering a weeks worth of emails, etc, etc…).  But until then – a little picture of what I would look like if I were on an episode of South Park.

All Mery's and Bill Stickers fault.

 

NHSBlogDoc reports on Geek Nurse taking down their blog.

Owing to concerns raised by staff and management, GN's archive has been removed from public display. Thank you to all those that took part.

After the recent trouble with the police bloggers, and now this - I'm not only feeling a bit nervous, but am starting to get the urge to 'do something'.

Who'll be next I wonder?

After two days of struggling with people, it was nice to go back to the simple jobs that are a joy to do, it's also nice to see a sense of community.

In this case it was a little old lady who had tripped over a wobbly pavement in one of our local markets. She was surrounded by people of all backgrounds - there was a black market warden who had put cones over the offending paving stones. A Bangladeshi man was chatting to her and two Greek looking men met me at the ambulance and led me to the patient. A Sikh stall keeper also pointed me in the direction of the patient.

The patient herself was one of the dying breed of 'traditional' English East Londoner. Normally an extremely healthy eighty year old, she had a graze to her nose that refused to stop oozing blood. A real pleasure to talk to, we chatted about how the East of London has changed in her lifetime - and how she still enjoyed living here.

"I'm an ethnic minority now", she told me, "but there are still a lot of people around who'll help you out".

And she was right - as an ambulance person I tend only to see the worst of people. I go to the assaults and the arguments. I hear about the murders and the abuse, the neglect and the trouble. Just as this woman was, for me, an unusual patient in that she was a healthy eighty year old, so it was that I saw the 'unusual' event of people helping someone in distress.

One of those jobs that leaves you with a smile on your face for the rest of the day.

After two days of struggling with people, it was nice to go back to the simple jobs that are a joy to do, it's also nice to see a sense of community.

In this case it was a little old lady who had tripped over a wobbly pavement in one of our local markets. She was surrounded by people of all backgrounds - there was a black market warden who had put cones over the offending paving stones. A Bangladeshi man was chatting to her and two Greek looking men met me at the ambulance and led me to the patient. A Sikh stall keeper also pointed me in the direction of the patient.

The patient herself was one of the dying breed of 'traditional' English East Londoner. Normally an extremely healthy eighty year old, she had a graze to her nose that refused to stop oozing blood. A real pleasure to talk to, we chatted about how the East of London has changed in her lifetime - and how she still enjoyed living here.

"I'm an ethnic minority now", she told me, "but there are still a lot of people around who'll help you out".

And she was right - as an ambulance person I tend only to see the worst of people. I go to the assaults and the arguments. I hear about the murders and the abuse, the neglect and the trouble. Just as this woman was, for me, an unusual patient in that she was a healthy eighty year old, so it was that I saw the 'unusual' event of people helping someone in distress.

One of those jobs that leaves you with a smile on your face for the rest of the day.

Yesterday I mentioned having a similar job to the early morning 'madness' of my 68 year old man. It's partly why I asked you to keep in mind that opposites attract...

We were called to a fourth floor flat in one of the many housing blocks in the East of London where we found an unkempt man in his forties pacing back and forth along the access balcony to his flat.

He wasn't wearing any shoes, socks or a shirt, and his trousers and pants were falling off him.

While pacing he was muttering about God and the Devil. Next to him was another man and the next door neighbour of the patient.

The other man disappeared as soon as we arrived.

The patient obviously had mental health issues, but we also suspected something else was causing this change in behaviour. At one point he made to throw himself over the balcony - we stood in his way to prevent him doing this, and more importantly to stop him making us go through the, frankly hard, work of trying to save his life in the face of major trauma.

As we led him back into his flat to get some shoes/clothes we realised that the reason why he was behaving so strangely might have been exacerbated by drug use. We nearly tripped over an empty bottle of methadone.

The flat was - as I've mentioned before, exactly how you would expect a drug den to look. There was drug paraphenalia strewn around the place, mattresses on the floor and the heavy curtains looked like they had never been drawn.

The patient continued to pace around while occasionally becoming quite agitated. While we didn't think that he would become violent we were still rather wary of getting too close to him or letting our guard down.

After half an hour we had managed to get him dressed and were able to lead him downstairs where we *ahem* 'gently' got him into the ambulance.

While I drove us to the hospital my crewmate did his best to keep the patient calm. We pre-warned the hospital that they would need security and the secure room ready for us. Unfortunately the hospital switchboard wasn't picking up the phone so there was no-one there to meet us when we rolled up outside the A&E doors.

At one point he exposed his genitals to my crewmate - something that the patient I wrote about yesterday did to me.

A bit of a struggle began where the patient wanted to jump off the ambulance and run away, so my crewmate and I ended up restraining the patient until security arrived to help drag the patient into the department's 'padded room'.

So for two days on the trot I've been wrestling with patients in the back of the vehicle.

Once more (and this is with a different crewmate) we felt that it was this sort of job that you have to enjoy in order to remain as ambulance staff. While we like the little old ladies, and the two year olds wth runny noses, there is nothing quite like struggling with a 'mad' person in order to get them the care that they need.

What sturck me as amusing was that on consecutive days the first job of the shift was to someone with an altered mental state who was blaming their God and the Devil, and who would later go on to show us their genitals.

I wonder if it's something in the water?

I've been told by those 'in the know' that people with mental illness now prefer to be called 'mad', I think it's to do with reclaiming the term, much as homosexuals have with the word 'gay'.