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'.