It's 3 a.m. in the lonely hours of the morning and I'm nervous.

We are in the bedroom of a six year old boy. His mother found him having trouble in breathing half an hour ago.

His airways are so tight that every breath that he takes turns his chest inside out. He is trying to breathe so hard that I'm waiting for his breastbone to snap under the strain.

From across the room I can hear the air whistling through a tiny airway. He has the classic posture of the asthmatic trying to force air into their lungs - he's sitting upright, hands on knees.

He can't cry - he hasn't the breath for it.

I want him in the ambulance. No, I want him in hospital.

But we can't go just yet. The single mother has two other children, both under the age of five and they can't be left alone in the house. They need to be woken up and dressed. One needs to be thrown, still sleeping, into a pushchair.

I'm counting the seconds, I'm waiting for the boy to start turning blue.

I'm eyeing the kit in our bag, how much experience has my crewmate had in intubating a closed down airway?

We are already giving him all the drugs that we can. He's so sick that he quietly accepts the noisy nebuliser mask.

I help the mother dress one of her children - socks and shoes slipped onto sleepy feet.

Then it's time to go. Like all parents she worries about out insistence that we leave the child topless as we walk out into the cold air. It's due to his high temperature I tell her. I don't tell her that it's also so we can easily see that he's still breathing.

For once my big fear isn't a complaint from the mother - it's that the child will die in the back of our ambulance.

I pass the blue call over the radio to prealert the hospital, the radio isn't working too well so I have to repeat some of it. I don't think that the radio operator understands one of the medical terms that I use, it's not their fault as it's pretty obscure. The broken radio means that I can't be sure of the read back.

I don't care, as long as they have the paediatric doctor waiting for us there I'll be happy.

We are 1.9 miles from one hospital, 2.4 from another. I go for the further hospital, the drive is straighter and I can use the A13 which at this time of the night is clear. The other hospital has too many speed-humps and side turnings on the route.

I'm listening to what is going on in the back of the ambulance. My crewmate sounds relaxed and over the sound of the engine is the reassuring noise of the child's breathing.

I glance at the speedometer - I'm hitting 80mph, I didn't know that these ambulance reached that kind of speed. I'm thankful that the road is clear and empty, and that there are no hazards.

I spot the patient's young sister looking at my face in the rear-view mirror, her eyes wide open now.

We pull up to the hospital and I take care of our patient's siblings, I bed them down in the relatives room while the doctors and nurses and mother look after their brother.

It's only half an hour later that I'm talking with the paediatric nurses - while it looked touch and go for a bit, our patient responded well to the medications that we can't give. His breathing is back to normal.

I love the paediatric A&E nurses at this hospital, they are experts at what they do and despite the cynicism that is endemic in the NHS, they really do care for their patients.

We are chatting and laughing at the memory of our fear. We have fought back against death, and this laughter is our victory cheer.

The family are reunited.

I still have that memory of fear though.

It's getting late in the year, so the nights are drawing in and I find myself driving to work in the dark and making it home again before the sun rises above the rooftops.

At 4 a.m. in the morning I feel like killing myself as my body just wants to shut down. Instead I find myself going to people who have called an ambulance because they have had a nightmare.

There are a few bright spots, an easy home delivery results in a happy baby and family. We save the life of a six year old and think that we've done something good.

But these are overshadowed by the sixty-five year old drunk woman who makes to hit me and tells me to "fuck off" as we pull her out of the freezing puddle. The patient who calls us 'just because' at five in the morning could do with a thump as well.

I'm not eating well, pasta for three days running in order to try and keep my energy levels up through the night, it's not the most interesting food.

The nights are wrecking havoc with my heart palpitations, I'm trying to keep off the caffeine, but I think that the missed beats are my bodies way of telling me that the job is slowly killing me. I'm getting more of them every night.

A station officer tells me that I could always swap to permanent day shifts - I ask myself how I am supposed to survive on a 25% paycut that coming of rotating shifts would mean. From £10 and hour to £7 an hour? For the same work - no thanks.

The job is going down the drain - we are pulled from one directive to another. I hear something that makes me angry - looks like the slow privatisation of the NHS has reached the ambulance service. I wonder how I'm going to write about it, to describe my utter disgust at the idea of 'private' FRU cars.

I waiting to make a mistake that'll cost me my job - will it be my 'attitude' to another wasted call that does for me? Will I be so tired that I miss a treatment or diagnosis? Will I cause a crash in my ambulance? Will it be something that I write on here?

I float around my flat, all enthusiasm drained from me by that 4 a.m black hole.

It's that time of the year again. Maybe I should start thinking about better living through chemistry.