"Oh blimey", I thought, "another call to another bloody mosque".

The woman had apparently collapsed, people do a lot of collapsing in churches and the like, and with the proliferation of mosques in my area it's only natural that some of them collapse a well.

We were met by lots of women in the full covering Niqab, eyes staring accusingly out at us.

They managed to find someone who spoke English (a miracle in itself) who told us that we weren't allowed to enter the mosque while wearing our boots. There was a bit of a Mexican stand-off when they realised the I was refusing to take them off.

Finally they decided to let me in, but I didn't need to speak Bengali to realise that they weren't happy about this, and the muttering continued.

The patient was laying on the floor, obviously she didn't speak English so we had to make do. One of the women was concerned that a man would be touching her - I soon let them know that it was too bad - I was the person that they had and they would best put up with it.

We got out of there as quickly as possible - there are lots of places in Newham where us non-muslims feel threatened. You never know what they are up to.

And that's enough fantasy - now for the reality of the call.

We were met by the women who welcomed us into the mosque, boots included. I've sometimes been asked if I can remove them, but as soon as I apologise and that say I can't do that for health and safety reasons I've been allowed in without a second word.

One of the ladies there was doing a sterling job of translating for us, she'd already jotted down the patient's details on a bit of paper for us. The ladies also helped us get the patient onto our carry chair.

As we were about to leave, they came to the ambulance and offered us some drinks and cakes, we declined as we'd just had a fry-up breakfast, but took a drink for the patient and her daughter.

At no point did I feel threatened, worried or out of place. The only thing I was worried about (besides my patient) was that they had a really nice carpet and I didn't want my size twelve boots getting it dirty. As they were welcoming to me I wanted to be as accommodating as possible.

There is a lot of huff and puff about offending people, of cultural sensitivity, but as long as you treat people like human beings I've found that you can't go far wrong.

(I'm now off to install Vista *shudder* on my Macbook for gaming purposes, I may be gone some time... A quick question though - is the UK dar al aman? Assuming I've spelt that right...)

So there I am, sitting on my computer at silly-o-clock in the morning.

Then I feel a shaking.

It's all part of my plan for being awake for my morning shifts. I come in from work at around 3pm, go to bed and wake up around 11pm. Then I stay awake until I head off to work at 6am. Lather, Rinse, Repeat.

Which means that I'm stretched out on the futon, typing away on a blogpost when I start vibrating. I consider twittering a joke about being in an earthquake but then just put it down to my body doing strange things. I reckon it's just that my laptop was sitting on my femoral pulse or some such.

But no - it's an earthquake.

My very first earthquake and I think it's my heart beating.

Makes a change, normally I'd sleep through such things.

Out patient is in her late eighties, she's demented, she's frail, she's bedbound and she has a pressure sore.

She's in one of the nursing homes that we are familiar with - one of the big-chain 'don't care homes'.

The reason for us being called is that time-honoured reason of "Not eating or drinking". Unlike some previous visits the reason why she isn't eating isn't because the staff are trying to feed a corpse.

We have been as gentle with her as possible, trying to make her comfortable and warm on our trolley. When we wheel it out to the ambulance every bump in the floor makes her wince. It also makes me wince.

The home has sent the normal type of escort 'carer' with her, the "I don't know her, I've only worked here for two days, my English isn't so good" sort of carer.

One day I'm going to leave my job and inspect nursing homes - I will be feared for my ability to make these 'nurses' cry as I point out their many flaws adn get them to do their job properly.

I drive as carefully as I can, but there are too many idiots in my area that insist on walking out in front of my vehicle forcing me to hit the brakes.

One day someone will do this when I'm nearing the end of a tiring thirteen hour shift, I won't see them and they will regret their attitude of 'ambulances always stop'...

We reach the hospital, it's busy and one of the lead nurses take the hand-over from my crewmate. This is where we meet the difference between good nursing and excellent nursing.

Hospital trollies aren't the softest things to lay on, especially when you are so frail you can't change your own position. So the nurse decides to put her on a normal hospital bed, but there is none in the department. She phones one of the wards and arranges to borrow the bed from them.

But there are no porters to go and fetch the bed - my crewmate and I volunteer to go and get it.

By the time we return to the department the patient's daughter has arrived - we explain what we are doing and she thanks us.

We settle the patient into the side-room, she's wrapped up warm again and the bed has a special mattress to help prevent any more pressure sores. Her daughter and the escort watch over her.

I take the escort aside, "Now is your chance to do some one-on-one nursing. Ask the nurses here for a mouth care kit, make sure she is turned every two hours. Sit with her. Look after her".

I'm impressed with the lead nurse - she has reduced the time they have to deal with the patient before she 'breaches' the government's four hour target. But in doing this she has actually cared for the patient.

Shame there isn't a target for that.

I'm driving on this particular shift, my crewmate is in the back dealing with the patient.

I'm grinding my teeth at the waste.

The patient is almost certainly going to die - he's taken an overdose. The tablets he's taken, and the way he's taken them, mean that parts of his body will start to fail over the next few days. His immediate future is hospital bed, then an ITU bed, then either waiting for a transplant or death. It's too late for any treatment to work on him.

He's not in any pain, he doesn't feel weak, he has no symptoms.

He talks to my crewmate. The body language suggests that he is upset but not suicidally depressed.

It was one of those 'cry for help' things - asking why he did it gets the answer that he wanted to die, but now they don't. It's a common enough reason - that they change their mind and then phone us.

Everyone can get these pills - you can read the inference, how can they be that dangerous if you can buy them over the counter?

He lives in a nice house, has a family, had his future ahead of him.

I suspect that he thinks that they'll have a 'stomach pump', a chat with the psychiatrists and then come home. He doesn't realise the damage that he has done to his body.

We don't talk about the outcome to the patient - we'll leave that to the hospital after his blood tests show if he is telling the truth or not. We'll only see him for the ten minutes it takes us to drive him to hospital.

I'm hoping that the patient is lying, that he hasn't done what he says he has, but the empty pill packets speak for themselves.

I know I'll be thinking about him for the next few months long after I've forgotten his name.

His mother is travelling with him.

He's fourteen years old.

I feel relaxed. I had time on holiday to rest and recuperate. I sat around and did very little, no writing, no thinking about writing, no picking up drunks. It was bliss and I'm rather sad that it has come to an end.

I feel re-invigorated.

I feel re-susc-i-tated.

I'm also going to release, that is to declare bankrupcy over my un-answered emails, any podcasts I have left to listen to and all the RSS feeds that I need to catch up with. I don't like doing it, but I honestly have no time to catch up on all the things I've missed out on during the winter doldrums. This is a failure on my part. If you are expecting an email reply from me and it's important then please send the email again and I'll deal with it as it comes in. For all those people who emailed me to thank me for the book or the blog, I do read them all and they do all bring a smile to my face.

What this will allow me to do is rebuild some form of workflow and get involved in some interesting new things, some of which you will see on this very blog, some will be at one of my other internet 'hang-outs'.

So, this break has given me the chance to catch my breath, absorb some honest to goodness sunshine, and restart with new vim and vigor.

Rebooting in 5...4...3...2...1...

(And of course, as soon as I finish typing this blog-post while at Florida airport they announce that my flight will be an hour late and so I'll miss the connecting flight back to the UK. Bollocks).

Later today I shall be on a flight to Florida, while the thought of the flight doesn't fill me with joy, the whole idea of laying by the pool sipping drinks and doing a lot of nothing does indeed hit that part of my brain that makes the happy-fun chemicals.

I have no idea if there is any internet at the hotel, or more importantly if there is any internet by the pool - so I may be offline for a week*. At best I'll be offline for the next 24 hours or so.

At least I should be able to catch up on my email and other such things - like reading a book or two.

*Assuming that the plane doesn't crash into the sea, which may restrict my posting for a bit longer.

It's a couple of minutes before we officially start our shift when Control phone us and ask us to go on an 'early job'. It's a cardiac arrest so we agree and jump into the ambulance.

Two FRU are already there, we are met at the door by a very calm looking elderly lady.

"He's upstairs, so are the paramedics. I'm sorry I shut the door, I didn't know anyone else was coming".

From upstairs I can hear the bump, bump, bump of the patient's head hitting the floor as one of the FRU drivers is doing CPR.

I bound up the stairs and ask the other FRU, who is currently intubating the patient, what he wants me to do.

I can hear my crewmate talking to the wife downstairs, getting a history. The FRU has finished intubating the patient so I put a pillow under the patient's head to stop the banging.

We settle into the familiar rhythm, IV access, drugs every three minutes, constant CPR, check the heart rhythm, check the pulse, repeat from start.

It's obvious that we aren't going to get him back, so I take the time to talk to the wife.

"Your husband's heart has stopped", I explain, "We are doing everything that we can for him and we need to make a decision now. Do we take him to hospital, or do we continue here and stop if there is no chance of getting him back. We are doing everything that the hospital would do for him".

"What would you like us to do?", I ask her.

And she replies, and my heart just breaks, right there on the spot.

"Well, we are both in our eighties - so we have spoken about this before especially after his heart attack. It's not a surprise and I know that he's going to stay dead. I think it's best if you continue here and stop when you think it's right".

She calmly stands there watching us working on her husband until we get a rhythm change and are forced to take him to hospital. While my colleagues work on the patient I offer to take the wife to the hospital in one of the FRUs.

I help her tidy up the bedroom, we make a mess when we are running a resus. Packaging everywhere, bloody needles*, discarded equipment. She offers to help me tidy up and gets a plastic bag for me to put the rubbish in.

Still she remains calm.

Her son arrives to take her to the hospital - he is also calm and thanks me for my help.

Driving the FRU to to hospital my eyes are damp as I think of the complete acceptance of this sudden death. The British reserve, the "we'd spoken about it in the past", the quiet thanking of everything we'd done.

Death and bad news affects everyone differently, so cry, some beat their chests, some get angry. But this quiet acceptance is one of the saddest responses I've ever seen.

*None of us had a sharps box as we'd run out on this job before we had a chance to check our motors.

Twelve Hours Ago - Cup of tea, drunk in two halves with a job in-between.

Eleven Hours Ago - Big Mac, Fillet of fish burger, medium fries.

Work without a break.

Twenty minutes from now - Pizza.

Two Hours from now - Sleep.

Nine Hours from now - Wake up and head into work again.