A murder investigation is under way in east London after a man found stabbed in the street died in hospital.

Smack bang in the middle of my patch, yet strangely I still feel safe walking around those same streets in uniform, or in civvies.

There is a good chance that one of my mates went on that call. No doubt I'll learn the full story tomorrow - and obviously won't be able to blog about it.

So I did my talk at the Guardian Public Services Summit.

I managed to tell a load of people in suits (including people from the Department of Health) that the ORCON target is clinically worthless.

I feel like I have justified five years of blogging.

If you think that I am wrong in my assessment of ORCON then you can post a comment here and we can enter into an open discussion. This being part of my talk about how blogging can break down the barriers between blogging.

I hope that some of those DoH managers can see fit to spend ten minutes a day casting their eyes over some of the UK medical blogs out there in order to get a real view of what it is like to work for the NHS.

"Live in hope, die in despair".

Ergh. I shouldn't have drunk the wine last night. That and a too warm room has left me feeling rather grotty.

Never mind! I get to command the attention of a room full of people later today, maybe point out a few things. Who knows.

Yesterday I managed to speak to the Director General of the NHS workforce, the woman who is ultimately my boss. How could I let such an opportunity slip?

I told her that the reason that a lot of NHS staff are unhappy is because of having to chase targets, and that these targets are often clinically pointless. That because of resources being directed to hit these targets patient care is suffering and that, no matter how cynical we might be, ultimately we get annoyed when we can't give the care we would like to.

She appeared to pay attention and jotted a few things down in a notebook, although obviously I'm not hugely hopeful - she has her bosses to report to as well.

In about two hours I'll get to hear Nick Clegg talk about mental health. Perhaps I'll collar him and let him know the truth about the out of hours provision, or rather lack thereof...

Then I get my chance to present something which, contrary to tradition, starts with an insult rather than a joke. I'm not quite sure where to go after insulting everyone, but I've got two hours to work it out.

So far everyone I've met has been really nice and the Guardian are looking after me very well (as an aside, is it Guardian policy to only employ women who are lovely?) Last night during dinner I shared a table with someone who works in the cabinet office, a PR person, one of the bosses of the Guardian, someone who works with an advisory charity and Tim Campbell (and yes, I was the only person who didn't know who he was). Despite moving in these lofty circles I still found everyone to be very personable and had a nice chat with them over a very tasty dinner.

Right - time for me to get ready to hit some politicians and planners with the big stick of truth. That or stand up and make a prat of myself by not using words such as 'dynamic' or 'engage'.

No real blog post today as Im preparing for being a guest at the Guardian Public services Summit. I'm jotting this down as I'm waiting for my bath to fill. It should be interesting and I get a free hotel room out of it.

Unfortunately, due to someone dropping out the format of my session has changed and so I have to rapidly plan a ten minute presentation before sitting down to be questioned. Oh well, should still be fun.

I need to perform well as people have paid over £600 to come to the summit (which I consider silly money).

And no, there hasn't been mention of a fee for my appearance. But I do these things because they are fun and because I get to meet interesting people. At this one I might be able to shout at a few politicians...

Which reminds me that I need to check that I've packed my pepper spray and brass knuckles.

One of our 'frequent flyers' died a little while ago. I realise that I haven't really written much about the people who keep calling us, our 'regular customers'.

Some are a real annoyance, others have a little smile hitting your lips when you realise that you are going to see them again. Some have medical problems, some have mental health problems. Some have, what our psychologically trained colleagues, untreatable borderline personality disorders. Many are alcoholics, or drug users.

Some become the stuff of legend, a tale to scare the new recruits with.

Freda was one of the nice ones. An elderly couple, she lived with her husband, both of them had long-standing medical problems. They looked after each other. When one of them was poorly, the other would do their best to help them before calling us out.

Freda was a diabetic, and a poorly controlled one at that. Her husband would call us out when her blood sugar dropped too low. We'd arrive to find her on the sofa, or in bed, snoring away and deeply unconscious.

"Normally I give her jam and bread", her husband would say, "but she's too far gone this time".

It's a simple job, jab her with an injection of Glucagon, wait a couple of minutes while making sure that her airway was clear, and she'd wake up and be surprised to see us standing over her.

"Did I go low again?", she'd ask, "I'm so sorry to be a nuisance".

But she wasn't a nuisance, sure we'd grumble if it was 4 a.m. in the morning, but once you arrived the thanks you'd get from the pair of them more than made up for any disturbed nap.

But now she's dead, killed in a way that could cause any of us, young or old, fit or unhealthy, to die.

I'm not sure if her husband will still live in the same house, I don't know if we'll get called back there, maybe he'll move to a warden controlled flat.

It's hard to think of him without his beloved Freda, it's hard for me to think that we'll never go there again - and leave her sitting up in bed, smiling and tucking into a jam sandwich.

So, after missing Saturday night because of a lack of boots (since resolved by me buying my own pair and the LAS promising to repay me), I finally returned to work and did a full shift.

The first thing to do is to catch up with your crewmate. She tells me about being the responder to the man who was killed by his dog. She tells me about the patient who went into cardiac arrest in the back of the ambulance. She tells me that she has had to use her extended skills more times in the past two weeks than in all the time we've been together.

It's obvious that I'm the one cursing us with non-sick patients.

As mentioned previously the first patient was a five year old with chickenpox, the mother wanted her to go to hospital and we can't refuse.

Then a patient with a mild, but long term medical problem who wanted to go to hospital.

Then a belly-ache that got better if you kept talking to the patient. Strange job because they had gone to the neighbour's house to call an ambulance. That they both looked like drug users is probably just my suspicious mind getting the better of me.

Then a maternity patient who couldn't get to her booked 'birthing centre' because no-one would pick up the phone. By the time we'd got the woman to the hospital the midwives there had managed to get in touch with the birthing centre. The birthing centre would accept the woman.

"How will I get there?", asked the patient.
"Oh", replied the midwife, "the ambulance will take you".

The midwife seemed most upset when we told her that we were for emergencies only, and that she'd have to book an ambulance just like any other hospital transfer. You'd think that they'd know better...

Then a child with a high temperature that we left at home according to the mother's wishes. She, as a lot of people want us to do, just wanted her son 'checked out'. So we do our 'mobile GP' bit and hope that the child doesn't drop dead.

A few more simple little jobs of similar seriousness - no need to carry anyone, no need to do anything other than chat to the patient and record the basic observations.

The final job was a 'frequent flyer' who I haven't seen for two years, but has apparently moved back into the area and is calling for an ambulance twice a day at least.

Oh well, nature abhors a vacuum and given the recent deaths of two of our frequent callers, it was obvious that someone would pop up to fill the gap.

So it was a nice easy night to ease me back into the swing of things. The only problem is that my foot is still as injured as it was before I went sick - but I'm getting an occupational health appointment, and it's with our new private contractors. I should give them a fair shake of the stick, but they must be cheaper than the old occupation health lot who were all NHS.

Anyhow - I'm now 23.5 hours without sleep and my brain is dripping out my ears. Perhaps something more lucid tomorrow.

Back in an ambulance for the first time in ages.

First job? A bright and cute five year old with Chickenpox.

Child was a real sweety, a real shame that mother wanted her to go to
hospital.

Oh well, the walk home should do her good.

Sent from my mobile.

Absolutely fucking fuming, so please excuse my language.

I leave the station, having headed back home from doing one of the coolest things ever (more of which later), turn into the car park to drive to work and discover my car is gone.

Some thieving scumbag has stolen my car.

Along with the car is a uniform or two, some hi-vis jackets, my personal travel first aid kit, my work phone and, most importantly, my work ID card and my entry card to one of our local hospitals.

Top Team Leader and top AOM (my local management team) have given me permission to blow off tonight's shift so that I can kick something soft. They know that if a patient pissed me off tonight I'd be likely to be less than gentle with them.

I think that this brings the number of times my (lovely) car has been stolen up to eight. I'm feeling that familiar feeling of wanting revenge, of wanting to punch someone in the face repeatedly - but because they stole my property rather then try mugging me, there is no-one to punch.

It's the feeling of powerlessness that gets me, the desire to visit bloody revenge on the shiftless scum who did this to me. They are probably the sort of people who I spend my night shifts picking out of the gutter, drunken and violent. At moments like this I think, "Fuck it, let 'em die".

So instead, if you were the person who stole my car, here's a suggestion.

There are some plastic vials with a drug in them - if you want to get really high, why don't you try injecting it into your bloodstream and see what happens?

It'll make at least one of us happy...

---

I may feel saner in the morning.

UPDATE: I'm getting special treatment, because of the uniform and ID card, 'intelligence' is being passed to the counter-terrorism squad. This makes me hopeful for a dawn raid with the suspects being tazered. In the head. Several times.

And normally I'm quite liberal...