Just time for a quick one (I'm working twelve hour shifts at the moment and am spending as much time as possible asleep).

I get a call to a stabbing in a park. Not as nasty a stabbing as they can be, but bad enough to have me sweating a little while chanting my mantra 'scoop and run, scoop and run'. I like to get people in this sort of position to hospital as quickly as I can, I'm not the gung-ho type to perform surgery in the back of my ambulance, and that is what this patient needed.

The job is going remarkably smoothly - a team leader on a FRU was already there and was of the same mind as me.

So, we are just doing the needful things before we can move when an officer from another complex turns up.

"Can I help?", he asks.

I let him know that we are going to be leaving soon as there is little that we can do for this patient besides get him to hospital sharpish. So no, thanks for the offer but we have things under control.

"I notice you haven't got epaulettes on", he says.

I'm cutting the patient's clothes off (to make sure he hasn't been stabbed anywhere more serious than where he has already been stabbed), so I throw the comment that, yes, I know - but the were in my car when it got nicked and I'm waiting for some more.

He mutters something, but to be honest I'm not hugely interested. I've put in memos, spoken to my officers and I'm still waiting, it's not my problem any more.

(Also I'm wearing boots that I bought in good faith so I could get back to work, but our office has lost the paperwork on them so I'm £60 out of pocket until they decide to pay me for them - I might threaten them with not turning up to work wearing 'personal' footwear - that might get a few cogs moving).

We get the patient to hospital, the patient should be fine.

Now, I'm not saying that proper uniform isn't important. Personally I think that crews who don't tuck their shirts into their trousers look awful, it doesn't give us a professional look. Likewise, epaulettes are important as they are the marker of our 'rank'. It's just that there are better times to bring this up with a crew than when we are dealing with someone who might die in the next few minutes. Especially when the officer in question doesn't know us at all.

I'm not the only one who gets pulled up for uniform while doing something a bit more important.

I was met by a friend and as I walked into the corridor I saw my patient sitting on the stair-lift. She saw me, turned and smiled at me.

Eighty three years old, Jamaican born and already dressed ready to go to hospital.

"Hello there, what seems to be the problem?", I asked, kneeling down so I wouldn't be towering over her.

"I fell down the stairs", she replied.

She'd fallen down all fourteen stairs, tumbling backwards from the top. She's landed at the bottom and had hit herself on the stairlift parked there. She couldn't remember the fall and the only obvious injury was a swelling to her leg. Nothing obviously broken but she'd probably have a few bruises the next day.

I take these sorts of things seriously, it's a long fall and with old bones there is a real chance of serious injury. While she looked fine, I wasn't going to take any chances, so I popped a hard collar around her neck to help protect it if she had injured it.

It was only after we had safely secured her in the ambulance that she told me that the fall had happened more than twenty-four hours ago, and that it was only because she couldn't walk on her painful leg that she had called us there.

She hadn't been able to walk because of the pain, yet had only now considered it serious to call an ambulance. I also suspect that it was only because her friend had visited and 'bullied' her into calling an ambulance that we were there now.

Thankfully, after a load of x-rays at the hospital, it turned out that the pain in her leg was from a large bruise and that she hadn't seriously injured herself.

This is why any suggestion for a charge for an ambulance, or for a charge for an inappropriate call won't work. The people who need us will struggle on because they 'don't want to be a burden', while the people who think they are 'entitled' to our free taxi every time they get a sniffle will continue to use us as such - if only because any 'fine' won't be paid, or the person will be so poor they won't be eligible for being charged.

I can't begin to count the number of elderly who I've picked off the floor where they have spent the whole night because, "I didn't want to bother anyone at that time of the night".

I fear that the only solution is education, maybe education administered by me and my stick o' pain.

'Category A call - 25 year old woman with thrush, itchy genitals. Difficulty in breathing'.

Yep. Thrush.

This warranted a fast car response as well as my fully equipped ambulance.

I have two options here.

Option One
I explain exactly how this is a waste of an ambulance, especially as how the hospital is 800 yards away from the woman's address. I suggest that a taxi would have been more appropriate. I could explain how people who are actually ill are now waiting for an ambulance while she gets a free ride to hospital. I could refuse to take her.

Then I get a complaint, then I get fired.

Option Two
I shut up, take her to hospital, make ready for my next call as son as possible and get to keep my job.

Yeah, I'm a coward - I always take option two.

The problem is this, the people up in Control aren't allowed to use the 3lb of grey squishy stuff nestled between their ears to determine how important a call is. They have to mindlessly follow a computer script, if they deviate from the script they'll miss out on any chances for promotion.

While the computer script is useful it's a real shame that our call-takers can't use their common sense. It's why we end up going to people who 'aren't breathing', yet are able to make a 999 call.

And all because the computer system we use has never been sued.

SCENE ONE

Two men of the same age in a sparsely decorated bedroom. One man (REYNOLDS) is an ambulanceman, the other (SPOTTY BLOKE) is a man suffering from Chickenpox.

REYNOLDS enters

REYNOLDS
Hello sir, can you tell me what the problem is?

SPOTTY BLOKE
I have Chickenpox.

REYNOLDS
(Slightly non-plussed): Yes, sir, why have you called an ambulance?

SPOTTY BLOKE
I have a pain in my chest. I went to the hospital yesterday and they said to take painkillers.

REYNOLDS
And what else did the hospital say?

SPOTTY BLOKE
Nothing.

REYNOLDS
Nothing? Surely they said something, they must have spoken to you.

SPOTTY BLOKE
They said I have Chickenpox.

REYNOLDS
See, that's something. So the pain is the same?

SPOTTY BLOKE
Yes - I want to go to hospital.

REYNOLDS
I don't think that they are going to do anything different from yesterday sir.

SPOTTY BLOKE
But I'm ill, my son has Chickenpox and it's not bothering him.

Reynolds is obviously biting his tongue.

SPOTTY BLOKE
I want them to do blood tests.

REYNOLDS
For Chickenpox?

SPOTTY BLOKE
Yes.

REYNOLDS
It won't do any good, they'll just give you more painkillers.

SPOTTY BLOKE
I don't care - I want to go to hospital.

REYNOLDS
(Worried about being sued for leaving someone at home)
Fine sir, your choice. The ambulance is outside, we'll take you the 800 yards to hospital. Did you have an ambulance turn up like us yesterday? With blue lights and sirens?

SPOTTY BLOKE
Yes.

REYNOLDS
(Wondering if someone at the hospital might sue him for bringing a potentially infectious patient to sit in the waiting room for a few hours)
Sigh...

SCENE TWO

REYNOLDS again, now with a WOMAN a year or two older than him. The WOMAN is coughing rather a lot. We join them as the initial patient assessment is nearing the end.

REYNOLDS
...So, you've had this cough for a few days now?

WOMAN
(nodding) COUGHCOUGHCOUGHCOUGH.

REYNOLDS
Would you mind putting your hand over your mouth please?

WOMAN
(The woman doesn't move) COUGHCOUGHCOUGHCOUGH.

REYNOLDS
Ah. No then. Never mind, it's been a while since I've had a chest infection, and I'm only in a *little* bit of trouble for being sick so much.

WOMAN
COUGHCOUGHCOUGHCOUGH.

REYNOLDS buries his head in his hands and wonders how long he has until retirement. The WOMAN spits on the floor of the ambulance.

---

(And yes, I know the formatting is a bit wonky for a proper script, but it can be a complete pain to format stuff for this blog, some of the dialogue on REYNOLDS part may be slightly made up. But not by much).

I sitting opposite my patient, the patient that the police have managed to stop from killing himself. This wasn't a cry for help, he had chosen three different suicide techniques, and then tried them all at once.

Blood drips from him onto the floor, he's crying as well so his tears mix in with the blood. Mucus is dribbling from his nose as he lets out huge heaving sobs. The police officer with him rubs his back with a gloved hand with her other hand she holds his arm, to stop him beating himself. The officer has formed a bond with my patient, one that I won't be able to replicate in the short time he is in my care. I leave the police officer to it as she's doing a fine job, one perhaps not in her normal job description.

We let him have a cigarette in the back of the ambulance with the doors open to let the smoke out, we are thankful that it's not a cold night. It's not 'allowed' but sometimes you have to break the rules for the patient. This is only the second time I've let someone light up in my ambulance. I'm away that the curtains are twitching in the tower blocks around us. A real life soap opera, entertainment illuminated by blue flashing lights.

He tells us the story of his life, one of pain and the worst forms of betrayal stretching from his childhood to the events that have brought him here tonight. Sometimes he has shown weakness, at other times a strength that I'm not sure I would have had. Often I wouldn't believe such stories, he won't meet my eyes as he talks but, instead of signifying deceit, it only makes his words truer. As his story comes to a conclusion I can see why he would want to kill himself. Everyone he has ever trusted has turned against him, not from simple neglect but from active abuse.

We leave him at the hospital, a side room with privacy. I thank the police officer for her help. I book him in, then head back to station to mop the floor of the ambulance - to remove the blood and the tears. It's my last job of the evening so I drive home. My car radio stays off, I drive in silence.

I have known him only for a moment, the police will know him for a little more, the nurses longer still.

But what he has told me will stay with me.

One of those jobs we get a lot of - 'male collapsed in street, facial injury'.

So we arrived to find him face down.

I rolled him over, he didn't have a pulse, he wasn't breathing.

We did what we do - we tried to restart the heart, to bring him back to life.

The details are unimportant. What is important is that on that day someone's husband died, someone's father, someone's son.

There was no warning, he just dropped dead.

One moment alive, the next moment gone.

He was only a little older than me.

If this job has taught me one thing, it's that our time on this planet is precious, and that time can end at any moment.

So live life to the full. Make yourself happy. Try to make those that you care for happy. Your life is the only thing that you truly own and you only get one - so don't sweat the small stuff.

I'm writing this on the train home from seeing 'Waterlillies'; I'd just like you to know that I don't read film reviews so I have little idea of the format of such things.

I wanted to go and see this film because of my own background, from the age of eight until I was twenty-three I was a competitive swimmer. This meant that I entered manhood while spending half my free time in water, surrounded by girls who were turning into women.

Waterlillies is the story of three teenage girls and their first steps into developing more adult relationships. Set against the backdrop of synchronised swimmers it deals with the total weirdness of teenage girls. This film drops us into their lives for a few days.

Now I have to admit that I am a very stupid person when it comes to 'art' - subtext and subtlety flies right over my head with a worrying whooshing noise so it's completely possible that I have missed some really obvious points.

It's also difficult for me to comment on this film as I have never been a teenage girl, but it does a good job of putting you in their place, their concerns seem to be the ones that I remember from my own youth.

The dialogue is sparse, similarly the soundtrack is almost non-existant - yet strangely this works as part of the charm of the film. It's a French film so this means a lot's of lingering shots of moody teenagers looking moody, mostly at other moody teenagers.

There are nearly no adults in this film, we don't see the teenager's parents because, as in real life, at this age your parents just sort of vanish into the background as your mind takes on the much more pressing business of being a teenager.

But somehow it works - at the end of the film I was left speechless, I sat there chewing my lip as the end credits rolled.

Somehow it had bypassed the part of my brain that likes giant exploding things, and plugged straight into my emotions. It left me silent and thinking for a good hour, I wanted to hug someone (but had gone to the film alone) and my eyes were manfully damp. I think that it is a film that will stay with me for quite some time - much longer than the whizz-bang films that I normally like.

Waterlillies is limited release, if you have the chance to go and see it I would recommend it completely - even if nothing explodes or gets shot.

As an aside - I think that paedofear is getting to me, as I felt vaguely embarrassed by some of the lingering shots on the teenagers in swimming costumes. I think that if this film was made in the UK some tabloids would be calling for it to be banned.

"Come!", she said to me.

She didn't even glance over her shoulder as she repeated, "Come".

"Oi!", I said back to her, more than a little miffed, "Don't talk to me like I'm one of your clients".

-----

We'd been working on the edge of our area so it was a pleasant surprise to find ourselves sent back to our own patch.

Top priority call - a transfer from the Mental Health Unit to the A&E department. All of 400 yards.

But no matter, the patient apparently had a swollen foot, and the mental health unit can't treat that - given the nurses I meet there I doubt that they could treat a shaving cut. We do this all the time, transferring patients this short distance.

I wasn't sure why this was a high priority call, apparently the nurse wanted it to be so. As they are on the scene and are apparently a trained professional our Control follow their lead.

So, at risk to me, my crewmate and any members of the public dumb enough to get in my way we blue-lighted it to the unit.

At the unit we were met by the the nurse who said nothing to me except, "Come".

This is not the best way to get into the good books of the nice ambulance man.

She mumbled an apology as I followed her to the patient. There was another nurse in the patient's room and the patient was laying on the bed. I asked the nurses what the problem was; they looked at one another and umm-ed and aah-ed before telling me that she had a painful foot.

I looked at the patient's foot, it was a bit swollen and the blood test results in her notes showed an infection. She'd had the problem for at least four days.

"Who called the ambulance?", I asked.

One of the nurses admitted to being the guilty party.

"You see, by asking for a blue-light response I have had to drive to this call with the same speed and risk as if I was going to someone who is having a heart attack".

"She isn't having a heart attack", said the nurse.

"I know, that's why it is inappropriate to ask for a blue-light response for a case like this".

The nurse made no indication of understanding.

We spoke to the patient, she was refusing to go to the hospital, I tried persuading her but she was adamant that she wouldn't be leaving the bed.

I asked the nurses about the patients mental health issues.

"We don't know", one nurse said, "she's only been here four days, so we don't know much about her."

Ok - fair enough, maybe she has a long and complicated mental health history.

My crewmate flicked through her notes, "Says here that she is delusional and hasn't left her bed in two years".

Yeah, that'll do for a history - seems that my crewmate suddenly knew the patient better than the nurses who'd been looking after her for the last few days.

The patient was refusing to leave the bed, she told me that one reason for this was that her foot hurt.

I turned to the nurses, "You've been giving her painkillers?"

"Yes", they replied, "Paracetamol".

"O.K. Paracetamol is a painkiller, that's good. When did she last have a dose?"

"Yesterday".

"Errr, you know it only lasts about four hours".

The nurses looked sheepishly at each other.

I continued, "what you are saying is that this patient has been in pain, yet she hasn't been getting any painkillers. Is there any reason for this?"

The nurses said nothing.

We finally managed to get the patient to the hospital, accompanied by the traditional nurse escort that doesn't know the patient at all.

It was a stroke of luck that my complex manager was on station as we pulled up. I let her know what was going on, I let her know that we'd been run on blue lights across town so that we could quickly get to someone who'd been unwell for a few days, I let her know about the nurse being rude to me and I let her know that the patient hadn't been given painkillers.

She took our paperwork from us and promised to bring it up in the meeting that she has with them later this week.

It's nice to have a manager who supports you - but without having a complete turn-over of staff at the unit I can't see there being much of change. This isn't the first time I've had a problem with this unit.