"...shouted at the paramedics who helped her. The source added: “When she came to she started mouthing off and told the ambulance crew, ‘You have to respect my privacy’. She then told them to get out."

Although, blimey, reading that copy make my teeth hurt. 'pretty 19-year-old', 'raced to the scene', 'pal'. Seriously, does anyone ever refer to people as 'pal' these days?

So, is this story in the 'public interest' and if not why does the Sun have the right to breach patient confidentiality? Because no ambulance crew would go to the press about this - we have ethical standards.

Today this blog is five years old. It's moved beyond the terrible twos and is now happily walking around on it's own, only occasionally falling over and skinning it's knee.

This is the longest period of time I've ever stuck at doing something. I've stuck at it because for some aspects of my life this blog *is* me, what I write here is the part of my personality that I extrude onto the internet. I've stuck at it because I love blogging, I love the community and I love evangelising about blogging.

I've had great opportunities because of this blog, I've done interesting things, become an international author, and most importantly I've met some really great people.

I've had a chance to be involved in a conversation with thousands of people, some of whom have become good friends to me.

Writing this blog has enabled me to reflect on my own internal thought processes and has changed me for the better, I think so at least. When I started this blog I hated my patients, now I am practiced at viewing their situation from other angles (a process I use to try and stop repeating myself) and this has made me a better ambulanceman.

While there are tropes that I've revisited I don't think I've ever repeated myself, somethings I want to bring to the attention of everyone and this blog has let me do that. Every drunk is an individual.

I love blogging and I can't see myself ever giving it up.

But.

I can feel my health slipping away due to shift work, and while I still enjoy the job to some extent, it's not stretching my mind at all. I get paid (before tax) £25,000 a year to wreck my body with shift-work, surround myself with the violent and the sick and then get threatened with disciplinary procedures for being ill too much. I watch how the job is changing and I hate the changes being made in order to please our government masters.

I look at all the things being done wrong and have no power to change them, nor will I ever have that power.

So, from today, I am officially looking for another job. I'll do (pretty much) any work for £25,000 or more. I'll work in an office, I'll wear a suit, I'll sit at a computer all day - I don't really mind. Obviously my ideal job would be something where I can be evangelical about something I love - journalism, podcasting, teaching people to use the internet, doing online PR, helping a company with it's social media strategy. Something like that would be perfect. I don't think that I want to stay in the NHS, not patient-side at least*.

Time to start looking forward rather than at the walls of this rut I've made.

Lets see what the next five years bring...

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*However, I think I'd sign on to do bank, or 'casual' ambulance work at the weekends - I'm not sure I can get blue-light driving completely out of my veins.

A little later on in the shift, after we'd dealt with the patient mentioned in the previous post, we were sent to one of the police stations on our patch. The person there, who had been arrested, was complaining of chest pain.

Patient's in their twenties rarely suffer from heart attacks, and one look at him as he dejectedly sat in the police cell was enough to tell us that it was really rather unlikely it was anything serious.

But we are professionals my crewmate and I, and treat everyone the same, arrested or not.

We tried to get a history from the patient but, like a fair few of our 'clients' he didn't speak a lick of English, so we asked the custody sergeant what was going on with the patient. The police doctor had seen him and was worried that he was having a heart attack - as I say, quite unlikely, but 'unlikely' isn't 'certainly' and the doctor was quite rightly covering his bases by asking for him to be seen at a hospital.

Talking to the sergeant it soon became apparent that this patient of ours had been arrested on suspicion of beating up our patient from earlier and it was only after some hours being incarcerated that the pain had developed.

It's not often that we get to treat both sides of a fight. Dealing with 'assaultee' and 'assaulter' is incredibly unusual, especially if they aren't being seen at the scene of the fight.

We also learned from the sergeant that the victim of the assault had been sent to ITU, but had woken up with apparently no life-threatening injuries. It would appear that a large part of his unconsciousness was due to the prodigious amount of alcohol that he'd drunk and wasn't in fact suffering from a brain injury.

Still, I feel justified in blue light transferring him to a neurological centre because he'd obviously done a good enough impression of being seriously injured enough to worry the A&E doctors enough to warrant a stay in ITU.

And after doing an ECG on my current patient it was highly unlikely that he was having a heart attack.

We took him to a different hospital.

'Male, collapsed in alleyway ?attacked"

We are supposed to wait for the police before we go to such jobs, just in case the attackers are still on scene. Like many ambulance crews we don't worry about such things if the text of the job doesn't set off our 'danger-sense'. This job was during the middle of the day and in the middle of a rather busy part of our patch.

If there is an assault in a public place we'll normally cruise up to it - if there is still something dangerous happening we'll be able to drive off quickly and wait around the corner.

In this case we arrived a few seconds before the police, they had followed us down the road. At first we couldn't see the patient, but then it soon became apparent that he'd wedged himself between a wall and some street furniture. The police were talking to a group of men who were standing nearby.

We approached the patient - there are two reasons why a person wedges themselves in place like that, the first is that they think that they are going to die, don't ask me why, but people just seem to do that, the other reason is that he is so drunk he thinks that he'l be safe and comfortable like that.

His face was turned away from us, and as we turned him over to see if he was still breathing we caught a whiff of alcohol, and if I can smell it then he must *really* be drunk.

Then we saw his face.

Swollen, misshapen and with missing teeth, he'd obviously been seriously beaten. The way that he didn't resist when we pulled him out of his cubby hole made me aware how badly he had been hurt. Something clicked in his arm as we rolled him onto his back.

Now, in an ideal world we would put a hard neck collar on him before we moved him, but as we were unsure if he were breathing properly clearing his airway takes priority (as it always does).

We stepped our speed up a gear - a quick assessment showed that the patient was deeply unconscious. Time to load him onto the ambulance, stabilise him and drive past one hospital to get him to a hospital with neurological surgeons.

As we got him into the ambulance he started to twitch, a sign that there may have been brain or nerve damage. We cut his clothes off to make sure that he hadn't been stabbed somewhere, secured him to the bed and made ready to leave under blue lights.

One of the policemen poked his head into the back of the ambulance, "How is he", he asked.

"Potentially life-threatening", I answered - that's the phrase that gets the police's attention, and in this case it was certainly true. Without a CT scan and other investigations I couldn't be sure if the patient's unconsciousness was due to drink or due to his brain being rattled around his skull.

"I'll follow you up to the hospital then", said the policeman and he ran to his car.

So we blue-lighted him into hospital where we later learned that the patient was sent to intensive care.

But that wasn't the end of the story.

To Be Continued...

There was no blogpost yesterday as I was doing a five hour round trip drive to the other side of London in order to drop off the baby pigeons.

The Wildlife Centre had some really lovely staff and they assured me that the pigeons would be well looked after, once they had learned to fly they would join the flock of three hundred other rescued pigeons that lives in the area and that they feed regularly.

So a really nice result even if the journey was extended somewhat by the failure of my sat-nav at a particularly crucial point...

At least I can now sleep knowing that they are safe and that they won't end up killed to death because we don't know how to look after them.

And a big thanks for everyone who gave advice, it was very much appreciated.

Ok, so I'm a soft git sometimes.

We have had some pigeons nesting the stock area of the ambulance bay for a while - a few days ago we noticed that there were some pigeon chicks there as well. Somehow they have managed to get quite large without us noticing.

Their parents had built their nest of sh*t in a cardboard box containing (ironies of ironies) the infection control suits.

Obviously we can't have pigeons nesting in our stock area as, no matter now much I like them, they spread diseases. Phone calls were made and exterminators were called.

I have a mate who is an pest control worker, and I know exactly what would happen to the babies. So I've snatched them up and brought them home. More specifically home to my mum* who'll be able to look after them during the day. I've taken on the cat**, who is currently sulking behind the futon in my flat.

However, we have no experience in dealing with pigeons, or birds of any sort. The websites and forums have let us know what, and how, to feed them, although I don't have any experience on the physical skills needed to actually carry this out. The pigeons are a bit older than they are in that photograph.

The thing is, I don't think that the RSPCA care much for pigeons - as they are considered 'vermin', I don't think that they are allowed to look after them (and their 24 hour advice line is unhelpful in this regard).

So really, what I need to know is how to look after them until they can fly away and be wild (I'd rather not keep them, but if that is the only option then I've plenty of room in my garden to build a pigeon home... thingy...), or if there is anyone out there willing to take them off my hands.

I think that this might be related to my reading about pigeons saving lives in the two world wars when I visited Bletchley Park.

So... erm... daft soft git asking for advice here folks.

*She who used to do physical therapy on our pet rats after they had strokes.

**Yes, that cat dear twitter followers...

UPDATE: Thanks to commentator 'mc1rvariant' I got in contact with the London Wild Care Trust who will take them for me - excellent, and thanks to everyone who sent me advice. It was all very, very much appreciated.

Home Secretary Jacqui Smith is to unveil plans to shock young people who carry knives into a greater awareness of the impact of stabbing on victims.
Her proposals include visits to hospitals where people are being treated for knife wounds.

...Because, if you'd just been stabbed there is nothing more you would like to see than a gangster (possibly from the same gang who stabbed you) standing over your bed.

The thought that it will 'shock' young people into not running around stabbing each other is incredibly misguided. The reason people run around stabbing each other is because they are in gangs.

People are in gangs because of some well understood reasons, poverty and jealousy are the main things. We've always have poverty and we've always had gangs, it's just a lot more reported on these days.

A desire to call something 'theirs' is another reason why people get into gangs, to carve out a bit of the world that is theirs.

Look at the explosive popularity of Facebook and you see people separating into tribes.

With no external threats to safety these gangs turn on each other - Nothing unites Britain at the moment and so internal strife rises.

Gang members see the rich on TV all the time, the footballers, the actors, the politicians and they want what they have - but now the problem is that they don't want to work for it, TV like Big Brother has led to children, when asked what they want to be to answer "famous".

It might seem simplistic, but working around gangs and the things that they do, going into the sink estates on a daily basis, you get a feel for what the causes are. Everyone wants to be special, everyone wants to 'belong, and because they aren't special, or because they feel alienated, some people turn to tribalism and crime.

I was talking to a police officer about a particularly nasty piece of work the other day, he couldn't understand why some people in poverty turn to crime while the majority of people don't. And if he doesn't know, I'm damn sure the politicians don't either.

Young people today are invulnerable, they have never been disciplined effectively so they think that nothing can touch them. When I see the police arresting someone, all I can hear is the suspect shouting, "You can't arrest me!". The response to a teacher disciplining a pupil is almost always, "I know my rights". No-one has ever told these children "No". Parents don't chastise their children when they misbehave in the supermarket, so why would they discipline them for other things at home.

We are reaping what we have sowed in becoming a more permissive society in the 70's, 80's and 90's. You have to ask yourself if the cost to society for our permissiveness is too much.

That's what you have to treat, not the symptom, the knives, but the causes. You don't treat meningitis by trying to get rid of the rash, you treat it by getting rid of the infection.

But of course, that isn't an easy and quick fix, and it goes a lot deeper than the politicians would like to admit.

Look at the perpetrators and victims of knife killings, most of them are black youngsters - is this a coincidence? By saying that people can be 'shocked' out of carrying a knife they must be saying that black people don't normally think of their victims and this is how to 'uplift' them into changing. This, of course, is utter drivel.

Human beings have been killing each other for years, why should we suddenly stop? Have our brains evolved overnight to find killing abhorrent? I would suggest not, we are no different than we were 1000 years ago, or even 70 years ago.

But of course, politics is all about 'quick fixes', and I foresee new and 'improved' laws to deal with this surge in knife crimes. It won't fix anything and the crimes will eventually fall out of the media's gaze and turn to something else. The killings will go on, but less people will be interested and it will fade, once more, into the background.

Until then I'm guessing that we will have to endure more rapid and ill thought out legislation, and no increase in the infrastructure to enforce it.

Normal service will be resumed.

---

Please excuse this post, it's a stream of consciousness thing and I really should have tidied it up, and had some sort of point, before posting it. Oh, and has anyone ever noticed how short the paragraphs are on the BBC News website?

Over on Mental Kipple I thought up some ideas for iPhone applications that I'd like to see.

The one most relevant to people who read this ambulance blog is #10

10) A copy of the BNF for offline reading, and not for £100+ please.

And what should I find on release but Epocrates Rx, a free application that does much the same as the BNF (British National Formulary, a list of all the drugs in circulation) but will also help me out when I come across pills in unmarked boxes and makes it easy to look up potential drug interactions.

Trust me when I say that it is infuriating to ask a patient what medications they take and they don't know and instead hand me a plastic box with half a dozen different pills in it.

It can be especially dangerous when we want to give them drugs of our own but have to be careful about it interacting with the patient's own medicine.

Really rather quite handy and quick to look at when I don't have my BNF to hand. The only problem is that it is American software and they have some different drug names that us Brits, but it is good for some things and is definitely worth what I paid for it.

I still want #2 though,

2) An Augmented Reality Game, perhaps crossed with social software overtones - consider if you will a game that is location based to where you *really* are. Using the location services in the phone (either original iPhone, or the AGPS of the 3G iPhone)

Anyone writing one want a story consultant? Or have we enough coders here who could group together to write such a thing under my benign dictatorship...?

A hospital has admitted clamping ambulances for parking infringements and charging £50 for their release.
Security staff at King's College Hospital, south London, are clamping the non-emergency ambulances for spending too long in drop-off bays.

These ambulances are privately run ambulances who took up the contracts for patient transport. This is something that the LAS used to do in London, but then with the sneaking privatisation of the NHS the private companies started to do things cheaper and so the LAS lost a lot of these contracts.

They have, as far as I know, no exemptions to where they can park (unlike us proper emergency ambulances).

I'm not quite sure how "They clamp ambulances parked for more than an hour "to allow other vehicles into the area," works though, surely if they are clamped then they are still blocking the area?

I don't know, I'm an ambulance driver, not an ambulance parker. And if you've ever seen me park, that much is pretty obvious.

Kal has wetted my eyes. Bloody swine, he knows I'm soft for the old ones.