As is typical on nightshifts my brain has turned largely into mush. I work, I sleep, I eat and I wash. Beyond that very little penetrates the gray haze that surrounds everything.

Which is my way of trying to excuse any impenetrability of the following blogpost.

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I am trying to get away from writing about patients who are being a bit daft anymore. A lot of the time it's not really their fault that they just don't understand their body enough to realise what is an emergency and what isn't.

But.

Last night we found ourselves going to multiple calls with multiple patients all suffering from 'shock'.

For those of us in the medical field Shock means something rather definite, it means that the tissues of the body are lacking in oxygen, in most cases this is caused by people losing the red, sticky stuff that flows around the body and carries oxygen to those same tissues.

What 'shock' seems to mean for everyone else is 'a bit worried, a bit scared or a bit upset'.

This is not a medical emergency.

While I dearly love the police, they do seem to have a habit of sending us on calls to patients suffering from this second form of shock. So during the shift we found ourselves going to a woman who had been involved in a verbal argument with her son and two car crashes.

Take one of the car crashes as an example.

When I say that I could do more damage to their car with my size 12 boot than had been caused by this collision you understand that it was a minor bump rather than anything serious. But still we are sent to the woman who was hit who was complaining of... well... feeling a bit upset.

And, of course, she wanted to go to hospital in order to be 'checked out', and as she wanted to go we had no choice but to take her. After a ten minute drive with my crewmate chatting to her in the back she was feeling somewhat better, but still seemed surprised when the triage nurse (rightly) sat her out in the waiting room.

A later call had someone who had been mugged as, once more, 'shocked'. And once more it would be fair to say that they were actually just a bit shook up. Nothing that a fully equipped emergency ambulance and A&E department could do. Certainly nothing more technical than to make a cup of tea and have a good sit down and a natter. Important, yes, but not really something for a vehicle that has the word 'emergency' written on the side in big un-friendly letters.

My point about the use of terminology is not one of making sure the 'right' term is used out of some sort of grammar nazism - instead it's so that people think twice before calling an ambulance for someone a who is 'upset' rather than 'shocked'.

Night shifts.

Brain frazzled.

Emails backing up again.

Please send sleep, drugs and weapons.

Interestingly I have new allocator.

I'm on night shifts at the moment - all I want to do is curl up and die somewhere warm that is away from people that find themselves awake at three in the morning and who are so worried about a runny nose they have had for the past two weeks they decide that they need an ambulance now...

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So.

I've decided to commit myself to a Podcast - just audio at the moment and very unpolished, not only because I'm no an expert in such things, but also because I have limited time and resources.

Rumours that I only did this after drinking a full bottle of wine are unfounded.

I will warn you - not only have I the face for radio, but I sadly don't actually have the voice for radio either.

To start with these podcasts will consist of a few minutes of me talking about whatever is on my mind followed by the complete reading (in episodes) of my first book. All coming in at around half an hour, which I think is a reasonable length. There are all sorts of things to be sorted out, like if I think a soundbed is a good idea or not - and if I want to do an enhanced iPod version.

When the second book is due to be released I'll read that as well. I'll record it as part of the copyediting process.

Please be aware I am obviously not a performer. Although with some luck I may get better with both practice and sobriety.

You can download the first episode from here - and if you are clever and have a podcast catcher, the RSS feed is here.

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Ok, Monday's question is this - Who is your favourite band/type of music/musician and why? I ask because I like all sorts of music and can't put a find on why. I'd make an awful music journalist - not least because I'm not an elitist tosser, nor am I swayed by hype.

I have ideas. Terrible, dark, painful ideas.

But I'm not talking about those today. Instead I'm talking about the ideas that I have about doing things with the internet. It was as I was looking at some of my hosting providers I realised that I have a terrible habit of having a good idea, registering a URL and then utterly forgetting about it and/or just not having the time to do anything with it.

Here are some of the URLs that I own and short notes on what I wanted to do with them.

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Ambulancenews.com
Ambulancenews.co.uk

This was going to be a site where all the ambulance news in the UK would be posted up. I realised that I wasn't a news editor very early on in my blogging 'career' and so the sites have lay fallow.

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blogher.org.uk

I was thinking about running a UK 'Blogher' conference - a place for women who are active in the blogging/internet world to have a bloody good chat and learn from each other. I suspect I'll never have the time, or expertise, to sort this out. So I throw it open to anyone who is interested in doing this.

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blogmeme.info
blogthoughts.info

Heaven only knows - I got these URLs years ago - I suspect it was going to be some sort of blog scraping site - or maybe a groupblog.

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blogwear.co.uk

My brilliant 'get rich quick' scheme - a 'one-stop-shop for purchasing blogger related items, if you wanted a Scaryduck t-shirt, you could come to this site and get one. I'm still trying to think about such 'accessory goods' for this site, it's a shame I don't have a logo that I can stick on mugs and then sell to my readers. Perhaps I should work on it...

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bluesandtwos.org

It was going to be a weekly webcomic. Unfortunately it all fell through due to lack of time. However I am working on some new scripts which may see the light of day, perhaps under this URL. Ultimately I'd need an artist. Either that or throw them up under a Creative Commons license.

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britishwarhammer.com

This was going to be a fan site/Podcast for the Warhammer:Age of Reckoning online game. Unfortunately Warcraft dragged me back with the Wrath of the Lich King expansion. W:AR is a bloody good game though.

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godsoflondon.net

Another blog - it was going to be an 'encyclopaedia' detailing the 'small gods' of London, such as the God you pray to in order to find a parking spot, or the God that you give offerings to in order to avoid the attentions of the free-paper distributor on the street corner.

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jobblogs.net
workblogs.net

Aggregation site for people who blogged about their jobs.

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healthpodcasts.org

Was going to be another aggregation site for... you guessed it, Podcasts related to health.

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knightsofalbion.org
londonvampire.net

realheroesunion.co.uk

Three gaming/guild forum sites - one for City of Heroes, one for a Live Action Roleplay game and one for a guild I set up in World of Warcraft. Knightsofalbion and realheroesunion may still be active...

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micropodcasting.org

Aggregation site of Podcasts lasting less than five minutes. Hour long podcasts are fine, but sometimes you just want something to dip into.

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randomreality.org

Pretty much used for hosting images and the like for this site to avoid potential bandwidth issues - when I can be bothered I'll set up a redirect to this blog.

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randomrealityforum.com

I was going to run a forum based off the website, something that never really happened, although there is an empty forum over here that I was going to run but then realised that there wasn't really a direction for it, so what would be the point.

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stimcast.com

Potential Podcast named for Stuff That Interests Me. Never even got off the ground.

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unvarnishedtruth.co.uk

Either a political activism blog, or a website for a Roleplaying game I was going to run. Think 'X-Files' crossed with 'Network'.

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urbanmagic.org

I think I was drunk at the time. Possibly related to Godsoflondon.com, only detailing the fictional miracle workers that live in cities. Think 'Neverwhere'. May have been a gaming resource. May have also been a way to link up the various 'Magikal' practitioners of London. Have a guess.

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90secondreview.com
92ndreview.com
ninetysecondreview.com

Not actually dead. The idea is to have a 90 second video podcast reviewing books/gadgets/technology/news as a way to present ideas in small chunks. After I stalled following a few example episodes I really should get working on it again. Especially now that I've found the power lead for my camcorder and read a book on Final Cut Express.

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cctvsafari.com

A site that would have encouraged people to document where CCTV cameras were placed. I still have the first post sitting in a folder on my computer somewhere along with the pictures of the 40 CCTV cameras I passed on the way to my local newsagent.

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endoftheworld.com

I was drunk at the time. I think I was watching 'I Am Legend'. Dunno. I'm so good at this internet stuff that I can arrange Domains after two bottles of wine. Just don't ask me why I arranged them.

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mentalkipple.com

Supposedly a blog of all the non-ambulance things that I fancy writing about. It would be updated more if I had a shade more free time. I think I may turn it into a pure short fiction site. Get me into practice for the potential 'Book Three'.

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theshadowring.com

Another World of Warcraft gaming Guild site. But no-one joined so has sat there gathering dust. Nobody loves me. *Sob*.

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tomreynolds.net

The complete collection of all my writings, including Twitter updates. Mainly put in place for those who use RSS feeders that can't read the RSS feed on this site.

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txfromfuture.com

I may still get around to doing this - essentially it was going to be the homepage of the Twitter feed of transmissions sent supposedly from the future. Part apocalyptic, part war-story and part Utopian hope. All in under 140 characters at a time.

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humansforskynet.com

This site I really want to do. A cynical/ironic 'mock news' approach to encroaching technology. 'Campaigning' for universal databases and bar code tattoos in order to 'fight crime and terrorism' - in reality to allow the highly advanced AI computer system of the future to enslave mankind. The NHS database is a fine target for this. I'd love to still do this (in part because I think it's important), but... I think I need partners for this one.

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As you can tell, I have the ideas but seldom follow up on them, partly because of a lack of time and partly because it's awful tricky doing these sorts of thins on your own. So, lets open this out for people - if there is anything you would like to give me a hand with, anything that you would like to take on yourself or anything that you think shouldn't be allowed to languish in the back of my mind while I grind reputation in world of Warcraft, please let me know. I'd especially like to take humansforskynet.com into an actual physical form, perhaps as a group-blog.

Of course, the big idea that I had that I know I haven't the technical skills to handle would be the Amazon-like site that lets you collate and download any e-book from the number of publishers that create such things. There are e-books out there that people can't find because they are on the individual publishers website or because the Waterstones e-book search is so awful it makes my eyes bleed.

But it's hard to do any of this when large chunks of my time at home away from work are devoted to recovering from the previous twelve hour shift. My sex drive sadly died last year for much the same reason, but I need to fight having my brain just turn to mush and drip out my ears.

Don't I?

Once more it's the elderly that causes me the most sadness.

We were sent to an extremely demented woman in her nineties, she lives with her husband and, while in the kitchen, had collapsed.

When I spoke to the husband he thought that she was about to die.

Not any more though, she had taken a shine to me and was grabbing my hand, singing songs and pretty much dancing around the living room.

I tried to get the story of what happened from the husband, but it was quite hard as our patient would keep interrupting us with streams of confused conversation and singing of hymns.

It was in the ambulance that I saw her husband bury his head in his hands. His eyes were wet with tears.

He was the only person caring for her, and so, for twenty-four hours a day, seven days a week, with no weekend breaks and no holidays he was nursing this confused and agitated hyperactive woman.

They had no other relatives to help them out, social services had arranged for a cleaner, but he did most of the cleaning for himself so there was little for the cleaner to do. Three or four times a night she would wake him up so that he could take her to the toilet, he hadn't had a good night sleep in years.

"It's like looking after a baby", he told me.

He had to run down the shops when she was asleep, and he constantly worried that she would wake up and find herself alone in the house.

Sometimes she would get angry and hit him.

Once more I found myself more concerned for the relative of our patient than for the patient herself. Thankfully one of my favourite nurses was taking my handover and I let her know that I thought that the pair of them could do with some more effective social input, perhaps respite care for her once a week so that he could have a day when he wasn't caring for her.

There is always a danger that you will become over cynical in this job, that you will be so determined to not be 'fooled' that one day you may make a mistake in the treatment of someone.

Take the call we had the other day, it was given as a 'male, collapsed in the street'. By the time we had arrived an FRU had been on scene for some time.

It was obvious that the man had been drinking, he also had the rough beaten hands and skin tone of someone who spends large parts of his time drinking in the park. We were just down the road from the hospital and he still had a dressing on his hand where someone had removed a cannula.

But he wasn't waking up.

He had a small wound to his head, consistant with him falling from the bus stop seat that we found him lying under, this was his only obvious injury.

Unfortunately no-one had seen what had happened, so we had ourselves a drunk man, but who was rather more unconscious than we like.

If we had been feeling cynical it would have been easy to throw him up on the trolley and drive him back to the hospital that he'd originally come from. It would have been easy enough to do that, to assume that he was 'just' drunk.

But we were in a good mood so we treated him as if he'd been hit by a car, because he may well have been. We collared and boarded him, checked him out from head to toe and, because he was still unconscious, we ended up blue lighting him straight into the resus room.

We started our handover to the doctor as, "He's probably just drunk but..."

Unfortunately this isn't one of our regular hospitals, so I'll never find out if he was just drunk or if it was something a bit more sinister.

But in the end, no matter how embarrassing it is to us, I'd still rather be over-cautions than end up giving evidence to a Coroner.

The patient sat across the ambulance from me. I'd spent a few minutes trying to work out what was wrong with him, it certainly wasn't the 'difficulty in breathing' that we had been sent on.

His head was twisted, his teeth were clenched. His legs were twitching. His eyes were darting around, sweat dripping from his forehead.

He was obviously in some form of distress, but I was at a loss as to what was causing it.

Then he mentioned he'd taken some of his brother's medication.

Medication that could cause these physical symptoms as side effects. Suddenly it all fell into place - by taking the medicine that hadn't been prescribed to him (and a sizeable dose at that) he'd brought these symptoms on himself.

I looked at him across the ambulance, while distressing I reassured him that the symptoms would be temporary and were not life-threatening.

"You won't be taking medicines that haven't been prescribed to you again will you?", I asked.

"Nnnnneeeerrrrrggghhhh", was pretty much all he could say through clenched teeth.

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I saw him walking out of the hospital a few hours later, fully recovered. We cheerfully waved at him as we drove past on our way to another 'difficulty in breathing'.

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For those who didn't spot it, the post yesterday was a parody of a BBC news item - a few changed words and a final insane sentence, and yet still all too believable. I would imagine I'm on a 'list' now...

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For this week's Monday question, my mum always complains, after she breaks a fingernail, that 'that's the one I use to pick my nose, how am I going to to pick it now!". And I'm sure that we've all had parents say, "If you fall and break a leg, don't come running to me". My Nan taught me that the Salvation Army kidnap and brainwash children.

What weird things have your parents said to you? What strange things have they had you believing?

The government is compiling a database to track and store the domestic travel records of millions of Britons.

Computerised records of all 250 million journeys made by individuals within the UK each year will be kept for up to 10 years.

The government says the database is essential in the fight against crime, illegal immigration and terrorism.

But opposition MPs and privacy campaigners fear it is a significant step towards a surveillance society.

The intelligence centre will store names, addresses, telephone numbers, car licence plate numbers, train tickets, hitchhiking signs and credit card details of travellers.

Shadow home secretary Chris Grayling said: "The government seems to be building databases to track more and more of our lives.

"The justification is always about security or personal protection. But the truth is that we have a government that just can't be trusted over these highly sensitive issues. We must not allow ourselves to become a Big Brother society."

Liberal Democrat home affairs spokesman Chris Huhne said: "This is another example of an intrusive database without any public debate about safeguards on its use.

"We are sleepwalking into a surveillance state and should remember that George Orwell's 1984 was a warning, not a blueprint."

A spokesman for campaign group NO2ID said: "When your travel plans, who you are travelling with, where you are going to and when are being recorded you have to ask yourself just how free is this country?"

The 'Nightwatch' scheme covers cars, flights, ferries, bicycle, taxi, ambulance and rail journeys and the Home Office says similar schemes run in other countries including North and South Korea, China, Iraq, Cuba and the historical Nazi Germany.

Minister of State for borders and immigration Phil Woolas said the government was determined to ensure the UK's homeland remained one of the most watched in the world.

"Our hi-tech electronic travel system will allow us to count and record all movements of UK citizens and [it] targets everyone," he said.
Answering concerns about the security of the database he went on to say, "The government has learnt from previous mistakes and we can categorically state that there will be no new data losses. Nor will there be any abuse of the RIPA rules to allow local councils to spy on their citizens".

He concluded, "If you have nothing to hide then you have nothing to fear citizen. Beware the terrorist and the illegal immigrant for they spread heresy".

The original, and just as scary, article is Here. If you look at the number of people that the actual scheme has caught it's 0.0036% of all travellers scanned. Is that cost effective when it comes to (a) money and (b) the damage to civil liberties?