Hi Tom, This low blood sugar thing, another black mark of my scale of normality! Four hours between meals when working as a paramedic technician, is tantamount to self abuse. You should have learned by now that working out on the street, either your own or with a partner is much more stressful than working in the casualty of an accident and emergency unit. Paramedics are a bit like angels in that they have to go where most others would fear to tread. They have to treat with kindness and care, some of those that the average world citizen would rather pass on the other side of the street! Dealing with other peoples trauma, whether it be physical or psychological is often traumatising in its self. Not having to deal with real emergencies, such as the half hour or acute belly- ache which in the vast majority of cases is later resolved after a good fart, whilst relaxing or even better walking around the casualty waiting room. But transport is free in a BWT and of course these “plonkers” and neurotics (they are the ones who are really and secretly infectious!) are under some stupid illusion that ambulance patients get some sort of priority. A little practice at standing in the entry corridors of majors, some times waiting one or two hours before being able to transfer ones patient to a trolley would soon set them straight. It’s the same sort of selfish nutters who cause halvoce on the roads by always having to be at the front of any que that cause deaths by the thousand every year as precious resources are squandered on sociopath the socially incapable and irresponsible. As one dear female friend of mine used to say and most likely still does,” CUNTS!”! As is her right, silently whilst with the patient, saving her very vocal stress release, for the ambulance park of Newham Hospital or on the odd occasion back at station! Of course if you don’t transport these pricks and they get all self righteous about the NHS charter and go complaining to Big Brother or Big Sister then one had better look out! One letter from some creative hack, working for the Independent Complaints Advocacy Services, such as the one at the Mare Street Citizens Advice Bureau and which seems to be run by a bunch of failed Nigerian law students and you are init right up to the nostrils. Like I said in a previous comment, there is no quicker way of getting Sue from the Professional Standards Units, knickers in a twist, than to do something like asking “Does the patient speak English?” or not transporting a belly-ache that lasts longer than the standard hour, the type that only need a casualty laxative and a good ----! Trouble is and always has been and always will be, there is always the one where it is a bit more than bit of wind or indigestion. With your years of medical experience you’re not likely to be caught out by the stoical, because you examine the patient and note and consider history and symptoms! But there is also the Wally’s! Those who don’t notice the obvious and of course the tired and the worn out after a long and exhausting twelve hour shift. People just like you, slightly hypoglycaemic and in need of a little rest and a good feed! Little wonder some crew staff rushes into their stations whilst passing on the way to a call and grab a forgotten sandwich or packet of sugary biscuits. Better to get there sane and safely, than to end up in an RTA on the way or be mentally befuddled on arrival and miss the obvious! Safety first rules the day! You did the right thing, call control and make it their responsibility! If they send you on a call when you’re in the state you describe, they would be acting irresponsibly and would have to take responsibility for anything that went wrong. Of course irresponsibility and socio-pathological behaviour are everywhere! Even in the LAS Ambulance Control. (Comment, “Community Relations”). I remember years ago at Newham, when a QAP crew (brothers and now a senior officer of the service!) responded to Call Red Accident given as severe abdominal pain, as “Just another Paki with a belly ache!” When they eventually got to the scene, having travelled in their usual style, no lights, no horns, stopping at every set of traffic lights and every other zebra crossing before finally applying lights and horns just around the corner from the house (THIS WAS STANDARD PRACTICE WHEN I AND OTHERS ARRIVED AT NEWHAM AS TRAING QAPs. IT WAS ALSO TRUE OF MOST STATIONS IN THOSE DAYS. What did Mr Flaherty, Mr Sayle and Mr Morris do about it! Fuck all! Gutless bastards! They sneaked off to the Training School leaving the shit on the matt and got under cover leaving real men and women to sort out the mess.) The trouble with all this grief and what I would call micro-trauma, is the operational Paramedic (not one of those green bag carriers living near the top of Waterloo Ivory Towers), can become subject to many subconscious stresses, anxieties and ultimately to severe depression. I would suggest that it’s most likely that what you experienced was a bit of post-crapauma, exacerbated by a reduction of electrolytes due to insufficient carbohydrate in your system. It could always be an early symptom of bad news! Four years ago, I was attending an initial assessment with a very attractive middle aged female LAS councillor when she asked the simplest assessment question, "If you had an invisible glass of water in your hand would it be half full or half empty?”. I was very naive then, “These days every glass of water I pick up very quickly develops a leak and pours all over my trousers!”, I told her. After two one and a half hour sessions, with a real psychiatrist in the same counselling suite, he told me I was suffering from a moderate clinical depression and had done so for a number of years! When I suggested that I was no different from most of the people I worked with he said, “I know. Quite a large proportion of them are depressed as well. It’s that kind off job! Why do you think the turnover rate is so high?” When I got back to station, I told various people what the shrink had said and was astounded by the number of colleagues, who the told me that they were taking anti-depressants and all to avoid having to go sick. Unfortunately I have an atopic physiology and can develop sensitivity to various medications. When I tried this strategy it made the situation worse by inducing quite a severe allergic reaction and I ended up off the road for good, so Eat well and prosper!