More Blood, More Sweat and Another Cup of Tea

The area was cordoned off and as the woman was being looked after by the crew I went to make sure that the policeman who had been driving was all right. He was quite shaken up by the event, and I hope he gets support from his work.

Wee-Wee

The plan was perfect—we’d just taken a drunk to hospital and the patient (a 45-year-old man, married, father of two) had decided to urinate in the back of our ambulance. Both my crewmate and I were happy at this as we would have to return to our station to mop out, and on the way my crewmate could grab a chicken takeaway meal.

And I could get a cup of tea.

This apparently flawless plan was spoilt when we stopped for the food and a man came running out of a pub to tell me that a friend had ‘a fuckin’ big gash in his head’ from when he had fallen over.

So I dutifully entered the pub, to find a 50-year-old man with a cut down to the skull running from his hairline to his eyebrow. Most impressive.

Less impressive was his friend telling me that the patient had taken some speed earlier.

I don’t know about you, but I consider myself too old to be taking that stuff, let alone someone old enough to be my father.

Not that I’ve ever taken speed myself. I like my brain cells exactly how they are, thankyouverymuch.

Luckily another ambulance turned up and took the patient off our hands, and so we returned to the station where I completed the job of mopping out the urine that had been washing backwards and forwards on the floor as we drove along.

I just wish I could be a fly on the wall when our original drunken patient tries to explain to his wife exactly why he has pissed his trousers.

Swagger

‘He’ll end up in the bush,’ I said.

‘Nope—the road,’ replied my crewmate.

‘Bush.’

‘Road.’

The man we were watching dropped to the floor—in the road.

It was the last call of the night—a police CCTV camera had seen a man sitting in the middle of the road in what can only be described as a ‘dangerous’ part of town.

We arrived to find our patient rather drunk and sitting in the road under a CCTV camera. Circling him was a hungry pack of feral children who scattered when they saw us arrive.

We had a pleasant little chat with him—he had scraped his face when he had fallen over, and had no desire to get out of the road.

We spent twenty minutes trying to persuade him to get out of the road. We tried being nice, we tried reverse psychology and we even tried explaining that the police would soon be here and they would make him move on. He refused to move, and he refused to go to hospital—he was a very stationary object.

We got back into the ambulance, where it was warm, to await the police. We’d already parked in a ‘fend off’ position so that a passing car wouldn’t hit our patient.

I don’t believe in making work for myself.

‘Control, have we got an ETA for the police please?’

Control replied, ‘I can only tell you what they have told me—there are no policemen in the big policemen storage box, as they are all out dealing with other things.’

Great.

Right, I thought, time to try a little trick I learnt while reading a book about how the human brain works. Certain gestures and objects have ‘hard-coded’ responses in your brain. So if you walk up to someone who is sitting in the road and give them your hand (as if you were about to shake theirs), they will often take it, and from there it is fairly easy to get someone standing.

Success! Our patient was now standing (well…swaying) and indicated that he wanted to go home. His home was about 400 yards away in one of the tower blocks that surrounded us.

He took two steps and started to fall—he grabbed at my crewmate’s jacket, spun himself around her and by some miracle remained upright.

‘I’m fine,’ he said. ‘I don’t want you helping me walk home.’ He pulled his arms out of our grasp and started to stagger home.

We got into the ambulance and slowly followed behind him.

A message from the police (via our Control) appeared on our display terminal. ‘Are you all right? Does the man have any warning signs?’

Warning signs?

‘Control,’ I was back on the radio, ‘I’ve got this message about “warning signs”. Well, I don’t think he has any signal flares, or any of those reflective red triangles you put behind your car when it breaks down.’ Yes, I know…I was being silly.

While trying not to laugh Control replied, ‘I wondered what the police meant by that as well.’

What I think had happened was that the CCTV operator had seen what looked like my crewmate being attacked by the patient when he was just stumbling around.

We kept following the patient.

He started to swagger.

He started to sway.

He swaggered some more.

We quickly laid bets on him falling into some bushes by the road.

I chose the bushes.

I lost.

We got out of the ambulance and picked him up again. This time we decided that ‘technically’ breaking the law and frogmarching him home would be in the patient’s best interest. So we grabbed an arm each and in a jolly fashion walked him home.

With the three of us all with linked arms making our way down a deserted street, it was inevitable that I’d start whistling ‘We’re off to see the wizard’.

The patient got home safely, although I’d guess that the family member who answered the doorbell wasn’t too pleased with him.

Scent

Way back in my past I trained to be a teacher (of small to medium-sized children). Rather thankfully I’ve managed to block out much of the trauma from those days. My poor memory does have some positive sides.

However, I’ve just done a job in a primary school, and all those memories came flooding back.

To be honest I think it was the smell that did it. Smell is strongly tied to memory, which is why certain odours can transport you back in time, say to helping your mum bake a cake, or to painting a shed with your father.

In this case it was the smell of the floor polish coupled with the scent of the powder paints in the air that flung me back to my days of trying to control 33 mini-disaster machines (or as they are known to the general public ‘children’).

I’m sure that new parents must have the same experience when they first visit their child’s school.

The job itself was quite an easy one, one of the teachers was having a panic attack, which is fair enough really—I know that if I were still trying to teach, I’d be in a constant state of panic attack.

Betting Shops

I know I’ve written about having a wager with my crewmate about which way a drunk would fall, but I don’t want to give you the wrong idea.

I think betting is silly.

I have no idea how to work out any odds. Terms like ‘odds of 11/7’, ‘each way’, ‘accumulators’ and ‘handicap’ make no sense to me at all. Since childhood the betting shop has always seemed to me to be a seedy place where hard-drinking, and hard-smoking, men flush their money down the toilet. Not somewhere I would ever visit.

Occasionally I do find myself, because of the duties of my job, frequenting these dens of vice. And to be honest most of them aren’t that bad. The most common reason why I am sent to these places is because someone has passed out in the toilets due to drugs, or less commonly, drink. For some reason betting-shop toilets seem to be really popular places to take drugs.

Don’t ask me why.

These jobs are fairly rare, so I was surprised to find myself called to betting shops on two separate jobs in one day. Even more surprising was that neither of these jobs was junkie related.

The first job was to a 50-year-old male who had collapsed, and when we arrived the FRU driver was looking a bit concerned. The patient was as white as a sheet and not talking. We were all worried that he was going to die while in the shop, so we quickly loaded him into our chair and removed him to the ambulance.

While trying to do this, every other user of the betting shop continued around us without batting an eyelid. Normally we’d get a bit of an audience, but not so in this case. At one point a man ‘tutted’ me because I was standing between him and some vitally important bit of paper on the wall.

I’ll leave it to you, dear reader, to guess my reply to that.

As soon as the patient was in the ambulance he started to come round. All of our investigations showed nothing unusual, so we concluded that it was just a ‘simple’ faint. As it was a slightly prolonged one we took him to hospital for a few more tests.

The second job to a betting shop was for a 60-year-old male who was having a critically low blood sugar. He was a diabetic, and when we arrived he was rooted to his stool watching the horses racing on the TV screens. His wife was starting to get frantic at his refusal to talk.

On checking his blood sugar we discovered that it was very low, and this would explain his strange behaviour.

We tried to persuade him to drink a can of coke but he refused so we made the decision to give him an injection of glucagon. This drug, when injected into a muscle, is often good enough to reverse a low blood sugar for a short period of time. The plan was to get his blood sugar high enough for him to come out of his confusion for long enough so that we could get some sugar in him.

That was the plan at least.

Instead, we just gave him enough strength to start fighting us, his wife and the betting-shop lady who threatened to ban him if he didn’t do what the ‘nice’ ambulance people told him to do.

In an effort to get him into the ambulance, we ended up wrestling with him in the street. It was a bit strange to be physically restraining a pensioner while trying to (a) not hurt him, and (b) not look like a bully, even though he was a good couple of inches taller than me.

Then a police car drove past us.

It did a U-turn in the middle of the road and pulled up in front of our ambulance.

A couple of police officers got out and helped us persuade the patient to get into the ambulance where we could finally get him to drink the can of Coke we gave him. Sometimes it just needs a couple of big men in black and white uniforms to get a patient to do what you want.

This is one of many reasons why we like the police.

What didn’t help was the wife who would alternately berate her husband for poorly controlling his diabetes, and then spend time telling us that she was a devout Christian.

Thankfully the Coke did the trick and the patient made a full recovery—we left him and his wife in the nearby café getting something more substantial than a can of Coke and a Mars Bar.

Two good jobs, and not a trace of drink or drugs on them.

Makes a nice change.

It Says ‘London’ on the Side

Last night was a bit strange, which for a change had nothing to do with the patients I was seeing.

Newham hospital was packed to the gills with patients, there were no beds available there, so a lot of my workmates ended up transferring patients from Newham to other hospitals around the area. At one point it got so bad that for two hours Newham ‘diverted’, or closed to non-‘blue light’ ambulance jobs. Hospitals don’t like doing this as they get fined for restricting their services, but when the situation is dangerous it’s actually in the best interests of the patients.

But my crewmate and I had to be that little bit different.

We had managed to return to station for three minutes when the phone went. Control wanted us to transfer a patient from a hospital out of our area to another one on the other side of London. We were told that there were no ambulances available in the originating hospital’s sector.

The patient was a young lady who might have been in premature labour with a pregnancy of 30 weeks. The nearest SCBU (specialist care baby unit) with an empty bed was in Hammersmith. Hammersmith is on the other side of London. I suppose we should have counted ourselves lucky that it wasn’t in Brighton.

So I drove through our sector, into another sector to pick up the patient and the midwife. We then drove 30 miles through the centre of London to get her to Hammersmith hospital. I don’t drive through London very often—I don’t need to, London Underground is cheaper and easier than trying to find a parking space. Thankfully all our ambulances now have GPS navigation systems installed—so it’s a simple case of following the arrows on the little screen and avoiding the cars that insist on trying to crash into you. I had a strange feeling of pride that I managed to find the hospital without getting lost or crashing. I then cruised around the hospital looking for the maternity entrance, and managed to find it by sheer luck and good fortune.

The hospital itself was completely different from the hospitals in our area—it was clean, it had comfy chairs, and the doctor who met the patient showed us the staff kitchen so we could get a cup of tea.

The only thing the same as the hospitals ‘back home’ was the angry glare from the midwife as we entered the unit.

On our way back to Newham we managed to get a job.

‘Aha!’ we thought, ‘this might be an interesting one.’

But no—it was exactly the same sort of patient/job that we get in Newham: an elderly Bangladeshi gentleman with all over body ache and a heavy head.

Still, he was a very pleasant man so we didn’t mind.

This patient went to St Mary’s hospital by request, and I’ll admit that on my first attempt at getting him to the hospital I drove past the obviously well-hidden entrance ramp. So I had to enter the one-way system, adding an extra mile on our journey. St Mary’s have a ‘welcome mat’ outside their A&E department. You don’t get welcome mats at Newham. At Newham you have to force open the ambulance bay doors…

Good Job/Bad Job

Good Job

Any time where a patient actually needs an ambulance.

People having an acute flare-up of a chronic condition (diabetes, asthma, heart disease)

People who can’t walk, but who live on the ground floor.

People who make an effort towards managing their chronic conditions.

Maternal emergencies.

Nice people.

Old people.

Children who don’t cry.

Any time a patient, or their relative, says a simple ‘Thank you’ at the end of their trip.

Bad Job

Runny noses, coughs and colds. Verrucas.

People who have had an argument with a family member.

People who can’t walk, but live at the top of a block of flats with no lifts. And are heavy.

People who abuse their bodies with drink or drugs.

5 a.m. matern-a-taxis.

Gangsters crying because they have been stabbed for dealing drugs on the wrong street.

Awful nursing homes.

Parents who weep over their child’s cut finger causing them to have hysterical screaming.

Mr ‘I know my rights’.

Valentine’s Day

First off…

…Bah humbug.

(It’s not just for Christmas.)

I’ve just finished with a job that makes me question this whole ‘love’ idea.

I had been sent to an alcoholic who had just had an epileptic fit and I arrived to find his fiancée looking very worried.

She told me, ‘I’ve known him for ten months and I’ve only seen him fit once, so I’m afraid I got scared and called for an ambulance.’

I reassured her that this wasn’t a problem and that she had done the right thing.

I looked after the patient, it was an easy job, and I spent some time waiting for the ambulance to arrive. (I was ‘single’, so I had been asked to work on the FRU again; the alternative was to work out of Waterloo station.)

I looked around the room they were staying in. It was not what you would call ‘homely’; it was the typical house of a young alcoholic (he was the same age as me). Cans of cheap cider were lying around the place, there was no furniture apart from a settee and a TV, empty cigarette packets littered the floor and the pictures hadn’t been mounted on the walls.

There was an axe leaning against the fireplace.

His fiancée was young and not obviously unattractive, she didn’t seem particularly stupid and she didn’t look like a fellow alcoholic. So I was confused as to why she would want to marry an alcoholic.

I’m afraid it just befuddles me as to how you can love someone who loves their next drink more than you. In any partnership you will come second to an open bottle of cider.

I just don’t understand.

Tagged

We help the people of Newham.

One of these people has seen fit to ‘tag’ one of our ambulances with graffiti.

This means that the ambulance will be taken off the road so that it can be cleaned.

This will cost money.

It will also remove an ambulance from the road.

This means an ambulance might get delayed coming to a call.

I hope it is a call to the ‘tagger’, and I hope that they are in a great deal of pain.

In the past we’ve had people break into our ambulance station to steal radios from the cars parked there as well as steal the station’s TV. When you are working yourself into an early grave on a cold and wet night shift it makes you want to pack the whole job in.

Lost Words

Canary Wharf has a skating rink at the moment and my crewmate and I were sent there to attend to a ‘fall, head injury’.

‘Excellent,’ we thought, ‘a nice simple job—nothing complicated.’

We were met by a worried-looking ice rink worker who wobbled across the pavement on his skates to meet us.

‘We wouldn’t normally bother you guys, but we think it might be serious.’

Grabbing my bags I was led to a woman sitting in the changing area with two youngsters, both of whom were looking a little concerned.

‘Hello there. I’m with the ambulance, what seems to be the problem?’ I normally start with a version of this as a conversational opening gambit.

The patient replied, ‘Well, I had a bit of a fall—’ She paused. ‘I—’ She paused again. ‘Head…hit…migraine—’

She seemed to be having trouble finding the right words to use. I quickly examined her, and was happy that she hadn’t hurt her neck and the small lump on the back of her head didn’t look serious either. So why was she acting so strangely?

‘I get migraines,’ she told me. ‘I…lose…um…er…um…words, and I…eyes…eyes…go blind.’

This is a pretty rare presentation of migraines, but not unheard of.

We got her into the back of the ambulance and all my examinations there were normal. She was complaining of ‘losing her words’ (expressive dysphasia) and of going blind in her right eye. She didn’t seem too upset by this and had already taken her normal migraine medication, although I’m not sure how paracetamol and metoclopramide would help with these symptoms as I’m not an expert on migraine treatment although I know that triptans can sometimes be used.

Her symptoms started to get worse, she couldn’t find any of the words that she wanted to use, and so I needed to get a more thorough history from the two youngsters. They were her nephews and she had been treating them to a trip to London. Although young, they were both very mature and helpful and after some prompting from the patient (‘Laptop…look…laptop’) we found a patient information card in her purse. The card let us know that all the symptoms that she was experiencing were indeed part of the presentation of her migraine.

It was a short trip to the hospital, during which she started to make a slight recovery and we left her in the capable hands of the A&E nurses. Unfortunately for the patient, the hospital was extremely busy, so I’m guessing that she had to wait a little while for any treatment.

The three of them had come from Surrey, so they didn’t know the area well, although we were able to give them directions home from the hospital. We had chosen this one over another slightly closer so that it would be easier for them to get home after any treatment.

A day out in London turning into a trip to the hospital—it happens more often than you would think.

Bleurgh

For the past five nights the majority of my patients have been sick with one or more of the following:

High temperature,

Runny nose,

Vomiting,

Night sweats,

Lethargy,

Cough,

‘Generally unwell’.

So there must be at least one highly infectious disease epidemic in the area. While you or I might want to curl up in bed with some Lemsip and paracetamol, it would seem that a large number of Newham’s population would rather sit for hours in an A&E waiting room.

Madness.

Which leads me to the point. Ambulance crews spend a lot of time around these infectious patients, who have often never been taught the good manners of putting their hand over their mouth when they cough.

So is it any wonder that I’ve got painful eyes, a streaming nose, a constant mild headache and a feeling that I’m suffering from a mild hangover.

But:

Ambulance crews mustn’t have more than three periods of sick leave in an 18-month period.

So I’m having to drag my potentially infectious body into work—where maybe I can infect some more people…

So in conclusion:

Send me nurses—pretty female ones with plenty of drugs.

Free-Market Oxygen

Some patients with chronic lung disease need oxygen, and rather than keep them in hospital, these patients often have cylinders of oxygen delivered to them at their home.

Until recently it was the pharmacist who supplied these cylinders, but the government in its infinite wisdom has decided to privatise the supply of oxygen. This means more paperwork.

And now a patient has died, possibly because of a delay getting her oxygen delivered. It drives me crazy that I spend my time in my ambulance going to 23-year-old men with coughs, yet apparently no ambulance was called for this woman.

It all comes down to the government wishing to run the health service like a business.

I know that some people believe that the free market will constantly provide superior service to anything run by the government. Unfortunately healthcare isn’t a ‘market’ and this market view of the NHS leads towards some very silly initiatives. It’s why ‘failing’ hospitals get less money than ‘successful’ hospitals. Who would want to throw money into a failing business?

Why are hospitals so dirty? It’s because of the free-market contracting of cleaning to the cheapest supplier—regardless of the quality.

It’s also why, despite increasing numbers of patients, more calls, very few new staff and all the other reasons why we may not meet our government ORCON target this year, we’ll get less money to be spent on improving our service.

But what do I know—I’m a van driver not an economist.

Uniform