Control will always ‘try’ to keep ambulance crews within their complex areas so as to maintain good coverage of the 999 calls that come in.  However, with a computerised system currently in place crews are allocated a job dependant on how close they are to it.  So, if all ambulances are tied up with jobs in one area and you happen to be closest, and regardless of how far away it may be – you will be sent to it.  Its not that uncommon to end up many miles from home by the end of your shift – with nothing but rush hour traffic to look forward to.

There are many ways to tell when an ambulance crew have had the misfortune of suffering this wild goose chase and are a long way from their ‘home complex’.  Obviously there’s the fact that you may never of seen their faces round your local hospital before, but there are subtle differences that give it away too – for example;

• they may be in better, newer and cleaner vehicles (it is a well known ‘Sunday Sport’ fact that your home complex always has the duff fleet)
• they may be shy and/or timid when they exit from the ambulance with their patient at hospital (as if the place was laced with booby traps)
• they may be presenting with an angry or deflated disposition as it is their off-job and they are miles from home
• they may be shrugging their shoulders and have baffled looks as they stand at the coded entrance to the hospital without a clue on how to get in

The last two descriptions were very appropriate for my crew mate and I as we stood at the A&E entrance of Ealing Hospital, West London W7 3BE (OS Grid Ref TQ 5146 1798 – Latitude/Longitude 51.5062, -0.3498).  We’d tried several ‘standard’ codes on the key pad but none had worked.

A local crew, sitting in their ambulance watching had clocked us for what we were – lost.

Local Crew:       Where you guys out of?
Binder:               Hackney
Local Crew:      **together**  AH-HA HA HA HA HA HA HA HA HA HA HA HA HA HA!
Binder:               . . . . !

After gaining the correct code from them we wheeled our patient in but were immediately presented with our next challenge – a T junction in the corridor, with no directions.  I turned back to the entrance and caught the attention of the local crew again.  Shrugging my shoulders and gesturing left or right with a questioning expression they answered helpfully.

Local Crew:      **together**  AH-HA HA HA HA HA HA HA HA HA HA HA HA HA HA!

I smiled through gritted teeth.

Eventually they pointed to my left and we soon found the triage area where we started our handover.  Our patient was an elderly lady who’d been stuck on the floor for a couple of days with a snapped wrist.  When she lifted her arms one hand would dangle as if it were a conker on a string.

During our handover a short squat eastern European man with the cuts and bruises of someone who’d very recently been kicked-the-shit-out-of was marching up and down the department in an unhappy mood.  As he did so he expressed his lack of happiness with shouting, swearing and spitting demands for immediate attention to some apparent pain he was in.

Cuts and Bruises:    OOOOH!  FUCKING PAIN!  FUCKING GIVE ME SOMETHING FOR PAIN!  COME ON BASTARDS – GIVE ME SOMETHING!!

The nurses had the look as if they’d been suffering this man for a loooong time.  And looking round the department we could see it was full of patients in various states of personal suffering – but who were trying to deal with it in their own quiet fashion.  No one seemed at all impressed with ‘cuts and bruises’ man.

We carefully put our patient on a bed and wished her well just as ‘cuts and bruises’ threw himself onto the floor and started thrashing around.  The doctors and nurses asked him to move but this only antagonised him more.

Cuts and Bruises:     I not move!  Give me something for pain!  GIVE ME FUCKING SOMETHING!  YOU FUCKING BASTAAAAAAARDS!  GIVE ME!!!!

My crew mate and I walked across and stood over him with our hands in our pockets.

Binder:                       Oi!!!  Listen to you!  Stop that noise now!
Cuts and Bruises:     BU-
Crew mate:                No!  We said SHUT IT!  Look around you man – there are people here in proper pain.  Not your bloody mincing – so keep your noise down!

‘Cuts and bruises’ sat up, his mouth open.

Cuts and Bruises:     Bu-
Crew mate:                We said SHUT IT!  You are being pathetic.  you’re an utter disgrace.  You should be ashamed of yourself – now get up, sit over there and DON’T say another word!!  UNDERSTAND!?

‘Cuts and bruises’ did as he was told and for the remainder of the time we were there, at least, he didn’t make a sound.

My crew mate turned to the Doctors and nurses at the main desk – who gave him their full attention.

Crew mate:                Bit of a nob really eh.  Guess he’s suffering from MAC Syndrome

Noticing that everyone was slightly perplexed with his diagnosis my crew mate gave them a sidewards grin.

Crew mate:                Man’s a c**t!

We left them all giggling to themselves.

Binder

I’ve got my third shift on the car coming up tonight and strangely enough, I’m looking forward to it.  However, there are some apprehensions.

This being my third shift has meant there’s been a second shift . . . which was yesterday.  This was an eclectic collection of typical jobs ranging from young drunks collapsed in the street to COPD patients with difficulty in breathing (DIB).  But it wasn’t the jobs that made the evening ‘interesting’ . . . no, it was more my ability to break things.

Shortly after midnight I noticed the fuel tank on the car was less than a quarter full so I decided to fill it up.  I was about nineteen litres in when I suddenly remembered that this car was diesel yet I was filling it with unleaded.

“Oh . . . bollox!”  I threw the nozzle back in it the pump as if it was poisonous to touch.  And, jumping in the car like a naughty school kid I reversed back out the way as if the pump itself were about to explode.

I’d now switched the engine on AND moved the car with unleaded in it.  With a wince and a yelp I snatched the keys out and threw them at the passenger door as if they were on fire.

“Double bollox!  Fuckety fuck fuck bugger bugger bugger bugger frig bugger bollox!”

After calming down somewhat I finally admitted my little mishap to Control – who, after taking the piss, arranged for a truck to come over and take me and the car to the fitters where I’d try and find another vehicle.

En route we came across quite a surreal sight.  One ‘Shoreditch Trendy’ type person lay sprawled across his single speed bike whilst another slightly less looking ‘Shoreditch Trendy’ type person stood over him berating him for something.  Beside them the window of a cafe was completely smashed in giving the impression a car had driven through it.  People – in the typical Samaritan fashion of London – were gathering round laughing and trying to capture the incident on their camera phones.

My shoulders dropped and my eyes glazed over, “Oh dear,”  I sighed, “best go and see what’s up”.

As I stood beside the two trendies listening and watching them point blame at each other for something that appeared to be nothing more than an episode of bike rage I quickly deduced that there were no injuries.  This was slightly odd seeing that one of them had been pushed through the window of a cafe on his bike.

However, the two trendies appeared hell bent on starting a fight with each other and the general public seemed happy filming this ensuing escapade with the sole purpose of publishing on YouTube.

No one seemed at all interested in my presence so I slowly retreated back to the truck asking anyone in general,  “Anyone hurt?  Any chest pain?  Anyone want treatment from my ambulance car?”  I pointed to my broken car sat on the back of the truck,  “No? Good!  Fine!”

My voice petered out in the chaos so, sitting back in the truck I radioed for the police to let them deal with it.

I did eventually get another car and was able to do a few more jobs – mainly drunks – until nearing 4am I noticed smoke bellowing from the bonnet.

“Oh dear . . . ”  It smelled like water from the radiator.  And, after checking under the car and finding a small puddle gathering, my fears were confirmed – there was a water leak – from somewhere.  I RTS’d (Request To Speak) Control.

“Hiya Red Base, this is  G850*. . . . um . . . I think there’s something wrong with this car now”
“What now?”  They didn’t sound so amused as before.  But after my brief explanation they allowed me to limp back to station where I remained until my shift finished.

So, second shift in, two cars down.  I’m doing well – and can’t wait to see what tonight holds in store for me.

And as for the barrage of abuse that I’m most likely to get?  Well, very much deserved but I’ve had worse.

Binder

*not the real call sign of course

I am now FRU trained.  This means I can go out on the car as a solo responder and attempt to arrive at Category A calls within the 8 minute [tippy title=”ORCON” URL=””] ORCON (Operational Research CONsultancy) These are the timelines set out by the government for us to reach patients from the moment the call starts.  8 minutes is our deadline for Cat A Red calls (“immediately life threatening” . . . but oddly are not when we arrive).  So, taking into account that the person calling rarely speaks English and that this has to be translated, Ambulance crews are tied up dealing with someone who’s called us for a broken finger nail, the route to the patient is full of pot holes, speed bumps, trendies on single speed bikes, black cab drivers “surfing the blue wave”, general idiots in cars and the en-masse population occupying the road – it is no wonder that these targets are hard to meet!. [/tippy] time limit.

I had my official ride-out yesterday and finished the shift on my own.  To be honest, I enjoyed it and think I will enjoy it in the future.  There is clearly no difference in the clientèle we go to its just I would be aiming to get there first.

I went to one job yesterday – ’70 year old male fallen, hit head – Consc: No’.  I arrived outside a busy shop in the city to find several bystanders crowding round an old gentleman sat on the floor.  He was dressed smartly and had a posh appearance.  He looked like he was smiling.

Good, I thought, he’s alive and going to be a happy chap.  This should be a nice easy job.

Stepping nearer I did a quick primary survey – ie did he look like he was about to die?  No he didn’t – and then knelt down beside him asking folk if they’d seen what had happened.  Only one person had seen it saying the old man had teetered a little before falling backward and smacking his head hard on the concrete floor.

I looked down at the gentleman and smiled.  Nonchalantly, he stared back.

Binder:       Hello sir, how are you and what’s happened today?

Nothing but the stare.  Hmmmm, I thought, perhaps he’s concussed.

Binder:       Hello sir, what’s your name?  Do you know what’s happened?

Without changing his expression and without taking his eyes from mine the gentleman started to speak.  Posh, slowly and precisely and in just the same way Cary Grant spoke to Ann Sheridan in the film ‘I Was a Male War Bride’.

Patient:       Fuck off you utter idiot!
Binder:       . . . . um . . .

I didn’t see that one coming.

Binder:       Well, I guess we can at least say you’re ‘alert’ then
Patient:       Who the fuck do you think you are!  You retard – get off me and kindly fuck off!
Binder:       Sir, what’s your name please?
Patient:       I’m not telling you
Binder:       Ok I’ll just call you sir then
Patient:       Too fucking right you will.  Now fuck off!
Binder:       Have you been drinking sir?
Patient:       No I fucking haven’t!  Get stuffed!
Binder:       There we are then*.

And so it went on, until an ambulance crew and a police unit arrived, where our patient continued to be of interesting character to them.  However, the police eventually put him in his place and ‘assisted’ him onto the ambulance.  They said the gentleman reeked of alcohol but neither the ambulance crew or myself could smell anything . . . guess that’s years of ‘odour conditioning’.

The police soon left us and the patient quickly became delightful again and eventually opted to leave on his own accord.  But not before offering more abusive expletives and spitting disdain at our efforts to help him.

This was a shame as we would have very much liked to have conveyed this man to hospital as his temperament could well have been masking underlying problems.  We are only too aware that sometimes, an individual’s behaviour can show dramatic changes if they are suffering bleeding into the sub arachnoid space after a head injury.  Whereas other times, an individual’s behaviour can appear like they are drunk should they be suffering from a low blood sugar count . . . . but then sometimes, just sometimes, an individual’s behaviour can simply be the result of them being nothing more than . . . . . . . . . a complete arsehole.

I’d like to think, and hope that our patient was the latter

Binder

*take the first letter of each of those words . . .

I threw up at work for the first time a while back.

It was after spending three hours on scene at a flat that was damp and mould ridden . . .

The call came down as ’65 year old male, unwell ?cause’.  That narrowed it down then.

It was about 3am and we’d been knocking on the front door for a few minutes with no answer.  The police soon arrived as they’d also been called out – something to do with suspicious circumstances.

We were about to kick in the door when we heard movement from within.  The door very slowly creaked open to reveal a small wildly unkempt old lady standing half hidden and nervous behind her door.  The hallway disappeared into the darkness beyond and the smell that poured out from the tenebrous depths made us all reel backwards and catch our breath.

When the woman spoke it was with a piercing Gaelic whisper and a sidewards glance.  One eye stared larger than the other but both seemed to burn right through your soul.

“He’s not well,”  she paused for perfect effect, “and only a doctor will see him, so he will”

I think I swallowed.  Loudly.

One of the police officers stepped forward to speak but the woman backed away bringing the door to.  Her voice raised in pitch but not in volume.

“Only a doctor mind – it has to be a doctor”  We could barely see her now in the darkness.
“We have Paramedics here dear, they can hel-”
“No!  Not the ambulance men.  No.  Only a doctor.  It has to be a doctor to see him.  He’s not well so he’s not”.

This went on for about ten minutes until the police finally persuaded the woman to let us in.  We could just make out her frightened expression in the darkness.  It almost resembled a plea for help but was too wild or frightened to seem obvious.  She kept glancing over her shoulder at something in the darkness but this only added to the suspense of what might be going on within.

Eventually she allowed us through.  None of the lights were on so we crept in slowly.  The floor was matted with years of filth and dirt and whatever we stood on clung to our boots like ghostly hands pulling us down into the sticky depths.  The stench ripped through our nostrils and tore at the insides of our lungs.  Stagnation, mould, damp, faeces, urine, infection and rotting all moulded into one overpowering maladour.  Within seconds our clothes were stuck to our skin as if we’d stood in a steam room for half an hour.

The woman led us to the first room.  Her fear was heightened now.  The door opened and the stench tripled.  The policeman’s mini-torch darted round the room revealing nearly all the walls pouring with decades of mould and damp.  His torch came down to bear on the bed.  An old bed from the fifties it seemed – and within it there lay a figure, still and motionless.

I felt round for the light switch.

“No, please don’t turn the light on”  The woman pleaded.  But it was too late – the old 40w bulb sprung into life and dispersed a flicker of low light around the room.  The room was cluttered with boxes and things that had clearly not been moved for over half a century.  The walls looked like the setting of some ghostly dungeon – blackened, wet, dripping and foul.  The bed was old and bowed in the middle and a harsh brown woollen blanket lay neatly across it covering an old man.

The woman’s voice was tear ridden now, “no, please don’t wake him, please don’t wake him”

The policeman and I snatched a glance at each other and both knew instantly what we needed to do.  He gently took hold of the woman and moved her aside to start asking her deflecting questions whilst I approached the man in the bed.  His eyes were shut, his mouth was open and his skin was that deathly pale and yellow tightness of someone who’s not been of this world for a long while. My god, I thought, how long has she been harbouring her dead husband like this?  I knelt across the bed and rested the back of my hand on his cheek to see how cold and stiff he was . . .

. . . His eyes snapped open.  Terrified, the old man jumped to his side with a start.  But not as bloody terrified as me!

Every synapse in my body sprung into life and I near destroyed the wardrobe behind me as I flew backward into it letting off the most high pitched shriek of fear ever.

“Wh-wh-what’s going on?!”  The old man stammered.
“Oh, I’m so sorry Patrick,”  the woman went round to his side to stroke his hand, “I called for a doctor for you so I did”

I eventually stopped biting my fist and turned to the policeman.  Simultaneously we both let out a huge sigh of relief – and then proceeded with laughing hysterically.

“Right then,”  the policeman clapped his hands together and eyed the exit, “um . . . you won’t be needing us anymore then will you?”  He was practically out the door before he’d finished his sentence.
“Nope.  No, you guys can go.  Thanks and thank fuck”  I was still reeling at my instant cure of constipation.

The rest of the time there was spent organising an on-call Doctor to come and visit the old man.  It turned out that he had recurrent back pains that hadn’t been resolved.  However, his bed was so old it had an actual 3 foot hole in it where his back was and he’d simply ‘plugged’ it in with news papers and magazines!  God knows how many years he’d been sleeping like that.

They were recluses and had no family – and clearly needed help.  I spent about three hours there gathering as much details and information as possible so that I could try and build a case for social services to help.

Upon return to station I sat and completed all the relevant paper work but eventually the stagnant mouldy damp air got to me.  Overwhelmed by nausea I ran off to be sick in the staff toilet.  Walking back to the mess room I was met with a barrage of mocking laughter and abuse – the type only your friends and workmates can get away with but the type that ultimately makes everything better in the long run.

Binder