When a job comes down as “One Under” it means that someone has either fallen or jumped under a moving train.  This tends to happen on the London Underground system more often than it does on the overground.  Sometimes the patient can be alive with no injuries (amazingly), sometimes they can have multiple and massive ones.  And sometimes they can be just plain proper dead . . .

. . . I hurried on behind the underground staff leading me down to the platform.  Oddly enough, my mind wasn’t full of concern about what we were about to witness.  No, it was concentrating desperately on holding onto everything I was carrying and not tripping up.  I think it’s safe to say I looked a lot like a fat American trying to run and catch a flight with both arms packed full of suitcases.

Rushing down the underground stairs along side me was a motorcycle paramenace by the name of Shane*.  We’d both arrived at the same time and as we raced down below he held out his hands to offer some help.

“You need a hand with some of that?”
“Nope . . . I’m fine”  I lied.

And by the time we reached the platform I was knackered.  The multitude of kit I was carrying was instantly dumped to the floor where I quickly glanced over it all, making sure I had everything . . .

O2 bag – check
Paramenace bag – check
Lifepak – check
EZ-IO – check
Suction Unit – check
Cervical Collars – check
Dressings pack – check
High visibility jacket – check
Service Safety Helmet – . . . . . . oh bollocks.

There was clearly no time to go back upstairs to get these so Shane and I just cracked on.  And whilst he ran from end to end to check that the SCDs (Short Circuiting Devices) were in place I tried to find out what had happened and where our patient was.

Unfortunately there was still pandemonium and chaos and no one seemed to know the full details.  And being on the platform it was impossible to see where the patient was so, we both jumped down to have a look.

Now, I’m pretty sure there will be folk reading this who, right about now, will be sucking in air through their teeth saying things like “silly idiots”.  And let’s face it, they’re right.  We had, after all, just broken every safety rule in the book – e.g. both down on a potentially live track and neither of us wearing safety helmets.  To make my case worse, I had to take off my high visibility stab vest to give me room to crawl under the train carriage.  I would never have fit through with it on . . . and I AIN’T that fat!

Our patient was about 12′ back from the front of the carriage and was lying perpendicular to the train tracks in an awkward position.  Shane edged his way along the side between the far wall and the carriage and bending down, he was able to reach the patient’s head.  It was lying face down over a track.  There was no response.

I belly crawled my way to the patient and stopped when I could reach him.  Everything about the way he lay looked out of proportion to how a human should look.  This was hardly surprising seeing as how a rather heavy train had just rolled over him.  Shattered bones protruded from the patient’s body in various directions and both ankles were bent at right angles.

“Binder.  Can you reach him?  What do you think?”  I could just make out Shane’s figure to my right.  He was trying to check the patient’s head.

“I’m not sure Shane . . . I think . . . um, hang on – ”  I reached forward to check for something like a pulse in his neck.  He was still very warm.  Instead of feeling a pulse though, my hand slipped into what was left of his neck and rested upon the patient’s severed and smashed vertebrae.  Basically, the only thing keeping his head attached to his body was the skin on the back of his neck.

“Yep.  He’s dead.”
“Proper dead?”
“Oh yeh.  Proper dead.  Like if you were to stick an iGel down there, I’d be able to pull it out from the bottom.  He’s proper dead dead.”
“Righto”

I clambered out from where I was and brushed myself down.  Looking up my gaze was met by dozens of people staring back.  By now, everyone had arrived.  Several LFB, HEMS, a DSO, another LAS crew and BTP were all milling around the platform and on the tracks.  And, after a quick chat with HEMS and the DSO, death was pronounced.  This allowed LFB to initiate extraction of the body – which was awkward seeing as how he was sprawled across all the tracks.  But, after some effort they were able to slide him out and straight into a body bag.

Afterwards, the DSO pulled all the LAS bods to one side and gave us a “debrief” highlighting specifically mine and Shane’s poor safety admin.

“Right, first up, everyone ok?  Good.  Right.  You two – shit safety.  You MUST have your skid-lids and high vis jackets.  ALL THE TIME.  Other than that . . . good job all of you.”  He looked me up and down.  I looked like someone had dragged me up and down several chimneys.  “You, book yourself off the road and get yourself cleaned up.  Anything else?  No?  Right.  Let’s bugger off!”

I liked that debrief.  Proper old school.

This section of the station was shut at this stage . . . for obvious reasons.  The train wasn’t going anywhere for a while either.  And as we headed out to our vehicles I heard a female voice state loud and clear over the tannoy;

“. . . and there is still a good service on all London Underground lines”

Binder

*not his real name of course