It’s happy (mostly) hour again

Being part of an ambulance crew at a rural station frequently meant long journeys into the main hospital in the city. This often meant spending time in the back of the ambulance with a patient. If it was an emergency you were usually busy, and the patient was most likely unconscious. For a general admissions, the patient was conscious and it was our job to offer reassurance when necessary.

It was like being a barman inost situations – the patient would open up and talk about anything and everything. There was an unexplainable trust, like they knew they could tell you anything. Obviously there was the whole patient confidentiality that meant what was said in the back of the Ambulance went no further, but it was more than that.

I worked in a bar one summer, and I learned things about people because I was somebody they could comfortably share their problems with. Being in the back of an ambulance with a patient was the same.

Sometimes the patient was terminally ill. It was a privilege to be a listening ear to them. To help them by allowing them to get things out of their system to someone who was disconnected from their situation, but could still show sympathy.

Elderly people would talk of the changes the had seen, the difficult times during and after WWII. Some spoke of their experiences of war. Not as innocent victims at home, but as active soldiers involved first hand in the fight. I’ve spoke before of the heroes, not looking for glory.

But being in the back of an ambulance can also be a challenge. There are the aggressive patients – more than once I….”asked” a patient to leave the vehicle. There are some things that won’t be tolerated and, generally, if the patient is able to threaten the ambulance crew then they most likely don’t need their help.

I had many humbling experiences, I have many special memories of patients. It is very like being a barman, but a million times better!

The One and Only

They say everyone in frontline medical care has that one job. The one that sticks with them, sometimes forever.

Mine was an 11 year old, hit by a van while they were actually playing on a dual carriageway. The van driver had no chance of stopping or avoiding them. I often wonder how the driver fared afterwards. For a long time I was angry at the parent that allowed them to be there, but then I realised that they had lost much more than me. I drive past the location sometimes on the way to places, there are still flowers and other tributes tied to a lamp post near to the site.

I know for one colleague it was the 15 year old we cut down from a tree in their garden.

This is not about doom and gloom. It’s about the fact we are all human. No matter how tough the exterior image, we all have the sleepless nights where we wonder “could we have done more”. The answer is always no, but that doesn’t help.

“Stress” was a common ailment in my time. Only now is it being recognised as PTSD. Still the support is not there. Managers still tell you to call a helpline if you’re struggling, rather than recognising the fact that you are not coping and dealing with it themselves.

The title of this post, yes, it’s from the Chesney Hawkes song. It was the theme song of my group during my training. We knew what we were getting in to. Our instructors were veterans and held nothing back.

But still we all went into it. From the first death, the first CPR job – we toughened ourselves and went on to the next job. Most of the public didn’t care, they just wanted what they felt they were entitled to. We did our job, many still do. Not because of the glory, there is none, but because we made a difference. I always said for every hundred patients, if just one says “thank you” then the job was worth it.

It’s New Year and most of us will have made a toast at midnight on the 31st. Something positive and forward looking. I want to end this post with a toast a friend sent me. A friend who still serves with an ambulance service despite a severe period of diagnosed PTSD, after their one job:

“Here’s to getting out of bed when you don’t really want to. Here’s to going to work knowing no one really cares. To doing your bit. To making a difference, to getting by, helping them ambulance types that need it. To making yourself available to the ambulance types that haven’t realised yet that they need some help. Cheers!”

I’ll stand by you.

It’s coming up to that time of year again. The time when all the charities ramp up their appeals on TV and on the streets. All the main organisations have started. In his post, I’m not going to tell you who to give your money to. I just want to mention a few causes that I feel deserve extra support around now, a couple not often thought about. All have already been mentioned in previous posts but they are still important, perhaps more so to me because of my personal experiences with them (that is what this blog is all about after all).

Firstly, elderly people. Winter is a dangerous time for many. With fuel costs rising, hypothermia becomes an actual killer. When you casualty turn up your heating without, think of the older ones who can’t afford to. Loneliness is a huge problem too. Some elderly people may have recently lost their partner of many years, possibly facing their first Christmas alone. More than once I was called to such a person around this time of year, who saw no reason left to live any more and just gave up.

Those are the people who need practical support. Friendship, food, heat, people who show they still care about them.

Secondly, not only the people with terminal illnesses – also the frequently unsung heroes who support them. Family members, who are terrified that this might be their last Christmas with the loved one they are supporting. Also the support charities. The people who try to help it all be that little bit more bearable for everyone, while trying to walk away and hold on to anything they can to keep themselves going.

There are many others but finally, I want to mention one very close to my heart – of course, emergency crews, primarily ambulance crews. I’ve already highlighted PTSD, stress, depression…all the problems brought on by giving everything they have to help other people, while very few people give anything to help them cope. Suicide season is near, it’s a difficult time for ambulance crews. The ones who cut down bodies, who try to save someone after an overdose. Many times the patient doesn’t want to die, their “attempted suicide” is a cry for some attention, someone to show them that they are interested. That’s hard to walk away from at the end of a callout, but ambulance crews have to do it.

This next part is not an appeal, I just want to highlight a few charities that help with the situations I’ve mentioned, a couple I have been involved with personally:

For the elderly –

Help the Aged. Essential work with elderly people, especially at this time of year, with your support.

For victims of cancer, and their families –

Maggie’s cancer support centres. They provided a lot of valuable support to my partner after surgery. The staff are amazing and give more than we could have ever expected.

Two(ish) for the Ambulance crews –

PTSD999. PTSD is starting to be recognised more and more in our emergency crews, it’s not rocket science, but no one thinks about that when they see ambulances around towns and cities. PTSD999 is one of a number of charities highlighting this, and helping emergency crews up and down the country.

Frontline Coffee (https://frontlinecoffee.co.uk). Set up by ex-firemen, they have created a number of different very high quality coffees in various forms (beans, ground…), the profits of which support different emergency services. One of the blends is specifically for Tasc, an ambulance support charity that I know does good work from inside the service. They also give you the opportunity to send a bag of coffee to your favourite emergency services station so you can show practical support. Coffee and emergency services – genius!

And finally, one for all of the above –

You! You can give practical help to them all –

Keep an eye on elderly neighbours, cook something for them, show them you are interested in their welfare.

Ask cancer support groups how you can help, many require volunteers for events etc.

Emergency crews love when someone shows their support by dropping a box of chocolates or biscuits at their local station, or drops by on Christmas Day with a wee gift. I know this because I spent one Christmas Day single crewed, and was visited by a few people who made the shift much more bearable.

I hope this post hasn’t been boring, and that it has made you consider some of the groups I’ve written about. Don’t leave it to “somebody else”, be that somebody. They say Christmas is about sharing, I say it’s about caring too.

Gone, but never forgotten

This post is a tribute to two people, but it also applies to many others around the world. The ones for whom the job becomes too much and they see no alternative. The ones who the system fails to recognise and support.

We trained together, without their help and motivation I might not have been as driven as I was. Then we lost touch. I heard about them through another training friend, the one who found them. It had been thought through, and there was no going back. On reflection, there may have been warning signs, but we deal with death and dying every day. We’re supposed to be immune to it, or so people think. Management don’t care, they are insulated from it in their offices. Forgotten by management, unknown by the public, never forgotten by us. One of us.

A trauma gp, a paediatrician, an anaesthetist… Those were a few of this person’s skills. They were trained to drive with systems by the Ambulance Service and they’d be on call for incidents involving trauma. Because they lived near my station we’d see them often at RTCs. When you felt their hand on your shoulder, and heard their voice, you knew everything would be ok. They didn’t take over, their voice usually said “hey, what can I do to help?”. That’s the kind of person they were. No one guessed there was a problem, until it was too late.

I’ll tell memories of both in later posts, this one is to remember them.

Gone, but never forgotten. To all the emergency workers who have passed away because the job got too much and the support just wasn’t there. Hopefully we learn from the tragic loss before many more die, saving other people’s lives….

Oh, no doubt about it.

“You couldn’t make it up if you tried”. That’s what they told us in basic training, and it turned out they were correct. I came across many bizarre situations, some funny, others sad. “Never a dull moment”.

Situations like the time we drove 15 miles, well my partner did, as I gingerly held an empty coffee jar at arms length. Empty other than the Scorpion that had hitched a ride in a bunch of bananas then stung a superstore worker as they laid out said bananas on display in the store. It stung them on the back of the hand, when we arrived the worker said it felt like their hand had been hit with a hammer. We took the Scorpion with us so the staff at A&e could identify the species and apply the correct antioxin if necessary. It later transpired the poor Scorpion was in a mildly dormant state after being chilled with the bananas during transport, making it a lot less toxic than it could have been. It saw its days out, spoiled, in a university laboratory.

I’m no fan of football, but I worked at a couple of games as overtime. One was against a German football team. I was placed next to the Ambulance, and the German TV crew. I’d often seen toilet rolls being thrown around at football games. At this game somebody, in what must have been a moment of madness, decided that till rolls would be left under the seats of the highest levels of the stands, and these would be opened and thrown over the side when the local team scored creating a huge ticker-tape-like display.

These fans were not interested in such dramatic displays. Within seconds of the home team scoring a goal, the calls came in – head injuries, wrist injuries…all the kinds of injuries imaginable that can be caused from being struck by an unopened till roll thrown from a great height. We got busy.

That was not the end of it that night. I have no idea what the final result was, but the German presenter decided to do a live broadcast from the pitch side once most of the fans had left. A podium was set up and they went live. Right in front of the home team’s disabled stand, who were waiting until the rest of the fans had gone before leaving. I tried not laugh out loud as they heckled him on live TV.

The joke was sometimes on us, not always our fault. “Alpha362, 999 call to ******. Patient in respiratory distress”. The coffee cups were put down and we went to the Ambulance. The address was in the city so we had a long drive. We radioed Control for an update but they had nothing, the job had been passed from the out of hours service. Eventually we arrived, blue lights flashing, expecting to find a very ill patient. Instead, the door was answered by a relatively healthy, and very confused person. “Why are you here? Did you bring an inhaler? I’m not that desperate!”. It transpired that they had called the out of hours service to ask what pharmacies were open late because their inhaler was running low and they had a prescription for a new one. They were going on a trip and wanted to collect the prescription before they left!

The snow is always an object of happiness for rural ambulance crews. It makes the countryside look pretty, it creates car crashes (usually slow speed) and it’s a challenge to drive in. Rural crews are usually proud of their adverse weather driving abilities, compared to city crews.

Snow is also a means of stress relief. Snowmen (snow people?) usually appear outside stations, adorned spare items of uniform and medical equipment. It’s amazing how physiologically accurate some crews can be…

I wrote about some snow related jobs previously. During one of those situations it was suggested we created snow angels in the central reservation of the dual carriageway, but we decided against as it was right under a railway bridge and we didn’t want to end up all over social media should a train go by as we lay in the snow. And it might have seemed slightly unprofessional, maybe. That was the year a police officer had been disciplined for using their riot shield as a sledge, ironically it was a police officer who suggested the snow angels.

I did, however, get a wet posterior that year from the snow – as we were leaving the Ambulance on arrival at a job, my partner got out first since I was driving. They were in the process of shouting “watch out for the ice!” as I found out it was icy underfoot, covered by a fresh layer of snow. As I picked myself up I discovered my bum was very wet and very cold. I tried to cover it up as we walked into A&E later, but the staff got a lot of mirth from it for a long time after the night.

I could go on. Full moons, Black Friday…. Maybe I’ll write about more some other time.

Driving with the brakes on

Driving an ambulance is a scary business. It takes training and skill, plus a bit of bravery and fearless concentration. The training is similar to a traffic police officer’s and there is no room for mistakes when you are all that is between hope and death for a patient. That may sound somewhat dramatic but it’s often, unfortunately, true. That adds another element of stress to the driving – consideration for your partner working on the patient in the back. The drive must be urgent, but safe and smooth for everyone on board, and on the road around you. Progressive driving isn’t about speed, it’s about planning and constant awareness. That awareness becomes more sensitive with experience.

I’ve already written about a few incidents and near misses in other posts, here are a couple more:

We had dropped our patient off at A&E in the city and were on out way out of town, heading for our home station. A 999 call came in while we were on the main road across the city, a dual carriageway. I was driving, I checked around me and turned on our systems. Sirens howling, I moved to the outside lane. It was lunchtime and, as we approached traffic lights, I could see a long tailback across both lanes. Since there was no central reservation on this stretch of road, it was common practice to move over to the outside lane of the opposite carriageway. The speed limit was 40 and it was obvious to oncoming traffic that you were coming from a fair distance away. The roads were damp but the rain had stopped, visibility was good. I proceeded with caution down the outside of both lanes on my side, constantly changing the tone of my siren. The oncoming traffic I was facing was moving to their inside lane in plenty of time.

To this day, I have not managed to work out what insane brain process caused what happened next.

As I drove past the two lanes of traffic on my inside, someone who was stopped in a large car in the outside lane on my side decided to be impatient. They seemed to think that the traffic had stopped for no reason and that they could pull out into the oncoming traffic and overtake it, as we were doing. But they weren’t on their way to an emergency, nor were they an emergency vehicle with lights and sirens. Nor had they seen us. As they pulled out into oncoming traffic, it must have dawned on them slightly what was happening. When they saw me in their mirror, around 3 car lengths behind them rapidly approaching, lights and sirens in full swing, I think their folly may have become apparent to them. Despite my cursing, I was blessing the person who invented ABS braking systems as I stopped behind them with inches to spare. That was one of many “butt clenchers” throughout my career. Eventually, they moved back into their lane and we continued. There was no time, and no point stopping for a rant. I’m not sure who got the biggest scare, but I’d like to think they might have learned a lesson in patience that day.

Our ambulances were put through a lot during their active lives, and they were well looked after and maintained by some expert mechanics. This, however, did not prevent occasional failures. These often happened at the most inconvenient of times.

Before the reintroduction of tail lifts in ambulances, they had an automated ramp that folded out and the rear suspension could be lowered. This lowering was done by deflating airbags that the rear of the vehicle sat on. Once the ramp was raised , the airbags were inflated and the rear of the ambulance was raised again. This system worked well…mostly.

In winter especially, these airbags would sometimes burst.

Winter, night shift – we had received an emergency call to an elderly patient. On arrival, the duty out of hours doctor was on scene. We knew the doctor well and we suggested that, because of the patient’s condition, they travelled with us to hospital. They agreed and we left, en route for A&E in the city.

We managed around 3 miles before the loud bang! From there, the rear of the Ambulance was actually resting directly on the rear axle. We bounced along the road, very slowly, for a few yards, before I was able to park the vehicle in a small roadside supermarket car park. We radioed control and explained the situation, requesting an urgent back up vehicle from the city. Fifteen mins later, we saw the blue lights approaching us. The patient, doctor and my partner were all transferred to the new ambulance and disappeared off into the distance. I was left, alone, in the car park, waiting for the recovery truck. What felt like an eternity turned out to be around 2 hours. I finally caught up with my partner at A&E, drinking coffee and chatting to the nurses.

It looks glamourous on TV sometimes, but driving an ambulance is far from it. My initial driving instructor once told us “If you ever lose the buzz of driving to an emergency job, it’s time to retire.”.

They also said “If you want glamour, become an airline pilot. If you want to be a hero, join the army.”.