’tis the season

Christmas and New Year – the festive period. Parties, celebrations, presents, cheer, making merry, over indulgence, fights, depression, suicide……

It’s difficult to feel festive sometimes when your Christmas is filled with the latter. It’s sometimes known as “Suicide Season” by emergency personnel, a time when it becomes too much for some people and they try (and often succeed) to end the pain inside. Depression becomes a bigger problem for many who suffer, as they see everyone around them having fun and enjoying themselves. I’m not going to apologise for painting a bleak picture. It’s a very real one, and many ambulance staff are in the middle of it. It’s difficult not to feel it when your eyes are opened in the back of an ambulance.

Regular calls to city centres for broken ankles caused by crazy high heels and icy conditions. Revellers, drunk and incapable, filling hospital beds because there is nowhere else to take them, and to send them home could be fatal. Ambulances stocked with space blankets (large, foil blankets designed to help retain body heat) to wrap half dressed patients sitting on kerbs, feeling sorry for themselves.

Then there’s the obligatory Christmas Day stroke/heart attack. One Christmas Day I was on shift with a probationer. We began our shift at 6am and I explained we’d have at least one “stroke” or “heart attack” call that day to somebody’s granny or grandad. They told me I was being negative and that it was going to be a good day, so I suggested a small wager. It was an icy day, no snow, and we had a number of calls to elderly patients who had slipped and fallen on the way to the car as families were drawing together around the country. All our patients, and their relatives, were in good humour that morning. Then came Christmas lunch.

We had taken our own Christmas lunch in, and a couple of other crew members dropped by with goodies. Then it came – an elderly relative was having a heart attack after their lunch and was unresponsive. My partner was a tad disgruntled as we rushed to the ambulance. Because we worked twelve hour shifts, we drove six hours and attended patients for six. I had been attending all morning, now I was driver. We rushed to the job as I explained to my, somewhat naive, partner that it was probably nothing, and that the patient was probably just having a snooze after a large lunch. They called me a cynic and prepared themselves for the worst; having to tell a family that their loved one has passed away on Christmas Day is never pleasant (nor any other day). We arrived at scene and my partner ran inside, to find the elderly patient fit, well and wide awake, also extremely confused about all the fuss. Tests proved the patient healthy and that nothing untoward had happened. We left the family to enjoy the rest of their day and returned to our station. There I explained further the parasympathetic nervous system – simply explained, after a large meal the body diverts energy to digestion. This is why many people feel like a nap after something like…..Christmas lunch. For many elderly people this can be a deep sleep, often mistaken for unresponsiveness and a stroke or heart attack.

Unfortunately, this isn’t always the case, and ambulance crews give sad news to many families, more poignant around this time of year. While the Ambulance crews walk away and go to the next job, the relatives are left mourning their loss, often tainting future Christmases for years to come.

I mentioned depression and suicide at the beginning of this post. It’s real, and we don’t always see it in daily life, but if you know someone who suffers from depression, you can make a difference by talking to them. Don’t overpower them, just let them know that you are there for them, watch them and their behaviour. If you suffer the horrible effects of depression yourself, and watching everyone else enjoying themselves takes you lower, talk to someone. Perhaps even write a blog!

Ambulance crews can go through a world full of other people’s emotions at this time of year. Some of those emotions can get through their defences sometimes. I watched a programme on TV this week that ended with some statistics, one being that 25% of the UK’s ambulance crews will experience PTSD, one in four! There is little or no support from most ambulance services, and little or nothing being done to lower these figures from inside. Often seeking support feels like, and is viewed as weakness or failure.

I’ve spoken about charities that offer support before, but public awareness is also important. PTSD999 is a charity that I’ve also highlighted, providing support to all types of emergency workers. They have just released a version of the song Heroes to raise funds for the work they do, and to raise awareness of the need for such services across all the emergency services. The band is, appropriately, called Burn Out and it costs a mere 99p to buy the song via iTunes and Amazon Music. So, among the festivities and gift giving, help support the people who make it safer.

Another way you can lift emergency workers is to show your appreciation – a simple “thank you” if you see them out and about, buy them coffee if you see them at the petrol station on a night shift. Simple things go a long way.

As the great philosopher, Michael Buble, once said: “It’s beginning to look a lot like Christmas….”.

It’s based on a true story… Honestly!

Of course I’m talking about the well know UK television show based in the ED of a well known, entirely fictional, English hospital. While I used to watch it purely for the clinical inaccuracies and the abnormally dramatic lives of the staff, now some of the the storylines are close (sometimes very) to jobs and realities I have dealt with. Most recently; Man down, the loss of a colleague. During my career that spanned more than a decade, a number of fellow ambulance colleagues passed away. Some through illness, others in accidents, one more tragic. Most I didn’t know too well, others i knew a bit better, all were sad and their loss was felt across the service. The latter I trained with.

I knew the person closely for 10 weeks, we trained together back at the start of my career. They were a major help towards me passing the exams, a close friend for those weeks away from home, then I never saw them again. but that didn’t ease the impact the news of their passing had. I don’t know the full story, but I know that the job we did had a big involvement in their passing, and that greater support and intervention may have prevented it. I recently met up with a friend who was closer to them. The loss has been very obvious in that friend’s life but, thankfully, support is finally in place for him. But it came from his GP, not from within an Ambulance Service.

The coming episodes of the TV series apparently show the paramedic, and other ED staff left behind after the loss of their colleague, slip into a dark places. I remember the last radio call for paramedic Jeff on the program, my colleague received none of that. Circumstances may be different, but the emotions are the same, as are the questions in peoples’ minds – once again, could more have been done to prevent it?

Ambulance services across the country need to step up care of their staff. I loved my job, but most ambulance crews see and go through things that change the way you view life. “here’s a number you can call….” never has, and never will be enough. I realise this post might ruffle a few feathers in a few ambulance divisions but I hope that, rather than the usual brushing problems under the carpet, they might try to change things if that’s the case. When someone feels unsafe, unsupported by the organisation they work for, something is very wrong!

The TV show may be fictional, but some of the characters and stories are closer to life than you might think. Yes, this post might read like an angry grumble about the lack of support available to ambulance crew members, probably because it is, but I’ve not even brushed the surface of the problem. No one should be abandoned for doing their job, for trying to save lives.

For every “Jeff”, every “Sam” and every “Iain” out there……

You only live…..once

Despite the James bond book/film that claims otherwise, the above is unfortunately very true! When it’s your turn, nothing can change it. Some people, however, choose to bring their time forward. Warning: this post is a blunt one!

Many times we’d be called to an “Overdose”. Sometimes it was a drug user who had overdone it unintentionally, often we could reverse the Overdose with a drug we carried, other times we were too late and the patient had passed away (usually before the 999 call was made). There were also the patients who wanted someone to pay them some attention. These were the ones who took 5 – 10 paracetamol or ibuprofen, thinking that it wouldn’t kill them. Some were spoiled kids who’s parents were too busy, others were so sad and low that you desperately wanted to hug them, but that wasn’t part of the job – all they wanted was someone to listen. None of the patent types I’ve mentioned actually wanted to die.

Then there were the ones who did. The ones who’s lives had gotten into such a state, or who had reached such a low point, that they saw no point continuing with their lives. These patients generally managed to see their wish through, and we were only called when someone found them.

Fatalities were part of the job, and I always managed to treat the majority as just that – jobs. I never knew them, I’d never met them, and I couldn’t tell you what they looked like once we left them. That was the easiest way to deal with death. They were someone else’s loved one, it was their job to grieve. But the ones who took their own lives, they were different. I was called to an unconscious patient, and rolled up to find a very drunk foreign gentleman. He was quite cheery and chatted a lot about how he had come to the UK to work, but he missed his family. Two weeks later, we were called to cut him down from a tree in the middle of nowhere. Another job involved a 15 year old, who was being cut down from a tree in their back garden by the police as we arrived. I remember that one, mostly because there was a strange peace about the scene, and the patient almost looked relieved. Then the mother came out and shattered the peace, understandably hysterical when they saw their dead child.

Then there was the parent who chose to end their life in the stairwell of their home, in full view when their ex when they brought their young children home. I’ll remember that as a job, their children will never forget it for many other reasons.

But we were given the usual 5 minute rest afterwards, then it was on to the next job. No support, no debrief, no health checks. Yes, we chose to do the job. Yes, it was all part of the job. No, no-one is hard or tough enough to deal with situations like that, or worse, and not be affected. The emotions involved in these jobs vary – anger at the selfishness, despair that society has let these people down, sadness for the family and friends.

Then the screen lights up and we go to the next job….

“But that only happens to soldiers!”

That’s actually what a friend said to me recently when I told them another friend, who is still with the Ambulance Service, had been signed off with PTSD (Post Traumatic Stress Disorder). Until a few years ago, I’d have agreed with my friend, but now I know different.

It’s difficult to describe the emotional hardness you develop. When you walk into a drug den and see the addict, clearly dead, with the needle still in their arm. When you cut someone down from a tree. When you have to explain to someone that the last time they spoke to their partner was just that. I could go on, but there’s no need. The emotional hardness happens because the people you work with understand, and there’s an unconscious support there.

When I left the Ambulance Service that support ended overnight. I wasn’t aware at the time, but looking back I can see the signs and symptoms. My support mechanism ended overnight and I went through a form of PTSD. An ex-colleague and myself often chat about jobs we’d been called to, but sometimes…very often…that’s not enough. We recently lost another friend and fellow crew member that we both trained with, the job became too much and broke him. Now we have become acutely aware how huge the lack of support for ambulance crews all over the country is.

After a particularly nasty job, I was once given a phone number I could call, should I find I was struggling. For those who don’t know any ambulance crew members, they may appear kind and caring, and they are, but underneath they become a certain amount of tough and hard. It’s the only way they can survive. To call a number and talk to an anonymous person, who knows nothing about you, is beyond failure!

The purpose of this post is not to point the finger at the Ambulance service. It is to highlight the vulnerability of every person who works in an ambulance, and to highlight the need for a much greater system of support. I am fully aware that other services deal with the same situations, but perhaps someone else will write about it from their perspective.

Next time you see an ambulance go by with its lights flashing, spare a thought for the crew. Think about what might be going through their minds. When you go to sleep at night, think about the crew members, and what nightmares they might be having. If you know a crew member, show your support. Sometimes they look tough, but underneath they’re just normal people……….well, most of them are!

After I posted today’s blog, someone sent me this link. They only cover some parts of the country, but it’s a start: https://www.mind.org.uk/information-support/ambulance/mental-wellbeing-ambulance/

Another charity just released a single to help raise funds to provide assistance for emergency workers suffering PTSD. The charity is PTSD999, the band are Burn out and the song is (appropriately) a cover of the late David Bowie’s song Heroes. Download it from Amazon or iTunes for a meare 99p.