Tears in Heaven

I’ve mentioned this job in a post already but, since it was my “one job”, I feel like it deserves more. I realised that I’ve never written or spoken about it in any kind of detail before, but a recent conversation with a friend and colleague made me think perhaps I should.

The patient was 11 years old. Only 11 years old. Our screen said they were 7. I only found out a few days later what their true age was. I never knew their name, but I was the first person to look into their empty eyes after the life had gone from them.

I was attendant at that point, my partner driving. We had passed the point on the road, a main dual carriageway, minutes before the incident. There’s a strong chance we had seen them alive at the roadside. The job came up on our screen and we had to find a gap to turn the ambulance around. It was rush hour so traffic was heavy, our blue lights stopped the vehicles around us as we crossed onto the other side of the road and made our way back to the scene. The job was a “person vs vehicle”, never good on a main road. Then it was updated “7yo vs van”…

We passed the incident on the opposite carriageway and desperately looked for a gap in the central reservation. Traffic was at a standstill, making it hard to negotiate. As we approached the scene I jumped out and ran over to the patient. They were face down with people around them. I asked two of them to help me carefully turn the patient over while I managed their neck and head. As we rolled them over, I saw the head injury, in the shape of a large, open wound. Their eyes were empty and staring. I found a very weak pulse at their neck, they weren’t breathing. My partner arrived, having brought the ambulance closer. I asked for the immobilisation kit and a trolley, and explained the lack of output. The patient was rapidly immobilised and wheeled into the ambulance, a line in their arm, a tube for breathing. We agreed I’d drive, my partner was smaller than myself, so could fit in the gap between the trolley and the attendant’s chair performing cpr as we wound our way through the busy rush hour traffic. I took the keys and turned the ambulance carefully, then began the dangerous drive. We were around 10 miles away from the hospital, we had a number of hot spots to pass through.

The police hadn’t arrived, but we couldn’t wait. I called control on the way in with an update on the patient’s condition and requested the paediatric trauma team met us on arrival at the hospital. I recall talk of a police escort but we had no time to waste while it was being arranged.

I don’t remember much about the journey, but I broke a few speed limits (legally), and somehow made it through traffic in record time. Oddly I felt no satisfaction in that for a long time.

The staff at hospital were indeed there to meet us, and they took over CPR. After a swift hand over we went back to the ambulance and sat. Said nothing, just sat, then we had to go back to our station as our shift was over.

I was on days off the next few days, probably not the best thing as it played on my mind as I sat at home. Calling the counselling service was not an option, that would be seen as failure. Three days later I went back to work, to find out my partner had taken 2 days off because of it all.

We were invited to join the A&E staff at their debrief meeting, there we found the patient’s true age, and the fact that they were dead before we reached them the impact had crushed the base of their brain. It wouldn’t have changed what we did.

I have vague recollections of a conversation with the van driver. I sincerely hope they had some kind of support. Also the patient’s 7 year old sibling, who saw the whole thing and stood at the roadside watching as we tried to save them. There are often fresh flowers at the scene that remind me, but now I’ve put the incident where it belongs, in my memories. I did my job, now it’s not for me to grieve.

In the months after I left the service I turned that young, lifeless patient over on that road lots of times in my head, in my dreams. I knew there was nothing else we could have done for them, but still it played over and over. No one in the service cared. Why would they? It was my job, I signed up for it.

Today I found out a close friend had a similar job in another part of the country. This is their one job. The service has done nothing. Offered no support.

Crews go through this on a regular basis, and there are no official checks or support. Stress, PTSD and suicide are all very real and far too common results.

Something needs to change, but it has to start in the offices of managers.

Turn to the Dark Side PtII

Angry post warning.

I’ve already spoken about ambulance crews’ dark humour and other coping strategies that they use. I mentioned how “normal” members of the public often don’t get it. Recently I was horrified to read an article relating to this.

It revolved around a message sent to ambulance crews, in their ambulances, telling them to “Please be mindful when outside A+E of how the public view your actions. Eg. Being on mobile phones/Snapchat or taking refreshments.”

Firstly, what narrow minded, uninformed person actually sent that message? Any member of any ambulance service should know what their staff go through. To send something like that to crews, while they are still on duty, is utterly thoughtless!

Secondly, the message began “Following a complaint from a member of the public…”. Whoever took that complaint should have put that member of public straight and explained what the crews actually go through on a daily basis and ended things there. It should never have made it past that first person.

There are blinkered people out there who think ambulance crews should go round expressionless and unemotional. Unfortunately robotics hasn’t progressed that far yet so the job is still done by humans, with emotions, and coping strategies.

Sometimes, after certain jobs, they just need to chat with a friend or a loved one, outside A&E, on their phones. Sometimes one of the few chances they get to drink coffee etc is after a job, outside A&E. Normally because they are so busy serving members of the public. They might even have been on their phone to a counsellor after a particularly traumatic incident.

Please don’t ever judge crews for being human. That “member of the public” probably had no idea what the crews they were complaining about had just dealt with. Maybe they actually just needed a break and a brew, perhaps they were taking the chance, between jobs, to check in with their loved ones they’d not seen for a long time because they’d been doing long shifts.

I hope the person who actually sent that message was suitably dealt with.

Finally, if you think I’m wrong, and if you think crews should behave differently, most ambulance services are usually recruiting – why not put yourself in their shoes and see if you are right.

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!”