50 Shades

"27 year old male, abdo pain"

As far as shifts go, this one had been as dull as they come! You literally cannot please an ambulance crew. It is an impossibility! If we are busy, we moan about the work load and lack of breaks. If on the rare occasion it is quiet we moan about time going so slowly! That's just how it is! Anyway, today was slow. We were sat on standby watching the world rush by when eventually we got a call!

Hardly exciting! As a general rule, 27 year olds are not ill or needing an ambulance. 27 years are generally healthy, they may smoke, do drugs, drink and get colds but they are not ILL! Unless they have been shot, stabbed, hit by a car or fallen from a great height, realistically, 99% should be able to make their own way to hospital and will be none the worse for doing so. I was fully prepared to go through the motions of finding out about the pain, learning that no pain killers had been taken, offering pain killers and referring on to the GP rather than clog up A & E.

We pulled up outside the rather nice looking house and noticed someone at the upstairs window, who promptly disappeared. As we got out the vehicle a guy was standing in the doorway to the house. We trundled over to see him! He looked very awkward, almost embarrassed to see us.

"My friend is upstairs" he said pointing at the staircase.

Sheepishly, he followed behind us and pointed is towards the bedroom. 

Sitting on the bed looking very distressed was our patient. Some people just have a look which makes you think they actually have something wrong with them and he had this look. He was holding his arm across his chest.

"What's the problem today?"

"........." he looked at his friend who was now in the doorway who gestured with his eyes to talk.

"We can't help you unless we know what has happened."

"I can't move my arm."

"So what happened?"

"I fell off the bed". His face went bright red. 

"And how did you land?"

"With my hands out first."

I was about to ask how he managed to fall in such away but luckily everything suddenly clicked into place. One of the skills you pick up when dealing with patients on a day to day basis is to look around houses while talking to the patient. You can learn an awful lot about them, from dietary habits, drinking problems, medications, hobbies and in this case, sexuality and love life! It didn't take a genius to work out that if you take two embarrassed guys and cross it with the paraphernalia on the floor beside the bed, you had all the tell tell signs that this 'fall' had interrupted some serious fun loving! Maybe I wasn't supposed to see them hurriedly, yet badly hidden away, but the lube, toys, condoms and 'stuff' were easy to spot. 

"It's OK, what goes on tour, stays on tour as it were, it happens to the best of us!"

He gave me a half smile! I looked at his shoulder and sure enough it was dislocated. We gave him some entonox and put it in a sling. 

"Right, do you think you'd be able to walk down stairs to the ambulance?"

"........." he looked at his friend again. "Just tell them!" he said.

"Tell is what?!"

"...........there's something stuck in my.......,.."

AWKWARD!!!!! In my head there was a celebration going on! AT LAST! A foreign body! Whoop whoop! Don't judge me! Everyone always asks me if I have been to any with something stuck up their arse and I always begrudgingly say no! Now I have and I was pretty chuffed! My face however showed professional concern with no hint of a smile! Well.....kind of!

"What is stuck?"

He reached to the pillow and pulled out a candle. Well, half a candle! I imagine the candle snapped during the 'fall'! Maybe it was the force of the candle that caused the fall! Let's just say it was 'sturdy' candle! Or we could say it had plenty of body! Sod it, it was bloody massive and the thought of it made me wince an tad! Good effort boys!

"Maybe we'll get you a chair then?!"

He nodded! We chatted for a bit while the chair was being fetched and he started to see the funny side! He was just mortified! His friend (now known to be his fiance) didn't know where to look, equally as embarrassed! I was in my element! We got him to hospital swiftly, taking it smooth over the bumps and handed him over to the doctor. I requested to do the handover in private, out of earshot of the other patients who surprisingly CAN hear through a curtain!

We said our goodbyes and left! Needless to say, I was beaming and the second we got into the ambulance and closed the doors we cried with laughter! At least their love life is burning strong! Sorry, had to shove in a candle.........pun somewhere! ;-)

The Sixth Sense

"38 year old female, ? assaulted, ? pain after C-section"

I think it's fair to say that everyone who works on the front line of the ambulance or police service develop a sixth sense regarding the general public. You can tell when something isn't right, you can tell when someone is ill and the police can tell when someone is up to no good. It didn't however, take a well homed sixth sense to realise something was amiss with this job. It had come from the police and every bit of information we received had a question mark in front of it.

'UPDATE: ? Intruder in house, ? Partner on scene, sounds distressed'

'UPDATE: ? Baby on scene, ? sexual assault, police now on scene'

It all just seemed a bit odd! There was snippets of information but no real presenting complaint or firm idea of what we were walking into! Nothing new there! We pulled into the road and headed up to where the police car was double parked.

As we approached the front door, it swung open. One of the coppers was standing there and we shared the police / ambo look! The look that says 'Hi, how are you, glad your'e here, this is a load of rubbish, I wish I was at home, why do we do this job?' in one half smile, slight nod of the head and a aura of resignation! We walked down the hallway to the other copper in the living room. Again, we shared the look!

'Hi guys, this is Jayne. Jayne had a baby 2 weeks ago and today is scared that someone is going break into the house and try to get her pregnant again.'

With a rather smug, gloating look he backed out the room leaving me to do the questioning. Jayne was sat on a chair, rocking back and forth slightly, her strawberry blonde hair was tangled and messy and she had a very intense look in her eye. I introduced myself and my crew mate and asked how we could help. She responded in kind and introduced as to her 'partner' Eamonn, who was sat in the arm chair on the other side of the room. He seemed totally unmoved by the whole situation.

Jayne went on to explain how she had given birth to Layla 2 weeks previous, by cesarian section. Lying in a moses basket next to Eamonn was Layla. All of the commotion hadn't made her cry, she just laid there, eyes glued to the ceiling. Apparently, for the last day or so Jayne had become convinced that someone was trying to break into her house to impregnate her. She had a real look of fear in her eyes but constantly tried to reassure us that she 'wasn't mental'. It's always awkard to ask about mental health history but I had to. She denied any and said she only suffered with mild depression. On cue one of the coppers handed me a discharge summary from the local mental health unit. A quick flick through revealed that Jayne was a medicated paranoid schizophrenic who frequently suffered from manic episodes.

It was of little surprise but when questioned about it she vehemently denied it, telling us they were wrong. She said she had been bullied by the psychiatrist and they had a vendetta against her. She said the reason she was so upset today was because Eamonn was angry that other men were trying to break in and impregnate her. I told her that I was sure that he wasn't angry but she snapped back 'well he's not talking to me'. He had nothing to say to the accusation. The whole room felt the air of awkwardness at the silence that ensued. We didn't know what to do or how to act. Family disputes are often difficult to be stood in the middle and this was no different. Eamonn's apathy was overwhelming. He had no response to her accusation and just stared blankly towards us.

"Would you prefer it if Eamonn wasn't here? Or maybe come to the ambulance to talk in private"

"Yes, take him away she snapped."

With that, one of the coppers walked over and picked up Eamonn under his arm and walked out the room. As Eamonn's leg hit the door frame he let out a squeak. 

Oh......didn't I mention?!

Eamonn was a blow doll.........

With Eamonn gone, Jayne got up and walked over to Layla and begun stroking her face. I couldn't bring myself to play along with the charade of talking to the 'My Little Baby' doll and suggested we went to the ambulance. She refused and said she wasn't going anywhere as she needed to protect her house and her family. There is no training for this type of situation for us or the police. You just have to improvise, adapt and overcome. Jayne clearly needed help desperately but being in her own home our hands were tied in the short term. Section 136 was useless and Section 135 would take time so it was the old fashioned good cop / bad cop routine with me playing the role of good cop! She didn't have capacity as far as I was concerned but there were less restrictive options available to us. Her life wasn't in imminent danger so we didn't really have the option of removing her against her will. It would also cause her more distress and we didn't want that.

I explained that I wanted her to come voluntarily to get help and talk to someone. She said no. She said she wanted her baby back. With that she pulled up her top and revealed a wound. It was a healing wound from a cesarian section. Her notes hadn't revealed anything about a pregnancy or a baby. 

"Where is your baby Jayne?" I said with real concern!

"They took her?"

"Who took her?" The copper said.

"Social services."

With that she handed me her hospital notes from the maternity unit. Twelve days ago she did give birth to a baby girl called Layla. She had been having frequent psychotic episodes since her partner, Eamonn, had left her and the baby had been taken away due to Jayne's inability to care for her. Clearly though there was no one caring for Jayne! Something as traumatic as having your child taken away would leave anyone distressed but for a paranoid schizophrenic already suffering manic episodes was a recipe for disaster. She certainly wasn't in a position to be left alone at home! What were they thinking?! 

Luckily for us, the fear of being put in handcuffs and taken away meant after some convincing she was willing to go to the mental health unit voluntarily and seemed keen to get some help. She refused point blank to go to A & E saying she'd rather die, so we decided to present to the mental health unit uninvited and deal with the staff when we arrived! 

As was expected they kicked up a stink about her needing to go to A & E first. They also wanted to know why she wasn't under section! It is as if they have never read the mental health act! After much arguing they eventually accepted her. Being reminded by the police that their choice to discharge her are a two night stay was a) irresponsible and b) the cause of us being here, swung it our way. We left Jayne in their 'care' hoping desperately that she would get the help she needed.

This job had two sides to it. The funny and the sad. It's extremely hard to keep a straight face when introduced to a blow up doll and a 'My Little Baby'. What do you say to that?! We certainly had a good giggle about it afterwards and I have no doubt it would be the talk of the mess room at the police station! It certainly was in ours. Some situation you have to laugh at purely because it's how our much vaunted black humour works. It's how we all rationalise the stuff we deal with. We are also well aware of the upsetting side to this job. The woman who's husband has left her, who went through the trauma of giving birth and having her child taken away. Having that mother and baby bond destroyed. Then the pain of being shipped back to her house. The house she shared and had expected to raise a family. The house with the babies bedroom as the constant reminder of what had happened. Pure torture. That alone would be enough to tip the most stable of people of the edge. She had been abandoned by the system, left to fend for herself and unfortunately for her, she had only been able to find solace in a blow up doll. This job was a stark reminder of just how much work is needed to bring mental health care up to the high standard of the rest of the NHS. 

Presumption

I often talk about not judging a job based on the information given to us. Ideally we walk into every job with an open mind, without bias and taking what we see at face value. Sometimes however it is hard not to presume. A ’21 year old, unconscious’ on a saturday night in a trendy part of town I will presume is ’21 year old, completely wasted, must show self restraint, will probably vom’. There will be the very odd occasion that I am wrong, but normally it will be exactly that. A ’17 year old female, DIB, chest pain, pins and needles’ to me, will be ’17 year old female, panic attack after argument with boyfriend, will be crying’. Again, most of the time it will be exactly that, or at least a variation on that! Bearing that in mind, when this job appeared on my mind I suspected exactly the same as what you are all thinking.....

“39 year old female, chest pain, bailiff on scene, patient is being evicted”

I read it as:

“39 year old female, saying she has chest pain to delay being evicted”

OK, OK. Best keep an open mind!

We pulled up outside the high-rise block of flats, got in the lift with it’s urine perfume and headed on up to the 17th floor. The views were amazing, the clientele.....not so much! Inside the flat were 2 bailiffs and our patient. One of them was changing the lock, the other looking frustrated. 

“Hi guys, sorry to call you out, I know you probably have better things to do but we had no choice. We have to cover our backs!”

“No problem, what going on?”

“We are here to serve an eviction notice on behalf of the council. This lady is living here illegally, she was staying here with a friend apparently, that friend has since left the country and she has been living here rent free for 5 months, she doesn’t qualify for a 2 bedroom flat, or any flat for that matter and despite numerous notices she won’t leave. When we arrived she refused to leave, when we explained the police would be called if she didn’t vacate the premises she said she had chest pain. That’s where we are at. I’ve tried to explain that regardless of the pain, the locks have been changed and minute she leaves she won’t be getting back in but she insisted she wanted an ambulance.”

“Okey dokey, no worries, we’ll have a chat with her.”

Call me cynical, but this sounded exactly as I predicted. Similar to chest pains in police custody suits, people time and time again, abuse the system in a vain attempt to delay the inevitable. 

“Hello my dear, do you still have the chest pain?”

“Yes”

“You do know that we will have to take you to hospital don’t you?”

“Yes”

“And if we do so, when you are discharged in 4-6 hours time you won’t be able to get back into this flat to get all your stuff.”

“What do you mean?”

“The locks have been changed, you won’t be able to get back in.”

“But it’s my stuff, they can’t do that.”

“I think they can, you have a chance now to pack your stuff up and take it with you, but if we take you to hospital you won’t.”

“I want the police, they can’t do this.”

“OK, well I believe they are on their way, but we need to take you to the ambulance to check your heart out.”

“No, i’m not going anywhere.”

“I thought you had chest pain?”

“Fuck off”

Charming! Great use of an ambulance! It is hard not to judge calls when you repeatedly go to things like this. I don’t think there is anyone who works for the police or ambulance service who don’t make presumptions based on information given. I’m sure i’ll get some people who will lie until they are blue in the face saying that they don’t......but they do! It’s human nature.

As for the lady suffering acute avoidevictionitis we waited in the corridor outside chatting to the bailiff (who was actually a really nice guy) until the police arrived. They dragged her out kicking and screaming within a few minutes.

“You can’t do this, I ‘av rights, I have chest pain.”

DAMMIT!!!

Good milk, bad milk

Ahh the joy of feeding newborn babies! Every child is different, every couple is different, there are different ideals, different routines, and different formulas. Some mothers want to breast feed for as long as possible, some mothers don’t. Some mothers can’t breast feed, some can. Some babies like to breast feed, some don’t. As parents we find out what works and what doesn’t. That may mean breast-feeding, bottle-feeding or a combination of the two. My boy had breast for a short while then bottle from then on. That is what worked for us. He’s always been a healthy child so I don’t buy into the ‘breast is best’ doom mongering that goes on. As far as I’m concerned, ‘whatever stops the crying best is best’! Simples! Milk formula comes in all different shapes sizes and colors. There is SMA, Cow and Gate, Aptamil, Hipp, Organix and many many more. They all claim to be the best and do all sorts of magic things. The fact is, like some of us only like Heinz ketchup, babies can be fussy to. They will only eat what they like and we went through 4 different ones until we settled on Aptamil. The result of finding the right non-breast milk was our secret to ‘the boy’ sleeping 8 hours a night from 3 months old and 12 hours a night from 9 months old. Yes, I know, I have NO idea what being a parent is like; I’ve had it easy. I could give you my tips but to be honest, like I’ve said, you just find what works for you that match your child’s needs with your parenting ideals. Most people would have found our way of doing things haphazard but it worked for us and ‘the boy’ seemed fine on his 5^th birthday. 

I’m not one to criticize other peoples parenting styles, but I see things at work which really make me question people’s suitability to nurture a baby. What will these children grow up to be like? I’d love to know.

“3 month old male, chest pains, clammy, not eating, has a fever”

I trust you are all asking exactly the same question as I was when this popped up on our screen!

“How in god’s name does a 3 month old baby explain that he has chest pain?!”

I was desperate to know! We arrived outside the location to find a lack of front door. It was a flat above shops so we had to wonder around to the dark ally way behind the block. We climbed the wet, metal staircase, walked across the flat room of the shops and knocked on the door. A frantic looking mum came and opened the door.

“This was”

She hurried off; we followed at our ambulance pace. For a first time reader, an ambulance pace is slightly slower than a walk but looks faster than a walk. Hard to perfect but maintains the pretence of an emergency whilst covering up out apathy. We entered the bedroom; the familiar sight of double bed next to a cot greeted us. The only difference to the norm was that the baby was lying on the double bed….fast asleep. It was 3am after all!

“What makes you say he has chest pain?” I simply had to know.

“He was really sweaty and isn’t eating”

“He doesn’t seem in pain now, he looks fast asleep”

“I know, but he hasn’t woken up for his feed”

“Isn’t that cause for celebration?!” She didn’t seem to appreciate my humor.

“I changed him from this (points at Aptamil) to this (points at a weird looking organic thing) yesterday and now he’s not eating at all”

“So change back!”

“I read that this one (Aptamil) was bad for him.”

“Then try a different one”

“Are you sure he’s not ill?”

“He’s asleep, he hasn’t got a temperature, he is a good color, he is breathing normally and you haven’t said he has a cough at all. His nappies are normal, the only problem I can see is that he is asleep and doesn’t like his new milk.”

“Can you check to see if he has meningitis?"

“He doesn’t have meningitis. We can take you to hospital if you like.”

“I’ve already been twice today.”

“By ambulance?”

“Yes”

“And what did the hospital say?”

“That everything was OK”

Three ambulances, two hospital visits and still, she was convinced there was something wrong because he was asleep at 3am and didn’t like the odd looking organic tree hugging formula. If it tasted as bad as the packaging looked I wouldn’t be at all surprised if he refused to eat it! 

There seems to be a recurring theme with my blogs of late, and that is the issue around what to do for inappropriate uses of the ambulance. This woman had cost the NHS almost £3000 today in ambulances alone, add to that the 2 visits to hospital. This kind of use is unsustainable and costing millions. Education, education, education. I don’t want to be quoting Tony Blair but that is what people need. This woman was eastern European, her son was born here but she had only lived here for five years. I’m not complaining about her ethnic origin, she was here legally, she and her husband work and pay taxes, they both have a good grasp of the English language and that is all I expect from anyone who lives here, British or otherwise. The problem is, they are not brought up with a health care system like ours in their country and as such, do not seem to grasp how it should be used. Far to often people don’t seem to know what and when to use their GP, they call ambulance thinking we are a mobile pharmacy and there seems to be no education structure for immigrants coming into this country. We cannot simply expect foreign visitors to know what to do. A simple leaflet on a rack in a GP surgery is not enough. Someone needs to take the time to explain it, multiple contacts with the NHS in one day clearly shows there is a flaw in the system as well as her parenting. That is what needs fixing.

Russell Athletic

NB: This blog contains very offensive language throughout.

“42 year old female,? Ethonolic, *LOCALITY MATCH* Police required, known violent”

Friday nights are always busy! Without fail! This is partly because of the higher call volume and partly because there are less ambulances. I know it seems strange to have less ambulance when there are more calls but that’s just how it is. Less staff work weekends because of an old fashioned rotaring system and the staff that do only about a 1/3 do nights! That means come the weekend, the service is stretched to bursting point and the people who pay the price are the crews that ARE working! 

There was a job waiting for us the second we officially came on duty. Obviously, we started earlier than that, not being paid, so we could ensure the vehicle had all the kit it needed for a 12 hour shift. Having to do this every shift is a bone of contention amongst staff but we don’t want to be in a situation where a patient needs something and we don’t have it! That argument will probably grumble on for eternity! Anyway, the first few jobs went without incident. Slowly but surely we had been dragged into a grim part of town which was pretty typical of a weekend!

Within 3 seconds of coming up available we were sent the next one. Aaah, nothing like a violent drunk to get the weekend going. When a ‘?’ proceeds ‘ethonolic’ 99/100 it means they ARE indeed drunk. Joy! We headed round to the estate and arrive the same time as the police van. Out climbed 6 of our finest police officers all looking rather miffed to be here. 

“Evening all!”

“You been here before?”

“Nope!”

“You probably won’t be needed, they’ll both be pissed and arguing about something. They usually are!”

“Joy!”

We all stood patiently by the door waiting to be buzzed in. Eventually the intercom was answered and the door opened. As we walked in we heard a muffled ‘Fuck you’ in the background! Here we go! We made out way up to the third floor and along the external corridor. The door was open, but we heard the argument as soon as we made it onto the landing.

“You fuckin’ cunt. Come back ‘ere”

“Pipe down woman”

“You what?”

“Pipe down, I’m gonna go ‘ome now”

“No, no your’e not, I fuckin’ paid for ‘em”

“Sit down and shut up”

“You’re gonna get arrested. Get him arrested”

I looked at her blankly.

“Shut up you old hag”

“Tell ‘im to take that top off, I paid for it”

“Shut up you slag, it’s mine”

“It’s mine and you know it. Gimme my fuckin’ jumper”

“Sod off”

“Officer, arrest him, it’s my fuckin’ jumper”

The officer looked blankly, shaking his head slightly

“I ain’t done anythin’ to be arrested for you nut job”

“You ‘av. You’re wasting the cops time and the paramedics”

“You fuckin’ called em’”

“You won’t gimme my fuckin’ jumper back”

“You owe me a tenner anyway”

“Oh fuck off, gimme my jumper you nonse”

“You what? I’ll clump ya, ya cunt”

“Nonse. Fuckin’ nonse. Dirty little cunt”

“Fuck you”

“No fuck you. Gimme my fuckin’ Russell Athletic jumper and fuck off”

“Officer. She’s unstable. Arrest her. I apologise for her behavior”

“Arrest him, that nonse has my fuckin’ jumper”

“It’s my fuckin’ ju....”

“RIGHT! Both of you, pack it in. We have much more important places to be and i’m sure the ambulance do to. You are both wasting everyones time, now you get out, I don’t care who’s jumper it is. You, stay here, don’t call the police, don’t call the ambulance. It’s the same story every night, how about, for once, you don’t see each other. If I hear a peep from either of you, you’ll both be arrested for a breach of peace, wasting police time and anything else I can think of at the time. Do we both understand?”

“But it’s my fuckin’ jumper.”

“I don’t care.”

“You’re all a bunch of cunts.” *spits at police officer*

*gets bundled to the floor* 

*gets arrested* 

“Told you she was a silly cunt”

“I thought I told you to leave”

*Sticks up middle finger and spits* “Fuck you ya cunt”

*gets bundled to the floor*

*gets arrested*

We never said a word. Just watched and enjoyed the show! Just another friday night in the city! Perhaps when people moan about having to wait for the police or an ambulance they could take a moment to think what we are actually up to?! Right, onto the next one!