by Wharton, Kit
The restaurant manager loved every minute of it. He didn’t ban them or anything. He asked when they were coming back so he could make sure he was there.
Lucky people.
Apparently Napoleon’s advisers were once recommending a general to him before a battle, saying how good the general was at this or that or the other. Yes I know all that, said Napoleon. But is he lucky?
The trouble is, no matter how lucky you are, sooner or later it runs out.
Susanna
Morning.
An old joke: What do you give the man – or woman – who has everything? Penicillin. Ha bloody ha.
But the next job isn’t funny.
I’m on my own on the car, with no Val to talk to, called to a female with breathing difficulties. The patient is paralysed from the arms down after a riding accident and also has a brain tumour which is killing her. That’s all I know.
The house is like nothing I’ve ever seen. Rolling hills and woodland and deer wandering about. Down a long drive the road winds into a circle in front of the house, forming a parking bay with three or four spaces. A squillion’s worth of shiny BMWs and Mercedes are out front. The patient’s carer takes me into the house, which is a bit like a modern flat-roofed bungalow. Except modern bungalows don’t have seven million bedrooms, a study, a library, a cinema and an indoor swimming pool next to the front room, which is twice the size of my flat. The whole place is sumptuous and enormous. Like a James Bond set. The kitchen is so huge I practically have to shout to the carer over the other side. Must be worth millions.
The patient’s husband is there. The couple have a million children – there are pictures of them everywhere, all gorgeous.
This is the life.
And then there’s the patient. A woman in her thirties. Gasping, overweight, and confined in her wheelchair. Unable to wash or feed herself. She can talk and move her head and hands but that’s about it. Her paralysis is so bad she can no longer move her chest muscles effectively and therefore can’t breathe without help. She is slowly, inch by inch, minute by minute, being asphyxiated. There is a machine called a positive-pressure ventilation unit, which blows air into her lungs through either her nose or mouth to inflate them and keep her alive. She prefers the nasal cannula, which she has been using all day. As a result her nose has become inflamed and blocked up and she can hardly breathe at all now.
By changing her onto the mask which covers her whole face (and which she hates) some of the pressure is taken off her nose and she can breathe slightly more easily.
So: job done. But I can’t help wondering what else to do for her – she’s in such a desperate state. What on earth could the hospital do? Even getting her there would be a nightmare. Eventually I call out the doctor for want of anything better to do. The GP is a lovely man who arrives within the hour. Before he goes in we talk the case over. The GP knows it well – he’s been caring for the patient for years – but he also knows the score. There’s nothing to be done. The patient is nearly at the end of the road.
Basically, if she dies peacefully tonight of a chest infection, that would represent a good outcome, the GP says.
Jesus. When you put it like that it sounds stark, but that really is the way it is. It’s torture, what she’s going through physically, but it must be even worse seeing your beautiful house and family, knowing time is slipping away and ripping them from you.
I say goodbye but can’t get the job out of my head. Didn’t someone once say behind every great fortune there’s a crime? But you wonder how anyone could deserve that.
I saw the GP some months later on a different job and asked after her.
No surprise what he said.
12
Road Traffic Collisions
The only time I’ve ever been a patient myself was one winter morning in 1994. I collided with a lamp post. I was riding my motorbike south out of London, in the outside lane. A brown Mercedes pulled out into the road from the left to join the traffic. It was morning and I had my headlight on, so I assumed it would pull out into the inside lane, but it pulled out straight in front of me. I braked sharply. There was a patch of diesel on the road which my front tyre hit.
The whole sensation was a bit like being blown up. You don’t really know what’s happened, except that something bad has happened, and you’re suddenly not riding your bike, you’re winded and wondering where you are.
Interesting, really.
The next thing I thought was: shit, I’m lying in the middle of the road in the morning rush hour, and I don’t really want to be run over. I saw that there was grass behind me, so I picked myself up on two arms and one leg and threw myself back onto it. I only used one leg because the other one seemed numb. When I looked down at it, lying on my back, I could see that the shin bone was completely smashed, and the foot flapping uselessly below it like a dead bat as I held the leg up.
I thought: oh well, they can do amazing things with prosthetics nowadays. The next thought was: bloody hell that hurts. It was like having the worst case of cramp you’ve ever had, but being unable to do anything about it. All the time I was lying by the road with my leg hanging off a passing motorist knelt next to me, holding my hand. He didn’t say much, just held my hand. It was amazing how much it meant. I never had the chance to thank him but I’ve never forgotten it.
Especially with the elderly, in pain or lost with dementia, sometimes just holding someone’s hand makes a lot of difference. They don’t always teach you things like that.
Susie, Jezz and Keira
Sunday morning. Called to an RTC, three patients, car versus house.
—House? asks Val.
—Yes, says the controller. House.
This is a little bit worrying. Houses don’t usually drive down roads, so the car has travelled some way to meet one. Also, houses tend to be a bit stronger than cars, and can do them a lot of damage.
At the scene, we find a fair bit of carnage. The car’s been driving round a smart new housing estate, left the road and driven straight into the front of a house, demolishing the wall below the front window. Inside a young mother is sitting shocked with her little baby at the end of the room which doesn’t have a car poking into it. Both are thankfully unhurt, and the baby seems to think the whole thing is hilarious. Mum doesn’t.
Outside the occupants of the car are three young girls. They’re sisters, out for a drive. The driver’s not complaining of any injury but her younger sister’s got pain in the back of her neck. This is a big warning sign for us, so she’s immobilised, which means fitting a cervical collar around her neck while someone holds her head, and then fitting her into a special mattress on the stretcher to keep her still until we can get her to hospital. There’s no obvious injury to any of them, and we’re not too concerned, but we’ve protocols to follow. Only a doctor, and an X-ray, can say for certain she hasn’t broken her neck.
I’m more worried by the mental state of big sister Susie, who was driving. As we fit the collar to little sister and get her sorted out, big sis is looking at us with a look of frank terror on her face.
—What have I done?
I try to reassure her this is all precautionary and her sister will almost certainly be fine, but nothing I say seems to make any difference. No one in the house was hurt either, I tell her. Don’t worry. Could have been worse.
She just stares at me, tears pouring down her face, terror-struck.
Eventually we get immobilised sister on to the ambulance and take the two other sisters with us. Immobilised sister is fine – all her observations are coming up roses – but elder sister is looking more and more distraught. Halfway to hospital she’s almost gibbering with horror, sobbing, sniffling, staring around her wide-eyed.
—Look it’s all right. She’s going to be fine.
—You don’t understand.
—What do you mean?
And it all comes out.
The three girls are pretty and smartly dressed and obviously not from the wro
ng side of town, so to speak, but they do look a little, well, young.
In fact they are a little young. Too young to drive.
Big sister has decided that, at seventeen and with only a provisional licence, it would be a good idea to borrow Mum’s car without asking and take little sisters for a Sunday morning drive. And everything was going swimmingly until a dirty great house got in the way.
I begin to understand the look of terror on big sis’s face. The car was, repeat was, a very nice saloon. Now it’s a write-off stuck in a house. Little sister was a fit and active sixteen-year-old. Now she’s lying immobilised on her way into hospital. Mum is not going to be pleased.
I do my best to reassure her, but in reality there’s nothing much to say. Her Mum is going to turn up at the hospital and she is going to go mad and she is going to kill her – figuratively speaking. There’s no way to dress this up. Her life is over.
Eventually, I fall back on the only thing I can think of to say.
—Nothing lasts for ever. Even this will pass.
I don’t think it really registers. We get to the hospital and unload our patient and the doctors get busy making sure her spine isn’t damaged (it wasn’t). Big sister waits out in the corridor, staring into space, almost catatonic by now. I have a last go at saying the right thing, but she’s unreachable, lost in a world of fear. We manage to get out of there before Mum arrives.
It wasn’t going to be pretty.
I spent a year and a half ferrying people around in minibuses taking them in and out of hospital when I joined. It teaches you where the hospitals are, how to drive smoothly, how to talk to old, ill people, reassuring them life hasn’t just reduced itself to pain and misery. Even when it often has. It’s half the job. Then I did a two-month training course to move into A&E work and spent a year as a trainee.
You go from driving old minibuses to driving around in a £250,000 state-of-the-art ambulance. In the back, it mostly resembles a spaceship – the Shuttle or the International Space Station – lots of bright light and white plastic, lots of buttons and cupboards and equipment and machines lashed to the walls, a tiny escape window in the roof. There’s equipment to help you deal with people who’re having a baby, or have burnt themselves. People who’re having a heart attack, or can’t breathe. People who’ve broken long bones and short bones and all the others in between. There’s equipment to help lift people who can’t stand up, and equipment to help us manage people who won’t sit down. There’s dressings and splints and gloves in four sizes and drugs for everything from vomiting to pain relief to allergic reactions. And a cat, of course.
Eh?
The firm that makes the ambulances needed a little door for the rubbish bin on the side of the ambulance, around the size of a catflap door, so they went to a catflap door company, and bought a thousand doors. So the bin doors in all our state-of-the-art spaceship ambulances say things like Pet Safe or Cat Flap on them. Honestly. Many of our patients are quite confused before they even get in the ambulance. This doesn’t help.
—Why is there a catflap in your ambulance?
—To let the cat in and out of course.
It says ‘Biological Hazard’ under the catflap, which probably fries their brains even more.
In quieter moments in the back of the truck with patients, I look at all the blinking lights and dials and machines and sometimes imagine myself in a spaceship, a million miles from Earth, warm and brightly lit but surrounded by a limitless void. Then the patient wakes up and vomits or something.
When I joined the service you did a week’s training for patient-transport work, to learn how to drive smoothly, and then when you went front-line you did another two weeks learning how to drive fast on blue lights. The training’s excellent and very thorough.
Only the service never calls it driving ‘fast’.
I’ve always found this funny. As if they think the minute they tell you to drive fast you’re going to floor it and plough straight into a bus-stop queue. They may be right. Instead they call it driving ‘progressively’; making ‘adequate progress’ through the traffic or along the road. Maybe this is to take the excitement out of the whole thing, trying to weed out the nutters who just want to tear-arse around town making a lot of noise.
Like I said, they may be right.
The training emphasises that while they want you to get to the job quickly, they want you to get to the job. If you drive so fast you have an accident you’re no bloody use to anyone, which is a fair point. Up to now I’ve done nearly a decade in the service without so much as a scratch, so I’m quite smug about the whole thing.
For eight years I drove on blue lights to jobs and never had an accident – some people had had hundreds.
Then I had a night shift …
Kolya and Paula
Tonight we sign on and fairly quickly get our first job of the night – eight-year-old boy, breathing difficulties. A Category A job – the most serious. And a kiddie. It’s in the next town along the road, about ten miles away.
I’m driving and off we go.
All goes tremendously until we drop down the hill into the next town. At the bottom are traffic lights on red at a crossroads. I edge through these slowing down (you must treat red lights as a give-way junction and only go through if people let you) and can’t see anyone coming. So I carry on through.
Then out of the corner of my eye I see a car coming through the lights to my right, still doing 30 mph or so, and not stopping. Smash! He drives straight into the side of the ambulance on my side, just behind where I’m sitting. The airbags in the car go off, and for a second it looks like the whole saloon of the car’s just exploded.
—Gosh, I say. Or words to that effect.
Val tells me to shut up bellowing swear words and get out and look after them, while she gets on the radio to tell control what’s happened. Now they’ll need to find an ambulance for our original job and another one for us – we’re off the road. The minute you have a crash you become a right royal pain in the arse.
Anyway, the couple in the car aren’t too bad. They’re a young couple from Eastern Europe, they’ve already got out of what remains of their car, and are really rather nice about the whole thing. The driver’s uninjured but his girlfriend has a nosebleed where the airbag’s gone off in her face. I usher them into our ambulance, where at least they’re safe and off the road, treat her nosebleed and check them over for any other damage.
The driver obligingly admits that as he was driving through the (green) lights he was looking in his mirrors at the car behind, which is being driven by a friend of his. They may have been racing each other or mucking about in a low-key way – this makes me feel better. The girlfriend’s crying and I think the driver’s frightened he’s in trouble – maybe you get shot for this sort of thing where he comes from. I try to reassure them it’s all right. Meantime I’m trying to stop my own heart hammering away and nursing a sore right knee. Eventually another ambulance takes them down to the hospital to be checked over, an officer comes out to see us, and we drive our truck to the station to do the paperwork. Other crews crowd around joyfully to have a look at the damage.
The paperwork takes about two thousand years. The ambulances are tracked by computer, which sends a signal every six seconds, saying what speed you’re doing, whether you’re on the brakes or the gas and other stuff. As I was slowing down into and through the lights, the last signal received before impact was 19 mph, braking. The officer reckons I was probably doing about 10 mph, which is judged fair enough. The very nice driver of the car saying he wasn’t looking is also a big help. I had my blue lights on but didn’t have the sirens on, but that’s OK. You’re not allowed to have them on if there are cars on a red light around you, as that may make them panic and push through the lights into someone’s path.
So no blame for me.
The officer’s really rather nice about it.
—It’d be better if you carry on with the shift, but I won’t blame y
ou if you go home.
Blimey.
The soft-soap treatment works. I put on a martyred expression, rub what’s left of my knee and stagger out to the garage to carry on with the shift.
One evening my father fell off his motorbike and ended up in hospital. My mother heard about it and phoned her sister, who worked at the hospital. Her sister told her he was gravely injured and not expected to live. She went out and got rat-arsed. Then when she got to the hospital to visit him, she found him sitting up in bed, eating a boiled egg. She went ballistic.
Luck again. If life’s a lottery, RTCs are even worse.
Kerry and Friends
About three in the morning. The lowest time of the night when you can barely stay awake – that time when you understand how effective sleep deprivation must be as a torture. Everything aches and you’re constantly trying to keep your eyes open and feeling slightly sick. Don’t know why they bother with waterboarding and the like.
Still – mustn’t grumble. Back with Val.
We’re called to an RTC down by the river outside town. Bad RTCs I find horrible, probably because I can remember how it feels. At night they are worse. It’s dark, noisy, cold, frightening, and the stink of hot metal and spilled petrol is everywhere.
This one is bad. Five youngsters gone sideways into a wall. Someone saw them going past the ambulance station down the road, probably doing seventy or more.
The scene is like a vision of hell. Fire trucks are already there, so there is bright dazzling light. Bodies in the road, still in the car. Cold and noisy. One of the passengers (the lucky one) sits by the side of the road with his head in his hands.
Why was he the lucky one? No one will ever know.
We’re the second ambulance on scene. The driver is badly injured but still alive, and a paramedic is looking after him. The female passenger beside him is dead already. Cans of stinking lager are all over the place.