by Wharton, Kit
I told Len about my parents one night when he was in a friendly mood.
—Bloody hell. They sound worse than the patients.
One thing you’re going to come across if you do this job any length of time is the exhibitionists. People who really seem to like showing you stuff other people prefer to keep hidden. I’m not one myself so I don’t really understand it, but it definitely happens.
Sometimes they’re subtle about it. Sometimes not.
Ian
Val and I get a 999 call to a male, fifties, abdominal pain.
Despite having a filthy mouth and pretty filthy mind, Val also has a certain – somewhat misleading – air of sweet innocence about her. She is striking-looking, with perfect skin, full lips, prominent cheekbones and doll-like bright blue eyes. She’s attending.
When we get to the job we’ve already been informed the patient is something of a frequent caller, and often goes into hospital with varying symptoms which are never fully explained but seem to resolve themselves. He’s also missing a leg through diabetes.
It’s the middle of the night, but the door to the house is open. The patient is on his own in the bedroom. He calls us through. The house is filthy and very smelly, with dirt and empty bottles everywhere. The patient is hugely fat, lying completely naked on top of the bed covers with his one leg spread to the side, his genitals glaring out at us. He doesn’t appear to be in much discomfort but stares at Val fixedly, as if to say – there, what do you think of those?
It’s not quite clear what she thinks, because she’s staring fixedly at the wall, so I step forward and flick the corner of the dirty bedcovers up to cover the patient’s modesty, but he’s having none of it. He grabs them and throws them back again to reveal all.
I’ve got this pain here, he says, pointing to a spot about three inches from his penis. It’s really painful. He’s still staring fixedly at Val, not obviously in any pain at all, and she’s still studying the wall, so I sort of manoeuvre myself between them and take over doing the obs, trying to shield her from the appalling spectacle.
Needless to say they’re all fine, so we persuade the patient to get some clothes on for the trip to hospital. By this time Val has fled to the ambulance to get the stretcher, and the patient watches her go with a disgruntled expression on his face.
And into the hospital we go. I go in the back.
At the hospital Fatima gives him one of her most ferocious stares.
He looks back, worried, and pulls the blankets up to his chest.
Unwell patient.
14
Suicide
The first experience I had of ambulance people was when I was about six. My mother told my father she’d taken an overdose during a row. He was furious, but probably thought he should do the right thing, so called 999. I still remember the looks the ambulance men gave us. And I still remember the mixed feelings I had. Fear my mum was dying, but also shame that strangers were seeing it. Whenever I go to overdoses now and there are kids staring up at me frightened, I remember what it was like and try and be friendly. I did one the other day. Mum had taken an overdose, Dad and four-year-old daughter were frightened. And it was Christmas Day. The overdose wasn’t a serious one and wasn’t likely to do much harm, so we had some time.
I ended up swinging little one round the room while she screamed with excitement, then blew her up an enormous balloon. We played catch with it in A&E. Hopefully she’ll have some nice memories of that night.
(My mother hadn’t taken the overdose after all. She just wanted my father to feel bad.)
Andy and Lorraine
A late summer’s evening.
The call is to a female, fifties, suicide bid, in a neat little cottage in a neat little hamlet outside of town. When we get there we are let in by a man, also in his fifties or so, who looks at us glumly and leads us through to the neat front room where a trendy-looking woman wearing an orange suede skirt is sitting on the sofa writing in a notepad. She does not even look at us, just carries on writing. But it proves she is alert, conscious and breathing. The couple don’t talk to each other and the atmosphere is charged with tension. They’ve had a row. Oops.
—What are you writing?
—A suicide note.
—Oh.
I ask the man to look around the house and pick up all the empty packets of pills she may have taken, before we go to hospital, and we take the lady’s observations. The man comes back with handfuls of empty pill packets, including nasty stuff like paracetamol and tranquillisers.
—She’s taken this lot, and I’ve taken this.
I stare at him.
—What?
—She’s taken this lot, and I’ve taken these.
—You’ve taken that lot?
Bloody hell. My mind’s racing. Val’s staring. A double overdose! Do we call for a second ambulance? Will we need the police? What about the cat?
Since they are both wide awake, breathing OK, and happy to go to hospital, we decide we’ll take them both in together – it will be quicker. But on the way in, it is the man who gives me more concern. His eyes are closing and he can barely stay awake. I have to keep shouting at him.
We get to the hospital without any mishap and hand the pair over to the staring Fatima.
She says nothing. Twice.
Two unwell patients.
Normally we wouldn’t hear anything more about the job. Probably wouldn’t give it a second thought.
Normally.
Three months later, I’m called to a doctor’s surgery in the area, to a patient with chest pains. As we draw up the doctor comes out of the surgery to give a handover.
It is the same woman. The overdose.
(Don’t know about you, but I never imagined doctors did that sort of thing. Shows how wrong you can be.)
I don’t know if she recognises me but I sure as hell recognise her. I stare at her briefly, then get control. For the rest of the handover I look anywhere but into her face, in case she realises who I am. She doesn’t appear to. We get the patient on board, all the time with me staring at the floor.
Afterwards Val stares at me.
—Wasn’t that …?
—Yes. Yes it bloody well was.
Benny and Lyn
April is the cruellest month, apparently. But January runs it close.
Night shift.
It’s midnight on a violent, stormy, freezing night lashed with wind and rain, and I’m on the car called to a male, newly homeless for the last week and not surprisingly, suicidal. Wants to jump in front of a train. Benny’s a nice quiet lad, freezing and starving and soaked and miserable, but he’s good as gold with me. Walks quietly over to the back of my nice warm car and gets in with no problem, happy to go to the hospital and not causing any fuss. Off we go. Apart from his lethally smelly feet, which are painful and swollen after a week of being cold and soaked, there’s no medical concern. Maybe he’s got trench foot.
All very routine.
Then halfway to hospital, as the heavens open again, we get to a long bridge over the river. Halfway over a car is stopped on the left, hazards on. On the right is a bunch of three or four people. As I slow and edge past, one of them flags me down desperately. I have a sinking feeling.
—Quick. There’s a girl, threatening to jump.
For fuck’s sake. I’ve got one in the car threatening to go under a train, and now another one jumping off a bridge.
I pull over to their side of the road and stop. I can’t think what to say to my patient. Guess what? You’re not going to believe this …
—Sorry about this. Just stay in the car would you?
He nods.
—OK.
I get out and get on the radio and ask for police as I approach.
It’s a girl, about the same age as my patient, dressed in a hoody and standing on the wrong side of the railings on a ledge about a foot wide, one step from, well … you know. There’s a couple on the sensible side of the railings, who’ve been
trying to persuade her not to do it. She says nothing.
There are probably psychological protocols and techniques and stuff for dealing with this sort of situation, but I haven’t a fucking clue what they are. I sidle up to her gently on one side with the bloke on the other and we have a bit of a chat. She doesn’t say anything, but at least she isn’t doing the don’t-come-near-me bit.
Helpfully, it’s pissing down.
She still doesn’t say anything, and luckily doesn’t do anything when I gently slip a hand around her upper arm so I have a hold of her. She’s not big, so now even if she goes for it I’ve got a chance. The other bloke will help. And his girlfriend’s being brilliant, chatting away quietly to her nine to the dozen. I look down. It’s maybe twenty or thirty metres, and looks very cold and unfriendly down there. The river’s at least a hundred feet across and flowing fast. If she goes in I’m not going after her.
Luckily, after a lot more chat we get hold of both her arms and she doesn’t resist and I plead with her to come and sit in the nice warm car out of the rain. Benny’s still in it with his smelly feet, thank God, and hasn’t come out to join us on the ledge. They’d probably have lots to talk about.
Eventually she agrees, so we lift her up bodily, while the girlfriend grabs her legs, and lift her over. I’m not letting her go so she can climb over. That’s when they always fall or jump. I know, I’ve seen it on the telly.
And we’re back on the safe side of the railings, and after a short wait an ambulance and the police turn up to take her to the same hospital Benny and me are off to.
He’s still sitting in the car good as gold when I get back soaked.
—Sorry about that, mate. Let’s get you into the hospital.
Off we go.
Later in the same crazy shift, I get called to another female, who might be suicidal or might not, the call-taker’s not sure. She’s not making much sense. She’s called 111 and they’ve sent us to check her out. Because she’s got a knife the police turn up as well. She has a lot of history, as it’s called, with us and the police. She won’t let us in but talks to us through the window.
—I didn’t want an ambulance, I just wanted to speak to someone. Why are the police here?
—Well I think it’s because you said you had a knife, love.
—Well I had the knife because I was chopping carrots.
—Oh.
—Anyway, I’m not suicidal and I don’t need an ambulance, thank you very much.
—You sure?
—Yes.
—OK.
We leave her in peace.
Seems a bit strange – chopping carrots at four in the morning. The policewoman doesn’t seem fazed.
—She should’ve used those small carrots. The little ones. They’re nice and you don’t have to chop them up.
Of course.
Off we all go.
15
Mistakes
After my mother’s overdose, I didn’t come across ambulance people until one morning twenty or so years later when she died of a heart attack. She and I were living together with her house guest – cancer.
She’d been getting worse for nearly a year, on morphine and chemotherapy. I’d been living with her all that time, happy I was doing the right thing but secretly frustrated my life was slipping away. I used to have dreams she had died, then wake up disappointed when she hadn’t. Then I’d have to deal with the guilt. I learnt that lots of people have mixed motives for the good (and bad) that they do. The important point is to do the right thing. The reasons why don’t matter.
It was a Saturday morning and she died upstairs. She’d been getting iller and iller, but the end was still shocking and sudden. I suppose they always are. We called 999. I still remember giving her the kiss of life, retching with shock. The ambulance helicopter arrived and we left them to it. They came down a bit later and said it was no good – she was flat-lining.
I didn’t know what that meant but it didn’t sound good.
The local funeral company were on form. They sent two old men to pick up her body who must have been 150 years old between them. They couldn’t lift her, so I had to give them a hand dragging her downstairs in a body bag.
Then they had an accident embalming her, and needed new clothes for the body. They lost her glasses, burnt the top of her coffin, then phoned up on the day of her funeral asking if they could drop her off at the house ‘early’.
Brilliant.
But hey. We all make mistakes. Fifteen years in the ambulance service teaches you that.
Fifteen years also equals maybe 10,000 jobs done, maybe 20,000. They get better all the time. There’s fewer and fewer times I come back and dive into my ambulance reference books, looking to see what I should have done, what mistakes I might have made.
—You haven’t killed another one, have you?
Jo says it every time I look at the book. Ha ha.
—No, I haven’t.
But not all jobs go smoothly, even if you know what you’re doing. All you can say is you try and cope, whatever happens. Shit always happens.
Especially when you’re just starting out.
Myra
I was still a trainee when I met Myra, working with an experienced colleague, thank goodness.
The ambulance service is all about making sure things get better, not worse. But when things go wrong, they go very wrong indeed.
Out in the countryside, afternoon.
Called to a female, sixties, cardiac arrest. We’re not off to a great start because we are several miles away and it takes us hours to get there. Well, minutes anyway.
Too many of them.
We find a large Indian woman in the passenger seat of a car outside a bungalow, dead. Husband is indoors, still on the phone to us. They’ve been out to a film together, and as they’ve got back she’s had a massive heart attack and died.
You haven’t any seconds to lose, but the problem is you can’t do effective resuscitation on a patient in a car. You need to be pushing hard down on a patient’s chest for the cardiac compressions that push blood round the body to the brain to keep it alive. Impossible in a car – there’s no room to move and you can’t get at them. So we have to get Myra out.
That’s the first trouble. She’s a hefty woman. I pull her torso out sideways from the car as my colleague grabs her legs and we try to bodily lift her onto the stretcher. But she’s a large lady and a dead weight and I don’t have a proper hold of her. I’m no weakling but I can’t hold her and she drops. I push my knees out to take some of the blow but it’s no good. Her back and shoulders hit the pavement and her head hits the slab with a sickening thud. Just as her husband comes out of the house, sobbing and gasping. We grab her up again but there’s already a smear of blood on the pavement and another on the sheet where her head finally ends up.
Great.
Never mind – she can’t feel anything at the moment. Her husband can, though. His world is falling apart in front of his eyes. We try and reassure him and ask him to go back into the house to get her details while we get her into the ambulance and finally begin work on her.
It’s not encouraging. She’s in asystole, which means her heart is doing nothing, and she’s been down ten minutes or more with no CPR. That’s long past brain-damage time. Her brain’s had no blood, so it’s had no oxygen.
So it’s dying. Or dead.
And things just get better and better.
By now another crew’s arrived to help out, so with my crewmate and me in the back with the patient, one of the other crew drives our ambulance while the other drives theirs with the husband on board. We set off for the hospital in convoy. The route from here to A&E is quiet country roads and the bloke driving our truck doesn’t know them. So we get lost. The husband being driven behind knows them only too well.
—This isn’t the way to the hospital.
Great.
There’s more. It’s raining and we’re pulling out from a T-junction with a learner d
river – just qualified – heading towards us. In the gloom she doesn’t see the blue lights, but the guy driving our ambulance thinks she does, so he pulls out on her. Crash.
She drives straight into the side of us at about 25 mph. I’m standing up in the back and go flying, head-butting my crewmate on the nose and then smacking my head on a cupboard. I’ve got blood coming from my head, and my crewmate’s got it coming from his nose. The patient is oblivious, since she’s dead. But that doesn’t make it much better.
So we now have the fun job of unloading the patient, with one of us performing chest compressions on her, and wheeling her over to the other ambulance, in full view of the husband and the poor girl who’s just qualified from driving school and bashed into us. She’s no way of knowing we had a resus on board. All she knows is she’s just crashed into an ambulance and next thing someone’s being wheeled out of it dead.
After what seems like a thousand years, all this gets done and we get off to the hospital and deliver the patient. It takes about three minutes for the doctors there to decide there’s no hope, and they call it and stop the resuscitation attempt, leaving the patient in peace. The family can come in and say goodbye. We do our best to commiserate with the poor husband, bitterly conscious what a bloody farce the whole thing must have looked.
Eventually someone arrives to make a better job of looking after him than we did and take him home. The patient goes off to the morgue.
And the poor girl in the car? Probably into a lunatic asylum.
Great.
When I was about six or seven, I was crossing the main road on my way back from school. A motorcyclist had come off his bike on the other side of the road and was surrounded by people. You couldn’t see any blood or anything, but you could hear him moaning as he lay there. It made my knees weak and I wanted to go to the loo. So I ran off home.
Not long afterwards a group of us were coming home from school and came across a child our own age who’d fallen off his bike. His arm was all bent and deformed – it was obviously broken. There was an adult helping him. He looked up at us and told me to go off and phone an ambulance.