999--My Life on the Frontline of the Ambulance Service

by Dan Farnworth

  If we can save someone, the fact that it’s a crime scene goes out of the window. But in this case, I immediately realise I’ve made a category one balls-up. I can feel my trousers getting wet with what I assume is blood. And when the police arrive, I shuffle out of the room backwards. I quietly explain to a copper what has happened, and to say he isn’t happy doesn’t even begin to cover it. He obviously can’t give me a bollocking there and then, but his eyes are ablaze and his features twisted into a look of utter contempt. The copper asks the son and his girlfriend to go downstairs before informing his sergeant that two idiot ambulancemen have done their best to contaminate the crime scene.

  The copper soon returns to give me a load of grief and tells us we should have left the building immediately after discovering the body. This is all well and good but leaving the building would have meant exposing the murdered woman’s son and his girlfriend to all the rubberneckers gathered outside.

  As we’re waiting for the copper’s sergeant to get back to him, we hear on his radio that someone has phoned the police control room and admitted to murdering someone. I naively think that that will be that, but the sergeant radios in to relay the order that the idiot ambulancemen will have to remove their clothes, so that they can be submitted as evidence.

  ‘He wants us to take our uniforms off?’ I ask the copper.

  ‘Yes, like he said, take them off.’

  ‘So you want me to drive back to the station in my pants?’ ‘I’ll see if I can find you something to wear . . .’

  A few minutes later, another copper appears carrying an evidence bag and a couple of Tyvek suits (those white zip-up coveralls you’ve seen on CSI). When I take my trousers off, I discover my pants are also soaked in blood, which is every bit as unpleasant as it sounds. At least they haven’t got holes in. When we emerge from the pub in our Tyveks and climb into the ambulance, bystanders are looking at us in bemusement, as if to say, ‘What the hell has gone on in there? And what have they done with the ambulancemen?’

  Because the boyfriend confesses, we don’t end up giving evidence in court. But this is one story I’m able to follow to its conclusion via the newspapers. The victim and her boyfriend were planning to open the pub together, up until the night the murder took place. They apparently had a row, she revealed she’d been unfaithful, he flipped and stabbed her multiple times in the neck and eye, before strangling her. That’s the sight that greeted us. About half an hour before the attack, she had woken her son, given him a hug and told him she loved him. She was forty-four. The one piece of good news, if you can call it that, was that her killer got charged with murder and banged up for life.

  ______

  These 999 documentaries you see on TV don’t really tell the full story, at least not as far as the ambulance service is concerned. They do give an insight into the stresses of the job, but their framing is very narrow. I appeared in the first series of the Channel 4 show 999: What’s Your Emergency? and they usually only showed one of my jobs a week. And it was always a varnished version of what took place. For example, when they filmed us doing CPR, they wisely chose not to broadcast the patient’s face, with their eyes wide open and staring straight into mine. They didn’t film a dead baby or someone who had been catapulted through a car windscreen. I understood why, because it would have been unethical, and nobody in their right mind would have wanted to watch it. Nevertheless, it would have been a more honest portrayal, because that’s the sort of thing ambulance people see with alarming regularity.

  One night, the documentary makers are desperate to get footage of the police, fire and ambulance services setting off from their respective bases and arriving at the scene of an emergency together. A camera crew has been out with us all night but decides to give up the ghost and knock off ten minutes early. Big mistake. A few minutes later, a call comes in for a house fire, which is why, unlike telly people, we don’t have the luxury of cutting a shift short.

  Normally when a call comes in for a house fire, it goes straight to the fire service, they deploy and pass the job on to us. But on this occasion, for reasons unknown, we get the call first. The first thing I want to see when I turn up to a house fire is a fire engine, because ambulances don’t have hose pipes. What are we going to do, chuck a glass of water on it? But when we pull into the street, we can see fire and lots of smoke – but no engine. My heart falls into my stomach. My stomach struggles to digest it.

  It’s seven in the morning, but the whole street is out. People are crying, wringing their hands and running around in panic. The fact that people are shouting ‘Help him! Help him!’ tells us that someone is probably inside. People see us in our uniforms and automatically think that we can help in any situation. But if someone has a heart attack on a plane, no one will ask if there is a traffic warden on board, on the basis that they wear a uniform as well.

  I look at the burning house, thinking, What the hell am I gonna do here? I’ve got to do something. I can’t just stand here like a lemon. I snap some rubber gloves on, walk up to the door, touch the handle and my glove gets stuck. While I’m trying to pull my glove off, I can see the silhouette of a figure through the glass pane. Me and my partner discuss kicking the door in, but because we’ve both seen the film Backdraft, we decide that if we do kick the door in, we might get sucked in or incinerated by escaping flames. I’m also thinking, I don’t want to die, I’ve got three kids at home.

  I’m about to be consumed by my impotency when Trumpton, as we call the fire service, appear on the scene (both the ambulance service and police refer to our friends in the fire service as this, after the old kids’ TV programme, or the water fairies, largely out of jealousy). I breathe a huge sigh of relief. A couple of firefighters jump out of the engine, smash a window and neither of them gets sucked in or incinerated. A few seconds later, the firefighters reappear, carrying a smouldering body. In the poor person’s outstretched hand is a set of keys. He’d obviously been trying to get to the door when he was overcome and was only a few feet from making it.

  Having made certain the poor man is dead and there is nothing we can do to help, we clock off for the day and return to our respective homes. When I wake a few hours later, I switch on my phone and have about thirty missed calls, twenty voicemails and umpteen text messages. What the hell’s gone on? A terrorist attack? A multi-vehicle pileup? None of that. I’m in the latest copy of Heat magazine, sitting pretty at the top of their ‘Manometer’, just above Gok Wan. Every cloud and all that.

  I roll out of bed, chuck on some clothes, pick the kids up from school and put on my smiley face. If anyone asks how work has been, I reply: ‘Fine.’ What else am I supposed to say? ‘Bloody brilliant. This guy died in a house fire. He was smoking when they dragged him out, with his door key in his hand . . .’ That sort of chat can be difficult to digest with your roast dinner.

  6

  FACES QUICKLY FADE

  In fairness to the system, there is no amount of training that will prepare you for a job on the frontline of the ambulance service. It’s sink or swim, and if you don’t learn fast, you will plummet to the bottom, maybe while clutching a P45.

  While most bodies work – or don’t – in the same way, every personality is different. As such, 99 per cent of the job is talking to people in the right way, what you might call the softer skills. We’re trained to recognise heart attacks, treat strokes and dress wounds, but that person who comes off his bike and snaps his femur, or trips, falls through a window and cuts herself, needs comforting as well as patching up.

  We also find ourselves dealing with deeper societal issues – relationship problems, domestic violence, drug and alcohol addictions and, on occasion, someone who has announced they’re feeling suicidal on Facebook or Twitter. As such, ambulance people have no choice but to be everything from medical professionals to social workers to vicars to crowd control.

  What I’ve learned is that if you treat every patient as if they were a member of your own family, you can’t go far w
rong. How many times have you heard a friend or relative say, ‘The ambulance people were just so lovely’? Hopefully, you’ve heard it a lot. If that’s one of a patient’s main takeaways from one of our visits, then we’ve done our job properly. If not, we haven’t.

  Some of what we do can be quite invasive, especially as a male dealing with a female patient. In those situations, it’s about being respectful and clear, explaining exactly what we’re doing and why we’re doing it. If a patient is having a suspected heart attack, I’ll do an ECG (electrocardiogram), which involves attaching little pads around the left side of the chest. But I don’t just whip a patient’s top up and start slapping these pads on. That’s unlikely to go down too well. Instead, I’ll explain why they’ll benefit from an ECG, because it will give us an indication of what’s going on with their heart. Then I’ll tell them what an ECG involves, before employing some distraction techniques, trying to make a patient think that what I’m doing is as humdrum as buttoning up a shirt, just general chit-chat, like asking what’s cooking in the kitchen or where they bought their stereo.

  Sometimes, I receive letters from mums and dads, thanking me for being so good with their children, which is gratifying. You can’t treat kids the same as you treat adults. I once saw a programme where they dressed a kid up in an astronaut suit before putting him through an MRI scanner, which they told him was a spaceship. Suddenly, a serious procedure was a bit of fun. I love stuff like that. An emergency can be terrifying for a kid. All they want is their mummy or daddy, and suddenly two strange people in uniforms walk through the door, carrying a load of weird kit. So we have to become something like entertainers (don’t worry, I never go full David Brent: ‘I’m a friend first and an ambulance person second. Probably an entertainer third . . .’). When we deal with kids, we often deal with hysterical parents, or at least parents who are struggling to hold things together. I understand that it can be traumatic seeing your child in distress. But if you keep a kid calm, usually their parents will stay calm as well.

  Treating children can be very rewarding. It’s all about doing whatever you can to make it feel like a game. While I’m assessing them, I might ask who their favourite cartoon character or footballer is. I might give them an instrument to play with and have a bit of banter:

  ‘You need to hold this red light for me . . . actually, I’ll give it to Mum . . .’

  ‘No! I want it!’

  ‘All right. But first, I bet you can’t sit still while I put it in your ear . . .’

  Sometimes, I’ll give a kid my phone to play with. It’s amazing what kids will do for a bit of YouTube. Calamity Crow is one of my favourites. It’s a cartoon about a crow. Who has calamities. It’s brilliant.

  I’ll say to the kid, ‘You remind me of someone I know.’

  ‘Who?’

  ‘Calamity Crow.’

  ‘Who’s he?’

  ‘You’ve never heard of Calamity Crow? Have a look at this . . .’

  And I’ll give them my phone, stick on Calamity Crow and get cracking with what we need to do. I might be dressing a wound, and the kid will be singing along with the theme tune. Tactics, that’s what it is.

  It could be argued that you can’t teach anyone how to break bad news, because there are just so many different possible scenarios. If we turn up and someone is already dead, we might simply say, ‘Unfortunately, your husband has passed away.’ If we turn up, attempt to save them and can’t, we might say, ‘We’ve done everything we can, but his heart has stopped. We could continue, but it’s very unlikely his heart will restart.’ But the words aren’t set in stone and are only part of the equation.

  What you say to a 90-year-old lady whose husband has just died, and how you say it, is often very different to what you say to a 30-year-old woman whose child has just died. The former is more likely to be calm and resigned, the latter to be hysterical and disbelieving. Working for the ambulance service, you become extremely versatile. We work things out as we go along and hope that we can adapt to any eventuality.

  ______

  Trundling along one fine afternoon, a strange call comes in: MAN FOUND FACE DOWN IN PUDDLE, CARDIAC ARREST. That’s all we have. We’re about twenty minutes away, so I deliver a heavy right foot and get the ambulance moving. If someone is face down in a puddle, we want to get there as soon as possible. We only hope the caller has pulled him out. We don’t want someone drowning in a puddle on our watch.

  The satnavs in ambulances are programmed automatically, which is wonderful: when a job comes in, we don’t have to muck about entering postcodes and addresses, we can just get on our way. However, the satnavs have a strange glitch, whereby they take you to the middle of properties, which sometimes means you end up being directed down a little alley that runs past the back door, rather than the whacking great, ambulance-friendly road that runs past the front. It happens enough that we have a name for it: the back-door boogie. On this occasion, the poor ambulance doesn’t have a choice, because it turns out the poor chap is face down in a puddle on a bridle path.

  How do you get a 5-ton ambulance down a bridle path? That’s not the start of a joke. The answer is you try to avoid smashing into every overhanging branch and bouncing in and out of every pothole, while hoping you don’t end up in a ditch full of mud and all your equipment is in one piece when you arrive at the scene. After some tense exchanges between me and my partner, centred on the belief that we might be on the wrong bridle path, perhaps in the wrong town, we see a woman with a dog frantically waving at us in the distance. We’re in the right place, which is always handy when you’re desperate to save someone’s life.

  The woman leads us to the man, who is still face down in a puddle. To be fair, it’s quite a big puddle, about 15ft wide and 6 inches deep. We wade out, roll the patient halfway over and it’s immediately obvious that not only is he not moving, he’s dead. The two things are probably related. He has a head injury, so I assume he’s tripped, knocked himself out, landed face down in the puddle and drowned. We all hope to die peacefully at home in our sleep, sat in our favourite armchair in front of a roaring fire, a rug over our knees and surrounded by beaming relatives. Sadly, not many people go out in such a dignified fashion. Still, this is a particularly unlucky way to make an exit.

  The guy has white hair, is well dressed and floating next to him is a gold-topped walking cane. He must have been there for a while, because rigor mortis has set in. Because it’s an unexpected death, it’s now a crime scene. That means we have to leave him as he is, face down in the puddle, so that the police can attend, arrange for crime scene investigation (CSI) to do their thing and hopefully rule out foul play.

  While waiting for the police to arrive, we do our best to block off the path, using our vehicle and an ambulance car that is also on the scene. But that doesn’t stop people trying to get through. It never does. Most people get it. You say to them, ‘The path is currently closed due to an incident,’ and they give you a knowing nod and find an alternative route. Other people are less compliant. The conversation will go something like this:

  ‘Sorry, you don’t want to go down there, there’s been an incident.’

  ‘I’m trying to walk my dog here, mate. This is all I need.’ ‘Not today, sir. Can you find another way?’

  ‘No. I go this way every day.’

  And with that, they’ll barge past you. I might feel like saying, ‘Listen, pal, there’s a man down there dead in a puddle. If your kids see him, they’ll have nightmares for weeks. Stop being an idiot and go another way.’ But I can’t say that, because I’d probably end up in a spot of bother. And we have no real power to stop the public doing what they want to do anyway.

  While we’re trying to manage the scene, a Toyota Yaris pulls up, an elderly lady climbs out and says, ‘I’m looking for my husband. He’s got dementia and has gone missing. I got in the shower and when I got out, he’d gone.’ I ask what her husband looks like and she says, ‘He’s got white hair and walks everywhere with a
gold-topped cane.’

  The obvious thing to say is, ‘Oh, he’s just over there, in a puddle.’ Which is true. A tempting thing to say is, ‘I haven’t seen anybody with white hair and a gold-topped cane.’ Instead, I tell her we’re dealing with a man who has been found deceased, and she instantly understands that it’s probably her husband. Still, I decided it’s better to break the terrible news in a more ideal setting.

  I sit her in the passenger seat of her car and drive us back to her house. If I have a prang, I’ll probably end up in hot water, but I can’t have her behind the wheel. She keeps firing questions at me and I keep stonewalling. As soon as I walk in the house, I see a picture of the woman and a man who is presumably her husband. They are on a cruise together, with big smiles on their faces. I can categorically say that the man in the picture is the man we’ve found.

  While I’m making the lady a cup of tea, I phone my partner: ‘It’s definitely him. What should I do?’

  The police still haven’t turned up, so I sit the woman down, take a deep breath and say, ‘We can’t say for sure, but I’m confident the man we found is your husband.’ By now, I’ve worked with a lot of fine paramedics, watched and learned and polished my technique. I speak softly, take it slowly, explain clearly what has happened and give it time to sink in. I leave out the part about finding him in a puddle.

  The woman starts sobbing and I put a consoling arm around her. She is so upset that she had that shower and left him unsupervised. She’ll probably carry that guilt for as long as she lives. When she’s calmed down a bit, she gives me her daughter’s phone number. I give her a call, explain the circumstances and she says she’s on her way. Unfortunately, she lives about five hours away. I ask the lady if she has any friends nearby, and she says there might be one at the bowling club around the corner. So I get on my toes and head for the bowling club.