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

by Dan Farnworth

  We put the patient on a stretcher, get her into the ambulance and manage to get her heart beating, although we still have to assist her breathing. I can tell just by looking at her that her injuries are too significant for her to survive. Ambulance people become very good at knowing if someone is beyond help. White people go grey. It’s more difficult to tell with black people, for the simple reason that they have darker skin. But people who are critically unwell often get a sense of impending doom, which is reflected in the expression on their faces. It’s a ghastly look of fear, that their life is slipping away and they’ve got nothing left to fight it. They won’t be able to speak, but their eyes will say to you, ‘I’m dying here, aren’t I?’ I wonder what someone thinks, when they know their time on earth is about to be up?

  We rush the woman to hospital, from where we take her to a major trauma centre. About twelve hours later, the woman dies in the intensive care unit. It isn’t the outcome we wanted, but there are positives we can take from it. Had we not been driving past when the accident happened, there is every chance she would have died on the side of the road. But we were able to give her and her family the gift of time and the chance to say goodbye. Second to saving somebody’s life, that’s the best thing an ambulance person can do.

  ______

  It’s the kind of cold winter’s day that makes you want to be tucked up snug and warm under your duvet. There is a big cycle ride taking place in the evening, which is lovely, but also means inevitable crashes and having to nose our ambulance through forests of bikes. We’re on our way to one of these stricken cyclists when we see a load of people gathered by the sea wall, roaring and screaming. I wind down the window and someone starts shouting at us, ‘There’s a man in the water! There’s a man in the water!’

  People see an ambulance person and assume they can do everything – apprehend criminals, rescue cats from trees, perform open heart surgery. But my first thought is, I’m definitely not David Hasselhoff. I contact the coastguard, but the rescue officers have to get to the boathouse and launch, which means an arrival time of ten minutes at best.

  The sea is rough and there are waves crashing over the wall. Apparently, this homeless guy had been walking his dog, the dog had jumped in the sea and its owner had jumped in after it. We trot over, have a look over the top of the wall and see this guy struggling to keep his head above water, while being repeatedly smashed against the steps and sucked back out again. Every now and again his head disappears, before popping back up. We quickly realise that this bloke doesn’t have ten minutes. As for the dog, he’s sitting next to us drip-drying, having jumped out pretty soon after jumping in. His calm exterior and the contented expression on his face suggests he really couldn’t care less.

  I can’t help thinking of a story I once heard: a dog jumped in the sea, its owner tried to save him, a policeman tried to save the owner and all three ended up dead. But we have to try something. My partner grabs a life ring attached to a rope and tries to land it over the guy’s head. He tries it once, he tries it again, but even when he lands it close, the sea is so choppy that within a couple of seconds the ring is about 10 metres away. And then – bingo! – my mate lands the ring over the flailing man and we manage to reel him in. The man doesn’t have a good enough hold on the ring that we can drag him out, so we run down the steps, I grab hold of my mate’s legs, he leans over the side and hauls this guy out, as if he’s a gigantic fish we’ve landed.

  Everyone is cheering and telling us well done, but we don’t really have time for any photos with our catch. In fact, our work has barely started, because this guy is now in cardiac arrest. We have to carry him up about thirty steps and we don’t have any gear with us, because we’ve left it in the ambulance. We get him in the back of the ambulance, do a round of CPR, and what happens next is like something from the movies: he suddenly coughs and water spurts from his mouth. He’s back in the room, which hardly ever happens. Seconds later, there is a knock on the window: it’s the coastguard.

  ‘Everything all right?’

  ‘Stand down, pal, we don’t need you any more . . .’

  We rush the guy into hospital and he lives to tell the tale.

  We’d gone above and beyond the call of duty, to the extent that we thought we were going to get a roasting from management. We didn’t overcommit, although one or both of us could quite easily have gone in. And I don’t think anyone in our position would have stood back and watched the guy drown. But sometimes in the ambulance service, we are faced with situations where we don’t have a choice but to breach health and safety guidelines in order to save someone.

  Unbeknown to us, an off-duty police chief inspector had been watching us pull this bloke out of the drink, while trying to hold the crowd back. He sent a letter of commendation to our bosses and we ended up getting a couple of bravery awards. I’m not sure how brave it was really. There is this theory that the more people who are around when someone needs saving, the less likely anyone is to help, because they all expect someone else to act first. But if you’re the only person on the scene, you will do something. In the case of the drowning man, we were the only people with blue flashing lights and wearing a uniform, so everyone expected us to do the business.

  The irony of being in the right place at the right time is that it’s a result of the patient being in the wrong place at the wrong time. A colleague once drove past a woman with a head injury: it turned out a sign had blown off a shop and fallen on her. My colleague couldn’t save her life, but he could make sure she was given every possible chance.

  I’m driving along with a patient in the back one day, and a guy flags us down outside a building site. I shout to my partner in the back, ‘I don’t know what’s going on, but someone needs our help.’ Fortunately, there is a carer with our current patient in the back of the ambulance, so we decide to investigate. It’s not ideal, but sometimes we just have to spin two plates at once. There is a plaster wall around the building site to keep the public out, but through a little opening I can see a guy laid out on a cherry picker. I grab my mate, get a kindly member of the public to give me a leg-up over the wall and my partner chucks all our gear over. Someone jumps on the cherry picker and lowers it to the ground, and it transpires that a big bolt has come loose and fallen on this guy’s head, smashing his hard hat to pieces.

  We try to establish what we call neutral alignment of the neck, to protect it while assessing the man’s airway (quite tricky on a cherry picker), which means my hands are cradling the back of this guy’s head. It feels like mashed potato, or a cracked boiled egg. Where once there was a skull, there is now shards of bone intermingled with soft tissue. We can’t really leave our other patient in the back of the ambulance, but luckily another ambulance turns up and takes him. By this time, I’m covered in blood up to my elbows. A helicopter lands and flies the patient to a trauma centre. I’ve got no idea whether he survived or not.

  Another day, another building site, another nightmare from start to finish. A brickie was building a second-floor wall and, for whatever reason, the wall toppled over on top of him, breaking his legs. There are still no stairs in the building, so technically, as far as our health and safety people are concerned, we shouldn’t go up there, because that would mean we’re working at heights. But how are we going to get this bloke down if we don’t?

  We have something called HARTs (Hazardous Area Response Teams), who are like the SAS of the ambulance service. At pretty much every major incident, a HART is on the scene. They would have been in the thick of it at the Manchester bombing and the Salisbury chemical attack, and are also straight in whenever there is a large-scale road traffic accident, a train crash, a collapsed building or a big fire (although they sometimes find themselves extracting bariatric patients, which I can’t imagine they’re thrilled about).

  Us common or garden ambulance people are a bit envious of them, because HARTs have the shiniest vehicles, the smartest uniforms, lots of James Bond kit (all-terrain vehicles, f
lotation devices for working on water, special ladders, breathing apparatus). Members of HARTs are even equipped with body armour, so that they can work at terrorist incidents, when a bomber or shooter is still at large.

  One night, an address came on the screen and just as we pulled up, someone came on our radio and told us to hang back, because there was reason to believe there was a bomb inside the house. How do you react to that? ‘Oh. Thanks for letting us know . . .’

  I reversed a few hundred yards down the road, the cops turned up and informed us that they believed the chap inside the house had been making pipe bombs. He wasn’t a terrorist, he was just a pipe bomb hobbyist. Who knew? They told us to rendezvous at the police station car park and await further instruction. I assume we were on standby in case a bomb went off, although no one told us.

  The HART arrived, which is when we knew how seriously the police were taking it. As well as all their James Bond kit, HARTs turn up with a portable control unit, from which they run the operation. But we refer to it as a brew wagon, because it has a kettle in it and we always fill our boots. Hot on the heels of the HART, a bomb disposal team turns up and a police sergeant says to us, ‘Right, we’re gonna have to evacuate the car park. When we arrested the suspect earlier today, we confiscated a rucksack, which is now in the police station.’ As we were leaving, the bomb disposal team were disappearing inside the police station. It was like a Keystone Cops film. The bomb disposal team did its thing, we got a couple of cuppas out of the job and I assume the bomb maker got nicked and banged up. If you will have strange hobbies . . .

  Alas, in the case of the man under a wall on a building site, a Chinook doesn’t appear, dispensing members of a HART on ropes. So we grab a ladder, climb up it and attend to the patient. We’ve now crossed a red line, because if we fall off and do ourselves a mischief, we’ll be told it’s our fault – ‘What are you doing climbing up ladders? Have you done the course?’ We call the fire service to get the man down, and off we toddle to the hospital.

  Even when an ambulance person isn’t in uniform, the instinct to help will kick in if we think someone is in peril. One day, I was wandering back from the shop when I heard what sounded like a smoke alarm coming from the sheltered accommodation across the road. It’s common to hear alarms going off and for it to mean nothing. But, being a nosey git, I went and had a look. I tracked the alarm down to a second floor flat, pushed the door open and was met with thick smoke and a burning armchair. It turned out that this old girl had fallen asleep with a ciggie in her hand.

  But while I was trying to usher her out, all she was bothered about was finding her cat: ‘I can’t leave! I’ve got to save Felix!’ Some old people become so set in their ways that they have little appreciation of danger or their own vulnerability. I was coughing and spluttering, even though my T-shirt was covering my face, and by the time I got this woman out – minus her cat – she was covered head to toe in soot. While I was waiting for the fire brigade to turn up, I went around knocking on doors and telling people to get out. The fire brigade extinguished the flaming armchair in seconds, but I never found out what happened to the cat.

  I was driving home from a late shift when I happened to look up and see someone sat on a bridge over a motorway. I went around the roundabout again, just to make sure I’d seen correctly, and sure enough there was a young woman sitting on the wrong side of the railings, with her legs dangling over the edge. I phoned the police (which I was a bit nervous about, because my MOT had expired that morning) and thought I’d better go and persuade this woman that jumping was a bad idea. Or at least try to.

  I parked the car up, hopped out and said, ‘My name’s Dan, I work for the ambulance service. I was on my way home when I saw you. What’s happening?’

  She replied, ‘I’m just waiting for a lorry to be honest with you.’

  This was a bit of a conundrum. Should I start talking about why she was thinking about jumping off a bridge? Or would it be a bad idea to dredge all that stuff up? Should I try to grab her and pull her to safety? What if I tried and she fell? I was a bit out of my depth. In the end I plumped for, ‘Do you want to come and sit in my car and get warm? I’ve left the engine running.’

  I saw a police car go flying past and wondered why it hadn’t stopped, before realising that they were off to close the motorway. Eventually, a lovely copper called Macca turned up, who was on the scene when I got punched in the flat. Macca was the nicest guy you could ever meet, a proper old-school bobby, who happened to have cancer. He should have been tucked up in bed, but was still desperate to help people in need. Between us, we managed to talk her out of jumping and get her back over the railings. And when an ambulance turned up, she was detained under Section 136 of the Mental Health Act – as a patient, not a law-breaker – and taken to hospital. On the drive home, all I could think was, What if I’d stopped for a chat after work? If I had driven past five minutes later, would that lorry have turned up? As it is, I hope the woman got the help she needed and managed to turn her life around.

  On the odd occasion, we’ll be in the right place at the wrong time for a member of the public. Me and Paul were winding our way down a country lane one evening, on our way back to the station for a rare dinner break, when we came across a car crashed into a bush on quite a severe bend. Bang went the dinner break. The two lads were fine and told us a mate was on his way to pull them out. So I said, ‘That’s fine, but we can’t stay here for ever. We have to phone the police so that they can seal off the scene.’ One of the blokes went into a panic and started telling us not to phone the Old Bill. And when I assured him it wasn’t a problem and that the police would just mop things up before the recovery came, this bloke took off across a field. His mate was shouting after him, calling him every name under the sun.

  The bloke who stayed behind wouldn’t have been much good under interrogation, because within seconds he’d told us that he was the owner of the car but his mate was driving, while pissed and without insurance. So when the police arrived, a couple of them went straight after him. Me and Paul were talking to the copper who had remained on the scene when I suddenly got a strong whiff of gas. When I looked under the crashed car – which was still running – I saw it had taken out a gas main. We jumped back into the ambulance, blocked one end of the road, the police blocked the other end and we called the fire brigade, only to be told it wasn’t their job and that we should get on to the gas board instead. The leaking gas main backed on to a caravan park, so I had to go knocking on caravan doors and suggest the occupants made themselves scarce. An hour or so later, someone from the gas board turned up and slapped what looked like a big blob of Play-Doh over the top of the main. So while we missed out on dinner at the station that day, maybe we stopped a few caravans from being blown up. Not really my job, but I was happy to do it.

  We ambulance people often find ourselves performing to a crowd, often with people filming us. Even if we’re trying to save someone who’s choking. Whenever we get called to a choking, it’s uncommon for the person to still need our help when we arrive. It’s usually a partial airway obstruction, and whatever it was they had in their throat – a fish bone, a piece of bread – has been dislodged. Thankfully, I’ve only ever been called to one child choking (they normally stick things up their noses or in their ears) but by the time we rocked up to the nursery, a member of staff had removed the offending item, in this case a humble grape. But on the few occasions I’ve been called to full airway obstructions, we’ve arrived too late to be able to save them.

  One Sunday afternoon, we get a call to a carvery restaurant. Our screen simply said: MALE CHOKING. We’re only around the corner from the restaurant, so arrive in a couple of minutes. As we pull into the car park, someone is frantically waving at us outside. And when we swing the doors open, the waft of carvery – old, sweaty vegetables and cheap lager – almost knocks us backwards.

  If you’ve ever been to a carvery on a Sunday afternoon, you’ll know exactly how busy this place
was. And the prospect of missing out on a giant Yorkshire pudding from the buffet is apparently far more worrying than the man lying on his back in the middle of the restaurant, turning blue. Wading through overly enthusiastic diners, carrying plates piled up to the ceiling, I can’t help thinking, You’re never gonna eat all that!

  As anyone who has been on a first aid course will know, this is a case of ABC – Airway, Breathing, Circulation. So the first thing I do is have a look down his throat, where I can quite clearly see a big piece of steak. So I pull out my mini-hoover and suck out the gravy, before pulling out my special forceps and fishing out the offending item. We ventilate the patient and a couple of minutes later he’s sat up talking. We help the guy up and put him in a wheelchair, and as we’re pushing him towards the exit, the whole restaurant erupts into cheering and clapping. I feel like an actor leaving the stage after a triumphant opening night, or a golfer walking off the eighteenth green after winning the Open.

  I resist the temptation to wave on my way out, but I’m not going to pretend I didn’t enjoy it. It was a nice bit of impromptu theatre for the crowd. As for the patient, he returned two hours later to finish his meal. Not really. But you can bet your life one of his mates took him home a doggy bag.

  14

  STORING UP PROBLEMS

  Not long after I started working for the ambulance service, a colleague said to me, ‘Are you in a relationship?’

  ‘Yeah.’

  ‘I give it a few months.’

  I didn’t know what he was on about. I soon found out.

  When I was twenty-one, I met Amy. We got on like a house on fire, made each other laugh and had a perfect friendship. The friendship grew, we ended up in a relationship and I thought, She’ll do nicely. I’ll ask her to marry me. I decided to do things properly and ask her dad’s permission, and I will never forget the walk up his driveway: it was only about 10 metres long but felt more like 10 miles. Thankfully, he gave me his blessing and liked my plan, which was to ask her while we were on holiday in Egypt, on my birthday.