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

by Dan Farnworth

  I’d had no training in how to deal with a situation like this and there was no one I felt I could talk to. So I hid my trauma from everyone and suffered in silence instead. I should have talked to my wife, but I didn’t want to burden her with my problems. I was the man of the house and needed to get a grip and pull myself together. My wife was always happy to listen, but she didn’t work for the ambulance service, so I didn’t think she’d understand. When I heard that the man had been charged with grievous bodily harm, I thought that might make me feel better. But it made things worse. I grew angrier and more frustrated. Whenever I imagined his vile face, I wanted to scream.

  Culturally, things hadn’t changed much since the time I was stabbed as a teenager. A stiff upper lip was still seen as a noble and dignified thing to possess. If you’re a bloke reading this, when was the last time a male mate said to you, out of the blue, ‘How’s life? Are you okay? Do you need to talk about anything?’ When was the last time a male mate gave you a cuddle? Whatever the answer, it doesn’t happen nearly enough. Often people don’t talk because they’re worried that their mates just won’t get it. I suspect that’s particularly the case in the services, whether you’re an ambulance person, a copper or a firefighter. But doctors, nurses and soldiers will have the same dilemma.

  It can be terribly deflating reaching out to someone and revealing your inner turmoil, only to be met with indifference: ‘Oh, that sounds awful . . . anyway, let’s keep it light, shall we?’ I can’t really blame anyone. I’m not really interested in the nitty-gritty of other people’s jobs, and I often assume they’re not really interested in talking about whatever it is they do for a living either.

  Sometimes, someone will ask me how work has been and I’ll really want to say, ‘Well . . . I’m dealing with more dead people than you can shake a shitty stick at. I went to this one bloke who was found dead on the roof of a pub. And I saw this other bloke being dragged out of his house with smoke billowing off him. I could feel the heat radiating from his body and smell his burning flesh.’ Stories like that, which I experienced in every dimension and rattled me to my boots, are not easy to bring up down the Dog and Duck: ‘A pint of Fosters and some Scampi Fries please, Trevor. When you get back, I’ll tell you about the man I saw face down in a puddle. Then we’ll have a go on the quiz machine . . .’

  I became more withdrawn at work, to the extent that I almost stopped talking. I stopped playing with the kids. It was as if someone had switched me off and I was sleepwalking, which isn’t ideal when you’re tasked with saving people’s lives. Then I heard that the girl had died and the man had been charged with murder. This pushed me further towards breaking point.

  I started drinking heavily, usually on my own, to combat my anxiety and help me sleep. It didn’t work. There was a three-month wait for the case to come to court, and the closer it got to the date, the more anxious I became about giving evidence. I felt such a heavy responsibility. Because I was desperate to do my best for the murdered girl, I was playing the scene over and over in my head, to make sure I didn’t leave out any important details and allow this scumbag to wriggle off the hook.

  I had a friend and colleague called Rich who was about my age, so I decided to reach out to him. But it wasn’t easy. My original plan was to phone him, but I couldn’t summon the courage. So I wrote him a text message, which I quickly deleted. I rewrote and eventually sent it, but immediately turned off my phone, because I was terrified by what he would say. When I turned it back on about half an hour later, I had a message from him: ‘I’m on my way round. Put the kettle on.’

  When Rich turned up I kind of broke down. I already knew what I had to do – make an appointment with my GP, speak to a counsellor – but Rich reaffirmed it. In addition, he let me know that it was okay to feel like I did, that anyone who had seen what I did might feel the same. In short, he made it very clear that he understood. That conversation was the start of the next chapter.

  Two or three weeks after attending the dead child, I paid a visit to my GP, at my wife’s suggestion. She offered to come with me, but I didn’t want her to see me cry. Sitting in the surgery’s waiting room, I was thinking, I can’t be doing with this. And even as I was walking into the doctor’s room, I was considering changing my story: ‘Oh, it’s probably nothing serious, but I’m a bit worried about this mole . . .’ I was embarrassed. I was a man, and real men don’t have these problems. And if they do, they certainly don’t share them. Not only that, I was supposed to be a hardy professional, not weak and feeble.

  I plonked myself down on the chair and wanted the ground underneath to swallow me up. The doctor said, ‘How can I help you?’ I sat in silence for maybe a minute. Eventually I said, ‘I don’t really know where to start. It’s a long story. I work for the ambulance service, I saw something terrible. And I’ve been having a hard time since.’ As soon as I said that, it was like the weight of the world had been lifted from my shoulders. That first step is always the hardest.

  My doctor was so understanding and supportive. She signed me off work and referred me for counselling. My counsellor was an amazing guy called Roger, who was based in the same surgery, a couple of doors from my house. Roger was a former police counsellor and totally got what I was going through. But while chatting to him helped, I felt like I couldn’t get well until the court case had been and gone.

  However, on the day he was due to stand trial, the man changed his plea from not guilty of murder to guilty of manslaughter, which meant my evidence was no longer needed. The Crown Prosecution Service accepted his story that he’d lost his temper and violently shaken her, and he was sentenced to nine years in prison. It felt like being kicked in the stomach. I’d built myself up, braced myself, and now it felt like this guy had got away with murder.

  The post-mortem examination had found that the girl had suffered severe head injuries, a lacerated liver, bruising to the lining of her stomach and other parts of her body. Her mother had been in police custody while she was dying, because her boyfriend hadn’t told the truth. And the person who had caused all this suffering would probably be out in a few years.

  I lost all faith in the justice system, but I had no choice but to accept the decision and try to get on with my life. But I still wasn’t right. I became less and less interested in the people around me. I wrapped myself in a blanket of sorrow and all I could think about was how messed up and dark the world was.

  I got the odd call from work, but the ‘How are you feeling?’ was usually closely followed by ‘When do you think you’ll be back in?’ or ‘Can you send another sick note?’ Nobody ever said, ‘Is there anything we can do to help you?’ I’m sure people cared, but it didn’t come across that way. If your bosses aren’t telling you not to worry about not coming in, you’re likely to think you’re letting the side down. Like a soldier injured in battle and dragged from the field, I felt guilty that my mates were still out there on the frontline.

  Mental illness doesn’t just affect the person afflicted by it, it also affects the people closest to them. My wife tried to reach out to me, but I wasn’t interested. And before long, my marriage was falling apart. I was there in person but not in spirit. Amy could see I was suffering and tried to help. But I shut her out, which was obviously difficult for her to deal with.

  But Roger was like a port in a storm. He left no stone unturned, delved right back to even before I was stabbed. And once he’d prised open the lid, everything came pouring out. He made me realise that a life is like a house. Your foundations are the childhood your parents give you (thank God my foundations were sturdy) and each year after that is like a row of bricks. Some of those rows will be laid with crumbling bricks and iffy cement, and if you ignore those flaws and carry on building on top of them, eventually the whole house will come crashing down. That’s what happened to me. Early fatherhood, the stabbing, the murdered woman, the dead child, the hangings, the drownings, the overdoses, the car crashes, the cardiac arrests, they’d all been compacted
, but now they had come loose. And now it was a case of gathering up the debris and trying to make it whole again.

  Roger encouraged me to channel the energy I’d not been able to use to give evidence in the court case into trying to instigate a change elsewhere. He suggested that before I return to work, I speak to my manager. So after about four months off, when I was starting to feel a bit more like my old self, I arranged a meeting. My manager insisted that HR be there, which made me think that they were worried I was going to lodge a complaint. That was never my intention.

  At the meeting, I explained that I’d attended this horrible job, which had led to me being diagnosed with post traumatic stress disorder (PTSD), and that I didn’t think I’d been given sufficient support by the ambulance service. Actually, I hadn’t been given any support by the ambulance service. My manager sympathised with me, before saying, ‘If you can’t cope, then maybe this isn’t the job for you.’

  I was quite taken aback by his response and couldn’t understand why they were so reluctant to help. I thought I was worth more. I told the manager I disagreed that it wasn’t the job for me and that it was more a case of me having a rough time and him needing to support me. But it was at that exact moment that I decided that if the culture within the service meant that my bosses couldn’t do anything about it, then I would.

  18

  ROAD TO RECOVERY

  Before I was diagnosed with PTSD, I thought I was infallible, hard as nails, tough as old boots. Looking back, I was quite naive. I thought that once I’d dealt with my first dead body, it would become gradually easier to deal with things.

  People sometimes ask me if there had been signs that the job was affecting me and I’d ignored them. I honestly can’t recall any, even in hindsight. That said, hardly anyone in the service knew what signs to look for. I’d have the odd colleague who would say to me, ‘After a long day at work, I need a couple of beers or a few glasses of wine to help me switch off.’ But I didn’t put two and two together and it would be dishonest of me to say that I saw colleagues disintegrate before my eyes. Instead, they were there one day, gone the next.

  One of the first ladies I worked with, who was a top trainer and the loveliest person you could meet, clocked off one day and I never saw her again. I heard on the grape-vine that she’d hit the bottle and I didn’t think to ask why. Just as in my case, the pressure had presumably built up gradually so that no one noticed, so that she was like the proverbial frog in boiling water.

  It’s only now that I can guess that some colleagues didn’t leave the ambulance service simply because a better offer came up, but because the pressures of the job were making them ill. It wasn’t really until I was diagnosed with PTSD that I realised I was vulnerable – and that everyone was vulnerable. And having made that discovery, I wanted people to know that no one is immune to mental health problems and that it is okay to have one. So the day after that meeting with management, I wrote and posted the first of many blogs, detailing my crash and subsequent road to recovery:

  In the ambulance service, we like to have this feeling that we’re bulletproof, and sometimes you can feel a bit ashamed to admit that there’s something wrong with you. But we’re humans, not robots, and I want people to know that they shouldn’t be afraid to talk and seek help if they need it . . .

  The main theme of the blogs was the benefit of talking, whether to your partner, your mates, your GP or a counsellor. I explained that there was no shame in events getting on top of you, and that reaching out for help was the best – albeit one of the most difficult – things I’d ever done.

  Publicly admitting I had a mental health problem scared me. I honestly thought I might lose my job. And what would my colleagues think of me? Would people not want to work with me because they thought I was weak, incompetent and therefore a liability on the frontline? Would they think I might break down on the job? I didn’t know how I’d cope either. I worried that I was more vulnerable than before.

  As it was, though, I slipped straight back into the old routine and felt mentally stronger than I had before. They call that post-traumatic resilience or growth – or, proverbially speaking, whatever doesn’t kill you makes you stronger. Some people didn’t know what to say, because a colleague being off for so long with mental illness was new to them. But almost all of them treated me as if nothing had happened, so that I immediately felt like part of the gang again.

  Back on the road, I worked mainly with my old buddy Paul. Those early shifts consisted mainly of bread-and-butter jobs – grannies falling over, heart attacks, fits and cardiac arrests. It was the same old hard slog with the same old stresses, but nothing overly taxing. However, I worried that if I had to deal with another child who had been seriously harmed – or worse – my world might implode again.

  I’d been back on the job for a few weeks when my blogs went viral, which was a bit embarrassing. But they had the desired effect. Those blogs, and the responses to them, changed my life for ever. The proverb ‘A problem shared is a problem halved’ is slightly optimistic, but there is a lot to be said for it. Ambulance workers from all over the country sent me emails, thanking me for sharing my story. These were people who had been through similar things, some of whom had recovered, some of whom had been suffering in silence before reaching out to me. It’s such a simple thing, having a chat with someone. But people find it so difficult. So it was great to see people taking the leap.

  One of the most hardened paramedics I knew collared me and said, ‘I read your blog. It was inspirational. I had a similar problem but never told anybody about it.’ With that, he shared his story for the first time. It turned out he wasn’t as hardened as I thought he was. Because I’d revealed my own vulnerability, others felt empowered to reveal theirs. They suddenly realised that they weren’t the only ones, so were no longer embarrassed.

  Becoming the go-to man for people wanting to unburden themselves was nice, but also a big responsibility. And while I could listen, I wasn’t able to provide any practical help or solutions. It also confirmed that we had a long, long way to go. Why had these people been suffering in silence for so long? Was the ambulance service doing something wrong in terms of mental health support? Yes, because there wasn’t any. But nobody had ever suggested that they needed to do more. There was a deep-seated culture in the ambulance service, as impenetrable as granite. Sharing my story and encouraging others to share theirs was just the start; next it was a case of getting the powers that be to take mental health more seriously.

  It struck me that there was far more discussion in the media about mental illness in the military. I’m sure the military’s mental health support isn’t perfect, but the myriad documentaries and stories in papers and on the news about soldiers returning from Iraq or Afghanistan with PTSD had made the Ministry of Defence take notice. But the media’s focus on the military gave me hope, because it demonstrated that raising awareness about an issue could lead to a change in culture. Soldiers publicly discussing mental illness sends out a powerful message, because it shows that however tough you are, you are susceptible. Our soldiers should receive as much support as possible. They’re incredibly brave and selfless people who do a vital job for our country, and they must see some terrible things in war. But ambulance workers see terrible things, too. Certainly, ambulance workers deserve the same level of support.

  ______

  A couple of months after returning to work, I’m in the ambulance with Paul and a job appears on our screen: FEMALE BLEEDING PV. PV is the abbreviation for ‘per vaginam’, or from the vagina. It’s not uncommon and there is nothing in this job description to suggest it will be anything out of the ordinary. The usual process is to assess whether the patient is hypovolaemic, which is a state of decreased blood volume, specifically a decrease in plasma. Meanwhile, we do what we can to stem the bleeding and get her into hospital to see a gynaecologist as quickly as possible. But when we turn up at the address, the situation is a bit more complicated than normal.

/>   A guy meets us at the front door and says, calm as you like, ‘In here, lads.’ We stop off for a quick chat with a toddler in a highchair in the living room before making our way through the kitchen and into a bathroom at the rear of the house. Sprawled in the bath is a woman. There is blood everywhere. All over the bath, all over the tiles, all over the woman. She looks like she has been drained of blood, so that her papery skin is almost transparent. She’s just about able to open her eyes and talk to us, but not able to make much sense.

  Despite the grisly scene, there is nothing to suggest foul play. My initial thought is that it could be a ruptured ectopic pregnancy, which is when a fertilised egg implants itself outside of the womb. Or maybe it’s a miscarriage. But when I ask the guy if there was a risk of pregnancy, he replies that there wasn’t. It doesn’t enter my head that he could be lying to me. And whatever it is, it’s not our job to find out. Instead, we slip seamlessly into battle mode.

  We aren’t able to get a canular into her to give her some fluids, because her body has almost completely shut down. She’s unable to stand on her own, so simply removing her from the bath is a major operation. I have to move all sorts of stuff out of the way to get to her – baskets and cabinets full of toiletries, towels and toilet rolls – and sling it all in the hallway. Paul arrives with the wheelchair and I try to get a grip on her top end, which is easier said than done, because of the blood and the clamminess of her skin. Paul grabs her legs, we lift her out and how we manage to get her in the wheelchair without either of us slipping over and breaking something is a minor miracle.