by Wharton, Kit
Anyway, around midnight, we get called to the multi-storey car park in the middle of the town’s shopping complex, to an elderly male, jumped off the roof.
Elliot.
We’re only at the hospital, two minutes up the road.
An elderly black gent, speechless and wearing a high-visibility jacket – some sort of security guard – meets us and leads us around the corner and onto a piece of bushy grass next to the building. I glance up at the car-park wall beside me. It’s at least four storeys high. Maybe 60 feet.
Shit.
The patient is lying on the grass on his back, unconscious but still breathing, legs twisted under him. We get a collar on him and some oxygen, and the paramedic gets an IV line into him. This sort of impact will almost certainly have caused massive, probably fatal, internal bleeding. Me and my crewmate are getting the truck as near as we can and unloading the equipment we’ll need to get him on to the stretcher.
The patient is an elderly man, dressed in pyjamas, dressing gown and slippers. What the hell is he doing here? The poor security guy still staring at the scene horrified is in shock. He holds out a half-empty black bottle. It’s morphine sulphate, a powerful painkiller of the type given to patients with things like terminal cancer.
—I found this on the roof.
The poor sod. It turns out he was sitting in his office on the ground floor when he saw the old man come into the car park and go to the staircase. He wondered what he was doing here – maybe he was lost or confused. So he followed him up the stairs, looking in on each floor to see where he’d gone. Eventually he got to the roof and found him there on the edge. When he approached to see if he could help, the man jumped.
There are no private houses immediately around here. So he’s either walked a while to get here, or perhaps got out of the hospital up the road. Maybe the morphine is because he’s got a terminal illness, and just wants a quick way out.
In which case, sadly, he may well get it. He’s still breathing on the ambulance, but when we push on his pelvis, there’s a grating feeling. This is called crepitus, and it’s the feeling of broken bone ends crunching together – his pelvis is smashed, and at his age he’s unlikely to survive that, never mind what’s gone on inside.
But he’s still with us, so we leave the poor security guard for the police to take care of and we scream off up to the hospital.
Once there we hand over to the staff in the resus bay to do what they can for him, then go and get a cup of tea and try to forget him. Which takes some doing.
5
Fear
I joined the service in 2003, but maybe the training started earlier than that.
I was born in London in 1965.
My parents were what was called at the time ‘interesting’ but would now be called ‘dysfunctional’. Or nuts. My mother was a freelance writer, married to another writer. He wasn’t my father. My father was yet another writer, deputy editor of a national newspaper. He already had a wife, and two children. And a dog. So I ended up in a family that included half-brothers, half-sisters and maybe even half-dogs.
Complicated. It was a mess. Like living in a lunatic asylum sometimes.
When I was a boy, me and my mum lived in a dirty ramshackle flat in south London with a Jack Russell terrier, a boiler that blew up all the time and a series of demented cats. Also a sea of empty wine bottles. All of these things were more or less connected.
My father was a funny and witty and kind man, but spent a lot of his time with his head in the clouds, thinking about politics and economics and that sort of thing. Also a heavy drinker. I think he probably first thought of his relationship with my mother as an affair – nothing too serious. But she had other ideas, and then his children, so it didn’t work out like that. My father never left his wife, which meant we only saw him every other weekend after my stepfather left, weekends which often descended into a drunken fight between him and my mother about when (if ever) he was going to leave his wife and come live with his second-class family. (My mother’s words, not mine.) He never did, and I used to dread the sound of his motorbike turning up outside the house, knowing the peace was about to be shattered.
My stepfather left when I was about five. When she wasn’t having rows with my father, my mother managed a few with him as well, though he was quieter. Both men got on fine.
The whole messy stew was pickled in alcohol. My parents would be described nowadays as problem drinkers, though they usually never had much of a problem with it. They were fun, don’t get me wrong. They worked, and there was a lot of laughter and affection when they weren’t smashing bottles over each other’s heads or throwing food around.
Freud said the ability to love and to work was a good guide to mental health. But I’d have liked a bit more than that.
And I ended up in the emergency ambulance service, which is a bit of a contrast. Life on an ambulance seems calm and ordered in comparison. Logical, sensible, rational.
Sometimes …
People always say you must see some things, doing your job. The nasty jobs with all the drama. They’re sometimes right. People ask about them and want you to remember them, but the nasty ones are the ones you’d rather forget.
Darren
Dusk falling. Midwinter.
We’re standing outside the ambulance station smoking. Me, my crewmate and Vicki, who’s on the fast-response car, and isn’t a flappable person. Her buzzer goes off to signal she has a job, so she goes and gets in her car to start the engine and look at the computer screen to see what it is.
Then she screams at me.
—Shit! Follow me!
—Eh? You what?
—Follow me! Follow me!
We follow her. The job comes over the computer within a minute. Man hanging in the woods. Next to the cemetery, just to make it even more ghoulish, as dusk falls. This is obviously on the time-critical side, so off we go.
We get there a bit behind Vicki. We can only see her lights, as she’s driven to the very far side of the graveyard, near the woods, where the man who found the patient has led her. I sprint across the grass to meet her.
When we get to the patient, there’s nothing to be done. Darren’s a young man, only in his twenties or thirties, kneeling under a tree. A rope round his neck leads up to a branch about six feet up. There’s an empty bottle of vodka on the ground at his feet, lots of cigarette butts. Maybe Dutch courage. There’s nothing we can do. He’s cold to the touch, and it’s obvious he’s been dead some time. Kneeling beside him doing the stupid paperwork, I can’t help thinking about the finality of what he’s done. We go out to a lot of overdoses where the patient’s taken pills and called 999 because they want help. But there’s no going back from a hanging. You can rebuild a lot of burnt bridges in this life. But not this fucking one.
By this time it’s almost dark and the police have arrived. From our point of view there’s little to be done. We need to take an ECG of his heart, just to show legally there’s no activity and he’s dead, then we can leave it to the police. They’ll organise the undertakers to come and collect the body and inform the family. But there’s still a few surprises in store.
First a woman comes suddenly through the woods, with a dog, clearly upset.
—Where is he?
It turns out the patient lived just on the other side of the woods, and left a suicide note. This woman, a friend or relative, has read it and rushed over, too late. Vicki and I go back to the ambulance to collect the ECG machine, then make our way back towards the patient, still hanging in the woods. By now it’s almost completely dark, so we head towards the lights of the police torches flashing in the darkness.
I walk straight into the body of a man, kneeling down, hanging from a tree, just like the first. His head bumps against my chest. My heart nearly stops.
Jesus Christ, what’s this? Another one?
It turns out the police have moved away from the body to examine a bench in the woods, surrounded by cigarette butts and an
other vodka bottle, where the unfortunate patient must have spent his last hour or so. The body I’ve bumped into is the original one, thank God.
The three of us do the stuff we’ve got to do, then get out of there as fast as we can.
There’s an old Russian proverb:
We are born in a meadow, but we die in a dark wood.
Bad things happen in woods.
(And not just to Russians.)
Ivan
Called to a male, thirties, fallen over with a head injury.
This turns out to be about as frightened as I’ve ever been doing this job. The location is a bugger for a start. The man’s on a path deep in woods south of town. This is quite a large area of thick woodland with different paths running across it. In the end it turns out the nearest we can get is a deserted industrial estate where we park the ambulance and walk up a path through the woods for about a mile.
Eventually we come across the patient and a rather brave woman out walking her dog who’s come across him. He’s in his thirties, thin, naked from the waist up, and intoxicated of course. He’s shaven-headed and has a large cut on his head where he fell on the pathway. He’s really whipcord-thin, with staring eyes and loads of old scars on his head and arms. He may have been knocked out – she’s not sure.
Nor is he, because he doesn’t speak much English – he’s Lithuanian. We explain that because of his head injury we’d like to take him to hospital for observation, and he seems quite happy with that. But first he has to get some belongings.
—Where from?
—You come. I show you.
So the three of us tramp through the woods off the path for a good few hundred yards in deep bracken.
Eventually we come across his ‘home’ just as it’s starting to get dark. Maybe I’m just tired or something, but I start to feel uneasy. This isn’t a home – it’s a lair. A tiny clearing in the woods, with two small tents opening on to it. Maybe one of the tents is for house guests, but there’s no one there now. There’s a clothes line between two trees, empty food packets, pill packets, and bottles all over the place. And it’s freezing and getting dark. I look in one of the tents and see what looks like a huge hunting knife in a corner, while our friend pulls on a jumper, singing to himself and dancing all over the place.
It turns out he’s been living here for over a year, all through last winter and well into this one. He used to have work on a farm, but not any more. God knows what he’s living on. Tinned beans, pills and alcohol by the looks of it.
Val’s a pretty tough cookie, but she’s not the biggest person in the world, and the more I’m around Ivan, the more nervous I get. He’s really nervy, twitchy and agitated, and spends half the time dropping into crouches and taking practice potshots at the woods. He says he used to be in the Lithuanian special forces (does Lithuania have special forces?) and shows me some sort of military ID card, so who knows? He says he got beaten up by the police there and ‘had to get out’. He’s been in England ever since, living rough.
Living rough deep in the woods and going stark staring bonkers, is what I think. I don’t want to think about the damage he could do if he really lost it. I can imagine the paranoia taking over and him killing some poor sod out walking their dog in the woods one misty morning as he wakes up and thinks they’re hunting him.
Anyway, maybe I’m just tired.
With a few more howls at the moon and a few more crouches and potshots at imaginary Russians, we manage to get him safely on the ambulance, and with me keeping a wary eye on him in the back, into hospital. And there we leave him in the waiting room, ticking away, eyes swivelling around, veins pumping in his head. I think I should report him to the police, but what for? He hasn’t done anything wrong. Trouble is I can imagine him doing something very wrong. Very easily indeed.
But, at least, not while Fatima’s around.
I wouldn’t give him much of a chance against her.
Given my childhood, perhaps another reason I was drawn to this job is that it’s simple. In any given situation there are protocols to follow. Learn the protocols and you’re laughing.
This is rubbish, of course. One of the reasons to love the job is that despite all the protocols, all the training, all the times you’ve seen similar jobs before, something always turns up to surprise you.
Or frighten the bloody life out of you.
Like pretty much any other functioning organisation, the emergency ambulance service has a hierarchy, although to be fair things are fairly informal. And job titles change practically every week, in a deckchairs-on-the-Titanic sort of way. (I jest of course.) At the bottom (and most are better than me, certainly Val is) are Emergency Care Support Workers. Then Associate Practitioners. Next come Ambulance Technicians – my grade. Next up are Paramedics (which is what the public call anyone in a green uniform who doesn’t work for Homebase anyway). Then you’ve got various grades of specialised Paramedic: Paramedic Practitioner, Critical Care Paramedic, Paramedic Who Does Magic and Speaks Urdu, that sort of thing.
Then you get the officers. The junior, the middle-ranking, and then you get to the exalted heights of the senior officers. From there you’ve got individual directors and board members, and above that the chief executive himself. The next grade up is God.
The other thing about the service is also universal. Senior officers are admired, respected, loved. (Obviously.) But you don’t usually want people like them turning up on a job. It’s a bit like your mother turning up to give advice while you’re trying to lose your virginity.
Mrs C.
It’s mid-morning and Val and I are driving through one of the local towns on our way to a cover point when a job comes through.
Female, fifties, collapsed in a car park near the hospital.
This is a dodgy call. The drunks aren’t usually up and about and falling over this early, and especially not round here. Then the radio starts beeping. This is an even worse sign. It’s usually the controller calling to say the job’s turned into a resus – the patient’s arrested. Uh oh.
—Romeo Two?
—Yes?
—Just to let you know, you’re going out to Mrs C.
—Mrs C.?
—Yes. Mrs C.
—Fuck, says Val. Fuck, fuck, fuck.
Mrs C. is one of the A&E consultants in our area. She’s nice and everything but she is a bit frightening. If brains were dynamite Val’s and mine wouldn’t even blow her eyelids open in the morning. She’s probably forgotten more than we’ll ever know. Lots of ambulance people don’t even work in the town they live in, in case they go out to someone they know. We’re going out to an expert in emergency medicine, in public, probably with something serious going on, maybe dead.
(No fucking pressure then.)
We scream round the corner to the car park, where we see a bunch of senior police officers and council people – the people Mrs C. was meeting – all surrounding her lying on the floor. We screech to a stop, grab our equipment, and dive on her.
And luckily, thank the lord and the fates and all who are on high, she’s all right. Fully conscious and already recovering from the faint – she’s been unwell recently, which hasn’t helped. She stares at us, doesn’t say anything, and lets us get on with it.
In fact she’s a model patient. We get her on the truck and do all the tests we can on her, then do most of them again, all a bit embarrassed. She just lies there with her eyes closed.
—Just do what you’ve got to do.
We take her into hospital, and make sure we don’t have to queue up in the corridor before handing her over to Fatima, which earns us some brownie points. She smiles at me.
—Thanks, she says as we file out. Thanks a lot.
She shakes my hand.
High praise indeed.
6
Alcohol
My parents weren’t the sort of people to become ambulance people. They weren’t alcoholics; they were a bit more like drunks, sometimes. (Alcoholics go to meetings, a
s the T-shirt used to say.) They were writers, and most writers of their generation drank. You wrote and you drank. Not always in that order.
One night (when I was about seven years old) we were trying to persuade my mother to go to bed. It was about midnight, and she was drunk. A friend (another writer, also drunk) was trying to persuade her to come outside and carry on drinking with him. I’d managed to push him out of the flat and lock the door, and was trying to push my mother towards the bedroom. But the friend was outside on his knees, cooing through the catflap.
—I’ve got another bottle! Come out for a drink!
Eventually my mother appeared from the bedroom in a dressing gown, looking serious and sober.
—Right, this has gone on long enough. I’m going to go out there and tell him to go home.
The effect was only ruined by the fact she couldn’t quite stand up straight, and by the empty glass she was hiding behind her back.
Good training.
Growing up with people who drank and lived their lives as if they were in a lunatic asylum has given me some sympathy for patients, who often drink and are living their lives as if in a lunatic asylum too.
Charlie and Ellie
Friday morning.
First job of the shift is a 27-year-old female, abdominal pains and vomiting, alcohol withdrawal, malnourished.
Twenty-seven years old?
The patient is lying on the floor, retching uncontrollably, stick-thin. We get told some of the story. She’s a long-term alcoholic (at twenty-seven!), hospitalised with the same symptoms last week. She’s living in a hostel fifteen miles south, down in town ‘visiting friends’ but basically killing herself. All week since her last admission she’s been drinking, eating nothing, and now for the last two days doubled up in agony and vomiting.
