by Wharton, Kit
You see an awful lot of unpleasant substances in this job, not always coming out of the holes they should come out of. You need a strong stomach.
William
Many people in the service have pet hates: some don’t do vomit, some don’t do urine, some probably don’t even like blood. Val doesn’t really do faeces well. On some jobs if a patient has pooed themselves she’ll go quiet and a certain look will come over her face – a bit like a hunted animal, eyes staring and panicking – and I know I need to step in because she’s about to throw up. I’m quite good in this way and can deal with most things.
But today’s different.
The day before yesterday we had the Station Wedding. Two colleagues who met in the service, tying the knot in a church up the road. It’s been planned for months. Lovely. A marquee, people staying the night, that sort of thing. An ambulance-service bash, with colleagues behind the bar. I ended up throwing up and passing out on the train home – Jo isn’t speaking to me, Val ended the evening being carried off the dance floor almost unconscious.
So we’re still a little fragile.
We’re called to an 85-year-old gentleman complaining of abdominal pain and constipation. The GP has been out and ordered us to come get him. The address is a pretty cottage in the countryside, and the patient is a pleasant and sprightly gent, but feeling sick and with the aforementioned painful stomach. It doesn’t look too bloated, especially considering he’s quite slim.
We assess William and do his observations, none of which are remarkable. It turns out he hasn’t opened his bowels for a fortnight. We bring a carry chair in and move the patient out to the ambulance. Getting him on to and off the chair necessitates a little movement on his part, but within a few minutes we get him comfortable on the stretcher.
I’m in the back with the patient. I ask him if he’s comfortable.
—I’m feeling sick.
He has gone a little pale.
Probably all that manhandling. I give him a cardboard sick bowl and get some tissue ready. We haven’t even moved off yet. Then the patient throws up.
Someone being copiously sick when it’s seven thirty on Sunday morning and you’ve not been long up yourself is not a great place to be, but this is worse. The patient’s vomit is light brown in colour – the consistency of French mustard – and there’s a lot of it. Bowls full. And it smells of exactly what it is – shit. Human faeces.
Among other very clever things, the human body is a container, for blood, urine, bile, food, liquids and so forth. The trouble is that if the exit for one – in this case faeces – is blocked, it’s going to back up and back up and eventually come out of the entrance. Which is what’s happening now. Our poor patient is vomiting up his own shit. And that’s exactly what it smells like. The bowel is so completely blocked the faeces have backed up through it, up through his stomach, and are now coming out where the food went in days or weeks ago. I look on in horror but pat his shoulder and try to say reassuring things, then realise my own stomach is turning over and I’m very close to vomiting myself. I have to keep holding the bowl for him and wiping his mouth and therefore can’t avoid looking at and smelling everything, and then unavoidably I retch and a bit of bile comes into my own mouth and I have to swallow it back down because I can’t turn away. Val’s in the front of the vehicle and is waiting for the signal to move off, but I can’t give it because I’m swallowing my own vomit while inches away from a man vomiting up his own shit.
This is the life …
Val takes one look at what’s going on and firmly slams the window between the saloon and the cab. The crisis passes after what seems an age. I get control of myself, and the flow of faeces from the poor patient’s mouth begins to dry up with the third bowl filled. Eventually, he stops vomiting entirely and we’re able to move off to hospital, where they’ll fill him up with olive oil or operate to get his bowel working again.
And we’re straight to the garage, to get some extra-strong mints.
Theresa
We’re called to a female in a care home, eighties, ‘inappropriate behaviour’.
It turns out the lady in question’s a dementia sufferer, who’s become too violent for the care home to handle. They’ve called us to transport her, well, anywhere, basically. The hospital first, then to a specialist nursing home which can handle her. However they do that.
Anyway, we roll up at the care home to find the job’s been classified as a stroke, and so they’ve sent the nearest resource they can to stop the clock – Len. Len’s got a student paramedic (learning on the job) in tow. Len doesn’t get out to see patients much nowadays because he’s an officer. They’re trying to assess the patient and they’re struggling.
Dementia’s a diverse illness and can have diverse effects. There are probably almost as many symptoms as there are patients. Some go quiet and never say a word to anyone. Others regress to childhood, cuddling teddy bears and the like.
And some just get rude. World-class, Olympic-standard rude. A lifetime’s suppressed aggression barges in the front door, inhibitions leave out the back, light the blue touchpaper and off we go.
Our patient today is a slim, well-dressed lady in her eighties. White hair, glasses, cardigan. Well spoken, well turned out. Quite the lady. But not quite the lady today.
Len and the student paramedic are trying to take her pulse and blood pressure and the like, but she’s not having any of it. She glares at both of them with venomous hatred.
—Fuck off!
Len – ex-forces, remember – has a whispering, soft voice, slightly menacing and staring eyes. He looks at the lady as if he’s deciding where to shoot her. (Mind you, he looks at most people like that.)
—Please darling, we just need to take a few observations, that’s all.
—Fuck off and leave me alone! Cunt!
Len’s experienced and he, like Val and me, has come across this sort of behaviour before, so he keeps well away. (Val once went out to a former nun with dementia and got slapped in the face for her trouble. The care worker took one in the balls.) But unfortunately, it’s pretty well impossible to take someone’s observations without touching them. Len reaches out to feel the lady’s wrist for her pulse and she grabs him by the arm with all her strength and digs her nails in so hard she draws blood.
—Fuck off. Bastard!
He draws away nursing his arm. The student paramedic’s not so experienced and not so lucky. He’s kneeling at her feet – big mistake – trying to take her blood pressure. Finished with Len, our lady looks around the room at us with equally venomous hatred, then her gaze settles on the student at her feet. She says nothing.
He’s looking down, not meeting her gaze, not sure what to do or say.
The patient looks at the student for a little while, expressionless, then sniffs as deeply and noisily as she can, and spits into his face.
Oh dear.
Bernard
We’re called to an upmarket pizza restaurant in the high street. It could be a serious one. Male, sixties, hit by a bus.
Have the staff in the restaurant just seen it outside? Has the male been thrown into the restaurant by the impact? Or has he been carried in, barely conscious, head cushioned on a plate of garlic bread?
It’s a busy Friday night in town, with loads of people out enjoying themselves, in and out of the restaurants and bars, having a good time. But the staff and customers of the chic Italian restaurant we arrive at are not having a nice time.
Our patient is sitting at a table by himself near the door, surrounded by lots of different bags. He’s looking around at the other diners quite cheerfully, not obviously in any pain at all. Everyone else in the place is looking horrified. Absolutely horrified. The reason is our patient is very obviously living rough, but more than that, in well over a decade working for the ambulance service, he’s the smelliest person I’ve ever come across.
The stink is really phenomenal, a composite of body odour, urine, excrement, unwashed skin and
clothing and decomposing substances. It’s enough to make your eyes water. And it’s making everyone in the restaurant panic with a mixture of horror, revulsion and embarrassment. They’re sitting over their pasta and linguine and this fellow’s smiling at them and making them all want to throw up.
Apparently, he’s just calmly walked into the restaurant and sat down, claiming to have been hit by a bus. So the restaurant’s called 999 as fast as they can.
He’s a big man in his sixties, with a massive beard with lots of things in it, a florid face, dressed in a huge collection of rancid, soiled garments. He has a huge booming voice, is quite well spoken, and doesn’t appear to be drunk. He looks like a sort of Father Christmas living in a rubbish dump. And there’s a certain sort of magnificence in him and the way he surveys the restaurant, totally unperturbed by the stink he’s giving off or the looks shooting around the place. It’s almost as if he’s done it deliberately, just for a laugh.
Certainly there’s no evidence he’s been hit by anything, apart from the glares of horror and terror from the restaurant staff and customers. But the stink’s unbearable, even for us, and we’re used to it.
—Why don’t we get you outside and onto the ambulance? The hospital’s just up the road.
So he gets up quite happily and walks outside and on to the ambulance, and we take him for a very short trundle up the road.
The smell’s so bad at the hospital I take the unprecedented step of leaving him outside while I go in and explain what’s happened and what he claims has happened. He’s a regular visitor. I get him a nice warm blanket and come out and cover him up in his chair and we leave him outside where a nurse will come out and see him. She might even bring him a cup of tea if he’s lucky.
We’re in and out of the hospital for the rest of the night. At first he falls asleep in the chair, and has a short doze. Then about 1 o’clock in the morning he gets bored and gets up and wanders off.
The last I see is a collection of bags and a head bobbing off down the road happily.
11
Luck
Afternoon.
We’re in a leafy, quiet part of town on a nice spring day having a nice quiet shift. Birds are singing and old ladies are gently falling over not hurting themselves too much. It’s all lovely.
Then, as often happens, it all goes tits-up.
Rita and Charlie
Called to a male, mid-twenties, back injury. Patient’s a roofer, apparently, but there’s nothing in the job notes that says anything about falling off the roof, so it doesn’t sound too nasty – probably put his back out lifting some tiles. Another object lesson in ignoring the notes that come over on the computer – they are often wildly wrong. Chinese whispers: ‘Send reinforcements we’re going to advance’ becomes ‘Send three and fourpence we’re going to a dance.’
As we draw up outside the house the controller comes over the radio.
—Could you take the dressings kit in with you?
Shit. No explanation as to why, but we’re already thinking: uh oh.
The next minute or so is the bit that’s really a nightmare. A man who looks like a builder ushers us around the side passage of the house pointing to another man kneeling on the ground clutching his back in pain.
—Don’t worry about me, he says. They’re round there.
He nods around the corner towards the garden. Around the corner we find the garden with a conservatory and a ladder leaning against the roof. Bricks and glass all over the place. There’s a man sitting on the sofa in the conservatory with blood all over his head and arms. We’re about to attend to him when we hear a child’s screams from inside and he says the same thing.
—Don’t worry about me. They’re in there.
So we move past him into the rear dining room where a woman – his wife – is sitting on the sofa with a girl of about two who also has blood all over her head and arms. She’s hysterical with pain and fear. Only then do we find out what’s happened. The builders have been working on the roof – the couple have been looking after their daughter. Dad is on the way out with child alongside to ask if they want a cup of tea, at exactly the point the roofer is halfway up a ladder with a huge hod of bricks. He’s lost his balance and dropped the lot.
The builder’s fallen onto a retaining wall, but the pile of bricks has somehow smashed through the conservatory roof or windows, sending a shower of bricks and shards of glass down on the heads of Dad and child below.
A bit of a fucking nightmare.
My colleague runs to get the analgesic gas for Dad, while I try and get some pain-killing medicine into the screaming toddler and calm her down, which is not easy. I also get on the radio and scream for backup. Both Dad and toddler’s heads, shoulders and backs are covered with a mass of cuts and blood, mixed in with bruises and brick dust and shards of glass – sorting it all out will be a job for surgeons. How neither of them are dead is a mystery.
Eventually, after what seems like a thousand years, backup arrives in the form of other crews and the helicopter doctor. Calpol hasn’t helped the toddler much, and the doctor decides to sedate her before she goes to the hospital where she can be knocked out properly so the surgeons can begin repairing the damage. Dad goes in another ambulance. His head and shoulders look terrible. The builder is not too badly injured but God only knows what he’s feeling.
It must have been a long and painful recovery for the three of them. All scarred for life. Just for a cup of tea.
A lot of life is about luck. Maybe all of it.
My parents were often lucky to get away with it.
My father used to spend his days writing articles about moral values and financial responsibility and that sort of thing. One night he came back to our flat so pissed he put the pressure cooker on to heat up some stew, then passed out on the sofa. The cooker blew up, the pressure cap smashing a hole in the ceiling of the kitchen. The hole was there for years afterwards.
He never even woke up. Just carried on snoring on the sofa.
He was a well-known and serious journalist who knew cabinet ministers and the like. Maybe the façade of respectability he had to exude in his working life led to a private life almost certifiable by contrast. He and my mother once visited a friend in Paris. A dinner party or something. My father ended up having a blazing row with a woman. She called him a motherfucker or something, objecting to his home life. I think he slapped her. She walked out and everyone else passed out. The woman went home and told her boyfriend, a bit of a hard bastard, who came round with a knife, intent on stabbing my father. But he couldn’t get in, no one in the house heard him carving up the door outside – they were all unconscious.
Like EastEnders, but with posh people.
And lucky people.
I know I’m lucky too. Why am I rich and English, and he’s starving and Ethiopian? Why have I kept it together and she hasn’t? Why am I healthy, and they’re ill? I sure as hell haven’t had anything to do with it.
Is that why people believe in God? Because they can’t believe it’s just luck? Perhaps that’s one of the lessons learnt from the service. I don’t really believe in God, and one of the reasons is the randomness of life you see. You scream on blue lights to a man fallen off a ladder, but on the way you go past two people up ladders who haven’t fallen off them yet. You scream on blue lights to a road accident, driving faster than you normally would, knowing more speed means more danger, no matter what training you’ve got, but you don’t crash. You rush to a man who’s suffered a stroke, but the fatter, unhealthier man you overtake gives you two fingers as you fly past because he’s pissed off about the traffic or something.
A colleague from a different trust wrote a brilliant blog about the ambulance service, with a perfect title. Random Acts of Reality. You think of all this randomness sweeping all over the world and you think: What the fuck?
Victor
Some people don’t recognise their own luck.
Night. Called out to a male, 20, rollover RTC (
road traffic collision), head injury. The sort of call that gets the trauma junkies salivating. Cars that roll over do lots of damage to their occupants, throwing them around inside or sometimes out the window. Gory stuff. Off we go.
The patient is sitting by the road in the rain with a small graze to the top of his head. The car is upside down on a dual carriageway – a fast bit of road. He’s taken it out for a spin, lost it on a bend, and … well, you know the rest. He’s crawled out from the wreckage on his own. We go over his spine, his breathing, and all the rest as quick as we can, get him safely on the ambulance, then go over it again, much more slowly. Apart from the scratch on the head, can’t find a thing wrong with him.
He’s moaning about how pissed off he is. The car’s very flash, brand new, and worth tens of thousands. This is more or less the first time he’s taken her out for a spin and he’s written her off. Then, to cap it all, the police come on board, breath-test him, and nick him for drunk driving. I’m beginning to feel a little sorry for him but then I step outside to look at the car.
It’s one of those open-topped sports cars with no roof structure at all – just a little pop-up windscreen, now mashed to bits and crushed under the car. To a layman’s eye it just looks like the upside-down car’s had its roof and windows all ripped clean off. And then I start to think how the hell did he get out of this with just a scratch on the head? It’s a bit of a miracle – we should have been shovelling his brains into a plastic bag by now. At the very least he should have broken his neck. I go back to the ambulance and as politely as possible tell him to shut up moaning. He’s a lucky guy. Then we toddle off to the hospital.
The police will come down and get him later.
One of my parents’ best efforts was in a Chinese restaurant – they were proud of this one. There were the usual insults and fighting, then one of them spat a mouthful of rice out at the other. The rice flew into one of those fans which restaurants and offices have, which then flung it all over the room and the other diners.
