by Craig Taylor
I think there were so many different factors involved in the physics of it, you know, that anything’s possible. But this girl just happened to get it right, if you see what I mean, and what stays with me is her determination not to fuck it up. She must have spent a certain amount of time watching other trains and working out what was going to be the best way of doing it, because if you’re going to do it, the worst thing is that you end up under the train but still alive.
The combination of the speed of the train and the speed of her jump and the absolute clarity of her jump as well, it was a clear jump into the train. She jumped slightly at an angle towards it, rather than across it. She jumped into it. She hit the target.
For a long time after that happened, I would turn around and walk away down the platform when a train came into the station. I would be happily waiting for the train and then as the train came in I would turn around and walk away to stop myself doing what she did. It was a kind of vertigo thing, you know that thing about vertigo where the fear is you’re going to throw yourself off. Not that you’re afraid of the height, but you’re afraid of losing your own self-control.
I think these things, whether it’s wanting to hurl yourself off the side of a mountain or in front of the Northern Line at Camden, from a psychological point of view, I think it’s the trauma process. It’s the rational mind slowly over time grappling with the irrational and the incomprehensible, throwing it up and confronting you with it, and you make the right choice, you keep on making the right choice and after time you’ve dealt with it.
I don’t have any sense of her pushing people out of the way. She was probably sort of four or five people along from me down the platform. But I don’t have any memory of her elbowing people out of the way. She just cleared a path, but it was the scream. Because she was right at the back of the platform, there was six, seven foot, two metres maybe, she’d got to cover. More maybe. And the scream started before she started to run and was extinguished when she hit the train.
The collective, undiscussed, instinctive reaction of everyone was just ‘go’. Everyone wanted to get out of there as quickly as they possibly could. No one wanted to stay. The whole classic drive-by thing of you drive past a car accident, it was exactly the opposite. Everybody wanted to leave as quickly as they could.
I was 24 when that happened, and at that point in my life it was my most immediate experience of death and mortality. And then about eight years later, one of my best friends from school and then university was murdered in Kensal Green.
His name was Tom. It was January 2006, and he was jumped. He’d bought a flat on one of those roads that goes just north of Kensal Rise station. He was a young lawyer, 31 at the time, and he was on his way home from work. He was getting married in June that year and he was planning his wedding. I still know his girlfriend, his former fiancée, very well. In fact I introduced them, so I was friends with her before they got together.
He was on his way back to her, walking down Bathurst Gardens and he got jumped by two guys, 17 or 18 years old. And they cut him down. They just cut him down. He fought back, because he would have done that, d’you know what I mean? They challenged him; he gave them some money, he gave them his wallet. I can’t remember the exact sequence of events, but they mugged him and I think he gave them some, but not all, of what he had on him and then they aggressed him again and he fought back, and they chased him down the street and cut him down. Cut him at the back of the legs, cut his hamstrings, and then stabbed him to death. For what in the end turned out to be £20 and an Oyster card. I mean, that was the value of the project, as it were.
What happened with Tom is not typical. You know, the idea we’d be safer if we weren’t in London, that’s actually nonsense. Statistically it’s nonsense. But experientially it’s nonsense as well. The media would have you believe it’s typical and it could happen to you at any moment. I think we’ve got a massive problem in this city, much more than the country at large, with the media, the local media and the national media that is London-centric, at best using fear to sell newspapers and at worst being used as an organ for crowd control, in terms of limiting people’s aspirations and hopes and self-confidence. I think experientially the chances of lightning striking twice, as it were, are next to nothing. The chances of a very close friend of mine being murdered in a street robbery are infinitesimally small. He didn’t do anything stupid. It was just incredibly bad luck, and the chance of that happening again either to me or to someone I know is even smaller.
I think I went through a period after he died thinking, maybe I’ll move out of London and go and live in the country. But that’s the dream that nine-tenths of this city have, you know, nine-tenths of the time. It’s ongoing. I’ll do it one day. So that became intensified, but four years later I still haven’t done it.
PERRY POWELL
Paramedic
We go everywhere, that’s one of the perks of the job. I’ve done jobs in bank vaults, I’ve done jobs in burger vans and cars and posh mansions. Everywhere really. Parks – I delivered a baby in a park once, that was an interesting job. Yeah, literally everywhere. You do get to see places that other people just never see. The Eurostar terminal at St Pancras, that was another one that was interesting. Interesting because the French police weren’t that happy about letting us through.
You get different types of jobs depending on where you work. Certainly in Southall you get a lot of medical problems. South Asian people are more prone to cardiac problems, for example, so you do go to a lot of heart attacks, you go to a lot of respiratory problems. In some of the most impoverished areas there’s a lot more drug use so you’ll go to more heroin overdoses, which is unheard of in somewhere like Ealing. And if you work up in town proper, say Westminster and the West End, you go to a lot of tourists. I think a lot of people from abroad are quite impressed with the service: that an ambulance will turn up within eight minutes, that there’s no charge wherever you’re from, whoever you are.
We are sitting at a table just off Charlotte Street, surrounded by late morning traffic – people in suits riding Boris bikes and pulling into nearby Scala Street, where the rack is full of bikes, no empty spaces, cursing the mayor, cursing the scheme. Nearby an Asian man finishes a whole egg and cress sandwich in two bites, like he’s been practising the move most of his working life. Lorries rumble up Rathbone Place behind him.
I think the main thing is talking to people, talking to all manner of people, many types I’d never come across before. Talking to the alcoholic who’s lying in the gutter at three in the morning and wants to lamp you. Talking to very elderly people who are terminally ill. I found that really challenging. Dealing with kids. I had no experience at all of dealing with kids and I think that for most ambulance staff, really unwell children is their biggest fear because it’s so difficult to assess them and because they can go downhill very quickly, and you’re dealing with parents at the same time. Yeah, and people who don’t speak any English at all. Trying to reassure them and take a history from them via a translator on the phone or via sign language and still smiling.
I had an idea of how mixed London was but I didn’t appreciate the pockets you get. I spent my last years working in Hanwell, which is Ealing way, you know, and we’re on the doorstep of Southall, which is just like another world. It’s like nowhere I’ve ever seen in London: you drive down the High Street and the Broadway and you don’t see a white face at all and you see all of these bazaars and shops spilling out onto the streets and people hawking food from open shop windows. It’s fascinating. It’s like nowhere else, it really is. I didn’t know that places like that existed. I always had this view of London being terribly mixed and everyone living side by side. It was an eye-opener. The same as when I was working in Oval, you do get pockets of African-Caribbean people which are quite segregated from the rest of the community.
I didn’t find culture as much of an obstacle as I thought it might be. You’re spoken to about the issues of, for examp
le, going into mosques, people will expect you to take your footwear off and we’re not allowed to take our boots off because they’re safety boots because they’re steel toe-cap, so they provided us with shoe covers in the end, sort of like a bath hat really or a shower cap that you put on your shoes. But I’ve never found that an issue. If an ambulance is called, there’s an understanding it’s an emergency, people just say ‘Come through.’ It’s not been a problem. The same with male and female segregated areas, that hasn’t been an issue.
And also people talked about obstetrics and how in certain cultures it’s totally unacceptable for a man to deliver a baby or be involved in any way. I’ve never found that either. I’ve delivered Muslim babies, Hindu babies, white babies, black babies, and it’s never really been a problem at all.
We generally take turns, we do a shift driving and a shift attending. I think most people become quite cynical about the number of jobs that we go to that we wouldn’t perceive as emergencies or in need of an emergency. The sort of jobs that a patient could have gone to their GP about in four days’ time or taken a couple of paracetamol and gone to bed and seen how they felt in the morning. Those sort of jobs start to wear you down and you spend a lot of time talking to these people in the back of the ambulance on the way to hospital and in their houses when you’re attending, i.e. when you’re not driving, and you spend a lot of time biting your tongue and maintaining a professional veneer when underneath you just want to say, come on, wake up, get a grip! They’re holding calls across the sector, they’re crying out for an ambulance which isn’t available, to go to a 14-year-old who’s stopped breathing, and we’ve got you in the back of our ambulance and I’m having to make polite conversation with you because you’ve stubbed your toe. You do want to smack them. I won’t lie to you. When you drive, you kind of get away from all that. You can switch off, you don’t have to listen to what they’re saying. You don’t have to bite your tongue. You can help out. You do a few obs and then you get in the front, drive to hospital, make the tea, clean the vehicle and go to the next one. Also there is the fact that driving on blue light just is quite good fun.
There’s something like four times as many calls per day as there were ten years ago and the same number of ambulances to deal with them. So we’re going from job to job to job most of the time. You get a few hours in the early morning where you green up, which means you push the button to say you’re ready for the next job at hospital and you don’t get a call straightaway, but that’s the exception to the rule. So they are trying to make staff more and more productive, which is understandable in a way, but at the same time, by the time you’ve handed over your patient, you’ve finished writing your paperwork, which especially if they’re quite unwell is very important, as it’s a legal document and you want to make sure you’ve written everything you can think of about the patient. By the time you’ve done all that you can easily have spent half an hour. If you’re a smoker and you want a fag as well, you’re looking at 33–34 minutes. So yes, whereas they want you to turn around in no more than twenty minutes and they’re constantly asking you to book delays if you’re any longer than that and twenty-minute turnarounds are tight, especially when you’re working a twelve-hour shift and the best you can hope for is a 45-minute break at some point, which maybe seven times out of ten you don’t get because it’s too busy. So these ten minutes or even five minutes after you’ve finished your paperwork here and there at hospital to eat a bit of lunch or to have a chat with your colleagues, it’s important.
In terms of staff sanity as well, I think the few minutes at hospital where you can talk over a job with other crews are very important because we do go to some stressful situations and you do need to let off some steam occasionally and you do need a bit of reassurance that you did everything you could for a patient. Often that’s all you need, but it is important especially now we rarely see station. There was a time when you would green up straightaway after a job and you’d go back to station and have a cup of tea, there’d be another crew there, you’d sit down, watch a bit of telly, make a few jokes, you know, and that was how it used be. But the busier it gets, the less frequently that happens.
I’ve never done a birth that was anything other than really straightforward, thankfully, because we have two days’ training in obstetrics: a day on the technician course and a day on the paramedic course. We know what to do if something goes wrong, but we never ever want to have to do it.
My first shift working with a student, I hadn’t ever delivered a baby. We were on Richmond Park, I was driving and my crew mate was attending, and we went in and the woman was really nice, and said, really sorry to call you, I know it’s not really an emergency but I have these really short labours. My last one was thirty minutes, so we didn’t want to take any chances. We said, no, it’s fine, it’s fine, and we got all our stuff together. I let my crew mate have a look at the business end while I got some kit out and we decided we were going to have to stay where we were because she was crowning. There are certain indicators for when you go to the nearest obstetric unit or when you stay where you are. You don’t want to have the baby in the back of an ambulance because it’s just cramped and dirty. So we explained that she’s doing well. She was very relaxed actually, there was no crying, no heavy breathing, it was all quite calm. She’d been there before, this was her third delivery. But then the husband turned to us and said, do you know the last time the crew came they’d never delivered a baby, can you believe that? So we kind of looked at each other and said, no, really? Shit. Well, it came out. Cut the cord, gave it to mum.
We waited until it was all over and said, you know, actually that was our first as well. The husband laughed. He said, well, you’d never have known it. That’s a relief. The veneer of calm worked again.
There was a recent cardiac arrest I did. It came through as a chest pain, which can be anything from someone having a heart attack to someone with a cough – it’s categorized the same. So we went there, a block of council flats somewhere in Southall. A grim old place actually. Just three floors of concrete flats in a long line. I think it was about ten or eleven at night. He was 40 and you do make assumptions based on what the computer tells you: 40-year-old male, chest pain. People don’t generally have heart attacks in their forties so we’re not expecting anything too serious but get there as quickly as we can. We go in and it turns out he has a long cardiac history, he’s had three heart attacks in the past and he looks like death warmed up.
He’s got the classic signs and symptoms of a heart attack, he’s very pale. He was black but he barely looked it, if you know what I mean, he was that washed out, pouring with sweat, shivering, complaining of a tight, crushing pain in his chest radiating down both his arms. There was a paramedic on the Fast Response Unit in the car who was there before us. So we decided to do an ECG and give him aspirin GTN on the scene before we moved him, and the ECG showed quite clearly that he was having a heart attack. So we got him on our carry chair, carried him down the stairs puffing and panting all the way down because he wasn’t a light bloke.
Some of our illest patients are very very heavy, which is no coincidence, you know, if you’re twenty-five stone your heart’s not going to be in the best shape and neither’s the rest of you. So it’s awkward. You can carry quite a heavy weight between the two of you down a straight flight of stairs but when you’re in an old Victorian house with corners or, worse still, a fire escape in the rain in the dark, it’s very hard work and there’s the constant fear that you might actually drop the person. Thankfully I’ve never done that but I’ve come pretty close. All it takes is one stumble and then you unbalance a bit and your crew mate unbalances and down they go.
So we carried him down the stairs, got him in the back of the ambulance and I was just getting IV access to give him some morphine for the pain while my colleague was getting clopidogrel, which is an anti-platelet drug which works by stopping the platelets binding together and making the blockage in the heart w
orse, when he gargled and went into cardiac arrest then and there. And this was the first witnessed, monitored arrest that I’d done, i.e. he was wired up to the monitor and we saw him arrest. So we were able to give him a pre-cordial thump, which is something I haven’t done before or since.
Basically it means punching them in the chest because that can sometimes create enough energy to restart the heart. Didn’t work. So we got the de-fib on, shocked him straightaway and he reverted to a normal sinus rhythm. Because he was having a heart attack ordinarily we could have taken him to a specialist centre where they do primary angioplasty, the nearest one would have been Hammersmith Hospital, which was quite a long way away, but it means they can cure the problem straightaway. They go straight into a cath lab, they thread a wire up through the groin and clear the coronary artery that’s caused the problem. It’s all very clever, but because he was in cardiac arrest we couldn’t do that because his airway was compromised. So we took him to the nearest hospital.
We managed to secure his airway but not until he’d vomited everywhere so there was a risk that he would have aspirated on his own vomit. As we were going into the A&E he regained consciousness and started to be aware of what was going on. But we got him in and the hospital were fantastic. Often district general hospitals dither. They have inexperienced staff. They don’t have any specialists, especially at night. There are no consultants on so they’ll take a few bloods, they’ll confirm this, that or the other and it can be an hour, an hour and a half before they’ve actually come to a decision that the patient needs to be transferred, which is a decision we know we could have made in ten minutes. Anyway, they were very good. They saw he was up and about. The anaesthetist checked his airway, was happy with it and he was transferred within five minutes to the cath lab and then we heard that he’d made a full recovery and he’d gone home.
