by Stuart Gray
A PARAMEDIC’S DIARY
Life & Death On The Streets
Stuart Gray
Monday Books
www.mondaybooks.com
© Stuart Gray 2010
First published in Great Britain in 2010 by Monday Books
The right of Stuart Gray to be identified as the author of this work has been asserted by him in accordance with the Copyrights, Designs and Patents Act 1988
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Thanks
My love and thanks to Jac, without you I may not have stuck this out. Thanks to Allan for holding the fort.
Thanks to all of my readers in the virtual world.
Thanks also to my friends and colleagues in the Service who gave me encouragement and support, especially B, K, I and T.
Of course, my deepest thanks to the many hundreds of patients who have become part of the diary and without whom not a word of it would have been written.
Finally, thanks Scruffs...frequent interruptions for attention helped break the monotony of writing!
About the Author
Stuart Gray is a professional paramedic who works for the London Ambulance Service. He was born in Scotland and grew up in a small town called Barrhead, near Glasgow.
When he was 16, he took a job as a cub reporter on his local paper. Then, in the 1980s, he moved to London and became a professional songwriter and musician. He also did a three year stint with the Royal Army Medical Corps before settling on a career in paramedicine.
He joined an ambulance service in Surrey and studied for a degree. He has a first in Paramedic Science from the University of Hertfordshire and now works in central London as part of an ambulance crew and also as a solo Fast Response Unit (FRU) paramedic, on his own in a car.
Stuart’s blog 'A Paramedic's Diary' is read all over the world. The Times voted it one of the ‘Top 40 blogs that really matter’ stating: that Stuart 'encounters more blood-curdling drama on a single shift than most people would in a year' and that his writing is 'compelling and plainly written.'
The award-winning 'A Paramedic's Diary: Life and Death on the Streets', is Stuart’s first book and has been a huge hit. Based on a year in his working life, it is an unsanitised account of the ups and downs of the job. Funny, poignant, heart-warming and emotional, it shows how people’s lives are literally in his hands on a daily basis.
As Stuart says; ‘There are graphic details in some of the stories. Some of it will make you wince, but if I sanitised things it wouldn’t reflect the job. There’s not always a happy ending, and sometimes it’s a heartbreaking job, but I do get to do some amazing things: my colleagues and I bring people back from the brink of death - I can’t think of a better reason to write about my work than that.’
A Paramedic’s Diary recently won an award:
His next book 'The Street Medic's Survival Guide' is aimed at people wanting to become a paramedic – a kind of insider’s guide about the profession and how to survive it.
Stuart has recently completed his first novel, ‘The Station’ which takes the reader through a single shift at a busy emergency ambulance station in London. As the story unfolds, the reader is given a glimpse of the world of the Paramedic. There is humour, fear and sadness mixed into a tragic sub-story that suddenly leaps out of the pages to shock the reader back into reality. The Station is not quite what you think it is...
Stuart’s lives in Hertfordshire with his wife and two children.
CONTENTS
THANKS
ABOUT THE AUTHOR
FOREWORD
HOAX CALLERS AND TIMEWASTERS
SEEING DEAD PEOPLE
TRAFFIC
STRONG ARM TACTICS
MATERNITY
SUICIDAL TENDENCIES
HEAVY PEOPLE
CYCLISTS
DRUGS
DRUNK
OLD
ACTS OF VIOLENCE
BRINGING THEM BACK
CLOSE CALLS
TERRORISM
SENSORY INSULTS
HIT AND RUN
STREET PEOPLE
FAKERS
BELLS AND WHISTLES
CREEPY CALLS
THE FESTIVE SEASON
HORRIBLE HOUSING
THE HISTORY OF STRANGERS
MORE FROM MONDAY BOOKS
ALSO BY STUART GRAY
YOU MAY ALSO ENJOY…
FOREWORD
This is an account of my working life as a paramedic in London. I came to the profession relatively late; I was a cub reporter back home in Scotland when I was only 16, spent a dozen years as a professional songwriter and musician, dabbled in business and computers through the late 80s and also did a three year stint with the Royal Army Medical Corps.
I finally settled on a pre-hospital career when I joined an ambulance service in Surrey. I underwent training to become a paramedic, in the days before the job title was protected as it is now, and when the training was a lot simpler. As the paramedical profession began to gain respect and importance in the ambulance service, I found myself out of the loop. I didn’t work for the NHS and I couldn’t continue using the title unless I became registered. So I completed a three year honours degree in Paramedic Science at the University of Hertfordshire (I got a first, which was an amazing personal achievement), got myself on the register and, well, the rest is history. (I nearly went for medicine but I missed UCAS registration by one month; it’s still an option I might look at in the future).
Much of the material used in this book is drawn from my reflective diaries of the last four years. The more recent of these appear on my blog, ‘The Paramedic’s Diary’ (you can read it at http://theparamedicsdiary.blogspot.com/ and you can email me from there if you like). It contains patient cases from my work as part of an ambulance crew and as a solo Fast Response Unit (FRU) paramedic, on my own in a car. When I describe situations where I’m with a crewmate, I’m in an ambulance, obviously. If I’m alone, I’m on the FRU.
Of course, some of it is skewed in favour of my own opinions and judgments but the call types, the emotions, the abuse and the hard work are all the same for everyone on the frontline.
Names, places and other details have been changed or omitted to preserve patient anonymity and confidentiality where consent has been impossible to obtain. This book is not endorsed in any way by the ambulance service I work for.
There are graphic details in some of the stories. Some of it will make you wince, but if I sanitised things it wouldn’t reflect the job. There’s not always a happy ending, and sometimes it’s a heartbreaking job, but I do get to do some amazing things: my colleagues and I bring people back from the brink of death - I can’t think of a better reason to write about my work than that.
HOAX CALLERS AND TIMEWASTERS
REGULAR CALLERS ARE known as ‘frequent flyers’.
Don’t get me wrong, some people call us often because they need us often - they have genuine problems. But a few are just timewasters, draining the resources of the NHS by calling us just because they can.
They are dangerous people who cost lives, and
there’s not a damn thing we can do about it.
One old guy on my patch - I’m talking a man in his early 60s, at an age where he really should know better - calls 999 almost every other day. He has it down to a fine art: he knows when our shifts change and he times his call to coincide exactly with crew turnarounds, ensuring a speedy response and a fresh face or two. He rings for chest pain that he doesn’t really have, abdominal problems that don’t exist and various other complaints that he knows will guarantee him an emergency response. Partly, he likes the attention, partly he just likes to get a free ride down to the hospital where he’s guaranteed more attention and a free lunch (or breakfast, or dinner). Some weeks, he’ll have a car and an ambulance outside his home every day; if he visits a friend or goes off on holiday with family members, the calls stop - he never seems to get ill on those days.
I’ve ‘treated’ him many times, and on the last few occasions I’ve lectured him at length about what he is doing. He abuses his right to an ambulance over and over again, and yet nothing is done about it.
A while ago, he called us and I was despatched with my crewmate to his home. He was rude and arrogant, and he insisted on being carried down the stairs (there are no lifts where he lives, and he’s on the third floor). He has no disability, and there was no medical reason that meant he needed to be carried, so we refused.
‘Do you have any idea how many of us suffer with back pain because we have to carry people down stairs,’ I said. ‘I don’t mind it when people can’t walk or are seriously ill. But you can and you’re not.’
He looked at me. ‘But I’ve got chest pain,’ he said. He knows full well we have to carry him if he’s got ‘chest pain’, and so we did.
In the ambulance, I spoke to him once again about ringing 999 just so he can get to hospital and have his breakfast (he gets free sandwiches, and will call in the a.m. for breakfast or the p.m. for lunch). He ignored me, so I stopped talking and we sat in silence all the way to hospital.
We spent almost an hour with him, all told.
Halfway through, another call was broadcast over the radio. It was for an elderly lady ‘trapped behind closed doors’. We could have been running to this call immediately, but we didn’t get it until we ‘greened up’ after dropping our frequent flyer off at hospital.
GREENING UP: When a call is completed and the patient has been taken to hospital, we are required to ‘green up’. This means hitting the ‘green mobile’ button on our systems so that EOC (control) can see that we are available for the next call. We also have a ‘green at station’ button so that they can call us at the station and ‘green away from vehicle’ so they can call us on a mobile phone when we’re in the loo or buying a sarnie.
When we got to the trapped woman, she was dying behind her own front door. She had fallen the previous night and had been lying there ever since, her body preventing the door from opening so worried neighbours had been unable to get in to help her. We forced the door and I pushed my way into her hallway. She was now so weak that she could barely breathe. I gave her oxygen and we got her out as quickly as possible. It was an awkward, messy job, but we managed to get her to hospital within fifteen minutes of arriving.
But it was too late. She was pronounced dead soon afterwards.
We’d lost probably 45 minutes with our friend from earlier on. There’s no way of knowing, but I believe that she would have had a chance if we’d got to her earlier. Even ten minutes might have made a difference, so it shouldn’t surprise you that I blame that selfish, time-wasting old man for her death. It wasn’t long before I was sent out to him again.
He was complaining of breathing difficulties which didn’t exist.
‘Last time you called me out,’ I said, ‘you delayed me getting to an old lady who had fallen and hurt herself.’
He looked at me, blankly.
‘And you know what?’ I said. ‘She might not have died if you hadn’t delayed us getting to her.’
He just sat there and shrugged his shoulders.
Other, less malicious people call us for what they perceive to be genuine emergencies but which turn out to be nothing of the sort.
I went to a one-month-old baby, ‘? Suspended’ - the worst kind of call for me and no doubt for a lot of my colleagues. I really don’t want to be holding someone’s dead child and explaining to them that I had done the best I could, because that’s a rubbish deal.
The call description stated ‘not crying’ and this was all the information I had when I set off. I called Control and asked them for a little bit more info. In fact, I asked them if I was going to a suspended baby or not. They replied that they were still taking the call so had nothing else to offer yet, except that they were treating this as a Red 1 - suspended.
When I arrived, an ambulance had just pulled up at the address and there was a motorcycle solo paramedic already inside. I felt that this must be a genuine dead baby - why else all the fuss? I went upstairs to the flat and entered the living room. I saw a very emotional mother, a worried relative, the ambulance crew, the solo paramedic and a baby lying on the floor. It was hiccupping.
The more liberal-natured among you may be persuaded that some of these people are simply ‘uninitiated’, or that their particular emergency is ‘a true crisis for them’. Fine, but remember that you pay for this (annually, it’s costing the tax-payer around £20m) and, more importantly, that one day it might be you or a loved one lying unable to breathe behind a door while we move someone’s bed from one end of the room to the other because the feng shui isn’t right, and the imbalance of yin and yang is giving them a headache.
It’s not as though many people are unaware of the problem nowadays. The press often carry tales of the troublingly stupid calls that are received by the emergency services in this country. Here are a few recent ones:
A 31-year-old woman who dialled 999 because her TV remote control was out of reach.
Another 31-year-old who was worried because she had sniffed deodorant by accident.
A lazy father-to-be who demanded an ambulance for his wife; she was in labour but he couldn’t take her to hospital himself because he was waiting for a pizza to be delivered.
A model who called Gloucestershire Ambulance Service when she broke her fingernail, for God’s sake.
Some nutter who called the Scottish Ambulance Service to ask for a crew to come out and help wrap up Christmas presents.
My own ambulance service recently issued a press release pointing out that time-wasting calls were potentially costing lives; on the very day it was sent out, we took a call from a 22-year-old woman who’d squeezed a spot which was now bleeding.
A pensioner told a frontline crew to wait 40 minutes before taking her to hospital because she was baking a cake. The crew gave her a warning and left - only for her to ring back exactly 40 minutes later.
Another phoned for an ambulance because her husband was refusing to listen to her. I wonder why?
The police get a lot of these dumb calls, too. Would you ring 999 to ask if your lost £20 note had been handed in, or to complain that your Chinese takeaway was cold? Or to try to sell the operator a pair of shoes? No. So who does? Ignorant timewasters.
NHS Direct have tried to help by supplying their website visitors with a list of situations which could be called true emergencies. These include unconsciousness, a suspected heart attack and suspected stroke. The trouble is that to a large section of the general public a sleeping drunk is ‘unconscious’, anyone with stomach ache or heartburn is suffering a suspected heart attack and many don’t even understand what a stroke is, never mind diagnosing the possibility that one is occurring. (And on the subject of NHS Direct, calling them for advice is all well and good, but I’ve still been sent to calls where this has been done and the patient either hasn’t been able to get through or has been told, unnecessarily, to call an ambulance anyway).
There’s been talk of a new number, a sort of halfway house where you can call the emergency servi
ces but they won’t have to rush out immediately - like they have in the United States, where you can dial 311 instead of 911 if your problem isn’t too pressing. Unfortunately, the UK’s telecoms industry regulator Ofcom dismissed the idea as impractical because of the massive and costly changes that it would have entailed. How typically British. Meanwhile, we still get called by people with shampoo in their eyes.
In my area, we do at least now have a screening system for not-really-emergency-calls. It’s called Clinical Telephone Advice (CTA), and it’s reasonably effective; trouble is, it can’t weed out those who know how to play the system and who insist they have ‘chest pain’ or ‘difficulty in breathing’.
* * * * *
Alongside the selfish and the stupid are the hoaxers. Across the country, almost 1,000 hoax calls are made to the ambulance service every week. Most are made by kids, bored out of their skulls and looking for stimulation and excitement; calling the emergency services ticks that box. You’re almost certain not to get caught (though new technology is fast catching up) and you get to see blue flashing lights and hear sirens. As a special treat, you also get to see professional grown-ups scratching their heads and looking around aimlessly.
Some people just want to have a laugh at our expense. I was working on All Fool’s Day when I received a call to a ‘suicidal female - threatening to jump’. I arrived with the police and we went to the location given, only to find that the place was a hostel and the staff knew nothing of a 999 call, let alone a potential suicide on the premises. We asked about the possibility of someone making the call from this place. We were told that there were no phones in the rooms, so we suggested that the payphone on the wall could have been used. That was impossible, they said, because nobody had been near it in the past few hours.
