A PARAMEDIC'S DIARY_Life and Death on the Streets
Page 6
Almost an hour into the drama, the policeman who was leaning out of the window persuaded the man to come closer; as he slowly sidled towards the window, the copper and his colleague suddenly grabbed him by the legs and waist. He was pulled back inside his room with little fuss. The whole thing was so quick that the suicidal man had no time to react.
He was brought down to us and we took him to hospital. He cried all the way and looked utterly beaten and hopeless. He had, of course, been drinking heavily, but it looked to me as though he was an emotional wreck long before the alcohol convinced him to kill himself. I left him in a cubicle with an unsympathetic police guard and a less than enthusiastic medical team at hand. Attempted self-harm brings few tears to long-suffering NHS staff.
My main feeling was one of relief. Unlike some of my colleagues, I’ve yet to see someone jump or fall to their deaths. I know it’s coming, though, and while I don’t mind seeing dead people any more I really don’t want to witness the act.
Alongside my relief, there was some anger. People who commit suicide cause a lot of turmoil, to their families and to the people - like me - who come along and clean up after them.
* * * * *
Of the 34 bridges crossing the Thames, the handful in central London are the favoured by the lonely and desperate who want to end it all. Stand on Westminster Bridge, say, with the lights of the Palace of Westminster to your right and the chimes of Big Ben in your ears: launch yourself off there and you’ll drop almost a hundred feet before you hit the water, and there’s a good chance that will kill you.
Over the years, I’ve been called to most of these bridges or to the river bank for suspected and confirmed suicide attempts. Once, I got there and the guy was actually sitting on the edge of the concrete, feet dangling, threatening to go over. There were already police on scene watching this young guy looking down at the icy water of the Thames and contemplating his immediate future. He had been caught here before, I was told, and had a long history of psychological problems.
He was eventually ‘talked down’ and I was asked to take him to hospital. During the journey, I tried to talk to him. ‘So why do you want to kill yourself?’ I asked.
He looked at me with dead eyes and a face drained of emotion. ‘What have I got to live for?’ he said. ‘Nothing. You’re taking me to hospital, that’s fine. As soon as I get out I’ll try again. Maybe next time…’ He left it hanging in the air. I wasn’t sure if he was bluffing, but I never saw him again.
A luckier young man was dragged out of the river one night after dropping from London Bridge into the winter water with his rucksack on his back. He’d downed a couple of bottles of champagne and had been seen sitting on the edge of the bridge by a number of witnesses. Then he’d simply slipped off and fallen in. Nobody knew whether he’d meant to fall or not. The police had been called, too, and we’d all raced down there to try and find him. All we knew was he was in the water somewhere downstream of where he had gone in. By now, he’d been in for 20 minutes; it was December, and cold, and that would normally be enough to finish you off, so I wasn’t hopeful. Then a police officer called: the guy had been seen floating serenely under Southwark Bridge, on his back, with a peaceful look on his face. He must have been admiring the night sky.
We fished him out a few minutes later. He was alive but very cold and dazed by his experience. Well, either that or he was just too drunk to know what he had done. He’d been saved from drowning by the large amount of air that was in his rucksack. It had kept him above the water long enough for a successful rescue to be carried out. A very lucky young man.
Almost unbelievably, these days we are increasingly called out to suicidal children. I’m not saying it never happened before, but it does seem to be on the rise: Childline says the number of calls it received from kids planning to kill themselves rose by 14% in 2006 and it now takes more than 1,000 such calls annually.
My first experience with this was when I was called to attend a ‘child on ledge, threatening to jump’. The child in question was a 12-year-old girl and she was standing on her bedroom window ledge looking down at the police and fire service personnel gathered 20 feet below. If she jumped or fell she would hit concrete, nothing soft in between would break her fall.
She, too, was pulled in by a police officer, a WPC, who talked her out of the mindless thing she was contemplating. Once she was settled down (she was very emotional) it was my crewmate and I who had to continue the necessary care. Her mother and brother had been sitting in the front room as the situation developed outside. They had both been told to stay where they were until the girl had been rescued. I’d anticipated tears of joy and hugs all round after the girl was brought back in, but that didn’t happen. Instead, she began accusing her mother of neglecting her and physically abusing her - she stood in the front room shouting in her mum’s face about how much she hated her and that she was the reason she wanted to kill herself.
The woman on the sofa sat and cried as her daughter released this tide of venom onto her and I felt very sorry for her, regardless of the accusations made by the young girl. It was clear she didn’t want her mother accompanying her to hospital, so the WPC travelled with us. The child was quiet and reluctant to answer any questions during the journey; I thought at first it might be because I was male, but the WPC had no better luck. She wasn’t interested in unlocking her emotions and that was a bad start in terms of treatment and future care. I left her feeling pretty down about her chances: I’d have put money on her trying it again, maybe simply in search of some attention from strangers. One day, she might accidentally succeed.
Sometimes, tragically, it isn’t a ‘cry for help’, it isn’t an accident and the police aren’t on hand to effect a dramatic last-second rescue.
We were called to a ‘male, suspended’ at a house a few miles off. The journey would take ten minutes on blue lights. When we arrived, the police and a Fast Response Unit paramedic were already on scene. The paramedic shook her head at us as we pulled up. This gesture meant that it was a non-starter of a job, either because it was not as given or because the patient was dead.
‘He’s inside,’ she said. ‘A young lad. Dead in his bedroom.’
He had been found by his parents earlier and they had called an ambulance in the mistaken belief that he could be saved, although they had not attempted resuscitation themselves. In fact, when I looked at the call notes later, I saw that they had ‘refused to resuscitate’.
We went into the house and found him lying on the floor of his little bedroom. He had been pulled from the bed by his parents when they discovered him and was now on his side, almost in the recovery position, one arm across his chest and one leg raised slightly. Those limbs were still rigid with rigor mortis and that told us a lot about how he had been positioned when he died. His dad looked at me and said, ‘Can’t you do something for him, then?’
Of course, I couldn’t. There’s a tremendous feeling of helplessness, but there are limits to our skills.
He was only 19. ‘He was right as rain when he got in last night,’ said his mother. ‘Everything seemed normal. He took himself off to bed without any fuss and that was the last time we saw him alive.’
I looked at the body. At some point, it seemed, he’d placed a plastic bag over his head and suffocated himself. He hadn’t struggled much by the looks of things; his body was in a position of sleep, almost as if he had died whilst lying peacefully on his side. I don’t know if I could just settle down for a kip with a plastic bag denying me oxygen and life, even if I wanted to kill myself. I’m sure instinct would kick in, and that I’d end up trying to tear the damned thing off my face - but then I’ve never tried to kill myself, so I may be mistaken. Whatever, in this case there was absolutely no sign of such a struggle taking place. Maybe he had sedated himself with drugs and alcohol prior to placing the bag over his head. Maybe he had resolved not to try and save himself, however powerful the urge. There was no suicide note and he’d arranged things in his
bedroom as if he intended to get up the next day as normal. His clothes were laid out ready for the morning and he’d been in the middle of some work on his computer; there was paperwork lying around it. He did have problems with depression, according to his mum. ‘I don’t know,’ she said. ‘Maybe he has been a bit more unhappy than usual recently.’
I found both parents strangely unemotional under the circumstances. Maybe the shock had numbed them. His father had discovered him first. No attempt had been made to breathe for him or compress his chest. He’d just pulled his son’s body to the floor, removed the plastic bag and put it in the rubbish bin. I couldn’t understand why he felt he needed to do that. He had to rummage in the rubbish again to bring it out for the police to see. It was a strange call.
HAVING A GO: I have taken calculated risks with patients, people who are in very grave danger of dying imminently, where it could have gone the other way, and I’ve been criticised for that. My attitude is, if the circumstances are right, you must have the courage to try anything. If the patient dies that is a tragedy, but if they die and you’ve tried everything – instead of sitting back and watching – you can look at yourself in the mirror.
I’ve had a fair few strange calls, and as I’m curious and investigative by nature that suits me just fine.
I was asked to attend a hanging in one of London’s parks. It was cold and foggy and the call came in in the wee small hours. I set out hoping I wouldn’t be the first to come across the body. I don’t like hangings; it’s a creepy way for someone to kill themselves and the face tends to be contorted and grotesque and screaming at you, like you’re to blame for its woes. Luckily, I didn’t have to get too near this one. When I drove into the park there were a number of other crews already on scene, as well as the police.
I walked toward the area where they were milling about and saw a man dangling like a sick Christmas ornament from the middle branches of a tree. It was quite surreal. He was obviously dead. I’ve seen a number of hangings. It’s comparatively common - Government stats show that it’s the most common means of suicide for men (women prefer to poison themselves) - but it was the first I had seen where the act was carried out in public.
He had been found by police because, as they patrolled the deserted service road, they had come across a heavy litter bin which had been lugged into the middle of the asphalt. One of them had got out to move it and had spotted our man dangling lifeless from the tree nearby. They surmised that he might have dragged the bin there as a sort of marker, to attract attention so that he would be found after he’d done the deed. It’s even possible that he wanted to be found trying to kill himself. If so, unfortunately, fate wasn’t on his side.
I stood watching and shivering as he was cut down. He’d chosen the quietest, coldest, foggiest night of the year on which to do away with himself, and it was an eerie and spooky spectacle. Bizarrely, it flitted through my mind that, not too long ago in the past, the sight of a person hanging from a tree in a public place would have been quite normal. Local children would have stood under the corpse and chucked things at it, no doubt.
One bizarre attempted hanging happened on a busy road in north London. I was asked to check on a man who had tried to hang himself from a speed camera and was now fitting. It was a couple of miles away and when I arrived the ambulance crew was on scene and already dealing. The man had bought himself a brand new step ladder, taken it to the camera, pulled a sign over his chest proclaiming how unfair Britain was, gone up the steps, chucked over a ready-noosed rope, covered his head with a brown hood (execution-style) and prepared to step off into oblivion.
Luckily for him, two police officers happened by and casually asked him if he was OK. As he replied he toppled over and began to hang in his (very well-tied) noose. The quick-thinking cops grabbed him and eventually got him down. Now he lay on the pavement, not talking to anyone and being treated for a suspected neck injury. It was a strange call and I have no doubt that he intended to kill himself; everything was too well thought out... except for the possibility that two police officers would stop for a chat mid-suicide; inconvenient, to say the least.
For some reason, there are a lot of suicides in the City. Wealthy people with no apparent problems just throw themselves from buildings, and they rarely leave notes. Not that long ago, a colleague of mine went to one where the guy was in a restaurant, 25 floors up, and he just went to the window and stepped out. The eye witness account was quite horrific. It was daylight, and the guy landed on the roof of a bus. A witness said that, at the moment just before he hit the bus, he let out a little yelp. Normally, people don’t make a noise when they jump: I think in this case the guy realised, right at the last second, that death was coming fractionally earlier than he’d thought. They said the usual things about him - he was a happy-go-lucky, well-paid, popular man. No one could understand it.
Of course, the act of suicide may be a dramatically impulsive thing. Many of us will admit to thinking about jumping or falling from a height. When you’re on a cliff top, or in some high viewing area, don’t you think, for a moment or two, about what it would be like to pitch yourself over and just... fall. Or is that just me?
‘One-unders’ are good examples of possible ‘impulse’ suicides. ‘One-under’ is the term we use for a person who has jumped in front of a train. In London it’s a shockingly common way for people to kill themselves, common enough that London Underground has a special ‘Therapy Unit’ to help drivers with the stress and trauma of seeing it happen. The emotional shock can radiate way beyond the death of the person doing the leaping. London Underground employee Dan Kuper, writing in Notes from Underground, says: ‘The drivers take the brunt of the trauma, frequently - ridiculously - blaming themselves for not stopping in time. Each takes it differently, of course, but quite a few never drive a train again, suffering nightmares and flashbacks for months.’
The thing is, you can pop yourself in front of a speeding tube in almost any station in the capital; only a few, between Westminster and Stratford on the Jubilee Line, have safety doors to keep people away from the tracks. (Equally, you can be pushed or knocked accidentally - personally, I never stand anywhere near the edge of the platform because you can be on the tracks in a millisecond.) Strangely, the majority of such incidents happen underground, despite the fact that only around 45% of the London Underground is actually subterranean. Maybe there are more depressed people inside than outside the City, or maybe it’s something about the dark claustrophobia of the Tube.
Many jumpers do not die instantly. The deep underground stations have pits under the tracks. These were designed as drainage gutters, but are now known as ‘anti-suicide pits’, ‘suicide pits’ or ‘dead man’s trenches’, depending on how colloquial you want to be. Rather than falling onto the tracks, the person often ends up in the trench, and while very few survive - there is tremendous force involved when something so big hits you at speed - this sometimes prevents them from dying instantly.
As Dan Kuper says, ‘How the Tube got its reputation as a good spot for suicides is a mystery. It is a completely stupid choice. A large number of jumpers don’t die immediately. Those that are successful often manage because they get themselves crushed between the far wall and the train, instead of on the rails. It is very far from clinical. At the first one-under I attended, the woman was still alive underneath the train, screaming and trying to get up. The image stayed with me for years.’
Picking up the pieces after a ‘one under’ is never pleasant, and for the individuals who choose to end their lives this way it will be no ‘cry for help’. These usually involve a long, drawn-out process like overdose, poisoning, wrist-cutting, that sort of thing. You can’t call a leap in front of a fast train a cry for help.
Someone posted a photo on Londonlogue.com entitled ‘Looking for attention on the Tube’. It shows a young woman, dressed in a jacket and tracksuit, lying inside the suicide pit at the edge of the platform. She has her hood pulled over her head and appears
to be in an almost foetal position. She looks determined to stay there. Ironically, if a train had gone over her she would have been unhurt because it would have been too high up to make contact with her, unless she planned to stand up and face it at the last moment. The commenter makes this statement about her:
She was saved after fellow passengers managed to get staff to stop the oncoming train and switch off the power, after she’d refused their help to get back on the platform.
There are a number of people who get killed by falling or jumping onto the Tube lines every year and the knock on effect for travellers can be a nightmare with lines closed down for long periods. Why turn commuting into a more miserable experience for thousands of people just by showing off and jumping in front of a train?
This woman told police who arrested her ‘If not today, I am going to do it tomorrow’. They should say fine, kill yourself if you want, but here’s a length of rope and a jar of sleeping pills. Do everyone else a favour and either overdose or hang yourself but don’t screw up people’s journey home.
A commuter’s point of view that may be, but selfish acts on the Underground do, indeed, have a knock-on effect.
I was called to a young drunken man who was pulled out of the pit during a shift near Christmas. He had stepped over the edge accidentally and then laid down for a sleep. He had a head injury and was completely oblivious to the danger he had put himself in. Luckily for him the train was still a few minutes away and Underground staff had been alerted by passengers who witnessed his stumbling stupidity. Railway platforms are no place to be drunk; they should consider banning people from travelling if they are legless.