by Stuart Gray
I was called to a 20-year-old who had slammed into a lamp post at full speed in an attempt to navigate his way around traffic. The traffic was moving and he was cutting in and out between cars, which isn’t clever. He fell foul of one when it almost clipped him; he lost control and hit the post without braking. He wasn’t wearing a helmet and he was lucky not to be killed. As it was, he sustained a nasty head injury and a badly broken collar bone. Obviously, he was in some discomfort but he was stable with no neck pain or other significant injury. There was plenty of blood around from his head wound, but a first aider had rushed out from a nearby office and put a large dressing on it. This Good Samaritan had also offered to secure the man’s bike for him while he was taken to hospital. His acrobatic cycling had almost cost him more than a lost Raleigh and he made one sensible comment as I treated him: ‘I think I’ll take the bus next time.’
As it happened, I had a second cyclist the same day. She, too, got off scot-free, but it could have been horrendous. She’d been behind a large lorry and had tried to nip in between it and the pavement, just to save a few seconds of time. The driver of the truck hadn’t seen her, and had effectively driven over her. He’d managed to crush the bike underneath a wheel and caught her under his trailer. Luckily - does ‘lucky’ describe this? - an alert passer-by had seen it happen and had screamed and waved to the driver. He’d slammed on the anchors and then, under the guidance of the witness, had gingerly reversed a few inches, allowing the trapped woman to free herself without injury. Another second, maybe a second and a half, and she’d have had a 20 tonne truck roll straight over her.
A two car RTC that was caused by the erratic cycling of a man who had tried to dodge in between them as they moved across a junction had me trying to keep the drivers and the cyclist involved apart. They wanted to beat him up and it eventually took the arrival of the police to calm things down. Luckily nobody was seriously hurt, but both vehicles were damaged.
Car drivers aren’t innocent, either; I’ve never had a cyclist die on me but I’ve been to a few who have gone over the bonnet or bullseyed a windscreen because the driver has cut them up.
During the summer, the traffic police held a free demonstration on safe cycling in which cyclists were invited to come onto Trafalgar Square and park next to a lorry. Then they could climb into the cab of the lorry and see just how invisible they were to the driver if they parked too near his vehicle. The idea was to simulate the stopping behaviour of cyclists when they are at traffic lights (when they aren’t running them) and to encourage discussion about the danger they put themselves in.
I spoke to the officers running this demo and they told me that of the very few cyclists who bothered to show an interest, some of them had argued their rights instead of taking in the lesson.
Of course, not all cyclists are mad and more than a few of them do behave properly on the road. But I spent an hour or so one shift counting the number who ran red lights and zipped through active pedestrian crossings - 30 out of 33 I saw broke the law.
DRUGS
THE INCREASE IN DRUG abuse in the UK has had a direct and serious impact on the NHS in recent years.
From a purely personal perspective, I find I am dealing with more and more drug-related incidents as time goes on. Many of these calls are to unintentional overdoses; others are the victims of drug crime… the shootings, stabbings and robbery-assaults.
If an overdose has been caused by an opiate, like heroin, I can effectively reverse it and save the patient’s life with a drug we carry. I’ve had to do this many times - I couldn’t count how many - and, in the early days, I got the sense of satisfaction that you should get with the recovery of any dying patient. Unfortunately, as the jobs and years passed, that feeling depleted. Nowadays, I tend to feel as if I have been used.
Why? Well, for one thing, no drug user - not a single one - has ever thanked me or my colleagues (as far as I know) for saving their lives like this.
In fact, you usually get the opposite.
This may surprise you, but I’ve treated heroin overdoses - I’m talking semi-conscious people who are very close to death - and brought them back from the brink… only to have them recover and launch a verbal, even physical, attack on me for ruining their ‘fix’. They don’t like it when their money has been poured out of their veins.
The drug we use, Naloxone, is usually harmless, though some people can have serious withdrawal symptoms if it is given too quickly. It has only one purpose - to reverse the physical effects of a narcotic - so it’s also known as ‘Narcan’ (Narcotic antagonist). We’ll give the drug where we find anyone unconscious with depressed breathing and pinpoint pupils, unless there is another explanation.
As you get more adept at giving this drug, you start to reduce the dose or dilute it, so that you can reverse the life-threatening effects of the heroin without fully awakening the patient. That way, you can keep them ‘groggy’ enough to handle until you leave them at hospital. This means you keep yourself and your colleague safe and the hospital security staff can deal with any uprising afterwards. They’re more equipped for that than we are. Patients who were at death’s door an hour or two ago frequently storm out of the Accident & Emergency department in a rage when they realise where they are and what has been done. Again, never a word of thanks.
Sometimes we don’t get there in time. Sometimes, no-one could have. I’ve attended fatalities where people have been found dead with the needle still sticking out of their arm or groin, such was the speed of their demise. They rarely have anyone in the immediate vicinity to mourn for them, except for their addict friends.
I went to a murder scene a few years ago in which the victim had allegedly been killed over a drugs dispute. At first, the call seemed innocuous: ‘Strange smell coming from flat, please investigate.’ In itself, not that concerning: the last time I went to one of those calls, the householder had simply left their rubbish sacks in the hallway and gone on holiday. Over the weeks, the heat had made everything organic stink and that was what was upsetting the neighbours.
So we made our way to the estate and climbed the stairs to the correct floor. The door to the flat had been forced and was slightly ajar - not much, but enough for us to know that someone had either entered recently, or had left and forgotten to close the door properly. Needless to say, we were very cautious.
I peered into the hallway after knocking several times and getting no reply. ‘Hello,’ I said. ‘Anyone in?’
Still nothing. I leaned further in.
At first I didn’t see anything, but then, through a doorway, I saw an arm sticking out. I moved position, squinted, and realised there was a man’s body lying on a narrow bed just ahead in the front room, which was also the bedroom. As my eyes adjusted to the different light, I saw his face. He wasn’t moving. I was about to go in, but my colleague pulled me back.
‘Crime scene,’ she said.
Good point; if the guy inside had died suspiciously, the police would confiscate my boots and probably my uniform for their forensics people to pull apart. I didn’t fancy having to wait on scene in a white coverall until my DSO showed up to supply me with another uniform, so I stood my ground. That left us with a problem. Somehow, we had to confirm that he was dead and didn’t need immediate help. From the doorway, it looked quite obvious; his arm was stiff and very discoloured and I could see that his chest wasn’t moving and his face was still. We needed to make sure, though.
We deliberated for a few minutes before we hatched a plan. I put a blanket on the floor of the flat and used it to shuffle into the room while my colleague stayed behind to bring in the police, who had now been called. I approached the man, keeping a very wary eye on the kitchen door, which stood ajar to my left. I didn’t know if there was anyone still in here, and we’ve all seen those horror movies where the unsuspecting minor character gets butchered when he least expects it. I convinced myself that it was safe and looked closely at the man on the bed. He was dead for sure, a definite pur
ple plus. Rigor mortis had set in and he was mottled in blues and greys throughout his body.
He looked strangely at peace, except for the fact that his mouth was open, as if in a final gasp or at some sudden shock. He had a head injury on his right side; his face was badly swollen there and his skull looked deformed. It looked to me as though he had been hit unexpectedly and very hard, and had died instantly as a result. His body hadn’t moved from a lying position - you can tell by the staining and pooling of blood, drained by gravity into the lower extremities of the corpse - and he hadn’t made any obvious effort to struggle. He couldn’t have screamed, either, because none of the neighbours had reported anything unusual.
An ashtray, overspilled with burned out spliffs and cigarettes, was on the floor next to him.
And he had lain here, from the moment the hammer or bat or bar had connected with his skull, for several days. With the door slightly ajar. None of the neighbours even knew what was inside the flat. Nobody - not even the kids living on his floor - had bothered to push open the door to find out what lay inside.
When the police arrived, they interviewed the immediate neighbours but nothing had been seen or heard. The man had a ‘friend’ who visited regularly but nobody knew who he was or when he was last on the premises.
We lost our blanket of course - it was evidence. But better that than my boots.
Other drug addicts just want to rid themselves of their lives. It’s often easier for them than trying to kick the habit. I took a Red Cat A call for an ‘overdose, needle in arm, not moving’. It sounded like a classic heroin OD and I was sure this was going to be a messy resus.
I knew the location. It’s a hostel for the lost and unlikely-to-recover individuals of society, the drug addicts, alcoholics and ex-cons who inhabit its squalid rooms. They either live alone or, occasionally, with a dog for company.
I arrived to find the people in charge of the place milling around outside, banging on the front door and screaming for someone to let them in. They had locked themselves out. At this point, I thought the call was going to descend into farce.
We got in and I found the man. He was sitting outside his room, and he wasn’t dead. He told me that he had injected himself with heroin (at least, he thought it was heroin - it doesn’t come with a money-back guarantee) and that he had also taken a load of prescription pills of various colours and types. I checked him over thoroughly and decided that it was actually unlikely he had taken anything at all. I looked up at the battered door to his room: he had taped a note to it reading, ‘By the time you read this I will be dead - take care of my dog for me.’
Poignant but pointless, I thought.
The man was generally unpleasant and this ‘cry for help’ was just the latest of many. There is counselling, advice and structured support out there for guys like him, but some of them just don’t care. Drugs do that to people. It’s a vicious circle: they take drugs, so they lose the self-interest and self-respect which are vital if they are to improve their lot, so they take more drugs.
I popped my head around his door to say hello to his dog. On the floor, wrapped in a blanket, was a well-mannered and frightened mongrel. I offered him my apologies before I left the scene. I think he understood, although I could still see deep misery in his big brown eyes.
Another overdose took me and my colleague on a journey into a dark and dangerous part of town. There was somebody peering out of a window of the premises we had to enter and none of the lights were on. I decided it might not be a good idea to venture on until we had some reassurance that this wasn’t a trap. I get a bit paranoid when things don’t feel right. A neighbour came out and assured us that he knew the people inside and that we would come to no harm. And since the police had been called and were on their way, we took the man’s word and entered the building.
TRAPS: I’ve mentioned that we regularly get assaulted and, even more regularly, abused. Less commonly, some people also lie in wait to rob us. They may be after our drugs, our stab vests or the Mobile Data Terminals (MDT) from our vehicles. They make a 999 call and find a good place to hide before either confronting us or getting to our vehicles while we investigate the call. They’re wasting their time, however; we don't carry enough drugs to make a robbery worthwhile, our vests are tailor-made, so won't necessarily fit them, and our MDTs are useless without the service software that runs them.
Inside, lying on the grotty floor of an even grottier kitchen, was a teenager. He was unconscious and barely breathing, a large and strong-looking guy who didn’t fit the profile of a regular user. He will soon enough, I thought. If he survives.
The paraphernalia around the room, which included loaded and ready-to-use syringes, told us all we needed to know about his current condition. His skinny, greasy-haired girlfriend cried and shouted uselessly beside him, demanding that he ‘get up and behave’. It looked like it was her first time with a heroin overdose; he wasn’t getting up any time soon, or ever again if we didn’t get a move on.
She turned to us. ‘Help him,’ she yelled, tears streaking her wild-eyed face. ‘Don’t let him die!’
‘We’ll do all we can,’ said my colleague as I prepared the IV equipment and got the Narcan out.
It didn’t take long to get some of the stuff he needed into his veins, but he didn’t respond. There were three of us on scene now; the FRU had just arrived, and the patient was being ‘bagged’ to keep his breathing rate up while my crewmate and I got ready to move him to the ambulance.
The police turned up. They took one look at the scene and let us get on with our job, temporarily ignoring the incriminating evidence that littered the room. I think they knew better than to upset this apple cart just at that moment. A few minutes later, we’d done all we could for him at the scene.
‘You guys ready to go?’ one of the officers said.
‘Yep,’ I said. ‘Just give us a minute to get the trolley bed in.’
Once he was on the bed and in the ambulance, I gave him another bolus of the good stuff and watched. He started to come round; he was groggy but becoming more stable. His breathing rate was increasing and his blood pressure was normal.
‘Is he alright?’ asked the skinny girl.
‘He should be now.’
‘But he’s not awake properly. What’s wrong with him?’
‘He’s a drugged-up idiot,’ I almost said. But the words slipped by when I realised he could probably hear me. ‘I’ve kept him a bit sleepy so that he doesn’t cause any problems for us,’ I said instead.
‘He’s as gentle as a lamb,’ she sobbed. ‘He wouldn’t hurt a fly.’
I wondered if she knew how many times I had heard that line, especially from the mean owners of meaner dogs.
We took him to hospital and left him in the care of the staff on duty. We were back not long after with another patient, and I wasn’t flavour of the month. Our overdosing teenager had woken up after another Narcan injection and had gone crazy in the Resus room. Apparently, he’d abused the nurses, thrown some stuff about and then stormed out, threatening to sue the hospital and the ambulance service for the money he had lost. Gentle as a lamb, eh?
* * * * *
As with our friend above, not all druggies look like hell (though most do). A few weeks back, I was on earlies on the FRU and I was called to an overdosed drug addict who wasn’t breathing very well. I went up to the sixth floor of this shabby block of flats in Camden, expecting to find a horrible, disgusting, skinny, spotty drug addict. Instead, lying in the corner of a junkie flat, was a vision of beauty. She was stunning, a slender young woman with long dark hair and big Spanish eyes. But for the needle hanging out of her arm, she might have been asleep.
We brought her round, and I spoke to her.
‘How long have you been doing this?’ I said.
‘About two years,’ she said.
I looked around the flat, which was obviously a regular haunt for crackheads and heroin addicts. I strongly suspect she was selling her body for
gear. What the hell are you doing here? I thought. There’s a life out there, just waiting for you.
‘You’ve got to stop this, or else one day you will go under and you won’t come back,’ I said.
She nodded, but she was elsewhere.
This was one of the saddest jobs I’ve been too. It really depressed me: she was the same age as my son. And it was so bloody pointless.
Earlies: Shifts which start at 6.30am or 7am. They usually present a slower start because people are not yet up and around so they aren’t trying to kill themselves by falling, crashing, running into brick walls, arguing with their drunk neighbours or mainlining speed. You get to see daylight and it’s safer than working late at night. You might even get breakfast.
One of the strangest drugs calls I attended didn’t look like an OD at first; I only found out how the guy had died much later on, when I treated another addict weeks later who just happened to know him. I called this one ‘The Mystery of the Dead Man with the Shiny Shoes’.
I was called to a ‘possible lifeless person’. It came from the police and it was the second time they’d asked for one of us to investigate. I was a bit confused: tends to be you’re either lifeless or you’re not, and the police are pretty good at spotting the difference. I went to the address given but nobody in the street knew what was going on. There were no cops there and nobody had called the Service. An ambulance arrived soon after I did and we hung around while I called it in. Control gave me another, more accurate, address and off we all went.
We drove around the corner and we still couldn’t find the police or the supposedly lifeless body. I called Control again. As I did so, a motorbike solo paramedic arrived with us; now it was beginning to look like the Service staff meeting. Just as we were all about to quit, a police van came round the corner and stopped, quite casually, in front of my car. The officer got out - no hurry - and said to me and the motorbike solo, ‘You want to see it then?’
