999--My Life on the Frontline of the Ambulance Service

by Dan Farnworth

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  For Maddison, Rhianna, Courtney and Harrison. And for Mum and Dad – my beacons in the toughest times, who helped make me the person I am today.

  In memory of Paul Edmondson, a true legend and an amazing son, father, brother and friend.

  CONTENTS

  Author’s Note

  Prologue: All We Can Do

  1 One In, One Out

  2 The Hardest Job

  3 Burying Trauma

  4 A Lifelong Apprenticeship

  5 An Alarming Regularity

  6 Faces Quickly Fade

  7 Making Me Despair

  8 Picking Up the Pieces

  9 Moments of Madness

  10 Find a Bloody Dock Leaf

  11 A Lack of Respect

  12 The Seemingly Humdrum

  13 Right Place, Right Time

  14 Storing Up Problems

  15 The Q Word

  16 A Scary Feeling

  17 Messed Up and Dark

  18 Road to Recovery

  19 Why?

  20 Something Positive

  21 Doing Better

  22 Another Way

  23 Softening the Blow

  24 Tremendously Proud

  About the Author

  Acknowledgements

  AUTHOR’S NOTE

  Although I have not identified people and places, for reasons of privacy, the events in this book are described as happened. I wrote this book for a few main reasons: first, so that the public might have a better understanding of what an ambulance person’s job entails; second, as a tribute to my colleagues, who continue to work wonders in difficult circumstances, and to the NHS, which is undoubtedly creaking, but remains a beacon of hope for so many; and third, to highlight the strain the job puts on an ambulance person’s mental health and my efforts to raise awareness of this problem.

  PROLOGUE: ALL WE CAN DO

  It was a dark and stormy night. The rain fell in torrents . . .

  Actually, that’s a big, fat fib. It’s never that dramatic and there are rarely any omens. The night in question – as with most nights in the ambulance service – was like any other bog-standard midweek shift. We may have attended an elderly woman who had fallen over on her way to the toilet and a middle-aged man who had woken up with chest pains. What you might call our bread and butter. Did a drunk bloke try to punch me? Maybe. It’s happened more than once. There was hardly any traffic on the roads and more foxes than people on the pavements. Which was preferable, as foxes have the good grace and manners not to get bladdered on Jägerbombs and collapse in shop doorways.

  We get a call from the police: ‘We’ve got this guy on the phone, telling us he’s killed his mum with an axe. Thing is, he’s always saying this. Either he had ten mums or he’s making it up again. Will you go and have a look?’

  Just to confirm: the police want us to attend a patient who’s claiming he’s killed his mum with an axe, even though we don’t have weapons, stab vests or any training in dealing with the mentally ill? This could be interesting. I turn to my partner and say, ‘Sod this, unless they provide us with full suits of body armour, I ain’t going in without the police.’

  The bloke is most likely talking a load of nonsense, but what if this is the one time he’s telling the truth? I’ve got four kids, for God’s sake.

  So we drive to the address, at the most undramatic speed imaginable, park up around the corner from the axe murderer’s house and stake the place out. But staking places out is a bit difficult in an ambulance: I don’t know if you’ve noticed, but they’re custard yellow with a flashing blue light on the top.

  Me and my partner spend the next forty minutes swapping tales of dramatic and traumatic jobs, before the police finally turn up. Thanks for popping in, lads.

  We line up behind two coppers on the axe murderer’s doorstep, the door swings open and there he is in all his drunken glory, staggering all over his hallway and telling us to piss off. In the strongest terms, he denies making any phone calls, and while he’s doing so, his cat escapes. Now he’s telling us that he used to be in the Royal Marines and that if we don’t find his cat, he’ll beat us all up. The police’s reaction? ‘Can we go now?’ Our reaction? ‘Can we come in and assess you?’ His reaction? ‘Clear off, ya bastards!’

  This is a bit of a dilemma. If we leave without assessing him and he falls down the stairs, the fact he’s told us to leave him alone is neither here nor there. But what can you do when you’re faced with an aggressive ex-Marine-cum-axe murderer? The police have a quick look around his house, find no sign of a dead mum and get the hell out of Dodge. We’re right behind them.

  Back in the ambulance, a new job appears on our screen: SEVEN-WEEK-OLD CHILD, NOT BREATHING. CARDIAC ARREST. My heart sinks. This is every ambulance person’s worst nightmare. I switch on the blue lights and floor it.

  It’s not uncommon to be told a child is not breathing, only to arrive at the job to find a panicky mum and a toddler with some mucus stuck in his throat. I don’t blame the parents; it must be terrifying. But sometimes you just have a bad feeling in the pit of your stomach. You might call it an ambulance person’s sixth sense, the ability to predict whether an emergency is genuine.

  This job is just around the corner from the hospital, so we have a decision to make. The hospital has doctors, nurses, paediatricians and a hundred other specialists, while our ambulance contains an emergency medical technician – i.e. me – and a paramedic, who in this case is fairly new to the job. If we were miles away from the hospital, we’d stay in the house, administer the drugs and try to do everything in our power to resuscitate the child before whisking it away. But on this occasion, we have a quick chat and decide to get to the house, pick up the baby and leg it, as fast as our ambulance will carry us. In the trade, we call it a ‘scoop and run’. As is often the case in the ambulance service, it’s a cheery phrase that belies its seriousness.

  We can only drive an ambulance 20mph over the limit, and it’s not a rule that’s usually flouted. There’s no point in driving so fast that you crash into a wall and never make it. I call it ‘driving to arrive’. And it doesn’t matter if you’re on your way to a family stuck in a house fire or a car wreck, if you run someone over and they die, you will end up in court. But this particular job is a case of bollocks to the rules.

  We pull up outside the house, jump out of the ambulance and can hear a woman screaming, ‘My baby! My baby!’

  And it suddenly hits me, like a breeze block to the face: this is it, the job we train for. If an elderly woman falling on her way to the toilet is a league fixture, this is a cup final. I have to be at the top of my game. I have to do things right, because there is so much at stake. I jump in the back of the ambulance and grab everything we might need: the defibrillator, an ALS (advanced life support) bag, oxygen, drugs and a bag of other tricks. Unfortunately, the bag of tricks doesn’t contain a magic wand.

  We march through the open front door looking like a couple of packhorses – equipment and bags hanging over shoulders, round necks and off every finger and thumb – and head in the direction of the screaming. As I climb the stairs, the adrenalin kicks in and everything starts moving in slow motion, which means I’m able to process things faster. I repeat
to myself, ‘ABC – airway, breathing, circulation. Just do what you’ve been taught.’

  We walk into the main bedroom to find the baby on the floor, with its dad attempting CPR (cardiopulmonary resuscitation). The baby is seven weeks old. It is white, floppy and bleeding from the nose. In short, it looks like the odds are stacked against it.

  We shoo the dad aside and try to do what we can. A child will normally stop breathing because of an airway obstruction, so we try to oxygenate it and apply compressions to the chest to get the circulation going. Instead of doing it with two hands and jumping up and down, like you would with an adult, I lightly press with two fingers. But I don’t even bother opening my bag of tricks. Instead, I go straight to the radio on my hip and call the hospital: ‘Red pre-alert. We’re coming in with a child. Seven weeks old. In cardiac arrest. You’ve got sixty seconds to get ready.’

  My partner grabs the baby, I grab the bags, we run to the ambulance, bundle Mum and Dad into the back and get going. While I’m tear-arsing it to the hospital, my partner is battling to save the baby’s life in the back, which is like trying to thread a needle at sea in a storm.

  From arriving at the house to arriving at the hospital takes no more than three minutes, so I kind of expect them not to be ready. Ambulance people are cynical like that, but for good reason. It’s not uncommon to arrive at the hospital and find people queuing out of the doors, which means we have to wait with our patients while they deal with other emergencies. As harsh as it sounds, there is a pecking order. If you go to hospital with a broken arm, you might have to wait for hours. Even if you’re having a heart attack, you might have to wait ten minutes while they deal with something more pressing. And there is almost always something more pressing. But on this occasion, the staff are waiting like coiled springs. What happens next is incredible to witness.

  I place the baby on a bed and continue ventilating before the specialists take over. An anaesthetist sweeps in, along with paediatricians, who intubate the baby (put a tube down its throat to assist breathing). There must be between fifteen and twenty medical professionals working on the patient, including me, passing bits and bobs to the doctors. Being part of that process is like being part of a magnificent machine, each component working in perfect harmony.

  The whole time we’re working, we can hear the baby’s mum screaming, ‘My baby! My baby! Why won’t she open her eyes?’ and her dad muttering, over and over again, ‘It’s all my fault . . .’

  The story of how the baby came to be in our care follows in snippets. The dad had fallen asleep on his bed next to the baby, rolled over and suffocated it. Maybe that explained the bleeding nose. Meanwhile, the poor mum had been out with friends for the first time since her baby was born. Imagine that, popping out for a couple of drinks and a catch-up, before coming back a few hours later to a baby that was seemingly dead. He blames himself, she blames herself, maybe they both blame each other. I turn to see the dad on the floor, curled up into a ball, next to the mum, sobbing uncontrollably. By being in the room, at least they know we’re doing everything we can. How much that will help is up for debate.

  After almost an hour of non-stop treatment, the decision is made to cease CPR. The mum screams again, ‘No! You can’t stop!’ But the baby is dead, so there is nothing more we can do. A nurse dresses the baby in a babygro, places it in a Moses basket and puts it in a quiet room where Mum and Dad can say their goodbyes. I’m not sure you could imagine a more tragic scene. As I slip away, I can’t help wondering what life has in store for that poor couple. Will they ever get over it? Will they ever make peace with each other? Will they ever have another baby? If so, will it rid them of the pain?

  ______

  Ambulance people come barging into people’s lives at the most critical moments, do what they can do, then disappear into the ether. I’ll often pick up little bits of the backstory, usually from a friend or a family member. Or, at least, their interpretation of it. But more often than not, I’ll turn up at the house of someone who’s had a cardiac arrest, for example, put them in the ambulance, take them to hospital, head to the next job and never find out if they survived or not.

  Occasionally, curiosity will get the better of me and I’ll phone the hospital and say, ‘Hi, I was with the ambulance crew that brought in so and so. Could you tell me how he is?’ And the nurse will almost always tell me that they can’t, because of patient confidentiality. Unless the story is newsworthy enough to make the papers or appear on the internet, we never find out. That means we’re able to tell an awful lot of dramatic stories with no neat resolutions. That can be frustrating but is probably for the best. Ambulance people invest enough emotion in their jobs as it is. Learning that a patient I fought tooth and nail to save didn’t pull through is unlikely to make me sleep any easier.

  Nevertheless, the story of how we tried to save that baby’s life illustrates a powerful point: all those articles you’ve read in the newspapers about the ambulance service and the whole NHS being at melting point are true. But when things go really pear-shaped, we pull out all the stops. I honestly believe our paramedics and technicians are the finest in the world, and the doctors in our hospitals are trained to within an inch of their lives. That baby might only have been seven weeks old, but it had hundreds of years of expertise trying to save its life.

  In my fifteen years on the frontline, I’ve seen so many lives lost, but so many lives saved. Either way, and despite all the obstacles strewn in our path, we’ve always given it our best and I’ve never stopped being enormously proud.

  Unfortunately, pride isn’t a salve for what we witness. Ambulance people work themselves to their absolute limit. We graft for hours on end with very few breaks so that we’re there when your mum falls over and breaks her hip; your dad has a stroke; your son falls out of a tree and fractures his skull; your partner takes an overdose. And they’re just the regulation jobs. Some of the other stuff we deal with would be considered too graphic to make the final cut of a particularly horrifying horror film. And after we’ve done what we can do to make things better, we put what we’ve witnessed in a mental filing cabinet, kick the door closed and head straight to the next job.

  While we always do everything we can possibly do to help, it sometimes feels that nobody is there to help us. Knowing that I work for an institution as beloved as the NHS is a comfort. But not as much as someone simply saying, ‘How are you feeling?’

  1

  ONE IN, ONE OUT

  I often get kids coming up to me and saying, ‘I want to be an ambulance person. Is it a good job?’ If I’ve just had a bad day I might reply, ‘Maybe have a look at being a train driver first. You can earn a lot more money and it’s a lot less stressful. Or if you’re any good at football, give that a try instead.’ But if I’m in a better mood I’ll say, ‘If that’s what you really want to do, give it a crack. Being an ambulance person is better than sitting behind a desk all day.’

  I work with people who are clever enough to be bankers, insurance brokers or businesspeople. They could have opted for working in an office earning 100 grand a year instead of working in the ambulance service, resuscitating the dying, taking away the dead and not getting paid a great deal for it. But would their life be as fulfilling? Probably not. NHS staff, from well-paid consultants down to those earning not much more than the minimum wage, just want to help people. That’s a good way to spend a working life. At least when I finally hang up my defibrillator, I’ll be able to say, ‘I didn’t make much money, but at least I was working for the greater good of humanity.’

  People sometimes ask me what a normal day consists of in the ambulance service. There is no normal day. But, believe it or not, the job can be quite routine. We try to arrive at the station fifteen to twenty minutes before the start of our shift so that we can grab a cuppa and the previous crew can knock off early (although they’ll often still be out on a job). If there is a crew waiting, we’ll grab the keys and radios from them, open up the ambulance and make sure ev
erything is shipshape and Bristol fashion. Have we got all the drugs we might need? Are they all in date? Do we have splints and bandages, an oxygen mask, a stretcher? It’s not cool for a crew to leave an ambulance in a ramshackle state – when you hand over the keys, it should be ready for the next crew to jump in and go. That said, if they’ve had a really rough shift, they might leave a note saying, ‘We’ve cleaned it, but you might need to stock up on a few things.’

  I know I might not have a break for six to eight hours, so I’ll stash a sweaty sandwich in the door pocket, before turning on my radio, logging on to the dashboard computer and waiting for the first job to come in – which usually takes less than a minute. An address will appear on the screen and off we’ll pop, automatically guided by a very clever satnav. If the call has been waiting a while, we’ll get all the information straightaway: ELDERLY MAN, FITTING. If not, we’re dripfed updates on the way, depending on what questions the call-taker has asked and what answers have been provided by the caller. We’ll also be provided with a category of seriousness, more on which later.

  Every gig is different, because every person is different. But different bodies still go wrong in the same way. We deal with a lot of people with chest and back pain, shortness of breath, cuts, bumps, bruises and breaks. After a while, applying a particular set of solutions to a particular set of problems becomes second nature. I wouldn’t say being an ambulance person ever gets boring, but it can be quite samey.

  There are days when I wake up and think, I hope nothing big happens today, because I’ve had a bad night’s sleep or I’m just not feeling too chipper. But thinking like that is tempting fate. An ambulance person can never allow themselves to become complacent. It’s not as if we can go out and get hammered, drag ourselves out of bed the following morning, turn up late and breathe whisky fumes over some poor old girl who’s taken a tumble. Even seemingly ‘normal’ days in the ambulance service – which you might define as any day when nothing happens that makes you despair of the world – can turn into horror shows in the time it takes to say, ‘Shit, there’s been a major traffic accident on the M40 . . .’