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

by Dan Farnworth

  But I couldn’t wait that long. One night, with the help of my future sister-in-law, who was also on holiday and in on the plan, I kitted out our hotel balcony with candles, led Amy out there, went down on one knee . . . and lost the power of speech. I think the penny dropped when I fished a ring from my back pocket. She said yes.

  My mum and dad went out of their way to make our wedding the best day ever, as did Amy’s, who are also amazing people. They helped us out with money, so that we were able to afford things we wouldn’t otherwise have been able to. After what I’d been through in my previous relationship, I think they were just desperate to make me happy.

  I slept terribly the night before but woke up to a belting summer’s day. My old mate Neil was my best man and probably upset a few of the old folks with a joke about buying me a wedding present of some silver condoms, so I could come second for a change. But me and Amy loved it, the kids loved it and the whole day just felt perfect. I felt strong back then and knowing the family unit had been cemented made me feel even more secure.

  Alas, the honeymoon in Cancún wasn’t so great: it hosed it down for ten of the fourteen days and Amy got a dose of Montezuma’s revenge, which confined her to bed for a week. I found myself watching daytime American TV and ordering room service, while it was chucking it down outside and Amy was writhing and groaning on the bed next to me.

  We’d been married for about eight months when Amy fell pregnant. I already had three girls, so really wanted a boy. And even though I was only twenty-two, this felt like the last chance saloon. I’m sure my parents hoped so. I got my wish. And when Harrison was born, he immediately became my best mate. I was determined that whatever happened previously, any mistakes I made, wouldn’t happen again. I was going to be the best dad ever for this little lad.

  But when you work in the ambulance service, it’s very difficult to lead a normal family life. We give an awful lot of ourselves. We work long hours and unsociable shifts, which makes us unreliable. We’re often not home when we say we will be. And when we finally walk through the front door, we might be carrying a lot of mental baggage from whatever it is we’ve seen that day. We also miss anniversaries, birthdays of partners and kids, christenings and school plays. Compared to some hospital doctors, who work such ludicrously long hours it’s scary, ambulance people have it easy. But it still makes me feel guilty. I’ll explain to the kids that I can’t be at this or that because there are people who need my help. And hope their nan and grandad can go instead.

  You might think that I’d rush home after reeling in a drowning man from the sea or saving a choking man in a carvery, burst through the door and describe the story chapter and verse to anyone within earshot. I’m sure there are some people in the ambulance service like that. But I’ve never wanted to come across as if I think my job is more worthy than anyone else’s.

  Partners of ambulance people also go to work or stay at home with the kids, which is no picnic. They might have had a bad day, partly because their ambulance worker husband or wife has turned up late again and they’ve had to feed and bath the kids and put them to bed. Again. So they might want to spill their heart out about what a nightmare it’s been: Johnny wouldn’t eat his dinner, Sally punched Billy, Billy did a poo in the bath. That sort of thing. Everyone has their own stresses, and everyone’s stresses are important to them.

  Sometimes I’d listen to my wife’s woes – about the new printer she’d bought that wasn’t working properly, or the fact that they’d stopped stocking milk in the office fridge – and be groaning inside. But outwardly, I’d act as interested as I could: ‘You’re joking? No milk? Grrr. These people . . .’ And once she’d offloaded, I didn’t want her to think I was trying to trump her – ‘Well, let me tell you what happened to me today . . .’ It would be difficult to hold my tongue at times. But I also knew that if I lost my rag, I’d really lose my rag. It would be like a volcano erupting, and probably not very pretty.

  Not that I’d have time to chat anyway, because I had my own responsibilities around the house. But while it’s difficult knowing what to leave at work and what to bring home with you, what’s certain is that not talking stores up problems. It seems easier to put your stories in a box and forget about them. But that box doesn’t disappear, it sits on a shelf in a dark corner of your mind, until one day it bursts open and everything comes tumbling out in a mess.

  The ambulance service defines its workers. That’s why a lot of ambulance staff hook up with colleagues, because they’re the only people who fully understand. Who else would know what it’s like to give CPR to a baby? Or to a woman who’s been flung from a moped? Or bring a drowned man back to life? That’s also why I’ve seen so many colleagues’ relationships fail, because the life of an ambulance person can seem so alien and all-consuming.

  If someone told me they’d met an ambulance person and were thinking about taking the relationship to the next level, my simple advice would be: ‘Make sure you know what you’re getting yourself into. Make sure to give them time to unwind after work and understand that they desperately want to be at that play or birthday party.’

  Sometimes the job can blindside you, which is why being able to talk to someone is really important. Just because you feel fine one minute doesn’t mean you’ll be feeling fine the next.

  ______

  A job appears on our screen: ROAD TRAFFIC ACCIDENT, YOUNG MAN NOT BREATHING. We are directed to a remote country lane, where we find a cyclist on the ground, next to his bike. He isn’t breathing and his heart is doing nothing at all. He has no apparent injuries and his bike is fine, so it doesn’t appear that a vehicle has hit him. We can only assume that he’d been cycling along, had a cardiac arrest, toppled off his bike and died.

  As with the Bolton Wanderers footballer Fabrice Muamba, who had a cardiac arrest on the pitch a few years back, this could have been down to something called car-diomyopathy, which is a disease of the heart muscle that makes it harder for a heart to pump blood to the rest of the body. Whatever it is, ambulance people can’t turn up to a job with a defeatist attitude. This stricken cyclist must only be about twenty, so we’re going to give it everything we have. An ambulance car soon turns up and we also radio for an air ambulance. Between us, we work on this guy for over an hour on the side of the road. There is no point in putting him in the ambulance and racing him to hospital, because administering CPR in the back of a moving ambulance is virtually impossible. Alas, ambulances don’t have specially calibrated suspensions, so the journey alone can be enough to finish someone off. Imagine trying to juggle while standing up in the back of a delivery van, hurtling round corners at 70mph, and you get the idea.

  We put tubes down the guy’s throat, give him loads of CPR, oxygen and all the drugs we can, but it reaches the stage when we have to think about calling it off. We never like to call anything off, certainly not an attempt to resuscitate a young man. But there comes a time on any job when logic must take over from emotion. We get a senior person on the phone, tell him what we’ve done to try and save the patient, he considers the facts and tells us we can consider terminating resuscitation. By this time, the patient is in the back of the ambulance, and nobody wants to be the first person to step away. But eventually we have to concede that the poor lad is beyond saving.

  After we’ve made the decision to cease CPR on the cyclist, we could quite easily discover his identity. He has a phone in his pocket, which can be unlocked using his thumbprint. So we have the discussion: should we use his thumb to unlock his phone, so that we can inform his next of kin? Or would that be breaching his confidentiality? I think it’s just thinking outside the box, but one of my colleagues points out that emergency workers have been disciplined for doing it in the past, so we decide against it (I should say here that everyone should set up their medical ID on their phone, which means potentially life-saving information about allergies and medical conditions appear on your lockscreen for anyone to see without needing a password).

  When
you’re administering CPR, you’re not really looking at the patient’s face. Well, you might be, but in that moment they’re just a generic human being who desperately needs your help. You find your rhythm and do what you have to do. But on the way to the mortuary, it suddenly dawns on me that I know the cyclist: he’s the brother of a good friend of mine.

  Watching my mate’s brother being placed on the mortician’s table, slid into the fridge and tagged up, I’m in a daze. This is the first time I’ve treated someone I know. Or, more strictly, someone I used to know. And it’s a terrible feeling. I don’t feel like it’s my place to inform his brother that I was there when he passed away. It’s a grey area, there is no textbook guidance on a situation like that. Not that I had much time to weigh up my dilemma. Me and my partner left the mortuary, grabbed a brew, didn’t drink it and went straight to another job.

  It wasn’t until about a year later that I told my mate I was on the scene when his brother passed away. I apologised for not telling him earlier and explained that I didn’t know if it was best – for me and for him – if he knew. Thankfully, he understood. And he took great comfort from knowing that me and my colleagues did everything we could to try and save him. We were about five pints in at the time, which made the conversation that much easier.

  I’d once told myself, ‘The day I zip up a bodybag containing someone I know is the day I’m finished with this job.’ But the morning after trying to save my mate’s brother’s life, I was back on the beat, plodding on and pretending as if nothing had happened. Carrying on and keeping calm. But only on the outside.

  ______

  Sometimes when someone asks me what I do for a living, I’ll make something up. I might say I work in a call centre or own an ice cream van. Because if I tell them I work for the ambulance service, there’s a good chance the next question will be, ‘What’s the worst thing you’ve ever seen?’ That’s not something I really want to go into while I’m trying to have a quiet drink down the pub or at a wedding. Usually, I’ll say something like, ‘Believe me, you really don’t want to know.’ If they persist, I might fob them off with a moan about the lack of breaks we get. They tend to be less interested after that.

  People have morbid curiosities. That’s why there is such a huge interest in violent crime and serial killers and the like. I think there is also an assumption that because we signed up for the job, we don’t have a problem seeing the terrible things we do. But what if I was honest with them? ‘Well, there was the time someone plonked a child in my arms and she was covered in bruises and I could feel her broken bones clicking.’ Where do you go from there?

  People don’t mean anything by it, it’s just natural inquisitiveness. But they should remember that the person they’re talking to might be horribly scarred by the worst thing they’ve ever seen. It’s like going up to a soldier and asking how many people they’ve seen blown up. The last thing we want to be doing is reliving our nightmares on a night out with someone we barely know.

  A colleague said to me once, ‘Working as an ambulance person is like compiling a book of stamps. Most jobs will fill a little corner of a page, some jobs will fill a whole page. And when the book is full, the job’s not for you any more.’ Before or after an ambulance person bows out, they really don’t want to be flicking through that book with Joe Bloggs down the pub. But they should be able to flick through it with a mental health professional. And when you’re talking to a mental health professional, you’re ‘allowed’ to break down and cry. That’s not ideal when you’re propping up the bar in Wetherspoons.

  What’s funny is, when I give talks in schools (which I absolutely love, but don’t get paid for), they ask a lot of the same stuff as adults. Little boys, just like grown men, will ask how fast my ambulance goes (not much more than 90mph, unless you’re going downhill with the wind behind you. Although I tell them it goes as fast as Lewis Hamilton’s car). And they’ll also want to know the worst thing I’ve seen. That suggests a morbid curiosity about what can go wrong with a body is inbuilt in humans. But when a little kid asks that question, I’ll tell them that I once saw someone being sick. And if I really want to give them a thrill, I’ll tell them that I once saw someone being sick twice.

  It would make a funny scene in a film. Imagine an ambulanceman, perhaps played by Will Ferrell, at the front of a class full children, sat cross-legged on the floor. One of the kids puts their hand up and asks, ‘What’s the grossest thing you’ve ever seen?’

  Ferrell smiles and replies, without skipping a beat, ‘Well, only last week, I was called out to a multiple pile-up. One man had been decapitated and his friend had been thrown through the windshield . . .’

  Cut to children crying, before a stern-looking teacher jogs over and cuts the ambulanceman off. Don’t worry, I’d never say that to a classroom of kids. But I sometimes feel like saying it to adults who should know better.

  15

  THE Q WORD

  There is a superstition in the ambulance service that if anyone says the word ‘quiet’, the shit will suddenly hit the fan. So we call it ‘the Q word’, just as actors refer to Macbeth as ‘the Scottish play’. But there must have been a lot of ambulance workers forgetting themselves of late, because the shit is hitting the fan every day. I can’t pinpoint exactly when it was, but someone seemed to flick a switch and things got ludicrously busy. It hasn’t calmed down since.

  When I first started answering the calls in the control room, it would get to 3 or 4 a.m. and there wouldn’t be one job on the screen, across the whole county. Now, at 3 or 4 a.m. the screen is full of calls. The population has gone up, but not by that much. And people can’t suddenly be getting sicker en masse. We seem to have been hit by a perfect storm. Many of the reasons are political, and this is not meant to be an overtly political book. Suffice to say that the state of the ambulance service scares me. When that ambulance arrives, I guarantee you will get the best treatment possible. But will it arrive too late?

  The last thing I want is for people to think I’m moaning about my lot. But I would at least like people to understand what us ambulance people go through. Maybe then people might think twice about swinging a punch when we walk through their front door or threatening to kill us because Mrs Miggins next door has had a stroke and we’ve parked an ambulance across their drive.

  In an average working day, which can sometimes be part of a sixty-hour week, I might do ten different jobs. That works out at about 200 patients a month, and 2,400 patients a year. That means that over fifteen years, I’ve seen something like 36,000 patients. Maybe one in a hundred jobs could be classed as particularly traumatic – seeing someone die, being attacked – which comes to well over 300. Ambulance people are supposed to help, but often we’re in pieces ourselves.

  Last Christmas, I was lucky, because I had Christmas Day and Boxing Day off. However, I had to do a run of sixty hours between Boxing Day and New Year, during which I attended three suicides. After each one, I went home to my family, put a happy face on and pretended like nothing had happened. But while I was tucking into my leftover turkey, I couldn’t help thinking about the guy I’d just seen, whose life had got so bad that he’d attached a piece of rope to a rafter in his loft, tied it around his neck and jumped through the hole in the ceiling. When I walked up the stairs, the first thing I saw were his legs, swaying from side to side. When we pulled him down, his head was facing the wrong way. Money troubles, apparently.

  About a month before that, I was called to a hanging on the roof of a pub. I’m not sure what they thought we’d be able to do about it, because he’d been there since the summer. He was only found when the ceiling sprang a leak and a contractor went up to investigate an old elevator shaft, in which he made his grisly discovery. Nobody seemed to know who he was or how he got up there.

  Sometimes in my job, reality merges with fiction. I look back and think, That can’t have actually happened. But in the case of this hanged man, I’m absolutely certain of what I saw, the details of w
hich are just too graphic to share with you. His toes were resting on the floor, so I’m almost certain there was no way of moving him without his head falling off. I didn’t hang around to find out, but some poor bastard from the funeral parlour would have had to do it. It was one of the most messed-up things I’ve ever seen. It would certainly take a sick mind to imagine it.

  As I was climbing back down the ladder, a manager shouted up, ‘Lads, you shouldn’t be working at heights! Health and safety!’ If only he was as worried about the toll the grisly scene we’d just been exposed to might have taken on our minds.

  There are some diehards who love the job so much that they won’t leave until they absolutely have to, but people are leaving the ambulance service in droves. From when I started at my station, there is probably about 10 per cent of the original staff left. Some retired naturally, some left to be a paramedic or technician elsewhere. Paramedics can work in GP surgeries, police stations, call centres (although most people who went off to work for 111 came back pretty damn quick), on cruise ships and oil rigs. And most of those posts will be better paid.

  Then there are those who left for a different job entirely, simply because working for the ambulance service left them at the end of their tether. Some remember the days when there would even be time for the occasional chat in the station. A moment to switch off. A moment to breathe. They started pining for those halcyon days and hating a job they once loved.

  Now we’re hitting the staffing targets again. But the staffing targets aren’t high enough. Over the previous six years, the number of incidents classified as most serious increased by 50 per cent, while the number of paramedics increased by just 16 per cent. In Parliament in 2018, it was revealed that in my own ambulance service, one in four ambulances attending the most serious incidents do not have a paramedic on board.