An Unconvinced EMT

At one time, I used to post a lot of true stories about my time in the London Ambulance Service. Eventually, they can become repetitive, such is the nature of the job. And some are hard to believe, I understand that. Because truth really is stranger than fiction. If anyone has never read any, they can all be found in the ‘Categories’ on the right of any page, under ‘Ambulance Stories’. And you have my sworn promise that each and every one of them is 100% accurate.

However, there is one thing about doing that job that you may not be aware of. People lie.

In their desire to make sure that an emergency ambulance will be sent, members of the public are not above lying. In cases where they are not actually inventing an illness, they do not hesitate to ’embellish’ what symptoms might be presenting, until an everyday bellyache can be made to sound like a ruptured Aortic Aneurysm. Others with indegstion after consuming a huge Indian meal and six beers will say they are ‘having a heart attack’, without trying to take any antacid medicine first.

And you may find it hard to believe that some people actually want to be in hospital. They like the attention, the sympathy, the company, and the sense of drama as they are wheeled into the emergency room. Would you be surprised to know that some people actually call 999 for an ambulance as much as 100 times a year? Or that so-called ‘nuisance callers’ are actually sent letters telling them that no more ambulances will be sent in response to their frequent calls? And it is not rare, and not just lonely people, or elderly people. Neither are most of them mentally ill, in any form. They just like having the emergency services come to them.

Then there is the strange world of ‘Munchausen by Proxy’. If you have never heard of this, it is where someone calls you on behalf of a relative, and tells you that they are very ill or injured, and need medical treatment. In most cases I experienced, this was usually a female caller, asking for help for a baby or small child. In a few very sad cases, it was discovered later that they had actually injured the child themselves, or poisoned them in some way that proved they needed emergency treatment. When I joined up as an EMT, I never expected to be called to a child injured by its own mother just so that she could get attention. This is also more common than you might expect, especially in a huge city like London. Here is a proper explanation of it.
https://www.nhs.uk/conditions/fabricated-or-induced-illness/

This also has a ‘twin’, in the singular ‘Munchausen’s Syndrome’, where the caller has injured or drugged themselves, or invented an illness in order to seek medical attention or admission to hospital.

As well as wasting the time of the control room call-takers, the ambulance crews that could be doing something better, and the overworked hospital staff, they create something else. After years of this, day in day out, ambulance staff become cynical, disbelieving, and jaded. Someone tells you that they have this disease, or that illness, and you don’t take their word for any of it. Don’t get me wrong here, they are still treated respectfully and professionally, but they have created a culture whereby only visible injury or diagnosed serious symptoms are considered to be ‘worthwhile’ by those doing the job.

By the time I had been in the job for fifteen years, this situation had become so widespread, that a term was invented for it. ‘Paramedic Burnout’.

Officially, this was used to describe working in a very stressful and often harrowing job for so long, that staff became overwhelmed by it, similar to PTSD. Unofficially, it was staff who were sick to death of constantly attending time-wasting calls, being lied to, and being verbally and physically abused. I got to the stage, and so did many of my colleagues, where I firmly believed that at the very least, around fifty percent of the calls we were being sent to were spurious, or did not require an emergency attendance.

It comes to something where going to a train crash where 30 people have been killed and over 400 injured, is referred to as a ‘good job’. Or when you walk over to the body of a young woman who has jumped from a twenty-second floor balcony, turn to your colleague and say “At least she meant to do it”.

The next time you move your car over for an ambulance coming past with lights flashing, and sirens blaring, thanks for doing that. As they take their lives in their hands to speed through traffic heading for the next emergency, let’s hope they are not just on their way to someone who has eaten too much spicy food.

Going the ‘Wrong Way’

Over recent days, I have posted a few stories and photos about my time as an EMT in the London Ambulance Service. The memories of those years rarely leave me, but they do tend to resurface more poignantly at times.

One thing I often think about is how we always seemed to be going into potential danger, as hundreds of people were fleeing in the opposite direction. During the IRA bombing campaign, ambulances would naturally be sent to the scene of explosions, or to standby after bomb warnings, as bomb disposal officers tried to defuse devices. It felt rather strange to be the only people heading toward such things, as we saw hundreds of pedestrians and vehicles making their way away from the scene.

After the St Mary Axe bombing in The City of London in 1992, we were sent into the area the following day. Our job was to remain on standby, providing safety cover for Fire Crews and investigators working in the affected area. This was a long way from our base, and not a part of London we usually worked in. Arriving on scene, it was incredible to see the devastation; but the strangest thing was the complete absence of people or traffic, and the thousands of documents and pieces of paper still fluttering around.

The following year, another IRA bomb wrecked the area of Bishopsgate, also in The City of London. Once again, we were only required to standby after the event, arriving to find something resembling a war zone.

Three years later, and I was in my house in London’s Docklands, getting ready to travel into work for a night-shift. There was the hollow thump of a large explosion, and the shock wave popped the seals on all of our double-glazed windows, making the large house tremble as it did so. I went outside to see what had happened, and could see smoke rising directly across the River Thames, in the area around Canary Wharf. I got ready quickly, and left to drive into work, expecting to probably be sent to what looked like a major disaster. Fortunately, by the time I arrived at my base, we were no longer required to go there.

On the 7th of July, 2005, I was no longer in the Ambulance Service. I was working as a communications officer with the Special Operations Group of the Metropolitan Police. Following a long night shift, I slept through a series of bombings that became known as the ‘7/7 London Attacks’. Waking up in the late afternoon, I switched on the news to see the full impact of what had happened that day. Four bombs had been detonated by Radical Islamist suicide bombers. Three had been on underground trains, and one on the top deck of a London bus. 52 people had been killed, and over 700 injured, in one of the worst terrorist attacks ever seen in London.

Central London was at a standstill, with all the stations closed, and buses diverted away from the scenes of the bombings. I knew that every emergency resource would have been required, so decided to go into work early, to see if I could be of any help. As I lived close to where I worked, I was able to walk in, a journey of less than thirty minutes.The most direct route was to walk south, straight along Tottenham Court Road. in the direction of my base close to Trafalgar Square.

It didn’t take me too long to realise that I was the only person heading in that direction. Everyone else was heading north, away from potential danger
I smiled as I thought to myself, ‘You’re going the wrong way’.

Ambulance memories: Disasters

During my time as an EMT in London, I attended the scene of a few significant major incidents. Some were accidents, others related to terrorism. Whatever the cause, you might well consider them to be disasters. These are my recollections of some of those.

1981. Oxford Street London. The Wimpy Bar bombing.
Mandatory Credit: Photo by ANL/Shutterstock (1445884a)
Devastation After An IRA Bomb Exploded In A Wimpy Bar On Oxford Street Killing Kenneth Haworth The Metropolitan Police Explosives Officer Attempting To Defuse It.<

Following a warning from the IRA, a civilian bomb disposal officer attempted to defuse a bomb planted in a burger bar. It detonated as he worked on it, killing him instantly. I was in an ambulance at the end of the shopping street, and we heard the sound of the explosion, and saw the smoke rising. We were not required to go to the incident, as he was beyond medical help.
I later wrote a blog post about that brave man.

https://beetleypete.com/2013/11/20/ambulance-stories-43/

1982. Hyde Park, London. Household Cavalry bombings.

The IRA detonated two bombs that day. One in Hyde Park, the other in Regent’s Park. The targets of those attacks were soldiers of the Household Cavalry, returning to barracks after ceremonial duties, and bandsmen of The Royal Green Jackets. I was in an ambulance sent to the Hyde Park incident. Four soldiers were killed in Hyde park, as well as seven of the Blues and Royals cavalry horses. As it was a terrorist incident, it was treated as a crime scene, and I did not have to treat anyone on scene.

1983. Harrods Store Bombing, London.


The famous London department store was hit by an IRA bomb in December of that year. I was sent in an ambulance to standby if needed. I was very worried, as I knew that my wife had gone to the shop that afternoon, accompanied by a friend from Paris who wanted to buy some Christmas presents. Luckily, they were still in the tube station opposite at the time the bomb went off, so they were unharmed. We were not required to do that much more, as there were many ambulances available. Six people were killed, including three police officers. Another ninety people were injured, some seriously. The high casualty rate was caused by the failure to evacuate the store when the bomb warning was received. My only part in that job was to confirm to a police officer that I could not render any help to one of the victims, a man who had been blown in two by the blast.

1999. The Ladbroke Grove Train Crash.

With my colleague, I was in the first ambulance on scene at what is still one of the worst transport disasters in British history. We were there for most of the day, dealing with numerous casualties, victims of severe burns, and attempts to identify body parts. Thirty-one people were killed, and two hundred and sixty seriously injured. It was the most serious job I ever attended, in almost twenty-two years. I later wrote this blog post about that terrible day. Perhaps the worst day of my entire career.
https://beetleypete.com/2013/06/22/ambulance-stories-41/

Just a snapshot of what we called major incidents. There were many more in London, but those stick in my mind.

My Medal


(Photo by Monster Medals)

A comment by Jennie Fitzkee on one of my ambulance posts reminded me about my medal. When you work in the Ambulance Service in the UK, which is part of the NHS, you receive a medal after twenty years of service. The following conditions must be fulfilled, to receive it.

Operational staff who reach their 20-year milestone with the Ambulance Service are awarded a Queen’s Ambulance Service (Emergency Duties) Long Service & Good Conduct Medal provided they have completed 20 years’ service, with at least seven years on A&E duties, and hold a clean disciplinary record.

During my service as an EMT, we had the long-running National Ambulance Strike, which I actively participated in. As a result, the London Ambulance Service decided to deduct the six months we were on strike from our service, meaning we had to complete more than twenty years to receive one. (I know, spiteful…) Most of us regarded the medal with some cynicism. If you stayed in the job long enough, you got one, whatever your actual operational experiences might have been.

So some staff worked flat out every day in busy areas, doing all sorts of dangerous and difficult jobs, whilst those in the outer suburbs had a comparatively easy life. But everyone got the same medal. It became known as the ‘Turning Up Medal’, as all it really signified was that you had shown up every day, for at least twenty years.

Then there were always delays in the presentations, as they had to accumulate enough eligible staff to make the cost of the occasion worthwhile. So by the time I had completed almost twenty-two years of service, I had still not received one. Then I decided to leave, and work for the Metropolitan Police. I gave up all hope of ever getting my medal, which I only really wanted so that my Mum could accompany me to the presentation ceremony.

Almost a year after I had left, I received a letter telling me that I could attend the medal ceremony, and bring two guests. However, as I was no longer employed by them, I would not be granted the benefit of wearing the dress uniform that everyone else would wear to the occasion. I wanted my elderly Mum to be able to see me get it, so I agreed to go anyway, wearing a conventional suit and tie.

The ceremony was held in the impressive Assembly Room of Church House, next to Westminster Abbey, in Central London.

Once all the recipients had been presented with their medals, we were allowed to retire to the rear balcony, where drinks and snacks were served. That place has an impressive view of the ancient Abbey. My Mum made the evening, by looking across at the most famous church in Britain, and declaring, “I’ve seen that church before”. (Failing to recognise it as Westminster Abbey) She then sipped her tea, and wrinkling up her nose, she remarked loudly, “This is as weak as water, and tastes like cat’s pee”.

But I got my medal, and Julie and my Mum were there to see it presented.

It now rests in its box, in a drawer somewhere. I have nobody to leave it to, so will probably give it to a museum one day.

The Ambulances I Worked In

This is not of much interest to most readers, and is mainly by way of me making a record of something personal. I spent a third of my life working in and driving ambulance vehicles on the streets of Central London. (We drove one day, worked in the back the next) I often look back on the jobs I did at the time, but rarely even mention the vehicles that we used to traverse the City, with its difficult traffic conditions. When I first started in the job, we still had some vehicles that resembled museum pieces, even then. As well as the distinctive two-tone siren, known as ‘Nee-Naws’, we had a bell to warn of our approach too. It was fitted into the front of the vehicle, and operated electronically from a switch inside.

By the time I was on operational emergency duties full-time, most of the vehicle fleet had been replaced with the more modern Bedford CF (General Motors) 2.3 litre ambulance. With three-speed automatic transmission, very light (not power) steering, and a thin-skinned lightweight body, this ambulance was very easy to drive, and to get around the narrow streets in parts of London. The sliding doors meant that we could park quite close to obstructions and still exit the vehicle, and they were also welcomed in hot weather, when we could secure them in the open position. They still had an electronic bell, which had now been moved inside, in front of the engine.

I worked in vehicles like that one for a very long time. The equipment inside had hardly changed from the 1960s, but the nature of the job was changing faster than it ever had. We were being expected to travel longer distances to cover work in other districts of London, and more and more equipment was introduced, making the interiors of the ambulances overcrowded, and unsuitable for the work. And it was also decided that we could no longer have sliding doors, due to ‘health and safety’ considerations.

After a lot of consultation between management and the purchasing authorities, with some input from the staff too, a new ambulance was commissioned for London. General Motors lost the contract to Leyland-Daf, now part of the old British Leyland car company, and we got the ‘modern’, wide-bodied ambulance. This had a lot more storage inside, and dedicated mountings for equipment like defibrillators and cardiac monitors. Still with automatic transmission, and now with full power steering, it boasted a very big engine in the V8 3.5 that was sourced from Range Rover.

Of course, it was heavier, so needed that extra power. It was also rather ‘top-heavy’, with a tendency to wallow when pushed hard. The extra width also made it less useful in getting through dense traffic, or negotiating small alleyways in some areas. In general, it was less suitable for the job in such a crowded city, and was initially unpopular with operational staff. I worked in vehicles identical to the one above for the latter half of my career, up to and including my last ever shift. We lost our beloved sliding doors, and the bell inside the bonnet too. The bells were removed, and stored in the garage workshops. Then they would be polished, mounted on a wooden stand, and presented as much-desired retirement gifts to old hands. Unfortunately, by the time I left, they had all gone.

I found this photo of the staff outside a London Ambulance Station. It is not the one where I worked, and I don’t know anyone in the picture. It was taken in the 1980s, but looks almost ‘vintage’. That was the uniform I was issued with when I joined, and wore for half of my service.

Ambulance stories (12)

On a cold and wet June, I was thinking about hot summers of the past. I think only Eddy has seen this one before. Another EMT job I wish I could forget…

beetleypete

The Tramp’s leg

If someone dies in a public place, it is the responsibility of the Ambulance Service to remove the body. That is unless there are signs of foul play, crime of any kind, or a suicide note. In these cases, it becomes the job of the Police, and the Coroner. To some extent, this becomes a kind of game, between the LAS crews, and the Police in attendance. Both sides want to absolve themselves of responsibility for this onerous task, with the attendant unpleasantness, and necessary paperwork. Please bear this in mind, when contemplating this next tale.

The area between Paddington, and Notting Hill Gate, was not always one of gentrification, and desirable properties. Many of the once former residences of quality, had been long ago converted into multiple-occupancy dwellings, of small flats and studio apartments. The basement areas housed small cupboards, tunneled into the pavements beyond, that …

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Ambulance stories (11)

Another old EMT post, from 2012. Hardly anyone has seen this one, and it is not as gory as some of the others. 🙂

beetleypete

One under

As anyone who commutes around the London Underground Railway network will tell you, delays caused by someone jumping under a train, are commonplace events. In London, this network is commonly called the Tube, not the Subway, which for the edification of American readers, is a passage underneath a busy road junction. I say jumping under a train, because people rarely fall under them, though they are sometimes pushed, or hit by trains as they attempt to cross tracks.

To simplify this for the various Emergency Services, this type of call is given out as a ‘One Under’. After all, for our purposes, it is irrelevant how they got there in the first place. During one particular rush-hour morning, we received such a call, to a busy Central London Tube Station. The prospect of attending these calls requires a lot of preparation prior to descending into the depths, where…

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Ambulance stories (13)

Another old ambulance post from 2012. My first baby!

beetleypete

It’s a boy!

When I did my training to become an ambulanceman, the maternity module was basic, to say the least. It consisted of a plastic pelvis and a woolen doll, with a placenta and umbilical cord (also in wool) attached. A short session of passing this through the pelvis at different angles was followed by an instructional film. This seemed to have been made in the late 1950’s, judging by the vehicles, and the clothing worn by the small cast. Using a willing female ‘star’ of a certain age, a real delivery in the back of an ambulance was filmed in glorious technicolour. It all went off well, with no complications, and ended with smiles all round.

There was some talk about breech births, cords around baby’s neck, and infant resuscitation, as well as pregnancy complications, like Pre-eclampsia, and placenta previa. This was added as information, as we were…

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Ambulance stories (8)

Another story from my time as an EMT in London. I don’t think anyone has ever read this one.

beetleypete

Experience not necessary

This is another example of how experience does not always guarantee good performance, and how the wisdom of age can be cast aside by events.

One evening, I was working with the oldest, and most experienced man on our Ambulance Station. I was almost 40 years old, and he was over 50. Between us, we had some 38 years of experience in the job. Towards the end of the shift, which had been very busy, we were called to a traffic accident. It was described as a ‘hit and run’, a pedestrian had been knocked down, and the car responsible had left the scene. We had some way to travel to this job, and on route, we were updated on the radio; the situation was believed serious, Police on scene had advised us.

On arrival, things did indeed look serious. A man in his 30’s was lying…

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Ambulance stories (18)

A rather sombre post from 2012, about my time as an EMT in London, with particular emphasis on dealing with death. Only one of you has left a comment in the past, and it has hardly ever been read. Given the content, I suppose that is understandable.

beetleypete

Living with the dead

This is not an anecdote about a specific job, like the other posts in this series. It is rather a reflection on death, and on dealing with it in the role of an ambulanceman. It is not meant to be depressing, though it may read that way. It is part of my reflection on those years, as I get older.

Before I joined the London Ambulance Service, I had seen one dead body. When I was young, my maternal grandfather died. He was only 65, and died suddenly. I was taken to see him in his coffin, which was in my grandparents’ front room, for a vigil before the funeral. My enduring memory of that night, was not of my first dead body, but of my uncle crying. My grand-dad just looked as if he was asleep, and I did not find it distressing.

Decades years…

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