Ambulances

An Alphabet Of My Life: C

~ beetleypete ~ 57 Comments

C= Cold and Cars

I could not decide between these two choices for ‘C’, so included them both.

Cold.

Many of my childhood memories are about being cold. Until I was fifteen years old, I did not live in a house with central heating. We relied on one main coal fire for warmth, with the addition of a paraffin-filled heater to ‘take the chill off’ in communal areas like landings. That thing chucked out enough fumes to give you a headache, and was the cause of many house fires too.

This meant we had to have hot water bottles placed in the bed early, or face that freezing feel of ice-cold cotton sheets in an unheated bedroom. I also wore thick pyjamas, and in the dead of Winter, socks too. I still remember my feet coming into contact with the hot water-bottle when it had got cold, and kicking it out of the bed.

Once I was aged ten, I was considered to be old enough to light the fire when I got home from school before my parents returned from work. This was a lengthy process, and quite tricky to achieve. Old twisted newspapers would be placed in the grate, topped with kindling wood, then just enough coal to get the fire started. It could sometimes take ages for the coal to ‘catch’, and if I added more coal before it was actually glowing, I was in danger of extinguishing it completely.

We lived through some harsh winters too. The bad one of 1963 lives on in my memory. It was the coldest for 200 years, and even froze the sea around the coast. We had frozen pipes that caused water shortages, and I can remember arriving at school shivering, despite wearing my duffle coat, balaclava helmet, school cap, a scarf, and gloves. Although the school had heating, the old Victorian building seemed to retain the overnight cold, and we were not allowed to sit in class wearing our outdoor coats.

Small wonder I hated being cold as I got older, and even now I dread the arrival of snow and ice.

Cars.

My dad had a car when I was very young. I remember being in the car as a child, and watching him change gear as we drove along. Cars were very different then. They frequently broke down, had tyres with tubes that punctured easily, and required a fair level of mechanical knowledge on the part of the owners to keep them running reliably.

By the time I was 14 years old, all I could think about was driving, and having my own car. Even before I could apply for my driving licence, my dad bought me a used car. He stored it in the garage, and showed me the controls, how to check the oil, and how to do routine things like adjusting the points, changing spark plugs, and checking the tyre pressures. He would reverse it out of the garage so I could wash and polish it at weekends, but as it was not insured for me of course, I never got to try it out properly.

Some time later, once I had my learner licence, I was put on the insurance so that friends who had already passed their test could sit next to me as I drove around. Though I resented having to display the prominent ‘L’ plates front and back.

When the time came to apply for the driving test, I learned in a driving school car that was much smaller than mine, because it made sense to have dual controls. On the day I passed my test, I put three gallons of petrol in my own car, and drove the fifteen miles into Central London, into the busiest traffic in Britain.

That started me on a lifetime of driving, during which I drove almost every type of vehicle imaginable, including quite large trucks before the need for a separate Heavy Goods Licence. Then later I drove emergency ambulances around London, using blue lights and sirens. In between, I passed my motorcycle test, and used a motorbike to commute to work.

It has taken me almost a lifetime to stop being excited about cars. My current car is 15 years old, and is the oldest car I have ever owned and kept. It was 5 years old when I bought it second-hand, and I hope to hang onto it until I am no longer driving.

I wrote about the cars I have owned and driven on this blog, with photos of the models concerned. Here’s a link.

Cars: My Life On The Road

I also featuured the various ambulances I drove and worked in in London. Here’s a link to that.

The Ambulances I Worked In

An Alphabet Of My Life: A

~ beetleypete ~ 66 Comments

A=Ambulances

An obvious choice of course. Until I retired in 2012, I spent over one-third of my life working in emergency ambulances as an EMT in Central London. Up to the time I left in 2001, being an ambulanceman defined me. From having to work shifts, to being a union organiser, and dealing with things every working day that most people will never see in their lifetimes.

Even now, almost 21 years after I worked my last shift in an ambulance, that experience lives on. It lives on in my dreams, my attitudes, my life in retirement. It is more than a job, even though at the time it was ‘just a job’. It is an unforgettable experience that makes you feel part of something that so few people outside of medical and emergency workers really understand. Being present at historical events that will long be remembered, or doing as something as simple as to put a dead man back into bed to give him some dignity in death.

In some ways, it was a thankless occupation. The management treated us badly, many members of the public thought it was acceptable to abuse us verbally and physically, and the pay was low by comparison with almost any other lifetime career. But other aspects of it were glorious. The times when someone thanked you sincerely, the wonderful relationships and friendships with colleagues and nursing staff at hospitals, and the feeling that you did something useful, instead of making more profit for faceless international conglomerates.

I like to think of it as one of the truly worthwhile jobs. Working in unsuitable conditions to help people as best as you could. Usually too hot or too cold, tired, wet, and frequently exhausted by the relentless workload and the pressures of dealing with difficult situations. Trying to stay cheerful and positive in the face of unspeakable scenes and sights, and remaining professional at all times in the public gaze.

There could be no other choice for ‘A’.

If you want to read more about my time doing that, I have posted many examples on this blog. Here are some links.

https://beetleypete.com/category/ambulance-stories/

The Ambulances I Worked In

Ambulance memories: Disasters

An Unconvinced EMT

~ beetleypete ~ 55 Comments

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.

The Ambulances I Worked In

~ beetleypete ~ 50 Comments

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.

Blatant Advertising

~ beetleypete ~ 11 Comments

I am unusually puffed up once again today. For the third time, I have had an article published on a film website. These small things may seem unimportant, and carry an element of ‘so what’? To me, it is very exciting, to see my name in print, somewhere else, under a piece of writing.

As this is not a re-blog, and was written specifically for the other site, I will not publish it on beetleypete. What I will do though, is post a link here, and hope that any readers who are interested in film, and my writing, will go over and have a look at it.

The rest of the site is well worth a visit, with interesting, intelligent, and well-written reviews of films, cinema articles, and everything connected to both. (And that’s just my stuff! Only joking)

Thanks in advance for looking at it. Pete.

Blood and Bandages: Paramedics on film

Ambulance Stories (44)

~ beetleypete ~ 19 Comments

The National Dispute

By the autumn of 1989, relations between the Trades Unions and the Thatcher government were at an all-time low. The Tories were determined to use their large majority in Parliament to crush the unions, and remove any power that they once had. Empowered by the guarantee of government support, managers in Ambulance Services all over the UK were standing firm against any requests for pay rises, or better conditions for staff. In London, the managers were going one better, introducing changes in working practices, with little or no consultation. It was all getting very serious, and we could see that it would soon come to a head.

One of the new demands was that we move from our normal place of work, if our crew-mate was off sick, or on holiday. This might seem reasonable, but the previous arrangement had relied on overtime being offered to staff on days off, ensuring a full complement of emergency ambulances was available in all areas of London. If one of us moved to another base, up to ten miles away, we would operate from there, leaving our normal station undermanned by at least one vehicle. This not only left the remaining staff with a greater workload, it also meant that the local population did not have the guaranteed vehicles available to them, in the event of an emergency. The decision on who moved, and where to, was left to Control Room staff, often with no operational experience.

Protracted pay negotiations had got nowhere, and there was already a limited work-to-rule in place. This simply meant that we did the job properly, by the rule book. We took vehicles to be re-fuelled, refused to operate without adequate supplies of oxygen, or with faulty equipment, and carried out all the necessary checks, before commencing duty. Any defects with the vehicles, normally tolerated for the shift, would result in that vehicle not being used. All of these were safety rules, and for the benefit of the patients. They were routinely flouted at other times, just so the workload could be managed, and always at the suggestion of the managers, who used guilt and custom as leverage. Another rule, also ignored normally, was that no Ambulance should be operated, under any circumstances, by one person. There was limited rearward visibility, and also the chance that you would be flagged down to attend an incident, when you were alone, and unable to properly assist. Working to rule meant that we refused to operate vehicles on our own, so could not travel to other bases in them. We could not use our own transport, if we had any, as this would have necessitated insuring our own cars for business use. Public transport was not really an option either, due to the location of some bases, and the long journey times involved.

In an atmosphere of antipathy, an attitude of non-cooperation developed, and this was made worse, by the belligerent attitude shown by some managers. Despite the problems over pay and conditions, and the many factors affecting our working lives, it was the issue of moving bases, which was to become the spark that ignited one of the longest, and most acrimonious disputes, in the history of the National Health Service. As the Union Shop Steward at my Ambulance Station, it also fell to me, to become the instigator of this whole dispute, as it just so happened, that on that day, I had nobody to work with. On that morning in September, I had no idea that the outcome of my decision would result in a bitter six-month dispute, that would see us through a harsh winter, with no pay; staff losing their houses, marriages breaking up, and deep resentments being formed. It would never be the same afterwards, and the long-lasting effects would stay with me, through a further twelve years of service.

When Control asked if I was fully crewed that day, I replied no, and asked them to find someone on overtime, to work with me on that shift. After a few minutes had passed, they called back, and instructed me to take the ambulance, and to report to Chiswick Ambulance Station, to work with someone there, who was also single-crewed. I refused, advising them that I was unable to use the vehicle on my own, by their own rules. I then telephoned the person at Chiswick, telling him to expect a call, instructing him to drive over to work with me, as I anticipated that this would be the next step. Sure enough, that was what happened, and he also refused to move, citing the same rules. They called me back, someone more senior this time, and gave me a ‘direct order’ to do as they asked. I refused once more, and I was told that I would be suspended from duty, pending disciplinary action. Ten minutes later, the same scenario was played out with the man at Chiswick, and within an hour of starting work, we were both suspended, and potentially unpaid, unless we relented, and agreed to move.

I advised the other crew members on my station, and at Chiswick, and they all withdrew their labour, in support of both of us, demanding that the suspension be withdrawn, and the threats rescinded. I then contacted the next nearest base, at St john’s wood, and told them what was happening. They in turn, contacted Camden, Willesden, and Park Royal, and before long, almost the whole of West London was ‘on strike’, until we were reinstated. This soon got through to the full-time union officials, and the local media. I gave an interview to the local TV news programme outside the Ambulance Station, explaining the reasons for the action, and it was shown at lunchtime, and again that night. By now, we were occupying the bases, and the unions were running scared, fearful of having their funds sequestered, as this was unofficial action. They tried to get me to return to work, pending negotiations, but they were overtaken by events, as the dispute spread all over Greater London, the staff angry and frustrated by management attitudes, and frightened unions.

During the rest of that day, we had local meetings, and agreed that we were not on strike, and that we were still prepared to answer emergency calls, based on the terms and conditions that preceded the current dispute. However, the managers had seen their chance to break us, and refused to pass calls to the individual bases, telling the media that we were on strike. They began to use the Police, and called in volunteers from the Red Cross, and St John Ambulance, to respond to calls. They also used private ambulance companies for non-emergency work, and tried to portray themselves as the unfortunate victims of union agitators. Some operational managers took vehicles from Headquarters, and attended calls. We put up posters and banners, advising the public that we were still working, even though we were not being paid, and we gave them direct phone numbers, so they could ring in straight to us. We also told the Police and the local hospitals the same thing, and by the time night duty arrived, we were answering calls at our own instigation.

Some staff were still working normally, refusing to cooperate with their colleagues. Some had political, or religious reasons, some were scared of not being paid, and others just disliked some of us who were seen to be on strike. They had to be moved, so that they all worked in the same area. They were in no danger from us, we just lost respect for them, and they were never fully accepted again afterwards. They were surprisingly few in number, with the dispute, as we began to call it (as we were not on strike) gaining overwhelming support from the vast majority of staff. The whole thing escalated, and began to go national. Staff in all parts of the UK were joining in, and soon the unions could no longer ignore the overwhelming feelings of their members. In most of the major cities, solidarity was total, and we all still made our best efforts to provide cover for emergencies. Some bases actually attended more calls during some parts of the dispute, than they had when working normally.

This soon became front page news, and the first item on all the TV news stations. Government ministers were interviewed, union officials gave our side of the argument, and cameras appeared outside casualty departments, and the larger ambulance stations around the country. To the surprise of our management, the Government, and to some extent, those involved on the ground, the general view was sympathetic. Members of the public supported us overwhelmingly, and ninety percent of media reports were also very favourable. We were seen as the maligned carers, the professionals who put up with low pay, little recognition, and carried on uncomplainingly. For us to be in dispute, something bad must really be happening. The public believed in us, the hospitals believed in us, even the Police believed in us. It was left to our own management, and Tory politicians, to spread untruths about our motives, and to paint a picture of us as ungrateful strikers, callously disregarding the unfortunate sick and injured. Everyone wanted us to be paid more, and to receive decent conditions too. Opinion polls suggested massive support, and there were suggestions for a plan to pay more taxes, or higher National Insurance, to fund the changes, and to put an end to the dispute. The managers were on the back foot, and the government under pressure. They reacted spitefully, as you might expect.

Our occupation of the bases was declared unlawful, and they tried to get us evicted for tresspassing, but could find nobody willing to enforce this. They then technically sacked us all, withdrawing our right to use the ambulances, and the equipment owned by the services involved. They reported us to the Police, for ‘stealing’ ambulances that we were using to respond to calls. Again, the Police refused to enforce this, not wanting any part of a dispute that had caught the imagination of the public, who had soon realised that we were not actually striking. The attitude of all the staff was indeed admirable. Everyone continued to turn up for work, and to man all the shifts, even the most unsocial ones. Those on days off turned up anyway, to help with the occupation of the buildings, talking to the public, and answering the telephones. As the weather got colder, we had braziers burning to keep warm, and people turned up unannounced, with wood for the fires, and gifts and food for the staff. People also began to give us money. At first, we declined, feeling uncomfortable about this. We did get some hardship pay from the unions, but it was only a small amount, nowhere near enough to survive on. The donations were used to buy badges, stickers, and information leaflets, all handed out to the public, to advise them of our reasons for the dispute, and to ask them to wear the badges and stickers, to show support.

Staff began to attend busy areas with these; outside main railway and tube stations, at major junctions, like Oxford Circus, and also busy street markets, in our case, Portobello Road. We took banners, and boxes of badges, and we were soon overwhelmed by cash donations. From old ladies emptying their purses, to local celebrities giving wads of notes, the money started to flow in. By December, at least in London, we were receiving sufficient donations to almost pay staff the same wage they got when working normally. This stiffened our resolve, and made the earlier hardships seem worthwhile. With this continued level of support, we felt sure that we could win.

Without us ever imagining it, we were taking part in the most popular dispute in union history. We felt that we owed it to the public to continue, and we owed it to ourselves too.

Day to day, life was still hard. Staff divided into three groups. One would work on the ambulances, answering those calls we got through. Another would occupy the base, picketing outside, keeping the braziers burning, and putting on a brave face for the public. The third group would go and stand somewhere, advertising the dispute, receiving money from donations, and distributing badges. We had caps made as well, with our slogans on them, and often family members would assist too, standing with their husbands and wives, or mums and dads, showing solidarity with our cause. Each week, the donations would be divided, those with bigger families, or larger mortgages, getting the biggest shares. The meetings continued, locked in stalemate. The media kept the story alive, but also reported the tragedies that had happened, hinting that they might not have happened, if we were working normally. Army ambulances were brought in; unsuitable vehicles, doing an unfamiliar job, escorted by Police cars, as they did not know the areas. The managers, and more importantly, the government ministers, refused to budge on anything unless we first returned to normal duties. We endured a very cold, and miserable Christmas, with little hope held out, for a resolution in 1990.

Amazingly, public support never wavered. The donations kept coming, and the kind words too. We started the new year in an atmosphere of grim determination, on both sides. By now, former colleagues in supervisory roles had become bitter enemies. We no longer spoke to any managers, or control room staff. There was no local negotiation, of any kind, and all meetings were being held by union officials, with NHS management, and government ministers. We had become detached from the process, trying to deal with daily survival. I developed a deep personal hatred for some individuals, and for the voluntary workers, who were taking holiday time, to do our jobs when we were in dispute. For me, that never diminished, and remains with me, to this day. On the other hand, we formed bonds and friendships as well, with hospital staff, some police officers, and colleagues, that are unbroken as I write. Over 200.000 people attended a rally of support in Central London, and large events like this were seen all over the UK.

By the end of February, the unions were beginning to buckle. The management was willing to concede some points, but pay increases were a national issue, controlled by the government, and that was intransigent. Leading union officials began to hint at a possible solution, and this was accelerated by renewed media interest. The staff wanted none of it. We wanted to hold out, for all the reasons we had started on this five-month dispute, and could see no point going back to working normally, unless we got all our demands. The volunteers doing our job were running out of time, and would have to go back to their normal jobs. The cost of paying the police and army to carry on  was prohibitive. The total costs of the dispute already far exceeded what it would have cost to settle in the first place, but they would not back down. After meetings at the end of the month, the NUPE union leader, Roger Poole, announced that an agreement had been reached, and that we would return to work in March, six months after we began the work to rule. He didn’t think to ask us what we thought. He famously announced on TV, that he had ‘driven a coach and horses through Tory pay policy’.  And he wasn’t even embarrassed. What he failed to add, was that he had agreed, on our behalf, to accept the derisory pay increase that we had been offered originally, and that he had also agreed to the changes in conditions and practices that had brought us to this in the first place.

Some staff, me included, wanted to ignore the unions, and carry on. But there was no widespread support for this, and that was understandable. Some staff had suffered marriage break-ups, others had seen their homes repossessed. Many had just left, or resigned soon after, broken and disillusioned. All of us had endured six months with no pay, dependent on public goodwill from donations, and sticking through a harsh winter, with no end in sight. We went back to work in March, as if nothing had happened; though some people were shunned, others transferred by request, and some managers moved around. Our relationship with the unions was never to be the same again. I left the NHS union, COHSE, and joined TGWU, as a small personal protest. I had also stopped being the union rep for our base, as I had simply had enough at the time, though I did do it again, later on. We had lost, and it wasn’t a good feeling.

Or had we?

Within a short space of time, most of the old management was gone. Pushed out, retired early, or plonked behind obscure desks. Our public profile was raised beyond recognition, and training was brought into the 20th Century, with new skills, new equipment, and modern vehicles. Paramedics and Technicians were beginning to be portrayed in TV programmes, as an essential part of the emergency services, and as having a vital role in the NHS. They were filmed in documentaries, the often thankless job shown for all to see, actually as it happened. Other branches were introduced, rapid-response vehicles, motorcycles, and even a helicopter. (Actually run by the London Hospital) By the year 2000, ten years after the dispute ended, the job was being paid at a fair rate, and finally given the respect it was always due.

I don’t believe that this would ever have happened, without those six months of hardship, between 1989-1990. I am proud to have been a part of it, and always will be.

Ambulance stories (9)

~ beetleypete ~ 24 Comments

The fainting woman

After a very short time in the Ambulance Service, you soon learn to disregard the diagnoses given by Ambulance Control. They are at the mercy of the caller, and their own desire to end the call, within their protocols, as soon as possible. So, there is a constant repetition of the same diagnosis given for the call you are being asked to go to. Others can be wildly inaccurate, perhaps because of language problems, or lack of observation on the part of the caller. After a while, you do not expect what you are told, to be what you actually see on arrival.

One morning, we were returning from the Charing Cross Hospital in Hammersmith, when we were called to a well-known high-rise estate, not far from our base. We were told to meet a caller outside the entrance to one of the highest blocks, and that he would take us to the victim. The job was given as, ‘Female fainted; possibly unconscious’. We understood that this could mean anything. She may well be unconscious, possibly not. She may have fainted because she was pregnant, or she might well have tripped over a kerb, and not have fainted at all. There was a good chance that she had suffered a cardiac arrest, and an equally good chance that there was nothing wrong with her whatsoever. Either way, we would not find out until we got there, so the sirens and lights were engaged, and off we went.

On arrival, we saw a man at the end of the service road, directly outside the block address given. Although there was no other traffic, save an ambulance making its way at some speed, lights flashing, heading directly for him, he still felt the need to wave frantically at us, his arms flailing as he repeatedly indicated the point that we should bring the vehicle to a halt. This behaviour was so common, that I gave these people the affectionate nick-name of ‘Wavy Daveys’. He was standing next to a woman in a collapsed state, crumpled on the floor, and looking very pale. On first examination, she seemed to be uninjured, though getting a history from her proved difficult, as, confirming her Mediterranean appearance, she was speaking in what I knew to be Portuguese. She was gesturing to her right, around the other side of the entrance porch, her mouth flapping like a puppet, as she repeatedly exclaimed something in her own language, that we could not understand.  We decided that we had best get her into the vehicle, out of the cold, and examine her further. The trolley bed was brought over, and she was blanketed, lifted onto the bed, and placed into the vehicle. She finally managed some English, interspersed between her Portuguese ramblings. She wanted us to open the back doors she said, there was something important to tell us.

We could not calm her down until the doors were opened. As we did so, she pointed again at the side of the entrance porch. “There, there, look there” she shouted, before sinking down onto the pillows, uttering a stream of religious incantations. To placate the distressed lady, I walked over to look in the area that she had indicated. Just out of sight of the road, in a corner aspect of the building, a few feet away from the entrance to the block, was the shattered body of an adult male. From the amount of blood and bodily fluids, and the bizarre positioning of the limbs, I knew at once that this was someone that had fallen from a great height. The briefest of examinations told me that nothing could be done, and I returned to the ambulance to summon the Police on the radio.  I also asked for a second vehicle to deal with this new job, and returned to the body, to carefully cover it with a blanket. We then waited the short time for the arrival of the assistance, and our lady in the back grew calmer during this interval.

She had indeed fainted. Then again, if you were just about to go up to your flat, and a body whistled past you, hitting the ground with a never-to-be-forgotten sickening crunch, you might well faint too.

Ambulance stories (3)

~ beetleypete ~ 35 Comments

Betty’s toes

When you work in a particular area for some time, you soon get used to the ‘regulars’. These are patients with chronic illness or disease, drug users, alcoholics, asthmatics, diabetics, and housebound people requiring different kinds of help and assistance. Betty was in this category. She was in her 70’s, and she had Diabetes, as well as circulation problems and arterial disease,  caused by decades of heavy smoking. She may have been a widower, or divorced, as she lived alone, in a small terraced house, not too far from our base.

It was common to receive calls to attend her address, either emergency calls made by Betty, or as an arranged admission by her G.P. She was a cheery character, and seemed to manage well, despite constant pain in her legs and feet. When this got too bad, or life got on top of her, she would either dial 999, or contact her G.P., in the hope of getting some additional pain relief. As she did not manage her medical conditions well, there was little more that could be done, though we did not mind going to her, as she was always friendly, and pleased to see us.

On one particularly cold and bleak evening, we had such a call, made by Betty, complaining of pain in the legs, and asking for assistance. She met us outside her house, smoking a cigarette, and she apologised for calling us, assuring us that it was just that she had no sensation in her feet, and that they were cold. We went into her tiny living room at the front of the house, and asked her to sit down, so we could examine her.

The room was stifling, with a gas fire going full blast, all windows closed tight, and the overwhelming odour of disease, and old age. She had moved a foot-stool dangerously close to the fire, where she told us she had been trying to warm up her feet, as well as putting on some long thick socks, which were as tight as balloons, due to the obvious swelling. The skin on her legs above the socks was discoloured, with a sinister purple hue, that did not bode well. The overriding smell in the room, even defeating the well-stuffed ashtray, was one of morbidity of the flesh, like meat that has long since gone off. The undersides of the socks were damp and squelchy, soaked by leaking fluid, pressed through by Betty’s insistence on walking out to greet us.

She lit another cigarette, and asked us what we thought. I exchanged a glance with my partner, no more needing to be said. I told Betty that we would have to take her to hospital immediately, and that we should not delay to await her G.P., who she had also called out. She agreed to follow our advice, and went to get up to go to the ambulance. I had to sit her down again, as my colleague had gone out to the vehicle to get our small carrying chair; and we could certainly not allow her to walk any further than she already had. We took her to our ambulance, and transferred her over to the trolley bed. She was chatting away, lamenting the fact that she was not allowed to have a cigarette during the short journey to the local Casualty Department.

On arrival at hospital, I advised a male nurse that in my opinion, Betty should be seen as a matter of urgency. He knew her well, and was used to her constant appearances in the department, so was unimpressed by my apparent overreaction to her condition. I went off to book her in at reception, exchanging a look with my partner that said, ‘he’ll be sorry’. When the nurse appeared again, I asked him if he had looked at Betty yet. He gave me an exasperated look, and marched off grumpily, mumbling under his breath.

Shortly after, we heard him shout something unintelligible from behind the cubicle curtains, though it did include many expletives. He then rushed into reception to telephone a Doctor, telling him to attend immediately. It transpired that he had unceremoniously removed her right sock, probably presuming that she was wasting everyone’s time again. As he did so, most of the flesh of her foot came away with it, exposing some of the bones in her feet and toes. The gangrenous tissue had simply rotted away, becoming fused into the sock. It was amazing that she had managed to stand, let alone walk. Poor Betty was oblivious to all this. Lying flat on the bed in the cubicle, unable to feel any pain, she was bemused as to why everybody had started rushing about.

Our part of the job was now complete. We had to clear up the ambulance, and get ready for the next job. My colleague, who as the driver that night, was responsible for tidying and cleaning, took the trolley bed back to the entrance, and removed the carrying chair from its place, ready to clean off Betty’s fluids from it. He came and got me, telling me that there was something I needed to see. On the metal footplate of the chair, exactly where we had placed Betty’s feet during transport to the ambulance, was a row of neat and shiny toe buds. They had obviously protruded through the socks, and become attached to the cold metal, like the bizarre footprint of a fleshy spectre, the sight gave us both a shudder. Cleaning those off was not a pleasant task.

We never saw Betty again. Both her feet had to be amputated shortly after arrival at hospital, and due to ongoing circulation problems after that surgery, parts of her legs were also cut off. She remained in hospital until her death, not long after. I will never forget her, neither will my crew mate on that night. She was a nice lady, a salt-of-the-earth type, who blamed nobody for her problems, and got on with things as best as she could.

They don’t make them like that anymore.

 

Ambulance stories (2)

~ beetleypete ~ 22 Comments

Jimi Hendrix pubes

For those of you who do not know, Jimi Hendrix was a once-famous rock guitarist, who reached his height of popularity in the 1960’s. More information, and pictures, can be found at; http://www.jimihendrix.com For the purposes of this post, his hair is the only thing of interest. It was quite wild, usually in an Afro style, with a headband habitually worn around it. The reasons for this explanation will become apparent later.

Not all the interesting things that happen to you in the Ambulance Service happen as a result of 999 calls. It is a popular misconception that ambulances operate from specific hospitals, and are run by those same hospitals. This is not the case. In London, the whole area is covered by the London Ambulance NHS Trust, and the vehicles and crews are based on Ambulance Stations, at various points around the Capital. This means that they can go to any and all hospitals, usually choosing the nearest one to the incident, for convenience. In recent years, this has changed a lot, with specialisation, but at the time I am writing about (early 1980’s) an ambulance could go to almost any hospital, and as a rule, chose the nearest one to their own base. Where I worked, in the area between Notting Hill and Paddington, we tried, as often as possible, to use the small Casualty Department just off Ladbroke Grove. Our frequent arrivals here meant that we knew the staff well, and we were conversant with the layout of all the wards and departments. It was more or less a second home to us, where we could get the occasional cup of tea, meet up with other ambulance crews from different areas, and generally feel like part of the furniture.

This accepted familiarity also meant that we would help out, when we could. At that time, there was no computerised admission procedure, so we would fill out the name and details of the arriving patient in a large ledger book, like something Uriah Heep would have used in Dickens’ ‘David Copperfield’. These details were transferred to a smaller card, for the nurses and doctors to add comments to. If the staff were all busy, and we were at the reception window, we would also enter the details of people walking in off the street, as well as those of the person we had brought in.

One particularly busy night duty, there had been a lot of serious incidents. Added to the usual parade of unconscious drug users, violent drunks, and patients awaiting admission to the ward, it had all made for a difficult night for the staff. By the time things had quietened down a bit, around 4am, we arrived with instructions to take home a frail old lady, who had been waiting almost all day to return home after treatment earlier. The staff were having a well-earned tea break, when we entered their rest room to let them know we had arrived. After a brief discussion about keys, whether or not she had eaten, and what clothes and possessions she had, we heard the bell ring at the desk in reception. I told the staff to finish their tea, and that I would go and see what it was. In the small waiting room at the front, I saw a tall man, about 30 years old. He was of mixed race, with frizzy hair, and wearing a raincoat. He spoke politely, though he was obviously agitated, and asked if he could see a doctor immediately. I advised him that I would take a note of his details, fill in his card, and pass it to the nurse for assessment, and I began to do so. When I reached the section requesting a diagnosis, I asked why he had come to casualty at this late hour, and why he needed to see a doctor so urgently. “It’s my pubes”, he said, “they won’t stop growing”. This was uttered without a trace of sarcasm, and with complete sincerity, his face remaining severe and grave throughout, his expression one of concern, with furrowed brow. I thought at first that he must be mentally ill. I asked why he had not done anything about this condition previously, or seen his GP, instead of bothering a busy Casualty Department in the early hours. He was close to tears, telling me that his family doctor was of no help, and he could not be taken seriously, as it was not painful, or life-threatening. However, he told me, it was affecting his life in many aspects, and making him distressed, as well as depressed. I went back and told the staff. They were too tired to argue, and asked me to book him in, then someone would get round to seeing him eventually, and probably refer him to a psychiatrist.

We left, to take our old lady home, and had a bit of a chuckle about the ‘man with the pubes’. A couple of hours later, we had another job nearby, and had to go back to that same hospital. As soon as I dropped off my patient, I was met by an excited nurse, who ushered me into the rest room, hardly able to contain her giggling and obvious delight in something. ” You have got to have a look at that guy’s pubes” she hissed. She continued by telling me that she had never seen anything like it, in all her years of nursing. As the story unfolded, it turned out that they had brought the chap into a cubicle, deciding to have a quick look, before writing him off as a nutter. When he got undressed, he revealed a thatch of pubes, the like of which had never been seen before, by any of the staff. It was so amazing, that they were ringing other wards, so that their colleagues could get a look at the phenomenon. This man had been examined by more staff than if he had been at a private clinic, he must have thought that he had finally gone to the right place to get his problem sorted. Little did he know, that he was the subject of morbid curiosity, in the same way as John Merrick would have been displayed in Victorian times.

I was not going to miss out, that was for sure! I was given a white coat to cover my uniform, and I borrowed a stethoscope from a nurse. I would have to trust to luck that he did not remember me from earlier, or just presumed that I was one of the staff. I entered the cubicle with a flourish, barking in a loud voice, “good morning, what seems to be the problem?” He lifted the sheet, and raised his gown, no other explanation necessary. Luckily he was wearing underpants, though they were of the Y-Front type, so could hardly contain the veritable forest of pubic hair that greeted my gaze. From above the belly-button, extending down both thighs, almost to his knees, covering his genitalia to the point of invisibility, stood a four inch tall mat of hair, as frizzy as that on his head, and where the underpants intervened, sprouting like dark cauliflower florets, under some pressure. ” I cut it, and it just grows back like this really quickly” he told me, and I heard tiredness and resignation in his voice. ” Can you do anything about it please?”  “I will have to see” , I replied. Of course, what I did do, was to stifle my near hysterical laughter, then pass on my coat to the next in line to have a look, with the added inspiration, ” his pubes are like Jimi Hendrix’s hair, his pants even make the headband effect, you’ve got to see this!”

Sometimes, you just have to look on the lighter side.

Ambulance stories (Introduction)

~ beetleypete ~ 12 Comments

It has been suggested, by family and friends, that I should add some stories of my experiences in the London Ambulance Service. These may be amusing or diverting to some, perhaps informative to others. I have added a new category for these tales, although they will also be categorised ‘Nostalgia and Reflections, for obvious reasons.

As many of the subjects of these recollections will still be alive, as will many of their families, I shall be careful not to identify them too clearly. I will be changing real names, omitting surnames, and not including actual addresses. Please be assured, that no matter how fanciful or contrived these incidents may appear, they will all be 100% true, memory permitting.

In recent years, television programmes, both factual and fictional, have sought to portray the life of Ambulance Crews and Paramedics as exciting and vital. They are seen rushing from one emergency to another, sirens wailing, and blue lights flashing. In reality, much of the job is repetitive and mundane. Attending the same addresses constantly, picking up the same vagrants and street drinkers on a daily basis, and being used to transfer patients from one hospital to another, or to take them home after treatment. Even when you are given a call that sounds serious, or potentially exciting, it rarely turns out to be so.

Of course, there are many incidents that call for complete professionalism, and the use of all the skills taught and acquired. Cardiac Arrests, Cot Deaths, Major Incidents, ‘Jumpers’ under trains, delivering a baby at home; these are just a few that spring to mind. However, it must be remembered that these are the exceptions.

With this in mind, you will appreciate that it was necessary to have a rather black sense of humour, a strong stomach, a tolerance of swearing and bodily functions, and the ability to deal with people from all classes, all races, and of all ages. If you are easily offended by descriptions of human waste, delicate situations, or upset by the reality of disaster, please avoid these posts at all costs, as I do not intend to apologise later for any of the content.

I once saw an American A&E Consultant being interviewed on a documentary about Cook County Hospital, Chicago. He summed it up very well, with the following comment.

” I spend fifteen minutes of my time, in the worst day of the patient’s life, and I do it for 12 hours a day, every day.”