Ambulance Stories (50)

Nothing To See Here

When I started this blog, I used to post a lot of factual stories about events that occurred during my long time working on emergency ambulances in London. But over the years, other categories took precedence, and I began to wonder if there was much more to tell. After all, you can only relate so many tales; some tragic, others amusing, before it all starts to sound like more of the same. But I was thinking back to those days this morning, and this memory popped into my head.

A warm summer evening in west London, probably around 1995, maybe 1996, I don’t remember the exact date. I was on the late shift, starting at 3 pm, and finishing at 11. My regular partner was on holiday, and I arrived for work wondering who I would be crewed with that day. An awkward-looking young man appeared, tall and gangly, with an edgy and nervous demeanour. He asked if I was Pete, and told me he was working that shift with me. I hadn’t seen him before, and it transpired that he was a new guy, recently out of training school, and assigned to the divisional relief rota. He had what sounded like an Australian accent, but when I asked, he told me he was from New Zealand.

As we checked over the vehicle, he was keen to let me know that he was a very experienced first-aider in his home country. He had helped out in the voluntary services there for five years, before coming to live in England. He was quite scornful of our training and equipment, gabbling on about how much better things were in New Zealand, and how the volunteers there were more professional than the staff he had met in London. I could have taken him to task of course, but I had heard all that stuff before, and it was like water off a duck’s back to me. He asked to drive, so he could get to know the area. That meant I would have to spend all my time shouting directions to him, whilst looking after the patients in the back. But I said OK, telling myself that it was only one shift, and it would soon be over.

On the first couple of jobs that afternoon, he drove the ambulance like a maniac, at breakneck speed, stamping on the brakes, and shouting obscenities at drivers who were slow to move out of our way. I sat relaxed in the passenger seat. I had already decided that I was not going to like this bloke, and I wouldn’t give him the satisfaction of arguing with him about his driving. As the evening rush hour began, he hadn’t calmed down, and seemed to be trying to prove a point. I gazed out of the window, seemingly oblivious. Just before 6 pm, we received a call to attend a road traffic accident, not far from the base we operated out of. The radio operator added the words “Believed serious, possibly fatal” after giving us the location. That got him really fired up, and we arrived in record time.

The scene was one of carnage indeed. A woman and female child had been struck by a car as they ran across the road. The child wasn’t moving, and her mother was obviously badly injured too. To make matters worse the car had swerved after the accident and hit a traffic island. The driver wasn’t wearing a seat belt, and had impacted the window, and steering wheel. I jumped out, shouting to the New Zealander to call for another two ambulances, and to request the police and fire service too, all usual in such accidents. At the busy junction, and the height of the rush hour on a hot summer evening, there was naturally a large crowd of onlookers. Traffic was stopped, drivers out of their cars, and people hanging out of nearby windows to see what was going on.

The child, a girl of around ten, was fatally injured, with no vital signs. As well as a massive head injury, her neck appeared to be broken. Her mother had one badly fractured leg, with bones protruding, and she was also bleeding profusely from a head injury sustained when dragged along by the car. Fortunately, she was barely conscious, so unaware of what had happened to her daughter. A witness was telling me that the car hit the girl at some speed, and then ran over her mother, dragging her under the car until smashing into the concrete base of the traffic island below the sign. I put a blanket over the dead child, and proceeded to treat the head and leg injuries on her mother. I shouted to the new guy to check the driver of the car, who appeared to be a teenage boy. An overview of the scene would have looked dramatic indeed. A dead child, lying in a pool of blood, covered by a blanket. A badly injured woman, with a trail of blood, tyre marks, and road dirt leading to where she was lying, as well as a car crashed into a traffic sign, windscreen smashed, and the driver’s face covered in blood.

As I struggled with the woman’s injuries, I listened out for the sirens that would announce the arrival of some help. But there was a delay getting another ambulance, due to a shortage of crews, and the fire engine was having to come from some distance too, which I obviously didn’t know. A young police woman arrived, and I sent her to check the driver of the car, as I couldn’t see my colleague anywhere nearby.
Then, above the noise of the crowd, the passing trains, and the sounds of traffic I heard someone shouting. “NOTHING TO SEE HERE, MOVE AWAY NOW, NOTHING TO SEE HERE”. Recognising the accent, I twisted round, spotting the other ambulance man some fifty yards away, arms outstretched, and gesturing to the crowd gathered on the road. I heard him shout again, “NOTHING TO SEE HERE”, before yelling at him to get his arse back to the scene, and get on with looking after the driver.

Fortunately, two more ambulances arrived, along with the fire service. One crew dealt with taking the child away, and another stood by as the firemen cut the roof off the car, ready to extricate the driver. We could now leave, taking the mother to the nearby casualty department. As we were cleaning up later, I explained to my temporary partner that he should pay less attention to the crowds in future, and concentrate on looking after the patients who have a chance of surviving.

As we got back into the vehicle, I added, “And by the way, you were wrong. There was plenty to see”.

Ambulance Stories (48)


I have just seen a link posted by a good friend who still works in the London Ambulance Service. It is to a You Tube film, a documentary from 1974. It is a serious current affairs programme from the time, probably from the BBC. I don’t recall seeing it back then, but it was broadcast five years before I applied to join. Despite that, it is incredibly familiar. Many of those featured were well-known to me later on, and I worked with some of them on occasion. It was filmed in London and Yorkshire, but predominantly set in and around North Kensington Ambulance Station, where I worked for over twenty years.

By the time I was there, nothing had changed from how it is shown in the film. I wore the same uniform, used the same equipment, and probably even drove some of the same vehicles. The emergency calls shown in the film are all genuine, and the way they are dealt with is exactly as I would have dealt with them at the start of my career. The interior of the Ambulance station was the same, and the descriptions of laundering the blankets, washing the vehicles, and even cleaning the toilets, all too familiar.

Much of the film deals with the period of transition that the Ambulance Service was going through during the mid-1970s. Where the crews had once been competent drivers, trained only in basic First Aid, they were starting to get the first items of real life-saving equipment, and beginning to be trained to become the professional service we would soon see. They still had employment issues and were receiving pitifully low pay, and these problems were causing dissent, which resulted in strike action. The film is very much on their side, showing them as ordinary people; caring individuals doing their best in the situations they encountered. It is also a wonderful fifty-minute snapshot of England in the 1970s, and makes forty-one years ago seem more like seventy. Hard to believe now, but wonderful to behold.

The uniforms have changed, the vehicles and equipment are different, and the training is in another league. But the job is still the job, and that Ambulance Station is still there, as busy as ever.

Here’s the link. If you know anyone who ever worked in any Ambulance Service, or if they are just interested in fascinating social history, please share it.

Ambulance Stories (45)

Drunk, or Diabetic?

At the time I joined the Ambulance Service in London, equipment and diagnostics were still fairly basic. We didn’t have defibrillators until later, and blood pressure had to be taken manually, with a stethoscope and wrap-around cuff. There was nothing to take a temperature with, and drug administration was restricted to the gases Oxygen and Entonox. It was to be some years before we progressed to things like blood sugar testing kits, pulse oximeters, and intravenous drugs. As as consequence, I once made a major mistake, and this the first time I have ‘gone public’ with it. Fortunately, it did not have any serious effects on the patient, or on my reputation.

When a person is affected by low blood sugar, the symptoms can vary, depending on the severity, or the individual. Some patients can quickly realise that they are about to experience problems, and can counter this by eating or drinking something sweet. This will give them a temporary respite, and allow them to seek medical help, or manage the problem themselves. Our main treatment of known Diabetics back then was to get some sugary fluid, or even powdered sugar, into their system as soon as possible, to help them recover enough to take them to hospital. If this failed, we had to move them on stretchers, unconscious, or semi-conscious, and convey them to the nearest casualty department. This worked reasonably well, if you knew the medical history of the person concerned. In their home, or perhaps that of a friend or relative, there was normally someone else to give you the patient’s history of Diabetes. On the street, or in public places like stations, you might discover a ‘medic-alert’ bracelet or neck-chain being worn. This distinctive item of jewellery opens up to give you the necessary information to confirm a diagnosis, and you can act accordingly. There are other situations where none of this information is available, and where the patient is not necessarily presenting with recognisable symptoms.

On one occasion, we had started a night shift at 22.00. After going straight out to do a transfer from one hospital to another, the next job was given as ‘a male in a collapsed state’. The address was outside a pub, and it was almost an hour after closing time. It is fair to say that we went off to this job expecting to find a drunk lying in the street, having had too much to drink in that very pub. As we arrived, we were directed by bystanders to a man rolling around the pavement, in an alleyway beside the building. He was shouting incoherently, and he appeared to have urinated in his trousers. When we approached him, he swung his arms at us, and kicked out violently. He continued to shout and swear, though it was hard to make out anything he was saying. Trying to make some examination of him was difficult. He looked to be in his early forties, and although he was reasonably smartly dressed, his clothes were filthy, from contact with the ground. He stared at us aggressively, and opened his eyes wide. He was spitting and slurring, and kept lashing out at us with his feet. We decided that it wasn’t worth the trouble of getting too close, and having to end up in a fight with this man. So we called the Police.

At that time, it was perfectly acceptable for the Police to remove someone who was being violent to an ambulance crew. Anyone refusing to cooperate with us was fair game, and very likely to be arrested. When the local van turned up some ten minutes later, the two officers tried to reason with the man, and to get him to stand up. He refused to assist them, and eventually managed to kick one of them in the leg. He was arrested for being drunk and disorderly, and for assaulting a Police Officer. They dragged him into the back of their van, and handcuffed him. We considered ourselves lucky to have passed him onto them, and continued with our shift. After a busy night of constant calls, we finally managed to get back to the base at about 04.30. I was just about to make some coffee, when the emergency phone went, and we received another job. This time, it was to the cells at Notting Hill Police Station. Apparently, they had an ‘unrousable male’ detained there, and they had called out the Police Surgeon (an on-call doctor) to examine him.

Of course, it was the man from earlier on, the aggressive drunken male, who had been collapsed outside the pub. The Police Doctor had determined that he was almost certainly in a diabetic coma, having been able to take a reading of his blood sugar. Occasionally, the symptoms of  diabetic coma are very similar to drunkenness. Slurred speech, incoherent phrases, disorientation, and violent behaviour. This man was very unwell. He had not been drinking at all, and it turned out that he had been on his way to work on a night shift in a local factory, when he happened to collapse outside the pub. The doctor had no idea that we had previously attended him. The Police had said nothing, save the fact that he had been arrested as a suspected drunk. We took him off to hospital in Paddington, where he was given glucose via an intravenous drip, and soon made a full recovery. He remembered nothing of the original incident, or of being detained in a police cell. Chatting to staff in the early hours, we managed to get the full history of his case.

Nobody had mentioned us, or what served as our neglect of this diabetic patient. Some time after, Police would no longer take drunks in charge, in case underlying causes of illness surfaced later. We also received instructions to treat all ‘drunks’ as potentially unwell from other causes, and the hospitals had to cope with a sudden influx of drink-related problems. I learned a valuable lesson. Look beyond what you perceive to be obvious. Diabetes was and still is a massive problem, and the symptoms of coma are so easily confused with other problems, like being drunk, or a stroke. I escaped serious consequences that night, and fortunately, so did our unlucky patient. I didn’t repeat that mistake, during my remaining years in the job.

Ambulance Stories (44)

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 (43)

The Wimpy Bar Bomb

On the 26th October, 1981, we received a call to go to a standby point, known as an RVP. (Rendezvous point) There was an incident taking place in Central London, and there might be a need for an ambulance. We were told that it was a ‘suspect package’, possibly a bomb. This was not that unusual at the time, as the IRA were bombing the mainland on a regular basis back then; at least they had been during the 1970’s, though there had been a lull during 1980. Sixteen days earlier, there had been a bomb outside Chelsea Barracks that had killed two people, and injured around forty more. When we arrived at our RVP, at the Marble Arch end of Oxford Street, a policeman confirmed that it was an explosive device, and that it was in the basement of one of the Wimpy Bars.

For those of you unfamiliar with the layout of London, Oxford Street is the main shopping area of the city. It runs for a considerable distance from East to West, with the landmarks of Marble Arch at the western end, and Centre Point ( a tall office block), at the eastern. Just over halfway along its length, is the major junction called Oxford Circus. All the major stores are nearby, or on the street itself, (except Harrods) with branches of most high street retailers, as well as huge department stores, like John Lewis, and Selfridges. Closing this street, for any reason, causes traffic and pedestrian chaos over most of the area of London known as the ‘West End’. In 1981, there were two branches of the Wimpy Bar chain on this street. It was a popular burger restaurant, and existed in the UK long before Burger King, or MacDonald’s.

We were soon informed that the branch nearest to us was not the one targeted. The restaurant where the bomb had been planted, in the basement toilets, was at the other end, so out of sight from our position. The Police asked us to stay anyway, ‘just in case’, and we took our place with various other emergency vehicles, from the Fire Service, as well as the Police. It was then a case of ‘hurry up and wait’. We had got used to these alerts, and they often turned out to be false alarms. Cases left by forgetful tourists, shoppers’ bags overlooked in a rush, or parcels placed in inappropriate spots. I wouldn’t say that we were blase, just used to it, and unexcited by the prospect of sitting there, staring down the now deserted shopping area. Chatting to nearby policemen, we were told that the Metropolitan Police Bomb Disposal officers were dealing with a device that was confirmed to be a deliberately planted bomb. This made us sit up, and keep an eye out. It was not unknown for secondary devices to be planted, or detonated, once there had been a gathering of the emergency services to deal with the first one.

We had already checked our equipment that day, but we went over all of it again, to make sure we had anything to hand, that we might need in a hurry. Even though we were some distance from the location, we had no idea how large it was, and what devastation might be caused, if it went off. Getting back into the front of the vehicle, I was sure that I heard a loud ‘thump’ from somewhere, and my colleague confirmed that he had also heard it. Moments later, we could see dust swirling around in the distance, and what appeared to be smoke, a long way off. I asked the nearest policeman if we should go and check the area, but he told us to wait, as they were unsure about other devices.

What seemed a long time later, we were told by a senior police officer that we could leave. He thanked us for attending, but said that we would not be needed. I presumed that the bomb disposal officer had got out, and remotely detonated the thing. That was not the case. The sombre looking policeman told me that the officer had been killed, as he tried to defuse the bomb, in a ‘massive explosion’ that had killed him instantly. ‘We won’t need an ambulance’, he told me, ‘it’s a crime scene, a coroner’s job’. We left the scene, feeling very bad about what had happened in that elusive cloud of dust and smoke.

Kenneth Howarth was 49 years old, and married with two children. After serving as a bomb disposal officer in the British Army, he joined the Metropolitan Police, as a civilian explosives officer, in 1973. He went into that basement on his own that day, and paid the ultimate price for his dedication and service. In 1983, he was posthumously awarded the George Medal, one of the highest honours for gallantry that can be bestowed on a civilian.

I think of that day often, and of the lonely death of a brave man.

Ambulance stories (42)

Part of The Union

When I joined the Ambulance Service, there was a closed shop agreement in place with the unions, making membership of one compulsory. I did not have a problem with this, as I was a supporter of unions, and aware of the struggles over the years to get proper recognition for workers, decent conditions, and fair hours of work. Even though the power of some unions had been attacked in the press, particularly those operating in the newspaper and car industries, I saw nothing wrong with workers flexing their industrial muscles, and getting ever better agreements.

At the time, the Ambulance workers were represented by no less than five different unions. This was a hangover from the time when local councils had been in charge, leaving staff belonging to unions no longer really appropriate, such as the General, Municipal, and Boilermakers Union (GMB). There was some membership of the Transport and General Workers Union (TGWU), then the largest in the country, though most staff belonged to one of the health service unions, like The Confederation of Health Service Employees, (COHSE) or the National Union of Public Employees (NUPE). All the unions had agreed local representation, as well as combining membership on committees. The setup was simple enough; each ambulance station had a shop steward, each area two convenors, elected by those stewards. Meetings took place with management either locally, or at head office level, with the convenors from each area. Various committees dealt with uniforms, vehicles and equipment, and other issues considered important enough. Representatives from both staff side and management would sit on these committees, at various dates throughout the year. Local agreements were discussed by the convenors, and national deals, like basic pay, would be handled at higher levels, by the full-time officers of the various unions.

This system had existed for some time, prior to my arrival on the scene. There was also a generally accepted local agreement that each union would be represented on a geographical basis. This meant that depending on where you were posted, you joined the union most represented in that district. In the South-West London area that I first worked in, this would be COHSE.  Had I been posted to East London, I would have been expected to join GMB, and so on. During our training period, we were sent to spend a few days as observers at our local ambulance station. During my time there, I applied to join COHSE. This meant that I returned to the training school, as the only trainee (at the time) to already be in a union. This caused some irritation to the training officers, who felt that my action was premature. I was marked as a  potential ‘barrack room lawyer’, and someone possibly politically motivated, before I had even passed the course.

Because of the sheer size of London, the different divisions that we were split into had a tendency to run slightly differently. Local agreements were tenaciously clung to, and any new ideas considered to be borderline revolution; and that was by the staff! Most shop stewards had been in place for as long as anyone could remember, and were rarely opposed at election time. They had a tendency to be ‘cosy’ with management, at least on a local level, and to tell their members what was going to happen, rather than asking for opinions, or debating anything. I was part of a huge new intake of staff at that time, and we came from a very different background to many of our longer-serving colleagues. They had come into the job from the armed forces, the local councils, and even the old civil defence associations. We had NHS contracts, and a view that it was a medical job, more in tune with the Health Service, and the increasing trend for better training, involving greater skill on our part. The days when someone was plonked in the back on a stretcher, and the crew both got into the front, were long gone. We now all had to drive, and I was amazed that some staff still had ‘non-driving’ contracts, harping back to a time when they were employed as either a driver or attendant, and not expected to be able to do both.

The predictable result of these changes, was an ‘us and them’ attitude, which could be seen in the resentment of some older staff. They did not include you in simple things, like when tea was made. They would not give you directions when you were in an unfamiliar area, saying things like, ‘there’s a map book, look it up’. They refused to intervene if you were doing something stupid, when you didn’t have the experience to see an obvious mistake. Some would not even speak to you, other than to give the most basic instructions; and if you returned to base, they would sit in another room, and ignore you. The only way to overcome this, was to have a very thick skin, and to grin and bear it, until you had completed your one year as an ‘unqualified’ ambulance person. When this was over, you were presented with cloth badges to sew onto your uniforms, known as the ‘Millar Badge’, and you received a certificate, stating that you were qualified. This simple patch was a prized possession, as it signified that you had finally arrived, and were the same as everyone else. During my time in South-West London, I was involved in one small industrial dispute. The shop steward told me that we were on strike, and that I would not be going into work that day, and probably not the next day, either. When I asked what it was about, he was vague, and didn’t really give me a firm answer, other than it involved ‘conditions’. I was not going to cross a picket line, so I joined it. We stayed this way for three days, then we were told that we could go back to work, as the dispute had been resolved. I made my own resolution, that I would want more information next time, and would not be so easily led.

During this brief local dispute, I had my first taste of something that I didn’t like the look of, and that was to reappear later in my life too. Standing outside the ambulance station, a novice picket, unsure of why I was there, I saw ambulances passing along the main road. I asked who they were, as all our local units were solid in the strike. I was informed that they were vehicles operated by the St John Ambulance Brigade, and the Red Cross. It seemed that these volunteer first-aiders would happily take time off from their regular jobs, to do our job for nothing, any time we had a dispute, or larger strike. It was as if I had taken a week’s holiday to work down a mine, when miners were striking. I was appalled by this at the time, and for what it’s worth, I still am. I was never to view them in the same way again in my life, and even today, I have difficulty being civil to them, if I chance to encounter any. In a strange twist to this tale, I also met many LAS staff later, who were actually in these organisations, seemingly oblivious to the dilemma this presented.  I hardly spoke to them, either.

This event had put fire in my belly as far as the unions were concerned, and I decided that we needed to change things. I transferred to the small ambulance station in West London, where I would stay for the rest of my career, and set about investigating the existing arrangements in that area. Our station steward, known as the ‘rep’, was a likeable man, who had been in the job for some time. He lived locally, seemed to know everyone, and he had a good reputation with the staff. I got on well with him from the outset, and I am pleased to still call him a friend today. Despite the politics associated with union activities generally, virtually nobody was actually in a political party, or remotely active in mainstream politics. Many of the crews had no interest in politics at all, and like most men (there were few women then), discussed football, mortgages, and cars. I was in a political party, the Labour Party, and had been for a few years. Before this, I had been a Communist, though young enough not to become too involved. I saw the unions as intertwined with the political parties, and felt that they should have held a fierce left-wing stance, and must be active against any attempts to undermine their members. As far as the Ambulance Service was concerned, this was far from being the case.

Trades Unions had gone through a period when they had been lampooned, on TV, and in the cinema. Films like ‘I’m alright Jack’, and TV sitcoms such as ‘The Rag Trade’, had left the public with a view of union officials as belligerent, obstructive buffoons, and inane catchphrases such as ‘one out, all out’, or ‘everybody out’, seemed to typify union activity in the workplace. This was not the case in the LAS. Pay was low, and strikes meant loss of pay. So, it was never a decision taken lightly, to withdraw labour. Not only that, we also had to contend with a hostile press, portraying us as little better than murderers, removing the emergency ambulances from the streets, with all that entailed. The Ambulance Service was not a car factory, halting exports, or a newspaper company, unable to get out an evening edition. The consequence of any strike action by us, brought with it the real possibility that people might suffer as a result. This did not escape us, so we all took it very seriously.

I was occasionally asked to stand in for the steward, when he was indisposed, or unable to attend meetings. Not long after this, he was diagnosed with Diabetes, and had quite a long time off sick. I stepped in to the role, taking to it like a duck to water. Much later, he was told that his type-one diabetes would stop him from working effectively, and I became the full-time steward, with the agreement of  all the staff. My first job, was to fight the forced retirement of my predecessor, and I took it on as forcefully as I was able. Much to my surprise, his (and my) union, COHSE, declined to offer support, stating that they agreed that ‘disabled’ staff should not work on emergency duties.  Months of trying. backed by numerous medical reports, did not dissuade either management or union, and he was pensioned off medically, at a ridiculously young age. I was so incensed at the behaviour of COHSE, that I resigned, and joined the TGWU. So, I was the steward, and in a union with little representation in the LAS. Fortunately, this did not matter. Later that year. I was re-elected, unopposed, and began my long career, beside my actual career, as a Trade Union rep.

My attitude, from the start, was belligerent, to say the least. I would seize on any issue, and take it as far as I could. Representing staff accused of disciplinary issues, I would cite management failings, and well-known incidents of local corruption too. This was not considered to be ‘playing fair’, so they soon had some idea of how I was going to work. I was as obnoxious as could be, and as militant as I could manage, given my ‘back-up’. I was called a ‘Red’, a ‘Commie’, and the old favourite, ‘barrack room lawyer’, more times than I can recall. I lived and died union militancy, it was meat and drink to me. If all else failed, I would resort to actual threats. My South London background was well-known, and I was suspected (wrongly) of association with criminal gangs. I used this to advantage, and would say to managers ‘I know where you live’, or ‘watch out your house doesn’t burn down’, I had no scruples, when it came to representing staff over management; it wasn’t a moral issue for me. However, my main problems were with my colleagues; those on the local area committees, and the convenors. They fell into two groups. One of these was militant enough, though allied to the Socialist Workers’ Party. I had no truck with these modernist Trotskyites, and let them know that. The other, larger group, was the middle of the road, working with management types. I despised them, as little better than collaborators, and let them know how I felt also. So, I was almost alone, a hard-liner in a world of other views, determined to get the very best for my members.

My other adversaries, were the unions themselves, represented by the full-time officers responsible for Ambulance issues. Those people, all men at that time, had little understanding of our job, and had never actually done it. Every time we forced an issue, they quivered in fear of government action, and possible sequestration of their funds. They were only worried about wider issues, and were hamstrung by their association with the Labour Party, always asking them for direction, or instruction. They saw strikes as potential PR disasters, and they similarly regarded local issues as things that might escalate, and give them bad press. As a result, I sought other areas to promote our cause, and joined a fledgling group, the Association of Professional Ambulance Personnel. This was a ‘pure’ Ambulance union, run by staff, and only having existing Ambulance Personnel as members, nationwide. I got many of the LAS staff to join, and took off to their annual conference, hoping that I had found the solution to our problems. I was wrong of course. They wanted no changes, nothing to upset the existing situation. All they sought, was professional qualification and recognition, and they were essentially anti-union, and run by right-wingers. They did not want Bolshie Londoners in their ranks, and were running scared at the possible power our large membership might bring.

So, it was back to the TGWU, and the everyday struggles. We were constantly at loggerheads with Ambulance Control, as well as our local management. The issues ranged from insufficient breaks,  refusal of annual leave, and inappropriate use of resources, (sending the wrong ambulance station)  to inadequate uniforms, and deficiencies in equipment. It may seem to the outsider, that it all runs like clockwork, but I can assure you, this is far from the case. Staff were working unsocial hours, at a fraction of the normal wage, and being treated unfairly. One of the biggest issues, was refusal of annual leave. It was all but impossible to get occasional shifts off, to attend weddings, or other unscheduled events. When you worked four weekends out of seven, it was stressful enough, let alone being refused leave that you were actually entitled to. As well as doing the same job as everyone else, the union work was beginning to take its toll, and I had a short break from being the rep.

Someone we all knew transferred in from another area. He was a famous union man, and I was happy to hand over the reins to him. This did not last long, as he was soon elected to convenor, and I went back to being steward. I also became his crew-mate, leading to the unusual situation of two union reps working together; one the steward, the other a convenor. This did not go unnoticed by management, or by Ambulance Control. They quickly ensured that we worked twice as hard as any other crew in the area, as well as making sure that we got off late, and had more than our fair share of ‘unpleasant’ jobs. We took it on the chin, realising that we had to be seen to be better than any other crew, and to not do anything wrong, for fear of victimisation. They soon found someone to complain about us, and with the most spurious of allegations, tried to get us sanctioned in the local Coroner’s Court. Luckily, the Coroner saw through them, but the stress was unbearable for my colleague, who eventually left the job, and went to live in Ireland.

I could see the writing on the wall. I was getting nowhere fast, and my colleagues were constantly asking me ‘what is the union doing about this, or that?’ My answer was,’you are the union, so what are you prepared to do?’ I was working with people, at the height of Thatcher’s excesses, who were voting Conservative. I couldn’t see the point of going on. I arranged for an election, and someone else became, reluctantly, the new steward. It was on the proviso that I would be there, to help and advise them. But I had a much-needed rest, after almost seven years in the role. Just around the corner, was the National Ambulance Strike of 1989, the worst dispute ever known in that job.

That is another post though, for a different time.

Ambulance stories (41)

Tuesday, 5th October, 1999.

I doubt many of you will remember that far back, but this was a bright and sunny day, though it was not very warm. I was on day shifts that week, the time when the rota arrived at a five-shift, Monday to Friday week, with hours of duty from 0800-1600. This meant that we were the third ambulance available at the small sub-station where I worked, just under the Westway flyover, behind Ladbroke Grove underground station.

As usual, the other two vehicles, that had started at 7am, were already out; it was a busy area, after all. We had arrived about twenty minutes early, allowing time to get changed, and have a cup of tea, before spending the day out and about in the vehicle. By 8am, we were checking the ambulance, making sure that we had enough equipment, sufficient fuel, and plenty of oxygen, ready for the day to come. I was to be the attendant that day, and my long-term partner would be driving. Not long after 8am, the emergency phone rang, indicating a message from Ambulance Control. I went to answer, expecting it to be a routine enquiry about the vehicle being in commission, which normally happened around this time. It was a job though, given to me as; ‘female fainted, Sainsbury’s car park, Ladbroke Grove.’ I went outside to tell my colleague, and he drove the vehicle out, as I operated the electric closure for the large doors. This location was very near to us, probably less than half a mile away.  We had not driven more than a few yards, when the radio button bleeped, and our call-sign was repeated, with some urgency. ‘The job has been updated, believed to be a large fire, possible train crash, please advise us on arrival’, was the new message.

As we turned right into St Mark’s Road, we could immediately see a pillar of smoke rising high into the sky, just at the far end. I had seen many fires, and some explosions, but I had never witnessed such a sight before. Ahead of us, fire engines were negotiating the small roundabout, sirens blaring, and we tagged on behind them. They headed straight for Barlby Road, which is across the tracks from Sainsbury’s, and was home to the grandly named ‘Northpole International Terminal’, where the new Eurostar Trains were often parked, and not far from Northpole Road, which had given it its name. We followed the appliances into a small service road, until we came to a large fence. The firemen jumped out, cut through the fence and nearby gate, and we followed them in.

I do not recall ever seeing a train up close, when it was not alongside a platform. The one I was now standing next to, was enormous, an Inter-City locomotive, that in my perception, seemed to facing the ‘wrong way’. Of immediate importance, was the fact that the engine compartment, and the large carriage behind, were blazing fiercely, flames and smoke ascending into the sky. The heat was incredible, and I immediately discarded my uniform anorak, for fear it would melt. Despite this, we saw a fireman place a ladder against the train, so he could climb up into the driver’s cabin, which seemed ridiculously high, from our viewpoint. We followed, and when we saw that the driver was dead, or at least beyond any help we could give, we went back down, away from the dangerously close flames, to look for other casualties. We had already requested all other available ambulances, and as first on scene, we had declared this to be a ‘major incident’. At that time, we had no idea how major it would turn out to be.

There is a protocol for this type of job. The first attendant becomes ‘incident officer’, until relieved. Casualties are not treated immediately, but are tagged with tie-on labels, indicating the severity of the injury. The most severe are tagged ‘Dead, or will die’, and are not treated at all. Walking wounded, and those able to assist others, are directed to a safe holding area, where they are immediately assessed, and placed into categories for removal to hospital. In theory, this is fine. On exercises, when nobody is actually dead, and all resources already in place, it is also fine. In reality, it is a living nightmare, where all preconceptions go out the window, and the human desire to help takes over. But we were experienced men, and we knew that we had to step up, and do the right thing. We were not about to wilt under pressure, as we had been to many serious incidents before, and we could remember how well we had coped previously.

But they had never been like this, and we had never been the only ones there.

I found an area of reasonable size, away from any danger, and began to place equipment there, also removing both trolley beds, and all other stretchers from the vehicle, to lay people on. I arranged the available blankets, oxygen and masks, burns dressings and bandages, and tie-on labels, ready for the anticipated large number of casualties. My colleague grabbed his equipment box, and a portable oxygen cylinder, and headed off towards the tracks, to see what he could do. I did not see him again, for almost five hours.

By now, we could clearly see that two trains were involved, the large Inter City train dwarfing what was left of a small commuter shuttle. Carriages and wreckage were everywhere, spread over the large terminal area, where large numbers of tracks met, on the eventual approach into Paddington Station, the main terminus for West London. There were small and large fires, with some carriages completely consumed by fierce blazes. Across Barlby Road, there was a small school, and the caretaker approached me, saying that he would open it, to use as a holding area for the emergency services. In the distance, we could see the car park wall of the large supermarket, and long ladders were being placed, to allow access from that side of the tracks. Transport Police had arrived, as well as many more fire engines, and heavy rescue appliances. Looking to my left, away from the main area of carnage, I saw a tall man wandering along the tracks in my direction. He looked dazed, and although smartly dressed, was in a filthy state. I thought at first that he was wearing a hat, and it had slipped off his head, resting on his left shoulder. I ran up to him, soon realising that this ‘hat’ was actually his scalp, and it had been torn off in the accident, barely still attached to his head. I sat him down, and bandaged his head, also giving him oxygen, as the black marks around his mouth indicated that he had probably inhaled smoke.

Behind him, I saw the terrifying spectacle of a crowd of people walking slowly towards me. They were all smoke-blackened, confused and shambling, and many had skin hanging from their limbs, burned off in the fierce fires. There was no screaming, nobody was hysterical or crying, and there was surprisingly little noise, other than the crackling of the flames. It was like a scene from a horror film, except that this was real.

Then help arrived.

Everything that had happened up to now, had lasted less than twenty minutes. It had already seemed like twenty hours to me. Ambulance crews from Fulham and St John’s Wood arrived, closely followed by many more. Within an hour, most of the available ambulances in the central area would be committed, as well as many from the Outer London areas, served by County Ambulance Services. I handed over my injured man, and showed the crews to the others that had already walked up to me. Most of the staff left immediately, to make their way into the wreckage, and help those unable to move. I stayed with a small group, that I nominated to run this small casualty clearing area, with the help of the local Police. Serious cases began to arrive, brought by stretcher. Assessments were made, labels tied on, and three distinct groups of patients began to form. There were those requiring immediate removal, to one of four nominated hospitals, and others who could receive intermediate treatment, and then wait at the school opposite. The third group were made as comfortable as possible, as they were not going anywhere. We were soon running out of the liquid covered burns dressings, and extra supplies of everything were on their way, from the main depot stations on the outskirts of London. The ambulances were in a long queue, like taxis on a rank, waiting to be called forward, to collect patients.

Then management arrived.

The London Ambulance service had no shortage of senior operational managers; from local supervisors, to Training School instructors, up to Divisional Commanders. They now arrived on scene, and taking a briefing from me, as first attendant, they took control of the incident. I was now superfluous. There were dozens of staff helping the injured, and the receiving station was working well. Things were getting into gear. The Transport Police were even setting up tents, and had already got a counsellor in attendance, for anyone who needed her.

The Ambulance Service had emptied its Training School of its classes, and brought the shocked trainees, in their pristine uniforms, along to the scene to help. I looked for something useful to do, and found a Fire Brigade officer nearby. He asked me if I had anything white, to use as markers. I got some pillowcases, and other things, like bandage tapes, and followed him towards the wrecked trains. He carried a small hand extinguisher, which he used occasionally, to put out some burning object. These objects turned out to be bodies, bits of bodies, and even tiny fragments of bodies. I marked each tragic pile with a piece of white cloth. They would all have to be collected, for later identification. I had seen and done a fair bit that morning, but that was definitely the worst, and I was glad when we completed this sad task.

By now, the only area not managed, was the traffic problem caused by the endless fleets of emergency vehicles, all trying to get access to the area. I decided that I would see if I could help with this. This would also give me a break from the unpleasantness around the tracks, and the chance to have a cigarette too. Walking the short distance uphill to Ladbroke Grove, I saw for the first time, just how huge this incident had become. The normally busy main road was closed to all but emergency traffic. There were helicopters above, and as far as the eye could see, a long line of waiting ambulances stretched southwards, almost as far as Notting Hill Gate, a mile away. I had never seen anything like it. There were vehicles from Bedfordshire, Berkshire, Hertfordshire, and Essex; also London Ambulance vehicles from across the other side of the city, marked by their divisional colour patches. I also saw the equipment tenders, bringing the supplies from as far away as Ilford. Using my radio, I contacted staff at the casualty clearing area, and slowly began to send vehicles individually down to collect patients, but only as they were ready to travel, thus avoiding the previous congestion. I bumped into many old friends and colleagues in these extra vehicles; some I had not seen for years.

I don’t really remember how long I was there, but it seemed like an age to me. I was eventually summoned by radio, to return to Barlby Road. The majority of the injured had been removed, and as far as evacuation was concerned, things were quietening down. I was directed to a parked car, where I saw my crew-mate, sitting on the pavement. He was absolutely exhausted, and completely traumatised by the whole thing, as he had not stopped working at the scene for almost five hours. He seemed to be on the verge of a breakdown, so I got him into a staff car, and we went back to our base. By the time we arrived, it was almost 2pm, six hours since we had left, expecting to go to a lady who had fainted in Sainsbury’s car park. She had indeed fainted. It was as a result of seeing this train crash happen, as she parked her car against the far wall. I never did find out what happened to her.

We were taken to Fulham Ambulance Station, to participate in a debrief on the incident. The place was in a state of upheaval. Equipment and empty ambulances were everywhere, with trainees and Training Officers attempting to reassemble vehicles into operational order. Hundreds of items of kit were missing, even large trolley beds could not be located. Four hospitals would have to be scoured for these items, as well as the scene of the accident, eventually. In recognition of the work we had done that day, by being first on scene, we were given time off, and also referred to counselling, some time later. My colleague never really got over the horrors of it all, and later transferred to Yorkshire, hoping for a quieter life, working for the Ambulance Service there. He is still there to this day, but it is not really any more peaceful. I declined counselling, suspicious that they would use any information to get rid of me. As a well-known Union agitator, I was always conscious of not giving them the rope to hang me.

Some time afterwards, along with Fire Officers, Police Officers, and others, we were presented to The Queen, in the new Community Centre, in Barlby Road. This was supposed to be an honour, but for me, as a confirmed anti-Royalist, it was just a day off. We were given brand new uniforms to wear for the occasion, then we were told to hand them back afterwards. I declined to do this, but it shows the sort of people that we were working for then.

To this day, this remains as one of the worst ever rail disasters in British history, and the worst ever on the Western Main Line. Thirty one people died in the crash, and and 258 were injured, many seriously. Some will carry the scars of their burns or injuries for the rest of their lives. All will live with the mental scars; the victims, and those who did their best to help them on that day.

Ambulance stories (40)

The incontinent old lady.

Incontinence is a curse for the elderly. Whether it is incontinence of urine, or faeces, it is uncomfortable, embarrassing, and often painful. It is very common of course, so no surprise to discover someone suffering from it, when you work in health care. There are many causes of this condition, and though some are minor, and easily treated, others may require surgery, and even be life-threatening. Doctors called to elderly people at home, will often send them into hospital, for a diagnostic referral by a surgeon, or further investigations; perhaps scans, or barium x-rays.

One day shift, we were called to the home of an elderly lady, in the Shepherd’s Bush area of West London. She had been experiencing stomach pains, and some incontinence of faeces for a few weeks, and had finally called in her G.P. He suspected that she might have an obstruction in the intestines, and arranged for an ambulance to take her to the nearby hospital, leaving a letter behind with a home carer, and asking us to attend within an hour, as a non-emergency. At the time, I was comparatively new in the job, though on that day, I was working with one of the most experienced men in the area.

Entering the house, it was obvious that this was the home of someone who found it difficult to cope. The whole place looked shabby, and felt unloved; many years had passed since any improvements had been attempted, and the carpets appeared to be approaching their first century. As was often the case, the elderly resident, in her mid 80’s, lived in just one room of this three bedroom house, never venturing outside of the small parlour that had become her entire world. She spent all her time on a single bed under the window, with a commode chair nearby for convenience. An ancient dressing table dominated the opposite wall, with a small, dusty television resting precariously on its edge. What clothes she ever intended to wear again, were on hangers behind the door, and a small bedside table was groaning under the weight of the assembled medications. It was unlikely that the window had been opened for years, and the carer was only tasked to give the lady a cursory wash, and prepare a small meal, before leaving the unfortunate woman to a long, lonely night. So, no housework was ever done, no clothes washed or ironed, and the lady had to fend for herself, as best as she could, for most of the time.

Approaching the bed, I could see that the patient was a tiny lady, no more than four and a half feet in height. Her once larger frame had been reduced, by years of poor nutrition, lack of exercise, and osteoporosis compressing her bones. Her lank white hair had been brushed until she concluded it was acceptably smart, and she was wearing a clean nightie, at least the cleanest she had available. Her skeletal fingers clutched the doctor’s letter, which she was determined to hand to us herself. I knelt by the bed, smiling and chatting to her, soon realising that she was also very deaf, so had little idea what I was on about. My colleague left, to fetch a small stretcher from the ambulance, and I explained, very loudly, what we were going to do. Once she had handed over the letter, she was happy to place herself in our hands, and the carer also left, to go to help others on her ever-growing list.

When my partner returned with the stretcher, he had to place it outside, as access to the room was impossible. I advised him that I would just pick the lady up from the bed, and bring her to him. After all, she was incredibly light, and small enough to allow me to make the turn at the door. He said that we should wrap her in a blanket first, then use a two-man lift as normal. I thought that he was adding unnecessary work, and repeated that I would just pick her up. As she was not wearing underwear, I pulled down her nightie for modesty purposes, and placed one arm under her legs behind the knees, and the other around her back, and under her left arm. She was as light as I had suspected, and no harder to lift than a child.  I gathered her up into my arms, and turned from the bed towards the door. I noticed that my fellow crewman had retreated into the hallway, and I presumed that this was to allow me room to place her onto the folding chair. My presumption was incorrect, it was years of experience that had prompted his move.

As I hefted her higher, for her legs to clear the door frame, she gave a small cry, and a fountain of diarrhoea exploded from her bottom. This came out with the pressure of a garden hose, and was watery in consistency, like a hot chocolate drink. It was everywhere, splashing between her body and mine, and continuing to pump out, seemingly from a limitless source. I could not put her down on the floor, and I had no time to return her to the bed. I just had to stand still, until the episode subsided. When I eventually got her onto the folding chair, conscious of the uncontrollable laughter of my colleague, I was covered from breastbone to knees in the foul liquid; it had got inside my trousers, and emanated a terrible stench. The lady apologised profusely. She had been unaware of any desire to go to the toilet, and blamed it on being ‘pulled about’. I could find little to help me in her sparse kitchen, and had to make do with using paper towels in the ambulance, to clean up as best as I could.

I had to spend almost the next hour in this awful state, as we drove her to hospital, then handed her over to the nurses, who were all hysterical with laughter at my condition. I eventually got back and showered; I had to change all my uniform, and complete the last part of the shift without underwear. But I did learn a valuable lesson.

When someone a lot more experienced suggests that you do something his way, take that advice.

Ambulance stories (39)

The new green overalls.

Not long after the National Ambulance Strike, the London Ambulance Service decided to introduce a new style of uniform for all operational staff. Despite protests from most of us, they settled on a one-piece overall, in a lime green colour. To an outsider, this may have seemed a sensible idea, driven by practicality. To the staff who had to wear it, it just seemed cheap, demeaning, and uncomfortable. This dislike was not helped by the fact that in London, many dustcart operatives and street cleaners, wore the exact same item of clothing, sourced from the same manufacturer. It was also synthetic, making it exceptionally cold to wear in winter, and unbearably hot in the summer. The one piece design, with a full-length zip, made going to the toilet tricky; and for female staff, this also necessitated complete removal of the overall, which was very inconvenient.

There were some plus points. Unlike the previous shirt/jacket/trousers combination, it didn’t need ironing. It could be washed and dried in a very short time too, with no chance of shrinking, or unsightly creasing. It also guaranteed that all operational staff were dressed the same, and easily identifiable as Ambulance Staff (or dustmen) from a distance. It was less official in appearance, and less confrontational as a result. There was no headgear, so the rarely worn formal caps could be discarded. We could also wear industrial style boots for the first time, as they had previously looked out of place with the dressier uniform that went before. The overalls had numerous pockets, on the chest, arms, and thighs, as well as slots on the sleeves, for scissors, small torches, and pens. The identifying logos and patches were sewn on, and easily distinguished. In theory, it seemed like progress.

The problem was that the material was just uncomfortable to wear. We had to be issued with white T-shirts to wear underneath, and long-johns, to combat the cold feeling on the legs. The short thin anorak supplied was not warm enough for cold weather, and too much for warm weather, so NATO-style pullovers were eventually issued too. There was some rebellion against wearing this new issue, myself included, and many chose to continue to wear the old uniform, resulting in a mixture of operational staff, clad in bits and pieces of either kit. The management soon tired of this, and our tactic of constantly returning the new uniform, stating faults, or sizing problems, was rapidly exhausted. An ultimatum was issued, and a date announced, after which the wearing of anything but the new overalls was to be considered a disciplinary offence. I had tried, and failed, so reluctantly donned the ridiculous jumpsuit.

On good days, when the weather was ‘just right’, and exertions were at a minimum, it seemed OK. Not having to iron it was a time-saver, and there were enough issued to have a clean suit every day. The numerous pockets came in handy, holding everything from a bottled drink, to a selection of bandages; and in my case proved to be ideal for a packet of 20 cigarettes, and a zippo lighter too. Once everyone was wearing them, they didn’t seem so bad, but I still felt like a road sweeper. Not that there is anything wrong with being a road sweeper, or a dustman for that matter, don’t get me wrong. It was purely a case of identity, and public awareness. That took a while, but they eventually got used to us turning up in ‘Kermit Green’. Once the weather warmed up, I really began to hate this polyester abomination. You could not cool down. Hospitals were swarming with ambulance crews, all of them having pulled the top of the suit down, tied the arms around the body, and appeared to be wearing T-shirts, with green trousers. So much for smartness and uniformity.

Then came an incident that changed my mind about these suits. After this, I never looked back, and no longer yearned for separate shirt and tie, smart trousers, and matching jacket. I was converted.

One early shift, not long after 9 am, we were called to Paddington Underground Station. This station has two branches, and we were sent to the Metropolitan Line entrance, a long way from the actual platforms and trains. The call was given as a ‘one under’, indicating that someone had fallen, or jumped, under a train. This is a relatively common occurrence in London, and I had been to many similar jobs before. On arrival, we saw that the Fire Brigade were already there, and we were soon joined by Transport Police, and London Underground Heavy Rescue. Staff on scene told us that the person was still under the train, and was not responding. It was a long way down, involving some steep stairs, so we took all our equipment with us, just in case. Arriving at the platform, we were overjoyed to see that the train had already been reversed away from the victim, saving us the unpleasant task of crawling under it. Staff told us that they believed that the person, a man in his twenties, was ‘well dead’, a phrase often used to indicate severe injury, from which there was no chance of recovery.

My colleague and myself joined some firemen and got down onto the tracks, as the strong electric current had already been switched off. A cursory examination showed that the man had sustained a massive head injury, with large parts of the scalp torn off, and an obvious broken neck. This left us with the relatively simple task of removing the body, and taking it to the mortuary at St. Mary’s hospital, a hundred yards away from the station. We first wrapped the man in a blanket, then tied straps around, to secure his limbs. This ‘parcel’ was then strapped into a rescue stretcher, a bamboo and canvas affair, called a ‘Neil-Robertson Stretcher’. This had rope handles top and bottom, as well as grips at the sides, making it easy for a group of people to carry, and manipulate around bends, or obstructions. As the man was very tall, it did not fully encompass his frame, and part of his head, and most of his lower legs protruded out of the contraption. We then enlisted the help of the many firemen on scene, to help us carry the stretcher and our various pieces of equipment back upstairs to the ambulance.

I got up onto the platform first, so was handed the head end, which I supported until everyone was in place to commence ‘the carry’. In the new overall, I was unbearably hot, but unconcerned about the filthy state I had already got into; with the dirt, and grease from the track-well, and the congealed blood everywhere. In stages, we made our way upstairs, finally reaching the last flight out onto the street where the vehicle was parked. This was the steepest flight of stairs, but was nice and wide, so presented few problems. For some reason, the others helping us carry the stretcher decided to turn at the last bend. leaving me at the lower end, and to carry the man up feet-first. As they began to ascend the stairs, the top of his skull suddenly detached, swinging open like a cupboard door. As my right shoulder was supporting him at the time, the entire contents of his skull, thick blood clots, and most of his loosened brain matter, slipped out onto my collar, then ran freely down inside the new overall, all over my back and chest, finally collecting in a hideous mass in the baggy crotch area.

As you can imagine, I was not pleased. But this was where this new uniform showed its advantage. After quickly depositing the victim’s body at the mortuary, I was able to wipe out most of the gunk from inside the suit, and return to our base. The suit and  T-shirt were deposited in a contaminated linens bag, my boxer shorts consigned to the bin, and after a quick shower, and a change of overall, a clean T-shirt, and improvising underwear with a pair of long-johns, I was able to continue with my shift. The shiny synthetic material had not allowed anything to soak in, and what was there, was easily removed. Had I been wearing the old style uniform, I would have been in a far greater mess, and a lot more uncomfortable.

There were other times that I welcomed the style of the new overalls, when kneeling in the rain or mud, for example. But it was always the incident at the underground station that confirmed the practicality of the previously hated one-piece suit.

Ambulance stories (38)

Dubious colleagues.

You would be right to believe that the majority of people who choose to join the Ambulance Service do so for the right reasons. They generally have a desire to help people, and are rarely motivated by financial gain, or the search for a powerful career path. Some are attracted by the potential of job security; after all, people will always have accidents, or become ill. A small minority are thrilled by the prospect of driving around with flashing lights, and blaring sirens, although that excitement soon fades. The chance to wear a uniform, be official, and wander around looking important at scenes of disaster might well be a draw to some; in truth, I can recall quite a few like that.

For most, they see a worthwhile job, that can be interesting, varied, often amusing, and occasionally rewarding. It is generally well-regarded by others, and considered to be a laudable choice of occupation. If it gives you the possibility of driving around like a maniac sometimes, and being able to tell lots of grisly tales, then so much the better. However, there were a few, admittedly very few, who had other motives behind their desire to work in this field.

The most innocent, though still strangely annoying, were the equipment junkies. Those people that joined for the uniform, the light bars, and the sirens. They would collect models of ambulances, and even purchase their own (often very expensive) ambulance equipment, which they would keep in their own cars. Frequently, these private vehicles were just as comprehensively fitted out as a ‘real’ ambulance, and the proud owners would contrive to turn up at jobs, when they were not even on duty. They did this by means of another item of kit, an emergency channel scanner. Not strictly legal, though not technically illegal, this grey area of radio ownership enabled these individuals to keep tabs on anything that they deemed exciting, going on in a nearby area.

Their acquisitive desires even extended as far as smaller items, like torches. The Maglite Torch was not supplied by the Ambulance Service, as it was far too expensive. Nonetheless, many crew members would buy one, as their durability and reliability were legendary. The ‘junkies’ would buy them all; from a tiny key-ring size, up to the huge monster torch, almost the length of a man’s leg. They could not hope to find any practical application for this extensive set, they just had to have them. Other strange people would install lights in their own cars. These could not be used in the conventional way in private cars, but they just loved to know that they were there. If they came across an accident, usually by design, then they could light up the night sky, with a blaze of yellows and reds, asserting that they were just ‘warning of the hazard’. The same weirdos would often spend their holidays searching out foreign ambulance vehicles, which they would photograph, and look inside, to compare international equipment levels and standards. They would also buy patches, stickers, and badges, with which to adorn their casual clothing, the windscreens of their cars, and presumably, their bedroom walls.

It should be noted, that these were invariably men, mostly under 40 years  of age, and usually lived alone, or with their parents.

The next class of ‘undesirables’, were those obsessed with the ‘power’ attached to the job. This was a strange one, as there was no tangible power, so they invented it instead. Once kitted out in uniform, bearing an I.D. card, and officially working for an organisation that gave them access to people’s homes, scenes of crime, and terrible accidents, they became ‘different’. They would arrive at a scene, immediately taking charge of whatever situation presented itself, but not in a good way. They would order bystanders around, talk loudly, and in an overbearing fashion; generally acting in a pompous, and officious manner, guaranteed to be totally inappropriate. They would use phrases such as, ‘I am talking here’, or ‘Listen to me’, always delivered at full volume, whatever the circumstances. Directing traffic featured strongly on their list as well. In the midst of carnage at a bad accident, if you could not find them, to help you as they should be doing, you could be sure that they would be at the end of the street, arms flailing, ordering hapless drivers hither and thither. They never saw anything wrong in any of it. They wouldn’t, would they?

As well as the relative ‘innocence’ of the behaviour outlined above, there was another small group who took things a lot further. Harmless vagrants would be shouted at, then kicked with the toe of a boot, eventually being manhandled around, shaken, pushed, or worse.  There was usually little justification for this. They could just do it, and normally get away with it, and the targets were soft ones, and unsympathetic ones at that. You could easily imagine the type of person picked on, or bullied as a child, getting their own back on nameless individuals, courtesy of a uniform, an ambulance, and a reason to be there. Unconscious drunks were similarly easy victims, and frustrations could be vented with ease. Of course, the arrival of CCTV put a stop to a lot of these acts,  as the numerous cameras could now record anything that happened out in the street; though nobody can ever be sure what went on once the ‘patient’ was inside the vehicle.

The final category is the most worrying, and one that gave me cause to act, on more than one occasion. As I have mentioned before, that job lends itself to frequent proximity to people in a state of undress. In addition, there are numerous vulnerable individuals, of all ages, who unreservedly trust ambulance crews to do the right thing. One of the mantras of the Training School is that there is; ‘No sex in First Aid’. One can be forgiven for admiring an attractive person in any circumstances, but acting on that attraction is another matter entirely. My first experience was soon after qualifying. Working with someone that I thought I knew well, a married man of a similar age. We were called to some public toilets in Central London, where we found a young woman in a collapsed state. She was unconscious, probably from an overdose of Tuinal, a sedative drug that was very widely used at the time. We made all the usual observations, and loaded the girl onto the vehicle, to take her to a nearby casualty. I was driving, and my colleague remarked how pretty she was, and what a shame she led such a sad life, to find herself in this predicament. I did not really see that job in the same way; as anyone unconscious, with vomit all over their clothing, and their hair matted from lying in a toilet cubicle, seemed far from attractive to me.  As I was driving across one of the bridges to the hospital, he called out to me from the back, and it took me a while to realise what he was saying. It was, ‘look at these!’ I looked into the interior mirror, that gave a view into the rear of the vehicle, and saw that he had lifted up her top, and was looking at her exposed breasts. It may be one thing to see this accidentally, but it is another thing entirely, to deliberately disturb clothing, to achieve that result.

I pulled the vehicle into the kerb, and went into the rear. I told him in no uncertain terms to cover the girl immediately, and it was all I could do not to hit him. When we got to the hospital, as soon as we had handed over the patient, I told him that he must report sick, as I would no longer work with him. I then told him what I thought of him, and that if he did not go home, I would report his behaviour. This was easier said than done of course, as he would be able to fabricate many reasons why he had to interfere with clothing. There was the other dilemma of that job to consider as well; it would be my word against his, and no witnesses. He could see how angry I was, and agreed to go sick. I went in to see the station manager at the next opportunity, and told him that he could never crew me with this man again. When he wanted to know why, I replied simply; ‘ask him’. This man was, as I said, married, and had an eight year old daughter. I still can’t explain it, even today. I never knew the outcome of the chat he had with the manager, but he did transfer very quickly, to an area miles away, near the borders with Surrey. It was said that he was having travel problems, and needed to be nearer home.

Years later, I was working with another ‘family man’, also well-known to me. I had been to his house, and met his wife, and teenage son. One day, we attended the nearby home of a severely disabled young woman. She spent her life in a wheelchair, suffering from a disease that made her bones the texture of sponge. We had to take her to a specialist bone hospital in Middlesex on a regular basis, where her unusual condition was monitored. Although she was almost 21 years old, she was very naive, and had little life experience. She was less than four feet tall, and had little adult physical development, all a direct result of the syndrome that affected her. I was in the back for this journey, and during the long trip, she secretly confided to me, that the ‘man driving’, was her boyfriend. She told me that he would come to her flat late at night, or sometimes early on Sundays, and they would make love, and he would tell her that he loved her. I initially dismissed this as fantasy. After all, I knew him well, and he was not a man to do such a thing, surely. I let her ramble on, without comment, and we dropped her off, as arranged. As the treatment was to take a long time, we left, assigning the return trip to the local Ambulance Service in that area.

The return journey was long, plagued by rush-hour traffic. After a while, I broached the subject of what she had told me. My colleague looked embarrassed, and laughed. I asked why she would say such a thing, about a married man with children, who would surely never abuse his position in this way, seeking some bizarre sexual gratification. Not only that, his job, long held, could be at risk, if the story became public knowledge. It may not have been illegal,  but it was certainly unethical. After a while, he suddenly said, ‘there’s nothing wrong with it, she is over eighteen, and it makes her feel good.’, I was amazed at his admission. I had known this man for more than seven years, and would never have suspected that he was systematically abusing his position in this fashion. I could see no point in anger. I just told him that he had to stop, and that if he did not, then I would tell his wife. He did not argue, and in this lack of argument, I saw realisation of his guilt. On this occasion, I am pleased to say that the girl in question moved on, and found love at the hospital, with a man who had a similar affliction. She later married, and to the best of my knowledge, is still happy.

My colleague also moved on, no doubt uncomfortable with the knowledge that others were aware of his transgression. He moved to work abroad, and I have never heard of him since.

The last episode I recount here, was something much more disturbing, and it eventually came to the attention of the authorities, I am pleased to say. One of my colleagues at a nearby station, was rumoured to be involved in something disturbing. I had occasion to work with him many times, and had seen no evidence of this. However, I was unduly diligent, so perhaps he was forewarned. He certainly fitted the bill, with an oily personality, and unctuous demeanour. He was unduly nice to patients,especially if they were disabled, or had learning difficulties. He also befriended their mothers, or carers, and went out of his way to be helpful, even outside of work. He would give up his spare time to run people around in his car, and was even known for this locally, where he was praised for his activities, by local associations. I was never happy to work alongside him, and watched him like a hawk. He was prone to ‘cuddles’ with patients, and excessive familiarity, none of which was deemed inappropriate at the time.

Some years later, a mother asked management why he was taking photos of her disabled daughter. He had told the young girl that he would enter the photos into a national competition, and that the family might get money for them. At first, the mother even agreed, believing that a Paramedic would be the last person to mistrust. Later, her daughter told her that he had also taken photos of her when her mother was absent. These had started normally enough, until he asked her to pose in underwear, telling the girl that these photos would be required for ‘elimination’ reasons. When he asked the girl to remove her bra, she did so, despite her reservations, but later felt bad about it, and told her Mother. She reported the actions to the Ambulance Service, who immediately told the Police. The man’s home was searched, discovering thousands of inappropriate photos, of dozens of young disabled women, in various states of undress, always in provocative poses. As he had not actually molested them, he was spared prison, but found guilty of minor sexual offences. He was also immediately dismissed from the London Ambulance Service, for gross misconduct.

The sad tailpiece to this story, is that the same man was able to find employment as an Ambulanceman almost immediately, in the private sector. Despite no reference, they had no knowledge of his previous activities, and being short-staffed, they were happy to employ him.

As I said at the beginning, this is not the usual behaviour of Ambulance Staff. Almost all are reliable, normal, and well-motivated; especially in today’s climate of background checks, and better vetting. You need have little fear that your loved ones will come across such people, in their times of need.

For me, it is an interesting recollection of a former time, when all was not as it might have seemed.