One under

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

To simplify this for the various Emergency Services, this type of call is given out as a ‘One Under’. After all, for our purposes, it is irrelevant how they got there in the first place. During one particular rush-hour morning, we received such a call, to a busy Central London Tube Station. The prospect of attending these calls requires a lot of preparation prior to descending into the depths, where most tracks are situated. London has one of the deepest systems in the World, with very few stations having any tracks at ground level. Any equipment that you think you may need, has to be taken with you at the outset, or long delays will be caused later.

On arrival at the station, Tube staff will meet you, and give you a fair assessment of what you will have to face below. As a rule, Fire Brigade appliances will also attend to assist, and there is a dedicated Heavy Recovery Unit, provided by London Transport, which is sometimes already there, or at least on the way. Laden with various stretchers, aid boxes, oxygen, blankets, and splints, you and your colleague make your way down the seemingly endless escalators and steps, until arriving at the track in question. The scene is usually surreal;the normally bustling and noisy area is cleared of all bystanders, the train quiet and empty.

On this occasion, I am met by a member of the Fire Brigade. He tells me that a cursory examination under the train, reveals an adult female, who appears to be still alive, despite significant contact with the train. There is nothing for it, but for me to crawl under the train, and try to assess her injuries, and decide how to get her out. This is an unpleasant job at any time. The accumulated filth of grease, litter, fluff, and dirt under the tracks, combines with oil from the train workings, to make an indescribable goo. Added to this, there was substantial blood loss from the patient,  already congealing like some sort of unspeakable jelly. At this time, Ambulance Crews still wore the two-piece ‘smart’ uniform, jacket and trousers in light grey, blue shirt, and tie. I removed the jacket and tie, and donned a ‘hi-vis’ jacket, not so much as to be seen easily, more to reduce contact with all the unpleasant substances. It was very hot of course, as it normally is in Tube stations. This was made worse by not having trains running, so no air was being pushed through onto the platforms.

My main concern was the electricity. The notorious third rail, through which the massive current runs, could kill me on contact, and I had a healthy fear of it. Before I would go under the train, I wanted complete assurance that the power was off in that section. A brief consultation with the Tube staff did not satisfy me. They were not sure, they told me, so they had sent for an engineer with a ‘tommy bar’. This was a long piece of metal, that when placed across the tracks, effectively shorted out the supply, rendering the third rail harmless; this was the name the arriving engineer gave it anyway, so it may well be a nickname for the device. He fixed it across, and called up to me that it was OK to proceed. I was still unsure, and approached gingerly, asking for further assurance that the power was disconnected. Losing patience with me, he leaned across to the third rail, and placed his tongue directly on it! “Happy now?” He yelled at me.

I could dally no longer, and began to crawl under the train, waving a torch around, so to see better ahead of me. I found the female towards the rear of the first carriage. She was breathing loudly, and muttering incoherently at the same time. The train had run over her at one side, causing massive injuries to her left leg, hip, and left arm. Most of the flesh on her left thigh had been detached, and her arm on the same side, was almost severed. With little room, and minimal head clearance, I managed to dress and secure her wounds as best as I could, and administer oxygen as I did so. My colleague was talking to me from the track above, and I was updating him on my progress. By the time I had dressed the wounds, I was completely covered in the aforementioned grease and blood, which was all over my face and hands, making it difficult to work properly. I was so hot, that it was difficult to concentrate, and on top of this, the patient was regaining her wits, and becoming increasingly agitated. And I still had to get her out.

There are only ever two options in this situation. The first is to jack up the train carriage, to make sufficient space to remove the victim; the second, to restore power, and move the train off the patient, back into the tunnel, leaving the track area clear. I preferred the first option, as the safest for all concerned. However, she was in a bad position for this, as she was not near enough to either end of the carriage, making jacking almost impossible. There was nothing for it but to make the situation as secure as I could, and move the train. I managed to get her as centrally located between the tracks as was possible. I then tied her legs and feet together with bandages, and did the same with both arms. This was to stop her moving, and putting us in more danger. When these preparations were completed, I got the lady to look me in the eye, and asked her if she could understand me. She nodded, wide-eyed, confused, and distressed. I was not at all sure that she understood what I told her next, but had to take that chance. I advised her that the power was going back on, and that the train would be moving slowly backwards. She should not wriggle around, and try to move (as she had been), or she may well kill us both, by either contact with the moving train, or the electric rail.

I eased myself into position slightly across her body, to restrain her further, and gave the signal to those on the platform to get on with it. The sound of the power being restored is not something I would recommend that you ever want to hear. There is a low hum, increasing in intensity, until you are certain that you can feel the physical presence of the electricity around you. The connectors give off sparks and light as the train moves, and the few feet of travel required to get the train off you, seems to take an eternity. Once the train had moved, everyone else was able to get onto the tracks to assist. The patient was placed into a Neil-Robertson evacuation stretcher, and finally moved off the tracks. Fire Brigade staff, and some colleagues from the Ambulance Service, carried her for the long journey up to the street, and into the vehicle.  I was left to stagger up the escalators, covered in grime, carrying my uniform. I got into the back with the patient, and we left for the short journey to the nearby hospital, where we handed her over to the Trauma Team.

After completing the necessary paperwork, I advised Ambulance Control that I would have to return to my base, to shower and change. We had been there for less than five minutes, when the emergency phone rang. They wanted to know how soon I would be ready, as they were busy, and holding more calls. Just another day…