And you may ask yourself:
How did I get here?
2
I joined the ambulance service in 2003 because I thought it would give me the sort of job I wanted. Something where you can make a difference. I may have a low boredom threshold. The service is rarely boring.
Up to then I’d had not exactly what you’d call a successful career. I only got to university because my girlfriend dumped me and went off to university herself, so I thought I’d better do the same. But I still didn’t have much of a clue, so I followed my parents into journalism. Which I wasn’t very good at.
I started doing shifts on the diary column of a well-known paper. I was so terrified my first morning I had to drink vodka before I went in to work just so I didn’t shake too much. I was supposed to write fun snippets of news about famous people, but I didn’t know any. The first piece I wrote ended up libelling someone so badly she won undisclosed damages in the High Court. I was told ‘undisclosed’ means at least five figures.
I never went back.
I decided to play it safe and went to work on a boring magazine called Fish Trader, about people who trade in … fish. The only interesting thing about working there was that along the corridor you had other magazines with titles like Disaster Management, which sounded fun.
From there I moved to Scotland, to work on a local paper, which was more like being a proper reporter, although I couldn’t understand most of the accents. It’s difficult to quote people when you haven’t a clue what they said. Good training for talking to people in pain and distress now, though.
Then I found out my mother was dying of cancer, and that changed things.
I left to live with her back in England. She lived alone. I spent a year watching her die in front of my eyes. That was probably good training for the ambulance service too. Just before she died she said the last year of her life had been the best.
I managed to get shift work on national newspapers after that, but never really had the confidence. I could never think of ideas for news stories, and felt frightened of most of the other people in the office. All of them seemed to have gone to Oxford or Cambridge or both. Sometimes I had to take a pill just to go and talk to the news editor or pick up the phone. So I left and painted houses and moved furniture. I don’t miss journalism.
Reporting and ambulance work, asking people questions and trying to make sense of what they tell you, do have similarities. In news reporting, you’re going out to people, trying to understand what’s happened to them, and telling the readers. With ambulance work, you’ve got to find out what’s happened a bit more quickly, then do something about it. Then report to the hospital. Otherwise it’s much the same thing. Sometimes just talking to people is the most important thing.
Sometimes their lives depend on it …
Douglas
Monday morning.
I apologise to any cardiologists, doctors or paramedics reading, but I may have invented a medical procedure. Maybe.
Called to a male, sixties, chest pains.
The symptoms are classic. Crushing central chest pain, radiating into left arm and jaw. Short of breath and dizzy and pale. Needs to go to the loo, sense of doom. Textbook stuff. Douglas is a tall, quite slim gent, alone in the house and very calm and pleasant. But it looks like a heart attack, and he knows it.
After he’s been to the loo, we give him oxygen and aspirin and a spray in the mouth that takes a little of the pain away, then pop him on the carry chair and wheel him out to the ambulance. Once we’ve wired him up to the monitor, there’s little room left for doubt. His ECG has what’s known in the trade as massive ST elevation – another classic sign. At the hospital they’ll do blood tests, but basically, if it walks like a duck and talks like a duck …
The doctors can give drugs that break up the clot, or even stick a tube into his veins to suck the thing out, but at the moment it’s close to killing him.
So off to the hospital we go with lights and sirens flashing. Val’s driving.
On the way in I do my best to reassure him, which isn’t difficult. He seems quite calm and sensible. I can’t imagine that I would be, in his situation. The spray has taken away some of the pain and he can breathe better, and I think he’s gone into crisis mode – he knows exactly what’s going on, and is almost waiting to find out what’s going to happen. (I suppose it’s not much fun having a heart attack, but probably the last thing you’d call it is boring.)
Anyway, all the way in I monitor him on the ECG and keep him talking. The ST elevation is getting bigger and bigger and the heart rhythm is becoming faster and more irregular as the heart is being damaged and becoming distressed, but he’s still with us. It’s only a three-minute drive in, and we’ve phoned ahead so they know we’re coming.
We arrive at the hospital and wheel him into the resus bay (where the really ill people go), where a doctor and nurse are waiting to receive him. They both settle down either side of him, trying to get a needle into one of his veins to draw off blood and to give drugs. One’s concentrating on his left arm, the other on the right. His veins are proving difficult, so for several minutes neither of them is looking at or talking to him, and this is when a strange thing happens.
In order to explain I need to go into a bit of detail. Apologies for the ignorance of what follows. Normal healthy hearts – as I understand it – generally don’t just stop. They don’t usually go from beating happily one second to stopped the next, except in the very old. They usually, or at least often, go from a normal heart beat into one of two rhythms: ventricular tachycardia, or more commonly ventricular fibrillation. With the first the heart’s going so fast no blood gets in, so none can get pumped round the body (so you die) and with the second the heart starts jerking away in an uncoordinated fashion. Same result. Either way you’re dead. Only once you’re good and dead some time will the heart slow down and actually stop.
So often with people who’ve just ‘died’ there’s a period where their heart is doing one of the two things above. This is why people are given electric shocks. The shock will stop the heart doing either of these things above, and hopefully it will settle back to a normal rhythm.
Hey presto.
You were dead, now you’re alive.
But if you haven’t got a machine handy for giving electric shocks, a big fat punch in the chest can also do the trick. It’s called a precordial thump. The effect is the same.
What I have invented (I think) is the precordial conversation.
Back in the resus room, the doctor and nurse are still busy trying to get needles in the patient’s arms, while I’m watching the monitor. The patient’s awake, but then goes even greyer and his head slumps to one side and his eyes close. I can see on the monitor that his heart rhythm is breaking up into ventricular fibrillation. This is the point at which he’s technically dying, I suppose.
So I shout at him. Very loudly.
Something like what’s your wife’s name? He appears to wake up, shakes his head slightly, and tells me the answer. The rhythm on the monitor settles back down again.
Then a minute later, the same thing happens. He goes grey, his head slumps to one side, and the rhythm on the monitor breaks up. Dead again.
I shout at him again. Are you comfortable? Or something.
He shakes his head, wakes up, and the rhythm settles down.
Val’s cleaning the stretcher. She can’t