I often get kids coming up to me and saying, ‘I want to be an ambulance person. Is it a good job?’ If I’ve just had a bad day I might reply, ‘Maybe have a look at being a train driver first. You can earn a lot more money and it’s a lot less stressful. Or if you’re any good at football, give that a try instead.’ But if I’m in a better mood I’ll say, ‘If that’s what you really want to do, give it a crack. Being an ambulance person is better than sitting behind a desk all day.’
I work with people who are clever enough to be bankers, insurance brokers or businesspeople. They could have opted for working in an office earning 100 grand a year instead of working in the ambulance service, resuscitating the dying, taking away the dead and not getting paid a great deal for it. But would their life be as fulfilling? Probably not. NHS staff, from well-paid consultants down to those earning not much more than the minimum wage, just want to help people. That’s a good way to spend a working life. At least when I finally hang up my defibrillator, I’ll be able to say, ‘I didn’t make much money, but at least I was working for the greater good of humanity.’
People sometimes ask me what a normal day consists of in the ambulance service. There is no normal day. But, believe it or not, the job can be quite routine. We try to arrive at the station fifteen to twenty minutes before the start of our shift so that we can grab a cuppa and the previous crew can knock off early (although they’ll often still be out on a job). If there is a crew waiting, we’ll grab the keys and radios from them, open up the ambulance and make sure everything is shipshape and Bristol fashion. Have we got all the drugs we might need? Are they all in date? Do we have splints and bandages, an oxygen mask, a stretcher? It’s not cool for a crew to leave an ambulance in a ramshackle state – when you hand over the keys, it should be ready for the next crew to jump in and go. That said, if they’ve had a really rough shift, they might leave a note saying, ‘We’ve cleaned it, but you might need to stock up on a few things.’
I know I might not have a break for six to eight hours, so I’ll stash a sweaty sandwich in the door pocket, before turning on my radio, logging on to the dashboard computer and waiting for the first job to come in – which usually takes less than a minute. An address will appear on the screen and off we’ll pop, automatically guided by a very clever satnav. If the call has been waiting a while, we’ll get all the information straightaway: ELDERLY MAN, FITTING. If not, we’re dripfed updates on the way, depending on what questions the call-taker has asked and what answers have been provided by the caller. We’ll also be provided with a category of seriousness, more on which later.
Every gig is different, because every person is different. But different bodies still go wrong in the same way. We deal with a lot of people with chest and back pain, shortness of breath, cuts, bumps, bruises and breaks. After a while, applying a particular set of solutions to a particular set of problems becomes second nature. I wouldn’t say being an ambulance person ever gets boring, but it can be quite samey.
There are days when I wake up and think, I hope nothing big happens today, because I’ve had a bad night’s sleep or I’m just not feeling too chipper. But thinking like that is tempting fate. An ambulance person can never allow themselves to become complacent. It’s not as if we can go out and get hammered, drag ourselves out of bed the following morning, turn up late and breathe whisky fumes over some poor old girl who’s taken a tumble. Even seemingly ‘normal’ days in the ambulance service – which you might define as any day when nothing happens that makes you despair of the world – can turn into horror shows in the time it takes to say, ‘Shit, there’s been a major traffic accident on the M40 . . .’
But I’d be lying if I said ambulance people don’t relish the different and the dramatic, because it challenges us to think outside the box and tests our training to its limits. There is something thrilling about doing a job that can chuck something new at you at any moment. I might spend eight hours on a shift dealing with coughs and colds, and then suddenly something comes in which has me sitting bolt upright in the ambulance thinking, I really need to have my wits about me for this next one. A child might have had an anaphylaxis – which is a severe allergic reaction – and will require the administration of a bucketload of drugs. Or someone might have jumped off the third floor of a multistorey car park and suffered traumatic injuries. At times like those, we need to be on our game.
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It was Christmas Day, although I can’t remember which year. It all tends to merge into one.
A call comes on our screen: ELDERLY LADY STOPPED BREATHING. I put my foot down and we’re at the scene before you can say ‘may your days be merry and bright’. All the family are round for turkey dinner, wearing Christmas jumpers and paper hats. I ask where the patient is and her son leads us into a bedroom. As soon as I see her, flat on her back on the floor, I know she’s dead. It’s rare for anyone to go into cardiac arrest out of hospital and survive. We administer CPR, give drugs and intubate, to no avail. Normally if someone dies at home, we leave them for a private ambulance to come and take them to a place of rest, but it doesn’t feel right leaving that lady on the floor on Christmas Day. So we put her on a stretcher, place her in the back of the ambulance and take her to hospital. One job down, how many more to go?
Next up, a childbirth. One out, one in, like some cosmic nightclub. When me and my partner arrive, a lady is sat on her living room floor, next to her partner. The baby’s head is already on its way out. ‘Hello,’ I say, ‘my name’s Dan.’ I don’t need to ask her what the problem is.
I’m not a big fan of childbirth jobs. For starters, it’s just quite an awkward, invasive situation. It’s the first time you’ve ever met and she’s lying on the floor with her legs akimbo. It’s also not nice seeing someone in so much pain. The smell is sickly sweet and, when you’re crouched at the business end, it’s certainly not a sight for the squeamish. Not only that, an ambulance person can go months or even years without delivering a baby, which means we can get rusty. It’s not as if we can practise, like footballers practise penalties or golfers practise bunker shots. People say that delivering a baby is like riding a bike, but it isn’t. We forget things. But we can’t use that as an excuse for not delivering a baby safely.
Childbirths are unpredictable, which makes them stressful. There are a million and one things to do, and they all need doing now. But we still need to do them in a measured, methodical way. An ambulance person is not really in control of a childbirth, the mother is. We’re just a coach, telling her to breathe and push at the right times. And when the deed is done, there are suddenly two patients: a mother who might be bleeding heavily and a baby who is at risk of all sorts of complications. All of the above is why we have midwives. Unfortunately, midwives don’t have blue lights and sirens.
The key to keeping a patient calm, regardless of how uncertain we are about a situation, is appearing calm ourselves. If we can appear calm on the surface, however frantically we’re paddling underneath, we’ll be able to keep control of things. With this in mind, never play an ambulance person at poker.
Another reason you’ll also hardly ever see an ambulance crew running into a house is that treating a patient, especially administering CPR or delivering a baby, can be bloody hard work. There’s no point huffing and puffing all over a patient when you’re supposed to be there to help them. So we usually go in slow and weigh up the scene, which can sometimes look like we’re dragging our feet. We do get people shouting at us, ‘Come on mate! Get a shift on!’ But we’re just making sure we’re on top of the situation. Or at least appear to be.
I’m trying to talk this lady through what to do when it dawns on me that neither she nor her partner speak English. So I have to act it out instead. I usually don’t mind a game of Christmas Day charades, but this is on a different level. I spend about an hour demonstrating heavy breathing and making squeezing faces. It must look like I’m doing my best impression of a turkey, but it seems to be working, so I carry on.
When the baby finally decides it wants to make its entrance, the umbilical cord is wrapped around its neck. We’re taught to flick the cord over a baby’s head, but I’m not able to. I’m fumbling and starting to panic, but can’t let the mum see that. Eventually I manage to get my fingers underneath, reduce the strain and, as a result of one last push, out pops the baby into my arms, like the proverbial bar of soap. Then, silence, which seems to go on for ever.
When you’re in hospital and you think there might be something wrong with a baby, you pull a cord and before you know it, every man, woman and their dogs are in the room. But ambulance workers don’t have a magic cord. Mercifully, the baby starts crying eventually. I get Dad to cut the cord, dry the baby, wrap him up and pass him to Mum. Mission accomplished.
When a woman has a baby, you can see the change in them immediately. When they look into that baby’s eyes for the first time, they forget about everything they’ve just been through. And so do we. It’s just so wonderful to see that instant love and utter devotion. How many people can say when they get home from work, ‘I delivered a baby today and brought joy to people’s lives’?
I sometimes wonder where that baby is now. I hope he’s happy we brought him into the world. But there’s no time to stand, stare and wonder when we’re wading knee-deep through a twelve-hour shift. There’s not even time to return to the station for a brew – those days are gone. The calls are stacked up waiting for us, so that we’re almost always on the road, ready to respond. We dispose of our gloves, clean ourselves up and breathe. Two jobs down, on to the next one.
Next up is a 97-year-old lady in a care home who has suffered a stroke. I deal with a lot of strokes. If a patient is treated within four hours of the stroke taking place, the hospital can administer a drug that will hopefully burst the blockage, stop tissue wastage in the brain and restore movement in limbs. If a patient has to wait more than four hours for said treatment, a different treatment will be administered that is less effective. Time is of the essence.
I stagger through the door of the care home with every last bit of kit and caboodle – the day you try to predict what you’ll need is the day you leave that all-important piece of equipment in the back of the ambulance. A carer shows us upstairs (people always seem to get ill upstairs) and when we’re introduced to the patient, we’re relieved to discover that she still has all her faculties. She’s lost movement down one side, which is a sure sign of a stroke, but she knows what’s going on. The whole time we’re assessing her, we’re also speaking to her, explaining what we’re doing and why we’re doing it, to put her at ease. But when we suggest we take her to hospital, she’s adamant she doesn’t want to go. The mere mention of hospital has turned her to jelly. She’s probably thinking, If they take me there, I might never come out again.
I completely understand, because that’s exactly what can happen. But this lady is within the four-hour treatment window and we want to give her the best possible chance of recovering, so, as far as we’re concerned, it’s all systems go. If she stays at home, she could die of her symptoms. But if someone doesn’t want to go to hospital, we can’t take them. We can’t force healthcare on people, drag them kicking and screaming into the back of an ambulance (unless a patient doesn’t have the mental capacity to make their own decisions, and even then you have to prove it’s in their best interests, which makes it a minefield).
Being an ambulance person isn’t just tearing about at 100mph, a lot of the time it’s about patience and taking the time to explain the benefits of our actions. I spend ten or fifteen minutes addressing the lady’s fears, explaining why we should take her in and what they might be able to do to help, and eventually she agrees.
In the back of the ambulance, I can tell she’s still anxious. So I decide we need a few tunes. I carry a Bluetooth transmitter that plays music from my phone over the ambulance radio. If we’ve got kids on board, I might stick on a bit of Peppa Pig. If it’s a teenager, I might stick on some hip-hop. If it’s an adult, I might stick on some panpipes or whale sounds. Anything that might help to calm them down. In this case, I find some Second World War-era songs on Spotify, press play and the lady goes from being scared out of her wits to singing along to ‘We’ll Meet Again’. I join in and we end up having the time of our lives. I can’t help wondering what she’s thinking about while we’re singing along to Vera Lynn. Her husband? Old friends long gone? Whatever it is, to turn this horrible experience into a positive one is quite overwhelming.
I love hearing old people’s stories from way back when, so I ask the lady what she did during the war. She tells me she worked in a munitions factory, about an explosion that killed a lot of people and how proud she was that she’d played her part. I want to help anyone who ends up in the back of my ambulance, but when it’s someone who has given so much, you desperately want to make their experience as comfortable as possible and repay them with your time. Otherwise it can feel like they’re part of a factory process, placed on a conveyor belt, quickly checked over, before being rushed back out again.
A few days later, I hear that the lady passed away in hospital, which was her worst fear. But at least I made the end of her journey more bearable, simply by showing how much I cared. That was the best Christmas present I could have given anyone.
As for my presents, I unwrap them while my kids are in bed. I kiss them goodnight, taking care not to wake them, make a turkey sandwich and have a couple of bottles of beer with my wife on the settee. That Christmas Day, I witnessed the start of one life and the end of two others. And whatever the outcome, I tried my very best. It sounds like something worth reflecting on. But reflecting is not something ambulance people do much of. We have private lives to lead, loved ones to look after and Christmas telly to watch.