Raising three small children as a young single dad was some of the best training for the frontline of the ambulance service I ever had. My alarm would go off at 6 a.m., I’d roll out of bed, grab the kids, line them up, change their nappies, feed them, get them dressed and stagger to the shower. By the time I’d emerged from the bathroom, they’d all be undressed and one, two or three of them would have done a poo or puked. I’d change their nappies and dress them again, while eating a slice of toast, sling them in the car (not literally, although sometimes I felt like it), drive to the nursery, wait for it to open at eight, hand them over and drive to the other side of town to start work in the control room at 8.30.
At 4.30 p.m., I’d finish my shift, attempt to get to the nursery before it closed at six, grab the kids, sling them in the car (again, not literally), take them home, feed them, bath them, put them to bed and fall asleep. And the following day, I’d do almost exactly the same all over again. There might be single mothers reading this and thinking, This is my life! Well, I tip my hat to you. If you can do that every day without losing your marbles, a career in the ambulance service might be for you.
At the time, I thought that my life had been set in stone, that this would be my existence until the end of days: a grinding cycle of long hours at work and domestic drudgery, which is what bringing up babies often felt like to a kid like me. Of course, it wasn’t all a drag. There were those beautiful moments every parent experiences, that made it all seem worthwhile: the first smiles, the first words, the first steps. But it’s not like I had much time to savour them.
Luckily, my mum managed to get relocated and started working nearer to home, which eased some of the pressure and even meant I could go for the odd night out with the boys. But it was around this time that I fell ill. My whole body was in pain like you wouldn’t believe. Every joint and muscle ached, my knee was swollen up like a balloon
and I struggled to get out of bed most mornings.
My doctor referred me to a rheumatologist and he diagnosed something called reactive arthritis, which he said was my body’s response to trauma. Apparently – and I had to take his word for it, rheumatology not being my strong suit – my white blood cells, which are there to fight infection, had started attacking my body for the fun of it, because of the stress it had been under. And they’d got so carried away that they’d started having a go at my joints. The rheumatologist put me on immune suppressants, but when I went back to see him, he told me that I needed to return at 9 a.m. the following morning, because if I didn’t get my knee drained, I might never walk again.
I was due in work the next day, so I phoned my boss, told him what the rheumatologist had told me, suggested I take the day off as leave, and he told me to stop being so silly: ‘It’s just a swollen knee. Can’t it wait a few days?’
‘Not according to the medical professional.’
‘Let me have a word with my boss . . .’
About half an hour later, his boss phoned me: ‘Dan, John’s asked me to call. He’s told me he wants you to know that you’ve got to be in tomorrow. If not, you’ll have to face the consequences.’
I can only assume the apparent lack of understanding was down to a breakdown in communications, but I was in so much pain that I couldn’t ignore it. So I went sick. And when I next saw my consultant, he signed me off work for six months. I’d had three babies in no time at all, split up with my girlfriend, been stabbed five times and was running around like a blue-arsed fly, trying to care for the kids and bring some money in. I was a complete wreck and agreed with the consultant that I needed a break. Who wouldn’t in that situation?
Taking that time off was the best thing I ever did. I was able to have a proper sleep during the day while the kids were at nursery. I was able to spend quality time with them, rather than simply get them dressed, wash them and shovel food down their throats.
Having gone through what I went through, I believe that stress can take a bigger toll on the body than the medical world currently understands, perhaps even kill people. But that break gave me the strength I needed to keep carrying on. The illness slowly dissipated and I became myself again. And feeling refreshed, I applied for a job as an emergency medical technician, on the frontline, because I felt I needed a new challenge to go with a new chapter in my life.
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To the layman, a technician looks no different to a paramedic. The key differences between a technician and a paramedic are that paramedics receive more training and can administer many more drugs, which are critical in life-threatening situations. But we’re both on the frontline together. Technician or paramedic, a lot of people still think of us as ambulance drivers. That’s fine with me – we do have to drive the ambulances – but it will upset some of the ambulance service’s more sensitive souls. Lots of people also call us first responders, but that’s because they watch too much American TV. First responder applies to anyone who is among the first to arrive at an emergency, whether they be a technician, a paramedic, a police officer or a firefighter. (That said, community first responders do exist in the UK, and are volunteers who are dispatched to attend emergencies, often in rural areas, when an ambulance might take longer to arrive.)
When I got the job, I was thrilled. The pay rise was negligible, but I loved the idea of being able to physically help people, rather than blindly guide them over a phone. It takes about ten years to qualify as a GP. If you want to become an anaesthetist, it will take you about fourteen years. Training to be a technician lasts about four months, or at least did in my day. That might not sound very long, but it was very intense, and I had to graft my backside off to pass the course. During those four months, I learned anatomy and physiology; the basic workings of the human body; a manual’s worth of medical terminology; how to recognise a host of different illnesses as well as how to treat them; wound care; resuscitation and how to use defibrillators and an ambulance full of equipment; manual moving and handling; infection control and prevention; scene management. Oh, and delivering babies.
Things I didn’t learn during training but which might have come in handy included: how to handle being spat at, called every name under the sun, hold a wee for hours at a time, survive hours without an official break and carry patients down spiral staircases. And that’s not even the half of it. Real-world incidents are rarely like training scenarios. Perhaps more than any other vocation, being a frontline ambulance clinician is a lifelong apprenticeship – almost every day we are presented with a familiar puzzle assembled in a slightly different way and we have to do what we can to solve it.
The driving course was very full-on, as it should be, given that ambulance folk are allowed to drive with some disregard for the Road Traffic Act. But it was also an enormous amount of fun. We got to drive a skid car, which meant tear-arsing around a disused runway, and the course ended with a time trial. After four weeks, I felt like I could have tackled the Dakar Rally.
When I turned up for my first shift, the paramedic said to me, ‘Tell you what, son, you get used to driving this ambulance today and I’ll do all the other bits. We’ll build it up from there.’ But when I jumped in the cab, I said, ‘Where’s the clutch?’ The paramedic chuckled and replied, ‘There’s no clutch, it’s automatic.’
At no point during my training had I driven an automatic ambulance. At no point in my life had I driven any kind of automatic vehicle. I know what you’re thinking: the whole point of automatics is that they’re a piece of cake to drive. Basically, you rev and go. Unfortunately, where once was the clutch was now a pedal that turned the siren on and off. So every time I thought I was changing gear, the siren started blaring. Thankfully, I understand this slight oversight in our training package has now been reviewed and corrected.
Having informed my partner that, in my hands, the ambulance would perform more like a clown’s car, he suggested we grab a brew and take it for a test drive around the station car park. But just as I was getting the hang of things, my first job appeared on the screen: a hot-air balloon had crashed into an electricity pylon and we needed to get there, pronto. My partner said to me, ‘You’re gonna have to drive with blue lights for this one. I’ll talk you through it.’ I was thinking, I didn’t see anything about hot-air balloon crashes in the text book. That said, I couldn’t wait to get there and see what was what. Would there be journalists and camera crews? Would it be on the news? This is what I’d envisaged before I’d signed up – helping to save lives at major incidents. I couldn’t help thinking of black and white footage from the First World War of burning zeppelins crashing to the ground.
The whole way there, I kept pressing the clutch, which wasn’t a clutch but turned the siren on and off: press once and the siren came on, press twice and it played an even more hideous tune, press thrice and it turned off. By the time we arrived at the scene, I thought I’d mastered it. I parked up the ambulance with clammy hands, sweat trickling down my back. I mentally prepared myself for the carnage I might be about to see and ran through the various treatments I might have to administer. It was a case of cometh the hour, cometh the Dan.
I jumped out of the ambulance and made for the back like a greyhound let loose from his trap. Just then a police officer wandered over and said, ‘It’s all right lads, you’re not needed. It came down with a bit of a bump, but nothing serious.’ I didn’t know if I was relieved, annoyed or frustrated. All the balloon passengers were fine and everyone was calm. That is, until I jumped back into the ambulance, stuck my foot on the ‘clutch’ and the siren started blaring.
‘What the hell are you doing that for?’ shouted the copper.
‘Because I don’t know what the hell I’m doing,’ I should have replied. But no one needs to hear an ambulance person say that. So I shrugged instead.
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Before joining the ambulance service, the only dead body I’d seen was my auntie. She fell down the stairs, was going to die, then wasn’t. My mum and dad had arranged to take me and my sister to visit her in intensive care, before getting a phone call to say, ‘Leave the kids at home, you need to come and say your goodbyes.’ That same day, my auntie passed away. She was thirty-six.
A couple of days later, we visited the funeral home. Mum and Dad gave me and my sister the choice of whether we wanted to see our auntie or not, and I decided to take a look and say goodbye. She’d been cleaned up by the undertaker and given a bit of make-up, but when I looked at her, I froze. She was still someone I knew, but it wasn’t her any more. It was a bit late for goodbyes. To be honest, it creeped me out. I had nightmares for weeks.
Seeing my first dead body on the job is etched on my mind. I’m in the station – back in the days when we spent time in the station – the radio starts crackling, and me and my partner, an experienced paramedic, calmly make our way to our ambulance and hop in. I say ‘calmly’, but my legs feel like fag ash. And when I see the job on the dispatch screen – MALE, CARDIAC ARREST – it feels like my head might explode. Before you do your first job of the day, you are required to log in using a pin number. I’ve forgotten mine. So there I am, fumbling through my diary, trying to find it. I desperately need the toilet. I believe this is what is technically known as ‘shitting oneself’.
It’s a short drive to the job with blues and twos (lights flashing and sirens blaring). When we arrive on the scene, my partner jumps out of the ambulance and heads for the front door of the house, while I follow with all the equipment clanging against my hips and knees. The patient’s wife is waiting for us in the living room. She matter-of-factly informs us that her husband is upstairs in the bedroom, so my partner asks her to lead the way. As soon as my partner sees the lady’s husband, laid on the bed, he knows he’s already dead. I thought people died with their eyes shut, but this guy is staring straight at the ceiling. As gently as I can, I ask the lady to return downstairs so that we can assess her husband.
My partner asks if I’ve seen a dead body before. I tell him I haven’t, apart from my auntie, and she was in a coffin. It doesn’t look like a person. It’s just the shell of someone who had been using that body and recently checked out. I’m wearing rubber gloves, but I’m scared to touch it. My partner, sensing my discomfort, calmly talks me through the symptoms of death, including how to check for rigor mortis. Before then, I thought rigor mortis made a body shake. I must have seen a film or something in which a corpse was twitching. But rigor mortis just stiffens the joints, hence the phrase, ‘stiff as a board’.
I’m stood there like a lemon thinking, What happens next?, when my partner does something that’s humbling: he closes the man’s eyes, to make it look like he’s doing nothing more dramatic than having a nice snooze. As he’s doing it, he chats to the body: ‘I’m just gonna shut your eyes, me old mate, to make you look a bit more peaceful . . .’ That little act of making the man look like he’s asleep instead of dead might save his family some anguish. Yes, he’s gone, but at least they can say he went in his sleep. My partner is treating this man with so much respect, almost like he’s still alive. To the extent that I’m thinking, Is he? I suppose that’s the point: dead or alive, he’s still a person.
Back downstairs in the living room, my partner breaks the bad news to the dead man’s wife: ‘Unfortunately, your husband has passed away in his sleep. We don’t know what happened, but it was sudden and peaceful, and he wouldn’t have known anything about it.’ He’s just so caring and his actions teach me a valuable lesson that I will never forget: an ambulance person’s job isn’t just to treat the injured and sick, or deal sensitively with the dead, it is also to bring calm and dignity and counsel the bereaved. I learn more in those few minutes than in the whole of my four or five months of training.