1 August 2017
I’d never admit this to civilians because it sounds in bad taste, but within hours of starting my air ambulance training, I experience something like peace.
It’s crazy soon. Our trainers haven’t even finished outlining the curriculum, but I know in my bones that Tim was right: this will fit me like an XS latex glove.
‘We aim to get you competent to deal with whatever might be thrown at you. But even if you do this for ten, twenty years, there will still be a patient or a scenario where you feel utterly unprepared, or afraid, or out of control.
‘This year, PHEM doctors – and their colleagues – have faced some of the most challenging incidents in decades, at Westminster, London Bridge and the Manchester Arena. You can never be ready for something like that.
‘But we chose you guys for the programme because we think you have the qualities to help those who need it, even in the most extreme circumstances. In the field, it’s just you and the team and your training and your instincts. Transcending fear to make a difference is an incredible privilege.’
It rings so true. These are my people. This is where I am meant to be.
After a month of drinking in every bit of knowledge and every skillset, I’m sent back to my air ambulance base. To begin with, I’m literally excess baggage on the helicopter, travelling alongside the crews but unable to do anything but the most basic tasks.
I make friends with the pilots first; I can talk aerodynamics with them and purr over the controls.
Next, I win the paramedics over with my willingness to clean up the mess that fills the helicopter after we’ve handed over a patient. Plus, they realize quickly that I can cannulate or intubate in my sleep.
Gwen, the consultant, is the hardest nut to crack, but still she’s nowhere near as frightening as the average ward manager. Plus, she’s awesome. If I ever get to be half as good a doctor as she is, I will be happy.
Life at base is about being prepared, like grown-up Girl Guides or St John cadets: stocking, restocking, counting, waiting. But when the red phone rings, the change is instantaneous. The first few times it happens, my response is physical – dry mouth, goosebumps, mild tachycardia. My body readies itself for the unknown and we board the helicopter.
‘RTC, Dorking Bypass. One artic, three cars.’
On the way, I always try to build a mental model of what we’re going to face. As we approach the crash, the pilot navigates the hazards of power cables and rows of houses to land in a playing field.
Gwen deplanes with Lars, her favourite paramedic, and I jump out behind them. My instinct to run first and think later is probably my biggest weakness, but I’m trying to learn from Gwen as she holds back, assesses the scene, establishes who is in charge.
‘Hi, what have we got?’ she asks the fire officer.
‘Car versus lorry. Couple of other cars shunted behind. The occupants of the Honda have come off worse. Two females, passenger looks worse and she’s pregnant.’
I’ve spent four years dealing with the consequences of these David and Goliath accidents in the hospital setting. But as we approach, it seems miraculous that anyone might have survived inside the warped remains of the little blue hatchback.
The passenger’s belly and the airbag have the same cushiony roundness, but everything else is harsh and sharp, the angles of the car helter-skelter.
Gwen leans in. ‘All right, love, my name’s Gwen, I’m a doctor and we’ll have you out of here very soon and off to hospital. Where does it hurt?’
As Gwen works, I am making my own assessment and soon she turns to me. ‘All right, doctor, what would you do now?’
‘Her pulse and sats look OK but even so, we need to watch for bleeding when the fire service start cutting. And she needs analgesia. Ket. It’s OK for a pregnant woman. Right?’
‘So don’t just stand there, go and get what we need.’
Gwen and I work together to get the ketamine administered as the fire service begin to slice into the car, cutting off the roof and rolling the dashboard away. It’s enough to stop our patient worrying about pain. Instead, she’s babbling happily and telling Gwen she really, really loves her.
It’s over an hour before our patient is on her way to the trauma centre by road, with Gwen ready to step in if she needs treatment en route. I fly back to base with Lars and Carrot, our pilot. As we take off, the scene turns back into a model village: other people’s lives in miniature.
‘Sound work there, Kerry,’ Lars says. ‘She’s warming to you.’
‘I don’t see much sign of that.’
When Gwen gets back, she asks me if I could stay behind after the shift. We only just fit into the cramped admin office: the air ambulance is a charity, so the facilities are even shabbier than the NHS.
‘So, Kerry. Baptism of fire, right?’
‘It’s challenging, but I love every minute.’
She laughs and her face softens. ‘This isn’t an interview.’
‘What is it then?’
‘It’s . . . a small apology. Apparently, I’ve been quite hard on you.’
I stare at her, genuinely lost for words.
‘Lars has pointed out that most of our medics are consultants by the time they come to us, so it’s hardly surprising you’re not quite as competent yet. And what you lack in experience, you’re starting to make up for in enthusiasm. A little too much enthusiasm at times, so do keep a check on your tendency to rush in. But overall, I like you.’
‘Really? I thought you’d asked me here to tell me I should go back to hospital medicine.’
Gwen peers over her glasses. ‘I don’t think so, dear. We’re spending a fortune training you, and it’s nice to have another female around, especially a competent one. But that’s not my main concern.’
‘Oh?’
‘I need you to speed up. Prove you’re up to the job and, specifically, for covering my shifts in December. Because otherwise I’m going to have to cancel my birthday trek in Myanmar and that will piss me right off.’
So December is when the real baptism of fire begins.
I learn more in the months leading up than I have in the previous four years. I’m OK at this. And I am going to be really, really OK.
Marek is going home for Christmas so I take him to Gatwick first thing on the 24th before my shift starts. We live together now. He moved into my flat six months ago after he left the uni postgrad accommodation. It works well, though part of me is looking forward to having the space to myself while he’s away.
We sit in the drop-off area, as the security men eye us, trying to work out if we’re up to anything more sinister than saying goodbye. Marek looks extra handsome in his suit, worn to please his mother, who’ll be waiting at arrivals.
‘They will be so angry I have not brought you with me as their Christmas present.’
I met Marek’s parents when we went to Warsaw in October. They were kind, but clearly unsure of what to make of me, or of our passionate-but-not-serious relationship.
They’re not the only ones. I do care about him, but I would choose my career over our relationship. I think he’s the same about ruins. Or is he?
‘A Polish Christmas sounds wonderful.’
‘Next year,’ he says. Is it a slip of the tongue or a test? Next year he’s due to be leaving the UK for good, and we don’t talk more than a month or two ahead. We never made it an official rule; it’s how things have developed.
I let the idea of next year settle. It sounds . . . nice. And he’s well thought of in his department, so they’d probably extend his stay. The only thing that’s non-negotiable is my training: I won’t let anyone get in the way of that.
The security guard taps on my window. ‘No waiting,’ he says when I buzz it down.
Marek leans across to kiss me. As he pulls away again, I hold on, though I can’t explain why.
‘Hey,’ Marek says. ‘You OK?’
‘Yeah,’ I lie. I am not superstitious but I suddenly have this fear we will never see each other again.
I shake it away. I’m tired, that’s all.
‘Back soon, zabka.’ Little frog. ‘Missing ya already!’
‘I bet you say that to all the girls.’
There’s a festive atmosphere at base – I’ve brought in some home-made mince pies, and we only get one callout in the morning, a walker found having a seizure on the Downs. We transport her to hospital by air because the Christmas Eve traffic would take an ambulance three times as long.
Dusk comes just before four and we’re all hoping that’ll be it for the day. It’s much harder to navigate and land in the dark, and today the rain is relentless.
When the red phone rings, I freeze, suddenly convinced that even thinking it might have caused trouble.
‘Train derailment, near Haywards Heath.’ Stacey, our scheduler, repeats the details. The temperature in the shed seems to plummet ten degrees.
‘I thought the bloody trains had stopped running by now,’ Lars whispers. ‘I’ll hold on for the coordinates.’
Carrot and I are already on the helicopter, headsets on, as more information begins to come in. Four carriages of the London train have derailed twenty miles north of Brighton.
‘It’s big,’ Carrot says.
Can I do this?
‘You’re ready,’ he says, answering my unspoken question.
Lars climbs into the front, pulls on the headphones and Carrot prepares for take-off. ‘They’re struggling to get access. We might be the first to get to some of the carriages.’ He turns round. ‘Talk it through with me.’
‘Primary assessment, triage using the CABCDE checklist. We don’t treat anyone until we’re sure the scene is safe and everyone has been assessed.’
‘It can be bloody hard not to jump in and help, Kerry. But stick to it. It really is the only way to keep control of a major incident.’
From the air, the ground looks so Christmassy: yellow garlands criss-cross wildly, the cars on the motorway and the A roads blinking like fairy lights, blurred by the heavy rain. Carrot’s been flying on instruments, but as we get closer, there’s a cluster of blue lights showing the way.
Not nearly enough people on scene.
Lars and Carrot discuss the safest place to land, so I focus on trying to make sense of what I’m seeing. Whatever has made the train derail, it’s happened in the worst possible place, bordering farmland and several ditches or streams. The rear two carriages look only slightly off-kilter, as though they’ve been indulging in a little mulled wine, and I can see movement down there – walking wounded. But the front two carriages hang down the banks, twisted like a child’s toy train.
The rain is still pouring and most of the emergency vehicles – two fire engines, three ambulances – seem to be stranded at the other end of a field.
We are easily the closest.
Carrot lands and Lars and I prepare to deplane. ‘We stick together, all right, Kerry?’
The adrenaline washes away my nerves. There are tens, maybe hundreds of people who need me. I have been building up to this moment for eleven years.
Maybe all my life.