‘Get Off and Walk…!’

December 31, 2008
Gorilla minus overcoat

Gorilla minus overcoat

Just a little seasonal taster of the type of patients we come across from time to time. Its these ones who really need to be sorted out and taken to task by all levels of society…and that includes our management and the Police and the courts!

We had been called to an assault in the old part of the city centre. It was early evening, very cold and the streets were full of punters staggering between pubs having a nice time. As the truck slowly meandered its way through the narrow streets with the occasional happy/drunk person bouncing off the side, we eventually found our patient. Laid out in the middle of the street was the shape of a male. A big male. Looking not unlike a gorilla wearing an overcoat and big boots.

My crew mate for the night was a new larker. Fresh out of training school and keen to learn the ropes. I was going to let him attend most of the jobs tonight so he could get the ‘patient exposure’ required to gain experience quickly. I would only intervene if the job got complicated of required further skills or drug therapy. At the start of the shift I had given him the wisdom of my years in the job…‘Speak to patients how they speak to you, don’t show weakness, know your stuff never bluff and above all else never turn down a cup of tea!’

With the headlights of the truck illuminating our patient my crew mate went over and crouched carefully near him. ‘Always make sure you are out of punching and kicking range when assessing levels of consciousness initially’ something I’d learnt the hard way years ago. ‘Hello! Ambulance!’ Can you hear me?’ my crew mate called out. The gorilla in an overcoat stirred…turning onto his side and slowly rising from the floor like a thawed out mammoth awakening from its ice encased sleep.

He had  blood and snot smeared across his face where his nose had parted company with its normal position. He was also slightly unsteady on his feet. Great strands of combed hair that had once been gelled and teased into a fashionable style was now slapped to his forehead like a wet fish. Shaking his head to clear his mind he suddenly focuses on us. ‘What the f****** ell is going on?’ Its at times like this that you determine how the job should play out. You need to get a hold of the situation and control it before it controls you. ‘Ambulance…and were here to help you!’

Usually that’s enough to permeate through alcohol induced fogginess to place us firmly as unbiased, neutral non-combatants in the mind of the aggrieved or injured. Usually! ‘Oh. That’s okay then! My bastard nose hurts like f***!’ Wheres the c*** who did this?’ Senses regained he starts to look around the immediate area for his attacker. Grabbing him by the elbow and motioning towards the back of the truck I advise him to get inside so we can clean him up, get him out of public view and ascertain what properly happened. Luckily he digested this information, processed it and thought ‘Yeah! Good idea!’

My crew mate leads him into the back of the truck and sits him down to get a better look at his injuries and do some basic obs. Before I get chance to follow into the back I am called over by another male. ‘How is e?’ Another unsteady on his feet punter asks. ‘Who are you? Are you a friend? Did you see what happened?’ I ask in reply. After a couple of minutes conversation with his mate the history of the incident becomes clear. Gorilla in an overcoat had upset someones girlfriend and then dismissed the justifiable protestations of her boyfriend. The boyfriend had said his piece though and was leaving the nearby pub with his girlfriend when the Gorilla in an overcoat decided to pursue the argument.

After the boyfriend had tried to walk away for the second time the Gorilla in an overcoat grabbed him…and was surprised to get a cracker of a punch smack bang in the middle of his nose which dropped him to the floor. Someone had seen this and called 999 straight away for the Police who contacted us straight away and we duly arrived minutes later. In the back of the truck his obs seemed fine, no history of loss of consciousness, memory intact, no signs of concussion. But due to the presence of alcohol we advised a check up at A/E. To which he agreed.

All was going well on leaving scene. He seemed affable enough but gave the impression of being the type who was a school bully at one time due to his size. He was sat nearest the back doors and my crew mate was sat near to the cab bulkhead. Every now and then I checked the rear view mirror into the back and craned an ear to make sure my new learned colleague was saying and doing the right things. ‘You’re nought but a little shit!’ My ears prick up. ‘I could have you any day! Wanker!’ I switch the microphone on to hear better. ‘You ambulance drivers think your something don’t you?’ ‘Tossers!’

Slowly and carefully I pull the truck into the side of the road and get out and walk round to the back. On opening the back door I catch the tail end of another stream of abuse directed at my crew mate. ‘Whoa! Whats going on? Why the aggro mate? Its no good taking it out on us. Were here to help you and so far we’ve both looked after you haven’t we?’  The gorilla in an overcoat turns to me and spits full in my face ‘F*** off wanker!’ Having decided in a nano second after his spit hit my face that diplomacy was not going to work it was time for the ‘F plan’.

Without giving him a chance to get more ‘fleg’ up I jump onto the back step and grab him by his collar. Pulling him down and towards the open back door I use his weight and his falling momentum to ‘wing’ him out of the vehicle. ‘Me and my mate don’t get paid enough to take crap…so ‘bye bye’…so sad, too bad.’ Quickly I shut the doors and tell my mate to stay in the back as I get back in and drive off. I inform control and ask for the Police to attend. In my side mirrors I see the gorilla in an overcoat sat on the floor wondering whats happened.

This happens on a regular basis…and management on a regular basis will try and make out that it was your fault the patient turned aggressive. And the Police will eventually turn up and ask for an ambulance to take him to A/E. And if we try and pursue a prosecution it is written off as not being in the public interest. So the gorilla in an overcoat will be out again drinking and causing offence and getting away with it until someone gets well and truly hurt…when it may be too late! But through hard experience I do not take any shit on my truck!

An Ambulance is for Life not just for Christmas!

An Ambulance is for Life not just for Christmas!

Mr.McNumpty-Numbnuts…!!! (He’s not the sharpest tool in the box!)

December 29, 2008


Roger Hargreaves was the creator of that famous band of brothers…the ‘Mister Men’. Millions of children, and quite possibly adults, have read the books and listened to Arthur Lowes lilting tones on the telly. The many various characters with their individual talents such as ‘Mr. Bump’, ‘Miss Tidy’, ‘Mr. Noisy’ and ‘Mr. Tickle’ to name but a few showed us in an informative way that it takes all sorts to make a world.

Here is my nomination for a new ‘Mr. man’.

Heading back to base the MDT started to crank out its incessant noise alerting us to another job. ‘Almost made it back to base’ I thought. I was looking forward to that mug of tea and chucking a sandwich down my neck. The MDT stopped its shrieking as we pushed ‘Mobile to Incident’. The screen gave us an address near to the city centre, the ‘Abandon Hope All Ye Who Enter Here’ community mental health hostel. The reason for our attendance? ‘DSH’ or ‘Deliberate Self Harm’. No further information was displayed as to the exact nature of the DSH. It could be an over dose or cut wrists, or it could be a hanging!

‘Blues and Twos’ were put on and gloves made ready for the short journey to our incident. We arrive at the address and make our way to the entrance with trauma bag, resus bag and monitor/defibrillator to cover all eventualities. We still had no idea what we were going to even asking control to get back in touch with the caller. The building was a late Victorian hospital annex which would not have looked out of place in a Hammer horror picture. Ringing the bell we await the arrival of either Vincent Price or Peter Cushing to open the door.

Everything sounded quiet…too quiet. A sudden ‘Caw’ from behind had us spinning round looking up into the dark trees over hanging the pavement. A huge fat, black raven sat perched on a branch squawking its protestations at us for disturbing its sleep. ‘Shit! I wish I had my air rifle with me. I’d soon sort that noisy twat out!’ My crew mate imitates taking aim and pulls an imaginary trigger. ‘Don’t be daft! You couldn’t find your arse with both hands let alone get a target in the  cross hairs!’ Disgruntled at his gun toting prowess being called into question my crew mate huffs and turns back to face the door.

‘They don’t seem to be in a rush to let us in do they?’ I mutter more to myself as ‘Billy the Kid’ leans against the wall. This could mean any number of things. First…its the wrong address, second…there’s no-one in, third…all hell has let loose inside and members of staff are frantically trying to stem the flow of blood from slashed wrists or struggle to cut down the body from the ceiling! Or fourth…its sod all and the staff are still finishing off their smokes outside the back.

At last after several assorted knocks on the big solid, timbered door we are bathed in light as the hallway comes to life. We can make out a shape through the stained glass windows behind all the wire and mesh grills. Bolts are slid back, chains are undone, keys are turned and the huge door lumbers slowly open revealing a woman holding a set of keys, pager, hand held radio, papers, cigs and lighter. (She had big hands!) ‘You rang?’ I say in my best Vincent Price accent which comes out more like Joe Pasquale. My crew mate tries not to snigger and does an excellent impression of ‘Muttley’ from the ‘Wacky Races’ in doing so.

‘Come in please. I’ll just lock up and show you where to go.’  Whilst the rather nice looking lady warder, although with big hands, secures the front door I ask what we have been called to? ‘Oh its Mr. McNumpty-Numbnuts. hes stabbed himself…again!’ After asking if its safe to see him and being assured that he is harmless to others, we make our way to the back of the property where a communal lounge echoes to the sounds of the telly and people coughing as they smoke their way through to various chest infections. ‘Hes in there, I’ll just go and get his records from the office.’

The room is semi dark and shrouded in a fog of tobacco smoke. The big old heavy curtains (fire retardant material) keep out the light from the lamp posts standing outside. The walls seem to be dull, yellow with a hint of brown on the ceilings. I think the carpet is dark red, or maybe off black?  The furniture is plain, functional and occupied by people of various shapes and sizes all doing a very good impression of experimental smoking beagles. I try to locate our patient. Thinking that some one who had stabbed themselves would be easy to spot we look around at the dozen or so people in the room.

‘Are you looking for Mr. McNumpty-Numbnuts?’ a tall person standing in the centre of the room, watching the late News on the TV and holding a cup of coffee asks us. ‘Er…yes. Can you tell us where he might be?’  Finishing the coffee in his cup he then pulls out a roll-up from behind his ear and lights it (the roll-up not his ear!). Taking a big drag on his cig he turns half to us, cocks his head to one side and with a smile of someone not playing with a full deck says ‘Its me lads!’ I step back involuntary with my crew mate, scanning at the same time for weapons or threat of attack. No weapons seen…no threat as of yet!

Its at times like these we have to remember that things don’t always appear as they seem. A quick recce of the possible scenarios play through my mind. 1/ This is not Mr.McNumpty-Numbnuts but someone obviously with a problem of some sort? 2/ This is Mr.McNumpty-Numbnuts but the staff have panicked and not investigated properly the alleged ‘self stabbing’ . ‘Er…how you doing?’ I ask, still scoping the area for possible threats. I remember years ago being attacked with an axe by a psyche patient, and I was lucky that time that my ‘spidey’ senses were working properly.   

‘Yeah! I’m alright! I’m fine lads! Bit pissed off like but yeah I’m fine!’ He seems in control, but that just makes me even more careful. ‘Someone says you’ve hurt yourself Mr.McNumpty-Numbnuts?’ I cant see any obvious wounds or outward signs of circulatory compromise. Slowly he turns to fully face us and gingerly lifts up his sweatshirt…‘You mean this?’ Sticking out of his belly is a pair of scissors…that have gone in right up-to the handles! He flicks the handles expecting to hear a ‘Twwaannngggg!’ to prove that the scissors are well and truly stuck! ‘Er…do you mind not doing that please!’ I ask as I look at where the scissors have gone in.

They have entered his umbilicus (belly button). ‘Erm…how long are these scissors Mr. McNumpty-Numbnuts?’  He uses his free hand and spreads his fingers apart and stretches his thumb out. ‘I guess about 6 – 8 inches!’  he states quite calmly. It doesn’t make sense, he should be bleeding like a stuck pig! He should be white as a sheet and not standing up drinking coffee, smoking roll-ups and watching the telly! ‘Do you mind if I take a look?’ I ask as I move towards him. ‘Not at all, feel free, help yourself!’ he says.

Looking at the wound, the scissors have indeed gone right in but I can see the outline beneath his skin of the blades. It looks like he has inserted the scissors in and then up towards his chest! ‘Right…I think we need to take a trip down to A/E to sort this out, is that okay with you?’ Mr. McNumpty-Numbnuts nods and then quickly moves around the room shaking everyones hand saying that he’ll see them later. Half of the residents tell him to ‘**** off’, the other half seem oblivious to it all and continue smoking their cigs and watching the telly while maintaining a constant cacophony of coughing.

Thinking that we really need to get him on a stretcher and not to make any sudden moves I ask him the obvious things..‘Dizzy?…breathless?…any pain?’ All are answered in the negative and he insists on walking out to our truck. The female member of staff, the only member of staff we have seen, comes back with the paperwork and motions us towards the front door.‘Are you sending a staff member with him for continuity of care?’ I ask. ‘No we dont tend to send anyone with him as its such a regular event. Have a look at his file at A/E and you’ll see what I mean!’ 

Our patient refuses to get on the stretcher and insists on sitting down on the seat opposite. Before I have chance to explain that due to the position of the scissors sitting down might cause them to piece his diaphragm or other organs…he plonks himself in the seat…and lets out a blood curdling scream! I go to catch him as he falls to one side as as I do he sits bolt upright and starts to laugh like a drain! ‘Gotcha!!!‘ The smile and his nicotine stained teeth flash across his face. I’ve had enough of this joker and tell my crew mate to get going and let the hospital know were on our way.

Travelling to the A/E I ask Mr.McNumpty-Numbnuts why hes done what he has. The reply…? ‘I was bored and fed up so I thought I’d have a little trip out for the night!’ Arriving at the hospital again he insists quite forcefully on walking in. I show the wound to the triage nurse who almost faints and points to resus. Inside resus he bimbles over to the trolley-bed and leaps onto it, crossing his ankles and gets comfortable putting his hands behind his head. In walks the consultant and before I get chance to give a verbal handover he lifts up the sweatshirt and flicks the handles of the scissors. I wish people would stop doing that. ‘Its alright…me and Mr. Mc Numpty-Numbnuts go back a few years. Hes done this that many times he has a pocket of skin inside like a sheath. That’s why he does not bleed.’

Completing my paperwork I nod to our patient and wonder how he discovered this feat in the first place. Later on in the shift I discover that he had used ‘hairdressing scissors’ which are lethally sharp. They were removed, he was seen by the on call psychiatrist and then discharged back to the hostel…only to do it again before the end of my shift. This time he was seen by another crew who said that he’d used a steak knife! Its only a matter of time…!!! 

He is my nomination for a new ‘Mr.Man book!


Foot note: In no way do I mean to decry or belittle the many thousands of people who self harm. But on further investigation I found out that this chap had a severe form of attention seeking which causes him to be totally selfish and treats it like a ‘get out clause’ for when he cant get his own way in life. He has not been diagnosed with any significant disorder and continues to be a drain on all around him.

Strictly Come Dancing on Ice meets Bambi…in the Car Park!

December 22, 2008
Icy Night

Icy Night

Its half past four in the morning and the dark skies contrast starkly with the snow on the pavements and verges. Its a real bone chilling icer of a night. I’m constantly stamping my boots in the passenger foot-well of the truck to maintain the circulation. I can feel the coldness seeping through my steel toecaps and creeping up my legs.

As we gingerly drive towards our intended patient the blue strobes are bouncing off the black ice on the road surface. Never mind having ‘Sat Nav’ we should have ‘Ice Nav’ to help us avoid the treacherous ice. The vehicle is slipping and seems to be flying slowly just above the tarmac. I see my crew mate constantly correcting his steering as the wheels struggle to purchase some grip.

As we approach the vicinity of our incident we start to slow down even more…and gracefully glide past the junction we need to turn down. Luckily there is minimal traffic at this time in the morning but there are plenty of parked vehicles around. Eventually after a 300 point turn we slip and slide into the industrial estate in search of the factory car park where someone has crashed their motorbike on the ice.

How someone made it this far on their motorbike seems a miracle as we constantly bump the wheels against the kerb failing to get proper traction on the road. After what seemed like an eternity we are flagged down by a security guard and pointed towards the large car park at the rear of a very large industrial unit. ‘Be careful of the ice! Its treacherous round there!’ says the guard. ‘No shit Sherlock!’ I think as if we need reminding!

After several demonstrations of doing ‘J’ turns and ‘handbrake turns’ without having to do anything we see a group of people crouched over a figure in the middle of the road. A smashed up motorbike lays on its side nearby. My crew mate makes sure that he steers away from the group before gently depressing the brake pedal. Once again all we can do is wave from our cab as we sail majestically by like some sort of  ‘Federation Space Battle Cruiser’ slowly drifting through deepest dark space.

The vehicle comes to a sudden stop as the front wheels bump into the kerb, but then it carries on by swinging the rear round not unlike a very slow version of the waltzers at the fair. All we can do is wait for the ride to stop. After two more very slow 360s the truck comes to a rest. I feel as if I’ve taken part in the worlds biggest game of pinball! We are now more than a hundred metres from our casualty. Opening the cab door invites the cold icy breath of Jack Frost into our faces and his ice cold fingers seek out the gaps between neck and uniform collar.

On the Waltzers

On the Waltzers

Keeping hold of the door I place one boot on the road carefully followed by the other boot. It seems okay as I dig my heels into the surface to determine how deep the ice is. ‘I’ll go take a look first and give you a heads up on the road conditions.’ My crew mate nods enthusiastically knowing that he can stay in the warmth a bit longer. I’m cold, I’m tired, I,m hungry and its me that has to make my way across this black ice tundra…so I leave the truck door open to get my own back.

It takes a couple of interesting minutes of modern dance moves before I arrive next to the casualty. I have never experienced ice conditions as bad as this before. The casualty is a woman lying face down, helmet off, groaning with pain. I quickly establish a GCS level of 15 and determine her main injury being a possible mid shaft fracture of her right femur. Colleagues from a nearby factory who heard the crash have covered her in coats etc to try and keep her warm.

Once again I set out on the perilous journey across the car park over the black ice tundra towards the big yellow thing with its twinkling blue lights and its steamed up windows. Eventually I sidle up alongside the truck ‘Ninja’ like with a stealth befitting any assassin. My crew mate has closed the passenger door to keep warm. With speed of hand and deftness of foot I yank open the truck door and scare the living shit out of him. A major spillage of hot steaming coffee occurs betwixt mouth and cup. ‘Arrrghhh! You mad bastard! What you doing?’  he calls out plaintively.

Together we get the lift down on the truck and using the stretcher as a make shift sleigh we skate across to the casualty. The moon suddenly makes an appearance casting its spotlight onto us revealing us in perfect tandem keeping one foot each on the floor and propelling ourselves gracefully with the other foot. Sheer poetry in motion.  Arriving by our patients side we make plans to get her off the ice cold floor and onto our sleigh  stretcher.

‘I think we’ll use the scoop then we can use some bystanders to help us lift her.’ I leave my crewmate to explain to her colleagues our plan. After another couple of interesting forays into the world of modern dance I bring the scoop stretcher over. An ingenious piece of kit designed by someone ingenious enough not to have a job that requires you to work in all conditions in all weathers at all times of the day and night! We quickly assemble the scoop under our patient and prepare to lift.

I take the head end so I can explain to our casualty what we are doing and my crew mate takes the foot end. Two work colleagues, one either side, get ready to help with the manoeuvre. ‘Right on the word of command LIFT! we all need to lift at the same time…and watch your backs!’  ‘Ready? 1, 2, 3 and LIFT!’  The strain is taken, knuckles whiten as they grip tighter under the scoop stretcher with an audible intake of breath as oxygen is sent to muscles for the effort about to be undertaken.

Everything goes well as the patient slowly rises from the floor…then I realise my feet are slipping…sideways! I see people around me get taller as I get smaller. My boots cant grip with the extra weight and as I approach the final stages of the splits I am reminded of ‘Bambi’ suffering a similar fate on ice! As my groin reaches towards the floor, my voice is changing octaves as I speak, shout, yell…eventually shrieking  ‘Put the scoop down! Put the scoop down!‘  Just as I am about to do a very good impression of Jean Claude Van Damme doing the splits I regain traction and with one last effort our patient is on the sleigh stretcher.

Me since the incident...!

Me since the incident...!

After a slow skate back across the car park we safely place our casualty in the truck where we warm her up with blankets and  get the heaters going full blast. Eventually we set off to A/E on a journey that should take only twenty minutes but which in fact takes us almost an hour!

The next day I am still sore around the old groin area but now have remarkable flexibility! I make a mental note to myself…to do less nights and especially less freezing cold nights!!!