Jul 26 2009

Friendly smiles

Tag: Abu-Dhabi DCKal @ 12:23 pm

Came across this image in my Flickr photostream and realised I’d forgotten to tell you all the story of it.

While we were taking this picture, on the last night of the ADDC, a security guard in a peaked cap was standing behind the photographer, shouting at us.

“No! No! Get off the stage!”

We weren’t being disruptive, or obstructive. We were just using their backdrop.

The security guard got increasingly irate, hopping up and down and visibly panicking that his normal instructions weren’t having us scamper away from him.

At one point, someone in the group said to him “Ok mate, we’ll get off the stage right up until you get out of the way of the photo.”

Because what he learned, is that a group of people which comprises of military, special forces and emergency medics, who are absolutely accustomed to being The Last Word in a situation, tend to be irritatingly steadfast when they JUST WANT THEIR PHOTO TAKEN WITH THEIR FRIENDS.


May 24 2009

ADDC Day VIII Part 2

Tag: Abu-Dhabi DCKal @ 4:01 pm

The day gets better and better from then on.

On the occasional stretches of tarmac we drive to cut corners off the rally route and catch up with the pack, we play “Name that tune” by blasting Ipods into the two-way radios between the vehicles. We stop for lunch and the driver of the lead car opens the bonnet to reveal a half dozen chicken and mushroom pies, wrapped in tin foil, that have been baking in the engine compartment all morning. They’re boiling hot and delicious and I scoff mine with relish, turning my body against the wind to avoid the sprinkling of sand the desert offers as garnish.

Driving along the rally route we get stuck.

A lot.

Several times my driver’s vehicle grounds on the ridge of a dune and we have to get towed off by our companions. On two occasions the drivers drop down into hollows and crash into shrubs and bushes, the branches tangling in the wheels, tying the trucks to the floor.

Grounded on a bush.

We’re winding down for the end of the day, cruising along dirt trails, matching the pace of the last few riders on our final approach to Abu Dhabi and the race finish when a message comes over the radio from the last car in our convoy.

“Boy on a bike here wants to talk to the medic.”

We pull over and the motorcyclist catches up with us, barely manages to dismount on shaking legs and sits down heavily in the sand.

“Have you any salt?”

He’s made a serious error in his rehydration plan, drinking nothing but water all day is all well and good but doesn’t replace the salts, sugar and electrolytes the body sweats and pisses out through the day. His metabolism is shot, despite drinking enough water to float a battleship.

It’s the end of the event and I can’t see that I’ll have any use for them back in Scotland, so I skip the Dioralyte in the medical bag and instead mix him up a sachet of the raspberry isotonic energy drinks I brought over. Each day I’ve mixed a canteen of this stuff and chucked it in my bag in case I became dehydrated, each night I’ve drunk the remainder over dinner. It doesn’t taste bad, like very sweet, faintly salty juice.

I’ve been mixing mine in a litre canteen. This rider gets a whole sachet in a 300ml bottle. The drink is so thick and pink by the time the granules have dissolved that it makes my teeth itch to look at it, but I press it into his hands and encourage him to drink, chasing it down with another litre or so of chilled water from the cooler in the back of our vehicle.

In minutes he’s standing, smiling, laughing.

“How do you feel?”
“Amazing! Fantastic! Thankyou!”

We’re chuckling at his miracle cure when one of the sweep drivers pulls me aside.

“I’ve had a call from Rally Control, they’re shutting the event down, he’s too late to finish. They say we’re to pull him, load his bike and transport him to the finish line.”

“But why? He’s not medically unfit, he’s fine.”

“It’s an ops thing, they want him pulled off the course, he’s the last racer of the pack.”

“But he’s nearly finished, there’s only another 20k to go”

“I know. Ahhh, fuck it.”

The driver calls Rally Control back and explains that he’s not prepared to pull the rider, they agree that the rider can travel to the next check point and they’ll review the situation on his arrival. The racer, number 40, jumps back on his bike and burns off into the distance. We smile at his dust cloud and make our own way to the third and final check point before the finish line, 40 only visible as a grimy smudge of exhaust fumes and kicked up dirt on the dunes ahead.

At the checkpoint , number 40’s bike is up on its kickstand by the official’s desk, we spot him walking across the sand towards a helicopter touched down in the distance. I jog after him and Christina, Laura and I check him out comprehensively.

He’s fine. The figure of health, a professional racer raring to finish his job.

The officials still insist that he is to stop racing. He’s now 12 kilometres from the finish. It’s just not fair.

As a group, we three medics contact Patch and argue 40’s case, he’s not unwell, he’s capable and competent and he’s been working at this race for the past four days. Pulling him from the event here is inhumane.

Patch agrees, pulls strings in the background and a few minutes later a checkpoint official grudgingly approaches us; the message has come through. 40 can finish his race.

We’re all beaming; never mind saving lives, saving someone’s race is just as satisfying. 40 high-fives the three of us in turn and once again takes off into the distance. We all mount up into trucks and choppers and make for the finish.

Another five kilometres pass and we happen upon the Kamaz, that beautiful behemoth we’ve been lusting over all week. Technical difficulties have crippled the vehicle, her Italian crew stamping up and down the sand alongside, spitting and swearing.

Stranded Kamaz with dejected Italians.

We speak almost no Italian, they no English, but we all bump along together in French. There’s no way we can tow the Kamaz out over the sand, it’s far too big; their support team are en route in another Kamaz to pull them to safety. We leave them with the leftovers of our breakfast and lunch and a crate of water, as we drive away the three crew members are hungrily decimating cold bacon sandwiches and woody apples in the cab.

We’re minutes from the finish line when my mobile bleeps, a message from Gus at Rally Control with a message that makes me shiver.

“Racer 40 now stationary, no distress call received”

The message is followed by a bewildering GPS coordinate that leaves me scratching my non-military head. I text back:

“Locus in laymans, please?”

I can see Gus shaking his head at me and laughing back at Control, but he replies in my language.

“Four clicks from you now, helo to over-fly as backup. Keep us up to date.”

We floor it, bumping and bouncing through the sand. The fact that 40 hasn’t hit his panic button or contacted Rally Control worries me – has he collapsed? Come off? Is he unconscious? Crippled?

Is 40, our rehydrated, race-finishing champion, now lying in the dirt staring at the clouds?

A few minutes later we come across him, sitting in the dirt, his bike lying silently on its side.

He’s sobbing, his face in his hands, he looks up as we approach.

“Fuel pump. Can you believe it? Fuel pump.”

His bike has given in before he has. We’re two kilometres from the finish line.

Two.

We help him into the back of our truck, the sweep team load his bike onto the trailer and we’re about to set off when the helicopter swoops overhead. I cross my arms over my head and as they swoop lower make a big “OK” with my fingers before waving them on. The pilot gives me a thumbs up, turns the helo in the air, the thudding of the blade turn from treble to bass as they push away and they leave us to it.

We drive 40 to the finish line where his support team are awaiting his triumphant arrival, having heard he’s being allowed to finish. They are equally crushed to see his bike jacked up on the trailer, to see him slump from the back seat of the truck.

The whole team rendezvous in Abu-Dhabi, at the same club where the event started five days ago. Each rider is brought up onto a podium for photos with their vehicle, to shake the hands of the organisers and receive their awards.

The bikes celebrate by wheelying off the podium and down the avenue of adoring spectators.

There’s a party atmosphere at the club, but we’re all beat – we hail cabs, hijack Patch and Gus’s cars and drive in a slow convoy back to the hotel.

We are not the clientele the Crown Plaza in Abu-Dhabi are used to. Grimy and sweaty, wearing camo gear and boots that shed little piles of sand with every step, we slump at the reception desk while the staff cock up our bookings.

Everyone just wants a shower, a bath, a seat, some coffee, maybe a half hour of shit telly.

Home comforts are only missed when they’re so close and yet denied. Gus, calm and exact as a Stanley blade talks the hotel staff through their own booking system, he seems to be restraining himself from grabbing the ledger off the lassie and doing it all himself.

There’s a gala dinner planned for this evening, the rota was swung so that only male staff worked on the sweep vehicles and the women flew in choppers today, the thinking being that they’d have more time to get glammed up in the hotel.

Right now the thought of a shower I don’t have to wear flip flops in or a bed that doesn’t fill up with sand if you do something revolutionary like, say, turning over in your sleep sound like some form of cosmic orgasmic nirvana.

Rolf and I are sharing a room and we trudge the length of the corridor. Rolf enters first and I’m still struggling with my bag when I shout out to him.

“Is the room ok? Are we happy?”

He laughs his big keg Swedish laugh at me.

“I think you’ll like it.”

I find myself standing in the lobby of my hotel room.

From here I walk into the living/dining room. Then on into the hall (with bath and shower off) and through into the master bedroom with its king size bed crowned in cool, crisp linen.

But only one of them.

I shout through to Rolf.

“Ummmm…mate? I think we may have a bed problem…”

But he’s way ahead of me.

“I’m not staying. My flight home is tonight, I’m leaving straight after the party.”

“So why did you check in?”

“I registered my Platinum card at the desk for any expenses, I knew if they THOUGHT I had money they’d upgrade me and I thought you deserved the treat. We don’t have a bed problem. Welcome to your hotel suite.”

Whattaguy. Seriously. Whattaguy.


May 21 2009

ADDC Day VIII – Part One

Tag: Abu-Dhabi DCKal @ 4:38 pm

Day eight and I’m back on sweep, my heart sulking, kicking piles of dust around inside my chest; my last day in the desert and I’m to spend it sweating and dozing, sidelined and surplus.

I pack up breakfast for the sweep team, flatbreads, sausages, bacon and pots of honey, fruit and juice, crammed into sweaty polystyrene packets. Baz drives me back to the rest-house and I find my team, shuffle into their ranks, kicked-dog head down, apologising for myself and my presence.

These guys are, in general, much nicer than the last lot. Friendly and welcoming, packing me into a four by four, laughing at my tales of the last sweep I did.

“Well, maybe you can show me a better day?” I enquire, hoping to make some friends. I am met with a dead pan glare from the driver of the lead car.

“We’re not here to show you a good time, we’re here to work.”

Once again I realise I’m back to being the new boy, having spent the week proving myself, fitting in, earning my spurs, now I’m just another passenger in their team.

My work starts over.

My driver is fantastic, instantly gets me to work, involved and explaining everything as we deflate the tires on the vehicle – “You can be the tire bitch for the day…” We head off in convoy, dipping and swinging through the dunes like last time, but this time with happy banter over the radio, my driver throwing me a race chart, explaining the features and navigational points by which we’re meant to make our way through the sand.

It may be the same trick as getting a bored kid to count yellow cars on a long journey, but it engages me and suddenly I understand what the rally drivers are doing, how they progress along the route, spotting dunes and berms, barrels and posts along the road side. The race chart even describes the types of sand we’re rumbling over, I begin to appreciate the differences, realising the skill and presence of mind it takes to drive in this environment.

Our vehicle being lower slung than the lead car, my driver spends some time picking routes around sand bowls and over dune lips, not wishing to ground himself unnecessarily. We lose sight of the lead car behind a dune but are called back into convoy with a terse message on the radio.

“We need the medic. Get Nursey up here. Now.”

My driver floors it up and over the dune. Punching through the arrete we see the lead truck parked beside a floored bike, the sand around it mashed and thrown apart. As we drive closer I spot the rider sitting on the lead truck’s trailer, his helmet off, staring into the middle distance. I hop out of the my motor and make my way over.

“Hi there mate, I’m Kal, one of the medics. What’s your name?”

“Ashram.”

“Hi Ashram, can you tell me what happened?”

He looks at the bike in the sand, tries to peer around at the surrounding dunes, but is stopped by my hands on his temples.

“Just look straight ahead at me, please Ashram, try not to move your head. You were going to tell me what happened?”

He furrows his brow.

“I think I came off my bike.”

You think?

“Do you know how fast you were going?”

He looks down at the hard packed sand on the ground, kicks it with his toe.

“I’m not sure…On this? Fast. I would be fast.”

“How fast?”

“Maybe about a hundred?”

I don’t understand the metric system, but I’m aware that a hundred KPH equals roughly 70mph. I think.

Fuck it, even if my calculations are off? This is a man whose job it is to drive over the desert quicker than everyone else and he described himself as driving “fast”.

Good enough for me.

I gesture at his jacket and neck brace; every motorcycle crash I’ve ever attended in Edinburgh has been played out against a background of grousing about leathers.

Bikers hate having their jackets cut, they whine bitterly when we try to, opting instead to thrash their necks and backs around as they writhe out of their clothes on the floor. Clearly, given the option between paying for a new jacket or having a knackered cervical spine, the latter is the more attractive option.

The racers out here have no such hang-ups; possibly because they’re all sponsored up the wazoo – a new jacket won’t make a dent in your racing budget if an oil company has paid for you to be here in the first place. Ashram smiles and shrugs as I unclip his neck brace and slide his jacket down his shoulders.

“If you need, you can cut…” he begins, but I’m down to his neck without breaking out my shears. I walk my fingers down his spine.

“Any pain here? Or here? Or here?”

“No, no, no.” He answers without a shred of impatience or irritation, he seems genuinely glad to be looked after, a refreshing change from home.

The only injury I can find on Ashram is a deep purple bruise on his forehead, just over his left eye. I’m a little concerned as to where that’s come from, considering that he had a helmet on.

More concerning to me is the fact that he can’t remember hitting his head off anything, but then, he can’t remember coming off his bike either. Memory gaps in head injuries are a bad sign, this guy’s going to hospital. Hell, at home, I’d be crashing him into resus based on the indicent history alone.

I wrap a collar around his neck, leave my hands on his temples, tell him to keep staring straight ahead and call over my shoulder to the sweep team.

“Could one of you shout up for a chopper, please?”

There’s a pregnant pause before they laugh at me, one of them grins in a way that can only signify “Aye, good one, Kal.”

I stare for a moment.

“Guys? Can you call for an aircraft.”

They blink back at me.

“What do you want a helicopter for?”

I would have thought that was obvious.

“Because I want to cas-evac him and we can’t do that in our trucks.”

“But he’s alright.”

“We don’t know that. Can you just make the call, please?”

“But what do you want to fly him out for? He’s not hurt. Look at him.”

Communication is everything, Kal. There is no situation that can’t be overcome with education and mutual understanding. .

“He’s come off his bike at a hundred plus KPH, his head was travelling at the speed and has hit something, we don’t know what, and now he has unexplained head injuries and a history of unconsciousness. He’s getting immobilised and flown out.”

“Are you kidding me? I’ve had worse than this on my bike and ridden home.”

Fuck’s sake, even bams on Leith Walk will call an ambulance for you if you ask them….I silently count to ten and am disappointed with its calming effects.

Why are we discussing this? More to the point, why the fuck are we discussing it in front of the patient?

Fizzing, I weigh up my options and faced elect to pull rank.

“Who’s the medic, mate?”

“You are”

“Thankyou. Call a helicopter, please.”

Grumbling, he heads back to his vehicle, calls up to Patch and relays the message via the iridium satellite comms system that all the vehicles carry.

I slide a cannula into Ashram’s wrist and am debating the pros and cons of fluid therapy for him (dehydration vs increasing blood pressure on a closed head injury) when I’m interrupted by a steady whupping noise over the horizon.

Behind me, coming out of the sun like a benevolent orange angel comes the 412. It lands a hundred yards away and Hurls, Laura and Christina jump out, hurrying over. I bring them up to speed and together we secure Ashram onto a spinal board before lifting him over the sand and into the belly of the aircraft.

I’m walking back towards the sweep vehicles when I realise with a start that Ashram is leaving with my first-response kit’s one wide-bore IV in his arm – what if I need to get access on another patient later today? I have to restock.

Waving my hands above my head to attract the pilot’s attention I point towards myself, then the doors of the aircraft. He nods, throttles down and sits the chopper a little more securely on the sand while I run up to the side door. Laura peers at me out of the window, clouds of dust and sand whipping around me. I sling the side door open and bellow over the blades.

“Need another IV set!”

She nods, digs in her kit and replens me, I’m about to leave when Christina shouts something that I miss. I lean into the cabin and she puts her mouth next to my ear and yells.

“Great job, kiddo!”

I’m ducking my head as I run from the helicopter, just as I’ve been trained, but I’m walking a foot taller inside.

The sweep team and I saddle up, one of the drivers moans that I’ve “dripped blood all over the sand”, but the tone has changed. I’ve shown them I know my stuff and together we head off into the dunes.


May 18 2009

ADDC Photos continued!

Tag: Abu-Dhabi DCKal @ 4:14 pm

Stuart alerted me to the fact that I’d missed lots of photos out! I’m a bad person.

There are another 20 or so pictures I added to the set today. They include the brilliant tiger vs dragon on a sky scraper tattoo and a portrait of Frankie Valley (yes, really)

Go look!


May 17 2009

Anyone wanna see some holiday snaps?

Tag: Abu-Dhabi DCKal @ 5:43 pm

Right there.

Photos from Abu-Dhabi and Dubai, photos of helicopters and medics dressed as pirates. They’re quite good fun, really.


Apr 16 2009

ADDC – Day 7

Tag: Abu-Dhabi DCKal @ 2:00 pm

Before the pirate party last night we had prayers and were assigned our roles for the next day. With Craig incapacitated, Gus relinquished his place in the control room and took a SAR seat on the 212.

I’m sure it was all in the interests of operational efficiency and nothing to do with the fact that he’d spent the entire week so far sitting in a gigantic yellow truck watching the race courtesy of a constantly refreshing satellite feed.

He managed to get out of the control room yesterday and performed the most beautiful maneouvure which was duly reported back to the rest of the team

. Riding out in the back of an aircraft with a pretty young journalist from Scandinavia, he chatted at length about our role and remit as the helo scudded over the sand.
“You’re all so brave…” she gushed, biting her pinky, stroking his chest.

Gus just set his jaw and smiled, the other medics in the helicopter grinned wryly at each other; let the boss have his moment.
Minutes later they were en route to an emergency, a vehicle on fire. The journo fizzed and quivered in her seat, Gus filled her in on the situation – the aircraft would land and he’d get out first, recce the situation and then return for the medics if they were required. It could have been scripted and as the helicopter swooped down onto the dunes, Gus had his hand on the door handle, ready to roll.

No sooner had the skids hit the sand than he had the door open, the howl of the rotors deafening, dust whipped up in storm clouds around them. He swung his feet out of the side door, stepped onto the ground and, head ducked low, began to run from the helicopter towards the crash.

Which should’ve worked well. Should’ve looked amazing. Should’ve sent our blonde pigtailed journalist colleague home with a mental image worthy of any Oliver Stone epic.

Except Gus was still wearing his headset.

And it was still plugged in to the ceiling of the helicopter.

So he only got a few steps away before he ran out of cable, yanking his head and neck back like an errant terrier on a retractable leash.

I’d love to read that journalist’s copy.

At prayers, the story was recounted in detail (with actions!) for the entertainment of the surrounding throng. Gus put his hands up.

“Fair cop. There’s beer in my car for everyone.”

I love working in a team that can laugh at themselves.

Come Thursday morning I was standing on the HLS with Booker and Gus. I wasn’t sure what to make of these two choosing to me to fly with them; either they don’t think I’m a total tool and are happy to work with me, or they’ve heard I’m a screaming incompetent and need to keep an eye on me. Either way, Booker was in a flight suit instead of his normal medics garb.

“I’m working alongisde Gus today, need to learn a bit more about the SAR side of things. So you’re the medic for the helo. If you need anything, tell me and I’ll assist, but other than that, you’re the clinical lead. OK?”

Cool.

Flying along with us is Laurie the cameraman from earlier in the week and a young photographer who we’ll call Nick (principally because I can’t remember his real name, and also because I think a wee bit anonymity might be nice for the laddie).

The two press guys were strapping themselves into “Monkey Harnesses”, essentially a chest and groin harness similar to those bouncey things you hang babies in in doorways, the strapping allowed them to be secured to the aircraft and hang out of the side door to take pictures and film. Once airborne I watched jealously as they sat on the door sill, feet on the skids, the helo swooping along only a few hundred feet above the racing vehicles below. My bench seat and lap belt on the far side of the aircraft leave me a long way from the action.

We chase cars and bikes for a while, then slide the door closed to cover distances faster,closing on the lead racers. Nick the photographer closes his eyes, wipes cold sweat from his forehead and taps my knee. I look up at his pale face and he mimes opening a bag.

No bother, mate. I grabbed a “SicSac” from the aircraft yesterday, just because its name and design made me laugh. The text on it was lovely “Even veteran air travellers are subject to occasional motion sickness.”

DSCF6010

Nick leans over the bag and ralphs his hoop into the bottom of it. The smell is horrendous, I’m not a great one for vomit’s individual bouquet, but here in a hot, vibrating, cramped metal box it’s worse than ever. Booker takes the bag from Nick, ties the top and slings it out of the side window. One advantage of the Empty Quarter is the chances of hitting anyone with puke from above are greatly reduced.

I am deeply, deeply pleased about the fact that I took motion sickness tablets this morning. They mean that I can join in with the “Amused, sympathetic and somewhat world weary” looks and grins that Laurie and Booker are giving Nick. Don’t worry son, happens to everyone, don’t feel bad. Look at me, I’m so at home in this chopper I’m practically in Air Wolf.

We fly some more, Laurie shoots more film, Nick forces himself to take pictures but after twenty or so minutes he scrawls a message on a piece of paper. The resultant conversation was so brilliant, I saved the notes and photographed them once I got home. I share them with you now.

Note one was from Nick to Booker and read:

DSCF6013

That’s “When R we going back bivouac?”, for those of you struggling with the handwriting. Note the desperation in his penmanship. Note the phrasing, not “How long are we out for?” Or “What’s our destination?” but “When R we going back bivouac?” Poor guy wasn’t feeling well and wanted to go hoo-oome.

Sadly, a dose of pukey guts isn’t reason for the helo to turn around and take people back to the camp, so Booker compromised with him.

DSCF6014

For some reason, the word “Check Point” is abbreviated to “PC” out here. I have no idea why. Unless we’re dropping Nick with a police constable, but I can’t see a reason for that. Making the back of the aircraft smell of spew is hardly an arrestable offence.

Nick gives us the thumbs up at Booker’s suggestion and we start making for the nearest checkpoint. He remained pale and sweaty for the journey, burping and repeating his “bag” mime for us.

I pass the following note to Gus, sitting alongside Raph the pilot.

pukebagsv1

He adds a simple answer.

DSCF6012

Shit.

I dig in the medical bag and come up with a ziploc bag full of needles and IV dressings. I pour the contents of the start kit back into the rucksack and Booker glares at me, gesturing towards the mess I’ve made of the kit. I remonstrate with him:

DSCF6011
(note “#/52″ = weeks, A/L, annual leave)

He grins at me behind his shades. Nick fills the bag with vomit.

Touching down at the checkpoint we watch Nick walk off on wobbly legs and Gus, Booker and I stand in a line, pissing into the sand.

I broach a cheeky subject.

“Sooo….Gus?”
“Yes?”
“Strikes me that, with Nick gone, there’s a spare monkey harness and a space on the skids…any chance of a shot?”

Typically Gus, there is no “Yes/No”, but a reserved “I can’t see a problem with that.”

Ya dancer, I’m going to *fly*.

I’m no sooner celebrating being trusted to fly on the skids when we receive a text message – a rider has decked off his bike outside this checkpoint but ridden in regardless. He’s right here, can we check him out?

He’s under a gazebo with his team mates, the same team, as it transpires, as the vocal man who complained so very unpleasantly the night before. The patient is alert and upright, no head or neck pain, but reports coming down hard on his right hand side. I prod and rub his shoulders and collar bones, run my hands down his chest and apologise when he yelps as I push on his ribs. The pain is clearly awful, he grimaces and squints as we walk him towards the helicopter.

Back home I’d shoot him full of morphine to make the journey bearable, but thanks to the UAEs laws regarding benzoes and opiates, we’re stuck with paracetamol and ibuprofen derivatives.

His team mates have already stuck a horse-sized Voltarol down his throat and he’s disappointed to hear that that’s all he’d get from us as well. We sit him on the bench seat, Laurie and Booker sit alongside him and I sandwich myself onto the floor,leaning against the response bag.

No open-door skid riding for Kal today. Can’t help thinking the patient might feel it was a little off that he’s sitting suffering while his medic hangs out in the breeze going “Wheeeeee.”

We all ride in silence, the rotors make conversation near impossible. I write in my note book “Name: DOB: Team: Home Address: Next of kin:” and hand it to the patient to complete. I have no way of gauging his pain other than monitoring his pulse and face. We’re twenty minutes from the hospital.

Ten minutes into the journey I’m aware that Booker, Gus and Raphael are all discussing something in earnest, their hands flying up and down the to “press to talk” buttons in the ceiling that opens comms on their headsets. They’re clearly talking at length, their hands are busier than a group of swotty school children.

I look out the window and realise that while I’ve been focussing on my patient, the conditions outside have deteriorated rapidly. A sandstorm howls along, the wind is high and the loose sand and dust blast against the side of the aircraft. Raphael slows the helicopter down and climbs higher, I assume to avoid the worsening visibility at lower altitudes.

Booker passes me a note:
DSCF6015

I nod and watch as Booker shows the patient the same information. The patient, by the looks of things, couldn’t give a shit where we go, just as long as the pain his ribs abates sometime soon.

I’m settling back down for the long flight to the bivvy when Booker hands me a second note.

DSCF6016

Now I’m listening, a hot off-load is one where you don’t shut the rotors down before disembarking, just dump the passengers as fast as possible. I’ve been warned about them, warned about the risks of low rotors, about flying debris. I pull my Buff up over my mouth and nose and my goggles down over my eyes. We touch down at speed, the skids bumping and banging on the concrete expanse, nothing else to be seen.

I write a note to Booker and he replies.

DSCF6017

The patient doesn’t have a clue what’s going on, we don’t have the time to update him, so the first thing he knows is the aircraft is on the ground and the door is being flung open. I slide out, ducking my head from the blades and reach out for his hand, leading him out onto the tarmac. The briefings are loud in my head and I put my hand on the back of his neck, pushing him into a half stoop and running with him from the aircraft at a ten o’clock angle, just like they said. The noise is deafening, the sandstorm and downwash make visibility almost non-existent. Fifty feet from the heli I turn and look back, expecting to see Booker or Gus following with my kit and jump bag.

I turn in time to see the side door slam and the heli lift off into the sandstorm.

Oh.

Bye then.

With the downwash gone, things are quieter, but the stinging sand blast of the storm continues to scratch our bare arms and my patient’s face. I look around and get my bearings, we’re in what appears to be an abandoned car park, no cover or shelter, save for a small brick wall over the otherside. I lead my patient to it and we hunker down into the lee of the wind. More comfortable now, thanks to the painkillers, he tells me about his family, his history, his racing career. I’m grateful that he’s so well, my kit is still in the aircraft. I’ve got a stethoscope and a tourniquet in my pockets, so I’ll be fine if he suddenly develops an undiagnosed chest infection, or develops a catastrophic bleed from one of his extremities.

Other than that, I’m screwed. I don’t even have a mobile with me to contact Control. I’ve nothing to do but trust Booker and believe that Patch will arrange an ambulance for me.

And, sure enough, ten minutes of anxious waiting later, a red and white ambulance appears over the horizon, lights flashing and siren howling. I walk my patient across the car park to the vehicle and am met by three members of ambulance staff, a driver and attendant, both in natty wee blue waistcoats. They look a lot like they should be standing at the door of a large superstore, greeting people. In the back is a slightly manic nurse, he leaps from the back door as we approach, an unsheathed cannula in one hand. I back away from the open sharp, the nurse grabs the patient and hustles him towards a spinal board on the floor. My patient isn’t keen and, in fairness, I can’t see a reason to lie him down, since I’ve been marching him around and sitting him up without strapping him to a backboard. The patient pops himself down on the bench seat alongside the stretcher, the nurse sits beside him and I squeeze myself down onto the stretcher. The vehicle is small, laid out similar to mine at home, but without the shiny toys. This is a van for driving people to hospital. I can’t imagine trying to run an arrest in here, I can’t stand up, for one thing, plus with the patient on the floor.

The nurse is staring at me quizzically.

“You are a doctor?”

I shake my head.

“Paramedic.”

“Oh. From America?”

“No, from Scotland.”

“How much money do you earn?”

Scuse me?

The patient, a Scotsman now living in UAE is giggling to himself, the nurse persists.

“How much money?”

“Enough.”

“But how much?”

“Its ok, it pays my bills.”

“Oh yes. I see.”

I smile at him, pleased we’ve come to an understanding.

“But how much?”
The patient is still laughing, the nurse continues.

“Two hundred? Four hundred?”

“Dirham, or pounds?”

“Dirham.”

“In a year?”

“In a month. How much dirham in a month?”

I do the maths and tell him. His eyes turn to saucers. He tells me he earns 400 dirham a month. That’s roughly 80 quid.

We’re at the hospital in fifteen minutes, a welcoming committee of nurses and orderlies stand in a polite line outside the entrance to the emergency room. Smiling as they are, my patient seems a little apprehensive and reaches out for my sleeve.

“You’re sticking with me, mate, right?”

In fairness, I don’t know where I am, I have no car, no phone, no money, no contact details for any members of my team and there’s a force 9 sandstorm blowing outside. I couldn’t go anywhere if I tried.

The patient is taken into a room with a smiley wee lady who introduces herself as “Sister Dahlia”. She’s friendly and welcoming, greets me by namem explains that “Mr Sean” (Patch) has phoned ahead and alerted them to our impending arrival.

A group of nurses start to undress the patient and I can feel myself getting sidelined; I remember watching Christina in hospital earlier this week and have my lines all ready.

“Can I speak to a doctor, please?”

Sister Dahlia nods and smiles, shouts down the corridor and a doctor in a white coat strolls into the room. He listens politely to my handover, has a brief chat with the patient and then turns to me.

“I think xrays of wrist, arm, shoulder and chest. Do you agree?”

Uhhh….I drive a van, mate. Sure, why not?

The patient is rolled away to Xray and I take a seat in the corridor, a nurse brings me a glass of iced water and I catch a glimpse of myself in a mirror – goggles and face mask, desert camouflage and huge sand boots, my face still bearing the daft wee pirate moustache and van dyke I shaved into it for last night’s party. I look like an villain from a Biggles novel, or a 1930s boys’ adventure annual.

Sister Dahlia chats to me while we wait for the patient to return with his films, she tells me that the hospital is fully equipped to supply a wide range of services, but the lack of skilled staff means that they’re limited to running a basic A&E and GP service. Upstairs there’s operating theatres, ICUs (adult, paediatric and neo-natal) and rehabilitation wards. All lying empty.

“How come?” I ask “Can’t you afford to staff it?”

“We can afford it, but they’re not interested…this country, they put up buildings, build these hospitals and once they’re done, they don’t want to keep them running. We do what we can, but….”

She flaps her hands in an exasperated gesture, just another health care worker struggling to do the best job with limited resources.

An orderly rolls my patient back down the corridor, an envelope of xrays tucked under his arm. I’m invited into the doctor’s office to review the films.

I’m no radiographer, this isn’t my area at all, but the doctor’s concludes that nothing appears broken, that the chest pain is “probably just cartilage damage” and that his aching shoulder isn’t, as we feared, a sprung AC joint.

The doctor leads me into his office where the patient is sitting fearfully, he listens to the doctor’s diagnosis and, after each statement turns to me with a question on his face. I nod along, reassure him. We come to the end of the consultation, the doctor writes up a prescription and the patient asks me “Is that ok? Will that work?”

The orderly goes to resecure the sling around the patient’s aching shoulder and struggles with the design, unfamiliar with the arrangement of straps and velcro. The patient leans back in the chair, looks over the orderly’s shoulder and catches my eye.

“Kal? Mate? Please?”

I tighten the sling up, support the arm. I’m humbled and flattered by the level of trust he places in me. We walk together back to the waiting room where I bump into Gus, who’s driven up to collect me. I get him up to speed on the patient’s situation and ask if there’s anyway we can give him a lift back to the bivouac.

“There’s only two seats, mate…” he begins, glancing at the patient sitting on the plastic chairs, looking sorry for himself. Sister Dahlia approaches and I break out my “charming young man” role.

“Sister Dahlia, I want to thank you and your staff for looking after me and my patient so well this afternoon. Really, your service has been outstanding.”

I turn to Gus and fix him in the eye.

“I’m assuming we still have emergencies outstanding, boss?”

He looks at me blankly for a moment before my insistently raised eyebrows get the message through.

“Oh. Oh. Yeah, yeah we do…”

I turn back to Dahlia.

“Sister, we have a number of other patients that we need to attend to, but this patient here needs a ride back to our bivouac at Tal Mareeb. Is there anyway you could organise transport back for him?”

“Of course!” she beams “I will arrange an ambulance immediately.”

Gus and I shake hands with Dahlia and our patient and head back out to Gus’ car, he laughs and shakes his head at me as we drive back to the bivi and at prayers that night, after fines, I’m given “kudos to Kal, for blagging an ambulance for his patient.”

There’s worse things to be in this world than a charming young motherfucker, every now and again it pays off in spades.

We wrap up the evening with cold beers, I’m disheartened to hear that I’m back on sweep for the final day; I don’t relish another day baking in those trucks, but the job rolls on. We finish tomorrow in Abu Dhabi and I spend the evening packing my gear, ready to load onto a truck that Baz will drive to the finish line for us. I settle onto my cot for the last time, sleeping soundly through the roaring engines and diesel fumes. I’m woken in the night by a mouse who scampers over my sleeping bag and perches on my legs…and to think I was worried about scorpions and camel spiders.

A mouse? I can handle a mouse.


Apr 11 2009

ADDC Day 6 – Part II

Tag: Abu-Dhabi DCKal @ 2:52 pm

Back from sweep the team congregates in the clinic to swap stories. There’s a party planned for the evening, a pirates themed fancy dress party. Though the society out here is restrictive when it comes to alcohol, there’s a bar in the bivi. A quick glance at the prices makes me thankful I picked up a bottle of rum at duty free on the flight in.

No mixers, though….

I catch up with Gus – can I borrow your car? I’ll nip into Liwa and buy some cokes.

“Just speak to Baz.”

I sigh inwardly. Baz is a lovely guy, but he drives like a scared pensioner. The 45 minutes to Liwa will stretch out to an hour and a half at his driving speed.

“I really can’t be arsed sitting in Baz’s bus for three hours, mate. Can I not just pinch your motor?”

“What? No, I mean, just SEND Baz.”

The idea of sending a man old enough to be my dad on what will likely turn out to be a two hour round trip just to buy me mixers feels a little uncomfortable.
“Are you SURE, Gus? I mean…”

“That’s what we’re paying him for. That’s his job.”

Fair enough.

Sitting outside the clinic is Craig, one of our SAR guys. He reclines in a plastic garden chair, his foot up on another, wrapped in compression bandages.

Yesterday while we were hanging around upsetting checkpoint staff, Craig and his aircraft were despatched to a rider with an arm injury. They touched down at the incident and Craig turned to the pilot and asked “Are we ok to go?”

“Ok to go.” the pilot apparently replied.

Craig’s role is to get out of the aircraft first and then let the medics out, leading them along a safe path away from the rotors. He’s the first liasion between the medics and the pilot.

He opened the door, put his foot onto the skids and stepped onto the ground.

Except he didn’t.

Somewhere along the way there’d been a miscommunication between the pilot and him. The aircraft wasn’t on the ground, it was still hovering. The down draught and dust and debris that were thrown up left Craig blind as he disembarked.

He describes his gut clenching as he stepped off into oblivion, not knowing how far he was going to fall, not knowing if it was 8 feet or 80. Thankfully it was the former,but when he hit the deck he felt his ankle give way beneath him and commando crawled away from the aircraft. Putting myself in his situation I’d be terrified of those rotors – if the helo isn’t where you thought it was in the air, maybe it’s coming down after you, maybe it’s banking, maybe the blades are turning into the sand.

Lisa and I have a standing joke in the bivi, like Queen Victoria refusing to outlaw lesbianism because the idea was so abhorrent to her it couldn’t exist, we don’t talk about how helicopters are the most dangerous form of air travel. We also don’t talk about scorpions and big spiders. Sorted.

Craig was fortunate, one of the medics working with him was Tom, an orthopaedic surgeon and they got him patched up and xrayed at the nearest hospital quick-smart.

No more flying for him this year. He works in the Control room for the remainder of the week.

Inside the clinic a rider has presented with fatigue and muscle cramps, diarrhoea and vomiting. Classic dehydration, as we’ve seen in dozens of patients all week. Several of the medical team have suffered from the same thing, we’ve nursed each other through it. This rider lies on a cot, a drip in his arm while we encourage him to sip Dioralyte.

Everything goes swimmingly, people slip away to their tents and change into their pirate outfits. I am completely underdressed – I thought I’d been rather inventive with my kilt shirt and sash, but Booker has an entire pirate-in-drag costume. Christina is dressed as a cross between Captain Hook and Peter Pan, all stripey jagged edged knickerbockers and tricorns, Rolf has earrings that would put Pat Butcher to shame, a stripey vest and enormous cutlass. Tom has a blow up parrot on his shoulder that is bigger than his torso. We all look terribly silly, but it’s a good laugh.

Until the dehydrated patient’s friend arrives.

He isn’t happy, wants to know what we’re doing for the patient and why we’re not cas-evaccing him (in the dark!) to the nearest hospital. We explain that there is no need to attend hospital, that we’re treating him as we treated ourselves.

He isn’t interested and starts asking various people “On what basis are you making your decisions?”

Christina quantifies things neatly – “On the basis of my fifteen years experience as a physician.”

He becomes increasingly belligerent, aggressive, shouting and swearing. Honestly, I thought I’d left tossers like this behind when I left Edinburgh.

The medical team are quiet, calming and professional. Patch steps in as our leader and helps sort things out.

It’s distressing and disappointing, but a part of me can’t help giggling at the sight of my colleagues arguing and reasoning with a huge man while they’re all dressed as pirates. Surreal doesn’t come close to it.

Things calm down and we gather around a campfire outside the clinic, people get pissed, the lovely Sarah (one of the race staff) dashes around drawing tattoos on pirates. I get an anchor on one leg with “Marrrrr” and “Parrrr” written beneath it and on the other she’s about to draw a skull and crossbones when I stop her.

“I don’t WANT a skull and crossbones.”

“But I’m really good at them.”

“EVERYONE’S got one. I want something different.”

“I’m quite good at chickens…”

“Nut. I want a tiger, fighting a dragon, on a skyscraper.”

“But…”

“You heard me.”

She gets stuck in. It’s a masterpiece.

I retire to bed with a fuzzy head around 1am, the party runs on while I sleep.


Apr 08 2009

ADDC – Day 6

Tag: Abu-Dhabi DCKal @ 9:54 am

Day 6

My oh-so-clever sleeping arrangements of the previous night fail to take into account the fact that extreme rally drivers probably aren’t all that careful with their vehices and there may be mechanics working on said vehicles for some time after dark.

And by “may be” I clearly mean “are certain to be”. Also, by “some time after dark” I clearly mean “all motherfucking night”.

From sunset until I wake at quarter to five, they hammered and welded, testing their motors, revving engines and hurling bikes and quads up and down the dirt tracks that circle the bivi. I clamber out of bed and dress by the light of a head torch. Rolf will be up in an hour , but I remember how lovely that extra hour was for me the other day when he was getting up early. Breakfast is a hurried affair, I pack sausages, bacon and rolls into a polystyrene box for the sweep drivers who won’t have an opportunity to eat before we set off.

Baz drops me off at the Liwa rest house, a decrepit building with crumbling baroque stone work, populated by hundreds of screaming, yapping finches, their shit dribbling down the flaking plaster facade. There’s a concierge, an eldery man in a stained robe who holds holds the door and points for me when I ask my one piece of pidgin, phonetic arabic. “WC, fen?”

Ablutions complete, I introduce myself to the sweep team, hand over breakfast and am claimed by a driver. We all head out of Liwa in convoy,swinging off the tarmac at an anonymous and apparently unmarked spot and cruising into the sands. The drivers leap out of their trucks and begin letting down their tires, softer wheels have a greater surface area and are less likely to dig themselves into the loose sand. The team is clearly tightly knit, they’ve worked together for years and I struggle to break into their conversation of race and leg leaders, mechanical intricacies and engines.

“Do we follow the riders, then, or what?”

One of the drivers grins at me “Its sort of like running with the bulls, we’ll let most of the pack pass us, then head along the rally route. The remainder of the riders will overtake us as we drive, we normally arrive a checkpoints alongside the slower racers.”

He’s barely finished talking when we hear the distant thumping growl of a quad. It’s amazing how much noise these little things make. When they’re idling it’s easy to mistake them for an approaching helicopter. The red quad comes screaming through the concrete underpass we’re parked beside, spitting sand from it’s back wheels as they dig in to power up the side of the adjacent dune. The noise is awesome, the speed exhilirating and I’ve hardly time to turn to the sweep team and grin when another six bikes and quads hurtle past in quick succession.

The drivers are mildly entertained by my excitement and smile in good humour before tucking back into the cold sausages and flat bread I brought from the bivi. Fully breakfasted we pile back into the vehicles and head into the desert after the racers.

Desert driving is a skill I know nothing about and my driver fills me in briefly on the concepts behind it. Keep the wheels turning, keep the momentum up and pay attenion to the other drivers’ tracks ahead of you. We’re the middle car of our three vehicle sweep convoy, the first seems to have the hardest job, picking a route over and through the dunes for the rest of us.

We start off on small dunes, gently rolling waves of sand but within a few minutes we’re driving up the sides of sheer slopes, swinging the vehicle back and forth as we climb like a shepherd climbing a tough hill. At the top of each one we pause, check our route down and then plunge dizzyingly down slopes several storeys high at angles up 80 degrees. The drop is amazing, the floor comes up to the windscreen fast and I’msure the front of the truck will bury itself and we’ll flip end over end, winding up upside down in the desert. But the driver’s competent and guns the truck hard, spinning the bonnet back up onto the flat.

It strikes me, again, how dangerous the terrain really is, you wouldn’t want to be Joe-Shmoe in a hired 4×4 out on a day’s jolly. These are proficient drivers handling these vehicles, but we still get stuck at times. The trucks ground on the arretes between the dunes when they drivers don’t push them hard enough; huge sand bowls suck us down sideways, the tires drifting laterally away from under the vehicle. At one point the first truck vanishes sharply over the top of a dune and the lead driver’s voice comes back “That’s a bit of a sharp one.”

My driver hits the arrete hard, the bonnet slams down near vertically, an inadvertent “Ohhhh you mother fucker” slips out of my lips, followed by nervous laughter when we make it out the other side.

We follow this pattern hundreds of times through the day, the windscreen shows me sky, then sand, then sky, then sand. I’m tired, very very tired, the car is hot and, as the driver explains, “The AC doesn’t work too well in my truck if the vehicle is working hard.”

“Like, working hard like dune bashing?”

“Yeah, like that.”

I struggle to stay awake, the rocking of the vehicle, my driver’s concentration cuts down on his conversation and the heat (which I later discover tops out at 52 degrees today) is immense. And when he says the air conditioning doesn’t work? He doesn’t mean it doesn’t work. When it stops working, it blows oven-hot air into the car. My head nods up and down as the truck roams over the dunes.

My eyes won’t stay open, the motion of the vehicle rocks me to sleep but my brain is yelling hard that I’m working, with a stranger, that this is my first time working on this event, that I have to make a good impression.

My eyes flip open and closed; I start to micro-sleep, dreaming as soon as my eyes are shut. The images from my dreams are over-laid on top of the view through the windscreen, waking and sleeping merge irretrievably. I am, effectively, hallucinating.

An alligator marches, grinning, down the side of a sand bowl. I see it clear as day.

The lead vehicle transforms into a massive, green John Deere tractor. I mention this to my driver. He glances at me nervously before returning his eyes to the sand.

We do this for hours.

There are no patients.

We recover one motorbike, I stand aside and photograph the team as they load the bike onto the trailer.

By the end of the evening we park up on a ridge, overlooking a fodder farm in the valley below and the lead vehicle breaks open a cooler full of beer.

We sit, six blokes in the desert and drink cold lager, watching the sun begin to set in the distance.

The team chat to me, they ask about my job and I ask about theirs, we understand each other, we natter about home and families.

They drive me back to the bivouac.

Patch seems concerned by my knackered face, he apologises “It’s a part of what we do here…”

I’m not bothered in the slightest.

Sure, I’ve had a long day and it’s not been exciting.

But I’m here to work, to do my job.

Back in Edinburgh I frequently work long days that aren’t exciting.

This is what I do.

It’s just today…I did it in the desert.


Apr 05 2009

ADDC- Day 5

Tag: Abu-Dhabi DCKal @ 2:32 pm

Tuesday morning and I’m bright and awake. I’m awful at sleeping in strange places; sleeping soundly that is, I’m very good at dozing off whereever I am, but new surroundings always have me fitful for a night or so. On Sunday night I’d slept wrapped in my sleeping bag with my thermarest tucked inside, like the man in the camping shop had suggested. It made the bag very small, very claustrophobic, made me toss and turn, fretting that I was trapped. Instead of opening the bag out and enjoying the breeze I was bull headed, remembering that “the desert gets cold at night”.

Does it bollocks. Not this desert anyway. By Tuesday morning I’d worked out the best sleeping arrangements; thermarest on the bed frame, sleeping bag open on the thermarest and sleep in the open air with the tent sides open. The occasional faceful of dust blown in by the breeze was nothing compared to the bliss of sweet, fresh desert air blowing into the tent.

I’d been told I was back on the 212, this time with Adam the SAR crewman and Lisa, an English A&E doc. Worried about the helicopter’s motion, I pop a travel sickness pill with my breakfast. The catering team arrived overnight, apparently, as breakfast is a fairly grand affair – a full English for those who want it. There’s something very strange about eating crispy bacon at dawn in the remotest corner of a devoutly Muslim country.

Weather conditions in Abu Dhabi ground the police aircraft we’re expecting to join us, so we sit in the bivouac for a few hours while Patch and Gus determine the best way to deploy our depleted resources. The team sit in the mess, drinking endless cups of tea, swapping stories and ringtones, quietly coming closer together as a group. Common ground is established, insults are slung across the table. People begin to understand and trust each other.

By mid-morning, Lisa, Adam and I are despatched to stand by at a checkpoint – there’s several scattered along the rally route where riders get their cards stamped, proving that they followed the correct course. The iridium satellite link all the vehicles have should, I would have thought, serve this purpose equally well and avoid the necessity for a small army of ex-pats to camp out in the desert for days on end. I get the feeling that it’s become more traditional than anything else and for all the complaints the staff make about their work, they complain with smiles and a somewhat affected put-upon air.

There is a practical advantage that I could see,it gives rally officials an opportunity to spot drivers who are injured, or dehydrated and collect them at a predetermined point.

We fly out to checkpoint 2, I spend the flight gazing at the colours and shapes of the dunes below us. “The Seven Sands Of Arabia” I’ve been told are responsible for the sweeping, curving paint strokes below us. Red, yellow, white, ochre, blue, grey and purple. There must be a physical and geological explanation for how the sands collect as they do, something to do with wind patterns and particle density ,I’d imagine. The dunes are topped with sharp arretes, amazing star-burst dust bowls sink away into the earth below us. Occasionally the patterns are interrupted by a camel farm, an irrigation pumping station or a derelict, burned out truck or house. Miles from anywhere, I think about the Bedouin caravans that walked for weeks through this landscape that I’m zipping over at 800 feet. I feel a real affinity with the landscape, it has more in common with the Scottish Highlands than I’d imagined – warmly inviting hills and valleys, decorated with soft plants or sand but deceptive in its scale – is that dune ten or a hundred feet tall? And those ones over there, are they a mile away, or five? It’s near impossible to tell.

This is geography that welcomes you in, then kills you.

There is no landing site at checkpoint 2, so Raphael casually touches down on the hard shoulder, parking in line with the cars and trucks that are already there. He hops out once the rotors have stopped spinning and pulls the two blades into a 12 o’clock/6 o’clocl position; his one concession to the fact that he’s just parked his helicopter on the road.

“We don’t want the trucks hitting the rotors….”

Cool as cucumber Mojito Slush Puppy, this boy.

We attract a crowd, rally spectators, bored with waiting for the pack to arrive and pass them, throng around the helicopter, posing for photos, leaning into the cabin, poking their fingers into the kit. I’m amused by how blase I’ve become in twenty four hours; yesterday I was creaming my pants over flying in one of these things.

Today, I watch the crowd of beaming thumbs-up tourists with mild amusement – “Oh this old thing? It’s just my helicopter…”

I stroll around the check point, natter to some of the officials and nip behind a dune for a piss. The colour of my pee has become a matter of great importance to me over the past few days. Well hydrated people have clear or pale yellow pee. Dark yellow or brown urine is a sign of impending lying-on-the-trolley-with-a-drip-in-your-arm. I’m thrilled to see what appears to be Evian squirt out of my fly, although this has its own downsides, I’ve clearly drunk enough water to be pissing every half hour.

My phone buzzes in my pocket, a text from Rally Control – “SAR POINT ON TASK – YOU ARE SAR POINT”

The helicopter that’s first in the queue for responding to incidents has got a job, so we’re next up. We use the same system at home with ambulances parked on station – the vehicle who’s been here the longest is the next to go out – we call it being “on the bell.”

I nip back to the helicopter and we evict various tourists and photographers from the sides of the cabin. Lisa wraps up a conversation about our defibs with a race official and Adam joins us both in the cabin. We’re to move to Checkpoint 3 and standby there, positioning ourselves close to the main body of racers.

Back in the air we fly out to our destination and Raphael circles the space. There is a wide, flat expanse of sand adjacent to the tents and a race offical runs to it, standing with both his hands in the air – our signal for “land here”.

Raphael shakes his head and his voice comes through the headset – “No reference there.” The helicopter gains height and he turns circles over site, the offical jumping up and down on the spot, sticking his hands in the air. It apparently doesn’t strike him that we’ve seen him and may have reasons for not landing there other than sheer spite. The pilot isn’t happy – “There’s nowhere else safe…unless…”

Closer to the checkpoint is a tiny scrap of flat ground, scrubby bushes to one side. Raphael drifts the helo down into it, ginger and tentative, sliding the helo’s skids down into the sand.

The race official is apoplectic, hopping up and down, waving his arms in the air. The down-wash from the blades blows sand over him, into his camp. I can appreciate why he’s upset.

Raphael spins the blades down and they’re barely still before the official is with us, swearing and blustering. He’s distressed that we didn’t land where he suggested, that we blew sand and dust over his equipment. Raphael tries to explain that the original landing site wasn’t suitable, the lack of any markers on the ground making it near impossible for him to gauge the helicopter’s forward, backward or lateral movement, but the camper isn’t happy and returns to his gazebo, shaking his head angrily.

Our pilot is concerned, explains his situation to us, they’re a private company who are flying for the event for the first time – he clearly doesn’t wish to offend. We reassure him, insist that we are more interested in landing safely than placating a political situation.

The offical returns to the aircraft and invites us to share the shade of their gazebo. We thank him for the invite, but he continues to argue about the landing site. We conclude that it would be quieter and easier to remain with the helo and do so. Raphael and his mechanic stretch out in the shadow of the fuselage like lions, Lisa and I stroll onto the dunes and roll up our trousers, baking our pale British skin. Adam snoozes in the cabin of the aircraft.

Hours pass. An impasse develops between the checkpoint staff and ourselves. The heat worsens. Eventually a woman from the checkpoint approaches us with an olive branch.

“Are you sure you won’t come and sit with us?”

Kudos to Lisa, she smiles and accepts. She’s a bigger person than I, I’m still sulking. The two of them walk into the distance and, it later transpires, sit down to afternoon tea together. Goes to show, Kal my son, swallow your pride sometimes and you might get cake. Thrawn bugger that you are.

I wander off for another pee, vanish behind a dune and just stare at the landscape; one of my team members had explained the dimensions of where we are – “A few hundred miles south is the Saudi border and then….sand. Thousands of miles of sand.” The horizon is dunes as far as I can see. No landmarks, no buildings, no people. The flatter areas shimmer in the heat like vast lakes. It’s beautiful and terrifying.

Standing up to return to the aircraft, I plop my feet into a patch of sabhka, sand as fine as talcum powder with a crust across the top. The dune swallows my leg up to my thigh and I have to lie flat and commando crawl over it to get off the loose dust. Looking back behind me the sand runs away exactly like water. This is a place where the physics of home simply don’t apply.

We fly back to the bivouac for prayers and dinner, I’m assigned to “sweep” for the next day and Christina sits with me for ten minutes, running over my role and responsibilities for the day. There are three sweep teams operating each day, each made up of a pick-up and two 4x4s, their role is to follow the riders and pick up stragglers, assist with technical issues and recover stranded vehicles. A medic on board is necessary, but I’ll be happening upon incidents, rather than despatched to them.

I check my kit again and again. Tomorrow I’m working alone. I’m confident I can handle things clinically, but I’ve never been comfortable not knowing the script, remind me to tell you someday about the school play when I was four that continues to illustrate my working hang ups.


Apr 03 2009

ADDC Day 4

Tag: Abu-Dhabi DCKal @ 3:43 pm

I’d known I was booked for “clinic” on the first morning – Patch had emailed me before my departure from the UK, insisting that clinic wasn’t the short straw it seemed, promising that it would only be for one day, swearing on his childrens’ lives that he’d have me in helicopters before I knew it.

I wasn’t so fussed, the idea of a gentle run-in was rather attractive. I started out in this emergency care lark with the Red Cross, sitting in Portacabins, treating blisters and tummy aches and handing our paracetamol while huge public events continued around us. Now, six years down the line, I’m sitting in a Portacabin at a huge public event, treating blisters and tummy aches and handing out paracetamol.

This is progress.

The majority of our customers are the local labourers and support staff. Too poor to afford health insurance in a country with no state medical support, they flock to the clinic with chronic complaints, minor bumps and scrapes.

Their faith in our abilities to fix problems they’ve had for years is flattering and humbling, but the clinic is geared towards acute and emergency care and my irritation at immediate care facilities being abused for minor or chronic conditions is deep seated and hard to shake

Christina, a leading physician in disaster medicine from the US and far more experienced in bringing first world medicine to third world countries explained to me that my understanding of their expectations were too high, “They don’t expect to be cured and they rarely take over the counter medication, give them two paracetamols, one for now, one for later, they’ll be thrilled and the drugs will hit them hard.”

By lunchtime, Gus had arranged an aircraft for Christina and I – the first leg of the rally was taking place well away from the bivouac where we were stationed. Any major cases weren’t happening here at the camp, they were miles away on the rally route.

Running the search and rescue aspect of our aircraft was Kev, there was a cameraman from ESPN, Laurie,coming along for a lift out to a checkpoint on the rally route. Flying us out was Raphael, a demure, smiley fellow. We were flying out on a Bell 212, a twin bladed “Huey” of Vietnam fame, its rotor giving it an evocative “whub-whub-whub” as it flew which had me pretending I was in M.A.S.H.

Within minutes of take-off, I realised that evocative engine noise does not a pleasant flight make, the aircraft was not a modern machine, lacking the automatic stabilisation systems that its more modern cousins depend on for a smooth ride.

Skilled as Raphael was, he couldn’t smooth out the ride as well as we’d hoped; with every “whub” the entire aircraft bounced up and down in the air by a half inch.

Turns out? Christina is not a good flier, the vibration had her pale and breathing insistently through her nose. Ten minutes later I was in the same boat, panicking slightly – if this is how I respond to being in a helicopter, my career plans are on the skids.

We were in the air for twenty minutes or so when Kev passed us back a note that read “Cas – ?# wrist – ETA 10”

If we thought the ride was bumpy before?

Oh ho.

Tightly banking, nose down, high speed whub-whubbing. Though nauseous as hell, Christina and I agreed our plan of action; she’d take the guy’s primary survey, I’d do vitals, splinting and IV access. I hadn’t this been this organised to attend an incident since training school.

The aircraft touched down and, just as we’d been trained, Christina and I sat sedately in the back, waiting for Kev to open the doors and lead us away. Gus had done an exceptional job at scaring me shitless about the rotor blades, insisting that we went nowhere without a SAR crewmen by our side, without making eye contact with the pilot, shaking the image of tilting, spinning blades into our collective consciousness.

Kev walks Christina and I over to a sweep truck, Lisa, one of the other doctors, already on scene. The pt is a quad biker, standing, his right wrist at an angle nature never intended.

“It was worse before,” he explains in perfect but heavily accented English “I pulled it around, it’s straight now, at least?”

We hack his jacket’s sleeves off, he waves away our apologies. Refreshing, I’ve never met a biker in Edinburgh who was happy for me to cut his leathers. I mould a splint for his wrist and Christina bandages it in place while I cannulate his right arm.

“Hey!” he warns Christina “Not too tight, you’ll cut off the blood supply.”

She stares at him over her sunglasses, “Who’s the doctor, here?”

He laughs, shrugs “Ok, doctor. No problem.”

We’re warned to expect a long flight to A/E, twenty minutes or so, illustrating just how far from civilisation these racers were operating. He never winces or complains, simply chugs cold water from the box in the corner of the cabin.

As we approach the hospital, the aircraft began to slow, banking tightly against itself. We swung left and right, back and forth. Christina put her face in her hands and tried not to puke over everyone. In my headset I hear Kev and Raphael talking about coordinates.

We don’t have the coordinates for the hospital. The coordinates we have take us to a helipad, sure, but it looks like a private house.

“I’m not landing there,” complains Raphael in the radio “It might belong to some sheikh or something.”

We turn a search pattern over the town for a good ten minutes before Kev spots the hospital, a fair distance from our original bearing, a huge red crescent painted onto the helipad, an ambulance parked nearby with its lights running.

I’m not one to tell patients bad news en route to hospital, preferring to tell people comforting things – “We’re going to take care of you,” “We’ll get you sorted out, don’t worry.” Even bad news can be sugar coated “It’s serious and we’re taking it very seriously.”

Can anyone come up with a euphemism for “We’re a bit lost and don’t know where the hospital is?”

An ambulance with a nurse in the back is waiting at the helipad for us, we load the patient in; it’s cramped, narrow bench seats on one side. I perch on the stretcher – I wouldn’t want to run an arrest in here.

Round the corner we disembark, stick the patient into a wheelchair and walk into the main entrance, Christina’s presence raises eyebrows, she should be using the “female” entrance next door, not marching around with the men.

I watch with interest; Patch had warned us that hospitals weren’t used to prehospital staff being in control of a patient, weren’t used to taking hand over from ambulance staff and the like. Christina is very clear- “I need to speak to a doctor. Please fetch one.”. Nurses sprint to the corners of the corridors like startled mice on a tiled kitchen floor.

A doctor duly arrives, sharp white coat and 1970s moustache. He shakes my hand and starts chatting until I point at Christina “She’s in charge, its her patient”

He looked horrified, briefly, before appearing to accept that the tiny blonde woman was in charge of this duo, the big hairy bloke in the background was simply there to carry her gear and fix the paperwork.

We leave the patient in bed, Christina steps off to a bathroom “I need a prophylactic vomit.” and ten minutes later we’re flying back to bivouac, Raphael murmuring in our ears, soft Spanish tones apologising for the turbulence.
Flying back, the heat and vibrations from the aircraft are powerfully soporific. Christina and I both doze against each others shoulders all the way home.

Baz the driver continues to be massively chilled out. Later in the afternoon we receive a “Standby to move” order from Control, effectively an instruction to be ready to take off and respond to a call. I jog from the clinic to find a vehicle in which to drive to the helipad and can only find Baz’s bus. Not wishing to leave it stranded out at the landing site, I called him over.

“Baz – come and sit in the bus, I’ll drive it to the helicopter and then you can bring it back, ok?”

“Ok, boss.”

Good.

“Boss? One minute, ok?”

I figured Baz meant “one minute” in the way *I* would mean “one minute”, meaning “I will quickly do something before returning to you: you are still my top priority.”

Nope, turns out Baz and his response times really aren’t geared up for this emergency medicine lark, he ambles off to the toilets, drifting his shoes through the dust. I give him a minute and then give up on him, heading off to the helo alone.

Our second job turns out to be a false alarm and we are instead tasked with flying “Rally Route” back to the bivouac. Raphael buzzes 4x4s and dune buggies, tilting the aircraft left and right, circling back to allow us to take pictures through the windows.

We round the day off with dinner in the mess tent (salad, rice, flat breads, hummus, grilled meats, pulse and vegetable curries and, bizarrely, creme caramel for pudding) and “prayers” at eight o’clock. I have no idea where ‘prayers’ comes from, as the meeting is a straight debrief, but I sit attentively, write everything down and listen and laugh with everyone else as ‘fines’ are handed out to members of staff who’ve done something of exceptional stupidity that day.

I still feel a lot like the laddie, like I’m feeling my way with both hands, but nobody’s ripped my steth from around my neck and pronounced me a fraud yet, so I must be doing something right.

Before bed I grab my kit for the next day and check it over, repack it as I wish. It’s a comfort blanket, a relic of home. Check and pack your kit, review the use of the scarier pieces of equipment, reevaluate the drugs you’re not familiar with. Knowledge is power. If you’ve checked it, you’ll not need it.

With any luck.


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