May 05 2011

Comfy Shoes

Tag: ADDC 2011Kal @ 6:53 am

My final day on an aircraft and I’m flying out with Fish, John and Hurls.

We’re busy.

First flight out we’re tasked to a car “Hard landing, car rolled, sweep team on scene.”

Last year the sweep teams had a bit of a epiphany when they pointed out to one of my colleagues…”See what we’ve worked out? If there’s an accident and we’re close, its our job to get you there as fast as we possibly can.”


To their credit, until now the role of the sweep medic has largely been to check that drivers the sweep guys are digging out are adequately hydrated and fed. With the realisation that they could have a response role its now not uncommon to fly out to an incident and find a sweep team on scene.

And here we find one.

Landing on the dunes we jog over to the crash site to find Ed, a paramedic from England on his first Desert Challenge, holding the head of one driver at the bottom of the bowl. He bren-guns off a handover to me and I point at the other patient at the top of the dune.

“What’s he doing up there?”

Please don’t say thrown….

“Climbed up to warn off other vehicles, I think. This guy’s worse.”

“Cool. We’ll take him first, then?”


You’ve got to admire the courage of the codriver, to climb from a flipped vehicle (and a flipped vehicle thats come a good thirty feet down a slope), run back up that slope and flag down other riders, warning them around the crash site, ensuring that nobody else is hurt.

Iphone Rip 1176

We load up Ed’s patient onto a spinal board and he dashes off to the second chap on the dune. I nod to Hurls.

Iphone Rip 1178

“I’ll check on him, you load this guy, I’ll be two minutes.”

He nods, directing a team of sweep drivers and stopped racers to lift and carry the patient on the board back to her aircraft.

At the top of the dune I have a quick conflab with Ed.

“You need anything else?”

He gives me a short shopping list and I’m able to resupply his sweep kit from my, larger, heli bag.

“You’ll be alright here on your own?”

He nods once, turning his attention back to his patient. Desert sand aside, its no different from arriving at a scene with an RRU already in attendance and its clear that we both recognise the picture and know how the game gets played.

I scramble back down the dune and join the rest of my team back in the heli.

We’re dropping the patient in the ED (and stocking up again! Kerching!) and airborne within the hour.

We’re barely refuelled before the phones bleep again and again we fly out to another roll over.

This one a little more severe, the patient complaining of thoracic spinal pain. Once again we load him up onto the stretcher and pack him into the helo.

Iphone Rip 1184

En route to hospital, I grab Fish’s “Sick/Not Sick?” textbook (he’s studying for EMT exams and we’ve been chatting about his studies) and point to the front page, then to the patient.

He thinks for a moment, then points to “Not sick.” and I can’t help but laugh at the image of him studying frantically as he crouches over the patient on the floor. We share the joke with the patient and he finds it just as funny as us, posing for photos (annoyingly, on Fish’ camera!)

Iphone Rip 1192

And there I have my own realisation. It’s essential we take care of these people, of course. It’s essential we’re vigilant with our patients and recognise the massive responsibility that we carry for their lives and well being out here.

But, unlike back home, these patients dont give the impression of just waiting to write to their MP, or complain to the NHS, or run to the tabloids that the blanket they were given was the wrong shade of beige and triggered a life threatening hissy fit.

Out here the patients are reasonable and grateful for our work. There’s no reason to put up the professional vs patient walls that we have to operate behind at times in the UK. Here you can laugh and joke.

And crucially, I’m sufficiently comfy,
both professionally and clinically in this environment to sit back and relax a little.

So I do. When we land at the hospital I recognise that there are eight other people who can unload the patient (and I know they can, because for every patient I’ve ever offloaded here I’ve marched along next to them, wired as a speed freak Jack Russel, barking orders at orderlies), so I shoot pictures.

Iphone Rip 1198

And instead of trying to help load the patients into the waiting ambulance (in which I don’t undertand the clamps, or the back door, or any of the kit, it being, you know, not my ambulance) I stroll along beside them, shooting pictures. And then, instead of glaring as I climb into the back of the vehicle, daring the hospital staff to try and stop me, I stand back. I’ve worked with this hospital now on three different flights over the past few days – they KNOW we want to ride in the back and step back to let us clamber onto the bench seat that lies alongside.

(As an aside, the ambulances in the hospital are amazing. Dozens of perfectly empty cupboards, diligently and scrupulously labelled: “Trauma” “Obstetrics” “Cardiology”. Not a plaster in the bugger!)

We load up and fly home, it’s been a long day, but a great one, marking my third trauma of the week – I certainly can’t complain this week’s been quiet…

May 01 2011

Life Skills

Tag: ADDC 2011Kal @ 3:52 pm

Iphone Rip 1173

A photographer is attached to our team for a few days, he’s producing a feature for a men’s magazine about the MEDSAR team.

Each day he’s plopped into a sweep vehicle, or onto a helicopter and we cross our fingers that he sees enough exciting stuff to take pictures of.

One night he gathers us together for a group portrait and lines a bunch of us up on plastic chairs on the back. This is all well and good until the chair I’m standing on gives up and the ghost and I fall clean through it, slicing a chunk of flesh off my right shin.

The sympathy of my colleagues cannot be expressed here in words.

We fly the photographer out to RV with a sweep team and while we’re sitting waiting for them to arrive, I realise how much I take for granted out in this environment.

Unused to the desert, he’s assailed immediately by the wind blowing sharp sand into his face. His eyes screw shut and he spits sand onto the road.

I lend him a pair of goggles and teach him to tuck into the tires of parked vehicles to shelter from the storm. Down at ground level, with your eyes protected, it’s almost comfortable.

Life skills, indeed.

Apr 30 2011

In an emergency…

Tag: ADDC 2011Kal @ 3:50 pm

Iphone Rip 1166

In an emergency?

Read the instructions.

Follow the instructions.

Don’t walk towards the tail.

Even if the front of the aircraft is on fire.

Don’t walk towards the tail.

No, really.


Apr 29 2011

Desert Paediatrics

Tag: ADDC 2011Kal @ 3:49 pm

Iphone Rip 1155

A text from Patch.

“Can you go to the clinic and relieve Shereen and Sarah so they can eat lunch, please?”

And so I go.

Inside the portacabin I find Shereen talking in Arabic to a young man who’s glaring at a bottle of rehydration solution, his shoulders slumped, his feet balefully swinging on the trolley.

Shereen hands over to me.

“19 year old racer, in yesterday with dehydration and back again today with the same. He’s been throwing up all day, so we’ve given him a couple of bags IV.”

And then, a little quieter…

“He needs a bit of encouragement, he’s…not very responsible.”

And so began my first experience of dealing with Arabic teenagers.

I’ve had discussions with ex-pats out here about the difficulties young people face when handling the transition to adulthood in the local society. A typically affluent social background with staff to cook, clean and tend to you doesn’t necessarily engender an independent mindset. Alex tells me about living with flatmates who’d phone her, frantic, while she was at work.

“Alex! I have no socks…how does the washing machine work?”

In addition to this, let’s bear in mind the family picture. Your elders are revered, your parents’ friends your aunties and uncles, regardless of blood line. There is no problem that can’t be solved by your family, or knowing someone whose brother runs a business.

It’s a water tight, unshakeable foundation on which to build a community.

But it’s not so hot at generating young people who can stand in their own two sandals when the shit hits the fan.

As is, the young man sitting on the bed was the picture of Kevin the teenager in a dish-dash, texting rabidly and occasionally stopping mid-conversation to answer his phone, his sunglasses blanking his eyes. When he spoke English to me, it was with a mid-Atlantic snap, punctuated with the occasional “awwww, shit…” (though that came with a sideways glance for my reaction to his vulgarity).

“How you feeling?”

“I feel sick, man. I need to eat dinner.”

“We can do that. I think you should stick around here for a little while, though. You’ve been throwing up all day, yeah?”

A nod.

“Ok, you need to drink some fluids too.

“I already did…and the lady doctor gave me this.”

He points to the IV in his arm.

“So you can go ahead and take that out, and I’ll go eat dinner.”

“I think, first of all, you need to drink that bottle and we’ll check it stays down. If you eat dinner and then throw up, you’ll be sicker than you are right now.”

He sighs and stares again at the bottle in his hand.

“Go ahead, just drink it slowly.”

“It doesn’t taste nice.”

“I know, but it’s important.”

He unscrews the cap and take a sip, screwing up his face dramatically and hacking like a cat with a hairball.

“Awww, c’mon. It’s not that bad.”

“I hate it. It’s horrible.”

“Sorry, dude.”

I leave him to it for five minutes while I write up some paperwork, figuring maybe he’ll get on with it without me hanging over him. Every now and again he sips again and repeats his ostentatious poisoning routine.

“Can’t I just go?”

“Not yet. You’ve got to drink it first.”

“I don’t want to.”

“You’ll only get sicker if you don’t. All you have to do is drink it. If you drink it all and it stays down for ten minutes, I’ll take the IV out of your arm. If you can wait twenty minutes after that without being sick, you can go eat dinner.”

He mutters something under his breath in Arabic.

I don’t ask for a translation.

Another five minutes passes while he fails to drink any solution and I decide to change tack. If he’s not able to approach his role as patient as an adult, maybe I should stop expecting him to do so.

“I know it tastes bad, mate. But really, your body needs it.”

He flounces back on the couch.

“It’s SO disgusting.”

“Ok, look. Do you want another flavour?”

He immediately perks up.”

“What flavours do you have?”

I dig around in the box of spares. Different manufacturers make rehydration solutions in different ways and I’m sure last year’s supplier had some variety. There, in the bottom of the crate are some left over sachets.

“Here, do you want lemon or lime?”

“Can I just drink water?”

“Nope. Lemon or lime?”

He literally pouts his lower lip at me.


I mix his bottle at the work station and hand it over, unable to resist a dig.

“Would you like a straw?”

He doesn’t answer, takes a mouthful.

“It still tastes bad.”

“But better than before?”

“I guess.”

“Good. Carry on.”

He slurps at the bottle a little and then apparently decides that, dammit, he’s a man. An adult. He doesn’t have to put up with this. If he wants to go to dinner, he’s going to. And nobody’s going to stop him.

He’s on his feet. Slamming the bottle on the table. I look up.

“Everything ok?”

“I’m going to dinner.”

“No you’re not. You’re going to sit there until you’ve finished that drink.”

He sighs dramatically.

“Do you think I’m telling you to drink this because I’m trying to be funny?”


“Right. You’re lucky right now, but if you don’t look after yourself you’ll be really sick and we’ll have to drive you to the hospital. Now sit.”

And he does, his butt pulled to the couch as uncontrollably as an obedient border collie, his costume of grown-up clothes apparently not fitting that well yet.

“The doctors yesterday were nice.”

“Yeah well, the medic today isn’t. Drink.”

And slowly, surely, he does.

His co driver joins him, an older guy in his twenties and we tease the patient about his youth. Ten minutes pass and I slip the IV out of his arm while he winces and turns his head away, giving a short “aiii!” when a bead of blood runs down his arm.

Continuing on the “three more bites” theme I set the alarm on my phone.

“When my phone beeps, you can leave, as long as you haven’t vomitted. Ok?”

He sits patiently while the countdown runs. Other patients come and go. As I pass his bed I say to him.

“How are you feeling?”


His friend nudges him in the ribs, glares at him until he contiues.


I smile.

“You’re welcome.”

And then, passing him my phone as it counts down and then rings.

“Three…two…one…! Bingo! No vomit!”

He grins.

“Go eat dinner. Slowly”

We high five and he slouches off behind his co-driver, still texting as he goes.

Apr 24 2011

Command and Control

Tag: ADDC 2011Kal @ 5:02 pm

I spent a day in Rally Control, despatching aircraft around the sands and working alongside the staff who answer the radio when a car or quad tells us they’ve crashed, even before the driver gets in touch. Its sort of like Minority Report, except instead of crimes bein solved, its broken collarbones.

The team have (because this is an FIA event) a heavily French influence and they lean close to the mike – “Allo? Allo?” It all feels terribly WWII, especially when I find a screen in the laptop that lets me slide aircraft around on the map like some sort of operations directing croupier.

Iphone Rip 1153

The racers talk to Control a lot. Typically to say things like “Don’t send the helicopter to me, its only a broken arm, I’ll gaffer tape it to the handlebars and ride home”.

I wish I was exaggerating for effect.

Iphone Rip 1150

The technology that runs the place is astonishing. When one recovery truck wanders off course and drifts close to the Saudi border, we’re able to zoom *right* in and find that he is, in fact, a comfortable eight feet from an international incident.

Its nothing like the satellite systems we have at work that frequently forget where you are and direct you through rows of tenements.

And there were other perks too. Like a day in an air conned building.

Iphone Rip 1148

And the nice man from the FIA who brought us iced coffee and Haagen Dazs.

I can see why Patch and Gus stay there…

Apr 21 2011

Air Con

Tag: ADDC 2011Kal @ 1:24 pm

Air Con

The helis have air conditioning.


The helis have air blowers.

There is no cooling behind those surprised little mouths in the roof.

When the rotors are turning in flight, they blast air at us, it’s cool by virtue of moving fast and we lean up towards them like sweaty baby birds, unzipping our flight suits and aiming the breeze down inside where our teeshirts stick and stink to our chests.

When on the ground with engines idling, they blow exhaust fumes into the cabin, hot and thick with nauseous aviation fuel.

With flight, comes comfort.

Let’s get in the air.

Apr 20 2011

Common Bloody Sense

Tag: ADDC 2011Kal @ 5:25 am


For such precisely engineered pieces of kit, it always amazes me how unpolished these aircraft can appear, there are no panels that cover up the inner workings of the cockpit.

How do you avoid pulling the cables and fuses out with your feet when flying?

I’m guessing the pilots’ response would be “You don’t put your feet in there…”


Apr 19 2011


Tag: ADDC 2011Kal @ 9:00 am


Day 1 debrief.

The press don’t want me.

They take their ball and helicopter home and wont come out to play.

I have no aircraft.

My plans for the week are scuppered.

I spend the next morning, when I should be flying with a camera crew, ferrying medical teams back and forth to the HLS and seeing catering staff in the clinic, lancing blisters and dressing burns.

By the afternoon I’m rotated onto an aircraft for a few hours and the buzz of swooping over the desert is still fresh and bright.

But I feel like I’m sitting in the wrong seat. I want to be tracking us on a personal GPS, chatting back and forth with the pilot and control. Most of all, I want an overview of what we’re doing, where we’re going. I want to know what’s happening *right now*.

As a medic, that doesn’t happen so much. Before I came out here for the first time I asked a pilot colleague for any advice regarding helicopters. He taught me to think of the rotors as a plate spinning on a spike, tilting and whirling. But he also said to me “As the medic, you’re a passenger until you land; then once you’re on the ground, you come into your own.”

And thats all well and good. But I don’t want to be a passenger.

I’ll wait another year.

Apr 18 2011

Standby to move…

Tag: ADDC 2011Kal @ 1:01 pm


If you get a headset with working comms in the back of the heli, you stay up to date when the aircraft gets tasked. If not, you have to depend on reading the situation, the sudden tension in the shoulders of your SAR crew as they write down coordinates to confirm with each other, passing a notepad back and forth. Better to write them down than recite them.


On this job we flew to a biker who’d landed heavily in a sandbowl, compressing his thoracic spine until one of the bones exploded, squishing a section of his cord out and knackering his sensation below his waist.

The heli landed once and then the pilot decided he didn’t like the spot he’d chosen, took off again, spun the aircraft through 90 degrees and dropped us down again. In the sand the rotors had thrown up, we were completely disoriented when we debussed and the four of us had to run to the top of a dune to get a visual on the crash site.


Tom and I had planned our approach – he’d take the head and airway, I’d do the rest. But I’m first by his side as we jog over the sand and without thinking about it I slide in on my haunches, taking his temples between my hands.

“Stay still and don’t move, I’m Kal, one of the medics.”

And then, because you can’t take it for granted in an event like this.

“Do you speak English?”

He does, introduces himself. A Kiwi. I pass his head to Tom when he joins us and we get to business.

He’s scared, understandably, but cooperative and accepting of our attention, lying stock still as I slash and hack at the straps holding his armour to his chest and shoulders. My scissors split and fall apart, I’d known the screw holding them together was dodgy, so I move to my knife, sliding the blade up his sleeve and making a nick, then ripping the clothes apart with my hands.

Certain things don’t change, regardless of where you are – the patient frets about his wife, their kids, staying at the hotel. He called her already and I marvel at the partners of these racers who can receive a call “I’m injured, bad, and waiting for the helicopter. I love you.”


We package him on the spinal board, shove a needle in one arm and haul him across the sand back to the helo. Inside he gets all the analgesia we can give him, paracetamol and declofenac, the sort of stuff that back home you’d get from the doctor for a pulled muscle. The laws here forbid the carriage of opiates outside hospital, and you can get imprisoned for importing cocodamol, so the idea that we might have buckets of morphine on our belts is a pipe dream.

The emergency department we touch down in has been renovated since I was here last, now its clean and shining, with endless hands that come from the walls to roll your patient into a designated trauma room.

While Tom hangs back with the patient, I approach one of the nurses.

“Excuse me, I wonder if we could replace some equipment we’ve used with this patient?”

“Yes sir, of course.”

He leads me to a supply cupboard stacked to the roof.

“What do you need, sir?”

“Some IV supplies, a few bags of fluid.”

“I’ll get you a bag, please, help yourself.”

I laughed.

“I’m from Scotland, sir. You tell me to do that, there’ll be nothing left when you come back.”

He laughed back at me.

“Help yourself, we have lots. Whatever you need.”

And so it was with bags laden that I walked back to the aircraft, Wayne laughing at me.

“Been shopping?”

“Something like that. Let’s get out of here before they change their mind…”

Apr 18 2011

Wet on the inside.

Tag: ADDC 2011Kal @ 8:56 am


Hydration is clearly essential out here, though this year we’ve seen an increase in people drinking too much water and not replacing their electrolytes by taking salt or rehydration solution. We hand sachets of the stuff out at the clinic like its Halloween, though the NHS dog in each of us rears its head when people turn up asking for boxes to take away.

“You knew you were coming here…why do your support team not bring some too?”

Every member of the team has their own way of ensuring hydration. Me, I titrate my fluid intake to the colour of my pee and make a point of chugging a bottle of rehydration solution at least twice a day. Other guys wear Camelbaks, a reservoir with rucksack straps and a drinking tube that lets them sip at fluids through the day.

Flopsy is a big fan of these.

Except for when he forgets, tucks the end of the drinking tube into the chest pocket of his flight suit and ends up looking like a lactating new Mum who’s forgotten to put a pad on.


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