I’ve mentioned that we’re running on electric bikes this year, they’re a God-send when you hit a hill, or find that every junction you have to inch through is on red, knocking off your momentum everytime you stop.

They’re lovely and tasty.

But next year, I want one of these. They’re only $78,000.

Anyone?

An ambulance passes, rolling to the hospital. Shall we sneak inside and see what’s going on?

In the vehicle a heavily intoxicated woman lies on the trolley while a paramedic sits opposite her. Their conversation runs thus:

“D’you love me?”
“I don’t love you, no. I’m your paramedic.”
“Stop! Stop the car! I wanna get oot!”
“I know, we’re nearly there. Don’t touch your seatbelt.”
“I’m starving.”
“What do you want to eat?”
“Coffee.”
“How’s about steak and chips?”
“Nawwww! Radge…”
“Ok. What then?”
“Yerra fuckin’ radge…..gizza kiss?”
“Away!”
“Ah’m gorgeous! Will you love me in the morning?”
“Hah! My mother warned me about women like you!”
“Yerra fuckin’ radge…you never loved me…fuckin’….fuck’s SAKE…I cannae get oot! Did you ever love me?”
“I’ve never met you before. Do you stay with anyone?”
“Mffgrrhh…”
“Do you just stay yourself?”
“Ah dinnae unnerstan’….”
“How many Valium did you take today?”
“Will you take me home?”
“No. Hospital first.”
“Fuckin’ RADGE!”

Let’s leave them to it…they’re getting on so well.

I’ve just collected my dinner, salad and fruit, my sessions at BMF encouraging me to eat a little healthier - not through some holistic weight loss plan, more that I resent paying someone to beast me and I’m not prepared to piss the sweat, pain and cash away by eating crap.

The car’s indicator ticks patiently while I wait to turn right across traffic when the phone rings, I extend a finger from where my left hand rests on the gear knob and press the green button - the despatcher’s voice comes through the speakers.

“Kal? I need you on a cardiac arrest in PalaceHill, double Tech crew making from the ED.”

“Got it.”

I pull the RRU back into traffic, pushing the “999″ button on the dash that makes the Carnation system light up - halogens, LEDS, headlights and siren. Tap the horn to activate “wail” and boot it up The Neighbourhood’s main drag. A left at the roundabout and I’m shifting fast, four lanes of road are effectively empty at this time of night and I’m soon shifting down the broad street at over twice the limit, buses ahead pulling into their greenway to let me past.

Through the lights and hard on the brakes as I approach a skewed junction, the road on the left stretching away at an acute angle, almost a five o’clock I’m almost stopped as I crane my neck over my shoulder to check the road is clear before I move. The phone rings again.

“Kal - update, the caller says he can’t do CPR, he can’t get the patient on the floor. You’re going to beat the crew by about four minutes.”

“Thankyou.”

They hang up for both of us.

Ahead I see a car in my lane, pooting along at thirty or less, since he just passed the speed camera and I saw no flash. I’m moving closer to sixty and I make rapid mental calculations - has the driver seen me in his mirrors, does his road position suggest he’ll pull over smoothly and let me pass, or panic-brake in his lane?

I elect it’s faster and safer to pull into the oncoming lane and pass the car directly, watching the right side of the road intently for any emerging traffic who won’t be expecting me to come from their left hand side. I’m past the obstructions before he knows I was even there, the Honda’s all-wheel drive controlling each wheel automatically, ensuring that nothing skids or slides on the damp roads.

Outside the address there’s an old man standing at the doorstep, waving me down. Family members waving you down from the door are hardly ever good news…

I grab my bag and defib from the boot, leaving my roof lights and rear reds flashing to signal the locus of the job to the incoming crew.

“Thankyou for coming so quickly…” he begins, “…he’s in here.”

I follow his pionting finger into a living room, running lone-rescuer CPR guidelines through my head. With a crew four minutes behind me I’ll concentrate on chest compressions - balance the pressure in the chambers of the heart before we shock.

The living room is clean and tidy. So clean and tidy, in fact, that there isn’t a corpse in it.

In fact, aside from a cooling cup of coffee on the table, the place is like a shrine.

“Who am I here to see, sir?”

“Tom!”

“Where is he?”

“He’s…oh.”

The old man casts his gaze over the room.

“Well…he was here a minute ago.”

The fuck?

I’m immediately trying to work out what could cause a patient to appear dead and then recover in the space of a few minutes, giving him sufficient faculties to stand up and make off. Seizure, perhaps? Diabetic episode? Faint? None of the explanations I’m coming up with suggest a patient who’ll be tickety-boo on exam.

“Where could he have gone, sir?”

The old man begins to ramble an answer at me and I elect, instead, to search the house. Pushing doors open and flicking on lights and it’s only a matter of seconds before the house is lit up like Vegas. There’s still no sign of Tom, though and I jog out the back door into the garden.

I’m suspicious of the caller’s abilities to think clearly and beginning to suspect that this job may be simpler than it seems, but I’m still determined to search the place high and low as I envisage tomorrow’s headlines.

“Paramedics leave elderly man to die in back garden after assuming his friend was “confused”.”

I’ve got an idea, though.

Back into the house.

“Sir, does Tom live with you?”

“No.”

“Where does he live?”

“Just down the road.”

“Do you have his phone number?”

“Yes.”

“Could you call him for me?”

“Of course.”

Alarm bells ring loud and long, the man’s perfectly happy to call his friend who he believes is dead on the living room floor?

The call to Tom reassures me. He’s asleep, tucked up in bed and, yes, sometimes his friend does get a bit confused.

The crew arrive and we make the caller a cup of tea. He tells us he dozed off in his chair, woke up and “Tom was on the floor, he wasn’t breathing…I think he was dead.”

We reassure him that he’s had a bad dream, just a bit mixed up, sir. He downs his tea and agrees to go to bed.

The crew return to their vehicle, we crack a joke but he hangs on my mind for the rest of the shift.

There are better ways to wake up…

Late last week I was crouching by a young woman by the side of the road, wiping blood from scrapes and grazes. She’s wiped her bike out against another and come off the loser. The other bike had taken off, having confirmed that she wasn’t going to call the police. Chivalry is not dead.

While we were sitting there waiting for the ambulance a young man in a pink teeshirt walked past, stopped, looked and approached my patient.

“Excuse me? Would a puppet cheer you up?”

And from his bag he produced a kick-ass, foam headed muppet with googly eyes and waggly ears. It was (and bear in mind, I used to operate some cool puppets) a fucking awesome puppet. My patient was extremely cheered up by this, not only the puppet itself, but by the sheer loveliness of this stranger.

So it was with a big grin that I noticed a familiar, jester-hatted figure loping down George IV Bridge this afternoon.

“Excuse me?”

“Yes?”

“Didn’t you give my patient a glove puppet last week?”

“Yes!”

“That was the coolest random act of kindness ever.”

He was thrilled, really excited to meet someone else who gets the idea of being nice to people just cos. I told him about the random cake give-away of last year (remind me to tell you about that).

We parted, he dancing and jiggling, happy to have made someone else happy. I took his picture, promised him I’d big him up on here.

And so I will.

This is Eric Mutch, he’s in “Eric Mutch’s Nuts” at Jekyll and Hyde every at 12 noon. He’s a nice guy who likes making people laugh and making the world a nice place. You can find out about him at www.thefunrevolution.com

You should go see his show - it’s free!

So I’m standing on a street corner with my bike, giving directions to lost tourists and trying to stop the local kids from switching the lights on. Suddenly, down the hill, two cops come careering past and “dynamically deploy” me to a job.

“Might need you, mate.”

Fair enough, I swing onto the bike and free-wheel down the hill while a police van hammers past me on the right hand side. A total of six cops hair down a wee alleyway between two shops at gather at the foot of a flight of stairs in a small courtyard.

“What’s the issue?”

“Disturbance call…but they say he’s smashed some glass, so there might be an injury too.”

I look up at the building, a traditional Edinburgh tenement. Well kept, clean courtyard, one window smashed out, a black eye in its face.

“You guys crack on. I’ll be here if you need me.”

They gather at the door, ringing the buzzer, shouting at the intercom.

“Police! Open the main door.”

The door buzzes open and they tramp inside, I can hear their footsteps zig-zagging upwards, back and forth on the staircase. Police calls with injured parties are usually a paperwork exercise, they can’t discharge an IP without having them medically assessed.

I casually remove my bike gloves, slide the bags out of the panniers and am gloving up when a lone set of footsteps zig-zags back down the stairs and a police officer arrives, white faced, at the front door.

“Kal!”

He beckons me in and I follow him at a run up the stairs, onto a landing and left into a corridor. The room is about fifteen feet long, five feet across. There isn’t a clean patch of lino to be seen, the entire floor is covered in blood. It spreads a good half foot up the skirting board, splashes on the walls, shards of glass from the broken window float in it.

In the centre of this gory tableau lies a young man who appears to be doing backstroke while his left wrist squirts blood. His right hand is pinned to the floor by a cop, squeezing a tea towel onto his forearm.

I throw my bags beyond the scene into an open doorway (which doesn’t have claret all over the floor) and unzip them, grabbing a couple of large bandages. The patient’s left arm has a wide, triangular hole in the centre of it, blood pours out until I pack the dressing into the wound, wrapping the bandage around it as hard as I can, then tying a second over the top of it. It holds for a moment before a dark red stain blooms through to the surface, spreads and stops, holding its shape as a circle on the dressing.

Fair enough, that’s almost controlled.

I realise, with a fair dose of alarm, that I’ve come running up the stairs without A. an oxygen mask and B. a tourniquet, both of them are in the saddle bag on the bike and not in the main bags. This is a major issue, since I have a tank of oxygen right here, but no way to give it to the man whose entire supply of blood is trying to escape. I’m also keen to get some IV access so that once the crew arrives we can start pushing fluids into him in an attempt to , you know, make him not dead and that.

I improvise.

Looking over at the cop on the patient’s right hand, I see that the pressure he’s pushing on the arm is making the patient’s veins bulge in his lower arm - better than any tourniquet I could put on, it should be a simple matter to slip an IV cannula into that.

“Open that bag and pass me a grey needle, please?”

The police officer by my kit unzips one of my bags and looks in bewilderment at the contents, I try to explain.

“On the IV board?”

He lifts the defib and hands it to me.

“Don’t worry, just pass it over here.”

I expect him to hand me the kit, but instead he slides the entire thing across the floor and into the blood puddle. That’ll take some cleaning up.

Snagging a grey cannula from the board, I move to stick it in the patient but realise I’m going to have to secure his arm somehow before I go waving sharp pointy things about. The traditional method is to shove the patient’s hand between your knees, but I’m crouching, loath to put my bare skin on the filthy floor.

There’s nothing for it.

I splosh my knees down into the bloodbath, wishing I was wearing long trousers and not cycling shorts. The cannula slides easily into his vein and we’re able to move to protecting him against shock, lifting his legs above his head and delivering high flow oxygen therapy via a bag/valve mask, rather than a normal non-rebreather.

The crew arrives, we bundle the patient down into the ambulance and run bags of fluid into him. They take off to hospital in the wake of a traffic car escort, leaving me with a conundrum.

On an ambulance, if you get tagged by body fluids, you’re normally going to the hospital anyway. You can slide your green shirt off, or scrub the worst of it off your trousers with wipes before heading back to station to change clothes. You’re in the vehicle, nobody sees you, it’s all terribly discreet.

Out on the bike, I’ve nowhere to hide. My bare arms and legs are literally dripping with blood and though the police pull a roll of paper towels from their car with which to mop up, I’m still a ghoulish figure that walks back to the Fringe office to clean up.

The next morning I see the cop who deployed me, she laughs when I tell her I’m ignoring her next time. I’m crap with names and I tend to fall back on “Alright, mate?” when I meet the cops who populate the Information Centre on the High St (free coffee, handy loos, my favourite stand-by point!). Regardless of learning names, however, it’s another step to a closer working relationship.

There aren’t many stories to tell you, on account of how I’ve seen few patients of note.

My days are full, currently, of organising the Parabike and its coverage for the city centre. Last year we ran a bike through the crowds of the Fringe and Edinburgh Festival and it worked in a big way - this year we’re pushing it a little further. There’s awesome new equipment like electric bikes that pull you up the hills, pocket GPS transmitters that tell Control exactly where we are and a lights/siren system that parts crowds like a shit covered tramp with poor personal space awareness.

Sinky, another paramedic, is working alongside me so I get to share the shifts this year. The city centre bike has always been my baby and now that it’s growing up, I have a whole range of other issues to face. There are suppliers to contact, press relations to manage, operational demands to answer and requests from others within the service to field. The challenge of running a bigger project is enjoyable, but not without its stressors.

“Quiet bairns get no sweeties…” one colleague said to me this week as I negotiated a deal with an equipment supplier, but I’m also aware of what they say about tall poppies.

On top of this, I had a friend’s dog to stay while Bam and Sootie headed off to a festival. I wish I’d taken more advantage of having her here, gone for some nice walks in the park and similar but my time was short and my schedule brutal. We nipped around the block twice a day to let her avoid pissing on my carpet and I ran out the door. She was content to settle down on the sofa for hours and await my return, while I worried that she’d shit in the DVD player and eat things.

Meanwhile, our living room is being decorated. We elected to get someone in to do it rather than attempt it ourselves, so haven’t had to do much more than move furniture out of the way, but it’s one more pothole in the path.

Last night I stood on the High St and watched the afternoon’s pissing rain evaporate from the pavement as evening sunshine broke through. A woman approached with a smile and I returned it, expecting her to ask for a photo of the bike, or to have a request for directions. Instead she surprised me.

“My son’s just joined the ambulance service in Bath. Can I buy you a coffee?”

I smiled and a scale of stress fell with a “plink” between my feet.

“That would be lovely, thankyou.”

She vanished inside Starbucks, fought with the queue for a few minutes and returned with a mug of steaming filter for me. I switched my head to “polite public servant” mode, expecting her to want to discuss the job but she just smiled.

“It’s the least you guys deserve. Have a nice afternoon.”

Sipping at my coffee, I scanned the crowds and made a real effort to reset my head. I’m working in the biggest party in the world for a month, everyone’s here to have fun, to enjoy themselves. Work stress is nothing, it’s only a job. In a few days my living room will be clean and freshly painted, new curtains up, new rug on the floor, new furniture.

You can stress, piss on the carpet and chew on cables. Scratch at the door and drive the neighbours crazy while you howl at nothing

Or just turn a few circles and settle down. You can’t make your owner come home early.

-
PS - Evilontheinside? Thanks, mate.

A night out with friends, including dinner suspended from a crane in the middle of Princes Street Gardens, cocktails afterwards and a giggly ride home on the bus.

Then flip open the headlines to catch up and feel my stomach shiver.

“Three children found dead in Edinburgh blast.”

The crack and whine of the job flying over my head is nearly audible, while I sat in my living room playing video games and drinking tea, my friends and colleagues from all three emergency services were handling something unspeakable.

Raise your glass, or mug, to families of those lost and the others who pick up the pieces.

Off the back of my recent post about stress responses, I found myself the only HCP amongst a host of volunteer first aiders recently. As a team we’d managed and packaged the sort of patient that gave me the shivers, the type of patient who clearly thinks that they’re dying, asks if they’re dying and I am unable to answer honestly.

Volunteer first aiders train for this sort of thing to an extent and I have to say that the group I found myself inadvertently leading were slick and proficient. They did exactly what I said when I said it and stopped when instructed to do so. They performed tasks that were far beyond what they anticipated on their first aid duty.

One held a young man’s head in her lap and told him he’d be fine, to just keep breathing and try to relax.

Another was improvising dressings from a first aid kit that was never intended to treat injuries such as this and she kept her cool when I snapped at her to “just open fucking everything”.

One guy was standing over us, handling the burgeoning crowd and organising marshalls to bring an ambulance immediately to our side.

And the fourth was opposite me, kneeling in mud and piss up to our thighs. She had her hands under mine, my fingers moulding and turning hers just so and pressing them down. She was pushing onto parts of a human body she’d probably never seen before, let alone held, hot and wet and twitching in her grasp.

Aware that five sets of eyes were expecting me to know exactly what to do, I wasn’t about to let on that I’d only ever seen that body part before on an autopsy table.

The patient shipped out on an ambulance, we reconvened as a group. Reactions were interesting. One was talkative, jabbering excitedly that she’d never seen multi-trauma. Her excitement lasted half an hour before she dissolved into embarrassed tears . The coordinator was grim-faced, though the water in his drinking bottle trembled when he lifted it. My equipment specialist was cold and analytical, asking pertinent questions about her performance and the patient’s prognosis. And the fourth was silent, fascinated by her shoes.

My brain swung into “bad job” mode, automatically playing the cards that we do at work, that just a few weeks ago I’d been analysing amongst my colleagues and myself. My arms swung out, clapping shoulders, touching arms and shaking hands. I dropped my paw around the shoulder of number four and she stiffened at my touch. The team fractured into a one, two, one formation.

I gave them a minute and cracked a joke; humour didn’t go down well and I realised that the rest of the group were not only unaware of how we decompress, but that they mistook my attempts to do so as crass and degrading.

And I, recognising the offence I was causing, backed away from the process and joined them in their brooding.

For me there was no reset. I did my best to warn people about adrenaline come-down, to ensure that they would get home safe and be looked after by friends. I tried to explain about questioning your own performance and realising that finding out the patient’s outcome may be impossible. I strove to make people see that what they’d done was amazing, had probably saved the young man’s life and encouraged them to take comfort from that thought.

It was only on the following evening, when I gathered with like minded friends, that I was able to hammer through the stages, to get my quota of physical contact, to make flippant remarks about a horrendous situation and to clink beer bottles together and agree that things had gone well.

We all have our rituals, developed through years of experience, trial and error.

Until you know what works, you have no choice but to have a go at decompressing through any means you can conceive.

Find a your system and employ it when you need it.

Just realise that it’s a personal or collegiate decision.

And it may not translate beyond borders.

We held a blanket around her like parents at the beach while she shook and shimmied her soaking jeans and knickers to her ankles. A twist she never thought she’d dance

You hit the floor with a thud and while I dropped a towel over you to protect your young Dad’s shining eyes, I was praying you were a clot like that one time.

But I knew you weren’t. I knew what you were. Experience does nothing to soften these.

No dark red, sharp edged flesh.

No slices and angles.

Your surfaces smooth and soft like a sea-pebble in my pocket.

You are entirely contained within your form.

You’re a shining, translucent red, bright and vigorous as a childhood jelly.

We’d giggle as it slurped and farted lusciously from its mould onto good china, off-white with pale yellow flowers painted on the edge - “That was my granny’s…” I was told each time I took it down from the dresser.

The sun would shine through April windows, causing it to glow as though alive and alight, Jelly Tots and Babies floating within, suspended forever in sickly aspic for my wide eyes, level with the table top, to gawp at.

Twenty five years later…I gawp.

Vast head and stubs of arms, their scalloped ends yet to stretch into probing, inquisitive fingers. Your elbows curled spastically against the ampersand curl of your chest and back.

A tiny poppy seed eye stares up at me while everything else telescopes away into darkness.

For a moment there is nothing but you and me, staring at each other.

Far from the ten weeks your Mum declares, you clearly shook loose your apron strings some time ago, floating in a plateaued sea until you slithered, rude and luscious, from your mould.

The pavement holds a crusting rusty pool. Inside its darkened spotlight, stark and flawless, are two girlish footprints, white as legs first-bared on a spring beach.

Two footprints where you froze her to the spot; tiny, staring basilisk.

Business over, standing about like the father of the bride at the wedding - we’ve handed over our charge.  We were *it* for an hour, everything that the weeping parents in the room held dear rested in our hands and now we’re extra baggage.  We confirm with the team in resus that there’s nothing further we can do, I apologise to one nurse for snapping at her.
 
We sidestep the parents for now.
 
As we walk back to the ambulance there’s a lot of physical contact, shoulders punched and clapped.  We make a laughing show of wiping our damp palms before shaking hands and nodding - “Good job, thankyou.” 
 
The contact unifies us, reinforces the “us-ness” of the team. 
 
We are three, we dealt with something horrible. 
 
It’s still horrible, there is no euphoric victory, no moment to laugh at a little face on the bed, tousle their hair and chide them, grinning, for making us sweat. 
 
The face on the bed in that room has a mask clamped to it, stabbing fingers holding its airway open, a nurse squeezing air into lungs that count their years in single figures.
 
We are three.
 
We sit, one types, the other two chip in with recalled details, debated discrepancies.  It’s almost a debrief.  The job runs and reruns.  We thank the probationer for hurtling, unquestioning, around the scene in the house as we clipped instructions.  Move this. Pass me that. Wire this up. Park my car.  Give me the phone.  Start driving, soft as morning snow but fast as fuck, please. 
 
She smiles - “I was sweating…”
 
We were all sweating.
 
Somebody cracks a joke, it’s a vital part of the system.  Never at the expense of the patient and often directed at a colleague. 
 
The target retaliates and the situation escalates, the jabs are foul, obscene.  You’re a deviant.  She’s a whore.  So’s your Mum.  Aye, but she said you were shite.
 
It’s puerile and offensive and how we tell each other that everything’s ok - “If we thought you were a wank we’d never take the piss out of you.”
 
Paperwork to resus and a quick run-down from the consultant as to the plan, the prognosis.  He has no answers.
 
Our pulses slowed until we’re sure we won’t say anything stupid, we’re able to talk to the parents, reassure them about the skills of the doctors in the room, wish them all the best, try to meet their eyes.
 
Back in the ambulance the crew run me back to my car while I phone Control and update them - “All three of us need a stress break, we’ve worked our arses off.”

They drop me at my RRU, patiently hunkered outside the house. We thank each other a final time, awkward, everyone appreciating the unspoken sentiment. It’s not quite “dodged a bullet”, more that it clipped us and we limped back to safety. 
 
I turn up the tunes on the stereo and sing along,  loud and fierce, my arms tingling and twitching.  There’s no need to sit somewhere and weep, there is nothing to weep for and it would do no good anyway.  This isn’t grief, it’s potential energy.  Unleashed it would manifest as a scream, a shout.
 
If a punter took a swing at me, I think I’d go through them.
 
Stress breaks aren’t there to make you feel better, that takes a lot longer than half an hour in the mess room; they’re there to straighten your head out and ensure the remnants of the last job don’t spill into the next.
 
Your next patient needs you sharp and clear, switched on, not chewing on the details of what-might-have-been.
 
That’s what the break is for, the cup of tea, the filthy humour.
 
It’s how you keep doing what you do, and how you make sure you’re ready to do it all over again once the 30 minutes is up.