Oct 01 2012

Turn, turn, turn.


I'm a fairly easy going guy.






Outwardly serene


It takes a fair bit to rile me, to scratch this smiley patina and expose the hungover howler monkey within. But one word will do it, one word is my hair trigger, the blue touch paper on my supa-fly TNT, mutha-fucker.

The public insist on using it to describe patients who aren't responding normally.

“He's taking a turn, son…”. In my experience patients who are taking turns have been convulsing.

Or smacked off their chops.

Or having a haemhorragic CVA.

They might be acting funny because they're drunk.

Or they might be dead.


The word means precisely nothing, and yet it still gets passed to us -“Pt having funny turn – making strange noises.”

What kind of strange noises? People who are choking on their vomit make strange noises, but then, so did Sade and nobody ever crashed HER in for an emergency CT.


(I haven't checked this out. If Sade has ever needed an emergency CT, I'm going to look like a proper heartless cunt. I'm not going to check though, because my interest in incorporating an 80s pop culture reference into a point of humour about brain injuries is too great. This is my cross, and for you I bear it.)

I accept that callers can't be expected to give medical chapter and verse, but surely the call handlers are allowed to intercept this loathsomely vague phrase?

They do it for other jobs, we don't get sent to “Some boy's chibbed this cunt a fuckin' sair yin, like, an' there's blood pishing aw ower ma new suite.”


Although, to be fair, there have been occasions when I've felt that the call handlers probably could do with editing the complaint somewhat.

I have in the past been despatched to “male, really, really, really drunk.” and on one memorably hilarious occasion “male assaulted by whores and junkies”. The latter was changed rapidly, I'm assuming by a more experienced member of control staff who saw it come up and said “You cant send a crew to THAT!”


A turn can be the last minutes of your life, or left at home with a call to the GP in the morning.

Will I be hoovering vomit from your lungs, or putting you back to bed with a Rich Tea?

If I'm honest the reason I hate the word so vehemently is because it disarms me; it gives no indication of what gear I need to take or be in while approaching the job.

And that makes me uncomfy.



Sep 20 2012



We're trialling a mechanical CPR device. Imagine an ironing board that you lie the patient on and it does chest compressions for you.

We tried it on resusci annies, then we tried it on full size dummies.

And then we took it to the fire college and hauled their 80kg rescue dummies up and down a six storey training tower, all soot and stairs and haunted leaning furniture, while the machine hammered on their sternums a hundred times a minute.

People always complain that we don't test gear “where you'll use it, in a high flat, or down a stairwell.”


We tested it.


Then, three days ago, I hauled ass to a cardiac arrest and strapped it across the chest of a woman who we all suspected wouldn't make it out of the house, let alone to hospital.

And it cramped and squeezed her chest and poured blood into her heart muscle which began to twitch and then beat as normal.

And that heartbeat produced enough blood pressure to push oxygen to her respiratory centres and she started breathing spontaneously.

And instead of leaving a corpse on the landing for the mortuary workers to zip into a black bag and bump down the stairs?

We took a very sick mother, wife and sister to hospital and called her family to come say goodbye.




Sep 07 2012


So, I'm at at the Queen's Garden Party (as a medic, not a guest, though it's a rather lovely opener to any story) when Jax sneezes.

“Oooh. Bless me.”

“You can't solicit blessings…” begins Sarge “Either people will bless you or not, but you can't go round demanding it.”

Jax looks at Sarge like he's mental.

She's got a point.


But it gets me thinking.

We all know the drill. Someone sneezes and it's considered polite to say “Bless you” or, if you're terribly posh, “God bless you.”


We all know the probably apocryphal origins of the custom, that during the Black Death, a sneeze was one of the earlier symptoms, and to be caught sneezing in public was to alert others to the fact that you were probably about to die in a fireworks cascade of pustules and boils and rats piss (I haven't studied bubonic plague very much…that'll have to do). So people started blessing each other, in the hopes that the Big Yin would drop a urinal block or two in the Thames to negate the nastier effects of old Rattus Norvegus tinkling in the Evian.


I can't help thinking a bottle of Dettol and a green scrubby might have been more effective.


Still, we're left with this ridiculous legacy of invoking a deity whenever someone's nasal airways are irritated and they expel mucus and air at high speed to remove said irritation. Not only is it a custom, it's practically etiquette – people like Jax get upset if you don't offer them the blessings of the almighty just because they haven't taken an anti-histamine this morning.

The thing is, when you fart, or burp, or cough, it's up to YOU to say “Excuse me”, because we recognise that those involuntary actions your body makes have no place in polite company. Largely because they're the sounds associated with expelling something that it doesn't need anymore and have no place lolloping around in polite company.

For some reason sneezing is exempt, like a flatmate who's offended because you pointed out their pubes on your soap, sneezes demand that everyone else makes it all better in the interests of keeping the offending party sweet.


So in the interests of removing this daft anachronisism and avoiding any risk of offence by the summoning of a Judeo-Christian god with a box of Kleenex, I'm advocating a new system which still acknowledges the sneeze and yet is up to date and unlikely to offend.

It simply requires you to point at the sneezer and shout “You sneezed!”

Before you dismiss it, it's marginally less ludicrous than requiring the gods to attend to your sinus drip. I hope they have more important matters to attend to than your snottery beak.

Failing that, if you're still up for pulling celestial beings into your bodily expulsions, I've devised a whole new range of sayings.

For instance, when you've excused yourself from the dinner table to use the bathroom, from now on I think it should be only gracious, on your return, to tell your fellow diners – “Peace be upon you, I shat.”

Also, please feel free to use the following lines in polite company.

“By the grace of Shiva, your tummy is rumbling.”

“May the Buddha smile upon your productive cough.”

“Apollo's flight, true and straight, guide your wee to the porcelain.”

“Pray the angels sing in the key of your queef.”

Obviously, being a etiquette trail blazer can be a lonely business, so I'm going to need you guys to all start using these with immediate effect. Report back, readers.

Today is the first day of a wonderful new era of partnership between farting and heaven.



Sep 05 2012

Kept in suspense.

A touring theatre company asked for a paramedic in the wings for each performance, one of their actors was to be suspended by his ankles for some time and they were nervous the top of his head would blow off.

Each night, after shift end, the day shift team leader would make their way to the theatre and stand in the back stage for an hour, listening to tech cues and watching the scene we were required for.

By the time I caught the whole show as a punter I could mouth along with the actors in our bit.


Aug 08 2012

ALS course


Which, it transpires, stands for “Assorted Lovely Scones”.

Doctors get the best free munchies.

Jul 16 2012

Obligatory accommodation shot.

On our last night, I look down the length of the bunk house.

“Jesus…this place is a shit-hole.”


James looks up from his bedroll.

“In our defence…it was when we moved in, too.”


Fair point.


Jul 15 2012

Revenge:best served cold with semi skimmed milk.

They laughed at me when I won coco pops. They laughed when I squirrelled them away in my pack.


And on the last day? When breakfast was dead hash browns and “deep fried cooked egg” (I still don't know).

When the locals had started herding the camels back along the nearby roads, confident that some nutter rally driver wouldn't plough through the middle of them?

I had coco pops.


And I was even nice enough to share.


Jul 14 2012

“A little dust, and the engine kicks.”

So I've written in the past about Sweep duties. You can read about my previous adventures here and here and here. I'm not going to lie – the attraction of driving through the desert is one that is largely lost on me. I love the novelty of it, I love the landscape, I love the omnipotence of the sand; much like the Cairngorms, there's a clear message from the terrain that, whoever you are, the landscape will kick your ass if you don't respect it.


But tooling through the sand for 14 hours just because?


Not for me.


If, however, you're the type of person who would LOVE to drive around dunes for hours on end, you want to get in touch with Marina at Living Life To The Full In The Empty Quarter. She blogs about her weekly drives through the sand with some awesome pictures that should make you smile.



This year my day of sweep involved driving out to meet the sweep teams at their accommodation early in the morning,

I'm not great at driving on the wrong side of the road. I'm a pretty good driver in the UK, but a huge amount of the “odd” stuff that we do as emergency drivers happens by instinct. When I'm driving on the wrong side of the road in Edinburgh, it's not that I'm suddenly working on a complete reversal of the rules of the road, but more that I'm operating under an absence of them.


Driving abroad fries my brain, I have to think long and hard every time I make any kind of manoevure, typically chanting “Drive on the right, drive on the right.” to myself whenever I have to navigate a junction or similar. Roundabouts are a fucking nightmare, I simply cannot get my brain to remember that you indicate right to pull off at an exit, rather than to the left.

So the prospect of driving a hundred clicks in a country where the average motorist isn't known for his religious adherence to the Highway Code? And further more where the application of the law can be described as “subjective” by local law enforcement? Was not one that filled my soul with enormous enthusiasm and deep joy.

I was even less reassured when I questioned a colleague on the directions that read “Don't do a U-turn on this bit of motorway…do it at this bit.”


“Because a U-turn there is less illegal,” he answered.

How jolly.

Most irritatingly, James, one of our desert virgins, was due to drive the other truck and was skipping about in the dawn light, singing about convoys and looking for all the world as though the thought of our little sojourn bothered him not a jot.

My concerns notwithstanding, after the opening minutes of gut wrenching terror (including the U turn on the motorway, yes) I have to admit I sort of enjoyed the trip. I even managed to find some suitably Arabian shouty-waily-ululatey music on the AM/FM radio in the cab and barrelled along with one window down, my arm hanging out the side. I was a Middle Eastern trucker.


An hour or so later we made it to Liwa, only slightly behind schedule. Lisa and James hopped into their respective units and headed off into the dust, while I took advantage of the fact that I was Sweep 3 – the last out and the last back, for sure, but that allowed me time to catch a quick cup of coffee in the canteen.


Outside Streaky, my driver for the day, and two other members of his team set to the job of preparing their trucks. Spanners and gaffer tape, filthy jokes and hastily assembled packed lunches, not to mention the traditional slotting of pies into the engine compartments to bake in the sun through the day.


We lost one member of our convoy early on.

We'd all three gone over a lip that led to a fairly heavy hit at the bottom of the bowl Streaky and I were heading onewards when a voice on the radio called us back. The last man in the convoy had taken them same route as us but struck the sand harder than expected, his vehicle taking a sufficiently solid impact to dislodge his bumper and push it backwards a couple of feet. He had no head or neck pain and hadnt struck anything in the cab, but told me he felt “funny”. He was a bit pale, a bit sweaty and his pulse at the radius wasn't awesome. All in all he seemed like a man who'd dumped his blood pressure, probably through the fright of the hard landing. I kept an eye on him for a while until he felt ready to continue but within a few miles he was back on the radio.


“I don't think I'd be smart to carry on…”


Sweep drivers are no wilting violets, so I figured if one was telling me he needed to bail out, then it was as good a diagnostic sign as any.


One problem, how to get him back to the pc point and onto home?

“I reckon I can drive back myself…”


I wasn't thrilled with the idea, but we set up a network for him. He took my cell phone number and we checked that he had a working GPS. As he set off for the PC point (where I knew there'd be an aircraft standing by) I SMSed my SAR colleagues and told them to watch out for him, telling the driver not to leave the PC point until a medic had seen him. We also arranged a fail safe, whereby we estimated how long it would take him to get back, doubled the time and agreed we'd scramble a helo for him if we hadn't heard back.


And with that, as safe as I could make it, I shipped a patient off into the desert under his own steam.


Comfy much?


The day was typical sweep, over some brutally unforgiving routes. We grounded and stuck time and again, each time having to dig or tow each other out of the sand. At one point the bottom of one truck got so embedded in a dune that we snapped a tow-line trying to haul it out. It was tested for 11,000 lb.


All day we picked up and dropped off broken down riders, often simply bussing them to the nearest major road where their support teams could rescue them. One chap we collected climbed into the back of the truck and so promptly fell asleep that we forgot he was there; he scared the shit out of us when, miles down the road, a voice from the back seat came out with “Do you have any water?”


It was late afternoon and we were enroute to collect a broken down bike when we crested a rise and found a quad lying on its side in a puddle of fuel, a helmet lay next to it, but no rider. We pulled over and fanned out around the crash site, looking for foot prints, looking for any clue as to the rider's location, recognising that he might be riding out with his support team already. Strange that theyd leave the quad, though, and stranger to leave his lid. I walked back to his quad to kick sand over the spilled fuel and casually picked up the helmet.


Turning it over in my hands the situation suddenly became much more grave. The visor was snapped from its hinge, there were fractures marks along the jaw line and at the back of the helmet an ugly dent was stoved right through to the lining. It wasn't hard to imagine the mechanism; a heavy landing throws your head forwards, smashing first the flimsy sun visor off your forehead and then slamming your chin guard against the handlebars.


You flip forwards and off the quad, but although you've stopped moving after a roll and bounce or two, all four of the quad's wheels are still spinning and propelling it forwards, bouncing and spinning after you “like a fucked off dice” as one rider once described it to me.


There are no big rocks on the road, no kerbs at the side to dent your helmet, so the only explanation for that hole in the side of his lid is that his quad spun into him, hammering a handlebar, or foot plate, or even just a protruding corner of chassis into the back of his head as he lay on the ground, dazed and frightened.


I needed to know where this guy was, right now.

Thankfully my SMS back to control was rapidly answered with the information I wanted to hear. He was in the air, flying hard and low and fast towards a trauma centre. I took photos of the helmet and communicated the damage back to Patch, just in case the receiving crew had missed it; an easy enough point to skip when you're focussed on your patient, but a useful piece of knowledge to have when deciding imaging and treatment options back at hospital.


By the end of the afternoon we'd got stuck again. I was knackered and there was little that could be done without a tow line, so I eschewed a shovel for my camera and backed off to a nearby dune to take the following video, recognising that a photo doesn't always capture the perpetual unending permanence of the sand.

Id like to apologise for my Barry White-esque timbre and gruffness. It was hot, I was dry and tired. I'm normally more melodious.


Jul 12 2012

Whiter than white.

Every year we spend an evening cutting loose, letting our hair down (which is sometimes tricky, when the best haircut for this environment is a half-all-over) and kicking it to some crazy beats.


Wednesday night. The fancy dress party. This year's theme?


The 80s.

I was born in 1981, so I was kinda tempted to turn up wearing a pair of Osh-Kosh dungarees and eating a Wham bar while inviting people to debate whether Panthra was cooler than Lion-O.


Clearly, Panthra, obviously.

But no, instead I did my normal trick of walking into the awesome costume shop near the university in Edinburgh and saying “80's themed party, Need a costume. Less than £40.”


The lovely woman behind the counter rummaged around before coming up with satin bloom pants, a shoulder padded jacket, dollar sign medallion and oversized shades.


“Wanna be Vanilla Ice?”





Come the Wednesday evening, though, my claims to being Vanilla Ice were quickly shot down by everyone walking up to me and saying “Ooooh! MC Hammer.” respect went to Ed, though, who'd spent several days before the event painting squares onto a cardboard packing crate in a Rubiks pattern, then wrapping said crate in brown paper, packing his gear into it and using it at his luggage.


His. Luggage.


I hate clever people.


The evening ran on as it typically does, beer flowed, the music struggled to be heard over the associated hubbub (every year we bring shit speakers, every year they don't work), the police officers stationed at the event sat and glowered at our haram dancing, drinking and canoodling and I was just about to turn into my bunk for my 0430 start the next day (sweep duty after the party…yeuch) when we were all gathered into a huddle by the Clerk of the Course.

“I feel it's only right that we recognise the fantastic work that the SAR/MED crew do, and as such this year we've brought along some prizes to thank you for your excellent outfit efforts.”


He worked his way through a number of themes, you know the sort of thing, best male, best female, best dressed, most imaginative deployment of hot pants. People were ushered up to the front where they shook the Clerk's hand and received their prize, a box from a Variety pack of breakfast cereal.


“And now we have the glittering grand prize, the prize that will be issued to Mr or Mrs 80s. It's….a box of Coco Pops.”


The crowd dutifully oohed.


“And the Coco Pops go to…..MC Hammer!”


Slaps on my back, cheers around me. I'm trying to tell them “But I'm Vanilla Ice!” when a hand pushes me to the front of the crowd.


Fuck it, I'm MC Hammer.



Jan 07 2012

And so this is Christmas.

I’ve hammered down the road, fast as I dare trust the tires on wet Christmas roads. Control rousing me from a much needed doze with the words I didn’t need to hear.

“Topcat job for you…”

Edinburgh’s Topcat paramedics are a small team who are despatched to cardiac arrests with the sole purpose of managing the scene. We try to ensure high standards of resuscitation and assist crews with decision making, leaving them free to concentrate on the hands-on clinical role.

I shove through the front door and am pointed into a back room by a young, blasé looking woman.

“Twenty eight, twenty nine, thirty. Breathe.”

The patient’s chest flexes and a long, farty exhalation bubbles up out of her throat. The paramedic at the head swears under her breath and readjusts the tube poking out the slack mouth.

“I fucking hate LMAs…”

They tell you that a Laryngeal Mask Airway is the ultimate “fire and forget” for a cardiac arrest, just stuff the tube blindly down the throat and know it’ll end up ventilating the lungs. I’m yet to find a para that likes them, raised as we are on only trusting an airway that you’ve *seen* enter the trachea.

“You need a spot?”

The Community First Responder nods, a ox-bow of sweat spreading across his chest. He was here before us, turning out, unpaid, in the middle of the night when most others in the town have been enjoying the festive festivities.

I step over the patient and bend double from the waist, counting the responder down and taking over the CPR as he straightens up. It’s not the best angle to do compressions from, but it works in a pinch and reduces the time off-chest to an absolute minimum. I press and pound, looking left to right. The para at the head catches my eye and smirks, thinking the same as me.

She calls to her partner, a new technician.

“Are you planning on taking over CPR from Kal at any point? That’s not a comfortable position to work from.”

There’s a wee surprised “oh…right…” and she kneels down alongside us. I regain my feet.

“So what’s the story?”

“Found….about twenty minutes ago now. Asystolic so far.”

“Bystander CPR?”

“Not when we got here.”

Shit. Her chances aren’t good, but…

“She’s *young*, Kal.”

I nod. She is. Barely older than me.

“Ok. So here’s the plan. We stay on the chest, we push adrenaline on time and we rhythm check every two minutes. We concentrate on compression depth and hold out for a reversible rhythm.”

The para nods, bagging gently.

“Do we know anything about her? Drugs? Drink? History?”

There are medicine bags on the bedside table, a quick sift shows nothing more sinister than anti depressants, vitamin b12 and a bottle of methadone. But no incriminating empties to point us down a route.

I shove an IV into one limp arm and brief the First Responder on how to set up a prefilled syringe of adrenalin.

“The paramedic will need one of these every five minutes or so. You can get them ready if you’re not doing compressions, yeah?”

He nods.

“I’ll go and get some history.”

Outside in the corridor I find a young man, skinny and pale. Teary.

“What’s your name, mate?”


“Alright Martin, I’m Kal. How are you connected to the lady next door?”

“She’s my mum.”

Oh Jesus.

We sit down on the floor. The blasé young woman, Martin’s girlfriend, sits next to him.

“How old are you, mate?”


An adult.


But an adult nonetheless.

And that makes things, if not easier, then more straight forward.

I write his name on my glove, I’m terrible with names, can’t be forgetting his.

“Martin…your Mum is very ill. Her heart isn’t beating and she isn’t breathing. We’re doing everything we can for her, just the same treatment that she’d receive at the hospital.”

He nods, lifting his face up from his shoes.


“Saying that, Martin…your Mum is really, really sick, ok? Dangerously sick…do you understand what I’m telling you?”

He nods.

“Where’s your dad?”

He mentions a village several miles away.

“And your mum and dad, they get on?”


“I think he should be here. Seems like tonight would be a good time to have your dad with you, right?”

He nods, digs in his trackie bottoms for a phone and finds a number, he’s about to dial when I reach my hand out to him.

“Would you like me to…?”


I take the phone from him and I’m about to push the green button when there’s noise from next door.

“Is there someone else in the house?”

“My wee brother,” he nods towards a closed door “in there.”

“How old is he?”



I take Martin’s phone from him and stand outside the front door. The man who answers has been drinking, but sharpens up fast when I introduce myself. There’s no time for niceties on the phone, he needs to know exactly what’s going on and I tell him, finishing with.

“Can you come to the house? I need you to look after the boys.”

There’s a woman screaming in the background of the phone call, “Is she dead? Is she fucking dead?” but the man ignores her.

“I’ll get a taxi, pal. Thankyou for phoning.”

He hangs up.

Back in the house Martin is standing in the corridor chewing his thumb bloody.

“What’s your brother’s name?”


“I think he should know what’s going on, what do you think?”

He nods sadly.

“I’ll speak to him, but maybe you want to come in and back him up a bit?”

We walk in together, Gerry is playing XBox in his room, there’s lad mag posters on the walls, a smell of socks and dope, a bmx leaned up against one room. Martin sits down next to him on the floor and I sit opposite, using the exact same words as I did with Martin earlier. The lad stares at me like I’ve punched him, nodding when I ask him questions. I’m not convinced he’s taking it in, so I clarify with him.

“Gerry, do you understand that your Mum might not get better?”

He nods again and shuffles under the wing of his brother.

“OK, I’ll go see how we’re getting on.”

Back in the bedroom and the picture is unchanged. Twenty minutes have passed since we arrived on scene.

“What’s the rhythm?”

“Still flatline.”

“Ok. We due another adrenaline?”

“She just had one.”

“So…we give it a few minutes and see if it has any effect?”

“Went in three minutes ago.”

If it was going to do anything, it would have done it by now.

“Blood sugar?”


“Anything to suggest OD or poisoning?”


They’ve thought of all of this, they don’t need me checking, but I’m fucked if I’m giving up without dotting the I’s.

“So to recap, adult female, unwitnessed arrest, no bystander CPR. Airway is secure, we’re getting good chest movement, good CO2 trace on the monitor, high flow o2 throughout, minimal cyanosis with CPR. She’s had maximum time on chest, good quality CPR, she’s got IV access and drugs as indicated. She’s had twenty minutes of ACLS and has shown no signs of responding and is neurologically unresponsive. ”

It’s a comprehensive summary and I’m confident of the answer that I’ll get, but I ask the question anyway, because I don’t like pronouncing people without asking it.

“Can anyone think of anything else we could do for this lady?”

Three heads shake at me.

“Then we stop, all agreed?”

They nod.

I check my watch.

“Zero two thirteen…I’ll go and speak to the family.”

There’s clearly something on my face, because the para frowns at me.

“You ok? You want me to do it?”

“No…it’s ok…I’ve got it.”

I’m in the corridor, calculating. Do I tell the boys what’s happened, or wait for their Dad to get here? He’s miles away, sounded pretty drunk, will need to wait for a taxi, at this time of the year that’ll take a while.

I can’t have them sitting in one room with her growing cold in the next.

I can’t.

I turn the handle, swing the bedroom door open, step into the room again.

They look up at me.

“Guys? I’m afraid I ha…”

My throat closes, the backs of my eyes burn.

Jesus, come on, Kal. Get your shit together.

I swallow.

Look down at my feet and breathe in deep.

Look up.

Breathe out.

“I have some very bad news. When we got here your Mum’s heart wasn’t beating and she wasn’t breathing on her own. We’ve done everything we can, but she hasn’t responded to treatment. I’m afraid she died a few minutes ago.”

They implode into each other, both of them screaming. I stand with my hands folded behind my back, looking at their trainers.

The younger one stops howling, breathes in hard and lifts his head over the parapet of his brother’s shoulder, stares me in the eye.

“Is she dead? Is my Mum dead?”

“Yes mate. I’m sorry, she is.”

The second time he hears it looks like it hits harder than the first.

He shrieks again, they cling to each other, gripping at teeshirts, scrubbing their eyes against each others bony shoulders.

I sit on the edge of the bed with them, as scared of being in this room full of grief as I am of the damage I could do by standing up and leaving them alone.

I need to be here, to stay here, to answer any questions.

And while I’m here, I have to listen to their world fall apart.

Dad arrives and any fantasies I had about his steady parental hands vanish as he crashes about the house like a frightened horse, lost in his own grief and shock. He screams and swears, while his girlfriend sits in a drunken haze on the sofa asking if we’d “done that heart shock thing”.

The boys split like atoms.

Martin sits in the living room with a cop and Gerry curls into a ball in the corner, lit by the screen on his mobile, texting frantically.

I shiver to think of the messages he’s sending.

Their father grumbles and curses, shouting at the police officers, occasionally throwing his arms like a blanket around his face and sobbing from his guts.

I stand on the side and stare and all I can think is:

“This moment. This confusion and grief. This terror and uncertainty about the future. This empty feeling of making adult decisions with absolutely no preparation? This is Christmas now.”

It makes me cold.

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