You should go and watch this.
It’s eight minutes long, you can afford eight minutes.
Really, trust me on this one.
You can.
You’ll get to minute three and think you should go and do something else while it runs.
Don’t.
Just take eight minutes.
It’s worth it.

And using them.

Having coffee with the lovely Aino I dig in my wallet and pull out the bloginess cards I had printed at Moo.com. They’re simple and tasteful and stylish. Half the width of a classic business card they have a faked up resus sceneI took many months ago on one side and on the reverse in hot pink it reads “TraumaQueen….I write it…you read it.” with the URL.

I bought them because people are always HEARING about the blog and saying to me “What’s the address again?” and I’m sick of going “Have you got a pen?”

Amber has some Moo cards for her new photography business, they’re beautiful and elegant and I fancied them.

Anyway.

Aino is cooing over the card I’d given her when she drops it on the table and says “So, are you leaving them everywhere?”
“No.”
“Why not?”

Because…because, well, because that’d be ADVERTISING, wouldn’t it? And I’m just a little blogger, with a fairly small readership. I’d like that readership to grow, but have, until now, depended on word of mouth.

I agree that leaving the cards around would be a smart way of attracting more readers and lodge one in the sugar bowl as we stand up.

We’re standing at the front door when she nods at the notice board.
“Put one up there.”
“You sure?”
“Why not?”

I’m pinning one to the cork when a woman brushes past, sees the photo and reaches out.

“That looks interesting, what is it?”

Shit! Suddenly I need a sales pitch!

I smile my best winning grin and open my mouth.
“That’s TraumaQueen, it’s a blog. My name’s Kal, I work for the Ambulance Service, the blog’s a darkly humourous look at my job and my patients.”

Phew, that wasn’t so hard to say (and yes, I did introduce myself as Kal).

“Sounds interesting, my name’s Mary, I’m an author, I’m just getting my book onto Amazon.” She studies the card again. “Can I keep this?”

“Sure.”

She smiles, steps outside, I see her chatting to her friend who’s waiting on the pavement, catch snatches of conversation “…Ambulance….writer…..blog online…”

Aino slaps my arm.
“Wasn’t that easy?”
“Yeah! Did you set that up?”
“Of course not, you tit.”

I make for the door, she catches me by the shoulder.

“Aren’t you going to put another one on the board?”

And I do.

“Allo mate.”

Dulcet Welsh tones, we’re being controlled by Nova, it’s always a pleasure, he’s down to earth, knows his job, doesn’t mess us about and realises how silly the job can be.

“There’s a bit of an emergency at Anonymised Supermarket, a male with a piece of plastic up his nose, apparently.”
“There’s a what?”
“A male with a piece of plastic up his nose…oh, wait, more’s coming through now. Apparently he’s two…and breathing quite fast.”
“Mate…”
“I know mate, I know.”
“Nova, mate, I’m attending, what do you expect me to do?”
“I *know*, mate, sorry, I don’t come up with this stuff!”

We swing into action, lights and sirens and arrive at the Supermarket where, hours earlier, we’d bought our lunch. On that occasion the lad parking the trolleys had dashed to my window.

“What’s the emergency?”
I’d answered with a smile, “Nothing mate, I want a sandwich.”

This time he calmly smiled at us as we drove past.

There, by the front door, stands a woman with a kid in a buggy and two other wee ones. The buggy-bound one has a face smeared with snot and dry blood but is otherwise apparently unaffected by whatever tragedy has befallen him.

“This is him,” says Mum “I don’t know what’s up there, but he’s been trying to get it out on his own.”

I have a squint at the kid’s nose, there’s two little yellow ridges poking out of a big bloody bogey.

“He was playing with this.” says his brother, handing me a Lego figure. A Lego figure with one suspiciously absent hand.

“Ahhh, ok.”

The kid, who we’ll call Ross, for that wasn’t his name, was absolutely, positively not interested in having some big green bloke poking about with his nose. He slammed both his hands over it and when I asked him to “look up at the sky” for me, contrarily shoved his chin into his chest. Awkward little git.

Nobody has ever said to me “When you have a kid with something stuck up their nose, do this.”
The only experience I have of this situation is a personal one, having shoved a bead up my schnozz when I was a similar size to this lad. My parents took me to the hospital in that case, they certainly didn’t phone an ambulance, as my presence here is, frankly, something of an overkill.

I swither over whether to take the kid to hospital, I’m not convinced I’m supposed to go digging in his face for this chunk of plastic, but simultaenously, I’m a thousand per cent certain that I’ll have the screaming dancing piss ripped out of me if I take the child to A&E.

“What we need…” begins my partner “…is a pair of tweezers.”

We don’t carry tweezers on the vehicle, we don’t handle many splinters. I do, however, have a pair of suturing forceps in my belt pouch. SMM got them from a drugs rep a while back and, while I don’t do a lot of sutuing on the road, the fact that they’re long and strong and lockable in the closed position makes them exceptionally useful for picking up things you wouldn’t want to touch with your hands. I particularly use them in at OD’s “I took all the pills, you’ll find the packets in the bin.” I’m not digging in anyone’s rubbish, I don’t get paid enough!

I pull them out, wipe them down and set to trying to persuade Ross to let me stick them up his nose. I galvanise myself with the though that, were he unconcious, I’d have no problems pushing a rubber tube up his nose, nor would I have a difficulty suctioning his nose to remove gunk from it. Anyway, what’s the worst that could happen? I might pull it out and his nose will bleed, in which case we have a nose bleed, which we can treat. I might push it further into his nose, in which case he goes to hospital anyway. Right.

He’s still insisting on not looking up. I pull another toy from my belt, a little blue LED SMM brought me back from a theme park. It’s staggeringly bright and I tend not to use it for much at work, other than catching the attention of kids (and occasionally drivers who pass the ambulance too close when I’m standing by it). I blink it at him, he’s transfixed, follows it as I move it left, right. I pass it to my partner “Gonna get some extension with that for me, mate?”

He flashes the light at Ross as he moves it up above his head, just above his crown. Ross, like a lamb to the slaughter, looks up, up, up and unwittingly gives me unrestricted access to his nostril.

With a soft “Schloop”, the lego hand comes free, festooned in bloody bogeys and is dropped into the bin.

Ross, Mum, brother and sister take their leave, and we drop into the coffee shop into the supermarket. It perhaps wasn’t the most dramatic job, nor life threatening, in fact, it was a complete piss-take of a shout. But we managed to fix someone’s problem, we avoided taking them to hospital, and, frankly?

How many of you have ever been paid to pick someone’s nose?

You are:

Seventeen.

Staying away from home for the first time.

Tall and slim with hazel hair and skin as luminescent and soft as polished alabaster.

Stunningly beautiful.

Folded over with pain, grasping your abdomen, resting your forehead on your desk and weeping softly into your study notes.

Scaring the shit out of your flatmates, barely lassies themselves, lapel-thrust into an adult world of illness and responsibilty.

Adamantly shaking your head at me, insistent of your health, hiding your face, refusing my gently probing questions.

Rummaging for excuses that will satisfy me and make me leave you alone.

Running low on adult language, pain regresses us all, “stomach” becomes “tummy”, “pain” becomes “hurt”.

Shaken to truth by your own distress.

Bulimic.

Suffering the pain that comes from starving and gorging yourself, shrinking and stretching your stomach.

Convinced your flat, firm belly is vast and disgusting. You push your teeshirt’s hem against your thighs, fold your arms across your navel, shake your head tearfully, refuse to let me palpate or auscultate it.

Persuaded into the ambulance and transported with your friends, hiding your frame from us all in a sterile NHS blanket.

A month ago…and still getting me down.

“Control, any further information on this one?”
“Negative, all we know is the crew requested back-up.”
“Is there a problem? Heavy punter or what?”
“Can’t tell you I’m afraid, they hit Priority and requested help.”
“They hit Priority?”

Her voice takes a grim edge.
“That’s affirmative.”
“Right.”

We only hit the Priority button in real emergencies. I’ve hit it before with scarily injured (like him) or when I need information *now* (like her). We wonder if the patient’s too heavy to carry down stairs, but that seems unlikely, he’s a twenty year old laddie. The crew we’re going to assist are a Paramedic and Technician, so it’s not like my partner’s advanced skills are needed. Perhaps it’s an arrest and they just need the extra hands?

We turn into the village and see a group running down the road towards us. Running people are rarely good news. I scramble for things I might find useful, a hand-held radio, extra gloves and the big red Mag-Lite.

The running pedestrians (one older woman, one younger, an older man and a baby in a car seat (who we’ll call “Mum” “Sister” “Dad” and “Sister’s Kid” for easy identification and for obvious reasons)) are ahead of us through the front door, past Girlfriend who’s sitting on the stairs shrieking from the base of her lungs.

“He’s alright! He’s alright!”

My mental voice responds:
“Well…good, let’s stop screaming, shall we?”

We all pile into the living room where the patient lies on the floor, spark out. The first crew kneel by him and raise their heads as the seven of us make our somewhat noisy and chaotic entrance. Mum runs to her son’s side, Dad, who is carrying Sisters Kid, retires into the adjacent bedroom and my partner joins the first crew for an update.

Sister turns to Girlfriend and goes mental, screeching at the top of her range.
“What have you given him? You fucking bitch! What have you done?”

“That’s enough of that…” I begin, but we suddenly find ourselves beyond the point of discussion, Sister yanks back her right hand to belt Girlfriend a solid one in the chops.

I’ve had long discussions with Pally about reacting to violent incidents, I’m a great big softy when it comes to situations like this, I’ve never properly punched anyone in my life and, frankly, I’ve been fairly apprehensive about how (and if) I’d react.

Turns out instincts are powerful things.

My right hand catches her upper arm and I shove her, hard, back towards the door. She pirouettes madly away as Mum turns to me and begins to bellow protestations and threats. My partner steps to my side and delivers a similar shove to the older woman’s chest, propelling her backwards.

It was just enough, and I thank my instincts for coming into play, the shove had a great blend of calm, force, control and aggression. We hustle the two of them out through the door and I slam it shut, chocking it with my instep.

“Get the police, Kal.”
I dig into my pocket and grab my phone, dial three nines and am no sooner connected when I find my foot shunted across the floor. Sister and Mum are shoulder barging the door from the corridor outside.

“Let me in! Let me in! Open this door!”
“Back off! Nobody comes in or out!”

The door slams against me, the impact sufficient to force my elbow through the thin plywood facing, a hole the size of, well, my elbow, appears.

Sister changes tack.

“My baby’s in there! Let me in to my baby!”
“He’s fine, he’s with your father, he’s safe, back away from the door.”
“You fucking cunt! You fucking CUNT! I’ll fucking kill you!”

I begin to wonder if I’m not in some weird Pyramus and Thisbe themed hidden camera show, only with more psychopaths than I’d expect.

The police despatcher is yelling in my ear.
“Hello? Hello? Police?”
“Police, this is Ambulance, I need immediate…”

*BLAM* The door smacks against my shoulder.

“Oof!…assistance at…”

*WHAM*

“…Road, Sometown.”
“Can you repeat? I got “Sometown.”

I figure it makes more sense to spell it slowly once, than repeat it fast several times while they try and get it. I’d rather they had an accurate destination to make for.

“Battle Road. Bravo”

*BLAM*

“Alpha.”

*KRACK*

“Tango, Tan”

*SLAM*

“go, Lima.”

*BOOM*

“Echo.”

“Got it, despatching cars to you now, what’s the problem?”

“We have multiple violent family members, we’re barricaded in with the patient and can’t leave the scene.”

I hang up, the door pock-marked with elbow holes, my uniform embroidery sports a fairy-dusting of splinters. The patient is deteriorating, we’re running low on oxygen and drugs as his treatment continues. The screaming and banging behind the door stop.

There’s a genteel knock.

“Yes?”
“Can we come in, please?”

I smother the urge to laugh out loud.

“No.”
“Fucking cunt.”

Silence, receding footsteps. I stay at my post, leaning my frame against the wood, grateful that the current diet hasn’t made me lose TOO much weight.

Another knock.

“Yes?”

A male voice - “Hi, ummm, I think my brother’s in there.”
“Uh-huh.”
“Can I come in?”
“Sorry mate, nobody’s going anywhere until the police arrive.”

The door is shoved.

“Back *off*! Did you not heat me? No access until the cops are here.”

Silence, footsteps.

I suddenly realise that I’ve given them an in. I have no way of identifying people on the other side of the door, how will I know it’s the police when they arrive? What if the family knock and pretend to be the police? I need a spy-hole.

I survey the door, it’s knackered, it’ll need replacing.

Sod it.

I pull my torch from my belt and, to use the local vernacular, panel the fuck out of the door, using one of my elbow holes as a starter. Two sharp smacks later and presto-change-oh! A spy hole!

Girlfriend looks up at the sound of splintering wood, screams at the room in general.

“Tell that FUCKING BITCH to stop KICKING MY FUCKING DOOR!”

Oops.

Credit to the police they’re with us in minutes, flooding the room with kevlar and batons, letting us worry about getting the patient down the stairs and into the ambulance. Once loaded we’re preparing him for transport when we notice, as one, that Sister and Mum are both in the vehicle with us; four stressed and wound-up green suits let fly and in unison bellow at the two of them.
“Out!”
“No way, no way.”
“Get out! Right out, go on.”
“Shift it, you’re not coming in!”

Cowed, the two of them troop down the ramp, muttering under their breath.

In true esprit d’escalier, I only realise later that I would have loved to tell them both how much they were endangering their son and brother by their actions. The only reason we were delayed on scene was because of them and their ridiculous behaviour that left him lying on the floor in their shit-hole house instead of getting the care he needed in hospital.

Arseholes, the lot of them.

I’ve got four weeks annual leave booked between now and the end of March. I got a “Use it or lose it” letter from the office at the station, pointing out that I’d been accruing leave throughout my employment, including the two months I spent at college.

Honestly? I didn’t know what the hell to do with it all, I’m a sucker for structure, I love knowing what I’m doing on a day to day basis, the idea of a day when I have nothig planned freaks me out something chronic. As such, I’ve been planning lots of lovely activities for myself, including driving up my paediatric knowledge.

There’s no real route by which you can specialise in the Ambulance Service, since we have no control over who is closest to emergencies as they occur there’d be little point in having “Cardiology Paramedics” or “Trauma Paramedics”.

However, there is a recognition on station of each other’s areas of expertise. I know which colleague to take my ECG questions, who will be able to tell me about patients’ medications. In a couple of years, I want to the conversation to go “Paeds or neo-nates? Ask Kal.”

It seems an appropriate mixture of my current job and my previous, I love the challenge of working with kids, of having to earn their trust, rather than having it thrust upon you just because you happen to be wearing the uniform. Kids couldn’t give a shit who you are, unless you’re their friend, there’s no chance of getting anywhere. They’re blunt and literal, their anatomy and physiology is different from adults, they maintain their vital signs for longer, then suddenly go down-hill. They are, in their own particular way, awkward little bastards.

I’ve driven the “Baby Truck” before in the course of my work, occasionally neo-nates need to be moved from hospital to hospital around the city, or closer to home after a period of treatment. Moving a baby in an incubator is less than ideal in a standard ambulance, so the local neo-natal unit has a long body ambulance with all the equipment and bindings to allow the transport. It’s a challenge to drive, in one count because it’s 30% longer than the normal vehicles and in addition to this, you’re brain-crushingly aware that you’re responsible for the safety of the tiniest, most vulnerable people in the world.

On that occasion, having returned the vehicle and tranfer team to the hospital, I was chatting to a nurse who was absolutely up-front about things. “We’re always happy to have people in here to see what we do, you’d be more than welcome anytime.”

Duly logged.

So a few weeks ago I popped in and spoke to one of their nurses, a member of the education team, could I come in for a day?
No hassle.

Monday morning I’m in the Neo-Natal High Dependency Unit, chatting to the lovely “J” who asked a number of important questions to ascertain my previous experience.

“So what do you want from today, then?”
“Well, our neo-natal training boils down to “Drive faster.” so any extra knowledge of exposure is helpful.”
“Have you worked with kids before?”
“I used to be a nanny.”
“Oh right, so you know which end eats and which end shits then?”

I joined J for rounds, listening to the night-shift running through the evening’s proceedings for each patient and then trailed her as she introduced me to each kid and their foibles.

“You’ll learn to ignore the alarms in here,” she began “Each incubator has a monitor connected to it with fairly strict limits of acceptance. If their heart rate falls outside normal parameters you’ll hear the alarms, same as their oxygen saturation. It’s only worth worrying about if the alarm doesn’t stop.”
“What?”
“They all periodically brady down, or have oxygen crashes, it’s perfectly normal for them. If you hear an alarm go on and on and on, then they probably have a problem, but other than that it’s not worth bothering.”
“So they just spontaenously crash and recover?”
“Yup.”
“Why?!”
She shrugged “Prematurity, I guess, I’ve never really found out, it’s just something that they do when they’re this size.”

This did nothing to avail me of my fears that I might break these tiny people by looking at them wrong. The fragility of their existence seemed to be everywhere. Some of these kids had been born at
28 weeks - across the corridor in the NICU there were kids born at 25. It shook me hard to think that these people I was meant to be learning about were meant to be inside someone else, *right now*. I’ve never really seen premature babies before, never really thought about what it meant, but these kids should have had another three months in utero.

Three.
Months.

I religiously washed my hands between incubators, like some green-suited Lady Macbeth, a fairly laughable attempt on my part since at this point I was still standing at parade rest by each baby, not touching equipment, not touching the incubators, barely breathing in case I spread some horrible infection. I’m genuinely at a loss to describe how fragile these kids seemed, “tiny” is the only word I can bring to mind. I can only give you illustrations. These kids were smaller than my shoes, my hand from thumb to fourth finger could stretch across their belly and around to their kidneys without trying. Their thighs were as thick as my thumbs, their thumbs like matches snapped in half. Some of them were still covered in the downy hair from the womb; when they cried they sounded like birds.

Nurse M came over “Have you met Belly-Boy?” she asked with a grin, referring to a baby in the corner whose abdominal distention was proving a mystery to all who saw him. I’d heard him mentioned during rounds, but he was wrapped so heavily in blankets I could see nothing untoward. M pulled back his covers and undid the poppers along his front, uncovering a tightly swollen abdomen. It looked agonisingly uncomfortable and one couldn’t help but sympathise, I inhaled sharply.

“Oof…buddo.”

“Looks sore, doesn’t it?”

I nodded, stretched out a tentative hand.

“May I?”
“Sure.”

I ran my fingers as gently as I could across the skin of his belly, it was utterly solid and unyielding, I couldn’t help but grimace.

M was extremely informative and helpful, we discussed the challenges of assessing children of this scale, she impressed on me the importance of trusting one’s gut instinct when handling babies “If you’re worried and you can’t pin down why? That’s a good clinical finding, in my book.” She also opened my eyes to the massive social difficulties that parents of these kids face, the stress they’re under and the joy that tiny achievements bring. “Parents love it when we allow the kids to wear clothes, it means they can go baby shopping, they can buy stuff for their kid, it’s the first normal thing they will have done as parents of the child.”

J called me back to her side and talked me through her work as she assessed and weighed one little boy, placed him back in the incubator, drew up a syringe of formula and handed it to me.

“Do you want to give him this? It’s straight forward enough, just inject it down his NG tube. Do it slowly though, the temptation is to push too fast. Oh, and then he’ll need to be dressed again. There are the clothes.”

And with that, she was gone.

I unclipped the ports on the side of the incubator and reached in with trembling hands, the span of the two of them exceeding this lad’s entire length by several inches. Injecting a baby with his breakfast felt very clinical and distant, not helped by the fact that reaching in through the circular holes made me feel like a Belarussian technician handling some kind of isotope. The milk slowly disappered from the syringe between my fingers and I got brave, cupped the crown of his head in my hand, gently stroked his back. He was warm and soft and…a baby. Just a baby.

I’d been wondering about the contrast between the human and the medical; frankly I’d had problems with the concept of nursing people who you couldn’t talk to, who didn’t understand where they were, what was going on. Surely it was just a scientific matter of balancing their body chemistry, observing their physical changes, maintaining their stability, putting nourishment in and cleaning up the waste. With that one moment of contact I realised that the social side of these patients was just as important, that part of nursing them *was* touching them, talking to them, the flexion of his shoulders under the warmth of my palm told me that.

From that point on, dressing him was no problem at all, albeit through those Perspex holes. He was just a baby, like the countless other kids I’ve dressed in the past. Granted, there were differences, where I’d normally reach down a sleeve to grasp a kid’s hand within my fist I had to perform the same motion using three fingers, drawing those flimsy filaments of digits up through the cuff.

And with that, the mystery was gone. They held no fear for me, I wasn’t intimidated by their size of fragilitity any more, it was gone. Learning had occured.

Galvanised by my experience I swung by the paediatric hospital in the middle of town to speak with a consultant who I’d been told was approachable. The conversation ran fast.

“Are you Mr KidDoc?”
“Jim, please.”
“Sorry, Jim, I’m Kal, I’m a friend of Doctor X, do you have a minute?”
He glanced around the busy A&E department.
“I’ve got about thirty seconds, what do you need?”
“I want more paeds experience and exposure, I want to understand them more, Dr X suggested I approach you with a view to shadowing you for a day.”

I fully expected “Mmmm, call my office.” or “That might be possible, let me check my schedule.” instead, he dug in his pocket and pulled out a PDA.

“Absolutely, you’re very welcome, when?”
“March the 8th?”
“Perfect. See you then, don’t come before nine in the morning, nothing ever happens. I have a review clinic that afternoon, but you’re welcome to join me for that. See you then.”

And with that we shook hands and he was gone, I can’t wait for March, I want more revelations, I want to learn all the things I don’t know I don’t know.

Teach me!

As you know, Glasgow will be applying to host the Commonwealth Games in 2014.

What you may not know is that many of the famous events which go to make up this spectacular event, are to be especially altered for 2014 to boost Glasgow’s bid. A copy of these changes has been
leaked, and is reproduced below:

OPENING CEREMONY

The flame will be ignited by a petrol bomb thrown by a native of Castlemilk, in the traditional dress of Burberry baseball cap and a white shell suit.

The flame will be contained in a large overturned police van situated on the roof of the stadium.

THE EVENTS

In previous Commonwealth Games, Scotland’s competitors have not been particularly successful. In order to redress the balance, some of the events have been altered slightly to the advantage of local athletes.

100 METRES SPRINT
Competitors will have to hold a DVD player and microwave oven (one in each arm) and on the sound of the starting pistol, a police Dog will be released from a cage 10 yards behind the athletes.

110 METRES HURDLES
As above but with added obstacles (I.e. Car bonnets, hedges, garden fences, Walls etc)

HAMMER
Competitors in this event may choose the type of hammer they wish to use (claw, sledge etc) the winner will be the one who can cause the most physical damage within three attempts.

FENCING
This event shall be sponsored by Cash Converters who shall alsoprovide the hardware. The contest itself shall be based outside kebab shops in Baillieston, Riddrie, Drumchapel, and Easterhouse….the winner shall be the one who can leave A & E first.

SHOOTING
A strong challenge is expected from local men in this event. The first target will be a moving police van. In the second round, competitors will aim at a post office clerk, bank teller or Securicor-style wages delivery man.
The traditional .22 rifle has been replaced in this event by a choice of either a Browning automatic handgun or Sawn-off 12-bore shotgun.

BOXING
Entry to the boxing will be restricted to husband and wife teams and will take place on a Friday night. The husband will be given 15 pints of lager while the wife will be told not to make him any tea when he gets home. The bout will then commence.

CYCLING TIME TRIALS
Competitors will be asked to break into the Glasgow University bike shed and takes an expensive mountain bike owned by some mummy’s boy on his first trip away from home. All against the clock.

CYCLING PURSUIT
As above, but the bike will be owned by a visiting member of the Australian rugby team, who will witness the theft.

MODERN PENTATHLON
Amended to include mugging, breaking and entering, flashing,joyriding, underage drinking and arson.

SWIMMING EVENTS
All waterways are currently being tested for toxicity levels, once one is found that can support human life, swimming events will be organised, please note that the Synchronised Swimming event for
this year will comprise of dropping acid and watching all the funky ripples on the pool, the specific musical support to this event will be provided by “Belle & Sebastian”.

THE MARATHON
A safe route has yet to be decided.

MEN’S 50KM WALK
Unfortunately this will have to be cancelled, as the police cannot guarantee the safety of anyone walking the streets of Glasgow, especially anyone that appears to be mincing…

THE CLOSING CEREMONY
Entertainment will include formation rave dancing by members of the Govan Health in the Community, anti-drug campaigners, synchronised rock throwing, and music by the Dennistoun community choir. The flame will be extinguished by police riot water cannon following inevitable pitch invasion by confused old firm fans.

The stadium itself will then be boarded up before the local athletes break into it and remove all the copper piping and the central heating boiler.