I’ve been fortunate enough to get two big chunks of venison, one has been defrosting quietly in my fridge all day and tonight, on returning from watching 28 Weeks Later (yes, thankyou, irony), I decided I should strip the flesh from the bones in preparation for casseroling tomorrow.

As I split sinew, severed joints and sliced flesh I was reminded of maternity lectures at college, the smell of meat, the stickiness of clots on my fingers, the smell of stale blood.

For someone who frequently pokes about in people’s newly exposed insides, I have become bizarrely squeamish about my dinner.

And my hands still smell.

*boak*

“Sore head, neck, back?”
“Just my right leg.”

I chop up the front of his jeans, a huge fat haemotoma is developing where his thigh impacted the central console of the car.

“That’s looking kinda broken, I’m afraid mate.”
We immobilise the leg and make our way up the road to A&E, on the way he locks eyes with me, upside down, as I sit at his head, his neck feld firm by a collar.

“You owe me a pair of jeans.”
I laugh, retort.
“You owe me a leg.”
“Fair enough…call it square?”

We shake on it.

When a triple nine comes in, we get sent immediately, regardless of the situation. As the call-handler continues to talk to them, that response may or may not change, as such we often get sent to “an emergency” and only find out what the score is once we’re en route.

As such, last week I found myself on the phone having the following conversation.

“That’s an emergency round the corner…old lady’s fallen over, it’ll probably go to a cold response….oh, no, she’s unconcious….sorry, she’s arrested…so that’s a cardiac arrest round the corner.”

It was, sadly, a fairly routine cardiac arrest; we turned up, smashed a little old person’s ribs to itty bitty bony splinters, shoved drugs into their veins which did nothing, stuck a big plastic tube into their lungs and, twenty minutes later, declared the person to be just as extremely dead as they had been when we arrived. Casualty and ER have a lot to answer for, people don’t come back from cardiac arrests, they start off as corpses and, largely, wind up the same.

Our patient was the dead woman’s husband, he was the one who needed helping up from the floor where he was gallantly compressing her chest, his arthiritic hips and knees screaming like twisting metal as my partner hit the deck beside his wife, fists clasped.

He was the one who needed our gentle words, reassurances, a supporting forearm to assist his walk through to the living room while my partner bagged his wife’s lungs.

He had helped her to bed at lunchtime as she complained of feeling unwell, had sat watching the match on television and risen to check on her at full time. She hadn’t been in bed, nor in the kitchen, nor the bathroom, “perhaps she’s gone out to the back green”, he’d thought as he stepped round the bed and found her on the floor, grey cheeked, mouth gaping like a landed fish, the peach valance draped over her shoulder like a lassie’s gathered ballgown.

She was comfortable, lifted back into bed by myself and my colleagues, the blanket shrouded around her.

He was sat in the living room, a congregation of framed Catholic prints on the wall, thanks from Francescan brothers to the happy couple for supporting their work for “Twenty years”, individually written in cheap Italic black marker. Brown haired, blue eyed Christs smiled down beatifically, their hearts radiating light, their faux mother-of-pearl backgrounds glinting in the early evening sunshine.

Hard of hearing, he strained to catch my respectfully lowered murmur, somehow perverse to raise my voice as I said “She hasn’t responded to the treatment…she died a few moments ago.” but he had to know.

“So she’s dead…” he began, old eyes damp.
“Yes sir, I’m afraid so.”
“And it’s my fault.”
“No, sir, thats not the case…there was nothing that anybody could have done.”
“But I should have sat with her, she wasn’t well, I should have read to her and instead I was in here watching the football. She’s dead and it’s my fault.”

He nodded, his chin dropping to his chest as the first gasping sobs rise in his throat.

I bowed my head and muttered “I’m terribly sorry for your loss, good night.” to his daughter, witness to her father’s grief and guilt as it pours out onto the rug at his feet.

We saw ourselves out, leaving them with grief and shock and a corpse in bed.

A story:

It’s late afternoon, Cluedo and I are preparing ourselves for a gentle spin-down to the end of our shift. Day shifts finish at six or seven and it’s fairly common to find yourself doing “GP’s Urgent” calls from late afternoon to tea-time, everyone’s too busy eating their dinner, doing their home work or watching Richard and Judy to be bothering their arse with getting sick, so we have time in between emergencies to transport people who’ve been seen by their doctor that day to hospital.

Cluedo’s brilliant, fresh out of school, with shiny shiny edges and the kind of ridiculous sense of humour that Node and I share, the kind of sense of humour that leads to conversations such as “Ooooh, we’re third car, will you join me for some pantomime villain laughter, Mister Node?”
(Node doesn’t even miss a beat) “Why of course Mister Kal, Mwwwuuaaa hahahah.”

Cluedo fits in well with this side of me, I thoroughly enjoy working with her, she rocks.

We head to a street just round the corner from my flat for “69 YOF, brain tumour, collapsed”. It sounds unpleasantly arrest-esque, “collapse” is such a cover-all, it can mean anything from “fallen over” to “not responding” to “blue faced and stiff on the deck”; it’s unpleasantly similar to “assaulted”. “Assaulted” doesn’t tell me anything about the person’s injuries, this person was “assaulted”, but then, so was Mr Tarrant’s dining partner.

I haul the response bag and O2 out of the side door of the vehicle, shout through to Cluedo who’s still punching buttons on the radio - “Get the box, yeah?”
“Sure.”
She’ll bring the defib up behind me, it’s heavy and takes a minute to dislodge from it’s mounting in the back, the driver normally follows the attendant with it. I tromp up stone steps, worn at the front from centuries of feet and chap the door, recognising the patient’s name on the brass gilded plate above the letterbox. A man in his sixties answers, a phone clamped to his head.

“Yes, yes, they’re here,” he hangs up, “She’s in here, it’s my wife, she’s in here.”

I follow him into the bathroom where, sitting on the toilet seat is a skeletal figure, loose skin hangs over her bones, her face is puckered and drawn, cheeks that once wore rouge and powder are sucked into the mouth’s cavity. Her upper body is slumped forwards, her skin pale, her hessian hair hangs in a ragged nicotine curtain over her shoulders. She turns her head, meets my eyes and in an Irish brogue creaks at me.

“Who the fuck are you?”

Ok. Not dead. Obvious airway, breathing and circulation. Excellent.

“How are you doing, darling? You ok?”

“I’m fine, what’s going on? Who are you? Get out of my house.”

Cluedo’s at my shoulder, I could use her right now.

“Look after her for a minute, I’m going to have a word with the husband.”

She nods and slide past me, crouches by our patient, takes her hand, smiles patiently at the mouthful of muttered abuse the ghaist is pouring forth.

“So what’s going on, sir?”
He shakes his head.
“I helped her through to the toilet, she can’t walk much on her own, not since the surgery.”
“Surgery?”
“She had a bypass a few months ago, then while in recovery they found the brain tumour.”
“Ahh, does she know about the tumour?”
“She’s been told, but I don’t think she’s taken it in. She’s had dementia since she was 30.”
“30?!”
He nods, the expression of a man who’s accepted his lot in life, who takes his altar vows seriously.
“Right, ok, so you helped her into the toilet and then what?”
“I was outside, she deserves her privacy, you understand?”
“Of course.”
“And I heard a bang, and when I went in she was leaning back, with her head on the cistern.”
“She was unconcious?”
“Oh yes, quite definitely.”
“Ok. Let’s have a look at what’s going on.”

We lift her off the loo, help her pull her knickers up and her nightie down. Floating in the pan is the largest, thickest, densest looking jobbie I have ever had the misfortune to be exposed to. This behemoth flicks a switch in my head.

Once settled on the sofa we run a set of basic obs, ticking off the possible cases of unconciousness, everything comes up fairly normal, heart rate is adequate, blood sugar’s fine, aha! Blood pressure’s low, systolic kicking about the 105 mark, a BP under 90 will normally cause somebody to black out.

“Does your wife have problems with her blood pressure, sir?”
“Oh yes, it’s always very low, the GP’s been looking into it.”

Somebody with low BP usually walks a finely balanced line between conciousness and lying on the floor, any exacerbating circumstances (standing up too fast, dropping heart-rate etc.) can often lead to a faint. One of the most effective way of slowing someone’s heartrate down is to stimulate their vagus nerve, a hugely prominent nerve that runs down the side of the throat. One of the best ways to stimulate the nerve is to have someone try and blow into a syringe to push the plunger out the far end. You can simulate this yourself, by sealing your lips around your thumb and exhaling hard. While doing this, dear readers, I’d ask you to think about your arseholes.
Don’t you feel like you’re about to shit?
Exactly.

Straining to move the bowels is one of the classic vagus stimulators, it slows your heart rate and as such, your blood pressure, this would explain why when you’re constipated and working hard to lay a track, you sometimes feel your head spin as you stand up.

God, TQ is educational, isn’t it?

So we have a little lady, with dodgy BP and a massive turd. Easy peasy, she’s vagused herself into a faint, nothing to worry about, but we’ll load her into the ambulance and have her checked out at A&E.

“Right, Estelle, I think it’s best we take you to the hospital to have the doctors have a look at you, ok?”
“No.”
“Ahhh, c’mon my love, you’ve had a wee funny turn today, don’t you think you should have an MOT?”
“No, I don’t, can I have a cigarette?”
“Not right now, we’re going to the hospital. Your husband’s coming up as well.”
“Will you listen to me? I’m not going to the hospital, I want to stay here.”
“But your husband’s worried about you.”
“I don’t care, just bloody well leave me alone.”
“No, listen, Estelle, you don’t normally have black outs like this, it needs to be investigated.”
“Leave me ALONE!”

Well. That’ll be that, then.

I phone the NHS central number we have, organise a GP to attend and assess her in her own home, joined up thinking, coordinated health care, gotta love it.

I stride back into the living room, thoroughly chuffed with myself, Cluedo looks up at me from the floor.
“Kal…?”
“Hmmm?”
“Her SpO2…”

While I’ve been out, Cluedo’s slipped the probe onto Estelle’s finger, it shines a light through the blood, reading how much light passes through it and, as a result, can calculate the percentage of oxygen in the blood. Anything between 95 and 100 is acceptable in the majority of patients.

Estelle’s SpO2 reads “<50″.

Cluedo’s face is concerned, I’m sceptical, I’ve only seen one patient with a reading of less than 50%, she had Chronic Obstructive Pulmonary Disorder and had spent a day and a night lying on her front, restricting her breathing; she was peri-arrest and the colour of a blueberry.

Estelle is pale, but fully concious and in no apparent distress.

“No way, that can’t be right, the probe must be knackered.”
Our probes really aren’t designed to be out on the road, they’re flimsy and work well in hospitals where they’re not straightened and recoiled 20 times a day, street-suitable they are not.

I spin the knob on the front of the monitor and review the data the probe is using to come to it’s conclusions, expecting to see an erratic, waggling line. Instead I get regular peaks and troughs, the oxygen levels rising and falling with her breathing, the data’s fine and still I don’t believe it. I slide it from her finger and, snapping my glove off, put the probe onto my own. The reading immediately jumps to 98% - the probe’s fine, the reading’s accurate.

Shit.

“O2 at 15, please Cluedo, see if we can push that up at all and repeat the obs, I’ll get a second opinion.”

We’re a double technician crew, a paramedic’s opinion would make me a lot happier. I haul my phone from my pocket, dial the control room, listen to the ring tone buzz in one ear, Cluedo’s obs in the other.

“Pulse is up 110, BP’s….dropping…Kal…KAL!”

An edge to her voice, I turn to the monitor, BP’s 90/45…she’s bleeding…somewhere.

“Are you sore anywhere, Estelle?”
“No.”
I touch her belly.
“Ow!”
“Painful there?”
“Yes, when you push it, leave me alone.”
I ignore her, palpate the four quadrants and swallow hard as I feel a pulsing mass on the abdominal midline.
“Cluedo…feel here for me.”
She slides her fingers under mine, I see her pupils crash wide and she mouths to me “Fuuuuck.”

“Stay here, watch her, get the pads out just in case, I’ll be right back.”
“But….”
“Just WATCH her, I’ll be right back.”

My boots slap hard on the steps, my heels flapping forwards as I fall/run down towards the front door and out into the vehicle. Red button.

“Kal’s vehicle, pass your priority.”
“Kal’s vehicle, I need immediate paramedic assistance at this locus.”
“What’s your situation?”
“Query triple A, I need a paramedic now!”
“That’s received, Kal, sit tight mate.”

An abdominal aortic aneurysm occurs when the wall of the aorta (the largest artery of the body that comes directly from the heart) weakens and balloons sideways, like a old tyre. This bulge is palpable in the stomach, pulsing with the heart’s beat. The aortic wall may leak slowly, causing a gradual onset of shock, but can rupture dramatically, pouring the body’s entire blood volume into the abdomen and leading to cardiac arrest. It’s a surgical emergency, maintainable, but not treatable in the field. The patient’s blood pressure can be supported with fluid therapy to replace the lost blood, but this is a paramedic skill. I need a paramedic. Now.

Within minutes, a paramedic from my station, Grissom, rolls up, single crewed in a vehicle.

“Kal, what’s the score?”
“69 yof found collapsed, GCS 15 on arrival, dropping BP, increasingly tachy, pulsatile abdominal mass.”
“Let’s get some fluids into her before she dies, shall we?”
“Please.”
Grissom hustles into the living room, cannulates Estelle’s arm and I run a bag of warmed saline into her veins.

“Right, get a chair and a blanket, let’s go.”
“Patient’s refusing transport.”
“What?”
“Long story, mate.”

Grissom breathes out slowly, turns to Estelle.

“Let’s get you up to hospital, my love.”
“Fuck you, bitch, leave me alone.”
“Now, c’mon, you need to see a doctor.”
“I need to stay in my house.”
“No, Estelle, you’re not understanding, you are unwell, you need to go to hospital, otherwise you’re not going to get better.”
“I don’t WANT to go to hospital.”
“Why not?”
“Because I don’t.”
“Well, that’s not a reason, that’s just you telling me you don’t want to.”
“Shut up, bitch.”

I head into the kitchen where the husband and, by now, his daughter and son in law are paitently waiting, chewing on their thumbnails.

“She’s still refusing to travel, folks.”
“Can’t you take her?”
“I can’t kidnap her, sir, she’s got a right to decide what she wants to do.”
“But she’s so ill.”
“Yes sir, I know.”
“Can’t you give her something to make her sleep?”
“Not ethically, sir, no. Perhaps you could try to convince her? If you can’t we either wait until she passes out again and CAN’T refuse transport, or we’ll have a psychiatrist visit to section her and we’ll remove her against her will.”

He steps outside, we hear him chatting to his wife and her shouted response, interspersed with spat “fucks”.

I make a phone call, arrange a doctor to attend.

And we wait, dribbling fluids into her veins, balancing her BP between the point at which she remains stable and the point at which we risk upping the pressure and her aneurysm bursts.

Sectioning someone takes ages, really, genuinely ages. We sit with her for hours, cajoling, encouraging, threatening, blackmailing, trying every trick in the book to have her consent to travelling. She complains of worrying symptoms, fatigue, cold, sweating, dizziness, her face begins to grey around the edges.

Our frustration diminishes our bedside manner and we are reduced to stating stark home truths.

“Estelle, we suspect you are bleeding internally, you are extremely unwell, without going to hospital you’re going to die. Do you understand?”
“Shut up, what would you know?
“Estelle…if you carry on like this, you’re going to die on your sofa while your daughter and husband watch. Are you really going to put them through that?
“Yes, yes I am. Now fuck off out my house, I don’t want to go to hospital.”
“So you’re going to let your daughter watch her mother die?”
“I don’t want to go to hospital. I don’t, I don’t, I don’t, I don’t, I DON’T.”

My stress levels burned off I’m left with only blue-light black humour, I whisper to Cluedo’s ear. “Ever watched Father Ted…?”

I return to the vehicle for extra oxygen and find the husband, eyes wet, cheeks flushed. Laying a hand on his arm, I ask after him.
“You alright, sir? This must be very difficult.”
“I’m just so sorry.”
“Sorry?”
“The way she’s speaking to you all, it’s dreadful, it’s so rude, you don’t deserve it, you don’t think badly of her, do you? She’s not well, you know.”
My heart aches for him.
“Sir, if she was an 18 year old laddie full of vodka talking to me like that, I’d have something to say back, but really, she’s fine, we understand.”

The GP arrives first and has us all roll our eyes as she takes her own set of obs, palpates Estelle’s stomach (”Oh goodness, there’s a real mass there, isn’t there?”) and announces to us that “It’s probably a triple A, she should go to A&E.”

The desire to throttle her is significant, but we smile sweetly and concur while staring at each other.

“To be honest doctor, we’re needing her sectioned, can you put that in place for us?”
“Oh, certainly.”

The mental health worker arrives within the hour (bringing our attendance at this house into our third) and assesses Estelle’s understanding of the situation. Our patient fails to tell us the correct day, year and is unable to tell us anything of significance that has occured in the past week (despite a massive political story in the news), she is approved for sectioning, the paperwork is completed and Grissom speaks softly to her.

“Estelle, its important that you listen to what I’m about to say.”
“Ohhh bugger off, leave me alone, I don’t care.”
“Ok, you don’t have to listen, but I’m going to say it, because then I’ve done my job. The GP and the Mental Health Worker have decided that you aren’t capable of making your own decisions about your care and as such we are sectioning you under the Mental Health Act. We are going to put you into a chair, carry you out of the house and take you to hospital. You can scream, shout and swear about it all you like, but we will not tolerate physical violence.”

Once in the chair her fire goes out, she sits, meekly frail, with a seat belt across her chest as Cluedo and I carry her down the same stone steps that, three hours ago, we climbed, ready to resuscitate her. It’s two hours after our finish, I have an assessment the next morning and my emotions are strung to their end.

I chat to Grissom at A&E, thank her for backing me up, describe the hollow depth that opened in my gut as I realised what was going on and how lonely it felt as a techy crew. She smiles, Grissom’s smile is legendary on Station, one part wolf, one part Jack Nicholson, a smile of experience, of urgency. A smile that’s seen us technicians struggle and grow over and over again.

“We’ve all been there, mate.” She consoles me. “I still have moments where I shit myself, it’s part of the job.”

Not a taxing night shift, that, which is handy really, because by half past one in the morning I was feeling…rough. I assumed it was just night-shift knackeredness, we got back to station and I knew I had to sleep.

“Mate, just you head inside, I’m going to crash in the back.”

We have recliners in the station which are almost comfy enough to sleep well in, if you’re five foot tall you can curl up into a foetal position and snooze.
I’m six foot two, I have an extra fourteen inches with nowhere to put it (I’d like to point out that I’ve deliberately avoided the very obvious joke there, I’m almost Oscar Wilde I’m so classy), include in the sleeping situation the telly which is *always* on, the conversation of colleagues and one member of staff who, apparently, is an only child, so brazenly does he march into a dark room full of sleeping people, slap on the lights and bellow “Alright everyone?”

Never shared a bedroom.

Still.

I clambered into the back and lay a blanket down on the trolley (trust me, clean as the back of an ambulance is, you want a nice fluffy NHS blanket to lie on) and rolled another as a pillow. It was at this point that I remembered how brilliantly uncomfortable the trolley is to lie on, my shoulders are too broad to lie on my back, so I rolled onto my side, stuffed my pillow under my cheek and dozed off.

Half an hour later I was woken up by a burning pain in my shoulder, my neck stiff and my right hand completely limp and lifeless from being laid on. My face felt funny, and as I reached up with my left hand to rub it I realised that the cellular honey comb pattern of my blanket pillow had transferred to my face. One half of me was limp, my face was checkerboarded. I looked like a stroke victim who’d been sniffing waffle irons.

Some hours later we’re at A&E having dealt with one of those jobs that makes you marvel at humanity’s ability to beat the living shit out of apparently innocent people and sneaking a quick up of tea when my stomach sends a telegram.

“Going to spew STOP Run to bathroom STOP Not even joking slightly STOP Why are you stil sitting in your seat?”

I followed its instructions to the letter and headed home at the end of the shift feeling decidedly shaky.

This lunchtime I woke up, pottered around the house and agonised for a while, I really didnt feel well enought to go to work, but felt bad for calling in sick. Eventually I came to the conclusion that going to work sick as probably the most stupid thing I could ever do, not including juggling napalm spitting wolverines, phoned in to let Control know that I wasn’t going to be in tonight and headed to bed.

And now I find myself in this difficult position. I’m night shift all week, I’ve nocturnalised myself fairly well, but have now spent most of today asleep, waking up abour elevenish tonight and now face a night of sitting up feeling crap. I’ll probably head back to bed and sleep until the morning, buggering myself up for tomorrow’s night shift.

Blah.

Further, less maudlin posts should follow soon.

It’s not clear yet what’s changed, but something has. I’m not saying anything different, nor have I altered my treatment. They’re all stable, but serious, they’re all swallowing my cautionary phrases “We’re going to move the traffic a bit, so don’t worry if you hear the siren.” and a group have all responded in the same way - “I’m not worried, son, I’m in good hands.”

How grateful I was at first for their trust, how appreciative of their kind words as I inwardly shat my breeks at their dwindling oxygen levels, dropping blood pressures, elevating ST segments.

It was just last week that I relaxed sufficiently to see through my nerves, to realise that, fuck me, they’re not being nice, they honestly believe what they’re saying, that they’re ‘in good hands’, even if they ARE just saying it to convince themselves.

Hypotension? Hypoxia? Elevating? Fuck ‘em, they hold no fear like the gut-twisting fright of trust and expectation.

I’ll almost certainly get lambasted for this, but I’m going to say it anyway. My superiors rock.

Work blogging is obviously a touchy and controversial subject, I’m no Dooce, so I’ll go into no great depth of discussion on the matter, as the subject’s been done to death on other more adept sites than this one.

But the following stands.

Work blogs are contentious, NHS work blogs are extremely contentious, because of the subject matter that we deal with. It would be the easiest things in the world for the Service to close me down. A ‘quiet word’ in the office at the station and TQ would be no more. It would remove the contention and make everyone breathe a little easier. But they haven’t done that, they’re prepared to take the chance on the blog, it’s becoming increasingly widely read by my colleagues and, while I may have the piss taken out of me in the mess room for some of the “touchy-feely wank” I post, it’s generally well received.

And that’s nice.

Otherwise, I had my eight month assessment this week, an assessor riding along with myself and my partner. We got a fair mixture of jobs, a couple of urgent transfers, a lovely little old lady who’d fallen overnight and lain on the bathroom floor until her carers came in to get her breakfast because she “didn’t like to bother anyone.” Dehydrated, coated in faeces and freezing cold, she still managed to peel her cracked dry lips apart into a smile at my feeble jokes. We slid her onto a board, quietly snorted the poo-infused air out of our nostrils and gently trundled her into hospital. My assessor asked me a few questions about my understanding of fluid therapy and, though it’s a paramedic skill, asked if I could imagine the symptoms and subsequent treatment of fluid overload. “Turn off the drip?” got me a grin and further discussion.

From there we headed to an emergency; “Baby fallen off bed” gave me an opportunity to show off my handy-dandy paediatric assessment skills gathered from these days. The little lad was absolutely fine, you could see he was fine by the fact that he was lying on the bed giggling with a wee graze on the end of his nose which didn’t even cause him to flinch when I touched it with my finger. Still, I ‘head-to-toed’ him, listened to his heart, lungs and belly with my steth and based most of my decision of ‘he’s fine’ on how much he laughed while I was doing it all. Mum signed the paperwork and we were on our way.

My assessor (who I’d usually anonymise medically, but her initials don’t lead to it, sorry dear!) had me jump in the back of the vehicle while we drove back to station and asked a host of questions about drugs, protocols and ECGs and finished it with “So, anything bothering you?”
“I’m still not comfy with multi-trauma.” I answered, “I know we don’t see a lot of it, but I really feel uncomfortable with the concept, just cos I’ve hardly seen any.”
She shrugged.
“It’ll come, you’ll be fine, I’m sure.”

(That afternoon, it did, with enormous consequences, I’m not at liberty to discuss the job, as it’s quite firmly in the public mind, but it reminded me that I really should just shut the fuck up when fate has her shell-like against the back doors.)

Later that day I got called into the office to receive my “Station Officers Report”, a wee paragraph that decides how rubbish or otherwise Management feel you are. It said some nice things, but was slid across the desk with the proviso “You’ve four months probation to go, don’t become a cocky little shit and fuck things up, will you?”

High praise indeed in an environment where “Wank” is a title reserved for the lowliest peons and “Good cunt” is the most elevated echelon of greatness.

I’ll take “Not a cocky little shit.”, thanks.

And itching for a fix.

Giles settled up with me, he’s owed me some cash for a while and since his Dad passed away, he’s sworn he’d use the money from his Dad’s estate to get square with me. True to his word, he has.

I wasn’t sure what to do with the cash, I knew I didn’t just want to spend it on rent or similar, I wanted something tangible, it’s been a long-standing debt and I didn’t want to piss Charlie’s money away paying my bloody council tax.

So a new camera is in order.

I have to do this every now and again when I stop taking pictures, a new camera kicks me in the ass and makes me take more shots; I’ve been lusting after Amber’s EOS10 for a while and so stopped into a camera shop today to see if they had such a model and what kind of part exchange they could give me for same.

The assistant misunderstood, thought I was asking about *spit* Nikons and passed me the D80.

My god.

It’s so heavy, so solid feeling, it feels like my Dad’s old Zenit SLR that I started shooting on many many moons ago, the shutter doesn’t go “click”, it says “bang”, you can *hear* the mechanisms working.

I’m going to migrate from Canon, I don’t believe it, but I really, really am.

Now, to find an extra couple of hundred quid….

Sirens are magical things, they part traffic jams like Moses’ paddling pool, they send a clear wolf howl to all around - “This box junction is mine alone, back off, stay out, because I’m about to drive in a manner that would cause your driving instructor to have a small aneursym.”

I tend to change the sirens from yelp to wail and back again faster than most, wail’s long vowels carry better at speed are easier to hear at a distance and, I hope, suitably pervasive to freeze other drivers in their tracks, waiting to see where I am, where I’m coming from.

Yelp’s strident, aggressive, shouty, for when you’ve not paid attention and I’m right. behind. you.

Wail stops cars, yelp shifts them.

The Highway Code is too wifty-wafty in it’s guidance, “Consider the route of the emergency vehicle and take appropriate action to let it pass. If necessary, pull to the side of the road and stop, but do not endanger other road users.” If ever there was an exercise in arse-covering, that one’s a Greek odyssey and has approximately…ooooh, zero percent applicable common sense in the real world.

People panic, their goodwill and desire to let us through eclipsing their common sense, most common are the drivers who just stop. Dead. In the middle of the road. Granted, it makes them easier to pass, but can be somewhat alarming at speed. Others pull into the left, like a good little Boy Scout driver, oblivious to the fact that everyone else has pulled to the right. Even more dangerous is the driver who can’t believe his good fortune as all the cars ‘in his way’ spontaenously pull into the kerb and swings out onto the mid-line to pass them, oblivious to our barrelling towards them, lights and sirens show-boating for all to see. We call these “ABS” moment, not due to the implementation of the brakes, but because we tend to shout “Arsehole! Bastard! Shit-head!” at these people.

My pet hate is those motorists who pull into the near-side, but maintain their original speed. This. Does. Not. Help. We’re trained to ‘tick off’ hazards as we drive, spotting them on approach, sometimes spotting their development and planning our avoidance of them before the hazards even know they exist themselves. By continuing to travel you’re just extending the length of time we have to think about you; you are not at the top of our agenda…we have other things to think about.

That’s not to say the vast majority of people get it wrong, most folk are pretty switched on, but if I were to have my way, the following points would be included in the Highway Code.

- Go with the crowd, bollocks to what you’re mother tells you, do not be an individual, do not be a free thinker. If everyone else is pulling in to the right, do that, don’t go left. Going left will result in wig-wag headlights, strobing blue grille lights and the outstandingly loud combination of a siren AND a horn being leant on.

- Think about where the vehicle is heading. We always signal our intentions, sometimes we’ll even stick our hands out of the window to stop you if, for instance, we’re on the ‘wrong’ side of the road and about to turn left in front of you. People not watching for signals classically causes problems with approaching exit slip-roads on motorways; we pull into the left lane, left signal on and drivers in front of us get into a tizz, “I’ve pulled over, why don’t they overtake? I know! I’ll slow down even more…” We hold in high regard those motorists who clock our left signal and pull to the middle lane, allowing us to power along their nearside and down the off-ramp.

- Forget the lights and sirens. Look at the driver . It’s often faster for us to ‘give way’ to you, particularly at tight junctions. Ambulances are big, we need a lot of space, so while we appreciate your sitting still, we may wave you through a bottle-neck ‘ahead’ of us, it means we can forget about you.

- Putting your hazards on acknowledges to us that you’ve seen us, but needs to be performed in conjunction with pulling in. Hazard lights to not alter your time/space status, you remain a solid object - we can’t just drive through you.

- Don’t tailgate me in my ‘wake’. If I stop sharply, the hydraulic ramp will come through your windscreen and his you roughly around the bridge of your nose. I weigh just over four tons, your nose doesn’t, I’ll win.

- Blue lights with sirens means EXACTLY the same thing as blue lights without. There’s an urban myth that came from somewhere that says an ambulance with lights but no sirens is carrying a dead body. This is not the case.
Let’s get some things straight; driving on systems through traffic is dangerous, it’s also bloody hard work and takes a lot of concentration, we don’t rush corpses anywhere, our pragmatism precludes it. Dead people are dead, dashing through the city streets with them to the hospital as fast as possible just means they’ll be dead in the hospital a little sooner. We run without sirens mainly because - the roads are quiet and there’s no traffic for us to move, it’s late at night and we’re being considerate and, most commonly, because listening to sirens day in, day out does your fucking head in and sometimes it’s nice to ‘double click’ the horn and make them go ’shhhhh’.

- Red lights. I get asked this fairly often, so thought I should set the record straight. If you are sitting at a red light and an ambulance comes up behind you with it’s systems running, you cannot legally drive through the red light to let us pass. We have exemptions from the road traffic act, us, not you, the exemptions don’t hang around the vehicle, gathering up those nearby and carrying them along in a miasma of legal indemnity. If you drive through a red light to let us pas and hit somebody, or T-bone another vehicle, or squish Paris Hilton and her ridiculous little dog on their way to the big hoose, then you are at fault and, with the most expensive lawyer in the world, you are still legally gubbed.

From my Court days, however, I can tell you that there’s not a Sherriff in the land that will have issue with you carefully pulling forwards on a junction to let us through, as long as you don’t convert anyone to strawberry trifle on the tarmac.

And we really, really appreciate it, really.

But dude, kill someone doing it and I’ll drop you like a hot rock. Don’t run red lights. It’s dangerous, take that from someone who does it every day.

Bill Sticker’s been having a rough time of it and it reminded me of a conversation between Pally, myself and a member of the local vagrant fraternity last Christmas.

“You alright mate?”
“I’m fine.”
“It’s just…you’re lying on the pavement, pal, people are worried about you.”
“So take me to hospital.”
“Are you sick?”
“No.”
“Are you in pain?”
“No.”
“Well we’re not going to be taking you to hospital then, are we?”
“I’m cold.”
“Me too, mate, it’s a shitty night to be out, have you nowhere else to go?”
“Nut.”
“You tried the Cowgate Centre? Or the Sally Army? The doors were still open when we passed by earlier.”
“They’re miles away.”
“Mate, they’re five minutes walk.”
“Give me a lift?”
“Sorry pal, not a taxi, you know that.”

He glares at the two of us and changes tack.

“I’ve got a blade.”
“Have you really, sir?”
“I’m gonna fucking cut you both.”

Pally and I straighten our backs and survey the small, shivery, drunken man lying on the floor in front of us.

“You’re not cutting anyone, mate.”
“I will, I’ll fucking chib you both, you’re both gonna fucking die.”

I look at Pally, he shrugs, I grin.

“Come on then.”

A look of confusion on his face.
“What?”
“I said “Come on then.” Come and fucking chib us both.”

He gets to his feet, shuffles down the street, glances over his shoulder.

“Cunts.”

“Merry Christmas to you too, sir, good night.”