I can feel the heat from the house as soon as you open the vehicle’s door, I’m pleased to close my visor over my face, it provides a little relief from the smoke ash and heat coming from the house’s windows.

Fire appliances are spread around the building, faceless firefighters in breathing apparatus plod in and out of the building, another stands at a notice board, timing his colleagues in and out.

A fire officer in a white helmet catches me, brings me up to speed.

“Three kids self-evacuated, they’re all over the road, we’re still looking for the father. Looks like he’s in the bedroom where it’s all started.”

I give him a glance, raise my eyebrows.

“Chances?”

“We’re working on it, but my boy’s can’t get in yet, so…”

I nod.

“I’ll check the kids out.”

Up the path and into the neighbour’s house, a sudden and unwitting casualty clearing station. The lady of the house shows me into the living room where three small faces sit in a row on the sofa. Hands folded in their laps, shoulders closer to each other than personal space would normally dictate, nervously picking at smoke-smudged pyjamas. Six eyes turn to me as I walk in, lower myself to the carpet, lift my helmet’s visor from my face and rip away the velcro chin strap.

Three factions wrestle inside my head, the medic flashes eyes across three faces, evaluating their colour, their level of responsiveness, are they struggling to breathe? Are there any obvious injuries? Is anyone on fire?

Shouting over these questions is a nanny, playing every child psychology and behaviour trick he ever learned. He’s shrinking my form, putting myself below their eyeline, flipping up my visor, taking off the intimidating helmet and hi-vis coat, forcing my mouth and eyes to smile. Cross legged on the carpet, looking up at them, all I need is a picture book and I could be back in my play-group days; if it weren’t for thewhumping of the pumpers’ hoses outside.

The third faction is an uncle of thirteen kids. He just wants to hug the three of them and make this all go away.He’s going to have to wait, he’s elbowed to the bottom of the pile and told to shut it for a minute.

“Hi guys. My name’s Kal and I’m an Ambulanceman. I’ve come to have a chat with you and see how you’re doing. What are your names?”

Like Mouseketeers they rattle their titles off. Alice, Sophie and Jack, six, eight and ten.

“That’s brilliant guys, well done.”

Lots of positive affirmation, let them know they’re doing well, because the alternative is trying to examine and question three screaming kids. And nobody wants that.

“And were you all inside when the fire started?”

Three solemn nods.

“Can you tell me how you got out?”

Jack’s the spokesman - “I heard the smoke alarm and woke everyone up. I couldn’t get down the hall to my Dad’s room, it was really hot and smokey and…”

He trails off.

“And…?”

“I was scared.”

“Ok, well, the firemen are looking for your Dad right now. Is there anyone else in the house?”

“No. We visit our Dad at the weekend.”

“Oh right, well, let’s have a look at the three of you, shall we? Does anyone have any sore bits?”

Both girls start speaking, Sophie has chest pain, her voice hoarse, Alice is similar, little lungs full of carbon and dust.

Jack waits behind for this sisters to be examined, then speaks up.

“My foot hurts.”

I check it out, his ankle is swollen and red.

“What happened, buddo?”

“I hurt it when I jumped out of bed.”

No bother, nothing to worry about. I’m concerned about the girls’ smoke inhalation, kids have a nasty habit of compensating before crashing dramatically and irrevocably. I want obs for both of them so I can monitor them, I want to know if their respiratory and pulse rates rise, if their lips turn dusky under the smudges of smoke and soot. An SpO2 reading can be misleading here; the machine can’t tell the difference between oxygen in the blood and carbon monoxide, their brains could be gently starving away while we sit and make small talk.

One of the older women in the room catches my eye.

“D’you know a paramedic called Pally?”

I smile.

“Yeah, yeah, I know him well. Why?”

“He’s my step-son.”

Holy shit. I’ve got an ally.

I’ve never been given a paper edict stating that I can use bystanders to look after vulnerable patients, but she’s damn near family. I send Jack to sit with her while I get baseline obs off the girls.

A paramedic called Woody appears in the doorway.

“Heard you might need a hand?”

“Yeah, great, can you transport all three to PaedsA&E? One ten yom, minor ankle injury and smoke inhalation, two females, six and eight years old, both with a good dose of smoke. Obs good at the moment, but I’d like them transported sharpish…considering.”

Woody nods, she doesn’t need me to expand on the situation. I want these three a long way away if Dad’s crackling when they pull him from the belching dragon down the road.

There’s raised voices at the front door, a woman’s tones “Oh Jesus…oh no,” increasing in volume as they approach. A lady in a red jacket sweeps in to a chorus of “Mummy!”

The three kids scramble from their perches on sofas and PallysMaw’s knee and leap onto the newcomer, burying their heads under her arms, in her shoulders, against her chest, violently desperate for her maternal closeness as hungry lambs.

Jack, previously stoic and calm, starts to lose it, tears rolling down his cheeks, climbing into his mother’s lap, curling his legs up into a foetal spiral.

I bring Mum up to speed, we’re not clear on what’s happened or how, but none of the three is seriously injured.

We’ll transport them, to be on the safe side, will she be coming up?

“I think I should stay here…my husband’s still inside.”

“Of course,we can take the kids to A&E and you can catch up later on? It’s not ideal, but given the circumstances…?”

“Can we wait five minutes? My parents are coming, they could go with the children?”

“Perfect, even better. That ok, kids? Your Granny and Grandad will come to the hospital with us and we’ll see Mum later on?”

The two girls nod obediently, Jack glares balefully before croaking his defiance.

“I’m not going to hospital.”

“You’ll not be on your own, mate, Granny and Grandad will come with you.”

“I’m not going.”

I figure while we’ve got time to wait for grandparents, we’ve got time to come to a proper solution. Shuffling myself along the carpet towards him I start my “calm and reasonable” routine.

“Jack?”

“Yuh?”

“Can I ask why you don’t want to go to hospital?”

“I just don’t want to. I want to stay here.”

“But we need to get your ankle fixed, it’s sore, isn’t it?”

He nods.

“And you’re not coming up on your own, your sisters and grandparents are coming along too. Have you been to the Kids’ hospital? They’re really nice people, nobody’s going to hurt you, they’re just going to check out that foot.”

“I want to stay here.”

“You want to stay with your Mum?”

He shakes his head.

“I have to stay here…I have to look after my Dad.”

An emotional fist slams from his eyes to my diaphragm, winding me. I wince, tears and bile compete inside me for the position of “First to excrete”, I slap them down and take a deep breath, my sternum caving with awe and empathy for this wee man.

“You know what mate? That’s the best reason for not going to hospital I’ve ever heard. You’re thinking like a real grown-up and you’ve done a brilliant job of looking after your sisters. But me and my mates and the firemen outside are here to look after everybody now. It’s time to be a kid again, ok?”

He nods, curls into a tighter ball and nestles into his mother’s arms.

“Good lad.”

We help the kids and grandparents into the ambulance, tucking little heads under our jackets as we step outside the house, shielding young minds from visuals they really don’t need, selling the ride to hospital to the younger ones as an adventure.

Woody drives off, I return to my motor, lean back and shut my eyes for a moment. The fire warm on my cheeks, my back sticky and wet from my hivis.

“Kal?”

An ambulance officer in front of me.

“You alright, son?”

“Yeah, just…”

“It’s a bad job.”

“Not the job, just kids, that’s all.”

“Yeah, I know. You alright to drive?”

“Sure.”

“Good man.”

I punch clear on the radio and our despatcher, on hearing my weary, blunt voice, books us off for an extended meal break.By the end of the shift I’m lugging a ball of emotions around in my chest, knots in my stomach and throat make speaking to patients difficult, so I’m pleased we only have one simple emergency to deal with after our stress break.

Woody and I rendezvous in the car park before going home, we chat and debrief, hug in the dawn light and I retreat to cups of tea and a safe place to burst into tears.

Memories of a rural childhood.

It’s the third time in the shift that Chop and I have been sent to this locus; just outside Prima’s flat, his uncle’s restaurant is bright and busy and noisy, the tight wee cobbled street lined with double-parked vehicles, everyone wants pizza and drinks before they hit the clubs.

You can’t move down here on a Sunday morning, well-off church goers swarm to the Italian deli down the road for their latté and biscotti, parma ham, fresh basil and property pages.

But of the early hours of the weekend the neighbouring clubs vomit out their football topped clientelle, swaggering and swearing, slinging bottles and punches; the under-18 disco across the road provides a steady trade in stranded, teary-mascara wearing teenaged lassies, gutted because one friend won’t talk to another, or will talk but not to her, or looked at her boyfriend’s arse…or didn’t…or something.

I’m getting old.

The first job here was for an elderly Polish man smashed over the head with a bar stool, having dropped him off we were called back to deal with a woman pulled to the ground and kicked in the head by a gang of twelve year old girls.

Third time lucky and the sun is setting over the Greco-Roman structures on the top of Calton Hill as we hustle down towards what is, apparently, ‘our’ patch for the night. The address is a bit funny, it doesn’t seem to make much sense and when we drive to where we believe we SHOULD be, there’s nobody on the pavement. We tend to look for WPCs (not Woman Police Constable…I’d tell you, but you all seem to have so much fun working out acronyms in the comments that I think I’ll refrain) outside houses to guide us in, but on this occasion the best we could do was start pushing on stair-doors and shouting.

After a few tries at this game we find our job, a young man lies at the foot of the communal concrete staircase, its grandiose sweeping spiral one of the many features that people love about Edinburgh’s tenements…until they fall down them.

There’s an older woman fussing about the patient in an efficient, but ineffective manner, she’s clearly had some sort of medical training, but nothing that’s prepared her for this.
“He’s had a seizure.”
“D’you know him?”
“He’s my neighbour, he takes seizures quite often.”
“Did you see him seizing?”
“Yes, I heard a bang and found him here shaking about.”

The patient has clearly fallen down at least a dozen steps, he would have fallen down a further four steps at the bottom of the staircase if he hadn’t done such a good job of arresting his descent. Unfortunately his braking method appears to have been to hit his face off the wall with significant force, his mouth and nose are one big bloody mess. I’m sure there’s are anatomical landmarks in there somewhere, but I’m damned if I can see them. I’m also trying to work out if his current level of consciousness (GCS-Oh-Crap) is due to recently having a seizure, or due to smacking his face off a tenement. Equally it would be nice to know if he had the seizure and fell down the stairs because he was dancing-lying-down, or whether he fell down the stairs, smacked his face and fitted as a result of the head injury.

By the looks of things he’s not going to be telling me much for the foreseeable future.

My medical memory banks spool and dot-matrix out a starting point for me - Airway with consideration for C-Spine, I want this guy to breathe, but I don’t want to extrude his spinal cord through his vertebrae like so much gnocchi in the process. His shoulders rest on the half-landing, his head lolls uselessly down the top step, his breathing bubbles and burbles in the back of his throat. Spreading my hands behind his ears I gather his head up so that his neck sits in a position as close to ‘neutral alignment’ as I can get, though his arm is twisted behind his back and stopping him from moving. I need a hand and Chop has reacted swiftly to the fact that this guy is affy-nae-weil by running back to the vehicle to get everything we’re likely to need.

“What’s your name?”
“Alice.”
“And you’re what? A first aider?”
“I used to be a nurse.”
“Awesome…I need your help.”
She nods and swallows, looking at the blood splattered lad snoozing in my hands.
“I don’t have any gloves.”
“I do, you’ll need to get them out of my pocket.”

She walks to my right and starts undoing ‘the rucksack’ on my belt, it’s a ludicrously big pouch, but it carries damn near everything I could need on a job. Except gloves.

“No, no, they’re not in there they’re in my back pocket.”
“Your back pocket?”
“Yup.”
“Do you say this to all the girls?”
We share a laugh and she digs herself out a pair before reaching over me to straighten the patient’s errant limbs out. By this point Chop has arrived with the trolley and spinal immobilisation equipment and between the three of us we manage to get the patient onto the bed and out into the ambulance. I over-rule Chop without thinking, the “you’re new” attitude in my head more potent than any actual maths regarding his time on the road. He corrects me as I pop the portable suction off the wall.

“I’ve got that.”
“You sure?”
“Sure I’m sure, I can handle this.”

I take another look at him, he’s right, he can.

We switch places, he takes the more challenging and vital role of maintaining our boy’s airway and I slap ECG pads and BP cuffs on him before hopping out of the back, ready to crash through traffic to the ED.

Outside someone has turned off all the lights, black rain clouds have covered the entire sky, the world is dark purple and black and as I swing myself into the cab, a belly-growl of thunder barges through the streets. Rain pours from the sky so viciously that I have to repeat my stand-by call to the hospital. My wipers struggle to keep the windscreen clear, the noise on the motor’s fibreglass roof is obscene and I mutter and curse as I crawl through town, lights flashing, peering through the glass like Mr Magoo.

I checked up on our boy later on that night, everything was clear, a broken nose from falling down the stairs, a night on the ward and a realisation on my part that my tenure increases in direct proportion to those who came after me.

Stretching seams.

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The car is on fire and there’s no driver at the wheel,
And the sewers are all muddied with a thousand lonely suicides.
And a dark wind blows.

The government is corrupt and we’re all so many drunks,
With the radio on and the curtains drawn.
We are trapped in the belly of this horrible machine,
And the machine is bleeding to death.

The sun has fallen down,
And the bill boards are all leering.
And the flags are all dead
At the top of their poles.

It went like this:
The buildings toppled in on themselves.
Mothers crushing babies,
They picked through the rubble,
And pulled out their hair.

The skyline was beautiful, on fire.
All twisted metal, stretching upwards.
Everything washed in a thin orange haze.

I said “Kiss me, you’re beautiful,
These are truly the last days.”
You grabbed my hand
And we fell into it.
Like a daydream,
Or a fever.

Kal- “Right Dog, we have a four minute old baby and a placenta in the toilet. One of these objects needs wrapping in a blanket and cooing over, the other needs fishing out and chucking in a plastic bucket.”

Dog - “I’ll get the placenta.”

Kal - “Are you sure? I’m attending, mate, it’s really my job.”

Dog - “No, no, it’s fine. First time for everything.”

Kal returns to cuddling the tiny person, Dog goes fishing.

I love not being the new guy.

An anti-masturbation suit from Prague. Apparently to be *glued* to your pants.