So I thought I’d better check my suit looked ok this afternoon, because in the morning I have to play the schmoozey interview game.

I’ve lost 2 stone in the past year.

I’m thrilled to admit that my suit no longer fits me, I could fit a mini-me in a wee harness, Dr Evil stylee, in the space between the buttons and my belly.

I only discovered this this afternoon at 5pm.

The fastest suit buying in the world has taken place.

New suit, shirt and tie.  And rather snazzy it all looks too.

Would rather spend the cash on something other than an interview costume, but hell, at least I didn’t ahve to replace it because I couldn’t fit into the old one!

I’ve got my hand on the door handle, ready to hop out of the cab and open the station gate when the CBT starts shouting.

“Awwww fuck.”

Images of wholemeal rolls and humus vanish from my brain, another late lunch for us then.

Stomach growling, I set the map to show me the location of the emergency.  It’s miles away, literally miles.

Kojak pops open the inbox to get a heads up as to what we’re going to.

He’s quiet in my left ear.

“Oh fuck….drive.”

I squint sideways as I three point turn the vehicle - “Two week old female found lying at foot of stairs.”

Fuck.

“Red Mist” is a condition emergency drivers develop, often when responding to jobs involving children, in which their desire to get to the job as soon as possible clouds their ability to make rational driving decisions.  I’ve had it before, I recognise it when it comes on and I counter it with some slick concentration exercises.

I do not have Red Mist right now.

I am, however, driving as fast as I possibly can.

Kojak updates me on a second message - “Possibly dropped by three year old sister.”

I’m immediately imagining the scene waiting for us, the little crumpled body, the screaming parents, the tearful sibling, confessional and humble, yet blamed and barracked by grief stricken adults.

“Kal?”

“Yes, mate?”

“I’m shitting myself.”

Yeah.  Me too.

The odds are on for every member of staff in a big city to have a dead kid at some point.  I’ve written before about my fear of them, my spotting them waiting in the wings of my career.

Seeing this one on the horizon, I’m strangely calm.  Kojak’s fear serves only to galvanise my thoughts.  When faced with bad jobs, at least one of you has to have their shit together.  Just as there’s no point panicking while driving, there’s no point being scared of this job.

“It’s cool, Ko.  When we get there, you jump and I’ll get the gear.  If the kid’s not breathing, we grab her, stuff Mum and sister in the back and run like fuck.  If she IS breathing, we lay her on the bed, secure her head and neck as best we can, stuff Mum and sister in the back and run like fuck.  Either way, we’re not fannying about on scene, right?”

He nods.

“Right.”

Fuck…I hope this works.

The house is still miles away, Kojak blurts out directions for me, guiding me in down a faster, but smaller road that our GPS wouldn’t consider.  He shaves a comfortable minute off our journey time.

As we pull up I see him hesitate and I can’t blame him.

“Just jump, mate.  I’ve got your gear.  Go.”

I’m a good thirty seconds behind him with the bag and oxygen when we spot the baby on the floor.  She’s lying on a changing mat, pink and wiggly, smiling up at us.  Big sister bounces on the sofa cushions.  Mum is shaken, but together.

Nobody is dead, or broken.

She’d been found at the foot of the stairs, sure.  Her big sister had dropped her, yup.

But, crucially, big sister had been standing at the bottom of the stairs at the time.

We don’t have an infant with a long fall.

We have a infant who’s fallen a height of eight inches onto carpet…

….

Once clear from PaedsA&E we both climb into the cab.  Kojak looks at me and, for what feels like the first time in the job, we both exhale.

“Ffffffffffuck!”

“RTA…sounds a bit nasty…”

And as we approach the scene, it certainly looks like it.

Crushed to its headrests, the car rests on its roof, the front of it buckled against the tree.

“Dynamic Risk Assessment” spools in my head, but the safety-by-rote process doesn’t allow for being the only emergency vehicle on site with anxious onlookers.  I can’t stand by and wait for a fire engine.

There’s a pedestrian on his belly by the car, chatting into the passenger compartment, his mate spots me approaching.

“We’ve isolated the battery, but the airbag’s not deployed, so watch yourself.”

I frown at him…I’d been expecting “He’s really really bad and there’s blood everywhere.”

He smiles.

“I’m a retained firefighter.”

Score.

Clamping my helmet onto my head and flipping down the visor I drop onto my front on the ground and commando-crawl into the wreck, the roof/floor is a mushy pool of mud, blood, beer and diamond glinting windscreen fragments.

Hanging above me is a young man, suspended from his seatbelt.  He was calm as I approached, but on seeing me he starts screaming.

“Get me down.  Just get me down, please, it’s killing me.  My belly! My belly!”

My mate Biff once found herself hanging upside down in her seatbelt after rolling a car.  She said the worst thing about it was knowing that as she unclipped herself she was going to land on her head.

Nobody’s ever taught me how to extricate a patient who’s hanging upside down from the ceiling.   I’m nervous about this guy’s head and neck, the car’s clearly walloped the tree at a significant rate, certainly enough to risk his spinal cord and vertebrae.  Dumping him onto the top of his skull would not be a wise clinical move.  In an ideal world I’d be able to lie him flat on a board and slide him gently from the side of the car.

Yeah…but that ain’t happening.

The doctor at this cluster fuck imparted some fine wisdom - “C-spine immobilisation is all well and good, but you’ve got to get the patient out somehow.  Perfect in-line extrication is the gold standard…but the patients haven’t all read the instructions.  Do the best you can with what you can in the time you’ve got.”

Right.

I marshall helping hands to catch his shoulders and hips and get the patient to brace his hands against the roof.  Handstands aren’t a common method of getting people out of car wrecks.  But when you’ve no choice…

With hands in place I saw through his seatbelt with my shears and between the four of us we roll him gently into a foetal position.  The retained firey catches his head and holds his neck in line while I dig and wriggle my hands under his clothes, against his neck, chest, abdomen and pelvis.  His pulse is present at the wrist, giving him an acceptable blood pressure, but its fast and thready.  I want him out of here.  I can’t assess him properly in this crawl space.

“SHHHHUNK”

The patient flinches and so do I and together we chorus:

“The FUCK…?”

Images of collapsing windows, buckling doors and exploding airbags fill my thoughts.  With my upper body stuffed in the car and the rest of it hanging above me I can do without the vehicle shifting or breaking around me.

“SSHHHHHHUNK”

A massive plank of wood shoots in from the corner of my vision, stopping inches from my chin.  I snap my head up, bashing my helmet off the door above me.  But I’m relieved to see them.   The chunks of wood are wedges that firefighters drive under the car to stabilise it, to stop it rocking and buckling.  Behind me a fire engine and six handy-dandy fireman are busying themselves around the scene.

I’ve just had a fire engine sneak up on me.

Must pay more attention.

We slap high flow oxygen onto him, my ignorance of his condition has me antsy.  I want to assess his breathing, his lungs, his chest.  I want to know if he’s bleeding internally, I want a definitive blood pressure.

Most of all I want him out.

The fire chief and I have a chat, he wants to cut the tail gate off the vehicle, swearing it’ll take only a few minutes.  We meet exactly in the middle, he knows far more about chopping up vehicles than I, while I know more about my patient’s condition and how I want him handled.  The compromise works perfectly, absolving the fire service of this arsehole’s actions.  We compromise, he wants to cut all the seats out to ease our patient’s movement.  I’m not happy waiting that long, so we quickly and amicably agree on “tail gate and rear seats cut away, front seat broken in half and pushed out of the road”.

Returning to the patient there’s little to be done but hold his hand and coach his breathing while the crunching of the cutting gear surrounds us.  Once clear of furniture we have enough space and hands to slide him onto a board and then slide the board from the car.

He’s stable, but panicky on the road into the ED.  Once we’ve left him in resus with a medical team (where I get a pat on the head from a consultant for a “great handover, very comprehensive, really helpful”, all those days of pretending to be a patient and getting assessed by trainee doctors are paying off); I drink a cup of tea with lots of sugar and head back to station, my jacket and trousers soaked with mud and blood.

It’s only later that I realise this was my first bad RTA without a senior member of staff on board with me.  I’m pleased with how it went, a nice balance, I feel, of speed and control.

I have an interview for a trainee paramedic position on Tuesday morning, I wish I could think I’ll be less stressed at that scene than on this one.

But I doubt it.

Loth asked that I make it clear that she is not really, really rough.

I’d like to take this opportunity to say that her smile is like the sun breaking through storm clouds over a glittering sea, her laugh akin to a dainty pixie tap dancing upon a fabergé egg and her repartee as sharp as frozen salt and lemon margaritas poured over a rippit frenulum.

There…she should be pleased with that…

A few weeks ago I met Loth.

She’s been reading me for some time, commenting frequently and we quickly developed to slinging abuse at each other via email.

Because we’re Edinburgers and that’s how we make friends.

Having mortally offended each other, we thought we should meet in person and continue the slagging; because, you know, you can’t really convey the loose flecks of spit when you’re raving at someone unless they’re right there.

She told me she’d be “The slightly dumpy lady in her forties wearing a red anorak.” I told her I’d be the slightly dumpy bloke in his twenties wearing clothes.

Come the Saturday I was sitting in the coffee shop we’d agreed as a location when a very dumpy, jowly woman who appeared to be in her sixties came strolling in, clad in the reddest red anorak I’ve ever seen.

I agonised over whether I should approach her, maybe Loth was lying about her age? Maybe she wasn’t, but was just really, really rough?

But no! In a whirr of red Loth strode in through the door and I was able to stop fantasising about accosting ugly old ladies.

We hit it off immediately, we were laughing within minutes and having a ball. By the end of my first pot of coffee I started to just talk, allowing my principal thoughts to enter the conversation. FMG and I are moving out of our flat over the next few months, I’m moving into a new flat with BamBam, potentially buying my own property this summer.

Loth listened and nodded. At no point did she stand at the table and yell “Are you kidding me? You can’t do this! You’re a kid!”

Instead she started making informed sounding noises about buying property in Edinburgh, dropping in handy hints about the housing market and sharing anecdotes about clients she’s helped buy their own place.

When it struck me.

I need a solicitor.

By the end of the morning I had her card in my wallet, she’d agreed to act on my behalf (”I prefer my clients to come to me from word of mouth…who the hell hires a lawyer out of the Yellow Pages?”) and I strolled from the café having ticked another item off my “things that are bugging me and I should really sort out” list.

Isn’t blogging wonderful?

A pink tracksuit stretched tight over the vast pudding basin around her navel. Her hips are slight, wispy vestiges of pubescent girlishness still present in her frame. She texts rapidly between contractions, abbreviated profanity and acronyms tell some fkng cnt that he’d bttr B there.

Daughters and mothers and grannies ride along. The only male in the back still in utero. We all crowd around the prints of the “4D” ultrasound, science keeking in where nature denies access.

She’s stalwart, refusing pain relief, breathing through the laborious cramping.

I was eleven when she was born.

And she seems so much more grown up than me.

I’m on my way out to the vehicle to get our patient a wheel chair when I’m accosted by an older man at the doorstep, he looks at me expectantly.

“Can I help you, sir?”

He coughs, stares at his feet.

“I was rather thinking I might be able to help you, perhaps I could take the dog?”

I’m baffled.

“I’m sorry?”

“Tell Jack I’ll look after the dog, or watch the house for him.  I’m next door, you see.”

“Oh.  Well, that’s very kind of you, I’m sure.  Maybe you can talk to him about it?”

The patient’s husband is behind me and the neighbour pushes me to one side, gathering the old man in his arms, pressing his friend’s face into his tweed covered shoulders.

“Oh Jackie, be strong, son.  She was such a good woman, it was just her time.  I’m sure she didn’t suffer.”

Jack is bemused.  I’m amused and feel I should cut in.

“Sir?”

He looks at me, eyes wet.

“Yes?”

“Estelle’s not dead, sir.  We’re just taking her back into hospital for a check up.”

“…oh…”

We all stand and look at each other for a while, I retreat to the back of the vehicle and manage to shut the doors before laughing so hard I nearly puke.

Memories of warm bed and hot shower.

Warm porridge.

Hot tea.

Early morning blog reading.

Outside the end of a clear, clear night with a bitter wind.

It looks cold.

And damp.

Don’t make me go out there?

Please?

We had a long chat with the patient before we got him out of the car, we confirmed that he had no head, neck or back pain. He had normal neuro obs and his pupils were equal and reactive. He had not been knocked out. The airbag had not deployed.  He had sensation and movement across all four limbs.  He was wearing a seat belt.

He was adamant that he didn’t want to travel to hospital and complained bitterly about the collar we applied as a precaution.

If he’d wanted to go to hospital or had any indication that it was necessary, we would have slid him out of the car onto a rescue board, strapping his head down and holding his spine in a neutral position.

Since there was no need for him to travel, we didn’t do that.  We, along with your fire fighters, lifted and shoogled him from the vehicle, moving him from chair to chair, letting him control his neck and head.

I was appalled when you crouched next to him, holding his hand and told him that you’d seen “hundreds of crashes” and that it was “better to get checked out medically.”

What the fuck do you think we’re doing?

He was adamant that he didn’t want to travel, but you persisted, placing the seed of doubt in his head that if he went home he could die.  You removed his independence and rights as a patient and adult by scaring him into submission.

I say again, if he had any indication that he should come with us? We wouldn’t even give him the option of refusing care.

As is, we turned up at A&E with a terrified patient who had no symptoms or chief complaint.

I don’t tell you what kind of water to squirt on the fire.

Let me do my job.

I’m something of a gift nazi.  When buying presents for people, I tend to be guilty of buying the present I think I SHOULD buy them, rather than always the present that I think they’ll like.

I’m going to Croila’s little lad’s fifth birthday party on Saturday night.  He’s declared it to be Scooby-Doo themed.

I have just bought a monstrosity of plastic, fiddly little pieces and repetitive electronic noises, all branded with Cartoon Network logos and deftly glossing over the whole issues of Shaggy-Is-A-Pothead, Scooby-Is-A-Binge-Eater, Velma-And-Daphne-Are-A-Pair-Of-Dykes and Scrappy-Doo-Is-An-Unholy-Little-Cunt-Who-Needs-Skinning-And-Dipping-In-Bleach.

It will make noise, wee bits of it will undoubtedly get lost, Croila will hate it and me.

I don’t care.

It looks fun, I think the BoyD will like it.

And you know what?

You’re only five once.