When I was asked to host The Handover for July, I chose the theme “A Pivotal Moment”.

It must be said that I was thinking more in terms of writing, than medicine. I occasionally refer to the “Trauma Queen Twist”, the moment in a Thrilling Installment when I hopefully illustrate just how nasty things have gone. I love watching people read my stories, I love watching them hit the twist.

Ha. I’m a sadistic writer, check me out.

The writers that submitted, however, have each taken their own view on “A Pivotal Moment”. There’s some fine writing here, folks.

Enjoy.

MedicThree glosses over details and brings us right to the crux of many a paramedic’s worst call.

“The dispatcher gives directions to a rather infamous intersection on the edge of my little county.”

This is StandBy For Tones.

ManchMedic reminds us all that the fanciest toys in the motor are no protection against a patient going downhill if what you really need is time.

“She had no blood pressure to speak of. I think I picked up a systolic in the 60’s, but I couldn’t be sure.”

This is Beyond Our Control.

The Insomniac Medic reflects on a straight forward job that changes someone else’s life forever.

“Mum must have forgotten to turn the lounge lights off.”

This is All Change.

Medic999’s harrowing story illustrates the fact that any call can turn around on you. Sometimes, when nobody’s dying in front of you and you’re sighing and tapping your foot, you’ve got a patient in real need standing in front of you.

“Whilst Rahim is speaking on the phone, he starts to weep. His muscular frame suddenly crumples and he seems far from the strong and imposing man that I saw when I walk into the room.”

This is True Asylum.

Michael Morse of Rescuing Provident writes about arguably the greatest pivotal moment for public safety personnel in the past century.

“Never forget that every time we put our gear on the truck we honor the memory of the 343 firefighters who died while doing their job six years ago.”

This is Never Forget.

The Happy Medic took the theme of “A Pivotal Moment” and took it literally - he’s all geared up for a fight and social reform. Good lad! Right behind you.

“Wish me luck gentle readers, I’m taking on the entrenched Old Ways and I intend to win!”

This is That Does It, I’m Changing This Thing.

CK from Life Under The Lights nails the issue of emotions and humour in prehospital care better than most. If you want to understand why your paramedic friend/partner/colleague reacts oddly to you when you’re sick, or when you hear about some awful calamity happening to someone else. You should read this.

“Don’t these sound like good calls? They were. Yep, they were sad and I felt very bad for the people that were involved. Good calls though. What’s for lunch?”

This is Splashed Sadness.

Mack505 writes Notes from Mosquito Hill and recounts a story we’ve all seen. Here, though, its a small town with no chance of anonymity. He handles it with grace and deference.

“Joe was a local boy and knew all of this. The accident investigation would reveal Joe’s car was going almost 60 MPH when it left the ground.”

This is Sunrise and CISD

Which brings this edition of the Handover to an end - next month is going home to be hosted by Medic999. Swing by and take a look at his concept - “Your First Ever Emergency Call.”

Submissions in by August 24th, please.

The PR side of the Parabike is an aspect of my work I’m trying to develop in myself. I’m pretty rotten, it must be said, at talking to adults about my job. Gimme a room full of eight year olds and I’m all Adam West POW! KRANG! BAFF!

Sadly, if the audience isn’t fascinated by wearing a fancy hard hat, shiny jacket and running the siren? I tend to be a bit “Aahhh…well….I’m a paramedic, aren’t I? Ummm…”

I was chatting to two women on the prom yesterday when one of them asked the question in the title of this post, followed by “Just wait around for people to get hurt?”

And I answered her with “Well…yeah. That’s pretty much what I do every day, whether I’m on the bike, or on an ambulance.”

“Hmmmph.”

But I’m trying, I’m really trying folks. The problem is that the ambulance service, by its very nature, isn’t desperately proactive. We tend to meet people when they’re sick and not before.

I’m off to a cycling open day today in a local park, will make an effort to schmooze a little more.

I’ve another post up at the BMJ’s Doc2Doc - go right ahead and take a look.

But they’ll never take our dignity.

Hmm.

The Gathering Of The Clans took place this weekend in Edinburgh - a central part of “The year of homecoming” where Scotland invites its lost bairns to come back to the motherland.

TGOTC was in Holyrood park and was predominantly populated by visitors from overseas. America, Canada, New Zealand, Australia, they were all represented.

And were, to the most part, lovely people.

Mostly.

The problem was that the event was firmly split down the middle. There was the part of it being governed by the Standing Council of Scottish Chiefs who, regardless of your politics about aristrocracy, tend to be your bona fide proper lairds and land owners, folk who genuinely own the land from which different clans originated. They were dressed impressively (there’s a certain poise that having eagle feathers in your hat gives you), but conservatively. Thousands of attendees from across the world fell into stride behind them, bringing outstandingly drilled pipe bands with them.

These folk seemed to approach the whole day with an air of “This is where my ancestors came from…I am thrilled to be here to see the country of my predecessors…isn’t it nice that this country welcomes us as visitors and shares itself with us?”

I liked these people.

Unfortunately, for every one of them, there were at least three people who’d read too much Edmund Spenser. A fair old number of folk seemed to have got dressed by thinking “What is the most ridiculous variation on a kilt I can squeeze my body into?”

I saw one massively fat lady waddling back from the food tent who was so festooned in Royal Stuart (bright red checks, for those of you at the back) and carrying so much food I thought a picnic had been summoned into sandwich waving golemry.

There was an entire group of folk attending who were dressed, not in Highland dress, but in leather britches and tunics, long flowing cloaks and tartan bunnets.

Others took it further still, hanging furs from their shoulders and chests, waving swords at each other as they walked past.

It made me furious.

You want to celebrate your ancestry? Brilliant, come on over, I’ll be thrilled to share my country with you.

But this is my country. My home. It might be all a jolly jape to you, but that’s MY heritage and ancestry you’re fucking about with. Scotland is not MacDisneyland, it’s not a terribly cute place that you can plunder for your next Renaissance Faire costume.

It’s a real place, with real people, who really live here.

If I attended a 4th of July party in the States dressed as Abraham Lincoln and told people how wonderful it was to be amongst my people? Or stood at Ground Zero and wept for “my fallen countrymen” I would, quite rightly, expect to be soundly shredded.

Why then, is it ok to do it over here?

Kal is - the newest guest blogger at Doc2Doc - the BMJ’s online presence.

Go right on over and read my thoughts on superstition in medicine.

Yesterday I had the following comments made to me while on the bike:

“Are you delivering prescriptions?”

“Two 99s plea….oh…”

“Bloody hell, that was fast.”

Public perception of CRUs isn’t always so hot, often people are just a bit bemused - “But how do you take the person to hospital?” to which I’m loving replying “I give them a backie.” - but Nick Hough discusses in detail the question “CRUs - are they worth it?” in this insightful and timely post.

Incidentally? If anyone else fancies writing well formed posts about subjects that I’ve currently discussing on TQ so I can link to them?

That would be awesome.

I love telling lies.

You should know, you’ve been reading them for years.

Aha….I’m kidding.

Maybe.

Naw. I am.

*wink*

Anyway. One of the games I love playing is, whenever someone asks me a question to which I don’t know the answer, just making up some vaguely plausible shit.

Unfortunately, on the last two occasions I’ve done this, the conversation has moved on too quickly for me to go “Aha! Not really, just winding you up.”

This means that my mate and god-children believe that the reason there are three eateries with the word “Elephant” in their title in Edinburgh’s city centre is because an elephant was once delivered by accident to Leith docks and spent the rest of its life chained up down there. The Leith Elephant was a local institution.

Also, I told a friend the other night that the reason he’d had a four hour wait in A&E was nothing to with the waiting lists, but because they had to wait for the adrenaline in his body to burn off before they sutured him - “Because adrenaline makes your blood vessels constrict, we couldn’t stitch it and then have them dilate, your stitches would burst and you’d bleed everywhere.”

Its fun. You should try it.

What lies have YOU told people recently?

No cheating, I’ve already read this.

So in comes a call, “thirteen year old female, very violent, threatening suicide”. Control call us en-route to let us know they’re sending the police too.

Pally, Corpus and I have a quick chat as we pull up.

“We waiting for the police?”

“For a thirteen year old?”

“She might be huge.”

“There’s three of us. I’m sure we can take our chances. If need be we’ll put her on the floor and sit on her and Corpus can watch and make sure we’re not beating her up, or molesting her.”

Because women are the ultimate witness. And men are, clearly, all rapists, thugs and paedophiles.

We all tromp into a youth hostel and get the skinny. The kid’s here as part of a chuch youth group, led by two students who are clearly way out of their depth. In fairness, I have nieces and nephews who are older than these guys.

They explain that the girls’ behaviour has been worsening over the past few days and that last night she threatened to kill herself and one of the group leaders. She has not acted on this threat, she hasn’t harmed anybody, but she’s being segregated from the rest of the kids because she “told horrible stories”.

“Like what?” I asked.

“Just horrible things.”

“Ok….like what? Did she threaten them?”

“I can’t say it…it was just….horrible.”

Oh for fuck’s sake.

“Really, this is important, what has she been saying?”

The leader just shakes her head, her eyes welling up.

We’re left baffled, is the kid disclosing abuse? Threatening abuse? Exhibiting distressing behaviour?

We do manage to pin down that she’s threatened violence towards the leader, so vehemently that they refuse to reenter the room.

Nuh-uh.

“One of you has to come in with us. If only to interpret.”

One of them wipes her eyes, steels her self and tries to hide behind Corpus’ skinny wee frame.

Inside the room sits a tall, gangly lassie. She’s calm, if slightly stroppy and looks alarmed to see three uniformed people in her room. The leader explains to us that the girl’s parents have been called and are flying over the North Sea to collect her. They’ll be here in four hours.

So…what do we do with a possibly suicidal minor who doesn’t speak our language, nor do we speak hers. Our interpreter is frightened of her and she hates our interpreter. The manager of her accommodation is refusing to have her in the building.

We explain that we’re here to help her, that if she wishes she can come with us to the hospital to speak to someone about whats bothering her.

She laughs in our faces. Who do we think we are? Superman? Her problems are very big. Bigger than we think.

The police arrive, ostensibly to back us up. We brief them on the situation and we all stand around in the corridor, the patient leaning against the wall, glaring at us all, occasionally texting people.

She refuses to come with us.

She’s not mad enough, nor do we have the time to section her.

The only option is for the police to arrest her for her own safety.

We discuss this at length.

Nobody likes it.

Nobody can come up with an alternative solution.

We all agree, through a system of euphemism and pointed looks, that if she kicks off we will restrain her, while all watching each other like hawks and confirming that nothing untoward ever happens.

Five emergency service personnel are in the room, preparing to cuff a thirteen year old girl.

None of them wants to.

The cops walk her out to the van.

I can’t help thinking how terrified I’d be at that age, in a foreign country, my only interpreter being someone I’ve had a vicious argument with, being arrested and waiting in the cells for my Mum to arrive.