Three of our jobs today had the potential to be upsetting, and while they were all sad, only one seriously upset me, and did so in a way I consider rather out of character for myself.
The first job of the day was to an 86 year old female in a nursing home with a 'blocked nose', we raced around there because…well…it was a Category 'A' call and those are the top priority 'get there in eight minutes to please the government target' calls.

Just as we pulled up outside Control let us know that the patient was upgraded to a 'suspended' (no pulse, no breathing), and sure enough we ran into the home to be greeting by a Fast Response Unit who was doing C.P.R. I jumped down and did a round of chest compressions which cracked her ribs (a recognised side effect of effective C.P.R) and then noticed that on the cardiac monitoring machine her heart rhythm had changed. She had a pulse!

…people don't normally get a pulse back from cardiac arrests of her particular type. We rushed her to the hospital, where a full cardiac arrest team was assembled. Her pulse was lost, and then returned. Unfortunately her prognosis was poor, but she stayed alive long enough for her daughter to reach the hospital. She died with her daughter there, which is a small victory, but one that we are getting more used to.

The second potentially upsetting job was to a one year old boy who had pulled some boiling milk on top of him. We turned up to find about 20 police officers on scene, and the HEMS helicopter circling above. The same FRU responder was there and the child had around 10% partial thickness burns to parts of the neck and chest. While nasty, this wasn't immediately life-threatening, but the HEMS doctor who turned up decided that it would be best to take the patient to the Paediatric Burns Unit at Chelsea and Westminster Hospital by helicopter. As the helicopter could get the child there in under 20 minutes it seemed like the right plan of action. My job during this call was to, (1) hold onto the other two toddlers in the house, (2) mix up some paracetamol for the child, and (3) to drive child and doctor to the helicopter which was around 300 yards away. The job was interesting because she was the type of parent who thought it was a good idea to wedge a settee into the hallway to stop her children from falling down the stairs…

The final job was a lot simpler – we were called to an 18-22 year old female who was 'unresponsive' in a bus. The bus had reached the end of it's route and the driver couldn't wake up the patient. (Possibly interesting aside – Bus drivers cannot touch any of their customers to wake them up). We turned up and soon managed to wake up the very sleepy girl. She remained drowsy but agreed to let us take her to a place where she lived, but after talking to her a bit, we soon realised that she was instead homeless. This, coupled with the way she would fall asleep as soon as we stopped talking to her, made us think that it would not be safe to leave her on the street, so we decided that we would instead take her to hospital. When we reached the hospital she refused to go in, and instead pulled out a 'crack' pipe and started to light up. We told her that she couldn't do that… So she jumped up, pushed my crewmate and ran off. As there was nothing physically wrong with her we couldn't chase after her, so instead returned to our station to fill in the necessary paperwork.

So why was it that this last job was the most upsetting, not only for myself but also for my crewmate? Well it wasn't because she was pretty (she wasn't, and she had a voice like Ken Campbell), and it wasn't because she was ill, nor was it because my crewmate got shoved.

With our first job, the woman was at the end of her life, and until she died, had enjoyed fairly good health – she didn't die a painful, protracted death, and she died with her daughter next to her. With the scalded child, he would forget the pain, and will receive excellent care from the hospital he went to, he would return home to his loving (if ever so slightly dense) mother.

With this girl, it was as if she were lost – at some point in her life her potential future had unravelled. Instead of getting an education, holding down a job, finding someone special and living a long and happy life, she is homeless, a drug addict and her future is probably painful and short. What is so depressing is that no-one was able to turn around this descent, and this is perhaps why I despair at society – that so many people are prevented from reaching their full potential. I understand that she has made her own choices, but how much power did she have to make those choices. I wanted to help her, but there was no way I could do this.

And it's that which annoyed and upset me.

19 thoughts on “Upsetting”

  1. That doesn't seem so very out of character to me, Tom. Surely part of the motivation for you in doing your job is to help people. So in such a frustrating situation, where her powerlessness to make good choices about her life was echoed by your powerlessness to help her in any way, it's not surprising that you, and your crewmate, ended up annoyed and upset. It is truly depressing, and there are no easy answers.

  2. The thing that pains me the most is seeing people like that sat on the streets at night this time of year. You just have to come to terms with the fact that not everyone wants to be helped………..

  3. I agree. There is nothing so hopeless and frustrating as to have to stand by and watch someone willfully harm themselves whether it be physically, or via drugs or drink etc. I guess 8 times out of 10 most patients 'surrender' to ambulance crews as they want/need/know they are going to be helped in some way. The girl in question probably didn't know she was asleep on the bus for a start and certainly wasn't up for being helped – but what do you do? I'm sure it is hard to get those haunting images out of your mind but at least you care enough to be bothered by it…and that unfortunately is all you can do. I'm equally astonished by the millions of people in this world who give people like that girl a reason to resort to such a desperate way of surviving. I chose that word on purpose – surviving not living. Indescribably sad. I really hope something happens whereby she can get some help.

  4. having just run a 12 week prince's trust team, it really can get to youcan't it one was an alcoholic who tried detox but couldn't stand the pain so his parents despairing threw him out, 2 were 5 & 10 dealers. I was a 5 & 10 user. The first one may yet make it he is going to AA meetings, the second two will bleed the system dry, the last one has, as far as I can see, no hope, and that upsets me because he is a nice boy at heart.

  5. I hear what you are saying and have felt that way many times myself. You can help a huge number of people but being unable to help just one makes you question so many things including the worth of your work and the type of society we live in.Some days the only thing that keeps me from despairing is knowing that I cannot help anyone until they recognize that they need help. It doesn't make things better but it does keep me from getting too distracted to see the good things that I have been able to do.

    As for out of character? Well, I don't think so. You may be a cynical person but if what you describe were out of character you wouldn't be doing what you are doing.



  6. I sympathise. Why is it that the nice ones don't make it and other's do? My partner's sister is an alcoholic although she hasn't touched a drop of alcohol since she was admitted to hospital with advanced cirrhosis (I think that is how you spell it!) of the liver last year. Up to that point some of the family had stuck by her, some had given up on her and some were frightened of her. She had seemingly got to the point of no return – she was and still is living with a chronic alcoholic, her flat was uninhabitable, she sold everything to buy alcohol and had resorted to shoplifting for food. She was red, bloated and unintelligable. Unbelievably, somehow the close call (we were told to expect her to die) turned her around. She found the strength within herself to stop drinking, get well and her goal being to stay well enough to be fit enough for a transplant next year. Ironically, she is still living with her partner who has seizures if he doesn't have a drink for more than four hours, can barely walk or eat and regularly wets himself. At one point, we were all so angry as we thought he would survive her which at the time didn't seem fair as at least she was trying to get well. I can really see that the only person that has helped her get better is herself and it is a remarkable achievement. It worries me that she lives with the temptation of a drink every day. As for her partner, I guess even though he can see how amazing she now is – it isn't enough to make him want to do it for himself. Human will is an incredible thing – it can make or break you.

  7. Another disturbing factor is how accepting we can be, as a society, about these things.”She needs help… but.. .well I don't see this kind of thing often and I'm sure someone ELSE is doing something”

    I fully admit to thinking like that on several occasions. Not nice. At all.

    Anyway, as has been mentioned, I think your reaction is a testament to who you are.

  8. Been reading your blog for a few months now, but this is the first time I've been moved to leave a comment. Your humanity shines through in this post; this is what makes Random Acts such a joy to read. What a nice, decent bloke you are.

  9. The Crisis Open Christmas 2004 will run from 23rd to 30 December, and the Millennium Dome in Greenwich is one of six venues providing skills training and activities, companionship and crucial medical services. If you would like to help,

    or look on the Crisis web site for more information about what you can do.

    I am suggesting this because I know (having worked as a volunteer) that those few days of regular meals, medical help, not being alone, being supported in beginning to kick an addition, has been a turning point in many people's lives. It is some years since I worked at the Open Christmas but I remember thinking, at the time, “this is what Christmas is about”.

    Rachel in SE7

  10. Powerful post. It is hard when we see the blunt realities many people face. Kudos to you on a job well done.- Janine

  11. Sir Tom, In family therapy training here, ca 1988, I heard this (difficult) concept of “Non-attachment to outcome”, the idea being that therapist cannot determine the choice(s) the client/customer makes, and so the professional has to feel satisfied by the quality of caring and effort & prof skill s/he contributed…. The challenge I find is to balance that with the basic wish to make a difference which got you/us into our areas of work/this mess in the first place – if you see what I mean. With respect, and good wishes for Xmas, which, I imagine, in your kind of work can be more busy than for many ?

    david / Brit. working in Chicago

  12. Hey Tom, your post reminds me of a couple of Christmases ago before I moved back to NZ. I was on a bus heading home from work in London. There was a guy a few years younger than me sounds asleep in the seat across the aisle. I thought nothing of it, having nodded off a few times on the bus myself. It wasn't until we got to the last stop that it became apparent the guy was dead.My reaction was much like yours. I found it really hard to come to terms with that lack of hope in life. I guess how i felt was compounded by the fact that it was Christmas…

    Hang in there, you do a phenomenal job (and a phenomenal blog!)

    Auckland Nic

  13. A touching story, and very true – unfortunately not many people have the willpower that your sister in law often has, especially when she is stil living in the environment in which she drank.I guess I'm just too used to seeing people who are drinkers, I don't get to see the non-drinking alcoholics (or they don't volunteer that information when I ask about previous medical history).

    I'm sending some good thoughts towards you and your family

  14. That's a great idea, and I hope someone who reads this is motivated enough to go and volunteer.I'm at work for all those days, so I'm afraid I shall be too busy to help out – perhaps next year.

  15. That's a good concept to think about. I think that the problem is that I can only do so much (which I accept) but that there are people out there who will encourage people into a life of drink and drugs. That and I tend to despair for some of the support services that exist for these 'clients'.

  16. but aren't we all? a little lost, in london.That's how it felt, anyhow. So many people, searching for something obscure.

    – re-minisce

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