Happy Thoughts

I wake up at 1:30 am, it's my 38th birthday and I'm awake because shift work has killed my bodyclock. Various parts of my body ache, consequences of a job where heavy, unsafe lifting is sadly a fact of life.

I stare at the ceiling, thoughts running through my head, becoming more and more hate filled as I reflect on my job.

I know that this is in part the trifecta of SAD, nightshifts and a couple of months without a 'decent' job. If I could just do a call where I actually helped someone by using medical skills my mood might improve.

I lay in bed thinking about alcoholics, drunks and wimps – about how personal responsibility seems to have become an incredibly rare thing.

I'm hating myself for doing a job where the health detriments are so pronounced while serving so many people who selfishly think that the A&E and ambulance service are there just for their benefit.

I think on the last few night shifts – of the drunks that we went to. Of people who drink and drink and drink, then 'collapse' in the street – knowing that some idiot like me will come and pick them up before they get too cold (it's only pensioners and hillwalkers who die of hypothermia these days), I'll then take them to hospital where they will continue to be mollycoddled by demoralised nursing staff.

And if you aren't mollycodled enough – well, you can always complain and get someone disciplined or fired.

The government tries to prevent heavy drinking by warning people of the effects on the liver, that they might make a fool of themselves. But people don't care, that is all so very far away. After all, isn't a hangover the sign of a 'good night out'? A badge of pride to be worn in order to prove that you are 'social' and 'popular'?

I like this advert.

But I don't think that it goes far enough.

What I think we need is something that is much more immediate, something much more telling and something that acts as a deterrent to others.

It'll need an act of parliament, but Labour seem to like introducing reams of new legislation.


My suggestion is this – in order to teach people that the effects of alcohol on both themselves and on society are damaging and far-reaching heavy consumers need to be taught a lesson.

When called to a drunk in the street, the ambulance crew should be allowed to beat the 'patient' up, to give them the fight of their lives, to fill them in, to give them a good shoeing and to knock seven shades of shit out of them.

This will have several effects – primarily it will act as a deterrent to people who get drunk and expect public taxes to be spent looking after them, secondly it will reduce the cachet of sporting a hangover the next day in work, thirdly it will ensure that the 'patient' actually needs the services of an A&E department, fourthly it will allow A&E staff to practice their minor (and not so minor if the ambulance crew gets carried away) injury treatments on a semi comatose patient and finally it'll help de-stress ambulance crews when they find themselves going to the umpteenth drunk of the night.

I suspect that once a person has had their nose broken a few times they may eventually get the idea that drinking in moderation is perhaps a good idea.

(Also the ambulance crew should be allowed to perform 'ABC' on the patient – taking their Access, Barclaycard and Cash. This will have the happy side effect of raising ambulance wages, and thereby raising staff morale.)


I am not mad.

But I would suspect that in countries where the police are… less 'customer focussed' there is much less public drunkenness.

Perhaps a less extreme measure would be to have the ability for A&E departments to issue fixed penalty fines if the only reason that you are in the hospital is because you were drunk and incapable. I wish the police would do this, but they are fully aware that in the great scheme of things their time is better spent elsewhere, or if not ''better spent', then tied up dealing with Kylee and Jason's domestic dispute over the bottle of White Lightning.


I suspect that over the next few days I'll be highlighting exactly how wasted my time at work has been – essentially being little more than a taxi driver, and worse than that a taxi driver that can't refuse a punter.


EDIT: It would seem that some people haven't recognised that this post is largely hyperbole, maybe I should have made it more explicit by suggesting that I 'kill a few – just as an example for the others'? Needless to say I don't actually think that we should go around beating up drunks, but I do think that we should introduce fines for these drunkards who abuse the NHS.

18 thoughts on “Happy Thoughts”

  1. Mate, I think it's time you called it a day. This job is eating you alive, it's just not worth it anymore. You've done far more than your share, it's about time you started thinking about your own health over that of the people you serve.I think we're not going to see real change in the Ambulance Service until patients start dying in significant numbers for want of crews. It might sound callous, but I just don't think society deserves the sacrifice that you and your colleagues make for us. I think we've all collectively forfeited the right to emergency medicine and need to be reminded of the fact that it is human beings that provide that service – intelligent, highly skilled human beings who have other options.

  2. Ahh! The joys of working frontline for the NHS. I've given up and I'm currently applying for greener pastures . Maybe you should think about it Tom. Fancy becoming a paper pusher? (There was this post for a policy maker for the LAS…..)Happy birthday!!

  3. I was always taught DRABC, but I suppose their Driving license and Railcard would be difficult to fence…Also, Happy Birthday!

  4. Tom,You make some very valid and important points and I agree entirely with your sentiments on public drunkenness and people wasting ambulance crews' time.

    However, I wonder if your job is just showing you the very worst of human nature. I also work in the frontline for the NHS and I am not nearly as demoralised or crushed as you sound in this particular post. Have you considered moving to a different area of healthcare where your skills could be put to better use?

  5. We all know the problem, but we need to talk to those who can enforce a solution. That means getting the LAS, the Met and publicans to work together in a task force to get the law changed.The suggestion is simple, that if you are brought to hospital or jailed when it is solely an alcohol induced matter, then you will be charged for the cost of the treatment/accommodation.

    It won't be long until the public realizes that a single incident can rack up costs of thousands each hour, and just how expensive it is to deal with this issue in the short term, and we haven't even touched on how much long-term damage is being done to the individual's health. After all, it is our taxes that pay for the service.

    I also think, Tom, that you are burned out, but there's no point in throwing your experience away. Get a book like 'What Colour Is Your Parachute', it's excellent in revealing how your set of skills is transferable to another occupation.

    I would also like to say that there are millions of people whose thanks and appreciation you don't hear. It is grinding to work day after day with the worst aspects of society and not feel appreciated, but you are, and with your blog you've given a voice and a face to the siren and the uniform, and you've made a positive contribution to the world. Be proud of that.

    Finally, happy birthday šŸ™‚

  6. 1) Happy Birthday!2) I know what you mean about the drinking problem. I hate it when I hear the phrase 'I had a really good time last night…I got so wasted' or variations on the theme…don't worry, there are young people out there who DO know that excessive drinking is bad for you and want to make something more of their lives than a series of drunken mishaps…

  7. I hope your birthday shift went well.Drunks are a difficult topic -as a bean counter in a previous job I would be certain that somewhere in HQ there is a ratio of staff to jobs if you had fewer drunks yopu may find there are fewer other things as well.

  8. The nearest anyone gets to dealing with the problem is to organise bike rides to highlight and raise awareness of the problem. Totally ineffective as those who get drunk and already aware of what will happen to them, they're just ignoring it. Really it all comes down to them trying to prove they are worthy of being one of the herdWhat we need is one piece of legislation whereby drunks have to pay for the medical treatment they receive and have it docked from their income before they see it.

  9. I've been reading your blogs and your books for some years now. I'm grateful that you've written all you have – it is entertaining, witty, poignant and – for many reasons – important.You have also pushed the boundaries of workplace blogging – eschewing anonymity after a while – and agreeing guidelines with the LAS.

    I wish I were in a similar position. As a police officer I have three choices: blog anonymously and risk career-damaging exposure; write an official blog which is so innocuous as to be worthless, or just keep quiet.

    Here though is the difficulty with your own type of 'open' blogging. You are so depressed, pissed off, angry – or a mixture of these and similar emotions at the moment – that you've ceased to be a 'critical friend' to the LAS and to your colleagues.

    I completely understand where you're coming from with this post. I recently dealt with an incident where an ambulance crew were attacked by a locally well-known chaotic alcoholic, and ended up treating his minor injuries while they themselves bled.

    The resources that such people tie up are huge. They cling tenaciously to life even while they poison and abuse themselves.

    When they do die there is often suspension, stress and suspicion for the police, ambulance or hospital team with the ill-luck to be 'holding the parcel' when the music stops.

    Also, as a result of legislation and policy, we have a situation where club and pub owners rake in the cash from packed establishments which sell spirits to teenagers for pennies – leaving the pieces to be picked up by emergency and health service workers whose shifts have lengthened into the night and become busier than ever this last decade. All paid for from our council and income tax.

    You suffer the results of a system that means you dash to jobs you've been called to by the savvy, the lazy and the thoughtless – while uncomplaining elderly people who don't want to make a fuss lie on the floor for hours.

    Similarly, the police have to meet the new Policing Pledge target of getting to someone quicker if they're 'upset', producing an exactly parallel situation to yours – with those who shout loudest, literally, going to the front of the queue.

    But no matter how frustrating, how infuriating, how stupid all of this is – beating people up can never be a solution.

    OK, I know what you've written is hyperbole, magical realism, exaggeration – or some other literary device. But that's not how it will read to your managers, nor to the public – who won't see it in context. They won't take into account the fact that you've long-used your supposed misanthropy in this darkly humourous way.

    But do you *really* think that arbitrary state-sanctioned beatings would make this country a better place? I don't. There's a lot we need to change – but that is definitely not the way to do it.

    And you know that though frustrating and dangerous, alcholics are ill – and that any one of us could end up in that position.

    Old John above says it far more succinctly. You need to call it a day for a bit. You must know that yourself, and I almost wonder if you're trying to precipitate a crisis with your bosses.

    The job you're doing is damaging you, and you've got to change that. Soon.

  10. I left the Anything Service and started my new job six weeks ago. Best decision I've made since I packed in smoking!Got to the stage I had nothing but contempt for Joe Public. Used to fantasise about smothering piss heads to death in the back of the van. Would happily sit around the corner while some urban warrior bled to death or choked on his own innit.

    The great unwashed are just not worth the grief. Sure there was the odd 'proper job' or deserving case, but not enough to make it worth risking my own safety for. I used to be proud to say I was an Ambulanceman. I'm now proud to say I've left all that shit behind.

    I am much happier and much nicer to be around. Seriously Tom, fuck 'em. Let some mad keen ECA or unibod wipe their arses 'til they've had enough.

    Get out mate. There are far more worthy and satisfying jobs out there.

    Happy Birthday, make it the First Day of your new life.

  11. Perhaps I should have put a disclaimer…Of course I don't think that state sponsored beatings are a good idea. The post was hyperbole, with the exception of the last bit – where I suggest that drunken abusers of the NHS get a fixed penalty fine.

    I suspect that most of the people who read this blog will realise that I don't *actually* think that beating people up is a good idea.

    If they don't understand that then I would hope that they stop reading any form of media more challenging than a tabloid newspaper.

    (I've never agreed guidelines with the LAS – I just write and hope for the best…)

  12. I've been burnt out in the past – this isn't it.This is just a bad few days, depression and nightshifts all building up. I know that I'll be feeling better in the near future.

    If I *were* getting burnt out, I'd be out of this job like a shot – before I did something that would get me the sack.

  13. Hey Rory,I can understand why you'd underestimate the intelligence of the general public but please don't underestimate the intelligence of Tom's followers. Tom is obviously (and understandably) tired and pissed off at the moment – this too will pass. The best we can do is support him and all the other guys out there doing a fantastic though too often thankless job in our public services – I salute you all.

    Happy belated birthday Tom x.

  14. Every single “ambulance” person in the country reading this, knew exactly what you meant Tom, we all say it every single weekend night shift (although “weekend” is becoming Thursday to Tuesday and its not just night shifts its days too) an extension to your thought would be a few extra boxes on the paper work, one tick from the crew and we know that the crew thought the patient did require an ambulance, another by the nurse re-enforces that and finally one from the doc shows us that yes indeed the patient wasn't wasting everyones time and money and did require an ambulance and a visit to A&E. no ticks and you pay for the ride and treatment…. obviously it needs a little tweeking, but the idea i feel might work in some form

  15. Nah, not me mate! I Meant it. Fuck 'em! you're better off out of it. And I would gladly volunteer to administer beatings to many scrotes and ner-do-well's of my past aquaintance.The job's had it. Get out while you're still relatively sane and physically fit.

  16. Belated Happy Birthday!I attend a festival and do some security work for them (Mostly-“Which one is your tent mate?..Are you reeeeeally sure it's this one?..That bloke inside disagrees, let's try over here…”)

    Anyway, our lovely first aiders are issued with guidelines stating that the must “First, ensure the casualty is injured…” .

    For some reason their requests for steel toe capped boots to do the ensuring with keep getting turned down.

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