That Word.

A lack of energy from these winter hours, night shifts and a feeling that no matter how hard I shout about things nothing is going to change has meant that I've been lacking the will to write. I keep thinking 'no-one listens', or at least nobody who has any power to change anything.*

What I should be writing about is the private ambulance companies that are being contracted to do our A&E emergency work, which is an incredibly bad idea. I should be writing about the utter tosh calls I've been going on of late. I could even be moaning about how our training day was 'postponed' because there is no-one to train us, and even if there was they have no idea how to train us, or what to train us in.

I'm sure it's just the season and that, come spring and a bit more energy, I will once more be waving my fist at the sky and shouting 'all Gods are bastards', albeit with the same effect that doing that always has**.


When I get angry I find myself doing two things. First I wave my arms around like an epileptic chicken. There is a simple reason why I do this, it's because I keep raising my hands to hit someone, but then realise that, while enjoyable, it probably wouldn't do much good. I also have worked far too long in emergency medicine to be doing anything stupid like punching a wall.

The second thing that I do is I vibrate. I get filled up with energy and start shaking – first on the inside and then as I get angry the shaking spreads to my limbs.

I also shout a lot. Well… not so much shout as 'talk loudly and firmly'.

I have a long fuse, but a huge explosion.


Why do I mention this? Well the other night I ended my shift an incredibly angry person.

We had picked up a young woman who was alternating between rolling around the floor and pretending to be unconscious. Her problem was apparently 'abdominal pain', but it turned out to be period pain.

Who am I to judge? Besides, it was nearing the end of the shift so if she wanted to go to hospital we were more than happy to take her.

We should have walked her out, but when dealing with someone suffering from Status Dramaticus it can sometimes be easier to just pop them on the carry chair and wheel them out – especially if they are light. So we did this and as we were about to load her into the ambulance she decided that she didn't want to go to hospital – so this poor flower, who moments earlier was 'unresponsive', undid the seat belt and started walking back towards the house.

I was just about to wave her goodbye when the FRU stepped in and convinced her to go to hospital. I can see the FRU's point, if our patient were to go back home and overdose on painkillers it'd be our fault.

So the patient agreed to come to hospital and I jumped into the driver seat while my crewmate did the things that we do in the back of ambulances.

We were halfway to hospital when the patient took off her seatbelt, threw herself on the floor and pretended to be unconscious again.


We got to the hospital and, expecting the patient to continue the dramatics, I went and got a wheelchair so that she wouldn't have to walk. She stepped down from the ambulance, looked at the wheelchair and, once more, threw herself on the floor. I say 'threw', what I actually mean to say is 'died like an extra in the original Star Trek or Dr. Who series'. You know, 'collapsing' without hurting yourself.

“Why did you do that?”, I asked.

“Fuck off”, she told me, then stood up and threw herself into the paediatric waiting room where she, once again, threw herself on the floor and acted like she were struggling with death itself.

There then followed a long ten minutes where myself and two nurses persuaded herself to sit her arse in the chair so we could take her around and put her on a trolley. This was accompanied by both swearing and drooling***.


I washed my hands while my crewmate booked the patient in onto the hospital system, and then went to leave.

One of the nurses then turned to me and asked me my name – I know the nurse's face but haven't really spoken to her.

“Why is that?”, I asked.

“Because she told me that you called her a nigger”, the nurse said – and the way she said it made me think that she believed the patient.


Oh yeah, the patient was black. Didn't really give it much thought until then. After all I can go days at work without seeing a patient that is to be recorded in the great UK ethnic coding database as 'White British', so different skin colours don't hugely register on me.

There are three points I would like to make at this moment in time.

1) I've marched against the BNP. Several times.

2) I don't hate people due to their race or colour or however you want to slice it. I hate everyone. Equally.

3) I may call you a moron, an idiot, a fuckwit, a wanker or an utter… well, you know. I would never use colour or nationality to insult someone – much as I hate hearing kids using 'gay' as an insult. You are what you are and you don't make that choice, so why would I insult you based on that? If I insult you, I'll insult you because of what you do.

What really riled me us was that the nurse seemed to believe the patient.


I think I said something in reply along the lines of, “Excellent – tell her to write a complaint, maybe I'll get suspended with pay, I could do with a holiday”. But inside I seethed with anger.

I phoned the on duty Station Officer for advice. He told me that I should go to the police, that I should have a cup of tea, and that there was nothing he could do about it.

What. The. Hell.

No, “Let me come down and see you and chat about it”. No, “Let me go and talk to the patient and see if we can sort things out”. No, “Don't worry, I'll take a statement from you while it is fresh in the memory”.

Nope – cup of tea and call the police if I feel that bothered about it. Oh, and the implied suggestion that I get back on the road within the next 15 minutes.

Thanks for that.


So there I was, stalking up and down the messroom before having to fill out the 'incident report' paperwork with my crewmate.

Knowing, full well, that this is the sort of thing that ends careers, after all remember, I was investigated for a complaint after I told a patient that he slaps like a bitch after he assaulted me.

Racism is, quite rightly, not tolerated in the ambulance service – but is the proof on me to prove my innocence in a 'my word against hers' complaint'? I just don't know.


As I write this I don't know if a complaint has gone in. Has this malicious liar decided to put pen to paper and complain? Or pick up a phone and ring our 'patient experience' line? I just don't know.

What I do know is that I found it very hard to sleep for the next two nights – not so much because of a fear of losing my job, but because I've put a lot into this job and the people who live where I work. My health is shot to shit because of the rota I work and the patient lifting I have to do. My social life is pretty much non-existant because of those shifts.

And yet – one of the people who I serve, and yes, it is serve, called me one of the things that I hate the most – a racist.

And she did it without thinking, as an easy way to try and get me into trouble.


My thanks are due to my station mates who were there that morning, firstly for giving me advice about what to do next, and secondly for making fun of me by suggesting that it was obvious that I'd soon be wearing a white hood while erecting burning crosses across East London…


I almost forgot – the lovely Kal writes a very insightful piece on 'Race Relations' in medicine. Go and read it.


*Brought about, in part by the testimony that Tony Blair gave at the Chilcott inquiry and how he seems to avoid arrest for war crimes. That and if I performed as poorly in my job as many of the people I come into contact with there would be a lot more dead people in London.

**i.e. none whatsoever.

*** Not attractive, and a reason to be wearing gloves.

22 thoughts on “That Word.”

  1. It always amazes me, how much we are at the mercy of the patients. I'm vulnerable to verbal and physical abuse.I have to stand there and smile sweetly while I am racially abused (yes we get it every day) and my loved ones are insulted. Yet all it takes is one little complaint and I,m out.

    The first response from the LAS, if a patient complains, is to send a letter of apology. Simply to reduce any potential legal costs.

    I, on the other hand receive a letter informing me that there has been a complaint and it is being investigated. I have been through this process. As it happened with a patient that I did not see. Due to being cancelled before I arrived.

    This letter is not nice. There is an implicit threat within it.

    This job teaches you that everyone is different and needs to be judged on their individual attitude. We are nice to people who are nice to us (it makes things easier for us) and if you treat us like shit you probably will be opening doors for yourself.

    Tom, the only good thing about your story is that most of these people (complaining idiots) never bother to put pen to paper.

    You have my sympathy and I have the T-shirt.

    Too many of these jobs will destroy your career, from the inside. They leave you feeling tainted, dirty. Yet you have done nothing to initiate this type of vileness.

  2. Hi Tom,I read you a lot, but this is the first time I'm writing.

    I think it must be very difficult to constantly pour your thoughts and ideas, your hopes and fears into this blog, knowing that what you say accurately reflects your experience of what is happening in your line of work. It's easy to see that you really believe that what you are doing is important, but that very few others seem to understand the pitfalls and barriers placed in the way of you doing your job properly.

    It might feel that you are screaming and not being heard, but I can assure you that this is not the case. The way you write makes it easy for others to see your point of view and to understand aspects of your work they might never have considered.

    While I no longer live in London, I would hope I am a more respectful and informed user of ambulance services as a result of your writing. I know it's a small thing, but it is often through smalll changes that large victories are achieved.

    Don't lose heart, please. The world, and the ambulance service, needs more people like you, not a person less.

    I'll now go back to lurking and learning.

    Be well. Maybe drop into a tanning booth for some vitamin D if you can ever find the time – London is so dreary in winter.

    Best wishes,


  3. A nice idea but probably illegal. We would need to have a sign warning about this. Managers would probably see this as a bad PR thing…

  4. To be straight I doubt she will make it official. The problem with accusations (even if they are of the non-racist sort) is that management will always side with the accuser, even though there is no concrete evidence. They do this to protect their own positions and to hell with someone's career.I have a few friends who have had to resign over unsubstantiated claims, even though they have 20+ years of dispute free employment. In their cases none of the accusations were in the racist vein, but cowardly brass hats protected their asses by taking the easy route.As per usual, feces always sides with gravity.

  5. In one of Bob Dylan's songs there's a line: “And remember when you're out there, trying to heal the sick, that you must always first forgive them.”It was only later that I really got it because I don't deal with the sick very much.

    Those of you who do, I don't know how you find it in you to deal with that part of it.

    And then, on top of that, comes management, which is even worse….

  6. Tuck a voice activated digital recorder amongst your kit and always have it on. Perhaps one of the ones that is also a functional wrist watch and has enough memory to last a shift.I had a situation a few years ago where I went into a company to sort a few problems out. In doing my background research, I realised one of the female middle managers was a serial sexual harassment complainant. Further quiet investigation revealed the complaints were always against male managers who put pressure on her to actually do her job and that her female staff saw her as a vicious bully.

    Forewarned is forearmed and I took a number of steps. A few months after I started, she requested a meeting about something trivial. It was quite straightforward but there was a certain edgy anticipation on her side.

    A few hours later I was summoned on to my boss's office where he, the MD and the female manager were waiting. I patiently stood through a harangue from my boss and the MD about my “letting the side down”, “this will have to go to a formal complaint unless you're prepared to…” and so on.

    When they'd talked themselves out, I simply said “you might like to listen to this”, pulled out a pen recorder and started playing backing a recording of the meeting. I'd been careful to establish the date and time of the meeting through careful conversation about the day's events, and it was clear I had the whole meeting on tape.

    I could feel the female manager writhing in her seat just behind me, where a few minutes before she'd been sitting triumphant.

    All I got from the senior managers was a “yes, well, er, perhaps you've got something to be going on with”.

    Nothing further was said to me about the incident, but the female manager left within a couple of days. As for the senior management, I didn't expect any more from them as I never trusted or relied on them in the first place. (And I had further back up in place, too, but it wasn't needed.)

    When you're dealing with attention seekers, bullies and liars you have to protect yourself and your colleagues. Few other people will.

    Look after yourself.

  7. Just when did the lunatics take over the asylum? I spent 2 hours the other day being lectured to by NON-CLINICIANS about how to keep clinical records, like I don't sodding well know how to after 20 some years as a nurse. I heard the usual tosh about the need for continuity of care blah, blah…bottom line, as I pointed out to their great upset, is to write shedloads of pointless crap to keep my backside from hanging out in court. There was a time when if you were in uniform you were treated with at least a modicum of respect for what you did ,if not for you as a person. Somewhere the backbone went out of management, fear set in and the poor bloody footsoldiers got hung out to dry with zip all support from the top. Zero tolerance of that kind of behaviour is the only answer. Any help from your union? They're not much cop in the NHS but sometimes all we've got on our side. Shame on the nurse in A & E for her attitude, personally I would never take the word of a punter over that of a crew but hey I was one of the good guys in A & E! You know you care too much don't you Tom?But if you cared any less you wouldn't be the person you are, not much in the way of consolation for sleepless nights and your own shot health.Thinking of you

  8. (OT. London is so dreary in winter. God, yes. The couple of winters I was there, I think the only thing that pulled me through was the once-a-month RHS garden shows in Vincent Square. You'd step through the door, the whole place lit up like sunlight, primulas and orchids and crocuses and everything. You could feel your mind just drinking it in.)

  9. Hi.Well, I'm not really sure if this is good advice, but I was quite shocked at reading this post and I thought about it the whole evening.

    First, I think that you should write down a statement and ask your colleagues who were with you to do the same while this episode is still fresh in your memory. Just in case, you know. After all, if management tries to sack or punish you for something that hasn't been proved “beyond reasonable doubt”, can't you appeal in court?

    Second, you should get statements on your general attitude towards racism (from people that were with you marching against bnp, from colleagues who witnessed specific situations in which you had to deal with patients with different national backgrounds, ethnicities, etc, and so on). This would strengthen that “reasonable doubt”, if needed.

    Third, if this actually gets official you shold press charges against the patient for diffamation.

    Fourth, while pressing charges, you should contact anti-racism associations explaining to them what happened, showing them all the statements you collected (including, if possible, statements from some colleague of yours with a different ethnicity or national background than yours), and you should ask for their support, asking them to press charges as well. You should base this claim of the (true) principle that people like that patient, who use false allegations of racism only to harass people who try to help, damage the anti-racist cause as much as they damage you.

    I was going to say that I hope this helps somehow… but the truth is that I hope that no help at all will be needed, and that this whole thing just won't have any consequences at all.

  10. There's all sorts of gadgets to record video with sound. ranging from wristwatches, ties and other wondrous items that can be secreted as buttons. If only these had been available 15 years ago, I could have made a fortune from suing certain companies.

  11. Some years ago, my brother who worked for the University of Kent was the victim of a wholly inaccurate complaint by a disgruntled student who alleged that he was a racist.My brother, a former Scots Guardsman was mortified. The University immediately launched an enquiry, and my brother subjected to extreme scrutiny about his alleged misconduct. The fact that CCTV footage exonerated, him, that he was jewish and in a commited relationship with his Asian girlfriend did little to appease the over-active determination by the University to 'root out' racism.

    The cost to my brother! An anxious wait as the cumbersome and expensive investigation took its course. The cost to the vexatious complainent. Nothing.

    Why bother?

  12. My two-pennorth. Who had the witnesses? You or her?If no witnesses, it's your word against hers.

    Agreed, LAS management tend to take the complainants word over ours, but WHERE'S HER PROOF??

    As someone else said above, she probably won't follow it through. Liars have to have incredibly good memories, and I doubt hers is that good.

  13. Hi “Tom”,As someone who has read your blog for a while now I thought I'd add a little to the discussion (apologies to those who might read something very similar on another ambulance blog I read).

    I share your annoyance at the time wasters , the drunks , the selfish , the unworthy of help who abuse both those that work in the 999 system and those who genuinely need it.

    I'd just like to remind you and your colleagues why you actually do it.

    This past Friday evening as a family we were all heading to the family home to celebrate my fathers birthday. Well past retirement age he was looking forward to that rare occurrence – the whole family back home under one roof. Probably happens once a year. My sister and nephew were already with my parents. My brother at home down the road having a couple of drinks after long week on call as an A&E consultant. I was in Brum breaking my journey up from the smoke before meeting up on the Saturday morning.

    When my parents went to bed they weren't to know that this would be the last birthday for my father. Around midnight he suffered a major CVA – stroke or MI – who cares now. Despite the best efforts of my sister and nephew and the FRU and ambulance crew attending he died that night.

    The experience , the professionalism , the sheer compassion of the emergency team attending brought so much comfort to my family in the most dreaded of moments.

    A gentle and respectful remember what you and your colleagues mean to some people next time you have a bad shift……

  14. Best defense is to attack> otherwise this device is up your computer alley it takes is one oh! Shite to destroy all your attaboys.Good luck and get some vitamin D and some 5500 deg. cel lights.

  15. Almost certainly illegal, plus a risk to patient confidentiality.To be honest the *vast* majority of our patient's are fine and lovely people – it just needs one or two to ruin your day.

  16. why oh why are we always living on the 'oh my god I hope they don't complain' notion when we have done nothing wrong!!!!

  17. Don't worry – it's not illegal. Just not admissable in court. I think for the purposes of this situation it was a very sensible course of action!

  18. I think this is something all of us in uniform face on a daily basis. I'm a PC in the met and I don't think I've had a single day when someone hasn't accused me of being a racist. I know, for us, it comes with the blue of the uniform but I do quite enjoy the following usual conversation:Citizen: You're a f**king racist, you are.

    Me: Why do you say that?

    Citizen: Because you all are.

    Me: So you're making sweeping assumptions based on my initial outward appearence, are you?

    Citizen: er, no. Just that you coppers, well – you white coppers are all racist.

    Me: So it's your assumption that because I'm white, I'm a racist?

    Citizen: er, yes.

    Me: So you're making an unjustified and un-evidenced accusation based on my membership of an ethnic group entirely beyond my control? That makes you a racist, doesn't it?


    I don't know if you agree, but I tend to find that the most outspoken accusers of racism are the most biggotted and closed-minded of all. And there's nothing we can do or say to change it. Modern society is obsessed with being a victim of things beyond their control. It's all about blame and jealousy. “If I can't have it, then no-one should be allowed it. Why hasn't anyone given it to me?”

    I enjoy your blog and the books very much indeed! I think the thing to remember is that the vast majority of people want us around. Unfortunately, that's not the demographic we tend to work amongst! Ah well – makes for much better stories!


  19. After the last “comment:” there was supposed to be a pause and a torrent of abuse, but it seems to have been edited out!

  20. In that case you made the mistake of writing what a lot of us feel to be correct. We work, predominantly, with the bottom end of our society.

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