Emergency Admissions: Memoirs of an Ambulance Driver

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We get a 999 call to a male, late twenties, with abdominal pain. The address is a council flat in a block, quite respectable, a frightened-looking elderly couple in the front room. No male, late twenties.

Edward’s their son. They tell us he’s left and gone down the pub – even though he’s barred and it’s closed. Odd. He’s an alcoholic and a frequent caller. Lots of ‘previous’ with us and the police. There’s a warrant out for his arrest – for shoplifting or something.

Wow! How bad can he be? We look at their frightened faces and hazard a guess. Then down outside the pub we find out.

He’s a wreck.

Filthy, stick-thin, with a grey pallor and sunken red eyes. Stinking of urine, vomit, sweat, you name it. Living rough and killing himself as fast as he can. Schizophrenic and alcoholic. He calls ambulances because whenever he gets sober enough to feel anything, his liver and pancreas – collapsing and inflamed through alcohol abuse – cause him agony. Then when he feels better, out of hospital he goes. It’s difficult to know what will break the cycle, except the obvious. I think of the terrified look on his mother’s gentle face.

At least he’s not violent. As we get him on the ambulance the police turn up.

—Is it him?

—Yes. Do you know him?

—Oh yes. Where’re you taking him? He normally goes to the local A&E.

—We’ll take him to our A&E. Give his usual one a rest.

—OK. We’ll come down and arrest him later.

In the ambulance he tells the policeman half-heartedly to fuck off then falls asleep – snoring and peeing himself – on the stretcher. The smell is bad. We set off. Halfway to hospital he wakes up and tries to focus.

—Who the fuck are you?

—Er, I’m the fucking ambulance man. You’re in an ambulance.

—Where are we?

—On the way to D—— A&E.

—Don’t want to fucking go there. I go to L——!

—Well we’re giving L—— a rest tonight, aren’t we?

—No!

He gets out his phone – with difficulty – and dials 999.

—I want an ambulance.

—You’re already in an ambulance! I shout, so the 999 call-taker can hear.

He continues to demand another ambulance, swearing into the phone, then hands it over.

—She wants to talk to you.

I press his phone to my ear.

—You’ve got a right twat there, the call-taker says cheerfully.

—Yes I know.

At hospital we unload him off into A&E. He lasts about two hours there, then wakes up and walks out. The police never show up.

—Bless, says Val.

He’ll probably be back at his favourite hospital tomorrow. Can’t help thinking about his frightened parents in their neat flat, blameless. How the hell did it end up as bad as this?

Anyway.

Even later. Dog-tired. But not bored. Not on this shift.

Seventy-three minutes and twenty-three seconds to go.

The last 999 call is in a dull little town acting as a dormitory for the big international airport nearby. Not much happens here. Supposedly.

We’re off out to a female – fifties – fainted in an art gallery. An art gallery? GP on scene – reports pulse very weak and irregular. Patient in and out of consciousness. The weak and irregular pulse in a woman that young is serious – could be a heart attack. We set off. Can’t help wondering why an art gallery’s open now and what a GP’s doing there.

On scene we’re led through the gallery, which is a large room with – not surprisingly – lots of pictures on the walls. There are at least fifty people in the room – all ages – the men wearing sharp suits and the women made up and wearing very low-cut dresses. Everyone’s standing around the edges of the room, holding drinks and looking rather embarrassed, saying nothing.

Looks like a racy cocktail party gone wrong.

In the middle of the room – with no one anywhere near it – is something that looks like a tan leather gymnasium pommel horse with lots of belts, buckles and straps attached to it.

What is this place?

We’re led to the patient, who’s been moved to a side room. As we enter, the woman who turns out to be the GP – also in a low-cut dress – rushes past us and out of the door without saying a word.

It’s not a heart attack, thank goodness. Davina’s a nice lady, polite, with short blonde hair. She’s wearing a black T-shirt, a black leather skirt and enormous black boots. She’s making a good recovery – pulse is coming back strong. There’s been no chest pain or shortness of breath. Her ECG, the electronic picture of the heart that we can look at, looks good.

As we assess her we see that her back and shoulders are covered with hundreds of tiny scratches and welts, as if she’s been dragged through a rose bush ten times.

Val shoots me a look. What the fuck is going on here?

The patient’s up for the night with a friend – another buxom lady in another low-cut dress.

—Has this ever happened before? Have you fainted before?

—Yes, when I’ve been running or exercising hard.

—But you’ve not been exercising hard tonight?

—Well … no.

She starts to look embarrassed and the penny finally drops.

This is an S&M club. Sadomasochism. Is that right? (Not even sure how to spell it.) Our patient is the ‘victim’ (presumably willingly), tied to the pommel horse somehow and thrashed to buggery with God knows what while everyone else looks on sipping their drinks politely. Nice. Not my cup of tea and very strange, but we’re far too polite to comment. Takes all sorts. Didn’t realise women did this sort of thing. Didn’t really realise men did it, for that matter.

I try to phrase things delicately.

—Would it be fair to say your pulse might have been a little elevated by what was going on tonight?

—Well yes. Maybe we were going at it a bit strong.

—Maybe go at it a bit less strong next time?

(You should always give patients advice on how to manage their condition.)

—Yes, I think I will. Maybe give it up altogether.

Off we go.

The hospital – like a lot of them – appears to have been designed by a child with attention deficit disorder, the architect having an epileptic fit. Departments, corridors, lifts and wards all over the place, in no order at all. To get from one side to the other you have to take two different lifts, and cross a street. You could lose an army in here.

We take the patient to A&E, and hand her over to Fatima, one of the regular triage nurses. Triage nurses are usually the first hospital person the patient sees. Most are warm and welcoming and lovely. Fatima’s … a bit different. She looks a little like Oddjob from Goldfinger. A large lady, ever so slightly menacing, she manages to look expressionless and disapproving at the same time – both of us and of the patients. (I’m sure she’s lovely really.) I explain the faint, the irregular pulse, and as delicately as I can, the S&M thrashing. It’s a bit like being a lawyer, in court defending a client before a judge. Fatima just stares, then writes unwell patient on the triage form.

All human life, as I said.

On the way out a colleague shouts cheerfully:

—Don’t use the coffee machine! One of the NFAs (no fixed abode) was taking the spoons out earlier, licking them and putting them back!

Nice. (Makes a change from drinking the alcohol gel I suppose.)

End of shift and good night.

When the going gets tough – we’re out of here.

We go back to the station – a huge, cavernous building with two sets of double doors that you drive in and out of. Ambulances come in one end and out the other, like sausages. Old and a bit dirty. Occasionally a pigeon flies in and we have to shoo it out. The station tells you a bit about the service. There are pictures on the walls of ambulances parked in formation, back in the 1970s and 80s and 90s. In the days when ambulance crews washed the ambulances, kitted them out, cleaned the station, even sat down and had a meal together. Nowadays, we’re so busy that teams of people do all that for us – we collect our ambulances at the start of the shift and we’re off out and might not see the station again until twelve or thirteen hours later. Though sometimes, on quieter nights, you can open up little cupboard rooms around the station and find old abandoned equipment and stuff in them, decades old. There’s probably a body in there somewhere. Or someone living there. Maybe a patient?

I tell one of the bosses about the shift.

He’s a very tall, thin man, slightly frightening and balding, called Len. Ex-forces, in the job a million years. A man of staring eyes and whispered words, unsmiling. Whatever bit of the forces he was in may not have been the Charm School Corps. He’s retired now. Modern ambulance officers are a little more … cuddly, I suppose. He ponders the jobs a few minutes, then gives his stock response to a lot of things.

—Stupid buggers.

—I felt sorry for them, says Val. Especially the one who’s mentally ill.

Len stares at her.

—What d’you want to feel sorry for him for? He’s a nutter.

I get home about midnight – dog-tired – as Jo’s going to bed. The kids who I left too early to see this morning are long in bed and I won’t see them tonight. I pour myself an industrial-sized whisky. There might be another after that.

Jo looks at me.

—You know you’re drinking too much, don’t you?

This is the life. Just another long, crazy shift. Ours not to reason why, ours just to bitch and moan and wonder how the hell we all ended up here. What’s the Talking Heads song? ‘Once in a Lifetime’?

And you may ask yourself:

How did I get here?