Hazel McHaffie

paramedics

Our NHS – what’s it worth?

Well, I don’t know how you feel about the proposed pay rises for NHS workers announced last week, but for me there’s an uncomfortable mismatch between the plaudits and superlatives and clapping during lockdown, and the value of the suggested tangible ‘rewards’ now. These people who save the lives of strangers, and treat our sick neighbours, and care for our children and our grannies, and keep vigil with our dying, are demoralised, exhausted, burnt-out, and now feeling undervalued.

I’ve recently shared on this blog several new publications about life on the frontline written during the pandemic, but I wanted to remind myself of the commitment and dedication health care practitioners always show, day after day, year after year, so often unseen and unsung. So, I turned to an old book on my shelves written long before anyone had ever heard of Covid-19 – A Paramedic’s Diary: Life and Death on the Streets by Stuart Gray (2007). Gray – who hails from Glasgow originally – came to the health service relatively late, having been a professional musician, dabbled in business and computers, and completed a three-year stint in the Royal Army Medical Corps, and he brings an interesting perspective to the experiences he relates.

You couldn’t get much busier than the streets of London, and I’ve often wondered how on earth service vehicles ever get to the emergencies there. London is Gray’s stamping ground, but far from lamenting traffic issues, he concentrates on the human obstacles to delivering the care he’s trained to administer: ‘ignorant  time-wasters’ he calls them, who stop him from saving other lives.

People who dial 999 …
for a broken fingernail,
or for help to wrap Christmas presents,
or to move furniture because the feng shui isn’t right,
or to be helped to their bed (because they’re vastly overweight).
You couldn’t make it up!

Then there are the hoax callers who attack or abuse the crews when they turn up, the  drunks who have to be removed from buses or out of the gutter, the drug users and any of their cronies who might be lurking in the shadows with malicious intent.

Not many of us joined this profession desperate to wade through as much drink, vomit and stupidity as we could. Most of us are here to care for people who really need it, not selfish self-harmers who go out of their way to blitz the system with their lifestyle problems.
My colleagues and I stand in the wasteland of other people’s lives and watch as they destroy themselves in a bottle.

At the other end of the scale he cares nothing for the inconvenience or danger if the call is legitimate. His commitment shines through as he describes the awesome responsibility of attending a birth, of comforting a mother with a dead baby, or dealing with someone traumatised by a miscarriage. He’s even been known to weep himself once he’s back at home re-living the emotion.

He’s moved by the poignancy of scenes of normal everyday activities like shaving or getting dressed or going shopping – activities which will now never be undertaken because the person who intended to do these things has suddenly left this world. He grieves, not only for the lives cut short by sudden medical catastrophes or accidents, but also for the relatives whose lives have been irrevocably changed in an instant.

Experience has taught him that much can go wrong with attempted suicides. He’s seen at first hand the mess of a botched job, or an incomplete death under a train or a bridge or at the end of a rope. He’s sat alongside people who’ve witnessed suicides, traumatised beyond coherent speech. And he’s all too aware of the risks to paramedics of electrocution, or crushing, or being trapped. To this day he refuses to stand near the edge of a station platform, all too aware of the possibility of being accidentally pushed (I thought I was alone in this obsession). There are enough dangers already in his job.

The hours are long, meal breaks often missed, the pay not commensurate with the tasks undertaken.

EARLIES. Shifts which start at 6.30am, or 7am. They usually present a slower start because people are not yet up and around so they aren’t trying to kill themselves by falling, crashing, running into brick walls, arguing with their drunk neighbours or mainlining speed. You get to see daylight and it’s safer than working late at night. You might even get breakfast.

These are the everyday incidents that make up the working lives of paramedics. Highs and lows, successes and failures. Sights and smells – ‘outrageous’, ‘hellish’ – that few of us could tolerate. But Gray has had his moments of high drama too. He was part of the massive emergency response to the 7 July 2005 (7/7) terrorist attack when three bombs exploded on three separate tube trains, and a bus was blown up in Tavistock Square (medical colleagues of mine were yards away from this one so it’s vivid in my memory). As fast as they could ferry critically ill patients to hospital, the paramedics were sent back out again and again to carry more casualties. ‘It felt like a war zone.’ Some were risking their own lives, alongside the police and firefighters, to get to the injured and dying deep underground.

In spite of it all, the good, the bad and the ugly, Stuart Gray loves his job.  It’s ‘almost addictive. It gets under your skin.’ It’s ‘exciting … varied … allows me the honour of walking across a stranger’s threshold and into their private lives.’

What kind of pay rise do YOU think such professionals deserve? And the nurses and doctors who continue where the paramedics leave off – dealing with the vomit, the faeces, the blood, the brain matter, the human emotion, the abuse, the violence, the massive responsibility, the guilt, the dread? What are these amazing people worth?

 

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Humble, fallible and bloggable

I must confess that I started my blog because I felt I needed
a) to make my website more active and
b) to relate to visitors more as the real everyday me.
But I’ve come to thoroughly enjoy writing it. It’s rather compulsive, actually. Getting feedback from readers has spurred me on and proved unexpectedly encouraging. Plus there’s the bonus this year, when my mind has been distracted, and time fractured by matters to do with my mother’s deteriorating health, of the therapeutic value of regular writing. Producing something is definitely better than producing nothing. The latest novel has hiccupped along; the weekly posts have demanded focus and imposed gentle but necessary deadlines.

The experience of writing my own blog has also given me a new interest in other bloggers – especially bookish ones. I’ve learned a lot from studying their entries, what appeals, what repels. You’ll find some of my personal favourites on the blogroll on my homepage (Cornflower, Dovegreyreader, Stuckinabook, top the list). I’ve been fascinated by their reviews of a wide variety of books, as well as the way they let readers into their lives. Not to mention gobsmacked by the sheer speed of their reading in the midst of busy lives, and the thoroughness of their analysis. Where do they find those 36 hour days?!

It was purely by chance though, that I discovered blogs by a paramedic had attracted sufficient interest to be converted into books. Tom Reynolds won the Medgadget Best Medical Blog and Best Literary Medical Blog for randomreality.blogware.com. I’ve been reading his books: Blood, Sweat and Tea and More Blood, More Sweat and Another Cup of Tea, on my travels this past month, and in odd moments when I needed diversion but couldn’t concentrate on my normal kind of reading. The short extracts lend themselves to those with a limited attention span; you can dip in and out without losing the thread. And these particular stories fulfill a useful function for me right now because I want to get a feel for the life of paramedics for my current book; these snippets give me a little insight.

I like the air of self-deprecation Reynolds adopts – the honest accounts of how he failed the ambulance driving test several times, how he fell for patients’ tricks and colleagues’ banter, how he froze at critical moments. And in spite of the serious nature of the work, there’s a pleasingly wry humour mixed in with the compassion. No effort is made to disguise the sheer mundanity and sameness of much of the work; the glamorous moments, the adrenaline rushes, few and far between.

But there were things about Reynolds’ writing style that irritated me, so I’ve moved on to Peter Canning’s Paramedic. At the age of thirty-six Canning left his well-paid and cushioned life as a speechwriter and top health department aide to a Connecticut Governor, to work on the city streets as a paramedic. Here’s a man who wrote for a living and it shows. But, though more fluid, the writing is delightfully unadorned too. And again there’s that light mocking tone that appeals to me. He recounts his failures more than his successes, and the effect they and his job have on his confidence and self-esteem.

I’ve been in a bad funk lately. Normally it is only on Tuesday morning when I ride into work for my first shift of the week that I feel the doubt and wonder why I am doing this, but this week the doubts last all week long. I just turned thirty-seven. I have no pension built up. I have no law degree or medical degree or business skill to fall back on. I am barely living on what I make, borrowing from savings to buy books. I will have to borrow again to get a new used car as my trusty old Plymouth has a limited future. I think if I gt married and have a kid by the time I’m forty, I will be sixty when he is twenty, seventy-seven when he is my age. That’s old. I wonder how I will be able to send him to college or help him out with pocket change. My body is stiff and sore now. What will it be like then? Will I be able to throw a baseball around with my grandson, or will I have to be led on a walker to his Little League games on day-leave from the nursing home?.’

I watch the doctors in their offices or at their workstations as they consult and hobnob with each other. There is a real class system here. The doctors are at the top, then the nurses, then us at the very bottom. I tell the nurses what I get for vital signs. They retake the vitals themselves and write them down on their pads. I tell them the story, they say thanks, then turn to the patient and ask what is the matter. They need to do it, but it makes me wonder what the point is sometimes. I might as well just pick them up, put them on the stretcher, and deliver them. I write my run forms, but they seem just like pieces of paper that will go unread.’

‘In a few days I will snap out of it. I will remember that I love this job. I will start doing challenging calls again. I’ll give nitro, Lasix, and morphine to a man in congestive cardiac failure, and it’ll chase the suffocating fluid out of his lungs, and he’ll be able to breathe, and relax, and live for a while longer. And I’ll be on scene just six minutes at a bad car wreck – I’ll get my lines, make a patch, and get the patient into the trauma room. And I will gently convince an elderly woman suffering from gangrene to leave her north end home which she loves for the medical treatment she desperately needs. And I will goof with some kids …’

Surgeon, Atul Gawande, adopts the same kind of self deprecatory tone too, in his series of books about life and experience in a busy American hospital. (I wrote about him back in July.) These are men who do a hugely valuable job, earn public trust, hold lives in their hands, but they know that they are but cogs in a larger machine, and that everybody makes mistakes. They are humble enough to acknowledge their own fallibility. As Canning says after one particularly gruelling call when everything seemed to go wrong: ‘I feel again that overwhelming burden of failure that I try to ignore for fear the sheer weight of it will crush me to the ground.’ Later that day he says, ‘I learn from every call I do. I have never done a perfect call.’

I guess I instinctively warm to people who aren’t puffed up by their own importance. And most of the people I know who have achieved great things are like that, in my experience. They don’t need to trumpet their prowess; their lives and achievements speak for them. And they’ve had the courage to learn through their mistakes.

Because, of course, very few successful people were born with a silver spoon. They’ve just not allowed failure to daunt them. I think I feel another blog coming on on that subject …

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