Hazel McHaffie

Stuart Gray

On the frontline

I wonder how you react when you hear, over and over again, tales of delays in response to 999 calls, or ambulances queued up outside A&E departments waiting hours to deliver patients, or endless waits on trolleys to be seen by a doctor. Or when you hear of healthcare staff driven to despair by their inability to do their jobs – leaving the profession; even taking their own lives.

Having been on both ends of such emergencies, as NHS professional and as patient, my heart goes out to them all.

Listening to a recording on the main BBC news last week of a nurse in a Casualty department speaking over the tannoy, advising everyone that there was currently a seven and a half hour wait to be assessed by a medical person; there were 170 patients in the department, 90 of whom were still waiting to see a doctor; and by the time she went off duty the following morning many of the folk she was speaking to would still be there, made me think of the books on my shelves written by those who rush to the aid of people in dire straits. People like London paramedic, Stuart Gray: Life and Death on the Streets. Or Tom Reynolds (aka Brian Kellett), an Emergency Medical Technician, also based in London: Blood Sweat + Tea and More Blood, More Sweat + Another Cup of Tea

Unsanitised and brutally honest, not refined by a professional scribe, these stories don’t flinch from the hard reality of life on the streets; the abuse, the time-wasters, the heartbreak, the futility. But they also share the miracles that can be wrought which save lives and mend broken people. And those troubling cases where they save the life of a seriously ill patient, only to wonder if they’ve committed them and the family to a fate worse than death. Such cases I was involved in fifty years ago haunt me personally to this day.

Dipping again into their recollections and cases was a salutary reminder of the price these people and their like pay to keep us safe, and give us a sporting chance when an emergency fells us.

Reading again about their emotional connection with those they meet and care for, their fury with those who prevent them doing what they do best, took me a little way into the lives of those who are currently facing the worst conditions our NHS has known, the frustrations, the impotence that they must endure because the system is broken. Both these authors were at some point Fast Responders who go out alone in cars to the sickest patients, and their descriptions of waiting, waiting, waiting for an ambulance to arrive vividly capture the practical consequences of inadequate provision.

It’s only a matter of time before I have someone die in front of me while waiting for an ambulance.

And as if all that were not enough, carrying the burden of having complaints made against them, an occupational hazard with which they are all too familiar.

When these books were written (2007-2009) somewhere in the region of 4000 calls over 24 hours were received in their jurisdictions (more during a heatwave or a bank holiday weekend); around ten ambulance crews were assaulted each night. What?! Blows the mind, doesn’t it?

Whilst the writing of these books might not inspire me, the men behind it do. I would want people just like them to come to my aid if I were in trouble. Simply caring, genuinely caring, makes the world a better place. A massive thank you to them all.



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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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