Hazel McHaffie

Tom Reynolds

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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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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