Sunday, 28 November 2010

Breathing Again

They came in their masses. Call after call, day after day, week after week, for well over a month. In that whole period I don't think I saw a single person who genuinely needed an ambulance other than a few elderly fallers. Coughs, colds, three-week old ailments that suddenly needed immediate attention at four o'clock in the morning. It was infuriating and demoralising. And to top it all off, in the midst of this lull, before the days when I only worked nights, there was the dreaded "office week". A week of shifts that runs from Monday to Friday, nine in the morning until six in the evening, just like being back in an office.

I used to despise that week. It came round every three months or so. It meant fighting the traffic on the way to work and on the way home. It meant being left with the least suitable vehicle with the least amount of equipment. It meant, more often than not, coming in, taking the ambulance to get fixed, spending hours making sure it was working, ready, stocked and cleaned, seeing one patient, and then going home. Late. It meant always, always finishing late. And it meant that after spending a day making sure that the vehicle was fixed and ready, that someone else would come in and steal it, and you'd have to go and do it all over again the following day.

All in all, it left me frustrated, angry, and burnt out. Office week had finally destroyed the enthusiasm that I'd harboured since the day I joined several years previous. It was just a straw, but the camel's back had been well and truly broken. I had never before taken a sick day when I wasn't actually sick, but I was very close. The end of office week brought, as a reward for surviving its arduous torture, a long weekend. I wasn't due back until the Tuesday morning. Monday night, I picked up the phone and called in sick. Or at least I tried to. Three times I tried, and three times I hung up the phone as soon as someone picked it up. I slept even less than my normal two or three hours that night. Tuesday morning came, I had an ambulance that worked, it was equipped, and there was even a crew mate I was pleased to see.

Although not thrilled to be at work, I was determined to fight through the lull, and go back to enjoying my job. Whatever it may throw at me.

The first call came in seconds after the clock struck seven. The call was more routine. Abdominal pain. A young man with a tummy ache. The MDT updated with more details as we approached the address. A fortnight of pain now culminating in an ambulance being called. My hopes and determination lay in ruins once again. Normally I'm exuberant to the point of irritation. Ask any of my colleagues. Nothing at work really gets me down. Patients who called for inappropriate reasons would be fodder for venom only within the confines of my brain, whilst mostly I'd be all sweetness and light to them, as though they were the most important patient I'd ever had. But now, even I had lost my positive outlook. One minor abdo pain too many, and I was completely and totally fed up and burnt out.

I sat in the front of the ambulance after we'd dropped him off, another one ticked off on the list of the multi-drop delivery van-driver that I'd turned into. As I filled in the paperwork, I wondered how much worse was it going to get. I pressed the green button to tell control we were available and ready for the next call. Barely had we pulled away from the kerb, when the MDT rang again. Just an address appeared, no details as to what was happening. Another waste of time, probably. 

Less than a minute away from the address, and the details popped up on the screen. A lady in her 50s, asthmatic, breathing difficulties. In the extra information it mentioned about the husband who was making the call was difficult to understand as he sounded distressed and that he was possibly crying. We pulled up outside the house, took out the bags of equipment, and as we stepped over the threshold into the lounge where she was lying, she took one last, deep breath, and then stopped.

There was a blur of activity. We requested an extra crew, or at least another pair of hands. We plugged the mask into the oxygen bottle and started breathing for her. We added the kit that produced a cloud of steam containing salbutamol, a drug that would hopefully help to reopen her airways. Needles in, drugs administered, and more and more oxygen pumped into her lungs. Her heart still worked on it's own, whilst her lungs went on strike, but even that wouldn't last much longer if we didn't help it by taking control of the lungs. Another ambulance arrived, making the removal and treatment just that little bit easier and smoother.

Her lungs that were initially silent now had a harsh wheezing sound, a sign that they've opened just a little. Enough for us to be able to push the vital oxygen in just that little bit easier. Once in the ambulance, we warned the hospital we were on the way and a brief outline of what was happening. Half way to hospital things changed.

She took a breath on her own.

Then, after a few long, tortuous seconds, she took another. Still not enough on her own, but a huge leap in the right direction. We kept up our assistance with her breathing, arrived at the hospital, and handed her over to the team. As we stood watching, she took more and more breaths on her own, the regularity returning, the external interventions diminishing.

"Well done, guys", the doctor who'd met us with our patient treated us to a pat on the back. "You've saved another one." Another one maybe, but the first genuine patient in well over a month.

I was beaming as I walked out the department. A patient who not only desperately needed our help, but whose life we'd actually saved. A couple of hours later when we returned to the hospital, I peeked round the door to see that she was sitting up in the bed, a chest drain in place treating a collapsed lung. Her eyes were open and she was talking to her family.  

We breathed life back into her, and gave her another chance to face the world.

She'll never know that she'd already returned the favour.


Kita said...

Do you know - I love you, your writing, your passion, your ability. Please, never stop! :-)

oneunder said...

Ummm, I like you, I don't love you but I do like you.
Actually I like your writing more than I like you.

Anonymous said...

I know that feeling.

MattG said...

Funny how is seems to go in waves isn't it? I too have had a month or so of rubbish but before that I had a week of almost all genuine jobs.
It's hard not to be out and out rude to some of the time wasters. conversations that go: "So, you've been like this for a couple of weeks have you?" "yes". "have you been to see your GP?" "No". "Have you taken any pain killers" "No". "So why has it now, at 3 in the morning, become enough of an emergency for you to call an ambulance?" "urrr, well, I don't feel well" ... a journey to hospital in frosty silence follows. Handover given, nurse rolls eyes.

Fee said...

I feel for you guys, I really do. I can't help but sympathise when the job gets you down.

As a nation, we spend huge amounts of money training paramedics, buying ambulances, stocking them with equipment and medicines, only to send you chasing around after people who need a reality check much, much more than they need an ambulance. I still don't grudge the money, because one day, it might be my life you're saving.

Michael Morse said...

Ahh...the one that makes the difference. You, not the patient. Great job!

oneunder said...

Jobs like this make it all worthwhile.

A few years ago, as a first responder, I had a call to an asthma attack. When I arrived I was met by a 6 year old boy who said "daddy's having an asthma attack" and pointed to a slumped figure in the corner.

There must be some visual cues that I am unaware of but you take one look and you know, you just know.
The patient was in cardiac arrest.

He was breathing when the ambulance arrived and talking before we got him to hospital.

Still one of my favorite jobs. But then again that is why we do this.

Green Girl said...

Well done! I've yet to feel the satisfaction of getting one back like this and knowing they will go on to live another day. You conveyed the feelings well though... and I live in hope!

Anonymous said...

Fantastically written!!