Emergency Admissions: Memoirs of an Ambulance Driver. Kit Wharton

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СКАЧАТЬ basically, if it walks like a duck and talks like a duck …

      The doctors can give drugs that break up the clot, or even stick a tube into his veins to suck the thing out, but at the moment it’s close to killing him.

      So off to the hospital we go with lights and sirens flashing. Val’s driving.

      On the way in I do my best to reassure him, which isn’t difficult. He seems quite calm and sensible. I can’t imagine that I would be, in his situation. The spray has taken away some of the pain and he can breathe better, and I think he’s gone into crisis mode – he knows exactly what’s going on, and is almost waiting to find out what’s going to happen. (I suppose it’s not much fun having a heart attack, but probably the last thing you’d call it is boring.)

      Anyway, all the way in I monitor him on the ECG and keep him talking. The ST elevation is getting bigger and bigger and the heart rhythm is becoming faster and more irregular as the heart is being damaged and becoming distressed, but he’s still with us. It’s only a three-minute drive in, and we’ve phoned ahead so they know we’re coming.

      We arrive at the hospital and wheel him into the resus bay (where the really ill people go), where a doctor and nurse are waiting to receive him. They both settle down either side of him, trying to get a needle into one of his veins to draw off blood and to give drugs. One’s concentrating on his left arm, the other on the right. His veins are proving difficult, so for several minutes neither of them is looking at or talking to him, and this is when a strange thing happens.

      In order to explain I need to go into a bit of detail. Apologies for the ignorance of what follows. Normal healthy hearts – as I understand it – generally don’t just stop. They don’t usually go from beating happily one second to stopped the next, except in the very old. They usually, or at least often, go from a normal heart beat into one of two rhythms: ventricular tachycardia, or more commonly ventricular fibrillation. With the first the heart’s going so fast no blood gets in, so none can get pumped round the body (so you die) and with the second the heart starts jerking away in an uncoordinated fashion. Same result. Either way you’re dead. Only once you’re good and dead some time will the heart slow down and actually stop.

      So often with people who’ve just ‘died’ there’s a period where their heart is doing one of the two things above. This is why people are given electric shocks. The shock will stop the heart doing either of these things above, and hopefully it will settle back to a normal rhythm.

      Hey presto.

      You were dead, now you’re alive.

      But if you haven’t got a machine handy for giving electric shocks, a big fat punch in the chest can also do the trick. It’s called a precordial thump. The effect is the same.

      What I have invented (I think) is the precordial conversation.

      Back in the resus room, the doctor and nurse are still busy trying to get needles in the patient’s arms, while I’m watching the monitor. The patient’s awake, but then goes even greyer and his head slumps to one side and his eyes close. I can see on the monitor that his heart rhythm is breaking up into ventricular fibrillation. This is the point at which he’s technically dying, I suppose.

      So I shout at him. Very loudly.

      Something like what’s your wife’s name? He appears to wake up, shakes his head slightly, and tells me the answer. The rhythm on the monitor settles back down again.

      Then a minute later, the same thing happens. He goes grey, his head slumps to one side, and the rhythm on the monitor breaks up. Dead again.

      I shout at him again. Are you comfortable? Or something.

      He shakes his head, wakes up, and the rhythm settles down.

      Val’s cleaning the stretcher. She can’t see his face or the monitor. She gives me one of her looks. What the fuck is wrong with you?

      I wonder how long we can go on like this.

      —What’s your favourite colour?

      —Who’s going to win the FA Cup?

      —Do you like ice cream?

      The answer’s probably not long, but it definitely seems to work a couple of times before the doctors and nurses finish what they’re doing and they can start shouting at him and keeping him busy and not dying. So we say goodbye and wish him luck and walk out of resus and into medical history, having invented the precordial conversation.

      Like I said. Maybe.

      Part of the reason I failed in journalism was I was terrible at job interviews. At one I saw the news editor of a major Sunday paper on a hot August day. I began to sweat so heavily rivers were running down my face. The editor looked concerned, as if I might have malaria, and asked if I was all right. Another time I went for a job with a big charity. My research was going to the library to look them up and find out they were the largest pressure group in the UK. One of the panel was an enormously fat woman.

      —What do you know about us?

      —I know you’re a pressure group.

      —What else?

      —You’re large, I said. Very large.

      Silence.

      Shit.

      Even with a bit of experience, in this job, it’s very easy to say the wrong thing. It’s called foot-in-mouth disease. Val’s often very helpful in pointing it out to me.

      Val

      When I joined the service there was a strict progression of experience before they let you loose on an emergency ambulance. (There still is.) First you did patient-transport work, ferrying people in and out of hospital for booked appointments. Then if you wanted to move to A&E you had to do a two-month course to become a trainee ambulance technician. You worked as a TAT for a year, always with someone more experienced. Then you had a two-day assessment to see what you were like, hopefully followed by qualification. After that you were let loose – allowed to work with someone who was less experienced than you.

      You are in charge.

      The first day of doing this – I’d been in the service about three years – was frightening. My first day in charge was a while ago now, with a trainee – Valerie. We had dead bodies both ends of the shift, my blood pressure went through the roof, but I think we got away with it.

      Val’s a bit like me, falling into the service after various jobs – airline stewardess, office worker – hating them all. I think she worked in a zoo once, which she quite liked. I bet that was good training for the job.

      Val and I stayed together after this, as regular crewmates, for a while. You learn to depend on each other. You end up knowing the other’s opinion on everything from Islamic fundamentalism to emulsion paint. Having a good solid crewmate’s like having a good left leg. It’s difficult without it.

      Monica and Gordon

      Midnight.

      We’re called to a female, twenties, in labour, childbirth imminent. This is not an unusual type of call, СКАЧАТЬ