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True Stories of my Life as a Paramedic
By Lysa Walder, Jacky Hyams
John Blake Publishing LtdCopyright © 2011 Lysa Walder and Jacky Hyams
All rights reserved.
A heroin overdose usually comes through to us as 'young male collapsed' or 'difficulty breathing' – an overdose will stop you breathing. But when someone dials 999 to report such an incident, they're unlikely to want to flag up the truth. If they're heroin users, their main concern is not alerting the police.
Addicts buying heroin sold on the street don't really know the purity of what they're buying. It could be cut with other stuff. Or they might get the dose wrong. Seconds after injecting what they think is the right dose into their vein, they turn grey-purple. Their breathing stops. And that leads the heart to stop through lack of oxygen.
There are times when a heroin overdose can be a very quick end. But in some cases the person's breathing just trails off. So if we are called there in time, there's a chance we can save them. In this situation we can give them a drug we carry at all times. It's called Narcan and it reverses the effect of any narcotic-based drugs like morphine or heroin. It can actually reverse the effect of an overdose within minutes.
But amazingly to us, heroin users are not always grateful or relieved if we manage to save them from a sad end. Often, once the effect is reversed by the Narcan, they're up, alert – and angry. Their view is they've spent their money on heroin and we've gone and wiped out all the 'benefits' as far as they're concerned! Amazing, isn't it? But we don't say, 'Excuse me, you were dead a minute ago and you're still worried about your drugs?' But that's really what they're thinking. Sometimes they'll just walk away from us.
This can be more dangerous than you'd think. Because the life of the heroin still in their bloodstream is longer than the life of the antidote, there's a chance they'll go into respiratory arrest again. If we can sense that they're likely to run off straight away – and you sometimes get to spot the signs – we may give them another injection of Narcan. We don't want them to collapse. For us, it's a case of making the best of a bad job. But only if they let us.
Drug addicts are occasionally verbally abusive. But over time you realise that the verbal abuse you might get from them isn't really personal. It's just aimed at whoever is doing the job. If you're female, the abuse is 'fucking blonde bitch' or 'stupid blonde cow'. If you wear glasses, you're a 'speccy git'. A bald paramedic (like my husband) is a 'bald git'. And so on. The abuse or aggression can be much worse when you're trying to help someone on crack. Heroin's a bit of a downer but there's no reasoning with someone on crack. You're wasting your time.
Tonight I'm called out with my husband Steve to a familiar address. It's a rundown bed-and-breakfast, a hideously depressing building, tatty, seedy, hasn't been decorated or touched for years. At the front desk there's a scruffy, unshaven, unkempt individual with a fag clamped firmly to his lips resembling Onslow, the slob played by Geoffrey Hughes in Keeping Up Appearances. The whole place reeks of tobacco, stale sweat – and despair.
'Have you got a room for two weeks in August?' quips Steve, deploying gallows humour: we know we're probably going to need it. The call's come through as 'breathing difficulties' – but we're pretty sure someone's overdosed on heroin.
'I've never been called out to this place for anything else,' I remark to Steve as we follow Onslow down the shabby corridor to a squalid room. It reeks overwhelmingly of cannabis.
Sitting by the window is a 20-something man slumped in a chair. He's not a pretty sight. His skin is mottled, purple. A crust of dried vomit is covering his face and chest. Three other people, two men and a girl, are just standing there blankly, no flicker of any kind of emotion from anyone. They're completely spaced out.
One of the men gestures to the chair. 'He's not very well,' he says in a matter-of-fact way. 'We had to resuscitate him.'
'When did he last talk to you?' I ask, putting down my bag.
'Oh, just a few minutes ago.'
Steve and I start to move the man from the chair to the floor so that we can get going on resuscitating him. But it's impossible to move him. He's as stiff as a board. It's almost as if he's moulded to the chair. Now I'm confused. Stiff means rigor mortis, when all the muscles in the body become stiff and inflexible. It's a good indication of death, because you find it happening in the body in the first two hours after death – and after about 8–12 hours the body becomes completely stiff. So this man's been dead for hours. Not minutes.
'Are you completely sure he was talking to you a few minutes back?' says Steve.
'Yeah, he was movin' around an' everything.'
As paramedics, Steve and I know there's no way in the world that this is true. The man is very, very dead. And he has probably been so for some time.
Now another paramedic turns up, ready to help us. But I stop him. There's nothing at all we can do. Again, we try to get some sense from the trio: what happened?
This time the story takes a slightly different tack.
'Well, we were up all night 'cos we were talking. And at about 6am we noticed he'd stopped breathing. But we did resus and we got him back, we did. And then we put him in the chair. He was movin', definitely. So then we went out for a bacon butty from the cafe.'
Nice, eh? But whatever you might think of their behaviour – leaving a half-dead friend because you suddenly decide you want your breakfast – in these people's minds they actually think they did a good job. We don't believe for a minute that they really did make any attempt to revive him. What they probably did was reluctantly call 999 when they got back from the cafe. And in fact he'd been dead for hours.
The police were called but it wound up as 'a suspicious and unexpected' death and we were never asked to give evidence. Probably it was an accidental overdose. But, unluckily for him, he was using in the wrong company. They just didn't realise he was gone. But that's not unusual. A lot of people don't know a dead person if they see one.
On TV or in the movies, death is always violent, there must be blood coming from somewhere. Fictional death always has a lot of drama around it. Whereas in reality most people die fairly intact. And look quite peaceful.
Quite often you'll go to a house and someone will say, 'She's upstairs, dear. She's been very quiet.'
And very dead.CHAPTER 2
ATTACK IN THE PARK
We're in the ambulance station and I'm bored as hell. Some people like it when it's quiet. Quiet times mean sitting around, joking, watching TV, gossiping. But it's too flat for me with nothing happening. I prefer to be busy with challenges, things happening fast.
'I want a really interesting job right now,' I say to Carole. 'Something different. Haven't had one of those for ages.'
Carole looks at me as if to say, 'Are you bonkers?' She's one of the quiet life brigade.
Don't they always say, 'Be careful what you wish for'? Out of nowhere, we get what's termed 'an abandoned call'. It means someone has rung 999, given a bit of detail and just hung up: the only information is a man and a woman have been attacked in a south London park, no precise location. The police are already on their way. Can we meet them at one of the entrances?
By the time we arrive, the police have had more 999 calls from the man who has been attacked, ringing on his mobile. He's been trying to explain to the police where he is in the park, but they can't yet locate him. He keeps saying he's near the bandstand – which doesn't really help. He's told them he doesn't have a clue where his girlfriend is. The story is, they've both been attacked by a gang of black men, but the men took his girlfriend away.
The best option for us is to get to the closest park entrance to the bandstand. We get in there with our equipment and torches. Two of us, me and Carole, go with police officers into the dark and deserted park, shining our torches around. But we get nowhere: not a sign of anything. Back to the vehicle for another police update.
And now a bit more information comes through: the girl is just l6. Police have asked the man if he knows if she is still breathing – he can't confirm either way. He keeps telling them she's been beaten up and taken away.
Now it's getting quite serious. We've already lost 20 minutes looking for the girl and not only is there no trace of her, we don't know what state she's in, how bad the attack was. Then a breakthrough: one police officer has located her and directs the control room to 'the middle of the park'. She's not breathing, he says, and has no pulse. He tells control he's already doing mouth-to-mouth on her. Overhead a helicopter buzzes, joining in the search for the elusive 'gang'. A group of kids on bikes are relishing the kerfuffle.
'What's going on, who's dead?' they hassle us.
'Go home,' I tell them. 'It's very late.'
We're frustrated, to say the least. As the minutes tick by, this young girl's life could be fading away. The sooner we get to work on her, the better. Now police are directing us to a wooded area. It's virtually inaccessible: to get in we have to climb over a six-foot-high metal fence. And finally, in a clearing, we see the lone copper, desperately carrying out mouth-to-mouth resus on the girl.
He looks up at us. 'I found her like this,' he says. We tell him to keep going while we set up our equipment. Despite what the public may imagine, one thing 999 crews don't do as a rule is mouth-to-mouth, unless it's a real emergency with a baby or small child. There's a risk of contamination or infection via saliva so it's regarded as too dangerous for ambulance crews. But the policeman quite rightly wants to do something, anything, until we turn up.
Carole and I then start to use the bag and mask to try to get oxygen into her, ventilate the girl's lungs. I notice purple bruise marks on her neck and this important bit of information is instantly relayed to the police: could be attempted strangulation. Then Carole starts chest compressions on her, irritated by the helicopter whirring noisily above, shining the spotlight right on us. 'Interesting enough for you?' she snaps at the chopper. We're desperate to get the girl back. And yes, after ten minutes, with four of us working away, we get a sign of life. Her pulse comes back. And her heart is starting to beat for itself. It means there's hope at least. But she's still not breathing properly for herself, so we continue to use the bag and tube to squeeze oxygen into her lungs. Another ambulance has turned up to help us. And the fire brigade are trying to cut open the gates to the area.
While we've been working, a group of police have finally managed to locate the boyfriend elsewhere in the park. 'Do you want a quick look at him?' we're asked over the radio. We refuse. The girl is our priority. And the police say there's no obvious sign of any attack on the man. They'll get another ambulance for back-up.
Finally we get the girl out of the park and on the way to hospital. She's still got a pulse as they wheel her into intensive care. But the problem is, we spent too many crucial minutes trying to find her. So there could be brain damage – that's if she survives at all.
The hospital is swarming with police. They're trying to find the girl's family. The man has been taken to another hospital, accompanied by police officers. Already they are starting to have serious doubts about his story. For starters there are the marks on the girl's neck. And their suspicions only increase with the boyfriend's detailed description of the attackers' clothing. The fact that he could recall that they all wore Nike trainers, for instance, strikes a very odd note. The last thing anyone recalls when they're being attacked is the brand of shoes or top their attacker is wearing. And, though he claims he's been beaten up, there's not a single piece of physical evidence to back this up.
For a few days it's touch and go for the girl in intensive care. Tragically, despite everyone's best efforts, she dies, surrounded by her family, who keep a round-the-clock vigil in muted shock. Not long after, the police have enough evidence to charge the boyfriend with her murder. They've had real suspicions right from the start, but they let him continue with his story – and he keeps stringing himself up with every detail. He admits that he's taken the girl for a romantic stroll in the park – and they've had sex: he insists it was with her consent. Then, he insists, the 'gang' attacked them out of the blue.
No one knows what really went on between the pair that night in the park. But the evidence shows he strangled her. And fortunately two very brave ex-girlfriends eventually stand up in court and describe how he'd attempted to strangle them – after they'd tried to finish with him. He is subsequently convicted of murder. It looked as if this girl, too, had tried to end the relationship. But tragically she died for her wish to end it.
So at least justice has been done. And yes, this was a challenging job. I'd have preferred a happier ending.CHAPTER 3
I can hardly believe what I'm seeing. I'm in Norwood, trying to get into an old, dirty and unloved Victorian house that looks like it probably saw better days a century or so back. I struggle even to get the front door open; the owner has left the key hanging from a shoelace inside the letter box, but I have to fiddle around for ages to locate it. When Rick and I finally manage to get in, it's quite a shock. 'Squalor' just about describes it. Think Life of Grime and you've got the idea.
First there's the smell. It's overwhelming, and knocks you back as you walk in: a combination of cat's and human urine. Paint is peeling from the walls. And every single inch of floor space that the eye can see is covered with rubbish, boxes, newspapers, cereal packets, paper bags, envelopes, plastic bags, every bit of junk mail that came through the door – nothing has been thrown out of this house for decades. Someone's been living like this for years.
The kitchen would have Aggie and Kim from How Clean Is Your House? in raptures. They could do a whole series just on this one home. Every surface is thick with grime and grease, filthy plates, smelly rubbish and empty tins everywhere. Health, safety, fire hazard, you name it – this place is a rotting tip. And there are manky cats running around. Somehow they're managing to survive in all this filth.
The control room say there is a man in his 70s with chest pain and difficulty breathing. The control room warned that we'd have to let ourselves in. He's in a ground-floor bedroom, surrounded by another tidal wave of rubbish, junk and yet more paper, an old man, lying there in urine-stained, wet, filthy sheets. By the bed are a couple of dirty glasses containing some sort of liquid pond life. He's in his underpants – and very short of breath. Somehow, in all the dirt and chaos, he's struggled to get by all these years. But now illness has taken over and he's stranded in his home, adrift in a sea of grime.
'I can't breathe,' he groans at us. Rick and I manage to sit him up but there's no question: he's very poorly and needs the hospital. But it's quite difficult for us to get to him; clambering around the boxes and clutter to reach him is no easy matter. How on earth did he even manage to get around? He must have been crawling over all this stuff.
I try kneeling on the bed – and note that the urine is already seeping through my trousers – but it's impossible to stand properly on the floor, it's so thick with clutter.
'We're going to get you to hospital,' I tell him. I sound like I'm in control, but I'm not because I can see there's a real logistical problem involved in getting him out of here. There's no way this man can walk. And there's no way we could get our carrychair, a version of a wheelchair, out to the hall or the front door because the rubbish and clutter everywhere make it impossible to do this safely. So we have to call control and ask for assistance from the fire service. We manage to set up an oxygen mask to help him breathe. And then we get a bit of his story. His wife died many years ago and he hasn't been able to get out very much.
Excerpted from Rapid Response by Lysa Walder, Jacky Hyams. Copyright © 2011 Lysa Walder and Jacky Hyams. Excerpted by permission of John Blake Publishing Ltd.
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