Many times I have come so close to vomiting at work but only once have I actually ever vomited, well it was three times but all on the one occasion. I’ve never been affected by the sight of blood and gore, in fact I actually enjoy looking at it in a strange way. It’s like getting a glimpse inside the human body and I find it absolutely fascinating. What does affect me is smells and mucus, those are my two big things that I struggle to deal with, anything that offends my nose or looks gloopy in consistency.

Sam and I had been sent to a regular caller in our local area. We had been to this patient a few times before, he was a middle-aged man with learning difficulties. I’m sure he only called when he was bored or fancied a trip out of the house. He and his girlfriend, who also has learning difficulties, lived independently in one of the dirtiest homes I’d ever seen. All the soft furnishings were tarnished with old, brown stains. The floor was littered with discarded takeaway wrappers and various other items that should have been in the rubbish bin and smell was a mixture of rotting food and stale tobacco. It was a place that ambulance folk would often say “You want to wipe your feet on the way out”.

Not wanting to spend any longer in their home than was necessary, we ascertained that he was complaining of chest pain and required a trip to A&E. He didn’t look unwell at all so we weren’t concerned but you can never be too careful with chest pain and it’s not worth the risk of leaving someone at home, you will get caught out. We invited them both to gather their belongings and follow us out to the ambulance where we could record an ECG (electrocardiograph). We all got in the back of the ambulance, sat the patient and his girlfriend on the seats. Sam was “on the board” and took up his position in the attendants chair and questioned further the mans’ symptoms.

I began to get out all the necessary equipment to record his observations, I got the blood pressure cuff out and asked him to roll up his sleeve. I got close to him and began to wrap the cuff around his upper arm, his body odour was strong and unpleasant. He had a long, straggly beard that reached down to his chest, it was dirty and unkempt. My eyes clocked a few, small irregularities to his beard, within a split second I realised they were bogies. In that same moment, I heaved, legged it outside the ambulance and vomited on the grass. I took a few moments to catch my breath and breathe in a few deep inhalations of fresh air, composed myself and re-entered the ambulance.

They all seemed oblivious to my leaving, I attempted again to take his blood pressure, this time trying my hardest to avoid eye contact with the beard, but I kept thinking about it, I managed to fasten the blood pressure cuff and press the button to start the recording before legging it for a second time out the back door of the ambulance where I proceeded to vomit again. I was dreading what was to come, the ECG, where I’d have to ask him to lift his shirt so I could apply the dots to his chest. It was difficult, I battled with my mind to think about something else, something nice, but halfway through applying I made my final retreat outside the ambulance to let out my third vomit. Sam of course found it hilarious, I did too, once I had fully recovered from the struggle against my own physical and mental adverse reaction to the sight and smell of this man. He and his girlfriend had no clue what I was doing, they were too wrapped up in trying to get their story straight regarding this “chest pain” he was having.

Other times I have been close to vomiting include seeing a mans long and matted hair with flies flying all around his head, a woman whose toilet had broken long before and she had taken to excrementing in her bathtub, which was now at the brim and close to overflowing and many other times when I’ve had to clean faeces, vomit and phlegm from the floor of my ambulance. But the smells were the worst, putrid, and the ambulance behaved like a funnel. Even when you were driving you weren’t safe from a bad smelling patient, with the drivers window open, the smell from the back would be sucked through to the front, right past your nose. The smell from unwashed patients would linger on your uniform, making you relive the job again and again throughout the shift, it also made you itch like crazy, I guess mentally you feel as if something is crawling on you. There have been too many occasions to recall where I’ve stripped off in my kitchen as soon as I’ve got home, put my uniform on the hottest wash and scrubbed myself stupid in the shower.

Sam and I were dispatched to a female in labour in the early hours one morning. This was the typical time to be sent to a call most ambulance personnel refer to as a “materna-taxi” job. The occurrence where two people, whom seemingly are responsible enough to raise a child, have failed in nine months to pre-plan their transport to hospital when said child makes it known that they are ready to emerge.

These jobs are extremely frustrating, I found it so difficult to disguise my anger to these people, even though I knew it was the start of a new and exciting chapter for them. They were oblivious to the fact that for me, it inevitably meant I was going to be dragged away from my “patch” to some distant hospital of their choosing as they’ve only heard bad things about the maternity unit at the hospital closest to their home, resulting in a late finish and even more sleep deprivation for the following shift. I still, after all these years can’t figure out why some people think this is normal practice to call an ambulance when you go into labour. It’s beyond me. Make your own way people or failing that, call a taxi or a relative.

Having had my little rant on the subject, there is invariably going to be the odd time when you get caught out. This was one of those occasions. The pregnant female was in her late thirties and this was her 3rd baby, clue number one, the third comes quickly! Her contractions had started 45 mins beforehand and she stated that she had no urge to push, I asked her to lay on the bed and I had a look to assess the situation. She was wearing a long nightdress without any underwear which made it easy. There was no obvious signs of bulging or crowning, she was relaxed and calm and we were less than a mile from the hospital. I made the decision to convey and we made our way out to the ambulance, her husband following behind with multiple bags and a car seat.

It was winter and there was a thick layer of snow covering the ground, we came out onto the front door step of the block of flats, I held the door open and suddenly this woman used both hands to grab me by my shoulders, we were face to face, her eyes wide and staring into mine, she said “He’s coming” and proceeded to squat, pushing me down with her. Both of us now squatting on this snow covered, concrete step, just a mere few feet from the ambulance which was parked at the kerbside closest to us, facing uphill. She let out a moooing sound, Sam was following closely behind and said “I’ll get the bed out.”

“I can feel the head, the heads out” she yelled. She had most of her weight leaning on me, I tried but I found it difficult to move or look or do anything. Sam had managed to get the trolley bed out and lowered to the ground, he was rushing to get it to us. I said “Sam, I need you now” in a calm but urgent tone. I read on his face what was going through his head “Trolleybed, baby, trolleybed, baby” as his head gestured back and forth, working out if he had time. He came to us, leaving the trolleybed to make its own way off the tail lift and down the hill with the husband clumbsily running after it, Sam went behind the woman and lifted her nightdress just in time to catch the baby before it landed on the snow.

Now, there was four us on this door step, all connected together in various ways, we slowly moved toward the ambulance in sync, Sam slightly behind with the baby in his hands, I reached in and fumbled in the rear cupboard of the ambulance and grabbed the only thing I could reach to wrap the baby in which was a large incontinence pad and handed it to Sam, he wrapped it around the baby and then tried to pass the baby through the mothers legs, which wasn’t quite working in the position we were in, so the woman still leaning her weight on me managed to swing her left leg over the top of the baby to allow us to bring him in front. The husband was making his way towards us with the trolleybed which he had retrieved from the bottom of the road.

We assisted the new mum to lay on the trolleybed and hastily got her and baby inside the ambulance and whacked the heating up to full. We instructed dad how to cut the cord and spent the short journey to hospital in disbelief about what had just happened. I congratulated mum on delivering without any pain relief, the atmosphere was fantastic, we all had massive smiles on our faces and were constantly on the verge of laughter over the ordeal. Lesson well learnt on this one, expect to be surprised.

During the course of a night shift, Big Al and I were dispatched to an address for a male in his mid twenties. His girlfriend had made the call, she was working the night shift at a local Sainsburys’, received an odd message or phone call from her boyfriend and believed that he had hurt himself. We presumed it was mental health related and arrived at the house to find that it was in complete darkness. There was no answer at the door so we requested for the police to attend to assist us.

The porch to this house must have contained around thirty or so plants, one of the police officers began searching the plant pots for a key, using only torch light made the task more challenging. The other police officer on scene didn’t seem to like this idea and went straight for the enforcer. The door banged open and the four of us tentatively entered the dark hallway. We found the light switch but it didn’t work, there was no bulb in the light fitting, a second switch turned on the upstairs light.

Feeling nervously excited, I started to go up the stairs, Big Al and the police officers began to search the downstairs. At the top of the stairs, on my right, was a door that was open just a crack, the room was dark inside, as I slowly opened the door, the light from the hallway shone in and illuminated a figure laying in a double bed. “He’s here” I shouted and was hurriedly joined by Big Al and the two officers.

The man in the bed was topless, the duvet pulled up to his chest. His face was deathly white, eyes closed and mouth open. I remember thinking ‘He’s dead’. I walked around the bed, his right arm was dangling down over the edge. On the floor was a large puddle of congealing blood. A single, bare razor blade was laying centrally atop the puddle. I got closer to the male to assess if he was alive, avoiding stepping in the blood. I recall a very strong smell of iron, the blood smell you get when there is a lot in a closed environment. I was almost in touching distance when he suddenly woke up startled and gave me the fright of my life, as I did him.

“Oh no, not again” he said as he sat up. The laceration on his right wrist had clotted and was no longer bleeding. “What do you mean?” I asked. “This has happened before” he replied. He got out of the bed, put on a pair of jeans and t-shirt. I applied a bandage to his wrist and advised that we attend the hospital so his wound could be properly cleaned and closed. He got his things together and we made our way out to the ambulance whilst the police officers secured his front door.

In the back of the ambulance, he opened up to me about the previous incidents. When he sleeps, he tries to kill himself. He sat with this despairing look on his face and confessed that multiple times before he has awoken to discover that he has taken overdoses, cut himself and jumped out of windows. He bowed his head and said “Three years ago, I came downstairs to find I had beheaded my dog in the night, he was my best friend.” Tears streamed down his face. My first thought was how sorry I felt for this guy, my second was, no wonder his girlfriend works night shifts!

He suffered from the disorder known as Parasomnia pseudo-suicide. A condition where an overlap between the transition of REM and non-REM sleep occurs. During REM sleep the brain effectively paralyses the body so that the person doesn’t act out their dreams, this can fail to happen. During non-REM sleep the parts of the brain that control movement and spatial awareness are active but the parts responsible for reason and judgement are not, therefore the sleepwalker can have their eyes open and be physically active without any conscious thought. These parasomnia episodes can be triggered by an excess of caffeine, long standing stress and sleep deprivation, there can also be genetic factors invovled. It’s not yet undestood why sleepwalking adults can sometimes behave in a violent manor.

We conveyed him to the local hospital, he was a really likeable man, he was polite and grateful and had a sweet and kind vibe about him. I can’t imagine how he must feel, it reminded me of a real-life Freddie Kruger situation, where he plays both roles but has no control over the destructive character. I wish I knew what happened to him, I hope he got some sort of treatment or medication to stop it happening. I’ve read about cases where people have resorted to tying themselves to their bed at night to stop them hurting themselves or others.

Christmas time 2018 was a really tough time for me, I had returned to work on light duties after three months of being signed off sick. Sam had dislocated his shoulder on a job in the July, he was off work long-term whilst he awaited his operation to repair the damage and that was one of the pivotal reasons that worked in my favour in deciding to end my frontline career.

I thought about Lilian often after that day and then five months later in April 2014 Sam and I received a ‘thank you’ letter. It was in our work tray, we found it at the start of our shift. It was dated January 2014 which I thought was unfortunately typical of the service to have had it that long before we knew anything of it. Anyhow, Sam and I stood next to our trays both reading our copies and it really made me cry. It was adoringly sweet and I have treasured it ever since.

A few years later I saw Lilians’ name written on the whiteboard at the local hospital and dashed round to the cubicle number that was written. It was empty, I asked the nurse where the patient had been taken and she stated that Lilian had been taken up to the ward. I contemplated going to try and find her but again with time pressures and the watchful eye over us I decided against it, plus I had no idea how Lilian was, she might not be in any fit condition for visitors, especially one she didn’t really know.

Maybe a few weeks or a month after this, Sam and I found ourselves attending a local call in a retirement housing block and I said to Sam “This is where we picked up Lilian”. I passed a few old girls in the communal hallway and and said “Excuse me ladies, is there a woman that lives here called Lilian?” One of them replied “Oh, poor Lil, she passed away a few weeks ago in hospital”. I was gutted, annoyed at myself that I didn’t take the chance to visit her when I could have. I had envisioned this special moment of reconnecting with her and I’d blown it.

It became one of, if not the top job that I would recount to friends, family and colleagues. I loved the fact that she said “Goodbye world” at what she thought was the end, I think it shows genuine gratefulness for life. When she said “Thank you for all you’ve done” shows genuine humility and I really admired her for that. Little did I know, this wasn’t the end of my encounters with Lilian.

The story of my most treasured job begins in December 2013. Sam and I were sent to a local address for a 77 year old female with chest pain. A colleague of ours, Nathan (on the Fast Response Unit/ambulance car) was already with the patient, her name is Lilian. Sam and I entered the block of retirements flats and found our way through the corridor. Lilian was sat on a chair in her bathroom. We said hello to Nathan and he handed me a print out of the most recent ECG (Electrocardiogram). I took a look and straight away asked Sam to get the carry chair from the ambulance.

Lilian looked grey, clammy and very typically “cardiac” unwell. We needed to move fast. In the ambulance on the way to the hospital I explained to Lilian that she was having a heart attack but not to worry as we were going straight to the cardiac catheter laboratory where she would have a procedure to correct it. She explained to me that she had been under some stress recently as her 83 year old brother had fallen and broken his hip and she was having to travel a long distance by taxi to visit him. She asked if this stress could have contributed to her having a heart attack. I just shrugged my shoulders and said “I don’t know, it may have”. The journey was pleasant, despite the morning rush hour traffic. Lilian asked if the sirens she could hear was us and seemed surprised when I said “Yes”. I liked Lilian a lot and I did my best to reassure her on the way.

We used the Lifepak to deliver a defibrillating shock, I also performed a round of chest compressions. She came round slightly and was groaning. We unclipped the trolley bed and moved her onto the tail lift, Sam pressed the button to lower it to the ground. As it touched the ground Lilian went into cardiac arrest for a second time. We did the same, delivered a shock and carried out some chest compressions. This time as she started to come round, she was grabbing out with her hands, and whimpering “somebody hold my hand”, I took her hand and held it tight with my left hand and used my right hand to steer her through the hospital corridor whilst Sam pulled in front, into the lift and up to the cath lab. We stayed a short while and watched some of the procedure through a window but as always you don’t want to feel that the control room are watching you and think you’re taking the piss by hanging around unnecessarily, so we went back out to complete the paperwork and prepare the ambulance for the next job.

Sam and I became crewmates at the beginning of 2012. I had previously had two crewmates, my first being Big Al, we were together for a year in total and had a good relationship. My second crew mate was Jemma, we were together for approximately 8 months and she has a heart of gold. Sam has a reputation for being quiet and for keeping himself to himself. I had worked that one shift with him and we got on well. I was given a choice of two people to be permanently crewed with, stay at my base station with Sam or go to another station, further away from home to work with a female colleague. I did take some time to think about it but I’m so thankful I chose Sam. We are on the same level, we have similar values, morals and work ethic. I had trust in him and felt safe whenever we found ourselves in scary situations and I always knew he had my back.

I hadn’t quite realised the extent of the relationship that was involved in having a long term crewmate. It’s a bond that becomes strong, we came to rely on each other to make the shift bearable, especially in our later years. I developed an anxiousness whenever Sam was off work and I would try to take my annual leave at the same time as him. I had become dependant on him to make me feel comfortable in an environment where comfort was constantly being revoked.

The job is an endless driver of emotions, good and bad, and to share it with someone so calm and understanding has without a doubt allowed me to become a better medic. Not only have I learnt so much from Sam over the years, I’ve enjoyed the friendship that came with it. Sam has seen more emotions spill out from me than anyone else in the world. Not only emotions produced by the things we deal with at work but he’s been a strong and constant support when my personal life has been left in tatters after relationships have broken down and family bereavements have left me numb.

What became one of my favourite things about him is the expression on his face when we were with someone he liked. In a role that draws on you to despise the general public and all they stand for, all we needed was a feisty granny, a patient with Down Syndrome, a sweet child or a dog. Sam would then transform, his whole demeanour would change, he would be right there with them, on their level and offering kind, supportive words. You could see it on his face, it was like his insides had been warmed and this softness seeping out was the ultimate show of empathy. This extended to me too in a work capacity, he would always reassure me if I became concerned or paranoid that I had done something wrong, he always believed in me and my abilities even though I had so many doubts about myself.

One occasion only did we disagree and I’m blaming it on being hangry. As long as we managed to get ourselves fed and get some coffee, the stresses and perpetual thoughts of wanting to quit were that little bit quieter. It was something we talked about regularly, many times did we wish for a little accident on the road that would cause a small fracture each, somewhere important, rendering us unable to work over the summer and giving us the break we so desperately craved. Our wish did transpire but manifested itself in a different way.

The gentleman in him is natural and unspoken, Sam always took the oxygen bag, the heavy bag to carry, unless I got there first to try to even out the ratio in an attempt to appease my own guilt over the issue. It was a completely selfless act of modern day chivalry which unfortunately for him led to an incident that dislocated his shoulder and left him unable to work for a year. For this I am forever grateful, without Sam sat next to me in that ambulance I crumbled and I needed to crumble to change my life for the better.

The first day I met Sam we were put together as a crew for one shift, I remember one of the jobs we went to that day very clearly. It was to an elderly lady called Phyllis, she had fallen at home and was unable to get up. It transpired that her post was spilling out of her letterbox and her neighbours were concerned. They were outside when we arrived and gave us some background information. They said that Phyllis had lived alone for as long as they’ve known her and that she is a very private lady who never lets anyone into her home.

The house was aged and not maintained, the front garden was overgrown and the paintwork was flaking off of the door and windows. We managed to talk with Phyllis through the single glazed front window. Sam decided he would try and kick the front door open, he gave one kick and it flung wide open making a loud bang. The smell that then entered my nostrils made me run to the kerb and dry heave several times. I’d already learnt by now that I had a hard time dealing with unpleasant smells and following advice from another colleague purchased a tub of vapour rub, I kept in my pocket and I would rub a little around my nostril area every time I came across a whiff that was disagreeable. The vapour rub did not do much for me in this scenario and I actioned plan B. It was around the time that swine flu was big news and therefore the ambulance was equipped with lots of disposable face masks that would cover your nose and mouth.

Sam had already gone inside and discovered Phyllis in the front, downstairs room. This room is something I never would’ve contemplated seeing in all my years. The floor was not visible due to approximately 50 plus black sacks all tied up with god only knows what contained inside, these were surrounded by at a guess somewhere around 100 plastic milk bottles. Some were white, some were yellow and some were brown. Phyllis had been relieving herself into the bottles as her level of mobility no longer enabled her to manage the stairs to the bathroom. I cannot accurately describe the smell to you, it was putrid, it was as if all the worst smells in the world had banded together and unleashed a torrent of abuse upon my nose. The smell lingered on me for the rest of the day, it got into my hair and into the fabric of my clothes. It was one of many shifts where upon returning home, I stripped off completely in my hallway, bunged my uniform straight in the wash and jumped in the shower for a deep scrubbing.

Behind the door and pushed up against the wall was a single bed, the sheets weren’t on properly and were heavily soiled. The slats underneath had broken causing the mattress to sag in the middle, it created a v-shape that rested on the floor below. Phyllis was amongst all this and looked up at me with a big grin “Ello luv”. The face mask was not helping in the slightest so I took it off and introduced myself.

The smell was all I could think about, I was on the verge of vomiting throughout my entire time with Phyllis. I felt guilty about that and tried to hide my natural disgust because as odd as she was, I liked her. She was quirky and eccentric both in looks and personality. She had long, grey, wiry hair that looked as if it hadn’t been washed or brushed in a very long time. Her clothes were mismatched and garish, she had a wound on her left leg that had become infected causing the whole lower leg to look red raw. Phyllis tried to play it down “oh that’s alright luv”. We got her up off the floor, her long and dirty fingernails grabbing onto our arms and our uniform. She managed to hobble into the hallway, she couldn’t really put any amount of weight on that bad leg and I knew she had to go to hospital.

We had a job on our hands as Phyllis was fiercely independent and repeatedly refused when we suggested she go to the hospital. She was in denial about the current condition of her health but after spelling it out to her, that she was risking not only losing her leg but possibly her life if the infection continued without treatment, that she finally agreed. It was heart melting watching her go from being jolly and upbeat due probably to having company for the first time in ages, to watching her become insecure and embarrassed about her appearance. We gave her time and assisted her to change her clothes and get together some personal items. We used the carry chair to wheel her out to the ambulance where she flat out declined to lay on our trolley bed. I didn’t try to convince her, I knew I was already pushing my luck by getting her to this stage. I had a feeling that if we left any time for hesitation on her decision, that we may well have been wheeling her back into her home. I said to Sam, “Let’s get going and I’ll do the rest of her observations on the way”.

The other topic I had to tackle with Phyllis was the way she was living, it was clear she wasn’t coping to care for herself adequately and her home conditions were hazardous and deeply upsetting to see. I understand that we all have very varied standards but it felt so wrong to see an elderly lady sleeping on a bed that was basically split in half. I chose my words carefully, I didn’t want to offend or upset her but I knew I needed her consent to refer her to social services, so I casually suggested we get her some help at home, it would involve a visit from a lovely social worker who would discuss her needs, eg housework, personal care, meal preparation etc. She accepted the positives I sold her and agreed. It can be such a uncomfortable subject to bring up, it’s accusatory to the way someone is living, you’re basically telling them that the way they live is sub-par to the standards expected from society and it can sound so offensive and make the person feel terrible about themselves.

We had a lovely chat on the way to hospital and what was extremely adorable to watch was when she pulled out an old comb from her handbag and began to comb her hair. She asked me if her hair looked ok? And actually after the comb had been run through it several times it didn’t look too bad at all. “It looks great” I replied.

During my first mentoring period with Phil, we had a conversation about hangings, then I recall having a nightmare where Phil and myself were on a job where a man had hanged himself in a bathroom. He was confirmed dead and my dream-self was hesitant to look. Phil then encouraged me and said “You have to look, you need to learn”. Reluctantly I entered the bathroom and saw exactly what had been described to me, a rope around the neck, a swollen purple face tilted to one side and the tongue engorged and poking out of the mouth. The eyes then opened and this grotesque vision came to life, removing the rope from around his neck with both hands and bursting into laughter, him and Phil both pointing and laughing at me.

Almost eight years of frontline work passed by until I went to my first hanging. My colleagues were shocked by this as although they aren’t too common, they also aren’t too rare. It was early in the morning, Sam and I were sent to our second call of the day. The initial details came through as a 23 month old hanging “STILL HANGING”. We were less than two miles away. I was terrified and panicking on the inside, on the outside I was repeatedly saying to Sam “I don’t want to go, I don’t want to go”.

We arrived at a half-way house type place which was a mental health rehabilitation facility. We were led through an office area out to the back kitchen and to an open back door. Outside there was a concrete stairwell leading up to the back garden. At the top of the stairwell were metal railings.

He was 23 years old, not 23 months. This was a huge relief for me. He had very dark, black skin and was hanging from the railings above. His body dangling into the stairwell. It typically was winter time, not long after the New Year and it was freezing outside. He was wearing trainers, jeans and a short sleeved T-shirt, I touched his right arm, it was ice cold and stiff. His eyes were half open, his pupils were fixed and looking down at me vacantly whilst I looked up at him. He was a good looking guy with a fantastic physique but his unhealthy mind had driven him to permanent self destruction.

The atmosphere amongst the staff was sombre, they were clearly disturbed and upset despite their best efforts to remain professional. The police arrived to do the necessary tasks that are involved with an unexpected death and I helped one of the staff tape newspaper to the windows so the other residents weren’t able to see the body from the upstairs windows. He had been there since the night before.

This was hanging number one for me, the next five hangings I attended were then in quick succession over the next few months. The difference with this one was that there was nothing to be done. It was too late.

The humour in this job can be fantastic, the situations people can find themselves in from either pure stupidity or an unfortunate set of circumstances have had me crying with laughter. Working in the control room and answering the emergency calls completely leaves you at the mercy of your own imagination to visualise what’s happening at the other end of that phone. Here are some of the most amusing calls myself and my dear friend, Francesca have taken.