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Ambulances & Programming

The Ones We Remember

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Content note: trauma, graphic description

“What’s the worst call you’ve ever had?”

Don’t be that person. I’ll give you one of my pre-prepared Funny Calls™, and then be very wary of ever talking to you about my job again. The honest answer is the one that’ll leave you wondering if I’ve lost my mind and all sense of normality, and how I’m still doing the job. It’s the same for everyone in the emergency services.

I keep a little blue notebook in the bag that goes to work with me. In the notebook are all the calls I’ll remember (identifying details removed, of course) for whatever reason — the funny, the weird, the complicated, the sad, the traumatic. I can’t recall every single call in there off the top of my head, but that’s why the book exists — reading an entry in there immediately brings to mind in technicolour detail the call it’s talking about. Who was the caller? Who was the patient? How did they come across — were they scared, sad, excited, bored? What happened? Why? What did I do?

Did I help?


Absolut-ly Ridiculous

There are the funny calls, of course. When I was just a few weeks into taking calls on my own, I had one come through as an elderly gent in a care home with a head injury. “Okay, so tell me how that happened.” At this point, I’m fully expecting the staff there to say he’s fallen — that’s what the vast majority of these calls are, to be fair — but no. The gent in the room next door to his was apparently not the easiest to live next door to, so in true 1800’s style my patient had challenged his neighbour to a duel… with their walking sticks. And lost.

Even before that, on my sign-off shift, I had a Russian man call me, who I could’ve sworn was a paid shill for Absolut vodka. “What’s the reason you need an emergency ambulance, sir?” “I have pain! Vodka! Absolut vodka!” I… see.

The Good, The Bad, The Ugly

Then there are the abusive calls. I’m in the minority of call handlers who love dealing with abusive callers. They go one of two ways: either you calm the caller down and convince them that you are, actually, there to help — or there’s no convincing them and your professionalism and politeness only annoys them more until they hang up on you.

Most abuse directed at us is unintentional. Folks calling the emergency services are often in a stressful situation, and depending on how you manage stress that can come out in outbursts of swearing and abuse. It’s not personal. I can usually bank on getting at least one of these calls every shift.

True abusive callers are more rare, and usually funnier because of how far-fetched some of the things that get said are. I’ve been called a “stupid old f***ker” by someone three times my age. I’ve had people who I’ve never spoken to in my life tell me they know where I live. I’ve had someone with four broken limbs and a collapsed lung threaten to come and beat me up then and there. Good luck with that, buddy.

In the end… I’ve got a direct line to the police, and you’ve just told me your address.

Getting Excitable

We do take a handful of happy calls too, which always make for a nice break from everything else we deal with. The obvious one here is new babies — delivering a baby over the phone is a nerve-wracking thing to do, but also incredibly rewarding. The first baby I delivered will always stick with me: in the middle of the pandemic when we had no spare ambulances, I got a call to a woman in labour at half past two in the morning, with not a free ambulance to be seen inside ten miles. Ten miles is an okay distance on clear, fast roads, but ten miles of big-city roads is a 20-30 minute drive, even on blue lights.

I spent 25 minutes on the phone with this family, talking them through a process that I’d never gone through in detail before, trying to come across as though I’d done it hundreds of times. The list of things that can go wrong in childbirth is right there at the bottom of the screen, constantly reminding me of how quickly this can go very badly. It almost did — the cord was wrapped around baby’s neck and we had a terrifying minute of her not breathing until we got it off. I’ve never been so relieved to hear crying.

These kinds of calls, where a baby is born before a crew arrive, are always a hot topic: some love them, some hate them, some dread getting them. Often, it seems to depend on whether you’ve had one before that’s gone well, or one that’s gone badly.

Under Arrest

Cardiac arrests are relatively easy calls to deal with in terms of instructions — get the patient on the floor and start doing chest compressions — but their presentations and situations are some of the most varied we get.

One that’s always stuck with me was a cardiac arrest caused by hypovolemic shock (low blood volume) due to a GI (gastrointestinal) bleed. The patient’s wife had found him in bed, surrounded by pools of blood, still coughing more up. She was terrified — out of her depth would be a vast understatement. It wasn’t entirely clear what had happened initially or whether there were any suspicious circumstances, so we sent the police in first. A firearms unit was the first to arrive; the UK’s firearms teams are some of the bravest officers on offer. I will never forget them walking in. The first thing said was “Fuck.” That officer couldn’t have sounded more small and scared if he’d tried. “Go and get the ambulance crew — RUN!”

The casually, callously clinical comment from our advanced paramedic team that was on the log when I looked back later was a horrible illustration of exactly what they’d walked into. In unfeeling capital letters, it said:

CONFIRMED ARREST DUE CATASTROPHIC GI BLEED. 4.5LTRS OF BLOOD ON WALLS. NO BLOOD PRESSURE. NO PULSE. CPR NOT STARTED. RECOGNITION OF LIFE EXTINCT COMPLETED.

The Worst Call

Asking what my worst call was will probably get you a funny call as an answer, or maybe a half-hearted pick of various trauma calls I remember but which weren’t that bad, really. Most of the calls we take are routine and easy to deal with, some are more unusual, and only a very few really stick with you. In other words, not every call, but any call.

“Worst” can be pretty difficult to define, and very much subject to change — your opinion of something may change, trauma can fade with time, circumstances change, and new calls come in. Certainly one of the worst calls I’ve taken was a few weeks ago, listening to a 19-year-old gurgle, cough, and choke on his own blood after being stabbed in the throat, and finally — mercifully by that point — die just as the ambulance crew pulled up.

Isn’t that a lovely image?

Written on March 9, 2021