Friday, January 30, 2009


The house is easily identifiable. There are two police cars and a fire truck outside, the focus of all the neighbours in their front gardens and driveways. Although this focus is a shifting thing, turning inwards to chat, or shuffling about in the cold to keep warm, or looking up at the sky, or laughing and pointing at something, or simply watching, these are the eddies and swirls of a river flowing in one direction, an irresistible pull towards the open door we now walk briskly towards.

A bulky fireman burdened with equipment struggles out of the doorway before we reach it. He smiles and nods: ‘Hello, mate. All right to go in.’

A narrow hallway leads us through to the kitchen out back. I can feel a strong through-draught of cold air running along the floor, and by the afternoon light tipping in through an opened patio door ahead of us we see a policeman leaning over the figure of a man stretched out on his back on the floor. The policeman has the man’s left arm upright in both his hands. He looks our way and shouts: ‘Through here.’

My first thought is ‘What’s happened?’, but the second is even more specific: ‘Where can I stand?’ The man is lying with his legs up on a toolbox, surrounded by a large pool of blood which someone has tried to cover with kitchen cloths, towels – anything absorbent. I pick my way over to the policeman.
‘Let me take that,’ I say to him.
‘Thanks. I’m starting to cramp up.’
‘So what’s the story?’
‘He’s called Eddie. Forty-odd. His wife came home, found him like this. He’s cut his arm with a razor and by Christ there’s a lot of blood. Check the sink!’
Eddie is barely conscious, shivering beneath us, waxy, breathing hard.
There’s no room to get a trolley in; there’s barely room for us.
‘Chair please, Claire’, I say, then ask the policeman to help set some oxygen running.
‘Look on the side there,’ he says, fumbling with the strap around the back of Eddie’s head. There is a Leatherman on the kitchen counter, next to a green plastic safety razor. The blade has been torn out.
‘That’s what he used.’
‘And what’s the story about a gas leak?’
‘Yeah – he set that going, too.’
There is a boiler cover dumped on a plate rack, its white metal surface smeared with blood.

The mass of extemporary bandages around Eddie’s arm is stained through, but it’s not getting worse. When Claire comes in the with chair I get her to wrap a couple more bandages around the site just to be sure, then between us we haul Eddie up and on to the chair. He flops about, in this dreadfully emptied and unstrung state the purest measure of his weight. We hurry him out to the truck.

When he’s on the trolley, it’s a simple calculation: the time it would take for a paramedic to get here and set some fluids running, compared with a straight run to the hospital. I choose the latter.
The policeman comes to the door of the truck with his arm guiding a thin young woman who has a mobile pressed to her ear.
The policeman asks me: ‘Are you all right with Cheryl in there? Or do you want me to follow up with her in the car?’
I look at her. Her narrow face seems emptied of everything but a frown, a dark line low across the top of her eyes. She looks to the side, as if the phone is some independent, alien thing offering bizarre advice.
‘I don’t know about that,’ she says. ‘We’re going to the hospital. No, the other hospital. I can’t talk now.’ She lowers it to her side without seeming to hang up. The policeman helps her up the steps, then with a wave is gone. She sits down.
‘Is he going to be all right?’
‘He’s lost a lot of blood, but he’s still conscious, he looks strong, so I’d say he’s got every chance.’
I can hear Claire putting the ASHICE through in the cab.
‘I’ve got to ask you a few questions, Cheryl.’
‘Ready to go?’ shouts Claire through the hatch.
‘What do you want to know?’
The ambulance sways violently as we drop down off the curb, and we’re away. I check that everything’s okay with Eddie, then sit down and reach for the clipboard. Cheryl moves forward in her seat so she can take Eddie’s hand in hers. I think of the policeman, and how he had stood crouched over him, with his upper arm clamped in his hands.
I start in with the usual questions: date of birth; past medical history; allergies; GP. Cheryl is crying now, but despite her grief there is still a part of her that is able to tell me everything I need to know.
‘Sorry for asking you all this.’
‘That’s okay.’
‘Has he ever done anything like this before?’
‘No. No, I don’t think so. Maybe ten years ago. Before I knew him.’
‘How was he this morning?’
‘No suggestion he might do anything like this?’
‘So tell me exactly what happened?’
She makes a small, forward and backward rocking motion in her chair, urging the ambulance on.
‘I left for work, usual time. I was meant to be out till three but I came home early. There was a note on the door saying Keep out / gas. The chain was on the door and I couldn’t get in. I rang the police, and they broke in. We found him in the kitchen.’

She kisses his hand, touches it to her forehead, kisses it again, holds it in front of her, closes her eyes, starts in on a low, choked-up prayer, with the little red ball in the mask valve clicking up and dropping back, and the sats probe flashing, and the siren drawing and wailing and spinning away from us, flying out, falling across town like a furious, glassy blue web.


Wren said...

What a horror for that woman to come home to! My heart goes out to her, but also to her man, who must have been terribly disturbed to do something so drastic. And you, Spence -- did you go out on other calls after this one, that day? And if so, did this call affect you as you went about your job? It seems like it would take some decompression time after responding to a call like that, so fraught with tension and emotion. Yours is work, I think, that only a few people are really cut out for. Thank goodness for the rest of us that you are!

mrkester said...

good post as always

1 question..........ASHICE?

keep up the good work


stuart said...

Do you ever get to find out what happens to these people? Or is it something in the profession that's best left alone?

I can understand both sides - nice boost if what you did helped save them, but knowing every patient that you couldn't save might be an unwelcome burden.

Spence Kennedy said...

Hey Wren
It was a pretty awful situation - but I think in many ways, writing (and reading) about it is worse than actually attending it. When you pitch up to these things, you're very much in 'what needs doing' mode. The practicalities of the situation dominate your thinking, and you can remain pretty detached.

We didn't have any time off after that job - just the usual cup of coffee at A&E. But that's okay. It's only extremely severe/distressing jobs where you'd need extra time out, and those jobs are quite rare. If it's a difficult resus, for example, you get plenty of time to talk and think about it whilst your cleaning & re-stocking, so that's okay. Thanks for your comment and concern xx

Hi MrK
Thanks for the comment (and for hooking up as a 'follower').
Wikipedia has a good section on ASHICE -
(what did we do before google and wiki, eh?)

Hi Stuart
We do like to find out what happens to those more interesting calls, but it's not always possible. It very much depends on your workload / which hospitals you end up at that same shift / whether you remember to do it! The insights that you get when you f/up a pt far outweigh anything else: it's great to know the outcome!

Thanks for reading.

Carol said...

Poor bloke. Thank goodness she came home early, eh?