Contemplating life.

An Insomniac’s Guide to…Professionalism

Yesterday, I went to the theatre.

Today, I did some study.

The connection? I read an article about “Becoming professional in the 21st century|. It is written that:

“Health care professionals of the 21st century cannot afford to be technically competent only; they need to be competent in social and communicative aspects of practice”.

This was said in a context of mainly communicating with the patient, but I would take it one step further: it is important for the profession; I would go as far as saying vital for an emerging profession (such as paramedicine) that members of the profession communicate and promote themselves as professionals to the public. Making a good impression (through proper treatment) on each individual patient is important, but equally important is to reach out to our “potential” clients. The public must know we take pride in our profession, study hard, work hard, can deal with a variety of situations and are becoming an integral part of healthcare, rather than just a transport adjunct to the hospital.

So, Yesterday? Yesterday, I went to the theatre to see a (possibly the worlds first) play based on a paramedic blog – namely InsomniacMedic himself. I can really recommend going if you are anywhere near London in the next few days. There are still tickets available…just go. After the play there was a Q&A session, so I asked the cast what knowledge they had of “our world” prior to having a role in this play, and then how playing a role had changed their perceptions. The answers were interesting: Most hadn’t had any contact with the ambulance service at all before and regarded the big yellow vans as part of the city landscape. One actor that had been a patient fairly recently stated that after a few panicked minutes, the attending crew managed to calm her down, make her comfortable and take her in to hospital for further treatment; she was impressed with the ‘ambulance drivers’ (followed by a palpable wince amongst the paramedics in the audience).

Only after they had been accepted for the role in the play did they start doing their research, and realise the world we work in. The lead actor said he started turning around, watching after ambulances passing him on the street. If he saw the paramedics attending the job near him, he would observe their actions from a distance (what he stated as “feeling weird, a little voyeuristic, kind of wrong but highly interesting”). Playing the roles of the different paramedics, the cast could immerse themselves in to the lives of paramedics, both professionally and personally; only then (and with the great help of the blog authors former student who was in charge of clinical oversight of the play) did they realise what our world is made up of.

I found this rather interesting, and it highlighted a point that many of us like to forget: the great majority of the public don’t know or sometimes even care about us – until they need us. If we want to improve our standing within the population, we need to have a stronger presence within the mind of the population. And that must come from each and every one of us, reaching out not only to those that are in need of our assistance, but to those who may need our assistance in the future. Everyone.

Beer, Balloons and Birthdays

On one of the first nights of my trip I met up with the InsomniacMedics (@InsomniacMedic1 and @MrsInsomniacMed) and Melph (@Melph, who works as a LAS dispatcher) for a round of drinks, hellos, welcomes and stories. Was great meeting people in person that I had been in virtual contact with for ages, putting faces to names!

I told you, don’t put the Ice Cream Van in the dryer!

The night went on, the pub got louder, the glasses emptied further, and all of a sudden I found myself being a lucky and proud new owner of a fabulous toy! A bunch of friends were exiting the place, when this girl walks up to me, enthusiastically remarks: “here, have this!” and thrusts a balloon towards me.


“A balloon?” I hear you remark nonchalantly.

‘Twas no ordinary balloon though, let me tell you! A rather large, firm, transparent balloon, with a hint of flour inside, just enough to gently dust its innards. Resting inside was a two pence coin in mint condition, also gently dusted with flour (well, we assumed it was flour). What the heck? A quick demonstration yielded results: hold balloon on the pointy edges (not that a balloon has pointy edges really, but, you know, the bits at the knotty end and opposite the knotty end). Then shake the balloon up and down vigorously – the coin will spring to life, and enthusiastically spin round the balloon, leaving little tracks in the flour. Simple things for simple minds, but we were all highly entertained. Chance had it that two minutes later the group sitting two tables down suddenly broke out in a cheery ‘Happy Birthday to you, Happy Birthday dear Kerry!’. So, in true ‘caring is sharing’ fashion, I grabbed the balloon, wandered over to their table, and asked which of the lasses is Kerry. She owned up, and I presented her with her very own “pence in a balloon” action toy. To say she was happy would be an understatement, they whole group was thrilled to bits. I live to give 🙂

(Very) short Demonstration of a slightly over enthusiastic and manic student paramedic with a balloon.

The night carried on, exchanging stories from our cities, countries and services, first trying to trump each other (“12 leads? had them for ages!” “Yeah, but we have Ketamine, ha!”), then trying to persuade each other that our service is actually worse than the others. Strange how we hoomins roll…

Another great thing that happened that night was more of preparational nature: firstly, the night shift with InsomniacMedic was sorted out (here and here, if you missed it), and secondly, I was cordially invited to meet the control room staff over a glass of water later in the week. How good that glass of water tasted is a whole different story in itself…


A night out on the town: an observer shift with InsomniacMedic (part II)

…and after a bit of thinking, the memories come flooding back to me – ‘Railway Panic’ and ‘Onion Allergy were the answers I was looking for. I won’t waste too many words on the latter – if you reckon you have an onion allergy, don’t eat onion salad. Quite simple really.

The former though was an interesting job – hyperventilation at the train station, and what a hyperventilation that was! Had never experienced it in such and extreme, even IM admitted that he placed this at the top end of his experienced hyperventilation scale. IM did the whole talking/calming/medical bit while being pawed, then grabbed, and finally hugged by the panicked patient. I diplomatically shifted out of her reach, and moved the partner out of the way to ‘get some details’, which calmed her down a little. The crew arrived, and patients partner and myself went back to the patient for the handover – only for the hyperventilation (and the hugging) to flare up again. I took said partner again to ‘get some more details’, and the situation finally got under control. Panic attack, or possibly a metabolic disorder – or something entirely different? We’ll never know. One of the downsides of working on the car; it makes following up on patients that little bit harder. All in all, an interesting job to attend though!

The next job just reaffirmed that everybody loves IM. After being hugged at the train station, the next patient (an ever so slightly inebriated feller) commented how smart he looked. Unfortunately moods change quickly, and after accusing IM of having connections with the Russian, Israeli and Polish secret police, this newly found friendship ended as abruptly as it had began just three minutes earlier.

Our last job was noteworthy too: Called to an elderly patient, feeling generally unwell over the past few days, deteriorating steadily until the family thought she really needed to be seen. Indeed she did, but more by medical people than the two police cars that came racing to the scene just as we pulled up. Why they had been dispatched? We don’t know, and neither did they. They had just been sent. They marched upstairs with us, and promptly marched back down again when it was clear that they had been sent in error.

We hadn’t though, as our patient wasn’t looking too good at all – awful colour, altered conscious state and all other little signs that send little alarm bells ringing in your head. Rapid extrication down some narrow and steep stairs, and a few minutes later the patient was on the stretcher in the ambulance, getting the full workup – only to go in to cardiac arrest. You know that extra pair of hands you always wished you had on a cardiac arrest? That was me. “You happy staying in the ambulance to do CPR?” I was already getting in to position, and seconds later, was cracking the poor patients ribs. Makes me cringe every time, horrible feeling, those first few compressions. Urgh. Again, never got the final outcome, but an interesting job to be involved in!

Spot the taxi!

Dawn was quickly approaching, and we were sent back to station for the last part of the shift – we were both tired at that stage, and my eyelids were becoming pretty droopy.

Here’s a summary of jobs we did:

  1. ?? (stood down)
  2. OD & ETOH (stood down)
  3. Fainting & ETOH (stood down)
  4. Chest Pain (stood down)
  5. Faint (stood down)
  6. Panic attack
  7. Drunk bloke with a cut to head
  8. Chest Pain
  9. Onion allergy
  10. Abdo Pain (stood down)
  11. Generally unwell turned resuscitation.


Back on station for the last hour of the shift, another similarity struck me. IM and myself both have developed the great genius of answering secret telephone calls for other people on station. The difference being that in Perth, they call you  on the defib batteries; in London, they call you on the TV remote.

– ~ –

A big thank-you for everyone I met in the LAS that night for making me feel welcome. Great chatting to you.

And of course a massive thanks to Mr InsomniacMedic for organising the shift and taking me out!

A night out on the town: an observer shift with InsomniacMedic (part I)

The tube is packed, brimming full of commuters who are heading home after a long day at work. I blend in with the masses, the only thing potentially giving me away that I haven’t spent my day at a desk is the stripe of reflective tape on my dark green uniform trousers – people probably think I am a street sweeper. The train snakes its way through the tunnels, passengers swaying gently from its sidewards movements. All doing the standard practice amongst busy public transport worldwide; people keeping to themselves, hiding in their own worlds by means of books, headphones and blank stares. All unaware that instead of coming from work, I am on my way to work. Well, not technically work, as I’m on holiday. Maybe an adventure holiday of sorts?

I’m on holiday for a reason: to relax and recover from the stressors of work, and catch up on some sleep that shift work has robbed me of. What better way to achieve all of the above by going out on a night shift in one of the biggest and busiest cities in the world? See, just my point.

Apparently it was a typical night out, with communication breakdowns being an integral part of the shift as I struggled to exchange words with patients. We were either cancelled (~54% of calls), and didn’t get to see them, or thick foreign accents and a poor grasp of the english language prohibited clear communications (~36% of calls). One the patients was in cardiac arrest (~10%), which didn’t help much either (dead people don’t tend to be too talkative anywhere in the world it seems).

But let’s start from the beginning. I met Mr InsomniacMedic (hereafter known as IM) at his his ambulance station, where he was dutifully checking his bags for the upcoming shift. We jumped right in to it, IM showing me what he carries whilst on shift, whilst I dutifully munched on a banana (he hates the things). After a brief introduction to the station, its surroundings and inhabitants in green, we were ready to go…if the car had have been there. The day shift paramedic was on a late call, and was delayed bringing the vehicle back. Too bad so sad, time for a cup of tea for IM and some answers from me: What the heck is an Ambulance Officer? I had genuinely confused the crews with my uniform and its associated emblems: Officer is a rank that designates a managerial position within the London Ambulance Service (LAS); was I some sort of manager seeing how things were working out on the road? But why is the uniform different, with all that reflective stuff…new uniforms begin introduced? Upon closer inspection: St John Ambulance Shoulder Patches – are you a volunteer? What are you doing in London, how long are you here, is it part of an exchange programme, where are you off to next, how do you like it here, how do you know IM? The last question proved to be tricky on occasion, I reverted to tactical silence and let Mr IM tell his colleagues we were either pen pals, or if they knew about the IM blog, that we were blog buddies. IM isn’t too fussed about secrecy in regards to his online precence – he just doesn’t want people to make a connection between the virtual IM and the real IM.

Educational poster at the station 🙂

The car is still not on station, but there is more to be explored. One of the Hazardous Area Response Teams (HART) are at the station too, and IM organises a quick tour with one of the HART team members. We don’t have anything similar in our service, but had read dribs and drabs about HART – so it was great to see the ins and outs of the trucks, what their area of deployment is et cetera. Basically they are their own self contained medic units wit breathing apparatus, CBRN suits, generators, Geiger counters, life jackets for water rescue, CO detectors. And bulletproof vests – the HART team are the tactical medics amongst the LAS too! Admittedly, they don’t get many call outs, and can get through night shifts without leaving the station, which makes them a great target for collegial jokes of being lazy, but – as a few paramedics point out – when the faecal matter hits the ventilator, the HART team are going to be right in the hot zone earning their money, with the rest of the service looking at them through binoculars from a safe distance. A place preferred by many.

Hart to Hart

The last bit of HART equipment had just been shown and explained to me when, by perfect timing, Mr Dayshift brings in Mr Vauxhall for another 12 hours of punishment, a.k.a. our Rapid Response Vehicle for the night had arrived. IM has been working permanent nights on the ‘car’ as it is known here for many moons now, and loves it. Initially hating the solo response and night shifts, it was the only way of managing family and work comfortably. Out of necessity came toleration, followed by appreciation of this shift pattern – nights bring out special people, roads are generally clear, and the emergency lights make  funky patterns and shadows as they bounce off the surrounding cityscape. We definitely have something in common.

IM and myself got talking about spelling errors. Seems the LAS is not immune either!

We grab the car, have a brief chat to the day shift medic who seems like a thoroughly nice but mad bloke (must be an entry requirement). This is one thing that struck me very positively in the LAS: everyone was really welcoming, chatty, and interested why I was there. Seems everyone knows at least someone in Australia, or has been there on holiday, and was super keen to compare experiences. Professional comparisons were also very interesting, comparing organisational structures, skills, meds and of course my uniform (which was well received!).

Our office for the night. And a shot of IMs leg…pure hawtness!

The car is in a bit of a state – it has seen better days. I am told (and later experience) that everybody is so busy that there is hardly time to give them vehicles a clean – but then again they do get external cleaning agencies to mop their vans which is a nice thing 🙂

IM quickly explains the interior gadgets (SatNav, radios, job screen, procedures) to me, and leaves the best to last: the gloriousness of the electronic air horn!

Yup, his boots are as polished as he claims!


As our bags were checked, off to our first standby point it was, which for memory we didn’t reach. Somebody, somewhere had dialled 999 and we had been automatically activated as the closest vehicle. We never found out who called, and why – we just got told an address to go to. No priority, no details, no name, no nothing. Bit dodgy if you ask me, sending a single paramedic to an unknown scene. Violence and knife crime is not unheard of in London, and crews tell me they frequently drive past addresses of calls like these until more details, another ambulance, or the police arrive as well. I should mention that we did ask for some details regarding this job – but whilst waiting for them, we were cancelled. Next job was similar – automatic activation, but this time we actually got some details about the job. Unfortunately the route we were sent on was blocked by a locked gate (two minds, one thought: WTF?!). Whilst finding an alternative route on the map, we were cancelled. In fact we were cancelled on the first five jobs.

Judging by my notes, further jobs included a ‘Railway Pume’ and an ‘Onion altney’. Maybe I should check my handwriting…


to be continued, stay tuned!




Moving right along from my last post, I would like to announce my way of making sure I keep sane, seeing ‘the big picture’.

I’m coming to see YOU!

Holidays are quickly approaching my republic. I thought travel would be a great way to spend my time. Plus, I thought to myself, I would try to turn as many virtual acquaintances in to meeting and seeing the real person behind all the text they write. So, dear tweeters and bloggers – if you want to know what a real Australian looks like, your out of luck. But I am able share some great insights in to Australia (yes, including the the ambulance service), and can come up with a bad joke or three if required as well (check my facebook profile as a repository for them…).

I might even bring my pet kangaroo Skippy with me, and whack a croc meat steak on the barbie, if quarantine allows…

If you’re close to any of the following cities at or around the following dates, give us a shout (comment, email, tweet or telex). My travels will be taking me to the UK first, and InsomniacMedic and I have organised a tweetup in London for the 4th May, exact location to be confirmed. I will be then travelling up to Scotland (why? why not! Kal seems to like it there), and hopefully stopping on the way somewhere, maybe Newcastle if Mister and Mrs 999 are around!

…and then I’m off to the US and Canada – again, let me know if you are around, and what date suits you best!

  • NYC: around the 17th of May
  • Toronto: around the 21st of May
  • San Francisco (hopefully with Monsieurs Schorr and Setla): around the 25th of May.

Oh, and if any of you need a hand on a shift, I’d be thrilled for a ridealong!

See you all out there under the CoEMS banner 🙂