Please

Tomorrow, MiniRRD turns 17. Tomorrow he becomes another one of those legally able to get behind the wheel of a car. He is desperate (BOY is he desperate!!) to start driving. Mrs RRD and I have heard little else from him in the past few weeks. He's not starting just yet; he needs some cash first, but this is, even so, a special milestone in his life.

Understandably, my thoughts turn to the youngsters who thought they could drive, who drove fast to impress their friends, who couldn't say no to just one more drink before we go home, to the 17 and 18 year olds whose families now spend each and every birthday grieving for their son or daughter, and so I send a plea to you, MiniRRD:

Remember, Son, that nothing is more precious than life, and no-one is more precious to me than you, your brothers, your sister and Mrs RRD.

Remember that you are not invincible.

Remember that it only takes a second, so take a minute, just to be safe.

Remember that it might not be you who can't drive, but that there are many out there who shouldn't be on the road - watch out for them, because they won't be watching out for you.

And remember, we all love you, and want you to stay safe, always.

Have a fab birthday tomorrow.

Help!

Why is it always between 2 and 4am? Why is it always raining? Why didn't MrsRRD and I go to bed early, rather than staying up to watch ANOTHER episode of "Modern Family?" These three questions run through my head as I jump out my car and rush towards the car wreck. At least the rain is waking me up, clearing my head, and making everything crystal clear in my mind.

The car has come off the road and struck a railway siding. There is just one occupant, and she looks at me as I squeeze my way between the burly fire crew, all intent on cutting away the metal that is trapping her. She is conscious, complaining of pain in her right shoulder. At least that means we have some time - her airway is intact, and her breathing and circulation, at least for now. I am, however, concerned that the shoulder is not all that far from the chest, and so there could easily be associated lung injury, that may make itself apparent only if we watch carefully for it. The saturation probe, placed on a finger and used to measure the amount of oxygen getting into the bloodstream, is pretty useless in a cold patient, where the arteries in the peripheries are closed down. So, we'll just have to use our eyes instead. We'll watch her conscious state, her respiratory rate and her colour. Much more preferable (but it is nice to hear the reassuring "beep beep" as well.) I ask her some questions, mainly to assess her conscious level, rather than for the answers. She tells me her name is Sam, and that she doesn't remember the accident. "Where were you going?" I ask. She replies, "Just out for a drive." Hmm, a bit late for a drive, but, there's nowt queer as folk.

She remains stable, as we prepare to lift her out of the car, along a spinal board placed behind her back. I am very careful as I hold her right arm to her side, to minimise any movement of her shoulder, but she still cries out in pain.

Out of the car, and on the ambulance trolley, she shivers from the cold, and we quickly roll her into the back of the ambulance, so that I can assess her better. I need to see her chest wall, to check for rib injuries and to ensure the movements on both sides are equal. I reach for the shears, asking half-jokingly if the jumper she is wearing is one of her favourites. Fortunately for her it isn't. I begin to cut the jumper, starting at the bottom.

Oh.

A criss-cross patchwork of scars is revealed as I expose her abdomen. All old, and none of them surgical. I glance at her left forearm - the pattern is repeated here, some newer than others. I look at Sam's face, and her eyes stare back at me, the fear and the guilt so evident. And, suddenly, it all makes sense.

I know

I know what happens to you. I've seen it. I know what you look like when you drive too fast and hit another car, or spin out of control into the central reservation. I know what happens when you get hit by a bottle, or get stabbed in the chest. I've cut you out of car wrecks, watched you fall from a second floor window. I've cannulated you, I've tubed you, I've even opened your chest and held your barely-beating heart in my hand. I've saved your life, and I've watched you die. You are my patients, and while you owe your life to me, I owe mine to you.

Circle

They stand there, the three of them, holding hands, a family circle so much smaller today, because of the one who lies only a few yards away, and yet who is unreachable. They call out, beg, plead for her life to be saved, but I know, as I walk out of the resuscitation room towards them, that this is one prayer that will not be answered.

No!

3am, I am woken from troubled sleep by Control. Can I attend FarAwayPark, where a man has been sledging (at 3 am!!!???) and has hit a tree. Massive head injury, CPR in progress? My muggy brain starts doing the Math - 2-3 minutes to get up and dressed, 5 minutes to dig my car out of the ice, 3 minutes to get to the end of my icerink of a street, another 20 - 25 minutes to get to the entrance of FarAwayPark (maybe longer in this weather), and a final 3-4 minutes to get from my car to the patient, without going a over t in the snow. That all adds up to - No!

Weather Report

I'm at work in the hospital. Nice and cosy, not too much in the box. I am suturing up a thumb when my 'phone rings. Not much I can do at this stage, but I am on the last stitch, so I cut the thread and, stripping off my gloves, reach for the 'phone when it starts its insistant ringing for the second time. Can I attend a call on the M25? No probs, I leave the cleaning up to my junior and head on out to the car.

The wind hits me as I leave the relative comfort of the A&E. Blinking heck, but it's cold!! I throw on jumpsuit and boots (steel toe caps an essential for M25) and start the engine. As I speed out I depress the lever to spray windscreen wash over my front windscreen. Big mistake. I now have a thin sheet of ice barring all but the tiniest view of the road ahead. I glance at my outside thermometer gauge - -2.5 degrees centigrade! I hit the wipers and they quickly clear enough of a hole in the ice for me to start rolling.

The journey is uneventful, and I reach the scene in record time.

The car is on its side, the driver buried beneath a mound of groceries. He had clearly been shopping, and the bags had had as much of a tumble as the car rolled over and over as he had.

We are all standing around as the fire crew dig him out of loaves of bread, milk cartons and bags of pasta. He isn't badly injured, so the fire crew are taking things steady.

Only one problem - it's blinking cold out here!! We are all shuffling around, trying to keep warm, and yet he is stuck, immobilised both by the fireman at his head and the tins of peaches, the crumpets (oh how good they would be right now, toasted, with a smidge of strawberry jam!) and the root vegetables that surround him.

Eventually he is freed, and we slip him gracefully out on to a spinal board.

"Where to?" I ask the crew. The hospital isn't mine and the patient is only suffering from the cold, so I leave them to it, jump into my car and turn the heater on full blast.

Back at my A&E Department, I decide that my boots are staying on - far to cold to change in the car park.