Sudden Death x2

He lies there, the driving rain beating down on his upturned face. I look at him and know, without a doubt, the eventual outcome. The tube in his windpipe lets the paramedic inflate his lungs, but there is no movement of their own. His body shows me all too clearly the trauma that he has suffered, when the cars collided, when he was ejected through the windscreen. I pierce his chest, deflate the tension pneumothorax, and again on the other side. But still, the monitor attached to him shows a straight line, asystole, death.

His family watch in horror, as I stand, my job done, and the paramedics draw the blanket over his head.

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He lies there, unable to stay still, unable to catch his breath. He calls out, pleading for me to help him. I look at him, and know, without a doubt, the eventual outcome. I have nurses, monitors, a whole hospital at my disposal this time. I listen to his chest, fight to find a vein to give life-saving drugs, and watch as his eyes glaze over and he takes his last breath in front of me. I pass a tube into his windpipe, breathe for him, and give him clot-busting drugs, in an effort to dissolve the clot that is blocking his pulmonary vessels.

His family are brought in as we continue the resuscitation attempt, and watch in horror, as I switch off the monitors, and the nurses draw the sheet over his head.

Leather

Well, Constant Reader, I would like to share with you something about me. Three years ago tomorrow, I stood beside a beautiful lady, slipped a ring onto her finger, and turned her into MrsRRD. Yes, tomorrow is our 3rd wedding anniversary, traditionally celebrated with a gift made of leather.

And, very publicly, I want to say thank you, MrsRRD, for standing by my side three years ago, and for continuing to stand beside me. You are the one who makes everything possible, who supports me in what I do, and who always helps me make the right decision. Without you, I wouldn't be RRD. I wouldn't be anyone.

Dreams, Rain and Driving

Sitting down with friends, talking about dreams. We've just come out of the cinema, having seen Inception. Princess RRD isn't sure, not totally, what had been going on. Mrs RRD isn't sure, not totally, whether she liked the film or not. Break Dancer wants to know what her dream about chasing a labrador around the garden in her nightie means. Break Dancer's husband is checking it out on www.whatsmydreammean.com. And I am just sitting there, enjoying the company of true friends.

Buzz!! Buzz!! I glance at my pager, set on silent during the movie. I must remember to bring my reading glasses out with me. Squinting, and holding the pager at arms length, I can just make out the characters: 29D02, local motorway junction. My pager is linked to the Ambulance Service coding computer. AMPDS, for those who care, is the way in which the computer translates the information the call taker gets from the caller into coded information for the crews, including the priority of the job. 29 is the code for an RTC (road traffic collision - don't call it an accident, oh no!) and D02 is high speed. Well, it is a motorway, after all. I sigh, theatrically. My family and friends know the score - I might be off. A lot of these are simple shunts, and don't amount to anything. I generally wait for at least 2 calls before calling in my availability. And anyway, I still haven't heard about the labrador and the nightie!! The sound of rain on the conservatory roof is a comforting backdrop to our conversation.

Buzz!! Buzz!! I sigh theatrically again, and squint at the characters: 29D05. Suddenly, all thoughts of dogs, dreams and gardens are swept away. D05 - all services required. I call it in, and hear that there has been a 3-car pileup, with one man unconscious.

As I enter the motorway, the rain starts in earnest. I can barely see out of the windscreen; my wipers are ineffectual in this weather. And it just gets worse. Cars are stopping on the hard shoulder, but I grimly carry on, my speed dropping lower and lower, my hands gripping the steering wheel knuckle-white. I am leaning so far forward that my nose feels as if it is pressed against the window; like I used to in my old house, watching the rain from my bedroom.

I can see blue lights ahead, but know that my journey is not yet over - they are on the other carriageway, and I have to go up to the next exit and back down again.

My eyes flick across to the scene as I am about to pass it, then flick back ahead again.

What the ....!!!! Twisted metal appears in my windscreen through the driving rain. A lamppost is down, and the lantern arm is across my lane. I swerve to the left (we're in the UK, remember) and slide past it with inches to spare. Fortunately, my 4x4 is able to cope with the maneouvre, and I regain control of my beating heart.

A few minutes later I am jumping out the car and running through the rain towards the waiting casualities; I know that getting there is only the beginning.

Half Price, Special Offer

"Oh, he's gorgeous!" exclaims MrsRRD. "You must buy him, especially as he's on special offer."
"Half price," I said. We buy him, and I put him in the back of my car, staring out of the window. He looks so funny, and so appropriate to what I do.

Later that evening, as I am stashing my gear into my boot, the pouring rain against my hood, his lopsided grin seems so wrong, so out of place. His blue body and bandaged head mirrors the body lying behind me, my lights reflecting off his skin.

And there he sits, my special offer, half price, Mr Bump.

An Image From Vancouver

So, there we were, about to get on our rented bikes, when I see a young kid with a bike helmet. It must be the first time this mother has been asked for a photo of the back of her son's head, but I just couldn't resist!!

Another One Bites The Dust

First Medic999, now NeeNaw. There seems to be a trend appearing here. No-one comes out and says why. Not in so many words. We all know why we write. I can guess why some of us stop. Pressure. Pressure from above, to stop giving away our sectrets. To stop giving away the secrets of those we serve - our patients. Confidentiality is one of the cornerstones our our professions - without it, no-one would ever trust a doctor or health care professional again.

I believe strongly in confidentiality. Mrs RRD could tell you a thing or two about being the wife of someone who holds as a sacred secret anything they find out in the course of their work. It wasn't easy for her at first; the cryptic phone calls from friends and family, asking for advice, or occasionally for a visit. And she hears nothing! Our friends don't always get it either. "Didn't your husband tell you I was really ill?" they ask, expecting her to know all about their ailments, expecting her to be party to their secrets.

And why do you, Constant Reader, come back for more? Isn't it the same need to know, need to see, that makes people slow down to gawp at accident victims? Do you think I don't slow, even if I know that I can do nothing? Even while on holiday these past few weeks, I would casually wander past a parked ambulance, "just in case they needed some assistance." Some assistance, my foot!! I just want to know what's happening. I'm nosey, just like everyone!!

I think I do quite well in my blog. I don't breach patient confidentiality. Some bloggers retain anonymity, and so have little problem with confidentiality. That was how I started out, but it soon became apparent to many out there just who I was. So I had to change tactic, and modify the stories, so that they became just that - stories. Sure, someone who was there may think they recognise a patient or an event. But they don't. I change enough so that it is not possible to discern which patient I am describing. Some are recent; others far less so. And remember, I have been a BASICS Doctor for nearly 10 years, and a HEMS Doctor before that. So I have a lot of cases to call upon.

But it is still a risk. If someone thinks they recognise a case, that might be enough to cause trouble from one's seniors. And, I guess, that is where I have an advantage over my ambulance colleagues. Up until now, I haven't really had a boss, when it comes to my prehospital work. I am tasked by the Ambulance Service, but I am not employed by them. That is, I wasn't. There is a change afoot in London. We will all have contracts with the London Ambulance Service, a contract which, I have no doubt, will have a clause somewhere about keeping confidentiality. And, at that point, I will be in exactly the same situation others have found themselves. And I will need to have a long, hard think...