This Time, Please!

This time, please let this time be different. Let this 18 year old survive. Altered consciousness, breathing noisy, Control have told me, as I rush to the scene of yet another RTC. As I negotiate the roundabout, and I see a motorcyclist swerve out of my way, my mind, inevitably turns to three hours earlier:

He was 17, only 17. Why he had come off his motorbike, no-one knew. There were no other vehicles involved, he just clipped a kerb and lost control. I wasn't called - it probably wouldn't have made a difference anyway. He might have been conscious on scene, but he wasn't right, according to the crew. He was very combatative, and very VERY pale. And then he had a cardiac arrest in the ambulance, six minutes away from the hospital. As I gathered the Trauma Team, I was in no doubt that this man would not survive, had in fact already died, even before he arrived in the hospital. But we worked on him anyway - he was only 17, after all. Into automatic mode, we tubed him, decompressed both sides of his chest, and poured in as much fluid as we could. Six minutes later, I called it, the inevitable end result. And then, I get the inevitable backlash, from all the staff: how could we have stopped so soon? He was only 17; we should have tried more, done more, spent more time. Doing what? Doing anything, comes back the answer. And this is from the nurses and from the doctors. Despite the fact that they all agree that the resuscitation attempt was futile, that he was dead before he arrived in the Department, they all still wanted to carry on, to throw all the resources, all the magic of resuscitation, to try to achieve the impossible. I leave the hospital with a heavy heart.

And, now, here I am, 3 hours later, hoping that, this time, there will be something, anything, that I can do.

100,000 Visits - Now It's Your Turn

Dear Constant Reader,

Today, just over a year since this Blog went live, I have reached the 100,000 mark! 100,000 visits to my blog. I accept that most of the hits are from Mrs RRD, but still, that's a whole heap of people who now know about BASICS, who previously had never heard of us. I look at the map of where visits have come from, and I am astounded at the interest from so many different countries.

My life has changed so much, as a result of this blog. I have found an outlet, a way of expressing myself, that I never had before. I have joined and become part of a community, the blogging world, and been accepted by it. I have "met" and made new friends. I have a new name, and so have my wife and children.

There was always a purpose in writing this blog - to raise the profile of BASICS-London, and try and get as many people as possible to be aware of who we are and what we do. But now we move into Stage Two, and this is where you come in.

BASICS-London is a charity. It costs a lot of money to put a doctor on the street, and every penny comes from donations. The doctors themselves get no payment for the work they do, and pay for the extra fuel, insurance and wear-and-tear on the vehicle out of their own pockets.
Each doctor needs blue light driver training (£1000), modifications to their car (£1500), personal protective equipment for themselves (£1200) and the necessary medical equipment to save lives (over £10,000). All of the doctors currently on the road have the first 2, most cadge some form of protective equipment, and few have all the necessary equipment needed. There are currently 15 active doctors in London and the surrounding regions. Many more are standing in the wings, waiting to be trained and equipped.

You may have noticed a new button on the top right of this Website, entitled "Donate". Press it. Give something, anything. There are about 250 visits per day. If every one of those visits paid £2, then, in 2 days we would be able to get another doctor trained on blue lights. In a week, I could have him equipped and ready to go. If you pay more, it will happen sooner.

This is a legitimate request. We are a Registered Charity (look us up on the Charities Commission website - http://www.charity-commission.gov.uk/, Number 1002819). Your payment is securely sent direct to the Charity's bank - I will have no individual access to any funds coming in. I will keep you informed of how much is being raised.

For my part, please watch this space, as I will be telling you about some exciting ways in which I will be trying to raise some more money for BASICS-London.

Thank you

RapidResponseDoc

Annual Leave

Another week off this week, so that I can use up all the remaining holiday before March 31st. So, what do I have planned? A trip to Costco, paint the toilet (the bathroom, for my trans-atlantic readers), daily visits to the gym. Not going to the hospital, not worrying about the Department, is a holiday all on its own.

So, just getting ready for my first trip to the gym this week, having spent FAR too much at Costco, and having looked at the walls and deciding that the preparation will, as usual, be far worse that the painting; guess what? "Can you attend an elderly lady, who has fallen off a ladder?"...

He sits there, on the front step, pulling his dog to him, in an embrace that is born from fear. She lies on the ground in front of him, not moving. The three of us work silently, securing her cervical spine, getting intravenous access, assessing for injury, and moving her from the ground where she lies to the back of the ambulance. He watches every move, his gaze a mute plea to save his wife of 49 years, his wife who was well enough to climb a ladder to clean the upstairs windows, yet not lucky enough for the ladder to not slip on the wet grass. Her stillness, her silence, tells him more than I do, later, after I have seen her CT scan.

Back at home, forgoing the gym for today (tomorrow, definitely tomorrow!), I look once again at the toilet walls, and start the grim task of stripping the old wallpaper.

The Book Sale

They come knocking on our door, in ones and twos, laden with bags or boxes of books to add to the growing pile. Mrs RRD bustles around them, proffering tea and biscuits, as they search for a literary gem, for a much loved author. The questions: "Who brought this fab book?" "How much for this one?" The chat, about the kids, about school, about ailments, about BASICS. And then they leave, carrying with them treasures for an evening soaking in the bath, for a train or plane journey, or to shade their eyes from the sun on the beach this Summer.

All of them are here to support our charity. All of them give generously, both of books they no longer want, and for books that they have found.

Thank you to all of you, but especially, and as always, to Mrs RRD, for caring so much.

Good News!!

I feel good tonight! I just wanted to share something with you all:

About a month ago I went out to a man hit by a taxi cab. Unsurprisingly, he wasn't in a good way. I tubed and ventilated him and transported him to my hospital. A little later that evening he was transferred to a cardiothoracic centre for major aortic surgery. I didn't expect he would survive, and indeed, I didn't hear anything positive from the hospital, just that he needed more surgery.

Fade to this evening:

I am standing in A&E, coat on, just about to leave to go home. BlarneyNurse walks up to me. He stops, and points his pen at me. I wait, patiently. "Someone's looking for you," he mutters. I wait, patiently. "Cubicle 2," he eventually says, and wanders off.

I pop off my coat and go and see who wants me. A family member? A barely recognised friend, who wants to jump the queue? No, not this time.

Lying there in Cubicle 2, smiling up at me, is the man from the taxi. (Well, from under the taxi, but you get my drift.) He looks well, considering. He and his wife have been asking after me. They are in because one of his stitches needs removing.

We chat, the three of us. She tells me about the agonising wait outside Theatre, repeated only a few days later. He tells me about waking up in ITU, 2 weeks of his life just ... gone.

Then they both tell me about their family; how their 8-year old and 10-year old want to thank me for making sure they still had a Daddy.

I take out his stitch, wish them both well, and float home.

Musings

I could have got there in less than 25 minutes. Maybe 20. Less than that, if there wasn't too much traffic.

Mrs RRD and the Micro RRDs could have got themselves home from the restaurant. I know it was cold, but they could have got a taxi - we were only a few minutes from home. It wouldn't have cost much.

I had eaten well at lunch, and had had the starters tonight, before the call came in. I wouldn't have suffered unduly, had I skipped out of the main course that was on its way from the kitchen.

True, it might have been difficult getting Mini RRD and Princess RRD back from their party, but I'm sure I would have been back well before then.

The caller said the patient was unconscious - he could have benefitted from my presence.

But I still said no.

I have a right to a life, to some 'time out' with my family. What I do is voluntary, and I need to be able to choose. My family also have a right to be with me. The Micro RRDs need me, need to spend time with me. Mrs RRD is always so long-suffering, always understands when I rush off. Yet, she'd much rather me stay, and she, too, deserves some time off from coping with the difficulties that my BASICS volunteering causes. And, there are plenty of times when I rush off, only to find that the call was not as given, and I wasn't needed after all.

But I still feel guilty.

Hello Down There!!

Something a bit different today:

I am on my Rounds in the hospital when my 'phone buzzes in my pocket, I excuse myself from the patient and his family, and answer the "Unknown Caller". Surprise, surprise, it is Control. Can I attend a chap who is trapped in a hole? I decide that Rounds will have to go on without me, and I rush into A&E to see if anyone wants to join me on my trip.

Beardy jumps up, as usual, then looks around in dismay at the department devoid of junior docs - they have all gone to teaching, and he is one of the few docs left to man the Shop Floor. Sadly, he gives up the opportunity, and Ginger chases after me, hotly pursued by two nurses - that's a first for him!!

We all bundle into the car and I program the Sat Nav. Ginger, a new Medical Student, is looking rather bemused - he's not quite sure what's going on yet!! Fasten your seatbelt, Ginger, we're going for a ride!

We turn up at the address -it's 2 doors away from Princess RRD's friend, so I know I'm going to be quizzed big-time by her when I get home. I jump out and hand bits of equipment to my rather green- looking passengers.

The scene is a simple one; builders putting up extension, man digging deep hole for foundation, walls of hole collapse while he is in it, man trapped by clay up to mid-thigh.

First difficulty - none of my passengers have ppe (personal protective equipment), so none of them are going to be coming anywhere near this hole. They don't look happy about this, and go and sulk in the back of a fire truck to keep warm.

Second difficulty - there is very little access to Johnny, the man in the hole. There is a large piece of hardboard that he has been using to shore up the sides - rather unsuccessfully, as it happens - in front of him, and a fence behind him. He is well and truly stuck. Fortunately, he is standing upright, and is fully conscious. Unfortunately, the clay is beginning to set.

You may at this stage be wondering why I had been called. Well, to be honest, so am I. I know that there are dangers associated with crush injury, especially when the blood supply to a limb is cut off. Toxins build up in the affected limb, then, when the pressure is released and the blood is able to flow again the toxins rush around the body, and can cause circulatory collapse. It might happen, but I am unconvinced. Still, if I complain about not being called when I am needed (which I do on a regular basis) I can hardly complain when I am called.

So, I stand around for an hour or so while Johnny digs himself out. Yes, you heard that correctly. There was no room for anyone else down the hole, so the fire crew lower empty buckets down to johnny, who fills the buckets up with lumps of clay that he has dug out with his bare hands. There really is no other way we can help him, despite the three hundred and fifty seven different suggestions offered by the attending fire crew.

Eventually, he has removed enough clay from around his legs to be free. He is lifted out of the hole, placed on a spinal board, and carried out of the area, to the waiting ambulance. I remember my three passengers, and they join me on the back of the rig, as I cut up his trouser legs, and find cold legs, with no injuries.

"You've got away without any injury," I tell Johnny. He asks me about his shoulder, and I see a hugely deformed fractured collar bone. "This hurts a bit," he says. I think about how he has been able to dig himself out of a hole with a fractured collar bone, and decide that he's a braver man than I will ever be.