By Sean Coughlan
BBC News Magazine
Violent drunks, time-wasters and drivers that won't clear the way... the tough reality of life for an ambulance crew is recorded each day in a blog which has been turned into a book.
When you see an emergency ambulance on the street with lights flashing and sirens wailing, it's rarely a sign of good news.
And Tom Reynolds's first-hand account of an ambulance crew's daily life, Blood, Sweat and Tea, is a ride into the dark underbelly of urban life.
"We tend to see the worst of human nature," says the 34-year-old author, who works as an emergency medical technician for the London Ambulance Service.
Alcohol-fuelled violence, isolated pensioners and dysfunctional families are recorded in a gritty, deadpan style that often picks up the surreal as well as the sad moments in his working day.
This publication is the latest example of a blog being turned into a book, with the stories drawn from Mr Reynolds's online diary, Random Acts of Reality.
And it's the sense of reality that is the book's appeal. "It's not Casualty, it's not ER - it's actually what we do, day by day," says Mr Reynolds.
'Flood of drunks'
Unlike television drama, the more squalid reality currently challenging ambulance crews is trying to cope with a "huge flood of drunks" - a problem which he sees as getting much worse.
"On a night shift, every job or every other job can be a drunk. People falling over, getting into fights, people falling asleep in the street.
The tales offer an insight into city life
"There are a huge amount of alcoholics you don't notice - people who go out to the off-licence and buy cheap cider, fall over at home or get sad and call us," he says.
In the book, he describes alcoholics who call out an ambulance six times a day.
"I don't mind the crazy people, they're ill, they can't help it. It's the drunks and druggies I mind, people who shouldn't call an ambulance, who don't really need an ambulance."
This can give the ambulance crews a world-weary perspective. When an England football match is approaching on a summer's day, he knows this will mean glassings in pubs and crew members having to wear stab-proof vests.
Each day in London, patients and relatives inflict at least one serious injury on an ambulance crew member in London, he says. "And there are countless cases of people swearing at us. It drives me spare."
But this isn't a gloomy book. It's peppered with dry humour, records the more bizarre call-outs (a man with a carrot stuck up his back passage) and reveals a strong sense of anger at the selfishness of the public.
He's angry that so many cars do not get out of the way when ambulance lights are flashing, angry at hoax calls, angry at crash injuries faked for insurance, angry at drivers who get aggressive when they have to wait for an ambulance to collect a patient.
Most night calls are alcohol-related
There are grim glimpses of deaths in families and the loneliness of the capital. But what makes him most unhappy in his job, he says, is the mistreatment of the elderly.
"What really gets me is the state of care that some of our old people get. You get some very bad private nursing homes - frankly god-awful ones. They're not technically wrong - they don't beat people - but there's no care.
"Everyone knows about child abuse, but you don't hear about elder abuse. Some nursing homes are just waiting rooms, patients left staring at the telly, terribly isolated. It's absolutely heartbreaking and nothing gets done about it."
But he also says there are times when "maybe I'm wrong about people being so nasty".
"You also see great things - next-door neighbours who look after each other. There was a job that always sticks in my head, where a frail old lady and her husband were being looked after by a Muslim family - you do still get that community sometimes, it crosses race and religion."
The blog on which the book is based has been running for three years - and its author (Tom Reynolds is a pseudonym) says that this direct way of writing adds to its impact.
"Blogging is a very honest way of writing - if you're doing it every day, you can't do it in a false voice," he says.
Cars often don't make way
But how do you sleep after writing lines like: "There are jobs that haunt you. Try calming down an eight-year-old girl who is dying in front of you because they can't breathe." Especially when the parents of the child who has died in the asthma attack keep smoking.
"You get jobs that cut you up. But you go back to the station, you have a cup of tea, you chat it over with your station mates, and you get over it - and writing about it helps."
But despite having to pick up the pieces from the parts of life that everyone else wants to avoid, there are upsides.
"Driving on the wrong side of the road still makes me happy, driving over kerbs is often a giggle and, let's face it, who wouldn't like to treat red lights as 'give way'."
Add your comments on this story, using the form below.
I've been reading Tom's blog on ond off for about two years. It's very interesting reading, and often very emotive. One of the few blogs that is worth its server space.
I myself have witnessed paramedic crews trying to treat someone around a crowd of drunks. Alcohol is a massive problem in this country. Perhaps the government should take bigger steps to punish those who obstruct emergency crews, they are endangering the lives of others in reality.
I have an uncle who is a retired ambulance driver and his worst call was to pick up a motorbiker after an accident, only to find that it was his own son. Thankfully he recovered from the accident, but it did affect my uncle for many days. God bless all of those who are there to help us.
Trasie Howard, Mitcham, Surrey
I have nothing but respect for the job that they do. Last week the neighbours called an ambulance because my elderly mother (who lives alone) was extremly confused and distressed. They did a fantastic job, in not taking her to hospital, but by provinding comfort and making her a cup of tea. Thanks
The abuse, assaults and general antipathy towards ambulance crews and A & E staff are yet another symptom of a segment of society that has never been brought up to respect themselves or other people. Never the less, I hope Tom and his co-workers never lose sight of the fact that the majority if people are deeply appreciative of their caring attitude.
Terry Ozbourne, Collingham
A lot of my friends are technicians/paramedics and some of the stories they tell me really make me dispair - drug-users treating the ambulance as a taxi, people calling them out because they have a hangover, medics being thrown off buildings while trying to treat a rowdy patient (yes, really!). They tell about good jobs with happy outcomes, but it's the bad jobs that stick in my mind. There isn't enough money in the world to make me do their job. If I wore a hat, I'd take it off to them all! They're stars.
These people are the real heroes, and it is dreadful that they have to put up with abuse every day. I have twice had to call out paramedics for my elderly mother-in-law, and the tender care they gave is beyond measure. About time they got the sort of bonus that useless city fat-cats scoop so often.
You should all have a 100% pay rise and a free cattle prod to deal with the abusers.
I owe a lot to ambulance crews; my sister had a bad asthma attack and nearly died at the age of 10; she was saved by a quick-thinking and skilled paramedic who also had asthma. It was not just the treatment, but the care that impressed me. Also, my father died a couple of years ago despite the best efforts of the East Anglian air ambulance; They managed to get to him whilst he was still alive (despite being in the middle of the countryside) but he died at the scene. It was comforting to know that he at least had a fighting chance.
Dean Belfield, Stockport
Ambulance crews are saints, they are kind, efficient and often brave. They have saved my life and my son's life during severe asthma attacks. Their patience and kindness to my ancient mother who was suffering from dementia was extraordinary - they teased and flirted with her and jollied her out of her distress at going to hospital, wonderful wonderful people.
In the hope that Tom and other emergency crew members read this article - thank you. Remember that for every person who takes you for granted there are countless out there who, despite never personally needing you, are grateful for all that you do.
Simon Powell, London
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