Thursday, November 09, 2006

Ride-Out

Like the sacrificial pawn that bursts dramatically into a public house full of Royal Marines smugly proclaiming, ‘Death to the kuffar!’ in a very loud voice, but whose improvised explosive device, so lovingly and meticulously constructed in his lonely bedsit the night before, despite repeated, clearly visible and increasingly desperate attempts, fails to detonate, I was overcome by what I can only describe as a sinking feeling.

An experience equally disagreeable to that of being suspended in fearful anticipation of being stomped imminently to a bloody pulp beneath two dozen angry hobnailed boots is coming into work at twenty minutes to seven on a dreary winter’s morning to discover that one has been scheduled without prior notice to spend the entire shift with neither one’s regular crewmate nor some tolerable alternative, but in the company of Barry Crack, the recently appointed team leader, one of whose official and solemn duties it is to observe, assess and submit a written report on the length, depth and breadth of one's clinical knowledge and skills, identify any notable areas of deficiency and formulate a programme of remedial training to be undertaken prior to re-assessment in a month’s time.

This gratuitous torment is known in Ambulanceland as a ride-out and is a far cry from the gentle Sunday outing of the same name that involves nothing more arduous than pootling around country lanes on a motorcycle accompanied by your local Road Rats.

In theory it takes place twice a year, but the practical reality is that the ride-out is thankfully a much neglected facet of ambulance life and indeed this was to be only my second experience of the ordeal, the first having been endured a year or so after passing out of the training school a thousand lifetimes ago, since when I had managed successfully without noticeable effort to erase from my memory virtually every last vestige of the ambulance stuff which had been so thoroughly drummed into my impressionable young mind back then; and as I stared mournfully at the gleaming new pip sitting proudly on each of Crack’s narrow shoulders, I had to face the simple truth that my incomprehension of all things medical lay somewhere about midway between the profound and the divine.

I looked around the messroom at the sniggering faces behind the diminutive team leader’s back and a wave of something not unlike panic swept over me as the full implications of my predicament became clear. I felt my head swimming and I had to grasp the back of a chair to support myself, my thoughts swirling chaotically as I struggled desperately to find a way out of this purgatory.

For a brief moment I actually gave serious consideration to the time-honoured ruse of simply throwing myself to the floor and feigning some form of vasovagal attack or an episode of autonomic dysfunction or something, but I was restricted by my total ignorance of the symptoms of such conditions, and the ridicule to which I would be subjected when the true nature of my collapse became known was unthinkable.

So, bearing in mind the inherently corrupt nature of all ambulance managers, I turned my attention to wondering if team leader Crack might be amenable to a little financial incentive to ensure the submission of a favourable report on my clinical management, praising the judicious application of my emergency medical skills, finely honed by extensive practical experience and a broad theoretical knowledge of anatomy, physiology, pharmacology and those electro-whatsit things, but a glance at his face revealed only the deep-rooted zeal of the healthcare fundamentalist, unbesmirched by humour or compromise, and I replaced my wallet in my back pocket.

My thoughts moved on from bribery and I was examining the possibilities of blackmail when the phone rang, and with the coarse, mocking laughter of the messroom ringing in my ears, Barry Crack and I duly set off on our first job of the day, to a forty-two-year-old male with a suspected acute aortic aneurysm.

‘Acute’ was easy enough — I’d studied Euclid as a schoolboy and knew it to be the converse of ‘obtuse’ — so I reasoned that what we were up against here must be an aortic aneurysm with an angle of less than ninety degrees, though what the aortic aneurysm itself might be, well, it could be anything. I had the vague notion that an aorta was in some way related to the ignition system of an internal combustion engine, but I was far from certain, and how this might apply to a forty-two-year-old male in need of an ambulance I really couldn’t imagine.

Aneurysm, aneurysm, what on earth was an aneurysm? How was it pronounced and what did it mean? I felt quite certain that I’d never encountered the word before and the more I repeated it the less familiar it became, until it was nothing more than a meaningless humming sound and I found myself chanting it aloud over and over again like a mantra. I looked at the word on the job sheet and began rearranging the letters as though it were an anagrammatical clue in the Telegraph crossword puzzle — Nurse May; emu yarns; any serum — but it didn’t seem to help much.

I looked over at Barry as if enlightenment might somehow present itself for examination upon his humourless features, some nuance of their configuration perhaps revealing at least a hint as to the seriousness of the thing, but his face was a grim mask of concentration and forward vision as he steered the ambulance with practised efficiency through the heavy morning traffic, the sirens wailing and howling without respite and echoing through my head with an unbearable urgency until finally I could take it no longer.

“Barry?” I began in a tone of earnest enquiry, the eager student addressing the wise tutor. “What’s an acute aortic aneurysm when it’s at home?”

He turned to me and stared for what seemed an age with an expression of stunned disbelief, a kind of horrified perplexity, as though I’d informed him in all seriousness and with irrefutable supporting evidence that ninety-five percent of ambulance journeys are a complete waste of time and therefore his whole life’s work was but a meaningless sham, his very raison d'etre nothing more than a senseless waste of public money. His lower jaw dropped and his mouth gaped in the manner of a particularly unintelligent goldfish as the ambulance ploughed into a queue of school children at a bus stop at about forty miles an hour.

Although it could hardly be viewed as a compelling argument nor accorded credence as a valid proposition in a serious theological debate, it’s just this kind of seemingly miraculous incident that can cause me to consider, despite my lifelong and deeply held beliefs, if maybe there is a god after all.