Sunday 2 September 2007

Dead babies

One of the faces of Big Ben stopped at midnight. The others told the correct time (5.15).

Six emergency calls. One conveyed home, one gone before arrival and the others went to hospital; one of them didn’t stand a chance.

The shift started out routinely and slid down the rubbish chute in a short time. Ironically, I had been chatting to a colleague about newborn babies – he and his crew mate had just delivered one in the back of their ambulance. I told him that BBA’s were my worst nightmare. I have had several horrible jobs involving neonates. Of course, I have delivered and assisted the delivery of more healthy babies than not but when you get a bad baby job it numbs you for a long time. I shouldn’t have mentioned my fears because it tempted fate.

I started the shift with a call to a 21 year-old female who had fainted ‘due to shock after hearing bad news’. I went to this call with no feeling of crisis. I didn’t expect to see anyone is serious trouble.

She was collapsed on the floor of a small house in which she was one of the carers for a severely disabled person. She had been told some bad news about her brother, who had been injured in a car crash, and now she was wailing and thrashing on the floor of someone else’s house. I calmed her and explained to her that she was emotional and I couldn’t help her other than take her home. She relented and I had to taxi the woman all the way to her suister's place. This was, of course, very inconvenient for the family who needed her to be there.

I made my way back to the West End after dropping the emotional lady off. I sat through several cancelled calls until one came through that stuck. It was a ‘Born Before Arrival’ (BBA). I looked more closely at the call details and saw that the baby had apparently been born on a street. More seriously, the report stated that it was not breathing. I called in for clarification and was told that the call was still in progress. Then an update confirmed that a driver had stopped when he saw what was happening and that the baby had been confirmed to be in cardiac arrest. I knew then that this was going to be a horrible job.

I raced to the scene and arrived to find the police already there. An ambulance was just pulling up too. I ran out of the car with my red paediatric bag and the crew were heading back towards me with a police officer who was holding a little bloody bundle in a foil blanket. It was the baby. It wasn’t moving.

We piled into the back of the ambulance and I began ‘bagging’ the baby whilst my colleague compressed the chest. We had tried the ‘stimulation’ stuff but this little thing wasn’t even trying to respond. It was floppy, heavy and pale. We attempted to resuscitate for five minutes before deciding to get going and continue resus on the way; the quicker the better. The whole scene was confusing – nobody knew exactly what was going on or what had happened.

I left my car keys with a Station Officer who had arrived shortly after me and stayed in the ambulance to travel with the child. I intubated and had to struggle through fluid and meconium which had gathered in the upper airway. Suctioning cleared the problem only temporarily – it soon filled up again. This was looking bleak.

There was also a smell that seemed familiar. At first none of us mentioned it but it was the smell of putrefaction; rotting flesh.

Attempts to resuscitate the baby continued at hospital but they were fruitless and it was called after a while. Another ambulance had transported the mother to hospital. She had mental health issues and didn’t show a single emotion during this drama. The whole story is one of the most bizarre BBA’s I’ve ever heard.

The baby had simply fallen out of its mother while she was walking down the street. It had fallen head-first onto the ground. This was witnessed by a passing motorist who stopped and called an ambulance, thinking the baby had stopped breathing as a result of the head injury. The mother must have pulled the cord, ripping it from the placenta (we wondered who had cut the cord but it transpired that nobody had) before slumping down with the lifeless baby on the ground.

I think the smell told us that the baby had been dead for some time in the womb – that may or may not already have been known. We couldn’t identify the sex of the child either because it didn’t have any external sexual organs, probably due to a genetic condition.

It took me the rest of the shift to get through the numbness that settled over me. Every insignificant job after that wound me up.

After a long rest and a re-stock I was sent on a Red1 goose chase for a 20 year-old male who had collapsed in the street and was not responding. Drink or drugs I guessed as I made my way there.

It was drugs. He had left the scene before I arrived. The caller told me he is a local user and that he just wanted him moved from the front of the posh hotel where he works. Glad to be of service I’m sure.

Then an 83 year-old who had fainted and hit his head. He was in bed when I arrived but he was very pale and shivered all the time. Both his temperature and BM were high and he was very vague at times. He had very little strength and was unable to pull himself out of bed when the crew arrived to take him to hospital. He had no pain but he vomited several times and it was clear he wasn’t well.

A 54 year-old female who reported DIB and then walked out to the ambulance as if it was her taxi to the ball had me completing my paperwork for yet another ‘not required’ after which I made my way to Waterloo bridge and watched the London Eye turning as the engineers checked it over before the start of the tourist rush. This was my calm time and it helped me recover from the bad start of shift I’d had.

My shift ended with a RTC involving a moped and a car. The moped rider was in the middle of the road in a pool of oil. He had no significant injuries, apart from pain in his arm and leg on the side that took the impact of his fall and he was able to move to the side of the road, out of harm’s way. I had already been passed by buses and trucks with inches to spare, it was only a matter of time before one of them hit me and I joined my patient on the ground. Yellow jackets make no difference in rush hour.

The LFB, police and an ambulance arrived and I was free to complete my day and go home. It would take me the rest of the next day to get over the sight and smell of that little baby.

Be safe.

7 comments:

Anonymous said...

hi fella.
You done well big man, no amount of help would have made any difference to the wee thing and i'm sure you already know this. However jobs like these tend to focus the mind and the little things do start to annoy you.
The public think we are supermen/women. We are not. You do a job and you do it well, but you are only human too.
As for the bus thing...crikey!

YOU be safe!

Yorkie

Anonymous said...

Hi. .I dont know how I landed at your journal but I read with great interest.Thats a sterling job you do . . so thank you.I love London and will be back to read more .I was thinking of that poor baby too.What a horrible thing to happen.Reading through the back enries I was astounded at the chap who put his fingers in his ears and would not let you in. . some people!!

Anonymous said...

You gave the baby the best chance it had to live.

Anonymous said...

I cannot tell you how sorry I was to read your post. That must have been truly horrible for you. Thank you so much for the work that you do, and for choosing to write about your experiences.

David Waldock said...

I think the day you fail to feel emotionally whacked by a case like that is the day you won't be able to do your job properly.

You're in a caring profession: your motivation is that you give a f**k. It's what makes you put on the uniform and get in the car; it's what makes you worry about what you've missed; it's what makes you think about the emotional and social impact of your job and not just the technical aspects of keeping someone alive. These are what make you not just a competent practitioner but a good, even excellent, practitioner.

I wouldn't want to work with someone who was cold and didn't respond emotionally to distressing scenes. What makes you professional is that you were able to shelve your feelings until such a time as it was safe to express them, that you were able to identify how you felt and how it subsequently affected your work, and that you will probably find an appropriate way of working through the emotional issue (I've a sneaking suspicion that just writing the blog is quite cathartic in that respect).

The day you are able to treat jobs in a purely clinical manner without emotional connection, you'll have lost the ability to care. And that's the time to give it up.

Thanks for your writing; I hope that I (and other commenteers) can help give you the support that you, and other ambo crews, deserve.

D

Sian said...

Sounds like a shift from hell! just reading the blog about the baby has got me sobbing.

All you guys do such a good job!!

Anonymous said...

What a sad experience. Its also sad contemplating the history leading up to your arrival in the story.
Thank you for sharing it.