Saturday, 26 February 2011

Heavy people

This was entirely predictable.

I wrote my degree dissertation on the subject of childhood obesity and I proposed at the time that we’d see a growing number of huge teenagers and, likewise, a growing number of weight-related problems facing the ambulance services in the UK. Today, we are introducing ambulances that are extra-wide and have the capacity to bear the weight of a small elephant. The teenager in the recent news story weighs about a third of a ton and she can expect some really painful physical complications; joint problems, spinal problems, muscular aches and pains. Then there’s the added stress on her heart and lungs, diabetes, high blood pressure and a very unfavourable outlook generally.

But she was born heavy it seems and the trend for weight-gain has never left her, except for one USA fat-camp stint that helped her shed an amazing 15 stones in 9 months. So, physically, if she stops eating so much, she can lose weight. It’s not all genetic. Even she admits that when she gets depressed about her weight, she eats to feel better!

I have been writing about this subject for years and I am not unsympathetic but we are reaching a point where, once again, instead of dealing with the problem head-on, we are simply pandering to it by ‘accommodating’ the needs of those who don't help themselves, such as extra weight and space humans.

A recent study has revealed that we will soon run out of available land for growing food. The world population is increasing faster than we can recover arable land. Obese people, who will increase in number hugely over the next few decades, will be responsible for the consumption of a lot more of the available food than those who are not fat.

The cost to tax payers increases with this trend too; we have to help foot the bill for an ever-growing demand on the NHS for long-term care of the illnesses and injuries that accompany obesity. Ambulance services, like mine have to use (at great cost) specialist vehicles, called bariatric ambulances, to carry these patients to hospital and then they have to be put into special beds so that they can be treated. My colleagues and I suffer back problems and often injure ourselves lifting and carrying obese people because, without us, they simply would not be able to get up when they fall down. Nobody else will do it; nursing and care home staff call us because, apparently, their backs are more valuable than ours.

Without sounding insulting because I really don’t want to be, it’s worth remembering that over-feeding starts in childhood and it’s generally the parent (mum in most cases, according to sound research) that entices and encourages eating when the child isn’t even hungry. It’s habitual. It’s also worth remembering that stress doesn’t make you fat – FOOD does!

My eldest son thought I would like this – it’s a follow up to my rant on equality and racism and freedom of speech. I’m sure nobody will mind giving the Avenue Q cast a pat on the back for being frank with their point of view.

Be safe.

Saturday, 19 February 2011

Do what you wish


I remember a call to an elderly lady who was sitting in her front room on a chair, staring into space as if dead. My colleague and I peered in through the patio doors in the back garden and called to her, banging on the window to attract her attention, hoping that she’d move or say something and prove herself to be not-dead.

She wasn’t dead – eventually, after we’d roped in the police and a neighbour – she moved enough to let us know (the four faces staring in at her), that she couldn’t get up to let us in. With no option, we broke the door down. I say we broke it down but, in all honesty, all I had to do was push it hard and the thing peeled itself away from the frame, leaving the Yale lock engaged and hanging in the air. Her house was a mess and there was rot in the woodwork; it was amazing that she’d been left alone by the local drug addicts and burglars.

We asked her if she was alright and she said she was. A relative had called because he was concerned that she hadn’t phoned for a while. The same relative refused to come and persuade this lady to go to hospital. We spent almost three hours in that house, joined eventually by her GP and a local Priest. She was dishevelled, hypothermic, had a low blood pressure and her breathing was off. She was sitting in her own faeces and had been in that chair for days by the look of it.

‘I’m not going to hospital! I’m staying here!’ she said repeatedly as the little gang of professionals tried to convince her that she needed urgent medical attention.

She wouldn’t let anyone touch her, except to allow myself and my colleague to stand her up so that she could convince us she was fit enough to walk a few feet. She wasn’t and she promptly crashed down onto the chair again.

The doctor told us, as we huddled in conspiracy in the small, smelly hallway, that she would certainly die, probably during the night, if we couldn’t get her to go. But the law was against us and I struggled with this call at that time for a long time afterwards, before I ended up here, working on the CSD, helping others make the same decision that I and my co-conspirators in that hallway had to make.

You see, you cannot force anyone to do anything – you cannot deprive them of their liberty or go against their expressed wishes unless they lack capacity to make decisions affecting them. The Mental Capacity Act makes it very clear that any professional person who forcibly removes someone from their own home without a damned good excuse, is liable to prosecution – tantamount to kidnapping and false imprisonment I’ll bet.

Now you may think that the physical state and clinical observations gained from the patient would be justification for removing her against her will but, unless we could actually prove (that is, we were convinced beyond doubt) that this lady would die unless we did so and that she lost consciousness there and then, we could not touch her. Even the doctor’s remark wouldn’t be enough and when we pressed him, he was very reluctant to base our planned kidnapping on his comment.

So, we had to leave her there, as she’d wished. She told us to leave and we had to go – she knew what was happening, she understood what we’d said and she acknowledged the risk she was taking and the consequences of her actions. She had capacity and therefore the right to say ‘no’ to treatment and care.

We are allowed to remove someone from their own home if they lack capacity and their removal is in their best interests because they cannot make the decision for themselves… but even then we have to be very, very sure that it is necessary (they will definitely die if we don’t). But people with capacity have the right to lie on the floor of their own home and bleed to death as we watch, as long as they retain capacity until they become unconscious, in which case they lose it by default.

Tricky and complicated it may seem but I see it as very simple. The Act protects us and gives every human being the right to make their own decisions, whether others see it as wrong or not. It is not illegal to commit suicide, so if someone wants to kill themselves in their own home, nobody can stop them and remove them, unless they can be sectioned under the Mental Health Act (and that’s not a rapid process), so long as they are not assisted in killing themselves, in which case the person helping them will be prosecuted.

Advising crews about this is hard because clinicians don’t want to hear it; they want to help, even if that means imposing that help for the sake of the patient. Unfortunately it is not legal to force care on people. They just don’t teach us about that in any depth during training, although that may well have changed.

Be safe.

Friday, 18 February 2011

Barred and bust

Blame culture

It’s becoming a hot topic these days., although there is more than likely, as is usually the case, more to the story than is being blasted out by the hand-wringing Press as they attempt to sling as much mud at us as possible so that the Big-Brother loving public can point a finger and say ‘bad people’ in a really loud voice, thus freeing themselves from any sense of responsibility for seeking the truth through facts.

As I said before, if that Service’s policy is not interrupt a crew’s (legally imposed) break then why is it a critical matter in this case? If an ambulance crew were busy on another call at the time, let’s say a drunken teenager outside a bar who is ‘unconscious’ (category A), would they be criticised for that?

And the solo paramedic simply wasn’t allowed to go near the scene. If the Control Room bod hears anything going on in the background of a call, or sees anything suspicious on the screen, then the responder will be told to stay back until the scene is made safe. Our remit is to save lives, yes but not at the cost of our own – we are not soldiers and if we try to behave like soldiers, we get heavily criticised and have no recourse, in terms of compensation, when we get injured as a result of ignoring this order.

None of us want to sit around waiting while someone is suffering of course and I think that’s why the paramedic went in on her own anyway but it’s clear that the atmosphere was less than accommodating and the situation would not have been helped if there were angry, shouting people around.

I’ve gone into a pub on my own, with a cardiac arrest patient on the floor and I had to physically move people out of my way because, as I attempted to help the patient, grown men with no sense of decency, were barging across me to get to the bar… to order drinks!

Again, it is extremely sad that someone lost their life in such circumstances but not all of these tragedies are the result of emergency service personnel incompetence; some of them, when the details are looked at closely, are predictable and caused by external influences.

Bad debt

And here it comes…. If anybody actually believed that we would escape this financial disaster, they were fooling themselves. There simply isn’t enough money to support a huge system like the NHS. Nobody is safe and I suspect that in the next two to three years, things will be much worse. We have an impossible debt to clear – it will take generations to cut because it isn’t just a few tens of billions, it’s not even a few hundreds of billions – it’s trillions of pounds. We will limp back to normality, not with a cleared account and a zero debt balance, but rather with a reduced debt on which we can scavenge a sustainable society while we whittle it down by degrees over the next hundred years! We are much like a person who gets so far into debt with credit cards that he takes out more credit cards to clear it, whilst cutting back on essentials to make enough money to pay the interest.

What we need to do is go to a friendly debt-clearing planet and ask the well-off aliens for a repayment plan; it will cost us 2% of the debt plus we won’t be able to borrow for seven years because our credit rating will be mashed. Or we could stop spending so much money on so much rubbish. We could start by telling drunken idiots to pay for their own ambulance transport and hospitalisation; that would save us a few quid – and by sacking everyone involved in the ‘there is no Christmas’ conspiracy.

Be safe.

Friday, 11 February 2011


This is exactly the type of criminal behaviour I was expecting as the financial crisis in this country deepens:; sorry it took so long to let you all know about it – that was baaad manners.

Love hurts

Domestic violence is a two-way thing. Although mostly perpetuated by men, there are a large number of males being beaten and abused by their female lovers and wives. Take, for instance, the case of the man who called an ambulance and the police because he’d been stabbed in the leg. At first his story contained dramatic sequences in which he had been attacked by a number of large and very hairy men. Then, after the police had calmed him down and the ambulance crew had tended to his non-life-threatening wound, he confessed that his wife had done it and that she was generally and commonly abusive towards him.

As is the ritual in these cases (and please don’t come back to me with ‘you don’t understand’ comments, cos I do) he didn’t want any action taken and he was very reluctant to get the police involved and make a big legal thing of it. He’d rather be stabbed in the leg and have a circus gather around him than make his violent partner face the consequences of her actions. She, inevitably, would continue her abuse until, quite possibly, he ended up under the sofa with a meat cleaver stuck in his head…. or something similar. I’ll keep you posted.

Rest Breaks

It’s been a bad start to the year for the profession and although I can’t detail any specifics on a recent problem within my own service, I can highlight this one:, which was brought to my attention last month.

Now, I’m not going to defend this Technician’s actions but there is a point here that is missed; as usual there is a devil in the details. We are told to take rest breaks – we don’t necessarily want them, even though we often need them but European law has forced our hands and our employers are obliged to give us breaks whenever possible. However, during these breaks, we are not ‘employed’ and therefore not covered by the Service. Compromises are agreed, as with my Service, whereby life-saving calls will be attended and our breaks will be interrupted. A small financial compensation is offered and generally there is no problem with the response. However, it may well be that in this particular instance, there is no agreed compromise and the Technician chose to continue his legally-entitled break, as if he wasn’t even there. He could have wandered off in civilian clothes for an hour if he’d wanted to I guess.

This isn’t a defence; I’m trying to provide a less emotional reason for the decision he made. I doubt very much that he refused to go, knowing that the woman was dying. I think other things were in play – the information he was actually given; the historical nature of the calls he’d had in the past that had deprived him of a break… other things. None of which are worth the life of a single human being I know, but I hate seeing Press stories that throw up the dirt on my profession before looking into the facts behind the tragedy.

Of course, I’ve just offered a perspective and I could be entirely wrong. Maybe he just couldn’t be bothered and someone died as a result. That, if it were true, would be a depressing thing to learn.

Speak up

I was asked to comment on aspects of free speech – probably because I’m so free with mine and often get it in the neck from fragile people with no sense of humour – so I decided to look into the subject and see what I could trawl from the bottom of the ocean of humanity. cited a media quote in which someone stated “There is no law against offending people. This applies to all sides of the argument. You may choose to give offense, take offense or neither. I choose to be offended by attempts to replace self-restr¬aint, manners and etiquette with legislation.”

This is true but it didn’t stop one of the most ridiculous cases of ‘racist’ reactionism from taking place at local Government level: This story makes me feel physically sick. The woman making the accusation is the only one who was seemingly ‘offended’ by the remark and yet she successfully pursued a campaign of bigotry against the person who said it. To cap it all, she comes out with ‘people need to think before they say things that could cause offence’. What? Is she our mother or something? And who is she to determine what might or might not cause offence? How on Earth is anybody supposed to try and predict the outcome of what they say? If I said it’s raining cats and dogs today and someone who loves cats… or dogs (or rain) said to me that they found it offensive, would that be a kind of racism/animalism?

That woman’s petty campaign cost the local taxpayer a lot of money and deprived a local service of its funding. She must be very proud. I’d love to know how many names of ‘offended’ people she gathered during her investigations. None, I would guess. She needs a reality check – we are in debt; we do not need people like you spending our hard-earned and easily-taken money on power trips that prove how great a human being you are. We cannot afford your wasteful stupidity any more.

Frankly, if someone is offended by anything I say – tough. What is offence anyway? It’s a personal and completely immeasurable emotion that causes no real harm. Yes, constant offensive remarks made in a malicious manner are unacceptable but that’s bullying and nothing more. If we choose to believe this sort of tripe we will cease to function as communicators because we will be too afraid to say something that might be construed as ‘offensive’.

The Americans use the word fanny to describe a person’s rear end – we don’t; to us it’s something quite different and not to be mentioned in polite society. So what are we to do when one of our Atlantic cousins pops over for a Women’s Guild conference and uses the word in a perfectly innocent sentence? I say we weigh her down with bricks and see if she floats – if she does she’s a sexist!

If I used the word in London it would cause offence – if I use it in New York, nobody gives a damn. But if I choose to replace it with a childish euphemism like ‘petunia’ then I’m safe. It’s all kind of stupid.

They’ve tried to remove Christmas from under our noses with their shabby reasoning and I’ve yet to see any evidence, written or otherwise, that our non-Christian brothers and sisters were ever been offended by the celebration. It isn’t really about racism you see, it’s about pandering to people in such a sickly, cheesy way, that you think they’ll see you as a better person and that you are just and fair, etc. It’s about holding on to your council job because you have a large minority voting pool and you mustn’t upset them. In my book, ‘protecting’ people against possible offence – people who had not asked to be protected in such a way in the first place - by harassing and witch-hunting others is the worst kind of racism.

I know Jews who love Christmas and I have Muslim friends who care not a bloody jot that we prance around in white beards and stupid boots and strip our land of trees for the bling. They are too busy honouring their own belief system and cultural heritage. A tiny minority of Brits however, are determined to dismantle ours. They are hypocrites.

And don’t lecture us on equality like it’s a bloody science! We all know what is equal and what is not; I will decide when and when not to give someone something equally – even if that means my respect and courtesy. Stop trying to own our God-given personal points of view and emotions.

If I don’t like one person as equally as I like another and the one I dislike just happens to be Irish, or black or a woman, does that make me racist/sexist? I’m a short-arsed Scot and I occasionally get called a ‘sweat’ or a ‘Jock’ and I don’t give a toss. I certainly do not want Mrs Miggins from the local council deciding on my behalf that I might be offended by it! In fact, I may choose to be offended by the fact that they put subtitles on TV programmes featuring Scottish-speaking (which is English with a Scots accent) people; Trawler men is a good example. Oh and there it is, another example of blatant ‘ism’ – Trawler MEN. Uh-oh. The fact that is a trawler full of men is irrelevant. But it’s okay, because it’s Scotland and we worry about far more important things up there, like quality of life and being able to laugh things off.

Racism occurs when you carry out an act or omit to do something in such a way as to deliberately and with aforethought, discriminate purely on the basis of another person’s race. Isn’t that the real offence, as defined by law? Now, the Deputy Leader of the Council involved states, with pompous authority I should add, that ‘The law makes it clear that what matters is not the intention of the person who uses the phrase but whether anybody is offended by it.’

Does it? Where? The law certainly takes racial discrimination seriously, as it should but I can’t find a damned thing that says you can be jailed or fined or castrated for saying something - especially if it’s an innocuous remark about drums! How can saying ‘you can’t stop the jungle drums’ be offensive to anyone? It’s an expression and is as innocent as saying ‘you can’t halt progress’. It does not mean you can’t stop Africans from telling stories, does it? And even if it did, so what? Show me an African person who is actually offended by the phrase.

Remember when they got rid of bah, bah, black sheep? And when they stopped us from saying ‘blackboard’, even though it was a board and it was black? I challenge any of my readers to find a black person who is not proud to be that colour. Black people are not offended by white people saying ‘black person’ – they are offended by any reference that white is superior to black, which it isn’t. The people who decide we are to be ‘taught’ equality are those in power and those who employ. There has to be a control for any sort of abuse, whether that be racist, sexist or whateverist, I agree – but only when it is fair and measured and logical. The people who push it too far are the ones who are now being exposed in the media as bigots.

These are petty, jumped-up people with high-paid jobs that have no place or function in society today. Most of us (that’s the majority and we are a democracy) are fed up to the back teeth with little people telling us what we can and cannot think, say or do. This is clearly a woman who has never and could never, go to a comedy club. She’d been writing up reports for years!

I love a good rant but this is a very serious issue. Let me know what you think. If you can find a law that states offending someone is actually illegal, please let me see it. If I’ve offended you with this post, by all means, keep it to yourself. There are much more important things to worry about these days if you want to worry about minorities and the dispossessed ;

And just to prove that the world needs fewer idiots, a recent emergency call was taken from a Mr Ivan Gravy stating that he had splashed burger sauce in his eye!

Be safe.