The potato chipper, p.3
The Potato Chipper, page 3
What occurred was that a fifteen-year-old boy had taken possession of his father’s car between 06.00 and 07.00 hours on the final day of the school term. The car was to be sold later that day. He felt that it would be daring for him to go around to a variety of his friends’ houses to pick them up and drop them off at school. The first two runs were successful. However, the third run was not, as he, and his friend, who happened to be staying with him as a guest on a sleep-over because his parents were away struck a lamp post at about seventy miles per hour in a thirty miles per hour zone. The incident played out roughly one hundred metres from the ambulance station that I had been in only forty-five minutes before. We had however been moved to a nearby town to provide cover there and this meant that our call to arrival time was twelve minutes, as we drifted around rolling bends in rural Essex.
On the radio, we were only told RTA with nothing further as to the severity. I was a newly qualified paramedic with about six months experience, working with a new lady Trainee EMT with less than three months experience. We were a potentially dangerous combination. She had left a job in the city to make a difference and lead a more purposeful life. She was a good girl who did everything that I needed her to do at the time.
On arrival, we couldn’t access the scene as closely as we would have liked, the car in question looked like a pancake on the passenger side and a Traffic Cop came over and just asked that we “be quick as it’s pretty bad.” The car was wedged in to a fence and on accessing the scene after hurdling over shards of metal that were hanging from the car, we were confronted by four fireman holding the guy up and pressing an oxygen mask hooked up to a mechanical respirator device (I initially thought he was an office worker in his early twenties, death ages people unfortunately). His legs were still dangling in the foot well of the car and the door had been ripped off. I never checked whether this was after a fire service removal or due to the impact.
Despite all the first aid training that people in a variety of industries carry out, I don’t think that ninety percent of the time, it has any effect, as a basic airway and breathing check would have revealed that this lad was in cardiac arrest. Time and time again, I’ve seen first aiders not respond in the trained fashion despite their best efforts. It’s a tick box culture that is justifying an industry of training that in my opinion isn’t working. I don’t say this to attack the well- meaning individuals who volunteer to act as first aiders, just to fill a gap in medical coverage. My advice here would be to do two weeks of training and get some overseen medical exposure, even if it’s in a casualty department, so you can touch patients and not just deal in theory and mannequins. Talking to people and dealing with the psychological implications of injury/illness is at least fifty percent of the battle when one is assisting in the healing process. Otherwise, I’m of the opinion that it’s better not to even attempt anything as you can do more harm than good.
Anyway, returning to the situation in hand, after confirming that the driver was uninjured (he still needed to be checked due to the forces exerted on the vehicle that had effectively caused the death of one occupant; thus requiring a medical check of the other occupant/s). Three of us lifted the patient over the shards of metal that were protruding while one policeman held his neck as still as possible. We placed him onto a spinal board on the stretcher, applied a cervical collar while my colleague Sarah was administering chest compressions. Temperature wise, it was just above freezing, but my body felt like it was on fire. An ambulance officer arrived to assist, and his help was welcome as he intubated rapidly and applied a bag valve mask while I secured the IV access into his arm.
We were now set and all the directions I gave to Sarah were followed and we immediately slammed the doors shut and hurtled off down the lanes of rural Essex to the receiving facility under lights. ETA was about seventeen minutes and I wished that I’d had an abseiling kit about me to tie off the interior of the ambulance as every sharp bend caused my body to be thrown around in the back, as I alternated between the chest compressions and pressed the bag valve mask to perform ventilation on the patient.
It was after a short while that the patient switched from a flat line asystole reading to a pulseless electrical activity reading. This meant that we had a 0.0005 percent chance of getting him back and the forced resistance as I pressed the (respiratory) bag indicated a Tension Pneumothorax (a collapsed lung where a pressure build-up in the pleural cavity area around the lung can compromise life and/or prevent recovery). The temporary solution to this is to insert a large cannula (basically a long needle) into the chest wall to drain the excessive air from the chest wall that is compressing the other lung and the heart. This I duly did on our patient, which is no mean feat when you’re doing fifty to seventy miles per hour around bends and over bumps. Times like these make you realise that road tax is not reinvested into the roads.
We arrived at the hospital, and I immediately called it as a let’s not go any further, with the clarification of the receiving Trauma Anaesthetist and overseeing doctor. It was then that I was told that the victim was a fifteen-year-old boy who had been on his way to school. The trip to the mortuary was a sobering experience and all I can say is that my driving slowed considerably after that job and I reminded myself that the one way I would push on is to realise that I never knew the patient and he wasn’t somebody I was close to. It was a horrendous experience to hear the story.
I can’t emphasise enough the value of genuine friendship/relationships with others. A good friend of mine also called Paul who qualified at the same time as me was a valuable listener with great knowledge of extreme psychological strain. He was a Falklands War Veteran who had fought in the worst battle of the war at Mount Longdon. He had qualified as a Parachute Regiment Pathfinder and served on an attachment with the US Army Rangers. He and I often compared notes and it was with great humour that he told me of a medical emergency call to a home for retired nuns that he had only recently been to.
Paul was dealing with a lady who had an unexplained illness which certainly appeared to be nothing untoward, although further hospital assessment was needed. He and his colleague proceeded to move the lady to the ambulance, and they moved off at a slow speed with the retired nun comfortably resting on the stretcher. It is at this point that I must inform you that my friend never knew his biological parents and after having been abandoned at birth, he was brought up by … yes, you guessed it, nuns, who were not the most forgiving of people and he was regularly thrashed for bad behaviour.
Believe in Karma Dear Reader? Press on and give me your opinions. During the transfer to hospital, the nun collapsed on the stretcher and went into cardiac arrest. My friend promptly spotted a Ventricular Fibrillation arrhythmia which he proceeded to shock with one 200j jolt and our sister returned to life wondering what the bejesus had just happened. My friend promptly asked her if she had just seen the light? She responded with a puzzled ‘nooohhh’ to which my friend retorted, ‘you should have done, you just died … before I got you back!’ I reiterate, if you witness an arrest, or can respond very quickly, you have a fair chance of saving the person’s life which was fortunately the case with our sister.
Days, weeks, months and years passed where I learnt the tricks of the trade that I needed in the important five percent of jobs. The other most valued trick was pulling up the jumper of the many drunks that I dealt with and wrapping it right over their heads as I didn’t want them to vomit anywhere else except on themselves.
A few other notable episodes included a twenty-three-year-old guy that was waiting for a kidney transplant who had been unable to dialyse for three days. We had been trundling in the ambulance into Chelmsford centre when the call went out. It popped up on the screen as a twenty-three-year-old male with Chest Pain. Bollocks! Both myself and my quick witted, dry humoured Lancastrian work-mate Mick felt the same about that. Basically, this had to be complete nonsense. Our thoughts were that ‘young men don’t have chest pains unless they’re suffering from self-inflicted BS or it’s subsequent to an assault.’ The call was in a town called Great Baddow and we were about to be proven completely wrong.
The guy’s wife was awaiting us outside the house and led me up the stairs to the room where our patient was lying, reclining on a chair, with various implements attached. The story was that the dialysis equipment had failed, and my understanding of such situations is that the potassium levels rise causing a developing toxaemia in the blood, thereby slowing the heart rate considerably.
It was immediately apparent that he was bordering on cyanosis, and we needed to move him quickly. I instructed his wife to clamp off and remove all the dialysis equipment and when Mick arrived to back me up, we needed the chair and a blanket to move him. This is an aspect of the job that ER rarely covers, basically lifting and handling and getting the chap down the stairs, wrapping the patient in a blanket really helps all concerned to secure, lift and reassure all concerned.
Once in the back of the vehicle, we lifted him on to the stretcher, opened the blanket and put him on oxygen before attaching the ECG leads to quickly ascertain his cardiac status. He had a profound bradycardia (a heart rate of 35) with hyperkalaemia (medical terminology for dangerously high levels of potassium).
Once that was ascertained, Mick jumped in the front and drove us at speed, under lights to Broomfield Emergency hospital in Chelmsford; and I set to work on getting an intravenous cannula into our man while we were flying around bends and hurtling past traffic. It took four attempts to get the IV line in, but we succeeded and within ninety seconds of administering Atropine (which blocks the Vagus Nerve – responsible for slowing the pulse rate) to his system, his pulse rate had increased from 35 to 140 and his perfusion improved dramatically. We had bought him time for the hospital to organise him some dialysis. That had been a close call and one of maybe twenty occasions in my nine year road career where I felt that we had really made a difference.
The weeks blurred into months, thrombolytic administration for heart attack situations, intubating rapidly in smoke inhalation cases, cutting the skin on the chest during burns cases to relieve the belt like tension that inhibits breathing were all useful skills but the daily and nightly pressure of patients and relatives’ torment combined with the increasing levels of self-defence requirements due to a public, that was becoming increasingly knowledgeable about their rights while forgetting their responsibilities insidiously allowed burnout to creep up on me.
I found that over the course of two years, the pumped up feeling that I felt driving in for shifts increased to a degree, such that by late 2006, I realised that the pressure of it was not subsiding during my down-time.
Ironically, it was at this time that I started to receive approaches from several acquaintances, friends and former colleagues who were working in the Middle East in the Risk Management field. Iraq was the main theatre, along with a small number of African countries and of course Afghanistan.
Constant encouragement to combine my medical skills with the military techniques that I had learnt in the previous chapter of my life made it a tempting proposition but my mind needed to resolve itself before I could consider entering an environment such as that. Three things made the late 2006 period onwards to 2009 an interesting, catalytic period of my life.
One of these was a physically stunning but bipolar woman becoming involved in my dating life, the second, was the opportunity to work with one of the best surveillance operatives in the business. Although both were mostly a positive for me initially, the latter caused further mental strains due to the exacting demands of the profession, as well as his complete paranoia and suspicion of everything (which I must add was the reason that he was so good at it). The final leaf of the shamrock was transitioning to training under one of the most sought after Martial Arts Training Sifu’s in the world, Sifu/Kru Paul Whitrod.
4. Martial Arts Baptism Part 1
In 1999, I became heavily involved in the hybrid style of Kung Fu, as well as Judo. I’d been stationed in the North Essex area of the UK and kept a house there after leaving the service. I had partaken in a bit of one touch Karate a few years before that with a very diligent and hard-working instructor who had done his time in Japan, but logistics meant that I could only complete fourteen months.
I was keen to get back to that and arrived at the Dragon Martial Arts School which had a good pedigree of producing guys and gals, boys and girls who could win tournaments and being competitive in the sporting sense, I was keen to get stuck in and learn.
The school mixed practical self-defence, traditional style work on old internal Kung Fu systems such as Tai Chi, Bagua Zhang and Hsing I, as well as American Freestyle rules kickboxing fought on a mat with sweeps being allowed.
My first session saw me paired up with a fourteen-year-old lad nicknamed Psycho who although enthusiastic, was nothing of the sort, and the name I was to come to learn was a compliment for his fearless brave nature. He would attempt things that his peers wouldn’t try. We worked on wall drills which consisted of one guy defending, blocking, parrying while one hand and foot remained rooted to the wall while the offensive guy moved around lunging through with precision kicks, punches and just generally trying to break the guard of the guy that was on the wall.
This was done in a semi-contact sparring manner where timing was, and still is of the essence. There’s a very fine line between striking with a touching, stinging blow that does not follow through with a full on, aiming to strike through to the back of the body or head blow.
After four months, working off the recently acquired learning premise of throwing somebody in at the deep end of a scenario to see how they perform, watching, learning and then subsequently de-briefing to praise the positive points before working on the chaotic idiosyncrasies to correct them, I decided to enter our own association, in-house tournament.
There were no weight categories for that and there were approximately eighteen fighters entered. The system was of a knockout nature, with each bout being one two-minute round, fast and furious with a points decision based on who had landed the most effective blows determining the winner. At the beginning of the event, the referee and overseeing judges called us all onto the mat to give us a facts of life lecture and this was to be the first of many such events where the nerves would jingle slightly and the excitement and anticipation would accelerate as one would look around thinking which one of these sultry looking dudes I would go up against.
There were gym loving meat heads (who actually proved to be extremely fast, flexible and of good character for the most part), a tattooed circus high wire walker, wiry but fit looking intellectuals, guys who appeared flexible and fast but you couldn’t gauge whether they were the kind that would fly in to a rage on the mat or use a counter-attacking tactic using their opponents energy – You’d always be surprised how people would combat one another.
The mats, at about eight metres squared had been set up at the end of an open hall that was about fifty metres by fifteen metres with about three hundred and fifty spectators sitting on a row of chairs, staggered back towards the door. Prior to the start of the fighting, it was fun to have your name read out as one half went to one side and backed up against one wall with the other half going up against the other wall and for a fleeing moment, the guys on my wall were an ally with the guys on the other wall containing the one initial enemy and I found myself still looking as the first two names were called (I wasn’t one of them), thinking ‘come on, who is it?’
The first two to three bouts passed with some serious skill and ferocity being shown. I was to first witness the often used whirlwind sweep where one guy throws his body on the floor while one of his legs acts in a scything motion to cut and take his opponent of his legs. It was devastatingly effective, crucially, if timed well.
My name was called and I looked up and heard the name Alan Matthews reverberate around. I didn’t know him. He was bigger than me, but it wasn’t pure muscle, he was stocky and held a brown belt so at the time, he had more experience. I looked across as the red belt was being tied around me while he had a white belt around himself. My corner gave me a quick pep talk saying, “go right into him and use speed. He’s big and he looks like he’ll try to use force.”
We fought one two-minute round, fast and furious with a few clean scoring kicks and punches. I threw a couple of roundhouse kicks which collided with his outstretched legs and as time was called, I didn’t know how I’d done to be honest, as different fighting sports score blows very differently. I lost but considering that I’d zipped through four months of training to his eight plus years, combined with his impressive levels of flexibility and speed for such a stocky bloke. I was not disheartened, just slightly confused as to the way forward as I didn’t really comprehend how I’d lost. It was just a fast and furious bout with an equal spread of kicks and punches landing, with him probably having fifty-five percent of the territory. Maybe that was what won it for him. He won his next bout and then lost his third to the eventual runner up. I felt a sense of accomplishment as I resumed my training and was not disheartened in the slightest, feeling instead that I’d shown a combative spirit to enter the fray and battle.
The following weeks and months led to intensive training with my coaches and a small, tight-knit circle of friends, as we aimed where we wanted to go on the fight circuits. We wanted to be as good as we could be, basically the best; and we looked to train our speed and power. Our coach, Sifu Keith Dwan, a tough South London guy, full of beans, with a big smile but with a rebellious side which I identified with due to our shared Irish links decided that Speed Work mixed with hard hitting power would be the starting point for our progression.
For this, he decided that Mok Gar splashing hands was to be the teaching tool. The sessions of splashing could be brutal, stamina wise. The quietude of a training hall or dojo could be broken by the powerful bellow of a peculiar kind of crackling as slaps and kicks shook the walls to their core. Punches sound like Bullwhips as the splashing hands system echoed through the hall.
