Warning! Ambulance related post! And possibly a bit of a rant too. Avert your eyes if you must.
Recently, I was called to a man threatening to jump off a motorway bridge, hanging precariously from the outer edge, one foot dangling and white hands grasping the rail with a shaking grip. The police asked me to talk to him as he was only willing to talk to a (neutral?) paramedic, and the police negotiators couldn't get on scene for another 45 minutes.
I called upon all my negotiating training (i.e. none) and proceeded to have a chat.
At one point, quite early on, he really looked like he was going to do it. I mean a proper 'This Is It' look of resigned defeat in his eyes. I decided that this wasn't due solely to my conversational style (although it wouldn't be the first time) and I adjusted my stance accordingly.
Once, not even that long ago, I might have stepped in at that moment and gone for a securing bear hug. There is an inherent risk in doing this as they can take you with them, and no-one will ever think less of you for not doing it. In the old days, it was a risk that I might have deemed worth taking.
Now, I'm not so sure.
My baby daughter is sitting on my lap as I type this with one hand, giggling and eloquently reminding me exactly where my priorities lie.
Instead, in this case, I braced my foot against the base of the railings, examined his jacket, identified a suitable hand-hold and resolved to grab it and it alone, should he do a very mediocre Superman impression. I reasoned that, should the worst case scenario occur, I would have a reasonable (but admittedly reduced) chance at preventing a plunge, but wouldn't succumb to being dragged over the rail and onto the carriageway below.
And to anyone who might say that this isn't enough? Well, tough titty. I'd rather have to explain to a coroner why I didn't put more effort into saving someone than have someone else tell my wife that she needs to find another
sucker partner to help pay the bills and look after the kids.
Of course, this might sound like a straw man argument, because who in their right mind would suggest a rescuer put themselves at undue risk when on duty?
Well, the coroner involved in examining the recent Derrick Bird massacre, for a start.
I wouldn't usually post a link to the Daily Fail, what with it being a right-wing homophobic, racist rag with the moral compass of a blood-hungry mosquito, but the headline is a grabber.
There is an old saying that a good rescuer is a selfish rescuer, in that they shouldn't do anything that turns them into just another casualty. Complete emotional detachment is neither possible nor desirable, but neither is getting so involved that you become of no use to the patient, and possibly just a drain on already stretched resources.
I wonder what the coroner's judgement would have been had a member of the emergency services gone in and been shot as well, especially if it subsequently turned out the original victim had been beyond help anyway.
Who would thank me for getting myself killed or injured trying to save someone else? The victim? The victim's family? My family? My employer?
We take risks all the time in this job. In the unfamiliar, dark house with the only information being "He's been cut!"; in the nightclub toilets where someone has been beaten unconscious; at the industrial accident where unfamiliar machinery is still running, or to the extremely well-known patient with a tenuous grasp of whether or not he's allowed to hit ambulance crews.
Often, with single occupant response cars being de rigeur at the moment until the media discover what a cop-out it is, we do these things alone, at night, with our hands full, and with only the briefest of information about what's been going on passed to us via the radio.
We make a decision, depending on whether or not we think the danger outweighs the response, on our familiarity with the location, on how we're currently feeling, and we hope out decision is the right one, both for ourselves and for the patient.
From a personal point of view, a victim apparently dead from a shotgun blast with the killer still possibly on scene is not something I would attend without armed police securing the area first.
If this is construed as cowardly, or health and safety gone mad, then you can colour me yellow and stick a Slippery When Wet sign on me, but at least I'll have a higher chance of going home at the end of the shift.
It's not something I feel the need to apologise for.
And the man on the bridge?
Well persuasion, and a graphic description of what injuries I would have to treat should he quite feasibly survive the drop, led to a happy (for us) conclusion, in that he decided to let me help him off the ledge and into a warm car, for a chat with the negotiators.
I think we both made the right decision.
Thanks for listening.