What is your emergency?

I’ve been watching a three-part documentary called ‘Ambulance’ on the BBC. If you haven’t seen it, it’s well worth a watch on iPlayer. 

‘Ambulance’ – BBC (c)

As fascinating as I found it, it challenged me. I used to think I had bundle loads of empathy, but watching some of the calls who ‘waste’ the time, money and resources of the London ambulance service, I find my true colours coming out and I’m not sure I like what I find. My levels of empathy definitely have limits! For example I feel immensely frustrated with the failing of the mental health provision available. It seems to me that we need a mental health A&E – for those who are having a lapse into unmediated bipolar; who are full of anxiety and can’t get hold of their care teams; who are threatening to jump off Hammersmith Bridge; who are homeless and incoherent; who are having a crisis in the throes of dementia and constantly, and I mean constantly, phoning for ambulances. I’m not cross with those people – and yet at the same time when there’s someone else, for instance, whose 6 year old daughter has fallen from a bunk bed and hit her head – it is frustrating to see the delays in others getting treatment. For those with issues of homelessness and/or alcoholism – is an ambulance what they really need? Wouldn’t sustained help to rehabilitate, to get warm, to get fed, to get cared for be better?

And what of the elderly? Some with no friends, no family and failing health – lonely, worried, vulnerable. One man has a carer come in three times a day, but it’s not enough to stop him calling for ambulances again and again and telling them his heart hurts. I almost wonder if it’s heartache – he seems so desperate for someone to look after him, to care about him. It’s not traumatic heart pain and he doesn’t need taking to hospital so the ambulance crew discharges him, again. You can’t help feeling that he may well call them back before the night is through. He is clearly troubled.  Where is our social care in all this?

The ambulance service staff talk about what avenues are open to them, and those which simply aren’t there. What would it be better to do with and for the homeless guy who discharged himself from hospital with a canula still in his hand (it can’t be removed by the ambulance staff – why, I’m not sure)? Back to hospital he goes, with his suspiciously diluted bottle of Coke which he gulps regularly, and clarifies his priorities, “when I get there, I’m going to tell them I want a sandwich, otherwise I’ll die.” They get there and they’re out of sandwiches for patients apparently (who even knew that was a thing?) and the best they can offer is bread and jam. Apparently that’s not up to standard – he doesn’t like bread and jam. Huh. Then he falls asleep sat in a chair in the warmth waiting for his canula to be removed. It’s a result of sorts.

It’s a strange kind of poverty that we see here, and compares peculiarly with what you see in other countries where we see people fall on a sack of uncooked rice or flour like vultures, desperate for anything to feed their families. Perhaps it’s a poverty of community, of social care, of family? I don’t know. Neither, it is clear, does the government.  

I feel frustrated for the paramedics on a Friday night dealing with an ecstasy drug overdose; a stabbing, sorry no – stabbing, after stabbing, after stabbing; a taxi driver punched; a guy in a pub glassed in the face…by a woman; people passed out from alcohol; people fighting – is the assailant still on scene? On with the stab vest. Seriously? This isn’t what these courageous, caring people signed up for (although one young paramedic does love the adrenaline of the unexpected and the chaotic – just as well really!).

The guy who has the unenviable job of assessing the calls and deciding who gets an ambulance, and who must wait when there is no one available – that’s right, no first responders, no ambulance crews, no air ambulance, no motorbikes, none of the private ambulances contracted to provide additional cover, no volunteer responders (again, who knew?) – he says he anticipated making a difference, helping deliver babies by phone,

and giving life saving instructions for CPR – it’s just not like that now, they are small percentage of calls.

I mentioned empathy – and I found it really hard to continue to feel for the woman who repeatedly calls up saying she’s having an late miscarriage of a stillborn baby when really she’s an alcoholic and just wants help and attention. Especially when that means a 92 year old ‘elderly faller’ who has been on the floor for hours (three hours, I think, in the end) has his ambulance diverted away at the last moment to help her. 

She has needs clearly – but an ambulance wasn’t the answer. 
What of the older man with bipolar who hasn’t been taking his medication. He has been sat outside in the cold for hours, and his son is at a loss as to how persuade him to accept help. He won’t let the paramedic even touch him. The police have to be called to assist.

The only ‘avenue open to them’ is to take him to hospital- it’s that or if he resists help and is a danger to himself or others, it’s the police station. Sadly he’s been there before. They do their best to care for him without having to resort to handcuffs and manage it in the end. You can’t help feeling though that this mental health problem and the man suffering with it, is like a ball in a pinball machine, passed from pillar to post. 


Now, they’ve done their bit, the police and ambulance can get on with dealing with other more serious call outs, and he becomes the hospital’s problem. I’m not entirely sure what they will be able to do for him, but it’s pretty certain that numerous nurses and doctors and other hospital staff will be involved. They will now get to tussle with him, cajole, persuade and placate him with a mental health band-aid until the morning comes, when I guess his social worker or mental health care professional will be contacted- “Aha! Tag! You’re ‘it’!”. But strangely no one is laughing; and the ambulance crew know that more likely than not, they’ll meet this chap again- in a week or a month. Do I feel cross with him for stopping taking his medication and ‘bringing this upon himself’? Momentarily, yes; but of course I know it’s not that simple, and medication isn’t the panacea we wish it were.

The call out for the ambulance is about £450. Imagine totting up the cost of all those resources and staff across all the different services – police, ambulance, hospital, social care, mental health.  And what of the human cost to this man and his family – this is no way to live.  What better illustration of a system which is clearly, if not already broken, then certainly at breaking point?

If I were to end there, it would be pretty depressing. As a tenacious problem solver, I can’t let it stop at that point. The question becomes, so what can I do?

There are different trains of thought here – many would be tempted to say, “well it’s the fault of the government isn’t it”, and then list a litany of criticisms; or perhaps complain about the local MP or NHS. Others might be spurred in to enter politics themselves.

On the one hand it’s too easy to blame; and on the other whilst making a difference politically may be laudable, personally I can bear neither the snail’s pace of progress, the schoolboy posturing of parliament or the untold bureaucracy of local government. Equally whilst campaigning at a strategic level is important – yes, you must lobby your MP and your local council when you see the opportunity to make a difference, if you leave it there, you miss the opportunity to make a difference yourself, today even.

“What can I possibly do, faced with these enormous issues??”

I mentioned community above, so how about some starters for ten: do you know your neighbours? Are there elderly people living on your street? Are there young people you can positively engage with? If you could extend care and compassion to those in your immediate vicinity, you – yes you, can make a difference. 

Pah! I hear you say, so what if I help just one person, how can that ever help our current crisis?

Have you heard of the starfish analogy? Where the little boy says, ‘yes but I made a difference to that one’. Some might say there are limitations to this parable in that blindly doing one thing, without looking at the bigger picture of the ecology and the root cause, could at best cause burnout for the ‘little boy’ and at worst perpetuate the problem with no long term resolution. 

If we want to see significant social change, I think we may need to acknowledge that Government can do some things that impact society, but I don’t think it can cause fundamental culture change; that has to happen from the ground up.

Much of political policy is about looking at dealing with symptoms – more policing, more prisons, more drug treatment programmes perhaps – but what of the root causes?  These are often too big for a political party with a 4-5 year mandate to get to grips with. They require cross-party consensus, cross-cultural participation and commitment to make a long term sustainable difference. 

What are the possible causes behind this panoply of social issues? Breakdown of the family and it’s dispersal far and wide – away from elderly family. Loneliness of older people – some living kinger than others, but sadly often outliving spouses and friends. And the loneliness of young people and children too – living in a world where people think they’re connected – by the wonders of the Internet, but we know according to research this generation is the loneliest ever; cyber-bullying continues unabated; parents are advised to talk frankly with their under-10s about the dangers of sexting. Wow.

We see both adults and teens desperate for escape – they don’t know how to deal with their problems, dysfunctional family life, the mental health issues (estimates vary from 1 in 4 of us having mental health challenges in their lifetime, to 1 in 2. I can put my hand up and say that I am and have been one of that number.) Do people know how to get help? Where do they turn? All too often it is to easily available alcohol – bargains abound in pubs, clubs and supermarkets? Or to drugs perhaps? 

It seems to me, these are people lacking two important things in their lives – hope and purpose. They don’t know what the point of life is any more, and they despair of their existence getting any better. 

‘Be the difference you want to see in the world’ ~ Ghandi

What if on your daily wanderings through life, you could inject a little hope into those who cross your path?

  • Perhaps with the supermarket checkout worker? Give them a smile or a compliment. 
  • Could you give a hearty or silly wave to the kids on the bus and see if someone waves back? See the delight on their little faces!
  • Let that annoying pushy executive car out into the traffic with a smile and a gesture of ‘you’re welcome’. Choose to bless rather than curse them in their stress and drive to hurry wherever they’re going.
  • Thank your child’s teacher for the job they’re doing with your kid – even if you don’t totally agree with everything they do – they’re doing the best they can.
  • See a police person out and about? Give them a thumbs up, or a smile, or a word of thanks.  Be a role model to those around you – show that we respect and are grateful to the defenders of our society and the upholders of the law. 
  • Greet older people out and about – they might look at you askance at first, but persevere – being the ‘salt and light’ in a bland and dark society takes courage and heart! Before long they’ll recognise you and greet you first, and how great does that feel?!

Imagine it starting with you, and with me. Then imagine an army of ordinary people rising up to stamp the ground, and shake the earth just where they stand. Tapping into the organisations already working in these areas*, finding more and more synergies and connections. Wouldn’t the tremors of positive social change start to spread far and wide? You might be just one lantern in the darkness – but what if we were one of thousands or even millions chasing away the shadows and the darkness that pervades our society?

 It’s the accumulated power of the little things. 

If a group of neighbours rallied round to look out for that potential ‘elderly faller’ and pick them up when they fall down. That’s one person quickly helped, an ambulance call saved, and a person having a stroke or heart attack more quickly attended to. 

What if more of us had first aid qualifications? I’ve had to give CPR before – it’s brutal, but it can be life saving. You can make a difference there and then – and if an ambulance is called out, then you know you’ve got that patient into the best possible position for a good outcome with the paramedics.

What if you took the time to find out who amongst the parents at the school gate had asthma, epilepsy or diabetes? What if you took the time to ask and find out what life saving care they could need? A diabetic going into a hypo could be saved by a sugary sweet or drink – life saving help right there and then with the right knowledge. 

I love Jesus with all my heart and I try to love him with every aspect of my life – hands to help, feet to go, voice to speak out on behalf of those who can’t, heart to love, eyes to see those in need, finances to bless, time to give and to serve. It strikes me that my first aid qualification is years out of date now – I still remember most of what I learned but it wouldn’t take much time, effort or money to renew it. To make myself available to those in my immediate surroundings.

Jesus’s told the shocked and appalled pharisees the story of the Good Samaritan (link) – and people today often say, well who is my neighbour? Let’s start with our neighbours. Knock on the door, introduce yourself, take biscuits  – invite them for a cuppa. You never know when you might be on the receiving end of their help. 

It took a bit of courage to knock on the door of our neighbours on a cold winter especially afternoon after we had moved in to our place, and some older folk were pretty suspicious at first.

But since then, neighbours have become precious friends: people who babysit for us; who have called to tell me that in my distracted state I had left the front door wide open; other neighbours who called to let us know that some unexpected tradespeople had tripped our burglar alarm on a Sunday morning; they’ve shared harvest from their gardens or allotments; they’ve provided a shoulder to cry on when times have been tough; we’ve helped with transport to hospital; they’ve watered plants; we’ve messaged to check everything was alright when the curtsins were closed and the lights off for more than a day or two – illness turned out to be the reason; we’ve watched films; commiserated over England’s sporting defeats; had a bring and share lunch, explored selling unwanted stuff on Facebook together!

Isn’t that what building community is all about? When you take a little time to become vulnerable yourself, to risk rejection, to be a little brave…who knows, you might just make the world of difference.
I hope these thoughts stir you up, and make you want to make a difference to your neighbourhood and your spheres of influence!

  • Who could you reach out and make a connection with today?
  • If you have elderly parents or friends – what would you want their community to be like – every day and in times of need?
  • If you have a faith- would you prayer walk your streets and ask for blessing and protection over all those who live there?
  • Could you make a point of smiling and saying hi to the dog walkers and the shoppers at your corner shop?
  • What will you do differently today? 

I’d love to know what resonates for you, and if you’d like to share in the comments below how you are creating a community you want to live in, or what you will start doing, that would make my spirit soar!
* Here in Gloucestershire for organisations I can recommend:

  • The Barnwood Trust – building communities and offering free training for this
  • Trinity Church Cheltenham – homeless ministry ‘The Garage’ and Street Teams
  • Age UK
  • GRCC manages befriending services for the elderly
  • CCP working with children, young people, families and vulnerable adults who have multiple and complex needs
  • Street Pastors engaging people all kinds of people out and about in the evenings and weekends
  • Young Gloucestershire works with young people not in education, employment or training – and offer Prince’s Trust programmes as well. They are always on the look out for volunteer mentors to support their young people  
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