My Private Passion

What has His Royal Highness Prince Charles’ appearance on Michael Barclay’s Private Passions (Radio 3, Sunday at noon) to do with a road crash (Glasgow, Sunday at 4)?  Let’s see.

I listened to Private Passions while driving into Glasgow to visit somebody recuperating from a fall.  I think Michael Barclay is the best interviewer on the BBC.  Of course this interview was always going to be slightly different; Michael wasn’t going to be on first name terms with his guest, at least on air.  But he handled what might have been a socially awkward situation with the utmost tact and charm, and he was able to ask quite penetrating and occasionally challenging questions without prying.  It was a real conversation.  His Royal Highness remarked twice, “You’re very well informed!”  I rather admired his choice of music which tended on the whole to lift the spirits.  Beethoven, Haydn, Wagner (twice)…  No Elgar.  No Parry, come to think of it.  HRH clearly has a strong sense of the absurd, and there was much gentle laughter.  He came across as rather modest, even self-deprecating.  Michael asked him what career, with his many interests, he might have pursued if he had not been born into his particular situation.  Impossible to know, was the reply, but whatever it might have been, he didn’t imagine he would have been very good at it.

Later, we were walking in the west end of Glasgow as dusk fell, enjoying the preternaturally mild winter weather.  It is the sixth night of Christmas, and the broom is in bloom.  My companion asked me what my Hogmanay blog would be about.  I said truthfully that I hadn’t a clue.  Maybe I would write up some sort of reprise of 2018, with a putative glimpse into 2019.  Or I would hear something on the car radio on the way home that would set me off.  Something would turn up.

At that precise moment came a crash so loud that I instinctively ducked.  Something had exploded right beside us.  I turned to my right, and saw the immediate aftermath of a road crash.  At least three cars were involved.  Everything on a busy thoroughfare came to a halt and people emerged from their cars to investigate.  It was actually my companion who alerted me: “You’d better go take a look.”

I glanced into the three cars and conducted a quick triage.  The girl in the front passenger seat of the most crumpled car looked very unwell to me.  Pale as a ghost.  I asked her how she felt but she could only moan.  I took her pulse.  Thready.  I went round to the driver’s door.  It was jammed but I wrenched it open and laid her supine across the front seats.  But there was a lot of smoke in the air and I realised we needed to get her out.  I tried to ascertain as best I could that she had neither a neck injury nor a back injury and then, with some help, as gently as I could, I got her out and on to the pavement.  I asked around, “Has anybody phoned for an ambulance?”  I can’t say I got a reliable answer.  So I dialled 999.

“Emergency.  Which service?”

“Ambulance.”

“Ambulance.  What is your phone number?”

I gave it.  Then I said, “I’m at a road crash that has just occurred at the junction of X and Y.  I think it has already been reported.  I’m a doctor phoning to say one patient is very unwell and we need a ‘blue light’ ambulance immediately.”

“Where are you?”

“As I said, at the junction of X and Y.”  I even gave the post code.

“Which city?”

O Lord.  Maybe they’d outsourced to Delhi.

“Glasgow.”

“And the location?”

I gave it again.

“Could you spell that?”

Well, the road on which this crash occurred is extremely well known, at least to Glaswegians.  I said, “Look, I’m just making this call to ask you to get an ambulance here as quickly as possible.”

“Are you on duty?”

“No.”

“In that case I have to go through a protocol with you.  Is the patient conscious and breathing?”

“GCS 14.”

I don’t know how that went down.  Actually, she was really GCS 12, but she had no English, and I had a sense she might have communicated better in her own language.  I endured a lengthy catechism that I could sense had been devised by a manager entasked to provide a bulwark against the last litigious onslaught.

There followed a delay.  It is very frustrating to provide bystander care to a patient in the absence of the tools of the trade.  There is very little you can do.  It was a great relief to me that she pinked up, that her pulse improved, and that she was able to communicate through her husband, who had some English.  The police arrived, and seemed to be absorbed directing traffic.  A paramedic arrived, and wandered around appraising the scene but made no contact with patients.  Lots of emergency vehicles arrived but nobody came near us.  Eventually the ambulance turned up and my patient received attention.  The trick of being a good Good Samaritan is to step in, make a difference, and then get out.  I hope I correctly identified the point at which I was no longer needed, and disappeared.

Is she okay?  I don’t know.  To know that, you need to be the emergency physician who sits down beside her, takes a very careful history with the aid of an interpreter, and conducts a very careful physical examination.  I hope she’s all right.

But I don’t think the response of the emergency services was that impressive.  It took about half an hour for the ambulance to turn up.  Finally, there were a lot of emergency vehicles and personnel on the scene, but a curious lack of meaningful activity.  I did find myself thinking, this wouldn’t happen in New Zealand, in Australia, in the United States.  This is a peculiarly British response.  Never volunteer, keep your head down, and if there is a protocol to follow, trudge through it.  UK emergency service personnel don’t have a high opinion of themselves.  They know their place.  Our society is hierarchical.  People do as they are told.

Hierarchical societies tend to espouse “social mobility”.  The only way out, is up.  Hedge Fund managers are more valued than carers.  But social mobility is tosh.  The human interactions that really matter are intimate, and one-on-one.  Jesus taught his disciples this when he washed their feet.  The interactions that really matter happen at the kerbside, in the gutter.  And we are not automatons.  We are not pieces of software.  You can’t create an effective emergency service by getting everybody to follow an algorithm.  You need to roll up your sleeves, step in, and talk to people.

I thought of Michael Barclay’s question to Prince Charles: what would he have done had he not been heir to the throne?  I turned the question on its head, and asked myself, what would I have done if I had been heir to the throne?  I suppose my answer must be the same; I will never know.  But I like to think that I would have abdicated and gone to medical school.

 

 

 

 

 

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