The Nation's Health

One under

"42 year old male, jumped in front of train"

Alarm bells ring. This is not a job even the most enthusiastic of trauma junkies particularly enjoy. A 'one under' is a term used to describe the rather unfortunate situation of a person under a train. This unfortunate situation occurs through either accident or suicide but more often than not, its sadly the latter. In almost 50% of 'one unders' the result is a fatality. This number is much lower than I had suspected it would be. I was expecting mortality to be in the 90s. After all, the human body is not designed to cope with the trauma, of the best part of two hundred tons of train, hitting it at a speed of 30mph. Over the past 10 years in the city there have been 568 'one unders' of which 261 have been fatal. That's over 1 a week.

Today we had about 2.5 miles to drive. Just enough time to get a game plan and remember what we need to do. Hi-vis's donned, safety helmet on and as much kit as we could carry including all our response bags, paramedic bag, rescue board, collars and pockets stuffed full of everything we might need under a train. We were met at the RVP by the Rail Incident Officer (RIO) and confirmed we had 'power off, trains stopped'. Short circuit devises were in place on the tracks and it was a confirmed 'one under' suicide attempt.

This was a deep station, a very long way underground, therefore it took a good few minutes to get down there along the maze of corridors and plethora of escalators. It also meant there was a high chance we would be incommunicado and would have to rely on station staff relaying messages to our control. We got to the platform, the train was three carriages out of the tunnel. There was an ominous spreading of blood on the front of the train. The 'jumper' had jumped when the train entered the station. Doing so at this end of the platform signifies much more intent on suicide and a decreased chance of survival. We climbed down onto the tracks and into a 'suicide pit'. These pits were introduced in the 1930's during the depression when suicide rates were extremely high. With the use of emergency lighting and torches we were able to see the motionless body, the length of a carriage away. He was just a silhouette against a back drop of track and train.

I made my way towards him, staying as close to the floor as I could. The heat under the train was like nothing I have ever experienced. So intense. The sweat was dripping of my brow with every movement I made. I could here the commotion on the platform, I could hear creaking from the train as the cooling metal constricted but more than anything I could hear my own breath. It was an aery experience. I was also all too aware that I may come face to face with rats but I tried not to think about that! The closer I got to this guy the more evident it was that this was futile. I could see the pool of blood he was in, I could see he was missing a shoulder and arm and I could smell burnt flesh. I finally reached him. He was lifeless. There was massive cranial and thoracic destruction. He was partially entangled between the wheel and the track. His torso contorted to the point where I didn't really know what part was what. This guy had been successful in his suicide attempt. There was nothing anyone could do. I laid there, on my front, under a hot train, filthy, covered in blood, just staring. I wasn't upset, to be honest I don't know what I was but I just starred. What could possibly have happened in this guys life to lead him to such desperation? I just don't understand the thought of killing oneself, and especially in such a public place in such a unreliable and disruptive way. I can’t help thinking that if I was at the point of taking my own life I would not go and buy a ticket at a station and stand amongst the silent commuting throng waiting for the next southbound train to greet me.

I climbed back on to the platform. Removing him wasn't our job. We spent a little while with the driver. Luckily it appeared not to affect him. He had an air of apathy about the whole thing. If anything he saw it as a bonus. He'd get a few months off work so was perfectly happen with the outcome. Morbid? Heartless? Maybe its just a coping mechanism. Maybe he just doesn't care. By this time, the platform was swarming with masses of people. HEMS had arrived, the British Transport Police were there in large numbers as were the Fire Brigade. We made all the relevant smalltalk, regaling the crawl, taking the jokes about looking like a chimney sweep and grabbing call signs for our paperwork. We collected our kit and made an attempt to remove ourselves from the circus. As we got to the top of the first escalator a smartly dressed man approached us,

“Did someone jump under the train?”

I looked at the blood on trousers and hi-vis momentarily before assuring him that, yes, they have. He paused for a moment, looked at his watch and said,

“So, how long before we get on the move again?”

I was to look back on this exchange with amusement and also, strangely, comfort: in the midst of the horror, normality was briefly restored by a commuter asking for alternative travel arrangements.