Emergency: Britons having fun

A SMALL trolley stood primly to one side of the reception desk. On it were stacked a clean pile of vomit bowls, a few hundred disposable surgical gloves and a heap of incontinence pads. It was new year's eve, but the mood was not exactly festive in the accident and emergency department of St Thomas's Hospital. 'We don't normally have vomit bowls laid out at reception,' sighed the assistant director, Susan White, 'but those are what we are going to need.'

Being in Lambeth, just south of the Thames, St Thomas's covers emergencies in Trafalgar Square. And on new year's eve, its busiest night, Trafalgar Square delivers emergencies of a monotonous kind. The first arrived, just as predicted, at 11.25, prone on his trolley, visible only in patches: large hairy legs, a pair of immobile trainers, some vomit-speckled hair.

'He's had a combination of beer, champagne, and something else,' said the ambulanceman, deadpan. 'We think he's Spanish.' A faint cry of 'Waaaa-aaaa' came from the trolley as it was wheeled away to what staff called, for want of a better euphemism, the 'medical area'. On its floor ('You can't put them on trolleys because they roll off,' said Ms White) rows of waterproof mattresses had been laid. At the young man's head was laid a vomit bowl. At his other end was placed an incontinence pad. Helen Stubbs, a 28-year-old nurse, had a 14-month-old baby at home. Instead of seeing in the new year with her child she gazed down at this larger, less attractive substitute with faint surprise.

By the main door, totally unsurprised, waited Inspector Stephen Grainger and Sergeant Paul Brooker of the Metropolitan Police, in case turmoil broke out in Trafalgar Square or at St Thomas's, or assault victims made statements. 'My wife's at home. She's not impressed,' said Inspector Grainger. 'And my other half's on a horse in the middle of Trafalgar Square,' said Sergeant Brooker. 'She's equally unimpressed.'

At midnight, the chimes of Big Ben came over the television, and the staff quickly looked up from their forms and vomit bowls and kissed one another. And then they returned to them again. 'The first casualty of 1993]' said Stuart Cable, charge nurse, as a young man in blood-splattered jeans with lacerations to his head was wheeled by. 'It's like the first baby of the new year]'

At 12.20 the ambulance crew returned with another find, this time from outside Charing Cross station. Moans came from the trolley. 'Hello again,' said the ambulanceman. 'This one has a bit more go in him.'

In they came, one after the other, bound to their trolleys. Almost all were men in their late teens or early twenties, in dirty jeans over which they had vomited. Some had tags attached to their wrists like newborn babes. So they lay, helpless and nappied, a strange end to so much macho manhood.

As the night progressed the space for mattresses ran out. Three young men had thrashed around and ended twined round one another, blearily convinced they were hugging a girlfriend to their sodden selves. Through a heady stench composed of vomit and alcohol fumes moved the slight figure of Helen Stubbs, picking her way round the prone forms, every half-hour checking pulses, peering into vacant eyes. I asked if she would manage a new year's breakfast with her family. 'Oh no,' she said. 'My husband works with the ambulance service, he's on shift at 5am.'

Outside the 'minor surgeries' department a line of men sat or lay: punchmarks embedded on their cheeks, bottles broken on their heads, noses broken, lips cut. One had been bitten, one had had a cigarette stubbed out on his eye. More than one had crush injuries from Trafalgar Square barriers. 'Happy new year]' the ambulancemen said with ironic detachment to their prone charges.

Kate Caine, clinical nurse manager, was leaning on the front desk, reminiscing cheerfully. 'Last year we had someone who had fallen in the water - did he fall or was he pushed? Absolutely gaga. Grinning from ear to ear. Some years I spend my time mopping up the blood from the corridors, there's so many stabbings.'

It was 1.30. The scene was becoming, as one of the porters remarked, pretty lively. Into it ran a man with a convulsing baby. 'Someone take my baby] Quick]' The registrar ran.

A young man was wheeled past breathing heavily, his distorted face covered in tattoos. A bell rang to warn that a man with multiple chest wounds was on his way: 'Clear the ramp]'

The staff had been doubled for the night to 14 nurses, five doctors and three cleaners. Every one of them was working flat out. 'Could you ask control if any other hospital has spare capacity . . . ' began Ms White to the ambulance crew as a woman urgently demanded her husband's whereabouts.

'Every single hospital in London is going mad,' one of them said. 'OK,' she said, resigned.

'This is another drunken gentleman picked up by County Hall,' said a passing crewman. 'There's loads more. We've got 20 calls stacked up. What are those people rushing in?' 'Multiple stab wounds,' came the answer. 'They got into the spirit of it then,' he said.

An older, stretchered man came by, hit by a bottle in a pub, his face covered in blood, only his lips moving as he told the ambulance crew to fuck off. 'Shut your gob]' cried a large woman behind him, covered in blood. 'I've got your teeth] You're all right]'

And then a very young man in evening dress, his black tie undone, lolled from his wheelchair while an elegant woman in an expensive fur, perhaps his mother, held a bowl to his sagging mouth. He was wheeled - there was no first-class compartment - to the mattress room, to lie in the common pool.

Sergeant Brooker surveyed the scene. 'Bane of our life,' he said. 'Drunk young men. Not just on new year's eve.' By 3am St Thomas's casualty department had dealt with 75 cases, of whom, according to Dr Chris Lacy, senior registrar, at least three-quarters were drink-related. The cost, in ambulance, nursing and police time, hardly bears thinking about.

Around 35 friends and relatives lay slumped about the room in various states of desolation. They were in for a long wait. Earlier a young man in hippie gear had wandered over to reception. 'Scuse me,' he said. 'I'm waiting for an X-ray. Can you tell me how long it'll be? 'Cos I'm dying for a drink.'

(Photograph omitted)