The medic fighting to save young victims of stabbings
‘If you’ve been stabbed in the heart, chances are you’ll die after bleeding in the street’
19 July, 2019 — By Emily Finch
Dr Stephen Metcalf: ‘If you open up the chest and take the blood clot out and put your finger in the heart chamber they can survive’
AN EMERGENCY medic has told he now treats three to four people every month who would have died from their injuries just a few years ago as doctors face the challenge of critical stab injuries.
Dr Stephen Metcalf, originally from Tufnell Park, is a consultant in emergency medicine at St Mary’s Hospital in Paddington – one of the capital’s four trauma centres where knife attack victims can end up.
“If you open up the chest and take the blood clot out and put your finger in the heart chamber they can survive,” he said.
Dr Metcalf was describing how to stop a patient dying after they have been stabbed directly in the heart.
“If you’ve been stabbed in the heart, chances are you will die after bleeding out in the street. But a significant number won’t die straight away,” he said. “What will happen is that the heart leaks blood into the bag that surrounds it and it becomes tense and can’t beat.”
He says the high rate of survival at his centre, which deals with serious traumatic injuries, is down to “streamlining” and highly effective team work.
He said: “I’ve seen a huge number of stab wounds and I can honestly say a large number of these patients would have died a few years ago. Trauma essentially is about stopping bleeding – it doesn’t matter if it’s from a knife or a car crash but if it’s bleeding that’s what you have to stop. We replace the blood and go through the arteries and veins to stop the bleeding.”
At St Mary’s there are no barriers to access imaging, ordering blood for patients or quickly calling in specialist surgeons, he said.
“If you come into our department alive and talking you generally come out alive,” he added.
He said his hospital’s success rate “comes at a price” with a high turnover of nursing staff.
“They work very long shifts, it’s back breaking and you can’t get the patients out of the hospital because there’s no social care. Social care is a disaster and you can’t get these elderly patients home for support. Councils have no money,” he said.
He suggested opening up small hospitals that do not require as many doctors where elderly patients could recover without so-called “bed blocking”.
“These halfway hospitals used to exist and be called cottage hospitals but they’ve all been sold off now,” he said.
Dr Metcalf came from an “impoverished and working-class” background where his father held two jobs as a postman and a factory worker in Holloway.
“My father saw that education was the way out of poverty. He used to get me books on science and how the body works. Took me to museums,” he said.
He chose to become a doctor after getting treated in hospital as a young boy when a glass bottle shattered and shards became embedded in his leg.
He said: “It was interesting watching all the patients get carried in through the waiting room from the ambulances.”
“I saw a lot of kindness from the doctors and nurses but also a lot of unkindness. Medicine is about human beings and you get bad ones and good ones. I felt I could be one of the good ones.”
Dr Metcalf went to Tufnell Park Primary School and later went on to study pharmacology at the London School of Pharmacy after he failed to get the top grades to get into medical school. After gaining a First in his degree he went on to study medicine at Middlesex University.
“If you don’t get the grades you want at A-level you can still go into medicine,” he said. “It’s not all about academia. You need to prove that you’ve got stamina. Medicine is an endurance test, you have to get through it, grit through it. You’ve got to be kind and sympathetic to people. That’s most important.”