10 years ago, Dr Chris Hill donned his Hampshire and Isle of Wight Air Ambulance flight suit and helmet for the first time. After countless missions, numerous challenges and untold interrupted lunches, Dr Chris reflects on the last 10 years and what’s in store for the next 10 years.   

Hi Chris, please introduce yourself.

I’m Dr Chris Hill. I’m a consultant in emergency medicine and pre-hospital emergency medicine (PHEM). I’ve been working for Hampshire and Isle of Wight Air Ambulance for just over 10 years now and it’s great to speak to you today. 

When did you know you wanted to become a doctor?

I love this question. Well originally, I wanted to be a fighter pilot.

“I was obsessed with flying at a young age.”

It was only during A-levels that I had a sort of enlightening moment, coinciding with meeting my now wife, that I fell in love with science and biology especially. That led me to wanting to know more and I’ve never looked back. 

What is one thing people might not know about being an Air Ambulance doctor?

I suspect it’s that most of us are not full time – whilst it works really well working full time initially when training, it works best when we work across both the hospital and Air Ambulance.

This model gives us the best exposure to both worlds and helps cross-pollinate ideas in both ways: we bring hospital level treatments to our patients wherever they are whilst also bringing significant frontline experience to our patients in the hospital.  

What is the question you are asked most frequently as an Air Ambulance doctor?

‘What’s the most gruesome thing you have seen?’ I’ve been asked this question a lot. I’ve done a few school visits and even six-year-olds tend to ask me the same thing – it’s obviously a human fascination thing! 

What is the most gruesome thing you’ve seen?

It’s funny how people always go to wanting to know the most extreme things we see. Trust me, you wouldn’t want to know the most gruesome thing I’ve seen, some of which is really horrendous.  

Some of the situations we go to are far more extreme than anything you see in a movie – so if you can imagine it, it’s likely to have happened.

What we do have is an amazing support system around us and a culture that helps protect from any harm this might cause.  

What are your top three tips for becoming an Air Ambulance doctor?

Great question. For me it’s: flexibility of thought, excellent communication skills and a high level of clinical skill. 

“Air ambulance work is like nothing else. You don’t have access to the tests and scans that you do in hospital, and the time frame of pre-hospital work is super fast. You have to be on it, that’s for sure.”

If you could go back 10 years to your first day with HEMS, what advice would you give yourself?

Pace yourself — it’s a marathon not a sprint. The work is intense and sometimes distressing, but there is downtime between jobs. We usually fill that time with training, developing systems and policies: trying to constantly be better.  

What I really would like to do is go back and give my younger self permission to just relax a bit more, especially in those early years where you want to change the world. Give yourself permission to rest — you never know when you’ll need the reserve you’ve saved up.  

What advancement in the last 10 years has had the biggest impact or surprised you the most?

Professionalisation – this has had the greatest impact. Over the last 10 years we have seen the creation of the General Medical Council subspeciality in PHEM, a proper training program and some fierce exams that you have to pass to now practice as a doctor in PHEM. Hampshire and Isle of Wight Air Ambulance has been a strong supporter of this and an active part of the ongoing development nationally.  

With my paramedic colleagues we’ve also seen the development of the critical care paramedic – now moving into advanced clinical practitioners. This has radically improved the skills, knowledge and ability to provide the very best care to our patients.  

In terms of the greatest surprise, it’s the change in patient demographic.

We are seeing a radical decline in road related injuries, and in fact a drop in injuries entirely. It’s the rise of medical problems that is one of our greatest challenges: cardiac arrests, medically unwell patients that need advanced care as well as a dramatic rise in self-harm and violence. That’s what we are trying to grapple with more frequently now.  

What do the next 10 years have in store for PHEM and for our service?

In the immediate term we are most excited about the base move, Operation Airbase – being located in the centre of our population base will give us the opportunity to reach more patients, quicker. This will have a major effect on how we operate, all for the better.  

Going beyond this I think there is a serious conversation to be had about providing cover 24/7. Whilst the need certainly drops off overnight, especially after 02:00am, there still is an occasional need, and I think we should be there whenever our patients need us.  

Alongside this there is a great opportunity for us to have a major impact in assisting our ambulance colleagues by helping with clinical advice: we have a lot we can offer and just need to join the dots.  

Finally, I am most excited about the clinical developments coming down the line – such as advanced cardiac arrest resuscitation, life support systems that are being developed like heart/lung bypass machines and further diagnostics that we can develop to help ensure the right patients get to the right place.  

What are 10 things you’ve learnt in your time as an Air Ambulance doctor?

1. People do silly things, don’t judge them, it’s just part of being human. 
2. Cars are now unbelievably better than they were: we go to very few car entrapments anymore, which is amazing. 
3. No matter how safe one area of society gets (like cars), we as humans find ways to take more risk: see E-scooters! Humans like risk. 
4. If it can go wrong, it will: prepare for it. Never assume anything. 
5. Flying in storms sounds like fun but it’s really not. Orbiting a scene with 40-knot winds is awful.  
6. However, flying after it’s snowed is awesome and magical.  
7. Eat when hungry, drink when thirsty: don’t wait until lunchtime, it’s probably going to be interrupted. 
8. Be prepared for the first job within seconds of starting the shift. Jobs always seem to come in at the very beginning and end of a shift. 
9. Sad things happen to people all the time but it’s still pretty rare – you have to keep reminding yourself of this otherwise you’ll paralyse yourself with worry.
10. Never pass a toilet without emptying your bladder: you never know when the next one will be available! 

And finally, do doctors ever Google their own symptoms?

Never!