By: Simon Brooke :: 17 May 2026
Multiple content warnings: autism, depression, traumatic injury
I spent most of Saturday at an in person, hands on, outdoor first aid course, although I knew I was probably in too poor a state of mental health to complete the course. I booked on the course before the start of my present depressive episode; because I've been in a chaotic state I hadn't cancelled it; and when my diary reminded me on Friday I felt that it would be useful to attend, partly as a challenge to and test of just how fragile my mental state is, and partly because what I would learn would be useful.
This isn't the first first aid course I've done by any means, but it was certainly the best taught and most intensive, and I did learn a lot.
We concentrated on cycling, forestry industry, hill walking and farming injuries, because those are the sort of injuries that the participants have to deal with.
In fact I lasted six of eight hours, and was able to come back at the end for a section on applying a tourniquet to oneself, so quite pleased with myself.
Severe injury first aid
First is, we were being taught by an ex-army combat paramedic, which was entirely suitable because the sort of injuries encountered when people are working on cold wet hillsides with chainsaws and axes and powerful hydraulic machinery and twisted, entangled fallen trees (or riding bikes fast in those environments) are very similar to battlefield injuries, and the means of evacuating a casualty are quite similar too.
We were trained on a number of different dummies (as well as being trained on one another, simulating non-penetrative injuries), specifically including a rubber model of a leg with a deep penetrating injury with a severed artery, with pumped water to simulate spurting blood.
In such a case you have to stop bleeding quickly, or the casualty will bleed out and die. We had to find the torn artery with our finger, compress it, and then while holding the artery compressed, pack material into the wound as tightly as possible to hold it compressed. We were advised that sterile soluble dressing is best if available but that in emergency anything clean will do.
If it's impossible to arrest bleeding quickly with wound dressing, you fall back to using a tourniquet. We were taught to use modern 'cat tourniquet gen 7' tourniquets — which are wonderful, and which I was able to apply satisfactorily to my own arm (and believe that I would be able to apply to myself if injured). The instructor said keeping one of these, a roll of sterile soluble dressing, and a combat dressing, in a bag close to where you keep your chainsaws, and always taking the bag with you while using a chainsaw, was a good idea. Noted, will do.
Once you've applied a tourniquet, mark both it and the casualty's forehead with the time it was applied; there's a fairly short time window from when the tourniquet is applied and when necrosis may start to set in, so the staff at hospital when the casualty arrives need to know this even if the casualty is confused or non-responsive (which they're likely to be). Once you've applied a tourniquet, you don't take it off — leave that to trained trauma staff in a controlled hospital environment.
The things you shouldn't do with tourniquets are, unsurprisingly, quite similar in many ways to the things you shouldn't do with bondage ropes — but also different, because you apply a tourniquet when the alternative is death within minutes, and you know that the consequence of applying it is that the casualty may lose that limb.
We definitely do not want the friends we tie to lose limbs, so we should not ever tie a limb, in bondage, as tightly as a tourniquet must be tied.
We were also shown how to improvise tourniquets out of (strong and non stretchy) cloth bandages, but also discussed other things which might be used in emergency. We were told that leather belts are generally not satisfactory because hard to get tight enough and hard to secure when tight enough.
This was a very useful section.
Autism and depression
But the other thing was I was able to introspectively observe myself having a meltdown, in a relatively safe situation where I had several people around me whom I have known for decades — and although I am always humiliated to have a meltdown when other people are present, this was an unusually safe place to have a meltdown. So this too was interesting.
I was aware of becoming overwhelmed, I was able to communicate that I was becoming overwhelmed. People on both sides of me moved closer to me — without being asked to — and maintained physical contact with me while my eyesight failed, and consequently I was able to continue to listen and attend to the instructer, and ask relevant questions, when quite far into sensory shutdown.
Eventually I needed to go into another room and sit quiet for half an hour.
But a friend came to me to tell me that the section on tourniquets (which I had said I wanted to try to attend) was about to start and helped me back into the main room — our village hall — and again I was able to listen, and, when I needed to, actually see for at first brief periods, but actually my sensory shutdown eased over perhaps half an hour and by the end I could see and hear more or less normally.
But observing myself through this, I wondered to what extent my personal experience of what the psychiatric profession describe as 'depressive episodes' are just enormously extended #ActuallyAutistic meltdowns. The experience and symptoms — the feeling of being overwhelmed and out of control, the dissociation from the world, the chaotic thought — are subjectively very similar.
Other autists, what do you think?
The benefits of community
And one final insight: I am, for the first time in my life, at seventy, comfortable with being a public madman in the community in which I live. I have such good friends around me who know me so well, and who can be trusted to respond lovingly and supportively when my behaviour slips out of my control.
I'm still humiliated when this happens, but no longer terrified.
I've never felt that I had this before. It's rather splendid.
Tags: Madness, Crofting, Cycling, Safety
