It's the strength that you need when you have picked up the fourth severely demented patient in a row, they curl up on our trolley having been unable to move for many years, their arms and legs contracted into the foetal position. Their bodies are skin and bone, as we pick them up their joints creak and crack and they shriek in our ears, long nails dig into our arms.
It's the strength that you need when driving the ambulance and you hear them start to cry in the back, your crewmate holds their hand and tries to reassure them but they can't get through. Instead all you can hear is the sobbing and the noises that are left them now that language has gone. they can't tell you if they are in pain or are scared - instead all they can do is moan, and cry and scream.
It's when you walk into a nursing home full of the demented elderly. Stuck on the walls outside the doors to their room are photographs from their prime. Happy mothers holding their children, proud men standing to attention in military uniform. Sepia memories from the past, what they were, not what they are. You open the door and the person in the photographs is lying on urine sodden sheets, legs heavily bandaged from ulcers that will never heal, with hands constantly grasping for something imaginary that floats just out of reach. The person that they were is gone, all that is left is the shell, no expression behind the face that smiled all those years ago for the photo outside the door.
Then one takes hold of your hand and looks up at you with bright blue eyes and asks if you are their dad, long since dust.
And your heart breaks.
I don't know how much longer I can do this.