Sunday, March 29, 2015

wound care

Despite the late afternoon sunshine, all the curtains and blinds in the Baxter’s flat are drawn. Mrs Baxter is standing in the hallway as we come in, her arms down by her sides, strands of hair frizzling out around her head like static. She doesn’t respond to hello or through here? but watches us as we walk into her son’s bedroom.
John is sitting on the edge of his bed in the greasy, airless room. A heavy man in his late twenties, as inert and fleshy as a mushroom, he has a disconcerting habit of closing his eyes when he looks at me, and then opening them again when he looks away, like he was using some other, deeper sense to gauge any response.
His left leg is markedly swollen, tightly bound in a discoloured bandage, his foot covered in a filthy sock. He obviously hasn’t changed anything in weeks. Unwrapping his leg is an appalling prospect.
‘Basically what I want is some advice,’ he says, his voice rapid and flickering. ‘Because I have to say thus far I’ve had conflicting information. Let me explain. Basically, and for reasons that haven’t been satisfactorily explained to me thus far, I developed a pain in my left calf muscle, which gradually, over-time turned into some kind of blister. Eventually, this blister grew bigger, burst, and left me with something of a crater, which then proceeded to grow wider. I was quite concerned, so I went to my doctor. My doctor told me that it was a venous ulcer, gave me some cream to use, and emphasised the importance of keeping the wound clean, all of which I have done. Unfortunately, after a week or two, the ulcer became quite a bit deeper and wider. I really was quite concerned by this point, so I saw another doctor, who said the ulcer would almost certainly start to heal soon, and that I should carry on keeping the wound clean and dry. I didn’t mention the cream, he didn’t say anything, so I wasn’t sure whether I was supposed to use it or not. Anyway, I’ve left it alone for a week or so, now, but last night I started feeling quite unwell, so I phoned for further advice. Things are a little complicated at the moment. We’re between surgeries, and I wasn’t sure who to turn to. What do you think I should do now? Use the cream? Or carry on keeping it clean and see what happens?’
There’s such a disparity between what he’s saying and the evidence of our eyes – and noses - it’s hard to know how to begin.
‘So no-one’s had a look at your leg in a week or so, John?’
‘No-one. I thought it best if I let it rest for a while.’
‘When did you last change your socks?’
‘My socks? Well – I would say about the same time.’
‘Your leg looks quite swollen.’
‘Yes. Yes, I suppose it does. It’s not painful anymore though. I just feel quite sick and dizzy most of the time. I do suffer with acid reflux, but this feels more like the flu.’
‘Would you mind if we cut the bandage off and had a look?’
‘If you feel you must,’ he says.
We dampen the bandage with saline to stop it sticking to the wound. Even so, cutting it is like breaking the skin of some malign fruit. Of course, the ulcer beneath it is horribly infected, a palm-sized crater so vibrantly coloured and textured you could be looking at the aerial photo of a coral island, blooms of scarlet and black in a darkening sea of green.
John looks down at it, too.
‘Is that good?’ he says.
‘Not really,’ I tell him. ‘It’s badly infected. We need to take you to hospital.’
‘To hospital?’
‘Absolutely.’
‘That’s not what I was expecting,’ he says. ‘I just wanted advice.’
I finish re-dressing the leg.
When I turn round to throw the waste in the bag I see Mrs Baxter, standing in the doorway, staring at me. She has the same expression as before, but this time she has her hand up to her mouth and nose.
‘Are you coming with us?’ I ask her, as brightly as I can. ‘We’ll be a little while getting John settled on the ambulance, so you’ve got five minutes or so to get whatever you need together.’
She doesn’t say anything, but turns, and quietly walks away.

Saturday, March 28, 2015

happy wednesday

Ralph is sitting on a bench in the garden, his hand raised in the air, wrapped in a bloody tea-towel.
‘Hey! I think I hit an artery,’ he says, lowering his hand and starting to pull the towel free.
‘Just a minute. Keep it up until we’re ready.’
‘It was squirting all over the place. I’ve made a right old mess.’
‘How did you do it?’
‘I was slicing up the chicken and I slipped and did my hand instead.’
‘Show me on my hand where you cut yourself.’
I hold out my gloved hand. He traces a line from the base of my thumb to the root of the index finger.
‘It’s deep,’ he says. ‘I got a new knife out of the packet and it was sharper than what I thought.’
‘Are you on any medication for anything, Ralph?’
He shakes his head.
‘Fit and well?’
‘I wouldn’t go that far.’
‘Let’s have a look at this hand, then.’
Rae unwraps the towel whilst I stand by with a dressing.
It’s a deep wound. Blood starts running out so I wrap it quickly and supplement the dressing with a few gauzes, tying the whole thing off to apply pressure.
‘We need to keep it elevated, Ralph. So look – we’ll use this triangular bandage... There! Can you feel me touching your fingers? Give them a wiggle. Excellent. Okay. I think we’re good to go. How much alcohol have you had this afternoon, Ralph?’
‘Dunno. About seven pints.’
‘Is that a normal amount for you?’
‘Depends what you call normal.’
‘Special occasion?’
‘Yep. Definitely.’
‘What were you celebrating?’
‘Wednesday.’
He trudges up the steps and sits down in the seat we’ve made ready.
‘It really stings,’ he says.
‘I bet.’
‘I can’t afford to lose my hand.’
‘No. Are you right or left handed?’
He holds up the good hand.
‘That’s something, then.’
‘Yeah,’ he sighs. ‘That’s something.’
A quick round of obs and we’re ready to go. Rae shouts the leaving scene time back through the hatch and we set off.
‘What were you cooking?’
‘Chicken.’
‘Fresh or frozen?’
‘Well I weren’t chasing it round the yard or nothing.’
He pulls an angry face – Yargh! – and raises his good hand like he’s waving a cleaver. Then laughs, and settles back again.
‘Nah, mate. I just got it out the freezer. I was slicing it up for a stir fry.’
‘Alcohol and cooking. A deadly combination.’
‘Tell me about it.’
‘I cut the top of my finger off, once.’
‘Did ya?’
‘I was showing my eldest daughter how to make an omelette. I was chopping the bacon and she was breaking the eggs. I just glanced over to say careful you don’t get egg on the floor when I sliced the tip of my finger off.’
He laughs.
‘So you know all about it, then?’
‘Yep.’
He blinks, thickly, with the buffered precision of several pints, then rests his head back on the seat.
After a while he says: ‘Am I gonna die, d’you think?’
‘Well. Yep. One day, Ralph. But probably not from this.’
He turns his head and glares at me.
‘Great. Thanks, mate. Cheers for that,’ he says. ‘I hope I get better treatment at the hospital. Although knowing my luck, they’ll probably mix me up with someone else and cut me leg off.’
‘Only if they’ve been drinking, too, Ralph.’
‘Yeah. Well,’ he says, closing his eyes again. ‘Like I say. I was celebrating.’
‘Happy Wednesday, Ralph.’
‘Happy Wednesday to you, too. Wake me up when we’ve landed.’

Monday, March 23, 2015

urban fairy story

‘What did you use to cut yourself?’
‘A knife I got from the kitchen.’
‘Have you still got it on you, or...?’
‘I chucked it. Listen to me, yeah? You don’t understand what it’s like. I’m having a mental breakdown. I just can’t cope with it no more. If I don’t get some help, trust me, I’m going to do something. I’m going to throw myself under a bus.’
‘I can see you’re under a lot of stress.’
‘Stress? Jesus Christ! You don’t understand what it’s like. I mean, I can’t.... I haven’t....’
Cherie chokes down on her tears, sobbing uncontrollably by the side of the road for a moment.
‘If you think you’ll be all right in the car...’ I say to her.
She presses a wad of tissue to her eyes.
‘...I can drive you to the hospital where you can talk to someone about how you’re feeling. How does that sound?’
She nods, picks up her handbag, and follows me to the car.
‘’Scuse the mess,’ I say, grabbing the box of gloves, lunchbox, spare sheets, the clipboard from the front seat, and throwing them all in the back.
‘Don’t worry about it,’ she says.
I shut her door, and climb in the other side.
‘I’m not a bad person, yeah?’ she says. ‘They’re trying to make out I am but I’m not. I’ve tried, you know? I’ve tried so hard. My mum says I do too much for him and she’s right. But I wanted to make a home for us both. I shouldn’t have given up what I did and now I’ve got nothing. I let my friends go ‘cos he was jealous. I let my place go in town. You don’t understand what it’s like. And now he’s gone off down the gym, and he’ll be drinking with his mates, and I won’t see him till later, all pissed up. And we haven’t even got a telly.’
Cherie is strikingly pretty, with long, auburn hair and dark eyes. If Disney ever thought of casting a gritty, urban version of Aladdin, she’d be a shoe-in for Princess Jasmine. With Jeremy Kyle as Jafar.
I pass her more tissue.
‘D’you know what?’ she says, blowing her nose and then sighing – a deep and shuddering thing – before tearing the damp tissue into shreds. ‘His family, yeah? His family have got it in for me, big time. Ever since my Dad came round and punched him in the mouth. That’s when my Mother-in-Law jumped on top of me and bit my arm. She took such a chunk out they had to do skin grafts. So she goes down for ABH, yeah, and then his brothers go round and put my Dad in hospital. So now he’s cut me off, and I ‘aint got no-one. You don’t understand what it’s like. I’m stuck in that flat with no electric, no friends, no money. No family anymore. I’m going out of my head. Do you know what I’m saying? If I don’t get some help today I’m going do something. I want to get that knife, stick it in my chest and let all the pressure out. It’s all too much. I can’t bear it. I can’t.’
She starts crying again. But whether it’s the movement of the car, the feeling that something is finally happening, or the fact she’s been able to vent some of her frustration, she seems to calm down, and her tears gradually subside.
Suddenly she sits up straight and slaps me on the shoulder.
‘Have a look. Over there,’ she says, leaning forward, her voice hard and glittering. ‘That’s where I live.’
She follows it as we pass, then settles back in the seat and flicks her hair back.
‘What a fakkin’ dump,’ she says. ‘Scuse the language.’

the invisible man strikes again

The next day – the second of two car shifts – I’m called to a twenty-three year old male collapsed in the street with a presenting complaint of back given out.
It’s Ricky again. A different part of town, but just as public.
He’s sitting in the middle of a pedestrian precinct, calmly rolling a cigarette whilst two police community support officers in yellow jackets stand over him, one on the radio, one writing in a notebook.
‘Ah! Here we are!’ says the one with the notebook, putting it away.
‘Hello!’ I say, dropping my bags down. ‘Hello, Ricky!’
‘You know this one?’
‘Yep. I met him yesterday. Similar deal. Although he’s looking a bit brighter this morning. How are things, Ricky?’
He ignores me, and concentrates on the cigarette.
‘It was a call from a member of the public,’ says the first PCSO. The other one has finished on the radio, and stands there with her arms folded, on guard, looking around.
‘Ricky wasn’t seen to fall or anything. He just decided to sit down. We were only round the corner. When we asked him what was wrong he said his back had given out.’
‘Is that right, Ricky? Is it back pain today?’
He shrugs, lights his fag.
‘Do you normally suffer with that?’
‘I’ve got complex mental health needs,’ he says, spitting a strand of tobacco off to the side.
‘How did you get on at the hospital the other day?’
‘They kicked me out.’
The second PCSO leans in.
‘I understand that Ricky was asked to leave by security. Isn’t that right?’
He looks in the other direction.
‘Well. I don’t think you need go to hospital today,’ I tell him. ‘There’s a Walk-In Health Centre just around the corner – I mean, literally, fifty yards...’
I point it out.
‘...so what you could do is walk over there and talk to someone about your back. How’s that sound?’
‘You haven’t checked me over or anything. You don’t know me.’
‘Do you want checking over, then? I’d have to call an ambulance again. Or do you think the Walk In centre might be better?’
‘I’m not going there. It’s full of people. I’d have to wait.’
‘Yes – well – I’m afraid that’s a bit of a national problem, Ricky. It’s been in all the papers. It’s no different at A and E. In fact, I’d say it’s worse.’
He closes his eyes and carries on smoking.
‘We can deal with this if you need to get off,’ says the first PCSO.

Our group is a little island of incident in the centre of the busy precinct. The crowd flows around us, anonymous, unstoppable, hardly giving a second look. You’d think we’d be safe in our yellow jackets, but still a woman almost crashes into us. She’s talking on her phone, not watching where she’s going. The second PCSO sees her coming, though, and gently guides her round. For a moment the woman looks up, as shocked as if the air had unexpectedly crystallised in front of her. Ricky isn’t bothered. He carries on smoking, as calmly as before.
I’m squatting down next to him. And just for a second I can see things from his angle. Despite everything, despite the wild, Rasputin beard, the extravagant headphones and the filthy parka jacket, despite the over-stuffed rucksack and the tatty bedroll, despite the focused and hostile detachment, plumped down here on the pavement in the middle of the day, in the middle of everything – despite all this, Ricky is effectively invisible. He just doesn’t figure. No one meets his eye – and if by accident they do, they quickly look away.
And it strikes me that Ricky’s high-profile collapses are just a crude way of testing the limits of his invisibility, a way of proving to himself he still exists.
Of course, he brings me crashing back to pavement level, leaning over and grinding out my empathy as ruthlessly as his cigarette.
‘I’m gonna have you struck off for not caring,’ he says.

the twenty pound stand

It’s lunchtime, and the square is filling up. A company has set up an advertising display in one corner, with a car and banners and beautiful women in heels and smiles handing out leaflets. Office workers are emerging into the bright sunshine to forage for lunch, but the place many of them would sit to eat their wraps and crisps, the curvy public artwork that usefully doubles as a bench, is curiously empty. The reason is obvious, though.  An NFA is sitting and smoking on one end; at the other, stretched out on his back on the floor, is Ricky.
I’m on the car, so I’m relieved to see it’s not a resus. An ambulance has also been dispatched to this, so I shouldn’t be on my own for long.
‘Hello? Ricky? Open your eyes for me.’
I pinch his shoulder. He snarls.
‘Don’t. All right?’
He closes his eyes.
‘Come on, Ricky.’
Another pinch.
‘What’re you doing that for?’
‘I need you to sit up and talk to me.’
He shuts his eyes again and lies still.
A thick-set guy in his early twenties with a full, black beard and a pair of Beats headphones, he looks like a monk DJ who hit the skids.
‘Come, on, Ricky. You can’t just lie here all day.’
‘Why?’
‘People will think you’re ill and call the ambulance.’
He ignores me. I poke him again.
‘Fuck off!’
‘Sorry, Ricky. All you have to do is sit up. We’ll have a chat and then I’ll leave you alone.’
The other NFA grins and nods and shouts out drunken advice. I give him a wave and then help Ricky sit up, propping him back against the sculpture. But no sooner is he upright than he starts slumping forwards again.
‘Have you taken anything today, Ricky?’
He slurs something that sounds like the name of an anti-epileptic medication.
‘Have you taken more than you should?’
I have to prod him for an answer. He jerks awake and sneers at me, his eyes half-closed.
Meanwhile, the other NFA has come over. He stands in front of me, hardly able to stay upright himself.
‘He’s a dead fucking loss, that one,’ he says. ‘Aint you, Ricky old son? Hey! D’you want ta see if he ken stand up?’
‘There’s a truck coming in a minute so we’re good till then, I think.’
‘Nah! I know how ta do this. S’easy. Watch me.’
He leans in to Ricky.
‘Hey! Ricky, me ol’ mate. See there – that twenty pound note? Is that your’n? I think it’s come out o’ yer pocket! Look! A twenty pound note, son.’
Ricky frowns and waggles his head from side to side.
‘A twenty pound note, man! Jes’ there, hanging out ya pocket! Yer sittin’ on it.’
Ricky jerks upright, hauls himself to a stand, then sways hopelessly from side to side, like a marionette with its strings in a muddle.
‘There ya go!’ says the NFA. ‘The twenty pound note test.’
He taps the side of his nose, winks and then points to me.
‘That one’s on the house,’ he says. Then laughs, and staggers off.

Friday, March 20, 2015

belts and biscuits

‘What’re you doing here?’
Michael leans forward on the hospital bed.
‘I thought you was dead,’ he says. Then he settles back again, finishes off the biscuit he was eating and slaps his hands crumb-free. ‘Maybe you are. Maybe you aren’t. That’s for another day. Now then. Who’s had it away with my tea?’
‘Here you are, Mike.’
‘I thang’yor.’
The nurse comes in with Michael’s notes and gives us a handover. Referred to the vascular team query TIA. History of dementia, CVA, a few other things. Plenty of medication. Social history.
Michael pulls a face.
‘I hope you’re paying attention’ he says to me.
‘Oh yeah.’
‘Good. ‘Cos I’m not.’
He has an early-onset form of dementia, which, judging by his neatly-clipped, silver goatee and moustache, seems to involve a gradual transformation into Colonel Sanders – at least, a Cockney music hall version of the chicken magnate, whose schtick involves making anything you say sound ridiculous.
‘Look at that!’  he says, leaning forwards again and pointing to my middle.
‘I know. I’m carrying a little holiday weight…’
‘No! That!
‘What d’you mean – my belt?’
‘Ye-es! Your belt. And now look at that.’
He points to Rae’s belt.
Hers is ambulance issue, with a decorated buckle.
‘M&S’ finest,’ I say, slapping mine, and then taking the opportunity to tuck my shirt in.
‘Say who?’
‘Marks & Spencer.’
Marks and Spencer. Of course. Tsch, tsch, tsch.’
He raises his eyebrows and stares at me.
‘Well it’s better than string,’ I say, shrugging. ‘It gets the job done.’
‘What job?’
‘Keeping my trousers up.’
‘Oh! Your trousers!’ He shakes his head, like this is the craziest thing he’s ever heard, and then he turns his attention to the table again, and carefully extracts the second biscuit from the packet of three.

Thursday, March 19, 2015

henry's war

‘We had this new Captain take over ‘cos the other one got killed. My mate said “Have you seen him? He’s an old fucker”. D’you know how old he was? Forty! Goes to show how young we all was then.’
Henry laughs, not an active thing, more like the gentle release of a deep bubble of humour. It’s a cold night, so we’ve bundled him up on the ambulance trolley under a pile of white blankets, the grave and liver-spotted bulk of his head vividly illuminated under the bright cabin lights.
Henry’s accent is so strong, his mouth so toothless and collapsed, the journey in to hospital so noisy, I have to lean in to hear him – and even then there’s a delay between Henry speaking and the sense of it percolating through.
‘I went through the lot. D-Day. I was there. It didn’t start all that good. We went aground in our landing craft. Bullets and bombs flying all over the place. So they says “Jump out quick lads. We’ll hev’ to walk the rest of the way.” Which would’a been fine ‘cept we were in about five foot o’ water. Carrying about seventy-five pound a kit. ‘Course, quite a few drowned. How I made it in I’ll never know. ‘Cept I was young then, and when yer young you can do a thing as soon as think it, eh? Anyways, a day or so later, when we was all set-up on the beach, like, they had these tractors with forks going up and down. And Billy says: “What’re they havin’ now, d’you think? A ploughin’ match? But it weren’t that. They was collecting all the drowned lads, you see? Scooping ‘em up and dumping them in a pile. A’ter that they put us on a forced march. D’you know what a forced march is? Five miles you run, five miles you walk. No change of clothes. Yer pockets and your boots full of water. Full of blood half the time. But you dried out, course. And you took yer ease where you could.’
‘I met ‘em all. The Belgians. The Poles. The Dutch were all right. The French were grateful but you couldn’t trust ‘em. The Russians were just fixed on revenge. The Americans were fine in ones and twos but when you got ‘em in a crowd they was a blasted nuisance. We used to hev’ fights with ‘em now and again. Depends where we was and what else there was to do. And the funny thing was, d’you know who we got on the best with? The Germans. You know where you are with your German. It’s all there and out in the open, if you know what I mean. Personally I don’t think Hitler was as bad as he was made out. I think he had some good ideas – and he certainly got the country going again, didn’t he? Trouble was, he was surrounded by some very strange characters. Goering, Himmler, Hess – they was all a bit weird. I don’t think Hitler was strong enough to resist what they was saying to ‘im.’
‘Anyway. Difficult days. A long time ago. I lost a lot of mates. And you know what?’
He turns his misty eyes in my direction.
‘I wouldn’t ‘a missed it for the world.’

Tuesday, March 17, 2015

driving the general

George is wearing so many layers it’s difficult to get to his arm for the blood pressure. And the more layers he sheds, the more the ambulance is filled with his body odour, a mature and seamy fug that speaks of airless rooms, empty cupboards, spotted curtains, damp corners.
For some reason he has an elastic band around his wrist.
‘What’s that for, George? To remind you of something?’
He stares at me, his face pale and slumped with the shock of it all.
‘Seventy years I’ve been driving and never had an accident. Seventy years and now this.’
He looks at me, his eyes watery and preternaturally large behind the thumbed lenses of his spectacles.
‘If you’d told me this morning what was going to happen I wouldn’t have bothered.’
‘Where are you living these days, George?’
‘I’ve got two places and that’ s half the trouble. One of them’s what you might call my old address where I keep all my stuff, and the other is where I live most of the time, where my post goes, so I suppose you’ll want that?’
‘Sounds good.’
‘My nephew’s always on at me to sell ‘em both. I  know he just wants to put me away so I can die and he can have the money. And now this. I suppose you’ll take me to hospital, then they’ll put me in a home, and that’ll be that. Still, I suppose it had to happen sooner or later.’
He grips my arm.
‘Why now, though?’
‘One thing at a time, George. There – just relax your arm.’
We run our tests. Everything checks out. He’s still pretty shaken after the accident, though, and there are concerns about his overall state of health.
‘Anything else you want out of the car before we go?’ I ask him.
‘Just my bag,’ he says. ‘It’s got my phone and keys.’

The traffic is starting to clear now. The first ambulance on scene has taken the other patient, and the police have moved George’s car to the side.
‘Look at the state of it,’ says the officer. ‘I bet he’s been sleeping in there.’
‘I wouldn’t be surprised.’
‘Are you taking him to hospital?’
‘Yeah. He’s pretty shaken up.’
‘Not as much as the pedestrian,’ says the officer, nodding to the bullseye on the windscreen. ‘Apparently he ended up doing a cartwheel over the bonnet.’
‘Oof!’
‘Yep. George drove straight through a red light. Poor guy didn’t stand a chance. Scary, when you think of it. All those Georges out there.’
The officer follows me back onto the ambulance and pulls a breathalyser out of his pocket.
‘Now then!’ he says.
George stares at him with the same slack expression he’s had the whole time.
‘Seventy years I’ve been driving,’ he says. ‘I learned in the army. And I was so good, I ended up on staff, driving the General about.’
‘Driving the General?’ says the police officer, snapping the mouthpiece onto the breathalyser. ‘Well that sounds – a long time ago.’

Saturday, March 14, 2015

triumph

‘They kept asking me all these stupid questions. I told them I had to see to Mike, he was bleeding, but they wouldn’t listen. They just kept on and on. Is he breathing? Is he this? Is he that? I couldn’t talk to them anymore. I mean, look!’
Mike is slumped on the edge of the bed. There’s blood around his nose and mouth, blood on the towel she’s used to staunch the bleed, blood over his pyjama bottoms, the duvet, and a patch on the floor where he fell.
‘Why did you fall?’ Rae asks him.
Sheila answers.
‘He’s not well. He’s got cancer of the liver that’s spread, and it’s making him weak.’
‘So what happened?’
‘I don’t know. Mike got out of bed to go to the loo and just pitched forward onto his face. I think he must’ve caught his foot in the rug or something. You can see where he landed.’
She starts crying again, one hand pressed to her face, the other reaching out to pick some strands of hair away from Mike’s face.
‘Were you knocked out, d’you think?’ asks Rae, resting a hand on Mike’s shoulder.
He shrugs.
‘What about your neck? Any pain here, where I’m pressing?’
He grunts.
Rae pauses, then squats down in front of him to look into his face.
‘How are you feeling?’ she says.
He mumbles and drools.
‘Give my fingers a squeeze,’ says Rae, taking hold of his hands.
After a moment she stands up.
‘Weak on the right,’ she says. ‘How’s Mike’s speech sound to you, Sheila?’
‘I don’t know. Say something, Mike.’
He mumbles again.
‘No. That’s not right,’ says Sheila. ‘Do you think he’s concussed?’
‘I think he might have had a stroke,’ says Rae. ‘What kind of treatment is Mike getting for the cancer? Is there a care plan?’
 ‘They said they can’t do anything for him. It’s still early days.’
‘Any Macmillan involvement? Cancer nurses, palliative care team?’
‘Just the doctor for pain relief. Mike doesn’t want to go to hospital.’
Mike lies back on the bed and stares up at the ceiling. He’s wearing a black and white motorcycle t-shirt. Triumph.
‘He’s got blood on that, too,’ says Sheila. ‘He loves his bikes. It’s how we met.’
‘If it is a stroke, we’ll have to act quite quickly,’ says Rae. ‘Every minute counts.’
‘Shall I show you what pills he takes?’ says Sheila. ‘Excuse the nightie. I didn’t have time to get dressed.’
‘That’s okay.’
‘I’ll go and get a chair,’ I say.
I follow Sheila downstairs into the front room, where she starts searching through drawers for the medication.
‘It’s here somewhere,’ she says. ‘Do you want to read some of his treatment letters? Where did I put them...?’
‘Anything that comes to hand, but don’t worry too much. Put it in a bag so we’re good to go. I’ll be back in with the chair in a second.’
Sheila straightens and stares at me.
‘He’s not going to hospital, is he? It’s just a nosebleed.’
She stands in the middle of the room, her arms by her sides, her hair wild on her shoulders, the rapid beat of her heart trembling through the silk of her nightie.
‘Sheila? I know this is really hard and upsetting, but we need to be clear. We think Mike fell out of his bed because he’s had a stroke. If he has, the sooner we get him to hospital and scanned, the sooner we can do something about it. If we don’t – worst case scenario – he could die. Sorry to be so blunt, but you need to know.’
‘Oh.’
‘So, look. I’ll go outside and fetch in our special chair so we can carry him out. Don’t worry about the medication or anything. Just take the next five minutes to put some clothes on and get yourself ready, then we’ll all go to the hospital together. How does that sound?’
She nods, but continues to stand there.
‘Because you know – we need to get going.’
She nods, and starts to cry again.
‘Try not to worry, Sheila. We’ll take good care of him.’
I give her a squeeze on the shoulder in passing, then carry on outside to fetch the chair.

Outside the air is crisp and cold. The early morning sun holds everything in a moment of sharp relief –a vapour trail thinning across the sky, heavy traffic on the top road, people walking quickly in one tidal direction, to work, to school – the activity and business, the community of everything, the life.
The cold on my bare arms feels good.
I take two blankets with the chair and head back inside.
Sheila holds the door.