film night

Stephen is being sent to a psych unit in another town because there are no beds here.

‘Sorry it’s such a long way,’ says Rae. ‘And so late.’

‘It’s not your fault,’ says Stephen, hauling an enormous black sports bag onto his shoulder.

‘Can we help with that?’

‘No. Thanks. I’m fine.’

A nurse comes over with a file of notes, but it turns out they’re the wrong ones –Steven, not Stephen. She tuts and goes away again.

The idea that we might take the wrong person hangs unspoken on the air between us. We make other, safer comments.

The nurse comes back, apologises – she has to go to the office to do some photocopying.

Stephen puts his bag down again.

The person in the opposite bed has been staring at us all this time; he doesn’t acknowledge me when I nod in his direction. I wonder if it’s Steven.

Stephen pushes his huge steel glasses up his nose, tips his head back slightly, and stares in the direction of the nurses’ station. Picks his bag up, puts it down again.

*

A long drive out, but easy enough. After midnight, and this busy commuter route has been cleansed of traffic. The moon is low and full, more like a ghostly sun. Its light has a strange effect on everything, on me.

I’m dreaming about driving.

I open the window and take deep breaths.

I’ve not been to this unit before. Even the sat nav seems vague. But after some last minute adjustments, I pull up outside.

The lobby is empty, hard-lit. When I buzz the ward there’s a long wait before anyone comes to let us in. Stephen waits anxiously between us.

‘It’s a long way for anyone to come and visit,’ he says.

‘Sorry.’

‘It’s not your fault,’ he says again. And then: ‘I’m a bit nervous. I don’t know what to expect.’

‘That’s natural,’ says Rae, looking around. ‘But it looks like a nice place.’

*

Two women come down to greet us, both in their early twenties, both dressed in jeans and t-shirts. They introduce themselves, shake Stephen’s hand, lead us back upstairs. In the ward itself one of them shows Stephen to his room whilst the other asks us if we want a coffee. She swipes us into a room, and goes off to make it.

The room has a stack of chairs in one corner, a bookshelf of DVDs, and a wide, beech veneer conference table in the centre. Rae sits one side of it, I sit the other. I put my feet up on a chair.

‘Thanks for coming,’ I say. ‘Shall we begin?’

The chair cuts into my back so I put my feet down again.

How are you feeling? she says.

The outside windows are more like panels in an aquarium – thick Perspex panels secured with rivets.

The nurse comes back with two plastic cups of coffee.

‘Take your time,’ she says with a smile, and goes out again.

We sip our coffee, yawn, chat.

Suddenly Rae nods at something she’s seen behind me.

I turn round and see someone pressed up against the security glass, a middle-aged man in a zipped-up top. Because he’s standing so close to the glass, and because his hood is pulled low over his forehead, I can only make out the smallest fragment of light reflected in his eyes. He doesn’t acknowledge that we’ve seen him. His breath mists up the glass.

After a moment, I turn back to Rae. Raise my eyebrows. Finish my coffee.

The man has gone when the nurse returns to let us out again.

Suddenly there are screams and ripping sounds from a room across the way.

‘Don’t worry,’ she says. ‘Film night.’

nappies

‘It’s dead boring, mate. The same fookin’ questions over and over and over. For what? For the paperwork, thassall. And you get treated like shit as soon as they find out you used to do a little gear. You can see it when they read them fookin’ letters: I V D U. Snigger. Point. Yeah? But that was years ago. I’m clean now, man. I’ve not touched the stuff in ten years. That’s what you get though. That’s what you get for being different.’

Alex is different. You can see it in the jaundiced glow of his face, like a solarised photo; you can see it in the way he walks, crabwise, jabbing at the ground with a stick, crooked over to one side with the drag of a leg that was damaged when gangrene set in from a filthy injection; you can feel it in the drum-tight swelling of his belly; you can hear it in his accent, a tight, Mancunian drawl, case-hardened in smoke and rage, and you can see it in his eyes, when he opens them wider than a slit. Pinned through Subutex.

‘Look at them porters,’ he says. ‘Loafing around. You can’t tell me that’s work. Skivers, plain and simple. And them nurses are no better. I’ve seen smarter monkeys. Fookin’ ell  – I can’t sit here much longer, pal. I’m off outside for a fag. Eh? In fact I think I’ll just fook off. There’s nowt for me here. Just hours and hours of hanging around – for wha? They can’t do nothing, mate. They do nothin’ for me. I’m fit for the knackers, that’s all there is to it. But I tell you one thing for free – when the time comes, I’m not going to be wearing no fookin’ nappy. That’s it. That’s the truth. No-one’s putting no fookin’ nappy on me.’

completing the circle

Mary isn’t being straight. Not with her doctor, not with her friend, certainly not with us. Even her cat Bob takes the long way round to the kitchen.

‘No. I haven’t had a drink tonight? What do you take me for?’

‘It’s just that your speech is a bit slurred, Mary. And there’s a carrier bag of empty vodka bottles just inside the door.’

‘Yes, well, I gave up drinking a long time ago, thank you very much. An’ the reason I might possibly-be-slurring....’ (she exhales down the three words with her eyes half closed) ‘... is because I’m very, very tired. Okay? Officer? I’ve had a busy day, what with one thing or another. Now then. What are you going to do about my back?’

Mary’s next door neighbour Janet came round as soon as she got in from work and picked up the message on her answer machine. She’s still got her coat on, and the spare set of keys in her hand. Caught between wanting to help Mary and wanting to go home, she sits perched on the edge of the armchair, periodically glancing at the door.

‘Mary’s had trouble with her back before,’ she says. ‘Haven’t you, Mary? She saw the doctor last week and he gave her some different pills, but they haven’t really agreed with her. And then of course she had that fall.’

‘When did you have the fall, Mary?’

She shrugs. ‘Last week.’

‘Did you see anyone about it?’

‘The doctor! Keep up.’

She tuts and closes her eyes.

‘And what did the doctor say?’

‘He gave me some more pills.’

Janet hands me a paper bag.

‘I think this is everything.’

It’s obvious from the blister packs that Mary hasn’t taken her full complement.

‘It’s no wonder you’ve got pain if you’re not taking your meds,’ I say to her.

‘You don’t like me, do you?’ she says.

‘Do you know, you’re the second person who’s said that to me recently.’

‘Oh? Coincidence, you think?’

‘Maybe. Maybe not. But that’s beside the point. Let’s see how we can help you tonight. Are these the only meds you take?’

‘She has diazepam, too,’ says Janet.

‘Really? So where are they?’

‘I told you, Janet. I don’t like taking them things. They make me go funny in the head.’

‘But were they prescribed for your back pain?’

She nods.

‘I don’t like them.’

She starts to cry.

Janet sighs.

Bob looks in from the kitchen, hesitates, then turns and goes out through the flap in the back door. I have a strong urge to follow him, but I take a steadying breath and carry on.

We’re there some time.

We refer her to the out of hours.

*

Much later, we get a call to an elderly fall. I’ve been to this address before – some time ago, but I know the ambulance makes frequent visits here. Agnes is ninety something, unsteady on her feet, but still living with her husband Norman, who has Parkinson’s.

We use the keysafe to gain entry and find Agnes sprawled half on and half off the bed. Agnes has activated her careline button – not so much because of her position on the bed, but because of Norman – and I can see why. He seems flushed and confused, wandering about the bungalow on some obscure mission. We can see from an ambulance sheet that a crew’s already been out tonight. All things considered we can’t leave them alone. We take them both in, as a job lot.

*

I park alongside another ambulance at the entrance to A&E. Dermot is round the back of his truck, putting the ramp up.

‘We just brought in someone you know,’ he says.

‘Oh? Who’s that?’

‘Mary.’

‘No!’

‘Yep. The out of hours went round, saw her slumped on the sofa, banged on the window but got no response, so he called the police who smashed down the door with their big red key.’

‘Is she all right?’

‘Pissed, is all. Complaining of back pain but we couldn’t get much sense out of her so we brought her in.’

I start to open the back of our truck.

‘Funnily enough, we’ve got one of yours.’

‘Oh? Who?’

‘Agnes.’

‘Agnes! So what about...?’

‘Yep. Norman, too.’

I swing the door open to reveal the bright interior, Agnes on the trolley, Norman on a side seat. They both look out, see Dermot, and wave.

He waves back.

‘And so the circle is complete,’ he says, in a mock heroic voice. ‘Our work here is done.’

a wash and brush-up

Mr & Mrs Taylor live in a house on a hill served by a system of concrete stairs so complex you’d think you’d blundered into a landscape by Escher. We go up to go down to go up again. None of it makes sense.

‘And I bet he’s upstairs,’ says Rae.

Early morning, last hour of the night shift. A heavy lift will probably kill us.

I ring the bell.

An elderly woman shuffles to the door with her zimmer.

‘Can you come in and help him, please?’ says Mrs Taylor. ‘Only I can’t get him up. I’m not good myself.’

Stan is sitting scrunched up on the floor of the little downstairs bathroom. He fell over when he went to spend a penny at eleven o’clock at night, and he’s been there ever since. But Stan is a heavy man; at least eighteen stone, his torso a great conical lump with a couple of stringy legs hanging from the base.

‘Get me back to my chair’ he says, puffing and blowing.

We have to slide him backwards to give ourselves some room. He yelps and swears.

‘Where’s that hurting?’ I ask him.

But he ignores the question and waves his hands speculatively in the air.

‘Why won’t you put me back in my chair?’

‘Oh, no, don’t put him back in his chair,’ says Mrs Taylor, watching from the sitting room doorway. ‘He’s stuck in that thing all day, all night. He won’t even use the bathroom. He just sits there and wets.’

‘Get me back to my chair,’ says Stan.

‘I can’t cope,’ she carries on. ‘I can’t. He won’t have the doctor in. He won’t take his pills. He won’t use his frame. He just sits and sits and sits. And wets. I think he’s going a bit...’ she taps her forehead with a bony finger. ‘You know.’

‘I’m not going to hospital,’ Stan puffs. ‘Just get me up, will you? What are you waiting for?’

‘You feel hot to me. Are you hot, Stan?’

‘Why are you leaving me on the floor? Why don’t you help me up?’

Rae comes back in with the Mangar inflatable cushion.

‘What’s that?’ says Stan.

‘It’s a device for getting you off the floor. You’re too big for us to just pick you up.’

‘Am I?’

‘Unfortunately, yes. But this is good. Look. It goes under here – if you could just shuffle backwards a bit...’

He yelps and screams again.

‘What’s up, Stan? Where’s that hurting?’

He grumbles, but doesn’t tell us.

We start to inflate the Mangar. Despite warning him what to expect and what he has to do as the cushions inflate, he reacts to the whole business with the same level of uncoordinated, hoofing panic you might see in a cow being hoisted out of a ditch. With a great deal of counterbalancing and bracing, we manage to inflate all four cushions without Stan falling off, and then help him to stand. He clutches on to the door of the bathroom, his spindly legs buckling.

I fetch a wooden chair in from the sitting room.

‘I took the cushion off,’ says his wife. ‘He’ll just wet it.’

‘I’m not going to hospital’ Stan says, collapsing back into the chair. ‘Why have you put me in this thing?’

‘Because you obviously can’t walk through to the sitting room and I don’t want you falling over again.’

‘Just help me up and I’ll be all right. I’m not going to the hospital.’

‘We can’t very well leave you here like this, Stan. Now – if you can prove to me that you can get yourself up and walk through to the sitting room, fine, I’ll leave you alone. If not, it’s the hospital and no question about it.’

He tries to stand up again, but his legs will not support him. He keeps a grip on to the doorframe, though, and looks at me to see that I’ve understood.

It’s looking increasingly as if we’re going to be stuck here for hours, and we’re off duty in a few minutes. Rae calls Control and asks for a second crew. We’re going to need help lifting Stan up and down those concrete stairs – and then they can take him to hospital whilst we clear up and hurry back to base.

‘They’re sending a reserve crew,’ she says, hanging up.

‘A what?’ says Stan. ‘I’m not going to hospital.’

‘You go with these nice people!’ says his wife, glaring at him from her zimmer frame, as homicidally furious as Davros of the Daleks. ‘You can’t go on like this, Stan. You can’t!’

There’s the sound of boots on the concrete steps outside.

The fight seems to go out of him.

I slap him reassuringly on the shoulder. ‘Don’t worry, Stan. It’s only for a check-up. I reckon you’ve got a little urinary tract infection and it’s making you weaker than normal. You need a thorough-going overhaul. Wash and brush-up ,tuppence. Maybe they can get someone in to look at the house, and see if there’s not stuff that can be done to make it easier for you generally. With any luck they’ll discharge you later today. But you absolutely have to go, Stan, because to be honest – you’re so weak, if I left you now you’d fall over again and then where would you be?’

‘On the floor,’ he says.

A knock on the door. A friendly face.

‘Hello! Who’ve we got here, then?’

Stan submits to the carry-chair, and we all struggle outside to the truck. 

the cuddly toy conspiracy

Sienna is sitting on the edge of her bed, crying into the phone, whilst two of the other hostel residents look in at the door.

‘I’ve made too many mistakes,’ she sobs. ‘I just can’t cope anymore. I can’t cope.’

Along with a packet of tobacco and an asthma inhaler, there’s a neat mound of empty blister packs beside her.

When we’ve chatted to her for a while, calmed her down, established that yes, she will come with us to the hospital, Rae asks if she has everything she needs. Phone, keys, money for the taxi home?

‘Humphrey,’ says Sienna, reaching for a tatty owl that’s reclining on her pillow. She stuffs it in her handbag along with the rest of her medication.

I carry the bag and her coat so she has her hands free to support herself as she goes down the stairs.

The owl stares up at me from the bag as we descend.

*

Waiting with Sienna in the triage area of the A&E department.

Another crew comes in, pushing a young man in a wheelchair. He’s slumped forward over something; at first I think it’s a vomit bowl, then I see a little more of it and think it must be a furry hat, but when they park themselves next to us I can see that it’s actually a little toy fox. He moans slightly, and strokes the head of it.

When the triage nurse comes over to them, the attendant smiles and waves a little bundle of empty blister packets in the air.

*

Giles buzzes us into the flat. A twenty year old man, he has the bland and fleshy complexion of celery forced in the dark.

‘I took all my meds at once and went to sleep. I’m a bit disappointed I woke up, to be honest.’

Have you got everything you need to go to hospital, Giles? Phone, keys, money...?

He hands me a canvas bag whilst he pulls on a Slipknot hoodie.

And yep, there in the bag, just visible beneath the headphones, the magazine, the drink bottle and cigarettes, a cuddly little toy hedgehog, staring up at me with an off-centre kind of smile, as if to say: Sssh! Don’t say anything. I’m hiding.

charles and emma

The door stands open. I knock and push it open even further. A dark hallway, with dull light spilling down from a first floor landing, over photos and pictures, a narrow shelf of souvenirs, a chair-lift track with the chair upstairs. I say Hello, but there’s no reply, no sound.

Ambulance?

Nothing.

We go in, head up towards the light.

Hello? Ambulance?

Charles Westinghouse is fussing over his wife in the main bedroom he’s adapted for her. Everything has been cleared out except the basics – a hospital bed, a hoist, a commode, an electric armchair by the window, and another, simpler chair nearer the door. Emma Westinghouse is lying in bed with the back fully in the upright position. Her wasted arms are along by her sides, the right one under the duvet, the left on top. She doesn’t wear teeth anymore; as a consequence her mouth is a puckered crater. A PEG tube winds out to the left, a catheter tube to the right. Her skin has the waxy pallor of the profoundly inert, someone whose main experience of movement over the past eight years has been the hoist or the body roll, and of the outside world, sunshine filtered through curtains, and traffic passing in the street. Apart from the rise and fall of her chest and a certain flickering of her eyes – which, for all the low light and late hour, seem sharp and blue – she is absolutely still. Surrounded like this by all the details of her care, utterly immobile, she could be the centre of a tough new display by Tussauds, something to bring the collection up to date, Domestic Trials and Tribulations, sponsored by the NHS.

‘Oh! There you are!’ says Charles, straightening up and pushing his thick grey hair back. ‘Sorry to drag you out like this.’

He called because Emma had started grunting in a new way, something that suggested pain. There’s no sign of it now, though. All her observations are within range.

‘We’ll be guided by you, Charles. We’re more than happy to take Emma to hospital. The other option is to see how you go tonight and get the GP involved tomorrow morning – on the understanding that if anything changes you give us a call back.’

‘Will do. Just give us a hand to make her more comfortable.’

Whilst we’re doing that, Emma stretches her face a little more, making strange little panting noises, her eyes flashing.

‘Is that what she was doing?’ I ask him.

‘No. She laughs at me sometimes. I think it’s when I bend over her and my stupid hair flops forwards. Is that it, Em? Is it my hair again?’

We lower the back of the bed.

And slowly, like a doll whose weighted eyes gently close when you lie them down, she drifts off to sleep.

definitely dumped

Five o’clock in the morning, and dawn’s a spill of ink. Clubbers clacking and scraping in the direction of taxis, or anything that looks like a taxi.

There’s a guy standing outside The Spur Hotel, his hands planted deep in the pockets of his parka. I nod to him as we pull up, but he doesn’t respond.

‘Did you call the ambulance?’ I ask him as I climb out.

‘Me mate? No mate?’ His face cracks into a dreadful, stumpy grin. ‘Why – someone dying?’

‘Well I couldn’t possibly say.’

He watches me as I pull out my bag; Rae locks the vehicle behind us as we go up to the revolving doors. I glance behind as we push through; he’s still watching.

Our boots don’t make a sound on the thick blue carpet. We cross the vestibule, walk up a shallow staircase and approach the reception desk, spot lit at the far end of the atrium. The hotel rises up around us like a renovated prison – layers of identical rooms forming the four sides of the atrium, with the dining room and bar in the middle. The silence is overwhelming, accentuated by the empty dining tables all dressed for breakfast, the jardinières, the fans, the fish tanks.

A red-eyed, puffy faced receptionist is waiting for us at the desk, his arms spread left and right along the desk as if he’d been flat on his face when the call came through.

‘Room two three two,’ he says. ‘Come. I show you.’

‘So what’s the story?’

‘Well – a man and his girl, they got back from club about an hour ago. He was propping her up, you know – like this?’ He smiles at me, does the mime. ‘I thought it was the vodka.’ He shrugs.  ‘It happen lot.’

The lift puts us out on the fourth floor, an identical floor to the one we’d just left. Without even looking up, the receptionist pads ahead of us along an endless corridor, turns at the end, then along another, turns at the next end, then two doors down stops and swipes the lock.

‘Hello ambulance peoples’ he says, rapping with his knuckles on the door before he opens it.

Lying on the tiles of the en suite bathroom is a young woman, her head underneath a melamine shelf containing twin sinks and a dressing mirror. Kneeling by her side is a heavily built guy in his twenties.

‘That’s fine now,’ I say to the receptionist, who is soaking up the scene from over my shoulder. ‘We’ll let you know if we need anything else.’

‘Okay, my friend,’ he says. He nods to the boyfriend, and quietly withdraws.

‘So what’s been going on?’

Craig tells us what happened. They’d come away for the weekend. Been to a club. Not drunk all that much. Not taken any drugs. Natalie had become anxious and wanted to leave. She’d collapsed on the bathroom floor when they got back.

Natalie starts to hyperventilate, but in a non-committal, stagey kind of way. I coach her resps back.

‘Have you ever had a panic attack before?’ I ask her. She nods. ‘Okay. So you’ll know how over-breathing can make you feel.’ She nods again.

In between encouraging the breath control, I ask Craig about Natalie’s medical history.

‘I wouldn’t know,’ he says. ‘I’ve only known her a month.’

Natalie lifts her head.

‘You’re going to dump me,’ she says.

‘I’m not going to dump you. Don’t be silly.’

But Natalie drops her head back to the floor and starts breathing quickly again – and too soon after for it to be at all credible, passes out.

‘She’s not unconscious,’ I say.

I show him how I can tell.

Over the next half an hour, and despite all our efforts, Natalie carries on as before, small bursts of hyperventilation followed by unconvincing faints. Rae and I play Good Cop, Bad Cop, but nothing works. We try to encourage Natalie to stand up and move to the bed where she’ll be more comfortable, but Craig intervenes, physically picks her up, carries her through.

‘Watch your back,’ I tell him.

He shakes his head and staggers with her into the bedroom. As soon as she lands on the bed she throws herself flat and pretends to pass out again.

‘Why’s she doing this?’ he says, red in the face.

‘I don’t know. Natalie? Come on. Let’s sit you up and have a chat about how you’re feeling. We’ve just got to reassure ourselves that everything’s okay, then we can leave you alone.’

She sits up and stares at me for a moment.

‘Natalie? How are you feeling? How can we help?’

She holds out her hand to Rae without taking her eyes off me.

‘You don’t like me, do you?’ she says.

‘It’s kind of immaterial whether I like you or not, Natalie. We’re here to help and that’s what we’re trying to do.’

Suddenly she jumps up and runs out of the room.

Craig follows her, shouting over his shoulder: ‘I’ll be okay from here in, guys. Thanks for your help.’

We stand outside the room and watch Natalie run down the corridor, followed by Craig. Right at the end, where the corridor turns to the right, she stops, and after hesitating a moment, neatly puts herself on the floor.

Wearily, we walk up to meet them.

Craig is kneeling beside her, stroking her hair; amazingly, he nods at us in a friendly way.

‘All right?’ he says.

I check Natalie over.

She’s feigning unconsciousness again, only coming out of it to look up at Rae and say: ‘I like you. You’re all right.’ Then lapsing back into a little fast breathing again.

‘Try to encourage her back to the room, Craig. I think you’re doing a great job. But obviously she can’t stay like this all night. The hotel security might get involved. I don’t think Natalie needs to go to the hospital, but if anything changes later or you become concerned, you can always call us again.’

‘Thanks,’ he says. ‘Sorry to have wasted your time.’

‘It’s no bother.’

We leave them to it.

Back down in the atrium, the receptionist has resumed his position on the desk.

‘What was matter?’ he says, looking up from an early edition of the newspaper. ‘Vodka?’

‘She’s not too bad,’ I tell him. ‘Lying in the corridor at the moment, but hopefully they’ll be back in their room soon.’

‘Okay chief. I keep eye on this business.’

Back outside on the pavement, the strange guy hasn’t moved.

‘No good?’ he says. ‘Nothing doing?’

‘Another life saved.’

He watches us stow the bags and get back in the cab.

‘One month in,’ says Rae. ‘Good god. If I was him I’d be running in the other direction.’

‘Dumped,’ I say. ‘Definitely dumped.’

We clear up, take another job.