Saturday, April 19, 2014

son of the moon

There’s a low, blood-red moon tonight. It’s impossible to resist the feeling it’s having an effect.

On John, for example.

John is standing in the middle of a recreational ground just out of town. The hectic, drunken fuss of the centre is half a mile east, but you can feel the pull of it in your chest, like the presence of so much adrenaline has skewed the emotional isobars of the place. Only the sea is immune, running out flat and mirror-black the other side of the promenade. Standing like he is, perfectly still and upright, his white t-shirt ghosting in the strange half-light, John looks like some kind of sacrificial victim summoned to this place by forces he cannot resist, forces the alcohol have only helped liberate.
‘Is there someone we can call?’ I say, carefully hooking the phone from his pocket whilst Rae drapes a blanket over his shoulder.
‘Mum,’ he says.
‘Okay,’ I say, scrolling through his contacts. ‘What’s her name?’
He looks at me like I’m speaking from somewhere deep inside his head.
‘Mum,’ he says.

Thursday, April 17, 2014

like marilyn

The smell permeating the house gets stronger the nearer you get to Philip’s bedroom. There’s a shakily written note taped to the door:

No carers admitted. I will not be taking pills or speaking to ANYONE if this door is shut. It means I am sleeping and must not on any account be disturbed.

Several crossings out, different pens, one over the other.
We knock, get no answer, go in.

Philip has a poster of Marilyn Monroe on the wall facing him. She’s in bed, too, lying on her side, smiling at the camera, partially draped in a white cotton sheet, her head propped on one arm, her short blonde hair mussing down over her face, whilst behind her golden sunshine spills around her through the window, holding her in a warm and sensuous wash of light.

But even though fifty years, a camera lens, Life and Death, separate the two, it’s still surprising Marilyn doesn’t jump up and run.

The atmosphere is fetid and thick. One small window is roped open, the rest are sealed with mastic. There’s a liberal scattering of desiccated flies along the sill; a half-finished plate of food on a dirty chair; a jug of urine maturing underneath.

Philip is as sick as the room. A tall, powerfully-built man in his sixties, he’s been clothed and in bed so long that getting him out will be more exhumation than extrication. Rotten with neglect, even his wild, white goatee looks like the flaring of some exotic fungus.

‘Please don’t touch my legs,’ he whispers. ‘You’ll just have to use your equipment to lift me as I am. I know you have your equipment, and you like to use it. But please – I beg you – just go carefully.’

We pull down the sheet to see how he’s lying and how we might get him out. His shirt is unbuttoned to the navel, revealing a shockingly distended hernia, full and round and veined, just like the crowning of a baby’s head. And with his septic demeanor, and in the feverish atmosphere of his room, it’s easy to think he’s somehow fallen victim to some obscure, vegetative process. He’s been staring at the poster on the opposite wall so intently, and for so long, through so many days and nights, that the image has taken root in him, and grown, and come to fruition, pushing out from the ripening pod of his body, turning slowly towards the light, its features resolving, like a woman’s face, those eyes, that smile. Like Marilyn.

‘I’ll get a chair,’ says Rae. 

Sunday, April 13, 2014

guess what

‘You’ll need a back board,’ says Paul. Then he lets go of the door, turns round and heads back inside, where he resumes his position, spooning with Cariad on the bed in the sitting room. It’s a double-sized frame with two single mattresses, a high one for Cariad, and a lower one with a spread of all her necessaries – two laptops, a pile of inco pads, a box of tissues, an assortment of treats, a landline, mobile phone and walkie talkie, all charging in a nest of cables.
‘I’m not going to hospital,’ she says, pushing her wig back to get a better look.
‘The bloody doctor needs to get off her fat arse and get down here now,’ says Paul.
He’s as bulky as Cariad is fragile. The bed dips alarmingly in his direction, and she has to bunch up her knees and cheat her weight forward to avoid being drawn back and the two of them roll off onto the floor. But even if they did they wouldn’t hurt themselves. The bed is surrounded by a clutter of soft toys, coats, cushions and assorted bric-a-brac.
‘So what’s the problem?’ I say, adding a little pathetically ‘We haven’t been told much.’
‘What’s happening,’ says Paul, shifting his bulk into a sitting position, ‘What’s happening is that Cariad has been choking to death, turning blue and everything and the doctor won’t do a thing about it. She just told us to call you lot.’
The way he says lot. A candy-coating on something bitter.
‘Well if you were turning blue it’s no wonder he said dial 999.’ I put my bag down. ‘So how are you feeling now?’
‘Like I’m going to die, that’s how I’m feeling now,’ says Cariad. ‘I can’t breathe properly. My inhalers don’t work. I’m going to choke to death and no-one cares.’
Her voice is sharp and short as a paring knife.
‘The good news is that you’re able to talk to me now,’ I say. ‘So your breathing is okay for the moment.’
‘Oh? It’s okay, is it? Well I’m sorry if you think I’m wasting your time.’
‘No, no. That’s not what I meant. I can tell even without listening to your chest that you’ve probably got a bit of a chest infection.’
‘A bit of a chest infection? Is that what he said? A bit of a chest infection?’
Paul stands up and stomps out of the room, muttering.
I have a sudden, empty feeling, like a mountaineer who’s stepped confidently out onto a slope only to find it’s really a bridge of snow over a crevasse, doomed whether he goes back or carries on.
‘Anyway, it doesn’t matter,’ she says. ‘I’m not going to hospital. How will I get home?’
‘Why don’t we check your SATS, blood pressure and the rest and then take it from there?’ I say, opening my bag. ‘One step at a time.’
Paul comes back into the room, red in the face, like he’d only nipped out to shoot steroids in his neck.
‘What’re you doing now?’ he says. ‘I’m her carer. You should ask me first.’
‘Cariad’s the one who has to decide about her treatment,’ Rae says. ‘But obviously we won’t do anything that everyone’s not happy about.’
‘I’m not happy about it, ‘ he says. ‘Not happy at all. First the doctor, now this.’
Rae takes some observations, I write them down, asking questions that Cariad answers reluctantly.
‘Everything’s looking pretty good,’ I say at last. ‘It sounds as if you do have a chest infection, Cariad. Lying down like this makes it difficult to clear your lungs. Are you able to sit up? Only I saw your wheelchair in the hall and I thought maybe...’
‘No! I have to lie flat.‘
‘Okay. Well. Given that you went blue a little while ago, and it’s obviously been distressing for you...’
Paul snorts.
‘...the safest thing would be to take you to hospital. Even though it might be difficult to get you there.’
‘Like I said,’ snaps Paul, ‘You’re going to need a back board. Why does no-one ever listen?’
‘I can’t go to hospital. Not after last time.’
‘What happened last time?’
‘No-one would take me home, so I had to lie on the floor of a taxi, screaming in agony the whole way. I won’t do it, Paul! I can’t!’
‘If she goes to hospital, are you going to bring her back?’ he says.
‘It won’t be us, and I can’t even say it’ll be a frontline crew. But this should be the last of your worries given the problems you’ve had with your breathing. You’ll just have to cross that bridge when you come to it.’
‘I’m not coming home like that again,’ wails Cariad. ‘I’d rather die here.’
‘I’ll protect you,’ says Paul, plucking up a teddy bear by the face and looking at me.
‘If we do decide to go in,’ I say, trying to keep my voice as low and steady as I can, ‘it’ll be a little difficult getting out. We’ll have to clear all this stuff off the bed to get to you.’
‘No! Not my stuff!’
‘We’ll put it aside somewhere safe.’
‘Then what?’
‘Then we’ll have a think what’s the best way to get you out.’
‘A backboard. Christ, how many more times have I got to tell you.’
‘Try to keep your temper, Paul’ I say to him. ‘We’re doing our best.’
‘The last crew dropped her.’
‘I’m sorry to hear it.’
‘Yeah. Well. You’re sorry.’
He throws the bear off to the side, snatches up a box of tissues, tosses them after it.
‘We’re definitely going in then, are we?’ he says to Cariad.
‘I don’t know!’ she shouts. ‘Why can’t the doctor come out?’
‘We could certainly call the doctor and see what they say,’ I suggest.
‘Do it,’ says Paul.
‘I’m not speaking to her,’ says Cariad. ‘Useless piece of shit.’

Rae calls the doctor. After a while she hands to phone to Paul.
‘She wants a word.’
Paul grips the phone, holding it a little way off from his ear, like he’s wary of infection. After a short series of grunts and sighs he hands it back, then leaves the room again.
Rae finishes the call, and hangs up.
‘She wants you to go in for a chest X-ray, Cariad. Just to rule out the possibility of pneumonia or other complications.’
‘But how am I going to get back?’ says Cariad.
‘They can’t do an X-ray at home.’
Cariad buries her face in a pillow.

We call for another crew to help. Even though Cariad isn’t heavy, the fact that she has to be kept flat makes things tricky. The front room is cramped, we can’t get the trolley in the front door, and the only way out is through the kitchen and down a short flight of concrete steps into the garden. It’s no wonder the other crew struggled.

Ordinarily – perversely – I quite like these difficult extrications. Three-dimensional puzzles that demand a creative use of kit, teamwork and a flair for cheating angles. But Paul changes the dynamic. He masses darkly behind us all  like a thunderhead storm cloud, flashes of disapproval, spots of anger.

Just before the second crew arrives I offer to help clear the second mattress.
‘You’ve fucking asked me that already,’ he shouts. ‘I’m doing it, aren’t I?’
‘Please don’t swear at us, Paul. Okay?’
He keeps his back to me as he unplugs the laptops. I’m increasingly mindful of striking distances. 

The second crew gets here. Between us we discuss how best to get her out, at the same time struggling to contain Cariad’s rising levels of anxiety. She won’t even let us look at her meds. She clutches them to her chest like she’s terrified we’re going to steal them.
Despite everything we manage to get ourselves into position, ready to slide Cariad from the furthest mattress onto the backboard.
Ready, set – slide!
She screams, even though I’m certain we haven’t done anything to cause her any pain.
‘That’s it! Stop! That’s it!’ shouts Paul, storming forwards. ‘You can fuck off, the lot of you! I’m not having this. Put her back. You put her back how she was! Now!’
‘Please don’t swear at us,’ I tell him, wishing I could think of something else. ‘We’re doing our best.’
‘Well it’s not good enough. Put her back, now.’
‘Is that what you want, Cariad?’ asks Rae, in a steady voice. ‘We can carry on and take you to hospital if that’s what you’d like us to do.’
But Cariad is just crying and shaking her head, so we slide her back, pack up our things and leave.

We rendezvous back at base to put in an untoward incident form, and to alert any other crews who might have to attend in future. Whilst we’re there, Control ring. They want me to tell them what happened. ‘Because we’ve got Paul on the phone,’ says the dispatcher. ‘Guess what? He says you refused to take her to hospital.’

Saturday, April 12, 2014


Dan meets us outside his mum’s house. He looks like a depilated bear gone punk, hair in spikes, a Damned t-shirt stretched over his belly, paws stuffed into a pair of rotten Converse All Stars, studs in his ears and nose and lip. Every bare patch of his skin carries a tattoo – ghostly figures, flaming pumpkins, a headless horseman, glaring skulls, all amongst a general tangle of black roses, Celtic knotwork and ivy.
‘Thanks for coming,’ he says, carefully lighting the cigarette he’s been rolling. ‘I thought I’d better give you the heads up.’
His mum is an alcoholic, he says. She’s been in and out of rehab, not doing too badly but gone off the rails this past week.
‘She’s started seeing things again,’ he says, flicking the match away across the drive. ‘Hearing voices. I phoned the unit and they said to call you.’

He takes us inside.

The bungalow has been built villa-style, with arches leading off from the main room, terracotta tiles on the floor, rugs here and there, and in the centre, an alcove with a statue of a saint raising his hand in blessing. The whole place should be flooded with sunshine – it’s a particularly bright afternoon – but all the blinds are drawn, and whatever bands of light make it through the slats only serve to accentuate the soupy darkness.
‘Through here,’ says Dan. ‘It’s a bit of a maze.’
He leads us through a sequence of rooms, each as gloomy as the last. He knocks on a bedroom door and we follow him in.

Mary is still in bed. She gathers the duvet tightly around her as we say hello.
‘It’s okay, mum. It’s okay. It’s just the ambulance. You remember I said I was going to call them, like the people at the centre told me? They’ve just come to see how you are.’
She scuttles back in the bed, rising up on the pillows into a semi-sitting position, and stares at us.
‘Be a love and open the window,’ she says. ‘He’s hiding over there in the curtains.’
‘Who is, mum?’
‘The man. The one I was telling you about. The one who’s been going on and on at me to drown myself. If you open the window he might go out in the garden and we can talk.’
Dan looks at us, then goes over to open the window.
‘There’s no-one here, mum,’ he says as he lifts the latch and pushes it open.
‘Can’t you see him?’ she says. ‘Really?’
She looks at me.
‘What about you?’
I sit down on a stool just off to the side and try to look as non-threatening as possible.
‘I can’t see anyone there, Mary. I think it’s probably one of those hallucinations you’ve had in the past. Do you think that’s possible?’
She roughly presses the heels of her hands into her eyes to clear them, then peers at me more closely. After a moment she reaches out to her bedside table and produces an alcometer.
‘I’ve been good,’ she says. ‘I’ve only been drinking enough to keep me on the level. Look.’
She shows me the screen, but the device is switched off.
‘That’s great,’ I say. ‘But these hallucinations are a bit worrying. Dan called the team at the unit about it, and they said to take you to hospital. Would that be okay?’
‘I’m fine,’ she says. ‘I can’t see the point.’
‘You need to go in again, mum,’ says Dan. ‘You’re not well.’
‘Aren’t I?  I don’t know. I’d be fine if it weren’t for him.’
She looks over at the window, as we all do. And just at that moment a sudden breeze fills the curtains, gently rolling them in, and then back, and then in again.

Friday, April 11, 2014


The ewe must have died in childbirth. Pete found her on his morning round, lying in the field with a bloody newborn nuzzled up. His son Craig helped him load the ewe into the back of the Landrover, and they all rode back to the barn with Pete cradling the lamb on his lap and Craig driving. They cleaned off the lamb and put it in a pen, then laid the dead ewe on her back. Pete took  up an empty bottle, then bent down to salvage as much colostrum as he could.
That’s when his hip dislocated.
He fell backwards onto a pile of straw, and lay there screaming whilst Craig called for an ambulance.


Once the morphine and Entonox have dulled the pain, we splint one leg against the other and then with Craig and some other farmhands, we slide Pete onto the vacuum mattress.

It’s a wonderful place to work. All around us in the muffled, straw-light and sun-warm peace of the shed, lambs suckle or chew intently with their snouts poking through the bars of their pens. Sparrows twitter and screech round the old oak beams, whilst out in the yard the chickens that were scared away by our arrival have returned to reclaim their territory, scratching around in the dirt. The lambs are all excited, trembling, watchful. Sometimes they spin around on the spot, or spring straight up and then bound away into the straw. They all have numbers sprayed in blue on their sides, the same colour as the vacuum mattress. Meanwhile, the corpse of the dead ewe lies off to the side just beyond the tail ramp of the ambulance, like an abandoned, upturned table, all four legs sticking straight in the air.


The ambulance bumps about on the road, but we’ve immobilised Peter pretty well and he seems content. We chat about this and that, farming, mostly, with Peter explaining about vaccination, vet’s bills, flooding, seeding problems and so on. He patiently hears me out each time I ask a question, holding the Entonox mouthpiece between his teeth and taking contemplative puffs, like he’s enjoying a pipe at The Bull.
‘Do you ever use any of the sheep’s milk for cheese?’ I ask him.
He takes another puff.
‘No’ he says. ‘There’s never any spare. It all goes down the lambs’ gullets, to fatten them up. You know – for chops.’
‘Lovely!’ I say. ‘I could do with a couple of chops.’ But for a moment and in spite of myself I feel a little dizzy. I think it’s the contrast between the beautiful lambs playing in the straw; the dead ewe lying on her back; the farmer harvesting milk to give the newborn a fighting chance; the warmth, the hour, the elaborate care of it all – and the fact that in a few short months, every one of those lambs will be killed, jointed, wrapped, labelled, table ready.
‘How’s the hip?’
‘Bloody thing,’ he says. ‘You may as well shoot me.’

Sunday, April 06, 2014


Yelena, a carer with a manner as brisk as her woven yellow hair, opens the door.
‘Hello!’ she says. ‘James through here in this way. Am sorry to call you, but James he have much blood in catheter bag and I think he might need to go hospital about this.’
She leans forward and examines my face for a response. It’s disconcerting. Her spiky mascara eyelashes give her wide grey eyes an extra-vivid splash of attention, and her red lips pout, pre-empting a fight.
‘He ex-navy man,’ she says at last, as if that might explain the blood. ‘Is favourite. You take good care.’
James is sitting in a riser chair, his ancient hands contentedly laced over his belly. Yelena is right about the blood. It’s obvious he needs to go in.
‘Can we get James’ medication together?’ I ask Yelena.
‘Of course. I do this already,’ she says, producing a well-stuffed bag. ‘His favourite pyjamas and all the bits and the piece.’
She puts the bag down next to the carry chair, and then reaches over to the table and picks up a set of laminated cards joined at one corner with a treasury tag.
‘James cannot speak because of stroke. But look at this’ she says to me. ‘This is new, very good thing. It has all picture of things James want to say. Look.’
She begins flicking through the cards. The front one has a series of clip-art pictures of health professionals: a doctor, nurse, district nurse, pharmacist, carer. The next card has pictures of ailments: joint pains, tummy and chest, and for headache, the picture of a head with lightning bolts jumping out in an arc from ear to ear.
‘Where’s the picture for paramedic?’ I ask Yelena. ‘How come we’re not on there?’
‘You here,’ she says, leaning over my shoulder and pointing to headache. ‘Is you.’


Marcia doesn’t want to leave her little dog. She hugs him to her breast so tightly his legs splay sideways and his eyes bug out. Still, he manages to cheat just enough room to turn his head and liberally lick her mouth. Marcia tips her head back in delight.
‘You be a good boy till I get back,’ she says as he squirms in her embrace. ‘You be a good boy. Don’t worry, Pippin. Mummy be back soon. Yes she will.’
The dog – a Papillon, apparently, some expensive cross between a spaniel and something else, a chinchilla, maybe – a tremblingly alert creature with dark lines under his eyes like he’s wearing Kohl, or not sleeping nights.
‘I wish I could take you with me,’ says Marcia, giving him one last squeeze, then plumping him down on the duvet and waving him off in the direction of her mum and dad. ‘Use the rest of that chicken,’ she shouts after them. They hurry out after the dog to get Marcia’s things ready.
‘So the doctor said for you to go into hospital on the phone?’ I ask her.
‘He didn’t like the sound of my head.’
‘Have you had it before?’
‘Yes. But not like this.’
She dabs a handkerchief under her right eye, and takes a steadying breath.
‘Sorry,’ she says.
‘That’s okay.’
‘A couple of other things I think you should know.’
‘Go on.’
‘Well, just lately my saliva has seemed thicker.’
‘Yes. I don’t know if it’s significant or not.’
‘Okay. Anything else.’
She looks down and starts twisting her handkerchief, like she’s wringing out the tears. Then she takes a long breath in through her nose, lets it out through her pursed lips, looks straight at me and gives me a brave smile.
‘It’s my lady time.’

Friday, April 04, 2014

his business

Early morning, and the day has just started to move up, clear and bright.
A young woman is standing over a figure lying prone on the pavement. She waves when she sees us, and puts her phone away.
‘Thanks for coming so quickly,’ she says. ‘This is how I found him.’
It’s a guy of about thirty. His thin and wasted face looks familiar, and I’m guessing he’s a street sleeper, because although his trousers are round his ankles, he’s wearing a pair of tracksuit bottoms under them.
I lean down next to him and shout in his ear.
‘Hello, mate! It’s the ambulance!’
He doesn’t respond, so I squeeze his shoulder.
‘Hello? Are you all right?’
He flinches, and bats my hand away.
‘Fuck off,’ he says, in a spasm of irritation – then instantly goes back to sleep. 
‘So he wasn’t unconscious,’ says the woman, looking embarrassed. ‘I just didn’t feel safe to touch him myself.’
‘No. Don’t worry. It’s very kind of you to help. We’ll be all right now if you want to get on.’
She adjusts the rucksack on her shoulder, and with one last perplexed look down at the man, strides away down the street.
I lean in to pinch the guy’s shoulder again.
‘You can’t just lie down on the pavement, mate. People are worried about you. They think you’ve died.’
‘Fuck off n’leave me alone.’
‘Open your eyes for me, would you?’
He’s instantly asleep again, so I open his eyelids. His pupils are as small and hard as poppy seeds.
‘Have you had some heroin this morning?’
This seems to rouse him more effectively than the pinches on the shoulder. He struggles up onto his feet, and stands there a moment, swaying from side to side, his eyes closed, his trousers still round his ankles.
‘Come on, mate. Why don’t you come on the ambulance and we’ll check you over?’
He turns his head, raising his scrubby chin and sniffing the air in a general way, like a snake sensing heat off in the undergrowth.
‘Fuck off and mind your own business,’ he says eventually, then turns to walk away. But the trousers round his ankles immediately trip him up, and he veers alarmingly into the road, flailing his arms around and paddling with his feet to keep up with the top half of him. It can only be the heroin keeping him upright; anyone else would’ve fallen flat on their face.
‘Whoa! At least pull your trousers up!’
Incredibly, he makes it over to the other side of the road. A van waits to let him go. When it eventually moves on, the driver smiles at me and shakes his head.
Meanwhile, the patient has draped himself over a metal barrier and fallen asleep again.
I walk over.
‘Seriously. You can’t go on like this. You’ll end up hurting yourself, and anyway, we’ll just get another call back.’
No response.
‘Mate? Hello?’
I reach out and squeeze his shoulder again.
He flinches, and pushes himself upright.
‘Get your nose out of my business,’ he shouts, then tries to walk off again.
‘At least let us help you get your trousers up.’
‘Fuck off.’
He penguin-steps further onto the pavement, and then as if drawn by some invisible, irresistible current, waddles off sideways into an alley.
‘I’m not following him around all morning,’ I tell Rae. ‘Get your nose out of my business. There’s gratitude!’
Rae pulls off her gloves and hauls herself back in the cab.
‘His business in your nose, more like,’ she says.