Jeanette has fallen over at the home. Although she only bruised her shoulder and knee and seems happy enough in herself, we find that every now and again her heart rate drops to the forty mark for extended periods, and it looks like this is the reason she went over.
‘I’m afraid we’re going to have to take you in to hospital to get this checked out,’ I say to her. ‘A nuisance, I know, but we want to make sure you’re okay.’
‘Fine. Yes. You carry on,’ she says, resigned to the whole affair, despite the late hour – on the coldest night of the winter so far – and despite the fact she’s ninety.
‘I’m in your hands,’ she says.
We bundle her up against the cold and wheel her out to the ambulance.
The nursing staff wave her off.
***
All our checks are done. The ambulance rocks gently from side to side as we glide along empty streets to the hospital. The heater whirrs in the background; Jeanette is tucked up to her chin in blankets; I’ve switched on the smaller overhead spots and turned off the main lights. Jeanette is perfectly awake despite the cosy interior. The light plays across her glasses as she looks around.
‘Comfy?’
‘Yes. Very comfy, thank you.’
‘You’re a good traveller,’ I tell her, putting my clipboard aside.
‘Oh – I’ve done it a few times,’ she says.
‘To hospital, do you mean?’
‘When I worked.’
‘What did you do?’
‘I was an air stewardess. For BOAC. I went all over the world. And when that was that I went into training and took care of the other side of things for a while.’
‘Where were you based?’
‘All over. London mostly. Do you know London?’
‘I was born there.’
‘Were you?’
‘In Pimlico.’
‘Pimlico! Fancy that. Where in Pimlico?’
‘Just off John Islip Street. Near the Tate.’
‘I know it! If I’d had a pound for the number of times I’d walked along Millbank.’
She settles her head deeper into the pillow.
‘We used to go dancing at that place in Victoria. What was it called…?’
She drifts off, the creases and folds of her face smoothed out beneath the spotlights like an actor’s mask left on stage.
I check the ECG and reach over to feel the pulse at her wrist. It suddenly drops down almost to nothing, the merest echo of a pulse from the wrist line of a leather glove waving at the doorway of a DC10 at Nairobi, the trace of an echo behind a wrist watch waving for a cab on the Horseferry Road. But just as I dab about wondering if I can feel it at all, getting up to ask Frank to pull over, the trace on the machine comes back again, quicker and stronger, and the pulse resurfaces beneath my fingers.
She opens her eyes and looks at me.
‘Where was it?’ she says.
Tuesday, January 31, 2012
Saturday, January 28, 2012
spelling bee
Orange street lights on frosted tarmac. A crescent moon hooked up in the sky like a suture needle.
I press the button on the intercom, a pause, then the squall of a voice through the speaker.
I lean in.
‘Ambulance.’
Buzz.
Mr O’Fallon is standing in his hallway, the subsiding wreck of a fifty year old, propped up against the wall, smiling soggily like a Halloween pumpkin left out in the rain.
‘S’ah. M’gon et ma goh sum’air mate. Eh? S’ah there to, innit.’
‘What’s that?’
He sighs.
‘S’ah. M’gon et ma goh sum’air mate. Eh? S’ah there to, innit.’
‘What’s happened tonight, Mr O’Fallon? Mr O’Fallon?’
He reaches down, grips his left hip, then swipes at the air with his free hand. I prop him back up.
‘Did you fall? Have you hurt yourself?’
He grinds his gums, laughs, then speaks.
When he talks, his Belfast accent, lack of teeth and many cider litres – many years of cider litres – all these things act like the layers of a perverse filtration system: he thinks of a response, pours it in at the top, it filters down through each layer, all the nuances of communication absorbed and lost, until all that’s left to come out of his mouth is a kind of primitive proto-language, the essence of the thing he wanted to say, lukewarm, with just a taint of the original sense.
‘Sorry?’
He says it again.
‘It’s hard to understand what you’re saying,’ I tell him. ‘Seeing as you’re on your feet, shall we get you out to the ambulance and check you over there?’
He makes some sounds. I interpret them as Can you get my jacket? When I fetch his jacket down from where it hangs on the back of the door, he nods as if that wasn’t what he meant but it’ll have to do.
We stagger out to the ambulance.
***
Mr O’Fallon is sitting on one of the ambulance seats. Frank takes his blood pressure and temperature whilst I try to get the basic details. We’re only round the corner from the hospital, so I need to do it whilst the ambulance is parked up.
‘What’s your first name, Mr O’Fallon?’
He makes a sound.
‘What?’
He makes the sound again, louder.
‘Spell it for me.’
‘Or’
‘R?’
‘Or! F’Orse.’
‘Oh! O!’
‘A’s roi, neh. Or.’
‘Okay. Next letter.’
‘Ay’
‘A?’
‘Ay. Ay! Fer Aynjin. Ay.’
‘I. For Indian. I for Indian.’
‘Ay. Ay.’
‘Okay. O, then I. Then what?’
‘Ass.’
‘Arse?’
He shakes his head – so hard it almost falls off onto the trolley.
‘Ass! Fer fer’s say. Ass!’
‘Yep. Got it. So that’s O, I and S – then what?’
‘Ay.’
‘I?’
He frowns. Then immediately raises his eyebrows.
‘On.’
‘On?’
‘On. Fer Nut’n. On.’
‘N! Okay – great. So that makes O.I.S.I.N.’
He shakes his head again, and leans right back in the chair.
‘So how do you pronounce that?’
He laughs, with his awful, craterous, old dog’s mouth.
‘Osheen,’ he says, the name wafting out in a hang of fumes.
He leans forward and slaps me on the knee.
‘Ay ‘us shah boy de Oy Uh Ray,’ he says.
‘You were shot by the IRA?’
Frank takes the cuff off his arm.
‘Well,’ he says. ‘They’re not as patient as us.’
I press the button on the intercom, a pause, then the squall of a voice through the speaker.
I lean in.
‘Ambulance.’
Buzz.
Mr O’Fallon is standing in his hallway, the subsiding wreck of a fifty year old, propped up against the wall, smiling soggily like a Halloween pumpkin left out in the rain.
‘S’ah. M’gon et ma goh sum’air mate. Eh? S’ah there to, innit.’
‘What’s that?’
He sighs.
‘S’ah. M’gon et ma goh sum’air mate. Eh? S’ah there to, innit.’
‘What’s happened tonight, Mr O’Fallon? Mr O’Fallon?’
He reaches down, grips his left hip, then swipes at the air with his free hand. I prop him back up.
‘Did you fall? Have you hurt yourself?’
He grinds his gums, laughs, then speaks.
When he talks, his Belfast accent, lack of teeth and many cider litres – many years of cider litres – all these things act like the layers of a perverse filtration system: he thinks of a response, pours it in at the top, it filters down through each layer, all the nuances of communication absorbed and lost, until all that’s left to come out of his mouth is a kind of primitive proto-language, the essence of the thing he wanted to say, lukewarm, with just a taint of the original sense.
‘Sorry?’
He says it again.
‘It’s hard to understand what you’re saying,’ I tell him. ‘Seeing as you’re on your feet, shall we get you out to the ambulance and check you over there?’
He makes some sounds. I interpret them as Can you get my jacket? When I fetch his jacket down from where it hangs on the back of the door, he nods as if that wasn’t what he meant but it’ll have to do.
We stagger out to the ambulance.
***
Mr O’Fallon is sitting on one of the ambulance seats. Frank takes his blood pressure and temperature whilst I try to get the basic details. We’re only round the corner from the hospital, so I need to do it whilst the ambulance is parked up.
‘What’s your first name, Mr O’Fallon?’
He makes a sound.
‘What?’
He makes the sound again, louder.
‘Spell it for me.’
‘Or’
‘R?’
‘Or! F’Orse.’
‘Oh! O!’
‘A’s roi, neh. Or.’
‘Okay. Next letter.’
‘Ay’
‘A?’
‘Ay. Ay! Fer Aynjin. Ay.’
‘I. For Indian. I for Indian.’
‘Ay. Ay.’
‘Okay. O, then I. Then what?’
‘Ass.’
‘Arse?’
He shakes his head – so hard it almost falls off onto the trolley.
‘Ass! Fer fer’s say. Ass!’
‘Yep. Got it. So that’s O, I and S – then what?’
‘Ay.’
‘I?’
He frowns. Then immediately raises his eyebrows.
‘On.’
‘On?’
‘On. Fer Nut’n. On.’
‘N! Okay – great. So that makes O.I.S.I.N.’
He shakes his head again, and leans right back in the chair.
‘So how do you pronounce that?’
He laughs, with his awful, craterous, old dog’s mouth.
‘Osheen,’ he says, the name wafting out in a hang of fumes.
He leans forward and slaps me on the knee.
‘Ay ‘us shah boy de Oy Uh Ray,’ he says.
‘You were shot by the IRA?’
Frank takes the cuff off his arm.
‘Well,’ he says. ‘They’re not as patient as us.’
Thursday, January 26, 2012
get cracking, mate
Mr Abbott is lying on the ITU bed, a corrugated tube connecting his mask to the oxygen supply, a tangle of chest leads running out to the ECG monitor, a blood pressure cuff round his arm, a SATS probe clipped to his finger, the ports of a central line dangling from his neck, and a urine catheter running out to a bag on the side of the bed. He is asleep when we roll into the department with our trolley; the nurse wakes him up.
‘Come on, Paul. Shake a leg. We can’t have you lazing around here all day. What do you think this is, a holiday camp?’
He opens his eyes.
‘I’m sure you do it on purpose,’ he says, his dry voice only just distinguishable above all the hushing and beeping and buzzing. ‘What do you do – hide in the cupboard until you see I’ve dropped off, then jump out? You’re a sadist, you are.’
‘Charming. I don’t know why I bother. Just because I wouldn’t give you any of my Kit Kat.’
‘You can keep your bloody Kit Kat,’ he says, then goes to fold his arms. He seems surprised to find that he can’t do it, so lays them down again.
‘Hello, Paul. I’m Spence, this is Frank. We’ve come to transfer you to the other hospital. How are you doing?’
‘Great. Thanks. Bloody marvellous. Who did you say?’
‘Spence and Frank.’
‘There you go,’ says the nurse, stuffing all his notes in a grey plastic bag. ‘I told you they wouldn’t be long. Your own private taxi. How’s that for service?’
‘Lousy.’
We help prep him for the transfer to our trolley.
‘Nice bed you’ve got here,’ I say, looking around. There are two chintzy pictures on the wall facing him – a Thames barge in sail, and a cottage on a country lane. I wonder how long he’s been staring at those pictures, what they’ve come to mean to him.
‘Ready, set – slide.’
‘Now don’t you go complaining too much,’ says the nurse. ‘I know what these guys are like. They’re not nice like me. They’ll fly-tip you in a lay-by.’
‘I only complain when there’s something or someone to complain about.’
But he reaches out to her, and when she puts her hand in his, he squeezes it affectionately.
‘Thanks for all you’ve done,’ he says.
‘Paul – you’re very welcome. Get better soon.’
We wheel him out.
‘And don’t come back!’ she says.
***
It’s difficult to chat to Paul on the ambulance. The motorway falls away beneath us like a river in flood, and the wind booms around the metal sides of the truck.
‘I suppose you’re retired now?’ I say to him.
‘Retired? Oh god, yes. Years ago.’
‘What did you do?’
‘I was an engineer. Telecoms. I was the guy they use to send in when no-one else could sort it out. I’d pitch up, they’d point me to a big room full of wires and relays and transformers, all higgledy-piggledy, and they’d say “There you go, mate. Get cracking.” And do you know what, when I walked out of that room, everything’d be back in its place and the air would be humming sweetly. And that’s what I did for a living.’
‘Sounds good.’
‘It was good. I went all over the world. Japan, Africa, the Middle East. Always the same thing. “There you go, mate – sort it out.” And I would.’
He pauses, and struggles to adjust his position on the trolley.
‘Are you okay?’
‘I’m all right. I just get a bit – sore, you know?’
I reposition the mask on his face and tuck him up again.
A moment passes.
‘D’you know – there was a woman in the bed opposite me,’ he says. ‘Not good. Not good at all. I’ve no idea what was wrong with her, but it wasn’t good. She’d cry quietly to herself. Felt like hours. I could hear her, especially when it was quiet and the visitors had gone. She had lots of people come to see her. You could tell it was bad because they didn’t say much, just sort of hung about. And when they went she’d cry quietly like that. The nurses did what they could, but it was awful.’
He turns his face to look at me, and his eyes are shining.
‘I couldn’t do nothing,’ he says. ‘What do I know about any of that? All I could do was lie there and listen.’
I hand him some tissue. He wipes his face and blows his nose, then re-settles the mask on his face.
‘And that was the worst thing. I had no idea what was wrong. I couldn’t do nothing. I just had to lie there. And listen.’
The ambulance rocks from side to side. He closes his eyes to compose himself.
We turn off onto the slip road and take the exit towards town.
‘Come on, Paul. Shake a leg. We can’t have you lazing around here all day. What do you think this is, a holiday camp?’
He opens his eyes.
‘I’m sure you do it on purpose,’ he says, his dry voice only just distinguishable above all the hushing and beeping and buzzing. ‘What do you do – hide in the cupboard until you see I’ve dropped off, then jump out? You’re a sadist, you are.’
‘Charming. I don’t know why I bother. Just because I wouldn’t give you any of my Kit Kat.’
‘You can keep your bloody Kit Kat,’ he says, then goes to fold his arms. He seems surprised to find that he can’t do it, so lays them down again.
‘Hello, Paul. I’m Spence, this is Frank. We’ve come to transfer you to the other hospital. How are you doing?’
‘Great. Thanks. Bloody marvellous. Who did you say?’
‘Spence and Frank.’
‘There you go,’ says the nurse, stuffing all his notes in a grey plastic bag. ‘I told you they wouldn’t be long. Your own private taxi. How’s that for service?’
‘Lousy.’
We help prep him for the transfer to our trolley.
‘Nice bed you’ve got here,’ I say, looking around. There are two chintzy pictures on the wall facing him – a Thames barge in sail, and a cottage on a country lane. I wonder how long he’s been staring at those pictures, what they’ve come to mean to him.
‘Ready, set – slide.’
‘Now don’t you go complaining too much,’ says the nurse. ‘I know what these guys are like. They’re not nice like me. They’ll fly-tip you in a lay-by.’
‘I only complain when there’s something or someone to complain about.’
But he reaches out to her, and when she puts her hand in his, he squeezes it affectionately.
‘Thanks for all you’ve done,’ he says.
‘Paul – you’re very welcome. Get better soon.’
We wheel him out.
‘And don’t come back!’ she says.
***
It’s difficult to chat to Paul on the ambulance. The motorway falls away beneath us like a river in flood, and the wind booms around the metal sides of the truck.
‘I suppose you’re retired now?’ I say to him.
‘Retired? Oh god, yes. Years ago.’
‘What did you do?’
‘I was an engineer. Telecoms. I was the guy they use to send in when no-one else could sort it out. I’d pitch up, they’d point me to a big room full of wires and relays and transformers, all higgledy-piggledy, and they’d say “There you go, mate. Get cracking.” And do you know what, when I walked out of that room, everything’d be back in its place and the air would be humming sweetly. And that’s what I did for a living.’
‘Sounds good.’
‘It was good. I went all over the world. Japan, Africa, the Middle East. Always the same thing. “There you go, mate – sort it out.” And I would.’
He pauses, and struggles to adjust his position on the trolley.
‘Are you okay?’
‘I’m all right. I just get a bit – sore, you know?’
I reposition the mask on his face and tuck him up again.
A moment passes.
‘D’you know – there was a woman in the bed opposite me,’ he says. ‘Not good. Not good at all. I’ve no idea what was wrong with her, but it wasn’t good. She’d cry quietly to herself. Felt like hours. I could hear her, especially when it was quiet and the visitors had gone. She had lots of people come to see her. You could tell it was bad because they didn’t say much, just sort of hung about. And when they went she’d cry quietly like that. The nurses did what they could, but it was awful.’
He turns his face to look at me, and his eyes are shining.
‘I couldn’t do nothing,’ he says. ‘What do I know about any of that? All I could do was lie there and listen.’
I hand him some tissue. He wipes his face and blows his nose, then re-settles the mask on his face.
‘And that was the worst thing. I had no idea what was wrong. I couldn’t do nothing. I just had to lie there. And listen.’
The ambulance rocks from side to side. He closes his eyes to compose himself.
We turn off onto the slip road and take the exit towards town.
Saturday, January 21, 2012
haute cuisine
The estate rises around us in the darkness like a ruthlessly illuminated housing machine. Layer upon layer of regularly spaced squares fitfully lit by plasma screens, measured out in a grid of walkways. But despite the scale of the place there’s no-one around, not even a dog walker or a posse from the clubs; no sign of life at all, just a skin of frost over the parked cars and the grass, and here and there faint wisps of steam rising from vents.
Ellie is waiting for us in one of the entrance halls, staring out at us through the scratched Perspex of the front door. Her eyes are so wide and dark they make the hall lights flicker.
‘Can we come in?’
She doesn’t answer, but relaxes her hold on the door and turns to walk back inside.
Her flat is clean and warm, the laminate floor clear of anything but a pair of dog slippers and a scattering of empty pill packets. Ellie goes over to turn off the TV – a cooking competition - and puts her feet into the slippers.
‘My name’s Spence. This is Frank. We were told you might have taken an overdose tonight. Is that right, Ellie?’
She nods, gathers the lapels of her pink towelling robe around her, knots the belt more tightly.
‘Are these the tablets you took?’ pointing to the packets on the floor.
She nods again, and goes to pick them up.
‘It’s all right, Ellie. I’ll get them. Were these all full when you started?’
‘Mostly.’
‘There’s quite a few here. I’ll do the counting up on the ambulance. What we need to do now is take you to hospital for some treatment. Is that okay?’
‘I’ll get my bag.’
‘And your keys? Good. Okay – let’s go.’
***
She lies back on the trolley, folds her hands neatly across her stomach and closes her eyes. She’s only twenty one; her face is as clear and unmarked as a sleeping alabaster angel in a church.
I calculate the number and size of the pills she’s taken, dropping the counted packets into a spare vomit bowl. The tally is dreadful, a shopping list for the damned. I put everything aside and feel the pulse at her wrist.
‘Did you take any alcohol with these pills, Ellie?’
She opens her eyes.
‘A glass of wine.’
I picture her alone in the flat, sitting on the edge of the sofa, taking little sips with each mouthful, tipping her head back, watching the chefs battle it out on the TV.
‘How long ago?’
‘Half an hour.’
‘Good. And how are you feeling now?’
She rests her head back on the pillow and closes her eyes again.
‘My tummy hurts,’ she says.
We turn up the slope to the department.
***
The Charge Nurse looks at the name on my sheet and then glances down the corridor to where Frank is waiting with Ellie.
‘Oh yeah. Yep. She was in about a month ago. What’s she taken this time? Whoah!’
She signs the board, hands it back to me, then asks one of the other nurses to come over.
‘Best crack on with this,’ she says. ‘Although why the hell she’s still got all these meds hanging around is beyond me.’
I go back to the trolley to help push her into a cubicle. Her dog slippers are poking out of the bottom of the blanket, so I pull it down a little to cover them.
‘The nurse will be with you very shortly,’ I say to Ellie as we move along. But I can see the nurse is already there waiting for us, smiling, a bottle of charcoal in her hand, shaking it.
Ellie is waiting for us in one of the entrance halls, staring out at us through the scratched Perspex of the front door. Her eyes are so wide and dark they make the hall lights flicker.
‘Can we come in?’
She doesn’t answer, but relaxes her hold on the door and turns to walk back inside.
Her flat is clean and warm, the laminate floor clear of anything but a pair of dog slippers and a scattering of empty pill packets. Ellie goes over to turn off the TV – a cooking competition - and puts her feet into the slippers.
‘My name’s Spence. This is Frank. We were told you might have taken an overdose tonight. Is that right, Ellie?’
She nods, gathers the lapels of her pink towelling robe around her, knots the belt more tightly.
‘Are these the tablets you took?’ pointing to the packets on the floor.
She nods again, and goes to pick them up.
‘It’s all right, Ellie. I’ll get them. Were these all full when you started?’
‘Mostly.’
‘There’s quite a few here. I’ll do the counting up on the ambulance. What we need to do now is take you to hospital for some treatment. Is that okay?’
‘I’ll get my bag.’
‘And your keys? Good. Okay – let’s go.’
***
She lies back on the trolley, folds her hands neatly across her stomach and closes her eyes. She’s only twenty one; her face is as clear and unmarked as a sleeping alabaster angel in a church.
I calculate the number and size of the pills she’s taken, dropping the counted packets into a spare vomit bowl. The tally is dreadful, a shopping list for the damned. I put everything aside and feel the pulse at her wrist.
‘Did you take any alcohol with these pills, Ellie?’
She opens her eyes.
‘A glass of wine.’
I picture her alone in the flat, sitting on the edge of the sofa, taking little sips with each mouthful, tipping her head back, watching the chefs battle it out on the TV.
‘How long ago?’
‘Half an hour.’
‘Good. And how are you feeling now?’
She rests her head back on the pillow and closes her eyes again.
‘My tummy hurts,’ she says.
We turn up the slope to the department.
***
The Charge Nurse looks at the name on my sheet and then glances down the corridor to where Frank is waiting with Ellie.
‘Oh yeah. Yep. She was in about a month ago. What’s she taken this time? Whoah!’
She signs the board, hands it back to me, then asks one of the other nurses to come over.
‘Best crack on with this,’ she says. ‘Although why the hell she’s still got all these meds hanging around is beyond me.’
I go back to the trolley to help push her into a cubicle. Her dog slippers are poking out of the bottom of the blanket, so I pull it down a little to cover them.
‘The nurse will be with you very shortly,’ I say to Ellie as we move along. But I can see the nurse is already there waiting for us, smiling, a bottle of charcoal in her hand, shaking it.
Friday, January 20, 2012
double take
Despite Mrs Henty’s thirty-year aversion to doctors, hospitals, medication or intervention of any kind – other than homeopathy – she feels so ill she allows herself to be helped into our chair and carried out to the ambulance. Her daughter is with her, relieved that after two months of these sudden episodes something has changed – serious though it might be – sufficient to force her in to see a doctor. We settle Mrs Henty on the trolley and whizz through our observations.
She has no pain, her oxygen saturations are good, her blood pressure, temperature and so on. But her heart rate is irregular and she looks poorly. When we do a twelve-lead ECG, the result is clear: Mrs Henty is having an anterior MI. We telex the result to the catheter lab, and blue light her in for treatment.
‘Apparently the new protocol is we go to the lab via A&E’ I shout to Frank through the hatch. ‘Last time I went in the old way, but I’m pretty sure I can find it.’
We make it in good time. Mrs Henty’s daughter is a nurse herself – at a different location, but sufficiently au fait with procedure to know what we’re doing and to be useful. She even carries some kit for us as we hurry in through the main A&E doors.
‘Mind your backs! Coming through!’
The department is packed out, as usual, but we bully a passage through to the corridors the other side.
‘Just head for what used to be the medical assessment unit,’ I tell Frank.
But in the six months since I was last there, the department has been reorganised. Partition walls put up, painted and signed for day surgery, a waiting room with lines of pristine blue chairs, posters on walls that used to be open space.
‘Through those doors,’ I tell him.
A porter carrying a rubber mattress is heading in our direction.
‘Is this the right lift for the cardiac catheter lab?’ I ask.
He puts the mattress down on the floor and rests his arm on it.
‘The cath lab?’
‘Uh huh.’
‘Only if it’s an emergency.’
I nod and widen my eyes.
‘Yes, then. Through them doors.’
He picks up the mattress again. But I have a sudden loss of confidence.
‘Can you take us there?’ I ask him.
He puts the mattress down again.
‘To the lifts?’
‘Uh huh.’
He props the mattress against the wall – prodding it a couple of times to make sure it won’t fall – then shuffles ahead of us through the new department. He opens a couple of swing doors, then stands in front of a pair of lifts.
‘Okay?’ he says, sighs, and walks off.
The lift door opens. Inside is an enormous man and woman with an equally inflated toddler in a stroller. In their shiny black PVC puffa jackets they could be a family of gigantic beetles heading out for the day.
‘This isn’t level six,’ he says. The woman frowns.
‘I’m really sorry guys but I’m going to have to ask you to clear the lift. Our patient’s not very well and we need to get her upstairs as quickly as possible. Thanks. Thanks for your help. Sorry. Thanks.’
Reluctantly they leave the elevator. We haul the trolley inside and I push the button to go up.
When the lift opens again we leave quickly and turn left for the lab as we always do.
It’s only then that we realise we’re a floor short, having started from a lower level. But the lift has closed now, so we have to call it again.
A moment later the doors open.
Inside are the family in the puffa jackets.
There’s nothing else to do but brazen it out.
‘Sorry guys. Sorry. I’m going to have to ask you to leave the lift. We’ve got to get our patient upstairs as quickly as possible. Thanks very much. Thanks.’
They shuffle out with a stunned expression and turn to look at us as we pass. As the doors close I see the woman turn to the man, raise a finger to point in our direction and say “Didn’t we just ...?”
We ride the final floor in silence, until Mrs Henty’s daughter shakes her head.
‘I think this is what they call a learning opportunity,’ she says. And then leans forward to read the name on my shirt.
She has no pain, her oxygen saturations are good, her blood pressure, temperature and so on. But her heart rate is irregular and she looks poorly. When we do a twelve-lead ECG, the result is clear: Mrs Henty is having an anterior MI. We telex the result to the catheter lab, and blue light her in for treatment.
‘Apparently the new protocol is we go to the lab via A&E’ I shout to Frank through the hatch. ‘Last time I went in the old way, but I’m pretty sure I can find it.’
We make it in good time. Mrs Henty’s daughter is a nurse herself – at a different location, but sufficiently au fait with procedure to know what we’re doing and to be useful. She even carries some kit for us as we hurry in through the main A&E doors.
‘Mind your backs! Coming through!’
The department is packed out, as usual, but we bully a passage through to the corridors the other side.
‘Just head for what used to be the medical assessment unit,’ I tell Frank.
But in the six months since I was last there, the department has been reorganised. Partition walls put up, painted and signed for day surgery, a waiting room with lines of pristine blue chairs, posters on walls that used to be open space.
‘Through those doors,’ I tell him.
A porter carrying a rubber mattress is heading in our direction.
‘Is this the right lift for the cardiac catheter lab?’ I ask.
He puts the mattress down on the floor and rests his arm on it.
‘The cath lab?’
‘Uh huh.’
‘Only if it’s an emergency.’
I nod and widen my eyes.
‘Yes, then. Through them doors.’
He picks up the mattress again. But I have a sudden loss of confidence.
‘Can you take us there?’ I ask him.
He puts the mattress down again.
‘To the lifts?’
‘Uh huh.’
He props the mattress against the wall – prodding it a couple of times to make sure it won’t fall – then shuffles ahead of us through the new department. He opens a couple of swing doors, then stands in front of a pair of lifts.
‘Okay?’ he says, sighs, and walks off.
The lift door opens. Inside is an enormous man and woman with an equally inflated toddler in a stroller. In their shiny black PVC puffa jackets they could be a family of gigantic beetles heading out for the day.
‘This isn’t level six,’ he says. The woman frowns.
‘I’m really sorry guys but I’m going to have to ask you to clear the lift. Our patient’s not very well and we need to get her upstairs as quickly as possible. Thanks. Thanks for your help. Sorry. Thanks.’
Reluctantly they leave the elevator. We haul the trolley inside and I push the button to go up.
When the lift opens again we leave quickly and turn left for the lab as we always do.
It’s only then that we realise we’re a floor short, having started from a lower level. But the lift has closed now, so we have to call it again.
A moment later the doors open.
Inside are the family in the puffa jackets.
There’s nothing else to do but brazen it out.
‘Sorry guys. Sorry. I’m going to have to ask you to leave the lift. We’ve got to get our patient upstairs as quickly as possible. Thanks very much. Thanks.’
They shuffle out with a stunned expression and turn to look at us as we pass. As the doors close I see the woman turn to the man, raise a finger to point in our direction and say “Didn’t we just ...?”
We ride the final floor in silence, until Mrs Henty’s daughter shakes her head.
‘I think this is what they call a learning opportunity,’ she says. And then leans forward to read the name on my shirt.
Thursday, January 19, 2012
a cat called keith
Sheila and Deidre became friends sometime in the Cretaceous period. They’ve been friends so long they fit together seamlessly, every nod and smile, every laugh and cough, hair-net pat and handbag hug all slickly co-ordinated, their conversation scooting along like a canoe with two paddles.
‘We didn’t take him in so much as he adopted us.’
‘Barbara up the road’s got five cats and couldn’t handle another.’
‘He just turned up one day and stayed on.’
‘They know the easy life when they see it.’
‘Not like dogs.’
‘Dogs – eurch – crashing about, wanting attention’
‘His name’s Keith.’
‘It was actually Chief but we misheard.’
‘He’s twenty something.’
‘Pick him up, there’s nothing to him.’
‘Just rag and bones.’
‘But he does all right.’
‘He’s got some bad habits.’
‘He likes to sit any old where.’
‘He was on the bread board this morning.’
‘Not very hygienic.’
‘But what can you do?’
‘And vomiting.’
‘From high up.’
‘Apart from that he’s all right.’
‘Yowling. Padding around the place, yowling.’
‘Especially when he wants something.’
‘You put down some biscuits and say “Here you are Keith.”’
‘So he takes a sniff then turns his nose up and walks off.’
‘So we have to give him chicken.’
‘Not a bad life.’
‘He can’t go on much longer.’
‘Bit like me.’
‘Don’t say that, Sheila.’
‘Well, look at me.’
Sheila rests back on the trolley and closes her eyes. After a moment or two Deidre leans forward and reaches out her hand.
‘Sheila?’
‘What?’
‘Just making sure you’re still with us.’
‘We’ve got another cat, of course.’
‘Dexter.’
‘He was already called that when we got him.’
‘Don’t ask.’
‘He must be getting on for eighteen or so.’
‘But you’d never think it.’
‘All his own teeth.’
‘Mostly.’
‘They work in cahoots.’
‘There’s nothing they won’t do for a bit of attention.’
‘He came from Barbara as well.’
‘Can you blame him?’
‘Are we there yet?’
‘Five minutes,’ I say.
Deidre hugs her bag and smiles at me.
‘Do you have any pets?’ she says.
‘Two dogs and a cat. Our cat’s getting on a bit. Same age as Dexter, by the sound of it.’
‘Where did you get her from?’
‘She came free with a sofa. The sales assistant just said it as an afterthought. She was handing us the receipt and she said “I don’t suppose you’d like a kitten as well, would you?” So here we are, eighteen years later. Outlasted the sofa, that’s for sure.’
‘What’s her name?’
‘Kasha. Which apparently is a kind of Eastern European porridge’
‘Kasha. Hmm.’
Deidre closes her eyes on the trolley again.
‘Keith’ she says. ‘Whoever heard of a cat called Keith?’
‘We didn’t take him in so much as he adopted us.’
‘Barbara up the road’s got five cats and couldn’t handle another.’
‘He just turned up one day and stayed on.’
‘They know the easy life when they see it.’
‘Not like dogs.’
‘Dogs – eurch – crashing about, wanting attention’
‘His name’s Keith.’
‘It was actually Chief but we misheard.’
‘He’s twenty something.’
‘Pick him up, there’s nothing to him.’
‘Just rag and bones.’
‘But he does all right.’
‘He’s got some bad habits.’
‘He likes to sit any old where.’
‘He was on the bread board this morning.’
‘Not very hygienic.’
‘But what can you do?’
‘And vomiting.’
‘From high up.’
‘Apart from that he’s all right.’
‘Yowling. Padding around the place, yowling.’
‘Especially when he wants something.’
‘You put down some biscuits and say “Here you are Keith.”’
‘So he takes a sniff then turns his nose up and walks off.’
‘So we have to give him chicken.’
‘Not a bad life.’
‘He can’t go on much longer.’
‘Bit like me.’
‘Don’t say that, Sheila.’
‘Well, look at me.’
Sheila rests back on the trolley and closes her eyes. After a moment or two Deidre leans forward and reaches out her hand.
‘Sheila?’
‘What?’
‘Just making sure you’re still with us.’
‘We’ve got another cat, of course.’
‘Dexter.’
‘He was already called that when we got him.’
‘Don’t ask.’
‘He must be getting on for eighteen or so.’
‘But you’d never think it.’
‘All his own teeth.’
‘Mostly.’
‘They work in cahoots.’
‘There’s nothing they won’t do for a bit of attention.’
‘He came from Barbara as well.’
‘Can you blame him?’
‘Are we there yet?’
‘Five minutes,’ I say.
Deidre hugs her bag and smiles at me.
‘Do you have any pets?’ she says.
‘Two dogs and a cat. Our cat’s getting on a bit. Same age as Dexter, by the sound of it.’
‘Where did you get her from?’
‘She came free with a sofa. The sales assistant just said it as an afterthought. She was handing us the receipt and she said “I don’t suppose you’d like a kitten as well, would you?” So here we are, eighteen years later. Outlasted the sofa, that’s for sure.’
‘What’s her name?’
‘Kasha. Which apparently is a kind of Eastern European porridge’
‘Kasha. Hmm.’
Deidre closes her eyes on the trolley again.
‘Keith’ she says. ‘Whoever heard of a cat called Keith?’
Monday, January 16, 2012
wolves and eagles
Charlie has been found lying on his side on the pavement. The caller said he’d been fitting, but when we arrive on scene he’s up on his feet and trying to light a roll-up. We help him on to the ambulance to check him over.
‘My son works in IT,’ he says, as we put an inco pad down on the seat and he assumes it happily like we’re laying out a table for him in a restaurant. ‘He had a baby the other week. Which makes me a granddad. Apparently.’
‘Congratulations.’
He nods, crosses his legs, hugs his right knee and rocks backwards and forwards on the chair.
‘Yeah. Well.’
His beard is patchy and rough, like he splashed his chin with glue and dipped it in a Hoover bag. Red pock marks crater his skin; there is a grimy fuzz of alcohol about him, and his clothes are waxy and black with dirt.
‘My mum killed herself on the twenty-third of August, nineteen eighty,’ he says, out of nowhere, and formally, like a schoolboy in an exam.
‘I’m very sorry to hear that, Charlie.’
‘She killed herself on my Dad’s birthday.’ He looks down, picks something off his lap and says more quietly: ‘The twenty third of August, nineteen eighty.’
‘Oh.’
Charlie looks up again.
‘He found the body.’
‘That’s tough.’
‘I haven’t seen him for about ten years. He’s not really that bothered.’
I take the blood pressure cuff from his arm. He rubs the spot for a second then says:
‘I’ve been writing a book.’
‘Oh yes? What’s it about?’
‘It’s called A Consideration of Wolves and Eagles. It’s about the life lessons you can learn by comparing human life with the natural world.’
‘That sounds interesting. Why wolves and eagles, particularly?’
‘Why what?’
‘Why are you writing a book about wolves and eagles?’
‘I don’t tell the others in the hostel about it because I don’t want them to think I’m – you know – clever.’
‘No.’
I test his blood sugar level.
‘So why wolves and eagles?’
‘Wolves?’ he says, sucking the blood from his pricked finger before I get a chance to sample it. ‘I don’t know. They’re just out there, y’know.’ He widens his eyes and grimaces. ‘They’re just wild. And eagles? Someone once said…’ he uncrosses his legs and sits a little straighter… ‘Someone once said: The eagle has landed. Well – it won’t be going anywhere soon.’
‘What do you mean?’
‘What?’
‘Why won’t the eagle be going anywhere soon?’
Because the eagle has probably only landed because it wants something to eat – it’s prey - and if that something happens to be a rabbit - well. Some of those rabbits can be pretty big. And if the eagle isn’t all that, it stands to reason it’s going to be there a while. That’s what I think, anyway. These are some of the things I try to explore in my book.’
‘I see.’
‘Can I go now? Only this thing’s not going to smoke itself.’
‘My son works in IT,’ he says, as we put an inco pad down on the seat and he assumes it happily like we’re laying out a table for him in a restaurant. ‘He had a baby the other week. Which makes me a granddad. Apparently.’
‘Congratulations.’
He nods, crosses his legs, hugs his right knee and rocks backwards and forwards on the chair.
‘Yeah. Well.’
His beard is patchy and rough, like he splashed his chin with glue and dipped it in a Hoover bag. Red pock marks crater his skin; there is a grimy fuzz of alcohol about him, and his clothes are waxy and black with dirt.
‘My mum killed herself on the twenty-third of August, nineteen eighty,’ he says, out of nowhere, and formally, like a schoolboy in an exam.
‘I’m very sorry to hear that, Charlie.’
‘She killed herself on my Dad’s birthday.’ He looks down, picks something off his lap and says more quietly: ‘The twenty third of August, nineteen eighty.’
‘Oh.’
Charlie looks up again.
‘He found the body.’
‘That’s tough.’
‘I haven’t seen him for about ten years. He’s not really that bothered.’
I take the blood pressure cuff from his arm. He rubs the spot for a second then says:
‘I’ve been writing a book.’
‘Oh yes? What’s it about?’
‘It’s called A Consideration of Wolves and Eagles. It’s about the life lessons you can learn by comparing human life with the natural world.’
‘That sounds interesting. Why wolves and eagles, particularly?’
‘Why what?’
‘Why are you writing a book about wolves and eagles?’
‘I don’t tell the others in the hostel about it because I don’t want them to think I’m – you know – clever.’
‘No.’
I test his blood sugar level.
‘So why wolves and eagles?’
‘Wolves?’ he says, sucking the blood from his pricked finger before I get a chance to sample it. ‘I don’t know. They’re just out there, y’know.’ He widens his eyes and grimaces. ‘They’re just wild. And eagles? Someone once said…’ he uncrosses his legs and sits a little straighter… ‘Someone once said: The eagle has landed. Well – it won’t be going anywhere soon.’
‘What do you mean?’
‘What?’
‘Why won’t the eagle be going anywhere soon?’
Because the eagle has probably only landed because it wants something to eat – it’s prey - and if that something happens to be a rabbit - well. Some of those rabbits can be pretty big. And if the eagle isn’t all that, it stands to reason it’s going to be there a while. That’s what I think, anyway. These are some of the things I try to explore in my book.’
‘I see.’
‘Can I go now? Only this thing’s not going to smoke itself.’
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