Sunday, October 26, 2008

the ghostly clubber

There’s no way of driving the ambulance into the multi-storey car park, so we drive round the side, take out the bags we think we’ll need, lock the vehicle, and set off up a ramp heading for the fifth floor.

It is utterly deserted. The barriers are down, the last car driven through an hour ago. All sense of human warmth has gone from the place, withdrawn now to the safety of lenses in high corners. Our footsteps echo away into the shadows. Level through level, zone through zone, the building rises up like an empty temple. Incense of piss and oil. God knows what happens on the roof.

I have a resus bag in one hand and a big flashlight in the other. I flick the light on and off, appreciating the action, and the weight.

We follow the signs - an energetic green figure sprinting towards a doorway. We move with much less enthusiasm. I lean against the heavy fire door.

Opening up the concrete stairwell, I release the booming sound of aggressive voices a few levels up. And like rain pattering down from a thunder cloud, sparkling droplets splash down into the puddle on the floor in front of us.

I look at Frank and he smiles. I gently close the door, turn round and we head back outside.

We’d only been inside the car park for a few minutes, but now the night air seems crisp and invigorating. Frank gets on the radio to call for police attendance. I put the bags back into the truck in case we need to make a quick getaway, but I keep the flashlight in my hand.
‘Five minutes,’ he says.
‘Great.’
I prop myself up against a wall to wait. Frank rolls a cigarette. Clubbers pass on the other side of the street, laughing, pushing each other, having a time of it. The smell of Frank’s tobacco threads the air.

Then an emergency exit door from the car park is flung open and a man steps out.
‘He’s gone and smashed me fookin’ radio!’
I push myself away from the wall.
‘I’m sorry to hear that,’ I say. ‘Who’d want to do a thing like that?’
‘Are you here for that nutcase? Are you gonna take that fuckwit away?’ he shouts, ignoring me.
Under this street lamp the man seems leached of colour, as if earlier in the day he’d been thrown into a boiling wash along with his clothes. His hair hangs in limp coils around his face; his eyes, couched in puffy pale skin, flick nervously from side to side. He has a kit bag squashed under his right arm, and in his left hand there is half a radio.
‘Look what he did. Honestly. With a crowbar!’
‘So who called the ambulance?’
‘I don’t fookin’ know. You’ve got to take him in, though. He’s up there, smashing his head against the wall. I hope he fookin’ dies.’
‘Well – we heard there was a bit of a commotion, so we came back outside to call the police.’
‘The police?’
The man pulls his radio back in to himself and grips his kit bag more firmly. ‘The police? Well I’m off, then.’
And he starts off on a brisk walk along the road.

At that moment, somebody else crashes out onto the street through the door: a man as dark with dirt as the first was clean. He stands in the middle of the pavement, gasping for breath with his hands on his knees, staring up at us. Seconds later he is almost knocked into the road by a woman in a baggy, multi-coloured jumper, her extensions flying around her like snakes around the Medusa. She launches a kick at him, which he sidesteps. She tries to slap his head.
‘You cunt!’ she shrieks. ‘You left me there.’
Then she sees us.
‘Finally,’ she says, pushing her face clear of all the hair, pulling her jumper down. ‘He’s just behind us.'

Radioman has changed his mind. I notice him walking back towards us down the street.

The emergency exit swings open again with a bang, and this time two men stagger out, the tallest one with his right arm slung round the neck of the other. He leans his weight on him, dragging his feet. From where I stand I look for signs of a head wound, but I can’t see any blood, bruising or swelling.

As if suddenly embarrassed to find himself out in the open, he pushes himself clear of his friend and stands up straight, swaying precariously from side to side.
‘I don’t need no hospital,’ he says.
‘Are you the patient?’
‘Mebbe.’
‘Are you hurt?’
‘Mebbe.’
The guy who was supporting him comes over to me, stands right in front of me and puts his face so close to mine that I have to take a step back.
‘He was losing it big time up there, mate. He was banging his head against a brick wall. You have to take him to hospital.’
His mouth is glistening black, as if he’s been eating liquorice. ‘He’s been abused since the age of five. You have to take him to hospital.’

Before I can say anything, Radioman is back.

‘What are you going to do about this?' he shouts at them all. 'Are you going to buy me a new one?’
The black mouthed man takes a step towards him.
'No. I’m going to shove the half you’ve got left up your arse.’

A police car pulls up and two policewomen climb out. One of them immediately attracts the attention of Radioman, who, glad of an excuse to withdraw, goes to wave his ruined plastic carcass at her. The other policewoman walks into the centre of the group. She puts her hands out, palms up.

‘Right. You - be quiet. And you. Please. Now then.’ She smiles at me. ‘What’s going on?’
I briefly tell her what the call was given as, what we found when we got here, and why we felt there may be some danger in hanging around inside.
‘So who’s been smashing things up?’
‘Me,’ says the patient, leaning against the car park wall, zombie-eyed. ‘I need help, man.’ He makes an ineffectual pass at banging his head against the wall, but frankly I could do better. Frank flicks his cigarette away. A little cascade of red sparks marks the spot it reaches in the middle of the road.

At this point, Radioman seems to find a new energy; he comes striding back into the group, windmilling his kit bag in the air and furiously blowing out his cheeks.

I take myself away to stand next to Frank. We look on, check our watches, fold our arms. The row grows in intensity, a cartoon quarrel, with no apparent centre or destination.

Suddenly, a young woman comes drifting along the pavement. She is about eighteen, slim and poised, her hair neatly caught up in a wide rainbow band, her shoulders bare above a strapless black dress, no shoes on her feet. I make as if to stop her, but there’s something about the way she approaches that makes me hesitate. I watch as, without the slightest deviation, without even seeming to register the existence of the squabbling gang in front of her, she pads towards them. I watch as they fall silent, separate, dissolve harmlessly away, all without a gesture or a shove, to let her through.

And she passes.

There is a pause as her figure diminishes.

The group hangs in confusion, like startled swimmers in the wake of a ghost ship.

Then, finally, she is gone.

After a moment or two the group shakes itself, closes back in on itself - and the whole damned thing starts up where it left off.

Friday, October 24, 2008

room number four

The alerter sounds. Somehow, twenty thousand leagues asleep, I manage to raise my wrist up in front of my face: the dial reads four thirty. Asking me to get up out of this chair is like asking an Egyptian mummy to unwrap itself. But I find myself upright. Rae is there, too, rubbing the feeling back into her face. A moment later we’re back in the cab reading the notes: fifty five year old male conscious breathing assault minor cut to face.

A sickly, sulphurous yellow mist drifts across the ambulance car park. It matches our demeanour perfectly. We pop minty chewing gum to help our mouths form words. We set off for the given address, a seedy little hotel near the front.

The Standard would once have been aptly named, a shabby but discrete ten bedroom hotel reeking of scandal and Shake ‘n’ Vac. But the town’s image has undergone something of a moral re-fit; now the hotel stands on the corner of a main thoroughfare, a superannuated beacon for old-school STI’s, handily placed between a lap-dancing club and an all-night diner, the principal attraction of which seems to be an underage staff who wear short skirts and wave pom-poms at the traffic.

We shuffle up the stairs and knock on the door. We wait. We knock again.

Eventually an interior door opens and a lumpish figure appears at the end of the lobby. He stares at us, makes a peremptory wave-away motion with his hand, then turns to go back.

We knock again.

He pauses, even leans forward slightly in a crude ‘who the hell are you?’ mime. Then shuffles right up to the door.

Rae says: ‘Ambulance’

He raps with two knuckles on the sign hanging on the door: No Vacancies. Then turns to go.

Rae knocks again. When the man turns back to the door, she pulls the material of her jacket straight so the ambulance emblem is clearly visible. She taps it with two fingers and mouths ‘Ambulance’ again. He reaches for the catch and opens the door.

‘Sorry. Sorry,’ he says. ‘I thought –can’t they read?’ He raises his eyebrows and adds: ‘So what’s the problem? What do you want?’

‘We had a call to this address. Room number four. A man has been assaulted, apparently.’

‘Room number four? There’s no-one in room number four. So that can’t be right. A man assaulted? Well. I own this establishment and I can assure you that if a man had been assaulted in room number four, I would certainly know about it. Room number four? There’s no-one in room number four.’

The owner is the product of forty years of dinner plates and optic prods. Five foot seven up and about the same out, he utterly fills the narrow little lobby. Swinging his hammy knuckles like an insouciant ape, he retreats before us.

‘Look. Let’s sort this out. Come in. Come in. I’ll set your mind at rest, officer.’

He wheezes and puffs in a slack-cheeked way back down the lobby, through another glass door. There are framed letters on the wall, yellowing letters of endorsement from long dead under-secretaries. He leads us to the foot of a steep pile of stairs. Suddenly, there is a man standing on the first landing with a phone in his hand and – tellingly – a small cut on the side of his head.

‘Jeremy? What are you doing up? You’re not in room four, are you?’

Jeremy – a man of about the same age as the proprietor, but as gaunt as he is inflated – holds both his hands out to the side, like a religious martyr appearing to his followers.

‘I don’t want the ambulance,’ he sighs. ‘I didn’t ask for them. I am not hurt.’

‘But who’s in room four, then?’

Jeremy lowers his arms and says in a rather flat way: ‘I don’t know. It’s not me.’

‘I think we’d better get to the bottom of this. There might be a dead body in there for all I know. It’s far too early in the morning for crap like this.’

‘Well I didn’t call the ambulance.’

‘Who did you call?’

‘The police. I had a little – incident – last night, and I was simply calling for advice. I think they must have got the wrong end of the stick and called the ambulance on my behalf. But I don’t need you. I’m fine. I’ve got a little graze on my head, but it’s nothing. I can cope. Honestly. Thank you, but I don’t want you.’

Rae puts her hand up, to stop him talking if nothing else.

‘If we’re not needed here then – fine,’ she says. ‘That’s absolutely fine. We’ll be on our way.’

‘Just wait here a second,’ the owner says. Jeremy retreats back up the stairs and the owner trudges up after him. We hear a door unlocked, a light goes on, some whispering, then a moment later the owner’s face appears mooning down at us from above.

‘I told you – there’s no-one in room number four,’ he says. ‘Sorry to have troubled you. Lock the door on your way out.’

We make our way back outside. A couple of lap dancing girls are being shown into their cab by a bouncer. They seem washed out, partially erased in this drizzly, early morning gloom. But one of them throws Rae and me a return look as she lowers herself into the car, and I realise she probably thinks exactly the same about us.

Thursday, October 23, 2008

astrological twins

A tall guy vigorously kitted out in active leisure wear waves over to us from the kerbside up ahead. We pull level with him. He smiles as I climb out of the cab.
‘So this is what happened,’ he says. ‘Gerry and me found this guy lying face down in the middle of the pavement. He smells quite a bit of drink, and I guess you’d say he may well be intoxicated. I don’t think he’s hurt himself, but you’re the experts. Anyway, he wanted to go back in his flat. This one, here. So we helped him up and inside, and – well – that’s it. I hope we did the right thing in calling you. I hope it isn’t a waste of time.’
He touches me on the shoulder, generating such a voltage of goodwill I’m sure I feel a tingle there.
He leads us up some stone steps and into a warm and neatly prepossessing hallway. The door to the ground floor flat stands open, and we follow him in.
‘The ambulance are here, Gerry,’ he says to a similarly tall and waterproofed man, with a smile as invigorating as his friend.
‘Thank you so much for coming,’ he beams, then stands aside, and with a magician’s sweep of his arm says: ‘And this is Jim.’
Jim sits slumped forwards on the edge of a sofa. With his beany hat pulled low over his brow, his chin buried in the folds of his jacket, his hands hanging between his knees and his shoulders rolling down after them, he seems like the illustration for a grimly modern tarot card: The Beaten Man. He has a bottle of white wine by his leg; when I introduce myself and Rae, he picks it up and takes a long pull.
‘Please don’t drink any more just now, Jim.’
‘You can’t stop me.’
He puts the wine back down, wipes his mouth with the back of his hand, and resumes his position.
The first helpful guy looks across at me brightly.
‘Well. I guess you won’t be needing us any more,’ he says. ‘Good bye Jim. Nice to have met you.’
Gerry taps Jim on the shoulder. ‘We’re going now, but we’re leaving you in the capable hands of these lovely people.’ Jim looks up, bewildered. ‘Good bye, Jim.’ He holds out his hand. Jim shakes it. They leave, shutting the door behind them with a barely audible click.
‘Jim? Do you mind if I take a seat?’
He gestures vaguely to some collapsible chairs over by the sash window. I put one up for me and one for Rae.
‘Great. Now then. Tell me what’s happened today?’
Between periods of silence and the occasional, choking sob, the fragments of Jim’s story are laid out before us.

He has a drinking problem. He had an appointment today at the Alcohol Abuse Centre, but missed it. He has been drinking since this morning, went out to the corner shop first thing, came back, drank some more, then fell over in the street on the way back to the corner shop for another bottle.

Like an incriminating exhibit in a courtroom, there is an unopened pot of coleslaw (with bacon pieces) on top of today’s paper on the cluttered table in front of the sofa. I imagine Jim shuffling round the shop, coming to just sufficiently to pay for the wine, the newspaper and the coleslaw at the till, and then staggering out.

Jim says he has an American girlfriend who had to leave the country a few months ago when her visa ran out. He says she tried to kill herself last week. Jim can’t cope with any of this anymore. He knows the drinking isn’t helping, but he can’t stop.

He gestures to some bar bells over by the far wall.
‘I’m fit,’ he says. ‘I’m really fit for my age. I go to the gym. I work out. But now. Well – now I’m just whacked out and done for. I’ve let everyone down. And I’m embarrassed, with you lot being here.’

He takes another swig from the bottle.
‘Jim. I really must insist that you don’t drink whilst we’re here. To be honest it makes me feel stupid – the fact that we’ve been called out to you because you’ve had too much to drink, fallen over in the street, can’t get yourself up, and yet here you are carrying on. I’d be failing in my job if I let you do more of the thing that’s caused the problem.’
No response.
‘It’s the same as when we’re called out to people with breathing difficulties who want to spark up a fag. It makes a mockery of us being here. So please don’t do it. If you carry on drinking, we’ll just have to go.’
‘You can’t stop me drinking,’ he says. But at least he doesn’t make a grab for the bottle.
‘Okay. I just need to take some information,’ I say. ‘How old are you?’
‘Forty five.’
The same age as me.
‘And what’s your date of birth?’

It’s so unusual to come across someone with the same birthday as me that for a second I almost say it out loud. But I hesitate, and the hesitation seems to jump from me like the flash from a camera, lighting up the studio flat, the bar bells, the pot of coleslaw (with bacon pieces), the beany hat, the bottle of wine, the sprawl of letters from the Alcohol Abuse Centre, the unopened utility bills.
I want to shake his hand and say fancy that, born on the same day, the same year. I want to ask him what time he was born and where. I want to swap notes on the journey so far. But I worry that if I do tell him, me sitting here with a clipboard in my lap and a biro in my hand, Jim with his head down, irresistibly reaching out again now for that bottle of wine – well, I'm worried that it just won’t help at all.

Monday, October 20, 2008

meat / hat

#1: meat
‘We’re all standing on the front talking about where to go next. Out of nowhere this funny looking guy comes up to us and asks if we know where he can get something to eat. Joe just stands there, all Joe-like, in that way he has, and he says “We passed a meat place back that way.” And the guy says “Meat?” And Joe says “Yeah, you know. Meat.” The guy looks at him kind of weird – like “Why would you be saying meat to me?” Then he turns round and walks off. So then we carry on talking about where to go next. Suddenly the guy’s back with a gang of his mates. Real rough types. One of them gives him a kind of leg-up, he literally flies up into the air behind Joe, and brings his fist down – wham – as hard as he can, right on the back of his head. Joe falls to the ground, and the gang runs off.”

She’s standing with the focus of her weight on her left leg, swinging her hips gently from side to side and hugging herself with both arms. It’s like she’s trying to rock an invisible baby to sleep.

‘Why would you do that?’ she says. ‘What’s wrong with people?’

#2: hat
‘Where’s my hat? Oh bloody hell I can’t have lost my hat. I’ve got to go back. I haven’t had it long.’
Mick is standing up in the back of the ambulance rooting through the pockets of his combat jacket. He dumps the contents onto the seat that he should be sitting on: an unopened can of cider, a bag of rolling tobacco, a scrunched up copy of the Big Issue, some Werthers Originals. The congealed blood on the top of his spikily shaven head glistens in the interior light.
“Mick. Sit down mate. We’ll think about your hat in a moment. The most important thing now is to take a look at your head.”
“No. You don’t understand. I can’t lose my hat. I just can’t.”
‘What sort of hat is it?’
‘Brown. Furry. Ear flaps. I haven’t had it long.’
‘I’m sure we’ll find it just as soon as we’ve finished treating you.’
There’s a policewoman standing in the road looking in at the back door of the ambulance. ‘Don’t worry about your hat,’ she says. ‘The whole place is a crime scene. No one’s going in or out. Your hat’s quite safe.’
‘No. No it’s not. It’ll be gone. With the rest of my stuff. I’ve got to go.’
‘Will you let us at least clean your head before you leave?’
‘Oh – quickly then. But be quick. My hat’ll go before you know it, and I can’t lose my hat.’
Rae shines a light on the top of his head and I start to clean the wound with some sterile water. Mick has been bottled in the park, knocked clean out. I can see and feel toothy shards of green glass in the gashes.
‘This is a serious wound, Mick. You’re going to have to come to the hospital for treatment.’
‘No. I can’t go to the hospital. I won’t.’
‘Is it your hat you’re worried about?’
‘Yes. Yes – my hat. But what’s the point going to the hospital? They won’t give me methadone there.’
‘Methadone? Well – I don’t know about that. But you can certainly talk to someone there about it. The most important thing …’
‘Yes. Yes. The most important thing. The most important thing is that I get back to the park and find my hat. I can’t lose my hat. Not my hat. Enough’s gone wrong today without losing my hat. Jesus Christ. And don’t worry about the methadone. I’ll just have to score some heroin tonight and think about the rest tomorrow.’
The policewoman takes one step into the ambulance.
‘So will you be pursuing this assault, Michael? It’s a serious thing that’s happened to you. You should take the advice of these good ambulance people here and go on up to the hospital.’
‘No. Forget it. I didn’t call anyone. Leave me alone.’
He re-stuffs his pockets, and suffers to stay still just long enough to have a bandage taped around his head.
‘So what happened exactly?’
‘I was asleep on a bench. Suddenly this guy was shaking me awake. I said “What do you want?” and he said something like: “Do you want to feel pain?” and I was confused and I said “What do you mean? Say what again?” He bent down to put his bag on the floor, I sat up, he produced a bottle, smashed it over my head, knocked me out. Next thing I knew I was walking out of the park and some kids were asking if I was all right.”
‘You’ve got to get this wound treated, Mike,’ I say to him. ‘It needs cleaning out and gluing.’
‘No it doesn’t. It’ll be fine. I can’t be doing with all this.’
He makes to walk off the vehicle.
‘I’m serious, mate. It’ll get infected. It’s got glass in it, for goodness sake.’
Infected', he says, bending down to retrieve a toffee that’s fallen on the floor. ‘Thanks for all you’ve done. I appreciate it, I really do. But this is ridiculous. I’m going.’

And he’s gone.

Friday, October 17, 2008

stop the world I want to get off

From the outside, the shelter for homeless people still carries itself with the architectural politesse of the few remaining Georgian houses in this part of town. The elegant windows in the front, the fan-shaped stained glass panels above the door, the simple white columns either side, and the three stone steps – worn in the middle by two hundred years of boots - lead us up into a tougher environment than the architects could possibly have imagined.

The great hall is now partitioned by security-glassed fire doors controlled by buzzers from a grilled and gated office. The walls are white, without decoration. There is strip lighting, fire exit signs, extinguishers. Easy-clean lino with non-slip grips at the danger points. The grand old staircase, still wide enough for a brocaded Georgian day dress, proves just wide enough for a key worker, two ambulance men, a chair and a bag.

‘So what’s the story with this guy?’

‘His name’s Brad but we don’t know too much more about him. IV user, drinker. Came to us late yesterday. Got into a fight outside – in fact, he got a right kicking by all accounts. Had the ambulance out but didn’t go in. Found him this morning incoherent, difficult to rouse. Acting like he’s taken something, but then his pulse is banging away. We were due to evict him for his aggressive attitude.’
‘Is he likely to be aggressive now?’
‘Not in the state he’s in.’
The key worker leads us up the stairs, up past landings that diverge into corridors so numerous it’s like she’s taking us into the heart of a grim metropolitan hive. Brad’s room is right at the very top of the building. I swap a pained look with my partner, Clive.
‘I think we’re going to need the oxygen, at this rate,’ he says.
But we’ve reached the door, guarded by another key worker.
‘Hi,’ she says, pushing it open. ‘Thanks for coming.’
She lets us in to a plain, boxy room with the morning sun blazing in through the sash window opposite.
‘This is Brad.’
Brad is sprawled on a low bed. He has an arm crooked over his face to shield it from the sun, his legs drawn up to his stomach. A blockish, crudely tattooed man in his late twenties, he breaths heavily, and only vaguely bats my hand away when I go to wake him.
‘Brad? Brad? Sit up and talk to us, Brad.’
He grunts and snorts like a tranquilised horse. I lift up an eyelid. His pupil is small, but not pinpoint. His pulse thumps away beneath my fingers.
‘What’s he taken this morning?’
‘We don’t know. Maybe some drugs. We wondered if he’d taken more than he should of his quetiapine. We found some empty packets.’
‘And he was in a fight, you say? Do you know if he was knocked out?’
‘No. Don’t know.’
I study his face. He has some scuff marks on his head and a graze to the side of his mouth, just visible beneath the stubble. He opens his eyes to look at me, but it is the abstracted focus of a sleepwalker.
‘We need to take him to hospital, all things considered,’ I tell them. They seem relieved. The key worker by the bed mimes a little cheer. The one that led us up here says: ‘How are you going to do that, then?’
‘Main strength,’ I say, but without much conviction. ‘Come on, Brad.’
Clive helps me sit him up. I use my body to keep him on the edge of the bed whilst they all make ready for the chair.

Brad has a crude tattoo on his left bicep: Stop the world I want to get off. Both of his forearms are striped with great waxy scars. I can’t decide what would be better: having him conscious enough to walk down but at risk of being violent, or sedated but needing a carry chair. I think the first option would have been better. At least then we could have withdrawn for safety reasons. But Clive has the chair up and ready, so we load him on to it, wrap him in the blanket, strap him securely, and set off on the long haul back down the stairs. The key workers follow, carrying our bag and clipboard.

A couple of times they say they owe us big time as we struggle downwards one step after another; by about the second landing we could tell them the exact weight of that obligation. But we battle on, and make it down to the foyer. They open the doors wide, keep a few early risers away, and then cheerfully walk along with us to the ambulance as we wheel Brad out into the bright and busy morning.

Wednesday, October 15, 2008

mandy

We swing open the heavy iron gate, walk down half a dozen worn stone steps, down to the binned and weed-strangled little flagstone forecourt of this basement flat. Rae rings the buzzer; almost immediately the door is opened by a policewoman.
‘Hi Guys. Keith’s in the bedroom. He’s had a row with his mum on the phone and told her he’s taken another overdose, prescribed medication. Mind your step as you come in.’
The flat is oppressively low and squashed in, dim and very dirty, a feverish thick red paint behind all the film posters, old bikes, clip frames, mosaic mirrors, collapsing bookcases and precarious towers of clutter. There are sentences in scratchy black ink on the walls. I can only make out the odd phrase in passing: Tell them everything, tell them it helps / Ring, ring, ring if you feel this / I wouldn’t if I were you because you never know.
I bark my shin against a bike pedal.
‘Careful,’ says the policewoman, who seems quite at home.
‘Can we get some more lights on?’
‘This is it, I’m afraid.’
We follow her along the passageway, the clogged artery that serves all the rooms off to the right. We come to the bedroom and see Keith, a man in his thirties, as thin and drawn-out as a spindly underground root. He lies on his front hugging a filthy pillow. Next to him is an ancient brindle and white English bull terrier, who raises up her long head to sniff the air as we stand in the doorway.
‘The ambulance are here, Keith.’
‘Why?’
He opens his eyes, but only one is clear of the pillow. Both dog and man seem to sense rather than see us in the gloom.
‘This is what he’s taken.’ The policewoman hands me some empty packets of carbamazepine.
‘Are you epileptic, Keith? Or do you take these as an anti-psychotic?’
He shakes his head.
‘Anti-psychotic?’
He shakes his head again. ‘I don’t want to go into hospital. I just want to get some sleep.’
‘Well, if you’ve taken all these – and had a bit to drink, by the looks of it – you will have to come to hospital.’
‘No.’
‘Sorry.’
‘Come on Keith.’
Rae grabs some trousers off a chair, and puts a pair of trainers next to the bed.
‘Let’s get you ready for the off.’
‘I’m not going.’
‘We can sort out something for your dog.’
Keith suddenly sits up.
‘There’s a number on a piece of paper just outside the door. Call Chris. He’ll take Mandy for me.’
‘Okay.’
I turn round and the policewoman is holding out a scrappy piece of paper to me.
‘There,’ she says. ‘Some kind of support worker.’
I look back at Keith, who is sitting cross-legged in his pants, scratching Mandy between the ears. The room is as forlorn as the rest of the house, great hammocks of dusty black cobwebs in all the corners, a pair of heavy red curtains sagging across the French windows, some acrylic paintings nailed up – abstracts, self-portraits, smeared straight out of the tube - and on every available wall space, more handwritten paragraphs, urgent scrawls, reading like the other half of an ongoing conversation.
‘He did the same thing a couple of weeks ago,’ says the policewoman, silencing her radio. ‘Do you need me for anything else or can I stand down?’
‘No. I think we’re good.’
I look back to Keith. ‘Ready?’
He throws himself backwards on the bed, his arms straight out to the sides.
Mandy waits for the bed to stop bouncing, then settles back down to sleep.

Tuesday, October 14, 2008

PPE

A full moon sharp as a security guard’s torch shines on us as we sip coffee and swap war stories round the back of the parked ambulances.

Kaz, the new SHO – a short, powerfully built Asian doctor who takes hungry bites of his cigarette every time he puts it to his mouth – crosses and uncrosses his legs, and points to us enthusiastically.
‘You guys. I don’t get why you guys don’t wear stab vests. All the crazies, all the druggies – you get it as bad as the police. I don’t know why you don’t get issued with something like that.’
Watching him endlessly shifting position, munching his way through cigarettes, it strikes me he’s probably bald because he doesn’t sit still long enough for any hair to grow on him. He speaks loudly, briskly to purpose, even his leisure time set at the same pitch as his life in the A&E department.

Suddenly Mel, who has been standing quietly to the edge of this group of ambulance and hospital staff, speaks up.

‘I wish I’d had a stab vest the other day. The whole thing really shook me.’

There is a pause as we try to imagine Mel shaken up. Although she has the physical demeanour of a sporty nun, there is something about the way she carries herself – a quietly hard-edged economy – that makes you think of professional killers, assassins, samurai for hire. She wears her long brown hair scraped back in a swordsman’s ponytail, and her silver rimmed glasses glimmer in the unearthly light.

‘It shook me so much I could hardly use the radio.’

She gives her pony tail a little flick, rearing slightly at the memory, then tells us the story:

“We got a call to a man, short of breath, Category A, the full monty. And then on the way we got a follow-up saying they couldn’t get anything out of the guy, he was struggling so much he couldn’t talk. And then the line had gone quiet, so this was now a query collapse.

“We hauled up outside this house, dead of night, everything dark, front door open but looking like no-one home. On a social housing street, nothing too awful. So I took a torch with me just in case, Bill took the resus bag. I knocked on the door. ‘Hello? Ambulance?’ No reply. Flicked the hall light but the power’s off. I really didn’t want to go in – I was getting a bad feeling about the whole affair, but this was a guy who was maybe breathing his last so I thought I’d go in a bit further. Nothing. No-one. Flashed the torch around. No-one in the kitchen, no-one in the sitting room. No-one in the little back room. So then I thought I’d take a look upstairs. Bill was right behind me, thank God. He asked me if I wanted to call the police and I said something like: ‘Let’s just see what we’ve got”. Like an idiot. So I crept up the stairs shouting: ‘Ambulance. Hello.’ All the doors on the landing standing open. None of the lights working. I thought: I really don’t like this. But then I thought: maybe there’s someone very sick who needs me. So I had a quick look into the bathroom, the toilet and the two bedrooms. Nothing. Everything quiet. We both went back downstairs, stood outside in the garden looking up at the house and wondering what we were going to do next. Bill got back to Control. They said the line was still live, and they heard us shouting in the background. They reckoned that the guy was on the floor somewhere. But then they also said they couldn’t be sure, but just before the phone went quiet it sounded as if there were some inappropriate words said, nothing distinct, they couldn’t be sure. But maybe this is a hoax. They said the police would be round as soon as possible, stay put in the meantime.

“But like an idiot I thought I’d better go back into the house one more time to make absolutely sure. I suppose I just didn’t want to look stupid when the police arrived and we all went in and found a poor guy lying dead on the bedroom floor. Maybe the lights blew and he had a heart attack trying to change the fuse. So we went back inside.

“This time I was a bit more thorough. I even opened some cupboard doors downstairs, looked behind the kitchen counter. Then we went upstairs. I went straight up to the first bedroom and stepped inside. I flashed around by the bed, on the floor. And then I had this horrible sick feeling, and I turned around.

“There was a naked guy standing behind the bedroom door, staring at me with his cock in his hand.

“So I screamed – which I don’t think I’ve ever done before – shouted for Bill to get out, and we both ran down the stairs three at a time and back out into the garden again. The police turned up right then and all piled inside. They found him masturbating up in the bedroom.

“It took me ages to calm down after that one. I think that’s the most danger I’ve been in since doing this job. It was horrible. I was shaking so much, when I eventually got on the radio to control I could only talk like this: Hello…. Control…. this is …. Mel. I just couldn’t get the words out. They were sticking way down. In here.”

“And to think I could have turned out to that one alone, on the car. Stab vest? These days I feel like I need a suit of fucking armour.”

Thursday, October 09, 2008

oedema

This modern quadrangle of glass and red brick could easily be a Halls of Residence in the grounds of a university. The shock would come, though – a lurch forward in time – when instead of a surge of teenagers running out into the yard you saw a derelict shuffle of elderly people, not text books but prescriptions in their hands, not jumping onto bikes with baskets on the front, but tentatively raising specialist footwear onto the running boards of mobility scooters (with baskets on the front).
With my colleague Frank next to me, zipping up his jacket against the cold, I press the flat number we need to visit the patient who is sick, unspecified. After a long pause towards the end of which I’m reaching for my mobile, the intercom crackles on. It’s almost impossible to understand what the voice is saying, distorted by dodgy electrics, accent and – is that whisky I can smell through the little aluminium grille? As far as I can make out the voice is saying, at top volume: It’s me you want. It’s me you’ve come for.
‘Could you buzz us in please?’
It’s me. It’s me you want.
‘Yes - could you let us in please?’
Nothing. Then, just before I buzz again we hear a door slamming and the sound of two maybe three voices from an interior stairwell.
Eventually, a grizzled man – intense, wild, like a backwoodsman who’s been trapped in his cabin all winter – hauls himself up the stairs and reaches for the door. He’s being pursued by a large middle-aged woman in a seedy black raincoat with markedly less drive than the man, and a young woman who looks like a scaled down version of her. He flings back the door and they all start talking at once.
‘That’s it. Go. Take me.’
‘I’m a nurse. He’s not well.’
‘Fucking hell it stinks. I’ve got better things to do than this.’
And a verbal dump of other stuff, none of which makes sense. I talk over them, as calmly and clearly as I can.
‘Could we just go back inside please and sit down? I need to find out what’s going on, then we can take it from there. It won’t take long. Bear with me. Inside, please. Inside. Thank you.’
They all turn around and clump back down the stairs, the elderly man flinging his arms out from time to time at furious spots in his continuing monologue. The young woman reaches the flat door first. She stands aside and holds her nose.
‘I ain’t going back in there. It stinks,’ she says.
We leave her by the door and follow the other two in. Wild man throws himself down in a knackered armchair, the woman in the raincoat sits on the edge of a nearby sofa. He blows furiously through his nostrils and glares at me, for all the world like James Finlayson in a Laurel & Hardy short.
‘So. Now. Let’s start this properly. My name’s Spence and …’
‘If you’re not going to do anything then fuck you, fuck you all for wasting my time. Look at this.’
He suddenly raises his left leg up and crashes the foot down on the table.
‘What are you going to do about that?’
I look over at Frank and he raises his eyebrows. I look back at Ian and lower mine.
‘Please don’t swear at me. We’ve come here to help, but if you start, we’ll simply walk away. Do you understand?’
He squints up at me.
‘I mean it.’
The woman starts undoing his filthy trainer shoe.
‘I’m a nurse,’ she says. ‘Ian’s foot has oedema.’
‘Are you here professionally?’
‘No. I’m – erm – a friend. I used to be a nurse. I know about all this stuff.’ She gives his foot a poke. ‘Look at that. Look at all that oedema.’
A dodgy relish to the word, like a bent lawyer using Latin.
‘And I’m guessing this is not normal for you, Ian?’
He sits up as if someone’s jabbed him in the back through the chair.
‘What did he say? What do you mean, I’m not normal? What the fuck do you mean?’
He stands up and hops around dangerously as he tries to snatch the trainer back from the friendly ex-nurse.
The young woman has decided to come into the lounge now. She stands next to Frank, smirking and rubbing her nose.
‘What’s your connection to all of this?’ I ask her.
‘Me? I’m his niece. For my sins. God it smells in here. How do you bear it?’
I’m about to tell her that – as these things go – this one isn’t too bad, when Ian stamps his trainer back into place and then comes at me.
‘Are you going to take me to the fucking hospital or not?’
He’s working up a head of steam, as if the next word I see will be the one he has tattooed on the knuckles of his right hand.
‘Ian, don’t!’ says the nurse. Then to me, in a curiously happy tone, as if she’s telling me something cute about a pet of hers: ‘I don’t think he’s had his diazepam today.’
‘That’s it’, I say. ‘Make your own way to hospital. There’s no way I’m having you on the ambulance with an attitude like that, foot or no foot. And even if we did take you, the nurses at A&E would throw you out in a second.’
‘Fuck you! Fuck you! You don’t care!’
‘We do care, Ian – but we’re not here to be abused. Make your own way.’
We walk back out of the flat, the niece lapping the scene up, the former nurse sitting helplessly on the sofa and Ian flexing and unflexing his hands as if he wants to grab hold of something or someone but can’t for the moment think what.

Wednesday, October 08, 2008

finn the driver

Finn is stretched out on the bathroom floor, his head just beneath the red emergency chord. He lies neat as a soldier, his arms straight along by his sides, palms, thumbs, fingers all parallel to his withered old legs.
‘Sorry to trouble you boys but I can’t get me self up. I toppled over on the way back to bed and I just can’t seem to do a thing about it.’
‘Have you hurt yourself, Finn?’
‘Well – I should say only my pride, boys. I had a touch of whisky with an old mate from Ireland. We haven’t seen each other in a good long while and one thing led to another thing and – well, I’m in the sorry state you find me now.’
‘Let’s get you up, then.’
Pete gets under one arm, I take the other. We help him bend at the knees, place his bare feet flat on the floor, then – on three – he’s up.
‘Thank you boys. God bless you. So now that’s the way up we’re all supposed to be and doesn’t it feel great?’
He ends the sentence with a little rising intake of breath, like he’s snatching a sample of the air we’re about to make our reply with.
‘Where would you like to go now?’
‘Back to bed, boys. Back to bed would be grand.’
Finn is eighty seven, his strong figure drained and made slack by the long passage of years. He shuffles between us to the bedroom, a chill, cell-like box with a low wooden bed and cheap wooden side stand. The bed linen is rucked up, grey and unwelcoming: pillow, sheet and mangy pink chenille bedspread. On the side stand he has a mug of water and a pair of dentures in a plastic container. There is a small enamelled portrait of the Virgin Mary above the headboard; behind the glass, she seems to clutch her baby against the silvery whisper of mould in the air.
‘Do you have any help here, Finn?’
‘Help? No, not really. I suppose I ought to. Do you think I ought to?’
‘Yeah, why not?’
‘Well okay then. If you think I ought to.’
Pete starts on the paperwork. I check Finn over and he’s fine, but we tell him we’re going to refer him to the Falls team and anybody else we can think of.
‘Ah you’re good boys,’ he says, pulling the awful sheets up around his neck. ‘Thanks for coming. I’m sorry to be a bother.’
‘Where are you from?’
‘Ireland.’
‘Where in Ireland?’
‘Kilkenny. Do you know it, Kilkenny?’
‘No, sorry. I don’t know Ireland at all, really. I’ve got friends who come from Cavan.’
‘Cavan! Well! I know Cavan. Up there on the border. Oh I know Cavan. I’ve driven all over there, of course. All over the place. All over the world. You name the place, I’ll tell you. I used to be a driver, you know. That’s what I did. Mercedes, Rolls Royce. You name the car, I drove it. Buses. Trucks. That was my job. I was good at it. Then when I retired, I used to drive coaches, on the voluntary.’
‘Good for you.’
Finn lies holding the sheet up to his neck. He runs his tongue over his chapped lips, and I ask him if he’s thirsty. He nods, so I help him to sit up, and hand him the mug of water from the side stand. It has a lurid green picture of a leprechaun holding a mug of beer and winking. I wonder who bought it for him.
‘My grandad used to be a chauffeur for a family in County Mayo,’ I say, easing him back down on to the pillow. I remember the photo: a skinny young man in an unbuttoned starch collar and straw hat, standing in front of a charabanc with a dipstick in one hand and a fag in the other. ‘He died before I was born, though. I never met him.’
‘County Mayo? I know County Mayo very well. Beautiful place. Fancy that. So your dad was a driver.’
‘My grandad.’
‘And he was a driver, you say? Who would’ve thought it? What a coincidence. Do you know the Heneghans? From Crossmolina? I think it was Crossmolina.’
And he tips off into a rambling commentary on people and places. It unwinds before us like a great foxed tapestry.
‘No finer people,’ he says, eventually. ‘No finer people in the world.’ He closes his eyes as if to see them all more clearly, smacks his lips once or twice, and suddenly falls asleep.

The paperwork done, we leave a copy on the side stand, turn the bedroom light out (but leave the hall light on) and creep away.

Monday, October 06, 2008

tell me something beautiful

‘Basically, Tara came back to the hostel tonight and blew a fifty four, which isn’t drastically over the limit – but still it’s over the limit, maybe one and a half times. So she’s scared that she’s broken the terms of her parole by drinking alcohol tonight – which she has, of course, technically – and she’s scared she may get sent back to prison. Which we don’t know, but still.’
‘What was her offence?’
‘GBH – landlady, child. ABH police.’
‘And what’s she done tonight? We’ve only been told she’s cut herself.’
‘She broke up a safety razor and used it on her arms and face. Nothing too serious, I think – but a couple of quite deep wounds that might need attention. She’s calm at the moment. A couple of members of staff are sitting with her. I don’t think she’s a threat any more.’
‘Have you called the police?’
‘Well, we didn’t really want to. We thought it might inflame things. We thought we’d take advice first from you first.’
‘And will you be able to spare a member of staff to come down to the hospital with Tara? If she’s this volatile she’ll need supervision at A&E.’
‘Oh. Um. Maybe.’
Sheila, the female hostel worker, folds her arms and exchanges a look with a colleague standing over by the office fire door. Of the two he is the calmest, sipping from a mug of tea and studying the CCTV. Sheila seems brittle, as if the padding of a generous disposition had been chiselled, thinned out by experiences such as this.
‘Let’s go up and see how she’s getting on, then.’

She leads us up a steep and narrow staircase that branches off through a network of small landings and fire doors. This tall Edwardian town house has been converted into a probation hostel, with anti-slip marmoleum treads and strips, fire extinguishers and exit signs, notices and rules. But to counteract the expedient institutional feel, the staff have put up motivational posters: we pass one that shows the silhouettes of two climbers at the peak of a mountain at sunset, the highest one reaching a hand down to help his mate. The tagline is: You can succeed best and quickest by helping others to succeed.

Sheila knocks on room number nine, and we go inside.

Tara is sitting on an unmade bed, intensely smoking a hand rolled cigarette. A male hostel worker sits opposite her with his arms crossed and resting on the back of a reversed plastic chair. Tara’s left arm is wrapped around with a bloodied white towel, she has a stripe of blood on her right cheek, and her right arm is bloodied, too. It looks as if she is struggling to keep the cigarette going; her fingers are too damp with blood.
‘Hello Tara. My name’s Spence and this is Rae. What’s happened tonight?’
She stares at us for a second or two, then looks away, tries to drop the cigarette in a yoghurt pot but it’s stuck to her fingers.
‘I’m not going to prison again.’
‘Can we have a look at your arms and see if any of these wounds need hospital treatment?’
‘Do what you like.’
We’ve been told that Tara is twenty years old, and she certainly looks it in her physical self, being a tall and thickset woman with powerful arms and hands. But her face seems curiously juvenile, utterly without mark or experience. In fact, the only visible sign of distress in or on her face is the cut she put there with the razor – and in her eyes, which continue to stare disconnectedly at the mess she seems to have found herself in.

Her arm is unwrapped now. She has carved the word HOME along the soft underside of her forearm. After the letter E she has swiped her arm across – a vicious underscore – laying it open to the muscle. The other arm has a series of swipes, nothing so deep. Maybe she practised on that arm first.

‘These are quite serious wounds, Tara. You’ll need to come up to hospital to have them stitched, I’m afraid.’ I go to my bag to fetch out a couple of bandages and a sachet of sterile water.
‘I’m not going back to prison,’ she says. There is no change to her voice or her facial expression, but the male hostel worker watching from the plastic chair – acutely, like a fisherman on a riverbank watching his float – straightens and unfolds his arms. Tara stands up.
‘Calm down, Tara,’ he says, ‘Take it easy.’
Suddenly she reaches over to a cluttered bedside table and grabs an orange safety razor hidden amongst the scrunched and bloody tissues there. She puts it in her mouth, bites the plastic guards away at the top, and then plucks out a shard of blade. She drops the plastic handle and holds the blade fragment to the side of her neck.

This could only have taken a fraction of a second, and the pause that follows only a breath or two more, but the silence seems to fill the room without end.

‘Come on, Tara. We’re only here to help,’ I manage to say. I’m holding the half-opened bandage and sachet of water, and it feels like some utterly lame demonstration of intent.
‘Put the blade down, Tara. This is not helping.’
The cool hostel worker from the office downstairs is standing by the door. He is as neutral as Tara. ‘This is not what you want.’
Tara looks at him, at us.
‘Tell me something beautiful or I kill myself,’ she says.

The silence that follows is deeper and more deafening than the first.

Later, in the ambulance, and then in my car on the way home, I try to think of all the things that are beautiful to me. And though I don’t know Tara, all the things that I think of first – images of family, homey things, feelings of love and connection – these are all things that Tara seemed violently removed from. And though it hurts me to replay that scene, to consider the fact that when I was called upon to make some meaningful statement, I hesitated, and joined my mute silence to everyone else’s, when I put myself back in that room the only reassurance I can manage for myself is the thought that if I’d mentioned any of these beautiful things I might well have only intensified her despair.

At last Sheila says: ‘We all care about you, Tara. We want you to be well.’

For the first time Tara flames with purpose.

‘Get out of this room or I cut my throat,’ she shouts. ‘Get out!’

We leave.

The police are called; half a dozen turn up within minutes. One of them accidentally knocks the mountaineering picture off its hook with his riot shield as he goes up the stairs. After half an hour of patient negotiation, a policewoman persuades Tara to open the door and submit peacefully to an examination. When we are invited back in, Tara is sitting back down on the bed, her elbows strapped behind her back. She doesn’t look up.

Friday, October 03, 2008

an urban willow pattern

Bill, the manager of the housing association flats, is using some gaffer tape to fix the black rubber cover back on to one of the key safe boxes outside the main door.
‘Thanks for coming,’ he says, straightening up with an audible click. ‘I don’t know what we’re going to do about Jack. It’s the second call today.’
He shows us inside to the lift. It’s already on its way down, disgorging with a shudder an ancient couple who smile at the three of us with amiable confusion.
‘It’s his breathing, in case you didn’t know,’ says Bill, leaning in to me confidentially. ‘Asthma, but he won’t leave his dog. It’s a terrible mess up there, so watch where you put your feet. If you need me, I’ll be down in the office. Don’t expect he’ll go, but see what you can do. All the best to you.’
We ride up to the tenth floor and find our way along booming corridors smelling of chlorine to a battered blue door standing half open. Just below the knocker there is a scrap of paper taped along all four sides. It’s written out in a blocky, green scrawl: ‘no callers papers sales no jahovers witness.’
As I’m reading this, a barrel-shaped terrier waddles out through the gap to meet us. Its body is so inflated it can only move by leaning from side to side, an arthritic kind of sculling action it performs with a grim set to its face. The dog’s eyes are cloudy like worn-out plastic buttons, and its muzzle sprouts a mess of fine white wire.
I push the door open a little more.
‘Ambulance! Hello!’
The dog – without any change of expression - leans aside to let us pass; its claws clack behind us as we go in.

The air in the flat seems to be made up of two distinct odours - dog piss and filter cigarettes. They fill the atmosphere in visible layers, geological strata of neglect folded one into the other, lain down over many years. Our boots crackle as we walk across the parquet floor.

There is a wheeze coming from the front room. I push the door open.
‘Hello?’
Jack is sitting in an armchair, leaning forwards, propped up on his arms, his elbows turned out and his hands in.
‘I’m not going,’ he says.

Jack looks dusty, a shop dummy dressed in a fright wig, chequered shirt and braces, then forgotten about in the storeroom.

The dog catches up with us and plops down on his right foot.

We fix up a nebuliser; Jack pulls it over his head in one practised movement.

‘You can’t go on like this, Jack,’ Rae says. ‘You must want help, or you wouldn’t have called for an ambulance.’
‘I don’t want help, I want oxygen.’
‘But we can’t stay here the rest of our lives, can we? You need to come with us, see a doctor, get your meds up to date. You need attention, Jack. I’m afraid you really absolutely cannot stay here.’
‘Well what about Millie?’
‘Millie’ll be fine,’ she says, scratching her behind the ears. ‘Bill says he’ll look in on her.’ Rae flicks me a look –mental note: speak to Bill before we leave. ‘The important thing is to sort your breathing out. One step at a time, Jack. You’ll be no good to Millie if you – er – pass out.’
Jack looks up at both of us.
‘She’s had her walk this morning. I took her out on the mobility scooter.’
‘So she’ll be ok for a little while whilst you come up the hospital. There are ways and means, Jack. We’ll sort it. Important thing is to get your asthma under control.’

He studies us. The silence is underwritten by the spluttering hiss of the nebuliser.

‘Well – okay,’ he says, finally. ‘But I’m not staying in.’
‘Let’s cross that bridge when we come to it.’

And I suddenly have an image of Jack as a painted blue figure on a willow pattern plate, escaping over a rickety wooden bridge in his mobility scooter, Millie in the basket in front, their hair and ears flapping behind them as the housing association pagoda gradually shrinks away below the tree-line.

Wednesday, October 01, 2008

demolition

A young man with a fussy beard and chunky media specs waves us over to the entrance. We park just down from it; I follow him into the foyer. He seems upset, which I translate into degrees of seriousness.

The elderly patient is sitting slumped against the wall, his left arm up on a plain wooden chair. He has the lumpish torso and receding forehead of a great silverback gorilla, white-haired and washed out, incongruously dressed in a Hawaiian shirt and nut brown slacks. He opens his eyes and looks up at me when I crouch down to him. I can smell alcohol, but the guy who flagged us down is standing watching over by the facing wall and he still seems very upset, which is puzzling, and makes me question whether this is just alcohol. But then – maybe he’s an unreliable witness and has issues of his own.

‘This is how I found him,’ he says, biting the quick of his finger, his eyes flicking from side to side. ‘Is he going to be all right?’

Another man comes into the lobby, a solid-seeming guy with more to tell us. Our patient’s name is David, and – yes - this is unusual for him. He tells us that David has heart problems.
‘David? Are you in pain? Do you hurt anywhere?’
The massive head pivots slowly on his neck, and his rheumy eyes seem to slide down the inclination. He is definitely very drunk.

‘Why are you people bothering?’ he says. And suddenly a tear runs down his pock-marked nose. ‘Why now? I don’t get it.’

We help David into the ambulance. At one point – alarmingly - he produces a GTN spray and squirts himself under the tongue. But the ECG doesn’t show cardiac distress other than some ongoing problems. He has a bulge under the skin of his left breast, just above the head of a big-breasted tattoo, but he isn’t able to tell us if it is a pacemaker or ICD. He wants to tell us instead about his long life in the construction industry.

‘I ended up in demolition,’ he says, almost falling off the trolley as tries to pull a vast chequered handkerchief from his pocket. ‘I could knock a building down with these arms.’

David seems to brighten up a little with all the attention, but keeps refusing to go to hospital.

‘The last time I went in one of these here fucking ambliences, with one of you lot, I went over boom and didn’t come up for a week,’ he says, almost rubbing his nose off with the handkerchief. ‘I should be dead now. Dead and gone and no bother to anyone.’ Then he stops absolutely still and studies us, frowning hard, as if we were ghosts he’d just shaken out of his handkerchief. ‘What the hell do you want with me?’

We tell him we’re worried about him and want him to be well. We tell him we want him to come to the hospital for a check-up.

He thinks about this, then seems utterly to lose interest. He settles back into the trolley, which creaks horribly.

‘Go on then,’ he says. ‘I’m past caring now. I just want to go to sleep and never wake up.’