Friday, May 30, 2008

what's out there

‘I’ve got three accountancy exams next week,’ Paul says, moving his eyes up to look at me. The eyes are about the only things he can move, trussed-up as he is on our spinal board. His head is between two blocks, strapped across the forehead and chin; his neck is in a cervical collar; his torso is held crossways over both shoulders and over the hips, and his legs by a loop around the ankles.
‘That sounds tough,’ I say.
Paul had been round at a friend’s house until the early hours, when he’d accepted a lift home. Within two minutes of finishing the last round of Grand Theft Auto he was sprinting outside through a sudden downpour to the front passenger seat; within five he was spinning out of control into a flint wall on the main coast road.
Paul wriggles his toes on the board. His Timberlands have been cut through the laces, taken off and placed backwards on top of his legs. It’s like the street version of the cavalry officer’s funeral, reversing the empty boots in the stirrups, but I keep that one to myself. Instead I ask Paul what he remembers about the accident.
‘We were going round and round and round and I was holding on thinking “I’m dead” – then there was this crunching mess – and everything closed right in – and slowed – and then silence. I really thought that was it. But after a bit of just hanging there thinking “shit, shit, shit” I kind of checked everything off mentally, and it all seemed to work. And I looked Sye over, and he seemed worse, but alive at least. Then I climbed out, and some people were there saying the fire brigade were on their way. And that was that.’
The car was such a beaten wreck, it seemed inconceivable anyone could climb out unaided. But apart from a bloody nose and some lower leg pain, Paul seems remarkably intact. Sye has suffered more, though. Cut out of the car and taken on ahead by the first crew on scene, he is being assessed by the trauma team in resus whilst we wait our turn in the corridor outside.

Three o’clock in the morning and it’s the busiest the department has been all night. First up ahead of us, cued up on the runway for inspection, is an old man in such an advanced state of decrepitude the son who stands by him at the trolley is himself a livery retiree. He stands clutching a plastic bag and a jacket, nodding and smiling around him like some benign school inspector having a lucid dream. Next to them on a trolley is a woman with her face buried in a vomit bowl. She gives a cat like heave every once in a while, but is otherwise silent in her misery.
Some of the crews here I haven’t seen in a long while. In between glib interactions with our clients, circus performers spinning the plate once in a while, we catch up with the latest. Richard’s industrial goth punk sado-metal band is doing well – they’ve just finished another recording session. He’s also a paramedic now, but it took months for his registration to come through. Mike seems unusually quiet, and it’s only when I ask him how Maria is he tells me he wouldn’t know, she kicked him out two weeks ago.
‘Taxi for Mr Kennedy,’ says Richard, jamming his hand into his mouth, the clown.
Another crew arrive. Their patient, a woman in her forties, is screaming in pain as they come through the doors. It is the kind of excoriating howl that rips through everything, that stops up all normal activity for a second and lays everything completely still. They go to the front of the queue, and are taken off to a cubicle. Rae goes to help them with the transfer. I chat to Paul some more to take his mind off her screams. I can guess how awful it must be to hear something like that without being able to turn your head and look.
‘So – is that what you want to go into? Accountancy?’
‘I don’t know. Maybe. Maybe not. I’m also doing Business Studies. But I think after these exams I’ll take a couple of years off. Do some travelling. See what’s out there.’
‘Good idea. There’s plenty of time.’
The doors to the resus room swing open, and a nurse gives us a nod.
‘RTC?’ she smiles. ‘This way.’
‘Come on then, Paul,’ I say, as we wheel him in. ‘Try not to worry.’
The team close round him with their scissors and their needles and their questions.

Thursday, May 22, 2008

mrs dacre's cat

On standby at our regular cliff-top haunt. The sea is a great curve of smoky grey glass glittering below us and out to the edge of the world. We are at the top of the sunniest day so far; we sit slumped like coastguards filleted by the heat as squadrons of seagulls waggle their little orange feet, zooming up on the cliff thermals. Dog walkers nod and smile or sneak disapproving looks, or both. We know that many of them think we’re hiding out here to avoid work. I wonder if we should have a sign to put in the cab window: On Standby. Ring this number for more information. Rae yawns, again. I worry that if I yawn, too, I’ll actually dislocate my jaw. I check my watch – incredibly, it’s only been fifteen minutes.

The terrafix suddenly beeps with a job: voluntary admission to a psychiatric unit further along the coast. I write the address and Mrs Dacre on my sheet as Rae hauls herself into consciousness and puts the ambulance into gear.

The satnav hates this area. You would think by the way it gets the layout so completely wrong that the residents sneak out at night to re-arrange the one way systems and dead ends. But then, there is so little to do here, it wouldn’t surprise me if that were true. So we ignore the crisis of arrows on the screen, and I direct Rae in using the map book.

We pull up outside what must be the house, working on the assumption that the numbers are following a logical progression. It’s impossible to visually check that this is the house we want, though, as it is surrounded by a hedge so impenetrably tangled it seems not to have been grown, but conjured by a vengeful witch. Luckily there is a gap that suggests an entrance. We walk through it, and suddenly the house rises up in front of us, a dirty, doomed hulk, its guttering clogged with grass and its windows obscured by ragged curtains. A scatter of desiccated plant remains hang out of pots stacked either side of the concrete stairs that lead up to the front door, a slab of wood artfully distressed with what could only have been an axe.
‘Nice,’ says Rae.
‘You knock.’
‘No, you knock. It’s your patient.’
I step up and knock. Wait. Knock louder. Look through the letterbox. Inside, a small hallway crammed with cardboard boxes, seed trays, telephone directories and – worryingly – a chain saw. Rae has a look, too.
‘Psychopath,’ she says, expertly.
‘It looks quite new. Maybe they bought it for the hedge.’
‘Or the next visitor.’
The heat of the day seems to have no power here in the lee of this hedge. A chill seems to settle around our shoulders.
‘We’d better just have a look round the back,’ I say.
‘Great,’ says Rae. She makes a lame, slasher movie-style face. ‘Yaah!’
‘I’m not worried. Are you worried? I’m not a bit worried.’
We walk around the side of the house, Hansel and Gretel style.

The only thing that makes the back door slightly more prepossessing than the front is the enormous chocolate coloured cat draped over an abandoned washing machine. It barely opens an eye as we crunch up to it from round the corner.
‘Hello,’ says Rae, offering the cat a sniff of her outstretched hand. The cat opens the other eye. ‘How did you get out here?’ There is a small window open on a latch above us, but surely the drop is too high (and the cat too round) to have made use of it. ‘Who’s a cheeky thing, then?’ she carries on, but the cat has seen and heard enough. A disgusted shiver runs through it from its whiskers to its tail; it hauls itself up and off the washing machine, and lumbers off into the undergrowth.
I knock on the back door, a resoundingly official rap, but again, no reply. ‘Ambulance’, I shout, but it’s looking hopeless. I notice that there is a small gap to the side of the curtains hung across a window to my right, so I step over some rubbish and peek inside. In the gloom I can make out a mattress on the floor, some heavy black furniture – is there a foot in that trainer…?
And suddenly there are two eyes staring straight into mine.
I start back and almost fall over. A face in the window, tangled hair, beaky nose, frown.
‘Hello. Mrs Dacre? It’s the ambulance. Can we have a word?’
Her expression does not change, but she drops the curtain. A few seconds later and the back door rattles as some bolts are drawn back. It opens, and a thin woman in her early forties steps hesitantly into the light.
‘What do you want?’
Apart from her bushy hair she is dressed cleanly, and talks in a well-modulated voice. Whether in another context she would strike me as perfectly normal, I don’t know. But here, in this house, and with our instructions, her reticence feels more like the synthetic, outward shell of something altogether more volatile.
‘Are you Mrs Dacre?’
‘Does Mrs Dacre live here?’
‘Oh. Is she in?’
‘You see – we’ve been asked to come here to take Mrs Dacre to, er…’
For some reason I baulk at using the word ‘psychiatric’.
‘…a hospital appointment.’
‘She doesn’t know anything about that.’
‘And you would know? If she knew? About the appointment?’
I really want to ask this woman quite plainly if she is, in fact, Mrs Dacre. But this is supposed to be a voluntary admission, and I would guess that pretending you were not the patient amounts to a refusal to travel.
‘I would certainly know. And I can tell you quite categorically that she doesn’t know.’
‘Okay. Well. It’s a mystery.’
‘Yes it is.’
‘In that case – sorry to have disturbed you.’
She nods once, grimly acknowledging the disturbance, then retreats back behind the door. The bolts clunk to.

I call Control to tell them what happened. The dispatcher is nonplussed, says he’ll get back to me. After a while my phone rings. He tells me that the social worker will be contacting the patient to make other arrangements, and that we can return to base.

‘Lovely cat,’ says Rae, nosing the ambulance back through the maze of streets and out on to the main drag. I have a vision of Mrs Dacre pushing it out of the tiny window with a broom handle.
‘Imagine getting that call at night, though.’
I wind down the window, and warm air floods the cab.
‘Honestly wouldn’t bother me,’ I say. And yawn.

Tuesday, May 20, 2008

the drop zone

Jozef is sitting hunched over on the side of the bed, his hands either side of him, kneading at the bed clothes as he struggles to breathe.
‘Oh God,’ he says, throwing us a desperate look. ‘This is worse than last time. Worse and worse.’
Jozef took some paracetamol in the early hours but the pain has progressed until now he says it’s like horses trampling across his chest. Rae puts the chair up whilst I fix up some oxygen, trying not to let the urgency of the situation infect the tone of our voices.
‘Poor Jozef,’ says the house manager, handing us his medical summary. ‘He’s not been right since his last heart attack. I’ll bring his stuff out to the ambulance.’
He pulls aside the hissing mask to say: ‘Please. My shaving bag. A change of clothes. My book.’
‘Yes, yes, Jozef, don’t worry about that. You just concentrate on getting better.’ She gives him a reassuring chuck under the chin. ‘He’ll be ninety one soon. You’d never think it, would you?’
We strap him into the chair, and then she leads us out to the lift.

On board the ambulance and the ECG is telling us what is obvious from his ghastly pallor and from the feeling of dread that seems palpably to crawl all over him – Jozef is suffering a heart attack.
‘Help me,’ he says, wrenching the mask aside. I spray him under his tongue with GTN, give him an aspirin to chew. He takes it like communion wafer. ‘My God,’ he moans. ‘This is worse than my wound at Arnhem, even.’
Rae is in the middle of cannulating his arm when he suddenly he seems to relax slightly.
‘I’m afraid this is it for me,’ he says, simply, then crumples in on himself with a gurgling exhalation.
I drop the back of the trolley down, snatch the pillow away. Rae punches him in the chest then begins CPR whilst I put some pads on him.

Over the next hour the early morning commuter traffic rises and flows around the ambulance as inside our grim little protocols are acted out. But the scattering of ripped packets, empty drug phials and upended kit bags, the convulsive voltages and broken ribs, all peter out, seem to fade in conviction along with the readout on the ECG, until, in the telescoping daze of these things, we find ourselves in resus back at the hospital, watching from the outskirts of the crash team as the registrar peels off her gloves and calls out a time.

Back outside, the ambulance cleaned and prepped, a cup of coffee, and the air is crisp and bright. Another ambulance parks alongside to offload.
‘All right, Spence. Rae’ says Frank. I can imagine him getting off a horse in the same trail-beaten way, tipping his hat back with a rangy forefinger. He stretches, there is an almost audible crack, then he makes his way to the back. ‘Working hard? Or hardly working.’

The coffee is strong and wonderful. I look at my watch, but it’s still too early to call home.
Rae asks me what Jozef meant by Arnhem.
‘I think it was something to do with an operation to capture some bridges in Holland toward the end of the war in Europe. It was what the film ‘A Bridge Too Far’ was all about.’
‘Never heard of it.’
‘Paratroopers. In by gliders. I think a lot of them were killed or captured.’
We climb back into the ambulance cab and clear up for the next job. Rae offers me a stick of gum. I try to imagine what it would have been like on the glider. I wondered who Jozef sat next to all those years ago as the flimsy aircraft shivered and cracked in the darkness, as they clutched their rifles, approaching the drop zone.

Friday, May 16, 2008

falls diorama

Three rows of dog design plates on the wall, four to a row. Newfoundland, Alsatian, Labrador, others.

A partially collapsed bookcase, a precarious herring-bone of spines: David Attenborough’s Life on Earth; A History of the Second World War; The RHS Horticultural Encyclopaedia; tatty romantic novels; three bronze darts trophies.

A watercolour – country scene – slipped askew in a chipped, cheap gold-leaf frame of flowers and leaves.

A slate mantelpiece where, amongst the piles of papers and letters, two bronze horses, one grazing, one rearing up, either side of a four-by-six colour photo where the tones have all leached away over the years. A man and a woman? Sitting at a table, looking up into the lens with their heads together, smiling. One of them may be wearing black glasses; the rest is lost.

A series of six plaster of Paris heads at an angle either side of the mantelpiece, three US Cavalry on the left, three Indians on the right. The Indian Chief is snarling; the Cavalry Captain is shouting.

A TV stacked-about with videos and cases. A stubby bronze candle holder, doubling as an ashtray, resting on the top.

Black bin liners splitting open with books and magazines.

A flowery sofa, partially buried beneath a drift of letters, calendars, free newspapers, shopping lists, prescription sheets, boxes of old electricals, two more bronze horses with their legs sticking in the air, a slipper.

Behind the sofa, a three feet long toy panda lying on its back, staring up beneath the dust with a glassily over-stuffed expression.

A pale pine sideboard. On the surface, amongst more anonymous clutter, a bronze tyrannosaurus rex rearing up behind a bronze man on a motorbike, souvenir of the TT 1962.

An elderly woman lying on her back, gradually waking up at the foot of the stairs where she exhausted herself trying to make the hallway phone.

Thursday, May 15, 2008



At the top of the road that leads up to the railway station we can see a frenetic chain of flashing blue lights: transport police, a response car and the first ambulance on scene that we have been sent to back up. Many of the people who live in the houses along this road have been drawn outside to watch. I am aware of their collective focus as Rae jumps out and goes to grab her paramedic response bag. I turn on the KRS to leave the engine running whilst taking the keys with me. We both stretch on our blue rubber gloves as we stride over to where a couple of police stand guard to the platform entrance.
‘Follow the stairs, you’ll be directed at the top,’ says a female officer, and smiles encouragingly, like a stage manager to the next actors out.
Up the stairs, and we emerge onto a platform of bright sunlight and a small crowd of fluorescent jackets, mostly rail staff, waving us on.
‘Just over there a bit and down on the track. Don’t worry – power’s off.’
‘But don’t stand on any rails, just in case,’ adds another.
We recognise two of our colleagues in an ambulance huddle around the figure of a woman lying across the rails: Frank, holding her head still, and Kent, busy dismantling a scoop stretcher. We jump down to join them. Richard, the officer on scene, lays out the story so far. We listen, whilst at the same time registering the bloody devastation to the woman’s lower legs. They have been rendered to a butchery mess along the shining rail, but elsewhere there is a curious absence of trauma. The only other potentially dangerous sign seems to be the worrying way in which her arms are crooking up and inwards. Head injury? It would be inconceivable to escape without one.
’Guys. This lady jumped in front of the train as it passed through the station and was rolled underneath it. She’s suffered massive trauma to her lower legs, has good, bi-lateral air entry, is conscious but GCS eleven, if that.’
We are all aware of the need to get things moving quickly now. We set to work, following Richard’s direction: Rae attempts to cannulate the woman around the rest of us as we manipulate the scoop stretcher beneath her. The left foot is nowhere to be seen; a policeman is dispatched to locate it. The right one is attached by the merest strip of flesh. I have to pick the remaining oil-blackened foot up so that the stretcher can be clicked shut either end; it feels cold and heavy in my hand. The extent of the trauma to the woman’s legs is so awful that despite our efforts, some fatty tissue snags in the mechanism. Rae cannot get the cannula in as the woman is moving her arms too much, but by this time we are ready to raise her off the rails and up onto the spinal board placed on the platform just above us. Once on, we secure the straps and then climb up ready to go. I take the foot end, Kenton takes the head, the others around the middle, and we all set off back along the platform towards the exit.
As we go backwards down the stairs, a sudden gush of blood pours down the front of my trousers and splashes onto my shoes.
As Rae and Richard put a line up in the ambulance, I make an attempt to bandage up the woman’s legs. I cut away the remains of her trousers as best I can, tangled as they are amongst the splintered bone. There is surprisingly little blood; the major vessels seem to have retracted, reducing the flow. I improvise a bandage from an incontinence dressing, then, after checking that there is nothing more for me to do, I rip off my gloves and jump out to move my ambulance out of the way and clear the exit.
A man is running up towards me.
‘My wife!’ he says. ‘It’s my wife in there, isn’t it? Please. Let me on. Let me be with her.’
I glance behind me into the ambulance and Kent is shaking his head vigorously. So I put my arms out to the man. I am aware of Kent shutting the door as I start to say to that there are too many people on board the ambulance, that everything possible is being done, that he can come with me to the hospital and meet his wife up there. He pushes past and tries to force his way round and on to the vehicle through the side door. Two policemen standing there hold him back, but after a second or two of rapid negotiation he is allowed to kiss his wife, then taken into a police car to follow the ambulance up.
It leaves on lights and sirens, along with the police car.

After I’ve turned the ambulance around, I drive away from the scene normally, calming myself down, radio on, windows open to let in the fresh air. I wave to the woman who lets me out at the end of the street, and she gives me a friendly wave right back. I start to think about what I need to do now. Change these trousers, for one.


Later that afternoon we’re called to an elderly man who has a laceration to his foot. We are met outside the block of flats by a round-faced, pleasantly smiling man with a plastic washing basket.
‘He’s inside, the old fool. He’s been walking around without anything on his feet, he’s trodden on something and his foot has bled. There. I tell him, but what’s the use? He bled quite a lot. Such a mess. But I’ve cleaned it up. Anyway. How are you? Lovely day. Thank you so much for coming out. I hate to trouble you when I know you’ve got better things to do.’
He leads us inside. The heat in the hallway, the dull light and the man’s sugary chatter combine to make me feel a sudden, crushing burden of sleep. When he introduces us to the patient, it’s all I can do to stop myself grabbing a cushion and lying down on the carpet. But with a lurch of consciousness, I force myself to see that the patient is a semi-naked, bulgingly fat man sitting in an easy chair with one foot up on a red, rattan stool. He smiles down at me as I kneel before him. I pull out my little black torch and inspect the foot. There is a little dried blood on the sole and around the toes, but no obvious cuts. Rae helps me open up a sachet of sterile water, and together we clean his foot. The only thing I can see is perhaps a tiny wound, almost like a paper cut, along the crease of one of his toes. But nothing serious. I push and prod his foot.
‘How’s that? Feel anything?’ He continues to smile down at me, happy with the attention. His friend still hugs his washing basket.
‘You should have seen the blood,’ he says.
‘How about that?’ I ask the patient, prodding his foot some more. No reaction.
‘A bit of shiatsu,’ I say. ‘No extra charge.’ Then I look at Rae and say ‘I think I’ve had enough feet today.’ And I have a clear vision of the policeman wandering slowly off along the track like a beachcomber in the sunshine.
‘You’re fine,’ I say, squeezing the man’s big toe. ‘But get yourself some slippers.’

Friday, May 09, 2008

the fantastic fusiliers

‘I got stationed to Berlin. The west of it. Nineteen forty eight. Christ, what a mess. It was the Russians, see? They came in. They looked at the map, at their bit. They thought Right – that’s got to go, and that, and that. Flattened the lot. Drew a ring around the rest, nothing in or out without their say so. We had to fly supplies in. Or come in on a train – which of course the Russians stopped, and searched, front to back. They were young, a lot of them Russians. boys really. They would look at you – stare at you – like this… not say a word. But we was all cockney boys. We were just the same. We stared right back at them – like this…. So it went on. Funny, really. The Fusiliers. Fantastic.

‘When I came back, I got a job working the railways, but then Margaret Thatcher came along and that was that. The only job I could get then was at the Coroners. People thought I was a policeman, with the black suit and everything, but no – I was a glorified usher, I suppose. I met a lot of famous people. (…) came up to me and said “I must say you’re looking good after that fight” and I said “What d’ya mean? What fight?” and he said “That fight. You’re whatsisname aren’t you? What you doing here, anyway? I didn’t know you knew (…)” And I realised he thought I was (…)

‘My wife met a lot of famous people when she was younger, you know. That’s her in the photo. What a looker. She was an usherette at the Academy. All the famous film stars would come in for the first night and what have you, and she’d be the one who’d hop on stage and give them a bunch of flowers. Oh yes. She met them all.

‘Sixty years we’ve been married. Well, this year – sixty years. One child, Peter, but he’s gone now. We could only have the one, you see.

‘And of course, since she got ill, it’s been difficult. For both of us. You know, she’s been stuck in this flat six years. Six years. Not even down the stairs for some bingo. It’s her nerves, mostly. She gets all het up, it’s a job to know what to do. Things play on her mind, especially at night. When she’s reading the paper or watching the telly, she’s all right. But when she’s finished doing that, she just kind of sits and stews. But you do your best – what else can you do? It’s difficult, though. No question about it.

Thursday, May 08, 2008


We pull into the long drive that winds like a river through this bleak canyon of housing blocks. Rae switches off the blue lights; this is an area you would turn on your cloak of invisibility if you could, an estate we know well, though mostly at night. An area on the map that could well be marked here be dragons, except instead of a coiled serpent there would be a can of lager and a syringe. The message says birth imminent, and Control assures us that a midwife has been dispatched. I point out the doorway with the right numbers, we lock the vehicle, and, watched by a small gang of kids who should really be in school, we give them a nod, ignore their questions, and hurry in with a maternity pack and some Entonox.
A man paler than his tracksuit top opens the flat door to us and steps aside.
‘Come in. She’s on the bed through there.’
I would guess he was about twenty, but with his gelled fringe, his spotted face and his spotless trainers, he looks like he should be outside kicking a ball against a wall. He shows us into an encouragingly warm and bright flat, though, and just before we go into the bedroom – where we can hear groaning – the girl’s mother comes out, a brisk, trim woman with lipstick as bright as her manner.
‘Hello. I’m Trish. I think Sandra’s about ready to give birth. They told us to get up to the centre when the contractions were about five minutes apart, but they started coming on fast and strong when she was on the phone. Her waters have broken and she wants to push. Her last baby was pretty quick.’
She gives us a wide smile and says: ‘I hope you’ve done this before.’
I match the smile and say ‘Hell, yes – at least three,’ which is true, but I omit to say that this was in the capacity of fetcher and carrier. I know Rae has actively delivered a couple, though.

Sandra is naked and on all fours.
‘I can’t do this! I can’t do this,’ she gasps, and grips her mother’s hands when she rejoins her on the bed. Trish kisses her forehead and rubs her back with her free hand. I tell her about the gas and air – she says she had some last time. I hand her the mouthpiece for her to use as she needs, then make things ready for delivery.
After this latest contraction passes, Trish tells us that Sandra already has a little girl of two. That birth went quickly and without problem, and all her current ante natal checks have been fine. But without changing her expression she says that there were some problems the very first time Sandra was pregnant, but only after the baby was actually born. Hours later it had stopped breathing and died. Sandra gasps again and says ‘Don’t’, and her mum grips her hands even tighter. I look over to her partner, standing in the doorway, and he shifts his weight slightly. I think he might cry.
‘Are you okay?’
‘Yeah. I just don’t like to see – you know.’
‘Could you get some clean towels? It’ll be good to have something to wrap the baby in when it comes. Which won’t be long now. Are you okay with that?’
He nods.
‘Don’t worry. It’ll be fine.’
Sandra starts to cry out with a low-down, animal conviction, and her perineum starts to bulge. The top of the baby’s head appears, its wet black hair a glistening whorl. I place my right hand to control it.
‘The head is crowning now. I don’t want you to push. I want you to pant – like this. It mustn’t come out too quickly or you’ll tear.’
After about three contractions the baby’s head is delivered, slowly squeezing out with an intensely squashed-up expression. There is a pause. I feel round the baby’s chin and ear for any sign of a cord, but thankfully – am I right? – it all seems free there.
‘That’s the worst bit over,’ I say, conscious of the fact that I have no actual idea what any of this might feel like. ‘The rest of the baby will come with the next couple of pushes.’
My words sound typed-out and unconvincing; but despite all this, despite these clunking interactions and interventions, the event advances as it will always try to through time, blindly working out another link in the chain, bloody, pure and remarkable.

I know that we should aim to have the baby delivered within about three contractions, or it might be that the shoulder is stuck. But after just two more pushes the baby slips out in a gloopy rush and I guide it up and out.
Together with Rae we clean it and check it over quickly. It cries, and I realise that I’ve been holding my breath for a little while, too. It’s like breaking the surface after a length underwater.
‘It’s a boy – and he’s absolutely fine.’
Sandra turns onto her back. We bundle him up in a couple of towels, then Sandra receives him on to her breast where he blindly smacks his tiny cupid mouth and waves his fingers in front of his face.
There is a knock on the door. The midwife hellos and enters.
‘How we doing?’ she says. I’m almost as happy to see her as I was to see the baby.


After the midwife has used syntometrine to bring on the birth of the placenta, checked it over and satisfied herself that everything’s fine, she says we can go.
Trish gives us a hug.
‘Maybe we should call the baby Spence,’ she says.
‘Poor little thing! I wouldn’t wish that on anybody,’ I tell her. ‘Congratulations. He’s beautiful.’
Sandra gives us a wave from the bed where she sits suckling the baby; her partner comes over and shakes our hand. ‘Thanks for everything.’
We walk outside with the remains of our equipment and give the gang of kids outside a bigger, brighter and altogether more confident smile than when we went in.
‘What happened?’ one of them says, about eight years old, leaning forward on the bars of his bmx like Marlon Brando in The Wild One.
‘A baby boy,’ I tell him. ‘A lovely baby boy happened.’
‘Ahh. Cute,’ he says. And then one of the girls next to him laughs and tries to push him off.

Tuesday, May 06, 2008

the whole picture

This area of town has been struggling for some years now. Of the surviving shops on the main drag, only a newsagent slash off licence and a tatty convenience store survive to filter-feed the meagre streams drifting along the pavements, but there’s not much business to be had. They open early, close late, then bolt down shutters so battered with graffiti they make the shops look like embattled settlements on an angry planet, violent paint storms descending every night.

Control tells us to stand off whilst they clarify the job, something we’re all too happy to do. Eventually they give us the nod, and we pull round the corner into view.

A woman is standing on the pavement, smoking. She grinds her fag out underfoot when she sees us, and waves us over. Rae climbs out of the cab, and in the moment it takes me to grab a torch and lock the vehicle, the woman is talking close-in to Rae as if they’ve known each other for years.

‘His name’s Michael. He’s a lovely boy, smack head, obviously, but you can’t have everything. We’re worried about him ‘cos he’s taken a load of methadone – his eyes are like this…’ (she rolls up the forefinger and thumb on each hand and holds them in front of her eyes like tiny spectacles, then speaks in a robot voice: I can not see you. I am a smack head.). She drops the voice, the pretend specs, carries on.
‘…then he’s well grouching out. Every now and then he’ll slump forward and stop breathing, and we’ll have to give him a poke. Hey, Michael,’ she acts out for us, ‘don’t die on us mate! Keep it going!’ She smiles at us, affectionate as a holiday camp entertainer on speed. ‘Ahh. Anyway – thanks for coming. I suspect you have better things to be doing. Bank holiday and everything. Eh, Spence?’ she says, giving me a dig in the shoulder and checking my name tag. ‘My name’s Lilly, but you can call me Lil. If you like. Or not. Anyway, he’s this way. Okay with dogs?’

She leads us into an abandoned shop, permanently boarded up but the door pushed through. There is no light; our flashlights pick out elements as we thread our way through the junked space – the old counter still standing at one end, polystyrene tiles hanging from the ceiling, wires and rubble, a pool table with a game half played – then up some wormy stairs. As soon as we touch on the first tread, some savage barking erupts above us.

‘Clancy! Cindy! Shut it!’ she yells overhead into the darkness, but it only seems to make them worse.

‘You are okay with dogs, aren’t you?’ Lil asks us. ‘They’re – how shall we say – enthusiastic? But they won’t do you any harm. Not whilst I’m here, they won’t.’ She gives a strange, low-down laugh from her belly, and with a slap on the shoulder we carry on in.

Clancy and Cindy are waiting at the top of the stairs, driven into a paroxysm of aggression by the numbers of feet coming towards them and the waving torches.

‘No! NO! Don’t you dare!’ Lil shouts at them. But the only thing that actually helps is when she grabs them by a collar apiece as they make an early lunge for our throats.

‘In you go!’ she says, hurling them both like bowling balls into a side room and slamming the door shut. She smiles at us in the gloom. ‘Just through here.’

She leads us into an oppressively smoky room lit only by a camping hurricane lamp. The light from this plays across a bare-chested man in his late fifties, sprawled on a mattress with a can of lager resting on his belly and a fag rising and falling to his slack face. He has long hair and a moustache that could be a set-piece from a fancy dress shop, over in The Sixties section. He raises the can in acknowledgement. Nearer the lamp and more thoroughly illuminated is a younger man, arms either side on the armrests of the easy chair, slumped forward with his baseball cap over his face.

‘Michael,’ says Lil, giving him a shake, then even louder ‘Michael!’ When he doesn’t respond she knocks off Michael’s cap, turns to the man on the bed and throws it at him. ‘You toss bag. You said you’d keep an eye on him.’

‘I did. He’s alright. Michael – come on now, son. Play the game. The ambulance is here for you now.’

Michael gives a jerky nod then sits up, just like someone falling asleep on a train and catching themselves awake one stop too late.

‘Shit. Sorry. Yes. What?’

‘Michael. The ambulance is here.’

‘Well what do they want?’

‘I called them. We’re worried about you.’ Lil turns to us again. ‘I had a friend like this – in just this state. In and out, in and out. Then she was out and out. I mean she was dead. That wasn’t so long ago, either.’ Back to Michael. ‘You little shit. You’ve taken way too much methadone and you’re going to croak on us.’

Rae sits down with Michael. She explains that everyone thinks it best if he come to the hospital so the nurses there can keep an eye on him. She says that the worry is that if he’s left to his own devices, he might well pass out and the opiates reduce his breathing to nothing.

Michael soaks up the concern with a drug-fattened detachment. He does agree to come in with us, though. Lil retrieves his cap from the man on the mattress, and between us all we manage to get him out to the vehicle.


At the hospital, we put Michael into a chair, and whilst Rae goes over to the desk to talk to the charge nurse, Lil and I stand either side of him.

‘Now you tell these good nurses everything. Don’t hold back. They don’t mind about the drugs – do they Spence? Look at Spence. Does he look like he cares? He doesn’t mind a bit. Do you Spence?’

I tell them that I don’t mind. I say we’re not the police. We’re just need to know exactly what’s been taken so we can take the right action.

‘See what I mean?’ she says to him, standing over him with one arm round the back of the chair, like an over-interested aunt. ‘It’s all good stuff.’

Lil straightens up and looks around, watches Rae at the desk for a bit, then looks at me and smiles.

‘So – are you two always together, then?’
‘Mostly. We change around sometimes.’
‘Are you – er – are you an item?’
‘No. I’m married with two little girls.’
‘Ah. That’s nice. Nice that you’ve got two little girls. And nice you feel able to tell me all these personal things. Some people wouldn’t. With some people it’s like – whoa!’ – she flattens both hands out in front her, like a wall. ‘But no – I appreciate that, Spence.’
She looks around her a bit more, straightens Michael’s cap, then says: ‘I didn’t know if you were gay or not. Not that that matters. Who cares? Not now. Not ever!’ She pulls off his cap again and gives it a tap against her thigh. For the first time I notice that Michael has a bald patch on the top of his head, like a monk.
‘It’s nice to get the whole picture, once in a while,’ says Lil.
Rae waves us over, and we wheel Michael into a cubicle.