Monday, July 20, 2009

curtain call

There is a dense strangle of vegetation either side of the track that leads up to the allotments; ferns and nettles, cow parsley, brambles, buddleia, bindweed and spindly grey willow – only the backwards and forwards of vans and cars keeps the track clear. Just a week without a visitor in these fertile days of warm sunshine and drenching rain, and the track would be completely lost.

Now, there are two cars stopped at the far end of the track one behind the other, their drivers out and leaning over a man lying on his back across the path. The people look quite content. The man is breathing, the sun is shining, the ambulance has come quickly. A woman in huge wrap-around shades smiles at us as we approach.
‘No rush,’ she says, and begins rolling a cigarette.

The man on the ground has long ropes of tangled hair and his jeans are ripped in several places. He seems as wild as the vegetation around us; in fact, you could easily believe some strange plant at the margin had just come into fruit and spilled him onto the track. When I lean over him and lift his eyelids, his washed grey eyes have pupils so pinpoint and alien he must either be a fallen woodland divinity or a user smacked out on heroin. Either way we decide to give him some Narcan.

The magic works.

Within five minutes he is sitting up, apologising, politely telling us his name is Marshall. He says he doesn’t want to go to hospital, but we persuade him to come onto the ambulance so we can move out of everyone’s way and have a chat. He only agrees to come on board if we promise we’ll leave the door open. We help him to his feet, up the little side steps, reverse back down the track to a passing point, and the other cars move on.

‘I’m not a user,’ Marshall says, almost falling off the chair as he rolls up the sleeves of his shirt to prove it. ‘I haven’t got a Roger Rabbit.’ Although there are only a couple of needle marks in one arm, both wrists carry stripes of scar tissue testifying to another kind of history.
Suddenly he says: ‘I’m gonna be sick.’
Before I can grab a bowl he has stumbled back down the steps and, leaning against a rough wooden fence by some compost heaps, empties his stomach onto the ground.
‘Sorry,’ he says as Rae hands him some tissues. ‘Sorry about that.’
We tell him we’d like him to come to hospital so someone can keep an eye on him. The Narcan will wear off. He’ll fall unconscious again. Maybe no-one will find him. He could die.
‘Don’t care if I do,’ he says. ‘I’ve had enough. I’ve tried really hard but I just can’t seem to get anywhere.’
He frowns at us, as if before this point we were strange, translucent figures of green who are only now beginning to take on a human form.
‘I’m a poet,’ he says. ‘Would you like to hear one?’
So Marshall stands by the fence, suddenly taller and more centred. He starts in on his poem, leaning into the lines, jerkily moving his legs and his hands like a market trader marionette, relishing the tricky skips of his words, riding the performance to the end.
He gives us a modest little bow when he’s done.
We both clap.
‘That’s fantastic, Marshall.’
‘Thanks. Thanks a lot.’
He rubs his nose and seems to fade again. He tells us about his website. His stage fright. His partner and her unsympathetic friends.
We ask him if he’ll come with us to hospital.
‘I can’t. They’re all back at the flat waiting for me to watch Billy Elliott. They’ll wonder where I am.’

We stand there by the fence.

A young family walks by and I nod to them but they’re confused by the scene and hurry past.

Marshall pushes his hair back from his face. He looks pinched and pale, like a child suddenly grown old, or an actor who started his performance in a packed theatre only to find that by the time he reached the curtain call, the walls and roof had disappeared and been replaced by a jungle.

4 comments:

medicblog999 said...

I try to spend as much time as I can with my patients who have overdosed on Heroin. I have never had one be aggressive with me yet, and mostly they have all accepted what I needed to do (i.e reverse them).
I always try and instill in my colleagues and new starters that the patient in front of us could easily be one of us or one of our kids (god forbid!).
Once you get to talking with them, the vast majority of them have been dealt a really crappy set of cards from life, and some of them are truly remarkable people, like Marshall.
If only their was more we could do to help them!

Spence Kennedy said...

I think so too. Addiction of any sort is difficult enough, but heroin really does occupy a special place. Everything seems to become subordinate to it, and whatever life the person had completely subsumed.

I've never had trouble with heroin users per se, but sometimes the environment you find them in gets a bit hairy! I've had far more trouble with alcohol (the patients I mean, not me particularly).

It is frustrating coming across some of these cases and you do wish you could do more. I think Marshall would've benefited from a trip up the hospital, but you can't kidnap them (and sectioning's a last resort).

mumof4 said...

You have such a wonderful writing style Spence. I could read you all night. Tremendous job you convey too....

Spence Kennedy said...

Thanks Jo!

It's definitely a worthwhile job. Although I felt I failed with Marshall (I didn't persuade him to come to hospital, which could've been a first step to getting some help), at least I felt he maybe saw that the help would be there if he needed it.

And one of the other good things about the job is the contrasts: one minute putting a bandage on a kid's arm, the next having a junked-up punk poet give you a recital in a wood!

Hope you're well and everything's good with you. Thanks for your comments! xx