Tuesday, March 31, 2009


Stanley opens the door so quickly he must have been standing right by it. Half past five in the morning but he looks as if he has been up an hour or more. There is an air of silence about him, hanging from his shoulders as thickly as the dark green cardigan he wears. He stands in the doorway with one hand clutching the frame and one hand fiddling with a top button I’m not sure is actually there.
‘Hello. It’s the ambulance. Shall we go inside and have a seat?’
He stares at me slackly.
‘Just for a moment, so we can find out what the problem is.’
He turns and drops back inside the house. We follow him into the sitting room, a gloomy parlour crammed with paintings of racehorses, a trophy cabinet, family portraits. It feels more like a memorial to a former jockey than a place anyone might live. Stanley plumps himself down in a high-backed chair and laces his fingers together.
‘What’s the problem?’
‘I’ve been getting rather a sore throat.’
He makes a tired little stroking movement with one hand up and down his neck.
‘And how long has this been going on?’
‘A few days. I don’t know.’
‘Any other pain?’
‘My knee, but that’s old and best forgotten about.’
‘Dizziness? Shortness of breath?’
I fish about for a while, making sure that Stanley is not in fact having the chest pain described in the message.
‘No. Just this sore throat.’
Stanley has recently been cleared of prostate cancer, still has problems urinating, but other than that seems in remarkably good shape for a man in his mid-eighties. It does look as if he needs to go to hospital, but I want to do an ECG to make sure it isn’t cardiac, so I ask if Stanley will come with us out to the ambulance.
‘I’m sorry to have troubled you,’ he says. ‘If you think it’s nothing then I’ll say no more about it.’
‘Let’s go on the ambulance and do a few more checks, just to be on the safe side.’
I help him up, and guide him out to the vehicle. On the way he coughs a few times, a dry, half-hearted affair, like someone clearing their throat in church.
‘How long have you had that cough?’ I ask him.
‘A few days. I don’t know.’
We settle him onto the trolley, and begin our round of observations. Whilst I’m sticking some dots on him I have to excuse myself and hurriedly turn to the side to sneeze.
‘Oh – look at me!’ I say, pressing my nose with the back of my blue-gloved hand. ‘I think we’ve both got a touch of the sniffles.’
Stanley gives a little jolt and straightens an inch.
‘If you think I’m wasting your time then please say so and I’ll go back inside. I didn’t know what to do. I have no one to ask. My wife’s in a home with Alzheimer’s, my daughter’s in Spain. It’s not easy you know, living alone like this. But I don’t want to be a nuisance. If you think all I have is a cold, then fine, help me up and I’ll get about my business. I will not be a burden and I will not waste anyone’s time.’
‘Stanley! Stanley!’ I say, as shocked by his outburst as if a teddy bear had suddenly reared up and bitten me. ‘That’s not what I meant at all! I don’t think you’re a burden!’
‘If you think all this is just a waste of time then tell me and that’ll be the end of it.’
‘Stanley! It was just that I sneezed – and you were coughing – and I thought we both might have a cold. But I don’t think you’re wasting our time. We’re more than happy to come round this morning and make sure you’re okay. More than happy.’

But Stanley avoids my eyes. Instead, he keeps his head up, uncomfortably looking around the ceiling and overhead lockers, like a tired old donkey sniffing the sky for signs of rain.

the gravity of the situation

An old house in an old part of town. A young girl stands framed in the enormous doorway, an elegant fan light spread above her, two broad steps inlaid with a multi-coloured mosaic pattern leading up. She leans back against the doorframe and smiles shyly, her teeth wired into line by a stout wire gantry. I wave, help Rae pull the resus bag, drugs bag and carry chair out of the back of the truck, then foot the door shut and head up towards her.
I think: I’ll be surprised if this really is a Category A unconscious.
But say: ‘Hello. Where’re we going, then?’
The girl blushes and points up at the sky.
‘Top flat. And no lift,’ she adds pleasantly, shrugging her shoulders, as if the Georgian architect had decided against installing one out of sheer cussedness.
We haul ourselves up the steep staircase, mindful of the rucks and folds of the carpet.
‘We’ll be needing oxygen soon,’ Rae says, repositioning the heavy yellow bag.
‘Not far now,’ laughs the girl from above us, her braces glinting in the light from a tiny landing window.
Another two flights and we step onto a sunny hallway with three doors leading off. One of them stands open, and the girl leads us into a bright bedsitting room, ordered in an ingenious, below-decks fashion, with every space and surface adapted to serve at least two functions, and every article folded, marked and stored neatly away. There are two sofa-beds in the room, but one of them is still in use from the night before. A middle aged woman is sitting on the side of it, her hands placed either side of her and her long black hair hanging straight down like black water from a pump.
‘This is Momma. Momma doesn’t speak English, so I’ll translate.’

The family is from Slovakia. The mother, Emilia, is working as a cleaner; Sara, the daughter, is studying at a local secondary school. Sara called a helpline number for advice when her mother fell ill with a temperature and a headache last night and still felt bad this morning. The helpline advised calling for an ambulance. We examine her carefully, but nothing Emilia says – earnestly reported back via her daughter – and nothing in her observations suggests anything more serious than a viral infection of some sort. The mother had not taken any pain medication, so we give advice about this, along with a recommendation to see her GP if there is still no improvement over the next twenty four hours.

Sara helps with the translation and gives us the information we need with a warmth that does not diminish even when we say that we think she should stay with her mother to keep an eye on her for the rest of the day.
‘Of course,’ she says, tapping her notebook. ‘There’s plenty for me to do.’
We complete the paperwork, pick up the bags and chair, and leave.

Half way down the stairs I turn to Rae and say: ‘At last - gravity working for us, for a change.’ And immediately trip on the carpet.

Instinctively I fling the bags ahead of me and flatten myself against the wall to stop myself toppling head first down the staircase. Amazingly I manage to avoid a catastrophic swallow dive onto my head, and instead end up my arse with my legs pointing upwards, one arm spread up the wall and the other out to the side, five or six steps below Rae. She looks down at me.

‘Are you okay, Spence?’
I flex a couple of things. Everything seems to work. ‘Yep. I think so.’
She looks down at me, sniffs and says: ‘Yep. That’s gravity for you, mate.’

Thursday, March 26, 2009

blown away

These air molecules, responding to a steady change in pressure between this stretch of land and the sea, flow down the steepening gradient, and eddy and rush according to the spinning of the earth, and the rising and falling away of the Downland rucks and rills, blindly flow on across the County, hurtle through stands of beech and sycamore, hawthorn, gorse and rhododendron, around the flints of a farmhouse wall, through broken fence slats, between the legs of these cows standing in the field and over the back of this one lying down, and on, through and across towards the town, scythe through an industrial estate, snatch up a strip of pallet wrap, ruffle the hair of a man on a fork lift, nip round the beeping end of a lorry backing up, rattle across the corrugated surfaces of doors and roofs, and then barrel on up a steeply inclined pathway to a group of three old cottages huddled at the top.
The door of the first cottage bangs in its frame.
‘Get that, would you?’
Malcolm, the eldest son, takes the door off the latch, closes it firmly, then rejoins the group in the living room.
‘Here’s a list of the medication she’s on.’
Stephanie, Malcolm’s wife, hands one of the ambulance technicians a prescription sheet. He skims it and nods, then turns his attention again to the old woman sitting in the chair.
‘How are you feeling?’ he says.
She looks at him, then away over his shoulder to the faces of the people standing around.
‘Where’s Barry?’ she says.
‘Barry’s here, Mum. He’s just here.’
Malcolm has his hand on Barry’s shoulder. Barry passively absorbs the attention. He has thick glasses, and his hair looks combed and wetted by someone else.
‘I want Barry,’ says the old woman.
Malcolm leads Barry over to the chair and stands him between the old woman and the fireplace.
‘Barry’s okay, Mum,’ he says.
Stephanie reiterates what the doctor found on his visit earlier that day. Suspected urinary tract infection on top of an existing chest infection, possible renal insufficiency – a general deterioration, not entirely out of keeping in a woman of eighty nine.
‘She was right as rain up until last week. Did everything for herself. Didn’t you, Molly?’
Molly sits at the centre of all this concern, desiccated and pale, her spindly legs drawn up and her arms around them, looking down on the scene like an ancient spider tucked up in the corner of a room.
Malcolm takes the ambulance technician to one side.
‘Of course we have two problems here. One is Mum and her well-being. The other is Barry. Mum's been the main carer for Barry ever since he was born brain damaged, and we simply don’t know what’ll happen to him if it turns out she can’t cope at home any more. We’ll take him for the time being, but after that...’ Malcolm takes off his glasses and cleans them on his t-shirt. ‘It’ll kill Mum to have him put in a home, but honestly – she can’t cope here any more. It’s been coming for some time. We’ve just been putting it off.’
The technician nods. It is a difficult situation, he says, one that will have to be resolved between the hospital, social services and the family doctor. For now the focus is on getting Molly better. The rest will have to follow.
Malcolm puts his glasses back on and thanks the technician for coming out. He asks him if they can all ride with Molly to the hospital.
‘We’ll just about fit you in,’ says the technician. His colleague goes outside to get a carry chair and blankets. As soon as the door is opened, the wind rushes in.
‘Hark at that,’ says Stephanie, wrapping her cardigan tightly around her. ‘We’re all going to get blown away.’

Wednesday, March 25, 2009

mother's day

The Receptionist, a tall, closely clipped man in his early twenties, stands with his hands planted either side of him on the cherry wood desk, scanning the hall with the proprietary smirk he has developed over the years along with his excellent customer service skills. It is quiet for a Sunday. There is an elderly couple sitting over by the window, studying the drinks menu so closely you would think they were going to be examined rather than asked to place an order. A poor advert for the hotel, he thinks. He must have a word with Gerry about reading the clientele and political steerage vis a vis seating arrangements. And then over in the palm zone, hiding himself amongst the foliage, his business raincoat draped over his business bags, a business man abstractedly tapping a Blackberry on his knee.
A woman appears on the other side of the revolving door. The Receptionist watches as she stands there staring through. Has she not used a revolving door before? This should be good. Although he can see she only has a small holdall – rather masculine, he thinks. Probably her husband’s. Where’s he, then?
As she pushes the door round and makes her way inside, the Receptionist runs a finger down the Expected list and taps it at the likely candidate. Single female, two nights paid, debit rather than credit card. He powers up his welcome smile as she approaches the desk.


The basement steps are dark and steep. The two ambulance technicians pause for a moment at the gateway. The one in front pulls a small torch from his jacket pocket, and slinging the bag over his shoulder with his left hand, lights both their way down with his right, until they find themselves in a little square courtyard, crowded with spilling bins and tangled piles of rubbish.
There is a door standing partially open, but the only light visible around it is from deep inside the flat; there is no hall light, and no sounds of life inside.
The first technician puts his foot out to swing the door fully open, but just as he does so his torch illuminates a policeman coming towards them.
‘Whoa!’ the policeman says, putting his hand up against the beam. The technician lowers it. Then: ‘Great. That was quick. Basically, what we’ve got is a forty something guy, very suicidal. He took some heroin today, a bottle of vodka. He’s emotional but not violent. We wondered if you’d mind coming and having a look, see what you think?’
The technicians follow the policeman into the flat, the diffuse circle of light from the torch playing around the hall floor.
‘Sorry about this,’ the policeman says. ‘He’s only got a lamp in the back room for some reason. It’s a dump, basically.’
Walking along the hallway is like walking through a cored, rotten apple, the air mealy with neglect. At the far end the policeman pushes open a door and shows them into a boxy room sparsely furnished with a low sofa, coffee table and a CD radio combo on the floor. The kitchenette that adjoins the room is as chaotic as the bins in the courtyard; in fact, it would be difficult to chose which one would be the safer place to prepare food. Lit as it is by a single standard lamp, the room is a vision of inhumanity. The shadows that rear up from every surface seem more an expression of shock than light.
In the middle of the room there is a man standing, sucking on a tiny, hand rolled cigarette. A powerfully built man, standing rooted in his big black boots, wearing a combat jacket with bulging pockets, at first glance he seems like a workman taking a break. But his mouth is pulled down by the gravity of something lost, and his eyes are rimmed with exhaustion.


‘Welcome to the Excelsior, Mrs Plunknett. I do hope you have a pleasant stay. Of course, if you have any questions about the hotel, its services or facilities, or indeed any aspect of your stay with us here today, do please let the desk know, either by using the little white phone in your room or indeed asking down here directly. There’s also lots we can help you with regarding the town, places to go, what’s hot and what’s not…’
The Receptionist nods forward and raises his eyebrows at this point, implying that they both know that what is hot is not at the top of Mrs Plunknett’s agenda. She smiles in a heavy-faced manner. Some people. He remembers with a shudder what it was like when he was holiday rep at that resort, chivvying along the cow-like hordes.
‘O-kay. Breakfast is from half past seven until nine thirty. Between then and throughout the day you’ll find a wide selection of snacks – healthy or otherwise – available from Gerry, our wonderful Bar manager. Gerry’s ham baguettes are world class - and his Banana Daiquiris aren’t bad, either.’
The Receptionist smiles. If it was an attractive woman the other side of the counter, he would say Screaming Orgasm. He is a professional, though. He understands the need for tact.
‘The Silver Leaf Restaurant is open from six thirty with a full a la carte service. I recommend the Fruits de Mer. I would also recommend an early booking, though – particularly today, Mother’s Day … ‘
That was a risk, though. He studies her face to see how she took it. Was she a mother? She was old enough, but what did that mean? He hopes she isn’t here to bury any of her brood. These things happen. He ought to be more careful.
He waits for her to say something. Again she comes back with a lumpy smile.
‘I’m sure you must be very tired and ready to jump in the shower. I see you’ve come from…’ He makes a show of reading her booking entry, but the woman says: ‘Liverpool’
‘Ah – Liverpool.’ He struggles to think of something to say. ‘That’s – a long way.’
‘Yes it is. Thanks.’ She sweeps the room card from the desk and walks off across the lobby towards the lifts. He studies her as she goes, but whilst she waits for a lift to descend she unexpectedly turns to look back in his direction. He lowers his eyes and pretends to be reading something, and when he looks up again she has gone.


Richard is sitting on the forward ambulance chair, staring down at his hands as the fingers pick and work at each other.
‘I’ve had enough,’ he says. ‘I’m forty five years old and I’m finished. I just don’t have the energy to carry on. I’d kill myself, but on top of everything else I’m a coward. I can’t even do that right.’
He has been clean of heroin for seven years. He took some training, learned carpentry. Got himself some tools and a job first fixing, got himself a nice little place – not this one. But then work started drying up, he fell in with the old crowd. Took a hit and it all started up again. Today he tried to kill himself with an OD and a bottle of vodka, but incredibly, woke up to hear someone banging on the door.
‘I thought I’d taken enough,’ he says. ‘What have I got to do?’ He looks at the two ambulance people as if they are representatives from an alien civilisation he has no connection with.
‘Throw myself off something, I suppose,’ he says. ‘But how do you do that? Jesus – what a fuck up.’
‘Who called the police?’
‘My mum. She got me on the mobile. She said she was going to come down and see me. From Liverpool. And she’s not well. I’ve fucked her life up and I just keep doing it. I’m no good. Just let me go, guys. I’ll take myself away and no one need ever know.’
The technicians talk to him some more, persuade him to go with them to the hospital to talk to someone there. One last chance. For his mother’s sake if no-one else.
‘I’ll go. But there’s nothing anyone can do. And I don’t want to see my Mum,’ he says. ‘I couldn’t bear it.’
The policeman says he will contact the mother at the hotel and at least let her know that Richard is safe, in the hospital, but doesn’t want to see her just yet.
‘I just don’t have the energy to start over,’ he says.
He looks at the technician, sitting there with his clipboard spread across his knees, surrounded by equipment, light and direction.
‘I just don’t have the energy,’ he says.

Monday, March 16, 2009


Ute is sitting on the floor, half in and half out of the kitchen, a baggy black felt bathrobe plumped up around her.
‘I’d have helped her up but she told me not to. She didn’t want me to see her naked.’
The meals on wheels guy is standing in the hallway looking on as Frank and I squat down beside her. ‘She passed the key through the letterbox.’
‘I tell you I want women ambulance only,’ Ute says in a trembling Germanic accent. ‘Where are the women I had last time?’
‘Ute – have you hurt yourself? Are you in pain?’
She rubs her shin. ‘There perhaps. Here – not so much. My bottom, where I’ve been sitting.’ She looks up at us. ‘And who did you say you were?’
‘The ambulance, Ute. We’ve come to get you up off the floor and see how you are.’
‘I’m not going to hospital. They’ll put me straight in the loony box.’
We help her into a chair, but as soon as she’s settled she says she wants her teeth.
‘I’ll get them for you. Where are they?’
‘In a cup in the bath.’

The flat could not be tidier if it were laid out on a grid. There is a measured distance between the Ercol chairs, the salt and pepper cruet and commemoration tankard, the oil painting of a barge on the sea at sunset, that group of cherubs flying in blessed formation over the gas fire.
Her teeth are where she said they would be, stewing at the bottom of an orange tumbler in the bathtub. The arrangement of teeth seem strangely chaotic; have they worn away into those positions, or did she have an irregular set made for authenticity? Either way, they don’t fit. When she stuffs them into place and tries to talk, she may just as well have crammed a handful of Lego into her mouth.
‘Do what you will – but I’m not going to hospital.’
We thank the meals on wheels man for his help.
‘What would’ve happened if you’d not come round when you did?’ I say to him.
He slaps me on the shoulder.
‘Roast pork and vegetables, Apple pie and custard,’ he says to Ute. ‘See you tomorrow. And stay off the floor.’
‘What did he say?’
‘Roast pork and vegetables,’ says Frank. ‘And if you don’t want it I’ll have it.’
‘Oh.’ She smiles, and her teeth almost pop out.
‘We’ll just give you a check up to see everything’s okay.’
‘Come on then.’ She bunches up her bathrobe.
As I’m taking her blood pressure, she straightens in the chair and points at the door.
‘Who’s that coming in?’
‘No-one. The door’s on the latch and it’s blown open a little.’
She settles back as I pump up the cuff. Then she says:
‘I thought it was the nuns.’
‘Nuns? What nuns?’
‘But they only come out at night, so it couldn’t be them.’
Frank brings over Ute’s care folder and points at a section that describes her hallucinations. The list of medications alone are testament to her on-going mental health problems.
‘Where are you from, originally?’
‘Vienna. I came to this country in 1948.’
‘My mother-in-law’s German, too. Prussian.’
‘Really? What part?’
‘Stolp. Of course it’s Poland now.’
She frowns at me.
‘Your blood pressure’s absolutely fine, Ute. Everything’s looking good.’
I roll up the sphyg and pack it away.
‘Yes. She escaped with her life in 1939. She’s Jewish. She just made it out. The British borders were already closed by then, so she ended up in Northern Rhodesia. What’s now Zambia.’
Ute leans forward.
‘Are you Jewish, too?’
‘Me? No.’
‘Of course, Hitler was quite mad, you know,’ she says finally, easing back in the chair. ‘Quite, quite mad.’
Frank writes out the form whilst I make Ute a cup of tea.
‘Thank you,’ she says as I place it on the little wooden table by her side. ‘You’ve even matched the saucer.’
Just behind her on the sideboard is a large old ceramic: an elephant with a tiger on its back. The elephant must have held that expression of terror now for a hundred years or more. Next to it is a small silver picture frame: a man in a yellow t-shirt, grinning massively behind a curly red beard.
‘My son,’ says Ute, replacing the tea cup onto the saucer with barely a click. ‘I haven’t seen him in ten years. Disappeared. Gone. The Salvation Army say he might never be back.’
‘So what happened?’
‘Drugs. The spoon and the candle. And then one day – poof! Not a trace.’
She picks up the tea again.
‘A nice colour, too. You really are kind. I don’t mind a bit you were not women.’

Back outside in the truck, we’ve just closed the door when we hear Rae come on the radio, somewhere the other side of town, updating Control on the outcome of the job they were sent on:

‘The patient was very drunk, abusive, aggressive, declined all assistance, told us to Foxtrot Oscar in no uncertain terms. He’s headed off in the direction of the shopping centre shouting and swearing, and we wondered if you could make the police aware.’
‘Roger to that. Could you pass a description?’
‘Yep. Can’t really miss him. Sixty year old male, big white beard, red skirt, wellington boots, carrying a basket with a toy fox in it.’

Thursday, March 12, 2009


Standby in the supermarket car park, four o’clock in the morning.

One day I’ll paint this. One day I’ll hang a wide, windscreen-shaped canvas on the living room wall so any time of day or night I could put myself back in this seat and wallow in the desolation of the scene – the recycling bins, the advertising hoardings, the pay-at-the-pump petrol station, the blasted saplings, the factory units beyond the hedge. But where would you buy the colours you’d need? And if you had them, how would you mix them, how would you spread them out, to even hint at the leached-out, down-lit, washed-up inhumanity of the place?

A car pulls over at the recycling bins. An elderly man gets out and begins popping bottles and cans through the correct holes.
Who does that at four in the morning?
We watch him from the cab. He folds the carrier bags as they become empty and piles them up on the roof of his car. He couldn’t do that if it were windy, I think. What would he do if it were windy? He finishes, rolls the bags up, secures them with an elastic band, stows them in the boot.

He drives off.

The car park is empty again.

Busy? Jesus – worst ever! Non-stop all day, every one a proper job. The last one was an arrest in the street outside a shopping centre. I was on my own for about five minutes until Chas came by off duty and pitched in, thank God. Then a crew turned up, so that was a relief. There were a couple of PCSO’s on scene, but I might as well’ve grabbed two shop dummies out of the window, stuck a yellow jacket on them and stood them up next to us all the crowd control they did. Honestly, there must’ve been about two hundred people milling about. The crush was so bad our bags were getting kicked over. One woman was right at the front with her hand over her mouth like this, like she was going to chuck. I said to her: You don’t have to watch this, love. Why don’t you just fuck off and let us do our job? But anyway – we got a few shocks in, he went down the usual PEA – Asystole route. We collared and boarded him in the end because – that was the other thing – he’d whacked his head on some railings as he went down and had this horrible boggy mass at the back of his head. We ran him in, but it was academic. Resus was crammed when we got there. We were coming in the door just as the porters were coming out with that lovely box trolley they have with the green tarp. I wouldn’t have been surprised if they’d been wheeling a handcart. But it cleared a space for us, and the team were nicely warmed up. Honestly – a fucking war zone.

The radio twitters and beeps. An all-call for a Category A breathing problem. Miles away. I hit the mute button and the cab’s silent again. Rae is slumped forward on the wheel, using her arms as a pillow. There’s a scene in that fifties film of The Time Machine where Rod Taylor is powering forwards through time. Slowly at first, the moon and sun chasing each other across the glass roof of the conservatory, and then more quickly, his house falling away around him as the dial spins on the dashboard and hundreds of years fly past, the scene changing constantly and quickly until suddenly a mountain rises up around the machine and he’s locked deep inside the rock, and it’s dark and cold, and he despairs that it’s his fate to be trapped like that forever, as the dial spins through tens of thousands of years until at last the mountain is eroded away and he’s back in the air again.

I check my watch. We’ve been here twenty minutes.

We had an elderly woman burned up in a fire. Fell asleep in her chair, smoking a fag. Dot dot dot. Trumpton were there and they pulled her out – no mean feat, considering her size. Twenty stone, at least. But there was nothing to be done. She was pretty comprehensively cooked. We took her on the vehicle, out of the public gaze, and then it was down to the mortuary. I had to bin my uniform. That’s our truck out front, all the doors open. I wouldn’t take that one for a while.

The car park seems to stretch on forever, following the curve of the planet. There surely cannot be enough cars in the world to fill all these marked out spaces. Where are the people to drive those cars? Where do they live? Instead of cars I watch as each space fills with people lying down asleep. Fragile, lucent figures, arriving alone and in family groups, drifting along, following the arrows, finding a gap, lying down. The petrol pumps unhook themselves and blow a peppermint scented mist across them. Birds fly over with messages held in their claws. One of them swoops down and in through the open window of the cab. It grabs me by the shoulder and begins to rock me backwards and forwards. I look up. Rae is shaking me. I was snoring.

I’ve never seen so much blood – and I’ve been to a few bloody ones. The kitchen was like a paddling pool. The poor old thing was lying on her back, one leg up on a stool. I thought they’d been a murder with a chainsaw or something, but what it was - she’d tripped as she’d come in from the garden and snagged a varicose vein on the concrete step. Amazing she was still alive, the blood she’d lost. And the air – it had a metally twang I’ve been tasting on and off all day. We were off the road for a good hour cleaning up the truck after that one. And the very next job we get? Breech birth infant resus. I’ve never been so tested in all the years I’ve been here. What can I say? That new kid I was on with? What a Jonah.

Rae hits the call button on the radio. After an age of static, Control gets back to us.
‘Vehicle calling, go ahead.’
‘We’ve been here about a thousand years, Control. Can we request an RTB?’
Another pause. Either end of the conversation studying the clock. We’ve been here forty minutes. They could insist we stay the hour.
But: ‘Return to Base, then. Thank you for your help.’
‘No problem.’
She replaces the handset on the little hook, grips the wheel and stares out across the car park.
‘Much as it pains me to leave this place,’ she says. Then starts the engine.


I never appreciated how sweet movement is until now.

Tuesday, March 10, 2009


The blond woman who took an overdose is not where she is supposed to be. No one down on the beach or the promenade seem to know anything about her, who made the call, where she might have gone, who she is, whether she ever existed. A slow, weekend river of people slips around us, absorbing our fluorescent jackets and over-stuffed bags, casually feeling out the potential for drama in this scene, and then moving on with a shared nod or smile, or an innocent re-pocketing of a camera phone, without dropping a step or a word of conversation, on to the next thing.

I feel like a bad street performer failing to drum up custom. We look east and west along the promenade, but there are no signs of anything going on, any concerned groups, any fallen figures. She really could be anywhere.
Someone taps my shoulder. A soupy-eyed woman leans in close, smelling of vinegar chips and a polo mint.
‘Sorry to intrude,’ she says, ‘but are you looking for an elderly man who’s fallen down some steps?’
‘No – but..’
‘Well, just in case you’re interested, he’s over on the steps of the museum. Just thought I’d let you know. No harm done. Goodbye to you.’
And she’s off before I can ask her any more.
Two policemen, their trousers tucked into their combat boots, appear from out of the crowd and plant themselves in front of us.
‘Blond woman? OD?’
They lean back, buttressed by their huge black boots, studying the crowd. It feels as if they should be carrying guns, but it’s just their hands tucked into the little front pockets of their flack jackets.
‘We got that too. But no-one seems to know a thing.’
‘Who made the call?’
‘Third party. Absconded. Hoax? You decide.’
‘We’ve got something else going on over by the museum. I think we’ll head over there and see what’s what. We’re not accomplishing much here.’
‘Later, mate.’

Whilst the blond woman was impossible to spot, this patient may as well be carrying a placard saying: Help Required Here. He is still on his feet, but he clutches on to the black iron railings beside him with the grip of someone who has suddenly lost all faith in the predictability of the world. An elderly woman stands beside him with one hand on his shoulder. With her other hand she raises up her handbag as we approach along the pavement.
‘It’s my fault,’ she says, breathily. ‘I lost my footing and pulled Malcolm down with me.’
Malcolm stands unsteadily, his frame rattling beneath his suit. But it seems they only stumbled down a couple of steps; Malcolm has a graze on his hand and shin, is in no pain.
‘Shall we take a slow walk to the ambulance,’ I tell him.
His eyes are scanning the crowd for something, recognition, direction, I don’t know, but when I repeat my question, he suddenly rests his eyes on me, as if he’s surprised that a response would come from something so close by.
‘We can’t miss the coach,’ his wife says. ‘How’ll we get back to the hotel?’
‘Let’s worry about that in a minute,’ I say. ‘Most important thing is to get Malcolm checked out, so we can be sure everything’s okay.’
‘There’s nothing wrong with him. It was my fault. I tripped and pulled him down.’
‘Let’s just take a minute or two on the vehicle, do all the usual checks, and then we’ll see.’
He takes my arm, and we head for the truck.

Malcolm is lying on the trolley with his chest laid bare and dotted up. There is a great knotted scar running down his sternum where the surgeons cracked his chest and performed a coronary artery bypass last year. Implacably the ECG rolls out its lines and numbers as Malcolm takes a minute to cry out the tears he was restraining on the steps. His wife sits on the seat behind him, looking at her watch, kneading her handbag strap.
‘I’m sorry,’ he says. ‘This is all so stupid.’
‘But it’s my fault,’ his wife says. ‘I’m the one who should be in tears.’
‘Why are you so upset, Malcolm?’
‘It was the fall. I felt myself going and – well, I know it wasn’t far – and it all happened so quickly - but just when I started to go and couldn’t stop myself I felt like I was falling into a great big pit, and when I reached the bottom I’d smash into pieces, I’d just fall apart down the middle, whack, and that would be it.’
He cries into the tissue I give him.
We talk about pragmatic things, grounded things, strategies for getting the couple back to their hotel, numbers we could call, whilst Malcolm gathers himself at the centre of all this, dabbing at his face with a wad of tissue, wired up to our machines, falling into the pit again.

Wednesday, March 04, 2009

running on empty

Bill does not so much stand in the room as continue to remain upright, like a condemned tower overdue for demolition. With a series of jerky little corrections to the vertical, his eyebrows raised and his eyelids half-lowered - the Stan Laurel School of Concentration - he tightens the cord of his towelling robe and sniffs around the perpendicular a few minutes more.
‘Bill? Hello – it’s the ambulance. How are you feeling, mate?’
An absent, smacking of the lips, the effort of which shutters down his eyelids even further.
‘Do you know where you are?’
The question soaks away without effect. But suddenly he says: ‘Bill.’ And then tightens the belt some more.
‘When we got here, he was standing in the hallway, naked. There’s something very wrong.’
The District Nurse is an active, busily thin woman who leans forward as she talks, whiskering out levels of dedication as vital as her own. She has an assistant, a fleshy faced young guy as squashy as she is sharp edged. He smiles, his ginger hair sticking out all angles, and shows us the blood sugar test he has just taken: normal.
The District Nurse tells us what’s happened.
‘Bill was discharged yesterday following investigations for oesophageal varices. There was also some mention of Korsakoff’s syndrome – you know, that dementia-like thing when heavy drinkers don’t get enough thiamine and lose brain function. But other than that, I don’t have much else to tell you, I’m afraid. I must say it looks as if he was discharged without too much thought to his living situation. It’s weird. He’s lined up all his TTOs on the kitchen table, but he’s thrown all the bedclothes off his bed into the corner. I can’t make it out. And he’s not saying anything to help. He doesn’t smell of drink. His obs are okay. I don’t think he’s had a stroke.’
Bill stands in the middle of all this, as massively absent as before.
‘Do you know who we are, Bill? You see our green uniforms? Who are we, do you think?’
I reach up and tap him on the shoulder. He opens his eyes, tightens his belt.
‘Bill,’ he says.
He does have a slight tremor underneath his eyes, the kind of twitch you get after a few late nights or a stressful difficult weekend. He doesn’t seem to respond to pain in the usual fashion, though, so this, in combination with his lack of orientation, has us mark his GCS down.
‘Let’s see if we can walk him down to the vehicle.’
‘Well this I must see.’
Bill is six feet something, a great hairless bear of a man, and his flat is on the third floor. It will take a second crew to help with the lift if we need to carry him out.
‘Come on, Bill. One foot in front of the other.’
I give him a gentle tug on his robe; the distribution of his weight changes, and somewhere deep inside him, some primitive place intact enough to be able to register gravitational shift and make appropriate compensations, sparks off a message to his left leg. It swings forward. Another tug and another step towards the door. In this way we operate him down the staircase.

When we reach the hallway, Rae goes on ahead to reverse the ambulance nearer to the door, fetch the trolley out and position it at the bottom of the concrete steps.
We step outside the front door. It’s like stepping onto the threshold of a vast world of perspective and movement. The early morning flaps about us; the trees in the park lean over, and volleys of birds don’t fly so much as tumble chaotically through the air. Bill stops and grips hold of the iron banister.
‘Harraph.’ He leans forward, supports himself on his left knee. ‘Harraph.’
We have just enough time to stand further round to the side when he empties his stomach. The watery vomitus splatters down the steps. Holding onto his arms, both me and the District Nurse peer into the mess as if we might divine an answer there. Rae comes hurrying up with a bowl and a wad of tissue paper.
‘Let’s get you on board, Bill.’
We move him down the steps, a machine called Bill, running on empty.