Sunday, May 30, 2010

the third circle

This night had no beginning, has no end.

We no longer drive. We climb in the cab and let the city move around us. It rolls past the window like a dodgy model city on an off-centred plate, crowds of tiny figures toppling against each other and calling out beneath the great grey lamp of the moon.

And the work keeps coming, job after job after job.

Falls.

They rise up and link arms, fifty bingo-winged Tiller girls advancing arm in arm, sequined support stockings, diamante slippers, feathery alarm pendants, high kicking an inch then falling in a line, left to right.

Anxiety attacks.

They scramble over each other, all hands on deck, a freaked crew of foundering sailors scrambling up the steps of the ambulance as the bulkhead bursts and the windows crack and the tail lift spits rivets along its seam.

Drunks.

They surf out of the bars and clubs on boards made from crushed fast food cartons, ATM cards and hair gel, crouched low, arms spread wide atop great breakers of blood and vomit, whilst their friends shout encouragement from the taxi stands: he’s never been like this before; her drink’s been spiked; he’s only had a glass or two; she’s got asthma.

Assaults.

They run in to each other, merge, rise up roaring as an unconvincing creature from the deep, suckered with weapons, smashing a bottle over its head with one tentacle, poking a beer glass in its eye with another, pushing itself over, slapping its beak, strangling itself, calling 999 on one mobile phone, filming itself on another, whilst we stand off yawning, watching the sou’westered police wade in with landing hooks.

But then, just when I realise my head has been twisted off and stuck back on upside down, the shift is over. In the space of an extended blink, someone has reached up, switched off the moon, wound up the night. Suddenly – unaccountably – instead of the Third Urban Circle of Hell, I’m on a charming country road, with plasticine trees tottering past the window of my little red and yellow car, and choruses of cheerful birds looping and fa-lah-lahing in the blue.

A hedgehog doffs his cap.

And stands there, smiling and stuffing his pipe, as the sleepy little ambulance figure gets kissed good morning, and carefully tucked away in a matchbox.

Tuesday, May 25, 2010

soundtrack

Ray’s wife Anne meets us at the top of the steps.
‘He’s lying on his side. I can’t move him. I think there’s something wrong with his breathing.’
‘Where is he?’
‘In the kitchen. But he’s big …’
We hurry in to the flat. Ray is lying on his left side on the floor of a narrow, galley kitchen, a pool of yellow vomit around him on the vinyl tiles. He is gasping spasmodically like a landed fish, his hands and nose and lips already a mottled grey blue. I feel for a pulse at his neck.
‘Nope. Agonal. We need to get him on his back.’
‘You be careful,’ Anne says, peering in over Frank’s shoulder. ‘He must be eighteen stone.’
I’d guess at least twenty-two. I grab his belt with one hand and guide his head with the other whilst Frank reaches in and uses Ray’s crooked legs as leverage. We manage to turn him on to his back in one haul, then reposition our grips and slide him a couple of feet away from the mess to a clearer space near the entrance. I pull his shirt up and start chest compressions; his eighty year old chest immediately snaps and cracks, giving beneath my hands like an old wicker basket.
‘Anne? When was the last time anyone saw Ray on his feet?’
‘I should say about half an hour ago.’
‘So he’s been down at least twenty minutes or so.’
Frank sticks the pads on and sparks up the defib.
‘Off’ he says, then after a moment: ‘PEA – on you go.’
‘Is he going to be all right?’ Anne says, one hand abstractedly plucking at the loose folds of skin beneath her chin.
‘He’s very poorly at the minute, Anne. His heart’s not working properly. This’ll be difficult for you to see. Why don’t you go out into another room whilst we do what we can? Is there anyone around who can sit with you?’
Just then a deep male voice sounds from along the corridor.
‘Stanley Green! says Frank, looking up from the head end where he takes care of ventilations. ‘I didn’t know you lived round here.’
A thick set guy with electric white hair and Fifties sideburns shows his face around the corner.
‘I live upstairs, Frankie. It’s Ray, is it? I saw the ambulance.’
Stanley watches me working on him for a second or two. Then he takes Ray’s wife by the shoulder. ‘Come on,’ he says. ‘Let’s go next door for a bit.’
‘Just before you go – Anne? What’s Ray’s medical history? What does he suffer with?’
‘Oh you name it,’ she says. ‘Do you want me to fetch you his appointment card? He’s supposed to be going in for a check-up in a couple of days. I suppose I’ll have to cancel that now.’
‘And how was his health today? Was he complaining of anything particularly?’
‘No. He was in a good mood. We were going out later.’
She frowns, watching me compress her husband’s chest but not seeming to connect with the desperate nature of my actions.
‘I’ll have to have a ring around,’ she says absently.
‘Come on, Anne. Let’s go and wait outside and let these guys do what they do.’
‘Do you want to know anything else? Towels? Water?’
‘No. Thanks. We’re fine. You go with Stanley and we’ll carry on. There’ll be another crew arriving in a moment to help us out. Maybe you could talk to one of them and give them all Ray’s details.’
‘Will do,’ she says, and Stanley leads her off.

***

An hour later and we all agree there’s nothing more to be done. Ray had a brief moment when it looked like his pulse might make a comeback, but it proved to be a false, adrenalized dawn (as they often are). We stand back from his body and begin to organise a clear-up. Frank goes to speak to Anne. After a few seconds I hear an agonised howl from a room out back. After a moment Frank re-appears.
‘I told her she could come in after we’ve cleaned him up,’ he says.
We drag him out of the kitchen and onto the carpet. It looks more comfortable than lying on the bare lino. We wipe his face, adjust his clothes, lie him neatly, place a clean white blanket over his length.
‘Are you going to extubate?’ I say to the paramedic.
‘No. I’ve got to leave it in situ for the coroner.’
‘Fair enough.’
But it seems a shame. Stanley comes in to the room and blanches when he sees his friend lying on the floor. But then he motions behind him for Anne to come in, and she takes her place by his side. After a moment she says weakly:
‘What’s that sticking out of his mouth?’
‘That was a tube to help him breathe. We’ve had to leave it in, I’m afraid.’
‘Oh.’
‘For the post mortem.’
‘Oh.’
We start to ferry our kit out of the way, discretely moving around Ray as he lies there, massive, motionless, jarringly out of place, run aground on the threshold of his kitchen. As I retrieve a scattering of drug packets from just the other side of him I notice the small bookcase, a CD player on the top shelf, rows of neatly stacked CDs beneath it. There is a tall, faded looking CD box leaning against the player where Ray left it: Dean Martin, posing in an open-necked, black silk shirt and rumpled cream jacket. Memories are Made of This.

Thursday, May 20, 2010

wrists

Half past four in the morning and the music in the emptying club has been set to chill. Smoke and a densely sweated heat roll out through the double chrome doors, past the two bouncers standing with their hands respectfully cupped in front of them, professional mourners at the end of the world. The forecourt is a fisheye of tragedy, eerily pale in the light misting down from the lampposts on the road above, the patterned brickwork of the beachside walk, the dark, railway sleeper kerb and the cobbles on the beach beyond them, ghosting through a screen of smoky blues and greys. A tragic scene, from the litter of overturned chairs, scattered plastic pints and bodies draped over tables, to the groups of guys staggering off, pushing each other, climbing stuff, jumping down, and girls holding on to walls, walking barefoot with shoes in their hands, whilst around us from the deeper reaches of the night, wild screams and shouts and cries. The epic scale of it reminds me of a print on my mother-in-law’s wall: Napoleon’s retreat from Russia. I wouldn’t be surprised if I had to step over a fallen horse.

A couple of guys wave over to us from beneath the prow of a beached fishing boat further along. One of them is holding the arm of a man who lies face down at his feet, dipping and struggling, his enormous mop of curly hair thrashing about. He laughs as he struggles to hold on to the man, like a fisherman who’s somehow caught a live sheep in his nets.
‘He’s out of it,’ he says. ‘Rich is really out of it.’
I shine a torch down on to him whilst Rae squats down to ask him who he is and what might be wrong with him.
The man grips his t-shirt, pulling it away from his throat, gargling like an actor in a bad death scene.
‘Rich. Slow down, mate. Tell us what’s happened to you.’
As far as we can tell he had come out of the club and lain down on the beach. He hasn’t had any drugs; he hasn’t hurt himself.
‘So what’s the problem, Rich?’
‘My throat,’ he rasps. ‘My neck. My chest. I can’t breathe.’
Rae manages to calm him down sufficiently to establish that his life isn’t actually in danger at the moment. We can’t assess him properly here, though. There are too many people around, too many distractions. It’s cold, too, with a freshening wind coming in off the sea. We help Rich to his feet and take a slow, faltering walk back up the ramp to the ambulance parked up on the top road. His friends wave us off, leave him to it.
Up on the vehicle we get Rich on the stretcher where he rolls about groaning and complaining that his throat hurts. I slam the door shut. It feels good to be in the ambulance. Now and again as someone walks by they slap their hands on the side and shout taxi! or help me, I’m dying!, but inside the heater whirrs along, the light is bright and everything feels well-lit and safe and to hand in the best tradition of sanctuaries the world over.
‘Let’s start over, Rich,’ says Rae. ‘What has happened to you tonight? Why are we here?’
‘I came out of the club and fell over,’ he says, holding his neck.
‘You fell over? Where did you fall over?’
‘Just outside. I whacked my head on a bollard.’
‘You hit your head on a bollard?’
He nods, and winces.
‘Don’t nod. Just say yes or no.’
‘Yes. No. What?’
‘Were you knocked out?’
He shrugs.
‘Rich, we have to be clear about what happened to you. Let me feel your neck. Does that hurt?’
He yelps before Rae even gets a hand to him.
‘You have to be braver than this, Rich. Let me feel your neck.’
‘Be careful. I hurt it in Rugby last year and I can’t do anything more to it.’
‘So you have an old neck injury and you fell over tonight and banged your head. Is that right? Don’t shake your head, Rich.’
‘That’s right.’
‘Then we’ve got to put a collar on you, and put you on a board for the ride in.’
‘You can’t put me on a board. Last time I was left on it for six hours.’
‘That won’t happen tonight.’
‘And I feel sick.’
‘How much have you had to drink tonight?’
‘Nothing. Hardly anything. Four cups of whisky and Red Bull.’
‘Cups? What do you mean, cups? How big’s a cup?’
‘I don’t know. A cup.’
‘Had any drugs tonight?’
‘No. I don’t touch drugs.’
We both lean over him and shine a light in his eyes. They stare back at us, large and clear.
‘I’ll get the board,’ I tell Rae.
‘Shit. My mum’ll kill me,’ says Rich, then clears his throat with a ghastly retching sound. Rae grabs a bowl.

***

At the hospital the doctor feels down Rich’s back, working methodically along the spine as a team of us hold him on his side.
‘Does that hurt? Don’t nod, Rich, just say yes or no.’
‘Yes. Yes! No. Yes!’
‘Okay.’
We lower him back down.
‘We’ll send you for an x-ray, just to be safe, but I don’t think there’s anything going on, really. We’ll sort some pain relief whilst we’re about it, too.’
‘You won’t inject me, will you?’ he says, struggling to meet the doctor’s eye without turning his head.
‘No. It’ll just be a pill.’
‘Because I have a dreadful phobia.’
‘A phobia? Of needles?’

Rich blinks and looks straight up at the ceiling. ‘No,’ he says. ‘Wrists.’

Wednesday, May 12, 2010

no biscuits

Two o’clock in the morning and the entrance to the residential home for troubled teenagers is all lit up. I buzz the warden and after a moment the latch clicks. Once inside we walk over to a serving hatch set into the wall overlooking the lobby. The man sat in the office there has a slack look to him, grey and poorly focused, like the security monitors mounted on the wall behind him.
‘Room 113. I’ll take you through. Sorry to drag you out. I’m sure it’s nothing.’
He leads us along corridors, through fire doors.
‘I expect you get a lot of this,’ he says, twirling and un-twirling the master key on a long piece of cord. ‘I couldn’t do your job.’
‘I’m not sure I could do yours,’ I say.
‘Don’t feel too sorry for me. There are benefits, you know.’
‘Same with us. All the bandages you can eat.’
‘Yeah – but all that blood and guts ...’
‘Yeah – but all those teenagers…’
He grunts, then breaks off to knock a couple of times on a partially open door, pushing it aside with a knuckle.
‘It’s the ambulance, Cheryl.’
A young guy opens the door.
‘I did my best but nothing worked,’ he says.
‘Let’s have a look.’
He stands aside and we move into the room, a utilitarian cube with a sink and shelf in one corner, a single bed along one side and a plain armchair opposite. Cheryl is lying the wrong way up on the bed, face up at the end, her feet on the pillow. She breathes quickly, holding her hands lightly on her belly, the pale fingers curled over into her palms like two strange creatures washed up on a rock.

Cheryl is having an anxiety attack. She’s had them before, she knows what to do. Except this time it’s gone on for longer, and she can’t break out of it.

‘My name’s Gary. I’m Cheryl’s friend from next door,’ the young guy says, squatting down and leaning back against the wall. He rubs his hands briskly with his face. ‘Jesus Christ. I’m supposed to be at work at eight. But I can’t bunk off. It’s my first day and I can’t screw this one up as well.’
‘We can handle things here okay. Why don’t you go and get some rest?’
‘Nah. I’ll stick around and make sure everything’s good. I’m used to going without sleep.’
It doesn’t sound an idle boast. He is long and pale, his bleach blond hair spiked upright like the shoots of something forced in the dark; even the tattoos on his arms have a shadowy quality, as if a sleepwalking tattooist inked-in the patterns by moonlight.

Gary reaches up and pats Cheryl on the shoulder. ‘I’m here for you, girl,’ he says.

Half an hour later Cheryl is sitting upright, breathing more slowly, looking exhausted.
‘She’s got to move out today,’ says Gary.
He stands up. ‘Shall I make some tea?’
‘That’d be great.’
When he’s out of the room Cheryl reaches under the pillow and pulls out a letter. She hands it to me without saying anything. I scan it quickly – something about internet grooming, a court case abandoned, a professional expression of support, a wish that things go well, keep in touch, and so on.
‘That sounds pretty tough,’ I say, handing her back the letter. ‘And you’ve got to move out today?’
She nods.
‘Are you getting all the help you need? Have you got a social worker?’
She folds the letter up and pushes it back under the pillow as Gary comes in with a tray of tea.

‘No biscuits I’m afraid,’ he says, looking around in vain for a clear space to put the tray down. ‘I had a fresh packet this morning but someone’s gone and scoffed the fucking lot.’

Monday, May 10, 2010

drama club

Imogen is lying across her boyfriend in the back seat of the car, thrashing her legs and arms around, reaching up to grasp the hand grip above the door, pulling herself up and then letting herself go again, kicking the back of the passenger chair, slapping the ceiling, kicking the door. But as we approach the car in the dark, the whole performance seems just that – a controlled, intermittently hysterical display; her boyfriend and her boyfriend’s father look out at us by the interior light of the car, pale-faced, in need of rescue.
‘Asthma. Imogen’s having an asthma attack.’
Frank leans in, long and slow as an old-hand detective sniffing a crime scene.
‘This isn’t asthma,’ he says after a second or two, then: ‘Sit yourself up, love, and let’s have you on the ambulance.’
She had paused for a moment, but suddenly launches in to another bout of thrashing.
‘I’m serious now, Imogen. It’s cold out here. We can’t be all night.’
The hard edge seems to drop from her distress. She lets her boyfriend sit her up, then after a few fluttery passes of her hand across her face, slips out of the car and stands in the sharp night air, swaying impressively but not falling down, breathing quickly into the top of her chest.
‘Just slow that breathing down for me, would you, Imogen? And then let’s have you on the truck.’
She scuffs her feet as she walks, but makes it to the ambulance without us having to carry her.
‘That’s it,’ says Frank, offering a hand to get her up on to the truck. ‘There we go. Let’s have a seat and a chat.’
Imogen grips the handrails of the chair and breathes deeply, strange gasping respirations. She is a frail seventeen, the fringe of her long straight hair overhanging her eyes.
I go to put the SATS probe on her finger but she pulls it away as if I was going to pinch her finger in a clothes peg.
‘Don’t worry. Look. It goes on quite easily.’
I show her by putting it on my finger.
‘I need to do your blood pressure as well.’
‘There’s nothing wrong with me. I’m perfectly fit,’ she says, then grips the arms of the chair and kicks her legs forwards. ‘For the love of God!’ she screams.
‘Where is the pain, Imogen?’
‘In my back. In my fucking goddamned back. Excuse me swearing.’
‘Is this new pain?’
‘No. Yes. I don’t know what you mean.’
‘It’s quite simple, Imogen. Have you had this pain before?’
‘I fell off a bench in drama class last month and they said I strained my back. Oh dear God!’
‘Did you go to hospital?’
‘Yes. D’ur. They took x-rays and everything.’
‘And what did they find?’
‘They just said it was a strain.’
‘Did they prescribe any medication?’
‘No. Look – stop talking. Do something.’
‘We can’t do anything until we know what’s the matter. Look – your SATS are perfect, your blood pressure is fine.’
‘Call yourself doctors?’
‘But we’re not doctors, Imogen. We’re the ambulance.’
‘Well do something ambulance-y, then.’
She takes traumatised gulps of air, her head craning up like a distressed baby bird, for all the world like a person in the very last extremity of pain. But nothing leads us to believe that she is in fact in pain. Her obs are fine, nothing we do or ask leads us to believe anything different, and her boyfriend, when he looks in at the door, is calmly playing his DS.
'Is she going in, then?’ he says, not looking up.
‘We’re just trying to establish that,’ says Frank. ‘Do you have pins and needles in your hands Imogen?’
‘What d’you mean?’
‘You know. Your hands go all tingly.’
She looks straight at Frank – as far as we can tell, the fringe so completely covers her eyes.
‘Who do you think I am? Fucking Tinkerbell?’
‘Less of the attitude, young lady,’ says Frank, leaning back against the bulkhead and fixing her with a stern look. ‘We’re here to help you.’
She laughs.
‘You remind me of my teacher.’
But then she seems to remember where she is and what she’s about.
‘For the love of God!’ she screams, arching back in the seat and slapping the arm rest.
She seems to have learned her expressions of distress from the pages of a Victorian novel.
‘What were you doing tonight?’ says Frank, ploughing on.
‘I was at drama club.’
‘So. You did your back in at drama club a month ago, and now you’re having breathing problems at drama club. It all sounds very – dramatic.’
‘Ha bloody ha. Oh – dear God!’
This flip-flop behaviour is extraordinary. One moment extravagant expressions of agony, the next the kind of sassy street shapes you’d expect from a twenty-first century teenager. If I had to make a differential diagnosis it would be either anxiety attack or intermittent possession by Nancy from Oliver Twist.
‘Let’s review the situation. You hurt your back a month ago but nothing was found, you’re not on any medication for it and you’ve been back to normal since. Your back started to hurt tonight in drama club, and then later on when you got in the car to be taken home it started to affect your breathing. Since you’ve been with us your breathing has calmed down a lot, and all of your observations are normal.’
Frank studies her for a moment.
‘Is your mum at home?’
‘No. She’s on her way back from holiday.’
‘Is there anyone else at home?’
‘My older sister.’
‘Do you two get on?’
‘No. I hate her guts. Oh my sweet God! Jesus!’
‘You see, Imogen. Normally I’d be happy to let you go back home, but every now and again you still seem ready to tip back into another panic, and that can’t go on, can it? So the only other option is to take you to hospital.’
Imogen says she doesn’t want to go to hospital. She doesn’t want to wait for hours to be seen by a doctor.
‘At least you’ll be safe there. I think I know what the problem is, but there’s always a chance it could be something else.’
‘I’m not going to no hospital.’
We confer with the boyfriend, who sighs when he has to prematurely finish his game and put the DS back in his pocket.
‘Don’t worry, Immie. I’ll come with you.’
The boyfriend’s father, a benign, slightly worn down character with a pair of thick glasses, a scraggy beard and a walking stick that could all be part of a kit, seems happy to let him.

***

We park Imogen and her boyfriend in the waiting room. In front of this more substantial audience – one without the same investment or interest in her condition – Imogen calms down, and sits perfectly happily in the wheelchair, looking over her boyfriend’s shoulder at the DS.

We’re asked to take a transfer to another hospital, but there’s a delay as the patient is stabilised. We’re still at the desk half an hour later when a harassed woman in a crumpled black suit hurries up to the nurse’s station.
‘My daughter Imogen was brought in by ambulance and I’ve come to take her home.’
‘Yes. I know the girl. But she hasn’t been assessed by the medical team yet.’
‘Yes. Yes. It’s okay. I know all about it. I’ll just take her straight home, thanks.’
The nurse pulls a wise but tough, Robert de Niro face – a sub-text something like: If you’re sure that’s what you wanna do, then by all means. Go right ahead.

‘Through there,’ is all she actually says. The woman hurries through.

Saturday, May 08, 2010

travel plans

There are two people under section at the hospital to go to Southview. One of them needs a police escort, and as a unit still hasn’t been assigned to the job, Control have asked us to take the quieter one. As we walk through into the unit a nurse jumps out, almost throwing us onto a bed in her eagerness to know who we’ve come for.
‘Please say Aleksandr,’ she says. ‘He’s such a problem and we can’t get anything done. Please, please, please say you’ve come for Aleksandr.’
‘Actually we’ve come for Nigel.’
‘No!’
‘Nigel’s easy,’ says Frank.
‘I’ve got chocolates! Look! I’ll even make you some tea whilst you wait.’
‘I’ll get Control and lean on them.’
I call them up on the radio as the nurse leads us round the corner to her station. Just across from it there is a bare chested young man being held in a wheelchair. His arms are out to the side, firmly gripped by two security guards, who nod at us as we take up position in two office chairs.
‘All right?’
‘Not bad. You?’
‘Yep. Good thanks. Busy night?’
‘So so. You?’
‘Not so much.’
Control say it’s okay to wait for the police escort, but to keep them updated.
‘Thank god for that,’ says the nurse. ‘Thank god.’
Aleksandr has been looking ahead, inert but intensely focused, the muscles of his chest and abdomen defined. He looks sprung, acutely aware, but his face is passive.
The nurse hands me and Frank a chocolate each, and then sits above us on the desk to whisper his story.
‘Aleksandr’s a language student. A few weeks ago he was doing fine, nothing untoward, quite happy, but then for no apparent reason started acting strange and withdrawn, not going to lessons, talking to himself and the rest of it. Eventually he flipped. Smashed up the host family’s house, ran into the sea, picked up by the lifeboat. Treated for hypothermia, and everything else checked out physically. He’s been sedated for a while now, but we can’t really give him too much more before you take him. He does need an escort, though. He’s been a nightmare, a real handful.’
At that moment, as if to illustrate the point, Aleksandr struggles to his feet and starts wresting his arms from side to side like a wild cat in chains, but all completely silently. The guards hold him firm.
‘Come on, Aleksandr.’
‘Easy there.’
‘Just calm it right down, fella. We’re not letting you go.’
After a few seconds he relaxes again, slumping back into the wheelchair and resuming the same, passive posture.

As things settle down again an inflated, raw-faced man suddenly appears from nowhere, tottering across to sit down with us at the station. The way he smiles identifies him as Nigel before he even speaks – oblivious, mildly amused, like an indulgent friend who knows the real reason behind the visit.
‘I just couldn’t stop the drinking,’ he says, slapping his belly. ‘Blew me right up. Organ failure. The shits. Voices and headaches. I don’t suppose you’ve ever been to Scotland?’
I smile at him. ‘Me? I’d love to go to Scotland. Overnight sleeper train. Pile of books, bottle of whisky. Or maybe orange juice. All the way to the top and fall off. All the way to the Orkneys.’
Frank flicks his chocolate wrapper over to a bin, but it bounces off the rim.
‘You’d need a boat for the Orkneys,’ he says.
Nigel laughs. ‘A boat!’ he says. ‘Classic.’
Aleksandr struggles some more, but the guards maintain his position.
Pilar, a Spanish nurse, comes over.
‘Do you know if the planes’ll be back in the air at the weekend?’
‘Where are you off to, then?’
‘Home. Gran Canaria.’
‘Gran Canaria? Is that Spain?’
Frank puts his hands behind his head.
‘Well, mate, yes, it is Spain, but really it’s Africa. An island off the coast of Morocco, if you must know.’
‘Let’s have a look.’
I spin round on the chair and call up Google Maps. In a few clicks I have the satellite version, the cobalt blue of the North Atlantic ocean ruffled with deep water mountain ranges. I use the hand tool to drag the picture so the bottom half of the UK shares the screen.
‘There you go, Pilar. That’s where you’re headed.’
‘I hope,’ she says, checking her fob. ‘I wish.’

Friday, May 07, 2010

touching heads

‘Wait a minute, now. Just a minute.’

Mrs Burrows fishes around in the pocket of her dressing gown, and eventually pulls out what looks like a massive pink plastic ashtray. She picks off the fluff with the tips of her fingers, then sets it in her lap.
‘Pass me down that tube, would you?’
There is a semi-circular glass shelf just above her head, covered with chintzy porcelain figurines; I find the tube at the feet of a startled shepherdess.
‘Thank you.’
She unscrews the top, and squeezes gunk all over the ashtray. Then she spreads her mouth wide and slowly inserts it – a dreadful sight, like watching a python swallow a snooker table. It’s impossible that she could fit that thing in there, but somehow she manages it. It must be some mistake. The dentures are so huge they seem to push the entire side of her face outwards; they must be the wrong teeth. But Mrs Burrow’s husband, the only other person whose teeth they could be, seems happy enough. He looks on sleepily, fumbling with his dressing gown cord.
‘Would you like some tea?’ he says.
‘Let’s get your wife up first. Now then. Have you hurt yourself?’
She smiles, and the teeth loom forwards through the opening.
‘Just a minute,’ she clacks. Then very methodically, item by item, she begins checking herself, turning each hand from side to side, extending her legs, nodding her head and wriggling from side to side. She looks up again.
‘I’m all right,’ she says.

We get her up and holding her hands, lead her through into the kitchen.

Mr Burrows is shuffling around the tatty kitchen, his dressing gown cord still trailing behind him, his hair sticking up in tufts like a duckling.

‘Sixty three years we’ve been married,’ he says. ‘That’s us in the picture.’

He swings the kettle dangerously in the direction of a large black and white wedding photo, a bustling crowd of people at the doors of a church, a young man in uniform leaning in and touching heads with a round faced young woman in an upturned veil, both of them laughing at the camera through a storm of confetti.

‘I drove steam engines after that,’ he says, setting the electric kettle on the hob.

Mrs Burrows taps me on the shoulder. When I turn to look at her she leans in and starts to whisper: dementia, but on the slippery third syllable her teeth seize their chance and try to leap out at me from her mouth.

Thursday, May 06, 2010

viewpoint

The last drag of light along the horizon. Dusk doesn’t sound right as a word - or maybe it sounds exactly right: dust, musk, dark – a fragile composite, a material thing, ghosting the landscape, reducing these isolated farm houses to a yard light, a tractor beam, a smudge of tree or hedgerow, wall or gate, a mirror of sky in a ditch, a scattering of shapes in a field. The higher we get the more it feels like flying. But the ambulance pitches and rolls, and finally the long road to the top of the escarpment turns us up onto the forecourt of the pub there.

It's been a warm and busy day, but the coming night is sorting the last visitors into those that stay for a pint and those that don’t. Car boots are open and people are sitting in them changing their boots; a man tips a bottle of water into the upturned mouth of a dog; a kitchen porter lounges round the bins and smokes as he watches us; shadows of late walkers on the footpath coming in; the interior lights of the pub blazing through its acres of glass; and from all around the sensation that we’re the focal point of an unfolding drama.

A man steps up to the window and plays his part.

‘The car park at the far end, mate, as far as you can go. There’s a load of police there. You can’t miss it.’

But you could. It’s surprising how the police van and the ambulance car are subsumed in the general confusion of shapes at the edge. A stand of Scots Pine rise up on the right; on the left, a great vacancy of dark, smelling of height and distance. The road surface is unmetalled rock.

A group of three or four police officers chatting and kicking around. We say hello, they point us over to a dark saloon car parked with its bonnet to the edge of the car park. The off-side rear door is shut, but every other one stands open. The lights are off, and all we can see as we walk over is the shape of a paramedic kneeling by the driver’s door. The window of the passenger door behind it is partially open, the gap stuffed with shredded paper. The driver is still behind the wheel, the seat pushed back, his filthy hands resting in his lap. A battered looking guy in his thirties. It looks as if he’s been living in the car.
‘Hi guys. I’ve only just got here myself. But anyway - this is Simon. Simon has tried to gas himself, unfortunately. He ran a pipe from the exhaust and kept the engine running for – how long, would you say, Simon?’
Simon speaks with his face pointing forwards, like an astronaut stunned by the curve of the earth through his windscreen.
‘An hour? I lost track.’
‘So. About an hour then. Maybe unconscious, not sure. Simon’s also took a bit of heroin, so he’s got a few things going on. A member of the public found him.’

Between us we help him out of the car, discreetly making sure he doesn’t have anything on him that he might suddenly use against himself, or us. But he walks calmly and steadily to the ambulance, and we sit him on a chair. I go to swap the oxygen spigot from the far side to the outlet nearest to him, but some reason it won’t click in.
‘Here. Give it to me. I’m an engineer.’
With his powerful, filthy hands he turns the spigot around until it snaps into place. He tests the flow, then relaxes his hands again. ‘I’m good at that shit,’ he says.
I put the mask on him and run through a set of obs whilst my crewmate negotiates with the police. At one point Simon raises his arms out to the side, turns his hands from side to side and flexes his fingers. He looks like a man coming out of a deep freeze.
‘I’ve fucked this up as well,’ he says. ‘I wasn’t supposed to wake up.’
Then he opens his eyes and studies me glassily.
‘I don’t even have any money to pay the fine when the police take the car.’
‘Don’t worry about that,’ I say, and then: ‘Try not to worry about that. These are special circumstances. I’m sure we can work something out.’
Simon closes his eyes again, and then the only sound for a while is the oxygen, steadily hissing into the mask.

Sunday, May 02, 2010

easy on the vegetables

The high street is so busy and bright I have to screw up my eyes to look at it. We cut a path through the muddle, our siren a madman’s rant in the market place. A young mother reaches over the back of her buggy to press her hands over her baby’s ears; a decrepit old man gets pulled back by the shoulder as he steps out at the pedestrian lights; a cyclist wobbles, puts a foot down, casts a look back, and on and on through a hundred scattered scenes, from balconies and shop doorways, car windows and the opened backs of vans, from the railings along the pavement and the groups of friends stopped like rocks in the river of lunchtime shoppers – amongst all this a sudden unexpected convergence of attention, a yellow truck, and its dramatic progress along the street.

But we’re hardened to the fuss. We have to get there quickly, to the thirty year old male collapsed, unconscious, life status questionable, on a pavement outside a bookshop.
‘There’s the patrol car.’
I press on scene as Frank pulls over to the side.

One officer is holding up a crumpled looking man by the collar. He has a disdainful set to his arm, looking out over his audience like a puppeteer about to stuff an unstrung marionette in the bin.

His colleague strolls over to the ambulance. I wind the window down.

‘Not sure about this one, mate. Sorry to drag you out. This guy – Gary, I’ve not met him before – apparently he collapsed on the pavement. Seems all right now, though. Bit pissed – might have something to do with it. Anyway, see what you think.’

Gary has that stubbed out vacancy you see in drunks. When I introduce myself he smiles, pushes out his bottom lip when I ask him how he is. It’s a strangely disconnected movement, like watching the bottom drawer of a cupboard slide out by itself.

‘I’m all right.’
‘Did you hurt yourself when you fell?’
‘I’m all right.’
‘Okay, Gary. Let’s get you in the back of the truck and give you the once over.’
‘Fair enough, chief.’

Shouting words of encouragement and guiding his arms and legs as best we can, we corral Gary up the steps into the ambulance, his hooves scrabbling and clattering on the steps; about the only thing we don’t use to help him along is a lasso. He dumps himself in a chair. The police officers step away, stripping off any further involvement with a snap of their surgical gloves.
‘See you later. No doubt.’

On the ambulance Frank settles himself at the far end of the trolley, draping one leg over the other and lacing his fingers round one knee, bouncing a foot up and down like a benevolent history teacher settling down in a disappointing class.
I begin.
‘Now then. Gary. Tell us what happened.’
Gary puts his hands in his pockets and looks up at me. He tries to gauge how level I am by closing one eye, and the action almost has him off the chair.
‘I had something to eat.’
‘What did you have to eat, Gary?’
He thinks about it.
‘An onion – and a parsnip.’
‘What did he say?’ says Frank. ‘An onion and a parsnip? Fantastic.’
I raise my eyebrows.
‘So – you had an onion and a parsnip. Anything with that? Any drugs, for example?’
‘Ten milligrams of Valium.’
‘Okay. Anything else?’
‘Some lager.’
‘Can you open your eyes for me, Gary, so I can get a look at your pupils?’
He raises his chin up, but the eyes remain closed. I reach over and prise it open. The pupil rolls back at me, fat and black.
‘Okay. So you had a few cans, some Valium cut with root vegetables. Anything else?’
He gives me a boneless smirk and shakes his head.
‘Not a thing, sir.’
He seems to pick up a bit with that. He stands up – a hideous procedure, his fingers spread wide, his sense of balance swarming round his head like so many bees.
‘Are you a straight crew?’ he says as he struggles to maintain his position.
‘What’s that?’
Frank uncrosses his legs.
‘A straight crew? What’s that got to do with the price of fish?’
‘A straight crew. You know what I mean. Especially you.’
‘I have no idea what you mean. What are you asking us?’
‘I want you to take a look at this.’
He starts fumbling with the belt of his trousers, a pair of jeans so shiny with dirt they could have been cut from the granite walls of a sewer.
They sag to his ankles.
I don’t want to look, but I’m morbidly drawn against my will. Even Frank has stood up from the trolley and is peering round.
‘What are we supposed to be…’
‘Look.’
He reaches round, tugs his pants halfway down, lifts the tail of his shirt, exposing the kind of scraggy arse you might see on a bear with mange.
‘See?’
‘Well – no, not really. What?’
‘I fell over.’
‘I can’t see any damage there.’
‘Look closer,’ says Frank, but I don’t.
‘Honestly, there’s not a mark there.’
Gary turns round and lifts his shirt.
‘What about here?’ he says, making a vague sweep of his torso with the flat of his hand. ‘I fell over.’
‘So you keep saying, but there’s not a mark on you. Gary, this is all a bit of a waste of time, don’t you think? Just pull your trousers up and let’s see what we’re to do.’

He manages to straighten his clothes in that vaguely magical way drunks have of remaining upright despite the odds.

‘It seems to me that you’re a bit the worse for wear, but it’s difficult for us to say exactly what the matter is. I don’t think you need to go to hospital, but we’re duty bound to offer it. The other thing is we can release you back into the wild and you can enjoy the rest of the day. What would you like to do?’
Gary pushes his bottom lip out again.
‘Go home,’ he says at last.
‘Good. Let’s help you out.’
At the bottom of the ambulance steps he turns and offers his hand.
‘I want to thank you for all you’ve done.’
‘No problem, Gary. Just go easy on the vegetables.’
He does a mock salute, and almost pitches backwards into a pile of rubbish bags.