Ralph normally works up country, but an overtime shift has landed his response car rudely and squarely in the centre of town. A paramedic for thirty years, Ralph carries his experience as lightly as his epaulettes. If it wasn’t for the uniform he could be a retired headmaster, his benign smile only slightly undermined by the ascetic pinch to his face, as if things just kept turning out the same despite all hopes to the contrary.
The first time we back him up he’s on a job at a solicitor’s office. We are shown in by a Kevlar stockinged secretary past a rack of leaflets and brochures on personal injury claims, through to a consulting room out back. The table and chairs have been pulled to one side, and lying stretched across the carpet tiles, crying and slapping at her forehead is a large woman in a white brocade dress. Ralph is kneeling next to her, trying to persuade the woman to open her eyes so he can shine a light in them. He smiles pleasantly as we come into the room.
‘Hello chaps,’ he says, standing up. ‘Well. I haven’t long been here myself, but what we seem to have is a woman in her thirties – Jamila - who complained of a sudden pain in her head and neck, looked as if she was going to faint, and was helped to the floor by this kind gentleman.’
‘She didn’t fall or hurt herself in any way,’ the man says in a clear voice. ‘I made sure she was still breathing, then I phoned for help.’
Ralph pauses for that to sink in, then continues.
‘And that’s as far as I’ve got really. Her pulse and SATS are fine. She’s shaking as you can see but it’s not any kind of seizure. I haven’t been able to get an awful lot more out of Jamila than her name, though.
I lean in past his shoulder to get a better look at her face.
‘I know Jamila. I went to her a few weeks ago.’
I straighten up and nod back towards the door, then step away from the patient. Ralph distributes his smile evenly around the room once more for good measure, retreats, then moves in close to me like a priest about to hear confession:
‘Frequent flyer. Always the same presentation – finds a floor to lie on, pains in head and neck, big shakes, big drama, they’ve never found anything at the hospital. Exactly the same as last time.’
We both turn back into the room.
‘Well,’ says Ralph, clapping his hands. ‘Shall we help you to your feet, Jamila?’ She stops crying and runs me through with a look. ‘Let’s get you out to the ambulance where it’s a bit more private.’
‘Is she going to be all right?’ asks the man in the corner, hastily putting aside a folder and adjusting his tie. ‘I thought it looked pretty bad.’
‘She’ll be fine,’ says Ralph. ‘Don’t worry.’
We help her up, and lead her back through the office. The receptionist scrutinises us from behind the desk.
‘I have a list of contacts,’ she says.
Ralph takes the printout and thanks her warmly.
Out on the ambulance, Jamila makes herself comfortable on the trolley, then resumes her attitude of distress, her long white dress flowing over the sides of the trolley like she’s the corpse of a Victorian tragedienne lying in state. She begins slapping at the side of her head.
‘I just want to press this vein, here. Could you press it for me? Everything went black, then dancing light, bright light, then flash! Then out of focus. You, for instance – when I look at you – to begin with it’s like oh my god what is this creature with two faces and many eye and then now it’s like oh, okay, almost normal. I just wish you would reach in and press my head here.’
‘I see,’ says Ralph. ‘So, chaps? You don’t want me for anything do you, guys? It seems as if you can cope. All right if I shove off?’
‘No problem, Ralph. See you later.’
But it’s sooner than we think.
Barely two hours later, we are heading back to base for lunch when we’re diverted to back up a car on scene at a collapse in a restaurant. Frank drives with the murderous precision of a hungry man, and within five minutes we’re turning into the road. Ralph’s four by four is parked up outside the pizza place, with a bored waiter standing guard, a cigarette discretely cupped in his hand. When he catches our attention he nods for us to follow him inside, then turns and flicks the cigarette away.
Despite or maybe because of the dazzling afternoon sun, the interior of the restaurant is muted and dark. Ralph is standing in the centre of a small group of people; sitting in the centre of the group, a young man in a pin stripe suit, an ornate black walking stick in one hand, a bag of medication in the other.
‘Well, well,’ says Ralph as we walk over to them. ‘Nice to see you again.’
The group parts to let us in.
‘This is Jasper. Jasper is twenty two. He appears to have had some kind of seizure. He suffers from a whole raft of illnesses, don’t you? ...’
I catch Ralph’s eye and as discretely as I can mouth the word: Munchausens.
Ralph’s expression barely registers the exchange, but I can see he has understood. He continues his train of thought for a second longer: ‘... Parkinsons, Diabetes, Epilepsy, heart problems – you name it, Jasper’s probably – erm – just excuse us for a second, would you?’
We both step over to the restaurant lobby.
‘I don’t want you thinking that every patient we go to today is a phoney,’ I whisper.
‘But Jasper is very well known up at the hospital. The diabetes is real, but everything else is strictly Hans Christian Andersen. Even if we took him up there they wouldn’t see him. Last time I saw him at A and E he had a security guard sitting on him in the car park, waiting for the police.’
‘Hitting a nurse with his stick.’
We turn back to the group. Jasper has struggled to his feet and is making a fuss about what bags he should or shouldn’t have.
‘Look here,’ he says, straightening his arms to adjust his starched cuffs and almost falling backwards into a floral display. ‘I don’t want to cause a fuss. I’m sure there are people much more deserving of your attention at the moment than I am. I simply want to go home and carry on with some extremely important, extremely high value business transactions.’
‘Why don’t we have a chat on the ambulance, Jasper? It won’t take long. Just to make sure everything’s in order.’
He sighs. ‘I honestly don’t – oh - I suppose if you think that’s what’s medically required. But this is highly embarrassing for me. It’s just Parkinson’s you know. And there’s not an awful lot one can do about that, is there?’
‘Come on, Jasper.’
Outside on the ambulance Jasper employs all his usual methods of delay, his campaign of passive resistance taken to the maddening, improvisational levels of a clown. At one point, an alarm starts to sound. He hunts through the pockets of his jacket, and the bag of medication, scattering packets of pills across the trolley, chasing the bleep into a document folder of phoney contracts and pseudo-business correspondence. Eventually he retrieves the electronic device and switches it off.
‘To remind me to take my medication,’ he says. ‘Now – what have you done with my stick?’
Ralph smiles and goes to leave the vehicle. ‘Goodbye Jasper.’
By the back door I say to him: ‘That’s weird. Two patients – two frequent flyers. But I don’t want you to think every patient we go to is a psyche, Ralph.’
He rests a comforting hand on my shoulder.
‘Don’t worry, Spence. But have you ever thought – and it’s just a thought - maybe you attract them?’
He laughs, shakes his head, and saunters off to his car. I climb back into the truck.
‘Ah. Good. There you are,’ says Jasper. ‘I was just telling your colleague. Chest pain.’