As I walk out into the bright sunlight of the ER loading bay, another ambulance is just pulling in. It parks up, rocks about, muffled shouts and sounds from inside, then suddenly the back door is flung open and Rae jumps down, stern words from behind her. Will you stop that? Hey! No! Come on!
‘Spence. Jesus. Christ. You couldn’t help us get this guy out, could you? I’ve just about had it.’
Her partner Colleen emerges from the cab. ‘You’re going to like this,’ she says, pulling on a fresh pair of gloves.
Rae grimaces and lowers the tail lift. When she swings open the main door I can see the long, lean figure of a man sprawled on the stretcher, his hands cuffed, a policewoman leaning over him from the side.
‘What’ve you got, then?’
‘A guy off his tits on something or other. The police called us to the shopping centre. I can’t tell you - he’s been such an incredible pain in the arse.’ She pushes some strands of hair back from her face with the back of her gloved hand. ‘But watch yourself, Pen. Now and again he’ll go for you.’
As I step up onto the back the patient senses the change in his environment and looks up. His blond hair stands out around his head like a sweated mane; his mouth is slack, and he rolls his head from side to side in a panic that his wide eyes cannot see the danger and he has to catch the scent of it instead. At the same time he blows air out through his loose lips, scattering flecks of white foam into the air.
‘Will you stop that?’ says the police woman, jerking his hands reprovingly.
A strong, square woman with a tattoo emerging from her shirt sleeve that looks like it was copied off an old dinner plate, she seems less like a police officer and more like a farmer controlling the stock.
‘So what’s the plan, d’you think?’ she says.
‘He's not going to walk in, presumably.’
The police woman makes a face.
‘So in on the trolley, strapped down as much as possible. I’ll control his legs.’
On cue, the man makes a sudden wrenching attempt to break free, snatching his arms forward, kicking his legs and jerking his head up from the trolley.
‘Easy! Easy!’ says the police woman. She has one of his wrists turned back on itself, and squeezes a little more pressure on to subdue him with the pain. It takes all my strength to control the legs, gathering up the material of his trousers into a handle and using the weight of my body to smother his movement. Without the trolley straps and the handcuffs, though, he’d be smashing his way out of the ambulance.
We wait until the spasm subsides, then carefully off load the trolley and run him inside. There’s a receiving room for volatile patients just inside the door. We take him into it, and with the help of another crew and a couple of porters, we bundle him onto the hospital trolley. The policewoman repositions her cuffs, and we use some spare straps to restrain him more effectively until the nursing staff can take him in hand.
In the struggle to put him on the trolley, a wallet and passport have fallen onto the floor. Rae picks it up and cautiously goes through it.
‘Well we’ve got a name, a nationality...’ Then she pulls out a sepia coloured business card, snorts then waves it in the air.
‘And guess what he does for a living?’
‘Reflexology and cranial osteopathy.’
Just at that moment the patient makes another desperate bid to break free. He writhes and arches his back, slams his body from side to side, the sweat running on his bare torso, his eyes flaring.
Horse! he screams. Horse!
He rages against his restraints, ramming and pulling and writhing, spreading his fingers wide then bunching them into fists. Horse! he screams again - and then holds himself still, and stares at his fists in horror, as if he could see them turning, curling in and down, hardening, darkening into hooves.