We had found Rachel collapsed in a shop doorway, her legs folded beneath her in an uncomfortable, zigzag way, like something heavy had been dropped on her shoulders. She was moaning softly, rocking backwards and forwards, pushing her face into her hands, her long black hair hanging straight down so I had to hook it aside to look at her. Once we had Rachel on board the ambulance the extent of her distress became clear: extremely high blood pressure, a searing, left-sided headache that travelled back into her neck, numbness in her extremities, visual disturbance. We made her as comfortable as we could and rushed her in.
At the hospital a little later, Caroline, one of the nurses, walks out of the department to have a cigarette. Seeing us leaning up against the railings, she pauses to light it, takes a long pull, then comes over to join us.
‘So,’ she says, leaning back, draping her left arm across her stomach to support the elbow of the right. ‘At what point did you find out Rachel was a transsexual?’
‘So she is! I thought she was. But I wasn’t a hundred percent certain, and it’s not the kind of thing you want to get wrong. It was all such a rush.’
Caroline nods and taps off some ash.
‘Take it from me. Transsexual.’
She blows out more smoke and obliterates the moon.
‘Was it a bleed?’
‘Bad enough. But I’ve seen worse. They’re taking her up to neuro in a minute.’
She leans forwards, laughs suddenly, then settles back down against the railings. She smokes hungrily; the cigarette crackles. Another ambulance rolls up the slope. It flashes its lights at us.
‘At least you’ve got the excuse it was dark,’ she says. ‘I had no idea, even when I was doing the ECG. I said “Is there any chance you might be pregnant?” “It’s unlikely” she said. Then she pulled her gown up and showed me her penis. “Oh” I said. “I think you’re probably right” But honestly – apart from the package, you’d never have guessed.’
She flicks her stub away in the direction of the oxygen stack.
‘And I’ll see you girls later,’ she says, and strides back inside.