Wednesday, January 26, 2011

one thing

The late night, mini-supermarket security guard is too big for his shirt. The collar squeezes his neck so hard it seems to distort his head, like someone has taken a partially deflated pink balloon, nipped it half way and drawn a face on the bulge.
‘He was all right when he came in. Well – drunk,’ he says, rubbing his nose on the back of his hand and staring down at the man who is lying half in and half out of the doorway. ‘You couldn’t just drag his feet inside a bit, could you? Then I can shut the doors.’
The moment after we do that a small crowd of zombied clubbers run up against the glass. ‘Let us in. Come on, man. We only want a few things. It’s not eleven yet.’
The guard glares at them and gestures with his hand.
‘Piss off. Can’t you see it’s an emergency?’
They move away, but one of them stays to press her face up against the window, making a shielding bridge with her hand to see inside. Then she takes a step back, and clatters off to catch up with the others.
Meanwhile I’m attending to the patient. He lies on the floor like a washing machine tipped on its side with the door open, a prodigious mess of blood, beer and noodles emptying out of him, fanning in noxious waves across the floor and on into the store. He snores horribly, ropes of blood and what looks like wallpaper paste spattering out of his nose.
‘Tell me what happened again?’ I ask the guard as I fiddle around trying to get an airway in. I could be James Herriott in a barn; any minute now I expect to land a bloody calf on the anti-static mat, but then he vomits copiously again and feebly tries to bat me away.
The guard takes a step back.
‘Jesus Christ. Okay. Yep. He wandered in, headed for the booze aisles, obviously drunk. I politely turned him round by the shoulders and led him back to the door. We even had a little laugh and a joke. Then he seemed to stumble at the entrance, slid down the wall, passed out, and started being sick.’
‘Did he have a fit at all?’
‘You mean did he shake? No. Not that I saw.’
‘Have you seen him before? Do you know his name?’
‘No idea.’

I’m on the car, so I strip off my gloves, stand up and radio for back-up.
‘There’ll be an ambulance along in a minute,’ I tell the guard as I clip the radio back on my belt. ‘Whilst we’re waiting, I’m just going to get a couple more bits of kit. Are you all right here for a second?’
‘Yes. Yes. You get what you need, son.’
He pulls a bunch of keys out of his pocket with a silver chain, then shakily activates the door again. I’m parked right outside, so I don’t have to go far.
When I come back, the guard is arguing with a young guy who wants to go in to the supermarket.
‘I only want one thing,’ says the guy.
‘How many times do I have to tell you? We’re closed.’
‘But it’s not eleven yet.’
‘It’s a medical emergency.’
‘What emergency?’
I come up next to him and for a second there’s the guard, me with a squawking radio, the body on the floor surrounded by a lake of bloody vomit, and the guy. He looks at all three of us, hesitates, then goes to step over the body. The guard grabs him by the shoulder, hauls him back, and shoves him outside again.
‘Out you go.’
‘But I only want one thing,’ he says, then stands back on the pavement, breathing heavily, flexing and bunching his fingers, like a stunt man screwing himself up to take a long, running jump.

Monday, January 24, 2011

two plates

Vera’s sitting room is a refuge for soft toys: a child-sized bunny in pinafore and bonnet collapsed in the corner, mobbed by a hundred smaller rabbits; a teddy bear ghetto crammed into an armchair – from eyeless, older bears through to cheap, foam-filled, fairground bears, Pudsey, Paddington and a fairy bear in wings and tiara, clutching a velvet heart that reads I wuv you; a sofa devoted like a hefty, brown leather ark to every duck in a lab coat, tiger in a flying hat, monkey in a space suit, pig in a tutu or giraffe in pyjamas that had ever been stuffed, stitched and put out for sale – whilst above them all, on a special shelf set high up on the picture wall, Minnie and Mickey Mouse, toy royals waving with fixed enthusiasm to the crowds below.
Vera is sitting slumped over to the left in her own chair, her own stuffing depleted by the high temperature she has been running these past few days.
‘Do you always keep it so hot in here, Vera?’ says Frank, throwing off his jacket. ‘Even Minnie’s got a sweat on.’
Vera smiles.
‘I feel the cold,’ she says. ‘Always have. Would you like something to drink?’
‘No. We’re okay, thanks. But look – I think we need to take you to the hospital. You’ve got a bit of a fever and I don’t think you can cope here on your own.’
‘I don’t think I can, either.’
‘We’ve got a chair here for you.’
‘I’m very heavy.’
‘But look how strong we are.’
‘I can see that.’
‘Come on then.’
We help Vera into our carry chair, the air almost rippling around her.
‘You’re like a little furnace.’
‘I wish someone would put me out.’
‘Don’t be like that.’
I hold the back of the chair whilst Frank gathers her medication together and puts it into a plastic bag. Vera watches him quietly, then says:
‘Can a high temperature make you hallucinate?’
‘I think it can, sometimes. Why? Have you been seeing things?’
‘Last night I woke up, and there was a woman standing at the bottom of the bed, staring at me.’
‘What did she look like, this woman?’
‘She was very tall and elegant, in an old style Empire line dress. And she had long grey hair that went all the way down to her hips.’
‘Did you recognise her from anywhere?’
‘No. I’d never seen her before in my life. I wasn’t frightened. I was just curious. She stood there for a long while, looking at me. Then she held up two plates. Just like that – two, plain white dinner plates. Up in front of her, and smiled at me.’
‘Did she say anything?’

Frank is standing there now with the medication bag.
‘How much for these?’ he says, and places the bag on Vera’s lap.

Friday, January 21, 2011

stevie wonder

The streets are shining with all the rain that’s fallen tonight. The front desk of the police station closed at twelve, so we drive round the back. It’s bigger than you think. Once you come in off the road – slowly, checking the large reflective screens positioned high on the walls, gently across the speed humps, between the chicanes of parked response cars, vans, civilian cars and unmarked pursuit vehicles – the building rises up around you, a hulking letter C, alternating lines of long, narrow windows and yellow PVC cladding, stacked like the layers of a cake, capped with a roof of concrete icing and a cluster of aerials.

A police officer is waiting for us by the back door. He waves us into position, then comes round to the passenger door and holds it open as I climb out.

‘What it is – we sectioned this sixteen year old girl this evening. Found in the street, very distressed. She’s cut her arms up some, and then the other thing – she’s tied off her right hand with some cloth, really, really tightly and it’s looking bad. We would’ve taken her up the hospital ourselves, but to cap it all she says she’s taken some pills, so we had to call you.’
‘No worries. Where is she?’
‘I’ll take you there. Her name’s Casey.’
We follow him along a series of anonymous corridors to an interview room. He opens the door.
‘I think they just took her to the loo. Shouldn’t be long.’
‘What do we know about Casey, then?’
‘Registered as missing from a home for disturbed teenagers up country. Some previous – petty theft, shoplifting, drugs.’
Frank perches on the corner of the only table in the room. There is the sound of a slamming door and then voices approaching from further along the corridor. I move over to the window.
‘Here she is.’
He stands aside, and two, blue gloved police officers come in holding Casey upright by either arm. She has a sulky, smudged look to her, a school disco casualty in black halter neck top and crudely painted eyeliner. There is a thick stud in her lip, an agricultural thing, as if the authorities had decided to start tagging teenagers like cattle.
‘Not more police,’ she says, dragging her feet.
‘Casey, this is the ambulance. They’re here to help you.’
‘I don’t need no help. I just want to be left alone.’
Frank gestures to one of the chairs.
‘Have a seat, Casey and let’s have a chat.’
‘You sure you’re not police?’
‘Yep. Look at me. Do I look like police? They’d never have me.’
She grunts, the police officers release her arms, and she throws herself down in the chair.
Both of her bare arms are striped with cuts, some of them gaping and needing stitches. But the most compelling thing about Casey is her right hand. She has used a strip of cotton material to tie off the circulation to her hand at the wrist. The hand balloons inertly beyond the tourniquet, puce-red and ghastly.
‘Why have you tied-off your hand like that, Casey?’
‘Don’t you touch it! Don’t you come near it!’
‘I just want to know why you’ve done that.’
‘If I tell you, you won’t do anything about it, will you?’
‘All I want to do is find out what’s going on with you tonight, Casey. That’s it. That’s all I’m interested in. So come on. Why have you tied off your hand?’
She cradles it in her lap.
‘It had to be punished. It stole things. It has to come off.’ She looks up at him. ‘It’s like the Arabs. If you steal, you lose your hand.’
‘Have you hurt yourself anywhere else? Apart from your hand and your cuts?’
‘No.’
‘How long’s that tourniquet been on, do you think?’
‘You’re not taking it off!’
‘I just want to know how long it’s been on, that’s all.’
‘About two hours.’
‘Okay, Casey. Okay.’
Frank stands up. He turns his back to Casey and looks at me intently, quietly slipping out a pair of shears from an inside pocket and handing them to me.
‘It’s coming off,’ he whispers. I nod.
He turns back to Casey and we both walk quickly over to her.
‘What are you doing? Fuck off.’
‘You’ll lose your hand, Casey. I’m sorry, darling, but the bandage is coming off.’
‘No! No! Don’t! Please!’
He has hold of her shoulders. I’m standing close in now so she can’t draw up her legs and kick me. The other two police officers hold her arms. She wrests beneath our control so violently it’s difficult to cut through the tourniquet without hurting her, but somehow I manage to work my way through the layers of material; one final cut, and it springs apart. We all relax our hold; she cradles her arm to her chest, crying and catching her breath in great, wretched sobs.
‘You promised! You promised you wouldn’t!’
‘I didn’t promise, Casey. I’m sorry we had to do it, but we were worried about your hand.’
‘I don’t want it.’
‘Sorry, Casey.’
Over the next few minutes she gradually regains control of herself. Frank speaks to the police officers about arrangements to take her to hospital.
‘I’m not going,’ she says. ‘Forget it.’
One of the police officers kneels down beside her.
‘Casey? You’ve got to go to hospital and that’s the end of it. You have two choices. Either you go with these ambulance guys, or you go in the back of a horrible old police van. That’s just the way things are. So – what’s it going to be?’
She thinks for a second, then slowly raises her eyes to look at me.
‘I’ll go’ she says. ‘But not with him.’

***

Outside, there has been a fresh shower of rain and the night seems colder. I walk on ahead of the group and make the back of the ambulance ready. As they approach, I make sure I’m out of the way as Frank and the police officer with Casey between them climb inside. I slam the door shut and go round to the driver’s side of the cab. When I turn the engine over, the radio comes on: You are the sunshine of my life.
I call backwards over my shoulder through the partition window.
‘Ready to go?’
‘Yeah, mate.’
I check the mirrors and turn the wheel.

Thursday, January 20, 2011

in the garden

Mrs Givens points to an empty parking space, then stands respectfully on the pavement as we climb out of the ambulance.
‘Thanks for being so quick,’ she says.
Her neighbour and friend, Mrs Hutchens, stands across the way, by the side entrance to number four, a stone tub of lavender between her and a little black metal gate; she smiles and nods as we walk across, swinging the gate open then making a sweeping invitation through it with her other hand, like an usher at an outdoor event.
‘He’s in the garden. We couldn’t get him up.’
The two women tuck in behind us along the narrow path that leads round the back. We pass a large green plastic storage bin, the lid propped open, a stock of gardening equipment neatly cleaned and stored away inside.
‘So what happened?’
‘It’s such a problem. We’ve tried to get things sorted.’
‘He’s so independent.’
‘Stubborn.’
‘He won’t accept any help.’
‘Turned away umpteen carers.’
‘They’ve never been good enough.’
‘His family are spread all over.’
‘Miles away.’
‘Never puts his hearing aid in.’
‘The telly’s on all hours, top volume.’
‘You can’t hear yourself think.’
‘We’ve tried everything but he just wants to be left alone to get on with it.’
‘Now look.’
Mr Richardson is lying on his side in the middle of the lawn. He is propped up on his right arm; with his left, he reaches feebly into the air, straining his head up, too, like a giant tortoise collapsed on its side, defeated, but sensing change.
‘He’s ninety four.’
‘We couldn’t get him up.’
Frank squats down beside him and assesses the damage.
‘How long do you think he’s been on the ground?’ I ask Mrs Givens.
‘I came back from work and I was upstairs getting out of my things when I though I heard someone calling. I looked out of the window and that’s when I saw him. He’s been out doing the gardening again. We’ve told him to be careful, but he just can’t help himself.’
‘So how long, do you reckon?’
‘Two hours? Maybe more.’
Mr Richardson is cold and wet, but otherwise uninjured. We need to get him warmed up as soon as possible, so we help him to his feet and walk him slowly out to the truck. Once he’s on board, the heater on full and his jacket and cardigan off, we wrap him in blankets, looping one over his head.

Whilst we check him over, Mrs Givens comes back with a tray of tea and shortbread biscuits; Mrs Hutchens has all Mr Richardson’s medications in a cracker box. She hands it up to Frank, then goes off to try to find some contact numbers. Mrs Givens takes a seat in the back, and we all sit around him, sipping our tea and discussing the situation. Frank helps Mr Richardson drink from his cup. He has to speak loudly and support his words with little mimes to make himself understood.
‘Where are your dentures? Your teeth?’ He tugs at his own. ‘I’d give you mine but I need them later. You’ll just have to dunk your biscuit,’ he says. ‘Dunk it.’
Mr Richardson shakily dabbles the biscuit in the tea, then slowly raises it up to his leathery mouth, gumming it unproductively, like a baby with a rusk. But when he lowers it again he makes appreciative smacking noises, and his faded gray eyes crinkle up. He tries to speak, but the words are thin and drawn together, an abstracted, strangely musical sound, like an ancient wizard chanting fragments of a spell.
‘Sorry Mr Richardson. I can’t understand what you’re saying.’
He reaches out from under the blankets, his hand a mottled, brick-red colour, the heavy nails rounded and pale; his touch is so cold it’s as if a garden statue had come to life and touched me on the hand.
‘You’re a little what, Mr Richardson?’
He repeats the phrase; it’s only by relaxing and letting the sound wash over me that I get it.
‘Little Lord Fauntleroy?’
He nods and smiles – then something else occurs to him, and he leans forward again. I have to grab the cup before he tips the tea in his lap.
‘You lost your glasses when you fell? He lost his glasses when he fell. I’ll go and see if I can find them.’
I step back outside the ambulance. The evening has moved on; the sky is indigo blue and the air is cut with frost.
Mrs Hutchens comes out of the house.
‘I’ve got those numbers,’ she says.
‘Thanks. I’ve just got to go round the back and look for his glasses.’
She heads over to the ambulance. I walk through the gate again, click on my torch and retrace our steps.

I close the lid to the equipment store as I pass.

The path leads me through to the back garden. The beam of my torch picks out the scene: a darkening muddle of shrubs and trees around the perimeter, cold frames at the foot of the wall, a bird bath, an upturned wheel barrow, the little pile of leaves he raked together before he fell, a tipped, white metal bench, a garden rake and a pair of open shears – and there, glinting dully in the torchlight, a pair of silver framed specs. I walk over to pick them up. Suddenly, from somewhere in the woods beyond the wall, the urgent craik-craik-craik of a pheasant. It cuts through the silence as I swing the light in that direction, moving quickly away, out into the growing deeps of the night.

Monday, January 17, 2011

what patty says

The business fuss of our visit is over. Nell has refused hospital despite everything, every threat, blandishment, trick and treat we know. The carer has gone, Nell is propped up on a dozen rotten pillows contentedly spooning a yogurt. Frank is on the phone in the sitting room talking to the out of hours doctor.
I look round the room.
‘Where are you from originally, Nell?’
‘Liverpool. I’m a scouser. D’you know what? When my sister Patty rings, she says “Are you okay, our wack?”
‘Our wack. I like that.’
‘She’s always said it.’
There are several photographs, framed or otherwise, spread across the walls. I point to one, a luminously pretty woman in a tightly buttoned uniformed, her lipstick mouth in a formal forties cupid. She has tried to control her hair, but it still looks as though someone filled her cap with springs and then dumped it on her head.
‘So is this you in the uniform, Nell?’
‘Is this what?’
‘Is this you during the war?’
‘WRAF, Carlisle. Nineteen forty two.’
‘Very smart.’
‘I went all over the place. Norway. Sweden. London.’
She points at me with the spoon.
‘Intake, compression, power, exhaust.’
‘What’s that then?’
‘I was a mechanic. I fixed the trucks. They said to me “Nell, what do you know about the workings of it all?” And I told them. Intake, compression, power, exhaust. The internal combustion engine. In a nutshell.’
She hangs on the memory for a moment, then dives back into her fruit corner.
‘Did you do it after the war?’
‘Wha’d’you say?’
‘Did you do it after the war? Mechanics?’
‘I was Head Usherette at the Hippodrome. See that one there?’
‘This one?’
‘That one there. He came and sang there once and he gave me that.’
‘He’s a fine looking feller.’
‘He’s a fool. He had a sack of them. Everyone got a picture, whether they wanted one or not.’
Frank comes back into the room.
‘The doctor says you’re to come to hospital with us, Nell.’
‘Well the doctor can mind her own business.’
‘You’re not yourself.’
‘There’s nothing the matter with me. I’m not going to hospital, and you can’t make me.’
‘You’re right there.’
‘I just want to be left alone.’
She scrapes round the yogurt carton then chucks it to the side.
‘That’s me Dad,’ she says, wiping her mouth on her cardigan then pointing at the wardrobe. For a moment I think Poor Nell. She really is confused. But then I realise there is a framed picture of a man on the very top of the wardrobe, the top edge of the frame almost touching the ceiling.
‘Lovely.’
Frank rearranges the pillows behind her.
‘Have you got everything you need, Nell? Can we make you a tea?’
‘No thanks.’
‘Nell - the doctor says she’s coming straight over to have a word. We’ll wait in the sitting room till she gets here.’
‘Righto. But I’m not going to the hospital.’
‘Talk to the doctor about it.’

We go next door, into a low-ceilinged room sparsely furnished with a display cabinet of dusty trinkets, a TV, a threadbare Ercol settee and coffee table, everything strewn with toffees, celebrity magazines and random scraps of paper. One of them has shaky handwriting covering one side, notes that Nell had obviously made for a letter to a newspaper: I fought for my country, she writes. This green and pleasant land, so called. And now what do I see out the window? Students marching in the street because they can’t go to college because the government won’t give them any money. I never had the chance of an education so I got it where I could and that was that and I don’t complain. But I didn’t go through a war just to see kids not given a fair chance. Something must be done. This old woman supports the students.

There is a photo book there too – A Day in the Life of Norway. The cover shows a young couple sprawled on a grassy bank beneath a pine tree. The girl is smiling as the boy points something out across the fjord. Behind them, two tethered horses are grazing – except for some reason the horse in the foreground is arching its back and neck, its mouth wide open, just as if it were about to be sick all over the boy. I show Frank.
‘What the hell is this one doing?’
‘I don’t know, Spence. A hairball.’
‘Why would you put a picture like that on a book about Norway, Frank?’
‘They’re trying to tell you something. Norway’s all right if you go by bike.’
Suddenly Nell shouts out from the bedroom. We both go back in.
‘I need the loo.’
‘Okay mate.’
We help her up. Even with her stick she wobbles about.
‘Are you okay?’ I say. She stops, plants herself as firmly as she’s able, and looks right at me.
‘You know all that business about Wayne Rooney? You know what Patty says?’
‘What does she say?’
‘She says if I was his wife I’d cut his nob off.’

Saturday, January 15, 2011

fire family

The hollow zone between late and early, and the streets are deserted. We keep our sirens off. Gradually, a growing fuzz of blue in the distance. As we approach it, I feel the low thrum of fire trucks shaking up the houses and flats either side. We come to a stop, and the lights of our vehicle add to those already there, racing across the faces of the people standing behind the cordon, evacuated from the block, or drawn outside to witness.

A Fire fighter in a white tabard waves us over.

‘So. Gentlemen. Three casualties. Two adults, one baby, exposed to quite a high level of smoke. Especially the adults – their faces are pretty black with it. The baby doesn’t seem too bad. They’re all on oxygen up in that cab.’
‘What was the fire like?’
‘It looks like an oven went into meltdown with a plastic kettle on the hob. Quite a bit of toxicity there, I should think. But not much flame, and no burns.’
‘Great. Let’s see them.’
He leads us up to the foot of the cab, its door standing open, and points up at the occupants.
‘That’s Rachel, the baby’s Mae or Rae or something, the man’s called Mick.’
‘Thanks. Hello.’
Rachel is sitting with the baby on her lap in the passenger seat, an oxygen mask between the two of them. Rachel’s face is sooty and black, with circles of pale flesh around each eye like graffiti glasses. Mae’s face is clear, except for a few black finger marks across her cheek. She wriggles about on her mum’s lap; when she sees me, she stretches out her arms as if she’s suddenly ready to fling herself out onto the night.
‘Whoa there squirrel,’ says Rachel, tightening her grip round Mae’s waist. Then laughs at me: ‘She’s a real stunt baby.’
‘Pass her down and then let’s all go to the ambulance. We’ll treat you there.’
She hands Mae to me, kicking and wriggling, then climbs out backwards unsteadily. Her partner Mick follows, looking as blackened and blasted as a miner climbing out of the pit after a long shift. Whilst Rachel is chatty and alert, Mick almost falls asleep on the short walk to the ambulance.
‘Are you okay?’ I say, poking him in the shoulder.
‘Wha? Oh. Yeah. Just tired, me.’
His eyes begin to close again and his chin drops.
‘How long were you exposed to the smoke, Mick?’
He doesn’t answer. We almost have to walk him up the steps. I sit him on the trolley and the woman with the baby on the chair facing. As soon as his legs are up, he lolls his head back and falls asleep.
‘Hey. Wake up,’ I say to him. ‘What’s the matter?’
Rachel leans across and pinches his arm.
‘It’s the baby. Keeping him up. He’s tired out.’
‘Is that what it is, Mick? Is that what’s making you so drowsy?’
‘Wha?’
‘Open your eyes for me, mate. Open your eyes.’
I have to open them for him. The pupils are constricted.
‘Mick? Have you been using tonight?’
I pull his oxygen mask away from his face so I can hear what he has to say.
‘Wha? No. I’m just sleepy – from the baby. You know.’
‘Sure?’
‘Yeah. I had some vallies yesterday. Tha’s it.’
He immediately nods back onto the trolley; I put the hissing mask back onto his face.
As I’m writing down some obs Rachel jiggles Mae up and down on her lap.
‘He was supposed to be making me something to eat,’ she says finally. ‘Something hot. He must have forgotten he put the oven on.’
‘Right.’
‘We won’t have to go to hospital will we?’ says Rachel, jiggling the baby up and down on her leg. ‘It’s not that bad, is it?’
‘It could be. All that stuff on your face – you were breathing it in as well. Who knows what’s in it.’
‘It’s just smoke.’
‘Still.’
‘She’ll be all right though, won’t she?’
‘Was she in another room?’
‘Yeah.’
‘That’ll help, then. Sooner we get off, the sooner we’ll all feel better.’
‘Okay then.’
Rachel fumbles around behind her for the seat belt.
‘Look at me,’ she says. ‘I’m still in my underwear.’
‘Never mind about that.’
She pulls the red chenille dressing gown more snugly around her shoulders, then kisses Mae on the head. I give Frank the nod to go.

**

Outside the resus room, we’re cleaning up the trolley when one of the nurses comes out with a clipboard.
‘Were you the crew that brought in the fire family?’
‘Yep.’
‘What was the situation?’
‘Mick was supposed to be cooking but forgot what he was doing and left the oven on.’
‘What was your impression of him? Has he had some heroin tonight?’
‘I think so. He’s grouching out all over the place.’
‘So maybe a child protection element, then?’
‘Rachel seems all right, but who knows.’
‘Okay. Thanks.’
The nurse goes back into resus. As the doors swing apart I catch a glimpse of Mae sitting on Rachel’s lap, with Mick flat out on a trolley behind them. As the nurse walks over, Mae laughs, jerks up into a stand, throws her arms wide, ready to fly through the air into his arms. The doors swing shut again. I wheel the trolley outside.

Friday, January 14, 2011

land of the great anglo saxon kings

With his vast belly, exuberant white beard and rumbling laugh, this could be Father Christmas relaxing on the sleigh after a tough night – except his chest is stuck with ECG dots, his arm in a blood pressure cuff, his finger in a SATS probe.
‘Do you drive the ambulance?’ he says, squinting at me from beneath a tangle of eyebrows like a frosted hedgerow. ‘Or do you always get to sit in the back with old farts like me?’
‘We change round at the hospital.’
‘Do you? Ah. Well that makes for a more interesting day, then.’
‘It breaks it up.’
‘Ah.’
Outside the road hisses wetly.
‘I should think it’ll take us half an hour to get there.’
‘More like an hour, this time of night.’
‘You could be right.’
‘I know I could be right. I could be wrong, n’all.’
I finish writing up the notes, unwind the cuff from his arm, take the probe off his finger and settle back into the seat. We are taking Mr Carrington back to his original hospital, post op. He seems well enough, comfortable, chatty. He smiles at me.
‘Like what you do, do you?’
‘Yeah, often. It’s like any job. It has its ups and downs. Mostly ups.’
‘Good. Good.’
‘What about you? I suppose you’re retired now?’
‘Had to, ‘cause of me health. I’d have carried on if I could, but events, you know. They overtake.’
‘Sorry to hear it.’
‘I’m sorry to hear it, n’all.’
‘So what did you do?’
‘I did my National Service, discharged, called up again for Suez. Got made a sergeant, five pound a week, good money in them days. Should’ve stayed on after that, but my wife wanted me home, so I got a job as an auxiliary nurse and did that on and off forty years until my heart attack.’
‘That’s pretty good going.’
‘Not bad. I should’ve been a nurse, but I never had the writing.’
‘There’s a lot of that.’
‘I can see. I don’t envy you.’
He folds his fleshy hands over his belly and closes his eyes. After a while I think he must have fallen asleep, but then he opens his eyes again and stares up at the ceiling. The ambulance sways and rattles.
‘My first wife died after ten years,’ he says eventually. ‘Never did know why.’
‘Oh.’
‘Lived on my own for a bit, married again.’
‘That’s good.’
‘She died after eight years.’
‘Oh no!’
‘Cancer.’
‘That’s hard.’
‘It was hard. I’ve lived on my own ever since. Not that I mind it, really. I get to do what I want, when I want. Which isn’t much. Fishing’s my thing. I like to get out. But these legs, you see. They’re not what they were. I used to be able to skip over a fence and not break wind, but now, getting into bed’s like climbing the bleedin’ Matterhorn.’
‘They do look swollen.’
‘Still get out down the Quay, though. I ride my scooter out with all my rods, set up there, lovely. Mackerel and what not. An easy fish to gut, mackerel. Hungry man like you, two of them would be a meal. All beautiful and crisp from the fire.’
‘I used to go fishing with my Dad. Down by the river, opposite the brewery. We’d watch the swallows swooping over the water. It was beautiful. We didn’t catch all that much. Dab, roach. Mostly eels.’
‘Eels is good eating. Fried up in a pan with a little oil and garlic. Lovely.’
‘We never ate them. Seemed a shame. ‘
‘Fishing’s good for wildlife. I had a kingfisher perch on the end of my pole once. What an animal. I do not have the words to describe the colours of that bird. Wouldn’t know where to start. Sparkling blues. Orange. Incredible.’
We both fall silent, and the sounds of the ambulance’s progress along the road dominates the space again. After a while he turns his massive head and looks at me.
‘Where was that? Where you fished?’
‘Cambridgeshire Norfolk border.’
‘Oh. Lovely. Lots of wildlife there. The salt marshes and dykes. Bitterns out on the Fen. You’d see it all there. Me, I’m from Essex.’
‘I don’t know Essex, but I went to Sutton Hoo once. That was great.’
‘East Anglia. Essex, it’s all the same. They’re the places. Land of the Great Anglo Saxon kings.’
‘Fantastic.’
And he folds his hands across his belly again, and closes his eyes, as the ambulance slows and turns into the hospital, and comes to a halt by the main entrance, ready to unload.

Thursday, January 13, 2011

blocked

Lou is sitting on the bottom step, forearms resting on his knees, hands slack, head bowed, in the posture of a man waiting for an axe to fall. His wife Belle is so frantic, when we come in through the open door a more terrifying version of her seems to tear itself from her body and come running up to us. But she stays where she is, gently combing the sweated hairs of his head with trembling fingers.
‘Hang on, Lou. Hang on.’
Frank turns me straight back out to prep the vehicle and fetch a chair. Outside the chill night air is heavy and damp; the red terracotta tiles are mined with snails.

We help Lou onto the chair. His face looks like a waxworks mask left outside for a year, deeply lined, grey and deathly. He groans through the oxygen mask.

Attached to the ECG machine and the tracings reel off what we expected to see.
‘Oh God. Is it bad?’ says Belle, frantically pulling a mobile phone out of her bag, then putting it straight back in again. ‘Please God don’t let it be bad.’
‘Lou? I’m afraid it does look as if you’re having problems with your heart,’ says Frank, handing me the strip. Belle is so abstracted with anxiety she almost stuffs herself into the bag after the phone. I manage her as positively as I can whilst helping Frank go through the protocols for MI. In a matter of moments I’m driving off to the Cath Lab, our blue lights turning and dancing in the fog.

***

The Cath Lab is a brisk, bright environment. Despite the late hour a PCI team is already assembling, shuffling into the pre op room in their rubber sandals, looking as crumpled and comfortable as their loose red scrubs, cheerful, rough about the edges, like a hockey team meeting for a pre-match rumble in the changing rooms. Lou sits up on the trolley, dizzy with the pain and pace of events. Twenty minutes ago he was sitting on the bottom step of his house, asking his wife to call the doctor; now he finds himself magically transported in the same passive posture, to a strange white place bristling with clinicians, reeking of cleanliness, stripped and gowned, as a seemingly teenage registrar smiles through a list of death and disability. His wife sobs, her arm around Lou’s shoulder. Eventually a nurse lets her kiss him goodbye, then leads her away to the relative’s room.

We take Lou through into theatre and help load him on the trolley. The team divides into those who will do the procedure and those who will monitor from behind the big glass control screen with its banks of computers. From behind the screen we watch as they cover Lou with sheets of blue paper, and swing a large white metal gantry elegantly into position around him.
‘Keep your hands to your sides now, Lou,’ says the Registrar, efficiently prepping the catheter and introducing equipment. ‘This area is sterile.’
The Radiographer begins hauling on her heavy green protective apron, waistcoat and neck guard, like a clinical marine going into combat. ‘Lead up boys. Unless you’ve had the snip, I don’t know. Maybe you don’t care about this stuff.’
‘I’m allergic to babies.’
‘They’re bad for your wealth.’
‘Put some music on. Pronto.’
One of the ODPs pulls a box of loose CDs out of a cupboard and after shuffling through them like a pack of cards tosses the others back and sticks his choice into the system. Seconds later ABBA fills the room, Dancing Queen.
‘Are you gay?’
‘Bi-curious.’
‘Bi-polar.’
‘God – where d’you get this junk from?’
‘It comes free with the pizza.’
‘Hey! Pizza. Call out for pizza. Pronto.’
‘I’ve got pepperoni-itis.’
‘Stop the clock, people.’
‘We haven’t started yet.’

The theatre doors swing open again and the consultant hurries in, breathing hard.
‘Sorry. The route the taxi took was blocked for some reason. How far have you got?’
‘Just in now. You should be getting it.’
‘Well it would help to have the pictures up. Can we get the pictures up, please?’
‘Oops.’
As the consultant unbuttons her gilet and unwinds the flowery silk scarf from her neck, the screen fills with the lucent picture of Lou’s beating heart. The harder, synthetic line of the catheter stands out as it gradually works in from the top. Every so often a puff of marker fluid picks out the delicate blood vessels, the major and minor vessels, tributaries and bifurcations, elegantly branching arterioles like the whorls of a pea plant.
‘Right coronary. I’ll scrub up and we’ll get going,’ she says, then turns to me and Frank. ‘Sorry,’ she says. ‘Hello. I’m Emma, the consultant. Thanks for bringing us the patient. Nice to have you in to watch.’
She hurries out – and before we’ve had a chance to point to a couple of things on the screen and ask the significance, she bustles back in scrubbed up and ready to go, so quickly she must have stripped and changed in the corridor.
‘Good God,’ she says as she takes her place at the table and picks up her instruments ready to begin. ‘Who the hell chose this music?’

Wednesday, January 12, 2011

interesting prescription

Maude is sitting hunched and watchful in her seat like some kind of geriatric astronaut. The armchair, an ancient piece of furniture perfectly moulded to her shape, has all the necessaries to hand – cup and saucer, Tupperware of biscuits, box of tissues, emollients, blister packs, inhalers and eye drops, remote control and TV guide – heaped around her on a put-you-up table and breakfast stand, her puffy legs propped up on a battered old brown leather pouffe.
‘Wait a minute,’ she pants. ‘Just a minute.’
‘You’re breathing’s bad today, Maude.’
‘I’m not going to hospital.’
‘And the carer says you’re not really yourself.’
‘I’m what?’
‘Not really yourself?’
‘Well who am I then?’
‘A bit confused.’
‘I’m not going to hospital.’
I stand up again.
‘She’s pretty clear about it.’
The carer, a vigorously empathetic woman in red ski pants and a fried mass of crimped, crow-black hair, squats down in my place. She rubs Maude on the arm.
‘Come on chuck,’ she says. ‘We’re worried about you.’ But she sneaks a look back up at me. ‘Everyone but the son. What a piece of work.’
‘I’m not going to hospital,’ says Maude, levitating with outrage. ‘You can’t make me.’
‘No. We’d be arrested for kidnap,’ I tell her. ‘I’ll get the doctor over instead. Maybe she can persuade you.’
‘No.’
‘I’ve just got to do the paperwork.’
Maude settles back into the chair again, and after a moment begins rooting through the piles of stuff around her.
‘What are you looking for, Maude?’
‘I want my bisexuals.’
‘Your what?’
‘I’m not signing till I’ve read it through properly, and I can’t read a thing without my bisexuals.’
The carer looks at me and smiles.
‘She’s not herself,’ she says.

Saturday, January 08, 2011

whatever

The housing estate feels so desolate it may as well be swept by searchlights. What light there is – from the hundreds of tiny halogen dots marking out the landings and aerial walkways; the rows upon rows of dimly lit windows or darker, curtainless rooms flickering grey and blue by the TV; the emergency lighting globes guarding the stairwells, and the hard spikes of orange light thrown down from the street lamps – all these things join together, point through point, like a pattern of lines on a star chart: sink estate, in the Constellation of Despair.
‘Over there.’
Frank pulls the ambulance to the side. Over on a patch of grass between two buildings, a figure sprawled, another standing over him, on the phone. We hurry up the steep bank towards them.
‘What’s happened?’
‘What d’you think? He’s had the shit kicked out of him. I didn’t see nothing.’
The man on the floor is unconscious, breathing with the stertorous rattle of the deeply unconscious. The side of his face is grossly misshapen, both eyes swollen shut; his right arm is bent mid-humerus, and his legs splayed. Despite the freezing night, he is only wearing a t-shirt and jeans, his trainers torn off and thrown against the wall. His body is profoundly cold to the touch.
‘We’ll need back-up, Frank. Can you get that running, and bring up the spinal board and stuff?’
‘Right.’
Frank strides back down the bank, talking into his radio.
‘What’s your friend’s name?’
‘He ain’t no friend.’
‘Do you know what his name is?’
‘Stu.’
‘And what’s your name?’
The man smiles.
‘Er – let’s say Bill. Yeah. Bill.’
‘Bill – Thanks for calling us. We’re going to need your help.’
‘Sure. Whatever. I don’t care what I do. Not like those cunts up there,’ he says, thumbing the air behind him. ‘They couldn’t give a shit. Leave him, they said.’
‘Bill – You did the right thing. I don’t care what you have or haven’t done tonight. How you help us now is all that matters.’
‘Whatever.’
He points the phone at the figure on the ground. It looks as if he’s about to take a picture.
‘Bill – you can put your phone away now. Frank’s coming up with the stuff and we’re going to need you to help us get Stu packaged up double quick. Is that okay?’
‘Yeah, man. Hey - this is good.’
Frank drops the gear next to us.
‘They haven’t got anyone to back us up. We’re on our own.’
‘Great.’
‘Police should be here any minute.’
‘Excellent.’
Bill straightens up.
‘Whoa! What d’you mean, the police?’
‘It’s an assault, Bill. They have to come.’
He hesitates, looks back up to one of the flats, then out along the road. For a second I think he’s winding himself up to run, but he relaxes again and squats down beside Stu.
‘Whatever,’ he says.

Thursday, January 06, 2011

jasper

I glance over the notes that Control send through, but I hardly need to. We’re both very well aware who Jasper is.
The radio buzzes.
‘Sorry guys. We tried to deal with this one our end, but he started speaking in riddles, so we had to pass it to you.’
‘Yep. No worries. We like a good riddle.’
‘Control out.’


The last time I saw Jasper he was roaring like an outraged banker, face down in the A&E car park, Geoff the security guard sitting on his legs. Geoff had waved pleasantly as we parked, comfortable enough. Apparently Jasper had attacked one of the nurses with his stick – an ineffectual attempt, but unpleasant nonetheless - and then run off. Geoff had rugby tackled him just before the ramp.
‘So much for the Parkinsons or whatever it is he claims to have.’
‘Munchausens’
‘Bless you.’
Frank pulls up outside the address.
‘Here we are then. This should finish us off nicely.’

There is a finely needled drift of rain in the air; a Christmas tree lies next to a shining black paladin, one red bauble and a few scraps of tinsel hanging from its branches, as if the thing hadn’t been dumped so much as jumped out of the tub and run away. The whole street has a post-event feel; the half-drawn blinds of the house make it look hung-over.
Jasper lives in the basement, down a dark and precipitous drop of stairs.
‘Just right for a patient with mobility problems,’ says Frank, clicking on his torch.
‘Let’s get this over with.’
I knock on the door – a scarred and battered affair with the number painted on in black with a decorator’s brush. I ring the bell, too. After a long pause, I knock again.
‘He’s working on his laptop,’ says Frank. ‘I can see him through the curtains.’
I bang on the window.
‘Yes? Who is it?’
‘It’s the ambulance, Jasper. Can you open the door please?’
‘But I called to cancel. Look this is simply ridiculous. Are you sure you need to see me?’
‘Well you rang to say you had chest pain. Is that right?’
‘Yes, I do have chest pain, but look – this is outrageous.’
‘Are you saying you don’t want to see us? Because that’s fine, Jasper. We just need you to sign our paperwork.’
‘Oh for goodness sake.’
He carries on talking, a bitter and bothered kind of mumble, but the shadow behind the curtain finally draws back and we can’t hear anything else. Eventually we hear a shuffling coming towards us along the hallway, and the door opens.
‘What do you want?’
‘Hello, Jasper.’
‘Hello.’
He stands swaying in the gloomy light from the hallway, immaculately dressed in a formal white shirt and dark trousers, and a pair of slip on shoes with fancy silver buckles. In his right hand he clutches an ornate black walking stick and a plastic yellow grabber. His face is doughy and unremarkable, with an affronted hang to his eyes and mouth, like a sulky child called in too early.
‘How are you feeling?’
‘How am I feeling? How do you think I’m feeling? I’ve got excruciating pains in my chest. I can’t breathe. My doctor couldn’t care less. I’ve got business to attend to and now this. What did you want?’
‘If you’ve got pains in your chest, Jasper, you should let us check you out.’
‘Check me out? Whatever do you mean?’
‘You should come up to the ambulance and let us do an ECG. And really you should come up to the hospital to see a doctor.’
‘This is ridiculous.’
‘But you don’t have to do any of that if you don’t want to. It’s a free country. Sign the paperwork and we’ll leave you alone.’
‘Oh – come in, then. If you must.’
‘You only need to get your keys, wallet and a jacket, Jasper. Then we’ll go straight back out to the vehicle.’
‘But can’t you do all your checks here?’
‘We can form an impression of what’s wrong, but the only definitive way to rule out any heart problems is to come to hospital for a blood test. I’m sure you wouldn’t want to risk anything happening tonight.’
‘No. Of course not. But they all hate me up at the hospital.’
‘I’m sure they don’t.’
‘They’re all tenants. They’ve all got their little axes to grind.’
He shuffles back along the corridor and I follow reluctantly.
‘Just get the essentials,’ I say.
‘Don’t rush me,’ he snaps over his shoulder. ‘I’m not so sure this is a good idea. I don’t know what you think you’ve got to achieve by making me do all of this.’
Frank loiters in the hallway. Above him, a tangle of electrical wires and heating ducts run exposed along the top of the wall; the flat feels half-finished, an abandoned project. Inside, Jasper is living in one room, an unmade double bed in the centre, a pine kitchen table over by the window covered with letters and magazines, a laptop whirring in the middle of it all.
‘It’s not my flat,’ he says, rootling around in the paperwork. ‘Excuse the mess.’
‘Just your keys, phone and some money for a cab home,’ I say, checking my watch.
‘Just a minute, just a minute,’ he says. ‘Now. Where are my cuff links?’
As he dresses he huffs and sniffs; now and again he seems to stagger – an unconvincing detail, like a poor actor forgetting his limp.
‘How’s that chest pain?’
‘Like I keep telling you, it’s absolutely crushing. I can’t breathe, I feel sick.’
‘All the more reason to come to hospital.’
‘Yes. Yes. Look. Could you hold these, please?’
He dumps into my hands a Blackberry, a glasses case, a packet of chewing gum, five pounds in loose change and a letter from his doctor. Frank smiles at me and delicately extracts the letter.
‘It says here you refused an ambulance yesterday, and ignored the doctor’s advice to go to hospital for investigations.’
Jasper tips his head back and with his eyes half closed seems to sniff the air, like a snake exploring the size of a mouse by the heat it gives off.
‘Well that’s my useless doctor for you,’ he says finally. ‘What does she know?’
‘You don’t have to come with us,’ Frank says, placing the letter carefully back on my precarious pile. ‘You’re perfectly at liberty to refuse treatment.’
But Jasper has found his cuff links. He snaps them on expertly, then swings his jacket over his shoulders.
‘Let’s go,’ he says. ‘You first.’

Monday, January 03, 2011

pauli

‘There’s no reply from number sixteen, but there is a key safe just round the corner. We wondered if you had the number for it.’
‘Stand by.’

I tap the radio aerial in the centre of my forehead waiting for the call back, idly watching my feet as they shuffle a hundred miles or so beneath me on the pavement. Frank yawns noisily, slapping his arms to warm up, like a restless yellow bird, dreaming of migration. It’s not that cold – all the snow has melted and gone - but at three o’clock in the morning your fire burns dangerously low and anything can put it out – the dismal fall of light from a streetlamp, the shadowy recess of a door.
‘834?’
‘Go ahead.’
‘Ring seventeen, eighteen or nineteen and ask for Pauli.’
‘Seriously? It’s three o’clock in the morning. You want us to ring every bell in the block?’
‘Seventeen, eighteen or nineteen. Ask for Pauli.’
‘Thanks for that.’
‘Control out.’

I re-holster my radio like a dumb-ass gunslinger, then reach out and press seventeen. Pause. Then eighteen. Pause. Then nineteen. I’m just pressing seventeen again when the door suddenly buzzes open. I drift through the magical opening, and Frank floats along in my wake.

The lobby is a chlorinated blue lino vacuum of institutional living. We ride up the stairs on the steely clean stink of it all.

Number sixteen is locked, of course. Shawn is on the floor, so how would he open it? I bend down, open the flap of the letter box and peer through.
‘Hello? Ambulance?’
A voice from somewhere inside.
‘I’m on the floor.’
‘Where can we get a key?’
‘I’ll let you in.’
‘How?’
‘I’ll shuffle along the floor. Just a minute.’
Then I hear him carrying on a conversation.
‘Shawn? Are you on the phone?’
‘Yeah. The ambulance.’
‘Well tell them we’re in. We made it inside. You can put the phone down now. Just concentrate on getting yourself to the door.’
‘They’re telling me to hang up.’
‘Just hang up.’
‘Right. Right. Okay.’
‘Shawn?’
‘What?’
‘Just hang up.’
But he carries on talking on the phone. I straighten up and let the flap of the letter box spring shut again.
‘I’m not getting this at all,’ I say to Frank, who’s standing with his arms folded and his eyes shut, leaning over at an unnatural angle.
‘Mm?’
There is the sound of shuffling and puffing from behind the door, like a huge seal making its way across an ice flow. I sigh, bob down and lift the flap again. In the dim interior of the hallway I can make out Shawn’s bulky shape dragging itself towards me.
‘I’m coming,’ says Shawn. ‘Won’t be long.’
‘Are you hurt, Shawn?’
‘Me? No.’
‘But you can’t get up?’
‘What do you want me to do now?’
‘Shawn? Hang up the phone, mate. We’re here now. It’s only complicating things.’
‘I’m dragging myself across the floor.’
I stand up again. The door to number eighteen suddenly opens and a huge black man is there, staring at us with bulging eyes veined red with sleeplessness. He doesn’t say anything, but slowly scratches his chest and stares, his plump mouth hanging open, his hair so dishevelled it would take an industrial team a week to bring it under control.
‘What the fuck you doing?’ he says at last, the recoil from that fuck tipping his head back a foot.
‘Pauli?’
‘Yeah, Pauli.’
‘Shawn’s fallen over and we need to get in.’
Pauli doesn’t blink for a full year. The hallway is silent, save for the dragging sounds behind the door, and Shawn’s endless prattling on the phone.
Eventually it comes back to me – our mission – what I needed, what I wanted. I came here to do something.
‘I don’t suppose you have a key?’
Pauli grunts, and suddenly what looks like a joke key appears in his hand. His huge feet slap on the lino as he comes across to open the door.
‘Thanks.’
But he’s gone before Shawn has even acknowledged that the door stands open.
‘Oh. Hi guys,’ he says, beaming up at us and breathing hard. ‘I was watching Air Wolf and I fell out the chair.’

Saturday, January 01, 2011

guttering

Mrs Ellery slowly descends on the stair lift, an enamelled Chinoiserie walking stick propped between her legs, her hands resting on the handle, her face as set as her hair, her gray eyes counting down the pastoral scenes on the opposite wall. Her husband William, a loose affiliation of braces and whiskers, stands to attention at the bottom of the run with a coat and hat, carrier bag of prescription medicines, toiletries and a crook to his back from the weight of it all.
‘Have you got everything?’
‘It’s all here. I think.’
‘What about the doctor’s letter?’
‘Oh.’
He shuffles off into the kitchen as the chair judders to a halt. We help her dismount.
‘Is it cold?’
‘The snow’s gone.’
‘Well.’
Mr Ellery hurries back in.
‘The letter!’
‘Let’s go.’
‘Just a minute.’
She swaps the stick from one hand to another, then raises her chin as magnificently as a prisoner being led to the firing squad.
‘Onwards.’

**

I wave goodbye to Mr Ellery and slam the ambulance door shut.
Mrs Ellery winces.
‘Sorry. I have to slam it otherwise the alarm sounds.’
She says nothing, but smoothes the blanket down in front of her as we lurch off the pavement and set off.

**

With the paperwork all done I settle in to the chair and smile at Mrs Ellery.
‘So. How long have you and William been married?’
‘Five years.’
‘Oh.’ I had expected her to say fifty. But the response is primed and goes off anyway: ‘That’s wonderful.’
The pause is a tragic acknowledgement of conversations the world over. Eventually – graciously – she picks it up again.
‘Of course, he’s not my first husband.’
‘Oh.’
‘I lived on my own for thirty years.’
‘Thirty years? So your first husband died young, then?’
She frowns.
‘He was eighty five. He died last week.’
‘Oh.’
‘We divorced after ten years.’
‘I see. Children?’
‘Three boys.’
My attempt at working out the maths is almost audible. I give up.
‘So – did you learn about your ex-husband’s death through your sons?’
‘Through the youngest. I hadn’t seen the eldest in thirty years. He’s in his fifties.’
‘So..?’
‘So when we divorced my eldest son went off with my ex and the other two stayed with me. I heard nothing more from them – until last week, when he turned up at the funeral.’
She looks at me. ‘The eldest – not the ex. You have got the doctor’s letter, haven’t you?’
‘Yep.’ I wave it in the air, Lame Chamberlain-style.
The ambulance yaws and staggers.
‘Oops,’ I say. ‘I think the bad weather’s broken up the roads.’
‘Really?’ She sniffs, and grips her stick more tightly. I seek shelter in the paperwork. Eventually I peek out again: ‘That must have been awkward, seeing your eldest son again like that.’
‘Like what again?’
‘At your ex’s funeral.’
‘Not at all.’
She takes the stick in her hand and pokes at her feet through the blanket like an arctic explorer sensing a crevasse.
‘What did you talk about?’
‘Guttering, mostly. That’s what he does apparently – fascias, soffits, guttering.’
‘Ah ha. And were the other two there?’
‘The youngest. Not the middle one. Who knows where he is.’
‘Why? What happened?’
‘I gave him some cheques to pay in. Which he did, of course. His own account. Then cleared off.’
‘But you’ve kept things up with the youngest?’
‘Charles? Oh Charles is fine. He lives round the corner. Didn’t approve when I married William, though.’
‘How did you two meet?’
‘An old friend of mine. She was coming round for dinner. She’d got problems with her hip, so a friend of a friend offered to drive. She told him to wait in the car. But I said: ‘Audrey. The man can’t just sit there whilst we eat. You’ll have to fetch him in. So she did – and he’s been there ever since.’