Friday, February 25, 2011

bad vase

The flat is up a steep track of badly carpeted stairs. The overhead bulb is on a timer and clicks out before we reach the landing, so I pull out my torch and light the rest of the way until I find the upstairs switch and put it back on again.
‘Nice,’ said Frank, wiping his shoes on the carpet outside the door. ‘Lovely.’
The door stands open.
I push it wider.
‘Hello? Ambulance?’
It’s dark inside. There is no sound, and I pause a moment. Frank taps me on the shoulder and leans in.
‘You know,’ he says, in a low voice, his breath smelling of coffee. ‘If I didn’t know better I’d say you were actually enjoying all this. You love these psych jobs.’
‘Well. Maybe that’s because I’m a bit of a psycho myself.’
I turn the torch up under my chin, widen my eyes and smile at him.
‘Careful,’ he says. ‘It might stick.’
‘Too late. It’s been years in the making.’
There is a noise from inside the flat, something like a muffled sob.
‘Hello? Ambulance?’
We go inside.


I went through a difficult time when I was in my twenties. I wouldn’t call it a breakdown, but I wouldn’t waste too much time trying to say what I would call it. My teens were pretty flammable, of course, but my twenties had a tougher, leaner feel to them. At least when I was a teenager I was still a kid and there really did seem no end to the things I could do to step up and change the course of my life; by my mid-twenties, life didn’t seem quite so generous, the margins were closing in, and there was a tougher cast to my plans.

I ended up sharing a flat in London with John, a friend of a friend. We moved in to a boxy flat in a boxy block overlooking the park. It was a narrow and meanly appointed building, which through the trees looked like a Thirties liner ran aground and left to rot. There was an old sink on the balcony with a pigeon’s nest in the corner, but it had chicks in it so we couldn’t clear it out straight away. Every time we went into the kitchen we could hear the creatures moving around, peeping feebly. I tried to ignore them, but now and then I’d be tempted to have a look – a clutch of skinned, sickly looking beasts stumping around in a mess of twigs. I wasn’t the only thing to find life a struggle.

A few people came to stay now and then. One Spring, Kevin, an old college friend of John’s, came back to the country after a teaching post in Mexico. He’d married out there, and his new wife came back with him. Maria was a solid and powerfully silent woman whose red lipstick was so thick it seemed to seal her mouth. When Kevin spoke Spanish to her it was with a strong Liverpudlian accent. Maria seemed to absorb his cheerful conversation in the same way she absorbed what light there was in these reduced circumstances, hungrily, without comment, soaking it all away with black brown eyes.

Kevin was between teaching jobs. He had another coming up in Guatemala in a couple of months, and in that time he wanted to visit family and friends in this country, to introduce Maria to them and make things well here before he started his new post. They made themselves at home. We set up a camp bed in the living room. They kept most of their things in the suitcases, but we cleared a couple of shelves for clocks, books and the little things they’d need now and again. Maria took the higher of the two shelves for her ceramic collection – a family of rabbits; a miniature wheelbarrow; a toadstool with a fairy reading a book cross legged on the cap; a mini being driven by a family of holidaying pigs – everything miniaturised, cartoon expressions, whimsical gestures. I picked the mini up to have a closer look.
‘Careful,’ she said, from over on the sofa. ‘Especial.’
I put it back.

John was a printer and out all day; Kevin had work at the university. But I was unemployed then and Maria had nothing to do. Even when I’d run all the errands I had to run, signing on or scanning the boards at the Jobcentre, I found myself with time heavy on my hands. I tried to stay out of the flat, but it was a wet Spring and I was forced back indoors more than I wanted. Maria had no English, I had no Spanish, and even though we both tried at the beginning to make the best of it and establish some kind of rapport, neither of us seemed able to bridge the differences. She kept to the living room. The blinds were down all day, and Maria spent all her time watching TV, the colour turned up until she was staring at the screen through a super-saturated haze. The heating in the flat was up in the red zone, too, a roiling shimmer of heat that made the warm Spring air outside seem frigid. Kevin was happy coming home each day. John was as savoir faire as ever. We ate our meals perched in a line together on the camp bed, me at one end, Maria at the other, laughing and drinking and everything fine. She enrolled in a short pottery course. I had an interview. Things were looking up.

But over the coming weeks I began to feel more and more uneasy about the relationship between me and Maria. That she didn’t like me was undeniable, and trying to shrug off the bad feeling I got from her was like trying to ignore the heat from the radiators – it only made me more conscious of it, and edgier. It seemed that whenever she was with John and Kevin, Maria would be relaxed and lively. She would take loving slugs of wine and tip back her head, laughing at John’s attempts to speak Spanish, revealing a brilliant rack of hard white teeth stained at the front with lipstick. The more I tried to join in, the more awkward I felt, until I started to think that maybe it was my problem, that I was paranoid and unreasonably down about the situation, a function of my general state of mind, and lack of direction. But as hard as I tried to rationalise my unease, the stronger it grew, until I was faced with the unshakeable conviction that Maria hated me, resented me even, and wanted me out. When I confided in John, he told me not to worry.
‘They’ll be gone in a few days,’ he said. ‘Cut her some slack, mate. She’s acclimatising.’

The plan now was for them to head up to Liverpool to see Kevin’s relatives, then head on to Guatemala from there. Friday was their last day in the flat.

I thought Maria would be looser and more friendly as the big day approached, but if anything she seemed to retreat into herself even more when the others weren’t around. She kept herself to herself in the living room, stewing in the hectic light of the TV, throwing me a look whenever I ventured past the doorway into the kitchen to make a drink.

Friday afternoon I was alone in the flat when she back in from pottery class. She was carefully carrying something in a green plastic bag, and put it gently down on the hall table whilst she hung her handbag up on the pegs by the front door.
‘What have you made?’ I asked, standing in the kitchen doorway.
She stared at me and nodded, once.
‘Can I see it?’
She hesitated, as if she was tempted to deliberately misunderstand the question and carry on into the living room with her haul. But when it became clear I wouldn’t let her go so easily, repeating my question, she sighed heavily and then carefully took her pot out of the bag.
Seeing it was like a physical blow. It was the kind of pot a camel could’ve made, a rudely hooved rectangular vase with a thickly gouged pattern around the outside and a rim of looped clay.
‘Bonito,’ I said after a pause, and then, the only other Spanish word I know: ‘Poquito.’ It wasn’t. She knew it. She gave me a brief screw of the mouth and headed into the living room. I turned away as discretely as I could, but she must have been aware of me sneaking a look as she cleared a space amongst her collection of ceramic figurines and placed her vase amongst them.

That night we had a bon voyage meal. Maria was in charge, busily rolling tamales and fajitas, filling the flat with delicious corn fried flavours and spicy aromas. We all drank too much. I felt hysterically happy, buoyed by alcohol, the weekend and the prospect of the flat to ourselves again. I made even more of an effort to connect with Maria, and she seemed to respond a little. I thought she was as relieved as I was that our enforced partnership was drawing to a close.
After the meal we drank and chatted and listened to music. My mood settled as heavily as the meal and the alcohol. I caught Maria staring at me a few times, hurriedly turning away into her glass or some other phoney distraction. And in that superheated, alcohol-saturated, early morning haze, the dreadful thought came to me that she actually meant me harm.
I’d tried to be friendly. I’d done everything I could to make her feel at home. But from the very beginning she’d taken against me, and now, after two long months in this hot-house proximity, it looked to me as if the enmity she felt had distilled into something more potent, more deadly, more actively hostile. She would be leaving the flat tomorrow, and the country in a couple of days. I understood now what she meant by that look, that contemplative swirling of her glass.

Maria meant to kill me.

It was a preposterous idea. I think when I thought it I actually laughed out loud. But in the manner of a suddenly revealed truth, the inevitability of the whole thing presented itself to me in the same lurid colours of the TV. Maria was crazy and she meant to kill me. I had a vision of her in the pottery class, violently thumbing that vase whilst in her mind she was gouging out my eyes. I had come to represent all the frustrations of her life. I reminded her of someone who had once done her harm. Whatever the reason, I was her enemy, and she wanted to kill me.

The evening hit the rocks somewhere around two. Kevin and Maria were the first to turn in. They had a long drive in the morning. We hugged each other – I thought Maria looked hungrily at my ear – and the two of them retired.
‘What a great night,’ John said, slapping me on the shoulder and giving me a hug. ‘Thanks for letting them stay.’
‘No worries,’ I said. ‘It’s been lovely.’
‘What do you think of Maria?’
‘She’s amazing.’
John looked at me for a moment and then smiled. ‘I think it must be a huge thing, to come to a new country like this, to start a new life.’
‘God. Yes.’
‘I think I’d struggle.’
‘Me too.’
‘Do you mind if I use the bathroom first?’
‘No. Go ahead.’

I began tidying up the kitchen. Whilst I was making a neat pile on the draining board, I noticed that one of the knives – the big jointing knife – was missing from the block. With a jolt I pictured Maria sitting quietly on the camp bed whilst Kevin was asleep, holding it in her lap and following the noises I was making in the kitchen. Horrified, I stood completely still.
‘Don’t worry about all that,’ said John, almost stopping my heart with the suddenness of his appearance. ‘We’ll see to it in the morning. Get yourself off to bed.’
‘Oh. Right. Sure.’
He padded off down the corridor, and I heard him close his door quietly behind him.

After a moment the flat was silent, except for the toilet cistern refilling after John had flushed it. I waited for that to stop, then waited. Nothing. No sounds, even from down in the street.
I walked to the bathroom and got myself ready for bed. I stared at my reflection in the bathroom mirror as I brushed my teeth.
‘You stupid,’ I said to myself, foaming at the mouth, pointing at my reflection with the brush. ‘Stupid, selfish. That poor girl, starting life over in a new country, and all you can do is make up ridiculous stories about her. You’re the crazy. You’re the one with the paranoid delusions.’
But the darker part of me that had fed these morbid fantasies was speaking at the same time. ‘She’s going to get you,’ it said. ‘She’s going to plunge that jointing knife into your heart. Then she’s going to cut it out and put it in the vase. Watch out. I’m telling you. It’ll be all over the papers tomorrow.’
I spat into the sink disgustedly, then dropped my toothbrush back in the mug. I should see a psychiatrist. I’ve been so down lately. I turned to look at myself in the mirror again, and pointed a finger.
‘You make an appointment tomorrow,’ I said, ‘Tomorrow!’ then turned out the light and opened the door.

The toilet was housed in a separate room just a step across the corridor from the bathroom. I went into it, turned on the light and lifted the lid.
As I did this, I had the sudden, certain and overwhelming conviction that there was someone hiding amongst the coats the other side of the toilet wall. I held onto my water and listened. There! Wasn’t that the noise of someone breathing?
I opened my mouth to breathe more quietly myself.
There again!
And in that instant I knew who it was. I could see her as clearly as if the wall had been suddenly turned to glass. It was Maria, standing with the jointing knife raised to her chest, her face turned in to the coats to listen.
Suddenly my heart was beating in great wooden thumps. What could I do? She really did want to kill me. How could I escape?
And there!
Definitely someone outside the toilet.

Thinking with painful clarity, I decided to turn off the toilet light, open the door slowly and creep out on my hands and knees. At least that way her first thrust would miss, and give me a chance to catch her wrist, and wrestle the blade out of her hand. It was better than nothing.

I turned off the light, hesitated a moment, then slid quietly down onto the floor. I built myself up for the exit, then opened the door and crept out on all fours.
No sooner had I come out then a figure stepped forward and brought a hand swinging down onto my head. Despite my fighting plans, the horror of the situation completely overwhelmed me. I cried out – a huge, unmodulated bellow that seemed to burst out of my throat like an animal howling through a metal tube. Both my hands went up and I rolled onto my back, closing my eyes, waiting for the cut.
‘Spence! Mate! It’s me!’
I opened my eyes and saw John leaning over. He was holding the chopping board with the handle, and he raised it up to show me.
‘When I put my head on the pillow I found this inside. I thought you’d done it, so I came out to get you back.’
I stared up at him with my heart still thumping.
Kevin came out into the corridor, followed by Maria.
‘What’s happening guys?’ he said.
John showed him the chopping board.
‘I gave Spence a bit of a fright.’
‘Well it’s April the first,’ he said. As I got to my feet they both laughed, but Maria, she just tied her red poppy robe around herself more closely, smiling gently, then moving up behind Kevin, putting her arms around his waist, and resting her head on his shoulder.

Wednesday, February 23, 2011


This housing estate is as real as a theme park, verges efficiently lain in squares, saplings with their labels showing, sleek, low mileage cars parked according to contract in sleek, low mileage bays. The map book is way out of date, but even the Sat Nav does not recognise the place; according to the screen I’m floating in a grey zone. I slowly drive the ambulance four by four towards the chequered flag around an intricate network of roads, cul-de-sacs and roundabouts so confusingly run together that you can probably only get the picture and sense of it all from the air - a giant chameleon, with its tongue extended. All the houses are dark and sleeping except for a few solar garden lights at jaunty angles in the grass carpeting out front, and the occasional stab of yellow behind an upstairs window. But here is a house with its uPVC door ajar and an elderly man raising a hand. I park up, grab a bag out of the back and head over.

Mr Muir is as carefully put together as the estate. His scarlet woollen jersey is shop-sharp, two neatly pressed shirt cuffs at his wrist, the crease of his linen slacks aligned with the centre of the crosses of his laces, his silver moustache clipped to the lip and his hair as buffed as the silver top on an antique box.
‘I took her pulse, which felt rather light and fast to me. But see what you think,’ he says, quietly closing the door behind me. ‘This way.’

He seems to move without making contact with anything, leading me up a pale carpeted staircase to a landing plumped out in creams and whites, past a Japanese bamboo print and a tall white biscuit vase filled with cracked willow spray painted silver, to a small and superheated bedroom.

Valerie, his middle-aged daughter, is lying on her side on the bed. She raises her head and smiles thinly as I put my bag and board down and introduce myself. Over in the corner, Lisa, her twenty year old daughter, shifts palely on a black velvet dressing stool. Mr Muir follows me in, then rests against a white veneer chest of drawers and examines his cuticles as I ask the woman what the matter is.
‘I’ve been getting this pain,’ she says, ‘all over. My neck, shoulders, into my arms and hands. My legs.’
Mr Muir clears his throat.
‘What would it take to get a scan done?’ he says. ‘We’ve had an x-ray but the doctors said it didn’t show anything.’
‘Tell him about the faint,’ says Lisa, chewing her lip. ‘Tell him what happened.’
‘Did you faint then?’ I ask, kneeling down and feeling her pulse.
‘I went dizzy, yes. There were these white spots, moving around.’
‘But did you actually pass out?’
‘No. I didn’t pass out as such.’
‘And this pain. How long have you had it?’
‘About three years. I wish I knew what it was. The doctors don’t seem to have an idea. I think they think I’m just some hypochondriac and they wish I’d leave them alone.’
‘So have you had any new pain tonight?’
‘Well it’s been getting worse and worse. I can’t do anything.’
‘Over what period?’
‘Three weeks or so.’
‘And does your doctor know about that?’
‘I don’t think he cares.’
‘You can’t go on like this, mum,’ says Lisa, sitting on her hands and chewing her lip. ‘You just can’t.’
Mr Muir stands more upright.
‘How is her blood pressure? Would you be able to find that out for us?’
‘Of course. I’ll run through the usual checks and see where we are.’
‘Because I wouldn’t mind betting it’s low. What do you think about her pulse? I thought it was dangerously thready.’
‘No. It feels pretty good to me. Regular, not too fast. Pretty good.’
‘Really? I am surprised. You’re sure about that? It definitely felt off to me. But I suppose you know best.’
‘Let’s do the checks and see what’s what.’
Mr Muir and his grand-daughter watch me carefully. I ask question after question, as much to lighten the atmosphere as anything else, but my efforts sound thin and unconvincing even to me, the soft furnishings absorbing my bonhomie as ruthlessly as the acoustics.
‘It all looks fine,’ I say, curling up and stowing the stethoscope, wishing I could follow it into the bag. ‘So now we need to think about what to do next.’
‘This can’t go on,’ says Lisa. ‘You’re not well.’
Valerie props herself up on one arm and flashes her daughter a look. ‘What can I do? No one seems to believe that I’m ill.’
‘Are you sure you wouldn’t be able to get her a scan? Wouldn’t that show if a nerve was being impinged in the neck? Or anything else? I mean – what can be causing all this?’
‘As far as the faint goes, it’s not uncommon for someone to be sitting down in a hot room then feel light headed when they get up. You didn’t pass out, you haven’t had any new pain – and you’ve recently started some strong pain killers, which might be making you drowsier and more susceptible to this kind of thing. I think it would be as well if you went back to see your doctor about how you’re feeling, but I don’t think you need to go rushing off to hospital tonight. I don’t think they’re in the best position to help.’
She lies back down and drapes a hand across her forehead.
‘It just goes on and on.’
‘If you’re not happy with your doctor, you could always change.’
She glances at me from beneath her hand.
‘Really? Do you think? How?’
‘I’m not sure. But you’re perfectly entitled to see someone else.’
‘And have him ring up the new chap and say: “Watch out for this one. She’s a waste of time.”’
‘I’m sure that wouldn’t happen.’
‘Are you?’
‘It shouldn’t happen.’
‘Well, there.’
Lisa sighs. ‘Go to hospital and get a scan.’
‘They won’t be doing any scans tonight,’ I say to her, as pleasantly as I can. ‘Your doctor will refer you if he thinks it’s called for.’
‘But it takes ages. Months and months.’
‘Not so long as that. And if they think it’s urgent, they’ll work one up right away.’
Mr Muir clears his throat.
‘My wife went to the doctor with shooting pains in her leg. He said it was muscle strain and sent her off with pain killers. Three months later she was dead. Riddled with cancer. If they’d taken action sooner, she might have lived.’
‘I’m sorry to hear that.’
‘”Just muscle strain”, he said. “Take these”. Three months later she was gone.’
‘How awful.’
‘You must get this sorted, mum,’ says Lisa. ‘Please.’
The room is silent for a moment. Valerie almost seems to fall asleep. But then suddenly she opens her eyes again, and as the brightly enamelled radiators quietly click and the night presses up against the window, she studies me from where she lies, glittering darkly against the pillow.

Sunday, February 20, 2011


I can imagine the Georgian architect lowering his papers and making a sign in the air – a simple twist of his hand – and the staircase rising up in front of him, the DNA of his vision for the building: a towering iron and stone helix, with an elegant cherry wood handrail and black curlicue spindles, spiralling up from the black and white squares of the hallway, six storeys up to the angled white glass of the skylight above.

Two hundred years later, Dave – dead drunk, one month into a breakdown - climbs onto the handrail on the very top floor and says he wants to slide down. Dixie, his fiancĂ©e, and Rich, his best friend, both lunge forwards. Rich gets a hand to him just as Dave starts to fall off at the first turn, manages to grab him by the collar of his shirt and swing him away from a fatally simple plummet; but he’s at the fullest extent of his reach and as Dave pitches head first into the void he only manages to turn him into a more survivable fall before the hand rail breaks his grip. Dave flies in slow motion, somehow missing the next curve of the balcony below to land with a jarring crash flat on his back on the carpeted landing.

Dave is stretched out in front of me, completely still, breathing slow and shallow from the belly as I kneel down by his head. A wet patch of urine spreads darkly in the crotch of his jeans.
‘Can you talk to me, Dave? What can you tell me about the fall?’
His eyes are half open but he makes no sound or sign of recognition.
Rich squats down beside me. He moves quietly for such a powerfully built man; his great, tattooed forearms resting lightly on his knees, he slowly rubs his knuckles together as he talks.
‘How bad is he? I didn’t move him, that’s what they said on the phone. I’d know that anyway, from the army. But it’s a fuck of a way to fall, mate.’
Dixie sobs loudly when he says this, hugging herself on the deep windowsill of the landing window behind us. Her mascara has melted across her face, and she shivers despite the heat of the building.
‘Let’s have a look. What’s his health like normally?’
‘Fine. He’s a tough little nut. I tried to stop him, but when he gets an idea in his head...’
I reach gently under Dave’s neck and feel for any deformities.
‘Does that hurt?’
He stares up inertly.
Whilst I’m trying to gauge the extent of his injuries, the back-up ambulance arrives. I hear a crash of doors and a cluster of voices down below.
Rich stares me for a moment.
‘I know you,’ he says. ‘You took me in a few months ago when I had too much coke.’
‘I thought you looked familiar.’
‘I haven’t touched it since, mind. It proper freaked me out.’
‘I bet.’
‘Yeah. Funny you turning up.’
‘Small world.’
‘And high.’
Whilst the crew is talking to someone way down in the hallway, Dave suddenly starts to moan and move about.
‘Keep still, mate. You’ve had a bad fall. You mustn’t move your head.’
‘What’s happened to me?’ he says. His eyes flick alight, two sharp and glassy beads; I feel suddenly compromised, like a chicken inadvertently waking a leopard. ‘Who the fuck are you? Where’s Dixie?’
Rich leans over him.
‘You fell off the banisters mate. About twenty feet, you cunt. You’re lucky to be alive.’
‘Get off me! Fuck off! Where’s Dixie?’
He shakes his head from side to side and struggles to get up.
‘Well his legs move all right.’
I let go of his head.
‘I’m not going to restrain him, Rich. It’ll only make things worse.’
Dave staggers to his feet, then groans and clutches his side.
‘You’ve had a significant fall,’ I say to him, as calmly and clearly as I can. ‘You have to keep still in case you’ve hurt yourself.’
He stares at me and frowns. ‘Who the fuck are you? You’re fucking dead.’ He bunches his fists and almost seems to waggle his hips, like a cat about to pounce.
‘Let me sort this,’ says Rich, stepping between us. He puts a massive hand in the centre of Dave’s chest. ‘Mate. Look at me. Look at me. It’s Rich. You’ve had an accident, mate. You slid down the banisters and fell off.’
‘Fuck off.’
‘I saved your life, mate. But listen. You’ve got to let the paramedics sort you out. You don’t know what you’ve done.’
‘Where’s Dixie?’
Dixie sobs again from over by the window.
He thrashes his head from side to side, sensing rather than seeing her.
‘Dixie! Dixie!’
She comes running over to him, takes his head in her hands. They put their foreheads together, Dixie crying ‘Babe! Babe!’ and Dave roaring ‘My side hurts, babe! I’ve hurt my side.’
The back-up crew have made it to the top of the stairs now. They lean on the handrail, getting their breath and taking in the scene.
‘My side, babe! My neck! What’s happened to me?’
‘My baby! My babe!’
Rich pulls his phone out of his pocket and idly checks a text. Then he flips it off again and turns to me.
‘I suppose you get this a lot,’ he says.
I move back to talk to the crew.

Thursday, February 17, 2011

making it home

Something must surely have happened today, something big. Or at least, a public announcement in the shopping centre, or maybe a plane dragging a banner across the sky: Come to hospital! Now! Everyone!

The department is overflowing, overwhelmed, bursting at the doors with patients and relatives - an expectant press of people, stewing dangerously like commuters at rush hour, all looking in the same direction, the desk at the centre, that plucky little veneered emplacement of computers, filing trays, dry wipe boards and coffee cups, the Rorke’s Drift of the A&E, where everyone, from ward clerk to registrar, are fielding requests and making decisions faster and more decisively than they ever thought they could, but saving the last canula for themselves.

I queue up to handover.

Ron, the Kiwi Charge Nurse, outwardly as smooth and unflappable as ever, is working so quickly his Maori tattoos seem to ripple up and down his arm like waves on the ocean.
‘Hey! Surfer Nurse!’ I shout.
He looks up and smiles. ‘I’m out there soon, mate’ he says. ‘I can taste it.’ He smiles with the shine of a wet board for a second, then he’s back in to it, crooking a phone to his ear, writing a name on the board, passing out an X-ray request to a porter and nodding to a patient’s relative who has begun shuffling dangerously behind us, foot to foot. I check the time. We need to finish promptly tonight, and I mentally pattern out the likely run of events: how long to handover, how many crews on tonight, the likelihood of copping a late job. I look back across that wretched stretch of humanity and catch Frank’s eye from where he waits with our patient. He is so focused, even at this distance he makes his opinion clear with nothing more than a gentle tilt of his head.


‘Okay. We can do this one and still finish on time. Buckle up.’
I put the truck in gear and edge forwards, but the A&E car park is impassably jammed with ambulances, taxis and cars. Frank surveys the scene for a second, then unclips his seat belt again and leaps out. He strides up to three cars in turn, giving firm directions to each. They follow the pattern he lays down – back up a foot; turn into that space; reverse into there; you, forward an inch, stop. Then he jumps back in the cab. ‘Go,’ he says, and calmly crosses his legs; we cautiously shimmy out through the channel like a ship through pack ice.


Mr Montague’s son, Jerry opens the door to us. A man in his thirties, he smiles with the wide, peg-toothed simplicity of a child. ‘Hello!’ he says. ‘My dad is on the floor. I did what the lady said. I did what the lady said to do on the phone.’
‘Okay Jerry. Through here, is it?’
‘Yes. Through that door, there. He’s on the floor, but I left him there, like she said.’
You would think the flat had been abandoned years ago. The bulbs are unshaded, the filthy curtains hang limply across the window frames, the carpet is tacky with ingrained dirt. The air has a rancorously sweet cut to it; it swirls around us as we move through, like the inside of a chocolate swiss roll.
Mr Montague is lying on the floor beside a ruined sofa, feebly clawing up at a plain wooden kitchen chair. His pyjama bottoms have ridden down, and the hollow scoops of his pelvis stand out like a dreadful signifier of his decrepitude.
‘How long has he been on the floor like this?’
‘I left him there like she said to leave him.’
‘Jerry? When did you see him up and about last?’
‘I did my jobs today. He hasn’t been very well.’
‘No? What’s been the matter?’
‘I don’t know. Not very well.’
‘Does anyone come in to help?’
‘Does who?’
‘Do you get any help?’
‘I help.’

I go back down to the truck to fetch a chair. A neighbour from one of the ground floor flats comes out to see me, smoking nervously and clutching the pink towelling bathrobe around her.
‘Sorry to butt in, but – can I have a word?’
‘Is he all right?’
‘I don’t think he’s great. He might have been on the floor a while. We’re taking him in to hospital.’
‘Good, ‘cos it can’t go on like this. We’ve been on the phone to just about everyone, and no-one seems to take us seriously. They’re not coping. His son’s got learning difficulties and they’ve always lived together, but have you seen the state of the place these days? Well of course you have, you’ve just been up there. Just last week Mr Montague was walking about in the gardens in a right old state, didn’t seem to know where he was. He’s refused help time and time again and you can’t force someone, can you? And the doctors and whatnot just seem to take the attitude that unless he asks for help they can’t do much. But it can’t go on like this, can it? You’ve seen what it’s like.’
‘We’ll do our best to get things going. I think you’re right. Something needs to happen.’
‘I mean – it’s a shame. But enough’s enough.’
‘Thanks for your help.’
‘You’re welcome. Just make sure they get the picture.’

But the picture I get is of us wheeling the decrepit husk of Mr Montague in through the A&E doors, Jerry shuffling along beside the trolley holding his hand, as we excuse our way in through that melee of competing claims, to bid for a bed, to bid for attention, and a quiet place in which to give it, for everyone to have a clear chance, Mr Montague, Jerry, the other patients, their anxious friends and relatives, the overworked hospital staff, and us, the ambulance crew, cleaning up as quickly as we can and hauling our exhausted frames back to base, to finish another long, long day at a reasonable hour, and make it back home.

Monday, February 14, 2011

before dawn

Low down and dozing in the seat, my knees wedged up on the dash. The interior lights are off but the engine is still running, the radio tripping quietly in the background. Dark figures move around the hospital forecourt, smoking, chatting, making calls, occasionally hurrying out from the lobby into taxis. The night is warmer than it was and a fog is coming in from the sea, rising up over the wall in hectic, luminescent rags. I watch the perimeter streetlamp; it darkens and dims, darkens, dims, as the fog rolls around it; and after a moment it’s easy to imagine that it’s not the fog moving but us, and that this is the deck of a ship, and we are its crew, standing or sitting, alone or in groups, all lit by that fitful orange lamp, sliding inexorably together into dissolution.

I am fading. Lain down and done. I see rather than feel my mouth slackening, my breathing becoming heavier. I am the ghost of an ancient photographer asleep behind the drapes of his tripod, dreaming images onto the plate:

a man shouting and crying, raising his arms; a police officer swiping them aside and speaking sternly;

a Community Responder kneeling in the hallway, bobbing up and down like a beam pump;

the livid red marks around the young girl’s neck from the dressing gown cord she hanged herself with;

the lightless pits of her eyes;

the co-ordinated mess of the effort to save her; the tubes, chemicals, syringes, pads; the paramedic coolly speaking to himself, watching himself – sharps away - the right thing done, the right order;

outside for more equipment; faces on the verge, watching and shivering;

the inconsequential weight of her as we snap the scoop stretcher into place, top, bottom; can we use the dressing gown to lift her hips a little? thanks.

the slick, blue fury of the drive to hospital; a car, pulling over to the side of a deserted street, putting on its hazards and watching as we pass;

the faces gathered round the trolley in resus all looking in our direction as we push through the doors; taking over compressions, thank you;

the facts; the flock of gloves efficiently following their appointed movements;

the police officer outside resus, opening a notebook;

liaising with the second crew; swapping back equipment that got mixed up on scene; tidying the back of the truck;

retrieving the scoop from resus; the doctors and nurses have dispersed now, the few that are left in the room are detaching lines, moving apparatus aside, finishing off, insulating themselves with banality;

the immature line of her hips as we ease the scoop stretcher apart; and on settling again, the gentle tipping inwards of her toes;

a cup of coffee, a sheet of paper, picking white fluff from my trousers;

climbing into the cab, turning the lights off, sliding down into the seat, the fog flowing up over the perimeter wall, the lamp beginning to move, and letting myself be dragged along behind it, irresistibly out to the very furthest line of that black horizon, the limit of the world, where the sun must surely rise again soon, as it always has, and people wake to see it.

Thursday, February 10, 2011

a vase of flowers

A broad and pleasant tree-lined avenue. Most of the Regency houses have long since been sectioned up into flats, but still, from the street at least, they maintain a facade of wholeness. The black wrought iron railings, Grecian porticos, black and white tiled thresholds and intricately leaded porch windows make me feel we should really be pitching up in a carriage and four rather than an ambulance. But the rack of chrome buttons by the front door are a reminder that time has moved on.

Mrs Mackenzie comes to the door.

‘Oh. You’re here. Come in.’
She turns and leads us past the letter boxes, bicycles, notices, hand-written reminders and alarm consoles, diagonally across the hallway to her front door. She shuffles like a careworn, domestic bear in a purple roll-neck top and brown slacks, a little absent, as if a long hibernation had been interrupted. We follow her into a bright and comfortably furnished studio flat, with silver family photos and porcelain nick-nacks on the mantelpiece, and a radio playing softly in the background. Mrs Mackenzie silently manoeuvres herself in front of a black leather sofa, then sits down in two distinct stages – the first, a slow and cautious bending of the knees; the second, a sudden release past the tipping point, dropping down with a gentle sigh. The silver haired cushion at the other end of the sofa turns out to be a cat. Bounced awake by the shock wave, it gives her a murderous look, then hurries away into the bedroom.
‘What seems to be the problem?’ says Frank, drawing up a chair. ‘Why have you called us?’
‘I don’t know. I’m not sure.’
‘So talk us through it. What happened this afternoon?’
‘I was at the hairdressers and I didn’t feel right.’
‘In what way?’
‘I’m not sure.’
‘Were you in pain? Did you feel sick or dizzy or short of breath?’
‘Any pins and needles anywhere? Numbness, loss of control? The shakes?’
‘Okay. So what did you do at the hairdressers?’
‘I came home.’
‘Right. Then what happened?’
‘I’ve got these numbers you see.’
She leans forward and picks up a neatly typed list of names and numbers from the coffee table.
‘I wanted to ring Janice to cancel her for this evening.’
‘Who’s Janice?’
‘Janice. My helper.’
‘But when I tried to dial the number, I just couldn’t do it.’
‘Do you mean your fingers didn’t work properly?’
‘Not really. And then when I got someone on the phone, I couldn’t find my words.’
‘Do you have any of these funny feelings now?’
‘No. Everything feels fine.’
‘Nothing untoward at all?’
‘No. I just feel a little foolish.’
‘Let’s do a few tests and see what’s what.’


Mrs Mackenzie is reluctant to come to hospital.
‘How will I get home?’
‘There are ways and means. The important thing is to get you checked over by a doctor. Worry about getting home later.’
‘But am I all right?’
‘Everything looks fine now, but there’s a chance you might have had a mini-stroke.’
‘But I’m all right now?’
‘Now, yes. Don’t worry about it. These attacks are quite common. But you are more at risk of a bigger stroke, so you should definitely come with us up the hospital now. Your health is more important than anything else.’
‘Yes. I suppose. Will you call Janice?’
‘Yes, I’ll call Janice. Let’s get your meds together, your coat and keys and whatnot. Okay? No rush. Let’s make sure we get everything.’
We help her up off the sofa. She wanders around the flat, dropping things into a carrier bag, muttering to herself. I leave a message on Janice’s answer machine, then open the door ready to go. For the first time I notice the strange vase in the centre of the mantelpiece – an old, craquelure white ceramic head of a smiling young woman, her eyes closed, the top of her head cut off above the ears; and from the hollow space there, a bunch of young carnations rising up in delicately spreading whorls of pink and red.

Monday, February 07, 2011

a day out

Cal and Lenny have just returned from a long and complicated job and look about finished for the day. Cal grunts and shuffles off to the kitchen; Lenny throws himself down in a chair, his legs flying up to come crashing back down onto the expertly timed, flick-up foot extension. He looks like the marionette of a grizzled wild west lawman, chucked back in the box after a showdown.
‘Well that was fun,’ he says.
Cal and Lenny have about a million years of service between them. They joined the ambulance service sometime after the last ice age but before Kennedy was shot. Together they’ve stepped out of a hundred makes of ambulance onto a hundred thousand scenes – every conceivable variety of tragedy and triumph, every kind of weather, all hours of the day and night. Their long years of work weigh in their faces, but they carry their experience well, as if the best and the worst has blown itself out now, and all they really need is somewhere warm and comfortable to put their boots.
‘What happened then, Lenny? I heard you had to come back for the bariatric truck.’
‘The guy was big. I mean phenomenal. Seriously. It was incredible. Forty stone and he collapses on the toilet – a tiny little shitter he must have to grease himself to fit. So then the fire brigade arrives. They take the door off, then a wall and window so we can get him onto this special lifting canvas and out with a cherry picker. Six of them, two of us, and even then it’s touch and go. So we get him down to the truck. You know the specially wide trolley? Well that almost gives up. Creaking and groaning. The hoist practically burns itself out dragging him on board. And then driving to the hospital – well, we were so low I thought I was back home, ploughing. But we get him to hospital, and there’s a team of porters standing by, and we rope them all up like huskies, heaving and dragging to get the poor sod inside. Cal was cracking the whip. Get on there! Come on! So then we get him inside and the charge nurse has to discharge about a dozen patients to make room. And then the doctors all come and have a butchers. Mm, they say. He’s going to need a CT scan. But he won’t fit through the hole, and anyway we’d never get him on the table. I know, says one. We’ll send him over the zoo. They’ve got a really big scanner there for the elephants. It’s okay. I’ve seen it done before. And he’s on the phone arranging it when the guy arrests, and that was it – game over. So he never got his day out at the zoo after all.’
Cal comes back into the room with two cups of coffee. He hands one to Lenny, then walks slowly over to a chair and lowers himself gently down into it.
‘The zoo!’ says Lenny, his eyes sparkling through the wisps of steam from his coffee. Then he settles back in the chair, and the two of them drink in silence.

Wednesday, February 02, 2011

old wounds

The flat is in uproar. Joyce is having her hair done by Janice’s friend Mary; she is sitting in a plastic bib at the kitchen table, her excitement as tightly wound and brightly coloured as the curlers in her hair; Mary is holding up her hands in their yellow washing up gloves like some crazed surgeon, chasing Joyce’s husband Harry out of the kitchen and back into the sitting room. Janice is still on the phone, and waves pleasantly as we come into the room. When Mary turns Harry round with the points of her elbows, we see the knitting needle he sat on sticking out of his butt like an arrow.
‘Wait a minute,’ he says. ‘Just a minute.’
‘What have you been playing at, Harry?’ says Frank, dumping his bag on the floor and going over to him. ‘Cowboys and Indians?’
‘I – what? No – you see – Joyce had to have the table for her hair, so we swapped places. Only she’d left her number sixes on the cushion, and I got one up me jacksy.’
The needle has gone through his jeans, the tails of his shirt, his boxers and about an inch into the flesh at the top of his right buttock.
‘They told us not to pull it out,’ says Joyce.
‘I don’t think you could pull it out,’ says Harry, wandering over in her direction. ‘But have a go, by all means.’
‘No! I’m not pulling it out. Who d’you think I am? King Arthur?’
Harry looks at us. ‘You see what I have to put up with?’
Frank gets out his shears.
‘Good god! What are you going to do with them?’
‘Just a little minor surgery, mate. Don’t worry. I’ve read all the manuals.’
‘Oh, yes? That’s encouraging.’
‘We’re just going to cut your jeans around the needle so we can inspect the wound. Sorry. I hope you weren’t too attached to them.’
He shrugs.
‘What can you do? If they’ve got to go, they’ve got to go.’
I help support the needle and stretch the material whilst Frank makes a few neat cuts. We get down to skin level, and Frank gently feels around the wound to get an impression of the depth and severity of the injury.
‘It’s gone in about half an inch, but it’s a fatty part of the body, so there are no other organs or blood vessels to worry about. We can pull it out for you if you want.’
‘Yes. Go on. I’m not bothered. It’s nothing to me.’
He points over to a glass display cabinet on the wall. Pinned to the red velvet of the case, a line of old battle medals.
‘See that?’ he says. ‘When you’ve had lumps shot out of you in North Africa, shrapnel in the leg at Suez and your eardrums blown out in Korea, you don’t worry much about – oh!’
He turns round and looks at Frank, kneeling on the carpet behind him, waving the knitting needle in the air.
‘There you go. That wasn’t too bad, was it? Now then. When did you last have a tetanus?’
Frank stands up and hands the needle over to Joyce, who makes a face as she takes it.
‘I’m not using that,’ she says. ‘I know where it’s been.’
‘You could always frame it like his medals’ says Frank.
Harry wanders over, rubbing the seat of his trousers. ‘Good idea. Maybe then I won’t end up sitting on it.'

Tuesday, February 01, 2011

case solved

‘A blue tag? Not heard of that before. Patient has history of exaggerating illness or injury for pain relief. Lovely.’
This street is so narrow and the terraced houses so tightly packed together it’s a good thing all the PVC doors open inwards. Frank has to drive half on and half off the pavement to make any progress.
‘This is it.’
He manages to leave just enough room to lower the tail lift, but at these angles it’s debatable whether we could ever really use it. I can see a young girl waiting for us by an opened door, hugging herself against the chill, watching us park up, smiling sweetly.
‘It’s my mum, Susan,’ she says, stepping aside to let us in. ‘Top of the stairs on the right.’
She quietly follows us up the narrow stairs, then stops outside the first bedroom on the landing, a teenager’s purple retreat: Twilight posters, CDs, school books.
‘I’ll be in here if you need me.’
She tucks herself away with practised economy.

Susan is groaning beneath a voluminous caramel coloured duvet, the back of her left hand pressed melodramatically to her forehead.
‘Oh god, it hurts.’
She slaps the bed with the flat of her other hand, submitting to the pain, wrestler-style.
Frank makes his introduction; Susan squints, then says: ‘Help me’ as soon as he finishes. ‘Please. Do something.’
‘So. Tell us what’s been happening, Susan.’
‘I’ve got this excruciating pain in my groin. Here. It goes all the way down. And now it’s starting up the other side.’
‘How long have you had it?’
‘Two weeks, but it’s much worse tonight.’
‘Have you seen your doctor?’
‘A few days ago. He wanted me to have a blood test, but I just forgot. I’ve been so tied up I didn’t get round to it.’
‘Why did he want you to have a blood test?’
‘He thinks the pain is tissue damage related to my anaemia.’
‘Oh? I’ve not heard of that before. And when you say tied up, what do you mean?’
‘My brother’s dangerously ill in ITU. I just haven’t been able to think about anything else. And then today the pain got worse and worse. So I came to bed, and now I can’t move.’
She looks at us with a doughy expression of need. ‘Help me.’
We’re both mindful of the blue tag, but she seems quite plausible.
‘I’m going to be sick.’
Susan suddenly sits herself up in the bed and makes a flapping gesture of urgency in the air. Frank passes her a bucket from the side of the bed; she dips her face into it, her lank, yellow hair effectively curtaining the event, and makes a noise like an angry bear growling in a cave.
Eventually she pulls back, wipes her mouth with a tissue, drops it in the bucket, places the bucket back beside the bed, then flops back inertly onto the pillows. I move over discretely and glance down. There doesn’t seem to be anything in it.
‘Have you had any diarrhoea?’
‘No. That’s normal,’ she says, breathing rapidly. ‘Aren’t you going to do anything? I don’t know how I’m going to get down the stairs,’ she adds, squeezing her eyes shut and rolling her head from side to side. ‘This pain is unbearable. I can’t move my leg at all.’
‘We’ll help you,’ says Frank, moving round to her side and feeling her pulse. ‘There’s no rush.’
I step back onto the landing and knock on her daughter’s door. When she comes out she’s unhooking a pair of iPod earphones, smiling benignly.
‘Is she going to hospital?’ she asks.
‘Well, she’s in pain, so hospital’s really the only place,’ I say, studying her response, shambling and innocent as Lieutenant Columbo.
‘I’ll get her meds and slippers,’ she says, and moves quietly downstairs.

I glance back into Susan’s room. She is sitting up on the edge of the bed holding on to Frank’s hand. They hold their position and look out at me, framed through the doorway like a moral Victorian painting.

‘I don’t think I can take any weight on it,’ she says, waggling a plump foot in the air.
‘You can always shuffle down the stairs on your bottom,’ says Frank. ‘There’s no rush.’


At the hospital, Frank waits with Susan whilst I go round to the nurse’s station. Susan reclines on the trolley, an entonox mouthpiece clamped between her teeth, drawing on the regulator like a professional diver.
‘Shan’t be a moment,’ I say.
Frank folds his arms and gives me a level smile.

Rachel, the Charge Nurse, is complaining to a student doctor about her bra strap.
‘It’s been chafing like a bastard all night,’ she says, squirming on her office chair. ‘I’ve wrapped some gauze round it, but honestly, I’m fit to kill.’
‘Where did you buy it?’ I ask, laying my clipboard on the counter.
‘Primark. Though what it’s got to do with you I don’t know.’
‘Primark? Buy cheap buy twice.’
The young doctor nods sagely. ‘That’s true,’ she says. ‘He’s got a point. Primark’s carp for bras.’
‘Anyway. What’ve you brought us? Something nice?’ says Rachel. ‘Jesus. Honestly. I’m going to scream.’
‘Well. I have to say this is a strange one.’
‘You’re not selling it.’
‘There was a blue tag on this patient’s address.’
‘Whatever that means.’
‘I know. I’ve not heard of it, either. But it seems to be some kind of warning. It said the patient acts up for pain relief. I’ve not come across her name before, but I wonder if you have.’
‘What is it?’
She swivels the board round and reads the name.
‘Yes – do I know Susan!’ she says. ‘It’s one of her aliases, anyway. I’ve been treating Susan since I started my training here, and that’s a long time. Munchausen’s. She fakes it. There’s nothing wrong with her. Have you given her anything?’
‘Just Entonox.’
‘Take her off it.’
‘So tell me about Susan.’
‘She’s a phenomenon. I’m surprised you’ve not met her. Just under the name Susan she’s had four hundred attendances in the last couple of years alone. What’s she come in with today?’
‘Groin pain.’
‘Yep. Seen that. But you know her favourite thing is to wait in a field for some ramblers to walk past, then lie down and pretend to have been kicked in the head by a cow. Fits, unco, the works.’
I feel a sudden chill.
‘Or maybe a horse?’
‘Yep. Horses. She’s been kicked in the head by a horse a few times.’
‘Was she brought in by helicopter just before Christmas?’
‘Why? Were you on that one?’
‘Me and a dozen others.’
Rachel shakes her head.
‘It’s outrageous. I thought there was supposed to be a management plan in place.’
‘So what happened when she was choppered in that time?’
‘A full trauma call went out and the team was waiting in resus. When the trolley came in, the consultant took one look and said “Oh, for fuck’s sake – it’s Susan”. Then they all threw off their aprons and walked out. She was sat up and out of the department in under ten minutes.’
Rachel leans forward, arching her back and shoulders to get relief.
‘The weird thing is, her family are absolutely lovely. You’d think they’d give some sign this was all a bizarre charade – but I suppose they’ve just grown up with it, and it’s a part of their lives.’
‘I’ll bring her round.’
‘Do. I look forward to seeing her,’ says Rachel, grimacing. ‘But don’t go using pat slides – she can transfer perfectly well herself. And take her off the Entonox. And tell her to cut the amateur dramatics because Rachel’s on duty, she’s tired, she’s in a cheap bra and she’s in no mood to fuck around.’