Saturday, September 24, 2011

a grinding

‘Does your son have far to come?’
‘No. He lives just the other side of town. He said he’d be over right away.’
‘That’s good.’
‘He is good. I’m lucky.’
Peter stands in the doorway of his lounge, next to the portrait his son made of him back in the Seventies: a sombre, charcoal and chalk three-quarter length study of a monolithic figure meeting the future in an open neck shirt. It’s a close resemblance; apart from a certain hollowing and softening over time, it’s still the man himself framed in the doorway now, looking straight at us.
‘So. Have you got everything you need, Peter? Did you want to put a jacket on?’
Peter has taken an overdose of paracetamol. We’ve had so many of them lately, it’s like we’re standing in a field trying to hold back a rag-tag militia whose shuffling advance is beaten out on a big white drum marked 500mg.
‘I talked to Simon,’ he says. ‘He’ll meet us there.’


The ambulance tips and sways. The bright morning light cuts in through the window blinds and rakes the interior. Peter sits neatly in his seat, making only the smallest, most economical compensations to maintain his balance.
‘I just wanted to sleep,’ he says, resting his eyes on me. ‘I’m tired of all the effort. You know – getting up, eating breakfast…’ he breaks off, faced with a great channel of despair. Then he sighs and links his fingers neatly in his lap. ‘Let’s just say I was tired,’ he says.
‘Are you getting any help?’
‘Everyone’s been more than kind. I couldn’t have had better support. And Simon, he’s wonderful. But really – at the end of the day – what can anyone say? If it’s not working, it’s not working, and with the best will in the world there’s not anything anyone can do about it.’ A band of light scans his face; he closes his eyes and lets it. ‘I’m a disaster area,’ he says, opening his eyes as we suddenly move into the darker zone of an underpass. ‘Everything I touch falls to pieces.’


‘We’ll be there in five minutes.’
‘Thank you.’
‘How are you feeling?’
‘I’m fine, thank you.’
He sits quite still and contained, despite the massive dose of paracetamol, the years that led to it, the hours he lay staring up at the ceiling from the early morning to the moment he picked up the phone and called his son – despite all these things, he maintains an impressive air of competence.
‘What line of work were you in before you retired?’ I ask him.
‘I was a diamond cutter,’ he says.
‘Wow,’ I say. ‘I’ve met people from about every other profession I can think of, but you’re my first diamond cutter.’
‘It’s a specialised field.’
‘I bet.’
I remember an article on the news recently about the discovery of a planet on the furthest reaches of the galaxy, a little planet so densely packed with carbon a good part of it must be pure diamond. I hesitate to mention it, for some reason.
‘So. How do you cut a diamond? I suppose you’d have to use another diamond.’
‘Diamonds do cut diamonds,’ he says. Then, after a pause: ‘But of course much of the process would be better described as a grinding.’

Wednesday, September 21, 2011

only me

Veronica’s flat is round to the side. There is a discrete number to guide us there – a metal square held out on a bracket, picked out in white and black. An aggregate concrete path, where the breeze block wall on the right has broken down over the years, yielding to a steep drop and a scrub patch of garden. At the front of it, a circle has been cleared and flattened with black plastic sheeting, weighed down with gravel like dried peas on a pie crust ready for baking, a deckchair in the middle of it all, screened from the road by a wild and straggling buddleia.
Veronica opens the door after a few minutes of persistent knocking. She stands holding onto the handle, dreaming us.
‘Can we come in and have a chat?’ I ask her.
She considers the question, but at last the door seems to answer for her, shucking her hand away, releasing her to drift back into the gloom. We follow her inside - a cramped flat with just enough room in the hallway to make the turn you require: sitting room, bedroom, bathroom. Veronica has come to rest in the galley kitchen; she leans against the worktop with her arms folded.
‘My name’s Spence. This is Frank. We were told you may have taken an overdose. Of paracetamol. Is that right?’
She nods.
‘How much did you take, Veronica?’
But I can see for myself. Across the worktop is a scattering of torn pill envelopes, the large, soluble kind, and over in the sink, an empty bottle of vodka.
‘Did you take all these?’
She gives me a Stan Laurel look, a sad little thin-lipped, loose-necked waggle of achievement.
‘We need to take you down the hospital to get some treatment for this, Veronica. You’ve taken quite a bit.’
A shrug that almost puts her on the floor.
‘Let’s get your shoes and coat and things and head out to the ambulance, shall we?’
She shakes her head.
‘No. They don’t want me there. They can’t do nothing.’
‘Yes they can, Veronica. But one thing at a time. Let’s get your stuff together and go out to the ambulance. When did you take all these pills?’
‘I didn’t take enough.’
She starts to rip open another pack and I reach over and take it from her.
‘When did you take these, Veronica?’
‘Just now. An hour, maybe.’
‘OK. So the sooner we go the sooner we can get things started. All right? Let me get your bag for you.’
‘Don’t rush me. Okay? Just don’t – rush me.’
She pushes herself clear of the worktop and drifts downhill out of the kitchen and into the bedroom. When she bends over to grab a pair of shoes from under the bed it’s a miracle of gravity that she keeps her feet.
‘Easy there, Veronica,’ says Frank. ‘Here’s your phone, look.’
‘Thanks. Thank you.’
We help her sit on the bed. Suddenly she looks absolutely defeated. She points to a flowery brass frame with a sepia photo of a smiling young girl.
‘Tha’s my mum, that is,’ she says. ‘She died at Christmas.’
‘I’m sorry to hear that.’
‘I miss her.’
‘I bet you do.’
‘And my dad’s just gone in to a home.’
‘You’ve obviously had a tough time of it, recently.’
‘It sounds like you’ve had a lot to deal with. A lot on your plate.’
‘I have. I have had a lot on my plate.’
She bends forward to pull on a shoe, but we prop her up again.
‘Let me get that for you,’ says Frank. ‘I used to work in a shoe shop. There. Try that on. We sell a lot of those.’
Veronica shakes her head.
‘Don’t worry about me,’ she says. ‘I know you’ve got a lot better things to be doing.’
‘Nope. You’re our patient now. That’s all we’re worried about. There. Let’s get you up and out to the ambulance.’
But she stays sitting.
‘I’ve got two brothers,’ she says. ‘One younger, one older, both equally useless. Do you know what? Not one of them will change one little thing about their lives to help. They haven’t even been to see Dad yet and he’s been there a month.’
‘That’s no good,’ I say. ‘They’ve got to do their share.’
Veronica shakes her head.
‘It’s just me,’ she says, smacking her lips drily. ‘Only me.’
She puts her hands down flat either side of her and closes her eyes. The room ticks quietly. A sudden void of silence opens up around her, and even though the double bed almost completely fills the space, the walls of the little bedroom fly out, and the floor and ceiling spin away, and the bed drops into a great black pit of nothing, with Veronica the centre of nothing, a breath at the vanishing centre.
We prod her awake.
‘Come on Veronica,’ says Frank. ‘Let’s go.’
‘Make sure you pull the handle up before you turn the lock,’ she says.

Friday, September 16, 2011

fag in one hand, can in the other

I’m guessing that the window three floors above me is the window to flat fifty-one. They’d said in the notes it was difficult to understand the patient because of the loud music in the background; even from down here, his Sounds from the Seventies album is horribly clear.
Getting in should be simple: press the button, ask for access, get buzzed into the foyer, wait for the safe to be opened remotely, retrieve the pass key.
‘Hello, Red Line Remote Care Facility Jeremy speaking how may I be of assistance?’
‘Hello. It’s Spence from the ambulance here on a call to flat fifty-one. Could you let me in please?’
‘Just confirming – ambulance attendance to flat fifty one – requesting remote access. Is that correct?’
‘Yes. Thanks.’
‘One moment please, Vince.’
I stand back. A series of piercing electronic squawks, until finally the door clicks and I go through.
‘Thanks,’ I shout over my shoulder.
‘You’re welcome. Anything else I can help you with this evening?’
But the door has shut behind me and I can’t reply.
I wait in the foyer for the safe to open.

Nothing happens.

Terry Jacks is playing now. I let him get as far as saying goodbye to his Papa before I give up, go back outside and press the buzzer again.

‘Hello, Red Line Remote Care Facility Jeremy speaking how may I be of assistance?’
‘It’s me again, Jeremy. The safe didn’t open.
‘Can I just confirm who I am speaking to?’
‘Yep. It’s Spence, the ambulance man from just a second ago.’
‘I see. Thank you, Vince. How can I help?’
‘The safe didn’t open. I need the key to fifty-one.’
‘Thank you. Buzzing you through now.’
The door clicks and I go back into the little foyer.
Flat fifty-one. It’s a wonder all his neighbours aren’t massing outside with firebrands and pitchforks.
Sweet. Are you ready Steve? Uh-huh. Andy? Yeah….
The safe remains closed.
… well all right fellas. Let’s go!

I go back outside and buzz.
‘Hello, Red Line Remote Care Facility Jeremy speaking how may I be of assistance?’
‘Yeah – Jeremy? Spence. Nothing’s happening, mate.’
‘Can I just confirm…’
‘Yep. Flat fifty-one. Look - I need the key otherwise I’ll have to kick the door in.’
‘You must let the front door close properly before the safe will open. Are you doing that?’
‘Okay. Sorry for the inconvenience, Vince. I’ll clear the call and re-send the signal. Try it now.’
He buzzes open the door. I walk through and close it firmly behind me.
Once the door is closed I can hear him on the intercom asking me if the safe is open, but he can’t hear my reply because the door is closed. By the time I get back to the intercom, jamming the front door open with my bag, he has gone.

I snatch up the bag and head for the lifts.

Of course the door’s open anyway.
‘Hello? Ambulance?’
The room is lit by a large plasma TV and a feeble yellow lamp on a table scattered with encrusted dishes, scattered cans and a littering of papers and letters. The air has a greasy rub to it; the floor is dark and sticky underfoot, as if he’d decided to skim the lino with burnt toffee.
A man emerges from the kitchen. He is an extraordinary sight – an adult sized chicken in a dirty parka, a can of lager in one hand, a spitty-little roll-up in the other. He has an astonished look to his face, as if a giant caterpillar had just materialised in front of him.
‘Can you turn the music off, please?’
‘What? Hurumph. I say – who?’
‘I said can you turn the music off? I need to talk to you. Look. I’ll do it for you.’

Leo Sayer, chopped off mid-need.

‘There. That’s better. My name’s Spence. I understand you called Red Line and said you needed help.’
‘Did I? Well – harrumph. Who-ha! What a turn up? Hey? Who’d have thought it?’
And he begins strutting around the bare flat, picking up his feet just exactly like a cockerel parading around the yard. Even his arms are bent and pulled back at the elbow like stubby wings. If it wasn’t for the intense set of his eyes and the grimly realistic chaos of the scene, I’d think we were being filmed.
He high-steps over to the window, rests both arms on the ledge and then raises one of his legs up behind him like a dancer warming up before a ballet about Care in the Community.
‘Who-oo! Harrumph! There. Look. Shit – what? A fag? A can? That’s a can, isn’t it? Faak! Mazing!’
I get his name from a blister pack that I exhume with my fingertips from a heap on the sofa.
‘Mick? My name’s Spence. What’s happened tonight?’
‘Wha’s happened? Nuffing’s happened? Hey? Who-ha. Harrumph. Wha?’
The TV is showing Cameron and Sarkozy in Tripoli.
‘Look at that! Wow! Mazing. Fag! Can! It’s all there. What?’
‘Mick – I’ve never met you before, but I’m guessing this isn’t normal for you. Have you got any pain at the moment?’
‘Pain? Wha’y’say? Faak n’ell. Tha’s a bit of luck, mate. Who?’

He carries on striding about. He reminds me of a music hall turn – someone like Max Wall, with the same kind of intonation, lopping off his words with an under bite, cluttering his dialogue with random questions, non sequiturs, and a periodic amazement that he should find himself here, now, in this flat, with a fag in one hand and a can of lager in the other.
‘Do you have a CPN, Mick?’
‘What? Mm? A CPN? Yes mate. Harrumph. I’m CPN’d up to here, mate. Lovely. Who? Ah-hum. They smoke hookahs, don’t they? Faak.’
‘Who do?’
‘The Arabs’
‘Mick? Did they give you a number you can call when things get a bit out of hand?’
‘Out of hand? Harrumph. Ah-hoo. Tell you what, mate …’
He struts over and stands right up close, his globe grey eyes flickering slightly like miniature versions of the TV behind me. He looks stage right, stage left, then smiles, spins around and chickens it back over to the window.
‘Fag in one hand. Can in the other. Faak. What? Harrumph.’

Thursday, September 15, 2011

mrs norbutt

Mrs Norbutt can’t cope at home. Despite a small militia of carers, district nurses, physio and occupational therapists, a CPN and a social worker, she still keeps falling out of her wheelchair. Another bout of respite care is arranged, with a view to something more permanent.
‘My neighbour will look after the house whilst I’m gone. If she remembers. If I ever come back,’ she says. ‘Don’t forget my bags.’
Mrs Norbutt sits like a ball of imploded matter, a dark star of misfortune. Being in her presence for any amount of time is like being an astronaut fighting with the controls of his ship to escape the Event Horizon of her gloom.
‘It’s a beautiful day today, Mrs Norbutt.’
‘Is it? I suppose it might be if you can enjoy that kind of thing.’
‘Have you been getting out much?’
‘Out much? If you mean tipping out onto the floor, then yes.’
‘Have you had lunch today?’
‘They came round. Late again.’
‘What did you have?’
‘I haven’t got much of an appetite. I had some toast.’
‘I love toast. It really hits the spot sometimes. What did you have on it? Jam? Marmite?’
‘Nothing,’ she says.
I wheel her outside.
The air is brisk and bright with an autumnal zest to it. A scattering of golden leaves across the lawn. On the other side of the road, a man is affectionately soaping down his car. He stops and waves in our direction; Mrs Norbutt sinks lower in the chair.
‘What’s he want?’ she says.
Frank is waiting with the ramp down. He’s met Mrs Norbutt before, and treats her with professional circumspection.
‘All right, Mrs Norbutt?’ he says. ‘Up we go.’
‘Mind my leg,’ she says. ‘I’ve got enough trouble as it is.’
‘Right you are.’
We help her out of the chair – not an easy thing, as she insists on doing it her way, which means no brakes, footrest turned in, wrong angle, wrong height.
‘It might be better if you…’
‘I think I might know what I’m doing by now, don’t you?’
She makes it into the ambulance seat and folds her arms.
‘I can’t do the seatbelt.’
‘Allow me.’
‘How long will this take? I get sick.’
‘Not long, Mrs Norbutt. It’s a busy time of day, though.’
‘Still – lovely day for a drive.’
‘You can’t see out.’
‘No – but..’
‘Where are we going anyway?’
‘The Bedlington Residential Home.’
‘I prefer the other one.’
‘Which one was that?’
‘I can’t remember.’
‘All set to go?’ says Frank brightly. He smiles at me as he slams the door.
‘Sorry we have to slam the door like that, Mrs Norbutt. It’s just the door sensor’s dodgy and the alarm keeps sounding.’
‘I’m not surprised.’
As we move along I try all the usual routes into conversation. Nothing works. I feel like Pollyanna on Prozac, skipping anxiously through a maze, struggling to be bright despite all the wrong turns, all the blind alleys.
I sweat, and look at my watch, but the minute hand is backing-up along with all the commuter traffic we seem to have hit along the front.
‘Where does your daughter live?’ I ask her.
‘Miles away. Too far to visit.’
‘Does she ever make it over to see you?’
‘Jenny? No. She’s not well herself.’
‘Oh? Sorry to hear that. What’s up with Jenny?’
Mrs Norbutt turns her head to give it to me straight.
‘All the nerves are breaking off her spine. It won’t be long before she’s just a jelly with a brain.’
‘Oh.’ And then: ‘That sounds bad.’
‘You have no idea,’ she says. ‘Do you mind if I put my foot up on the trolley?’
‘No. Go ahead.’
She raises it up.
‘I’d put them both up but they cut the other one off.’
‘Sorry about the traffic,’ shouts Frank from the cab. ‘Shouldn’t be too much longer now.’
‘How long exactly?’
‘Ooh - not long,’ he says.
Just then a song he likes comes on the radio, and he turns it up to sing along. I have an overwhelming urge to push myself through the little serving hatch window and bathe in the sunny warmth and vitality of the cab, but I fold my arms and smile at Mrs Norbutt instead.
‘So. Not long now,’ I tell her, breezily. I put both my feet up on the trolley. She keeps quiet, and after a moment I get the feeling she is staring at my feet. And though I try not to, I find myself pushing back into a more upright position, and slowly dropping the left one.

Tuesday, September 13, 2011

one under

Ricky sweeps the door aside, strides into the crew room and drops down into a nearby computer chair in a melodramatic swoon.
‘What a day! Too tired to fuck, so you’re bang out of luck. You, boy – rub my shoulders or something and be quick about it. In fact, just rub my something.’
Ricky is so flamboyantly debauched he could have stepped straight out of a cartoon by Gillray. He’d look utterly convincing, dressed as an eighteenth century gentleman, the buttons of his frock coat straining over his gym-pumped arms, the seams of his breeches straining to hold back the playful, uninhibited exuberance of his sexuality.
‘Honestly, I don’t know how I do it,’ he says, laughing at the effect he always has on the room.
Ricky is one of an elite band of paramedics that specialise in trauma and critical care. As a result of their extra skills and experience, Control keep them in reserve until significant trauma or resus jobs come up; consequently, their trauma quotient is higher than normal. If this were a Gillray cartoon, it would feature Ricky dressed as a dragoon guard in knee length riding boots and scarlet coat covered in braid and medals, banging his knife and fork on the table as an endless line of servants hurried in from a hellish kitchen with plate after plate of crashed cars, buildings on fire, piles of corpses and other miniaturised horrors. His speech bubble might say something like: Let me assure you gentlemen, I’m sodding well good for twice whatever you can bring me! And the caption: Anatomy of a Public Servant for Health on the Front Line – or – The best place to get a decent chop nowadays.
And like Gillray, Ricky would be rampant with innuendo.
‘I just can’t seem to get it up like I used to– the website, darling, the website. I’m not talking about my cock. Did you think I was talking about my cock? Did you want me to?’
Ambulance vocabulary is often tough, its common terms of reference every bodily function, variation, degradation and perversion possible to imagine. Once you’ve worked in the field for a while, you become inured to the effect, though, and it takes more awfulness - more dreadful specifics, more refinement of awfulness - to provoke a response. But of the people guaranteed to push the limits of what you thought you could bear, Ricky is in the extreme, experimental tip of the cutting edge of the vanguard. He has an exuberant way of describing the awful jobs he’s been to, segued neatly in with the details of his own sexual adventures, that would have The Marquis de Sade shrieking for the exit.

Except yesterday.

Yesterday even Ricky seemed more subdued than normal, like a trapeze artist that for once almost failed to make the catch.
‘Are you okay, mate?’ I asked him when he walked quietly into the room and sat down in a chair.
‘Yeah – well. Jesus,’ he sighed. ‘I don’t know why they send us to these jobs. I mean – what are we supposed to do? The guy jumped off a bridge under a train. Pretty much obliterated. Nothing left to speak of. I was never very good at puzzles, anyway.’
He links his hands together behind his head and frowns at the air in front of him.
‘Still,’ he says after a long pause. ‘They won’t have any trouble identifying him.’
‘Why’s that, Ricky? Did he leave a note?’
He closes his eyes.
‘No – for some reason his face was still intact. We found it sticking to the front electric shoe.’

Monday, September 12, 2011

the little cabin boy

Mr Stanchion is sitting on a kitchen chair, a washing up bowl balanced on his lap, vomit stains on his shirt sleeve. Mrs Stanchion scurries around in the background, stuffing essentials into a bag – wash kit, dressing gown, book of great naval battles.
‘Good gracious,’ he says. ‘It’s a while since I was sick like that.’
The two of them had been for lunch at their usual spot, The Endeavour, a pub with a rotten bay window but a view nonetheless. Mr Stanchion had plumped for the curry, Mrs Stanchion a cheese salad.
‘I think it was the curry,’ he says, then retches some more.
After we check him over we help tidy him up, freshen the bowl, make him comfortable on the sofa. We drape a fleece round his shoulders and he sits there looking like a ruined earl, pale and bilious. He doesn’t want to go to hospital, but we have no immediate concerns. Despite his eighty four years, he only takes an aspirin a day, and the whole thing looks pretty straightforward.
‘You can always call us back if you get worried,’ we say to Mrs Stanchion.
‘Lovely,’ she says, taking her coat off and settling down with The Puzzler.
‘My word,’ says Mr Stanchion. ‘Fifty years at sea and never been sick.’
‘I was five hours at sea and I was begging for someone to shoot me,’ I tell him as Frank finishes the paperwork. ‘We went five miles out to do some fishing and it wasn’t too bad, motoring out, even though it was quite rough. But when we pitched the anchor the boat started rocking like this, side to side to side, and that was it.’
‘Yes. Jolly unfortunate,’ he says, dabbing at his mouth with a kitchen towel, then taking a sip of water. ‘Luckily I was never affected. But I knew people who were. I remember we had this little Chinese cabin boy. Excellent chap, always there when you needed him. But at the start of every voyage, he only had to hear the bosun shout to cast off the dock and he was up in the fo’c’sle, heaving over the side.’
‘Didn’t Nelson used to get sick like that?’
‘A little before my time but yes, I think he did. Mind you, those days – the ships were made of wood and one shudders to think how they must have pitched about. Do excuse me. I must, erm…’
I help him to his feet, and he hobbles off to the toilet.
‘I had the salad,’ says Mrs Stanchion.

Sunday, September 11, 2011

lifestyle changes

Keith is sitting half on, half off the ambulance seat, one hand on the Entonox mouthpiece and one hand on the arm rest. When the pain in his right flank comes on strong again he bows his head, clamps down on the mouthpiece and takes several deep draughts.
‘Is this like them helium balloons?’ he says as the pain subsides. ‘Is this gonna make me go all Mickey Mouse?’
‘It lowers your voice a bit.’
‘Yeah? Well, so long as it eases the pain I don’t care what I sound like.’
‘Good. I’m glad it’s helping.’
A tall, powerfully built man in his early forties, the only thing that stopped the ambulance wheels lifting up at the front as he clumped up the back steps was the weight of his thickly gelled quiff acting as a counterbalance.
‘I’m stressed. I know I’m stressed,’ he gasps, struggling to find a comfortable position between the chair and the floor, his face pale and his eyes rimmed silver with the pain of it all. ‘Would that bring this on, d’you think?’
‘No, not really. Not if it’s renal colic or something like that.’
‘What else could it be then?’
‘Some kind of infection – don’t know. You need to see a doctor.’
He tokes on the Entonox and then studies me for a second.
‘Are you married?’ he says.
‘Yep. Married. Two kids.’
‘I was. We just split up.’
‘It’s not your fault.’
He takes some more Entonox.
‘Could it be the old Hong Kong Flu, do you think?’
‘How d’you mean?’
‘You know. The clap. An STD.’
‘It’s possible. Why?’
‘I saw this woman up town last week. Fifteen years, that’s the first time I done it.’
‘D’you mean a prostitute?’
‘I don’t know. I met her online. It wouldn’t surprise me if she was. Anyway, I seem to remember someone telling me it takes five days, then you can’t piss, and it feels like a donkey kicked you in the kidneys.’
‘Did you have unprotected sex?’
‘No. ‘Course not. I took a flick-knife.’
He laughs, but then the pain grabs hold of him again and he dives down into it with the mouthpiece clamped in his teeth and the demand valve hissing. When this bout ends, he slowly surfaces.
‘It’s good stuff, this,’ he says, waving the mouthpiece in the air. ‘Where can I get myself some?’
‘And it doesn’t give you a hangover.’
He hands me the mouthpiece.
‘No. You’re all right,’ I say.
‘Fair play.’
He takes some more as the ambulance moves off.
‘I’ve just changed my line of work,’ he says, shifting his position again. ‘That’s stress for you, right there.’
‘You’re not kidding. What did you use to do, then?’
‘I was in the house clearance game. Twenty years of it. It got so I could tell everything there was to know about a person, just by what they had around them in their house.’
‘I bet.’
‘I was good. I used to get all the best stuff.’
‘What about the relatives?’
‘Oh sure they’d circle overhead quick as you like. But I knew the tricky little places, you see. I knew where people liked to put things. I did all right. But it weren’t all plain sailing though. Sometimes we’d get called in to some terrible places. This couple I remember – hoarders, they were. Didn’t throw nothing away. I took three tonnes of paper out of that house. Piled up, great columns of the stuff, floor to ceiling. They’d made little alleyways – runs, you know, like rats - to move about. And of course the drains had packed in years ago, so you can imagine what the carsey was like. Hell on earth. After that job, my partner Malcolm, he burned all his clothes, shaved his head and took to wearing the strongest cologne you could imagine, but I could still smell it on him three weeks later. Made a profit, though.’
He pauses to draw on the Entonox again.
‘I could get used to this,’ he says when the pain has eased again. ‘But I know I’m stressed. I can feel it. What do you do about that, then? What do you do about stress?’
‘I don’t know. Talk to your doctor for one thing. There’s lots you can do.’
‘Like what? Pills, I suppose.’
‘Yeah – pills to help you sleep, calm you down, help you through the bad patch. But they could refer you on for some talking therapies – you know, counsellors who could help you with any lifestyle changes you might need to make.’
‘Lifestyle changes?’ he snorts. ‘Listen, mate. I’ve had enough of them already.’

Friday, September 09, 2011

why this thing happened

I pull alongside the scene and put the side lights on. They illuminate Taz, lying on his side on the pavement, his legs drawn up, his bloodied head pillowed on his arm. A young girl is shouting and pulling at his jacket: Don’t do this to me, Taz; Come on breathe, mate. Stay awake.
A large woman in a wide brimmed hat is parked alongside on a mobility scooter. She backs up a little so her shadow doesn’t overlie the scene, then rests forward on her handlebars, smoking a fag and taking in the action with the equanimity of a frontier Marshall.
‘It was one of Sam’s in-laws,’ she says as we walk in. ‘Weren’t it, Taz?’
‘Yeah. Something like that,’ he mutters. ‘Just leave me alone.’
Frank taps the girl on the shoulder and asks her to step aside.
‘The paramedics’ll take care of you now, Taz. Let them do their stuff. They’ll fix you up.’
‘I don’t want nothing,’ he says. ‘I just want to be left alone.’
Frank squats down.
‘Keep nice and still, mate’, he says, placing his blue gloved hands around Taz’ head. ‘Just in case you’ve hurt your neck. Now – no, no, quite still – whilst we give you the once over. Tell me what happened.’
‘Fuck knows. I was coming out of the party. And the next thing I know this geezer starts battering me. I went down, and he kicked me in the head.’
‘He’s an animal,’ says the girl. ‘A fucking animal. No way he deserved that. No way.’
The woman on the scooter laughs and flicks her cigarette away.
‘I’m off home, Taz,’ she says. ‘Good luck mate. See you later.’
‘Yeah, later.’
‘Were you knocked out, d’you think?’ says Frank.
‘I’ve no idea. I don’t remember.’
‘He was completely out of it,’ says the girl. ‘I thought he was dead.’
Frank sends me back to the truck to get together the trolley, scoop, vacuum mattress, head blocks – all the kit for immobilising a trauma patient.
‘Now Taz,’ says Frank. ‘You’ve had a lot to drink, you’ve been assaulted, fallen to the floor, maybe lost consciousness. All of that means we have to keep you nice and straight for the ride in to hospital, so the doctors there can see if you’ve damaged anything. Okay?’
‘You’re joking,’ spits Taz. ‘I just want to go home.’
‘Maybe later,’ says Frank. ‘But you need some attention in hospital.’
‘He’s a paramedic,’ says the girl, ‘Don’t you give him no trouble and do what he says. I’m gonna call Sam to meet us up there.’
‘No – don’t. I’ll see her later.’
But the girl turns away with her phone.
‘Oh man!’ says Taz. ‘This is fucking unreal. I can’t believe he did that. One minute it’s all happy, happy, falling out of the party, the next he’s like a fucking mentalist. I tell you what, mate – first thing I’m doing when I leave hospital is go straight round there and rip his head off.’
‘Yeah? Well if you keep waving your head around your ripping days are over,’ says Frank. ‘So keep still. I know it’s uncomfortable, but it’s for your own good.’
‘Yeah, easy mate – whatever.’
The police are on scene now. Two of them interview the girl and some bystanders; one helps us parcel Taz up and get him onto the stretcher.
‘Fuck me,’ says Taz. ‘This is too fucking weird.’
Whilst we strap him to the trolley the police officer who helped us takes off his bloodied glove, pulls out a notebook and leans in.
‘All right, Taz?’ he says. ‘Who did this?’
‘Ask Kelly. She’ll tell you,’ he says. ‘Wanker. I weren’t doing nothing.’
‘So why did he start, then?’
‘I don’t know. I’ve got no idea. I was coming out of the party, messing about, then suddenly he comes up, stands next to me and he’s like: Oh, so – that’s how it goes, is it? and he lamps me as hard as he can and I go down. He’s fucking dead, mate. I tell you that much for free.’
Frank sighs and shakes his head.
‘Who knows why these things happen?’ he says. ‘Come on, mate. A few bumps.’
We load Taz onto the ambulance. Kelly finishes her phone call, but just before she climbs up into the back she pauses and bends her leg back to look at the sole of her shoe.
‘I think I’ve stood in dog shit,’ she says.
‘Here. Put some gloves on and wipe them with this,’ I say to her.
‘Nah. Cheap Primark specials.’ She slips them off and chucks them out behind her where they clatter away into the dark street. She climbs in barefoot and plumps herself down in a seat facing the trolley.
‘Is he going to be all right?’ she says, crossing her legs, resting her phone on her knee and flicking through the screen.
‘I expect so. This is all precautionary.’
‘What d’you mean? I’m always all right,’ says Taz. ‘I’m better than superman.’
‘Show us your pants then, darling,’ she says, her laugh as light and sharp as her ear-rings.
‘I’m not showing you no fucking pants.’
‘Thank god for that,’ says Frank. ‘Now, Taz. It’ll feel a bit weird riding like this in to hospital, but it’s important we keep you flat. If you feel like you’re going to be sick, let me know and we’ll deal with it. Okay?’
‘Okay boss.’
‘This is dead exciting,’ says Kelly, flicking her fringe. ‘I’ve never been on an ambulance before.’ Then she bends back over her phone, scrolling through options, searching for something.
Frank nods to me and I turn to jump out and drive. But just as I’m pulling my gloves off, Kelly says: ‘I knew you shouldn’t have done it, Taz, mate.’
‘Done what?’ he says.
‘Booted that hedgehog.’
‘It was a joke,’ he says. ‘And anyway - what the fuck it’s got to do with him, I don’t know.’

Monday, September 05, 2011


Barbara speaks on the intercom with a strangely conversational tone, as if it was the most natural thing in the world for an ambulance to be calling by at six in the morning.
‘I suppose you’d better come up. But please - be very careful not to slam the door.’
We trudge up a neatly carpeted flight of stairs to her front door, a single pane of security glass with a floor-length cream curtain hung behind it. Barbara meets us at the door, a pale and pouchy, middle-aged woman whose dark bob of hair seems to accentuate the bitter fall of her mouth. Despite her comfortable clothes and polite speech there is an edge to her that glimmers beneath the bright hall light.
‘Hello. Ambulance,’ I manage to say. It’s been a long night. My lips are fat and my boots dipped in concrete. Any vitality I had has been rolled flat by the relentless passage of the shift, but this must surely be our last patient. That happy thought gives me just enough power to say: ‘Can we come in and chat?’
‘Oh. Okay. If you think.’
She lets go of the door and we drift after her into the sitting room.
‘Please excuse the mess,’ she says. ‘Organised chaos. But at least I know where everything is.’
In fact, the flat is as tidy as you could want. There is a laptop on an antique pine blanket chest, a large art book on the sofa, a blue bowl of fruit as tastefully set as the charcoal and pastel study of the nude above it. From the polished brown leather sofa to the tie-backs on the floral curtains, everything has the brisk domestic sheen of a Sunday Supplement article – except it feels off, as if, despite all the care, someone had come along and spoiled the photo by writing a terrible sentence – a bad thought, a dreadful curse - in small print somewhere.
‘Please. Have a seat,’ she says, taking one herself, perching on the edge and folding her hands neatly in her lap. ‘Now. What’s all this about?’
‘I understand you’ve taken an overdose. Is that right?’
She pauses, and self-consciously moves a few strands of hair away from her face. When she does speak again, she speaks in a close, low whisper, a slightly fussy tone, like a stressed teacher counselling difficult parents. She does not look up, but addresses the carpet between us.
‘Now. This is how things are, as I see it,’ she says. ‘Please – bear with me. I’ve had an awful lot of experience in these matters, both as a patient and as a friend of mental health professionals.’
‘I – well – from the beginning, I suppose. Last night I decided, for reasons I won’t go into now, because you’ve got better things to do, and so have I, and these things are complicated enough – and I know you’ve got a job to do, and I don’t want to take up any more of your time than I already am. I am in good health. I only suffer with a couple of things, one of them being depression. As you could no doubt have guessed.’
‘That’s the information we were given.’
‘Really? Fine.’ Her mouth seems dry, and she forms her words with that overly precise articulation you get with alcohol or drugs.
‘Firstly, yes, it’s true. I have taken an overdose. I have taken a packet of anti-depressants. Yes – I told this to the people on the phone, presumably part of your – erm – network. But as I explained, there’s nothing I want from anyone. It’s a decision I have made, and I’m perfectly within my rights to make it. So I don’t know what papers you’ve been reading, or to what rule you think you might be operating. But this is my house, these are my rights, and I know exactly what I can or can’t do. Let’s be clear on this before we go any further, or I’ll have to ask you to leave.’
‘Barbara – I’ve not met you before, so I’m completely in the dark about what’s happened today.’
‘Are you? Completely? Well that’s not much use.’
‘No. So let’s start with the basics. We need to know exactly what you’ve taken, how much of it, and when.’
‘Hm. This is interesting. So you want me to tell you exactly what it is I’ve overdosed on? Is that correct?’
‘I see. And on what study have you based this – erm – conclusion?’
‘It’s not really based on any study, Barbara. It’s a basic fact we need to establish before we can carry on. We just need to know the nature of the overdose.’
‘Yes. I can see what you’re getting at. But before we come to that, let me just go over a few things. Because as you know this is my house and I’m perfectly entitled to do or say whatever I want in my house without fear of you or anyone else telling me what I should or shouldn’t say. Is that clear? I didn’t want you here. I didn’t ask for you to come, I didn’t want you to come. I simply phoned the helpline for some information – information that I wasn’t managing to find myself. The person on the helpline offered to send me your good selves, acting as their representative, who might be able to help me understand a few things and if not make things better, at least move things forward to a more satisfactory outcome for all concerned. Now, if you’re telling me that you’re unable for whatever reason to keep your end of the bargain, I think I would have to apologise for calling you out like this, say good morning and draw this interview to a conclusion.’
‘Barbara. Let me be as clear as I can. We work for the ambulance service.’
‘Yes. I am aware of that.’
‘Our job is to make sure you’re okay. We were told you may have taken an overdose. If you have, we need to know what you’ve taken, when you took it, and how much.’
‘Yes. Go on. I follow.’
‘But the fact is, we can’t treat you here. It’ll invariably mean a trip up the hospital.’
‘I’m not going.’
‘We haven’t the equipment or the skills to treat you for any of the harmful side effects that you might suffer.’
‘I’m not going.’
‘Plus there’s the reason you took the overdose in the first place. Can I ask – was it to do yourself harm?’
‘No – it was to kill myself. I was looking up on-line at the thing to take, and that was why I phoned the helpline.’
‘Well you see, Barbara – the fact that you’re quite clear about wanting to kill yourself is another reason why we’d like to take you to hospital, quite apart from any tablets you may have taken.’
‘I am not going to hospital. I have wasted too many months of my life in awful places like that and I don’t intend to waste any more. If all you can do is threaten to cart me off to some unspeakable ward somewhere, you can forget it.’ She stands up and starts looking around for something. ‘If I’d thought that’s all you were going to do, I’d never have agreed to let you in. You’ve made me feel quite anxious and upset. I’d like you to leave, please.’
‘Of course. But Barbara – just let me say this before we go. If you were diabetic and your blood sugar was low, you’d be distressed and out of sorts, wouldn’t you? You might well struggle to stop us helping you.’
‘You’re making me extremely anxious now. What do you mean “struggle”? Just what are you planning?’
‘Nothing. I’m not planning anything, Barbara. I’m just trying to be clear and open with you. I’m trying to find an example that might help you see things from our point of view. The fact is, you suffer with depression. And depression is just as much an illness as diabetes. I don’t have a problem with you accepting or refusing help, but I do have a problem if I think you’re not making that decision rationally, because of your illness. We’re supposed to act as the advocate for your healthy self, Barbara. We’re supposed to look after your best interests. And if you’re so depressed that you’re thinking of killing yourself and taking an overdose, I’d have to say that doesn’t look like a rational decision.’
‘Please. I’d like you to go.’
‘Do you have a CPN, Barbara?’
She snorts derisively.
‘CPN! The last place I lived virtually all my friends were CPNs. And if you think I’m going to offer up my life for them to dissect and gossip about endlessly you have another thing coming. Please. I think it’s high time you were going. I’m sure you’ve got better things to do.’
‘We will go, Barbara, but I wish you’d come with us.’
‘No. Thank you.’
She flashes me a look and wets her lips.
‘What will you do now?’ she says.
‘I’ll contact the out of hours doctor, tell them what happened, and leave it up to them to decide what to do next.’
‘Fine. Let them. Good bye.’
She holds the door open as we go out, then comes to the top of the stairs as we descend.
‘And please don’t slam the door on the way out,’ she says.

Saturday, September 03, 2011

the real thing

The fog has really come down now. It slides through the park, an implacable wall of grey, wiping the form and substance from everything, absorbing the shouts of the children, the muted chatter of the diners at the outside tables of the restaurant, the candles in their red glass bowls pulsing like the hearts of strange flowers with ragged petals of dark.
The ambulance thrums into place by the bins and boxes at the back of the café. A shadowy figure is there to meet it, the manager of the place, hugging his arms against the chill, smoking a cigarette.
‘He was sitting on a bench opposite for ages, then I saw him stagger off up the hill a little way and lay down on the path.’ He takes a generous pull of smoke, exhales, and for a second you could imagine here was the source of the fog. He smiles and taps the glowing end out to the side. ‘I think he must be pretty whacked out on something or other, but you’re the experts. You can just make out his shape – there!’
‘Thanks. Do you know who he is? Is there anyone with him?’
‘I haven’t seen him before and no, I think he’s alone.’
We walk up the path.
Children stop playing on the green in front of the restaurant. They stand strangely still, turning their whole bodies along with their eyes to watch us as we go.

Jez is lying on his back, his right hand across his forehead. As we approach he shouts out:
‘I’m not a bad person! I haven’t hurt anyone! Please! I haven’t done anything!’
‘It’s okay. We’ve only come here because people are worried about you. What’s your name?’
‘I’m not violent! I haven’t done anything wrong!’
‘No-one’s said you have. But you can understand how worried they were when they saw you lie down on the path. They think you’re not well.’
‘I’m not well. I’m mentally ill. Look!’
He bunches up the sleeves on both arms and even in this light you can make out the thickened stripes of white flesh where he’s cut himself in the past.’
‘That looks bad,’ I say. ‘You’ve obviously had a lot to put up with. But first things first. What’s your name?’
‘Jez. Jez. They know me there. They know me at the hospital.’
‘Okay, Jez. My name’s Spence and this is Frank. Our ambulance is parked just behind the café there. Will you come with us and have a chat about what’s going on tonight? It’s perfectly safe. There’s nothing to worry about. But you can’t be very comfortable down there. It’s a bit chilly to be lying on the floor.’
‘Help me up!’ he says, raising his left hand. ‘I’m frightened.’
‘Come on then.’
We help him up.
As soon as he’s upright he grimaces and pushes the heels of both his hands into his face. We both take a step back.
‘I’m not a violent person!’ he shouts. Then makes an incoherent growl of a noise, flecks of saliva playing about his small, white teeth.
‘Jez! Jez! Just try to ease off a bit, mate. Look. I believe you when you say you wouldn’t hurt anyone. But when you shout and carry on like this, you do come across as violent. I want you to try really hard to calm down.’
‘I’d never hurt you! I just want to hurt myself! I want to die!’
‘Jez. Look – there are lots of children in the park. Can you see - just about! All the children? You’ll scare them if you carry on like this. I know you don’t want to scare the children, do you? Hey?’
‘No. I don’t want to scare the children. But I’m losing my mind!
He looks around him, a strangely melodramatic movement, sweeping his arms out and to the side, arching his back and throwing wide-eyed looks to the right and left. ‘The fog!’ he gasps. ‘It makes everything so – different!’

We manage to calm him down and head back to the ambulance. As we walk along the path, a child stops bouncing a ball and clutches it to her, staring at the strange procession. Jez twitches and makes a turn as if to shout something to her, but we discretely lead him away, all the time finding the kind of bland encouragements you might make to a jittery horse. Frank opens the side door of the truck; the bright light from within spilling out suddenly, cutting a square of yellow in the cool, grey air around us. Jez draws back.
‘It’s okay,’ I say.
He looks at me, and I feel myself tense up, anticipating an attack. But instead he smiles, puts a hand on my shoulder and starts singing: You to me are everything, the sweetest song that I can sing, oh baby. Oh baby….
‘The Real Thing,’ says Frank. ‘Nineteen seventy six.’
We climb into the ambulance, and he shuts the door as gently as he can behind us.

Friday, September 02, 2011


The job comes through as an adult / male, hit by car, giving as the location an estate agent in the high street. We’re not far from the scene; as Frank turns into the road, we expect to catch the tail end of the jam and see flashes of blue ahead. But the traffic is flowing as smoothly as ever, and the concourses free of the usual thrill of incident. The update comes through just as we pull up outside the shop: injury longer than two days, followed by a lower grade response code. There’s no time to call Control up for a chat about this; someone is waving to us from between all the housing cards in the window.
As we cross the threshold there is a low, rumbling growl off to our right, where a man is bent over a telephone on the desk by the window. The paws and snout of a giant Alsatian poke out from between the legs of his chair. It growls again, and I can almost feel it through the floor.
The estate agent, a glossy blond efficiently packaged in scarlet blouse and grey two piece, smiles wanly and backs away to the safety of the photocopier at the rear of the shop.
‘He just - came in,’ she says, and nods towards the man.
The subject of her horror is obviously still on the phone to the call-taker. I tap him on the shoulder; he almost leaps out of the chair.
‘We’re here,’ I tell him. ‘You can hang up now.’
He lurches round and faces us from the chair. A rheumy scoop of a guy, he flicks his head as he blinks, struggling to locate the can of super strength right in front of him on the desk. His hair quivers in clumps like the last remaining feathers on a stressed fowl, and his jacket and jeans are so spattered and filthy they could have been dredged from a swamp.
‘Hello Tony,’ I say.
Hello Tony?’ he says, slopping the can between us. ‘Hello Tony? I’ve had an accident. I’ve been run over. And that’s all you can say, Hello Tony? I can’t walk! I’m badly injured. I was hit by a car and I can’t do anything.’
It’s always difficult to keep pace with Tony. His speech pattern is as chaotic as his appearance, lurching from one state to another, one moment the traumatised patient, the next, pleasantly conversational.
‘So, where’re you from?’ he says, crossing his legs. ‘Do I know you?’
‘Tony – I want you to slow everything down for a minute and try to concentrate. No – just listen and answer my questions. How did you get here?’
‘Well I walked, obviously. The dog’s not mine. I’m looking after her. And now this! Don’t do this to me. Please. I’m badly hurt. I can’t feel my legs.’
He dry-cries, and then pushes the can up into his nose.
‘Let’s have that,’ I say, taking it off him. I hand it to Frank, who smiles and hands it back to the woman, who takes it with two fingers and arms a mile long in the direction of the bin.
‘Tell me about the accident, Tony.’
He reaches inside his jacket and pulls out a crumpled square of yellow card.
‘Ring Sheila. There – that number. She knows what’s what.’
‘Yep, I will ring her, Tony but first I want you to tell me why we’re here. What’s all this about you being hit by a car?’
He leans forward and puts his face in his hands.
‘Why won’t you listen?’ he moans. ‘You don’t care. You’re heartless and horrible. I’ve told you everything I know. What do you want from me? Why won’t you do anything?’
‘When did you have this accident?’
‘Yesterday. The day before. I can’t remember.’
‘Did you go to hospital?’
‘Did you have the ambulance out to you?’
‘Yes. No. I don’t know. Look I just need help but you don’t seem willing to give it for some reason. I can’t walk and someone has to get the dog back home. Ring Sheila. That number – there.’
I look back at the estate agent, who has sat down at her desk and buried her head in her computer.
‘Can I use your phone?’
She looks up, nods, gives her head a little shake, and ducks back down again.
Sheila answers on the third ring. A pleasant voice, kind and calm.
‘Tony lives a couple of doors down from me,’ she says. ‘I’ve known him for years, but I must admit he’s getting worse. It’s the drinking, more than anything. Don’t worry about the accident story. It’s – how shall I put it? – one of the aspects of his problem. I expect you’ve seen him before, have you? He’s often up at the hospital. Discharges himself after an hour. I’m so sorry to waste your time.’
‘Whose dog is this, Sheila?’
‘Oh – has he got his dog, Ruth, with him?’
‘I must admit I’m more worried about the dog. We can’t take her in the ambulance with us, and he’s quite a way from home.’
‘I’d come and get her but I’m out of town working. I won’t be back till this afternoon.’
‘Never mind, Sheila. We’ll sort something out. Thanks for your help.’
I hang up.
‘Who was that?’ says Tony.
‘That was Sheila. She says this is your dog. Ruth.’
‘Of course this is my dog. I told you.’
I turn to Frank.
‘How far away are we from Mannings Crescent? I can’t remember.’
And then to the estate agent.
‘I don’t suppose you’ve got a map book handy, have you?’
She gives me a look that’s barely one degree warmer than the look she’s been giving Tony, and it’s only then that I notice the gigantic map of the city centre spread across the wall facing me.
‘Oh. Good. That’s handy.’
Frank reaches out and taps Mannings Crescent, about two miles up the road.
‘You ought to get yourself a saddle,’ he says to Tony. ‘She’s so big you could ride her home.’
‘Fine!’ he says, standing up and lurching off towards the door. ‘If that’s all you think I’m worth. Come on, Ruthie. Thanks for nothing.’
He clatters out of the door.

‘Sorry about all that,’ I say to the woman. She smiles and stands up.
‘I think he might have spilled a little of his beer over here, so watch out. If he comes back in, call the police.’
She reaches out and steadies herself on the computer screen.
Outside, we both look up and down the street. Tony is immediately apparent, sitting on a table outside a tatty pub a few doors along, waving his arms and talking energetically to a couple of drinkers who, even though they are as derelict as you could wish to see, are appalled at their new companion, and shift uncomfortably on their seats. Ruth is already stretched out on the pavement in front of them; Tony doesn’t see us go, but Ruth – she raises her dark and massive head, and watches us intently all the way back to the ambulance.