Tuesday, March 27, 2012

where does it come from

Here we are at the custody suite again. Modelled on the bridge of the Starship Enterprise, the centre of it is dominated by a great circular dais marked out into separate counters each with its own computer terminal. The only thing lacking is Mr Spock leaning over a screen and rationalising a particularly dangerous reading. If the red lights start flashing on and off, I expect we’ll have to start throwing ourselves about.
What makes the suite seem even bigger is the group of teenagers who’ve been arrested. It’s absurd to see them here, being patted down. By rights the officer should be holding up lollipops, or at worst some unfinished homework. As it is, he holds up a batch of fat cigarettes and a Ziploc bag of herb.
‘This – this is very bad for you,’ says the officer, shaking it in the air. But even he seems suddenly to be overcome with apathy. ‘Name.’
But we’ve come for someone else - a psych patient called Mr Turner who was sectioned by the police earlier in the afternoon. Apparently he’d been behaving erratically in the shopping centre, shouting loudly and waving his arms about in a threatening manner.
‘We’ve picked him up before,’ says the Custody Sergeant. ‘Known schizophrenic. Was in around Christmas, similar deal, but went in for a week or two and everything calmed down. But it looks as if he’s been off his meds again so here we are. He might shout and carry on, but don’t worry, he’s never actually been violent. Will you be okay with that? You don’t need an escort, do you?’
He may as well be holding up subtitle cards: Please say it’s okay. We need the cell space. We can’t spare anyone.
‘Yeah fine,’ I say. ‘Forewarned and all that.’
‘Great. This way. Here’s his bag of stuff. I’ll need you to sign for the cash he had on him.’
‘Okay.’

Mr Turner is an extraordinary man. Six foot six, with a snow-cap of hair and icy goatee, he has the stringy but distinguished demeanour of a great explorer. If it wasn’t for the fact that they’ve taken away his belt and one hand is occupied holding on to his trousers, you’d have trouble getting anywhere near him. As it is, his left arm is constantly on the move, swinging his hand up to pluck some imaginary membrane away from his face, then swinging out again to pat and slap the air. His eyes are pale, a robin egg blue.

‘NO! I KNOW WHO YOU ARE! YOU’VE COME TO TAKE ME TO THE HOSPITAL. IS IT PRIVATE? I SAY, IS IT PRIVATE? ANSWER ME. DON’T LIE TO ME.’
‘No-one’s going to lie to you, Mr Turner. This is the ambulance crew and yes, they’re taking you to the psychiatric hospital, the NHS one. Now there’s nothing to worry about...’
‘NOTHING TO WORRY ABOUT? NOTHING TO WORRY ABOUT? DID YOU HEAR THAT? HE SAID THERE WAS NOTHING TO WORRY ABOUT. WHAT’S YOUR FAVOURITE BEER? DO YOU DRINK BEER?’
‘London Pride,’ I tell him. ‘Guinness.’
‘WHAT ABOUT GOAT’S CHEESE? DO YOU EAT GOAT’S CHEESE?’
‘Not much. Sometimes on a salad. I’m not over-keen.’
‘I’M IN DISPUTE WITH THE BANK. I PUT THREE HUNDRED POUNDS IN THE CASH MACHINE AND IT WOULDN’T GIVE IT BACK. DID YOU KNOW YOU CAN PUT CASH IN AS WELL AS TAKE IT OUT? BUT I’M IN TWO DISPUTES WITH THE BANK. ONE ABOUT THE THREE HUNDRED POUNDS AND ONE ABOUT SOMETHING ELSE.’
‘Well let’s talk about that on the way to the hospital, shall we, Mr Turner?’
‘IT’S NONE OF YOUR BUSINESS.’
‘Well, only if you want to talk about it, of course.’
His voice is so loud it’s hard not to lean backwards. I look over in Frank’s direction. He smiles at me – and I can read the imaginary cards he’s holding up, too: Funny how you always ends up in the back with the difficult ones.
‘WHERE DOES MILK COME FROM?’ bellows Mr Turner.
I turn back to him, suddenly feeling tired.
‘I used to know. I really did. I’m just not that sure any more.’

Thursday, March 22, 2012

marmite man

It’s no surprise Dave Leopold is in the meat trade. He looks like a generously stuffed pork sausage someone has dressed in gym slacks and a blond wig, and then inked on a face – a terrifying hybrid of startled and hostile, the eyes perfectly round, touching above the nose.
He is waiting for us in the ward lobby.
‘Have you come for me?’
‘Are you Mr Leopold?’
‘You’ve come for me. And I won’t be needing that for starters,’ he says, nodding at our trolley.
‘We haven’t been told much, Mr Leopold. Other than you have a bowel condition and you’re being transferred to a specialist unit…’
‘You haven’t been told much? How is that any good? How is that prioritising my situation? Eh?’
A nurse comes over to us.
‘You don’t need a trolley,’ she says.
‘They didn’t give us any details, so we thought we may as well bring it up. It’s a long...’
‘Never mind. Here are his notes. Goodbye, Dave. Good luck.’
She drops the package of notes onto the trolley and turns smartly about.
‘Shall we go then?’ says Mr Leopold, grasping the handle of his tow-along suitcase. ‘Or shall we stand around talking here all day?’

‘Don’t mind me,’ he says, settling in to his seat on the ambulance. ‘I’ve got a wicked sense of humour. Love it or leave it. It makes no odds to me. Maybe it’s because I’ve had this shock, but I’m looking at life very differently now to what I used to. What’s the point in worrying about all that stuff? I mean, don’t get me wrong. It’s important to have enough money. You’ve got to have food on the table and clothes on your back. It’s like I’ve always told my daughters: Learn your lessons at school. Get your Maths, your qualifications. Then you can fuck about. Then you can get out and learn what life’s all about. Listen. I’ve been round the block a few times. I’ve worked hard all my life and I’m good at my job. Bloody good. I can tell you the inside out of the business. There’s no one who knows more about burgers than I do. And I promise you this. If you taste one of my burgers, you’ll come back for another. And another. Because that’s who I am. It’s what I do. But it’s like I said. You’ve got to get your priorities right.’
‘Ready to go?’ calls Rae from the cab. ‘The traffic’ll be bad this time of day, so it might take a while.’
‘Great,’ I say. ‘Don’t worry.’
‘Just you worry about the road, Rae. I know what you women drivers are like.’
I can hear what Rae says clearly enough, but Mr Leopold settles back on his seat and folds his arms.

‘Don’t mind me,’ he chuckles. ‘I can’t help it. I’m like Marmite – love me or hate me. That’s just the way it is. Listen. I had the Consultant come on his rounds this morning. Everybody else on the ward is groaning away on their beds, you know, can’t do this, can’t do that. But my view is – use it or lose it. I’ve never been one for complaining. So I’m sitting there reading the paper beside the bed, which is all nicely made up. Anyway, the Consultant comes round, posh voice, shiny shoes, and he looks at me like this, right? And he must think I’m visiting or something because he checks his notes then he says: Is there someone in this bed? So of course, what do I do? I put my paper down, stand up, lift the sheet and look under it, then get down on my hands and knees and look under the bed, then I stand up and I say to him: No. I don’t think there’s anyone in this bed. I mean – what a question! What does he expect! So he goes all red, mutters something or other, turns round and walks off. What an idiot! He was asking for that! I know what my wife’ll say when I get home. She’ll say – Dave! What are you playing at, upsetting the doctors like that. But if someone asks me a stupid question I’ll give them a stupid answer. That’s just me. I don’t care who you are, mate. You could be the Queen of England. A joke’s a joke, and if you don’t think it’s funny, that’s your lookout.’

If you plotted a graph of my interaction with Mr Leopold, it would start high enough, but show a rapid decline over the hour or so it takes to transfer him to the other hospital. Less than half way through the journey and I’m avoiding eye contact, making only the barest conversational response. But Mr Leopold doesn’t need any input from me. He’s the social version of the air plant, spiking and flowering, apparently on nothing.

‘I didn’t say goodbye to anybody on the ward. Well, what’s the point? Do you know who they were? I’ll tell you. Junkies and Gypsies. But hey, it’s a free country. More’s the pity. So when they said I was being transferred today, I snuck out first thing and I’ve been waiting three hours in the lobby with my suitcase. And that’s what they call priority treatment, is it? Never mind. We’re here now. Why’s she going this way? Oi – Rae! That’s a boy’s name, innit? Rae? She’s ignoring me. Well if she doesn’t want my help, that’s her lookout. I’m not going to stress myself about it. I don’t do that anymore. That’s one reason I ended up with this problem. I suppose you get a lot of stress in your line of work, do you?’
‘Some.’
‘Take me, for instance. I used to get really stressed, but not anymore. I’ve cut that out of my life. Now if I go out I’ll get a taxi from the restaurant or wherever back to the hotel because I don’t want the hassle of town night life, you get what I’m saying? I’ll get back to the hotel and put my feet up and watch it all kick off below me. Not that I can’t handle myself. I can handle myself pretty well, thanks very much, as you can probably tell. I used to do power lifting before all this. I may be short, but I’ve got big hands. Take you, for example. Say you got it into your head to corner me in the ambulance. Well I’m here to tell you, doesn’t matter what you think you can or can’t do, mate, I’m coming out of there. Do you know what I’m saying? I’d be away and you’d be lying there on the floor, and that’s a promise. Or take my house, for example. I’ve got a lot of very valuable gear in my house, not least the van outside. That’s thirty grand right there. So say you’re walking past and you say to yourself ‘Hm, I like the look of that’ and you think you’ll have some. Well, listen. If you broke into my house, I can promise you it’d be the last thing you ever did on this earth. And you don’t think I’d get away with it? Listen. I’d take that baseball bat off of you, I’d smash your head in, then I’d wipe my prints off and put it back in your hands so it look like you done it. Yeah? She should’ve gone left here. You should’ve gone left, love! Never mind. You can lead a horse to water but you can’t make it drink.’

Monday, March 19, 2012

caught in the oyster

Oyster Court must have been knocked-off one Friday afternoon in the Thirties by an enthusiastic but Martini-muddled architect with an Escher fetish. It looks like a smashed Rubik’s cube, split apart on three levels, with two main doorways, and a chaotic stack of windows and balconies above them all, each with a slant-ways view of the ocean.
It’s midnight, black, a brackish snap of seaweed and coming rain. I can feel and hear the sea beyond the reach of the orange car park lights, massing restlessly on the tide line.

I’ve not been here before. The two doorways seem to lead either to even or odd numbered flats. But the first also has a sign that says tradesmen’s entrance, and looks to open onto a lobby that connects to the second lobby via an internal door. So what’s the point of having two entrances? There is a lift in the second lobby.
I’m here for flat one. I figure it can’t be far off the main lobby, on the ground floor. I buzz the buzzer, but no-one answers. After a while I call Control for advice. They tell me a key holder is on his way. As soon as I hang up he’s there – a diffident, heavy man with the heft of a freshly plucked bear in a gamekeeper jacket and corduroy slacks.
‘Hello. John, the key holder,’ he says, giving a friendly bob of the shoulders and shaking a set of keys in the air. ‘Friend of Gary, Myrtle’s son. He’s … erm .. he can’t make it, so I’m going to let you in.’
He pads up the steps to the second door.
‘I’m a bit confused by the arrangement here,’ I say. ‘I don’t understand why they can’t just have one door.’
‘No-one can,’ says John, scuffling around the lock, trying to make one of the keys fit. ‘Erm…’
‘Maybe they’ll fit in the first door?’
‘Okay. Yep. Good idea. Let’s try that.’
The same.
‘Shall I have a go? They look like a new set. Maybe they’re not quite right.’
‘By all means,’ says John, handing me the set.
None of them fit – the first or the second door.
‘It’s the first time I’ve been asked to do this,’ says John with a shrug. ‘I should’ve had a dry run.’
‘Not to worry. I’ll ring one of the other flats and get them to let us in. Then hopefully the keys will work on the flat door.’
‘Good idea.’
I ring flats two and three, standing back a little back so the video camera can see me. No reply. Then flat five.
Hello?
‘Hello. Sorry to bother you so late, but it’s the ambulance service. We’ve been called to flat one but the keys we have don’t work on the front door. We wondered if you could let us in, please?’
Who did you say?
‘The ambulance service.’
How do I know you’re the ambulance service?
‘Can you see my jacket? Look…’ I turn round so she can read ambulance written on the back.
Anyone could have a jacket like that.
‘And can you see that ambulance car parked up by the steps?’
Ye-es.
‘That’s mine.’

A long pause. Just before I ring again, the woman comes back onto the intercom.
Who is it you say you’ve come to see?
‘Mrs Logan in flat one.’

Another long pause.
Suddenly it occurs to me to mention the key holder.
‘John’s here,’ I say.
Who?
‘John. A friend of Gary. Gary? Mrs Logan’s son?’
Ah.

Another pause, but then suddenly the mechanism buzzes and we march inside.
John confidently leads me across the lobby, past the lift to a door at the back. I follow him through, and it clicks solidly shut behind us.
‘I think – it’s through here,’ he says. ‘But then - I haven’t done this before.’
We seem to be in a bare service passage with a single staircase leading up to a landing with a sign that points to flat two. John marches up the stairs and tries his keys, but none fit. He comes back down.
‘Ah.’
But then we find that none of his keys fits the door to let us back into the main lobby.
We’re forced to follow the passage out into the rear car park, and walk back round to the front.
‘I think we probably should’ve taken the lift,’ says John.
‘To flat one?’
‘I know. It doesn’t make sense, but that’s the … erm ... charm of the place.’
Back at the main entrance again, we both look at the intercom. After a second or two to gather myself, I step up to it and press the button for flat five again.
A long pause.
Ye-es?
‘Hello. I’m very sorry but it’s the ambulance service again. We took the wrong door and ended back out in the car park again.’
What?
‘We should’ve taken the lift. To flat one, apparently. But we didn’t, and we ended out in the car park.’
Who did you say you were?
‘The ambulance service. Again. I’m the ambulance. With John. For flat one.’
I don’t know what else to say, how else to say it. Oyster Court must be built on some twisted ley line; its warped magic has stolen not only my sense of direction, but my ability to speak, to make sense, to orientate myself in the world.
Who did you say you were?

I stare at the intercom lens.

Sunday, March 18, 2012

mother's day

The house at the far side of the close is dark and cool. An elderly woman meets us at the door. What light there is from the broad kitchen window behind her reflects dully on her greying hair.
‘Upstairs,’ she smiles pleasantly. ‘Mind the toys.’
The wooden treads on the stairs are stripped back, painted white. They creak under the weight of our boots and bags.
Beatrice is lying in the dark on a rumpled bed, cradling her four year old daughter, Cheryl. Beatrice pushes herself up as we come in the room and smiles.
‘Thanks for coming, guys,’ she whispers. ‘I’m afraid Cheryl went down with the measles about four days ago. The spots have all come out and everything has been going pretty well until today. She became quite floppy and out of it, moaning and obviously distressed. I phoned my GP and she bounced me on to you. Sorry to drag you out like this.’
‘It’s no bother.’
She leans back over Cheryl and tenderly clears the hair that’s stuck to her sweated forehead.
‘We made it dark because she’s become really sensitive to the light. So if you could just hold back from shining anything in her eyes that’d be great. Thank you.’
Frank sits on the opposite side of the bed and examines Cheryl. Her SATS are low, and she breathes quickly, with a hungry little tug at her throat. She has a temperature of forty.
‘We’ll be heading off down the hospital pretty soon,’ he says, taking the stethoscope from his ears and looping it innocently round his neck. I hand him an oxygen mask. Cheryl accepts it passively.
‘I’m afraid she’s really quite unwell,’ he says. ‘I don’t think this is a meningococcal rash, but I’m worried about her low oxygen levels, her temperature and general condition. Have you been giving her anything? Any paracetamol?’
Beatrice reaches for the side table and puts on her glasses.
‘We’ve been treating Cheryl homeopathically. Our practitioner said it was important to let the fever burn off the infection.’
Frank shifts uncomfortably.
‘Well – I don’t know about that,’ he says. ‘But a high temperature needs controlling. Not only is it a bad thing in itself, but the side effects will make you feel pretty rubbish. I know I wouldn’t want to go any length of time with a fever like this without taking something.’
‘So do you think…’
‘I really do.’
She pauses a moment, then gestures for me to hand Frank the syringe of Calpol I’ve drawn up. She watches as he feeds it carefully and tenderly to the little girl.
The grandmother appears in the bedroom doorway.
‘Now then, darling. Don’t worry,’ she says, touching her daughter on the shoulder. ‘I’ll settle things here. You go off with Cheryl. I’ve got your phone and bag.’
‘Keys,’ says Beatrice.
‘I’ll lock up. And I’ll come out to the ambulance to hand you everything you need there.’
‘Let’s go,’ says Frank.
Beatrice scoops Cheryl into her arms, and we all head back down the stairs to the ambulance.
‘Are you okay to pass the ASHICE from the back?’ I say to Frank.
He nods, then explains what that means to Beatrice.

Thursday, March 15, 2012

composure

Two o’clock in the morning, and all the beds on Short Stay have their curtains drawn. The place is as deep, dark and blue as an aquarium after-hours, but still there are people moving about in the corridor: the charge nurse, Saskia and her mum. Saskia is pacing up and down with the other two following right and left. The tight curls of her blond hair have shaken out a little and her eyes are swollen with crying and sleeplessness. In her baggy, flower-patterned jumper, nylon tracksuit trousers and battered moccasins she could be a trendy actress rehearsing the part of Ophelia, another modern take on the play, Ophelia on Section. As we come into the ward she looks up and heads straight over.
‘Stand still. There. Do not cross those lines. Stand between them – not behind or over but exactly between them. And no-one must stand to my left. I have to know that you mean me no harm, for it is said that the person ... the person who cometh will righteously know what it is not possible otherwise for them to righteously know, or feel to be known.’
The nurse is by her side.
‘Hi guys. Have you come for Saskia?’
‘Hello. Yep. Hi, Saskia. We’re taking you back home, to a hospital there.’
She stares at me, then backs away, shaking her head.
‘I only need to sleep. If I could just sleep, everything would be well again. Please. Don’t punish me for the sins – the sins that have been visited upon this earth. I love you, mummy but you will kill me. Here. Don’t cry. Let us hug and part as friends. I just need to sleep. Give me your coat.’
Her mum hands over a heavy purple coat to her; Saskia places it on the floor and curls up on it. Whilst the mother kneels beside her and strokes her shoulders, the nurse takes us aside.

‘No previous psychiatric history, but struggling a bit at college lately. Smoking a lot of weed, trying to fit in. Increasingly bizarre behaviour. Then apparently she took some LSD a week ago and hasn’t ever really come down off the trip. So she’s being admitted with an acute psychotic episode and a query on schizophrenia. We’re hoping against hope it’s not that, obviously. Mum has come over to travel back with her to the secure psychiatric hospital in her home town. The doctor and ASW are due any minute for another dose of Lorazepam and the section papers. She’s been agitated and volatile, but I don’t think she poses too much of a risk. Are you happy to go with just the mum as an escort? It’d be great if she could go tonight. We’re not erm... we’re not really set up for this.’
Saskia has leapt up off the floor and gone over to the sluice room where she jerks the light cord on and off. There are groans of protest from the curtained bed spaces just across the way. The nurse grimaces at me and then goes over to her.

The Doctor and ASW arrive.

***

I have put the lights on the back of the ambulance to low spots. The hope was that with the extra dose of Lorazepam, the early hour and the rocking motion of the ambulance, Saskia might fall asleep. But the reality is that if anything the drug has made her more volatile. Despite everything the mother can do to calm her – cradling her on her lap, stroking her hands and head, singing to her, kissing her head, rocking her gently like a poorly child – Saskia is blazing like a preacher inhabited by terrors. What makes it even harder to manage is those moments when she lapses into a whimpering kind of cry, followed by a sudden coming-to, a clear re-emergence of the girl that was. Now and again she straightens on the trolley, smiles, wipes her eyes with both hands and smiles freely and easily.
‘Well. That’s enough of that,’ she says. ‘God – this is the most boring trip in the world.’
‘How far are we now?’ says her mum, struggling to make out anything of the motorway through the small forward hatch, and the fog.
‘Do you know – I’ve absolutely no idea,’ I tell her.
We’ve been travelling an hour, the prospect at least for the same again.
Saskia ruffles her mum’s hair.
‘I’m sorry, mummy,’ she says, smiling. ‘I put you through it, don’t I?’
‘You’re my daughter and I love you,’ she says. ‘You know I’d do anything for you, Shashi. Don’t worry about a thing. Let’s just concentrate on getting you well again. That’s all I care about. And you will be well, darling. You will be well again.’
Saskia frowns, then closes her eyes and gives her head a bothered little shake. And with that simple movement it’s as if a veil has dropped between her and us. She starts to talk again, quickly, in an urgent hush.
‘I just need to... just let me explain something to you, okay? You have to understand. As much as it’s possible, as much as any one human being can understand. We must explore the concept – you know? Just ask yourself a simple question. What was the trigger? Okay? Where did this happen? Ask Carl. Carl knows. He died once but that was then and now he lives and if I were to tell you the place he’d have to arrive again to be seen unto man.’
She opens her eyes.
‘Don’t cry, Mummy. It’s perfectly natural. It’s a fairytale. An adventure. I simply have to make my way back there to be well again.’
Saskia suddenly drops her mum’s hands and turns round on the trolley.
‘Is Cassie here? Is she with him? She’s pregnant? Oh well. God give me the grace to grow as slow as I need to go and stop when I meet my head.’
Her mother turns to me and smiles.
‘You should see her when she’s well,’ she says. ‘Don’t think badly of her.’
‘Me? No – I’m just sorry this has happened. I wish I could do something to help.’
‘Get us there quickly,’ she says. ‘And thanks for all you’ve done.’
Saskia turns back and clasps her mum’s hands again.
‘I fell asleep – you know? I fell asleep for twenty one years and now I am back and everything is different. Carl knows. He dreamed the whole thing.’
‘Who’s Carl?’ I ask.
The mum shakes her head and tightens her lips. Saskia carries on talking, pressing her mum’s hands, then holding them up to look at them more closely.
‘I can see the colours of your veins,’ she says. ‘I can hear the pattern of your blood.’

***

We seem to have been travelling forever. Because of the thick fog, Frank has had to slow right down. The cabin rocks gently from side to side, and for a while Saskia has withdrawn into something resembling sleep. Her mum is leaning forwards with her head in Saskia’s lap, completely exhausted, breathing slowly. I rest my head back on the seat rest and close my eyes.

Suddenly I am startled awake by a kick in the leg. Saskia is leaning forwards off the trolley, staring into my eyes.
‘It’s so simple really,’ she whispers. ‘I never really knew. Just breathe. Don’t die. Just breathe.’
Then she leans back on the trolley, and as her mum straightens up, Saskia begins to sing – Alesha Dixon:
I’m gonna breathe slow
Count from one to ten with my eyes closed
'Cause ladies take it in and get composure
For I lose it get composure

Wednesday, March 14, 2012

baby zee

There is a spread of incident hot spots across town so notorious they should be commemorated in the pavement like Grauman’s Chinese Theatre – although rather than the hand prints of movie stars, it would be a splatter of plaster and brown mosaic tiles, an intaglio face, fuck off jabbed out in concrete with an index finger, the impression of a fist.

The ramp outside the Baby Zee nightclub would definitely feature on the tour.

We’ve been here so often, it’s always interesting to see how far the patient made it up the ramp before the tequila, vodka and simple gravity dragged them to the floor.
Shelley succumbed at the third pillar – classic – where the incline of the ramp starts to kick in. Initially we can see she is sitting up, sipping from a pint mug of water. But as soon as she sees us approach, she puts her forehead back down on the tarmac, splaying her legs out right and left at the knee like a giraffe in a faint at the water hole. Her friend puts the glass down and starts trying to pull her up, whilst her boyfriend leans back against the railings, chameleon-style.
A blissed-out clubber stands passively and beautifully, floating over the whole scene, commenting on the scope of it all, the emotion, the tragedy.
‘She needs help,’ she breathes as we reach the group. ‘By the way, I love what you do.’
Shelley’s friend, a bleach-blond harpy with an expression modelled in clay with a shovel, shrieks at us.
‘She going unconscious again. Do something. She needs her stomach pumping. Pick her up.’
‘Can you stand to the side and let us have a look?’
‘She’s got to go up the hospital and have her stomach pumped.’
She bends down and hugs her friend. ‘Stay with me, babe. The paramedics are here. They’re going to take you to hospital.’
‘I don’t want no hospital,’ says Shelley. ‘I want to go home.’
‘That’s fairly clear,’ I say to her friend. ‘How were you planning to get home tonight?’
‘Her mum was going to pick us up later.’
‘So couldn’t you just give her a ring now?’
‘I’ve tried but she’s not answering. She set her alarm for four. She’s probably still asleep.’
‘Why don’t you try again?’
‘But she’s unconscious! Look at her. She needs her stomach pumping.’
‘She’s not unconscious. She’s just had a bit too much to drink. Hospital’s not really the place for her.’
The girl bends down again and starts trying to pull Shelley to her feet.
‘Come on, Shell. Babe. Listen to me. You’ve got to go to hospital and have your stomach pumped.’
I tap her on the shoulder and she stands up again.
‘That’s not actually something they do for this.’
‘Yeah, but you could play along with me.’
‘Look. If she says she doesn’t want to go, we can’t force her.’
‘What do you mean? If she was having a stroke, yeah? And she said she didn’t want to go, yeah? Would you just walk away?’
‘She’s not having a stroke, though, is she? She’s just had too much to drink. All she needs is to go home and recover there.’
The girl bends back down.
‘Shell? Shell! You’ve got to get up.’
‘Just fuck off and leave me,’ she says. ‘I don’t want no ambulance.’
‘I’ll tell you what. We’ll go and fetch our trolley down. Maybe she’ll change her mind and let us help her up, then we can go up in the warm and talk about what to do there. All right? Shan’t be a moment.’
As we walk back up the ramp, I hear her say to her boyfriend: Can you fucking believe it? She’s dying and they don’t give a shit.

We come back with the trolley, park it alongside Shelley and make one last effort to persuade her to come. She’s not wearing much and her shoes are gone, but just in makeup and false lashes she’s got to be two hundred and twenty pounds. She does nothing to help.
‘I don’t want to go,’ she says, jerking her arms away as we try to help her stand. ‘Fuck off and leave me alone.’
‘That’s pretty clear,’ I tell her friend. ‘We can’t just kidnap her.’
‘Fucking unbelievable,’ she says. ‘I don’t pay my taxes for this. Look at her!’

Two men suddenly appear, cutting right in front of me. They are rounded, hairy, arms by their sides and palms-back, a couple of giant, undercover beavers in stoner t-shirts trying to fit in.
‘What’s going on?’ one says. ‘We’re first aiders.’
I tap him on the shoulder. It feels as if I’m in a waking dream where I’m going round town tapping people on the shoulder.
‘Excuse me, mate? Could you just move over there out of the way?’ I say to him.
‘We’re first aiders,’ he says.
‘Yeah? Well we’re paramedics.’
He gives a little movement, like the startle reflex of a baby.
‘Oh. Sorry. I didn’t realise.’
I want to point out the trolley, and the fluorescent lettering on our jackets, but I don’t have the energy. A wince is all I can manage.
‘Here. You can have a blanket to keep warm,’ I say, turning back to Shelley, fetching one off the trolley and passing it down to her. Then I turn to her friend: ‘Try her mum again. It won’t take her long to get here. And really, hospital’s not the place for someone who’s just had a little too much to drink.’
But in the time it takes for me to do this, the two beavers have stepped in again. They bend down, lift Shelley up and drop her on the trolley.
‘There you go!’
No-one is more amazed than Shelley, but as soon as her body registers the softness of the padding, she falls asleep.
Even though the intercession is galling, at least it means we can go.
We start pushing her up the slope.
‘Call yourself a paramedic,’ says her friend, sniping at my back. ‘You’re a fucking disgrace.’
‘And by the way – don’t think you’re coming with us,’ I tell her over my shoulder. ‘You’ve been rude and unhelpful and I’m not having you on the ambulance. Make your own way.’
‘Fine,’ she says, dropping back. ‘Shell – Shell? You’ll be fine now, hun. Love you, darl’.’
We carry on up.
But the stoner beavers are tagging along beside me now. The leader speaks.
‘I’m sorry about what happened back there,’ he says.
‘Forget about it.’
‘No – listen. I’m sorry. We didn’t really understand what was happening. But I’d like you to think about how you talk to people.’
‘Please. Not another word.’
‘I understand you’ve got a difficult job. You must see this a lot.’
‘Honestly, I don’t want to speak to you.’
‘But I think you should try to see the other person’s point of view sometimes. I don’t think you were listening to her. I don’t think you really got what she was trying to say.’
We load Shelley onto the tail lift and raise her up.
‘Guys – thanks for your help. You did what you thought was right, and that’s fine. Now, if you could just go away. I don’t want to say any more about it.’
‘Come on. Don’t be like that. We’re only trying to help. We thought she had alcohol poisoning.’
‘Alcohol poisoning? She was talking to us perfectly rationally. She was sitting up and sipping water when we got there, for God’s sake. She was perfectly able to tell us she didn’t want our help. She certainly doesn’t need to go to A&E for having a bit too much to drink. It’s crowded enough up there as it is without pissed-up teenagers lying around vomiting everywhere. So now we’re taking her in, and I’ve got to explain to the staff there exactly why the hell I’ve brought her up. So like I say – thanks for everything. But if you want the honest truth - it was no help at all. That’s just the price you pay, I suppose.’

They stand close together as I slam the back door shut.

***

By the time we’ve cleared up at the hospital and are sitting in the cab with a coffee, Shelley’s friend arrives in a taxi. She pays him off, then stands and waits by the entrance, jiggling her mobile phone in her hand and stepping anxiously from foot to foot. Moments later she straightens as a car swings up onto the forecourt. It parks quickly, any-old how, and a woman gets out, slamming the door behind her and stabbing it shut with the electronic key. She stuffs the keys into a shoulder-bag which she has in a headlock under her arm, then strides across the car park towards Shelley’s friend, who doesn’t so much as follow her inside, as allow herself to be dragged behind in her wake.

2012 EMS Blog of the Year

Very excited to have been nominated for EMS Blog of the Year. With thanks to Sally Miller for nominating me in the first place, and to Jamie and everyone over at www.ems1.com for running it. You’ve probably noticed the handy little widget that’ll take you straight to the voting page … er-hem. :0)

Friday, March 09, 2012

two packs

The moon is a hyper-radiant disc slung low in the sky. I can’t help glancing at it from time to time as we prep the ambulance, trying to read our fate in its brilliant surface.
We take a call immediately. Control want us to take a psych patient from Short Stay to Elm Ward, a secure unit twenty miles away.
‘It’s part of the hospital there,’ they say.
‘Are you sure? I can’t think I’ve ever come across that one.’
‘No, no. It’s on the notes. And don’t worry. She’s suicidal, but not aggressive.’

Everyone is asleep on Short Stay except for the charge nurse, hunched over notes, caught in an amber fold of light at her desk.
‘We’ve come for Laney.’
‘Ah-hmm,’ she says, stopping only briefly to look at me over the rims of her bi-focals. She gestures with her pen. ‘You’ll have to wake her.’

Laney is sitting in a chair, wrapped in a cell blanket and curled over so that her forehead is resting on her knees. The top of her hair has been pruned into something like a monk’s tonsure; from the scabs of the scissor marks, I’d guess it was her own handiwork.
I reach over and shake her gently by the shoulder.
‘Laney? La-ney.’
She bobs up unexpectedly and looks wide-eyed all around, anywhere but me, as if she’d been woken by a ghost.
‘Hello, Laney. It’s the ambulance. We’ve come to take you to Elm ward.’
‘My sandwiches!’ she gasps, rolling her lips drily over the spaces where her teeth should be. I’m shocked to see her looking so old. The notes said she was fifty-eight, but she could be twice that.
‘Don’t go without my sandwiches.’
I look back at the nurse. She gestures again with her pen, slightly peeved.
‘No. No. We’ll make sure we’ve got all your stuff. Sorry to wake you like this, but the hospital needs the bed. Just one of those things.’
She binds herself up in the blanket more tightly, and then deflates slowly back down into the foetal position.
‘Laney? La-ney.’
I shake her by the arm again. She springs back up.
‘Don’t touch me! I don’t want to be touched!’
‘Okay. Sorry. I won’t do it again. It’s just we’ve been asked to take you to Elm ward. It won’t take long. I’ve got your sandwiches.’
There are two packs: one of egg mayonnaise, still intact; one already open, the bare slices spilling out, the filling mysteriously gone.
‘I’ll put them in your bag, look.’
I show her what I’ve done, but she doesn’t seem that bothered any more.
The notes describe her as having nothing physically wrong, but we opt for as clean and quiet removal as possible, for the sake of the other patients in the ward. Frank brings up the wheelchair and we coax Laney into it.
‘Bye, then’ I call out quietly to the nurse. She conducts us away with her pen, without looking up.

We settle Laney onto the ambulance.
‘Sandwiches!’ she says.
‘You want your sandwiches? Okay. Here you are.’
‘The other ones.’
I put the egg mayo pack back in her bag and take out the opened pack of dry slices.
‘There you go.’
‘Not on me! On the trolley. Where I can see them.’
‘Okay.’
I put them on the trolley in front of her chair. The ambulance moves off and two of the slices jolt out of the container and spill onto the sheet. When I reach forward to put them back she screams out ‘No! Leave them!’
‘Okay.’
I leave them.
After a moment, she wraps the blanket back around herself, and retreats back into her foetal position. I change the cabin setting to mood lighting, and make myself comfortable.

The rest of the journey passes smoothly. At one point we hit a pothole and another slice is jolted free of the container, but Laney is dozing and doesn’t notice.

At the hospital Frank shouts out the arrival time and then disappears to find a chair. After a short while when the only noise is the ticking of the cooling engine and breathing sounds from under the blanket. I hear a rattle of wheels approaching the back door.
‘Here we are,’ says Frank, opening up. ‘Let’s be having you.’
Getting Laney down the steps is worse than getting her up. Just waking her is difficult enough, but then we have to negotiate the collecting together of the bread slices, helping her out of the seat without touching her, and smoothing the way down the steps into the wheelchair without startling her.

Above us, the moon rolls on across the car park sleek and white and cold.

There is another ambulance crew waiting to handover. Just before we squeeze past them I ask one if he’s heard of Elm ward.
‘Elm ward? Yeah – that’s part of Green Lodges, about ten miles away, just off the motorway. You can’t miss it.’
‘Ten miles away?’
‘You can’t miss it.’
Laney unwraps herself in the chair, craning up in the chair like an unprepossessing chick in a nest, sensing danger.
‘I don’t want to go back in the ambulance,’ she wails. ‘I want to go to bed.’
‘Me too, Laney,’ I say, reaching for the radio. ‘I’m very sorry about this. We’ve been given the wrong information.’
‘Don’t put me back in the ambulance!’
The other crew laugh and give us sympathetic shakes of the head.
‘Nice to see you,’ say the department nurses as we head back outside.

On the radio, Control confirm that the destination was wrong.
‘Don’t know what happened there,’ he says. ‘I’ll send the correct address through.’
‘If you could. That would be lovely,’ I say.

It takes ten minutes persuading Laney back up the steps into her seat again, but eventually she wraps herself up in the blanket and seems happy enough.
‘See you the other end. Or somewhere,’ says Frank. And he slams the door shut.
The noise wakes Laney up immediately.
‘I’m hungry,’ she says. ‘I want my sandwiches.’
I hand her the opened pack.
‘The egg ones!’
I put the opened pack on the trolley and hand her the others, then settle into my seat.
We move off.
There’s nothing much to do in the back but try to stay awake. Laney rakes open her sandwich pack with dreadful paws and hauls out a sandwich. She puts it up to her nose, sniffs it, then cautiously lifts the top slice and peers underneath it. She takes it off completely and lies it on her lap. Then she puts her face up to the exposed contents and begins counting the egg pieces with her forefinger. It’s a curiously tender performance; she smiles over the whole spread, like the most nurturing schoolmistress in the world carefully enumerating the infinite successes and blessings of her many students.

Then she starts to eat them.

It’s terrifying, something like the Devil, ploughing. Using the hooked crook of the same finger, she drags a path through the filling, gathering up the pieces of egg and gently transferring them to her mouth.
By the time we arrive at Green Lodges, she has another collection of empty slices.
I queasily put them in the bag with the others just as Frank opens the door.

‘That didn’t take long,’ he says.

Wednesday, March 07, 2012

stuck

An evil traffic mastermind has taken over the city. There is no route through town, no backstreet, rat-run, bridleway or smuggler’s path that does not sooner or later crash up against road works. The gas men, the water men, the cable men, the council men, the men who carry out the remedial work after all the other men have gone - the town is infested, over-run, congested, the whole grid in thrall to a sequence of flashing lights, red and white barricades and cones, cones, cones. During the mid part of the day it’s maddening enough, but at rush hour your only hope of reaching the other side of town before sunset is by hot air balloon.

And on top of all that, I was only at this address yesterday.

‘She self-discharged,’ says Control. ‘A CPN made contact back at the address today and says she’s taken another overdose.’
Molly has a history of overdoses and self-harm as chaotic and livid as the scars up her arms.
‘It took us ages to persuade her to come in,’ I tell Frank as he takes a shortcut through a main sewer. ‘And she lives at the bottom of a steep flight of steps. We had a hell of a job keeping her from pitching over backwards the whole time.’
Frank crashes up through a manhole cover, then presses a button I’ve never seen before that sets the axles up on stilts so he can pass above the cars.
‘And then when she was on board, I had to stop her from rolling off the trolley, and lighting cigarettes, and throwing the contents of her bag about.’
‘You’re not selling this job overmuch,’ he says, dropping the cab back down onto the chassis, converting it into a boat, and launching us off the promenade into the sea. ‘I was supposed to be going out tonight.’

We reach the address in good time, considering.

Jo, the CPN, greets us at the door.
‘Molly has taken thirty paracetamol. I’ve told her she needs to go into hospital and be treated, and to try not to walk out.’
‘I’ve met Molly before. I was the crew that took her in yesterday,’ I tell her.
‘Oh. So you’ll know the back history.’
She leads us inside.
Molly is slumped on an armchair as enveloping as a fungal bloom.
‘I’m not going to hospital,’ she sighs. The smoke from her cigarette ripples up to the ceiling. ‘I’ll just walk out again.’
Between the CPN, me and Frank, and Molly’s friend Jack – who was here yesterday, and who glitters on the fringes of the room like a gypsy whose prophecy has come to pass - we try every angle, every point of reasoning and emotional leverage to encourage Molly to leave the chair. But like the chair itself she simply absorbs all our efforts, soaking them up with the smoke and the heat from the fire and the muted images from the TV.
‘I thought you cared for me,’ she breathes, turning her shining eyes on Jo. ‘Why are you doing this?’
‘I do care about you, Molly. That’s why I called the ambulance. You’ve taken a damaging amount of paracetamol and you need to go to the hospital for treatment. I wouldn’t have called the ambulance if I didn’t care.’
‘Come on Molly,’ says Frank. ‘The sooner you get to the hospital, the sooner you can be back again.’
Molly doesn’t respond. She doesn’t even tap off her ash.
‘I just want to leave,’ she breathes.
‘What do you mean?’
‘I just want to leave the hospital.’
‘You’re not in the hospital, Molly. You’re at home.’
‘No. When I’m in the hospital I just want to leave.’
‘I’ll be straight with you Molly. If you don’t go with the ambulance now, I’ll have to go back to the team and make arrangements to bring in the police. That won’t be nice, will it? For you or for anyone. And all that will happen is the police will take you to hospital instead. So whatever happens, you have to go to hospital. At least this way you can go at your own speed, with these guys, and get treated all the quicker, and be back without any trouble. But the other way is a section. Do you understand, Molly? Which has implications. So what do you say? Hmm?’
Molly stares at the smoke rising in an unbroken line from her hand.
‘I just want to leave,’ she says.

I shift my position on the sofa, but I seem to have become part of it, my trousers melded into the covers, my hip bones hooked into the springs. Jack grins at me from across the room. He understands. He knows I’m trapped. But it doesn’t matter. Nothing else is moving, will ever move. We are entering a new age now, an ice age of immobility, and the traffic is a glacier of metal and rubber, inching to a halt on the road above us.

Sunday, March 04, 2012

following on behind

Rae has been standing off until we arrived. The notes accompanying this 25yo male, unco mentioned alcohol and drugs, so she thought it would be prudent to wait for support. We park up outside the address – the basement flat of a smart Georgian terrace row. A neatly arrowed sign points to the gate we need; Rae leads the way down the steps to the front door, rings the buzzer, and we wait.
Just at the point where we start to wonder if we have the right place, there is the sound of someone approaching along the hallway. A chain, a bolt and then the door slowly opens. The weathered husk of a middle aged man in a fisherman’s cap and filthy jacket peers out at us. With his cratered skin, rotten teeth, and with a palpable margin around him of cider sweat, smoke and bad thoughts, the man is about as disreputable as it’s possible to get without recourse to prosthetics or CGI.
He leans back against the wall, exhausted by the effort of letting us in.
‘Through there,’ he puffs, then frowns and smacks his lips, as if the words had unexpectedly left a trail of tar in his mouth. He watches us as we pass, then closes the door and tags along behind.

The brown throws tacked over the bay windows at the front of the room exclude most of the bright spring morning outside, but enough light spills around the edges to reveal a middle-aged woman sitting on the sofa, smoking, and a young guy sleeping on his back on a bare mattress in the corner. The woman is as ruined as her partner. She is a body of discarded things, her head extemporised from a basket of root vegetables.
‘I want him out,’ she gapes, pointing with her fag at the figure on the mattress. ‘I want him out. I’m supposed to be going to detox tomorrow. I can’t have anything stopping that.’
Frank goes over to the supine man with Rae; I try to calm the woman down.
‘I know it’s upsetting, but could you try to keep your voice down? It’ll be really helpful if you could, because otherwise we won’t be able to treat your friend.’
‘What friend? I’ve never seen him before.’
‘But still, if you could just keep it calm so we can see what the problem is.’
‘I don’t care what the problem is. I don’t want him here. He’s got to go. Get him out.’
‘Yep. We’ll be done just as soon as we can.’
I look over at Rae.
‘He’s not unconscious,’ she says. Frank leans in and gives him a gentle shake of the shoulders. ‘Hello, fella,’ he says loudly. Then to the woman: ‘What’s his name?’
‘I’ve told you. I’ve never seen him before. He’s a piece of shit and I want him out.’
‘Honestly - Barbara, is it - (seeing a letter on the arm of the sofa). You’ve really got to try very hard not to shout and get worked up like this. It’s not helping.’
‘I don’t care if it helps or not. I want him out. It’s my house. I can say what I want.’
‘Yep. Of course. But if you just let us find out what’s wrong we’ll be out of your hair in no time.’
‘I want him out. I want him gone.’
The man who let us in has wandered back into the room. He sits down beside the middle aged woman and struggles to put a cigarette in his mouth.
‘Has he taken any drugs?’ I ask the man.
The woman erupts again.
‘Drugs? I don’t want drugs in my house. You brought him here and he took drugs?’
The man has been interrupted mid-lighting, and he stares stupidly around him as the naked flame of his lighter burns in the air in front of him.
‘I didn’t bring no-one,’ he drawls. ‘He followed me.’
‘I’m sick of you bringing these wankers home,’ she says. ‘I’ll throw you out, n’all.’
The man takes the cigarette out of him mouth with his free hand, then a moment later forgets and tries to light the end of his nose.
Meanwhile, Frank has squeezed the mystery man’s ear. He sits up, suddenly awake. The contrast between the man and his two hosts is remarkable. Whilst they are sponge-like in their decrepitude, the man is as lean and bright as a scalpel. He takes in his surroundings.
‘What the fuck do you want?’ he whispers.
‘Your friends were worried about you,’ says Rae. ‘And so were we.’
The man sneers.
‘Worried about me!’ he says, then looks up. ‘What are you looking at?’ he says.
‘We’re the ambulance,’ I say, trying to sound as neutral as possible. ‘We’re here to help. You were flat out, unresponsive.’
Rae steps round the side of the bed.
‘Why don’t we go out to the ambulance and check you over there?’
‘What do you mean, check me over?’ he says, still staring at me. ‘Who do you think you are?’
‘The ambulance. We’re the ambulance. We’re here to make sure you’re okay.’
‘I’m not going anywhere.’
‘Well,’ says Frank. ‘You’re going to have to leave this flat whatever happens, because Barbara here wants you to go.’
The man hesitates a moment, then stands up.
‘Where’s my phone?’ he says, but then sees it amongst the debris on the coffee table along with his keys; he scoops them both up and puts them into his jeans pocket.
‘I’m going, yeah? But only ‘cos I want to.’
‘Okay. Fine.’
‘Yeah – fuck off,’ shouts Barbara from the sofa. Then slaps the back of her partner’s head so his cap flies off.
‘Easy Barbara,’ says Rae, picking up the resus bag. ‘Don’t go mad.’
‘This is my home,’ she shouts. ‘I’ll do what I want, thank you.’
Her partner has readjusted his position. He goes to cross one leg over the other, thinks better of it, then dedicates himself again to finding and lighting a cigarette.
I stand aside to let the young man go through the door, then I pick up the drugs bag and follow on behind.
He stops.
‘What the fuck are you doing?’ he says.
‘I’m following on behind.’
‘You’re what?’
‘Following on behind.’ The phrase sounds ridiculous. ‘I’m coming out. As well.’
‘How old do you think I am? Ten?’
‘What’s that got to do with it?’
Following on behind. Who the fuck do you think you are?’
I put the drugs bag down to free my hands, and consciously adjust my stance, to be sideways on, less of a target.
‘Just leave,’ I say to him. ‘Any more trouble and we’re calling the police.’
‘The police, hey?’ he says. ‘Okay. Yeah. You call the police. Let’s have them here. I’d like to see them.’
Rae speaks from behind me. ‘I’ve called them,’ she says. ‘They’ll be here in a minute.’
The man glances at her, then goes outside and sits on the basement steps for a moment. Then almost immediately he stands and strides up the steps to street level.
‘I’m taking your ambulance,’ he says.
I follow him, reaching the top just as he climbs into the cab. The engine is running on the KRS, the keys in my pocket.
‘You can’t go anywhere,’ I tell him, opening the door. ‘This is stupid, mate. Just be on your way.’
He look at me, his eyes dark flints. Then he snorts derisively.
‘Automatics’ he says. Then he leaps out of the cab, shrugs his hood over his head, stuffs his fists into his pockets, and slouches off down the street.