The night has come down quick and glassy, hard-edged with the lights in the shop windows, a huddled, hectic quality to everything, the restless herds of SALE shoppers and finishing office workers migrating east, west, north and south along the main thoroughfares, buses stacked full of people, their windows steamed, taxis and cars beeping and jostling for position. The store we’ve been called to is so centrally located it’s difficult to find a clear space to park. Luckily, one of the buses is just moving off leaving just enough room for Rae to squeeze the ambulance in. One of the store managers is waiting outside to greet us, shivering a little in his starched white shirt. He waits as we grab what bags we need out of the truck, and then hurries inside with us behind him.
‘It’s a twenty-eight-year-old man,’ he says, holding the door. ‘He came to the pharmacy with a scrip for inhalers of one kind or another, but when he was waiting in the queue he started complaining of chest pain. He’s with my colleagues in our little consulting room. This way.’
He eases us through the crowded store. As always it’s a shock for the shoppers to see us there. They double take as we struggle past with all our bags. Sometimes we have to ask twice to get round; I can only suppose we’re so crashingly out of place it effectively makes us invisible.
Michael is sitting on a chair in the tiny consulting booth, bent in half with both hands crossed flat across his breast, rocking backwards and forwards making a noise that’s a cross between a grunt and a growl. He’s such a skinny guy, my first thought is that he might have had a spontaneous pneumothorax. Checking his chest with my steth is difficult because he’s making so much noise, but it sounds as if there’s equal air entry. I hesitate for a moment, but his SATS are fine – and then, to reassure me even further, someone opens the door to pass a message to the manager, and Michael suddenly straightens up and looks directly at them.
‘Who’s that?’ he says, clearly and flatly. ‘What the fuck do they want?’
There’s an uncomplicated directness to the way he says this – and certainly not the way you’d expect someone to speak who was struggling to breathe.
The person delivers their message and with one last, appalled glance at Michael, withdraws in a hurry.
‘Thank fuck they’ve gone,’ says Michael, then bends forwards again and resumes his growling.
‘Come on, Michael. Sit up for us. It’ll help with your breathing. And you’ve got to slow it right down. Easy, easy. Like this, look. In through the nose, out through the mouth – blow it out nice and slow. In, two, three – hold and out, two, three...’
Eventually he sits back and stares at me with a skinned expression, like a feral creature trapped in a cage.
‘What’s the matter with me? They said I was having a heart attack. They did this. They wound me up.’
Michael’s partner Julie is in the room with us. A short, dark woman whose blunt expression is only emphasised by the metallic blue of her eyeshadow, she shifts restlessly and picks at her teeth with her scarlet nails.
‘He’s had a lot of stress lately,’ she says. ‘Before he ran over here he was getting himself proper worked up. He came out of the bedroom and just dismantled himself.’
‘Yeah, you know. Dismantled.’
‘Shut up!’ says Michael, shivering a little and jiggling his knees up and down. ‘I’m dying here and what are you talking about?’
‘Have you had any drugs tonight, Michael?’ I ask him.
‘I sniffed some stuff, yeah.’
He bobs his head down again and I can’t quite hear what he says.
‘Sorry? Was that heroin, did you say?’
He looks up again and sneers.
‘Fuck off! Heroin? Who sniffs heroin?’
‘I don’t know. I thought..’
‘Cocaine, mate. I did some cocaine. But so what? I do it all the time. That’s nothing new. I lived in Barbados for years. That’s some proper mad shit there, man. You should try it.’
He laughs, like he’s wasting his time with me.
‘Michael – we need to get you out to the ambulance to do some checks, an ECG and the rest of it. Heavy cocaine use can have an effect on your heart, especially if you mix it with alcohol. But I’m sure you know all this.’
‘No, man. I’m good. I just can’t breathe. Why’ve I got this pain in my chest? They said it was a heart attack. What’s the matter with me, bro?’
‘He just needs to get some sleep,’ says Julie. ‘Come on, babe.’
‘Yeah. Sleep. I gotta sleep. I can’t remember the last time I had a good sleep.’
‘Come on then. Let’s take a slow walk out. But I want you to concentrate on keeping your breathing nice and slow for us. Okay?’
We help him stand. The pharmacy manager and his assistant are so relieved to be getting Michael out of the store they do everything with super-brisk efficiency. The manager clicks his fingers and gives directions; his colleagues scatter right and left to make a passage for us through the crowds to the service lift. Michael is still clutching his chest, grunting and groaning and dragging his feet. I feel sorry for the shoppers who watch as we go. They stand appalled, clutching their selections from the Two for One promotions in skin care, suddenly face to face with Michael the crack head, sweating horribly, his prominent teeth glistening, rolling his head from side to side and casting silvery-eyed stares around him. He snarls at a woman.
She shrinks back.We frog-march him into the lift.