Thursday, October 31, 2013

true story

I hadn’t seen Mac for a while. He worked at a small satellite station on the outskirts of town for one thing, so our paths only used to cross occasionally at the hospital. Plus he’d had some kind of health scare lately. So all in all it was a nice surprise when I saw him with a cup of coffee outside A&E one night.
I leaned back against the railings, and we caught up on all the gossip.
‘Not smoking?’ I said.
‘Given up. Bad for your health, apparently.’
It seemed as good a chance as any.
‘How’ve you been?’
‘Oh. You know. I had a heart attack.’
‘A heart attack? Really?’
‘Only a small one, but that stent seems to have done the trick. Yeah – I’m having to watch a few things now. Smoking, my weight...’
His nickname was Big Mac, so it was probably a good idea if he slimmed down a bit. Mac had been in the job almost forty years, and just lately he’d been struggling to get up once he sat down. By rights he should’ve retired, but there was some issue with his pension.
We talked about this and that, but I could tell there was something on his mind. Eventually, he got round to it.
‘I was on the car when it happened. First on scene at an old people’s home, one of those very new places that looked like it was flat pack. Soulless, you know. Migraine carpets. Anyway, the job itself wasn’t all that. An abdo, no rush. She needed to go in so I ordered up a truck. The staff said they wanted to put some clean clothes on her, so I said fine, I’d finish writing it up next door. They told me to use the games room across the corridor, because it was late at night and everyone had gone to bed. I said fine.
‘When I went in, it wasn’t empty at all. There were three old men sitting at the round table in the middle of the room playing cards. “Sorry” I said. “Whatsername said it was empty”. “Shows you what she knows” said one of the fellows, and they all laughed. That was when I clocked their gear. I thought it must have been some kind of fancy dress night, because they were all done up very strangely, one in a highwayman’s coat, one in a Victorian actor’s cloak and felt hat, and the other like an engineer on an old steam train, in a pair of overalls and a little red neckerchief. All of them covered in dust and cobwebs. They’ve really made an effort, I thought.
‘But then I had to sit down, because to be honest I wasn’t feeling all that great. I’d been having raging indigestion all week, and I felt kind of puffed. “I’d take the weight off if I were you, mate,’ said the highwayman. “Or we’ll have to call a paramedic – no, wait! You’re here already!” And they all laughed again. I thought they were a strange bunch but harmless enough, so I sat down and put the clipboard on the arm of the chair ready to start writing. But I just couldn’t take my eyes off the three old geezers. There was something – odd about them. Not just their clothes, but the way they were, in themselves. D’you know what I’m saying?’
‘I think I do.’
‘I put it down to me not feeling right, because sometimes your eyes can play tricks – late at night, when you’re tired and not the whole ticket. But it seemed to me that when they turned their heads to look at each other, or at me, their faces blurred a little, like in old photos, when the person moves when they shouldn’t, and leaves their features behind on the glass. It was very disconcerting, and made me feel a bit dizzy. “Watch out! I think he’s going!” said the Engineer. “Hold on!” cried the Actor. “We haven’t finished our game yet.”
“What game’s that, then?” I asked, struggling to my feet again. I did feel weird, but I wanted to take my mind off it, and anyway, I like cards. I wandered over to the table.
‘They were playing poker with a set of cards that had seen better days. What a bunch of characters, I thought. “A nice little set up here,” I said. “Your own little club.”
“Something like that,” said the Highwayman. “We do all right.”
‘It was then I noticed what they were betting with. Little plastic figures.  At first I thought they were toy soldiers, because they were in all these different poses, leaning over, throwing grenades, pointing rifles and whatnot. But when I leaned over to get a closer look, I saw they weren’t toy soldiers at all, but people, doing things like begging on their knees, pointing, running away, or lying on the ground.
“I’ve never seen chips like them before” I said to them.
“So you know the acronym?” said the Engineer. “CHIPS. The Chosen Host in Purgatory. That’s good, Mac. I’m impressed.”
‘And he looked right at me. And it was only then that the smell came on really strong. I’d smelt it as soon as I came in the room, but I put it down to a mixture of something caught in the kitchen earlier on, like burned sugar for toffee apples, and bleach to clean the floor.
“Who are you?” I said, taking a step back.
“I’m Pythius, that’s Astoroth, and he’s Belial. Pleased to meet you.”
“So what are you, then?” I said, brazening it out. “Demons?”
“He’s good” said Astoroth, snapping down another card. “He’s very good. Raise you a bent parson”
“Almost done here” said Pythius, smiling at me with all his fishy teeth.
‘Well I have to say I was more than a little scared. But you know what it’s like. You find yourself in a dodgy situation, and the best thing you can do is keep calm, act like there’s nothing wrong, and buy yourself some thinking time. So that’s what I did.
“Mind if I play?” I said to them, pulling over a chair.
“I told you you’d like Mac” said Pythius. “Of course. Belial – deal him some cards.”
‘Even though Belial’s hands were pretty much bones, he flicked me over five.
“What are we playing?” I said.
“First Circle” said Astoroth, yawning, then smacking his lips disgustingly.
“Don’t worry. It’s a bit like Lowball, only the Joker is the Horned One and you burst into flames!”
“Only kidding,” laughed Pythius. “Look at his face! Priceless. No – Mac. Seriously, it’s exactly the same as Lowball.”
“Then let’s play.”
‘I did all right. In fact, more than all right. Straight off I could tell these demons didn’t know much about poker, for all their smart talk. I got quite in to it. Pythius had stood me some chips. When I held one up to the light it looked like a tiny little dictator, complete with medals. He seemed to wriggle a bit in my hand, so I put him down again. Well, it wasn’t long before I had a whole load of others, and the demons were looking restless. I made conversation, to put them a bit more at their ease.
“So how come you play here?” I asked them. “A bit modern for you, isn’t it?”
“This new building is, yes. Ghastly. But you have to take a longer view.”
“What d’you mean?”
“Well the nursing home hasn’t always stood here, has it?”
“It was a laundry before that,” said Astoroth.
“A row of labourer’s cottages before that,” said Belial.
“Nothing but ice for a while. A long while. Dullsville. I remember there was a family of hunter gatherers before that, wasn’t there, Pythius? You remember that guy? Used to make those patterns in the ground and wave those lighted sticks in the air to keep us out? He was funny.”
‘Pythius chuckled. “Oh yes,” he said. “And then do you remember that business with the sabre-tooth?”
“Before my time,” said Belial. “Four of a kind.” And he lay his cards down.
“Straight flush,” said Pythius, spreading out his cards with a proud little nod of his head.
“I’ve got nothing,” said Astoroth, chucking in. And they all looked at me.
‘Well I’ve had some great moments in my time, but I have to say this next one was the very best. I looked from demon to demon, then laid out what I had. “Royal straight,” I said. “So put that in your cauldron and smoke it.”
‘It didn’t go down well. Astoroth and Belial both jumped up, knocking their chairs back with a crash. “You little fucker!” said Astoroth.
“Cheat!” said Belial. And they both waved their arms about, making growling and snapping noises that I have to admit were pretty scary.
‘Pythius just stared at me, and in a funny way that was worse.
“Mac,” he said after a moment, waving for the others to be quiet. “I think we’ve underestimated you. Many congratulations.” He smiled at me in that fishy way he had, but his eyes were glittering hard, goat’s eyes, you know? With the vertical slit? “Come, brethren. Let’s leave Big Mac here to enjoy his winnings. And who knows? Maybe we’ll have the pleasure again sometime soon.”
‘And with that, the lights dimmed, the windows slammed open, and suddenly I was alone in the games room. I don’t mind telling you my hands were shaking as I swept all the chips into a medication bag. I thought I’d figure out what to do with them later.
‘Just at that moment, the door opened and one of the nurses came in.
“Your crew mates have arrived,” she said. And then “Are you okay? You’re all sweaty and pale.” And before I knew it I was in the back of the ambulance that was meant for the old woman, being blue lighted into hospital with an MI.
‘It was some days later, when I was sitting up in CCU after the angio, when I thought I’d have a sneaky peak at my winnings from the card game. They’d put all my property in the little locker by the side of the bed, so when no-one was looking I had a root around for the medications bag. But it wasn’t there. So I called the nurse over and asked her about it.
“Oh that?” she said “What was that? It was just a black mess, like little slimy mushrooms when they’ve gone off. We threw them away. Why? You didn’t want them, did you?”

“No, not really” I said. “But someone else might be wondering where they are.” And I lay back down to sleep.

Saturday, October 26, 2013

a cat-shaped onesie

I shine my torch up the path to the front door and two points of light reflect back – a  cat, crouching on the path. It’s a wild night for anybody to be out, let alone a cat. I bend down and make kissy noises; the cat trots over and wraps itself around my leg, but as soon as the door opens, the cat runs inside.
‘It’s all right’ says the woman standing in the doorway. ‘She live here.’
All the doors in the house are shut apart from one, up on the landing, a bedroom, where a young girl is sitting on her bed. The room is lavishly decorated, richly patterned wallpaper, an ornate bead and crystal chandelier, and a silvered chest of drawers. On the wall above the head-end of the bed is a black and white portrait of a young woman, the kind of three-quarter head shot you might see in a fashion portfolio, the frame surrounded by fairy lights.
‘Mariana took an overdose tonight,’ says the woman. ‘I’m her grandmother, Rosa.’
She kneels at Mariana’s feet and rests a hand on her foot.
‘I’m looking after her these days,’ she says. ‘That’s her mother in the photo. She died a couple of years ago and we’re still coming to terms with it. Mariana’s brother Felipe is a year older. I’m afraid Felipe’s gone off the rails, staying out, drinking, carrying on. He comes back and causes trouble. That’s why all the doors are locked.’
Mariana starts to cry.
As gently as we can, we establish what she took and when, and then encourage her to get ready to come to hospital.
The cat suddenly appears in the room. It jumps up on the bed and noses its way onto Mariana’s lap, demanding to be stroked. It flicks its head as a couple of tears land there, but purrs loudly, its little tongue poking out.
‘That was her cat,’ says Rosa.

We leave the room to give Mariana some privacy as she changes.
‘Just put your onesie on, querido,’ we hear Rosa say. ‘Don’t worry about that. It’s late. No-one will see.’
After a moment the door opens fully again and Mariana steps onto the landing.
She hasn’t put the hood of her onesie up, but I can tell from the pointy ears and from the tail dragging along behind what it’s supposed to be.

Wednesday, October 23, 2013


We can see Mr Collins through his lounge window. He’s sitting on the floor, resting up against the electric wheelchair he fell out of about an hour ago. He looks like Santa Claus – ten years after The Big Red One went off the rails, sold all his plush, thought bad thoughts, drank, smoked and stopped washing. He has a phone pressed to his ear, the mouthpiece lost in the mangy old hedge of his beard; when we knock on the window, he looks briefly in our direction, then irritably waves us away with a yellowing claw.

We walk back round the front.

At least the main entrance is open, letting us through into the c-shaped courtyard of this Victorian block. A black iron walkway circles overhead, shining wetly in the mist. In the middle of the courtyard, a raised flowerbed in brick, with a single, leafless tree. From one of the lower branches, someone has strung up a tatty straw object, the kind of thing a witch might hang as part of some dreadful territorial spell. It’s only when I get a bit closer I can see it’s actually a rustic bird-feeder.

Control get back to us.

He says he doesn’t know the keysafe number. We haven’t been able to get in touch with the carer, so it’s looking like you might have to force entry.
‘Have you asked him if he’s all right with that?
Stand by.
 I crouch down by Mr Collins’ letterbox and lift the flap to hear his side of the conversation:
‘Well if you don’t have the keysafe number you’ll have to break the door down... Yes I am hurt, thank you very much. My leg is excruciating.... No I can’t wait any longer.... I have to say you don’t sound in much of a hurry. I’m not impressed with your sense of urgency.... All I’m saying to you is I think it’s not like off the telly.... So when can I expect some help? Christmas? Because I’ve already been on the floor an hour and you don’t seem that bothered...’
I drop the flap and straighten up.
‘We’re going to have to kick the door in.’
Just as I say this, Control ring us back.
You’re going to have to kick the door in
I take a step back and then kick just below the lock as hard as I can. The noise reverberates around the courtyard. Three more attempts, and still the door remains intact.
‘It feels like a deadbolt or something,’ I say to Rae as I bend down to rub my knee. ‘We’re going to need the police.’

Whilst Rae is calling Control, a door opens off to my right and a guy in a wheelchair rolls out.
‘S’up?’ he says.
‘Sorry to wake you. Mr Collins has fallen out of his wheelchair and we can’t get in.’
‘You do know he’s got a keysafe, don’t you?’
‘Yes. We do. But unfortunately we don’t know the number.’
‘Ring his carer, then.’
‘Yes. Yes – we’ve tried that. But unfortunately the carer isn’t answering.’
‘Ask him.’
‘We’ve tried, but he doesn’t know it.’
‘Ask the guy across the yard. He’s got a keysafe.’
‘It won’t be the same number. Otherwise it wouldn’t be a safe safe.’
‘You’ll have to try kicking it in, then.’
‘Yes. I’ve tried that, but it’s not worked.’
‘No. It won’t. They’re tough these doors. What are you going to do then? Call the police?’
‘Just on it.’
He slowly rolls back inside.

After five minutes or so the police arrive – in impressive numbers. They stride into the courtyard carrying an  iron battering ram, a huge jemmy, thick gauntlets, lump hammers and a pair of safety goggles. After we’ve told them what we know, they examine the lock. One of them favours smashing the safety glass to reach round and flip the bolt, but another just wants to smash through with the ram. He puts on the gauntlets and goggles.
‘Stand back, ladies,’ he says. With three colossal, shuddering assaults on the door, it splinters at the jamb and flies back.
‘Don’t all rush at once,’ he says, putting down the ram.
The other one steps inside and examines the wreckage.
‘Yep. Should’ve gone in through the glass,’ he says.

‘Hello Mr Collins. Ambulance,’ I say as we all walk through into the lounge.
He bares his teeth.

‘Who’s paying for the door?’ he says.

Tuesday, October 22, 2013

light of the world

A dark, wet night.
A juicy scrunch as I step on a snail.
‘What a dreadful night!’ I say, reaching over to flip the latch of the garden gate, getting soaked as I brush up against the hedge.
‘Especially for the snail,’ says Rae.

Enid is waiting for us at the door, clutching the fluffy collar of her pink dressing gown around her neck, the light from the hallway spilling out around her onto the wet path.
‘He’s in the kitchen,’ she says, shuffling ahead. ‘Bert’s out looking for his other slipper.’

Enrico is slumped on a high-rise kitchen chair, resting his bloodied head against the door frame. He has on a khaki jacket and jumper, but below the waist just a pair of boxer shorts.
‘He’s ninety-six you know,’ says Enid, standing next to him and holding his hand. ‘I mean, I’m eight-three. But ninety-six.’ She gives his hand a squeeze. ‘Aren’t you, petal?’
Enrico lives over the road. He was going up to bed when he tripped and fell backwards, cracking his head on the way down. He managed to get himself up again, but instead of dialling 999 he decided to come over to Enid and Bert for help. It took a while for them to answer because they’d gone to bed, and anyway, they were nervous about opening the door so late at night. I mean, who could it possibly be? When they did they found poor Enrico, slumped amongst the pots and snails in the rain. They helped him into the kitchen, called us.
He has a nasty head wound, the scalp scraped open at the top, the dull cream of his skull below.
‘What? What’s this?’ he mumbles.
‘He hasn’t got his hearing aids in,’ says Enid.
I give him the quick once over. It’s going to be difficult to fit a collar on him because of his size and shape. We decide to get him out to the vehicle and immobilise him there on a vacuum mattress, as naturally and comfortably as we can.
I dress his head wound whilst Rae goes to fetch a carry chair.
‘What’s your past medical history?’ I shout in his ear.
‘Your past medical history. What do you suffer with?’
After a moment he raises his left arm.
‘What am I looking at?’ I shout.
‘It’s his arm,’ says Enid.
‘What’s wrong with your arm?’ I shout in his ear.
‘Strafed. By the Luftwaffe,’ he rumbles. When I push up his sleeve I can make out the scar tissue, visible as an odd ruck of pale skin, an incomplete tattoo.
Rae comes in with the chair.
As we’re helping Enrico onto it, there’s a stamping of feet in the hallway and Bert appears, a mac over his pyjamas, a torch in his hand.
‘I went up and down,’ he says, ‘but I couldn’t find it.’
He stands next to Enid as we help Enrico onto the chair. They watch with an appalled slack to them, witnesses to something they probably guessed must happen sometime soon but that came so unexpectedly tonight.
They snap out of it, though – Enid to move the hall table out of our way; Bert to light the path.

* * *

We’re rocking gently along to the hospital. I’ve dimmed the lights in the back. Enrico is held snug by the rigid sides of the vacuum mattress, the criss-crossing straps, the head blocks, the blankets. He opens his eyes when I ask him questions, but otherwise lies as still as an Egyptian mummy.
‘Who’s your next of kin?’ I ask him.
‘My mother and father,’ he says.
I stroke him on the shoulder and carry on writing.
He breathes gently and easily and seems to fall asleep for a minute or two, but then suddenly opens his eyes wide, his mouth open – not in fear, though. More in wonder.
‘What is it?’ I say, leaning forward in my seat again. ‘What’s wrong, Enrico?’
‘I can see a naked man,’ he says, looking up at the ceiling. ‘A naked man, shining.’

Monday, October 21, 2013

back in kansas

There was a plague of drunks that night. Everyone did their share. We had three – one of them, a guy of twenty or so, was sprawled face down on the pavement outside a fast food place, so covered in vomit it looked like he himself must have been eaten by a larger species of clubber and vomited whole a while later. There’s an art to moving patients like this. You swaddle them in blankets before you even think of getting them up, then after a few essential obs, postural adjustments, tactical placing of bowls and inco pads, you transport them to hospital and roll them onto a trolley in A&E. And there they lie, a collection of noxious pupae, waiting for the alcoholic tide in their blood to recede so they can be re-born. You’ll see them later in the morning, tentatively unfolding the stinking wings that will carry them home.

Our third drunk doesn’t even have the decency to be soiled.
A young guy in pipe jeans, denim shirt and punky, sugar paste hair as sad and folded as he is now.
Two friends stand over him.
‘What’s happened?’ I ask them.
‘Dave drank too much and says he can’t go on.’
‘I can’t,’ says Dave. ‘I’ve puked my guts up and it really hurts.’
‘Was it just alcohol tonight, Dave?’
Just’ says the other friend. ‘Look – how long’s this going to take?’
I ignore her.
‘Have you had any recreational drugs tonight, Dave?’
His friends laugh; I look up and repeat the worn old line that we’re not the police, we don’t care if you do or don’t take drugs, but as health care professionals we need to know so we can treat you appropriately.
‘I don’t do drugs,’ says Dave, spitting on the pavement, and the groaning some more.
‘What’s your medical history? Any problems – heart, breathing, that kind of thing?’
He shakes his head.
‘On any meds?’
‘Allergic to any?’
‘What are you going to do with him?’ says the girl, checking the time on her phone. ‘We’re sorry to have called you but we didn’t know what else to do. The taxi said no.’
‘Take me home,’ says Dave. ‘Please take me home.’
Then groans as another bout of nausea rolls through him.
‘The only thing we can offer is a trip up the hospital. You can sober up there and get a cab home later.’
‘Why can’t you take me?’ he says, looking up. ‘Please? I just want to go home.’
‘Just run him home’ says the girl. ‘It won’t take long.’
I shake my head.
‘It’s not going to happen.’
Rae sighs.
‘How do you think that’ll play? When people hear the ambulance is giving free rides home when the taxis refuse?’
‘I know, but couldn’t you make an exception in this case? We promise we won’t tell.’
‘No,’ I tell them. ‘Absolutely not.’
Dave retches, then spits.
‘But he’s only had a bit too much to drink. He doesn’t need the hospital,’ says the girl.
‘I agree with you. And the hospital certainly doesn’t need him. Look. I’ll tell you what I’ll do. I’ll give you a blanket. You can wear that round your shoulders to keep warm, and here you are –have a vomit bowl, too, just in case. I think if you make a big effort and stand up straight, you’ll look well enough to go in a taxi. What do you think?’
He groans.
‘Just take me home,’ he says. ‘I want to go home.’
‘No – Forget it. It’s just not going to happen, Dave. You’ve got to be realistic.’
‘Open your eyes, Dorothy,’ says Rae, pulling off her gloves. ‘You’re back in Kansas now.’

Sunday, October 20, 2013

the stag

All the other spit n’sawdust pubs round here were long ago traded in for soft furnished, easy drinking bars with cute names, but The Stag bellows on. The sign outside is so decrepit, and the view through the windows so down-at-heel, you could easily misread it for The Stab. The view of the clientele any time of day or night remains unchanged – slumped forms, slumped tables, big screens.
Charlie has rung for an ambulance and he’s waiting for us in the street.
‘It’s my wife, Julie,’ he says. ‘She’s been having one of her manic episodes. She met this guy in the bookies and they’ve been in the pub all night. I don’t know what to do.’
‘Does she have a history of mental health problems?’
‘Yeah. She’s been in and out of hospital. But she’s not been taking any of her meds and things are getting out of hand. I called the out of hours mental health number, but they told me to call you.’
‘Have you told Julie you called us?’
‘No. I didn’t want to scare her.’
‘Okay. Well, look – do you think there’s a chance you could explain what’s happened and ask her to come outside for a chat? I don’t want to march in an embarrass her in front of everyone.’
‘I’ll try,’ he says, tucking his phone away like he’s re-holstering a pistol.
He goes back inside.

We wait.

After five minutes, he reappears.
‘She doesn’t want to,’ he says. ‘Can’t you come in and have a word?’

As I walk through the bar there’s the usual shouts of Oi Oi! and  Take him! or Buy this man a pint! or Slow night, is it? I go over to the table at the back where Julie is sitting next to an enormous, red-faced guy with ratty hair and a glass in his hand. As soon as Julie sees me she turns to the side and buries her face in the man’s anorak.
‘Go away!’ she says.
‘Julie? Hello. My name’s Spence. I’m with the ambulance. Charlie has called us because he’s a bit worried about your health tonight. Will you come outside and have a quick chat? We won’t do anything or take you anywhere you don’t want to go. All right?’
The big guy takes a gulp of beer and puts the glass down with a whump.
‘Come on love,’ he says, belching lager fumes. ‘Go see the paramedics, love. I’ll come with you.’
Julie turns on me.
‘You’re weirding me out,’ she says. ‘I’ve never seen you before in my life.’
‘I know this is all a bit strange,’ I say. ‘Five minutes then we’ll leave you in peace.’
She stands up suddenly, scraping her chair back. The Big Guy grabs her arm but she snatches it back.
‘Leave me alone!’ she shouts, then pushes her way out of the bar. The Big Guy and Charlie both chase after her. I follow. A muted cheer from the bar.
Outside in the street Julie reacts to the sight of the ambulance by ducking down, raising her arms up and screeching like a chimp.
They’ve come to take you away!’ shouts the big man with glee.
Charlie remonstrates with him in an ineffectual way. Julie falls back against the pub wall, then takes a few steps into the road. Cars hoot and make room. The Big Guy grabs her again and there’s a messy, three-way struggle. I tell the Big Guy to let her go.
‘No! Don’t hold her like that,’ I tell him.
‘She’s going to hospital,’ he says.
‘No. You let her go and you listen to me. Back off! And – listen. No-one is doing anything they don’t want to do.’
I turn my attention to Julie, who is standing there, breathing hard.
‘We’re only here to help you, Julie. But if you don’t want us, that’s fine, we can go.’
‘I don’t want you!’ she says, flush with alcohol and the drama of it all. ‘I don’t want your help. Why should I want your help?’
She puts an arm round the waist of the Big Guy, who leers horribly and drapes an arm protectively round her shoulder. ‘ I’m starved of human touch, okay?’ she says. ‘So thanks very much, yeah?’
She relaxes her hug to sufficiently to reach out with her right hand. When I take it, she starts to shake my hand, but it quickly deteriorates into an aggressive hand-pumping that I’m forced to control and then release. ‘Now you fuck off,’ she shouts in my face, then turns with the Big Guy and goes back into the pub.

We stand by the ambulance talking to Charlie, finding out some more facts and then offering what advice we can.
The landlady comes out, a blousy woman in weapons grade makeup. She studies us a while from the door of the pub, then comes over. ‘What’s the matter with that one?’ she says, jabbing her thumb backwards over her shoulder. ‘Do I want her back in my pub, or what?’

Thursday, October 17, 2013

man on wall

‘I spoke to her on the phone.’
‘How did she sound?’
‘Not good, mate. I think she’s had a stroke.’
The trouble is, Janet’s son Pete was supposed to meet us here to let us in. But whether it’s because it’s early in the morning, or whether he panicked when he took the call, the fact is that in his haste he grabbed a handful out of keys out of the dresser drawer, certain that the right one must be amongst them.
And it wasn’t.
‘We’re going to have to break in,’ he says. ‘It won’t be easy.’
The front door of the house is a solid oak affair, mortice-locked in two places. The windows looking on to the street are all painted shut. I’ve had a quick recce round the back, using a parked car to get up high enough to grab hold of the iron trellis that runs along the top of the wall and pull myself up. But it’s a long drop beyond, into something more like a well than a courtyard garden. I jump back down.
‘Let’s have another look at the front door.’
‘We have to get in,’ says Pete. ‘Careful with the door, though. Don’t smash it to pieces.’
‘You can’t avoid some damage,’ I tell him, wielding a crowbar. But instead of working on the door I smash a little window off to the side. When I reach through, I find it’s been of no use. The keys are not in the lock, and now that we have this little hole to look through, we can see where Janet has left them, in a dish on the hall table, way out of reach.
Janet’s next door neighbour, Anthony, has been brought out by the sound of breaking glass.
‘Hello!’ he says.
‘It’s Janet,’ says Pete. ‘She’s been taken ill and we can’t get in.’
‘No. No I don’t suppose you can.’
Anthony has his hands deep in his dressing gown pockets. He has the detachment of a sedated colonel, his wispy hair standing up in peaks.
‘Want to come round the back?’ he sniffs. ‘You can borrow my ladder.’
He leads us through his house into the courtyard.

There’s a pre-dawn thrill to the air, something smudged and thickly blue. A fountain splashes in the pond over in the far corner, a concrete duck perched on the lip. The noise of the falling water echoes coldly about the space, making the walls seem even higher.
Pete helps Anthony out of the house with the ladder, and they set it against the wall that separates his courtyard from Janet’s.
‘There you are,’ he says.
‘I’ll foot it,’ says Pete.
I hand him the crowbar, the flashlight, and start to climb.
When I’m up on top, it’s an effort not to pitch head first into the void the other side. I struggle to keep my balance whilst Pete passes the ladder up to me.
‘Got it?’
I drag it up, then pause with it balanced at right angles either side. I feel like Philippe Petit doing the Twin Towers walk; by rights I should stop and do a handstand to the admiration of the crowd, but when I glance down behind me, Anthony has already gone back inside.
‘All right?’ says Pete.
Suddenly a light goes on in Janet’s lounge; a moment later, there’s a rattling of keys, and the back door opens. Rae steps out, Janet next to her (Janet?). They both look up at me, wobbling fifteen feet up on top of the wall.
‘What’s that up there?’ says Janet. ‘A cat?’
‘No,’ says Rae. ‘That’s my partner.’

Wednesday, October 16, 2013


The door slammed shut when Claire went outside to bring in the last of her shopping bags. Her keys were on the kitchen counter along with her phone, so she was forced to climb over a high garden gate to get round the back. As she jumped down, one foot landed in a pile of bin bags. When she put the other foot out to save herself, it disappeared down the drain that had lost its cover a week ago.
‘I can’t believe it. I’ve already had one fracture this year,’ she says, toking on the entonox, her foot up on some cushions. ‘I broke my nose at Christmas. It was right over to the side and I had to have an operation to straighten it. It’ll never be as good as it was, but at least it’s pointing in the right direction. You’re not going to cut my boots off, are you? I bought them to cheer myself up after the nose. Just let me have a bit more gas and I’ll work it off slowly.’
‘How did you break your nose, Claire?’
She leans her head back, her voice lowered an octave by the gas.
‘Cheerleading.’ she says. ‘We were stunting – you know? When you get thrown up in the air and do tricks? Well this girl, she was spinning round and round, and she caught me in the face with her elbow.’
She lifts her head again.
‘Oh God! We’ve got the area championships coming up.’

She reaches forward, and then slowly – agonisingly – starts to ease the boot off.

Monday, October 14, 2013


Dorothy is sitting forward on her chair, letting the first paramedic on scene do her blood pressure. The carer who called us in sits by her side, one hand resting on her shoulder.
‘Who are you?’ says Dot, peering up at us. ‘Are you the ones who’re gonna cart me orf?’
‘Don’t worry, Dot,’ says the paramedic, pulling the steth out of his ears and straightening up. And then to us: ‘Thanks for coming, guys. Funnily enough, I was just about to stand you down. There’s nothing acute going on as far as I can tell. This clown thing’s been an issue for three weeks or more. Hasn’t it, Dot? The scary clowns?’
‘Ye-es. Dancin’ about like they own the place. Baring their teeth. Horrible it is.’
The carer rubs her shoulder.
‘Dot has been having these hallucinations for a little while,’ says the paramedic, writing the BP down. ‘She’s being treated for a UTI, so that’s probably got something to do with it. But she’s also suffering from macular degeneration and they think that might be a factor.The carer here was a bit concerned tonight that Dot had got worse, but to be honest everything else is checking out, and she’s settled down since I got here. Haven’t you, Dot? Settled down?’
‘Ye-es. Well. The clowns are more interested in you now, I think.’
The paramedic shudders.

To be fair, Dot seeing clowns is not all that surprising. Even if she were completely well, she’d see at least a dozen. There are porcelain clowns gurning on the mantelpiece, a row of cloth clowns lain out  in clear plastic bags on the temporary clown mortuary of the sofa, and worst of all, a three-quarter size clown leaning next to the fireplace, its red glove up in farewell, a rictus of grief on its face.
‘I see kittens as well, you know’ says Dot, rubbing the spot where the paramedic unwrapped the cuff. ‘Playing around the sofa, like.’
‘Now kittens I can handle,’ he says. ‘Let's focus on the kittens.’

‘But it’s you the clowns want,’ says Dot. ‘I can tell.’

Sunday, October 13, 2013

martin's fortieth

‘If it is Martin, that’s some kind of record.’
We were only signing his birthday card that evening at nine. Happy fortieth. Have a good one. And here he is – we can tell as soon as we pull up it is Martin – lying in the recovery position on the pavement barely a hundred yards from the pub they started at.
Martin works on reception at A&E. He’s always looked slightly out of place there. A slight, well-groomed man, he should be the brand manager of a hair products company, or a journalist on a fashion magazine. Sometimes he wears a badge on his shirt: Gay Icon.
Jessica, one of the other receptionists, is kneeling next to him, stroking his lovely hair, her breasts ballooning dangerously out of the tiny dress she’s packed herself into, her sling-backs off and in the gutter. She coos and clicks, like someone coaxing a kitten out of a tree.
‘Matty! Matty! Come on, my lovely darling! Who’s a good boy? Who’s a good boy? You’re a good boy, that’s who!  Maaaa-ttttty!’
‘So tell us what happened, Jessica?’
She pushes the hair out of her eyes and adopts a clownishly serious expression.
‘You know Matty, don’t you?’ She puts a hand to the side of her mouth and whispers: From - the - hospital?
‘Yep. We only saw him a couple of hours ago. That’s pretty fast work.’
‘We were supposed to be going on to a club, but silly Matty took some ketamine and here we are! Maaa-ttty? The lovely ambulance people have come to rescue you. Come on, Matty!’
She smiles up at us again, her eyes so big they suck the light from the streetlamps along this section.
We check him over. As soon as we’re happy he doesn’t need immobilising, we get the trolley out and haul him on to it. The whole time we’re doing this, Jessica staggers around, trying to help but getting in the way, leaning in to kiss Matty on the head and each time almost pitching onto the trolley herself.
‘Just give us a bit of room there, Jessie. You can come on board when we’re all settled.’
‘Maa-tttty! I’m here, babe. Love you.’
She gets a phone out to call someone, but ends up frowning and holding it close up like she was trying to make it work with the sheer power of her mind.

* * *

A thrill of attention as we roll into the department.
Is that...?
Blimey! He said he was going to have a good time...
Oh my good god! Three hours!
And so on.
Martin senses where he is, and jumps off the trolley in horror.
‘Quick! He’s in a K hole!’ says Jessie, grabbing him by the hands and pushing her face into his. ‘Matty! Matty!’
Alison, the Charge Nurse, does her best to rescue him, but Martin pulls away, mumbles something, lurches off across the corridor to the far wall, then sinks to the floor.
‘Let’s get him in a side room,’ says Alison. Jessie staggers over, but Alison keeps her away. ‘You’re making it worse,’ she says. ‘Go and get yourself a coffee. Try to sober up.’
‘Love you, babe!’ says Jessie, kissing her hand and blowing on it.
Then she turns back to us.
‘What have you done with my shoes?’

Saturday, October 12, 2013


‘Crawl in the direction of the door, mum. Can you do that?’
Jim straightens up from where he’s been shouting through the letterbox.
‘I’m not sure she can do all that much when she gets there. I’ll have another look round the back and see if I can get in there.’
Jim’s mum Angela has fallen over in the hallway. We can just make her out, sitting on the carpet by the phone table. She doesn’t sound too bad, no pain, a little confused perhaps, but unable to get up.
‘She’s obsessed with security,’ says Kate, Jim’s wife. ‘We’ve got a spare key, but it’s no good when she puts the latch down. And she’s pretty good at locking all the windows at night. I don’t know. We’ve talked about this before, but I suppose you get set in your ways.’
I foot the door to see how much give there is. I should be able to break in pretty easily, but we’ve got time to find a subtler means.
‘We thought she’d had a stroke. When she phoned us, her speech was all slurred and she wasn’t making much sense.’
Suddenly a light goes on in the hall. A blurred shape behind the door glass, a rattling of locks.
Jim throws the door open.
‘I came through the window’ he says.

* * *

Angela is sitting on a chair in the kitchen, a blood pressure cuff on her arm.
‘It’s been a stressful time for mum lately,’ says Jim.
‘I’m all right,’ she says. ‘It’s everyone else. Poor Jimmy. He’s only just getting over the cancer. He had some of his you know what, his bowels removed and he had to go in a bag. But they reversed the thing the other day, so thank god he’s getting back to normal. But it was a tough time for him and Kate, that and her losing her job, when it was someone else who made the mistake and pinned it all on her. So they’ve got all those money worries, you know. And then there’s Kevin, my next boy. He married this girl, pretty but cold, you know. Never saw the funny side. I knew it wouldn’t last but you can’t say anything, not when you’re a mother. And then what happens? Fifteen months later, she turns round to him and she says “I don’t want to be married anymore”. Like it’s something you can just shrug off like that, like a coat. So now he’s down in the dumps. Then there’s Gillian, my daughter. She’s been trying for a baby since how long, and now they’re going to have some IMF and grow one in a tube. I mean, if it works then fine, but however much is that costing? I was lucky in that department, it was like shelling peas, but you just have to make the best of it. And then my washing machine packs up. There. How’s my blood pressure?’

‘Better than mine,’ says Jim.

Friday, October 11, 2013

out of the strong

Ron’s chest pain has resolved to almost nothing.
‘But even if it hadn’t, you still wouldn’t be hauling me off to no hospital. I want to die here at home, with my wife. And the cat.’
Ron’s lying on the sofa, propped up on pillows, surrounded by boxes of meds, remote controls, packets of tissues, a vomit bowl – the hectic standline of his illness to date. He was obviously once a powerful man, but his body has been wasted by cancer. Lying on his side like this, with his mane of grey hair, he reminds me of the lion on the side of the Lyle’s treacle tin. Out of the strong came forth sweetness.

‘Bloody hospitals. All they want to do is expearmint on you.’

Ron’s wife Rita is sitting on the opposite chair. A large woman in a red and gold dress, she’s been talking without interruption the whole time, not so much a commentary as a slow leak. But after you attune your ear to Ron’s base rumble it’s surprisingly easy to screen out.  The cat, well used to all this, has curled up on top of my bag and fallen asleep.
‘It’s an unusual situation, Ron,’ I say. ‘But I can quite understand why you don’t want to go to hospital. What we’ve got to do is make sure everything’s in place so that if you have another bad spell you know what to do.’
‘I want to stay here, mate, simple as that. I’m done. I’ll make no bones about it. I don’t want no hospital bed and no fussing around. I don’t want nothing. I just want to lie here and see my time out at home.’
That’s not difficult in this room; a giant clock face takes up a good half of the wall opposite.
‘Ten minutes fast,’ says Rita, before I think to ask, then carries on talking about where they bought it, how they got it home, how it looks old but actually runs on batteries, and so on.
 ‘Rita only called you out because that other number didn’t seem to work,’ says Ron, talking across her. ‘But everything’s always a bit more difficult at night.’
‘How long ago did you have the stents put in?’
‘Ten years. They did an amazing job. I tell you what – that stuff they gave me before they went in. Wonderful! I had blue sparks flying out of my hair.’
‘That sounds great!’
‘It was great. I could do with some of that now.’
He relaxes back into the cushions.
The cat raises its head, fixes him with a look for a second, then buries its nose a little more deeply in its paws.

Tuesday, October 08, 2013


Eileen is sitting on the sofa over by the bay windows, the late afternoon sunshine blurring her outline. She mutters to herself, plucking distractedly at her nightie one moment, then suddenly stopping and leaning forward pleasantly, as if she hadn’t quite understood what was said.
Along with her temperature, her confused speech and unsteadiness when she stands, I would guess she has a UTI – something she’s suffered with in the past. But Eileen doesn’t have any carers and she’s not safe to leave at home whilst we call someone in to find out.
Alice, her daughter-in-law, sits on the piano stool opposite.
‘Eileen is so independent. Which is a polite way of saying bloody-minded, of course. Won’t have anyone round to help, absolutely insists on keeping things as they are, even though she’s had a few falls recently. I mean, she’s wonderful for ninety-five, but it’s getting to the stage where we need to think of alternatives. Eileen’s been unwell with these damned UTIs before, but never as bad as this. It was lucky I popped round when I did.’
Alice is sixty-something herself, immaculately dressed. With her Louise Brooks hairstyle, scarlet lipstick, cashmere sweater and pencil skirt she could be the Head of some Parisian couturier. There’s a solidity to her, something you could depend on.
‘All in all I think it’s best if we run Eileen up the hospital,’ I say. ‘Just to rule out anything else. If it is a UTI, they can start treatment immediately. It’ll also give everyone a chance to review things at home and see what needs to be done.’
 Alice smiles. For a moment I think she’s going to say something, but her eyes have suddenly blurred and there’s a brave set to her face.
‘Sorry,’ she says after a moment, suddenly pulling a handkerchief out of her sleeve. ‘I’m so sorry.’
She blows her nose.
‘That’s okay. I know this is upsetting.’
She takes a few settling breaths, shakes her head, seems a little more restored.
‘Would you mind if I didn’t come with you to the hospital?’
‘No! Not at all!’
‘It’s just – I don’t think I can do this. Right now. This afternoon. It’s been a difficult couple of years. One thing after another. First my father-in-law. Then my mother. Then my husband – and now Eileen. I feel like I’m falling headfirst down some great big hole.’
‘I’m sorry to hear you’ve had a difficult time. Don’t worry, though – we’ll look after Eileen. You take care of things here, then ring the hospital in a couple of hours and see what they have to say. But I think it’s important you take some time for yourself.’

We sort out the chair, the medication and the basic information we’ll need. Alice helps us with all this, then gets a bag of things together and carries it out to the ambulance. She kisses Eileen goodbye when she’s comfortably settled on the trolley, then stands back and watches from the pavement as I slam the back door and climb into the cab.
‘See you later.’
She waves.

I catch sight of her in the rear view mirror as I turn at the top of the road, still standing where we left her.

Monday, October 07, 2013


It’s John’s birthday today but it doesn’t look like he’ll be celebrating.
He was woken in the early hours by a crashing noise in the bathroom. When he went to investigate he found his twenty-five year old son, Alex, unconscious on the floor, so he put him on his side and called the ambulance.

When I squeeze into the bathroom Alex is conscious but sweating profusely, his eyes wide, his pupils wider. He has a lump on his head where it struck the pedestal of the hand basin. When I talk to him, he doesn’t reply, but thrashes around like a man in a waking nightmare.
John is too upset to tell us much, other than the fact that Alex uses heroin and other drugs, and a few years ago was beaten half to death with a fence post.
‘Did that leave him with any speech problems or weakness anywhere?’
John shakes his head and retreats into the kitchen.
I put a SATS probe on Alex’s finger; he immediately puts it in his mouth and bites down on it.
Whilst I’m scrabbling around to pick up the pieces, Alex hauls himself to his feet and staggers around, knocking bottles and cups and toothbrushes off the shelf above the sink, and tearing a bathrobe off the back of the door.
Our best guess is that it’s the effect of some drug he’s taken, maybe GHB. But the head injury is a worry, so we’ll have to take him in. Getting him out to the ambulance is going to be difficult, so we call for a second crew.
Whilst we wait for them to turn up we try to guide Alex so he doesn’t hurt himself, but it’s dangerous work. Despite his condition – or maybe because of it – he’s wild and strong and difficult to control. We try to balance the risk of getting punched or head-butted with the job of keeping him safe. He staggers out of the bathroom across the landing into his bedroom, lowing like a bull. I try to guide him onto the bed where he’ll do less harm to himself and certainly less damage to the room. On the way over to the bed he grabs a lava lamp and makes as if to smash it, but we manage to get it off him. He knocks everything off the dressing table and yanks a wall covering down on top of himself. He falls across the bed, kicking and moaning incoherently.
The second crew arrive.
Between us we manage to coax Alex down the stairs, holding him by the wrists so he doesn’t lash out or pitch down head-first.
On the ambulance he becomes even wilder, screaming in terror, struggling to get away. We restrain him as humanely as we can with the straps on the trolley. There’s no point in trying to get any obs, so we run as we are and phone ahead.

At the hospital we’re met by security who take over the job of restraint. We wheel him through the department into resus, where a team is ready for us. I leave the room to book him in just as they’re drawing up a syringe of something to chill him out.

* * *

Later that morning I run into one of the doctors who dealt with Alex.
‘How was our man this morning?’
‘Alex? Bat-shit crazy,’ she says. ‘But I’ve had the pleasure a couple of times before. Once when he came in after an argument with a fence post. One of our more select customers.’
‘I felt so sorry for his dad. It’s his birthday today.’
She takes a sip of coffee then pulls a face and reaches for the sugar.
‘So what do you reckon it was?’ I ask, as I get myself a cup.
‘Alex? Crack and smack, no doubt, but we won’t be doing a tox-screen. We did a CT, though, just to make sure. And it confirmed our suspicion.’
‘What’s that?’
‘He’s a wanker.’

Sunday, October 06, 2013

the cake nurse

We’ve successfully transferred our patient onto the ITU bed. The nurse who accompanied us on the trip is completing her handover; she points us in the direction of the kitchen to make ourselves a cup of tea.
By the hot water dispenser and the draining board stacked with mugs is a tray of apples and a tray of cake. Another nurse pops in to fetch something. I ask her if it’s all right if we grab a bite to eat.
‘Help yourselves. Whatever you fancy. We’ve got Victoria Sponge Sandwich, Ginger cake, some iced buns. Fill your boots.’
‘Wow! Amazing! This is like – Cake Central.’
‘Cake Canaveral.’
She laughs and leaves.
When she’s gone, I take an apple instead.

I stand in the doorway of the kitchen and look around, alternating bites and sips.

A narrow corridor separates the kitchen, utility and other rooms on this side from the access points to the ITU bays on the other. Most of the curtains are drawn around the beds and the lights are turned down low. It’s a muted, heavy blue atmosphere, intricately paced by the various bleeps and clicks of the life support machines.
I notice an elderly woman standing off to my left. She’s holding a stick in one hand and a raincoat in the other.
‘Are you lost? Can I help?’
‘It’s his teeth. They don’t really fit with the tube.’
‘I’m sorry to hear that. Is he a relative of yours? Do you…?’
‘It shouldn’t be him, you know. He supported the rest of us all these years. It shouldn’t be him lying there.’
‘I’m afraid I’m out of area so I don’t know my way around that well. Let me find you someone who can help.’
She doesn’t seem to see me so much as lift her chin and sniff the air.
‘Just a minute,’ I say, looking for a place to put my apple and coffee.
But luckily the cake nurse comes back.
‘Come on, Margaret. This way.’
She gently guides her down one of the blue-curtained aisles.

I go back into the kitchen. Rae is leaning against a counter, cradling her empty mug. She looks tired. I wash our mugs up and put them back in the rack. When I go outside, the old woman is there again. She’s standing in the corridor, coat in one hand, stick in the other as before.
‘Are you going home now?’ I ask.
She doesn’t reply, but leans in to look up at the wall to the side of the kitchen door. There’s a framed picture there, a child’s drawing of a nurse: crazy pink smile; googly eyes; hair frizzing out around a red cross cap; stick arms and legs splayed out. There’s a bronze plaque just beneath the picture, but I can’t make it out in this light.
‘That’s actually a photo,’ I say to the woman.
‘She works here.’
The old woman leans in closer.
I wish I hadn’t tried to make a joke of it. She’s taken me seriously and I don’t know how to carry on. And anyway, the nurse probably does work here, drawn by the child of a former patient, maybe.
Before I can figure out what to say, the Cake Nurse appears again.
‘Come on, Margaret. Bill’s doing fine. Let me show you to the relatives’ room.’
As she gently turns her round she whispers to me: Had your cake yet?
‘Lovely. Thanks.’
She gives a kind of victory wave, then gently rests her hand back on the old woman’s shoulder.
I watch as the two of them walk off side-by-side down the corridor.

Wednesday, October 02, 2013

flight risk

It’s the first time I’ve ever been to ITU for a transfer and found the patient eating dinner.
Murat is sitting up in bed, cautiously spooning crumble. He has two black eyes, a cast on his right arm, a fat lip, and a bloody wound above his left eye.
‘He jumped from a lorry,’ says one of the border guards.
‘A stationary lorry’ says the other.
‘Landed on his face. One of us has to travel with him in the ambulance. Okay?’
I tell them fine. Whilst they get their things together, I introduce myself to Murat. He has very little English, and studies me warily as I mime.
The first guard yawns noisily, the skin of his bald head puckering in a V, the hefts of his great hands stretched out right and left.
One of the ITU nurses hurries over with his notes in an envelope.
‘I’m due off in half an hour and there’s another patient coming in,’ she says, pushing her hair back with the back of her wrist. ‘I’ll be lucky if I get off by nine at this rate.’
‘You’ll score the overtime though.’
‘Nope. Not even time in lieu.’
‘That’s outrageous! What does your union have to say about that?’
‘Union?’ she snorts. ‘What union?’  She hands me the notes.
‘You must get the union on it,’ I say. ‘That’s terrible. I can’t believe you don’t get paid for the hours you work.’
‘It’s a job,’ she sighs, smiling. ‘So I’m told. Now – what else?’
Murat interrupts. He says he needs the toilet before we set off. The nurse hands him a bottle. He shakes his head and drops his eyes.
‘I’ll get the commode,’ she says.
‘No,’ says Murat. ‘I go bathroom.’
One of the guards steps forwards. ‘What’s the matter?’ he says. ‘What’s happening?’
‘He says he needs the loo.’
‘Ones or twos?’
‘Ones. Or is it twos?  I get confused.’
‘You’re the medic.’
‘The sit down sort.’
‘Uh oh,’ he says. ‘Flight risk. I think we’ll be using the commode right here.’
Murat divides his attention evenly between us all. I notice he has a serpent tattoo on his right shoulder.  
‘Don’t worry. We’ll draw the curtains,’ says the guard. Then: ‘Those windows, nurse. How far do they open?’