Sunday, December 29, 2013

the rainbow world of dave

Christmas at the hostel and the tree in the lounge is lopsided but bright. Christopher is sitting on a sofa, holding a bloody wad of tissues to his mouth, which he takes away only to smoke, and to tell something else about the assault. The thrill of it has galvanised the place. Various characters appear and disappear, scuttling back to the squat round the corner where the whole thing blew up, either to report on who’s there now, or to carry out the vengeance they’ve sworn on Christopher’s behalf, or just hurrying to and fro in a pin-eyed, point-less kind of excitement.

Christopher is an impressive figure. I’ve seen him around, his shaven head nicked and scarred from other fights, his tall frame intensified by his years on the street. He carries himself with economy, a Kwai Chang Caine of Skag, loping from place to place, with his bag of cans and wraps.

‘He hit me with a block of wood. Shoom! And there must’ ve been a nail in it or summit ‘cos it ripped my face, man. Look at me! I can poke my tongue through. D’you think I need stitches? It’ll never heal, will it?’

Christopher’s friend Dave stands just behind his right shoulder. He’s the complete opposite to him – short, hunched, a sagged and pitted face. He fits his words into the spaces that Christopher leaves, skipping in and out like a Court Jester around a King.

‘You should definitely get him for this,’ he says. ‘I tell you what. You get him, I’ll finish him off.’

Christopher takes the wad from his face and looks at Dave.

‘Seriously, mate. Don’t. Look at me! He could’ve blinded me with that nail. I’m not like him. I’m not stooping to his level. I want the police here so I can point him out, then you can take me down the hospital and get me stitched up.’
‘Yeah, mate. That’s the best thing to do,’ says Dave. ‘Then we’ll do him when he comes out.’

* * *

We wait in the triage zone to handover. Christopher holds some fresh gauze to his face, and leans forward in the wheelchair. We’ve heard the whole fight scenario a few times now – how the squat had been building up to this, that nasty geezer from Tottenham who’d taken over; how there’d been trouble brewing with dogs there, a bite or two, a police raid; how it’s a shame that particular party had changed the mood of the place; how he’d tooled himself up for a confrontation with Christopher, who’d only wanted to talk to him about stuff.

‘I don’t know,’ he says, shaking his head, then displaying the gaping hole in his upper lip again. ‘If I hadn’t turned my head when he did, he’d have taken my eye out.’

Dave moves forward and clears his throat.

‘Did I tell you about Father Christmas this year?’ he says.

He has our attention.

‘It’s like – I told him in July all I wanted for Christmas was my two front teeth. Yeah? He’s had six months to get them made in his poxy little workshop in the North Pole. So what do I find in my stocking? Two cans of Stella and a tangerine.’

He pauses, staring down at the floor as if in his head he’s overwhelmed by a great volume of laughter. Then he snaps a look up again and carries on.

‘And what about those elves, hey? Santa’s Little Helpers? I hear they’re really into genetic engineering this year. Yeah. They’ve crossed a mouse and a donkey, so now you can tie up your own shoelaces, wear a moustache and still get home at night.’


‘I’ve got a million of ‘em. Welcome to the Rainbow World of Dave,’ he says. ‘So now you know what I think.’
He steps back again, bashfully toes the floor, shakes his head, blushes with pleasure.

Christopher glances at him coolly, then lifts off the gauze to show us his wound again.
‘Will it scar, d’you think?’ he says.

Friday, December 27, 2013

the old pine tree

A row of early-Victorian terraced houses over-looking the park, each house sweetly maintained with paths of black and white mosaic tiles, lines of clipped box and laurel hedges, multi-coloured fan-lights on lead-glassed front doors. A smart location, the kind of move high-achievers make two properties in on their Game of Life. Expensive houses, just a turn of the four by four from the commuter station, the Pilates studio, the good school, and that bijou row of shops on the top road selling handmade chocolates, shabby chic furniture, and more expensive properties, further out of town, with land.

Rae’s been here before, but even so we’d hardly struggle to find it. Mr Dyer’s house stands out like a rotten tooth in the middle of a smile. The garden is dark and wild. There are discoloured and sagging curtains in his window. Ragged curls of paint lift from the sashes.

The front door stands open.

Just inside the hallway is the neighbour who called us, a smart, peach-lipped, black-bobbed woman in fake fur and ankle boots.
‘He’s really not coping,’ she says, leaning in. ‘Especially now his sister’s gone. It can’t go on. We’re at our wits’ end. He’s got no relatives, at least none that we’ve seen. He keeps sacking his carers for one reason or another, but he definitely needs something because he’s got all these problems and he’s just – well – old.’
‘So what’s happened this morning?’
‘I came round to see how he was and I found him half-collapsed at the sink. I helped him back into his chair and then called you.’
‘I can lock up when you’ve gone.’
She opens the door wider, and stands aside.

Mr Dyer is sprawled on his kitchen chair, his long legs splayed right and left, the bandages on each foot seeping and discoloured. There’s a single barred electric wall-heater just above his head, broiling his scalp. He is wearing a huge pair of glasses so thumb-printed and dirty he may as well have cataracts. He squints as we go up to him.
‘It’s my groin,’ he says, plucking at his corduroys. ‘I’d rather you just cut if off. It’s not like I have any use for it these days – except for going to the you-know-what. I wouldn’t mind betting they could fashion some other arrangement. It sounds drastic but it’s how I feel. It itches so terribly it’s almost what I’d call pain, and all the creams the doctors gave me are useless. I may as well smear myself in margarine. And then there’s my hip. I get such pain from it, I just don’t know what to do...’

As he talks I take in the details of his kitchen – the wallpaper peeling down from the ceiling, the spotted photographs on the shelf, the meagre display of tinned salmon, packets of biscuits and mouldy fruit in the cabinet. A packet of sugar, a saucer of old tea bags.

‘Mr Dyer? Mr Dyer? Tell me what’s happened today? Your neighbour says you were collapsed by the sink? Had you fallen over and hurt yourself?’
‘I’m always falling over but I rarely hurt myself. I have this hip, you see. It gives me such a lot of bother. Normally I can get along by myself but today it was all getting a little too much. I used to have carers, of course, but I only have one a week now and she’s no earthly good. I let all the others go. I mean, they don’t do anything, certainly not anything I can see. And it’s not as if I need that much help. I struggle to get about, it’s true. I suffer with my hip and it’s as much as I can do not to cry out when I move, but that aside I think I’m doing pretty well. It takes me a while to get from one place to another, and although I don’t have the agility I once had, I get by, do you know? Of course, the one thing I do regret is losing my sister. She had a stroke and she’s in hospital at the moment. I don’t know if she’ll be coming out. No-one’s said anything. We used to manage pretty well together, but then again we were younger. We had a bit more vim...’

I decide to take him in, partly for the groin issue, partly for the hip, but mainly because his mobility does seem reduced and he’s not safe to leave at home.

‘Will you phone my sister? I don’t want to worry her but I suppose she should be kept informed.’

We pass a picture of her up on the wall. The two of them together, side by side, middle-aged, looking out of the frame with the same, gloomy expression.

We get Mr Dyer into our carry chair and manoeuvre him out of the house. The contrast between the dull interior and the blue of the sky outside is overwhelming. There  are families taking advantage of the brighter weather , strolling through the park, children shouting, playing on bikes, running around. Immediately opposite Mr Dyer’s house is a big old pine.
‘What a lovely tree,’ I say to him.
‘It’s not a tree, it’s a hedge.’
‘No, not that. Across the road, in the park. Is that a Scot’s pine?’
‘It’s always been there,’ he sniffs.
I try to imagine Mr Dyer as a child, eighty years ago, running around the park with his sister under the boughs of the old pine, but it’s too much of a stretch. He was always this old.

As I wheel him backwards onto the ambulance ramp, a little girl stops to watch. She waves, and then bites her mitten as she’s done something incredibly naughty – but then her mother catches up, grabs her by the arm and urges her on. ‘Don’t be so nosy,’ she says. The little girl glances behind at us, waves one last time – and then disappears round the corner.

Monday, December 23, 2013


I know this road. I’ve been up and down it the last seven years, blue lights and routine dawdle, am, pm, any hour you like. I’ve hacked along through queues of backed-up commuters, or flown through the early, empty hours. I’ve careened through rainstorms and idled through sunshine. I’m so familiar with every bump, camber, dog-leg, slalom and chicane you could blindfold me in the back and I’d be able to tell you exactly where we were and how far there was to go. I know that on-coming traffic always hesitates to pull over into the bus lane just here, so when I’m driving up the hill through this section on the wrong side of the road I have to allow for the fact that they won’t give me any room. I know I have to come wide at these lights or I’ll get boxed in. I know I can drive as fast as the ambulance will take on this stretch, but I’ll have to brake about now to get a reasonable line through the roundabout and not tip everything out.
But this has come through as a choking / cardiac arrest, so I’m pushing it.
‘I’ll take my stuff, you bring the green bag,’ says Rae, jumping out as we haul up outside the address.

We hurry inside.

Luckily, the elderly woman sitting on the sofa sipping from a mug of tea is about as far from choking / cardiac arrest as it’s possible to be.
‘I’m so sorry,’ she says. ‘I’ve no idea what happened.’
June’s daughter Rachel tells us her mum had dozed off in front of the TV, and the next thing they knew she was red in the face, coughing horribly and thrashing about. Rachel’s husband had grabbed her and slapped her back whilst Rachel called 999, but the whole thing seemed to pass as quickly as it started, with no harm done.
‘So there was no food involved?’
‘No. We finished supper hours ago.’
‘No boiled sweets or anything like that?’
‘No. All I remember was dozing off in front of Perriot.’
‘You know. The detective.’

We give her a check-up, but everything seems fine.

‘Looks like you’re all ready for Christmas,’ I say, packing away the kit whilst Rae finishes the paperwork. ‘I like your Nativity scene.’
It’s a beautiful thing – simply carved and painted, a loved family object, nicked and scuffed through years of getting out and putting away again.
‘My grandfather made it,’ she says, picking up a donkey and turning it round in her hands. I get the feeling she’d put it to her nose and lips if we weren’t there. After a moment she carefully puts it back, sighs and says:
‘I’m sorry to be a nuisance.’
‘Don’t be silly,’ we all say, her daughter sitting down next to her on the sofa and giving her a hug.
‘We’re just glad you’re all right,’ says Rae, standing up ready to go.
‘I know, but still – you must be so busy,’ says June. ‘You could do without people like me at Christmas.’
‘Actually, you know what, June? We could do with a few more. Happy Christmas!’
‘Happy Christmas!’
We pick up our bags, the son-in-law shakes our hand, and shows us out.

Friday, December 20, 2013

specially designed

Reece is one of the few people who’ve been on the bariatric training course, so he knows how to handle the chair. He unclips it from the charger, makes some adjustments, unfolds the seat, then quickly runs through some of the features. It’s an amazing piece of engineering. Tough, adaptable. It even has a mechanism for propelling the chair backwards up stairs.
‘What do you think?’
In fact, the last piece of kit that impressed me quite as much was the robotic forklift suit Sigourney Weaver operated in Aliens.
But it needs to be. The patient we’ve come to transport weighs thirty stone.

There are four of us. Reece and his crew-mate had fetched the bariatric truck and driven across two counties to rendezvous with us here. We went in together with the special chair, leaving the bariatric trolley set up down in the lobby because the lift was only big enough for six people.

Sheila’s door swings aside automatically. Everything about the place is super-sized, the furniture, the cushions and grab rails, even the WWF wrestlers on the plasma screen, parading and flexing their steroidal figures, roaring in hyper-coloured violence as the door closes behind us and we walk in.

Sheila is opposite the screen, contained by a gigantic chair, catheterised, padded, remote controlled, sweet jarred and diet coked, everything to hand.  
‘I don’t know how you’re going to move me,’ she wheezes, muting the wrestlers.
In all honestly, neither do we.

But after some initial discussion and exploratory examinations, clambering around her like drones around a queen, we set to work. Using Sheila’s gigantic zimmer frame and the tilt mechanism on her armchair, we help her to stand and turn just enough to get the chair in position. Every movement is slow and teetering, everything at its limit – bones, organs, spot-welded aluminium. And suddenly the chair doesn’t seem quite so all-conquering. The seatbelt that had looked so generous downstairs strains to go round Sheila’s belly; the straps to keep her legs in place are half a metre short. We address these problems as best we can, working round the vast folds of her corrupted flesh, cellulitic, multi-coloured green, brown and red, crusted, scabbed like the skin on a diseased whale.
In all honesty, the ocean is the only place Sheila could be comfortable now. Instead of the hospital we should be taking her for surgery at the aquarium, where they could fashion a blow-hole then float her out to sea for rehab. Because here in this room, landed like this, undiluted gravity is just too heavy.
‘Give – me – a – minute. Wait – a minute.’
All we can do is stand close-by at four points and stop her from falling.

Down in the lobby it’s the same problem. But even though Sheila is very unwell, she manages to do the minimum to rise from the chair, turn, and roll back onto the trolley. Once she’s on, we lower the back, slide her into a better position, wrap her up.  It takes all four of us to tow her out to the truck.

* * *

There’s a team of nurses waiting for us at the hospital, gathered round a special bed-cum-chair, with bars and grab-rails and automated plates to make the transfer easier.
Once she’s safely over, we take our kit and head back to the truck.

‘She was big,’ says Reece, putting the chair back on charge. ‘But anyway – hey? – what d’you think?’
‘Amazing,’ I tell him. ‘Brilliant bit of kit.’

Wednesday, December 18, 2013

the quickening

A scientist hurrying in to a lab.
Take a look at this, sir.
Leaning in to a computer, buttoning his shirt wrong.  
I’ve never seen anything like it.
Patterns of coloured lines shimmering like wild isobars across one area of the country.
All that gravity.
What can it mean?
A shared look.
Then, typed out in white letters across the bottom of the screen: CHRISTMAS 2013.

There are so many falls tonight there has to be some explanation.

Olive, 96. Propped against the dresser, chattering.
Len, 84. Wedged between the commode and the bed, bellowing.
Beatrice, 87. Lying on the floor of her room in the EMI unit, humming.
Alia, 86. Back in the chair she rolled out of, whimpering.
And Steve, 22. Sitting on the steps outside the nightclub, shouting into a bloodied phone.
‘I’ve never fallen over on the dance floor’ he says. ‘Not ever. I must have been assaulted.’ The doorman says no, takes our call sign, goes back inside. Steve is already on his feet, striding on to the ambulance. ‘I’ve broken a tooth and cut my chin,’ he says into the phone. ‘No, mate. I know. Never.’
He’s not badly hurt, but the cut on his chin needs a stitch.
He’d already taken his bloodied shirt off; he keeps dropping it onto the floor. I put a blanket over his shoulders and put the shirt to one side.
‘Yeah, mate. If you could. Just tell her I’m okay. Yeah, mate, yeah. Just one of those things. Who knows? See you later.’
He throws the phone onto the trolley, stares at it a moment, then gathers the blanket tightly to him.
‘I can’t believe it,’ he says. ‘I’ve only just got back from Hong Kong. And now I’ve chipped a tooth.’ He shakes his head, as if Hong Kong and a chipped tooth are entirely random events.
‘I’ve never fallen on the dance floor,’ he says.
I nod to agree that anyone could tell from looking at him he’s completely safe when he dances.

What I don’t tell him, of course, is about all the other falls we’ve been to tonight.
I slowly lower my clipboard, and peer out of the door.

And then the film cuts to a scene on a boat, a fisherman holding on to a wire, frowning into the darkness. And then a scene in a house, where all the toys in a child’s bedroom suddenly start to shake, the mechanical monkey thrashing its drums, then toppling off its shelf.

Because other, darker forces are at work tonight.

Forces that will become known as... The Quickening.

Monday, December 16, 2013

Happy Holidays!

Merry Christmas and a Happy New Year!

Thank you so much for reading Siren Voices through 2013, and for all your comments.

I hope you have a brilliant holiday, and that 2014 is a fine year for you and your family.

Lots of love


Thursday, December 12, 2013


‘I don’t know why I mentioned the sword business,’ says Derek. ‘It’s a letter opener. Decorative, really. I feel a bit stupid, to be honest.’
We’d been standing off for ten minutes waiting for police because we were told Derek was suicidal and had a samurai sword. But as it turns out, Derek is empty-handed, and even if he did have a letter opener somewhere, his flat is so horribly junked-up he’d have a job finding anything smaller than a shovel.

The police satisfy themselves everything’s okay, then leave us to it.

Derek’s flat is a mean, cold, rubbish-strewn hovel, a filthy sheet tacked across the window, a soupy consistency to the air.
‘This is the first time I’ve been out in a week,’ he says, draping an army surplus greatcoat over his shoulders like a cloak. ‘I keep myself to myself.’
For all the obvious signs of neglect, Derek is still an impressive figure. With his swollen belly, his fleshy breasts spilling out the sides of a cut-off Motorhead tee, his full beard and knotted grey pony-tail,  he wouldn’t look out of place at a heavy metal festival, or at the back of a lamplit cave, with a book, a skull and an hourglass.
‘People can be so cruel,’ he says, picking up the walking stick by the door. ‘They never used to be.’

Derek suffers from PTSD. He was coping all right until he lost his job under difficult circumstances a few years ago, and it’s been a slide ever since.
‘All that work I put in to the place,’ he says. ‘All those years. And then all of a sudden there’s a change of management. Some new kids come in – kids! – and they say Okay Derek. You’re no longer the manager. You’re the manager’s assistant. And it all goes to shit. And there’s nothing I can do to stop it.’ He starts to cry. I tear off some tissue from the roll and he buries his face.
‘Thanks,’ he says, after a while. ‘Sorry to be a pain.’
When I do his ECG there are some anomalies, nothing drastic, worth a check-up.
‘Is that my heart?’ he says, staring at the screen, hands palm-up on his knees like he’s receiving a blessing. ‘Well. At least it proves I’ve got one.’

Wednesday, December 11, 2013

crossing the river

‘Will Jack be okay on his own?’
‘I – hope - so.’
It was the last thing she said.

* * *

I’d never have guessed Jack had Alzheimer’s. He’d met us at the door, a well-dressed man, snugly buttoned in cardigan and corduroys, neatly made tie, nicely combed hair, perfect as a father figure in a doll’s house. In the little room he’d said. Right then right again. And then followed us in to see Vera, leaning forwards in a high-backed chair, breathing fast and shallow, hypervigilant, a pallor to her face like she was approaching some terrifying thing.
Shall I come with you? Jack had said. Or shall I rest here and ring in the morning?
I almost said: Your wife is dangerously ill. You must come with us.
But in the press of the moment what I actually said was: Stay warm. Ring in the morning.
Despite the bitter cold of the night, he watched from the shore of their driveway as we loaded Vera into the back.
I waved.
He went inside.

* * *

Whatever was happening with Vera – no doubt a massive PE but asymptomatic in some respects – there was nothing we could do to correct it. Despite our therapies she remained cyanotic, struggling. As Rae cannulated, Vera’s arm hung down over the side of the trolley like she was trailing her fingers over the side of a boat and the water was turning them blue.

We did what we could as quickly as we could, then hurried on through the night.

Just in sight of the hospital her breathing changed, her pulse disappeared, and I dropped the trolley back.
‘Arrested’ I called through to Rae.
She pulled over.

Five minutes of CPR and there was a return of circulation.
We stabilised as best we could, then ran on the last little way into A&E.
Vera arrested again moments after transferring in resus. The team closed in.

I completed the paperwork, helped clear up the ambulance, made ready to go. I went back into the department to make sure they understood Jack was home alone.

In the half an hour it had taken to do all this, Vera had died, and the team was round another bed.

Monday, December 09, 2013


Control give us two flat numbers. Apparently the caller is a third party in another city who doesn’t remember whether it’s 230 or 232. It’s after midnight. We feel bad ringing two numbers when we know one of them is wrong. But as it turns out, neither gets a response. Just as I pull out my radio to report back to Control, someone calls out to us from across the street.
‘Do you need to get in?’ says a guy, striding over. ‘You look like paramedics to me. And if you’re not, that’s a helluva lot of trouble you’ve gone to with the kit and the ambulance and everything, so fair play to you.’
He opens the door and then hurries on ahead, staggering slightly.

Up to the tenth floor, and the lift slides open to reveal a long, empty corridor, discretely lit by LED spots, humming with newness.
I knock on 230.
After a pause, someone speaks from behind the door.
Who is it?
‘Ambulance service.’
A pause – just exactly the amount of time it takes to press an eye against a spyhole – and then the cautious turning of a key.
A young Korean guy stands blinking in the doorway.
‘Can I help you?’
‘We had a call to this flat. A twenty-year-old female. Would that be here?’
‘No. No, no. It’s jut me. I think you have wrong number. I got go work tomorrow quite early, so I er.. so gu-bye.’ He shuts the door. Locks it.

We walk further down the corridor, to number 232. This time Rae knocks.
Sounds of someone coming to the door – a pause – and then a young woman standing there.
‘Yes?’ she says.
‘Hello. Sorry to trouble you. We had a call to a twenty-year old female at this address. Would that be you?’
‘No. Why? What’s happened?’
‘We can’t really say any more than that. But we had a call from a friend of hers who said she needed medical attention. He couldn’t remember exactly which flat number. We tried the other one and that definitely wasn’t it. So that leaves yours. But you say you don’t know what this is about?’
‘It’s not me,’ she says. ‘It might be my flat mate, but she’s out.’
‘Can I ask what your flatmate’s name is?’
‘Am I obliged to give it?’
‘Not to us, I don’t think. But it’d really help us out. And if you don’t, we’ll have to report it to the police, and then they’ll probably come round, and so it goes on.’
‘Okay. Her name’s Sandra Highsmith.’
‘Yep. That’s the name we’ve got. And she’s not here, you say?’
‘No. She went out some time ago.’
‘Any idea where?’
‘No. She didn’t say.’
‘Fine. Can I just take your name so we can report back to Control and let them know.’
‘Yes. It’s Jayne – with a Y – McDonald, with a small c, big d.’
‘Great. Well – thanks for your help, and sorry to have disturbed you.’
‘You’re welcome.’
She doesn’t close the door immediately, but stands watching as make our way back down the corridor to the lift.

Back outside in the truck, we wait for Control to get back to us with further instructions, or a stand down.
Nothing happens for some time.
The road ahead is utterly deserted. It’s as if when they designed this new quarter they spent so much on glass and chrome and ornamental granite features they had nothing left for people.
The radio buzzes.
‘The caller says she’s definitely there. Are you sure that wasn’t her you were talking to?’
‘Do you want us to go back and ask for ID?’
‘If you don’t mind...’
We get out of the cab again.

The girl in flat 232 doesn’t answer the intercom, so we have the same problem getting in. But luckily a young couple turn up. They don’t say a word as we tailgate them inside.
We ride up to the tenth floor.
As we walk back along the corridor I imagine the Korean guy pressing his eye to the security lens and wondering if he does, what he’ll make of it all.
Outside flat 232.
This time the woman comes to the door more quickly.
‘Yes?’ she says.
Rae comes straight out with it.
‘Are you Sandra Highsmith?’
The woman holds on to the door for a moment, flicking her eyes from Rae to me and then back again. Finally she says: Yes, relaxes her grip, and quietly leads us inside.

Sunday, December 08, 2013

free bar

A woman steps out and waves to us with one of her crutches.
‘Paul’s over there,’ she says. ‘I can’t get him up.’
I play the torch along the street and pick out a huge, snoring form, face down on the grass verge.
‘Did he fall?’
‘No. That’s just where his friends dropped him off.’
‘His friends?’
‘It was a free bar,’ she says. ‘I’ll have to go back inside now. The kids.’

Paul is lying with his face scrunched up on his work bag and open wallet, vomit over everything, his face, his eyes, his clothes. His shirt has ridden up, revealing an expanse of flesh vast as a de-bristled hog. The ripe smell coming off his trousers suggest other, deeper horrors.

I wipe his nose and mouth clear and reposition his head to ease the breathing.
Rae unloads the trolley and brings it over with the scoop. We pause for a second, gauging his weight. Can we lift this guy without a second crew? Because on the way here Control were in meltdown, constantly putting out all-calls for outstanding jobs with no-one to assign. If we ask for back-up, it’ll take a while.
‘What do you think?’
‘We could have a go.’
‘Come on then.’
Rae takes the foot end, I get the top.
‘Ready, set... lift.’
It’s only from the ground to the trolley, but Paul is at the very limit of what we should be lifting. In the few seconds it takes to get him over, I have a vision of all my vertebral disks popping out of my back, shooting up in the air and exploding like a line of clay pigeons.

On to the vehicle, and Paul resists painful stimuli to the point where I try putting an airway in. But he reaches up and pulls it out again, so his GCS isn’t as low as I’d thought. I take his obs en route. Halfway there he pulls off the oxygen mask and hawks up a wad of half-digested food.
‘Don’t spit!’ I tell him.
He ignores me and carries on.

* * *

The hospital has been besieged by drunks and bad trippers all night, and the staff have a crumpled, antsy kind of look.
‘You’ve just had too much to drink’ says a doctor, leaning over a young girl whimpering on a trolley. ‘You shouldn’t be taking up a hospital bed.’
We get nods from the other crews as we wheel Paul in to the department, appreciating all the nuances of size, age, smell, mess.
‘Good god!’ says the triage nurse, coming over. ‘What the hell have you brought me now?’
‘It was a free bar,’ I tell her.

Friday, December 06, 2013

kitchen towel

Gary’s asleep when the psych nurse opens the room and shows us in. She shakes him gently by the foot; he groans, rolls over and shields his eyes.
‘Transport’s here,’ she says. ‘Come on Gary.’
He sits up and blinks. Fumbles around on a side table amongst papers and newspapers, finds a pair of heavy black frames, puts them on, blinks at us through them.
‘Sorry to wake you so early, Gary,’ I tell him. ‘We’ll wait outside for you to get ready.’
‘Can’t I go like this?’ he says. He obviously just wants to walk straight out, for speed, but he’s only wearing hospital trousers. It might be twenty-four degrees in this secure room, but outside the stars are out and there’s a rime of frost on everything.
‘No rush,’ says the nurse. We leave him to it.
Outside she gives us the basics. Gary was sectioned in the street by the police. No violence to himself or others, low risk. Has had some diazepam just in case, and to help with any alcohol withdrawal. Is going to the only available psych bed, thirty miles north.
‘Last month was worse,’ she says, handing me the paperwork. ‘Last month there were no beds anywhere. Last month he’d have been going to Alaska.’
‘Cut-backs?’ I say. ‘Is that the problem?’
She shrugs. ‘Cut-backs. Demand.’
Gary gets ready pretty quick and we walk outside. I settle him next to me in the back and we set off.
I put the small overhead spots on and turn the big lights off.
‘Mood lighting,’ I say – my usual quip when I do this. But the way the spots glint off his glasses, it doesn’t seem so appropriate, suddenly.
‘Fine,’ he says. ‘Thank you. Thanks. Where am I going again?’
‘To another psychiatric hospital, Gary. So you can get better. It’s a nice place. I’ve been there before.’
‘You’ve been there?’
I want to add Not as a patient. But I don’t. ‘Plenty of art on the walls,’ I say instead, which sounds like we’re admitting him to a museum.

* * *

He’s calm en route. We chat about this and that.
‘How were the police?’ I ask him. ‘It’s not an easy situation.’
‘No – but they were great. No complaints at all.’
‘That’s good to hear.’
He asks me about my job, how I got into it, the kinds of things we come across. He asks me about the equipment in the back and I point the main things out from my seat.
‘What’s that?’ he says. ‘A cat-flap?’
Everyone notices it. For some reason the fitters used a cat-flap for the bin.
‘What about the cat?’ he says.
‘Never seen it,’ I tell him.

* * *

‘I’ve been drinking a lot more lately. A few drugs. Stuff. I suppose it was all getting a bit out of hand. Then dad died. I don’t know. I thought I was getting through it. Now this.’
He takes his glasses off, pinches his nose, like it’s quicker to adjust the bone than the frames.
‘I didn’t hurt anyone, though,’ he says, looking at me. There’s a tremor to him, a sweat of recognition. ‘Thank Christ I didn’t hurt anyone. Have you got family?’
I tell him I’ve got two girls, eight and twelve.
‘Have they been hurt?’ he says.
‘No. They’re fine,’ I tell him. ‘They’re absolutely fine.’

We’re silent for a while. He yawns so widely every minute or so I think his head will tip right off. But each time he comes back to himself, to his warmly illuminated seat, and the scattering of papers on the trolley in front of him.
‘Sorry,’ he says.
‘It’s late, Gary. I’m yawning too.’
‘You can’t yawn. You’ve got to stay awake.’
‘I suppose so.’

After a while he tells me what happened. How he’d got it into his head he was a paramedic on a call, a terrible emergency no-one wanted him to get to. He’d driven at speed through town with his head out of the window shouting nee nah nee nah. Until the police pulled him over on a main road, when he jumped out and stood there, with his arms outstretched in the middle of everything, screaming for kitchen towel.
Kitchen towel?
‘I didn’t know what I was saying,’ he says, folding his arms tightly, yawning again. ‘I thought it was an emergency.’

Wednesday, December 04, 2013

what the lights meant

Joyce is stretched out flat on one of the benches outside the cafe. Reece, the paramedic first on scene supports her breathing with a BVM; two waiters stand either side of Joyce’s husband, Ken, holding him up; a bystander helps to move tables ready for the trolley, and others shuffle around offering help with fetching and carrying.
‘Eighty-five year old. Sudden collapse whilst seated, making respiratory effort but not all that, pulse tachy, BP in her boots.’
We work quickly, getting the trolley out, grabbing a pat slide, using that to keep Joyce flat whilst we scoot her across, then legs raised, blanket on, and quickly away onto the truck. Once there, shears through clothes, pads, dots, obs, fluids – the whole tangled fuss of the peri-arrest situation.
As soon as we’re done I leave Rae and Reece in the back to go outside and see to Ken.
‘Can I be with my wife?’ he says. ‘We’ve been together sixty years and I can’t leave her now.’
I put that to the others. They shake their heads and I know what they mean. If Joyce arrests en route, CPR is brutal to watch.
Back with Ken, I put my hand on his shoulder and explain the situation.
‘Joyce is really unwell, and  you’ll find it extremely upsetting if the paramedics have to do CPR. Why don’t you ride up front with me? I promise we’ll let you be with Joyce as soon as we can.’
‘All right then.’
I help him with his bags, his hat, his cane, and I give him a little boost up into the front passenger seat.
Reece has to leave his car on scene as he’s needed in the back. As I reverse the ambulance down the street, I can see its blue lights revolving in the distance, playing around the street.

* * *

Joyce arrests at the hospital just as we’re transferring  her in the resus room. A team of nurses, doctors and consultants descend on her as I come back out to find Ken standing in the foyer. I lead him through to the relatives room and sit him down. On the way there, one of my colleagues offers to go and make him some tea.
‘Joyce is in with the doctors now. They just need five minutes to do what they have to do. If you’re okay here, Ken, I’ll go back and tell them you want to be with Joyce no matter what. I’ll make sure they understand, and I’ll be straight back to let you know what’s going on.’
‘I need the loo,’ he says.
‘Come on. I’ll show you where it is.’
I take all his stuff, because the relative’s room isn’t lockable.
He puts his arm through mine and I take him round to the nearest toilet. Whilst I wait outside, a cleaner comes by and laughs; it’s only then I realise I’m leaning on Ken’s stick.
‘I know,’ I say. ‘Busy day.’
Ken comes out and I lead him back to the relatives’ room. Reece is waiting for us there. He offers to take Ken through to resus. He gives me the smallest look as we both go to help him up, and I guess it means Joyce has died.
I say goodbye to Ken as he’s led away, and go outside to remake the trolley and tidy up the back. One of my other colleagues has already taken care of the trolley.
I thank her.
She smiles and shrugs.
‘You had your hands full,’ she says.

* * *

Three-quarters of an hour later we’re pulling up at the far end of the pedestrian street where Reece had left his car. He’d been given the wrong location when he arrived and had to walk most of the street to get to Joyce. Once he was with her, there was no time to go back and switch anything off. So for the past couple of hours, the car has been running on KRS with the blue lights flickering round and round, playing over the netted trees for sale, the tables covered in wrapping paper, ribbon and cards, the piles of meat in the butchers shop, can snow sprayed on taped windows.

It’s dark and late, the crowds are thinning, there are moves to pack everything away.

The man by the shop on the corner nearest to us comes out and stands there, folding his arms and shaking his head, as if to say: Fancy leaving those lights going all that time. I understand what he means. It must have been annoying. I want to explain the situation, but I don’t. It’s complicated, and I’m so tired I can’t trust myself to get it right. All I can do is raise my hand and mouth the word sorry, then wait for Reece to jump out, slam the door and shout for us to go.

Tuesday, December 03, 2013

whale song

Even though we’re carrying just about every bag we can think of, there’s still room in the lift for the workman and his big pot of paint.
‘Much to do?’ I ask as we go up.
‘Snagging,’ he says. ‘A couple of pipes here and there and we’re done.’
‘Must’ve taken a while.’
He shrugs.
‘Couple of years, give or take.’
There are so many flats in this block, he was probably a young man when he started. His hair and moustache are wiry and gray, like he fashioned them from old brushes.
The lift stops at our floor and the man steps out to give us room.
‘Take it easy,’ he says. ‘Hope everything’s all right.’

Mr Westland’s son Kevin lets us into the flat. He seems sad, a little strung-out but otherwise quite chatty.
‘I wasn’t expecting this,’ he says, leading us through. ‘I told them on the phone I knew he was dead. I just needed the doctor to come and write the certificate.’

His father is lying back on the bed, his hands in his dressing gown pockets, his legs crooked over the side with the feet planted evenly and neatly side by side on the rug. Except for his ghastly pallor and unnaturally slack expression, you would think he had sat on the edge of the bed and then lain back for a snooze.
‘He died yesterday,’ says Kevin. ‘But I knew nothing would be open so I waited a bit.’
Mr Westland is fully rigored, and I know the Coroner’s people will have a job getting him out in this position.
I say to Kevin that we just need to finish our paperwork and follow procedure, so could we do that in the lounge? He nods and shows us through.
The flat is scrupulously tidy, the only decoration on the walls a silver and black silhouette of a man and a woman kissing in the middle of a heart-shaped motif, and then two oil paintings, both science fantasy themes, one, the surface of an alien moon with a ringed planet low on the horizon; the other, a castle keep set against a deep blue sky, a line of sunlight rising up its side.
‘I used to dabble in oils, things like that, you know,’ he says, taking a seat. ‘It’s good ‘cos you can keep going back and adding stuff.’
We explain that as Mr Westland hadn’t seen a doctor in a while, it was classed as an unexpected death. The next step would be to get the police along, who’d handle things from then on.
‘Oh. Okay,’ says Kevin. ‘Things are more complicated nowadays, don’t you think? I mean – he died of old age. I just wanted to get the doctor along, not all this. I’m sorry to waste your time.’
He tells us he’s been looking after his dad for the last five years. Mr Westland had Alzheimer’s, so it was a little difficult, especially lately.
‘He wouldn’t talk so much as make odd noises, you know. I had to feed him, wash and shave him, keep him cheerful. It was quite hard work. And there’s no-one else around. I didn’t ever marry, so that was that. My mother died a while ago, all my nephews and nieces live around the globe, in Australia and the Far East. So I’m it – the last of the line. Sad, really, you know.’
There’s something so tentative and self-effacing about the way Kevin talks, the dry tone of his voice, the padding of all the conversational you knows and that sort of thing that, combined with the heat and quiet hum from the radiator and the muted city sounds from a hundred feet below us, the effect is intensely soporific. I struggle not to yawn, especially given the sensitivity of the situation. It only makes it worse, so I get up and walk about, using as an excuse the view from the window.
Rae rings for an ETA on the police.
A little while, apparently.
I stare out of the window, at the seagulls gliding through the air.
‘Sometimes they land on the balcony and look in,’ says Kevin. ‘I think they’re interested in the plastic bags out there. They want to know if there’s any food inside.’
‘Beautiful birds, when you get up close.’
‘Huge great beaks.’
‘I wonder what they’d be like to eat?’ says Rae. ‘I wonder if they’d taste of plastic?’
Kevin laughs.
‘Pizza and kebabs and plastic,’ he says. ‘And that sort of thing.’
‘Great view of the sea from up here.’ I say. ‘It’s so – interesting.’
‘Did you know that sound travels faster underwater than through air?’ says Kevin. ‘I read that in a book.’
‘Does it?’
‘Yeah. So when whales sing to each other, it travels miles and miles. But then I was thinking – wouldn’t that make the sea really noisy?’
‘I suppose it depends how many whales there are. And whether any other creatures sing.’
‘You’ve got all those crabs giving it plenty of that’ says Rae, making clack-clack gestures with her fingers.
I rub my eyes, then sit down again.
‘Just a few more questions about your father,’ I say, picking up the board again.
‘Go on,’ says Kevin.
‘Was he complaining of feeling unwell? Any pain, or sickness?’
Kevin shakes his head.
‘He stopped eating and drinking a couple of weeks ago. Then his breathing got shallower. It got to the point where I could hardly make it out at all – and then I really couldn’t, and I knew he’d gone. Old age, I suppose. He didn’t want to carry on any more, and I can’t blame him. He’d had enough.’
‘And you didn’t report it because you were waiting for the surgery to open, is that it?’
‘Pretty much. I couldn’t see the point. He didn’t like a fuss.’
Kevin watches me fill out the rest of the form.
‘Dad moved in here thirty years ago. Now I s’pose I’ll have to find somewhere else. But I can’t blame the council. Flats like these are in short supply. Never mind. I ‘spect something’ll turn up.’

There are more shrieks from outside. We all stop to watch as the seagulls come round again, gliding past on cupped wings, flicking their heads,  past the bedroom with the dead man, past the living room, the edge of the tower block, and on and out across the intricate and anonymous muddle of the city below.