Wednesday, July 17, 2013

slip, slop, slap (slurp)

A brief hiatus on posts – we’re off on a 10 day holiday to Greece.

I hope you all manage to get a decent break.

Thanks for all your comments this year. I’ll be sure to toast your health with a bottle of cold beer (after I’ve toasted myself on the beach).

Lots of love

SK

st agnes the eccentric

Who’s there?
‘It’s the ambulance.’
Come up. In the lift.
The lift is a substantial Thirties affair, with a steel door that clanks shut like the springing of a trap. It lurches up, makes two floors in so many seconds, bounces to a halt, and vomits us into the hallway.

Mrs Fontaine turns out to be as old and abrupt as the lift. She’s sitting on a wooden stool in the hallway of her flat, the door open, waiting for us.
There you are. Now look. I want you to take my blood pressure because I think it’s through the roof and I’m quite worried about it.
She talks emphatically, at an excitable rush that makes no distinction between important things and the stuff of casual conversation.
I’m sorry to drag you out in the middle of the night but I woke up and my heart was thumping and I thought I might be having a stroke. Do you think I’m having a stroke? A heart attack? Something like that? Well I must say you don’t look like someone who thinks someone might be having a stroke or a heart attack, so you’re either horribly callous or cool as a cucumber. I suppose you have to be cool as a cucumber in your job. It wouldn’t do to be flapping about at the slightest provocation, would it? Where shall I sit? Here okay? Here? Let me tell me you about my ailments. I have high blood pressure. I have arthritis in my knees. I am bi-polar. Bi-polar means you’re up one minute and down the next. It’s a damned nuisance but I’ve lived with it for fifty years so you could say I’m used to it, as are my acquaintances. Except they call it something else – eccentric, I don’t doubt. There goes St Agnes the Eccentric, and jolly good luck to her. My medications are listed here. I live on my own. I can make you tea if you’d like?
She stares at me as I take her blood pressure, breathing noisily through her nose, her lips pursed. She’s like a steam train in the siding, impatient to be off.
Ow! That’s quite tight, you know? Okay? Is it okay? Through the roof, I ‘spect.
‘Sorry. Almost done. There. Yep – I’m afraid it is a bit high, Mrs Fontaine.’
Yes I thought it would be. I lay there for ages thinking Damn Damn Relax, but then I just knew I’d have to call you chaps out and have something done about it. I’ve got a fluttery feeling in my chest, as well. Is that my heart, d’you suppose? Still, not surprising really, given my extreme decrepitude. What d’you recommend? A mallet? I can tell by your expression you think a mallet’s the thing. I expect you’ve got one in that bag of yours. You’re a professional sadist, that’s what you are. Rather too fond of inflicting pain for my liking.
Rae goes to get the chair. I carry on with some more observations whilst Mrs Fontaine chatters.
I don’t mind the heat. I lived in Africa for years, so one acclimatises. See that picture there? I took that.
She points to a framed photograph on the wall – a large spotted cat draped over a tree branch.
‘What is it – a cheetah?’
It’s a leopard, dear. Cheetahs can’t climb trees. Leopards often like to sleep like that. And they like to drag their prey up a tree to keep it safe from hyenas and so on. Hyenas are noisy, nasty brutes. I used to know a man who trained them, though. He got them to take meat out of his mouth.
‘Out of his mouth?’
Yes. His mouth. Look – am I going to hospital or not? Because if you don’t do something about my blood pressure soon I’ll go pop. Although I’d bet you wouldn’t mind that, would you? A professional sadist, that’s what you are.

Tuesday, July 16, 2013

one two / one two

Alf’s daughter Susan answers the door.
‘He fell in the living room,’ she says, standing aside to let us in. ‘I tried, but for some reason I just couldn’t get him up this time.’

Alf is lying stretched out on the carpet, a cushion under his head. Ten years ago he would have been a formidable figure, six feet tall, broad, powerful, a haze of navy tattoos up his arms, a boxer’s nose. But Parkinson’s Disease has undermined all that, wreaking its particular horrors alongside the blander depredations of old age. Alf has been felled like some grand old oak of the forest.

‘Who’s this?’ he says, straining to see.

Susan is dressed in a black t-shirt and slacks. She’s pale, quietly spoken, hunched over. Her mother Vi is there, too, an eighty-six year old projection of the daughter, same profile, same demeanour, but thinner, quicker. Lighter on her feet, actually.

‘What do you want?’ says Vi. ‘Cuppa tea or sommat?’

We get Alf back on his feet. He staggers, holds. We try to walk him to the toilet because he urgently needs to go. It takes ten minutes to make it as far as the kitchen, just next door.

‘Come on, Dad. Don’t forget,’ says Susan, holding his hand. ‘One, two. One, two. Like they said.’
He does the Parkinsonian shuffle, like someone glued his slippers to the floor for a prank.

One, two. One, two.

 ‘It’s going!’ he says. ‘I’m losing it!’ He voids his bladder on the laminate flooring.
‘Not to worry,’ says Susan. ‘Let’s get you a chair to sit on, then we’ll clean you up and fetch you some clean pants.’
‘Sorry,’ he says.
We clean him up.

Things aren’t progressing well. Alf is shakier than normal; the worry is that on top of everything else he’s developed a urinary tract infection. He’s not safe to leave at home, so after some discussion we decide to take him to hospital.
‘Just a minute,’ says Vi. ‘I’ll fetch him down his jimmies.’
It’s extraordinary to see how she goes up the stairs. She’s like some hyperactive, octogenarian spider, taking the steps two at a time, hauling herself up by the handrail, her knotty back crooked and bobbing, her slippered feet digging into the plush.

She’s back in no time.

‘There you go, darling,’ she says, dropping to her knees and manipulating Alf’s legs to feed the pyjama bottoms on. ‘Don’t you look a picture.’
Before we go, she cradles his face in both her hands and gives him a big, sloppy kiss on the lips.
‘See you later,’ she says. ‘Be good.’

Monday, July 15, 2013

wee little kittens

Janet Simpson is sitting in her wheelchair in the bedroom. She smiles when we walk in and introduce ourselves. There’s a balance to her as solid as the wheelchair itself, an enveloping kind of patience, something that has come to terms with the loss of a leg, a stroke and a slew of other complications. She adjusts the fall of her pleated skirt.
‘How can we help?’ I ask her.
She shrugs.
‘Well, I don’t really know if you can. It’s all a bit…’ She tails off, and gently shakes her head.
Mr Simpson is standing in the doorway.
‘I’m sorry to call you out,’ he says, ‘but we were all a bit worried with these things Janet’s been seeing.’
‘I’m not worried,’ she says.
‘Kittens,’ says Mr Simpson.
‘Kittens? Where?’
Janet sighs.
‘Wee little kittens. So big,’ she says, holding her hands about a hamster’s width apart. ‘They sit over there, amongst the TV cables, playing, messing about, you know.’
‘Can you see them now?’
She nods.
‘But it’s not all the time. And then sometimes I see these worm-like creatures. They writhe about, up the walls, across the ceiling. I don’t like those so much. And then sometimes it’s swarms of creatures, creatures I’ve never seen before, flying in through the window.’ She shrugs again. ‘I prefer the kittens.’
‘We thought it might be something to do with her stroke,’ says Mr Simpson. ‘She’s quite calm about it all, though. She just seems a bit put out we can’t see them, too.’

‘Wouldn’t you be?,’ she says, then smiles up at us. ‘What are you going to do with me? The Loony Bin, I suppose.’

Sunday, July 14, 2013

9 on a 12 till 12

1.      The intense midday sun only accentuates the lightless interior. Betty is reclining on her bed, her wild white hair standing up from her head like strands of fibre glass so fine you can trace the curve of her head. Her skin is as white as her hair; she hasn’t been outside in three years, and there’s a dreadful, vegetable pallor to her, like the flesh of some obscure root lain aside in the dark. ‘I haven’t been taking my ferruss sulphuss’ she says. ‘I think that’s it. That and the old pipes they left in the ground when they did all that renovation.’ Betty had fainted onto the bed when the neighbours downstairs came by to see if she needed her key charging. Betty relies on them for tasks like this – the neighbours, and the Dairy Crest milkman, who delivers most things these days. ‘Bread. Biscuits. They even do fruit,’ she says. ‘I try to keep up.’ But she won’t come to hospital. ‘Too many associations,’ she says. ‘Ever since mum died there I really don’t care to go back.’ Even the doctor on the phone can’t persuade her. ‘No thank you,’ says Betty. ‘I’m sorry to be a nuisance, but I really think I’m best if I stay inside.’ The doctor says she’ll pop round later.

2.      Gary is standing out on the first floor ledge that runs just below the windows. He has to hang on to some railings with one arm stretched up above his head. He changes hands now and again, swaying dangerously, glancing round at the sizeable crowd that’s gathered in the street, like an exhausted gibbon cornered by hunters. I notice one man discreetly filming the whole drama, his right hand on his young son’s head, absent-mindedly stroking the child’s hair, whilst he holds up the phone with the other. The police can’t get in to the flat. The woman who lives there won’t let them in, and some fierce dogs rage just behind the door. The fire brigade arrive. A ladder is fetched – a substantial thing, with  tall legs that extend from either side of the sections to give a steady base. They set the ladder against the wall, a fireman climbs up, helps Gary down. Someone gives Gary a cigarette butt to smoke. He slumps down on the pavement to light it. ‘I need help,’ he says. ‘Seriously. I need help.’

3.      There’s a small crowd standing on the beach around Angie, a middle-aged woman face down on the pebbles. Her boyfriend is holding their bags and things and standing ineffectually, perhaps even a little embarrassed, close by. ‘Angie’s  a dance instructor,’ he says. ‘Mega fit. We were drinking Pimms when she took a nosedive. She been going in and out of consciousness like this. Sorry to call you out.’ Angie is drunk, made worse by a day of hard exercise and the hot weather. We thank the crowd, tell them they can go now – which they do hesitantly, as if they were all half-expecting to come with us – then help Angie across the promenade and on to the ambulance. She vomits a couple of times, but starts to improve. ‘I’ve been running marathons,’ says the boyfriend. ‘Fifty one, and I decide it’s time I got fit again. Probably meeting Angie gave me the kick-start I needed,’ he says. ‘I’ve been running with these army guys. They don’t believe in all that scientific sports hydration, all that special diet nonsense. Their mindset is just get up, get out, do the miles, get back for more beers in the evening. You’ve got to admire that spirit. And you know for a fact that if they saw a gun they’d just run at it, wouldn’t care, they’d just have to attack regardless. You’ve got to admire that bloody-mindedness, haven’t you? It’s what keeps us all safe. Mind you,’ he says. ‘None of them finished the marathon. They all failed.’

4.      Rose has slashed her arm in the psychiatric hospital – a deep wound that caught an artery. The nurses are all on top of her trying to staunch the bleeding, trying to restrain Rose, who kicks out, screams, does everything she can to throw them off and run out of the room. There’s blood everywhere, great skidded puddles on the floor, soaked towels, a liberal splatter pattern across the bed linen, walls, side tables. The nurses have improvised a tourniquet; we supplement with a battle dressing of our own. It’s a struggle to get the trolley in, but we manage. She screams all the way in to hospital.

5.      Another middle-aged woman is prone on the beach. She tripped over her bag of towels and sun cream, breaking her arm as she landed. Her cheek and chin are scuffed up and bloody. ‘I feel so stupid,’ she says. ‘All I wanted was a swim.’

6.      A man has fallen off his bicycle and landed on his head. It takes a while to package him up. I tie a dressing around the deep laceration he has to his scalp. ‘Amish bonnet style’ I tell him. ‘Great,’ he says. The traffic is stacked up without any means of diversion. When I go back to the ambulance for some more equipment a man leans out of his window and asks me how much longer. ‘At least half an hour I should think,’ I tell him. ‘Sorry.’ The man waves his hand in the air, then loosens his tie another notch. He looks so red his head is in danger of exploding. ‘It’s not your fault,’ he says. ‘But we’re late for our luncheon appointment.’

7.      To a summer language school, called to Agneta, a fourteen year old Swedish girl with abdo pain. ‘She doesn’t like the food here,’ says Hannah, one of the organisers, thumbing through her list of special instructions. ‘The past four days she’s had nothing but gummy bears and candy bars.’ Before we make it into the dormitory, Agneta  is carried out by two boys, her arms around their shoulders. There’s a whole group of girls around them, crying, talking on their phones, looking around distractedly. It’s a scene of biblical proportions. Hannah shakes her head. ‘Good luck,’ she says.

8.      Mrs Rawlinson is sitting on a high-backed wooden chair with her arms folded neatly in her lap, superintending her middle-aged son Simon as he rushes around the house gathering together the tissues and pills, keys and glasses, books and charts and other necessaries that Mrs Rawlinson will not be dissuaded from taking. She’s had a bad experience at the hospital, and will only agree to go in if she can do so explicitly on her terms. Sarah, the daughter-in-law, plays with her twelve-month-old son in the middle of the sitting room carpet. There’s something emphatic about the way she plays with the baby. ‘Who’s a good boy? Yes you are! Yes you are! Clever boy! Clever boy!’ snuffling her nose in his belly, tickling his feet. Mrs Rawlinson looks on from the chair. ‘Where are his shoes?’ she says.

9.      We drive around the dark streets but can’t find the man covered in blood, shouting. I shine a torch out of the window as we slowly go along – a stack of bins, a bike discarded down an alley, the glittering eyes of a cat hiding under a car – but no patient. I ask a couple of people, but they haven’t seen anything. ‘Sounds dangerous, though,’ says one of them, a man with a beard as wild as Father Christmas. ‘You take care.’

The end of the shift. Another crew take on our truck and get a job straight away. I follow them out of the station in my car. They drive in front of me up to the traffic lights, and we wait there a moment. I switch on the radio. It’s on a classical station; they’re playing Spiegel im Spiegel by Arvo P√§rt. I brace my arms against the steering wheel and breathe deeply.

The ambulance must have got information to upgrade the job, because suddenly their lights go on, and they move out onto the wrong side of the road. I watch them as they head off, their blue lights rippling and sparkling in the soft night air. And with the music playing like this, watching them speed off into the night, suddenly I could cry with the muddle and the heat, the relentlessness, the beautiful complication of it all.

Monday, July 08, 2013

cassie's room

The last time I came here we had to leave the ambulance up on the top road. The snow was too thick, and we couldn’t make it down the lane. Then, the light had been low and soft, a blue tint to it, like we were fathoms underwater. Now, even though it’s late at night, the sky is broad and clear, and there’s a hard edge to everything, to the lampposts, the fences, the parked cars, that cat.
Rae swings the ambulance down the narrow access lane. One of the care workers is at the end of it, waiting to guide us in. He strides backwards, snapping a look over his shoulder once in a while, his left arm pointing straight out to the side, his right hand wind-milling in that direction.
‘It’s like Heathrow airport,’ says Rae, but nods and smiles to the guy.
He looks familiar actually, but I struggle to place him. I don’t recognise the dreads, the piercings along each ear and in his nose, the tattoos and the facial hair. There’s something about the line of his face, though, the way he walks...
‘Mick?’
‘Hey, Spence. How’re you doing?’
We shake hands, twelve years, right there.
‘Wow! Good to see you.’
‘You too. How’re things?’
‘Good! You?’
‘Excellent. Look – we’d better go on up and see Cassie, but maybe we could catch up soon?’
‘Absolutely.’
‘Let me just give you a quick heads-up. Cassie has only just come to us. She’s a long-time user. Heroin and alcohol, mostly. There are needles in there, so watch where you put yourself. Cassie’s had a bit of a crash tonight. I think she’s kind of bottomed-out, you know? She says she wants to go on a detox programme, and I really think she could make a go of it. I did explain to her that she needs to get a GP referral, but she’s been threatening to kill herself, so I’m not sure she’s really safe to be left alone. All right? Good to see you, mate. Small world, eh?’
He leads us upstairs to Cassie’s door, knocks, then opens the door saying: ‘Cassie? It’s Mick with the ambulance crew. Okay?’

The room is a functional box with a line of windows inaccessibly high up on one side, roughly provided with a bed, table, armchair, TV and kettle. You’d think to look at it that someone had said: Right - you’ve got five minutes. So the TV was plugged in here; the kettle there; the armchair dragged in front of the TV; the table by the armchair. Done. Out. It doesn’t help to have clothes spilling out of ripped bin bags in the corner, a half-eaten plate of ravioli and an empty bottle of vodka, a needle amongst a scattering of torn Rizla packets.
‘I heard them climbing on the roof last night,’ says Cassie. ‘They were muttering. They had something heavy. They were trying to get in.’
‘Okay, mate. Look – we’ve got the paramedics, like you said. They’ve come to help. Is that all right, Cass?’
She’s sitting in the sweated chaos of the bed, clutching the sheets either side of her, like they’re the one thing tethering her to this world. Cass is quietly spoken; despite the heroin and the alcohol, the prostitution, poor diet and countless other insults and abuses her addiction has wrought on her body over the years, she still seems like a nice Home Counties girl, unaccountably fallen on hard times.
‘Don’t tell my Dad,’ she says. ‘Promise me!


Sunday, July 07, 2013

under the floor

The front door is on the latch; a voice calls us in.
Mr Woodruff is sitting in an ornately carved chair ready to go, a little travel bag of things by his sandaled feet, his walking stick propped up between his legs, hands draped over the top.
Mrs Woodruff shuffles in from the kitchen wiping her hands on a dishcloth.
‘Lovely! You were quick. Caught me on the hop, actually. Just a minute whilst I get my face on.’
She disappears out back again.
Mr Woodruff smiles at us.
‘Busy?’
‘Yep. Always, these days.’
He nods.
‘Sorry to call you out like this, but I’ve become so weak these past few days, I didn’t think I’d make it into a taxi, let alone out of it the other end. And the wife doesn’t drive...’
‘Not to worry.’
He hands us a letter from the GP; I read all about his condition, whilst Rae goes off to get the carry chair.
It’s all pretty straightforward. I fold the letter back up and put it in my pocket.
‘Don’t lose it, will you?’ he says.
I pat the pocket.
‘Safe as.’
I feel his pulse and give him the once over.
‘How are you feeling now, Mr Woodruff?’
‘I’ve been better.’
Rae comes back with the chair.
‘Here comes the cavalry,’ says Mr Woodruff.
‘I like your paintings,’ says Rae, opening the chair next to him and laying out the blanket.
A group of three in heavy gilt frames. Through a muted fog of smoke damage and craquelure, you can just make out the subjects: hunting scenes, for the most part. Strange, elongated horses stretching out in mid-air, muscular sight-hounds bounding along with flaring eyes and teeth; a stag crashing through ferns.
‘I found them,’ says Mr Woodruff. ‘When we moved in.’
‘What do you mean, found them?’
‘We’d just bought the place – I’m talking fifty years ago, now. Course, the first thing you do when you move in is change it all round to suit yourself. It was all a bit of a wreck when we took it on, but I didn’t mind, I’ve always been quite handy. So I stripped it right back to the nubbins. It was all pretty good and sound, but I like to start with a blank canvas, you know? Anyway, I was just marking out some plaster board for the ceiling when I dropped my pencil and saw it roll along and drop through a gap in the floorboards.  When I looked a bit closer, I found out it wasn’t so much of a gap as the edge of a little trapdoor – why I hadn’t noticed it before I’ve no idea. I suppose if you’re not expecting something you don’t often see it. Anyway, it was all nailed shut, but I forced it open and at the bottom of a little run of steps was this secret room under the floor – not so much an attic as a little hidey-hole, if you follow. And in this hidey-hole was a whole load of stuff. Those paintings and a few more, a box of porcelain and silverware, this chair I’m sitting on now, a real Aladdin’s cave. Some of it I sold over the years, but some I couldn’t part with. Strange, isn’t it?’
Mrs Woodruff comes back into the room.
‘Ready?’ she says. 

Friday, July 05, 2013

the sea

Josephine is lying on her side in the middle of the living room.
‘I’m not injured!’ she says, in the broad and peremptory tone of someone who hasn’t got her hearing aids in (and won’t be putting them in any time soon). ‘I just need picking up and putting to bed. Thank you.’
Josephine is one hundred years old. Extreme old age has hollowed out the essential substance of her, honeycombed the fabric of her bones, until all that’s left is a hunched and liver-spotted form for a silk blouse, tartan skirt, sheepskin slippers.
‘That’s it!’ she bellows. ‘Now – into the bedroom with me if you’d be so kind. You were quick. It’s the first time I’ve called on your services, but it won’t be the last. If you take my meaning.’
We help her along to the bedroom.
Amongst the artwork on the walls is a long, cool life study of a young woman, one arm arched languidly over her head, her eyes studying the painter with as much objectivity as he studied her.
‘Yes! That was me!’ she says as we shuffle past. ‘You wouldn’t think it now, would you?’

Her bedroom is like all the other rooms in this elegant top floor flat – wide, cool and minimal.
A breeze blows in through the open window, turning the curtains.
‘Leave them open!’
We sit her down on the bed. She catches her breath.
‘I’m so very old,’ she puffs. ‘No idea why. All my friends and family are dead. It’s just me. Only me. Oh well.’
We help her get ready for bed.
‘Lovely view of the sea’ I say.
‘What’s that? You’ll have to shout.’
‘I said – you have a lovely view of the sea.’
‘Ach!’ She shrugs, and then holds both hands out to the side, palms up.

The sea!’ Then she pulls the covers up to her chin, and closes her eyes. ‘Turn the lights out! Thank you very much!’

Thursday, July 04, 2013

stage technique

The Pineapple Club has spilled its early morning crowd out onto the pavement. Two doormen are busy sorting the bad from the good. One of them, a massive nub of a guy whose head appears to be a crude continuation of his neck, has a man up against a shop window, one massive paw gripping his shirt collar.
‘It wasn’t me!’ whimpers the man.
‘Leave him alone’ shouts his friend, but doesn’t do anything else.
‘Let’s just wait for the police shall we?’ says the doorman. ‘You can explain it all to them. I’m really not interested.’
Meanwhile, the other one thumbs me inside.
‘One patient, bottled,’ he says, then carries on distributing a generalised kind of menace.
Just as we’re about to go inside, Amanda Holdmetight comes striding across the dance floor towards us, his make-up sliding off his face from the sweated heat of the place and water from the bar towel full of ice cubes pressed to the top of his head.
‘Take me away from this dreadful place immediately,’ he says. ‘It’s too embarrassing for words.’
He hurries up the ambulance steps and fluffs himself down on one of the seats. His assistant comes staggering after him with a couple of carrier bags of props and an armful of costumes.
‘What a crowd!’ he says. ‘Honestly, I thought they were going to eat us alive.’

As I clean and dress the head wound, Amanda tells us what happened.
‘I’d only got about half way through the show,’ he says. ‘They were rowdy, but I thought I had them, you know? It wasn’t too bad. Then I started my tribute to Cher and – I don’t know – this guy at the front. He was so drunk. He kept shouting out stuff – horrible stuff. So I thought I’d call his bluff. I stopped the track and said I’d like to see if he could do any better. I gave him the mic and he started singing and everything and it was funny at first but then he wouldn’t give me it back. So we had a bit of a tussle...’
‘A bit!’ says Amanda’s assistant.
‘It all got out of hand, anyway. And the next thing I knew he’d smashed a bottle over my head. Is it serious, do you think? Will I be scarred for life?’
I’ve finished cleaning it up. It doesn’t look too bad.
‘There is a cut that needs investigating, maybe gluing, Amanda, but I’m thinking your wig probably absorbed most of the shock.’
‘You see,’ he says, wagging a bloodied finger at his assistant. ‘The importance of a good costume.’

Wednesday, July 03, 2013

mechanics

There’s a sign outside Regency Mansions: Tradesmen - use rear entrance.
‘Shall we?’ says Rae.
I wouldn’t mind. Anything to postpone this meeting with Mr Landsman, a regular caller with so many warning notes on his address we may as well be space marines about to call on an alien stronghold.
‘I can’t believe they can’t triage this some other way.’
‘He’s probably used the magic words. You know what he’s like.’
‘Still.’
She rings the buzzer again. It’s noticeable that all the silvering has come off his button from overuse.
Ye-es?
‘Hello, ambulance.’
The door clicks open.

To the first floor, up a marble staircase serenely illuminated by multi-coloured panels of red and green and yellow from the stained glass windows. We’re both steeling ourselves to be as calm and professional as possible, but there’s an inevitability about the whole interview that strangely robs it of any tension.

Mr Landsman is waiting in his wheelchair by the front door.
‘Hello!’ says Rae. ‘How can we …?’
But he’s let go of the door and started to wheel himself into the front room before she can finish talking. We follow him into the lounge. We have to tread carefully; there are smears of faeces on the carpet, a jug of maturing urine, empty bottles of Vodka.
‘What seems to be the problem today?’ says Rae, breathing shallow through her mouth.
Mr Landsman regards her with a waxy and baleful expression.
He’s had countless referrals to social services and so on, a comprehensive package of care, but his uncooperative, non-compliant, and frankly unpleasant behaviour has effectively stymied any further help. So long as he passes competency tests, he’s free to live like this. And call us repeatedly.
‘Now, listen,’ he says, lacing his cadaverous fingers together in front of him. ‘As you may be aware – at least, I hope you are aware – some five years ago I suffered a minor stroke at the general hospital. As you are also no doubt aware, there were several issues pertaining to that episode that were never satisfactorily resolved, all of which are currently in the hands of my solicitor. The month following my discharge in the spring of two thousand and five, I spent some time in a rehabilitation facility on the outskirts of town, where further mistakes were made….’
‘Sorry to interrupt,’ says Rae.
He blinks, and stops talking.
‘We can come to all that later. What I need to know first is why you called the ambulance this morning.’
He stares at her.
‘I mean – I can see you have mobility problems, and that’s significant. Obviously. But we just need to know what it was that led you to call us today.’
He carries on staring.
‘Our notes said something about a fall…?’
Nothing. Silence.
‘Why did you call the ambulance, Mr Landsman?’
He unlaces his fingers and grips the armrests.
‘It was a mistake.’
‘A mistake? What do you mean, a mistake?
 ‘I should’ve called the AA. Or the RAC’
‘I’m sorry, I don’t understand.’
‘Because if I had called the AA or the RAC, at least they’d have sent a mechanic or something. You’re not a mechanic, are you, by any chance?’
‘Mr Landsman…’
Oh get out! Get out!
He bobs up and down in the seat like he’s about to spring at us.
And you will sign this paper to say to say you’ve refused to help me when I’m in trouble.
‘No, I’m afraid we won’t be doing that, Mr Landsman. You’ve asked us to leave and that’s exactly what we’re doing.’
We pick our way back through the flat and strip our gloves off on the landing.
Back out on the ambulance Rae calls Control to let them know what’s happened.
‘Well, funnily enough, he’s on the phone right now.’
‘Is he? Well – call me a saint, but I would be prepared to go back in there and talk to him. Only ‘cos I don’t want another crew to suffer.’
‘That’s not what he wants,’ says the Dispatcher. ‘He says he wants your ambulance off his property.’
‘Really? Well – funnily enough, we haven’t actually parked the ambulance in his front room. We’re out on the public highway. So with respect, could you tell Mr Landsman that we decline to accord with his wishes in this respect.’
The Dispatcher laughs.

‘I’ll pass on the message,’ he says.

Monday, July 01, 2013

down in the quarter

The Quarter has been up a few years now but still has the sharp angled unreality of an architect’s drawing. The shrubs in the planters may have grown taller and thicker, there may be a little moss coming up between some of the patterned-brickwork walkways, some insect husks in a green slurry in one of the walkway lights, but other than that, the whole place is untouched, unlived. When it was still in the planning stage there were probably some cool line drawings of the people who’d one day use the space – a woman and a man with a child swinging between them; two businessmen shaking on a deal;  a young guy striding along with a messenger bag; a group of young girls shopping – but the lights have gone out in the architect’s office, the Quarter is up, and at this empty hour of the night there’s just Jamal, lying on his side in front of one of the apartment entrances, a young woman kneeling next to him, cradling his head, whilst beside them both, an older woman talking on the phone.
She waves.
We go over.

We get the story in a rush. Jamal and Katie had a row earlier today. Katie ended their relationship. Jamal went off. Came back tonight unexpectedly. Rang the buzzer. They found him lying on the pavement. ‘What’s the matter with him?’ says Emma, Katie’s mum. ‘Is he unconscious? Is it drugs?’
‘No. He’s not unconscious. Other than that, not sure.’
Jamal is faking it. He frowns when I squeeze his shoulder; when I don’t quit, he bats my hand away.
‘Come on, Jamal. Tell me what’s wrong. Why are you lying on the pavement like this?’
He carries on the pretence as long as he can, holding his eyes shut, not moving, but eventually we persuade him to stand up, walk to the ambulance and have a chat to us there. At one point he staggers, as if he’s about to collapse. But with some stern words and a good hold of his belt we keep him on his feet.

*

On the ambulance, he throws himself onto the trolley.
‘He’s unconscious again,’ says Emma. Katie has sat herself at Jamal’s feet; she looks terrified.
‘No. He’s just choosing to look that way.’
A quick round of obs and everything seems fine. He smells of alcohol, but not excessively.
Rae carries on with her questioning, firmly but sympathetically.
Suddenly, Jamal cries out, and in a spasm of rage thrashes his arms and legs, his fists bunched up. Rae only just manages to avoid getting punched; on the return strike he drives his fist into the side of the ambulance, bloodying his knuckles. I grab his arm to control it and shout at Jamal that we’ll call the police and have him arrested if he carries on, that we will not tolerate stupid behaviour like this. Does he understand? He nods to show that he does. I relax my grip. He puts his hands over his face, draws his legs up and cries.
‘I’ll call his mum’ says Emma. ‘She doesn’t live far.’

*

Jamal is wearing a tight, garishly-patterned shirt. His hair looks freshly shaved. There’s a club stamp on the back of his hand. It looks as if he’s gone out on the town, tried to forget about the trauma of the morning, then ended up back outside his ex’s flat in the early hours. That’s just a guess. He’s still crying uncontrollably, refusing to answer questions.
‘You’ve been cheating on me,’ he mumbles to Katie, who looks even more appalled.
‘I’ve been with you the whole time,’ she says. ‘Why would I? How could I?’
‘How long have they been together?’ I ask Emma.
‘Six months.’
Emma has been writing a message on her phone. She taps me on the arm and holds it up for me to read.
He is paranoid
‘What do you mean? Is that an official diagnosis?’
‘Kind of.’
‘What do you mean, kind of?’
‘I’m sure it won’t be long before the doctor makes a referral.’
There’s a knock on the door. Jamal’s mother Ellie has made it out to us in dangerously quick time. She strides up the steps and puts her arms around her son, who curls into her and cries even more.
‘Can everyone else just leave,’ she says.
Katie and Emma quit. We don’t see them again.
‘There, there,’ she says, as they slam the door. She strokes Jamal’s back and kisses the top of his head. ‘It’s okay, baby. Come on. You think it’s the end of the world but it really isn’t. It’ll get better, you’ll see...’
After a while, she speaks to me over the top of him.
‘What’s happened?’ she says.
I tell her the story.
‘Does Jamal have a history of this kind of thing?’ I say. ‘I’m sorry to ask, but has Jamal ever been referred for mental health issues?’
‘No. Never. Why - did she say something?’
‘She mentioned a doctor’s referral.’
‘No. Nothing like that.’
She carries on comforting her son.

*

Jamal is still volatile, and whilst there’s still a chance that something else is going on other than just emotional trauma and some alcohol, we can’t recommend Ellie takes him home on her own. The plan is to go up to A&E for a while so he can be observed, tested further if necessary, seen to calm down and come to himself. If that’s all fine, Ellie can take him home with her.

Of course, A&E is as frantically busy as ever. It takes some negotiation on my part to get him a quieter place than the waiting room, which looks like a casting call for a disaster movie. So long as Jamal can resist putting himself on the floor and stay in his chair, he can sit with his mother in a doctor’s reviewing station near the front desk.
‘Can’t he have a bed?’ says Ellie, hugging his head and stroking his cheek.
‘I’m afraid this is the best we can do. We need the beds for people who absolutely have to lie down. At least you’re not in the waiting room.’
She gives me a terse smile.
‘Thank you for what you’ve done,’ she says. She settles up close to him, with Jamal half out of the wheelchair, his head on her shoulder, his right arm around her waist. Twenty-two years ago he would’ve been on her lap; now, his muscular physique utterly dwarfs his mother’s slight frame, and if he climbed on her lap she’d be smothered. It’s like watching a trainer who’s known the lion since it was a cub, and doesn’t see how big its paws have got.
‘Ssh, now’ she says, closing her eyes, kissing the side of his head. ‘Ssh.’
We leave them to it.

The nurse sighs as she signs my board on the way out. I know she was saving that space for something else.
‘Sorry,’ I say. ‘With any luck they’ll be out of here in an hour.’
‘Yeah, right,’ she says, clicking her pen. ‘With any luck, me too.’