Saturday, August 30, 2014

where he was

‘Be careful’ says Eileen.
I’m perched on a window ledge, holding onto the upper lip of the frame whilst I struggle to reach inside with a long piece of wire and flip the window catch. Even though finally it bounces up, I can’t open the window any further because it turns out the metal arm has been fitted with a security bolt.
‘It’s no good’ I say, throwing the wire behind me then lowering myself back down onto the bin I’d dragged there. ‘Let’s have another look round the back.’
‘Round the back?’ says Eileen. ‘Really?
I know what she means. If the front garden was overgrown, the back is impenetrable, brambles so vigorous they’ve shattered through the glass of the conservatory and washed up against the back of the house in a great tsunami of thorns and nettles.
The front door is a substantial frame of aluminium, secondary glazed security glass, double locked and bolted on the inside. At least the back door – if you ever managed to machete your way through to it – is a simple, single-panelled affair.
Whilst we look around for tools that can help us through the thicket of brambles, we can hear Eileen shouting through the letterbox.
‘George? They’re coming round the back,’ she says. ‘Won’t be long.’
There’s no reply, of course, nor has there been since we arrived. All we can hear is the radio playing loudly somewhere deep inside the bungalow.
‘A bit deaf’ says Eileen. ‘But you’d normally get him to say something.’
We find a couple of rusted shovels and start beating our way through to the back door. These brambles must be years old; the tendrils thicker than any I’ve seen, great coiled trunks, tough as twisted razor wire..
‘It’s Sleeping Beauty all over again,’ says Rae, chopping and hacking beside me. ‘Just remind me. How did that one end?’
We earn a little space to work. Rae finds a section of old ladder. I rest that on the top of the brambles and walk across it like a precarious bridge. Baskets and old boxes collapsing beneath me, but I make the back door. It’s locked, of course, so leaning back a little I use the shovel to jab at the glass which shatters inwards. Once I’ve used the edge of the shovel to level out the remaining shards, I take hold either side, climb up, and drop inside.
The kitchen is comprehensively junked-up, a high-chair over by the sink to my left with a tartan dressing gown thrown over it, boxes of stuff stacked around, old notices tacked to the wall, piles of newspapers, the bewildering mess of a hoarder. I pick my way out to the hallway, and unlock the front door. I hear Rae coming round that way, so I go back to look for George.
The radio is playing behind a door on my right. I knock and push it open.
‘Hello?’
A bedroom, with a messy, single bed surrounded by dark and anonymous piles of junk.
I check the other side of the bed, but really there’s only just room to climb out on the side nearest to me, so it doesn’t take long to reassure myself that George isn’t there.
‘Hello? Ambulance.’
I turn off the radio and knock on a door immediately opposite.
Into a lounge, a corridor of space from the door to an easy chair with a view of the television, but again, generously piled with junk. There are bookcases along one wall with a quantity of antique books. Family portraits, a cuckoo clock with the cuckoo rusted halfway out of its hatch. Dust on everything. Silence, deeper for the radio being off now.
‘George?’
Rae joins me in the room.
‘Where the hell is he?’
‘The door was locked from the inside, though. He’s got to be here somewhere.’
We  go back out into the hall. It crooks round to the bottom of a set of stairs, but we’d have trouble getting to them, let alone an eighty-nine year old with mobility problems.
Rae looks in a cupboard.
‘George?’
‘He’s definitely not in the bedroom. Definitely not in the lounge. So he MUST be in the kitchen. I’ll take another look.’

I go back to the kitchen, and stand in the doorway.

 A stage magician would understand why I missed him. They know all about the power of distraction, what you can hide with the right amount of confusion, how you often see only what you expect to see and nothing else. I’d been pumped-up with the difficult entry. When I smashed the window and climbed through, all I saw was a place in a mess. There was no body lying on the floor or in any of the other attitudes I’ve come across in these situations. My next mission was to get to the front door, open it, and then search the rest of the house as quickly as possible. I started with the front room, where the radio was playing.

Standing back in the doorway of the kitchen, though, the truth of the matter is like a blow to the stomach.

At some point George had been sitting on a high metal chair by the sink, fetching himself a glass of water in the night, perhaps. He’d fallen head first off the chair, hooking his leg in the frame of it. But the chair was so braced with junk it didn’t topple over. Instead it held him upside down – and worse, somehow his head had become jammed up to the chin in an empty plastic bucket that was on the floor at his feet. He must have fainted soon after, or presumably he’d have been able to free himself from the bucket. And then asphyxiated. In short order – you would hope, anyway.
Picking my way over to him, I can see he’s been dead for a while. I pull his tartan dressing gown back. His hands and arms are puce coloured, stained with pooling blood.
Rae stands next to me.
‘Oh my god!’ she says. ‘Poor George.’ And then: ‘Is that a bucket?’

Wednesday, August 27, 2014

on the edge

Mark has drunk so much, taken so many tablets – Tramadol, Quetiapine – it’s incredible he’s able to stay upright, let alone talk. He’s like some powerful animal that can’t be brought down no matter how many darts you fire into it. He should be flat on his back, but instead he’s sitting on the edge of the bath, wavering backwards, circling the vertical, poised on the lip of a bottomless pit; from his exhausted demeanour, I would guess that if he did start to fall, he would stretch out his arms and let himself drop forever.
‘I’ll be honest with you,’ he says, his eyes closed, his words fat and fuzzy. ‘I’ll tell you what it is. I’ve just had enough. I’ve had enough of feeling like this. I just want to be normal. I just want to live a normal life, with my wife and kids, and not keep fucking up. I don’t expect you to understand. You look around. What’s he going on about? Nice house. Beautiful wife and kids. But there’s this monster inside me and it won’t leave me alone. It comes sliming out every few weeks, and it doesn’t matter how much help I get, it doesn’t matter what anyone says or does, it gets its head right into me and I just can’t fight it off any more. I’m tired. And before you say it, no, I’m not going to hospital. I appreciate you coming out and everything. I don’t mean to be rude. I just want to be left alone to sleep.’
He sinks to his knees and rests his head against the edge of the bath.
Judith his wife is out in the hallway. It’s a new house. They’ve only just moved there and still haven’t completely unpacked. It has a warm but tentative feel, a well-lit space waiting for something to happen.
‘Mark,’ she says. ‘Please. You’ve got to go in.’
He pushes the door shut with his foot.

Tuesday, August 26, 2014

facing it

‘Why won’t you come to hospital?’ says Rae, leaning forwards and stroking Rita’s hand. ‘What is it that’s worrying you?’
Rita’s daughter Valerie sobs once, loudly, in the kitchen. After half an hour of fruitless persuasion she suddenly broke down and had to take herself away. Valerie’s husband John passes her another tissue.
Rita is lying on the sofa, emaciated, the worst I’ve seen, her flesh fallen away from her bones like the sea from a wreck at low tide.
Rae has the doctor’s letter on her clipboard, and a note for the crew: Rita has a large abdominal mass that needs urgent assessment. Do your best to persuade - otherwise we need to consider our options. The family have driven half way across the country this morning. They knew she was bad, but this sudden deterioration has been a shock.
‘Rita? We won’t do anything you don’t want to do,’ says Rae. ‘But you’re very unwell and you need your tummy looking at. You’re dehydrated and you’re in pain. We can help with that here, but ultimately you need treatment at hospital otherwise you’ll just get worse. Do you understand?’
Rita licks her cracked lips, but carries on staring up at the ceiling.
‘The hospital won’t keep you in any longer than they have to, Rita. Once they’ve made you comfortable and seen what needs to be done, you can think about what you want to do next. How does that sound? You really can’t go on like this, though. You need to go to hospital.’
Slowly, Rita turns her lustrous eyes on us, and when she smiles, her teeth seem too big for her mouth.
‘It’s cancer,’ she whispers. ‘I know what it is. And if I go to hospital, I won’t be coming out again.’
She gives Rae’s hand a squeeze, as if it were Rae that needed to hear the truth of it and not her. Then she turns her face back to the ceiling.


Monday, August 25, 2014

£250

It would be hard to understand what Michael’s trying to say because of his asthma, even if You’ve Been Framed wasn’t playing on the telly, so loudly that normal conversation is impossible. Michael’s mother sits right in front of it, held in the armchair by a series of strategically placed cushions and a moveable table. Behind her in the corner of the room is her bed, a hoist just beside it along with all the other pieces of kit you might expect.
‘She likes it loud,’ he says, walking over to turn the TV down. His mother stirs in the chair and starts looking around blindly with her chin up, as if it’s not her ears but her nose that’s sensed the difference; Michael rests a hand on her shoulder: ‘I’ll put it back up ... in a minute ... when they’re gone,’ he wheezes next to her ear. Pats her once and then comes back over to us.
We give him a neb and take some details. History of infective exacerbation, smoker, this and that. He’s in his early fifties but looks older. The walls of the flat have a yellow tinge to them. The whole place feels sick. I’m sure if I pressed on the back of this sofa it would ooze tar like a sponge.
‘Is the neb helping?’
He nods, gives us the thumbs up.
On the TV, a sequence of people falling off swings, stages, ladders.
A duck attacks the camera.
Advert break.
 ‘You could probably do with a visit from the out of hours, to see about your chest infection.’
‘Okay ... Fair enough ... I can’t be going anywhere ... ‘cos of mum.’
His mum has switched her attention to a cigarette lighter on the table in front of her. She clicks it off and on, fascinated by the flame. Michael doesn’t seem to mind.
An arthritic dog – heavy, hairy – knuckles in from the kitchen. It shows only a cursory interest in us and our equipment, then straightaway sinks to the floor at the old woman’s feet.
‘Good boy,’ says Michael, the neb misting and hissing through the mask.
We both look over at the telly again.
You’ve Been Framed is back on.
Some old feller dancing at a wedding, everyone whooping and clapping. He falls backwards into the sound system.
We both laugh.
‘That’s gotta hurt,’ says Michael, shaking his head. He puts both hands on the kitchen counter and takes a deep breath. ‘Still,’ he says, looking up at me over the edge of the mask. ‘That’s two hundred ... and fifty quid ... right there.’

mane event

With his full beard, wild hair and blue button eyes, Taz looks like a loveable toy lion, a little ragged at the ears maybe, nicked and battered by life, but a lion that’s learned to take care of himself at the tougher end of the jungle.
‘Don’t worry about me ‘ed mate. I’ve had worse.’
His dog, something massive and furious, appears to have given up trying to ram its head through the kitchen door, and has started trying to pick the lock instead.
‘We don’t mind if you let him through,’ I say, putting my bag down.
‘Nah mate. He’ll roll you on the ground and have your cards cloned before you’re up again.’
‘Fair enough. Let’s have a look at this wound, then.’
‘If you can find it in all that hair,’ says Chelsea, Taz’ girlfriend, tucking her legs up on the sofa and wrapping herself more tightly in her dressing gown. ‘If you find any brains, let me know.’
Rae holds a torch on the wound as I prod around.
‘It’s not too bad,’ I tell him. ‘A couple of stitches, that’s all. We could get one of our colleagues to come out and take care of that for you.’
‘Would ya? Thanks, mate. I’m dead allergic to hospitals.’
‘I’ve just got to ask – have you had any alcohol tonight?’
‘Don’t drink. Not anymore. Not since the illness. I’m sober as a judge, me.’
‘And just as bent,’ says Chelsea.
‘Ere!’
I shine a torch in his eyes. Take his blood pressure.
‘You’ve passed your MOT’ I tell him, as Rae writes the figures down.
‘Have I? That’s good then.’
‘Are you going to wrap his head in bandages?’ says Chelsea. ‘One under the chin. One round his mouth.’
‘Cheeky!’
Rae makes a bandana out of a triangular bandage and covers the top of his head. She steps back to admire her work.
‘There you go, Taz. Axl Rose.’
‘Wow! I’m never gonna take this off.’
‘Oh my God,’ says Chelsea. ‘We’ll never hear the end of it.’
‘So tell me again what happened?’
‘I was coming down the stairs and I missed my footing. I’ve been doing that quite a bit since I got sick. I fell over and whacked my head on the door, but I weren’t knocked out or nothing. I’m good really. It bled a lot but they do that, don’t they? I’ve had a fair few cut heads in my time. I know about this shit.’
‘When was the last one?’
‘A couple of months ago.’
‘Did you trip that time as well?’
‘No, mate. A friend of mine smashed my head on a urinal.’
‘Blimey! Why’d he do that?’
‘I’ve no idea. I was fucking his girlfriend at the time, but that’s probably just a coincidence.’

Sunday, August 24, 2014

sisters

‘Just rest, Agnes. You don’t have to talk.’
‘I know.... it just... keeps my mind occupied.’
‘Your SATS are holding up okay without the mask.’
‘Good! I don’t want that thing on. I makes me feel all ... hemmed in. I’ll be all right, love.’
‘And you say Joan might see you up the hospital?’
‘Joan? She’ll be over, you can bank on that. I don’t know where I’d be without Joan.’
‘Is she older or younger?’
‘Older. Only by a couple of years. We’ve always looked out for each other. Always. Had to. Dad was a drunk and Mum was no better. Joan used to make sure I was all right for school, fed and watered, you know. We had to grow up quick.’
‘Did you have children?’
‘I had five. Three that lived. Two died soon after they were born, both on their birthdays. Cot death you’d call it now. There was a lot of ignorance and suspicion in them days. It were bad enough losing the babies, but then there were all the funny looks. People stopping talking when you came in the room. After the first one was taken from me I knew there were problems with the second. I knew as soon as he started to go off his food. I told the doctor about it. He came round and he said “Don’t worry. It’s perfectly natural, after losing your first like that. You’re bound to be a bit anxious.” I knew it weren’t that, though. He was such a sweet little thing, golden hair, red cheeks – a cheerful little sprite, he was. But like I say, he went off his food, and then one morning I put him down to do my chores, and when I turned back to check on him I found he weren’t breathing. I blew in his mouth but it were no good. I ended up howling, running through the streets with him in my arms. I don’t know what everyone must’ve thought. I’d gone mad, probably. You don’t think you’ll ever get over these things, but you do. It takes a good long while, but you do.’
‘What about your husband? How did he bear up?’
‘Tommy? He were no good from the start. Tommy were a layabout, pure and simple. Drinking all his money away. Certainly never gave me any. I had to have a part-time job to run the house. Joan lived in the next street. I looked after her kids at night when she went to work, and she looked after mine during the day. Tommy said he were an electrician at the docks. I had to go round there to talk to him about something or other, and they said he hadn’t worked there these last five years. What he’d been doing I don’t know. Tommy was a terrible jealous man, n’all. I got friendly with Stan at work, and Tommy got wind of it. He came home drunk one night, threw the telly through the window and knocked me down. I never saw him after that, except at a distance. Which were fine by me. I found out a little later he were gay. He ended up living with the landlord from our local. I suppose it must have been hard for him, having to pretend all that time. I’m not making excuses. He could’ve been a bit nicer to me and the kids, but that was Tommy, for better or worse. Worse, in my case.’
‘Then what happened?’
‘Call me foolish but I got married a second time, to this miner called Fred. Fred started out lovely, but he had this bad accident at work. He were down the pit, and this young kid pressed something he shouldn’t have, and Fred was buried under tons of coal. Only survived because a prop fell in a funny way and kept a little space clear, just enough for him to breathe while they dug him out. It took days. He were never the same after. Became a hypochondriac. Always at the doctors worrying about this or that, convinced he was dying. And he stopped washing, too, which was the worst. He didn’t look after himself at all, and in the end I just couldn’t bear to be near him he smelled that bad. It was a terrible thing Fred went through, and I suppose sometimes it’s more than just the body that gets damaged, in’t it? But things have worked out pretty good. My kids have grown up healthy and happy, and I’ve got more grandchildren than I can count. And then of course, there’s Joan. What I’d have done without Joan I don’t know.’
‘I get the feeling you’d have coped all right.’
‘You’re probably right. But not nearly so well, though. Not nearly so well.’


Saturday, August 23, 2014

biro sketch

Carys is propped up against some railings, four nightclub bouncers buzzing around her. In fact, if her sheer black outfit had just a few touches of yellow she’d make an excellent queen bee, surrounded by a swarm of close-eyed drones. They certainly seem to venerate her. Two of them stand either side keeping her upright, passing her cigarettes, lighting them; keeping her warm, whilst the other two make phone calls, control the traffic and finally wave us in.
‘Someone spiked Carys’ drink,’ says the bouncer who meets us, whether on the verge of tears or extreme violence it’s hard to tell. ‘She’s lost the use of her legs.’
If her drink has been spiked, it’s had a focused effect. She doesn’t slur her words, has a good recall of events, isn’t dizzy or nauseated. It’s just that she has no feeling at all from mid-thigh downwards, and although she can weight bear, she has to be guided onto the trolley we bring alongside her.
‘It was that last Sambuca’ she says, quite clearly and calmly. ‘You’d never know if there was something weird in that shit or not, would you?’
‘Who gave it to you?’
‘I don’t know. Some guy.’
She shrugs, phlegmatic about the whole affair. When we’ve made her comfortable on the stretcher she takes a kiss and a hug from each of the bouncers, then waves to them with one of her shoes as she slowly rises into the air on the tail lift.
‘I used to work there’ she says as we push her inside.

* * *

At the hospital the triage area is as busy as ever. Carys surveys the scene coolly, her arms folded.
‘This is stupid,’ she says. ‘I feel such an idiot.’
‘We’ve got to get this problem with your legs sorted out, though. I wonder if your drink was spiked? Where’s my biro...?’
‘What you want a biro for? Shove it up me arse?’
‘No! I’m going to test your reflexes.’
I run it up and down the soles of her feet, but the plantar reflex is lacking.
‘I’m normally pretty ticklish,’ she says, looking gloomily at her inert feet.
A man in a blue coat wanders over. Out of the corner of my eye he looks like a nurse, but when I turn round to give him a handover, I see that he’s actually a member of the public. An elderly black man, with tightly curled, greying hair and a pair of bi-focals perched on the tip of his nose. He smiles, lowers his chin, and regards Carys over the top of them.
‘Well, well!’ he says. ‘And where are you from my dear?’
‘Where am I from? Where are you from, lover?’
‘Oh – hush!’ he chuckles. ‘Listen. I couldn’t help overhearing you say the word biro. A very unusual pronunciation.’
‘Is it? Biro. How else do you say it?’
‘There you are again, you see? Now, forgive me for saying so – but am I right in thinking you’re from Africa?’
Africa? What? No, mate. Cardiff.’
‘Ah! Cardiff!’ he says, smiling broadly, as if he’d just been proved right. ‘Ye-es. Bi-ro. A most unusual word. Laszlo Biro. Hungarian, I believe.
‘Was he?’
‘Yes. Yes he was. Unmistakable.’
‘Oh-kay then.’
He wanders away, cleaning his glasses on his coat and shaking his head.
‘Fucking hell,’ says Carys. ‘That’s given me the fear, that has. I need a hug, quick.’
She turns to me, but I shake my head.
‘If you don’t mind Carys I’ll leave that to the nurse,’ I say. ‘When we can find a real one.’
And I put the biro back in my pocket.

Wednesday, August 20, 2014

yo grandma

Luisa has lived in the UK ever since she married just after the war, but her Italian accent is as strong as ever. A frail, beautifully turned-out woman in her nineties, she is as perfectly maintained as her hair, the long, fragile strands of which lie expertly coiled and kept in place by a series of elegant metal grips.
Once the ECG is done and we establish that Luisa needs to go to hospital, she quietly gathers a bag of things together, turning down all offers of help. Finally she reappears in the doorway, wearing a smart black coat and sensible shoes. I offer to carry her bag but she graciously declines, electing instead to hold onto my arm as we head for the front door.
‘My bitches,’ she says.
‘Sorry, Luisa?’
‘My sweet little bitches.’
What can she mean? I'm as stunned as if she'd given me a kick in the shins. Is there something in her past medical history I've missed?
Luisa lets go of my arm, stretches a hand out to the fruit bowl and squeezes one of the peaches there.
‘We must eat them today.’

Sunday, August 17, 2014

the chair

Elsa has slowly been sliding off the kitchen chair ever since the carer left at five. Without the strength in her legs to push herself up, eventually she pressed the red button on the cord round her neck. We let ourselves in with the key from the key safe.
‘Hello? Ambulance?’
‘Never mind that. Git me up! I’ll be on the floor in a minute if you don’t get a move on.’
‘Okay. Do you have any pain anywhere, Elsa?’
‘Jes’ git me up. Why are you standing there asking these stupid questions? I’ll fall on the floor and it’ll be your fault.’
‘We won’t let you fall, Elsa. Can we help you up by the arms? Do you have any problems there?’
She turns to look at Rae with her eyes closed.
‘What’s he saying? I can’t make out a damned thing.’
‘He wants to know if you’ve got any pain anywhere.’
‘I will do soon if you don’t get a move on.’
‘Where do you want to go once we’ve stood you up?’
‘Go? I’m not going nowhere. I’m not going up the hospital. I’ve had enough of them.’
‘Okay. Let’s stand you up and see how good you are on your pins. Use the zimmer, Elsa. Take a good grip – no, no, not on me. On the handles of the zimmer. The zimmer, Elsa. Like you’ve been shown.’
‘Help me! I’m going to fall!’
‘You won’t fall, Elsa. We won’t let you go. We just want to see how mobile you are.’
‘Ooh – fetch me that bowl quick, won’t you? I’m going to wet.’
‘Shall we walk you to the toilet?’
‘The bowl! I want the bowl!’
‘But how are you going to use it?’
‘If you just shut up for five minutes I’ll tell you. Put it on the floor and I’ll stand over it.’
‘You’re going to wee standing up?’
‘On the floor. Go on...’
Reluctantly I put the bowl on the floor. Elsa shuffles forwards, only just managing to open her legs sufficiently to straddle the bowl.
‘It’ll never work,’ I say. ‘It’ll just run down your legs.’
‘No it won’t. Watch. Stand back a little or you’ll get splashed.’
She lets go of the zimmer to hitch her ancient housecoat above her knees – and would instantly have toppled backwards if I hadn’t been there to grab her by the shoulder.
‘Don’t let me go!’ she yells. ‘I told you!’
‘This is very unsatisfactory, Elsa’
‘I don’t care what it is, I’ve got to go wee. Here it comes. Watch out.’
She stares ahead with bovine insouciance as a sudden rush of urine splatters down into the bowl.
‘At least it missed your legs,’ I say.
‘Told you’
‘Have you been going more often?’
‘What’s he want now?’ says Elsa, as Rae passes her some kitchen towel to wipe herself dry.
‘Your toilet habits. Are you going for a wee a lot? Does it sting at all?’
‘No. Now get me back to my chair.’
‘I don’t think you’re safe to be left here tonight,’ I tell her.
‘I’m not going to the hospital. I only got out the other week.’
‘What were you in for?’
‘I banged my head. Falling off the chair.’
‘There’s a discharge summary here,’ says Rae, pulling it out of the back of the care folder. ‘Says she had a subdural.’
‘It’s just not a good chair to spend the night in, Elsa.’
‘Why not?’
‘It’s got no arms, for one thing.’
‘Oh I don’t care about that.’
‘But if you fall asleep, there’s nothing to stop you rolling out and cracking your head again. Or breaking your hip.’
‘I’m not going to hospital.’
‘Can’t we help you into bed, at least?’
‘No. Why would I want to go to bed?’
‘Because it’s safer and more comfortable.’
‘Just put me back in the chair and leave me alone.’
The chair is a perfect fit with the rest of the flat, which looks like it was furnished from a skip. I’m sure when the chair was in the furniture catalogue sometime in the sixties, the padded plastic seat and back rest would’ve looked charming and colourful. Fast-forward fifty years, though, and gobs of yellowing foam are spilling out of numerous tears, and the white, tubular legs are pitted with rust, splaying at the seams. I wouldn’t put a cup on it, let alone a woman in her eighties.
‘It’s not safe,’ I tell Elsa as I help her start the laborious business of turning her round.
‘Well I’m not asking you to sit in it, am I?’ she says.

Saturday, August 16, 2014

curbed

Hilary was heading home, drunk, when she stumbled over a kerb, landed on her arm and broke it.
As we pull up in the ambulance she’s propped up against a telephone junction box, leaning forwards, her left arm and her long, blond hair hanging down in front of her.
‘I’m sorry. I’m sorry,’ she slurs, lifting her face approximately in our direction. ‘Mr Ambulance people. I know you’ve got better things to do. I’m sorry to take your time, okay? But I’ve been well and truly fucked over by this stupid kerb and I don’t know what to do it hurts so much.’
We help her on to the truck and settle her on a seat.
‘Don’t cut the jacket,’ she says. ‘The fucking kerb’s not getting that as well. I’ll take it off. Okay? Just wait!’
She makes a couple of drunkenly ineffectual moves, then slumps forward again.
As gently as we can we ease the jacket off, then gauge the extent of the injury and splint the arm.
‘How was your night, then, Hilary?’ I say as I work. ‘Apart from breaking your arm?’
She squints up at me through a haze of alcohol and hair.
‘That’s outrageous,’ she says. ‘I can’t believe you just said what you said.’
‘You’re right. That was outrageous. What was I thinking?’
She stares at me some more. Eventually she says: ‘This just gets worse. You’re not even hot.’
I make a Soprano-style Ohh! and we carry on immobilising her arm in silence.
Finally we help her over on to the trolley and do what we can to buffer her with bags and blankets for the journey. When she’s reasonably comfortable, Rae jumps out and goes round to the cab.
Just as we move off, Hilary squints at me again.
‘I can’t believe you said what you said,’ she says. ‘Out- fucking-rageous.’
‘Never mind. Least said soonest mended.’
‘What? Oh – and a c**t as well, apparently.’

Thursday, August 14, 2014

characters

The sky’s a hard, ceramic blue, and the late afternoon so hot and close the park reached capacity long ago, filled with Frisbee throwers and skateboarders and people sleeping on the grass or drinking on the benches or just sitting looking around, while those still hurrying purposefully from work flow in an unbroken stream to the station, or stand staring down at their mobile phones in lines at the lights, waiting for direction, pedestrian or otherwise.
A man dressed as Super Mario in blue dungarees, red neckerchief and flat cap runs through them all, one arm working like a piston, the other bent up with his hand flat on his cap to hold it on. Suddenly he stops and leaps up, scissoring his legs. A builder leans out of his van in the queue of traffic and shouts something I don’t catch. Super Mario does though; he waves his cap in the air, shouts Wa-hoo!  then carries on running.

You could say that Ella’s been drinking to celebrate the sunshine, like everyone else in the park. Actually, she celebrates most days that way, the only difference today being not the weather but the fact that she fell over when she finally made it home, cracking her head on something solid in the kitchen. Her family called the ambulance.
Ella has already put herself to bed. When we prod her sufficiently to get her to talk, she sits up suddenly and irritably, beats a bunch of pillows, then peers out at us all. I think I recognise her from somewhere. The corset, the wide, painted smile, the smudged makeup, the deranged peak of her hair. Surely it’s Ursula from The Little Mermaid?
‘How are you feeling?’ I ask her.
She leers at me, rolls over, and pats the bed beside her.
‘Come here and I’ll tell ya’

Wednesday, August 13, 2014

working the turntable

Eddie hadn’t been feeling all that clever since he got up. Still, he always makes the best of it. He got himself ready for the usual Tuesday morning jaunt to ASDA. His niece picked him up at ten. He didn’t tell her how he felt. (He didn’t want to worry her. She’s got enough on her plate). She dropped him back just after lunch. He watched a bit of TV. Had a nap in the chair. When he woke up it was four o’clock. He did a quick shufty round the bins in the bathroom, bedroom, kitchen, took a bag full out into the yard. That was when the chest pain started to come on strong. He struggled back to his chair and took his spray. His neighbour Gill comes round every teatime to help him work the microwave. She found him still in the chair, grey around the gills, a bit tearful. She phoned for the ambulance.
‘Has the spray helped?’ I ask him as we blanket him up in our carry chair.
‘I don’t know,’ he says. ‘What do you think?’
‘Let’s get you out to the ambulance. We’ll do an ECG and then take you down the hospital for some more tests.’
‘Oh no. Really? I’ll be fine. I just need a rest, that’s all. I’ve been overdoing it lately.’
‘You might be right, Eddie, but we’re worried it might be your heart. That’s why we need to look into it. I know it’s a nuisance, but better safe than sorry, eh?’
‘I’m in your hands,’ he says.
‘You’ll be all right, Eddie’ says Gill, leaning in and kissing him on the top of his head. ‘Back before you know it. I’ll call the gang and let them know.’
Eddie clasps her by the hand and his eyes fill.
‘You old silly,’ she says, giving him another kiss. ‘Come on. Let’s be having you.’
We wheel him out.
The sun is so bright after the muted light in Eddie’s flat it’s hard to keep my eyes open.
There’s a gang of kids sitting on the low wall that runs along the front of these flats.
Where’s he going?
What’s happened?
Is he dying?
‘Ssh now!’ says Gill, following behind us with his bags.
Eddie does his best to smile and wave. The kids jump down off the wall and run on ahead to the ambulance. They stand either side of the tail lift in a cheeky guard of honour as Eddie rises up on it. He carries on waving, even when he’s inside and can’t see them.
The tail lift clatters shut.

* * *

‘I’m pretty good normally. I take care of myself, you know. I don’t need much. Mind you, I’ve got some good friends and neighbours. I dunno what I’d do without them. It used to be just me and Cheryl, ‘course, but she died three years ago and it knocked me off my feet a bit. I’ll never get used to it. I met her the day after I come out of the army, when I was wondering what I was gonna do with myself. So just goes to show. We got married a year later. Sixty-five years it would’ve been come Christmas. Sixty-five years.’
He rests his head back on the pillow and stares up at the ceiling of the ambulance as we bump along through the traffic.
‘Are you okay, Eddie? How’s that chest pain?’
‘Say what?’
I reach over and touch him in the centre of his chest.
‘How’s the pain now? Has it eased off at all?’
He shrugs, then carries on talking.
‘I was fifty year on the railway,’ he says.
‘Doing what?’
‘On the turntable to start with. Switches, signals. Bit of everything, really.’
‘It must’ve kept you fit.’
‘A life on the railways – nothing better. Funny, ‘cos when I was in the army I didn’t think anything of it. You know, trains.’
‘I think they should re-nationalise the railways.’
‘Well - it’s complicated’ he says. ‘It’s not what it was. They made a lot of changes, and it’s not always easy going back. Anyway, I never worried about any of that. I just took ‘em in, turned ‘em round and went back home for my tea.’
He shifts his position a little, looks back up at the ceiling, and grips the handrails either side of the trolley. He shakes his head, like someone trying to clear his thoughts, or struggling to bring to mind where something might be that’s now unaccountably gone.
‘All right, Eddie? Soon be there,’ I say, glancing through the hatch at what I can see of the road, then glancing at my fob watch.
‘Oh?’ he says, still looking straight up. ‘Where’s that, then?’

Tuesday, August 12, 2014

blue plastic

There is nothing and no-one out in the street tonight, certainly no Intoxicated female, collapsed outside number thirty-two. We’ve played our torches around the scene, over fences and flower borders, recycling bins and bad concrete statuary, over the cold forms of parked up cars on verges and brick-paved drives, but so far, the only sign of life has been the flash of a cat’s eyes before it disappeared beneath a gate.
We’d knock on the door of thirty-two – a wide, nondescript building, the kind that long ago traded looks for space – but it’s so late, we wouldn’t want to chance it. If there was someone needing our help here, surely they’d be on the lookout? Surely they’d be at the door waving us inside? And anyway, this ambulance is so noisy, I’m surprised the whole street hasn’t come out to beat us to death with their slippers.
We call Control and ask them to get back to the caller. They tell us the line has gone out of service.
‘But the caller said the woman had collapsed in the street? outside number thirty-two?’
‘That’s all we have.’
‘Well she must have walked off, then. There’s no sign of anything or anyone needing our help.’

They stand us down.

Just as we’re driving off down the street, Rae says: ‘Here we go.’
She’s looking in her wing mirror. I wind the window down and look back.
Adnan is run-skating after us in his flip-flops, one hand holding his bomber jacket together at the front, the other swinging out for balance.
Rae stops and lets him catch up.
‘Come!’ he says. ‘Wife.’
When he turns round, the back of his jacket reads: Planet Hollywood
Rae backs up the little distance we’d travelled whilst I call Control to let them know we’ve found the patient.
Adnan is waiting for us at the open door of the nondescript house. He frowns at me as I finish talking on the radio and put it back in my pocket.
‘Ssh please,’ he says. ‘No wake the house.’
We follow him inside.

There are no notice-boards or fire panels, no exit signs or any of those formal touches that would mark it out as a hostel or refuge. Definitely some kind of temporary accommodation, though; the air is thick and stale, and even if I can’t hear anything, there’s a pressure of silence around us that feels like people sleeping.
‘Here. Please.’
Adnan opens a door that has a small padlock and clasp on the outside, and shows us in to a small, dimly lit room with a double bed, a wardrobe, a chest of drawers with a TV on top, and a low table with a kettle and a couple of mugs.
Helga is lying on the bed, the duvet and sheets rucked up around her.
‘She go out and drink very much,’ says Adnan, ‘Then she come back and take pills. She says she want kill herself.’
I look at the pill strip. Four missing.
‘You’re sure this is all she’s had?’
He shakes his head.
‘But of course.’
They’re a strange couple. Adnan is a stooped, lean Middle Eastern guy with a frown in the centre of his forehead as precise as the crease in his jeans. With her yellow hair in two plaits, her make-up smudged, her spindly legs in a pair of wrinkled, stripy tights, dungaree shorts and mismatched shoes, Helga looks like some kind of  alternative Swiss clown, exhausted after a night’s performance.
‘Helga? Helga? It’s the ambulance. Will you sit up and talk to us?’
‘I want to die,’ she moans, rolling over and pushing her face into a pillow. ‘Too much problem. Go ‘way’
Adnan sighs and reaches down as if he’s about to put her over his shoulder and jog to the hospital.
‘Hang on a second, Adnan. Can I just ask – are you a relation?’
‘Yes. Her husband.’
‘Two weeks’ says Helga. ‘To stay in country. For money.’
Adnan shakes his head and backs off towards the door.
‘Helga? We need to find out what’s been happening tonight. We got a call to someone collapsed in the street. Was that you?’
She nods.
‘I help inside,’ says Adnan. ‘We go to hospital now?’
‘Just a minute. Helga? What pills have you taken tonight?’
She wobbles her head about in an effort to focus, and eventually taps the strip I’m holding in my hand.
‘Just these? Any others?’
‘No. I want sleep. Too much trouble.’
‘Did you take these pills to hurt yourself?’
‘I not want to wake up.’
‘I think you do need to come to hospital, Helga. These pills won’t have caused you any harm. What I’m worried about is your low mood, and the reason you took the pills. If you come to the hospital and sober up, you can talk to someone about how you feel. Okay? Ready to go? Come on.’
We help her up. She walks a little raggedly. When she stops at the door to wait for Adnan to open it, she swivels round and gives me a lopsided smile. I half expect her to pull a bunch of flowers out of her sleeve.

*

At the hospital, Eddie the triage nurse tries to get the story.
‘So you wanted to kill yourself?’ he says.
Helga finds the vomit bowl next to her and puts it on her head.
‘You like hat?’ she says.
‘Put the bowl down, Helga and talk to me seriously. This isn’t funny. It’s very important we understand what’s happened tonight. The ambulance crew tell me you took some tablets with the intention of hurting yourself. Is that right?’
‘What is that? Plastic chair?’ she says, looking over the side of the trolley.
‘Yes. That’s a plastic chair, Helga.’
‘Is blue. Is blue plastic chair.’ She squints at Eddie. ‘Like uniform.’
‘Helga…?’
‘Nurse uniform blue, plastic chair blue. You blue plastic nurse.’
Eddie sighs and clicks through the rest of the triage screen.
‘What are we going to do with you, Helga?’ he says, filling in the boxes.
‘This is right, mister blue plastic nurse. What we do with Helga?’
She flops back down on the trolley and puts the vomit bowl over her face this time.
‘Ah! Poor married Helga. Is much, much problem.’

Wednesday, August 06, 2014

hair o'the dog

Gary doesn’t want to open his eyes, let alone get out of bed.
‘Come on, Gaz’ says his girlfriend, pulling the duvet back and slapping his legs. ‘The ambulance are here. It’s embarrassing’
‘I don’t think this is at all right,’ says Angela, his mum. ‘I’m sorry if I’m wasting your time but I’m really worried. I’ve seen him hung over before, and he’s always grumpy. But this is something else.’
‘Grumpy?’ laughs his girlfriend. ‘That ‘ain’t the half of it! Come on, Gaz! Hell-o in there!’
He groans and pulls the duvet back over himself, and falls instantly asleep.
‘This is embarrassing.’
She laughs and leaves the room. ‘Good luck with that!’ she says over her shoulder.
Angela sits on the edge of the bed.
‘This is wrong,’ she says. ‘He was out last night. Got into some trouble or other and ended up banging his head on the pavement. They took him to the hospital, but the first I knew of it he was turning up here in the early hours and going straight to bed. Wouldn’t talk to me or nothing. I only got the story from the police, who came round later to get some details. They said the CCTV showed him taking quite a crack – but anyway, that’s for later. What do you think? Is he going to be all right?’
‘What did the hospital say about the head injury? Did he have any tests or anything?’
‘No. I think he discharged himself.’
Everything about the story is worrying. Gary’s had a lot to drink, taken MDMA, fallen and knocked himself out, discharged himself from hospital before being examined, and now he’s hiding under the duvet, breathing hard, flushed in the face, rousable only with significant pain and sliding back to sleep the instant you leave him alone.
‘He absolutely has to come to hospital,’ we tell Angela. ‘No question. It could be he’s just hungover, but on the other hand we can’t rule out a significant injury to his brain.’
‘Oi!’ she says to Gary, pulling the duvet off him again. ‘You’re going down the hospital. Now.’
He groans and curls up in a foetal position.
‘I can’t,’ he mumbles. ‘My head hurts. Leave me alone.’
‘We’re not going to leave you alone, Gary,’ we tell him. ‘Come on. We’ll let you rest on the ambulance. The sooner you get down the hospital the sooner they can start to make you better.’
‘No.’
‘You’re going’ says Angela. ‘Put these on.’
She throws a pair of jogging bottoms on top of him.
‘No.’
Angela turns him on his back and starts putting the trousers on him herself.
‘Jesus Christ,’ she says, hauling him about. ‘You’re twenty-one, Gary. I thought I’d left all this behind.’
Gary lets himself be dressed. We keep the momentum going by helping him stand and start walking unsteadily to the hallway. We’re relieved we won’t have to think about carrying him out. The house is cluttered, the stairs steep and narrow. Gary is huge, too – over six feet tall, heavily muscled and covered in tattoos – skulls, daggers, names in gothic script.
‘No,’ he moans. ‘I just need to sleep.’
‘You’re going down the hospital,’ says Angela, ‘so just shut it and keep walking.’
Between us all we guide him down the stairs.

*

I make the blue light ride to hospital as smooth but fast as I can.

Later that afternoon the resus nurse calls me over to a computer screen.
‘Do you want to see the CT of that guy you brought in?’ he says.
Whistling a song by Bastille just under his breath, the nurse casually scrolls up and down through the scanned transverse slices of Gary’s head, the intimate structures and folds rolling in and out of focus, the gyri and sulci, the rooted orbits of Gary’s eyes filling and falling away again like strange, alien blooms. Here! says the nurse, stopping to point out the faint line of a fracture, and Here! the milky white florescence of a bleed.
‘On his way to Neuro as we speak,’ he says.
‘Thank god we didn’t just write it off as a hangover.’
‘Hangover?’ says the nurse, switching off the screen. ‘It’ll take more than a hair o’ that particular dog to make him better.’

Monday, August 04, 2014

falling

Astrid has everything to hand: a copy of The Times, two homemade jam tarts on a plate covered with cling-film, a box of tissues, her nursing file, a radio, telephone, notepad and pen, and on a trolley just to the side of the bed, a jug of squash and a glass with a bendy straw. Astrid is propped up on a generous cluster of pillows, and for extra support, the kind of velour neck-pillow people use on long flights.
All this elaborate comfort accentuates Astrid’s fragility. She’s like some priceless artefact in a museum, so fragile even the sunlight on her bedclothes looks too heavy.
After a great deal of talking and questioning and a full complement of observations, it appears that the only change today is that Astrid remembered something her doctor once said, something about not having to suffer in silence. So she pushed her red button, and the ambulance came. But actually there’s no change, no new pain or unusual symptoms. It was more that she had forgotten what her situation was, and needed the whole thing explaining again. The other precipitating factor might be that her daughter Stephanie has gone on an afternoon shopping trip, and Astrid was unsettled by the thought she couldn’t be reached. For whatever reason, we’re here now, kneeling either side of her bed, doing what we can to reassure her that everything will be okay.
‘Look – do have a seat’ she says, gesturing with her fleshless arms to an empty space over by the window.
‘This is fine’ I say. ‘ I quite like it, actually. Your bed makes the perfect desk.’
‘You’re sweet,’ she says. ‘But what about a drink? I believe there are some cold cans in the fridge...’
‘Thanks Astrid, but we’re fine. We’ve only just had a cup of tea.’
‘Well. If you’re sure.’
‘How are you feeling now?’
‘Oh...’ She rests her head back and closes her eyes. ‘The usual. Falling, falling...’
Suddenly the front door opens and someone calls hello.
Stephanie comes into the bedroom, drops her bag by the door, takes a big, steadying breath, then sits down carefully on the bed.
‘Well,’ she says, the flesh of her hand contrasting with the bones of her mother’s. ‘I didn’t get very far, did I?’

donkey

‘Seventy-four,’ says Len’s daughter, Karen. ‘Going on eighteen’
Len fidgets on the bed and winces when he moves his legs.
‘It’s good to be active’ he says.
‘Yes, Dad. But there’s a difference between active and death wish.’
‘I like to keep busy.’
‘That’s true,’ says Karen, sighing, leaning against the door. ‘This is the longest he’s ever been in one place.’
‘It’s driving me crazy,’ says Len.
‘Driving you crazy?’ says Karen. ‘What about us?’
‘Ah well,’ he says, closing his eyes and lacing his fingers across his tummy. ‘Now the boot’s on the other foot.’
‘Whatever that means.’
Ken’s a farmer. He fractured one of his lumbar vertebrae when he fell off his quad bike last week. He was discharged from hospital after a couple of days with some physio booked and a bottle of Oramorph. When the Oramorph ran out his GP prescribed more, but at a lower dose frequency. Unsurprisingly, the pain got worse, and when it become unbearable Karen rang the helpline to speak to an out of hours GP. She didn’t get that far; an ambulance was dispatched instead.
‘It probably sounded worse that it was,’ I tell her. ‘Anyway, I think you should probably go back to the original dose at least until Monday, then talk to your GP for a proper review.’
‘Exactly,’ says Karen. ‘I wish I hadn’t phoned. Sorry to drag you out all this way for nothing.’
‘It’s no bother. I suppose it must have sounded worse than it was. But unfortunately we’ll still need to call the out of hours GP to authorise the dose. I’ve got the number here – let’s go down to the kitchen and leave Len to it.’

*

The kitchen is a vibrantly ramshackle collection of fish tanks, bookshelves, cooking equipment, piles of correspondence, ceramic chickens and a disparate spread of seedlings and plants at various stages of growth. Two dogs patrol the area – one, a large and generously furred Husky, who sits on his haunches over by the Aga, staring at me with a pair of steady blue eyes; and a bull terrier, who keeps presenting me with a punctured beach ball to throw.
‘Dylan!’ says Karen. ‘Will you leave the poor man alone?’
‘I don’t mind,’ I say, tossing the ball into the sitting room where it lands in Dylan’s basket. He clatters away over the flagstones after it, and is back sitting in front of me in the time it takes me to pick up the phone.
I give the basic details to the out of hours receptionist. She says twenty minutes to speak to a doctor and I say fine.
 ‘They’re going to ring back in a little while,’ I tell her.
Karen pours me a cup of tea.
‘Thanks. You know – your Dad’s doing really well,’ I tell her.
‘He’s always been like it. Always pulling some crazy stunt or other.’
The phone rings.
‘Blimey! That was quick.’
Karen glances at the number on the screen and slides the handset back towards me.
‘You’d better talk to them,’ she says. ‘I’m terrible with doctors.’
I click the phone on and put it to my ear.

- Hello? Is that the doctor?
(In what sounds like a joke country accent) Harse doctor, more loik.
(I laugh. Great! A doctor with a sense of humour. I bet he’s been on the phone all day and he’s decided to have some fun)
- ‘Absolutely! Anyway – thanks for calling back so promptly.’
‘That’s all-roit.’
(Still going with the fake country accent. What a laugh this guy is)
- ‘Okay. So. We’ve been called out to Len, a seventy-four year old man who fell off his quad bike last week and suffered a fractured L3. Was admitted to hospital, in for a couple of days, discharged with physio and a scrip for Morphine Sulphate, every two hours. Ran out last night, saw the GP, who issued a new scrip for the same but at a lower frequency. Funnily enough, the pain’s got worse, reduced mobility etc although can self-mobilise to the loo. No new trauma, neuro deficit or any other concerning symptoms. Obs fine, nothing there. So really we just wanted your advice.’
(A pause) ‘My advoise?’
- ‘Yes. What do you think they should do?’
(Another pause) ‘Waa’ll. Oi’ don’t know. I s’pose if it were down to me I’d jes’ shoot the ol’ bastard.’
(A long pause whilst I struggle to think of a response. Isn’t he taking this whole thing a bit too far?). ‘Don’t worry, mate. (He says, filling the awkward silence). You jes’ tell ‘em Donkey rang.’
(Donkey??)
- Okay. Will do. Bye.

I hang up and put the phone back on the table.
Karen is frowning at me.
‘That was Donkey’ I tell her.
She laughs.
‘Oh my god! Donkey?’
Two men in dusty overalls come into the kitchen, one of them about Len’s age, the other a young guy of twenty, his powerful arms covered in tattoos. They both pour themselves glasses of water at the sink, shoving the dogs aside with their work boots as they rush over to greet them.
‘How’s he doing?’ says the older guy, wiping his mouth with the back of his hand.
Karen leans back in the chair and shakes her head.
‘Spence here just spoke to the doctor about the morphine question, only it wasn’t the doctor – it was Donkey!’
‘Donkey?’
‘Yep! Donkey!’
‘No.’
‘Yep. That’s patient confidentiality for you. It’ll be all over the village by now. All the gory details.’
‘Donkey!’ says the young guy, shaking his head. ‘Oh my God.’
The Husky has settled back down to stare at me from the Aga; the bull terrier is presenting his deflated beach ball to the young guy, who completely ignores him.
The phone rings again.
‘That’ll be Donkey, I ‘spect. For a second opinion,’ says the older guy, switching on the kettle and flashing me a look.
‘At least I’ve rehearsed what to say,’ I tell them, blushing.
It really is the doctor this time. I go through the case again. He authorises a return to the original dose, on the understanding that the whole thing’s reviewed by the family GP at the earliest opportunity. I thank him and hang up.
‘Just the paperwork to finish off’ I tell them, leaning back in the chair. ‘Any further problems, just phone Donkey.’