Tuesday, October 10, 2006

A quiet pint

Saturday afternoon and these pedestrian backstreets are thick with people walking and eating and busking and window-shopping and drinking and staring blankly at the ambulance with the blue lights nosing impatiently through to get to the pub in the square where, we are told, a man is lying on the floor not breathing. It has taken me so long to get this far that I don't have time to think about parking the vehicle ready for a quick getaway. I put on the handbrake and we jump out, make a grab for the resus bag, and bully our way through a narrow passageway to the pub door. A woman is being helped out, an arm round her shoulder. 'He's gone', she says.
Inside the pub the first thing that strikes me is that one half is busy and the other empty. The landlord has cleared the section off to the left; he has put a menu board sideways across the little step to delineate the two halves. Like a comic book version of a normal pub, Lounge and Bar, this is one with two areas marked out: Living and Dying. Between the round tables, I see a man lying on his back with a white handkerchief over his face.
'Did anyone see what happened?', as I snatch the handkerchief away. (D. asks me: 'Is he breathing?' and then: 'Done a resus before?')
The landlord is standing over us as I check the man's airway and whether he's breathing or not. He isn't.
'What can I tell you? He's a regular. Nice enough. Comes in on his own. Told someone a while ago he'd got cancer and not long to go. Who knows? Never any trouble, though. Came in as usual for a quiet pint. Next thing (slaps his hands) - crash! off the stool, on the floor, gameover. I think he's probably dead, mate.' Checking his watch, hurrying things along. He turns to wave instructions to the girls behind the bar.
No pulse, either. D. has already cut down the centre of his shirt and pullover, exposing his chest. I start compressions.
Above my head on the wide plasma screen TV, it's half time and the experts are dissecting the match. As I call out every ten compressions I look to my right. The punters are well-provided for, dividing their attention between the TV, the resus in progress and their mates. Crisps, peanuts, another pint of guiness, a spritzer and a pint of lager, don't care what. Cheapest.
A man leans in at the window and says something like: 'I can see you're doing your best,' like he's giving encouragement to some clumsy painters and decorators.
D. asks the landlord to at least close the window. He does that, and then hangs the dog's blanket over the door window. He's not letting any more people in. This is a grim lock-in. He probably thinks it would be too much to explain to anyone new.
D. has placed the defib pads on. I stop compressions to let him evaluate the heart rhythm. Asystole. I'm back on the chest again whilst he calls for back-up on his mobile. Control says that they don't have a paramedic available nearby but will try their best. Police, too, he says.
This is his second resus today. I smile at him. 'Jonah' I say. This is my first ever. I wonder if I'm doing it right.
I look at the man's face. His skin is as grey as his long greasy hair. His eyes are like doll's eyes, dilated, immutable. There is nothing in this pub, not me, the TV, the noise of the drinkers or the buzz of the crowds outside that can reach him now.
We work for half an hour but the heart rhythm remains unchanged. A paramedic arrives and unpacks his kit but notes the time and declares the scene moments afterwards. The police arrive and clear the pub. I bring the trolley in as a policewoman searches his pockets for identification. She also takes his rings off and puts all his property in a bag. We lift him onto the trolley, and disguise the fact that he is dead by putting an oxygen mask on him, the blanket up to his chin. We wheel him out into the sunny, Saturday afternoon.
The landlord thanks us for our help as we leave. I know that he's lost a fair bit of money this afternoon, but he hides his frustration well.

Behind us, the bar staff clear the dead man's drink.

Monday, October 09, 2006

Resurrection

I knock once and then test the door. It's open. Calling 'Robert?' and 'Ambulance' we step into the flat. The first thing I see are a pair of legs in a room off to the left, and then as we push our way further inside, the whole man, lain out on his back on the dirty brown carpet, his shirt off, his arms outstretched, his head turned to one side, spread out like the martyred lord of all studio flats.
I step quickly across to him, kneel down and say loudly 'Are you all right?' into his ear. I pinch his earlobe. No response. 'This is for real' I think, and am just about to check his airway when F. leans in and rubs him vigorously with his knuckles in the centre of his chest.
Robert grimaces and opens his eyes wide. 'Ow! What did you do that for, man? That really hurt.'
'We were worried about you, Robert.' And then, covering my surprise. 'We didn't know if you were alive or not.'
'But you didn't need to do that. Why did you have to hurt me like that for? Fuck.'
F. withdraws his rough healing hand. Robert sits up. An invisible cloud of rancid sweat and alcohol rises up with him. There are several little bottles of pills on the floor next to him, some empty, some half full. I pick one up and ask him what he's taken.
'Who cares?' he says, swatting the question away. His eyes are fat, and there is a line of dried red wine running from the corner of his mouth to his ear.
'We care, Robert.'
'Just leave me alone. Just get out and let me die.'
'We can't do that, mate. We need to know you're okay.'
The room has so little in it, it seems emptier than if it were actually bare. A television in one corner. A sofa, an armchair, a bookcase with a packet of cigarettes and a mobile phone. Two dumbells on the floor. Every piece of furniture, even the paper on the walls, seems to be losing its light to the corrupting brown tide of this carpet. Robert suddenly looks up at us.
'What do you want with me?'
'We want to help you, Robert. We think you should come with us into the ambulance so we can check you over, and then maybe come to the hospital.'
'I'm not going. I just want to die.'
'Who called us, Robert?'
He passes the tip of his tongue over his chapped lips and then says quietly:'I did.'
'Well, then. That makes me think a part of you really doesn't want to die.'
He follows the logic of this, through a fog of nausea. Then: 'I couldn't hurt my parents. It would kill them.'
'So for their sake, come with us to hospital. Give yourself a chance. Give them a chance. And then take it from there.'
Robert rubs his chest. 'Okay. First I need a piss.'
We help him up, and he staggers off into the bathroom. Whilst he's in there, above the torrent of his urine, I hear him muttering intensely: 'I’m going to hurt someone tonight,’ he says, ‘I’m going to fuck someone up. Badly. Two hits.'

Out in the ambulance F. drives and I sit in the back. Robert refuses to give me any other details, not his last name, his date of birth, his GP. He lies back in the seat with his eyes closed and his forehead crossed with uncomfortable thoughts. I ask him a few times if it would be okay for me to take his blood pressure and other obs, but I'm cautious. He's been co-operative up until now, but I don't want to provoke him.
The journey to hospital is short. I wake him up when we arrive, and when F. opens the doors we help him down into a chair and wheel him in. I handover the details to the nurse in charge who listens with a blank face.
‘Last name?’ he drones. I tell him that he would only give me his first name.
‘Cubicle Three,’ he says with a sigh. When we wheel Robert past the desk, he looks up sharply and says: ‘What’s your last name?’
Robert makes a drunken pantomime of ignoring this question, but the nurse suddenly stands up and says: ‘Hey! Give me your last name.’
Robert says ‘Redland’
‘Redford?’, he snorts, ‘Don’t tell me we’ve got Robert Redford in tonight.’
‘Redland’, says Robert again. I’m astonished he’s being so coherent and submissive.
‘Okay Mr Robert Redland.'
We wheel him to Cubicle Three. Robert slumps back into the chair and puts both hands over his face.
As we pass the desk the nurse in charge says: 'There’ll be someone over in a minute.' And he writes his name up on the board with a fat blue marker.