Thursday, November 08, 2007

coming up for air

I slow down as I turn from the main drag into the street, shut the blue lights off, creep along on the lookout for a man on the pavement. Then up ahead, the familiar one hand waving, one hand holding a mobile phone to the ear; I sprint up to him, grab the torch, and we both climb out to see what’s happened.

The man who is patting his mobile phone away has the sharp chin and tailored suit of a model. This could be a photo shoot, if it was not past three in the morning, in the freezing dark, by a figure groaning up against a wall. The man’s demeanour is equally clean.

‘Thank you so much for coming. This is how I found him. It looks as if he has a nasty head injury. He keeps saying he’s been assaulted.’ And then he adds, as a favour: ‘I’m sorry, but would you mind if I carried on my way? I’m already disastrously overdue.’

I wonder where he could possibly be headed – but smile and thank him for his help. He clips smartly away, and we turn our attention to the patient.

He is curled on his side in a semi-foetal position, making a mewling noise, and screwing his features up into a childish expression of the hurt done to him. Rae tries to get him to talk, whilst I use the torch to look him over and establish the nature and extent of his injuries. He has a small gash on the crown of his head and some minor abrasions on his torso, but nothing serious. He reeks of alcohol and unwashed clothes; on the face of it, here is a drunk who has fallen and caught his head on the wall, but we need to find out more.

‘They beat me up! They beat me up! Why would they do that?’ he cries. But, strangely, his tone then turns completely around in an instant and he says, quite conversationally, ‘You seem nice. Do you like what you do for a living?’

We help him to his feet, and he stands competently enough.

At this point the police arrive in two cars, and the scene takes on a much brisker, more official demeanour, with blue and white police tape around where the man had been lying, and someone with a notebook writing things down.

‘What are the nature of the patient’s injuries?’, a policewoman asks me. ‘Was he attacked? Is he going to hospital?’

I tell her that we’ve found out his name – Darren – but apart from a rough outline of his injuries, we haven’t found out exactly what happened to him yet. I tell her that we’ll give him a thorough examination on the vehicle and let her know. We half prop, half pull him up the stairs of the ambulance and sit him in a side seat.

He is effusively grateful. I keep having to tell him to keep still whilst I take some obs and begin cleaning his head wound. His behaviour is bizarre – obviously influenced heavily by alcohol, but something else, too. Drugs? Head Injury? He certainly struggles to answer any of our questions, but instead repeats himself constantly, telling Rae she’s nice and asking her if she likes her job. He also drops into a clownish version of despair every now and again.

‘Why would anyone want to beat me up?’ he wails. ‘Why? Why?’

And then, smiling, as an afterthought, brushing some bloody hair from his face: ‘It’s so important to like what you do.’

Just then another policeman knocks on the door, and asks me to step outside for a moment. Rae is happy to carry on with the examination, but as I get up the policeman gestures for the policewoman to take my place. He obviously has some concerns, so I swap places and jump down to talk to him.

‘I know this guy. He’s a piece of work. He lives in a lovely house just round the corner. Absolutely loaded. Used to be a diver, working rigs in the Far East, Africa – you name it. I’ve been out to him a couple of times, always domestic violence. He’s got several convictions for assaults and generally drunk and disorderly.’

When I re-open the back of the vehicle, Rae gives me a look to let me know that although she hasn’t got the whole picture, she understands that a police escort in the back is necessary. I shut the door again and we set off for the hospital. I can hear Darren telling the policewoman how beautiful she is, and then in a moan that he hasn’t done anything wrong.

At the hospital it transpires that Darren is known to the staff. Another regular to add to the list. One of the nurses tells me that I should see the CT Scan of his head one day. Apparently his ventricles are so dilated by the effects of alcohol abuse it’s like someone’s been at his brains with an ice-cream scoop.

‘It’s a wonder he can function at all,’ she smiles.

As we wheel him into a cubicle, Darren raises himself up on his forearms. He looks up at the policewoman and squeezes one eye shut in the gross approximation of a wink.

‘We had a job once. In Japan. No-one knew a thing about it. We had to locate four hundred tonnes of gold bullion. We stayed in that chamber a month.’

He settles himself back down onto the trolley.

‘You’ve got some stories,’ the policewoman tells him. But he looks back up at her, without the slightest recognition at all.

Friday, November 02, 2007

moving on

Red car. Man slumped at wheel sounds interesting. It’s a minute from the ambulance station, too – a rough strip of road that cuts through a spread of allotments just above the cemetery, a rat-run between main routes. It’s the city’s shabby little version of Mulholland Drive, with sheds instead of penthouses; at night it’s like flying out above the city towards the sea.

Just as Rae turns the engine over and I write down the incident number and location, Control tells us that the police will be attending. At the same moment a patrol car rushes past the station exit up the hill.

‘Damn’, says Rae. ‘I wanted to get there first.’ She slams out of the car park and away after them.

Turning into the Drive I can see the splashing blues of the police car a little way off in the distance. As we careen along the poorly lit road, our blue lights tag after theirs, and we become mad paparazzi in the dark, wasting our film on some chain fencing, a group of kids, that tree.

They pull over behind a sports car without lights on the right hand side of the road. Rae hauls up immediately alongside. If the man has had a heart attack, time is everything, and we can worry about parking niceties afterwards. We both jump out. There’s a policewoman standing at the driver’s door. Rae goes to that one, and I pull open the passenger door and look inside.

As always on an incident – especially with high adrenalin calls, and especially at night – the details come to you in bursts. The challenge is to make sense of the scene as calmly and quickly as you can. Simple questions: Is there danger here? What’s happened? But although simple questions work best with simple answers, it’s an effort of concentration to ignore the peripheral and make straight to the essential.

In this case, the essential seem to be: a middle-aged man with facial injuries, conscious and breathing; car cold and not smelling of fumes; no sign of weapons.

Rae is the other side of him, now. We have him in a cramped little cross-fire of inquiry, both verbal and non-verbal. A torch to have a good look.

He smells of drink. I’m about to kneel in a pizza box. The back seat is rammed with clothes, other stuff. He can tell us his name, but is disorientated and slurred. Drunk? Or head injury? Is he sleeping rough in this car and has been beaten up? By those kids we passed?

A second patrol car has arrived. They are standing outside the car, one on the radio trying to get information on the licence plate, the others chatting about other things. There is a palpable sense of stepping back two or three levels from screaming emergency to Thursday night mystery. Who is he?

We help him out of the car. He is a heavily built man with a coarse goatee beard and an Eastern European accent. He is dressed like a shabby professor in a T-shirt that says: Don’t ask me to do anything. I’m retired, beneath a brown corduroy jacket.

‘I’m okay,’ he slurs, almost falling backwards as we manoeuvre him up the back step into the ambulance. We sit him down, shut the door, and take a breath.

‘Now then, let’s have a good look at you.’

His facial injuries are old, probably a few days, but it does look as if he had a beating. His nose is certainly broken. And he is definitely drunk. He has that slow, deep-and-off-to-the-side detachment from everything. He looks at his hands to move them. When I ask him for his surname he spells it out one fat letter at a time as if this is the first time he has ever really considered what his surname was or could mean.

‘B-u-r-o-w-s.’

‘Burows?’ I say, just as he continues with a K and an I.

‘Burowski?’

He nods. We have arrived somewhere awful and he squeezes his eyes. Another policewoman looks into the back and tells us that they have to go off on another call and are we okay? I tell her we are. She shuts the back door again, and we are left to piece his story together.

He is from Poland. He has been living in the city for ten years. His girlfriend has left him. His friends – he shrugs. His life – he makes a sad little gesture with both hands down towards the floor, like a man in handcuffs being dragged down a well. He had an accident three days ago and was in hospital until this morning. He is sleeping in the car. He thinks he’ll call his brother in Poland in the morning. Maybe he should move back there.

He looks steadily at me as I undo the blood pressure cuff.

‘You came at the wrong time,’ he says.

I tell him that we think he should come with us to hospital for observation, because he’s had a recent head injury and we can’t be sure that his current condition is solely due to alcohol. But he does not want to go to hospital. He wants to get back into his car and go to sleep. So reluctantly we end up helping him back off the vehicle, and when we say goodbye he is standing with his driver’s door open, nodding a farewell – which would, in any other circumstance, be a normal scene, except here when we leave it will be very dark, and the night is coming down cold, and all four tyres on his little red sports car are flat.

Thursday, November 01, 2007

drain

‘Don’t you dare look at me – aren’t you nice? – you’ve seen worse - I haven’t got my teeth in – toy boy like you – what’s your name? – I had a man who wanted to see me again – he was only forty four – I said I’m seventy three – he said I don’t care - just don’t look at me – oh, I do feel dizzy...’

We are sitting like disciples around her, Rae, me and the psychiatric nurse who called us out this morning. We nod and smile sympathetically, but we are mutely aware that our collective life force is being leached away by this woman. If people can really be classified as either radiators or drains, this woman is an oceanic trench. Her monologue is a hypnotically plosive drone, her wrinkled mouth wobbling around the words, her light blue eyes flicking open only occasionally to see if there are still people alive in the room.

The psychiatric nurse smiles at us, and taps her diary encouragingly, directing us back to the idea that time still exists outside this room.

‘Dotty did seem a little breathless and out of sorts when I got here. Sorry if I’ve called you out unnecessarily.’

She opens her diary and writes something in it. I hand Rae the blister pack that contains all Dotty’s medication so she can write it down on the patient report form. There is a crudely written note by the pack – a list of things to do. At the top of the list is 'put teeth in mouth'.

I stand up and approach Dotty to make the serial observations; I feel like an astronaut, bravely alone, moving towards the thrumming source.

‘…That’s the first time I’ve been touched by a man in a long while – oh, I’m getting a funny feeling in my arm – should I take my top off? - my first husband didn’t want to know – left me alone – not this house, another one - when I had my first he was nowhere – it was supposed to be the last baby on Christmas Day – they said ‘when’s it coming then, Dotty?’ – I said, 'there’s something not right,' – I could feel the elbows digging in – then it was the next day – and the next – no-one listened to me – no-one believed me – and then when it came out it took most of me with it – I was in for weeks – stitched me up with an infection and everything turning black…’

Occasionally Dotty pats her head, which is tightly wrapped in a transparent plastic bonnet. It’s as if you can see her brains – yellowing, tightly curled. Her hands are a puffy red, because she spends most of her day at the sink continually washing them.

I finish the health check and everything is fine. Rae patiently begins the build-up to our leaving, weaving in little encouragements and pieces of advice between Dotty’s constant output.

‘….what if I go unconscious? – what happens if I fall over? – at least you didn’t leave the door open – I used to have a dog, but he ran away – the last ambulance who came out left the door open – they pulled faces at me and didn’t give a damn – you’re all nice, though – especially you – oh, listen to me – did I say that? - everything’s swimming – I suppose you’re going, too, now….?’

I pack our equipment away and back away, nodding and smiling, through the door. The psychiatric nurse, clutching her diary like a bible, throws us a brave smile as we go.