Wednesday, December 24, 2008

Happy Christmas!

Thank you all so much for reading my blog through the year, and for all your comments and support.

I hope you have a great Christmas, and a wonderful New Year.

With lots of love, SK xx

Monday, December 22, 2008

losing it

Richard is flat on his back, on his flattened backpack. The weight of his fall has spilled the contents around him – little square sticks of pastel colours, a tin of fixing spray, a notepad and graphite pencils. Many of the pastel sticks have fractured, and their richly coloured dust stains the carpet where his feet and legs have moved over them.
‘Excuse me stepping over you, Richard.’
There’s no other way to get into the flat, he’s so close to the door. Frank stays the other side. We both crouch down to him. His girlfriend, Marie, steps over him, too, and goes to sit down on a computer chair near his head. Her black mascara has mixed with her tears, giving her face an expression of molten anxiety.
‘I thought he was dead. He came back from shopping, he stood there in the doorway, he said “Am I losing my mind?” and then just collapsed. I didn’t know what to do. He went all blue. He was shaking. His eyes were just all wrong. I was terrified. Rich – you terrified me.’
‘Sorry. I’m all right now.’
‘Richard. Did you hurt yourself when you went down?’ I check him over but he seems fine.
‘Really. I don’t need you here. I didn’t call you.’
‘You couldn’t call anyone, Rich. You were dead. I was shit scared. I thought I’d lost you.’
He lies quite still, his eyes open, idly surveying the ceiling. A slightly built man in his mid twenties, pale cheeks, wide brown eyes, dark curly hair and a sparse goatee coiling from the point of his chin - he seems strangely out of time, like a seventeenth century courtier crash landed into black jeans and t-shirt.
‘I’m fine. Really.’
He crosses his legs and arms, and wriggles a bit on the backpack to get comfortable. ‘I’m not going to hospital.’
Marie stands up and moves over to the window.
‘You fucking better not do this to me!’ she wails. ‘You fucking better not! If you die I’m going to kill myself. There’s no-one else I care about.’
Rich raises his eyebrows. ‘I’m not going. I don’t have to.’
‘Well let’s think about that in a little bit,’ I say, unpegging the sats probe from his finger and noting the results. ‘How are you feeling right now?’
‘Fine.’
‘Any pain?’
‘No.’
‘What can you remember?’
‘I ran up the stairs. I opened the door. I had this strange feeling in my head, like a zoning out. Everything felt stuffed up, yeah? Really close, but kind of hollow. I do remember saying “Am I losing my mind?” – because I felt like I was. Then the next thing I remember, you’re looking down at me. And that’s it. But I’m fine now.’
He pauses, licks his lips. Then without moving his head he turns his eyes up and raises his eyebrows again, as if he wasn’t talking to Marie so much as to a vision of her, he says: ‘Did I really go blue?’
‘Yes you fucking went blue. I never want to see that again. It was so, so scary.’
‘Well you did absolutely the right thing in calling for an ambulance,’ I tell her. ‘Marie, describe for us exactly what you saw when Rich collapsed.’
She describes what sounds like a tonic clonic fit.
‘Do you suffer from epilepsy, Rich?’
‘No.’
‘Ever had a fit before?’
‘Once. A month ago.’
‘And what happened with that?’
‘Nothing. I went to hospital. They let me go after an hour. Didn’t say anything.’
It doesn’t sound plausible, but I let it go.
‘What medications are you on? Any?’
‘I take a few things for depression. Well – I did. I stopped taking them last week. I didn’t see the point.’
‘Rich – what I’d like to do as a first stage is to get you out on to the ambulance so we can run a few tests. I promise we won’t do anything you don’t want to do. And we certainly won’t kidnap you. You don’t have to go to hospital if you don’t want to. But I have to say that I would strongly urge you to come with us today. It sounds like you may have had a fit, and I don’t know why. Imagine what would have happened if you’d had this fit alone. Imagine if you’d collapsed here today and Marie hadn’t been around to look after you. You could’ve died.’
‘I don’t care. I’m not going to hospital.’
Marie lets out an anguished moan. She pulls a crumpled leather sack towards her, dumps out the contents and paddles around in the debris for a pack of cigarettes and a lighter.
Rich laces his fingers, gently rubs his thumbs together.
‘I don’t have to.’
‘Well let’s just get down to the vehicle and do some tests. Okay?’
‘Fine.’
He rolls over and stands up in one clean movement, then – seeing the pastel crayons spread over the floor – begins to gather them up. He insists on sorting them right way up into the tray of a neat little portable wooden easel that he takes out of the rucksack. Marie watches him, alternately smoking the cigarette and biting the quick of her nail.
Job done, Rich wipes his hands on the back of his jeans, then turns to walk through the door. Suddenly, he stops to pick up three carrier bags.
‘I may as well take the recycling out,’ he says.
And just by the front door, without even seeming to look, he drops the plastic, the cardboard and the paper into their respective green bins.

Saturday, December 20, 2008

uncle ted?

Michaela has arranged herself on the sofa, Swanson-style, her white silk chinoiserie gown crumpled around her with meticulous abandon, her dry hair sprouting out like thatch from beneath an alice band she looks to have stolen from a barrel maker. Her legs are Ice Age in their hairiness: she has one hoofing great foot placed flat on the carpet, the other up on a low leather pouffe, the big toe of that foot oozing blood from the nail.
‘Hi guys,’ she rasps, ‘thanks for coming. I don’t want to waste your time, but I didn’t know what else to do.’

We have run from the other side of town on one of the busiest nights of the year. Traumatic haemorrhage / lacerations. Downgraded from Category A to B. And then in the notes: Torn toe nail. Control were as embarrassed to send it as we were to receive it, but their best efforts to PSIAM the call had failed, and we were required to attend.

I put my bag down next to the pouffe and kneel at the altar of pointless calls.

‘How did this happen then, Michaela?’
‘Well. It’s all so stupid. I feel such a fool. I was cutting my nails, and I seem to have overdone it on this one. I’ve been having problems with my leg ever since I was beaten up at a fairground ten years ago and had my hip pinned. It’s been a long haul. I’ve got such a lot going on with me.’
‘Such as?’
‘You’ll have to look at my folder. I’ve no idea. But it’s all there.’
‘Where’s your folder?’
She waves vaguely over to the kitchenette. ‘Over there somewhere. By the drug safe, maybe. You’ll see it.’
Frank goes over to look. I put an inco pad underneath the foot to protect the pouffe, then investigate the wound with a syringe of sterile water and some gauze. The nail has split vertically from the root, leaving about half in situ.

‘What will happen to me? Will I need surgery?’

At this moment the flat door is flung aside and a large man hurries in, looking like a six foot toddler in multi-coloured dungarees, a banana yellow t-shirt and red leather boots. His hair is as curly as Michaela’s is straight. They look as if they have pulled costumes from the same dressing up bag.
‘What’s up, Mikey? Everything okay? I saw the ambulance!’
‘Everything’s fine, don’t panic,’ I tell him. Michaela slumps back on the sofa and puts the back of her hand to her forehead.
‘I didn’t want to bother anyone,’ she says. ‘I just felt so – helpless.’
‘Why didn’t you call me?’
‘I didn’t like to. You know me. Soldiering on.’
The large man looks at me earnestedly. ‘Please. If there’s anything I can do to help. Anything at all. We’re all really so grateful you came.’
‘Yes. They’ve been absolutely marvelous,’ says Michaela, brightening. ‘So – good looking, too.’
‘Well if there’s a silver lining, darling, you’ll find it,’ the large man says, pushing some sweaty bangs back from his face and blowing out his cheeks. ‘God, you keep it hot in here.’

I dress the wound.

‘Michaela – there’s not much to be done with this. I’ve cleaned it and put on a temporary dressing which should keep you going tonight. Then first thing I want you to go to your GP and see the practice nurse to get something more permanent sorted out. And maybe see your GP about your ongoing problems.’
I look over to the kitchenette. Frank is thumbing through a thick yellow care folder. He smiles at me as he turns another page and writes something else down on our form.
‘Don’t I need a new nail or something? Plastic surgery?’
‘It’ll grow back before you know it, so – no – I think you’ll be fine.’
‘I simply didn’t know what to do.’
‘Try to bear in mind that the ambulance is really busy, especially at this time of year. I don’t think this really needed us coming out to you.’
‘I’m so, so sorry for wasting your time.’
I tidy up. Frank comes over and hands Michaela the non-conveyance form which she signs with a grand, stage door flourish.
‘Once again – thank you both so much for racing to my rescue,’ she says, giving me back the pen. ‘It means such a lot to me.’
‘Okay. Just – take it easy with those clippers.’
‘I’d get somebody else to do it, but my feet are too ticklish.’
‘Bye then.’
She smiles with as much warmth and breadth as her layers of foundation and blusher will permit.
‘I promise I’ll hold back in future. But if I thought I might get you two again…’ She lets the idea hang in the air with the scent from the apple and cinammon candles on the mantelpiece; but when she drops her head coquetishly, by the candles’ flickering lights she suddenly reminds me of my dad’s eldest brother, Uncle Ted. With his toolbox head, spade hands and flat nose, that old army boxing champ and P&O steward would struggle to look alluring, too.

Wednesday, December 10, 2008

a difficult man

We are waved over to the corner bungalow of the close. It’s a tight squeeze past a builder’s lorry; a Desperate Dan lookalike in cement spattered tracksuit bottoms, check shirt and woolly hat, folds back the offside mirror so we can squeeze past. He nods sternly as we roll by, gives us a mug-at-arms salute.

The door to number 9 stands open. Outside are two elderly women. One of them is sitting on a low garden wall. She looks pale and distressed. The other is standing beside her with a hand on her shoulder. From this slightly tentative contact I would guess that they don’t know each other that well.
‘Are you okay?’ I ask the seated woman.
‘I’ll be all right. I just can’t stand the sight of it. The smell. Urgh.’
‘He’s in the bedroom on the floor,’ says the other woman, a thoroughly tweeded specimen with metallic white hair and a frank smile. ‘I think he’s been there some good while.’
‘Any relatives around?’
‘No. His sister lives up country somewhere. He’s a difficult character. Doesn’t want help. Unfortunately he’s put a good few people against him in the close.’
I walk inside.
George is lying on his front on the floor of a cluttered little box-sized bedroom, in the narrow space between the bed and the wardrobe. One of the ladies has draped him with a blanket from the bed. Carefully I pick out a place to stand near his head and squat down.
‘George? George? It’s the ambulance.’
He seems utterly inert. I pull back the blanket to check for breathing – and yes, there is some minimal stirring there. He is wearing a cardigan and shirt, but his bottom half is uncovered, with his trousers and pants down by his ankles. His skin has a dreadful, mottled white appearance, ice-cold to the touch. Then – inconceivably – he moves his right arm and lets out a noise, a thin, spidery scribble on the surface of the air, the kind of noise a spirit might make, reaching across the void to contact the living.
‘George. Have you hurt yourself?’
I’m worried that he’s fallen and injured his neck, but he can’t tell me, and a quick examination doesn’t seem to cause any pain. He needs oxygen, warming, lifting off the floor, getting off to hospital as quickly as possible. I ask Rae if she could bring the scoop stretcher and get the trolley as close as possible to the door.
I get some oxygen running, cut off his trousers and pants, put a thermal blanket sandwiched between a couple of ambulance blankets over him, then stand up to plan the route out. It’s a logistical challenge.
I clear a space at his head and feet as best I can, carrying a mahogany cabinet out into the hallway, lifting a rickety white wooden occasional table and all its contents up into a far corner of the bed. Rae comes in with the scoop and shuts the door behind her. She estimates George’s height, extends the scoop, unclips it along its length and hands me one half. I place it on the floor next to him, we roll him gently up onto his right side and over onto his back, raise him up again sufficiently to slip the other section in, then snap the two halves back together. We attach straps to keep him in place, lift him on to the bed, then I stay with him there as Rae opens the door again. The angles are such that we just have enough room to scrape through into the hallway and then on into the garden, the trolley waiting on the pathway, head towards us.

The elderly woman on the wall has gone. The other woman is still there. As we pass I ask her to get together as much information on the patient as she can; she hurries away to do that.

Once on the ambulance we take George off the scoop, snapping it apart, Rae taking it to stash away. I reposition George’s oxygen mask again. It keeps riding up because the left side of his face is flattened, rubbed red and raw by the pressure of his time on the carpet. It has left him with a tortured expression, like a man caught in the side of the face by a sulphurous blast. In fact, he has terrible pressure sores all over his body, just as if a devil, to illustrate the poor man's agony, had pressed a flaming brand to each point of contact, and then – as a ghastly flourish – destroyed his penis, blackening the foreskin to the root.
Rae steps back aboard and we work quickly around each other. I cut his arm free of his cardigan and shirt, wrap the blood pressure cuff on him, attach the sats probe. His temperature is unreadable, his blood pressure so low it’s a miracle he can make any noise or movement at all. Rae cannulates his right arm with a large bore cannula, I prep a warm bag of CSL and unwrap the giving set.
There is a knock on the ambulance door. The elderly woman has returned with a piece of card she has torn off a cereal packet. On it she has written the two things she has found out: his approximate age, and the phone number of the woman who helps him with shopping once a week. We thank her for her help.
‘Is he going to be all right?’ she says. ‘I’m sorry we weren’t able to do more, as neighbours. You know. But he was just – is just – such a difficult man.’
‘Don’t worry. We’ll do what we can. Thanks again for helping out.’

Rae passes the ASHICE through to control, and we head off. I reposition the oxygen mask again, and stroke the hair from his face. His one good eye opens, then closes again.

He dies in MASU a few hours later.

Saturday, December 06, 2008

mixed

‘He’s a very sick man. Very sick. He’s been throwing up blood. He’s got an ileostomy, angina, rheumatism. He’s in and out of conscious. He was only discharged from hospital three days ago. He’s an alcoholic. Ten years ago he had a breakdown. Five years ago he had an operation on his foot. He takes a hundred different medications. It’s a miracle he’s here at all. Isn’t it, Bob?’
Bob raises his eyebrows. He is sitting under a bare duvet on a mushroom coloured sofa, looking so comfortable you would think the chair had grown up around him, like an old tree enveloping a metal post.
‘How are you feeling, Bob?’ I ask him.
‘Fine,’ he says. He certainly looks okay. ‘Absolutely fine,’ he says. ‘I didn’t want the ambulance.’
‘Have you been throwing up blood?’
‘No.’
‘So who called the ambulance?’
‘I did. I called the ambulance. Bob’s a very sick man and he just won’t admit it.’
The woman sits on a facing sofa with an obese Staffie behind her like an over-stuffed novelty cushion. The dog gives me the eye, and so does the woman.
‘Excuse me just a moment. Can I ask what your name is, and what your relation is to Bob?’
‘My name is Liz. I’m Bob’s carer.’ She scrapes her greasy hair back from her face as if she’s streamlining herself for a fight. ‘In fact I look after the two of them.’
The other person she refers to is sitting on yet another sofa, her hands folded in her lap, looking on the scene with a flat set to her lips. I remember being called out to her in the past – given as a Cat A unconscious, it had turned into a psych case, with the patient complaining that a neighbour had forced her to smoke crack, and she hadn’t been able to sleep.
‘So you’re not actually a relation?’
‘No. I live next floor up.’
‘But you’re an official carer for the two of them?’
‘Technically, no. But that’s what I do.
‘So Bob – you seem pretty compos mentis to me. Are you capable of making decisions for yourself?’
‘Yes.’
‘Has Liz been granted any kind of legal jurisdiction over you?’
‘No.’
I turn back to Liz. ‘Well, in that case, I need to be guided by Bob, Liz.’
‘Look. He’s desperately ill. He needs to go to hospital. He was unconscious. He takes all these pills. He recently came out of hospital. He was sicking up blood.’
‘For God’s sake! Let the man alone!’ snaps the other woman. She doesn’t move, though. She is as precariously immobile as the two garden spades incongruously propped up beside her chair. The room has the air of a well-to-do study commandeered during a time of civil unrest for use as a street-drinkers’ flop. High-end antiques and leather-bound classics struggle to maintain their identity amongst the scatterings of vodka bottles, pill packets, fast food containers and dog toys.
‘Bob. Are you in pain?’
‘No.’
‘Are you unwell in any way?’
‘No.’
‘Do you want to go to hospital tonight?’
‘No.’
‘Fine. We’ll take a few obs, and leave you in peace.’
‘This is ridiculous!’ says Liz. She stands up, strides over to a low table covered in spilling ashtrays and scrunched up tissues, and snatches up a grubby leather satchel filled with meds. ‘Just look at all these.’
‘For God’s sake! Let him alone!’ says the woman over by the spades. ‘Please!’
I take the satchel from Liz. ‘Thank you. Now - if you wouldn’t mind having a seat again and letting me get on with things, that’d be great.’
She dumps herself back on the sofa, nearly squashing the dog, who lets out a little whumping noise, and then gives me the eye again, as if him being flattened was part of my plan all along.
The meds are all mixed up: hers, Bob’s and Myrna, the other woman.
‘What were you in hospital for, Bob?’
‘The stoma got a bit infected, but it’s fine now.’
‘No discomfort?’
‘No.’
Frank quickly runs through the usual obs; they all come out fine.
‘Bob – if you don’t want the ambulance in future and someone rings on your behalf, you must try to stop them, or cancel it. It’s a waste of our time, otherwise. And someone who really needs us might suffer as a result.’
‘I know, but…’
‘So you’re not taking him in?’
‘Bob doesn’t want to go in. He doesn’t need to go in.’
Frank packs the equipment away, giving Liz a look he seems to have copied off the dog.
‘He should be in hospital.’
‘Bob – my advice is to get some rest tonight. Maybe see your doctor in the morning. Okay?’
‘Yep.’
I look across to Myrna. She sits as restrained and doll-like on her cushion as before, but it’s easy to imagine her suddenly snatching up one of the spades, swinging it above her greying head like a battleaxe and rushing at Liz. But instead she gives out a breathy little tsch, and brushes some crumbs from her lap.
Liz and the dog see us to the door.
‘Thank you for coming,’ she says. We feel the spike of their eyes in our backs as we push open the stairway door and head back down the communal stairs to the ambulance.

Friday, December 05, 2008

contagion

The sea is a sheet of liquid glass spreading in from the horizon, smooth around the worn wooden beams and concrete pillars of the old harbour wall, smooth around the pleasure boats and fishing boats riding at anchor, smooth around the jetty and the landing platforms, the steps down from the road, the ribs of ruined boats in the highest of the silt banks, black beneath the vast, shadowy bulk of the old swing bridge. The entire morning seems to leap up from this painfully bright surface; even the cormorant out near the harbour mouth has his wings outstretched, crucified by the surfeit of light.
Our patient, a middle-aged woman in a bulky blue winter coat, sits on a concrete block at the far end of the car park. She is hunched forwards like a fisherman asleep by the rod, her forearms supporting the weight of her upper body on her knees. Her left hand hangs down between her legs, fingers relaxed and open. In the other hand she has a Stanley knife.
‘Drop the knife! Now!’
The policeman who arrived on scene with us takes a step towards her, one arm out in front.
‘Drop it!’
She turns her head. Her neck is gaping open.
‘Drop it now!’
She stands up. Her coat is undone, reveals pyjamas stained with blood. She drops the knife and looks at us all with an expression as glassy as the water. Incredibly, she manages to talk.
‘Leave me here,’ she rasps. ‘I need more time.’
‘Put your arms out to the side,’ the policeman says. His hands are bare, so I give him a pair of blue gloves. He snaps them on. ‘Do you have any other weapons?’
‘No.’
He pats her down, then takes a step back to let us grab the woman before she falls. We walk her onto the ambulance and lie her on the stretcher.

She has a grievous wound to her neck, a frank, butcher’s slice that parts it neatly left to right, the adipose tissue and muscles exposed, her trachea laid open – but she has missed the major blood vessels, the other incredible aspect of this injury. As she breathes, the air rushes in and out with a gently wet flapping noise. I soak a dressing in sterile water and place it across the wound.
‘Please. Just one more minute.’
She sounds leaden with fatigue, a lumpish, domestic figure fixated on the last chore of the day.
‘I was supposed to fall backwards into the water,’ she says. ‘I have a bug in my stomach.’
‘Don’t talk. Try not to talk,’ I tell her, gently tying the dressing in place.
‘I have a bug in my stomach. My husband and daughter cleaned up a mess that came out of me, and now they have it, too. I’ve given them my bug.’
She tries to make little shakes of her head. We tell her to be still. Rae strokes her forehead like a child with a fever. ‘Ssh.’

Back outside the ambulance, the policeman asks me how she is.
‘It looked pretty bad,’ he says. ‘Was that her windpipe?’
‘Yeah. She had a pretty good go at it,’ I say, pulling off my gloves. ‘We need to get off.’
‘I’ll follow in the car.’

He tucks in behind us, a sparkling, early morning punch through the rush hour traffic back into town.

Tuesday, December 02, 2008

melissa

‘I’ve definitely been here before.’

Rae tries to remember for what as we walk up the concrete steps of the housing block. We had turned off the blue lights before we entered the estate, but the road had seemed to shiver like a tripwire; even before our bags were out, we were the multi-eyed focus of this stack of lighted windows.

On the second floor landing a door stands open. Just inside, a tall young kid of about seventeen, dressed in white trainers, a baggy white tracksuit, and a Nike baseball cap tilted up on his head, waits in the narrow hallway, cradling his right hand.
‘She’s in there, in the bedroom,’ he says. ‘And I’ve busted me hand.’
He turns, and leads us down the hallway. For a second I wonder if he’s injured his leg, too, but I realise that the stiff-hipped shuffle is a ghetto-style swagger. He shows us in to a room at the end.
‘Jayne. It’s the ambulance.’
A sickening wail rises up from a mattress on the floor. Jayne sits huddled up under the duvet, pressing herself against the wall. She holds the duvet up to her mouth, her hands either side like a tucked-up child, looking off into the shadows on the far side of the room. Her greasy hair shines dully in the light from the bedside lamp. Her face has the yellowy off-white colouring of old ivory, and her eyes are circumscribed by darkness. In front of her on the bed is a washing up bowl holding a slop of vomit, sopping tissues and a cider can. Beside the mattress is a cluster of vodka bottles. The rag rug is seeded with butts.

Rae says brightly: ‘The last time I was here you were just about to have a baby.’
The boyfriend leans in: ‘Yeah, mate, yeah. Taken into Care last month.’
‘Oh. Sorry.’
‘She’s necked all those,’ the boyfriend says, gesturing with his one good hand to a scattering of empty packets. I pick them up: fluoxetine, co-dydramol, paracetamol. ‘She also drank some bleach.’ He hands me a container of Harpic toilet cleaner. The swan-necked spout reminds me of the mouthpiece of a saxophone. I imagine putting it to my lips.

‘I’m not going to no fucking hospital. I’m not. Just leave me alone. I want to die.’ Jayne’s mouth gapes open with the grief of it all; threads of saliva quiver from tooth to tooth.
‘You’re fucking going,’ shouts the boyfriend, leaning over her, jabbing the air in front of her face with his bad hand. Then he winces emphatically.
‘God. Fuck. I won’t do that again.’
He laughs, then holds out his hand to me.
‘What have I done? Is it broken? I suppose I should’ve taken these rings off. My fingers feel like they’re going to explode.’
He has a ring that says DAD and another – a gold sovereign in a silver setting, distorted from the trauma, whatever it was. His fingers have swollen up around both of them.
‘Sorry – what’s your name?’
‘Johnnie’
He looks at me. The acne around his nose and mouth seems of a piece with the naïve clarity of his eyes. But there is something else about him, a twist of violence glinting below the surface, that makes me guarded and alert.
‘Johnnie – we’ll look at your hand in a moment. The first thing we’ve got to do is deal with Jayne.’
‘Of course. Yeah – go on, go on. You do what you’ve got to do. And you – you listen to them. They’re professionals. They know about this shit.’ His tone steps up to almost a shout. ‘Cos I’m not losing you. There’s no way you’re doing that to me.’
‘Mate – let’s be calm. You’re not going to help, otherwise. Just stand over here with me and let Rae see what’s what. Come on.’
He lets me steer him over to the other side of the room. Whilst Rae kneels down to talk to Jayne, I ask Johnnie to start gathering some things: shoes, a coat, a mobile phone, any prescriptions Jayne might have. The distraction works. He forgets his anger, and submits to the task with puppyish enthusiasm.
‘Don’t ask me where she put her trainers. Where did you put your trainers?’ he calls out. Then snorts: ‘Women.’ The word seems wrong from him, too adult, like the sovereign ring on his hand.
‘So tell me what happened to you?’
‘Shit. Some guy came to the door. An intruder. I don’t know. Never seen him before. A skinhead. I asked him what the fuck he wanted but he didn’t say nothing, he just tried to push past. So I battered him in the face. Like anyone would, fighting for their life, you know? I mashed him up proper. He fell backwards into the hall, and then he ran off. Look at this. It’s fucked, isn’t it? I’ve broken my hand, haven’t I? Christ – I can’t even turn it over.’
‘Did you call the police?’
He laughs. ‘The what? No mate, I don’t need no po-lice. They’re no good.’
‘Anyway. Those rings will need to come off, Johnnie. They’re cutting off the circulation.’
‘I can’t do it, mate. I promised my Dad I’d never take this off.’
‘Well I think your Dad would understand. And a good jeweller could repair it.’
‘Yeah? Hey – here they are. I’ve got your trainers, babe.’
He snatches them up and we both go back to the mattress.

Rae has persuaded Jayne to come to hospital. We help her to stand up, dress her in a parka coat and trainers, and walk her out to the vehicle between us. Johnnie follows behind, giving us an excited commentary on the skinhead in the hallway, what he did to him, what he will do when he finds out who he is.
‘No one does that to me. Especially not tonight, not with all this.’
We make Jayne comfortable on the stretcher. Her obs are good. Although she doesn’t tell me outright, I know that Rae doubts the number of tablets taken, the story about the bleach.
‘Here. Look at this,’ says Johnnie, carefully rolling up the sleeve on his injured arm. There is a tattoo of a girl’s name in elaborate, copperplate style - Melissa – with a date. ‘That’s when she was born,’ he says. ‘They let me cut the cord and everything. Fuck me, it was tough. That whole time - it was amazing. The way the head came out looking one way, then turned, like that…’ he does a comical, stiff necked turn to the left, ‘just like someone was inside, moving her. But of course they weren’t. I wouldn’t have missed that for the world.’ He cradles his damaged right hand in his left, then says in a different, quieter voice, half to himself and half to Jayne: ‘We’ll get her back. I promise you. We are definitely going to get her back.’

Wednesday, November 26, 2008

think of a name

‘Fuck off, Bizzies.’
‘It’s the ambulance, not the police, mate. We’ve been called to make sure you’re all right. These people here saw you slumped in the doorway and they were worried about you. As soon as we know you’re okay, we’ll be out of your hair.’
It really feels as if we are just like the leaf litter and twigs caught in his hair, an apocalyptic, sugar-watered, crow-black Gothic pile that makes his head seem roughly the height of his torso.
‘What’s your name, for starters?’
‘Fuck off, Bizzies.’
He lowers his eyelids and smirks; the effort of co-ordination involved in that has him sliding back down the shop doorway into a heap.
‘Come on, mate. Try to keep with it.’
The two people who called us are standing watching.
‘I didn’t know what to do. I thought he might be dead,’ says one, a fifty year old woman, hugging her shopping bags to her middle like they were children. ‘Do you think he’s on drugs?’
‘Well I don’t know about that. He smells as if he’s had a few drinks, though.’
The other one, an intense young woman in a beret and glasses, frowns. She still has her mobile phone in her hand, and I wonder if she’ll be tempted to take a few pictures.
‘Will you come on to the ambulance with us so we can reassure ourselves you’re fine?’
‘Fuck off, Bizzies.’
‘That’s not very nice, is it? We’ve stopped by to help, these people here have gone out of their way to make sure you’re okay, and all you can do is say “Fuck off, Bizzies”. How rude.’
‘Fuck off, Bizzies.’
‘Okay. Let’s try standing up, shall we?’
The middle aged woman takes an alarmed step backwards, but beret girl grips her phone with great resolution and leans in.
‘I think we’ll be fine now. Thanks very much for your help.’
The two women seem nonplussed.
‘Honestly. We can manage now. Thanks for calling.’
After a pause, they swap a confederate look of disappointment, then disperse East and West down the High Street.

Our patient is tall but lean. Standing him up is like helping some gigantic, alien fern to unfurl. He rises up between us, his dark-eyed pallor as much a part of his look as his pointy boots, drainpipe jeans, Fields of the Nephilim t-shirt and black jacket.
‘Fuck off, bizzies.’
‘Yeah. I think we’ve moved on from that one.’
He staggers between us to the ambulance and we load him on board, where he submits with haughty amusement to our checks.
‘Still not going to tell me your name?’
‘Ben. My name is - Ben.’
‘Right. Good. Okay, “Ben”. How are you feeling? Are you in pain? Have you hurt yourself? Tell me what’s been happening with you tonight.’
‘Fuck off, bizzies.’
‘All right. I don’t think we’re going anywhere with this, are we?’
I look at him. His pupils are wide and slow with drink. His obs are fine. When I ask if he wants to go to hospital he simply stares at me, his head moving as if his neck has been replaced by a large spring.
‘Can we do anything for you tonight? Or shall we simply release you back into the wild?’
He snorts. I make a quick grab for a bowl, but it really is nothing more than an attempt to show the level of disdain he has for this whole scene.
‘Come on then, Ben. Out you come.’
He steps off the ambulance, then – just as he seems ready to lurch away down the high street – he turns and comes back at me, holding out his hand for me to shake.
‘I love you,’ he says. ‘I really, really love you.’
‘Great. I love you too, Ben.’
Then he’s gone, riding the bucking pavement, using shops and rubbish bins to keep him on track.

I see a couple of young girls a way up ahead stand aside to let him pass. One of them turns to track his route back along the road; the power of her inquiry when it reaches us is like a wave crashing over the ambulance.

‘Fifty fifty we see him again sometime tonight. Those boots, sticking out of a paladin.’

But we don’t.

Tuesday, November 25, 2008

looking at monsters

The brave quartet turns to face the medieval gateway, waiting for the monster to appear. Close-up on their faces: half-open mouths, widening eyes, hands reaching for other hands. And then the monster does appear, a howling, black-cloaked figure coalescing out of vapours, roaring and clawing at the air, its face a mask, its teeth like stitches.

Chloe sits next to me on the sofa, legs tucked up into herself. She quickly presses a cushion to her face and tells me to turn the TV off.

‘But see – Chloe – see how Sarah Jane keeps looking straight at the monster. She’s scared, but she knows her best chance is to keep looking. That way she’ll be able to figure out exactly what the thing is. She knows it’s only by looking straight at it, it’s only by keeping her eyes open and figuring out what to do next, will she have any chance of winning. Chloe. Because although it’s scary, it’s still just a thing, in the same way a dog’s a thing, or a ladder, or a car. Say a big dog suddenly appeared in the gateway. You’d be better off looking at it, thinking about what it’s capable of, and then acting on that. So really, it’s good to look at these things – especially the things that scare you. Because then you’ll be able to see what needs doing.’

Chloe lowers the cushion. Together we watch the scene play out, watch Sarah Jane challenge the demon figure, and use her wits to send it back through the gateway. Cue music and titles.

**

A few days later I get the letter I’ve been waiting for, the results of the paramedic assessment day I sat last week, the first stage of the application process for the next university cohort.

It’s a thin letter.

I rip it open with a sick feeling. It’s all laid out coolly and plainly. I failed two of the four components. I won’t be called for interview.

I spend the next few hours trapped in caves of disappointment. Voices and echoes, sickeningly familiar, some I thought I’d heard the last of, some I knew were sleeping like viruses, ready to be activated when conditions were right. How could I have failed? Easy. I fail often. It’s the one thing I’m reliably good at. What must people think of me? What must they think of these crosses I’ve got to tote around with me now? These crushing dismissals? Even the trainees I helped find their feet have moved on. In a panic I see myself left behind. I thought I could simply strike into the next phase any time I wanted, but in reality I can’t. What else do I feel confident about that’s actually hollow, maybe even rotten, in the same way?

Eventually the crisis precipitated by the letter levels out, the sting of it eased by my family and friends. And it helps, too, to remember that night on the sofa, Chloe dropping the cushion from her face to look at the monster straight on. She’s seven. If she can find it in herself to confront whatever it is coming through the gateway, to see for herself what it really is, then - well – I’d better just get on and learn from her, and do the same, too.

Saturday, November 22, 2008

the getaway

Clothilde sits slumped in her wheelchair, the despondent centre of a Glade-scented hurricane of concern.
‘We’re very worried about Clotty,’ says the Warden. ‘Sam! Shut the door before I say any more. Sam!’
Sam is an intense twenty year old with barely a millimetre of nose between his eyes. With his shaven head, black t-shirt and black jeans, he looks like an off-duty commando. At the first bark of his name he flashes the door shut - just in time. A care assistant had been shuffling by with a decrepit old man on her arm, and he had been ready to smile at us.
‘She’s really not herself,’ says the Warden, and then: ‘Sam. Sam! Go and get Clotty’s notes, would you? Now, please.’
Her rather hectoring manner with Sam seems bizarrely misplaced. He’s standing right by us, is quick to do whatever he’s asked, doesn’t have a problem with language or hearing – unlike Clotty. Her twin hearing aids squeal dreadfully. You have to put your lips to her ears to make yourself heard.
Sam dashes out through the smallest gap possible and is gone.

The room still feels tiny despite his absence. An overheated, floral box, it has space enough for a bed, a side table, a wardrobe, and two child-sized teddy bears. They stare at us with an overstuffed placidity. I wonder how long they have been resident here.

‘In what way is she not herself?’ asks Frank, readjusting his position on the edge of the bed and taking Clotty’s hand in his. ‘How is she different?’
‘Well normally when I come round with the pills I shout “Hello Clotty! Good morning, Clotty!” and she makes a face like this … and holds out her hand … like this.’
‘Okay. Anything else?’
‘The other thing is that usually she tramps about quite confidently with her Zimmer. Not a million miles an hour, but quite effective in her own way, you know. But this morning she just stood there, and when we asked her she said her legs were all gone to jelly.’
‘Did she fall?’
‘No. We got her into the wheelchair, lickety split.’
‘Has she fallen recently?’
‘No.’
‘Was she okay last night?’
‘Fine. The old Clotty we know and love.’

The door opens a crack and Sam the Shadow slips back in with a blue folder. He hands it to the Warden.
‘Let’s have a look,’ she says, opening it on her lap.

Frank and I take this opportunity to check Clotty over. She passes the stroke test, says she is not in pain, does not feel dizzy or sick. Her sats are normal, breathing easy and clear, her pulse is irregular but for a ninety five year old we would expect nothing less. The only thing that seems out of place is the Warden’s concern.

‘Obviously we don’t know Clotty,’ says Frank.
‘Oh – we do,’ smiles the Warden. ‘Lovely Clotty.’

Clotty looks sideways at her, then back to the front. Her hearing aids squeal, making that minimal movement of her neck seem like the attempt of a rusted iron statue to have a look around. Her whole expression during this interview has remained a welded shield of disdain.

‘You’re a paramedic,’ says the Warden. ‘You must have seen this before. What’s wrong with her? What should we do? Call a doctor? Send her to hospital? We don’t want her waiting up there hours and hours.’
Frank tells them that in this situation we have to be guided by them. To us, Clotty doesn’t seem too bad. It doesn’t look as if she’s had a stroke (what the call was given as), but it’s possible she’s had a TIA and not showing it much. She may be developing a UTI – there are a number of things that could be up. All we can do is accept that she’s noticeably ‘not herself’, and take her to hospital to see a doctor. On the other hand, she could stay where she is and have a doctor out to her in due course.
Frank looks at the Warden. ‘So what would you like us to do?’ he says.
The Warden hugs the folder to her chest. ‘What do you think, Sam?’ But before he has time to open his mouth, she says ‘Okay. Take her to hospital. She won’t be there long, I’m sure.’

I strike the resus bag, prep the vehicle and return with a chair.
Nothing has changed in the room. The two bears on the bed have shown more activity than Clotty, who sits slumped in her wheelchair as before.

There is a lift in the home, a dark brown, shabbily veneered affair, with concertina doors and dirty plastic buttons. I wheel Clotty inside. There’s just enough room for the two of us. Sam leans in and pushes button number one – which surprises me. We’re currently in the basement; I would’ve expected him to press the ground floor button. But maybe this home is built into a hillside or something (I try to think – is it?) and the floor plan is misleading. Maybe he hit the button for me because it was easier to do that than explain.
The doors clank shut, and we grind upwards slowly. I hear Frank, the Warden and Sam walking up the stairs, the Warden describing how lovely all the residents are.
We approach the ground floor, and I can see the blurred image of the three of them through the square of safety glass, standing waiting. Then we continue upwards.
‘Er – Spence. Where are you going?’ says Frank. But he’s below me now and we’re arriving at the first floor. The doors clank open. An elderly woman is standing there with a plastic jug. She tries to get into the lift, despite me telling her that there’s no room, that I’ll send it straight back up. She frowns, as if the air has thickened for some reason and won’t let her progress. Luckily, Sam bounds up the stairs and up to us.
‘Edna. Let the man go. Let him go.’
He eases her backwards, and looks at me.
‘You want the ground floor,’ he says.
There’s no point in me saying that he pushed the wrong button. I smile and nod – and then just as I go to push the ground floor, he leans in and pushes it for me.
‘There,’ he says. ‘Ground floor. That’s the one you want.’
The doors clank shut. I can hear him trying to explain the situation to the woman with the jug, as we sink down with a loose-cabled judder.
We approach the ground floor. I hear the Warden talking to Frank. The little windows match up – and then un-match, and we carry on sinking downwards.
‘What’s he doing?’ says the Warden.
‘Spence?’ says Frank.
I reach the basement. The doors clank open. The care assistant with the old man on her arm is standing there. He plants the gummy smile on me that he’s been saving all this time; she merely frowns. I make a joke about the strange lift they have here but she shakes her head as if she doesn’t agree. Before I have a chance to press the ground floor button, the doors clank shut again. We rise up.
‘Sorry about this, Clotty,’ I say to my patient. She makes no movement or sound.
We reach the ground floor. The windows match, un-match. We continue to rise. We reach the first floor. The doors clank open. The old woman with the jug tries to get in. Sam runs up the stairs again and pulls her out.
‘The ground floor button!’ he says.
‘There were – people in the basement,’ I begin to say. I sound crazy.
Sam reaches in to the lift and looks at the buttons.
‘Button number one,’ he says. ‘It’s wedged in. Someone’s pressed it too hard.’ He prods around to free it, then looks at me.
‘Don’t press any buttons,’ he says, then presses ground. The doors clank shut. We sink.
We arrive at the ground floor and the doors clank open. The Warden gives me a doughy smile.
‘There,’ she says. ‘Well done you.’

Thursday, November 20, 2008

brownie points

The sky is a hard crystalline blue dome, the sun so bright that when I shut my eyes, the inside of my skull feels lit up. We are straight out on our first job this morning, singing along to the radio, slapping time on the dashboard, doing the hand-jive, flying off above the waking town and out to the sticks to an Overdose/Poisoning. Even the job sounds straightforward. We have everything we need. All is well.

The street we want is part of a development laid out in the thirties with a logic even the satnav seems happy with. Vividly displayed beneath this glittering autumnal sun, it’s apparent that the developer must once have travelled somewhere hot. Returning home with his sketch books, he attempted to graft a hundred acres of white-arched, flat-roofed, bougainvillea brilliance onto the scrubby native downland. Eighty years later, the villa-style bungalows have slowly lost focus, drifting from the rustic Mediterranean ideal, their simple lines silted up with pebble dashing, crazy paving, plastic gnomes, PVC sun porches, corrugated plastic car ports, barbecue sets, clematis, privet and conifer trees.

But parking is easy. Taking only the clipboard, we walk through the gate of the bungalow we want. To the side of the sun porch is a plaque that says: Willowfern, picked out in a storybook, Celtic script. I ring the buzzer and we both wait.

Eventually a woman opens the internal door and then reaches over to open the porch door. With her red face and her thick, squared-off physique, it’s as if she has struggled out of a compactor to answer the door.

‘She’s in the bedroom,’ she says. We follow her inside.
‘Who’s that? Who’s there?’ Another female voice, anguished and thin, from the room immediately in front of us.
‘Hello. It’s the ambulance. I’m Spence, and we’ve got Rae here, too.’
‘I didn’t call an ambulance. I don’t want an ambulance.’
I ask the first woman in a whisper what their names are, and then say: ‘Karen called us. She was worried about you. Gill, do you mind if we come in and have a chat? Nothing will happen that you don’t want to happen. We just want to see how you are.’

Gill makes a noise that we take as a muffled kind of assent, so we go into the bedroom.

She is standing over by the window. The room is stuffy, a long-nighted fug that makes you want to throw the windows open and breathe. Gill stands staring at us, her eyes wide with the kind of electrified poise you might expect to see on the face of a deer, startled, ready to run.

‘Hello, Gill. Sorry to barge in on you like this.’

I’m aware of Karen nudging Rae behind me, handing her a fist of empty pill packets. Rae starts to sort them like-with-like. A collection of pain, BP, anti-depressant meds.
‘Karen is worried that you may have taken an overdose of these things,’ I say. ‘Is that right?’
‘Leave me alone. Please. I just want to die. I’m no good. It’s time I took myself off. I’m sorry if you’ve been called out unnecessarily, but I don’t need you. Will you please just go.’
‘Well, we wouldn’t be doing our job if we turned around and left, knowing you were distressed like this, and taken an overdose. We can’t really just go, can we Gill? We’d worry that something would happen to you.’
‘Something will happen to me. I want something to happen to me.’
‘But Karen doesn’t. Karen wants you to be okay, as we all do.’
‘She doesn’t understand. She’s better off without me.’
‘Leaving all that aside for the moment, would you come out to the ambulance so we can do your blood pressure and such? I promise we won’t rush off anywhere or do anything you don’t want us to do. But seeing as we’re here, we may as well find out a little bit more and see if there’s anything we can do to help. Will you do that?’

It’s like trying to coax an injured animal out of the bushes and into a cage. I have to make continual adjustments, shifting the tone and direction of my words to perceived changes in hers, in an effort to tempt Gill out of the bedroom and onto the ambulance. Rae joins me. Between us we make her the focus of a fragile crossfire of compassion; eventually, after about twenty minutes, she shuffles out between us.

She insists we leave the door of the ambulance open. She sits, and later as she talks, her fingers clench and unclench around the arms of the chair.

‘My father didn’t love me. I let him down. Like I let everyone down, eventually. It’s just how I am. My eldest daughter won’t speak to me. I don’t have any friends any more. I’m always hurting Karen. She deserves better. I’m hurting her now – look – but what can I do? It’s been going on far too long and I’m tired and I just want it all to finish. I’ve tried and tried but there’s nothing more to be done. I know you’re doing your best, and I’m sorry if I’ve wasted your time, but please, just leave me alone to die. It really is for the best. I’ve thought about the options, God knows I’ve thought about what might be done to help, but I’ve driven everyone to the edge now, and I’ve reached the point where I know for a fact that nothing can be done. The only thing is for me to go away for good. So please just leave me alone. Don’t blame yourself. It’s me. I’m selfish. Useless. I’m a burden to everyone who knows me.’

She is rigid, her face taught and resolved, as if she is perched on a chair high above a black vortex, looking for the correct sequence of thoughts to release her grip and let her drop with the pull of it, deep down and away, feet first.

The ambulance suddenly feels chilly and I want to shut the door. Instead I ask Gill if she’d like a blanket round her shoulders.
‘Yes. Thanks.’
Suddenly, unexpectedly, she asks me if I have any children.
‘Two girls,’ I tell her, ‘three and seven.’
She smiles. ‘I bet they keep you busy.’
I put the clipboard to one side.
‘You know, I took Chloe – the eldest one - to a Brownie outward bound adventure camp thingy last weekend. She’s had sleepovers at friends before, but this was a much bigger deal – two nights away, sleeping in a dormitory. When I took her there, blimey! It was like dropping her off in the monkey enclosure at London Zoo – all these hyperactive girls leaping about between bunk beds. But really I think I was more nervous about it than she was. Anyway, the whole weekend we didn’t hear a thing. We kept wanting to call and find out how it was going, but our neighbour had had kids on the same course and she said they preferred it if you kept off the phones unless it was urgent. So we sat on our hands, thinking how strange the house felt without her. Definitely quieter. But of course she was absolutely fine. Hadn’t missed us at all. Had a great time. I’m so proud of her. She’s so plucky – much pluckier than I was at her age.’
Gill pulls the blanket around her. She suddenly seems weightier, more defined.
‘How are you feeling?’ I ask her. ‘You know they’re very good at the hospital. We could make you comfortable there, no fuss, get you someone to talk to, get someone to look at what you’ve taken, see what needs doing.’
‘Okay,’ she says.

The trip into the hospital was smooth. Rae is such a good driver it’s like being on a train. And with the doors shut, the heater kicking on full and the sun leaning in through the slatted windows, it really warmed up nicely.

Friday, November 14, 2008

full moon

The moon is so full and bright, its crater markings as distinct as the road we turn into, I feel I could drive there tonight. Up ahead, incongruously dressed for this freezing night in a halter top and multi-coloured ra-ra skirt, a young girl waves to us from the pavement. She rises up on her toes and leans out into the road; anyone would think she was hailing a cab. I drive up, put the hazards on. We climb out.
‘Are you the patient?’ Jerry asks, tucking the clipboard under his arm.
‘Yes. It’s me. I called. I need help.’
She folds her arms across her chest. Her hair is painted flaming scarlet, her lips a cherry red, but the rest of her in this weird lunar light seems translucently pale.
‘Okay. Well – let’s jump on the back, get you warmed up, and have a chat.’
A young man comes jogging down the street, shouting ‘Hey, wait for me.’
‘Do you know this man?’
‘Yes. He’s a friend. It’s okay.’
The man reaches us just as the woman has climbed up the steps on to the back of the vehicle. He has ropey, plaited hair, several piercings, and intelligent, clear blue eyes.
‘Is it okay with you guys if I come on board with Julie?’
‘If Julie says so.’
She nods, so we let him on, and shut the door behind us.
Jerry offers her a blanket. She hugs it around her shoulders.
‘So. What’s the problem, Julie?’
‘I was at this party. It was all fine and lovely and everything. They’re good friends. They so deserve better than me.’ She pauses, and seems to reset her shoulders beneath an invisible weight. Her friend leans across and grasps her hand. She continues. ‘Anyway - I had this sudden, overwhelming urge to kill myself. So I went into the bathroom to cut my arm, to take my mind off it, so to speak. But it didn’t work. And the urge just grew and grew and I knew I wouldn’t be able to escape from it. So I thought I’d better phone for help. So I phoned. And here I am.’
She starts to cry, great fat drops rolling out of her eyes, down her nose and onto her friend’s hand. He gathers her to him, and she buries her face in the crook of his shoulder.
‘Ssh,’ he whispers. ‘Ssh now.’
After a moment she collects herself. Jerry gives her some tissue. She blows her nose vigorously, then stares at the handkerchief as if she might find an explanation for her grief there.
‘Have you ever felt like this before?’
‘Yes,’ she says. ‘But never this bad. I’m having counselling.’ She looks into her friend’s face. ‘Nobody even knows I’m gone, PJ. I didn’t say goodbye or anything. What must they think of me?’
‘Don’t worry about that now,’ Jerry tells her. ‘First things first. Have you hurt yourself anywhere other than your arm?’
She holds it up; she has an abrasion where she raked the soft white skin of her forearm with a razor.
‘It’s nothing,’ she says. ‘It’s not serious. God – I know you’ve got better things to be doing with your time.’
‘Absolutely not,’ says Jerry. ‘In our line it’s strictly one job at a time. And right now you are that job. It takes as long as it takes. So don’t worry about that.’
There is a momentary silence in the ambulance. Jerry reaches behind him for the BP cuff. Julie wipes her nose on a fresh piece of tissue paper. PJ hunts around in his pockets for something. A car rushes past us in the street, making the ambulance rock slightly on its wheelbase. And I’m suddenly aware of the four of us in our cramped, well-lit little box, blinking by the side of an empty street in the early hours of the morning, a line of windows dark and sleeping a hundred yards to the front and a hundred yards to the back of us, whilst all the while the moon, scoured and battered and brilliant, higher now by a degree than when we first pulled up, slowly follows its blind nocturnal pathway across the sky.

Thursday, November 13, 2008

evidence

Frank is on his knees in the living room, a stethoscope connecting him to the chest of a tiny, seven week old baby boy lying quietly on the sofa in front of him. A woman and a man stand either side of him, looking on.
‘Hi Frank. What’s happened?’
He unplugs his ears and sits back on his heels. There is something wrapped up about the way he talks to us, a coded, guarded Frank, a ‘read between the lines’ Frank that I haven’t seen before.
‘This is little baby Pete. Mum left Pete in the pram outside a house – not this house, one further up the road – whilst she went in to look for something.’
‘I went in to help my mum look for her keys. It was only for a second.’
She hooks some loose strands of hair back behind her ear and smiles at me. Her expression seems curiously measured, as if she’s reading out words that someone else has written out in crayon.
‘I won’t bother next time,’ she says.
‘Anyway. What happened was that the brakes were not on fully for whatever reason…’
‘I did put them on. They just must have come off again.’
‘…the pram rolled down the slope, tipped over, and baby Pete was pitched out into the road. Unwitnessed. Mum came out after a minute or two and found him sprawled on his front beneath the pram, crying. They put him back in the pram, brought him home. Thought he’d only scratched his forehead, but after about half an hour they also noticed that he had a big swelling coming up on the back of his head. As you can see – look.’
Very gently supporting the baby, Frank turns him sufficiently for me to see an angry haematoma about a quarter the size of the baby’s head.
‘I definitely put the brakes on. I remember doing it.’
‘He’s been crying off and on since then – about half an hour, all told.’
‘We didn’t think he was hurt. I didn’t want to bother anyone.’
The father – a squashed-up looking guy with worrying scars along the inside of his forearms – leans in and touches the baby’s head.
‘I put some Germolene on him, look,’ he says.
‘Sats fine, no obvious neurological deficit, equal air entry, pupils reactive, follows my light with his eyes. A bit quiet, though. I had a quick look, and there don’t seem to be any other injuries. But Spence I think we need to get going with this one. Could you get me a medium vacuum splint? I think that’ll do to immobilise the poor little chap.’
The parents stand back whilst we work quickly to bundle Pete up and get him out to the vehicle. They chat casually as I carry him out, passing the offending pram in the kitchen. I know that suspicion is an infectious entity. I know that once an impression something is wrong takes root, you start to see only what you expect to see, to bend everything to fit the tenor of your concern. But I can’t help thinking that the pram looks as if it has been in the kitchen for a while, like a boat silted up in an old harbour, and that the parents are remarkably unconcerned.

A quick blue light drive through town and we arrive at A&E. There is an impressive team waiting for us – Consultant Paediatricians, specialist nurses, doctors, even porters and admin staff to expedite the reception of this little fellow. The parents stand to the back of the group as I give a handover, and expert hands begin plugging the baby in to the monitors, and assessing his injuries.

Outside resus, I take the senior A&E sister aside. I tell her that we have some misgivings about this case, and want to report them to the appropriate figures here at the hospital, on top of the forms that we’ll fill in back on base for suspected non-accidental injury.

After five minutes or so, the Consultant comes out of resus and we all go into a quiet room. He listens to our concerns with an air of cool appraisal.

‘This is a supremely difficult area,’ he says, cupping his hands around his knee and rocking gently on the chair. ‘Supremely difficult. I think firstly, as far as the delay in calling you guys to this accident, that doesn’t surprise me. You see it a lot. Because parents often think – consciously or unconsciously – that if their child has had an accident, they will be blamed or fall under suspicion, and the child may, in the worse case scenario, be taken away from them. So I suspect they probably suffered this accident, and waited a bit until the extent of the injuries became undeniable, and then they had to call for an ambulance. Skull fractures take a little while to appear. I bet they really did think the baby had escaped with only a scraped head. What will really be interesting to see is if their stories change over time. That’s what we must pay attention to. That’s such a good indicator. So please – write down exactly what was said, and we’ll see how it matches up later on. Your impressions, too, of course. It’s all grist to our mill. Thank you gentlemen.’

We leave the room. I arrange with control to come off the road to return to base and make our report. Outside A&E, the father is smoking, chatting on a mobile phone. He sees me and nods once, a perfunctory little bob of the head, like I’m a guy he thinks he recognises from the pub.

Not what you might call evidence.

a quick blast through town to base

Now turn in towards land. Cut in low over the waves, up over the pier – the dark iron platform offering out its rides and prizes to the weather and the sea – rise up with the seagulls planing the air along its leggy length, high over the heads of the winter crowds, and follow the boards to the end; snick over the pointy top of the old iron clock; drop in fast over the traffic nudging along the coastal road, up towards the Victorian one way system; go graciously by the hand of a green and bilious Queen, around her celebratory gardens and the council workmen prodding in bulbs for the spring; come in low along the cycle paths, the bus lanes and neatly surfaced roads, resisting the arterial tug up into shoppers’ town; flash along past the sombre tourist tick lists, the anonymous business frontages, past the fake Tudor pub, the computer-designed flats, the Georgian terraces and balconies - fast enough to blur the signs of decay, slow enough to see what the people who first lived in these buildings must have seen – leaving in your blazing wake the traffic stalled along by the skate park, the converted municipal buildings, mews apartments and student halls; pull up over the lights and blast away up the hill towards the edge of the great half cup that forms this town, easing off the power as you reach the top; watched from the upper levels of the old fever hospital as you fall below the line of thrashing horse chestnut trees, dropping in a blast of dust and easing down to come in between the redundant gas lamps by the furthest opening in the old brick wall and into the car park of the ambulance station, noting the line of white and yellow trucks, the cars, the scatterings of conker cases, blue gloves, cigarette butts, coffee cups. Shut off your engine. Climb out. Become aware, as your turbines cool and click, of the station’s worn old potentiality.

Take off your helmet. Stand quietly, and wait.

The alerter is about to sound.

Friday, November 07, 2008

fireworks

An hour into the shift and I’ve found my nerve; I don’t even flinch as a full scale air assault tears up the air close by. I was twitchy when I started work tonight, but now I hardly notice the continuous barrage of cracks and whooshes and bangs. Chemical vapours glaze the air like burnt sugar. A misty rain begins to drift down past the street lamps as we jump out of the ambulance at the incident address, but it’s late and thin, and won’t be enough to dampen the last few tonnes of powder being touched off in parks, driveways, gardens and allotments all across the city, and beyond.

Parked up ahead of us is a police van and a couple of squad cars. The block of flats that we’ve been called to rises above the vehicles on top of a dark, grassy bank. The block is ablaze with lights, and the people out on their balconies are motionless silhouettes against them. It’s not just the fireworks and the police cars that have brought these people out for a better view. As we walk towards a group of flak-jacketed policeman for some information, we can hear screams.

‘Follow your ears,’ one of them says. Another helps us along with a gesture to the steep concrete steps that lead up to the flats. They resume their relaxed conversation.

At the top of the steps the screams increase. We stand aside as four policemen emerge from a doorway, carrying between them a struggling woman, her rage as glittering and iridescent as any firework I’ve seen tonight. Her arms are vipered behind her back to her legs. It’s an effort for her to raise her head at all, but now and again she manages it, not to see where she is being taken, but to avoid wasting her sparks on the pavement.

We let them pass, then carry on into the block.

A policewoman meets us on the stairs just in front of the flat we need. She is relaxed, snugly buttoned in to her jacket, her glossy hair neatly tied back. She speaks in warm, quiet tones. If you shut your eyes and ignored the radio, she could be an estate agent greeting us at the door to a property with an awkward history.

‘Hello guys. Thank you for coming. I don’t know what you’ve been told about this one.’

‘Just that a one year old child had been assaulted.’

‘Okay. Fine. Well. Let me fill you in. The mother – she doesn’t live here any more – you may have seen her just leaving? Well, apparently the mother came round to see her ex. She was already quite drunk at that time, and had a little more to drink here. I’m afraid she has a history of instability, and in fact became more and more aggressive tonight, threatening violence to x, y and zee. Then at some point in the evening it appears that she pulled the child out of its cot, gave it a slap across the face and then – well, the house was in uproar, we were called, etc. So we got you guys in just to check the child over to make sure it’s okay. Okay?’

She smiles, gives her pony tail an encouraging little flick, then leads us through a boxy hallway smelling of spilled beer and damp coats, and into the sitting room.

There is a young man in a red football shirt and track suit bottoms, star-fished on the dirty brown sofa. He waves cheerily as we walk into the room, then carries on staring at the blank TV and sipping from a can of lager. Just over by a bookcase of DVDs there is an anxious looking young woman in a parka. Her face is as white as her hands, which she kneads in front of her. Out in the adjoining kitchenette, another policewoman is talking to a man, who, when he sees us, excuses himself and strides in to say hello. He holds out his hand for me to shake.

‘Hello. God – thanks for coming. Sorry to get you out like this. It’s all so stupid. I’m sure everything’s okay, but you know best.’

A small, trim man in his late thirties, he wears the same football shirt as the man on the sofa, but unfortunately in his case it only serves to intensify the stressed scarlet blush that has him by the neck and face. A pattern of old scars stand out on his cropped skull, mapping traumas weathered so far. But despite all the blows that life has rained down on his head, he still holds his shoulders and back with only the slightest protective curvature you sometimes see in boxers; a man blasted by life, getting by nonetheless.

He shows me over to the corner of the room and a large, blue playpen. In the pen, a toddler is sitting propped up on teddy-bear patterned pillows, sucking contentedly on a milk bottle.

‘This is Niles. Niles is a bonza baby, a strong wee lad. His mother and I don’t live together any more, but I let her come round now and again. She has her problems and you have to keep an eye on her, but I thought it was okay and under control. Anyways, she came round tonight, pretty smashed. Stupidly I let her in. One thing led to another. I think she just wanted to get at me. She didn’t know what she was doing. She grabbed Niles by the hands, pulled him up – like this – out of the cot. Dumped him on the sofa and before we could do anything she’d given him a slap around the head.’

The man on the sofa shuffles over to make some room. I look at Niles and he looks at me. He has a small red mark above his right eye. I lean into the pen, lift him up and out, and sit down with him on the sofa. He’s only one, but his strength is startling. Now that he is free of his little prison, he ditches the bottle and begins a concerted break for freedom.

‘Hang on, Niles! Whoa! Well, I’d say his motor functions are intact.’

Rae helps me undo his babygro so we can give him a thorough check over. It’s like trying to examine a tiger cub: he writhes and kicks and grabs whatever he can in his effort to break free, but his expression remains bright and happy. I pass Niles back to his Dad, who waggles him in the air and makes him laugh. Then he lies him on the floor to put the babygro back on.

‘I’m not letting her round again,’ he says, expertly guiding Niles’ arms and feet into the outfit. ‘I’ve tried and tried but that’s enough. God knows what’ll happen now.’

I finish the paperwork, collect a releasing signature and stand to go. He reunites Niles with his bottle, then shakes my hand again. The policewoman at the front door touches me on the shoulder. ‘Everything okay? Great.’

We step outside, and suddenly the sky is ripped with a spray of little green stars.

Wednesday, November 05, 2008

seventeen pounds' worth

The store manager punches in a four digit code and shows us through a heavy door at the back. Almost immediately we are met by a security guard, who points with the aerial of his radio for us to stop where we are, throws a look back around a bend in the access corridor behind him, then steps silently over to speak to us. He leans in to me, predatory as a stork, and whispers the story in my ear: he had witnessed the suspect stuffing his pockets with goods, trying to leave the store without paying, caught him, led him out here and up the stairs to the waiting room; the man had sat down on the steps and started complaining about pain in his side, but hadn’t fallen or anything. He leans back and smiles at me, gives me a slow-eyed nod – we understand each other. I readjust the weight of the carry chair, and follow Rae round the corner to the patient.

Kenny is sitting in a huddle on the steps that lead up to the holding room. His left hand is underneath his denim jacket, holding his ribs; his right is gripping his knee. He sneaks a look up as we approach, then leans in to a theatrical expression of agony. Rounded over on the steps as he is, speaking as hurriedly and prolifically as he does, he reminds me of a puffer fish, inflating itself, pushing out spikes, anything to avoid capture.

‘Listen, you, ambulance man. What’s your name? Spence? Whatever sort of name is Spence? Anyway – never mind all that. Just listen to me, please. Just listen. Take a photo if you want. I’ll be calling on you to be my witness. I’m phoning my lawyer and everyone. Everyone’s going to know about this. I can’t believe it. All for a few quid’s worth of stuff. It’s pathetic. I’m sick. I need medication. I was beaten to death with a baseball bat. I have serious head injuries, multiple fractures, to my ribs, my back. Look.’

‘No, Kenny. Just listen for a minute. We’ve been called here today to check you over. The police are on their way.‘

‘The police! No! What for? It’s ridiculous. I’ve got the money. I just need my medication. That’s all I was after…’

‘Kenny, listen to me.’

‘Okay officer. Sorry. Go ahead.’

Kenny suddenly shuts up and looks straight at me. His head and face are as heavy as a crudely thumbed pot; there’s something about his off-centre black wig, his black, letterbox spectacles and the rodent slant of his yellowing teeth that give him the expression of some ruined vaudevillian comedian.

‘We need to find out if anything’s happened to you – wait a minute, ah ah – to find out if you’ve hurt yourself in some way, if you’re sick and need medical attention. We’re not interested in the accusations that have been made, who said or did what, or what’s going to happen next. We just need to know what’s wrong with you.’

The store manager suddenly presents two policemen to the group. Their appearance acts on Kenny like a physical blow. He gives a grunt, a shriek, an imprecation, then hurls himself into a monologue.

‘Great. At last. I was wondering when you’d show. You need to arrest this security guard. I can’t believe what’s happened to me. It’s outrageous. I picked up some things around the shop. I was standing – near – the entrance, thinking about the important medication I needed to get – these ambulance people will tell you. And I was just about to go back in and pay but this – this animal didn’t give me a chance. He grabbed me by my injured arm, the one I broke in Madrid, marched me out here. And then when I said I had problems, I felt faint, I was scared of heights, I’m claustrophobic and don’t like people crowding me – like you are now – sorry, can you just stand back from me – and I know I’m raising my voice, but I can’t control that, either. Sorry. Not since my brain was damaged. Look at my notes. I have Cognitive Psychiatric Dysfunction Syndrome. So this so-called security man forced me up the stairs regardless, and the pain in my side was just excruciating, because I hadn’t had my medication. That’s the only reason I was in the store in the first place. Read my notes if you don’t believe me. It’s all documented there. In Spanish. I was assaulted with a baseball bat. They smashed my head in and put me in a coma for a month. And I told him all this, about this very, very serious medical condition, but still he forced me up the stairs. I immediately felt dizzy and collapsed. I fell onto my side. I’ve got rib fractures – ribs eight and nine, if you don’t believe me. I was unconscious for about five minutes. I panic, you see. With the pain and the anxiety. I haven’t any medication and this is inhuman. I’m on dydrocodiclodo-something or other. You’ll know it when you see it.’

He has a barbed wire tattoo around his wrist, and strange blue-point tattoos at the roots of his chubby fingers. Now and again he takes his hand away from his side to point at the security guard, or us, then winces melodramatically and replaces it. Everyone stands around him, hypnotised by this torrent of words, until one of the policemen – a sergeant, who watches Kenny with the kind of glittering, professional curiosity you might see on the face of a butterfly collector – takes a weighty step forwards.

‘Kenny’, he says, holding up his hand.

‘Yes, sir, officer.’

‘Enough now. Let the ambulance people have a look at you, then we’ll talk about the shoplifting allegation.’

‘Yes, sir, officer, sir. Of course.’

The sergeant withdraws with his colleague to talk to the manager and security guard, whilst Rae and I check Kenny over. There’s nothing to substantiate any of his claims, no marks of any description. He seems absolutely fine. The only detail that corresponds to anything he’s said is a MAD airport identifier on his rucksack. But he insists – volubly – that he must go to hospital, so we are obliged to take him. When I tell Kenny that this delaying tactic won’t accomplish anything, his outrage at the slur echoes around the corridor until the sergeant comes back over and asks him to be quiet.

‘Yes, of course,’ he says.

On the way out of the store, Kenny puts on a show. He stumbles, drags his feet, all the while clutching his side and calling out to the appalled shoppers for help.

‘What is this – Guantanamo Bay? For Christ’s sake, show some mercy. I didn’t do anything, I’m an innocent man. I’m seriously injured and you’re making me walk. I’m going to get my x-ray from the hospital, stick it on the front of this godforsaken store and write across it in big letters – SEE WHAT THEY DO TO YOU HERE FOR SEVENTEEN POUNDS’ WORTH OF CRAP’

Sunday, October 26, 2008

the ghostly clubber

There’s no way of driving the ambulance into the multi-storey car park, so we drive round the side, take out the bags we think we’ll need, lock the vehicle, and set off up a ramp heading for the fifth floor.

It is utterly deserted. The barriers are down, the last car driven through an hour ago. All sense of human warmth has gone from the place, withdrawn now to the safety of lenses in high corners. Our footsteps echo away into the shadows. Level through level, zone through zone, the building rises up like an empty temple. Incense of piss and oil. God knows what happens on the roof.

I have a resus bag in one hand and a big flashlight in the other. I flick the light on and off, appreciating the action, and the weight.

We follow the signs - an energetic green figure sprinting towards a doorway. We move with much less enthusiasm. I lean against the heavy fire door.

Opening up the concrete stairwell, I release the booming sound of aggressive voices a few levels up. And like rain pattering down from a thunder cloud, sparkling droplets splash down into the puddle on the floor in front of us.

I look at Frank and he smiles. I gently close the door, turn round and we head back outside.

We’d only been inside the car park for a few minutes, but now the night air seems crisp and invigorating. Frank gets on the radio to call for police attendance. I put the bags back into the truck in case we need to make a quick getaway, but I keep the flashlight in my hand.
‘Five minutes,’ he says.
‘Great.’
I prop myself up against a wall to wait. Frank rolls a cigarette. Clubbers pass on the other side of the street, laughing, pushing each other, having a time of it. The smell of Frank’s tobacco threads the air.

Then an emergency exit door from the car park is flung open and a man steps out.
‘He’s gone and smashed me fookin’ radio!’
I push myself away from the wall.
‘I’m sorry to hear that,’ I say. ‘Who’d want to do a thing like that?’
‘Are you here for that nutcase? Are you gonna take that fuckwit away?’ he shouts, ignoring me.
Under this street lamp the man seems leached of colour, as if earlier in the day he’d been thrown into a boiling wash along with his clothes. His hair hangs in limp coils around his face; his eyes, couched in puffy pale skin, flick nervously from side to side. He has a kit bag squashed under his right arm, and in his left hand there is half a radio.
‘Look what he did. Honestly. With a crowbar!’
‘So who called the ambulance?’
‘I don’t fookin’ know. You’ve got to take him in, though. He’s up there, smashing his head against the wall. I hope he fookin’ dies.’
‘Well – we heard there was a bit of a commotion, so we came back outside to call the police.’
‘The police?’
The man pulls his radio back in to himself and grips his kit bag more firmly. ‘The police? Well I’m off, then.’
And he starts off on a brisk walk along the road.

At that moment, somebody else crashes out onto the street through the door: a man as dark with dirt as the first was clean. He stands in the middle of the pavement, gasping for breath with his hands on his knees, staring up at us. Seconds later he is almost knocked into the road by a woman in a baggy, multi-coloured jumper, her extensions flying around her like snakes around the Medusa. She launches a kick at him, which he sidesteps. She tries to slap his head.
‘You cunt!’ she shrieks. ‘You left me there.’
Then she sees us.
‘Finally,’ she says, pushing her face clear of all the hair, pulling her jumper down. ‘He’s just behind us.'

Radioman has changed his mind. I notice him walking back towards us down the street.

The emergency exit swings open again with a bang, and this time two men stagger out, the tallest one with his right arm slung round the neck of the other. He leans his weight on him, dragging his feet. From where I stand I look for signs of a head wound, but I can’t see any blood, bruising or swelling.

As if suddenly embarrassed to find himself out in the open, he pushes himself clear of his friend and stands up straight, swaying precariously from side to side.
‘I don’t need no hospital,’ he says.
‘Are you the patient?’
‘Mebbe.’
‘Are you hurt?’
‘Mebbe.’
The guy who was supporting him comes over to me, stands right in front of me and puts his face so close to mine that I have to take a step back.
‘He was losing it big time up there, mate. He was banging his head against a brick wall. You have to take him to hospital.’
His mouth is glistening black, as if he’s been eating liquorice. ‘He’s been abused since the age of five. You have to take him to hospital.’

Before I can say anything, Radioman is back.

‘What are you going to do about this?' he shouts at them all. 'Are you going to buy me a new one?’
The black mouthed man takes a step towards him.
'No. I’m going to shove the half you’ve got left up your arse.’

A police car pulls up and two policewomen climb out. One of them immediately attracts the attention of Radioman, who, glad of an excuse to withdraw, goes to wave his ruined plastic carcass at her. The other policewoman walks into the centre of the group. She puts her hands out, palms up.

‘Right. You - be quiet. And you. Please. Now then.’ She smiles at me. ‘What’s going on?’
I briefly tell her what the call was given as, what we found when we got here, and why we felt there may be some danger in hanging around inside.
‘So who’s been smashing things up?’
‘Me,’ says the patient, leaning against the car park wall, zombie-eyed. ‘I need help, man.’ He makes an ineffectual pass at banging his head against the wall, but frankly I could do better. Frank flicks his cigarette away. A little cascade of red sparks marks the spot it reaches in the middle of the road.

At this point, Radioman seems to find a new energy; he comes striding back into the group, windmilling his kit bag in the air and furiously blowing out his cheeks.

I take myself away to stand next to Frank. We look on, check our watches, fold our arms. The row grows in intensity, a cartoon quarrel, with no apparent centre or destination.

Suddenly, a young woman comes drifting along the pavement. She is about eighteen, slim and poised, her hair neatly caught up in a wide rainbow band, her shoulders bare above a strapless black dress, no shoes on her feet. I make as if to stop her, but there’s something about the way she approaches that makes me hesitate. I watch as, without the slightest deviation, without even seeming to register the existence of the squabbling gang in front of her, she pads towards them. I watch as they fall silent, separate, dissolve harmlessly away, all without a gesture or a shove, to let her through.

And she passes.

There is a pause as her figure diminishes.

The group hangs in confusion, like startled swimmers in the wake of a ghost ship.

Then, finally, she is gone.

After a moment or two the group shakes itself, closes back in on itself - and the whole damned thing starts up where it left off.

Friday, October 24, 2008

room number four

The alerter sounds. Somehow, twenty thousand leagues asleep, I manage to raise my wrist up in front of my face: the dial reads four thirty. Asking me to get up out of this chair is like asking an Egyptian mummy to unwrap itself. But I find myself upright. Rae is there, too, rubbing the feeling back into her face. A moment later we’re back in the cab reading the notes: fifty five year old male conscious breathing assault minor cut to face.

A sickly, sulphurous yellow mist drifts across the ambulance car park. It matches our demeanour perfectly. We pop minty chewing gum to help our mouths form words. We set off for the given address, a seedy little hotel near the front.

The Standard would once have been aptly named, a shabby but discrete ten bedroom hotel reeking of scandal and Shake ‘n’ Vac. But the town’s image has undergone something of a moral re-fit; now the hotel stands on the corner of a main thoroughfare, a superannuated beacon for old-school STI’s, handily placed between a lap-dancing club and an all-night diner, the principal attraction of which seems to be an underage staff who wear short skirts and wave pom-poms at the traffic.

We shuffle up the stairs and knock on the door. We wait. We knock again.

Eventually an interior door opens and a lumpish figure appears at the end of the lobby. He stares at us, makes a peremptory wave-away motion with his hand, then turns to go back.

We knock again.

He pauses, even leans forward slightly in a crude ‘who the hell are you?’ mime. Then shuffles right up to the door.

Rae says: ‘Ambulance’

He raps with two knuckles on the sign hanging on the door: No Vacancies. Then turns to go.

Rae knocks again. When the man turns back to the door, she pulls the material of her jacket straight so the ambulance emblem is clearly visible. She taps it with two fingers and mouths ‘Ambulance’ again. He reaches for the catch and opens the door.

‘Sorry. Sorry,’ he says. ‘I thought –can’t they read?’ He raises his eyebrows and adds: ‘So what’s the problem? What do you want?’

‘We had a call to this address. Room number four. A man has been assaulted, apparently.’

‘Room number four? There’s no-one in room number four. So that can’t be right. A man assaulted? Well. I own this establishment and I can assure you that if a man had been assaulted in room number four, I would certainly know about it. Room number four? There’s no-one in room number four.’

The owner is the product of forty years of dinner plates and optic prods. Five foot seven up and about the same out, he utterly fills the narrow little lobby. Swinging his hammy knuckles like an insouciant ape, he retreats before us.

‘Look. Let’s sort this out. Come in. Come in. I’ll set your mind at rest, officer.’

He wheezes and puffs in a slack-cheeked way back down the lobby, through another glass door. There are framed letters on the wall, yellowing letters of endorsement from long dead under-secretaries. He leads us to the foot of a steep pile of stairs. Suddenly, there is a man standing on the first landing with a phone in his hand and – tellingly – a small cut on the side of his head.

‘Jeremy? What are you doing up? You’re not in room four, are you?’

Jeremy – a man of about the same age as the proprietor, but as gaunt as he is inflated – holds both his hands out to the side, like a religious martyr appearing to his followers.

‘I don’t want the ambulance,’ he sighs. ‘I didn’t ask for them. I am not hurt.’

‘But who’s in room four, then?’

Jeremy lowers his arms and says in a rather flat way: ‘I don’t know. It’s not me.’

‘I think we’d better get to the bottom of this. There might be a dead body in there for all I know. It’s far too early in the morning for crap like this.’

‘Well I didn’t call the ambulance.’

‘Who did you call?’

‘The police. I had a little – incident – last night, and I was simply calling for advice. I think they must have got the wrong end of the stick and called the ambulance on my behalf. But I don’t need you. I’m fine. I’ve got a little graze on my head, but it’s nothing. I can cope. Honestly. Thank you, but I don’t want you.’

Rae puts her hand up, to stop him talking if nothing else.

‘If we’re not needed here then – fine,’ she says. ‘That’s absolutely fine. We’ll be on our way.’

‘Just wait here a second,’ the owner says. Jeremy retreats back up the stairs and the owner trudges up after him. We hear a door unlocked, a light goes on, some whispering, then a moment later the owner’s face appears mooning down at us from above.

‘I told you – there’s no-one in room number four,’ he says. ‘Sorry to have troubled you. Lock the door on your way out.’

We make our way back outside. A couple of lap dancing girls are being shown into their cab by a bouncer. They seem washed out, partially erased in this drizzly, early morning gloom. But one of them throws Rae and me a return look as she lowers herself into the car, and I realise she probably thinks exactly the same about us.

Thursday, October 23, 2008

astrological twins

A tall guy vigorously kitted out in active leisure wear waves over to us from the kerbside up ahead. We pull level with him. He smiles as I climb out of the cab.
‘So this is what happened,’ he says. ‘Gerry and me found this guy lying face down in the middle of the pavement. He smells quite a bit of drink, and I guess you’d say he may well be intoxicated. I don’t think he’s hurt himself, but you’re the experts. Anyway, he wanted to go back in his flat. This one, here. So we helped him up and inside, and – well – that’s it. I hope we did the right thing in calling you. I hope it isn’t a waste of time.’
He touches me on the shoulder, generating such a voltage of goodwill I’m sure I feel a tingle there.
He leads us up some stone steps and into a warm and neatly prepossessing hallway. The door to the ground floor flat stands open, and we follow him in.
‘The ambulance are here, Gerry,’ he says to a similarly tall and waterproofed man, with a smile as invigorating as his friend.
‘Thank you so much for coming,’ he beams, then stands aside, and with a magician’s sweep of his arm says: ‘And this is Jim.’
Jim sits slumped forwards on the edge of a sofa. With his beany hat pulled low over his brow, his chin buried in the folds of his jacket, his hands hanging between his knees and his shoulders rolling down after them, he seems like the illustration for a grimly modern tarot card: The Beaten Man. He has a bottle of white wine by his leg; when I introduce myself and Rae, he picks it up and takes a long pull.
‘Please don’t drink any more just now, Jim.’
‘You can’t stop me.’
He puts the wine back down, wipes his mouth with the back of his hand, and resumes his position.
The first helpful guy looks across at me brightly.
‘Well. I guess you won’t be needing us any more,’ he says. ‘Good bye Jim. Nice to have met you.’
Gerry taps Jim on the shoulder. ‘We’re going now, but we’re leaving you in the capable hands of these lovely people.’ Jim looks up, bewildered. ‘Good bye, Jim.’ He holds out his hand. Jim shakes it. They leave, shutting the door behind them with a barely audible click.
‘Jim? Do you mind if I take a seat?’
He gestures vaguely to some collapsible chairs over by the sash window. I put one up for me and one for Rae.
‘Great. Now then. Tell me what’s happened today?’
Between periods of silence and the occasional, choking sob, the fragments of Jim’s story are laid out before us.

He has a drinking problem. He had an appointment today at the Alcohol Abuse Centre, but missed it. He has been drinking since this morning, went out to the corner shop first thing, came back, drank some more, then fell over in the street on the way back to the corner shop for another bottle.

Like an incriminating exhibit in a courtroom, there is an unopened pot of coleslaw (with bacon pieces) on top of today’s paper on the cluttered table in front of the sofa. I imagine Jim shuffling round the shop, coming to just sufficiently to pay for the wine, the newspaper and the coleslaw at the till, and then staggering out.

Jim says he has an American girlfriend who had to leave the country a few months ago when her visa ran out. He says she tried to kill herself last week. Jim can’t cope with any of this anymore. He knows the drinking isn’t helping, but he can’t stop.

He gestures to some bar bells over by the far wall.
‘I’m fit,’ he says. ‘I’m really fit for my age. I go to the gym. I work out. But now. Well – now I’m just whacked out and done for. I’ve let everyone down. And I’m embarrassed, with you lot being here.’

He takes another swig from the bottle.
‘Jim. I really must insist that you don’t drink whilst we’re here. To be honest it makes me feel stupid – the fact that we’ve been called out to you because you’ve had too much to drink, fallen over in the street, can’t get yourself up, and yet here you are carrying on. I’d be failing in my job if I let you do more of the thing that’s caused the problem.’
No response.
‘It’s the same as when we’re called out to people with breathing difficulties who want to spark up a fag. It makes a mockery of us being here. So please don’t do it. If you carry on drinking, we’ll just have to go.’
‘You can’t stop me drinking,’ he says. But at least he doesn’t make a grab for the bottle.
‘Okay. I just need to take some information,’ I say. ‘How old are you?’
‘Forty five.’
The same age as me.
‘And what’s your date of birth?’

It’s so unusual to come across someone with the same birthday as me that for a second I almost say it out loud. But I hesitate, and the hesitation seems to jump from me like the flash from a camera, lighting up the studio flat, the bar bells, the pot of coleslaw (with bacon pieces), the beany hat, the bottle of wine, the sprawl of letters from the Alcohol Abuse Centre, the unopened utility bills.
I want to shake his hand and say fancy that, born on the same day, the same year. I want to ask him what time he was born and where. I want to swap notes on the journey so far. But I worry that if I do tell him, me sitting here with a clipboard in my lap and a biro in my hand, Jim with his head down, irresistibly reaching out again now for that bottle of wine – well, I'm worried that it just won’t help at all.

Monday, October 20, 2008

meat / hat

#1: meat
‘We’re all standing on the front talking about where to go next. Out of nowhere this funny looking guy comes up to us and asks if we know where he can get something to eat. Joe just stands there, all Joe-like, in that way he has, and he says “We passed a meat place back that way.” And the guy says “Meat?” And Joe says “Yeah, you know. Meat.” The guy looks at him kind of weird – like “Why would you be saying meat to me?” Then he turns round and walks off. So then we carry on talking about where to go next. Suddenly the guy’s back with a gang of his mates. Real rough types. One of them gives him a kind of leg-up, he literally flies up into the air behind Joe, and brings his fist down – wham – as hard as he can, right on the back of his head. Joe falls to the ground, and the gang runs off.”

She’s standing with the focus of her weight on her left leg, swinging her hips gently from side to side and hugging herself with both arms. It’s like she’s trying to rock an invisible baby to sleep.

‘Why would you do that?’ she says. ‘What’s wrong with people?’

#2: hat
‘Where’s my hat? Oh bloody hell I can’t have lost my hat. I’ve got to go back. I haven’t had it long.’
Mick is standing up in the back of the ambulance rooting through the pockets of his combat jacket. He dumps the contents onto the seat that he should be sitting on: an unopened can of cider, a bag of rolling tobacco, a scrunched up copy of the Big Issue, some Werthers Originals. The congealed blood on the top of his spikily shaven head glistens in the interior light.
“Mick. Sit down mate. We’ll think about your hat in a moment. The most important thing now is to take a look at your head.”
“No. You don’t understand. I can’t lose my hat. I just can’t.”
‘What sort of hat is it?’
‘Brown. Furry. Ear flaps. I haven’t had it long.’
‘I’m sure we’ll find it just as soon as we’ve finished treating you.’
There’s a policewoman standing in the road looking in at the back door of the ambulance. ‘Don’t worry about your hat,’ she says. ‘The whole place is a crime scene. No one’s going in or out. Your hat’s quite safe.’
‘No. No it’s not. It’ll be gone. With the rest of my stuff. I’ve got to go.’
‘Will you let us at least clean your head before you leave?’
‘Oh – quickly then. But be quick. My hat’ll go before you know it, and I can’t lose my hat.’
Rae shines a light on the top of his head and I start to clean the wound with some sterile water. Mick has been bottled in the park, knocked clean out. I can see and feel toothy shards of green glass in the gashes.
‘This is a serious wound, Mick. You’re going to have to come to the hospital for treatment.’
‘No. I can’t go to the hospital. I won’t.’
‘Is it your hat you’re worried about?’
‘Yes. Yes – my hat. But what’s the point going to the hospital? They won’t give me methadone there.’
‘Methadone? Well – I don’t know about that. But you can certainly talk to someone there about it. The most important thing …’
‘Yes. Yes. The most important thing. The most important thing is that I get back to the park and find my hat. I can’t lose my hat. Not my hat. Enough’s gone wrong today without losing my hat. Jesus Christ. And don’t worry about the methadone. I’ll just have to score some heroin tonight and think about the rest tomorrow.’
The policewoman takes one step into the ambulance.
‘So will you be pursuing this assault, Michael? It’s a serious thing that’s happened to you. You should take the advice of these good ambulance people here and go on up to the hospital.’
‘No. Forget it. I didn’t call anyone. Leave me alone.’
He re-stuffs his pockets, and suffers to stay still just long enough to have a bandage taped around his head.
‘So what happened exactly?’
‘I was asleep on a bench. Suddenly this guy was shaking me awake. I said “What do you want?” and he said something like: “Do you want to feel pain?” and I was confused and I said “What do you mean? Say what again?” He bent down to put his bag on the floor, I sat up, he produced a bottle, smashed it over my head, knocked me out. Next thing I knew I was walking out of the park and some kids were asking if I was all right.”
‘You’ve got to get this wound treated, Mike,’ I say to him. ‘It needs cleaning out and gluing.’
‘No it doesn’t. It’ll be fine. I can’t be doing with all this.’
He makes to walk off the vehicle.
‘I’m serious, mate. It’ll get infected. It’s got glass in it, for goodness sake.’
Infected', he says, bending down to retrieve a toffee that’s fallen on the floor. ‘Thanks for all you’ve done. I appreciate it, I really do. But this is ridiculous. I’m going.’

And he’s gone.