Monday, June 30, 2008


We walk down the slope to the club, towards the epicentre of the thumping, subterranean rhythm. The club's neon sign punches out a lurid pink hole in the darkness; beneath it, drawn from the deep hollows of the night like exotic moths, clubbers are massing. One girl is draped upside down on a barrier, looking like a strangely animated piece of discarded clothing. She is shouting into a mobile phone, but she’s not our patient. We excuse our way to the head of the queue and catch the eye of the doorman, who nods an acknowledgement, then tosses the nod across to another doorman, who immediately pushes through to us. He is massive, constructed rather than born, his head as square as his shoulders, and his eyes drilled in deep.
‘She’s over there on a bench with her brother. My opinion? Too much to drink. Some ecstasy, she says. Nothing, really. Emotional, that’s all. Pain in the arse. Want a look?’
I ask him if she’s able to walk, and if so, will he bring her over to us, as we won’t be able to hear or do much over where she is at the minute. He accepts this without any change in expression; in a moment, like a big black dog retrieving a fallen bird, he’s back, gripping a slumped woman by the arm. A man stands touching her other arm. He is a brittle looking guy of about thirty, well-dressed in expensive leather jacket and jeans, but his eyes are puffy; he stares at us gloomily like we’re the next goddamned thing to happen.
‘Whilst she’s on her feet, let’s get her up to the vehicle,’ I shout, taking advantage of the momentum of events. The doorman straight away marches her back up the slope with the woman almost losing her shoes as she drags herself along by his side, trying to keep up.
‘What’s the story, then?’
‘This is my sister Susie, yeah? She got a bit down tonight, you know? She’s had a little bit too much to drink, taken half an e and some charley up the nose, but nothing to write home about. It’s all just proved too much for her. Can you help us?’
At the back of the ambulance the doorman shrugs off any help, dumps the woman on the trolley, turns round and says: ‘Call sign?’
I give it to him. Before I can really thank him for his help he’s marching back down the slope.
‘Right. Let’s get to the bottom of this.’
Susie has immediately adopted the same posture on the trolley as the clubber on the rails, hanging upside down. She makes a sudden, cat-like heave, and I only have two seconds to get a bowl beneath her mouth before she starts emptying her stomach.
‘And you’re sure she’s had nothing else tonight?’ I ask the brother.
‘God’s truth,’ he says, rubbing his eyes. ‘I’ve never seen her like this before.’
But after we’ve taken a round of observations including an ECG, and talked to Susie – who is perfectly able to talk to us – it looks increasingly as if the doorman was right, that the only thing wrong with her is that she’s had too much to drink and isn’t coping well.
The vomiting has settled her, though. She rights herself on the trolley and starts to talk to us in more detail.
‘You don’t understand. You don’t understand what it’s like.’
‘What what’s like?’
‘Being dumped.’
She looks up at me through a mess of makeup, her face a twist of dreadful anguish.
‘We were supposed to be getting married in four weeks. Four weeks. And now he’s dumped me.’
‘That must be very difficult for you.’
‘I can’t believe he just dumped me. In the street!’
‘Well you know what I think,’ says the brother, rubbing his face in his hands. ‘You’re better off out of it. He’s done you a favour. Tosser.’
‘Four weeks!’
Rae keeps Susie supplied with paper towel whilst I finish off the paperwork. Eventually we reach the stage where we have to decide what happens next. I know this is going to be difficult.
‘Now, Susie – there’s nothing medically wrong with you, so I don’t think you need to go to hospital.’ They both nod, which is a good start. She blows her nose, then lies back on the trolley, rolled flat by nausea, and broken plans, and other people.
‘I think – all things considered – the emotional upset, the drink and the drugs that you’ve taken – I think the best thing would be to get yourself home, sleep it off and figure out what to do next when you’re fresher in the morning.’
‘Can you take us home, then?’ asks the brother. Susie opens her eyes and looks up at me again.
‘Unfortunately that’s not what we’re here for. We can only take you to hospital, and like I say, that’s not the best place for Susie at the moment. Especially when you consider that it’s a Friday night, and A&E will be looking like a war-zone. No. What I suggest is that you get yourself a taxi and make your own way home.’
‘What taxi is going to accept her in that state?’
‘You’re right. Most taxis won’t even think about letting anyone on board who they think might throw up on their seats. So what I suggest is that – Susie – you make a big effort to walk over to the taxi rank looking as sober as you possibly can. You haven’t got far to go. They’ll take that into account, too.’
Susie stares at me.
‘You want to dump me, too,’ she says. ‘You want to throw me out in the street.’
‘No, no. It’s not like that. We’ve just got to think about what’s best.’
‘I’ve paid my national insurance. All these years I’ve worked, I’ve coughed up. Why can’t you take me home?’
‘Because we’re an ambulance, not a taxi.’
‘But a taxi’s not going to take us home.’
‘Sorry, Susie. But the only other thing I can do is take you to hospital – which I will do if you insist, even though there’s nothing wrong with you. But then you’ll be further from home than you are now, it’ll cost you more, and it’ll delay you getting home to your own bed and all the comforts that you need right now.’
‘Great,’ she says, balling up another tissue and throwing it into a corner. ‘Fucking hell. I can’t believe you won’t take us home.’
The brother stands up.
‘Come on, Susie,’ he says. ‘This is a waste of time. Just try to walk straight and look decent.’
We help her off the vehicle, discretely giving her another vomit bowl to hide under her jacket.
‘Thanks for your help,’ says the brother, but it doesn’t sound sincere.
‘You’re welcome. Good luck with the taxi.’
They don’t answer, but draw themselves up to cross the road. She looks fine from here.

Tuesday, June 24, 2008

four out of ten

[Eight in the evening. A fifteen year old girl is having her head wound cleaned in the back of the ambulance]

‘What the fuck was all that about? I have no idea why that happened. We were walking along the street, feeling merry. I had my iPod on and I was singing away to something – I don’t know – being stupid – being happy. Then this girl’s face appears out of nowhere and she’s like “I don’t want you singing no more” and I’m like “Excuse me. I’ll sing if I want to” and she’s like “Do you know who I am?” and I’m like “No” but my friend pulls me by the arm and says she’s one of the Brookses, one of the hardest families in town. I mean, everyone’s heard of the Brookses. And I’m like “I was only singing”. The next thing, she smashes me over the head with a bottle, and then walks off. I mean – why the fuck did she do that? Why would you do something like that? But then the worst thing was, she came back about five minutes later and put her arms round my shoulder and starts to make out like she’s sorry and wants to take care of me. What kind of psycho would do that? Saying she wanted to know I was all right, she had things going on –family things. Well, I mean, I don’t give a fuck if she’s having a hard time at home. I just want her to leave me alone. She had her arm round me, started dabbing at my head with a hankie. And I’m so terrified I’m sort of just quivering and letting her do whatever she likes because all I want her to do is go away and leave me the fuck alone.’


[Midnight. A man is lying in the middle of a busy street, police cars in the fend off position to protect him, a small bunch of people trying to help and keep him still]

‘I’d had a few drinks, it was getting on, I thought – I’ll go and see my girlfriend at The Beggar. Brilliant. Impress her, impress her friends, impressive. Yah! So I start to cross the road, waving and that, and I get run over. By a taxi. Was it a taxi? How cocking stupid is that?
[We fit him with a collar]
There’s nothing wrong with my neck, mate. I feel fine. Fuck me. Who’d have thought getting run over would be so complicated?
[We log roll him onto a spinal board and strap him down]
Hey! What’s all this for? I’m fine. It’s just my knee. Jesus fucking H Corbett. How embarrassing. And I bet they’re all outside the pub looking.
[We lift him onto a stretcher].
Well. I suppose it’s not that big a deal, being hit by a taxi. Was it a taxi? Fucking taxis. Where am I?
[We load him onto the ambulance]
If I don’t show up to work tomorrow they’ll let me go. It’s tough in the building trade these days. You’ve no idea. Any old excuse.
[We examine him more closely]
Honestly mate. I couldn’t be better. Considering. I can’t believe it. Run over. By a taxi, yeah? How pathetic is that?


[Five in the morning. A middle-aged man is talking in the back of the ambulance]

‘I came home from the pub and I was feeling a bit hungry, so I had a look round for something to eat. There wasn’t anything in the flat except this one bag of pasta, and I’m no cook – I mean, I usually just have those microwaveables. But I was that hungry I thought I’d chance my arm and try a bit of cooking. How hard can it be? So I got half a pack of butter, stuck it in a pan, fried up the pasta in that. Well tasty. But I was stirring it round and round for hours and it wasn’t getting any softer. It really hurt my gums. And then all that beer started to catch up on me. So I lay down on the sofa for a bit. Next thing I know, the room’s full of smoke, there’s banging on the door, sirens out in the street, God knows what else. But I’m okay. The landlord says he won’t let me back in the building until I’ve been to the hospital for a check up, but that’s my business, isn’t it? I feel fine. Tired and that, but okay. I normally wheeze a bit. Nothing new there. I just need some sleep. God knows I won’t be doing any cooking any more.’


[Six in the morning. A young guy has propped himself up against a wall and is talking into a mobile phone. The left side of his face is covered in vomit.]
‘The ambulance is here. Are you the ambulance? Yes. They say they are the ambulance.
[He holds out the phone]
She wants to talk to you.
[I tell him I’m not speaking on his phone because it’s covered in vomit]
He says he doesn’t want to talk to you because the phone’s covered in vomit. She says what hospital are you taking me to?
[Are you injured or sick in any way?]
No. I didn’t call you. Someone else must have. I’m on my way home.
[Were you lying in the street at some point?]
Maybe. Resting. It’s quite a long way home.
[That’s why we were called, then. Someone saw you and thought you were in trouble]
Well, I didn’t call you. Hang on. She says she wants to know what hospital you’re taking me to.
[We’re not taking you to hospital. You don’t need hospital. You just need to get yourself home.]
Okay. All right, mate. Whatever.
[Into the phone]
I’m coming home now.
[Stuffs the phone in his pocket, staggers off up the street]

Friday, June 20, 2008

the crumpled cigarette

The main shopping thoroughfare may be free-flowing with buses and taxis and people, but the discrete little stubs of pavement, alleyways and back entrances that serve it are so clogged with utilitarian chaos, and there are so many office workers lunching in the sunshine outside obscure new caf├ęs, Rae is forced not so much to drive the ambulance as to insinuate it through to the location given for our next patient.
Eventually we make out the likeliest candidate, a down-at-heel, middle-aged man sat flatly on his arse on a stretch of bare concrete behind a smart little mews garage, his legs crooked up, his arms on his knees, and his face propped on the right hand whilst the left serves his mouth with a cigarette. With the cans of lager around his feet, and his relaxed, relentless smoking, he looks like some weary philosopher, taking his ease whilst the world goes to hell.
Just next to him is a sweating businessman, urgently talking into a mobile phone. He nods to me – a cursory little tip of the head, as if he’s acknowledging one delivery whilst negotiating another – then takes a step to the side. I climb out of the cab and walk over to them whilst Rae manoeuvres the vehicle into a better position.
I squat down next to the patient, but before I have a chance to say anything, the businessman clips the phone shut then taps me on the shoulder with it.
‘For God sake, let him finish his cigarette,’ he says.
‘Hold on. Are you a relative?’
‘I called you,’ he says, showing me the phone, then stuffing it in his trouser pocket. ‘I called you. Is he going to be all right? I hate to see this. It just kills me to see stuff like this. I’m sorry if I’m a bit – emotional. My twin sister committed suicide two weeks ago and I’m not over it yet.’
‘Well I’m very sorry to hear about your sister,’ I say, squinting up at him, gauging whether I should stand and take a step back. Instead, I opt for the neutral calm I’d try to show before an angry dog. ‘That must be tough. Look. Thank you very much for calling us out to see this guy. But - I just need to ask him a few questions to see what the problem is. Okay?’
‘I mean – just look at him. He’s terribly, terribly sick. You must help him.’ But I study the businessman instead. His face is a more ghastly colour than the stripes on his tie. Booze fumes roll from him like scent from a cheap odouriser; he seems to be on the verge of tears.
‘If you’d like to step to one side – for one moment? Then I can get on and see exactly what this guy needs from us. Okay?’
‘Sorry. Sorry. I just – well, my sister dying like that. I see the ambulance. I see the guy lying there. And it’s just – well, you do what you can for him. I know you will.’
But instead of moving aside, he kneels down on the concrete next to the patient, who becomes slightly more alert, but not much. He takes his right hand in between both of his – which obviously inconveniences the patient, as he now has to support his head on his neck – and squeezes affectionately. The patient stares out at him from behind his heavy eyelids.
‘Get better, mate. Please. You’re in good hands now.’ The businessman releases his grip, produces a cigarette and puts it in his mouth. I have to tell him it’s the wrong way round.
‘These guys really know what they’re doing,’ he says, as if that just proved it. Distractedly, he stuffs the cigarette into his breast pocket. ‘They’ll do their very best for you, mate. Don’t worry. I’m sure the worst is over.’
I tell the patient that I’d like to talk to him on the ambulance so we can take a few details in private. He stands up with a little help, and I walk him to the back of the vehicle. The businessman tags along.
‘Are you taking him to the hospital?’ he says.
‘Well, that’s certainly one option. But anyway – thank you very much for all your help. I think we’ll be okay now.’
‘I’ll wait just over here. Let me know what happens,’ he says, pulling his phone out again.

Safe inside the vehicle I talk to the patient. He’s not unwell, simply worn down by his life, as drunk as he needs to be at this time of day, waiting on yet another appointment with the alcohol dependency team, the community psychiatric nurse, the housing support worker. He thanks us for coming out, apologises for wasting our time. He stumbles back off the ambulance.
Outside, the businessman closes in again.
‘What? What are you doing? Aren’t you taking him to hospital?’
‘No. He doesn’t need to go. He doesn’t want to go,’ I tell him.
Whilst the patient goes to sit back down on the concrete, the businessman follows me round to the cab.
‘Sorry if I’ve been a bit – emotional,’ he says, then gives a big, deflationary sigh. He pats himself down for a cigarette, eventually alighting on his breast pocket. ‘This thing with my sister. My twin, you know.’ He hauls out the crumpled cigarette and holds it up in front of him. We both stare at it, and his eyes seem to fill, as if he’s focusing on the remains of something vital he’d momentarily overlooked.

Monday, June 16, 2008


‘Look at me.’ Jonty holds both her hands out in front of her, zombie-style. ‘I’ve got the bloomin’ DTs. Do you know what that means? The DTs? It means I’m desperate for a tea. That’s the only thing that’ll sort me out. Just look at me.’ She laughs, a sweetly burbling, schoolgirl laugh. Her hands are not the only part of her jiggling about. Her jaw waggles up and down as if she’s eating a hot potato; only her hair has peace, rolled up in curlers and tightly bagged in a lincoln green scarf. ‘What a misfortunate article I am. Would you like some tea?’

We’ve just picked Jonty off the floor and helped her back into her favourite chair. Behind her through the window a beautiful blue stretch of sea and sky.

‘Do you know they want to make you pay more for a sea view? Add it on to your rates? I said not likely. I said you’ll have a Class A fight on your hands, mister. They don’t know what I’m like when I get going.’ She makes her hands into fists and holds them at eye level. ‘Pow! I can deal ‘em out when I need to. Mind you, my right shoulder’s frozen, and I can only lift my arm so high. I haven’t got the swing I used to have. And my husband died twenty years ago, so I’m out of practice.’ She gives me an elaborate stage-wink, and pats me twice on the hand. ‘But don’t worry. You’re safe with me. For now.’

The familial branches from Jonty’s ninety six years have spread across the walls story-board style: glasses raised at a work do, a man fishing, assorted bridal compositions by cake, by tree, by registry book; babies paraded to camera; gap-toothed children segueing into gowned adults; an inflated woman in shorts and sunglasses waving briskly from a summer garden a thousand miles and fifty years distant. And then amongst all these photos, Jonty has sellotaped up pictures of tigers torn from magazines.

‘Oh, do you like my tigers? I love my tigers. Here. Stroke this.’ She fetches out a stuffed tiger from behind a colourised photo of a soldier and a vase of plastic ox-eye daisies. ‘He likes his back roughing up - like this.’

I play with the tiger a little – ‘No! Really rough it up! Use your knuckles, man.’ I hand it back to her. She kisses it, then carefully places it back behind the photo – a man in a scarlet dress uniform and gold buttons, embalmed by a heavy-handed studio assistant.

‘My father. What a wonderful man. Looked after seven kids and had a job in the city. I don’t know how he did it. Mother had a heart condition, in hospital most of the time. He did have a woman who helped a bit with cleaning and chores, but mostly he’d come home from work and get straight down to it. Wonderful cook. Grew vegetables. Taught me to march around the garden – Boom! Bosh! Bosh! Just like him.’

We ask Jonty if she would like to go to hospital.

‘Would I like to go to hospital? Why? Whatever for? I’ve been in this body ninety six years. I think I should know by now when it’s not working properly. All I need to do is sit down, watch some boats, drink some tea. Okay?’

Her jaw works up and down, her head nods, every part of her not stabilised by an aspect of the chair trembling and ticking, as that ancient body like a vintage Bugatti gradually shakes itself out of whack. She pats my hand again as the home help brings her over a cup of tea and places it next to her on the trolley. I have no idea how she will manage to drink it.

‘Thank you dear,’ she says, then gives me a wink.

‘I just couldn’t get up off the floor, that’s all. ’

Thursday, June 05, 2008


#1: A cluttered room with an unmade bed in one corner, book shelves stuffed with cups, boxes, magazines and newspapers, the occasional book. A bulky old TV weightily sat on a stack of three: VCR, DVD, Sky. An occasional table with a pint glass three-quarters full of whisky. A floral sofa, shiny with dirt at the usual places of contact. Sitting on the sofa, the corpse of a hyper-inflated, naked man, his head angled to the left, his eyes and mouth closed, the lower surfaces of his body marbled with post-mortem staining, the remote control in his right hand partially subsumed by the rolling tympanic volume of his abdomen. A technician holding a clipboard and prescription sheet with one hand, pen in the other. A paramedic pulling back a grey net curtain and reaching through to open a window. A housing warden with a mobile phone to one ear, checking his watch.

#2: A gaunt man in a light blue windcheater and silver glasses, propped up against a low wall in the street, his bald head glazed by the sun. He is smiling bravely at the technician kneeling beside him, holding his wrist. There is a paramedic standing next to a line of three young women, all with their arms folded, looking down at the man like the chorus in some new, street adaptation of a classic Greek play.

#3: The strip-lit lobby of a dark block of flats. The lift is open, and four people are striding out: a technician with a baby in his arms, a woman in a light pink tracksuit and a paramedic carrying a red response bag and a cylinder of oxygen. The baby is wearing an unbuttoned white sleep suit; its arms and legs thrown out to the side and its head tipped back in the classic falling posture of the startled newborn.

#4: A silver saloon car outside a pub, its hazards on and all its doors open, no one there. An ambulance alongside it, headlights wig-wagging and blue lights sparkling, the back door open and the step down. Four men in blue football shirts walking into the pub, passing behind the vehicles. The second one is slapping or pushing the first one on the shoulder, but neither have turned to look inside the ambulance. The third one has his hands in his pockets, looking at the tarmac. The last and youngest one has his face turned to the dark interior of the ambulance; the compulsion to know holds his expression like a mask.