Wednesday, July 16, 2008

puppets on crack

Working the car has some advantages – periods on standby when you can simply be quiet and read; assessing patients at your own pace without interruption; listening to whatever radio station you feel like. But as I slam the car boot and struggle to gather together the three bulky bags I’ll need for this job, one big disadvantage is made weightily clear.

And then, of course, another disadvantage is that sometimes you’ll find yourself going in to a crack house on your own at three in the morning.

Control has reassured me that the police are on scene, and I’ve parked in front of their patrol car, but it’s not the same as having a crew mate to share the particular vulnerabilities of the ambulance position. Plus – this has been given as an overdose, and I don’t fancy spending half an hour bagging this patient without relief. The night is rolling on thick and close. The storm that would ease it has seemed imminent for the past hour, but maybe it will never come. I’ve only been out of the air conditioned car for a minute and already the frosting on my skin has gone.

During the day this is a busy street serving the railway station and the top end of town. Now the little café fronts and obscure record shops are dark. The flat numbers seem to be lower than I was expecting, and the police car turns out not to be immediately outside the address. I waddle past three dark entrances, unable to wield a torch and tote the bags at the same time. A young woman slides me a sympathetic look as she passes, then calls back a few seconds later.
‘In there,’ she points, just as a policeman peers round the corner of a shop.
I donkey my way over to him.
‘Here, can you carry that?’
‘All right, mate. Blimey – what’s in there? Gold bars? Anyway - what we’ve got is a woman of about thirty odd. Flat out on the floor. Looks like some kind of overdose, probably crack cocaine. We were called to the address because a guy said he’d been burgled. He answered the door with a knife, but it’s all okay now. Bit of a nut job, but nothing we can’t handle. Says the woman’s a friend of his. Can’t tell you much more. Thanks for coming. Watch your step.’
He leads me over the threshold of a dark and dirty back room, strewn with cushions, papers, carrier bags and cups – the usual flop house chic. In through a filthy galley kitchen where a policewoman is talking to a man in a dark suit, up a tight little dog-leg twist in the stairs, and into a sitting room where a woman is lying face down on the lino. She’s wearing an off-the-shoulder purple party dress, and would look as if she’d fainted during canapés were it not for the dreadful surroundings and the patterns of bruises and scars along her arms. I can see the rise and fall of her breathing even from here, even in the gloom of this place.
‘Have we got a name?’
‘Adie, we think. Trev’s not too clear about that. Or anything else, for that matter.’
I put the remaining bags down and go over to her.
‘Adie? Adie? Talk to me, Adie.’ I give her a shoulder pinch. Then a little harder. She groans and tries to shrug me off.
‘Adie. What have you taken tonight?’
On the armchair beside her is an asthma inhaler, but the cylinder has gone and there is some foil wrapped around the mouthpiece. The inside is charred. On a table nearby there is a clutter of vodka bottles, beer cans and a tall yellow canister of lighter fuel.
‘Have you been smoking some crack tonight, Adie?’
Her pupils are small but not pinpoint, and they react to my torch. Her respirations seem a little slow, and her oxygen levels aren’t quite what they should be, so with the help of the policeman I put a mask on her. As I’m taking some other obs the man in the dark suit comes into the room, followed by the policewoman. He walks over to me, a bobbing, curiously disjointed kind of walk.
‘She’s had the last rites,’ he puffs.
The black suit hangs off his slight frame with minimal contact. His face has an emphysemic, waxy gloss. His teeth are all gone – although he can’t be more than forty five – and his wide mouth flaps open and shut in an unhinged way. Everything about this man seems slack. Even his eyes pitch from left to right without focus. The policewoman is standing right behind him, and I could swear she has a hand up his back, and that her lips move slightly when he talks.
‘She’s going to die,’ he wheezes.
‘Trevor – it is Trevor, isn’t it?’
He nods, and his eyelids clack shut.
‘Trevor – is Adie your partner?’
The eyelids spring open.
‘No she is not. She is a friend. I’ve known her for fifteen years.’
‘Great. Can you help me out with a few details then, Trevor? Her full name, for a start.’
‘Adie. A-d-i-e.’
‘Thanks. And last name?’
‘What do you mean, last name?’
‘Her surname. You know.’
‘No idea.’
‘Okay. How old is Adie?’
‘No idea.’
‘Where does she live?’
He rattles his head.
‘Past medical history? Medication? GP?’
No. No. No. His level of consciousness seems to fall with each ‘no’.
‘Okay, Trevor. Can you tell me what happened tonight?’
His eyes suddenly widen again.
‘Adie came round. We had a few drinks.
‘How many drinks?’
‘Not much. Some cans of beer. A bottle of vodka. Then Adie had a smoke of her pipe. I went down to make something to eat. When I came back up she was on the floor.’
‘What happened about the burglary?’
‘Burglary? What burglary?’
I look over to the policeman. His expression reads: well what do you expect?
‘What are you going to do?’ says Trevor. ‘You can’t leave her here to die.’
‘Well, I don’t think she’s going to die, but she does need to go in to hospital so they can keep an eye on her. I’ll call for an ambulance.’
I give Control a ring and request a vehicle. Trevor seems to fall asleep standing up.
‘Why don’t you take a seat, Trev?’ I say to him.
He straightens with a little thrill.
‘I’m a section one patient,’ he says brightly. ‘But I’m off my medication.’
‘Why’s that then?’
He stares at me.
‘Why’s what then?’
He turns his head slightly to the side, his eyes stay to the front, and for a moment I think his head is about to spin around completely. Before I can shake off the image, the policeman steps over.
‘Come on, Trev. We need to have a little talk.’
He leads him back down the stairs. I squat back down to see how Adie is progressing, and turn over some rooted holiday talk with the policewoman for ten minutes whilst I wait for back up.


loveinvienna said...

Wonderfully written, as always :) Every time I read medical blog posts about drug addicts, it only strengthens my resolve to never ever EVER try anything remotely 'dodgy'. If recreational drugs were safe, we'd all be doing them...

Any particular reason why you're on FRU? (I assume you are, what with you being on your own...) Hope Rae is well :)

Liv xxx

BenefitScroungingScum said...

Another excellent post Spence. Crack is such a massive problem, but one that doesn't seem to getting the mainstream attention it deserves. A fair number of people I used to count as friends have gone down this road recently, convinced of course that they can handle it and that it's no different to any other drug they tried before. Heroin seems to be becoming more popular too.
Which is why I say they used to be friends. BG

Spence Kennedy said...

Hi Liv,
I suppose in defence of drug use (huh?!) it must be said that we only see the ones who can't handle it or who've let it take over their lives. I have known people - in professional jobs - who've taken hard core drugs and not let it impinge on their lives overmuch. But it's a dangerous game, no question.

I'm on the car 'cos they've introduced a new rota and everyone has to take a turn :( I'm not overly keen, as you can probably tell.

Hi BG,
Drugs and alcohol do make up a significant percentage of the workload, crack increasingly. They often seem to go hand in hand with serious deprivation. I can quite understand the reasons why people take drugs (having taken some myself at one time or another). I just wish it didn't happen so often that whole lives get sacrificed on the altar to them.