Friday, September 26, 2008

the first time

Rae drives with supernatural incisiveness, powering through the heavy morning traffic, anticipating with cool clairvoyancy the smallest deviation or hesitancy, flashing through gaps with a paint sweat of clearance, braking down before that driver even thought to indicate left and pull over to the right. We are heading out to a fifty year old female in cardiac arrest, and we want to get there quickly.

Swinging round into the close we can see the house we want: the one with the door open and a naked man pacing about on the grass verge outside. He holds a phone to his ear with one hand, the other the ends of a bath towel he has bunched around his waist. He flips the phone shut as we pull up.

‘Please, please be quick. She’s upstairs on the bed and she’s not breathing or nothing. Please, please, please, oh god. oh god.’

As I stride across the grass with the resus bag I ask him questions. He says his wife has a history of angina. She complained of chest pain when she went to get up this morning, but keeled over before she’d had time to grab her spray.

Inside the house and it’s horribly cluttered with junk. I wonder how we’ll fit the chair down these stairs, but immediately focus on the scene in front of me as I pick my way across the landing into the bedroom - an elderly man, pushing up and down on the chest of a naked woman sprawled on a double bed. Her body bounces lifelessly as he tries to compress her chest. He stops as soon as he sees me.

‘Help’ he says.

It feels like I’m climbing through some kind of waste facility. There are heaps of old clothes, boxes of video tapes and newspapers, chairs with dusty television sets and VCRs, lino squares and carpet off-cuts.

‘We need to get her on the floor,’ I tell the man. ‘Help me clear a space.’

In a few seconds we pick up and throw across onto the other side of the bed an occasional table with an overflowing ashtray and spilled packets of sweets and just enough boxes to make room for the patient. Rae is in the room now and she cheats the bed over to one side by another critical inch, just enough to get the patient down on the floor. I start chest compressions whilst Rae gets out the defib. The elderly man – the woman’s father – scrambles out of the way over the bed, and goes to stand with the husband on the landing. A technician working on the response car turns up to help. He fetches some extra pieces of kit we need, then takes the two of them to one side to get the paperwork going.

The readout is good for a shock. Rae hits the button. The patient gives a convulsive jerk and her head whumps back on the dirty carpet. I compress her chest for a further minute then we check the readout again. She has a pulse on the screen. And, crucially, at the neck. Her abdomen positively quivers with it. It’s fantastic to see. She starts to gasp beneath the mask with crude, primal intakes. I support these with the BVM.

After twenty minutes we have her wrapped in a blanket and on the chair ready to go. In those twenty minutes the father and the husband have cleared a path for us down the stairs. Fear lends them strength. Adnan, the technician, bussing our kit from the scene and making the ambulance ready, tells us that the father picked up an entire bookcase by himself.

We run the patient out to the vehicle and transfer her on to our trolley. Although she’s still unconscious, her vital signs are encouraging, with a respectable blood pressure and saturations. Rae passes the ashice and we set off for hospital. Adnan follows on with the husband and father.


I can see them now, standing side by side in the dirty frame of the bedroom door, the husband holding on to his towel, the father intensely still, watching us as we work. It seems to me that they were standing together at the edge of some new and extreme margin, the outermost point of their lives together so far, where the solid earth they had built their home upon had inexplicably given way to a great gulf of black water. They had watched us struggle to drag their wife and daughter back from this terrible place.

And this time – the first time, for me – we managed it.

Wednesday, September 24, 2008

a job holding on to things

The betting shop reaches back fifty feet from the glass doorway we push open on the highstreet. We step onto blond laminate wooden flooring, walk past a bank of screens, a neatly curving counter and a Wailing Wall of information – blu-tacked racing pages, dry-wiper odds and runners, magnetic titles, fluorescent notices – excuse our way through half a dozen men fixed like badly dressed mannequins beneath The Commentary, the great thundering drone that fills the place, over to a little protective semi-circle of chrome chairs on an area of dirty blue carpet at the back. An elderly man is lying on his side on this carpet with his head resting on a rolled up jumper. Two members of staff in blue t-shirts are kneeling next to him. One of them is holding an aluminium walking stick, a carrier bag and a brown tartan cap. He waves us over.
‘This is Bill. One of our regulars. Aren’t you Bill?’
‘Where’s my cap?’
‘I’ve got it here, mate. Bill had a funny turn and slid off his chair. I don’t think he’s hurt himself, but we left him where he was, just in case.’
‘I don’t want to lose my cap.’ He smiles up at me. ‘It’s a job holding on to things. It’s not so easy, finding yourself a good cap.’

We check him over, help him to his feet and walk him out to the vehicle. He settles back on the trolley and surrenders to our regime of tests with the air of an old man indulging grandchildren around his deckchair. The skin of his face seems waxy, stressed by age and circumstance, but his eyes are still sharp; his smile, balanced beneath the philtrum of his large nose, is a generous crescent-shape.

All his observations are normal, but he says he wants to go to hospital for a more thorough check-up as he’s never fainted before and can’t remember the last time he saw his doctor.
We set off.
‘I grew up in London,’ he says, folding his arms and offering me another smile. ‘Holland Park. Know it?’
I tell him my sister lives in Ladbroke Grove.
‘Does she? Well, isn’t that funny? I know Ladbroke Grove, of course. Years ago, mind.’
He seems to fade slightly, then comes back.
‘I had two brothers and a sister. All gone now. Do you know, I’m the last survivor of my kind? Lost my eldest brother in the war. He was in Burma. I was with my Mum when she got the telegram. I’ll never forget it. It just said “Frank missing on Burmese-Thailand border.” Nothing else. Never heard another thing about it. I was in the RAF. Ground crew. Went to Africa. Came back. Got a job doing this and that. Decorating, you know. Getting by.’

He looks out of the window, but can’t make out where we are through the blinds.

‘I lost my daughter last year. She had one of those brain tumours. They whipped out as much as they could, but left some in, and of course it grew back. My wife’s in a home.’
He smiles at me.
‘How long do you think they’ll keep me in, then? I’ve got things to do.’
I tell him it depends.
‘I know,’ he says. ‘Listen, I bet you thought I’d won a fair bit. Fainting in the bookies like that.’
We both laugh.
‘Anyway. Have I got everything? Where’s my cap?’

He pulls it firmly onto his head as we roll into A&E.

Saturday, September 20, 2008

the little black duffel bag

The doctor’s surgery looks closed from here. All I can see as we turn into the car park is a pair of yellow rubber gloves bobbing about behind the dull glass panes of the foyer. Eventually I make out the cleaner wearing them, finishing her rounds, gathering bags. But as we park up, a middle aged man appears in the doorway to watch. When we come to a stop he sets out towards us, walking across the deserted car park with a convicted, deadbeat shuffle, rounded inwards at the shoulders, head down, his demeanour as washed-out as his raincoat. All he has in his hands is a small black duffel bag, but it may as well be a medicine ball. He stops and stands still, swaying slightly as we climb out of the cab to say hello.
‘I’m guessing you’re Eddie’.
He nods.
‘And I’m guessing the doctor’s gone home.’
He nods again.
Rae opens up the back of the ambulance.
‘Here. Let me carry that for you.’
He gives the bag to me, and I help him up the back steps, suddenly finding myself up to the nose in a wake of alcohol fumes and stale sweat.
He lands himself on the trolley and draws his knees up to his chest.
‘So what’s the problem, Eddie? Why does the doctor want you up to the hospital today?’
‘I’ve got pains in my front, here.’ He makes a general sweep with his right hand. ‘I can’t bear it. I can’t bear it any more. Something’s got to change.’
‘Did the doctor give you a letter?’
He pulls one out of his raincoat. The doctor has sketched Eddie’s abdomen as a hexagon and shaded in the top margins with little crosses. Here be dragons. Eddie is having another bout of pancreatitis.
‘Have you had a drink today, Eddie?’
‘Just a quarter bottle of vodka. Honestly, my friend, this is true agony. I’m dying.’
We plug him into the monitors and take down the information, then Rae jumps out and goes back to the driver’s seat. We set off.

Eddie settles back on the trolley. His face is a boiled cherry-red, cooked through years of alcohol abuse. The silver-rimmed glasses that he wears give his face a strangely plastic complexion, like the model of a man made by an alien with no sense of human colouration. He opens his eyes again and studies me.
‘I buried my dad two weeks ago. Yeah. Two weeks ago.’
‘I’m very sorry to hear that.’
‘Two weeks ago. Yeah. I went to the funeral. I carried the coffin with my brother and sisters.’ I try to imagine him under one end of a coffin, but all I can see is Eddie struggling with his little black duffel bag.
‘I carried the coffin. Even though I’m a sick man. Even though I broke both my ankles a couple of years ago. But these things – you have to do them, don’t you? He was only eighty four. Cancer. I hardly ever saw him though. He didn’t want to know. I couldn’t stick around for long. I was only there for the service. When they all went back to the house for drinks I made my excuses. I think I was only there ten minutes. At least I went, though.’
He relaxes back on the trolley, and after a while seems to fall asleep. But there’s a sudden jolt and he opens his eyes again.
‘Two broken ankles,’ he says, turning his head to look at me. ‘Two of them. Make sure you get that down on your form.’

Wednesday, September 17, 2008


The retirement block is frankly laid out in new red brick, but a stand of young ash trees planted in front are already softening the geometric lines of windows and walkways, and there are vigorous bushes of jasmine hauling themselves up from the small patches of garden at the front. The sounds of children playing in a nearby park drift across to us, and to the group of elderly women standing by the open front door. It’s a cardigan-wrapped, whisperingly tight little huddle, although as I open the gate and walk up the path towards them, they chip in brightly enough:
‘Flat Eight.’
‘Ground floor.’
‘Turn right as you go in, dear.’

We make our way along a narrow corridor to number eight. The runner is rucked up outside the open door. ‘Ambulance’ I call out, and make my way inside. Another confined space, but this one strewn with a pair of broken glasses, the contents of a toppled plant stand, a discarded jacket. We pick our way through towards the voices we can hear in the sitting room.

‘In here, guys.’

Stanley is sitting on the edge of a flower-patterned arm chair. He looks up at us, and dabs at a small cut above his right eye with a blood spotted handkerchief. A policeman stands next to him; over in the kitchen a policewoman looks round the door and waves at us. They’re both wearing rubber gloves.

‘What’s happened here, then?’

Stanley – an eighty year old with a full eighty years of gravity expressed in his face – lowers the handkerchief.

‘I’ve been beaten up, threatened, locked in a cupboard and had all my savings taken. That’s what’s bleedin’ happened.’

The policeman puts a hand on his shoulder and tells us the story: two guys knocked on the door, when Stanley opened it they pushed him backwards into the flat and onto the floor. They punched him in the face but he wasn’t knocked out. They threatened him with further violence if he didn’t tell him where his safe was, then they locked him in the broom cupboard and stole his money. He managed to escape from the cupboard by undoing the hinges with a screwdriver.

‘I don’t understand how they knew I had a safe’, he says, dabbing his eye again. ‘How would they know that?’

We clean his wounds and check him over. He seems to have come through the ordeal reasonably intact. We offer to take him to hospital but he refuses.

‘They can’t do nothing. They can’t get me my money back,’ he says. ‘What I really need is a glass of brandy and a cigarette. Can I have those, do you think?’

I tell him he’s in his own home and he’s perfectly at liberty to have what he likes.

‘My own home,’ he echoes, closing his eyes and waggling his jaw slightly, as if he were rolling those words around in his mouth for the first time.

‘No good will come of these people,’ I say to him, packing my stethoscope away. But no-one in the room, not the neighbours looking in from the hallway to pay their respects, the Scene of Crime officer arriving with a detective, not Rae, and not the police completing their paperwork – no-one can say that this will be so.

I shake Stanley’s hand, give a copy of the PRF to the police, and we leave.

Outside, the day has moved on. The children in the park have gone and the sky has deepened. The air seems colder. For the first time I really notice that the trees have started to lose their leaves; I scuffle through a patch or two back to the ambulance. There is definitely, definitely an autumnal pinch about the place.

Friday, September 12, 2008

the jacket with the bible in it

We don’t need satnav on this one. I used to live in this part of town and I know the street well, an early Victorian terrace with brightly coloured houses packed together like fancy cakes on a shelf. The street has managed to hang on to some cute period details, stretches of raised pavements, cobbles, and intricate patterns of bricks dividing up the road, the nineteenth century equivalent of speed humps. And still determinedly flying its pub sign, a tiny drinking den squeezed into the middle of the row, last serving survivor of a dozen or so in this stretch alone.

The job is given as a forty nine year old male with haemorrhage/lacerations. The follow-up notes tell us that the guy has started bleeding from a burst blood vessel in his groin. The lighting in this street is poor, but we still make out a man flagging us down a little way ahead. He stands waiting by the kerb, and as we draw level with him he pulls out his iPod earphone with a sigh as audible as the electric window Rae puts down.

‘He’s over on that wall’, he whispers, but looks the other way down the street. ‘I guess he’s been doing something he shouldn’t.’
‘Sorry? I didn’t … what did you say?’
‘Who knows? Drugs, maybe? Anyway – he’s on the wall and he’s bleeding a fair bit. That’s it.’
‘Okay. Thanks for your help.’
He nods without commitment, reattaches himself to the iPod. It seems to steer him away into the gloom.

I grab a dressings bag and we walk over to a man who is sitting on a low brick wall with his trousers down by his ankles, one hand pressing a towel into his groin and the other keeping him propped upright. There is a substantial course of blood running from underneath his boxer shorts, across the pavement to the gutter.

‘I injected into a femoral vein yesterday and it’s just gone on me,’ he gasps. ‘Don’t forget my jacket. It’s got my bible in it.’

In a few minutes we have him on the truck, his legs raised, three dressings binding his leg, oxygen flowing, connected to various monitors. I hand Rae a cannula.

‘You’ll not find a vein,’ he tells her with a ghastly smile beneath the oxygen mask, but says ‘Fair play’ when she does. We set a bag of Hartmann’s running.

He watches everything with a grim, glistening detachment.

‘Don’t think bad of me. I’ve got titanium plates in my back. Five, six, seven and eight. I can’t bend my knee. I could tell you a few things about pain, mate. I quit the smack but, fuck it – things, you know? Beyond my control. I was clean for years. But then – don’t ask – it’s big, big, unreal. Another time, mate.’

He pulls off the finger probe and produces a packet of tobacco.

‘I need a smoke, mate.’

We stop him from smoking.

He absorbs that.

Rae takes the clipboard, jumps out and slams the door behind her. I hear her give the ASHICE in the cab.

‘Have you got my jacket?’, he says, raising his head up, pulling the mask aside and looking around the bloodied compartment like a man suddenly conscious in the middle of a dream set in a butcher’s shop.

‘I can’t lose that, mate. It’s got my bible.’

I hold up his jacket, a dirty brown corduroy sack, heavy with stuff. He sighs and replaces the mask. Rae passes the board back through to me. We set off in a rattle of blue.

Thursday, September 11, 2008

getting out

The patient’s house is easily identified by the ambulance standing outside. I park where I can – this is a crowded little red-bricked estate with cars up on any horizontal surface that will have them. But the first ambulance is already blocking the street for anyone at the end, so I don’t worry too much about leaving the way clear.

The front door stands open. We can see a trolley set up in the hallway. Going inside I hear the crew that has called for help chatting pleasantly in a bedroom off to the left. Walking round into the doorway I see an enormously heavy man standing supporting himself on a reproduction Georgian bedside table, something I expect to explode into splinters any moment. He is leaning forwards on his swollen arms, legs planted at shoulder width. His legs seem to have morphed into great, bandaged elephant trunks, patches of rotten brown skin flaking off on the inner aspects of his thighs. His body - a thirty stone reservoir of pendulous fat – sways in the gap between man and table. He smiles across at us, his pouty mouth underlined by a stack of chins.

‘Hi guys,’ says Frank. ‘This is Peter. Peter’s been seen by his GP this morning with an on-going cellulitis problem. The GP wants him into the hospital today to have a thorough-going look at that, and a few other bits and pieces. Obviously we needed a little help – erm – with the trolley.’

Frank smiles at me and taps the clipboard on his chest.

‘Go on, you can say it,’ Peter says, hauling one of his legs forward half an inch. ‘I don’t mind if you call a spade a spade. I’m a big fat bastard. There. It’s out. And I’m sorry to trouble you all.’

Someone leans on their horn in the street.

Monday, September 08, 2008

flimsy things

‘He had a bit of a fall earlier in the week. He didn’t seem too bad at first. A cut finger, a scrape over his eye, but other than that, fine. He’s normally so fit and well – better than any of us, actually. It’s just that yesterday and today he’s started to seem a bit, well, confused. Keeps talking about seeing things. I’ve never seen him like this before. I have to say I’m worried.’

The neighbour, Ken, a brisk and self-possessed old man in his eighties, has met us at the wrought iron gateway to the block of flats. It’s an imposing thirties construction that forms one corner of an old street leading directly off the front. The wind is strong here, barrelling in off the sea, squeezing between this canyon of buildings and up into town. Our little group leans slightly to compensate.
‘Let’s go up and have a look then.’
Ken hauls the gate open a fraction more. He leads us up a flight of stairs, along a narrow and shadowy corridor to William’s flat. The door stands open; Ken walks inside and says: ‘The ambulance are here, William,’ and we all walk in.

William is in his bedroom, pulling on a starchy white shirt and patting his trouser pockets for keys. If you looked at him quickly out of the corner of your eye you would think he were a slight young man in a rush to get ready for work. It would be a shock, then, to look straight at him, as we do now, and see that he is, in fact, a desiccated old man of about ninety, his face worked out in deep lines and liver spots, his neck as pendulous and ropey as a Galapagos tortoise.
‘Just a minute,’ he says, and almost topples over in his rush to pull his braces up.
I go across to him, introduce myself, then help him with his socks.
‘My shoes are in the other room,’ he says.
‘Okay. Let’s get those on, then we’ll have a sit down and a chat.’
We follow him next door into a crowded sitting room, a scattering of knickknacks on every surface, framed photos on the wall, a painting in vigorous lines of fishermen hauling in nets on a wild beach, and to the side of the fireplace a ceramic humpty dumpty with a placard round its neck saying ‘Don’t blame me – I didn’t vote Tory’. Laid out in front of this fire are a dozen pairs of shoes, laces spread apart, in three shades of brown.
‘It’s like a shoe shop,’ I say. ‘Which pair do you want, William?’
‘The brown pair.’
I help him on with the nearest. He relaxes back into the chair when the laces are tied.
‘So what’s this all about?’ William says, looking around.
‘You know what it’s about,’ says Ken from over by the door.
Ken has his arms folded across his chest. His chin is looking alarmingly soft, as if he might cry at any moment.
‘Ken has called us in because he’s worried. He says you had a fall a few days ago and haven’t been yourself since. Is that right?’
He looks at me with astonishment. His hair seems to stick straight up with the force of his bewilderment.
‘I suppose I have been a bit off,’ he says.
‘Ken says you’ve been suffering from hallucinations.’
‘I’ve been seeing things, yes.’
‘What kinds of things?’
‘Oh – people, tables, animals. Things that aren’t there. Paper objects on the ceiling. Flimsy things.’
‘And how does it make you feel when you see these things?’
‘It confuses me. It makes me feel a bit – unsteady. If I see a table in front of me I’ll make to go round it, but then when I see it’s not really there, I’ll go all wobbly.’
He wipes a finger under his nose and then hunts around in his pockets for a handkerchief. He has wrapped white sticking tape around one of his fingers, and there is a graze above the coarse white curls of his right eyebrow.
‘William – how about coming down to the ambulance with us? We can give you the once over, and then have a think about what to do next. Would that be okay?’
He stares at me above the handkerchief as he blows his nose, and blinks heavily a couple of times.
‘Will you be bringing me back? I don’t want to spend all day there. I’ve got things to do.’
The wind rages against the metal-framed windows. It feels as if we’re on the bridge of a doomed old liner, heading out to sea.
‘Make sure you hold on to my belt, though, won’t you, mate?’ he says, leaning over to one side and stuffing the handkerchief back into his pocket. ‘I’ll blow away, else.’

Saturday, September 06, 2008


#1 I used to work in a lovely little factory making bears. I started out on the stuffing machine, progressed up to eyes and bows. I loved it there – such a cozy team. The man who ran the place was a bit haphazard, but we managed. He’d stamp his feet a bit when we’d take our lunch break in the pub next door, and then finish off the afternoon with the arms and legs a bit skew-whiff, but he was happy enough. Five shillings a week. Not much, when you think about it. But I was younger then. I just seemed to cope with things better. It was just a tiny little mews factory. Not there now, of course. But the pub is.

#2 I was born in Sunderland, knocked around there until my National Service, then when I came out I moved down to London and got a job as an ambulance man. That’s why I’ve got this scoliosis of the spine and my knees are worn out, but that’s the way of it. All that lifting. I worked over in the Wembley area. We used to volunteer to do the big matches. Once, I was at the Cup Final, 1973, Sunderland versus Leeds United. Well. As you probably know, Sunderland won. Amazing. Fantastic. We were in the tunnel, and I says to my mate ‘Why don’t you go to the dressing rooms and get us some signatures?’ and he says to me ‘Why the hell don’t you go yourself?’ And I says ‘Well I’m shy’ And he turns to me and says ‘You’re a Geordie, man. Away with you to the dressing rooms.’ Well, I certainly was scared about doing it. It was one hell of an occasion. But I did go down to the dressing rooms. Of course there was this enormous party going on, shouting, carrying on, everyone spilling about and everywhere. And this man – don’t know who he was – he claps me on the shoulders and gives me a hug and says to me: ‘Can I help you?’ and I says ‘I wonder if I could have a few autographs, like.’ And he says: ‘Where are you from, then?’ and I said: ‘Wearside’. So he shouts across the room: ‘Hey! Let’s have that cup over here. This here ambulance man’s a mackem.’ And do you know what – they passed over the FA Cup, and I held it in these hands, and I had me a big old drink of champagne.’

Tuesday, September 02, 2008

boxed character

Angela is standing over by the far window, two thin white leads dangling from her ears to the pink DS Lite she grips fervently with both hands. She has an intensity about her that is accentuated by her bloodless face and hands and the mess of grey blond hair piled on her head like a wig made of wire wool. She is so engrossed it’s like the console is playing her.
‘Hello, Angela. Do you mind if we come in and have a chat?’ I say to her. ‘It’s the ambulance. My name’s Spence and this is Rae.’
She flicks up her eyes only briefly, something like a snake tasting the air, then settles back into the game.
It seems as if Angela has been standing in this room – crammed full of pop posters and soft toys - since she was twelve. She’s now forty, and I can imagine the view out of the window changing as she stands there: a new housing development along by the port, increasing numbers of cars in the road, deep green hedges racing up in one garden and mature apple trees torn down in another. The sun rising and setting, the moon waxing and waning, whilst Angela stands by the window or sits on the bed, and her dressing table gradually fills with a collection of boxed characters from films and TV shows – Princess Leia, Charlie’s Angels, Wonder Woman – twist-tied in action poses behind their yellowing plastic bubbles.
‘Did you know we were coming?’
She looks up at me briefly, nods once.
‘Do you know why?’
She stops playing with the console.
‘I’ve been having trouble again. The voices were back really strong and they were telling me to kill – certain people.’ She looks at me again as she says this, as if to check that I understand who those people are.
‘That’s what your mum told us downstairs. She’s pretty worried about you, Angela. She’s worried that you might try to hurt yourself again.’
Angela begins tapping at the console again.
‘We’ve just got to think what’s the best thing to do for you tonight. Have you got any ideas? Is there anything you’d like to do. Or not do.’
She ignores me.
‘Do you think you might hurt yourself tonight, Angela?’
With a sigh she sits down heavily on the bed, pulls out the ear pieces and lays aside her console in a dead flat sulk, as if I’ve just told her off.
‘I tried to kill myself last year. I climbed onto this bridge. The police were there and they stopped me. I ended up in hospital then.’
‘And do you think you might do something similar now?’
She shrugs.
‘If the voices tell me to, then – maybe, yeah.’
I hear a car pull up outside and the thunk of doors being closed.
‘Angela – the police were called here tonight, too. I don’t want you to be worried. We had to have the police along because it said in the notes that you were potentially violent – had been violent, to some hospital people, when you were last in. Is that true?’
‘What we’ll do – we’ll meet the police downstairs, talk to your parents, and then decide what we can do to help tonight. If you want to come downstairs, too, that would be great.’
She stares at me, her eyes half closed. The medication is obviously taking off a good deal of the pressure, but what little you can see of her eyes is a crystalline grey, hard and implacable. It’s like talking to a camera lens.
‘Shan’t be a moment.’
We make our way back down the narrow staircase to talk with the parents in the kitchen. The police are there – a man and a woman – and by the way the mother is up and making tea, it would seem they’ve been here before, many times.


The hallway is brisk and well kempt, its carpets swept and sprayed, white walls above the dado, aquamarine below. But there is a man lying on his side up the stairs from the bottom step to the sixth, inert and out of place, as if a giant child had been called away mid-game and left a figure there.
‘I said goodbye to Stanley when I left for work this morning. He was standing at his door, holding on to the frame, looking a bit confused, you know, but then he’s been like that for a few weeks now, so I didn’t think anything of it. Do you know what I think? I think he must have made it to the stairs and lain there till I got back just now.’
His neighbour, a generously proportioned black woman who lives in the flat above, leads us over to him.
‘Stanley?’ she says.
He twitches and looks up, then after a second or two of clownish focusing, repositions his glasses and gives us the old-school thumbs up.
‘What’s all this, then?’ he says.
Up close to him now and we can see the neglect. His windcheater jacket looks like it has been pulled from a skip, torn in a couple of places and fixed with safety pins, the lining poking through, and at every place of contact with the world - on the back of his jacket and trousers, round the pockets and sleeves, there is a grimy shine of dirt. His fly gapes open; he has a brown shoe on his left foot and a black one on his right, both unlaced.
‘What’s going on?’ he says.
‘Well, that’s what we want to know,’ says Rae. ‘Have you hurt yourself, Stan? Are you in pain or anything?’
He considers the question, then raises his eyebrows and shakes his head.
‘No. No – I’m absolutely fine. What’s this all about, Hope?’
‘It’s a funny kind of fine, though, Stan. Lying on the stairs like this. People are worried about you.’
‘Are they? How kind people are.’
‘So what are you doing on the stairs?’
‘I felt a bit off.’
‘In what way, off?’
‘Just – off.’
Hope is standing over us all, her arms folded, a guardian angel / security guard hybrid.
‘He’s been on the slide for months now, but I’ve not seen him as bad as this before. He doesn’t seem to have any oomph about him at all. He must be sick, but he won’t see the doctor. What can you do?’
Rae asks Stan if he’ll come out to the ambulance and let us give him the once over. He agrees, demurely, like a vicar accepting an invitation to tea.
‘But could I first get my keys and shut the windows?’

We help him to his feet and hold on to him either side as he sways slowly over to his front door. He smells bad, unwashed, a rank margin about him you could chip with a hammer. He pushes open the door, and we follow him into his bedsit room.

I remember reading a description of the moment Howard Carter and his team broke into Tutankhamen’s tomb – the rush of foul gas as the breach was made, the way they gradually made sense of the wonderful clutter of objects around them. The difference is that instead of ornamental caskets and golden effigies, here there are dozens of carrier bags stuffed and tied-off at the handle, boxes of junk, newspapers lined up in columns and stacked up on every horizontal surface. The walls of the bedsit are clear, with the exception of an alternative suit of clothes, even filthier than the ones Stanley is wearing, hanging from a picture rail, next to one small picture in a gilt frame – a pastel study of a series of lock gates on a canal lined with dark poplar trees. The gate in the foreground is open, inviting you to make your way up river.
If this really is a tomb – and it certainly doesn’t seem a place where you could expect the living to be found - then its occupant has woken up and been moving around. Between the seamy bed and the sink, the sink and the armchair, the armchair and the door, there is a narrow channel of access kept clear by the simple action of walking. Everywhere else is utterly silted up with junk.

‘I’ll just get my keys,’ he says, and puts his hand straight to them.