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?’
‘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


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


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’