Friday, January 16, 2009


‘So it’s pretty much always the same then? A fuck off through the letter box? That’s what happened the other day when we got a call out here, anyway.’
‘Yep. Same old same old. I’ve been out to Miranda maybe half a dozen times last year, and every time the same. But, we’ll see.’
George adjusts his heavy glasses and writes down the incident number and address as I pull away from the station. The ambulance doesn’t seem big enough for him. As he drops the clipboard back into the plastic well that separates us, out of the corner of my eye I half expect to see a great clawed paw rather than a hand. But even though he is too big for this cab, he’s otherwise perfect for the job. Strong enough for the lifts, empathetic enough for the patients, funny enough to do stand-by with. He has a slight under bite, his lower lip forward of his upper, which, with his scraggy beard and magnified dark eyes, gives him a lugubriously tolerant air. He reminds me of Spike, the bulldog in the Tom & Jerry cartoons, but crammed into greens and fresh out of anger management class.
‘What did you do before the ambulance?’ A lame thing to ask, as hackneyed as the so, do you actually drive the ambulance question that you inevitably field whenever someone finds out what you do for a living. But still always a surprising thing to ask, for all that. The ambulance service has something of the Foreign Legion about it: a place of mixed backgrounds, from teachers, plumbers and dental nurses to photographers, soldiers and horologists. Not a blue or white collar environment so much as a grey collar affair. We’re a mixed bag, a lucky dip of talent, and all the better for it.
‘I worked for a recycling company, doing the rounds on a big electric cart. I was one of the guys standing on the back, dumping cans in one stack and papers in the other, trying to hold on whilst the spliffed up driver ambled along the streets. I enjoyed it. It was a great craic. Hard in winter, but you had a laugh. There’s only so far you can go with that stuff, though, and your hearing takes a pounding. I studied music, originally. I’m a flautist.’

We pull up outside Miranda’s bungalow. We’re here so often I wouldn’t be surprised to see a space marked out for us. George hauls himself out of the cab and I follow him up the narrow concrete path to the front door. He knocks and we wait. He’s big enough to huff and puff and blow this house down, but he waits patiently, and then knocks again. There’s a dull stirring behind the net curtains. A shadowy figure leaves the living room and moves into the hallway. Any moment now I expect the usual expletives and half-hearted negotiations through the letterbox – but, incredibly, the door cracks open and she peers around the edge.
‘What do you want?’
‘It’s the ambulance,’ he says. ‘Are you all right?’
‘No of course I’m not all right.’
‘Well. Then. Can we come in and have a chat and see what the problem is?’
I half turn to go, but the door opens fully and Miranda says: ‘If you must.’
George looks at me, I look at him, and in that neutral little exchange there’s a great, psychic crashing of cymbals.
She leads us into her living room.
‘Sorry about the mess,’ she says, but the room has a measured tidiness, with magazines and papers and books forming regular margins of space that couldn’t happen by chance. Miranda takes up her position on a padded, high-backed chair, an orthopaedic throne within reach of a rack of remote controls, in front of a little plasma screen TV. There’s a DVD playing. Josh Groban in concert, singing with a curly haired sincerity that seems to be killing the audience. To the right of the TV is a sideboard of ceramic Arthur Rackham fairies, each one looking meticulously placed and dusted. Next to the sideboard is a stand of DVDs, each one concert footage, Bocelli, Bublé, Ball.
‘I want to die,’ she says.
George adjusts his glasses again and says, ‘Right.’
A scraggy black cat wanders into the room to investigate.
‘But I don’t want to waste your time.’
‘It’s no bother,’ he says, putting his clipboard to one side. ‘So what’s happened today? We were told you may have taken some pills.’
‘Temazepam. I just want to die.’
‘So how many temazepam did you take?’
She makes a vague gesture with her hand.
‘Not enough, obviously.’ Then she looks at him carefully. ‘You remind me of my son.’
‘Oh. That’s a good thing. Hopefully.’
‘He’s just like you. Big.’
‘And where’s your son now?’
‘Gone off and left me. Like all the others.’
‘Miranda? Would you mind if we checked you over? Did your blood pressure and that sort of thing?’
‘Do what you like. I don’t care.’
I get the kit out of the bag and start noting down the results. Alcohol fumes ripple off her like heat from a radiator. ‘How much have you had to drink today?’, I ask.
‘Not nearly enough.’
The cat noses around in the bag.
‘What’s your cat’s name?’
‘Atticus. Guess how old he is.’
‘Fourteen? Fifteen?’
‘He’s a hundred and twenty. Cat years.’
Atticus looks up at me as if to say I am, you know.

Miranda’s obs are fine.
George taps the board.
‘Look, Miranda,’ he says, ‘so far everything looks okay but obviously we’re very concerned. Not only that you’ve taken these pills – which may have a delayed effect – but also for the reason you took them.’
‘I’m not going to hospital. Last time I was there the security guard broke my jaw.’
‘Surely not.’
‘It’s true. He asked me to leave, punched me in the face and broke my jaw.’
‘Well I can guarantee that won’t happen this time.’
‘I’m not going.’
‘Whatever sort of person would I be if someone told me they wanted to die, and I just turned around and left them? Mm?’
‘No. You can’t make me.’
There’s a brief stand-off. I cut in from another angle.
‘But didn’t you call the ambulance, Miranda?’
She turns to look at me. For a moment it looks like my intervention may have nixed the whole peace process. But before she flicks off the safety catch, George speaks up again.
‘Miranda? Who’s going to look after Atticus if you kill yourself?’
She turns back to him.
‘Have you got a cat?’ she says.
‘Yes. I have a twelve year old tabby.’
‘What’s she called?’
‘Yep. And two dogs.’
‘We used to have dogs. I couldn’t have them, now.’
‘So what are we going to do then, Miranda? Are you coming with us to the hospital?’
‘Have you seen your doctor lately?’
‘He doesn’t want to see me.’
‘Don’t you have to see him at least to get your repeat prescription?’
‘He faxes it. He doesn’t want to see me anymore.’
‘Well – Miranda - if you won’t come to hospital, there’s nothing more we can do for you here. So if you’re absolutely sure you’re staying at home, I’ll just need you to sign my paperwork.’
‘I’m not signing anything.’
He shows her the board.
‘Will you sign?’
‘What – that you’re leaving me here to die?’

Josh Groban leans in to another ballad on the TV. She turns to look at him, folding her arms across her belly, the deep blue light of the screen reflecting in her glasses. Atticus rubs up against her leg but she doesn’t seem to notice it.

‘We’ll be going then.’
‘Suit yourself.’
We leave her sitting there, as fixed in her pose as any of the ceramic fairies on the sideboard.

Outside in the vehicle George finishes the paperwork, then gets on the phone to control to tell them everything that happened. Another crew pass us, waving and laughing and pointing. We all know it’ll probably be them sitting here tomorrow.


loveinvienna said...

Oh dear, another frequent flyer of sorts. I'm sympathetic to their plight but it's frustrating to read, never mind experience on a day-to-day basis! She must have some kind of psychological problem(s), or whatever the PC term for it is now?

I like Josh Groban, he has a fantastic voice (I probably shouldn't admit this, ain't very cool). His hardcore fans scare the living bejeezus out of me though. *shudders*

Liv xxx

Anonymous said...

I know how exasperated you seem to be, but on the flip side, I feel bad for this woman. Whether or not she pushed people away, they drifted off, or were never there to begin with, she just seems so lonely - to the point of calling in an ambulance as to not be ignored.

In life, everyone seems to have a favorite: a favorite uncle or aunt, your mother, a child, a spouse. Imagine not being anyone's favorite (or even preferred) person for years upon years. Poor woman.

Spence Kennedy said...

Hi Liv,
She definitely does have psycho/social problems, and it is incredibly frustrating - firstly, that she isn't getting the help she needs, and secondly, that the ambulance keeps going back to her, pretty much on a daily basis. I have no idea what the answer is. She's not acute enough to be sectioned, but not stable enough to be served with an asbo.

Don't worry about the JG thing. We've all got our guilty pleasures. I like Barry Manilow (but don't tell anyone). Is it true the hardcore fans are called Grobanites? Sounds like something off Doctor Who. :)x

Hi Alexis,
I do feel sorry for Miranda. I wouldn't want to be in the same position. But it hardly needs saying that repeatedly calling the ambulance isn't helping her. I just wish there was some other response we could offer. But of course, she keeps withdrawing from any alternatives. I don't doubt she's right that her GP has given up. I think there's nothing more exasperating than someone repeatedly asking for help then (mostly) swearing at you and telling you to go away.

It would be interesting to see how else she presents to the community - if she crops up anywhere else. In the ambulance we tend only to get a restricted view of people.

Thanks v much for your comment.

loveinvienna said...

The real full-on fans are called Grobanites which apparently was the best of a bad bunch! I think it sounds like some kind of hideous infection lol. I'm a fan of his music and voice, and sometimes look up his performances on Youtube but I'm not even verging on 'Grobanite'. It's a bit like watching a modernised Beatles concert sometimes - screaming, tears, wild dancing and waving... almost tribal lol! If he should chance a glance at a pretty woman in the audience, you can practically see the death stares radiating at her from the Grobanites :S eek!

Barry Manilow, eh? Lips are sealed! :D

Liv xxx

Anonymous said...

Hi Spence,

So if someone tells you they've taken an overdose but refuse to go to hospital; how do you decide what to do? Does it depend on their obs? mental fragility? Do you have sectioning powers?

Spence Kennedy said...

Hey Crazy!

Well - like so many of these things, it depends! With Miranda, the context is everything. She's been ringing 999 saying she's taken an od at least for the 2 years I've been on A&E in this area. So as long as her obs are within normal parameters, it's not so pressing. If it was someone unknown to us - even though their obs were the same - we'd think of other things ie persuade them out to the vehicle, then as a last resort having the police do a 136. Ambulance staff don't have any section powers. If someone's at home, there's nothing we can do other than subtle persuasive techniques! There might be some leverage - if the police are there - along the lines of an arrest for something or other (maybe a breach of the peace) and then a 136 once they're outside the front door. But it's a difficult and sensitive area. If someone's at home, it takes GPs and ASWs to get someone committed.

I hate this aspect of the job!

Anonymous said...

From this article, Spence - I liked your portrayal of George. I'm fascinated by people who aren't confined to their sterotypes... He seems like a very socially adept person, caring and gentle, despite his appearance.
A good man to have about. xx

Spence Kennedy said...

Thanks, DS. He is a good person to have around, definitely. I'm glad that came across in the piece.