Thursday, October 22, 2009

miss flite

Lloyd House, an architect’s scale model in clean white card, a meticulously detailed blank, rising up above a line of model trees with municipal functionality.

Lloyd House, a simple, well-disposed block set back from the road, ramps for access, balconies for fresh air and views, an accommodating lobby with twin lifts and a generous allocation of stairs.

Take fifty years. Pan slowly down towards the main entrance. For every centimetre you travel, watch the card acquire colour, texture, definition, a wash of reality rippling out into courses of brick, squares of dirty glass, a notice: no ball games. As you descend and become smaller the ramp roughens beneath your feet, the trees crack and spread up into life, dark green and grey and black, leaning over - real trees now, filling the air with a resinous tang.

You’re at the front door. A WKD bottle, a scrunched Coke can, a scattering of fag butts.

Look at your clipboard, read a number.

Punch it in and wait.


When we make it up to Miss Flite’s flat, the front door is on the latch. I knock and push it open in one movement.
‘Hello. Ambulance.’
A muted hello from somewhere inside. We walk in.

We find ourselves on a fetid black carpet, tacky beneath our boots. Corners of spotted wallpaper loll out from the walls; a fan heater whirrs somewhere, stirring up sweetly malodorous currents. The room has a sofa and an easy chair, a coffee table and a sideboard, but the surface of each of these - and everything else - is covered with a tumbling crust of old newspapers, grimy faced dolls, a plastic rose in a dusty bell jar, a desiccated sandwich, a family portrait in a cracked black frame, a fish tank whose stones can just be made out pressed up against the mouldy green glass, a dirty telephone with plate sized numbers, a bronze eagle, and a thousand other pieces of junk which have lain so long they would leave an outline if they were ever lifted. Clusters of tiny white feathers drift here and there across the scene, catching on corners and surfaces. They have come from three rusting bird cages, each containing a spindly yellow and green budgerigar. The birds chip and squawk as we move further into the room, gagging and pulling our gloves on.

‘Over here.’
Miss Flite is lying on her side between a chair and one of the bird cages. She is propping herself up on her left arm, struggling to get a better look at us.
‘I just need a hand back up,’ she says. ‘I’ve been rather stupid.’

Miss Flite is only seventy but she could pass for ninety, so deeply have the marks of physical and social neglect been etched into her face. She has a full goatee beard that with her square face and hooked nose makes her look like a mischievous old man in drag; her nails are yellowed and ingrained with dirt. She wears an emergency call button around her wrist on a padded cream strap.

‘Help us up, there’s a fellow,’ she says.


Miss Flite sits nicely upright in her favourite chair with a hand placed neatly either side on the armrests, frowning, looking slightly bemused, like a High Court Judge challenged to live a life of destitution for the day. Behind her through the window, the sky is a deep and resonant blue.
‘I must say you came very quickly,’ she says, her smile revealing a spread of waxy yellow teeth. ‘Very quickly indeed. Most impressive.’
‘Miss Flite, what we’ll do is refer you to our Falls Team. They’ll give you a ring to arrange a time when they can come and have a chat. I’m sure there’s lots that they can do to make things better for you here.’
‘Oh I don’t doubt it. I know I’ve let things go a little.’
‘And then maybe they could get some other help started. You really need your damp problem sorting out, for one. What have the council said about it?’
‘The council? My dear – they’re not the least bit interested in me.’
I finish writing up the paperwork, aware that Miss Flite is staring at me, her head tipped slightly to one side, like one of her birds.
‘Do you have children?’ she says quietly.
‘Two girls, four and eight.’
‘What a charming age. Just coming into their own.’
Then she looks at the cages, and the three birds all hop up onto their perches.
‘They think I’m going to let them out,’ she says, extending a claw to the nearest of the cages and rapping gently on the bars. ‘I do indulge them from time to time. Maybe when you’ve gone I’ll let them fly about a bit, poor things.’
Then she turns back to offer her thanks again, and waves to us, as we pick our way back out towards the door.

Wednesday, October 21, 2009

bert hurts

Half past goddamned five in the morning, the last hour of the shift, a full fat and featureless sixty minutes but it may as well be six hundred and sixty. If my hands get any heavier they’ll be bumping along behind me on the pavement. A Neanderthal would laugh to see us pick up these bags and trip on the stairs. Not such a great evolutionary leap after all. I know with numbing clarity there is nothing for us and nothing to do about it and no-one can help. We have no future. We will be late finishing. We are the kind of zombies even zombies would disown.

It rings the bell.


Buzz. Blah.

Up the stairs towards the flowery robed figure of a woman who peers down at us through glasses the size of dustbin lids.
‘Bert’s in the sitting room.’
She turns and slippers ahead of us into a cluttered and super-heated sitting room. A great, rounded knuckle of a man reclines over on the sofa, his t-shirt riding up over his gut, his left hand tragically resting palm-uppermost on his forehead, the other draped on his right flank.
‘There,’ she says, as if he might be overlooked.

Rae is attending. She kneels down next to the man whilst I stand with my giant hands folded carefully in front of me, swaying slightly and periodically straightening up with a startled squeak.
‘What’s the trouble, Bert?’
‘I’ve been getting these terrible pains in my side.’
‘When did it all start?’
‘I don’t know. When did it all start, June?’
‘My whatssit. When did it all start, she wants to know.’
‘I don’t know, Bert. Last week?’
Bert turns to look down at Rae.
‘Last week,’ he says.
I know Rae very well now. I can even read her hair. Her hair is telling me that Rae would consider a life stretch fair exchange for the pleasure of violent homicide. Anything to leave this flat. Anything for a bed. This sofa, for instance, bloodied or otherwise.
‘Have you seen your doctor about it?’
‘I thought I’d see what happened first.’
‘And what sort of pain is it?’
‘It hurts.’
‘But what sort of pain? Can you describe it? Is it sharp? A dull ache? Is it like cramp, or more like someone’s stabbed you as hard as they can with a kitchen knife.’
‘I don’t know.’ Bert looks over to his wife and laughs. ‘It’s just a pain type pain.’
He laughs. His wife smiles, and shifts her weight to her other leg. She looks at me and smiles. I smile back. The process is complete. I am now Stan Laurel.

‘Okay. So you have a pain here. Does it come and go? Or is it there all the time?’
‘Oh no. It’s there all the time. Sometimes I hardly notice it. Sometimes it’s completely gone. I don’t know. It’s just a pain.’
‘Let me have a feel, if I may? Tell me how it feels as I do it.’
Rae exposes the great dome of his abdomen and begins rolling her fingers into the flesh, working from the furthest point methodically back to the danger area.
‘No. No. No. No. No. No. No. Wait a minute…. No. No. No.’
‘So it doesn’t even hurt in the place where you thought it did?’
‘No. Typical. Just like when you go the Dentist.’ He looks at his wife again, who is now more intent on cleaning her enormous lenses with a dish cloth.

Covering the far wall is a collection of novelty clocks: a giant wrist watch, a clock in a racing tyre, a cuckoo clock, a Simpsons clock, a Playboy clock, a Mickey Mouse clock, a pixie alarm clock with two red and white spotted mushrooms on the top. I stand with my hands patiently folded in front of me, swaying slightly, staring at the clocks. I have stood here for all time and always will be here. Future generations will pay to come and walk around me. The lights will come on at the beginning of the day, go out at the end of it. Someone will dust me once a month. A scrawling tide of graffiti will rise up my legs and arms.
‘You do the obs, I’ll do the writing,’ says Rae, loudly.
I rummage around in the bag for the kit.

‘All your observations are fine,’ says Rae, dotting something on the form. ‘But that still leaves you with this pain, of course. How is it now?’
‘It’s gone.’
‘So that’s good, then.’
‘Yeah. But it might come back.’
‘Bert, we’re quite happy to take you to the hospital if you want, but you’ll be there a few hours.’
‘Will I?’
‘But something else you could do is wait until the surgery opens and make an appointment to see your doctor.’
‘They don’t do that.’
‘Do what?’
‘They’ll only see you in three days’ time.’
‘They have emergency appointments though.’
He closes his eyes and shakes his head.
‘They’re obliged to offer emergency appointments.’
Bert shakes his head sadly.
‘Tell them we’ve been out. Show them the paperwork.’
‘I could try I suppose.’
Rae tears off a copy of the form, folds it up and hands it to Bert. He takes it uncertainly, like a motorist accepting a parking ticket.
‘Anyway,’ he says. ‘If the doctors can’t do anything, I can always phone the ambulance again and they can take me to hospital.’

I only close my eyes for a second, but when I open them again I find myself walking down the stairs.

Monday, October 19, 2009

a sign of good will

Beneath the cold black early morning sky this high street has a blasted look. Saturday night has machined a path through town, leaving in its wake a trail of burger cartons, kebab wrappers, cans, bottles, club flyers, heels snapped off at the root and people lying in doorways. But by the time the sun has risen all traces of the evening will have been erased; the street cleaners have emerged to put things right. They move methodically along the pavements, singly, and in twos and threes. They pack it all away like drones.

There is a man standing at a telephone kiosk in the high street, leaning away from the perspex booth with the phone cable stretched out tight and an aluminium crutch dangling from his other arm. When he sees us pull over he replaces the receiver, grabs the crutch back into play and limps quickly across the road to intercept us. A taxi is forced to stop. I get out of the cab and wave an apology to the driver. He shrugs, and then raps his fingers impatiently along the top of the steering wheel as the man moves across his path.
With his Russian cap jammed low on his head and the collar of his combat jacket turned up, the man looks drawn in and contained, as if this were dangerous territory, and nothing should be left exposed. As he comes towards us he mutters spittily, his teeth clamped together, spiking out looks from side to side.

As he gets closer I hold up my hand, palm up, just like that image of a human being NASA scientists engraved on a plaque, the universal sign of good will tacked onto the side of a satellite and sent out into space.
‘Hello,’ I say. ‘What’s the problem?’

The taxi accelerates past.

‘I have fit, more bigger fit, another come. You take me, soon. You help me. God fucking damn these people. I take my pills, they not work. I fall down, I hurt myself little bit, here. I live like pigs and you, you don’t even care to help when I tell you what problem is. You think you know better.’
‘Just try and calm down, okay? First of all, can I ask your name?’
‘Tell me this. Tell me that. Gil. Now. Good. So now you have name. You tell me your name. What matters this bullshit? You get me in and you take to hospital. Here. I give you ‘scription, you give to doctor. Last time they never did give ‘scription and I not get good medications. All you fucking bastards.’
‘Listen to me, Gil.’ He stands in front of me, swaying from side to side, grinding his teeth. I think I recognise him, but it’s early in the morning and this whole roadside confrontation has come on me unexpectedly, more like a waking dream than a real experience.
‘Listen to me, Gil. No! Listen! I want to help you. That’s why we’re here. But you are not coming on this ambulance if you don’t calm down and ease off the aggression. Do you understand?’
He flicks me a look and gestures to the side door of the ambulance with his crutch.
‘Come. We go now.’
‘Do you understand what I’m saying, Gil?’
‘Come now.’ But he seems cowed, less certain.
Rae is next to me. For a minute we both watch Gil without doing anything. We stand there, a tight little triangle of disaffection, as the sweepers advance towards us along the pavement.
‘Okay. That’s better. You can come on board, and we’ll take you to hospital. But you must behave, Gil.’
He grunts as Rae opens the door and the perforated metal steps hinge outwards and down. He shuffles towards them, hops up all three with surprising agility, and plumps himself down on the first available seat.
‘Let’s just head straight off,’ I tell Rae. She nods and slams the door to behind me.
Gil wriggles about on the seat, fussing with his coat and his crutch, grumbling and mumbling and grinding his teeth like some dyspeptic old goat re-working a belly of bitter grass.
But the jolt as the ambulance moves away off the pavement suddenly brings him back to his furious monologue.
‘I have fit and fit and fit and medications no good no more. I give you ‘scription, you give to doctor. Last time he say get lost someplace. Last time them fucking bastards. I have hip replacement. I have pain here, here, here. I have no place to live, nothing, no damn nothing. I have fit and fit…’
I put my hand on Gil’s shoulder, and he flinches.
‘Gil. Calm down,’ I say. ‘We’re helping you, okay.’
The hospital is five minutes away.
He doesn’t turn to look at me so much as insinuate his eyes slightly off to my right.
‘I know you. I know you think clever.’
‘I’ve never met you before, Gil.’

But I think I have. I know I have.

‘I see what you do. But listen to me. I give you ‘scription and you give doctor. You tell doctor give me medications.’
He pulls out a tattered scrip and unfolds it.
‘You take now.’
He holds it out to me. His nails are bitten right down, his fingers leathery with neglect.

Two minutes from the hospital.

‘I’ve written them down on my form,’ I say to Gil, handing him back the scrip. ‘You’d better look after this now. For safe keeping.’
He stares at the paper.
‘What means this?’
‘Have it back. I’ve written down all I need. I think you’d be better off looking after this.’
He moves his eyes from the paper slowly up to mine.
‘You wouldn’t want to lose it,’ I say.
He turns in the chair, snatches the scrip from my hand and shakes it in my face.
‘You think you better. You think you easy clear. I know what you do. Well all I say is I hope your son fall like me. I hope your family and your fucking son get put on the street, live like pig. I see your family. I make sure. They go there. I meet with them soon, my friend.’
The ambulance pulls up onto the hospital forecourt. I stand up and move to the back. As we slow and park and I jump out, just as Rae comes to the door.
‘Call security, Rae. He’s being aggressive and threatening.’
She hurries inside to reception. I stand there looking in to the vehicle. Gil sits hunched forward on his seat, muttering and stamping his crutch on the floor of the ambulance. Just by chance, a policeman comes outside. I nod to him and he walks over.
‘What’s up?’ he says.

Five minutes later, Gil is backed up against the A&E railings, shouting ineffectually at the policeman and two security guards who’ve been rousted from their office. One of the guards detaches himself from the group and comes over to us.
‘Who the hell is that?’ he says.
‘I recognise him now. I brought him in about a year ago. He got aggressive then, really nasty for no apparent reason, threatened me and the staff, got thrown out by security.’
The shouting stops and we look back over. Gil is stamping off down the ramp out of the car park, waving his crutch and throwing curses backwards over his shoulder. The policeman comes over to join us whilst the remaining security guard makes a call on his radio.
‘I explained to him he’d be arrested if he carried on like he was,’ he said. ‘Anything wrong with him you could figure out?’
‘Nothing obvious – apart from the obvious,’ I say.
‘Steaming drunk of course. Whack job. Anyway – he’s off, I’ve passed his details, and I finish in ten.’
‘Thanks for your help, mate.’
The policeman smiles and holds up his hand.
‘No problem,’ he says.

Tuesday, October 13, 2009


The screen suddenly changes and starts yelping with a series of triplet barks, like a crazed robotic poodle chasing its tail. The new system works well, but there must surely have been better sounds to choose from. I wish – for the eighth consecutive time this shift – we could change it for some bongos, maybe a fog horn.
Rae taps the screen to acknowledge the job.
‘What is it?’
‘Cat C fall.’
‘Don’t know. Sounds familiar, but they all do. I’m sure we’ve been here though. Recently. Oh! OK. It’s Dolly.’
The Queen of the Wallop is down again. This is getting beyond a joke. We were only out to her last week.
‘Something has definitely got to change,’ I say, nodding to thank a car for letting us out, hauling away with all the enthusiasm of a donkey back in harness at the water wheel.

Outside Dolly’s bungalow, the carer is standing guard with her arms folded.
‘She’s stuck in the chair. The neighbour’s here with me but we can’t get her up just the two of us.’ She seems defensive, but no-one could take issue with the call. The BFG couldn’t get Dolly up without some help.
She turns to lead us into the bungalow.
‘Is she pretty much her normal self?’
‘I don’t think so. I think her mobility’s worse, if that’s possible.’
‘Will she need to go in, do you think?’
She stands aside to let us go first, shouting ahead:
‘It’s the ambulance, Dolly!’
There is a disgruntled kind of mumbling from the sitting room.
‘Well, hello Dolly,’ I say, pushing open the sitting room door, and only catching the connection with the big musical number after I’ve said it. I blush with embarrassment.
‘Very funny,’ she says. ‘Very droll, mate.’

Dolly studies me from where she sits packed into an old upright chair in the middle of the sitting room. She is a strangely abstracted figure, simmering like a volcano dressed in a filthy housecoat. The next door neighbour – a spindly young woman with lank hair and the kind of anaemically confidential manner you might find leaning upwards in the dark – unfolds her arms sufficiently to give us a little wave, then tucks back in to her vigil.

Dolly is slowly becoming that chair. She has been sitting in it for so long the essence of its shiny fabric has crossed the barrier of her skin, the outlines of its flowers visible beneath the bruises, dimples and folds of her arms and legs; the cushion stuffing has insinuated its plastic mycelia out through the ticking and in through her pores. She is now more cushion than person. I imagine her eyes will be the last to go – two small grey sofa buttons, permanently fixed on the TV.
‘How are you, Dolly?’
‘Fantabulosa, darling. What do you think?’
‘How can we help today?’
Dolly looks at the carer.
‘This hay bag says I can’t go to the toilet.’
‘I did not say that, Dolly! I gave you your frame and I tried to get you up but you said you couldn’t do it.’
‘Get me up? I can’t see you getting anything up, love.’
‘Look – Dolly – we’re all here to help,’ I say, putting my bag down and going across to her. ‘Everyone’s got your best interests at heart. So try not to say hurtful things.’
‘Who’s saying hurtful things? I just said she couldn’t get me up, that’s all. Where’re my fags?’
‘You can’t smoke with us all here, Dolly.’
‘Why not? It’s my house.’
‘Yeah, but it’s our lungs. And we’ll stink of fags the rest of the day if you spark up. Just wait til we’ve decided what’s going to happen.’
‘What do you mean? All I need’s a hand up so I can go to the carsey. Unless you want me to cack my strides.’

The neighbour speaks up: ‘She’s not herself.’
‘In what way?’
‘Well I’ve never seen her this bad before.’
Dolly frowns and leans forwards about half an inch. ‘What’s she saying?’
‘I’m saying you should go with these nice people to the hospital,’ the neighbour shouts, her voice taking on an unexpected metallic stridency. Everyone winces.
‘I’m not mutton, you know.’
‘Yes you are,’ she shouts, then resumes her position.
‘Dolly. First of all we’ll give you a hand up…’
‘And after that we’ll have a think what to do next.’
‘Oh we will, will we?’
‘Well you can think all you like mate. I’m not going to no hospital. I’ve had three friends carted off there and not one of them ever came back.’
‘Come on. Give me your hand.’
‘Not one of them! You’ll not get me there.’
‘We’ll talk about it in a minute.’

We set to the business of getting Dolly out of the chair, levering bits of chair out of the way, manoeuvring her feet into position, negotiating angles for her massive arms, our extemporary gang working together beneath the insults and curses of a tyrannical boss who would definitely use a whip if she had one, and the wherewithal to snap it.

Raising the Mary Rose would have been easier. Admittedly they had tides to contend with, but at least the Solent was fresh, and they could use a barge with a crane.

Eventually we have Dolly on her feet. With the carer and the neighbour either side, she stomps off to the toilet. I’m left with Rae in the sitting room, surrounded by the detritus of Dolly’s chair-bound vigil – great tumbleweeds of garbage, crumpled Pringles tubes, crisp bags and fag packets, balled up tissues and other, less readily identifiable matter.
‘This can’t go on. We need to get her in and assessed.’
‘It’s going to take a bariatric truck.’
‘I wonder how long that’ll take?’

But suddenly we’re hurrying back along the hall. Dolly is shouting in the bathroom, carrying on with all the puff and spit of a mad Berwick Street trader. I expect to see rotten oranges come flying out, knocking pictures off the walls. The neighbour seems to be trying to blend in with the shower curtains whilst the carer backs slowly out, feeling behind her, keeping her eye on the tiger the whole time.
‘What's the matter now?’
Dolly is sitting on the toilet, frowning under a dangerous head of pressure.
I will not be going to no crapping bone yard’ she yells.
‘Fine. But in that case we’ll arrange for the doctor to come out today, and I can tell you exactly what they’ll say. You’re only postponing the inevitable.’
‘I’ll do more than that, sunshine,’ she says, huffing like a boiler, making as if to get up, but then, finding she has no way of moving without our help, subsiding again. ‘I’ll do more than that.’ She breathes heavily, flicking a look from one to the other of us.
‘Get me back to the chair,’ she says. But her words suddenly seem as thin and hopeless as trailed smoke. The neighbour steps forward, sensing the change. Dolly sinks inwards a little. The carer comes back in and folds her arms. Dolly relaxes her grip on the white steel rails that corral the toilet.

‘Can I take my wheelchair?’ she says.

Rae calls for the truck.

Friday, October 09, 2009

queen of the wallop

‘If you’d all just stop bleedin’ going on at me for a minute and Aunt Nell! This is my latty and I say what goes. I don’t need all this bastard palaver about what I should or shouldn’t be doing. I don’t want nishta, mate. So just shut it and give me a hand back up on me lallies. If I don’t get to the carsey soon, well - I give you warning.’

We’re back inside our favourite bungalow, a decrepit sideshow booth that ought to have a banner draped above the doorway: Come and See the Enormous Bearded Lady (and Pick Her Up). Old Dolly Deakins is a frequent flyer, except of course it’s not so much flying as subsidence. Dolly is on the floor regularly, and when you come to help she chews your ear regularly, too, using slang that sounds like a curious hybrid of Cockney, Yiddish and who knows what else. Some of it I recognise from words my Dad’s family would use, some of it from Harold who ran the market stall I helped out on when I was a teenager. The rest I have to guess from the context.

Dolly is huge. If it’s glandular, she certainly isn’t helping the cause by packing away family size bars of chocolate, and chain-munching crisps. She has a dreadfully mottled, over-pumped look. The bandages around her legs, the buttons on her cardigan, the watch disappearing into her wrist – everything is stretched and straining and ready to rip.

We set to work with the inflatable mattress.

‘You’re a bit of a liability with your smoking,’ I tell her as she gently rises into the air, with Rae and her carer posted on either side to keep her in place.
‘What d’you mean?’
‘Your cardigan is covered in burn marks, Dolly. Fag holes. One of these days you’ll go up in flames.’
She stares at me, then pats Rae on the arm.
‘Ere. He’d be a nice little charver if he’d only keep his screech zipped.’

With the mattress fully inflated, Dolly wobbles up towards an approximation of the vertical whilst we fuss around her, blue-gloved drones around a massive Queen.
‘Wait a minute. Wait a minute,’ she says, making minutely painful adjustments by leaning from side to side on either hip. ‘Wait a minute.’
The carer brings her walking frame from out of the bathroom, turning it this way and that to negotiate all the obstacles in the hallway. Finally she plants it down in front of Dolly.
‘Not that one, you schlemiel!’
The carer, a blockish woman in her forties, a hairdo as tight as her smile, swings it back into the air with markedly less care than she took in placing it there.
‘Thank you, darling. She’s got a heart of gold, that one. I don’t deserve her.’

We keep a hold on Dolly until the carer comes back with another frame, which to me looks exactly the same as the original. Dolly seems happy.
‘Thassit!’ she says. ‘Ooh. Here we go, boys.’
And she starts shuffling off in the direction of the bathroom.
‘Off she goes, Queen of the Wallop.’
She stops and turns her head slightly to the side.
‘Whilst I’m gone, all you old steamers can help yourself to a bit of carnish.’

I look at the carer. She shrugs.

Thursday, October 08, 2009

status report

Our early update: two patients, both out of the car, no further ambulances required, fire and police on scene.

The black four by four is up on its nearside, balanced diagonally across the middle of this orderly suburban street. Lying there with its chunky tyres and pristine chassis exposed, it is jarringly out of context, like a fridge-freezer upside down in the middle of a kitchen.
As often seems to happen when something extraordinary cuts across the usual run of the day, there is an extemporary carnival feel to the air. The fire crews are standing around examining the car, their cheerful comments shouted one to the other above the fat diesel thrumming of their trucks; the police are striding about with fluorescent bonhomie taking names, putting up temporary signs, directing events; first aiders are introducing themselves, offering help and information; blankets and other supplies are being ferried out of houses, and groups are gathering at strategic viewpoints to mark out what they think happened, to wave to people they know, and take pictures with their phones.

Sitting on a pavement propped against a wall, her left arm supported up in the air by a first aider, is a middle-aged woman with her right hand covering her eyes, sobbing. A man in a suit is standing nearby talking to a traffic cop.
‘Are you the driver?’ I ask him.
‘I’m fine. Really. Look – just see to my wife, would you?’
I go over to the woman and crouch down beside her.
She was the passenger in the front seat. The car had clipped a pedestrian island in the middle of the road, flipped over onto its side, and when the glass shattered it cut her arm. I check her over, but it seems this is her only injury. We help her into the ambulance and make her comfortable on the trolley. The husband comes on board and takes a seat next to her.
As I clean and dress her wounds, Rae asks the usual run of questions which the woman answers in a whisper. Her husband groans and puts his face in his hands.
‘Stupid. Stupid.’
Then he straightens up again as his phone rings, rubs his eyes briskly, blows out his cheeks, roots the phone out of his jacket and says: ‘Gerry. Sorry. I can’t talk now. We’ve had a bit of an accident and Jean’s been hurt – not badly, thank God. I’ll give you a call in a minute or two. Okay? Bye.’
He presses it off and drops it onto the seat next to him. ‘Sorry about that.’
Jean starts crying again.
‘I just can’t believe our luck.’
The man puts a hand on her shoulder as I finish tying off the bandage.
‘We were up all last night. Jean had a miscarriage. We were supposed to come in to the hospital for a check-up. That’s where we were headed when we crashed. I can only think I must have fallen asleep at the wheel. I can’t believe it happened. I’m so, so sorry, Jean.’
She puts a hand on top of his, and then rests her pale cheek there, too.
The phone rings again. He picks it up and looks at it with his free hand.
Suddenly there is a vigorous rap-rap-rap on the ambulance door. It opens, and the traffic cop puts his head round the opening.

‘How’re we all doing?’ he says, brightly.

Wednesday, October 07, 2009

the fifth horseman

This morning when I saw I was down to work with Aidan, well, I may as well have climbed into the cab and shaken hands with The Grim Reaper. If ever a vacancy came up for a fifth Horseman of the Apocalypse, the only thing that would prevent Aidan getting the job are his looks. He would be marked down for clear blue eyes, gently freckled skin and that particularly engaging brand of innocent mischievousness you only ever see in children aged about twenty-five.

So – as is the norm for Aidan – we started the day with a difficult and fatal cardiac arrest at home, and then worked our way on through a paediatric respiratory distress in a public park through fits and falls of varying horror to a builder on a building site crying on the precipice of a heart attack. Aidan’s emotional working rhythm seems to be the doom-laden gong of a slave galley, his days characterised by a succession of terribly traumatised people in awful situations. No-one is immune – except Aidan, of course. He smiles and jokes and tweets and calmly smokes his roll-ups between jobs, the still eye of the hurricane, moving quietly across town as houses burst into fragments around him, and people run screaming into the streets.

‘Another chest pain, another dollar’ he says, piling the ambulance through the homeward bound traffic with such disdain cars bounce off our windscreen like hailstones. ‘Give me a break.’

The evening is grey blue and flat. A pervasive drizzle has rolled in off the sea and mugged the streets of all vitality. The statue of an angel holding up an olive branch marks the place on the promenade we need. When we pull up, I expect her to stuff it under her robes, climb down off the plinth and run off down the empty promenade. Surely she knows even a bronze angel would be in danger around Aidan.

‘There he is.’

A man bent over at the deserted coffee kiosk, supporting himself on the wooden shelf. But as I get closer I realise that he’s not in trouble, he’s just looking for a scrap of shelter whilst he makes a phone call. He frowns at me as I approach, and carries on frowning as I apologise and walk away.

‘No. There.’

An NFA windmilling from a sheltered bench further along the prom. I hunch my shoulders against the weather and head over.

John is sitting as drawn in as he can on the worn slatted bench, his hands buried deep in the pockets of his jacket, his chin tucked down into the collar. He only raises his eyes as I introduce myself, then gives a shuddering cough like a seal on a sandbank.

‘I didn’t call you,’ he says. ‘One of the others did.’
‘Well now we’re here – what’s been going on?’
‘My chest hurts.’
He takes out a reddened hand and makes a passing gesture. ‘It burns, all round here. Round the back.’ He tells me he has been feeling below par for a couple of weeks, a cold coming on. Four days ago he became homeless – ‘It’s complicated. There are two sides to every story.’ Spent most of the time since then sitting on this bench looking out to sea.
‘It’s got to the stage I can’t even stand up. I feel so sick and dizzy.’

We get him onto the ambulance. I help him out of several layers so I can listen to his chest, but I hardly need a stethoscope.

‘You have a chest infection,’ I tell him, draping the stethoscope over my shoulders and reaching for the thermometer. ‘You really need to come with us to hospital to get some treatment.’
He puts a t-shirt back on, the only one of his clothes to feel damp with sweat rather than rain, and shakes his head.
‘I’d rather not. They make me nervous,’ he says.
‘If you spend any more time outside you’ll become very ill indeed,’ I tell him.
Aidan takes another blood pressure and gives John a reassuring smile.
‘Come on mate,’ he says. ‘We’ll only be back for you later if you don’t.’

And I don’t doubt it’s the truth.

Friday, October 02, 2009

portrait of an amateur photographer

Dear Readers!

I hope you won’t mind if I include this next piece on the blog. Although it’s not about my life on the ambulance, it is about my life, so maybe it’ll fill in some of the blanks.

I’ve always tried in Siren Voices to keep myself in the background, to keep overt opinion out of the writing. There’s still plenty of bias, of course. I try to be even-handed, but it’s inevitable I’ll distort the truth of a situation by going after a particular feeling or effect.

I want to carry on doing that, but I thought now and again it might be interesting (and a bit of a change) to write some pieces with a more personal and personally revealing edge.

So here’s a piece I’ve written about the events surrounding my Dad’s death a few years ago. I have to say now – maybe more for my family than anyone else – that as personal recollection goes it’s as flawed as you’d expect. We all remember things differently, timings get changed around, and it’d be impossible to remember exactly what was said. The best I can do is honestly put down what seems to be the truest for me, my memory and my feelings about what happened.

I’d also like to include this piece as a respectful acknowledgement of the traumas and troubles of all those patients I’ve written about up till now. If I can write openly and honestly about their problems, I should expect to be able to do the same for my own.


Sometimes, an event happens in the life of a family of such consequence that like a syringe of dye dumped in a vein, the tangled network so long hidden is suddenly – dangerously - inked out for inspection, a thready network of kinks and loops, baggy thoroughfares, atrophied ends, tentative connections and recanalisations.

When what was hidden is laid open.

And then I suppose the challenge is not just how to read it all, but how to live with the consequences once you think you understand what is written there.


Dad had been suffering recurrent bouts of jaundice that left his face a screen print experiment in yellow. Even the rims of his eyes were golden. When the attacks came he would drag himself up the stairs to lie on his side in a darkened room, glittering beneath the covers, staring at the curtains, or throwing up in a bowl. The doctor was sent for, and a long road entered onto of hospital stays and investigations that led finally to an appointment with a Consultant Gastroenterologist and a biro sketch on the back of an envelope.

‘This is your stomach,’ the Consultant said, sitting on the edge of the hospital bed, smoothing the envelope out on his knee. He stretched his right arm out to ride his jacket sleeve up his arm, giving himself room to move, but looking like a magician proving he has nothing hidden there. Shirt cuffs a brilliant starched white.

Outside, through the sealed window of the eighth floor room, the sun lay across a patchwork of rape and wheat.

‘This is your duodenum, your bile duct, your pancreas, the rest of your small intestine here …’ He roughed out the pattern, his estimate for a difficult job.
‘Now, what we have in your case – what we’ve found – are a group of shadows here, here and here,’ scrawling a bunch of malign-looking dots. ‘They may be cancerous – the type of cancer that spreads, the bad sort – or they may be of a more benign pathogenesis. If they are the friendly sort, then they will only cause these intermittent bouts of jaundice and nothing much else. And there may be things we can do to make those bouts more tolerable. But if they are the cancerous sort, we would need to tackle them more positively.’
Dad cleared his throat.
‘So I’ve got cancer?’
‘Well – that may be. Our feeling is that you might well have cancer here. But we don’t know this for sure. We can only deal in percentage chances.’
‘What are the percentages?’
‘I would say maybe forty percent. That the shadows are cancerous.’
‘So there’s a sixty percent chance that if I do nothing, nothing will happen.’
‘But if they are cancerous?’
‘There’s a forty percent chance that if you did nothing your condition would deteriorate and you would die in six months or so. Cancers in this area tend to be quite aggressive in that respect.’

A sketch on an envelope. A spread bet on some dots.

Dad only ever bet on the football pools. A friend of his at work would drop by to collect the coupons and the money for the week. On Saturday at tea time he’d sit with his salmon and cress sandwiches on his lap, ticking off the results as they came rattling across the bottom of the TV screen. Methodically highlighting the score-draws, chewing over the results, looking for those vital games, the points that would change our lives, the golden points that would mean claims by telegram please, a huge cardboard cheque and a kiss on the cheek from some swim suited bird in a room filled with flashes and smiles and champagne showers, visions of big windows and bigger gardens, of space and light and freedom, an end to the eternal torment of the cycle ride to the office, an end to the double bed in the living room and territorial squabbles upstairs. But despite every new method he came up with – numbered sticks dropped in a heap, birthdays and high days, letting the children choose – the only telegram ever recorded in the family was from an aunt who couldn’t make the wedding.

It took a few days for Dad to reach a decision.

‘What would you do?’ he asked me, when the Consultant had left the room, and he sat there by the window, turning the envelope over and over in his hands.
‘It’s difficult. I don’t know. I think I probably would go ahead and have the operation.’
The Consultant had said that the chances of a full recovery from the operation were good. He’d done one the other week, the man would be going home soon. It sounded tough, though. There were risks.
‘So you think I should have the operation?’
‘He said chemo and radiotherapy wouldn’t work.’
‘So you’d have it?’
‘I’d want to do something.’

I was out of my depth. I didn’t understand the nature of the operation, other than it called for some radical re-plumbing, bits taken away, bits joined up in new and surprising ways.

Mum knew and I knew that my eldest brother Rich should have been sitting here. Rich, a GP, the one person in the family most qualified to be perched on a hospital bed trading percentage risks with a Consultant, translating envelope sketches into a family language of symbols we could better understand.

Of course, if what was really needed at that time was someone to come roaring up to the hospital on a motorbike, dump kit in the corner of the room, make stupid cracks, a cup of tea and whatever else it took, I was your very man. But these medical scripts? I was flailing around with my usual flair for the inappropriate, trying to imagine what I would do if I found myself with cancer of the bile duct, sitting there by the window, in that gown.

But what Rich thought or didn’t think was no longer available to us. When he left for medical school, no-one in the family realised, not my parents, not my four sisters, not my other brother, Craig (although he maintained later that it wasn’t a surprise to him, that the evidence had been there from the start), no-one realised that something more had happened than simply the freeing-up of a bed in the boys’ bedroom. Within a few years Rich had devolved almost completely from the family; after qualifying and moving up country, he was further away still, as inconspicuous as a satellite signalling from on an orbit at the coldest, furthest edge of things. He was absent from all family events and traumas. By the time of his second marriage, we saw nothing more of him. He had sloughed us all off like a skin.

What Dad made of it no-one could tell. He treated Rich’s absence with the same stoically dyspeptic face he turned to everything else, the same face he pulled when sometimes he would bite an apple and say: ‘This tastes like turnips’.

He had always thought Rich the least complicated, most effective, least troubled of all his children.

But then I learned that Rich had phoned home to find out what was happening, and had called the Consultant to discuss the case. None of us ever knew what he thought of the operation. Impressions of conversations with him only ever filtered back through Mum or Craig. But whatever he thought, the result stood nonetheless. Dad decided to go ahead.

Within a day or so he was in theatres, to ITU for recovery, then to a ward, then back to ITU with an infection, where he died the day after. All told, about a week.


How a life seemingly so settled and secure can suddenly fragment, burst apart and scatter not just into pieces, but into items of furniture, objects in a box, a scrap of paper covered with numbers or half a drawer of junk. How quickly we become the things we hardly thought of when we were alive. How quickly we move out of reach.

Like this overexposed photo of a Honda C90, the blue and white plastic scooter he’d ride up to the river to fish, or the shops on a Saturday morning to get the paper, or – astonishingly – two hundred and fifty miles to Exmouth, to stay with his elder sister Mae and her husband Frank. On the morning before each trip he would stand at the window, studying the sky.
‘I’ll leave it for a bit. Looks like rain.’

Or this metal detector, safely lain away like a shotgun at the back of a wardrobe.
Once I stood by with a trowel as he swept the disc back and forth across the clods of earth. There was a signal. I prodded around whilst he stood back, sniffing and watching.
‘It’s a washer.’
‘That’s not a washer. Pass it up here.’ Pressing off the dirt with the fatly gloved hands I grew into. ‘Yep. Thought so. That’s a dufer.’
‘A dufer?’
‘Take it to Brown’s. Slap it on the counter. Say “That’ll dufer a packet of fags.’

A neat stack of back issues of The Lady.
Dad was going to put in an advert, Situations Wanted: Hard working handyman / gardener seeks live-in position. Anything considered. He had worked in the estimates department of the local printers for thirty years. A strong man, practical and funny, somehow finding himself at the back end of thirty years staring out of an office window, making plans.

Thirty years too long at the printers. Quite an over-run. But too old and too tied up at the end to do much about it. I remember once he came home from work early, slamming upstairs, the only time I ever heard him cry – a series of awful, raging chokes from behind the door. But a week later he went back there. He knew, everyone knew, he would have to go back. Make his apologies to the manager, keep his job. What else could he do?

The Lady: England’s First & Finest Weekly.

But then blessed retirement was upon him, absolving him of the need for these petty negotiations, drawing him down into the softer, more padded territories of the slow afternoon bonfire, the strategic nap, the biro circles in the paper marking out the evening’s TV.

And now he lay with his eyes taped shut and a corrugated tube coming out of his mouth, the kind of pipe you might hang out of a washing machine. The intricate ITU mechanisms fussed and buzzed around him as we took it in turns to stand guard. He was sealed up along the centre of his abdomen by a brutal scar whose crimped ridge rode up like the edge of a pasty. When I saw the wound I imagined a surgeon up to his elbows in gore, periodically looking up to consult an envelope being held out by a nurse, riffling on impatiently until finally he straightened up, snapped the guts shut like a Gladstone bag and clipped smartly away down the corridor.

We lived for a couple of days in the relatives’ room. Slept on the chairs there. Made coffee in the kitchenette next door. Paced the room, took turns by his bed, read celebrity magazines, stared at them with paper eyes by the hard overhead strips and the blue light easing in through the window. It had been many years since we had slept under the same roof. But there were no revelations, no late night confessions.
‘These seats are so hard.’
‘What’s the time?’
‘I’m just going to the shop. Do you want anything?’
An assorted box of family members, like the pieces to an old game you come across unexpectedly and study closely, with a dislocated sense of time having moved on, and something significant left unchanged.

I know my answer to the question: What would you do if the world was going to end in five minutes?
‘I’m just going to the shop. Do you want anything?’

Dad carried on breathing for ten minutes or more when the machines were finally turned off. Stoking little gasps, without depth or hope, without end. My sisters, their families, a niece and nephew, Craig and me were all gathered around, touching his hands, forehead –a lacklustre crowd trying levitation by touch. Mum had her face pressed against his hand where it lay palm down by his side.
‘He’s still breathing. Can’t we do something?’
‘There’s nothing to be done. It’s a reflex action.’
‘But he’s still breathing. We must be able to do something.’
‘He’s a fighter. He won’t let go.’
‘Let go, Dad. Just let go.’
‘It’ll pass soon,’ said the nurse. ‘These are his last breaths now.’
‘But can’t we do something?’


Rich eventually phoned Mum to find out the time of the funeral. I guessed who it was through the hall door. I came through and asked if I could speak to him briefly. Reluctantly she handed me the phone.
‘Where were you?’
‘Excuse me?’
‘He was dying. He asked for you. He wanted to see you one last time. He was fucking dying, and you couldn’t even make that.’
‘You’re just mad because you told him to have the operation and he died.’
‘You’re a heartless bastard.’
A laugh. ‘And you? You’re mentally disturbed. You need help.’
‘I want nothing more to do with you.’
‘See a doctor, mate.’
I handed Mum back the phone.
‘Don’t,’ she said. ‘Don’t.’


A pause in the run of events. The coffin had been lowered into the grave, and time given over for the throwing in of a handful of earth, a bunch of flowers, a last glance before the ground was closed up again.

I had brought my camera but I’m pretty slack. The whole day I had only taken a few pictures of the garden back home coming into flower, and children chasing each other around the gravestones in the cemetery. I thought I needed something more substantial, so I went up to the edge to take a photo of the coffin in the grave, feeling self-conscious, wondering how it would look in an album but not wanting to miss the moment. I looked down and tried to imagine Dad lying there, the expression on his face close up against that lid, just about where the metal plate was screwed, reflecting the sun so I couldn’t see what was written on it. As I focused the lens I remembered a photo of Dad looking up from his deckchair in the garden, his favourite orange t-shirt riding up over his belly. The quizzical anger on his face, that frown, as he unlaced his hands from behind his head, as if he were going to get up, as if he were going to do something.

But I’m no photographer. When I got the pictures back, the three or four I took of the coffin all had my shadow lying across it.

Thursday, October 01, 2009

the message

‘What did the message say?’
‘Something like: Please come home and look after Ralf. I think tonight’s my time.’ I knew something was wrong so I came straight back, found him standing on that chair with the dog’s lead round his neck, just about to hang himself.’
‘So you grabbed on to him…’
‘I grabbed on to him, we struggled for a bit, his head came out of the lead and we both fell in this corner, where he is now.’
Steve is lying flat on his back on the concrete floor of the basement, his legs neatly pointing towards the steps that come down from the street, my gloved hands around his head to keep him still. A chair lies on its side in the alcove off to our right, a deeply shadowed arch cut into the ground beneath the pavement. His eyes are open, staring disconnectedly at the patterned dog lead hanging down towards us from one of the thick black railings.
Someone walks past on the pavement above, animated by the strobing blue lights of our ambulance.
The door to the basement flat is open. Radiohead plays loudly from a room inside: No surprises.
‘I’ll turn it off,’ Annie says, and steps over him.
When she comes back out she has a carrier bag.
‘His meds, what’s left of them. It looks like he’s taken quite a few diazepam.’
A second ambulance arrives above us. We need help putting Steve on a spinal board and getting him up those stairs.
‘Has he done this before?’
‘Only the overdose thing. He took all the dog’s meds last time.’
Annie puts the carrier bag down in the entrance and stands up.
‘I’ve just got to go inside and see about Ralf,’ she says, but at that moment a stiff-legged Staffordshire bull terrier clacks onto the threshold and stands there with its nose up, taking in the scene. The light from inside gives his elderly white flanks and blockish head a chalky, statuesque appearance, like a monument to a dog magically come to life.
But now the second crew are carefully picking their way down the steps with a spinal board, blankets, stuff. Space is so tight down here, every move we make from now on will have to be negotiated first, like a traumatic version of Twister.
‘Come on, Ralf,’ says Annie, ‘let’s get you back on the sofa, mate.’

He gives one disapproving, sneezing kind of huff, then follows her back inside.