Thursday, November 26, 2009

the bad part

Someone has opened a box of devils tonight; they howl through the dark canyon of these houses, mauling the trees, whipping the parked cars with great tails of rain, rocking the ambulance from side to side as we come to a stop outside the only house with a light in the window.
Madre de Dios.’
‘Police en route.’
‘Let’s have a look anyway.’
A woman calling about a nine year old girl; the call taker heard screams in the background.

Even though I have a good hold of the ambulance door, my arm is almost wrenched from my shoulder as the wind snatches it away. I struggle to slam it shut, then with one hand holding the edges of my jacket together and the other gripping onto my bag, I step across black water to the pavement and then up an overgrown path to the front door where a woman stands jiggling and swaying with a baby on her hip.
‘What a night,’ she says as we stamp into the hallway. I don’t think she means the storm.
From upstairs, a child screams out. The mother absorbs the sound, as glassily subdued as the baby on her hip.
‘I don’t know what to do any more.’
‘Who’s that?’ shouts the child upstairs. ‘Who’s come in? I want to see them. I want to know who it is.’
‘It’s the ambulance, Tammy. They’ve come to see if they can help.’
‘Oh my God! Oh my God! I’m not going to hospital! I’m not going! I have to see them. I have to explain. I’m in such pain. Send them up to me! Send them up!’
Frank stays to talk to Mum in the kitchen. I go up.

Tammy is scrunched up in the middle of the bed, her knees drawn up with her hands elbow to elbow beneath them. A pillow rests on her legs, just in front of her face. She turns and stares at me through a curtain of sweated yellow hair as I step into the room.
‘What a night, Tammy!’
Outside the wind rages along the house front; the curtains fill and turn in the draught, as somewhere off in another room a door bangs rhythmically. Even though the windows are closed, it’s as if the storm had found a way through and torn everything up. The carpet is scattered with picture books, magazines, CDs, half-dressed dolls. The chaos extends up the walls, where certificates, photos and drawings jostle amongst the pulsing red hearts of the wallpaper. With the banging of the door and the twisting of the curtains it’s easy to imagine the whole room turning over and over like the drum of a washing machine, everything mixed and falling inside, wall to floor to wall, with Tammy’s drawn face peering anxiously through the glass.
‘Hello. My name’s Spence.’
‘No one understands. No one cares and no one does anything. I know I should sleep and I want to sleep but I can’t because if I do I’ll only wake up feeling like I do now, so bad and just so fed up. I’m fed up!’
Suddenly she pushes her face into the pillow, takes a shoulder full of air and screams as loudly as she can.
I push some books off an armchair and sit down.
The pillow soaks up the scream. Finally she raises her face again. She stares at me, then starts in again as quickly as if nothing had happened.
‘I feel so bad. I feel as if my arms and legs are going to fly away and leave me on the bed like a – like a dead dog. Does anyone know what’s happening to me? I’m sick and I’m never going to get better. I desperately want to go to sleep but the bad part won’t let me. I’ve got a good part and a bad part, and the bad part’s taking over.’
She lowers her face to the pillow and screams again. When that one passes and she raises her head again, I say as calmly as I can:
‘Tammy? You’re perfectly safe here. There’s nothing bad going to happen and there’s nothing can hurt you. You’re safe in your lovely room, in your comfy bed. Mum’s here, your little baby sister, we’re all here, and I know the wind’s going mad outside but it can’t get in and everything’s okay. You’re feeling bad at the minute but that will pass. You’re very tired and soon you’ll be asleep, and in the morning you’ll wake up and feel so much better.’
‘There are monsters in my sleep. They’re waiting for me. They’ll get me.’
‘No they won’t. We won’t let them. When you go to sleep you’ll be completely relaxed and rested, and in the morning the sun will shine and you’ll be fine.’
My words sound written out in crayon, phoney, unbelievable.
Tammy stares at me.
‘I’m not going to hospital.’
‘I’m not going taking you to hospital. It’s horrible weather outside. You’re much better off all tucked up and cosy in here. We’ll think of something else.’

Frank appears in the doorway behind me.
‘Can I borrow him?’ he says.
‘Won’t be a second.’
I follow him back downstairs to where the mother stands waiting with the baby.
‘Tammy’s been like this for a month or so,’ he says. ‘She’s been checked out by the doctor a few times, nothing wrong. There’s a referral to the child mental health team – next week? – but we’ve got to think how mum’s going to get through tonight.’
‘She won’t go to the hospital,’ says the woman, kissing the baby on the forehead.
‘She said.’
‘But we could get the doctor out tonight. At least they’d be able to give her something if talking doesn’t do the trick.’
The woman leans back against the wall and gently nuzzles the baby’s hair.
‘Can you believe it? Their useless father says he doesn’t want to come round and see them.’
Tammy shouts down the stairs again.
‘What are you saying? I can hear you. What are you saying?’
She screams again.
The police arrive outside.
Frank goes to meet them as I go back up the stairs.
‘Hang on, Tammy,’ I say. ‘It’s okay.’ But when the front door opens a sudden rush of air pushes past me, as if the wind is reaching in through the house to snatch the girl away, up from the bed and out through the window, gathering her shrieks to its black and furious centre.


Anonymous said...

Poor Tammy. Poor Mum. I hope they made it through that night and the time until the mental health visit.

cogidubnus said...

How sad and only nine...a time when she should still be enjoying all the innocence of childhood...sounds like a harrowing callout Spence...don't know how you handle these...

Spence Kennedy said...

It makes you so glad that there are specialist places like the child and adolescent mental health services. Tammy's was such a complex situation - but one that felt very tied to circumstances, and so eminently fixable. We couldn't do much else other than call in the doctor (we weren't there when they attended / the mother was happy for us to leave when Tammy seemed a little more settled).

Like a lot of these cases, it always seems more harrowing in retrospect. At the time, you're much more objective, thinking about what you can do. I think in terms of stress, it's often better to be in a situation and busy than away from it with lots of time to think. And then the other thing, of course, is that this is just one situation in a 12-hour shift of stuff. That night was light to average in that we did 8 jobs. And that wasn't the most stressful one!

Thanks very much for your comments, Cogi & KMKat! :) x

loveinvienna said...

I don't want to think what the more stressful job was like!

It affects the whole family, doesn't it? Even the little baby :( And the idiot father (in a aroundabout sense). But I'm sure the mental health team will help her :) Have you any idea what it was that was troubling her?

Liv xxx

Spence Kennedy said...

I think she'd been drawn into an intensely anxious state, the kind of panic attack that feeds itself in a horrible loop of bad feelings and physical symptoms of distress - really difficult to break, especially when you're only 9, with a limited ability to rationalise these things.

It seemed like a few things had been happening: the baby was only 3 months or so, the Dad was separated... a pretty stressful environment. But Mum was doing a great job, the home felt warm and supportive, so all in all I think even though it was a distressing situation the prognosis was good.

:) xx

Ashley said...

From someone who has been a Tammy...

Thank you.

lulu's missives said...

Hi Spence,
Mental illness is a horrible thing, it's not something that can be seen or rubbed better. You can't put a band-aid on it.
I hope Tammy gets some decent help.
x jo

Spence Kennedy said...

Hey Jo
Couldn't agree more. It's such a specialist field. The best we can do in the ambulance is make sure the person's safe, start to get some appropriate help organised, and retreat (with a sense of impotence/incompetence, half the time). I do think Tammy'll be okay, but I can't base that on anything other than a sense that her mum was coping and supportive, and CAMHS were already informed. A difficult area, no question. :/ xx

Hey Ashley
Hope everything's good with you now. Thanks for the comment x

Rach said...

For fear of repeating myself I am still going to say it again, your writing just gets better with each post Spence, you always transform me to the place where things are happening so beautifully.

I hope Tammy got the treatment she so needs..xx

Spence Kennedy said...

These days it seems I'm in the middle of a constant storm. But that's global warming, I suppose (freezing cold and lashed with rain).
Thanks very much for your support, Rach. I really appreciate it.

911 and the Randomness.. said...

I'm with Rach, you keep getting better! Sounds like you and your partner did everthing you could for the girl. Thanks for sharing.

Chimera said...

Your writing is utterly complelling Spence. i have missed a few weeks but am catching up and this last one had me completely spellbound. I am so glad you are writing this - no one else can apture your 'otherworld' with the intensity, detail and tenderness that you bring... and you must get more peple reading this...just superb stuff!
Tanvi x

karen said...

This was so powerfully written, hoping Tammy is on the way to finding some peace now...

Spence Kennedy said...

Hi Karen
Thanks v much! I think Tammy and her mum were doing really well despite difficult circumstances. Not only had the marriage broken down and a new baby arrived in the house, but they'd had problems with neighbours and loud, late night parties recently, too.

Hi Tanvi
Thanks for that!
It does feel like 'another world' - especially at night, under a full moon. Especially last night (but I'm too post-shift to do or think much about it).

Hey 911 and the Randomness
Thanks for your lovely comment. I think with a lot of these jobs the best we can do is turn up and make sure the situation's under control - more like acute social work than anything else.

Thanks for all your comments xx

Gerry said...

Keep writing, Spence.

Michael Morse said...

I've been gone from the job for a while, hurt back. I haven't missed it a bit until I read this. Nothing bugs me more than seeing a person suffering from mental illness being treated like cattle by the police, family or even ourselves. Sometimes all the training we have doesn't add up to anything if you forget your heart in the truck, or at the station, or at home.

Thanks, Spence. I've been out of the loop, nice kick in the pants to get me going.

Spence Kennedy said...

Hi Gerry
Yep. The blog continues ... this rough-cut paper chain of despair and deprivation! (Must make more of an effort to highlight the humour). Thanks v much for reading. It helps enormously to think that you and everyone else are out there expecting another post. It's so easy to find reasons not to write, otherwise.

Hey Mike
Sorry to hear about your back. How's it doing today?

I only missed an injury myself a few weeks ago (a difficult transfer from a bed to the carry chair). It's so easy to do. There's a gradual accumulation of stresses and strains, building up to that one stupid job that tips it all off with a resounding ping!

Totally agree about the importance of keeping hold of your sense of fair play. The temptation is to harden yourself to the job, and of course you do need to stay objective. But that shouldn't be at the expense of basic humanity. I know how thin the dividing line is between coping and falling apart. Treat the patient as you'd want to be treated is a decent orientation, I think.

Anyway - hope you're okay, take it easy, and thanks for the comment.

Anonymous said...

Someone find this man a publisher.

Spence, this was haunting. I could SEE that room, that girl; feel your calm even as the storm made everything seem topsy-turvy. Fine writing.

Spence Kennedy said...

Thanks, v much Wren! (Although I don't know about a publisher - I think maybe a straitjacket might be more appropriate)

Hope you're well

Wayne Conrad said...

rheumablog, Yes, this man needs a publisher. He paints contrasts of light and dark like a Renaissance master.

Spence Kennedy said...

Wow! Thanks Wayne! (But I bet everyone thinks I've got loads of aliases, one of them being 'Wayne Conrad') :)