Thursday, December 16, 2010


The street is in the older part of town, a one way stub of workers’ cottages so tightly packed the occupants must sleep standing up. But Frank manages to find room to park the ambulance without blocking the street. Incredibly, this apartment block has been shoe-horned into the housing continuum, with parking spaces at street level between the struts and legs of the upper storeys. The sheer concrete lines and halogen spots of its balcony walkways is in contrast to the mullion windowed chintz of the rest of the street; it stands in the middle of it all like some grand, alien ship, ready for take-off.

All the notes tell us: a fifty-nine year old woman called Barbara, unwell at number fifteen.

Frank pushes the at scene button, grabs a bag from the side, we find number fifteen, and knock. After a minute or two, the door opens, and a slack faced woman with coral pink lips and a pan scourer hairdo sniffs cautiously round the edge.
After a moment Barbara says: ‘Yes, it’s the ambulance,’ into the phone she has pressed to her ear, then turns round and retreats back into the house without acknowledging us; we follow her inside anyway.
‘Should I hang up now?’ she says, we’re not sure to whom.
‘Yes. Just hang up.’
‘I’m hanging up now,’ she says into the phone, then presses it off without saying anything further.
‘Okay,’ says Frank. ‘Hello. My name’s Frank, this is Spence. What can we do for you tonight?’
She stands on the other side of the room, a dimly-lit space that could be a showroom at Past Times; there are framed prints of Aubrey Beardsley drawings, art deco mirrors and figurines, tapestry cushions, candle holders, faerie prints, and scattered strategically about the place, a hundred soft toys – from Jemima Puddle-Duck, Bagpuss and Peter Rabbit, to an audience of variously graded teddy bears, some in overcoats, some in cowboy outfits or homemade doily wraps, or simply naked, tagged in the ear like prize cattle, looking on from the margins.
‘What seems to be the problem?’
Barbara flutters a hand just below her chin.
‘I’ve never felt so unwell,’ she squeaks. ‘I feel dreadful.’
‘In what way?’
‘In what way do you feel unwell?’
The question seems to disorientate her; she pauses whilst it disperses through the air, then she continues.
‘I’ve been on these pills from the doctor for a week. He gave them to me because I was so ill.’
‘These here?’
She stares at him.
‘Well what do you think? Yes – those there.’
‘Okay. Antibiotics, I see. Was this for some kind of chest infection?’
She pauses again, then sits down on the sofa and rolls up her sleeve.
‘I’m so worried,’ she says. ‘I’ve come out in this rash. What do you think this rash is?’
‘Let’s have a look.’
Her arm appears to have no more than a light bruise by the elbow and a couple of spots of eczema. The light in the room is poor, so I click on my pocket torch to give Frank something better to work by.
Barbara glares – and when she speaks, her voice has dropped an octave.
‘I do pay my electricity bills you know. You can put another light on.’
‘Yes. Yes, I know. It’s just so Frank can get a better look.’
‘Mm. Well – I can’t really see anything here,’ says Frank. ‘Do you have any pain anywhere?’
Her voice rises again, a quivering, reedy tone, and her hand flutters up into the air.
‘I’ve never felt so ill. I’m sorry to waste your time. I just didn’t know what else to do. I called my daughter, and she said if I was as bad as that I should call the ambulance. But I know you’ve got better things to be doing with your time.’
‘Don’t worry. Do you have any health problems?’
The strange drop of tone again.
‘Of course I’ve got health problems. What do you think?’
‘Okay. Any medication for anything?’
‘Over there.’
Barbara is extraordinarily volatile, switching suddenly from one character to another like some grotesque, topsy-turvy doll - anguished child’s face on one side, angry, middle-aged woman’s face on the other.
Both Frank and I tiptoe around her with our questions, but it’s difficult to get much sense from her.
‘I don’t know what the problem is, Barbara. But you’re obviously very concerned. So perhaps the best thing would be for you to come with us to hospital.’
Angry woman.
‘I’m not going there. People go there to die.’
‘It’s not as bad as that, Barbara.’
‘It is. My daughter’s a doctor and she’s told me all about it. Left in the corridor for hours. Left to die.’
‘No, no. They really do their best.’
Anguished child.
‘I think it’s terrible what’s happening today.’
‘In what way?’
‘People falling ill. Having to wait hours and hours to see anyone.’
‘But we came out right away. We came to help.’
‘What can you do? You’re not doctors. I’ve never felt so unwell.’
‘Which is why you should come with us to the hospital.’
‘No. I’m not going there. What’s going to happen to me?’
Frank sits next to her on the sofa.
‘Barbara? What do you think your daughter would want you to do? She suggested you called the ambulance because you didn’t feel well. And that’s what you did. Now that we’re here, we think you we should take you to the hospital. So don’t you think your daughter would tell you to go with us?’
Barbara sniffs, draws out a handkerchief from the sleeve of her jersey.
‘I’ll just get my things.’
‘Good. Good! We’ll just stand over there by the door to give you a little space. A couple of minutes and we’ll be off. Okay?’
We go over to the door, and whilst Barbara mutters to herself, gathering things together and stuffing them into a floral bag, we pass the time, talking quietly.
‘So where were you the other week?’
‘I took a couple of days off with my back. We did a dodgy lift and it made my old problem flare up again. Just here,’ I say, pressing him between his shoulders. ‘I scored some decent painkillers off the doctor, though, so it’s not all bad.’
‘My back’s been pretty bad recently.’
‘I went to see this Osteopath, and she said....’
‘What are you talking about?’
Barbara has stopped getting her things together and walked right up to us.
‘Oh, we were just swapping horror stories about our backs.’
‘Your what?’
‘Our backs. We’ve both had back problems.’
‘Oh. Have you. Did you know I’ve had back problems?’
‘No. Have you?’
‘Yes. I had an MRI. I’m under Mr Coltishall.’
‘Right.’ An awkward pause. ‘Sometimes I think I could do with an MRI. Might not like what I find, though.’
I smile at Barbara, but it crashes up against the sheer wall of her face.
‘What’s your name?’ she says.
‘No. Your last name.’
‘I’m afraid it’s not really policy to give out last names.’
‘Actually it doesn’t matter. Because I have a daughter who works for the Met police in London. And she can find out your name like that. And she will find it out. Because I’m going to put in an official complaint about you. And d’you know what? I’m going to make your night. I am not going to the hospital. And I want you out of my house, right now.’
Right now!
We turn and leave.

We climb back into the cab. Frank phones control to put them in the picture. Whilst he’s explaining the situation they interrupt to tell him that Barbara has called again.
‘Where are you at the minute?’
‘Still outside the property.’
‘I don’t suppose...’


jacksofbuxton said...

Tough one Spence.I work with the general public(not in the same way as you,all I do is cut hair)and you sometimes have to just smile and crack on.

Another beautifully written piece.Pleased that I've found your blog.

BB said...

I guess you guys do have a lot of 'wasted' time if that's the correct term. Perhaps they should start dispatching psychiatrists out with you guys when you go.

Spence Kennedy said...

JoB - The general public. Smile and crack up, often.

Cutting hair's a great skill to have. You can take it anywhere (I'm thinking somewhere hot...)

BB - Yeah, another dodgy call. I think I'm describing a bit of a pattern here. I like the idea of a psychiatrist in the toolbox, though. With a big net and a syringe...

tpals said...

It's too bad the blatant time wasters can't be fined. Maybe fewer would try to use you as a glorified taxi if it was going to cost them.

Spence Kennedy said...

tpals - Maybe there could be a way. Along with a high-profile education programme. But it's difficult - especially in these litigious times. And no-one wants to discourage genuine callers. I wish there was something out there to dampen down the abuse, though.

In Barbara's case, I suspect there was a MH component! So she wasn't entirely at fault - I'm not sure how rational she was being. :/

Mariodacat said...

you seem to get a lot of patients with MH! Do you ever get to go on just "normal" calls? I think I'm happy I'm a cat!! You are a nice person - maybe you should have been a vet! he he

Spence Kennedy said...

We do! An average shift is 8 to 10 jobs. I think of those, at least 3 will be MH related in some respect. It's a huge area, as big as alcohol and geriatric falls for the ambulance (certainly here in the UK)

But you're right, mario. Maybe I'm focusing too much on the strange, unpleasant jobs, when in fact I'd say the majority of the people we go to are actually v helpful / nice / co-operative.

I'd love to have been a vet. I think I'd be okay - just ask our cat / dogs / fishes (but maybe don't ask the fishes - one just died, and the other is planning revenge).

Unknown said...

I don't know how you manage it. Trying to reason with irrational minds is just impossible. Of course, some of the fault clearly lies with all of those naked teddy bears. Everyone knows naked bears will drive people loopy.

Kyranthis said...

I don't know. I think the strange, unpleasant jobs need to be written about. I mentioned your way with words, but you have a way with characterization as well.

btw beware the revenge of fish. They have weapons.

Spence Kennedy said...

nari - I def blame the bears. Clothed or otherwise, you just can't expose yourself to such high levels of bearage without there being some serious fall-out.

kyranthis - it's the way it rises up to the surface of the pond when I go out there (when I remember to go out there) and frowns at me just below the surface.

I don't want to have to frisk it for weapons, though.

The Real Housewife of Greensboro said...

That was a great story Spence but I'm thinking that the woman may have had dimentia or alzheimer's because I know from personal experience that when they can't remember things, they sometimes get frustrated and take it out on whoever is trying to help them in whatever their need is at that time. Or maybe she was just a miserable old lady. I know that sounds bad but it happens.

jacksofbuxton said...

Any thoughts Spence?

Jane Brideson said...

The number of MH call outs is really high - must be so hard for patients - and of course for you with the abuse that goes on. I once worked as a home help for a while, great, until a confused client threatened me with a knife. Strange, she had naked bears too.....

Spence Kennedy said...

RHG - It's possible. She didn't strike me as symptomatic in that way, but you never know. My feeling is that it was some other, low grade MH problem, exacerbated by loneliness (and maybe a touch of the natural miseries anyway). :/

JoB - About time! We've been under the lash from response times for too long. They should not be the driver for vehicle disposition - clinical outcomes are much more insightful. They should keep 'an eye' on response times, but that's as far as they should go. More effort & resources into effective triage would help, too.

Jane - MH calls can be v draining - and of course it's incredibly tough on the patients. There's so much room for improvement in MH provision.

Naked bears - urgh. (Actually, soft toys generally...)


Unlimited-Unscheduled Hours said...

You know, if you weren't on another continent, I would SWEAR that I took that same patient in last week!

Spence Kennedy said...

UUH - I bet when they find life on another planet and the president broadcasts the footage, I'll look at the TV and say: 'Didn't I take that one in last week?'

Gentrie said...

Hahahaha! I can see you guys sitting in your ambulance, radio in hand, looking at each other and rolling your eyes! Deep sigh......

You have such patience. Good Job!

Anonymous said...

Aghhhhhh, frustration. But then I feel slightly sad, she is obviously not a happy women, for whatever reason.
As a child my 'fever nightmares' were always about bears :)

Spence Kennedy said...

gentrie - That's exactly what we did! How did you know?

It's difficult to maintain your cool with patience like that, but you get fairly resilient after a while. Your only comfort is the confessional-like ambience of the cab.

Thanks v much for the comment.

UHDD - You're right - I don't doubt she's unhappy, and I do feel worried that she's reached that position. I hope she finds some kind of peace with the world.

I can quite understand the bear thing. There's something unnaturally fixed about their expression. What do they know??