Something must surely have happened today, something big. Or at least, a public announcement in the shopping centre, or maybe a plane dragging a banner across the sky: Come to hospital! Now! Everyone!
The department is overflowing, overwhelmed, bursting at the doors with patients and relatives - an expectant press of people, stewing dangerously like commuters at rush hour, all looking in the same direction, the desk at the centre, that plucky little veneered emplacement of computers, filing trays, dry wipe boards and coffee cups, the Rorke’s Drift of the A&E, where everyone, from ward clerk to registrar, are fielding requests and making decisions faster and more decisively than they ever thought they could, but saving the last canula for themselves.
I queue up to handover.
Ron, the Kiwi Charge Nurse, outwardly as smooth and unflappable as ever, is working so quickly his Maori tattoos seem to ripple up and down his arm like waves on the ocean.
‘Hey! Surfer Nurse!’ I shout.
He looks up and smiles. ‘I’m out there soon, mate’ he says. ‘I can taste it.’ He smiles with the shine of a wet board for a second, then he’s back in to it, crooking a phone to his ear, writing a name on the board, passing out an X-ray request to a porter and nodding to a patient’s relative who has begun shuffling dangerously behind us, foot to foot. I check the time. We need to finish promptly tonight, and I mentally pattern out the likely run of events: how long to handover, how many crews on tonight, the likelihood of copping a late job. I look back across that wretched stretch of humanity and catch Frank’s eye from where he waits with our patient. He is so focused, even at this distance he makes his opinion clear with nothing more than a gentle tilt of his head.
‘Okay. We can do this one and still finish on time. Buckle up.’
I put the truck in gear and edge forwards, but the A&E car park is impassably jammed with ambulances, taxis and cars. Frank surveys the scene for a second, then unclips his seat belt again and leaps out. He strides up to three cars in turn, giving firm directions to each. They follow the pattern he lays down – back up a foot; turn into that space; reverse into there; you, forward an inch, stop. Then he jumps back in the cab. ‘Go,’ he says, and calmly crosses his legs; we cautiously shimmy out through the channel like a ship through pack ice.
Mr Montague’s son, Jerry opens the door to us. A man in his thirties, he smiles with the wide, peg-toothed simplicity of a child. ‘Hello!’ he says. ‘My dad is on the floor. I did what the lady said. I did what the lady said to do on the phone.’
‘Okay Jerry. Through here, is it?’
‘Yes. Through that door, there. He’s on the floor, but I left him there, like she said.’
You would think the flat had been abandoned years ago. The bulbs are unshaded, the filthy curtains hang limply across the window frames, the carpet is tacky with ingrained dirt. The air has a rancorously sweet cut to it; it swirls around us as we move through, like the inside of a chocolate swiss roll.
Mr Montague is lying on the floor beside a ruined sofa, feebly clawing up at a plain wooden kitchen chair. His pyjama bottoms have ridden down, and the hollow scoops of his pelvis stand out like a dreadful signifier of his decrepitude.
‘How long has he been on the floor like this?’
‘I left him there like she said to leave him.’
‘Jerry? When did you see him up and about last?’
‘I did my jobs today. He hasn’t been very well.’
‘No? What’s been the matter?’
‘I don’t know. Not very well.’
‘Does anyone come in to help?’
‘Do you get any help?’
I go back down to the truck to fetch a chair. A neighbour from one of the ground floor flats comes out to see me, smoking nervously and clutching the pink towelling bathrobe around her.
‘Sorry to butt in, but – can I have a word?’
‘Is he all right?’
‘I don’t think he’s great. He might have been on the floor a while. We’re taking him in to hospital.’
‘Good, ‘cos it can’t go on like this. We’ve been on the phone to just about everyone, and no-one seems to take us seriously. They’re not coping. His son’s got learning difficulties and they’ve always lived together, but have you seen the state of the place these days? Well of course you have, you’ve just been up there. Just last week Mr Montague was walking about in the gardens in a right old state, didn’t seem to know where he was. He’s refused help time and time again and you can’t force someone, can you? And the doctors and whatnot just seem to take the attitude that unless he asks for help they can’t do much. But it can’t go on like this, can it? You’ve seen what it’s like.’
‘We’ll do our best to get things going. I think you’re right. Something needs to happen.’
‘I mean – it’s a shame. But enough’s enough.’
‘Thanks for your help.’
‘You’re welcome. Just make sure they get the picture.’
But the picture I get is of us wheeling the decrepit husk of Mr Montague in through the A&E doors, Jerry shuffling along beside the trolley holding his hand, as we excuse our way in through that melee of competing claims, to bid for a bed, to bid for attention, and a quiet place in which to give it, for everyone to have a clear chance, Mr Montague, Jerry, the other patients, their anxious friends and relatives, the overworked hospital staff, and us, the ambulance crew, cleaning up as quickly as we can and hauling our exhausted frames back to base, to finish another long, long day at a reasonable hour, and make it back home.