Tuesday, August 30, 2011


Two o’clock in the morning, and Nerys is outside resus, standing by a trolley piled with equipment, scrubbing a head block. The department is strangely quiet, a vista of empty trolleys beyond her, and despite some quiet movements and murmurings from the cubicles, not a person in sight.
‘Hey Nerys. What’s up?’
She straightens and smiles. Frank goes on past her to hand over at the desk; our patient lies sleeping on the ambulance trolley, anaesthetised with booze.
She nods at him.
‘They’ll be starting to come in now, I expect.’
‘Yep. So it begins.’
She smiles again, but seems pale and wrung out, her eyes as blue as her tunic.
‘Are you okay?’
She puts the block down.
‘I just saw a ghost,’ she says.
‘A ghost? What – literally? Where?’
She glances behind her at the swing doors of the resus room, absently wiping her gloved hands with the cleansing wipe as she talks.
‘It was so weird. Resus is empty - which god knows is weird enough. I thought I’d take advantage and catch up on some cleaning. I was half way through when I felt this wash of cold go through me. I looked up because I thought the doors must have blown open, and saw this shape moving through the room.’
‘What sort of shape?’
‘Definitely a person, but just a blurry outline. I don’t know – it’s difficult – like if you press too hard when you do a drawing and it comes through underneath. All I did was just stand there and say ‘Hello?’, and watch it pass out of the room.’
‘Through the doors do you mean?’
‘Well – kind of the gap between them, actually. I was so freaked I brought all my stuff out to work in the corridor.’
She smiles thinly and picks up another head block.
‘Maybe I’m going crazy,’ she says.
‘I don’t think you’re crazy. Maybe you did see a ghost.’
‘Have you ever seen one?’
‘Me? No. Well – not that I know of. I try to talk myself out of all that stuff because I know I’d freak out if I let myself believe in it. I get so spooked out when I hear stories like this. Look at these goose bumps.’
‘So how did the ghost seem to you, Nerys? Sad? Evil?’
She raises her eyebrows and thinks about it for a moment. Eventually she sighs and says:
‘I don’t know. Lost. Like it had somewhere to go but couldn’t remember where.’
Suddenly a deep, slurry of a voice speaks between us.
‘Ghosts exist all right,’ it says.
My heart twitches, but in that same instant I realise it’s just my patient, who has woken up and raised himself on one arm to look at us both. He closes an eye and drills the corner of it with a filthy finger, smacks his lips together, then wriggles about to make himself more comfortable.
‘Are you all right?’ I say to him, but smile at Nerys because I can see he made us both jump.
‘I had this job in an off licence,’ he says when he’s settled. ‘Part of a big old building, used to be a bakery in the nineteenth century. Apparently the baker murdered his wife and bricked her up in the cellar. Anyway, when I got the job the manager was walking me round the place telling me about this and that, you know, the alarms, the toilet, what the job was, you know, when he slips it in all casual-like about the ghost. “What do you mean? What ghost?” I says. “Oh, don’t mind her,” he says, “but she’s got some rules and it’s as well you know about them.” “Okay, fine, what rules?” “Well, for a start, she doesn’t like anything hidden, so don’t bother trying. The last guy was supposed to set up a Hamlet cigar display in the shop, but he didn’t like it so he hid it under some boxes in the cellar and locked the door. When he came back in the morning the door was still locked, but the display was sitting right in the middle of the shop.” “Okay,’ I says to him, “What else?” “Well,” he says, “She throws things around sometimes if she’s in a strop, so just don’t piss her off.” The first day I worked there I was just finishing locking up the back when the bell rang at the front. I thought whoever it was would go away when they saw we were closed, but the bell rang more persistent like, so in the end I went out. But there was no-one at the door and the street was empty. Then the bell goes down in the cellar. All I thought was, someone messing about, kids or something. Anyway, I went down there and opened the little door that leads out into the back yard, but that was deserted too. Then I remembered about the ghost. So I just stood there and said out loud I know it’s you, ghostie. It’s nice to meet you and everything. I’m new here, I want to make a go of it, but I don’t want us to start off on the wrong foot. I’ll be around all day, but you can have the run of the place at night, and that way we’ll get along just fine. If there’s anything else you need, just let me know and I’ll do my best. And from that day on I didn’t have any trouble, apart from the usual ‘footsteps on the stairs’ and ‘cold shivers’ and ‘floating bottles’ and stuff. But I didn’t mind. It was a bit of company.’
‘Floating bottles? What do you mean?’
Suddenly he begins coughing, an eruption of rattles and dinks, like someone shaking a bag of marbles. I sit the back of the trolley up. He dredges a gloop of dreadful matter and flops it into the bowl. I hand him some tissues. When the moment has passed, he carries on.
‘I was doing a stock take when suddenly a bottle of Old Plymouth slid off the shelf and hung there in front of me, in mid-air. I just looked at it. A good couple of minutes it was hanging there, all shivery in the light from the window, and I couldn’t understand what the hell was going on. Then suddenly it fell to the floor and smashed. “Great” I thought. “You know who’ll get the blame for that.” I’d just fetched the dustpan and brush out and was starting to clean it all up when the door burst open and Carrie came running in. She was always running in with one thing or another, but this time she goes: “You won’t believe the news.” “Oh yeah? Try me” I say. “They’ve just found Old Nellie Ellington dead in her flat,” she says. Then she looks down at the floor and sees all the mess and says “Blimey. What happened here?” And it suddenly made sense. And I said to her: “It’s the ghost. I think she’s trying to tell us something about Old Nellie.”

Saturday, August 27, 2011


Mrs Rickson is lying in the hallway, her head propped up on pillows.
‘How did you come to be on the floor?’ asks Frank, crouching down beside her like an Indian scout reading the trail in a corny western.
‘My wife’s not got any short term memory,’ says Mr Rickson, leaning in and laying a hand gently on Frank’s shoulder. ‘She’s under the doctors for it – waiting on a scan.’ He withdraws discretely and folds his hands in front of him.
‘I see,’ says Frank. ‘Do you have any pain at the moment, Mrs Rickson? Any new pain?’
She winces and reaches round to the small of her back.
Frank looks up at the husband, who closes his eyes and shakes his head a little.
‘Always has pain there,’ he says. ‘Nothing new. When I saw she was going I helped her down gently. Nothing jarred.’
‘Good,’ says Frank. ‘That’s good. Now – is there anything else I should know about before we move you?’
Mr Rickson leans in and touches Frank on the shoulder again.
‘She has a lot of trouble with that,’ he says, pointing to her leg. ‘She’s had all kinds of work. Pins and whatsits. Operations – you know.’
‘Oh? What happened there, then?’
‘It’s a long story,’ says Mr Rickson, extending his jaw forwards to free it from his starchy collar. ‘She did it the same time as she did her back. We were driving on the motorway.’
‘Ah!’ says Frank. ‘An RTC.’
‘A what you say?’
‘A crash. You had a car crash.’
Mr Rickson frowns.
‘No. No – we were driving on the motorway when Dorothy said she was desperate for the loo. I said to her I said “Can’t you hold it? We’re almost there”, but she said she couldn’t. So I pulled over. Onto the hard shoulder.’
‘Ah. Right. So - you got hit by a car on the hard shoulder.’
‘A trip, was it?’
‘How d’you mean?’
‘Did she trip when she was getting out of the car?’
‘No. No. She got out of the car, quite safely, and she was looking around for somewhere to go, because as I say, she was desperate. And she saw this bush just a few yards from the car, so she decided to go behind that.’
‘Except it wasn’t a bush – it was the top of a tree. She fell twenty feet into a gulley, and the fire brigade had to fish her out.’

Thursday, August 25, 2011


The morning has grown in stature until it stands warm and wide and cloudless blue with everything before it. Even the sun wears shades; it pushes them further up its nose and leans in to scrutinise the bustling summer commerce of the city below – the cars and vans, bikes and buses, the pedestrians, joggers, buggies and wheelchairs, the skateboarders and bikers on the ramp, the early picnickers through the trees, the tennis players, toddlers, dog walkers and street sweepers, and that ambulance, like a wedge of pure sunshine, indicating to move over into the lane that leads to the park.
Inside the cab, Frank reads out the latest job to come through.
Man fallen from bike.
‘Not another one,’ he says. ‘How many of these are we going to do today?’
‘It’s the nice weather, Frank. Everyone gets their bike out.’
He writes the incident number on the sheet and tosses the board onto the dash.
‘If you ever see me on a bike,’ he says, ‘It’s not me. Call the police.’
But then the update comes through and he straightens in the chair.
‘OK. That would explain it. Cardiac arrest.’

Luckily we’re just a few streets away. As I pull round the corner we can see a group of people leaning over a figure in the road. I park up just beyond and protect the scene with the truck; Frank jumps out and when I join him he’s already giving CPR. As I stick on the defib pads Frank is asking the distraught woman leaning over him what her relation is to the patient – wife – what happened – he complained his arm had gone numb then he pitched off the bike – what he suffers with – angina. He tells her that her husband’s heart has stopped working but we’re doing what we can. I nod at the man who made the call, and he gently leads her to one side to give us more room.
‘VF. Hands off.’
Frank lifts his hands.
I deliver a shock. The man’s body gives a convulsive shudder, then Frank is straight back on the chest.
Another crew turns up to help.
A minute further and we shock the man again. This time a viable rhythm settles in to the monitor. A pulse at the neck, increasingly effective breathing. We cluster round the man’s attempt at life with the care of primitives tending a flame. Every bit of kit that could possibly keep the fire going is out on the road now. Until finally, incredibly, it seems as if his condition has stabilised sufficiently to package him up and load him onto the truck. The second truck tidies up and follows with the patient’s wife. At hospital he is stabilised further in Resus, then taken to the cath lab. He finishes the day in CCU.

‘Like I said,’ says Frank, taking a sip of his coffee and studying the sky, the light needling from the rims of his dreadful seventies sunglasses, ‘If you ever see me on a bike...’

Tuesday, August 23, 2011

fact / fiction

Roger leans back in his computer chair and half of his pastry disappears in one convulsive mouthful. He stares at me as he chews and swallows, then with the remaining half poised to follow the first, says: ‘I suppose you just believe everything you’re told, do you?’ He hangs for a second more before snapping it down, crumpling up the greasy bag and tossing it in a perfect arc across the room into the bin. He sucks his fingers clean. ‘Do you?’
Roger loves an argument as much as a fruit Danish.
He turns back to the computer.
‘Me?’ he says. ‘I like to make my own mind up.’
I can’t help being drawn in. I’m like that Danish, helplessly poised over the abyss.
‘Based on what? The internet?’
He swivels round to look at me again.
‘Based on facts, fella. Facts that are out there, if you know where to look. Straight from the coal face, people like you and me. Who live this shit, day in, day out. Come on! You’re not scared of the internet are you? Because there’s nothing they’d like more. They’d love you to think it’s the bogeyman and stay quietly in your corner. But you know it’s just another way for people to talk to each other. And at the end of the day, what’s more dangerous than that? It’s what governments spend billions trying to stamp out. The thing about the internet is it doesn’t have anything to sell. Well, the heart of it doesn’t. The soul of it. The soul that’s still intact despite all their best efforts to rein it in. Basically it’s a window out onto the world, Spence. Where you can find stuff out. From real people, working people who couldn’t give a shit about the bottom line or the mission statement or any of the rest of that poisonous stuff the management like to shovel out. Open your eyes, Spence. Look around. It’s all there for you, if you’d only let yourself see it. You’ve just got to read with a bit more of a question in your heart. And I don’t mean all the official bullshit they put out, the newspapers, the TV – all that sterile, boneless crap. What do you think they’re going to say? Do you think they want you to know the real reason they do stuff? All they want is that you keep doing what you’re doing, pulling on the oars and looking out the window whilst they bang the drum and keep their eye on the real destination.’
There’s a smoothly pulsating rhythm to Roger’s speech that’s completely sedating. I am Mowgli, caught in Kaa’s coils, staring into the concentric circles of his eyes.
I try to snap myself out of it.
‘At least with the stuff you read in books and newspapers you get to see who wrote the thing,’ I say, squirming. ‘At least there’s a chance you could hold them to account.’ As soon as I say it I realise what a fraud I am. Who writes a blog? Who uses a pseudonym? But Roger doesn’t know about any of that. I’m a worm in the apple of his tree.
‘Yeah? So how long has it taken a big fancy paper like The Guardian to bring News International to account? How easy was that for them, with all their money? How easy would it be for you, do you think?’
I shrug.
He turns back to his computer again.
‘I can’t believe you’re so na├»ve, fella,’ he says, perfectly pleasantly. I don’t reply, and after a while I become conscious of the hum and drone of the servers. Roger surfs a few sites, then logs off and folds his arms.
‘I don’t suppose you’ve heard about the ambulance X files, then?’
‘The what?’
‘The ambulance X files. All those jobs that are so devastating they’d blow your little world apart if you heard about them.’
‘And where did you hear about them? On the internet, I suppose?’
‘No. This was even better. I got this from a friend of a friend who knows one of the crew. Over East way.’
‘So what happened?’
‘Apparently, they got sent to a possession. A young girl, possessed by the devil. That’s how it came over on the notes. So of course they rang Control straight back but didn’t get anything different. You know, assess and advise. And they were giving it all the usual chat on the way over. Yeah, right. Possession, blah, blah. The usual lines from The Exorcist. But when they pulled up outside the house they felt terrible, like some dread hand had been lain across their soul. And when they went into the house it was dark, and completely trashed, and colder than a fridge. And there was the girl, standing in the middle of the room smiling at them. And then suddenly the door slammed shut and a sofa – a sofa – flew across the room and flattened them both. They screamed their heads off and got out as fast as they could, even though one of them had a broken leg. Months off work. Months. Therapy, the works. And they were forbidden to tell anyone anything on pain of their jobs.’
‘That’s a good story, Roger. I like that one. How did you hear of it?’
‘Frank told me.’
And just at that moment he walks in the computer room.
‘What?’ he says.

Friday, August 19, 2011

mrs ramstein

An ancient woman opens the door to us. She is smiling serenely, perfectly insulated from the buffetings of the world in a full length, bottle green quilted house jacket.
‘Are you the patient?’ I ask her.
She shakes her head and moves sideways without a sound; her coat is so long, you would think she was on casters.
‘Upstairs,’ she beams.
The house is so perfect it’s like we’ve been miniaturised and put inside a Regency dolls house. At the foot of the stairs is a white door. I open it, and we go up.
‘Ambulance,’ I call ahead.
A fierce voice answers.
‘For Gott’s sake, here, here, bitte. How long must you be in the coming? In here. Why do you take so long about it?’
‘Okay. Almost with you.’
We follow the sound of intense muttering, and find another elderly woman sitting on a lounge floor in her nightie, both legs straight out in front of her, supporting herself on her arms. She looks straight at us as we come in the door, a savagely uncompromising squint.
‘What is the matter with you? Can you not see the trouble I’m in? Look. Qvick. I tell you what to do and you help me because I’m in such pain.’
‘First things first. My name’s Spence, this is Frank. What - ?’
‘I don’t care who you are. Why won’t you listen? I’m telling you what to do. Now. Move that chair. Come here.’
‘I need to know your name, though.’
She sighs explosively and sinks an inch. After a murderous pause she fixes me with her eyes again and says: ‘You will address me as Mrs Ramstein.’
‘Mrs Ramstein. Thank you. Now. How can we help?’
‘How can we help he says. Mein Gott, if you would only listen you would know. I have fallen down onto my sitting bones and I am unable to stand. Now. If you would both take hold and give me assistance, I can get off the floor and in to bed. Do you think it is comfortable here? Do you?’
‘Why did you fall, do you think?’
‘I fell because I fell! What is this nonsense you are asking?’
‘Was it because you lost your balance, or did you pass out?’
‘Come on. Enough. Take my arms. This is ridiculous.’
‘Okay. But let’s quickly see if you’ve hurt yourself.’
‘I’ve already told you I hurt myself. I fell down on my sitting bones and I have brrr-oosed them.’
‘Can you just lift this leg for me?’
‘I know what you are thinking, but let me tell you, I have forty years a nurse been. Do you think I do not know what is the difference between a fracture, a dislocation, a haematoma or some simple brrr-oosing? Now will you stop all this nonsense and get me up.’
We help her up.
‘There,’ says Frank. ‘Good as new.’
‘Good as new,’ spits Mrs Ramstein. ‘What do you think? How many years you been ambulance?’
‘I’ve lost count,’ says Frank. ‘It’s all a pleasant blur.’
‘Well let me tell you something. In all my years I have never met such incompetence. Now. You will help me to the bedroom and I will rest on my bed. Not that way – this way. More slowly! Mind that!’
We help her into her bedroom – a forensically tidy space, with starched and ironed squares of pure white linen draped over the brushes on her dressing table, the books and pill packets on her trolley, and even over the top half of a cheval mirror.
‘On to the bed. No! Pull the qvilt to one side first. Not like that. In half, neatly, down the middle. Who taught you to make beds?’
‘Come on, Spence, sharpen up,’ says Frank.
‘There. Now. Gently down. Gently…gently….ahh.’
She stretches out, closes her eyes and folds her hands across her stomach.
After a moment – in which you would think she had fallen instantly to sleep – I dare to speak again.
‘We just need to do some basic observations, Mrs Ramstein, then we’ll leave you to rest.’
The eyes snap open.
‘Be qvick,’ she says.
Frank writes out the ticket as I canter through some obs.
‘Never in all my years have I met such incompetence, she says, but her voice is easier now – albeit the ease of a sated lioness. As I check her over I cannot resist finding out a little more about her.
‘So. Are you from Germany, Mrs Ramstein?’
The lioness roars.
‘Germany? No! I am Austrian. I would have thought you would have known that, at least? Are you really that stupid?’
Around us on the walls are some family photos – recent colour pictures of young women graduating; older, more faded photos of family groups with a stout blond matriarch in the background; a black and white photo of an athletic blond woman in a bathing suit waving cheerfully by a lake, and a dim, sepia photo of two dark figures posing side by side.
‘My mother-in-law’s German,’ I say.
Frank smacks his head and hides behind the clipboard.
German? I’ve already told you – I am not German, I am Austrian! What will it take to get through to you? You seem completely unable to understand anything.’
But she is frowning at me like a ferocious beast whose interest has been piqued by an unexpected titbit. As I finish taking her blood pressure and unwrap the cuff she says: ‘Where for in Germany is this mother-in-law from?’
‘Where for in Prussia?’
‘Stolp. Well – used to be Prussia.’ And I add as an afterthought, as if someone had been careless: ‘They moved the borders.’
‘I have not heard of Stolp.’
I put the cuff away. ‘Everything checks out,’ I say.
‘Is your mother in law there now?’
‘No. She left in 1939. Well – I say left. She escaped with her life. She’s Jewish, you see.’
Frank groans.
Mrs Ramstein adjusts her position and examines me more closely from the bed.
After a pause she sighs and says: ‘They were difficult times. Terrible times. I was just a girl. I expect your mother in law was the same. It is terrible the things that happen in the name of politics. I escaped with my life also. From the Russians. I came to this country after a while here and there. A woman at the hospital was kind enough to get me some training. How is your mother in law?’
‘Yes – she’s good. Health problems, but an incredibly resilient and resourceful woman.’
‘You had to be. We all were. It was the times. Terrible times. You wouldn’t believe.’
The moment passes. Even Frank seems a little more comforted, more confident. He hands me the clipboard, then notices a cat peacefully grooming out on the landing. He squats down, puts his hand out and makes kissy kissy noises.
‘Hello mate,’ he says. ‘You’re gorgeous, aren’t you?’
Mrs Ramstein’s eyes blaze.
‘Jessie! She must not be up here! Who let her up? You must have left the door open! My Gott – has she come up? Quick. Take her down. Take her down.’
Jessie looks up disdainfully, then carries on licking her paw.
Frank moves towards the cat to pick her up.
‘No! Don’t pick her up!’ shouts Mrs Ramstein. ‘If you just simply walk she will run ahead. Drive her out! And make sure you shut the door so she doesn’t come back.’
Frank disappears with the cat.
‘Anything else we can do for you tonight?’ I say after a while.
She relaxes into the bed. ‘No. You have done qvite enough.’
Frank comes back into the room.
‘Jessie has left the building,’ he says, then picks up the bags ready to go.
‘Pull the quilt over me a bit more. That’s it. Now I sleep.’
And with her eyes closed she says: ‘You know, till recently I would get up at six and go schwimming. But now? I am fit for nothing.’
‘Maybe you could do with a little more help. We could sort something for you. At least get the wheels in motion.’
She opens her eyes.
‘There is one thing you could do perhaps,’ she says. ‘And that is make sure I don’t wake up in the morning.’
‘Well – that’s a little beyond our remit, Mrs Ramstein.’
‘Ach!’ she spits. ‘Hopeless ambulance.’


As we shut the white door carefully behind us, the sweet old lady who greeted us is standing in the hallway.
‘Everything all right?’ she says.
‘A little brr-ooosing, but she’s resting in bed now.’
‘Good!’ says the woman. Behind her on an immaculate Regency chair, Jessie looks up from a busy grooming of her tail with her back leg in the air, and I could swear the expression on her face was the same as the expression on the face of the old woman in the housecoat.
‘Thank you so much for coming,’ she beams.

Wednesday, August 17, 2011


Midnight. My skin feels as waxy as the leaves on this umbrella plant in the humid night air.
I reach out, ring the bell and we wait.
Only Mr Rendell has lights on; the rest of the houses in the street are shut up, utterly still.
Frank unclips his radio to call Control for advice when Mr Rendell shuffles slowly into view behind the striped glass panels of the door. ‘Ambulance,’ I say. The rattle of a bolt. It opens.
He stands there a moment, staring out at us. He moves an inch, winces and crumples slightly on his right side.
‘How can we help?’
He regards us with a baleful expression.
‘You’d better come in.’
He releases the door, turns and pads solemnly into a bright and neatly ordered kitchen.
Frank helps him move a chair so he can sit.
‘I understand you’ve had a fall,’ I say, taking a seat opposite. ‘What’s happened?’
‘I have this fear,’ he says, his voice as thin and gray as a night sweat. ‘Well. A little more than that. A phobia, actually.’
He pauses, his eyes glisten and for a moment I think he might cry.
‘Okay,’ I say, as softly as I can. ‘What kind of phobia?’
His jaw drops, like someone gagging on an unpleasant taste. Finally he is able to say: ‘I can’t bring myself to use the word. So I hope you understand me when I say Arachnids.’
He hesitates again, and the horror of the subject percolates through him, scalp to slippers. Finally he gathers himself sufficiently again to tell us the rest of the story.
‘I had got myself ready for bed and was just settling down to read my book when I noticed a dark shape sitting on the wall by the chest of drawers. A disgusting, massive thing. Well. Normally my wife would take care of it for me, but she’s away visiting relatives, so it’s just me on my own. I had to force myself, even though I felt really sick and panicky.’
‘Take your time, Mr Rendell. Let me feel your pulse whilst you talk. That’s it. So. What happened next?’
‘I got out of bed - as carefully as I could - came downstairs, found some newspaper, then came back up. The - erm - visitor – had gone. I looked about, and then I saw it, further up the wall, on the ceiling. I had to climb onto the bed to reach it, and I was just about ready to stretch out and get it when it moved!
‘How awful.’
‘I’m afraid I screamed, toppled forwards and landed on a chair. I think I’ve hurt my side.’
He leans to his left and pulls his dressing gown aside to show me. A nasty looking haematoma on the lower aspect of his chest wall.
‘We need to get you to hospital to see the extent of the damage, Mr Rendell. Frank’s just going to go upstairs and have a look at how far you fell and what sort of chair it was. I’ll check you over whilst he does that, okay? But you’ll definitely need to come with us to hospital. Just to be on the safe side.’
‘If you think.’
‘For some good pain relief, if nothing else.’
‘What would my wife say?’
‘She’d just be glad you were looking after yourself.’


With Mr Rendell safely delivered over to the hospital, we tidy up the ambulance and then stop for a coffee.
‘I didn’t say anything at the time,’ says Frank, handing me a cup, ‘because I didn’t want to give him a stroke, but my god, you should’ve seen the size of that spider.’
‘Big, was it?’
‘Big? As big as my hand. Well – the palm at least.’
‘God, yeah.’
‘Did you kill it?’
‘No. I’d have needed a lump hammer. So I just left it.’
He takes a sip of coffee and stares off across the empty car park. ‘With its legs up reading the newspaper.’

Monday, August 15, 2011


Alex, the manager of the language school, meets us at the door. He waits, ministerially clutching a radio and clipboard, whilst below him on the stairs a cluster of teenagers argue about where to go tonight; they scarcely seem real, as sharp and freshly made as the office blocks, restaurants and loft-style apartments that tower above them.
‘Can we talk a moment in the office, please?’ says the manager.
The students part to let us through. Alex leads us inside.

A secretary smiles as we pass through the security point into her glass-fronted domain. Some more students wait on one side to let us through. When they show the secretary their passes, she resumes her usual demeanour, glowering through the glass, checking her list, ticking names, depressing a lever with her foot. They all try to see past her into the office as they jostle through the turnstile. A young Chinese boy stops and says: ‘You know, I’m feeling perfect tonight, Miss Angela.’ Before she can look up, he throws himself through the gate and hurries out to mass with the others in the street.

‘I want to keep this as low key as possible,’ says Alex, sighing, and putting his radio and board down on the desk. ‘Matteo is sixteen. He’s only been with us two weeks, but no trouble up till now. Here are his medications – some kind of anti-depressants. As you can see he’s not up to date. This evening when he came down for his mail he was acting a bit strangely.’
‘In what way?’
‘Going up to people – people he doesn’t know – and smiling. Right in their faces. A bit aggressive, actually. We had a special package to give him – a plane ticket, to join his father in Italy later this month. He ripped it up and scattered the pieces all around. When we tried to talk to him he was laughing and shouting, very loudly, upsetting the other students, which we cannot have. As I say, he’s only been here a couple of weeks, so I can’t say I know him all that well, but he’s certainly done nothing like this before. It’s very out of character. We didn’t want to call you, but I’m afraid in the end we had to act in the best interest of Matteo and the other students. We’re not sure what he might do, you see.’
‘Have you spoken to his parents?’
‘I spoke to his mother, briefly. She’s on a plane to Cyprus so the line went off. I’m afraid I’ve only managed to get voicemail for the father, but I’ve left a message. He’s on some kind of European business trip at the moment.’
I look at the pills container that Alex has given me.
‘Any chance you could look up on the internet and see what these are?’ I ask the secretary.
She swivels on her chair.
‘Chuck ‘em here,’ she says.
Alex folds his arms. ‘We have almost four hundred students boarding with us at any one time. We have a lot to think about. I can’t take risks with anybody’s welfare.’
‘That’s fine.’
‘Anti-psychotic,’ says the secretary, leaning back from the screen and tossing the pills back to me.
‘Brilliant. Thanks for that. Shall we go and see Matteo, then?’
‘Of course.’
He leads us through a main corridor to the lifts. Whilst we wait there, a student comes up to me and asks about a sore on her eyelid.
‘Is it bad, do you think? Do I need hospital?’
‘It looks like you might have a sty coming.’
‘A sty?’
‘A sty. An eye infection. It’s not serious. But maybe you should see your doctor, anyway.’
‘My doctor?’
Alex frowns at her and shakes his head.
‘The nurse is on duty at eight thirty, Ruksana. Speak to her then.’
She shrugs and moves off with her friend, just as the lift arrives. I hear her say sty? again, and they put their heads together and laugh.

Alex leads us along to Matteo’s front door.
‘He’s probably sleeping now,’ he says, hesitating with the master key.
‘I’m afraid we have to talk to him, though.’
He nods, pauses, raps smartly on the door, calls out Matteo? then opens the door and we go in.

Matteo is face down on the bed, the uncovered duvet rucked up around him in a deep V. The way he is sprawled there, with this pattern of discarded clothes, a shoe, phone and iPod, books and empty Coke bottles right and left, he is something like a spaceship crash-landed on a foreign planet.
A groan.
‘Matteo – we need to talk to you. Sit up, please.’
Alex reaches over and tentatively shakes him by the shoulder.
‘No history of trauma? No falls, no banging of the head or anything like that?’
‘Not so far as I know.’
‘And the only past medical history you have is of some kind of mental health problem.’
‘That’s all we have on record.’
Alex puts his radio and clipboard down on the bed and shakes Matteo by the shoulder again. When he talks to him he talks in Italian. It gets more of a response. Alex stands back as the boy slowly pushes himself into a sitting position.
‘He says he's sleepy.’
Matteo sits there on the bed, his cheeks flushed, his dark eyes shining in the hard overhead light of the room. His black jeans are ripped across one leg; he has one brown suede pixie boot on, the other foot is bare; his velvet shirt is heavily creased.
‘Matteo?’ says Alex. ‘Matteo?’
‘Can you translate for me, Alex?’ I say.
‘Of course.’
The room falls silent for a moment. Suddenly there is the sound of laughter out in the corridor, a shout, the chorus of a song. Matteo pushes his heavy fringe away from his eyes, and slowly looks up at us as the voices die away.
'Cosa?' he whispers.

Saturday, August 13, 2011


As I walk out into the bright sunlight of the ER loading bay, another ambulance is just pulling in. It parks up, rocks about, muffled shouts and sounds from inside, then suddenly the back door is flung open and Rae jumps down, stern words from behind her. Will you stop that? Hey! No! Come on!
‘Spence. Jesus. Christ. You couldn’t help us get this guy out, could you? I’ve just about had it.’
Her partner Colleen emerges from the cab. ‘You’re going to like this,’ she says, pulling on a fresh pair of gloves.
‘You think?’
Rae grimaces and lowers the tail lift. When she swings open the main door I can see the long, lean figure of a man sprawled on the stretcher, his hands cuffed, a policewoman leaning over him from the side.
‘What’ve you got, then?’
‘A guy off his tits on something or other. The police called us to the shopping centre. I can’t tell you - he’s been such an incredible pain in the arse.’ She pushes some strands of hair back from her face with the back of her gloved hand. ‘But watch yourself, Pen. Now and again he’ll go for you.’

As I step up onto the back the patient senses the change in his environment and looks up. His blond hair stands out around his head like a sweated mane; his mouth is slack, and he rolls his head from side to side in a panic that his wide eyes cannot see the danger and he has to catch the scent of it instead. At the same time he blows air out through his loose lips, scattering flecks of white foam into the air.
‘Will you stop that?’ says the police woman, jerking his hands reprovingly.
A strong, square woman with a tattoo emerging from her shirt sleeve that looks like it was copied off an old dinner plate, she seems less like a police officer and more like a farmer controlling the stock.
‘So what’s the plan, d’you think?’ she says.
‘He's not going to walk in, presumably.’
The police woman makes a face.
‘So in on the trolley, strapped down as much as possible. I’ll control his legs.’
‘Watch out.’
On cue, the man makes a sudden wrenching attempt to break free, snatching his arms forward, kicking his legs and jerking his head up from the trolley.
‘Easy! Easy!’ says the police woman. She has one of his wrists turned back on itself, and squeezes a little more pressure on to subdue him with the pain. It takes all my strength to control the legs, gathering up the material of his trousers into a handle and using the weight of my body to smother his movement. Without the trolley straps and the handcuffs, though, he’d be smashing his way out of the ambulance.
We wait until the spasm subsides, then carefully off load the trolley and run him inside. There’s a receiving room for volatile patients just inside the door. We take him into it, and with the help of another crew and a couple of porters, we bundle him onto the hospital trolley. The policewoman repositions her cuffs, and we use some spare straps to restrain him more effectively until the nursing staff can take him in hand.
In the struggle to put him on the trolley, a wallet and passport have fallen onto the floor. Rae picks it up and cautiously goes through it.
‘Well we’ve got a name, a nationality...’ Then she pulls out a sepia coloured business card, snorts then waves it in the air.
‘And guess what he does for a living?’
‘Drug advisor?’
‘Reflexology and cranial osteopathy.’
Just at that moment the patient makes another desperate bid to break free. He writhes and arches his back, slams his body from side to side, the sweat running on his bare torso, his eyes flaring.
Horse! he screams. Horse!
He rages against his restraints, ramming and pulling and writhing, spreading his fingers wide then bunching them into fists. Horse! he screams again - and then holds himself still, and stares at his fists in horror, as if he could see them turning, curling in and down, hardening, darkening into hooves.

Tuesday, August 09, 2011

i love you

Cynthia is sitting in her dressing gown on the edge of a luxurious, scallop-backed, aquamarine and corn yellow armchair, anxiously knitting and un-knitting her withered fingers. On every surface and every level around her, on bookcases, display cases, the mantelpiece, low tables, high shelves and deep window ledges, hundreds of porcelain Twenties figurines, every one a debutante, every one throwing the same coquettish backward glance over her right shoulder.
‘I’ve got tummy ache,’ she says.
‘How long has that been going on for?’
‘Months. Years.’
‘Worse today?’
‘Not really.’
‘Does your doctor know about it?’
She nods.
‘And what does he say?’
‘I don’t know.’
‘No idea what it might be, what you should do about it?’
She shakes her head.
‘Okay. Can you describe this pain for me?’
She untangles her fingers, then shakily moves her hands right and left over the lower part of her.
‘Down there.’
‘And what’s this pain like?’
‘I can’t put up with it anymore. I’m scared.’
‘Okay. Well let’s have a think about what to do.’
Frank gets back up off the sofa. ‘I’ll look for the folder,’ he says.
‘Do you have any help, Cynthia? Does anyone come in to help you with stuff?’
‘No. Not really. No.’
‘What about your family?’
‘He’s in Australia.’
‘No-one else?’
‘My husband died. I miss him.’
There’s a small framed photo on a space of wall to her left, the only real picture amongst a spread of Aubrey Beardsley posters, Art Deco mirrors and old adverts for Cartier and Coco Chanel. In the photo, a young couple: the man in a tweed suit and tie, leaning back from the camera, looking away, as if he had something more important to be doing, or was embarrassed; the young woman, holding on to his arm, leaning in to the lens, a strangely intent look on her face, as if it wasn’t exactly a photo she was expecting from this but something else, something altogether more illuminating.
‘Let’s do your blood pressure and whatnot, and take it from there. Have you had the ambulance out before?’
‘I don’t think so.’
‘Do you have any medical problems? What do you suffer with?’
‘I’m supposed to be going to a group at the hospital.’
‘Oh? What’s that for?’
‘My nerves.’
‘Okay. Well – you’re blood pressure’s absolutely fine. You don’t have a temperature or anything. So that’s good.’
Frank comes back in.
‘No folder,’ he says. ‘I found the meds, though.’
He hands me a faded plastic bag with something for AF and a couple of psych meds. In the bag is a scrap of paper – a worn kind of list, half shopping, half general notes. It’s been added to over time, in different coloured pen, starting out with patterned toilet paper, oven gloves, cake cases, then degenerating into a diffuse scattering of spidery capital letters – Ghana misspelled three times and then crossed out; Wembley, nr London, and in black and white underlined. Beneath that, a jumble of incoherent words and letters.
‘Someone’s been breaking in and leaving me presents,’ she says. ‘Things I like.’
‘Who has?’
‘I don’t know. I’ve never seen him before. A man.’
‘What’s he been doing?’
‘He left me a bar of chocolate. With some writing on the wrapper. I love you.’
And a shudder passes through her, from the top of her head to her feet. Her left foot stays planted on the carpet, but the right one starts to move – a curiously independent little dance, backwards and forwards along the fringed line of the armchair, toe / heel, toe / heel, toe / heel, and then back again: heel / toe, heel / toe, heel / toe. Backwards and forwards, backwards and forwards, whilst Cynthia knits her fingers in her lap, stares at me, and waits.

Monday, August 08, 2011

the arabesque

The foyer of the Excelsior at four a.m. has the dreary depth of an underwater cave, the dracaenas in their pots standing around like giant sea anemones, quietly filtering the thick air, waiting on the tide. There is a discrete spill of light coming from the porter’s room behind the desk, some music from a radio. He emerges, moving stiffly from the hip. He listens to the reason we are here with his eyes closed and his head tilted mournfully to one side, then points to a discrete lift set back from the rest.
‘That one,’ he says. ‘For the permanents.’ Then he turns and shuffles back into the light.

Molly is waiting for us, standing in her bra and shift in the doorway of their flat on the twenty-ninth floor. It’s surprising to see her like this, but Molly doesn’t seem at all awkward. I wonder if it’s because she’s distracted, or because she’s used to getting dressed in public. Her bra is so brilliantly laundered, so cleverly engineered it seems to be holding her whole body upright; the flesh is only slightly rolled up around the straps, with the inevitable slackness of age.
‘I’m so sorry to call you out like this but I’ve tried explaining things to him and he just won’t listen to me anymore. I’m at my wits end.’
‘Is it a relative of yours?’
‘He’s my husband. And I’m sorry I’m only half-dressed. You were much quicker than I thought you’d be.’
‘We were only round the corner.’
‘Thank you for coming.’
She leads us into a broad and modern flat, something like the bridge of a liner, with a spread of windows on two sides overlooking the city.
‘He’s in the bedroom. I can’t talk to him,’ she says, buttoning a blouse.
Gerald is sitting on the edge of the bed, gripping the mattress either side of him as if he were just about to spring up.
‘You’d be upset,’ he says as we walk in. ‘It’s not a nice thing. Not nice at all.’
‘So Gerald. I understand you’ve had a bit of a nosebleed tonight.’
Molly comes in and quietly sits in a wicker chair. ‘You’ll have to shout,’ she says, ‘He’s quite deaf.’ Then she cries quickly and cleanly into a wad of kitchen towel, a spasm of distress as surprisingly dramatic as a sneeze.
‘It must be difficult,’ I say.
Molly blows her nose and regains control. ‘I just don’t know what to do anymore,’ she says. ‘He’s got Alzheimer’s so it’s almost impossible to reason with him. He just doesn’t understand.’
‘I see.’
Gerald looks about a hundred years older than his wife. The only features about him that seemed to have escaped the ravages of time and illness are his slate blue eyes and his moustache, a tightly clipped article that rides his upper lip with parade ground precision.
‘If you had a nosebleed it seems to have stopped now.’
‘I say if you had a nosebleed, whatever you did to stop it seems to have worked. It’s not dripping or anything.’
‘It wouldn’t stop,’ he says. ‘I woke up covered in blood. It’s not a nice thing, you know. You wouldn’t like it.’
‘I wouldn’t. Horrible. But it’s stopped now.’
‘What are you going to do about it?’
‘Shall we check you over, Gerald? Is that okay?’
‘You wouldn’t like it.’
‘I wouldn’t. Especially late at night.’
‘Especially at night.’
He looks at me with utter vacancy.
‘It’s not a nice thing,’ he says, finally.
Molly beckons me into the kitchen area. When she’s quite sure Gerald hasn’t followed us, she pushes a little Tupperware box of meds towards me across the counter, then supports herself with both hands on the counter.
‘I didn’t want to call you but I couldn’t think what else to do. I know he’s all right physically. The bleeding stopped quite quickly so I’m not worried about that. I don’t want him to go to hospital, but I just couldn’t calm him down. He won’t listen to me. I can’t reassure him.’
‘Do you get much help, Molly?’
‘Oh – family and such. But they’ve got their lives.’
‘It sounds like you need more help. There’s two of you to think about. It won’t help things if you fall ill with the worry of it.’
‘I’m all right.’
‘But still. Maybe even a little respite care. Just to get things back on the level.’
‘Whatever you think.’
‘Let’s make a plan.’
She looks away across the flat to the wide, black windows and the glittering city beyond. Molly is quiet whilst I quickly write down the meds, then says: ‘I was a professional skater.’ She leads me over to a framed black and white picture on the far wall: a young woman flying towards the camera on one leg, the other stretched out in the air behind her, her arms winging out either side to the very tips of her fingers, her tutu flaring like smoke. Despite the heavy Fifties’ make-up, her smile is as brilliant as her blades.
We both look at the picture for a while, then she reaches out, and gently touches the frame.