Wednesday, November 30, 2011

the time or the place

We’ve been standing outside the ambulance station since six o’clock. The sky is lightening now, but heavy grey clouds keep appearing overhead and soaking us. We cradle our mugs to keep warm, shuffle from foot to foot, wave at the cars that hoot as they pass. Three hours already. The march through town is next. It’ll be good to move.

It was fraught at first. Despite the friendly tone, there was still a discernible charge of something between the crews that were reporting for duty in uniform, and those that had decided to strike.
‘It’s a question of conscience, mate. You can only do what you think is right.’
Everyone knows it. But this business of being in uniform, or out of it – the difference is more than just clothing.

People have been passing all morning, and we’ve chatted to some. About how the public sector is being throttled, the cost of living going up, the pay freeze, the pension hike. A cameraman arrives in a blacked-out van. He waits until the current shower passes, then wanders over to take mood shots of our flags. We wonder when the interviewer will come over to ask us some questions, but nothing happens. The cameraman gets back in his van. They drive off.
The march from a nearby hospital is due to pass by soon and we’re getting ready to tag along, when a shabby looking guy in a hunting cap and combat trousers, a black bin liner over his shoulder, pauses by the entrance, and makes a show of reading the signs. Then as if something he read there has interested him, he walks up and sets his bin liner on the wet tarmac in front of us.

‘Have you heard of *** (a minor celebrity)?’ he says. ‘Yeah? We used to hang out together. He was a mate of mine. Twenty years ago he was up on a murder charge. Did you read about it? It was in all the papers. I gave him his alibi. I lied for him so he didn’t go to jail. Then a few years later I was in trouble myself and I asked him for a loan. Ten thousand pounds. That’s all it was. Ten thousand pounds to set me straight. And him a millionaire and everything. But he was like he didn’t know me. Couldn’t care less. Set his monkeys on me. And now I haven’t got nothing. What do you think about that, eh?’
Frank folds his arms.
‘Mate – I’m sorry, but this is a picket line. We’re striking about our pensions and jobs. I don’t think this is really the time or the place for all that other stuff.’
The man shrugs his shoulders.
‘Okay. Fair enough.’
He picks up his bin liner and walks off.
I finish my tea and tip the dregs out onto the grass verge.
The hospital crowd is coming down the hill, whistling and hooting. We pick up our flags and join them.
The man with the bin liner watches from the other side of the road.

***

In the middle of town. The protest has swollen now, the tributaries of the smaller marches converging into an impressive river of banners, whistles, drums and chants. People hang out of office windows, wave from doorways, the pavements and shop doorways. The atmosphere is good-natured, accommodating.
A man with unlaced boots, a woollen cap tweaked up into a cone on the back of his head, a rucksack on his back, appears next to me.
‘Smash Macdonald’s windows!’ he shouts. ‘Corporate fascism! Batter the police!’
Then he turns to another protestor and says: ‘I’m an anarchist, me. This is all a bit tame, isn’t it?’
His influence is so unsettling it’s hard to think what to do other than blank him out and pretend he wasn’t there. But before we change our mind and summon the courage to confront him, he scuttles on ahead, lacing through the crowd in a curious, loping kind of crouch.

***

When the march reaches the common I listen to a couple of speeches, then hand my flag to a young kid - ‘Cool! Thanks. That’ll go with my collection! - and make my way back to the car. I sit behind the wheel for a minute or two. Another shower of rain rattles across the roof and windscreen. I let my mind drift across the day, trawling for something definite, some article of faith I could hold on to that was as light and clear and tangible as that flag.

It’s just before one.
I put the news on to hear how things went across the country, and turn the engine over.

Monday, November 28, 2011

out into the square

Lena is stretched out on the stairs, having what would at first glance appear to be an epileptic seizure. But there is something about the way her arms and legs drum up and down, her head nods forwards and back, her teeth clench and then release again, that make us think it’s psychogenic.
‘Slow your breathing down, Lena. Nice and slow.’
She still has the phone in her hand; I take it from her, tell the call taker on the other end we’ve arrived, then hang up.
‘Let’s sit you up and see what the problem is, shall we?’
Together we ease her forward. Her shaking subsides, and she seems to find a measure of control again.
‘What’s been going on, Lena?’
She talks in short bursts, snatched from the tics and jerks that still run through her body.
‘I have – a – movement disorder,’ she says. ‘Here – are some – papers.’
She hands us a wad of folded computer sheets, printouts from a website dedicated to neurological problems.
Frank glances over them, but I can tell he’s thinking the same as me: cyberchondriac.
‘I – have an – appointment soon,’ she says as we hand her back the papers.
‘Let’s get you sat more comfortably on a sofa, Lena, then we’ll have more of a chat about all this,’ says Frank. We help her up. It’s noticeable that when her attention is distracted, either by speaking or doing something – even something small, like reaching out to hand us the papers – her twitching subsides. She walks unsteadily though, her slight frame debilitated by months of these episodes.

Once Lena is sitting down on the sofa, she stiffens up and starts to shake again, drumming her legs up and down so the whole laminate floor vibrates, thrashing her arms on the pillows beside her, spasms twisting in her face, squeezing her eyes open and closed. It’s all strangely comprehensive, the kind of thing you might expect if you asked a member of the public to do an impression of a fit. But then, the difference is that their intention would be clearly readable; with Lena, it’s more complicated than this.
Frank carries on talking to distract her attention.
‘Where did you put that appointment letter, Lena?’ he says. ‘It’d help if we could have a read of it.’
She reaches over to the side of the sofa and pulls her handbag across. The letter is inside – a top neurological hospital. The logo stirs a memory – didn’t my father spend some time there? Is that right?
Frank quickly skims the letter then hands it to me. It’s a full account of her condition – a functional problem, with every other possible cause ruled out, from tardive dystonia as a reaction to meds, to a range of tumours and metabolic disorders. She’s being admitted for a course of botulinum injections to dampen down the tremors, and CBT to address the central cause, a complex and unconscious ‘learning’ of inappropriate physical responses to emotional stress.

Eventually Lena calms down to the level of tremors and shakes she normally copes with. There’s nothing more we can do for her other than take her to hospital, but given that her admission to the neurological centre is just days away, she elects to stay at home and self-manage until then.

We see ourselves out.

***

That evening I write an email to mum. I mention the neurological hospital, and ask her if I’m right in thinking Dad had been an in-patient there. Even as I write it I’m not at all sure I could have remembered it correctly. Wouldn’t something as significant as that be more clearly rooted in the family history? Maybe this memory of mine is more like déjà vu, my own kind of processing error – the kind that mistakenly dumps short term scraps straight in the long term file.

But it felt so real.

I send the email.

When mum emails me back she says that yes, Dad had been an in-patient there, back in the fifties. He had woken up one morning unable to move his legs, a paraplegic. Eventually, after lots of tests, they took him up to the neurological hospital for three weeks. A difficult time for her – three toddlers to look after, Dad’s mum sick with cancer, no clear ideas about what was wrong with him, no sense of how long it might last.
‘I suppose he must have had a nervous breakdown, looking back at it. John and Ollie used to drive me over there every day. It was a very difficult time which I’ve tried to forget.’
I immediately want to know every last detail about what happened, but then I don’t want to stir up painful memories. Instead I sit back in the chair and try to imagine what it must have felt like to be Dad, walking again, out onto the steps of the hospital, holding onto Mum’s arm (is that what he did?), looking out across the square. I try to imagine what Mum must have felt like standing next to him, the hospital behind them, the rest of the day, the weeks and months and years ahead, so traumatised they could never speak of it again.

Sunday, November 27, 2011

out of it

Bernie has fallen out of the loft. She slid down the ladder head first, scrabbling with whatever limb she could to slow her progress, then crash landing on the wooden floor on the point of her elbow to save her face. She got herself up, hobbled downstairs to the kitchen, sat on a chair to get her breath. Her parents phoned for an ambulance.
Frank was first on scene in the car. He put a collar on Bernie, then stood behind her holding her head whilst he waited for us in the truck.

When we come into the kitchen he greets us with his usual shtick.
‘Here they are, the cavalry. Sorry to roust you out of bed, Spence. He’s such a grouch when he doesn’t get his eight hours, Bernie.’
‘Whatever.’
‘So – guys. This is Bernie.’ He tells us the story of Bernie and the Loft.
‘Wow! That’s quite a way to fall.’
‘It’s no biggie. I’ve done it before.’
‘Any neck pain? Back pain? Numbness? Pins and needles?’
Everything checks out, apart from her elbow. But because of the height she fell and the distracting injury, we play safe and go for a full immobilisation.

Ten minutes later she’s trussed up on the floor and we’re ready to go. I’m with Frank at the head end, Rae at the feet.
‘On your call, Frank.’
We’re crouched down, ready to lift.
He starts to count.
‘On three. One.... two...’
The next thing, he’s pitching forwards, head first into Bernie’s lap. I just have time to put out a hand to deflect some of his weight off to the side. I look into his face which is white and slack. ‘Frank? Frank? Are you all right?’
‘Huh?’
He staggers about, but I manage to get him away from Bernie – who apart from a little shriek when he began to go seems incredibly stoical about the whole thing.
‘Jeesh!’ she says, looking upwards with her eyes. ‘This is hysterical.’
‘Are you okay, Frank? What happened?’
‘I – erm – I’m not sure.’
‘Sit down for a minute and get your bearings. Have you got any pain?’
‘No. I’m fine. I think it was a postural.’
‘Let’s get Bernie out to the truck, then we’ll come back for you, Frank. She’s no weight. We can manage just the two of us. Then we’ll get you on board and wire you up.’
‘Sure.’
He sits on the floor with his head in his hands. We carry Bernie out, then whilst I check her over and settle her in, Rae reappears with Frank in tow. She runs through the usual checks. Everything seems fine.
‘He can have the trolley,’ says Bernie, wriggling in her straps. ‘I’m not that fussed.’
‘Are you going to be okay, driving back to base?’ I say to Frank. ‘We can always get someone running.’
‘No. I’ll be fine. I think it was just bending down too suddenly.’
‘Take the rest of the shift off, though. Get some rest.’ I squeeze his shoulder. ‘I’ll write you a note.’
It’s a shock to see him like this, vulnerable, pale, objectified. A patient.
‘Thanks guys,’ he says, ripping off the ECG dots. ‘Sorry to be a pain.’
‘And you’re sure you’re okay to drive back?’
He nods.
‘It wasn’t nearly so exciting last time I fell out of the loft,’ says Bernie, squirming in her collar and blocks. ‘Last time I just got a spoonful of Calpol and a telling off.’

Friday, November 25, 2011

right

A key worker buzzes open the door to the lobby. He seems surprised to see us. He leans out on the bottom half of the reception door, holding a mug of coffee in one hand and a Snickers bar in the other. A portable TV is playing loudly on a desk behind him; he pushes himself back up, stuffs the rest of the Snickers bar into his mouth, flips the wrapper across the office, then turns the TV down.
‘Just when I was getting into it,’ he says. ‘It’s weird – but pretty good. The Tolpuddle Martyrs. Four hours long, though.
‘I’d rather be transported,’ says Frank, yawning, leaning back against the security glass. ‘But given the current climate, that’s probably on the cards anyway.’
‘Who’ve you come for?’ says the key worker pleasantly, fetching a polythene-covered list from a tray and smoothing it flat on the door ledge in front of him.
‘No name, unfortunately. Room ninety five’s all we have. Twenty six year old female with abdo pain. That’s it.’
He looks over the list.
‘Ingrid,’ he says. ‘Figures. I think she was up the hospital a week ago with K cramps. I’ll take you up there.’
He unhooks a bunch of keys, swings the lower portion of the door open and then locks it behind him.
‘Just to give you a heads up,’ he says, ‘Ingrid’s a sex worker and heroin user. She’s doing her best, but she’s on a last warning at the moment. Just so you know. It might be germane to your cause.’
‘Thanks.’
He leads us up the back stairs to the fourth floor. The hostel is a strip-lit, municipally signed seventies’ accommodation block with a moribund air of chlorine products, cigarettes and damp shoes. With the green paint, alarm consoles, pin boards, extinguishers, posters for activities, emergency hotline adverts, rules and announcements, it feels like an approved foothold on the side of a dreadful decline.
‘Here we are.’
The key worker knocks on ninety five and opens it with his key.
‘Ingrid? The paramedics.’
He steps aside and waves us in.
Ingrid’s room is lit by a desk lamp on the floor. A clutter limited only by the size of the holdall it spilled out of, lies strewn across a plain wooden chair and the open door of a closet. Ingrid is sitting on an unmade bed, with a laptop, a pack of cigarettes and a pack of baby wipes next to her. She is a pretty woman, frail and pinched. In her shot blue silk nightdress and white towelling robe, she has a strangely abstracted look about her, a socialite who lost her way to the bathroom and ended up in a flophouse. She ignores the fact that we have come into the room, and carries on staring down at the mobile in her hand.
‘Hello Ingrid. I’m Spence. This is Frank. What’s been going on tonight?’
She looks up slowly, without expression. Absently, as if her free hand belonged to someone else, she starts kneading her tummy and rocking forwards gently.
‘Ingrid? It’s the ambulance. How can we help?’
‘What’s wrong with me?’ she says, her voice as delicate and indistinct as the trail of glitter above her right eye.
‘Do you have any pain?’
‘What’s wrong with me?’ she says again, then looks back down at the phone.
‘Ingrid? Try to tell us what the problem is. I understand you have some abdominal pain. Is that right?’
She stands up, turns her back on us and walks over to the other side of the room.
‘Ingrid?’
The phone lights up. She puts it to her ear, seems to lose the call, then fiddles around with the buttons to get it back.
‘Ingrid? We’ve come here to help you. But we can’t do anything until you tell us what the problem is. Can you come and sit down again and we’ll see what’s going on? Ingrid?’
She drifts back to the bed and sits down again.
‘Okay. So do you have pain in your tummy?’
She nods.
‘Can you point to where it hurts the most?’
She squeezes the middle of her abdomen again and leans forward.
‘What will you do?’ she whispers.
‘What I suggest is we go down to the ambulance and have a look at you there. We can do a few checks, and then run you up to the hospital so you can see a doctor. You’re obviously in some pain. Ingrid? Will you do that, Ingrid?’
She stares at her phone.
‘Come on, Ingrid. Let’s get a bag together – your keys, money, phone.’
But she ignores me, flicking through the contacts on her phone. If we left or stayed, it would make no difference to her.
‘Ingrid?’
‘Okay,’ she says, and stands up.
‘Good! You don’t need much. Here are your keys, look. So let’s go.’
To say she follows us out of the room is to overstate the way she moves. It’s an abstracted thing, a dream of movement. If there was a heat sensor up there instead of a security camera, it would pick up three blurry red shapes and something else, something trailing behind, a wraith-like ripple of blue sliding along the corridor.

She stops when we get outside.
‘I’m not going to hospital,’ she says, and wraps her dressing gown around her.
‘Come on, Ingrid. You’ve got this far. I really think you should come with us and get checked out.’
A car pulls up. A dented silver Micra with the backseats flat beneath a dump of possessions. The driver, a pouchy middle aged man in a black suit gets out and stands with one hand on the door and the other on the roof. Ingrid slips her phone away into her pocket and walks over to him.
‘Ingrid?’
But she doesn’t look back. She opens the front passenger door and gets in. The man doesn’t even acknowledge us. He sits back behind the wheel and they drive off, both looking straight ahead.
‘So what d’you reckon?’ says Frank, folding his arms. ‘Right or left at the end of the road?’
They turn right.

Thursday, November 24, 2011

life on earth

Alan is waiting for us by the taxi rank, leaning on a cab window chatting to the driver, a grim faced man whose abstracted image is trapped in the glass of his windscreen, staring straight ahead, both hands on the wheel, engine running. Alan looks smarter than normal. In his PVC leather-style bomber jacket, starched white shirt and chinos, Ferrari cap and white trainers, a visitor from outer space who based his earthly disguise on a bad seventies cop show. When he sees us pull onto the forecourt, he taps the cabbie on the arm, straightens up and strides over.
‘It’s Alan,’ I say to Frank.
‘Uh huh.’
I climb out of the cab.
‘Hello Alan,’ I say.
He walks with curious, bobbing little movements, like an alien adjusting to new gravitational environments, with trainers made of sponge.
‘Hello,’ he says. ‘I was assaulted.’
‘Let’s have a chat on the back, then.’
I lead him on board.
‘So what happened?’
‘I was in this club, yeah? When this guy, yeah? He threw this plastic cup at me and it hit me here, on the back of the head. And now I can’t move my neck. It’s gone all numb. And my arms and legs feel weird. So what I did, yeah? I drank a double JD and coke – a Jack Daniels. A double. Straight off – like this. To numb the pain, yeah?’
‘And how long ago did this happen, Alan? Given that it’s now half past four in the morning?’
‘I don’t know. An hour?’
‘A plastic cup?’
‘Yeah. He threw it, and it hit me here, right in the back of the neck.’
‘Well I can’t see anything there, Alan.’
‘What d’you mean?’
He has that affronted slack about his face, an expression I’ve seen on him every one of the half dozen times I’ve seen him this year. His brown eyes narrow, drawing a flush of temper up over his jaw line to pulse at the bulb of his nose. ‘What are you going to do?’ he says.
I pause, and in that moment the weight of the long night shift rings around the shell of the ambulance as hard and blue-black as the morning.
‘It’s up to you, Alan,’ I manage to say. ‘If you want to go to hospital, we’ll happily take you. But if you’re complaining of neck pain, we’ll have to put you in a collar and immobilise you on the stretcher.’
‘Are you saying I shouldn’t go?’
‘I don’t know. You’re the patient. You’re the only one who can say how you feel.’
‘You think I’m making this up?’
I fold my arms, cross my legs, lean forwards and support myself there. It’s comfortable. I could sleep like this for a thousand years. You could dry me out and put me in a glass case. Put me on display with all the other mummies. So long as I didn’t have to do anything.
‘Do you remember the last time we met, Alan?’
‘What?’
‘It was about the same time of day. Dawn, I think. Over at the fish market. You were on your bike. You said you’d had a crash and you’d hurt your neck.’
‘I remember.’
‘The police were there, do you remember? You got really cross. They took you in the back of the car. But then they got another call, and let you out again a little bit further up the road.’
He stands up.
‘What do you want?’ he says.
‘I’m in your hands, Alan. It’s very simple. If you want to go to hospital, we’ll take you to hospital. So, Alan – do you want to go to hospital?’
‘You tell me.’
‘You don’t have to go, Alan. You can just go home and rest.’
‘You tell me.’
‘Yes or no, Alan? Do you want to go to hospital?’
He stands up, pulls his cap more firmly down on his head, turns and jumps off the ambulance.
‘You’re useless,’ he says. ‘You don’t do nothing.’
‘Go home and rest, Alan. Where’s your bike?’
But he doesn’t answer. He backs away from the ambulance, and stands watching from a little way off. When I close the cab door it nips off his curses.
I settle into the seat, and push the button to call Control.
The taxi moves off from the rank, but I can’t see anyone in the back.

Monday, November 21, 2011

technical assistance

Mrs Randall is sitting on the carpet, leaning back against an Ercol sofa, her legs in an outstretched V. She looks up at me as I come in to the lounge.
‘I hadn’t fastened the strap on my slipper,’ she says. ‘I’m all right, but I just can’t get up.’
I’m on my own, but the heaviest thing about her is probably that tartan skirt. I lift her up and help her into the nearest chair.
‘Not that one,’ she says, dabbling her feet on the carpet, something like the dance seagulls do when they’re teasing up worms. ‘That one’
I guide her over to a chair of exactly the same height. She sighs when I lower her into it, and places both hands on the table.
‘Now what do you want?’ she says.
‘I just need to get a few details.’
‘What?’
‘I say I just need to get a few details.’
‘You say what?’
We look at each other.
‘Do you have a hearing aid?’
‘What?’
‘DO YOU HAVE A HEARING AID?’
Every time I talk, her eyes drop down to look at my mouth, and her jaw bobs up and down. It’s disconcerting. I feel like a crazy ventriloquist shouting at his dummy.
‘Here,’ she says at last, scrabbling about under a pile of papers and drawing out a lump of misshapen pink plastic. She licks her index finger and thumb, moistens two prominences, then shakily raises it up to her left ear.
‘Just a minute,’ she says, scrunching up her face as she screws the thing into place. ‘There!’
I expect to hear the usual squeal as it comes alive, but nothing happens.
‘Is it working?’
‘Do what y’say?’
‘IS IT..... I DON’T THINK IT’S WORKING.’
‘It’s not working,’ she says, pulling it out again and dumping it back down on the table. ‘The battery’s gone ‘orf.’
She starts trying to open up the battery compartment, but I tap her gently on the arm and take it from her.
‘ALLOW ME,’ I say.
‘Don’t break it.’
‘I won’t.’
There is a fluted glass ashtray amongst the clutter on the table. In it, amongst the paperclips, pennies and drawing pins, a spare battery. I put that next to the aid, then carefully prise open the hatch. It’s stiffer than I expected. I change my grip, apply a little more force – the hatch flips off completely, and the battery that was inside pings off across the room.
‘Let me do it!’ says Mrs Randall, rising about an inch off her chair in alarm.
‘Perhaps you’d better.’
She takes the hearing aid in one hand and holds it up to her face. ‘What have you done?’ she says, putting her left eye right up to the tiny interior.
‘It’s okay. It just needs a new battery putting in.’
She doesn’t say anything, but flicks her eyes to me without moving her head.
‘I hope you haven’t broken it,’ she says.
‘Me too.’
I slide the ashtray towards her. She dabbles around, but her fingers are so gnarled and thickened with arthritis it’s like watching someone trying to pick up a pea with a hand of bananas.
‘I can do it’ I say to her.
‘What?’
‘I SAY – I CAN DO IT. I’LL BE MORE CAREFUL.’
‘Don’t break it,’ she says. ‘I haven’t got another.’
I take it back from her.
It’s a horribly old specimen. The mechanism for loading the battery is a strange affair – a flimsily constructed hatch like a hinged J, that carries the battery down into a compartment that doesn’t appear to have any terminals to receive it.
‘Just put the battery in the little door and close it. That’s all you’ve got to do,’ she says. ‘It’s not difficult.’
‘This way round?’
‘Do what?’
‘THIS WAY ROUND?’ I shout, carefully placing the battery in the door and offering it up to her.
‘The other way’ she says. ‘I’d better do it.’
‘No, no. You’re all right.’
‘What?’
I give her the thumbs up with my other hand, carefully turn the battery over in the little hatch, then gently close it. As soon as it’s shut, there’s an ominous rattle. I hand it back to Mrs Randall.
‘There’
She frowns, sensing my anxiety, but doesn’t say anything. She licks her thumb and forefinger again, wets the two prominences, screws the aid into her ear. She looks at me for a full minute.
‘Is it working?’ I say.
‘Do what?’
I raise my eyebrows and wait a second or two longer.
‘It’s not working,’ she says. ‘What have you done?’
She takes out the hearing aid and puts it on the table.
I undo the little hatch and look inside.
‘It’s not seated properly,’ I say. ‘I’LL GIVE IT ANOTHER GO.’
‘I knew I should’ve done it,’ she says.
But the battery will not come out. I shake it, tap it, prod it with the point of a pin. I make a probe with a tiny roll of tape and try to drag it into position. I use the tip of a knife, a canula. I try forceps. I rattle it, shake it, drum on it with my fingers. I lie back in the chair so I’m almost horizontal, and like a mechanic lying beneath the smallest pink car in the world, I coax the reluctant battery with infinitesimally patient movements to come to the hatch in such a way that it will drop out and let me try again.
‘I’ll get a needle,’ says Mrs Randall, dragging her three wheeler towards her chair and shuffling off to the kitchenette.
I rattle it, flick it, vibrate it, make little circular hopping movements in the air.
‘Come on. Come on.’
I hear Mrs Randall digging around in a kitchen drawer. ‘I hope you haven’t broken it,’ she says. ‘That’s the only one I’ve got.’
Just as I turn to look at her, and for no apparent reason, the battery drops out into my lap.
Yes!
I retrieve the battery from where I caught it between my knees. But when I look back at the hearing aid, I see a tiny little blue and white wire with a microscopic gold terminal hanging out of the opening.
I put it back on the table with the battery, and sit upright.
Mrs Randall comes back from the kitchenette, both hands gripping onto her three wheeler, a fat bamboo knitting needle poking out from the left.
‘This any good?’ she says, stopping at the edge of the carpet.
But even from over there she can read from my posture and comedy wince that something unspeakable has happened. She sighs, then guides her three-wheeler towards me like a tank.

Wednesday, November 16, 2011

mandy's cat

‘I could break the code.’
‘What code’s that then, Mandy?’
‘The street code. The code of honour. I could break the code and blow this city apart. I know every dealer, every smack head, prostitute, bent police. I know where they work, I know where they live. I could take you right there. I could solve every fucking crime that’s ever been committed in this dump if I wanted to.’
‘Okay. But first let’s sort out the cat.’

***

Eight o’clock in the morning. The plane trees along the street have dumped most of their leaves now; the dark pollarded stumps bristling with shoots make them seem like filter feeding animals at high tide, dragging their filaments in the run of air above the houses.
Mandy is sitting in the back of a patrol car with a tabby cat on her lap. Mandy is as strung out as the cat is inert; it sleeps peacefully, accepting the bangle-jangling strokes of its mistress.
‘I aint doing nothing without my cat.’
‘She can’t go up the hospital though, Mandy,’ says the police officer. ‘Wouldn’t it be better if we dropped her back indoors?’
‘What do you care? You weren’t there when I needed you. You didn’t answer my call.’
‘We responded as soon as we heard you were in trouble, Mandy. I don’t know about the other time – let’s talk about that later and focus on what’s happened just now.’
‘Like you fucking care.’
‘We do care, Mandy. We’ve arrested someone; we’re here with you, and we’ve got three other units working on the case. I think that shows a reasonable level of commitment.’
‘A reasonable level of commitment,’ she spits, and strokes the cat a little harder.
I’m standing by the open door of the patrol car.
‘Mandy? Come on. Let’s put the cat back in the flat and get you on the ambulance.’
When she talks she looks up and off to the side, her face slack. There’s a hostility to her, something hard and bitten down, as if she had spent years fighting something so terrible it could never be looked at straight. In her white cowboy boots, buckskin skirt and plaid blouse, she has the raddled look of a rodeo girl ten years too long on the circuit.
I squat by the open door. ‘Just tell me what happened again.’
‘He held a knife to my throat, yeah? He punched me unconscious, kicked me out cold. So I chased him outside and followed him back to his place.’
‘That’s the flat we attended,’ says the police officer. ‘The flat where you were staying. Is that right, Mandy?’
She nods, strokes the cat a little harder, then flares again.
‘Like you were there when I needed you. I had a knife to my throat, yeah? They cut me – look. They beat me bad – here, here, here. Like you fucking care.’
The only sign of trauma I can see on Mandy are three cat-like stripes on her forearm.
‘Let’s get the cat back indoors and then check you over properly,’ I say to her again. ‘You don’t have to come to the hospital with us, but if you don’t it’s against our advice.’
‘I’ll come,’ she says, passing me out the cat, smiling in its sleep as if it were dreaming of flying with all four paws hanging down. ‘No thanks to the fucking police. And I don’t want her coming with me, neither.’

***

On the ambulance travelling in to hospital. Mandy is sitting on a side seat, digging around in her handbag or biting her nails, one bare and mottled leg crossed over on the other, a cowboy boot tapping in mid-air, kicking the trolley from time to time. She ignores my questions, but uses them instead as bizarre points of connection to a shapeless and general misfortune. The police officer – a colleague of the first, a woman who has been sitting on the seat behind Mandy with a look of emotional ballast about her - sighs and folds her arms.
Mandy snaps her head round.
‘Just ‘cos you know me doesn’t give you the right to judge me,’ she spits.
‘No one’s judging anyone, Mandy. Just answer the paramedic’s questions, can you? We’re all here to help.’
Mandy turns back again.
‘Fucking police,’ she says. ‘Only get involved when it suits. I know how things are. You think you know it all but you don’t know nothing. I could tell you stuff but I wouldn’t dirty myself. I wouldn’t piss on you.’
‘And mind your language,’ says the police officer
Mandy stares off to a spot just beyond my right shoulder. Her volatility is a strange thing. It’s not that she calms down so much as she suddenly forgets what it is she’s angry about, and drifts on.
‘You’re a paramedic,’ she says softly. ‘You know about suicide, right?’
‘How do you mean?’
‘My mum died,’ she says.
‘I’m sorry to hear that.’
‘Yeah. Well. Not as sorry as me.’
‘What did she die of?’
‘Drink and drugs. Do you think it was suicide?’
‘I don’t know. It depends whether she meant to do it or not. Do you think she did?’
She shrugs.
‘Did she leave a note?’
‘Yeah.’
Then as if she had suddenly remembered why she was sitting there, she tips back her head.
‘He cut me. He held a fucking knife to my throat. Here.’
I lean in. But there’s no sign of anything at all.
She lowers her head again, gives a little shiver, then begins to unbuckle her seatbelt.
The police officer sits up.

Saturday, November 12, 2011

basic obs

We had found Rachel collapsed in a shop doorway, her legs folded beneath her in an uncomfortable, zigzag way, like something heavy had been dropped on her shoulders. She was moaning softly, rocking backwards and forwards, pushing her face into her hands, her long black hair hanging straight down so I had to hook it aside to look at her. Once we had Rachel on board the ambulance the extent of her distress became clear: extremely high blood pressure, a searing, left-sided headache that travelled back into her neck, numbness in her extremities, visual disturbance. We made her as comfortable as we could and rushed her in.

***

At the hospital a little later, Caroline, one of the nurses, walks out of the department to have a cigarette. Seeing us leaning up against the railings, she pauses to light it, takes a long pull, then comes over to join us.
‘So,’ she says, leaning back, draping her left arm across her stomach to support the elbow of the right. ‘At what point did you find out Rachel was a transsexual?’
‘So she is! I thought she was. But I wasn’t a hundred percent certain, and it’s not the kind of thing you want to get wrong. It was all such a rush.’
Caroline nods and taps off some ash.
‘Take it from me. Transsexual.’
She blows out more smoke and obliterates the moon.
‘Was it a bleed?’
‘Sub-arachnoid.’
‘Bad?’
‘Bad enough. But I’ve seen worse. They’re taking her up to neuro in a minute.’
She leans forwards, laughs suddenly, then settles back down against the railings. She smokes hungrily; the cigarette crackles. Another ambulance rolls up the slope. It flashes its lights at us.
‘At least you’ve got the excuse it was dark,’ she says. ‘I had no idea, even when I was doing the ECG. I said “Is there any chance you might be pregnant?” “It’s unlikely” she said. Then she pulled her gown up and showed me her penis. “Oh” I said. “I think you’re probably right” But honestly – apart from the package, you’d never have guessed.’
She flicks her stub away in the direction of the oxygen stack.
‘And I’ll see you girls later,’ she says, and strides back inside.

Friday, November 11, 2011

basement horror

In the mid-nineteenth century, the terrace in Aspern Road was put up to take the workers on the railway that was cutting in across town at the top. The railway is still there – a quieter, commuter-driven line – but the road has grown in stature. Now, the terrace sits back and up from it, a decrepit, ad-hoc levee, the whole thing threatening at any moment to lose its foundation and pitch face first into the traffic. One more passing truck and the whole thing’ll go - the rubbish bags and buckled bikes, the dried out window boxes, the no hawkers or canvassers signs, the peeling railings and buddleia bushes – the whole, red-bricked ruin of it crashing down into the road. And as the last satellite dish disappears downstream, a metro supermarket will sprout in the gap.

Edward is lying in bed in his basement flat, pale and oversized, like a subterranean urban grub. The room is green, a cavern at low tide, its wallpaper bubbled and spotted with mould. There is a miniature set of three shelves on the wall above the headboard, holding a battered Bambi figurine, a discoloured photo in a pewter frame and a snowman cake ornament, its yellowing face turned inwards to smile at the portrait. The facing wall is a shrine to the Spice Girls, a spread of posters and photographs, the brash poses of the women eerily out of place in the gloom.
‘It hurts’ he says, then yawns, stump-toothed.
‘Show me.’
He pulls back his t-shirt.
Edward has a stoma. The plastic circular patch of it riding on a kind of gross abdominal hump that bulges out like the head of something pressing against the skin to listen. The stoma site looks infected.
‘We need to take you in, Edward,’ I say to him. ‘Can you walk?’
He nods and yawns again.
‘I’ll call my cousin about the budgie,’ he says. Then stares at me, awaiting direction.

Thursday, November 10, 2011

boxes

Through the band of shaded glass along the top of the windscreen, the moon is a tarnished penny, but Venus hangs clear beneath it. Maybe it’ll come down. Maybe it’ll land here soon, touchdown in that back garden, nuzzle in to a heap of leaves and sit there, shivering its light through the hedges, the greenhouse glass and cucumber stems, along concrete slabs and the ribbed backs of slugs, through a stand of bins, the spokes of a rusted bike, the handle of a fork buried in a heap of leaves, to the upstairs window, and the cautious pulling aside of a curtain.
‘Here they come.’
A police car crawls up the road and comes to a stop where our patient lives. Frank puts our lights on and drives the short distance over to join them.
Two police officers, one as short as the other is tall, stand by the gate that leads round the side to the garden.
‘If I have to come back to this guy one more time...’ says the small one. The tall one has his hands buried deep in the armholes of his stab vest and looks down on us all with no comment.
‘We’ve been called because he’s taken an overdose,’ I tell him, holding the gate open for Frank.
‘Sounds about right.’
‘And he’s living in a shed?’
‘Yep.’
We each use a torch, except the tall police officer, who lights his way with five hundred watts of disdain.
At the bottom of the garden is a shiplap tool shed, the felt roof adrift and hanging down, chicken wire over a plastic sheet window and a muffled voice talking on a mobile coming from under the door.
The small police officer pushes open the door.
‘Hello? Malcolm?’
Malcolm is sitting bunched up on a dirty mattress.
‘Yes. They’re here now. I’ll say bye bye, then. Bye bye.’
He finishes the call and then shields his eyes as he looks up.

***

Malcolm sits on the ambulance seat and stares at me as I go through the paperwork. A middle aged man as derelict and malodorous as the shed he’s been sleeping in.
‘A lot of boxes,’ he says, folding his arms and settling back in the chair.
‘That’s one way of putting it.’
He rolls his face back over his gums like a contestant in a gurning competition.
‘So. Malcolm. Have you done anything like this before?’
‘Like what before?’
‘Taken an overdose.’
‘Oh yes. Lots of times. And hung myself. And walked into the sea.’
‘Okay. And tonight – did you take this overdose to hurt yourself?’
‘Me? I just wanted to end it all – you know, the usual. Dad died this year.’
‘I’m sorry to hear that.’
‘I went to prison. When I came out I moved back in with mum. But we don’t get on, really. We row a lot. She says she doesn’t want me in the house, so I’ve been sleeping in the shed.’
‘Isn’t that difficult?’
‘What? Sleeping in a shed?’
‘Well – with your mum in the house the other side of the garden?’
‘It’s all right. I sneak out in the early hours, and then back in again at night. But sometimes she comes down the garden and we have a row. She says I don’t understand this and that. I don’t understand how much she loved my dad. He may have beaten her now and again but she’s lost without him and what have I ever done? That kind of thing. She goes back in. You know.’
He leans over and frowns at the clipboard.
‘Where’s the box for that?’ he says.

Monday, November 07, 2011

behind the mirror

Mr Ellis is waiting for us in the driveway of his house, his soft, elderly frame picked out against the darkness by the flare of a halogen porch light. He stands completely still, his arms straight down by his sides, a garden statue dressed in a knitted jumper and slacks. He doesn’t say anything as we walk quickly towards him, but turns on the spot and leads us through the entrance at the side of the house. We follow him into a broad kitchen-dining room, everything set for dinner, a cooking clutter of saucepans neatly stacked in the sink, two plates of partially-eaten food either side of a sweetly laid table. But the domestic scene is ominously undercut by the bleep-bleep-bleep of a defib metronome through an open door at the far end.
‘She’s in the hallway,’ says Mr Ellis. ‘Is she dead?’
‘We’ll just go and check with our colleagues, then I’ll come straight back out and tell you what’s happening. Are you okay out here for a minute, Mr Ellis? I know this is very upsetting for you.’
‘I’m all right. Do what you can.’
Out in the hall the first crew on scene have been working for three or four minutes. Mrs Ellis is lain out between them, her blouse and bra cut down the middle and spread left and right, a tube tied off in her throat, a cannula in her arm, two pads on her chest, as fallen and exposed as a vivisected angel.
‘This is Mary. Eighty years old. Haven’t got a PMH yet, but fit and active. Was out doing some kind of community work, came home for dinner. Half way through she got up saying she felt breathless. Came out to the loo, was gone a while. Her husband heard her cry out. Found her collapsed. Dragged her out into the hall, phoned us. Was doing some CPR when we got here. So down about ten, I’d say. We’ve been going – how long is it? – six. Asystole throughout.’
Frank stays to help whilst I go back into the kitchen to talk to Mr Ellis.
‘It’s serious, isn’t it?’ he says.
‘I’m afraid so. Mary’s heart has stopped working. We’re doing everything we can to get it going again. We’re breathing for her, and giving her all the drugs and techniques we know of to keep her alive.’
‘I see. Thank you.’
‘And you know – the team with Mary now are about the best you could get. If there’s anything at all that can be done, they’re the ones to do it.’
‘Thank you.’
‘Have a seat, Mr Ellis. John, isn’t it? I need to ask you a few questions, John. To help my colleagues. I’m sorry to have to ask you these things at a time like this, but it might help.’
‘Fire away.’
We run through Mary’s medical history, how she’d been that day, her medications. He tells me that apart from a few minor aches and pains, she’d been perfectly fit. She’d come home to have dinner, and was due to go back out to her next call.
‘I’d better ring Mrs Napier and tell her she’ll be late,’ he says. He pauses as he picks the phone up, frowns, gives his head a little shake, then dials the number.
I go back out into the hall to get an update.
A plain, oval mirror - the kind you might check before leaving the front door – has been taken off the wall, and the picture hook used to hang up a bag of fluids.
Frank checks the timing on the defib, preps some more syringes. They swap around, the bagging, the compressions. There’s a settled, hopeless look to the whole scenario.
Back in the kitchen, John is leafing through a notebook.
‘So many people to ring,’ he says. ‘I don’t know where to start.’
‘Have you any relatives in the area who could be with you?’
‘My son’s on the way. He should be here in about an hour.’
‘Anyone sooner than that?’
‘He’ll be here in an hour.’
‘Okay. Can I get you anything? A cup of tea?’ I ask.
‘No. Thank you.’ He puts the notebook down and looks around.
‘We were just having dinner, you see,’ he says.
‘Yes.’
He pauses, and the beeps from the metronome measure out the length of it.

Wednesday, November 02, 2011

poppy

Mr Neuberg stands in the doorway of his house, clutching a heavy blue cardigan around him like the figure for anxiety in the psychiatric version of a weather clock.
‘Come in, guys. Come in. I’m so sorry to call you but I was cold and shivering and I just couldn’t warm up. So I started to panic – I know I was panicking – I shouldn’t do it but it just got ahead of me. I’ve taken my medication but look at me! And I feel so cold. And clammy. Feel me! Look. Could the medication do that? Or maybe I have an infection? I took my temperature and it’s low. Thirty-five it said. That’s hypothermia, isn’t it? Can you have an infection and not a temperature? I don’t know these things. I just don’t know. My god. I’m sorry but I couldn’t cope. My girlfriend’ll kill me. Close the door. The rabbits.’
‘Rabbits?’
‘In there.’
He nods towards the front room where two tiny rabbits are busily inspecting the back wheel of a bicycle.
Two weeks ago I would have had no idea, but now I’m able to say with some authority: ‘Holland Lops?’
Mr Neuberg grimaces.
Holland lops? Dwarf Lops!’
He hurries on ahead, squats down at the bottom of the staircase and hugs his knees. A quivering gantry of a man, he tucks himself up into as small a space as possible, rocking a little backwards and forwards. On the wall to the side of the staircase is a giant canvas – a still life of sweet jars on a chequered tablecloth. On the opposite wall, a toy moose head. The eyes on the moose are small and dark and glassy with a hint of a spiral twist – much like Mr Neuberg’s.
‘You won’t tell my girlfriend, will you? Please. She’ll kill me.’
‘No. But let’s worry about that in a minute. Just tell us what’s happened today.’
‘Just lately I haven’t been getting much sleep. Or eating. I haven’t been eating. I lost my appetite and I shed seventeen pounds. Look at my arms. Look at that. They used to be out here, but now this. Some of that’s thyroid, I know. And I’m due some investigations for – you know. And that’s a worry. But I’m active. I move around a lot. Which is probably just as well because the house is so damned cold. Does it feel cold to you? I think it’s really cold. My girlfriend doesn’t think so. She won’t have the heating on during the day. She says it’s not the time of year. But I don’t know. What do you think? So anyway. I was sitting at my computer and I started to freeze up. My hands. My face. I got the shivers and shakes. So I put on loads of jumpers and t-shirts – layers, you know? I went for a walk in the sunshine. But nothing made any difference. I just could not get warm. So I started to think something was the matter. And I know I shouldn’t but I couldn’t help it and I just got more and more anxious. I couldn’t break out of it, which is when I called you guys. And I’m so sorry ‘cos I know you’ve got better things to do with your time and I do appreciate you coming out. But please don’t tell my girlfriend about this. Please. She’ll kill me.’
‘Let’s do a few checks, get a few details, then think about what to do next. Okay?’
‘Sure. I’m in your hands. You’re the experts.’
I get out my thermometer. When I put it into his ear Mr Neuberg frowns and swivels his eyes in that direction.
‘It goes in your ear? The one I got goes in your mouth. Look. I only bought it the other day. It cost eight pounds, so it should be accurate. It said thirty-five degrees. What’s yours say?’
I show him the little screen.
‘Thirty-seven? But that’s normal, isn’t it?’
‘Yep. Bang on normal.’
‘Mine said thirty-five. Look. I’ll show you.’
He pops it into his mouth and opens his eyes wide, as if he were trying to inflate a very thin balloon. I take advantage of him being still to take his blood pressure.
‘Normal,’ I say, folding the cuff back up.
Mr Neuberg takes out the thermometer.
‘What did I tell you. Thirty-six. Well – it’s gone up a bit but it’s still low. And you’re saying thirty-seven?’
I shrug.
He looks at his thermometer, gives it a shake, like an old mercury model, then looks at it again.
‘That’s going back,’ he says.
Suddenly the phone rings on the step next to him. Mr Neuberg leaps up and looks at it in horror. He leans in, checks the number on the receiver, blanches, carefully picks it up, then just before he presses the answer button, sights us both along the bony blade of his nose and raises his index finger in the manner of a Judge commanding silence. Only then - when he’s absolutely certain we have understood what’s expected of us - only then does Mr Neuberg answer.
‘Hi Poppy.’
His voice is completely changed. The hyper-anxious patter of the last five minutes has been replaced by the sweetly insipid tone of a man calling home in his lunch break.
‘What? No – I was in the bathroom. Yeah, I’m fine. How’re you? .... No – I ate already. Yeah - I finished off that salad. With some crisps and the rest of that seedy bloomer. I wasn’t all that hungry. Who? Oh - yeah – y’know. Fine. Fine.... No, I won’t.... I won’t....’
He holds his finger up and frowns at us again, as if he thinks we’re becoming restless.
‘Okay, Poppy? I’ve got to go. What? No – you know. The usual. Okay, Hun? Yeah. Okay? Love you. Love you too. Take care. Oh – and Poppy? Could you get some pellets on the way home? Okay? Thanks sweetheart. Love you. Bye. Bye. Bye.’
Very gently he squeezes the phone off, then deflates about an inch.
‘Okay,’ he says. ‘That was Poppy.’