Tuesday, January 31, 2012


Jeanette has fallen over at the home. Although she only bruised her shoulder and knee and seems happy enough in herself, we find that every now and again her heart rate drops to the forty mark for extended periods, and it looks like this is the reason she went over.
‘I’m afraid we’re going to have to take you in to hospital to get this checked out,’ I say to her. ‘A nuisance, I know, but we want to make sure you’re okay.’
‘Fine. Yes. You carry on,’ she says, resigned to the whole affair, despite the late hour – on the coldest night of the winter so far – and despite the fact she’s ninety.
‘I’m in your hands,’ she says.
We bundle her up against the cold and wheel her out to the ambulance.
The nursing staff wave her off.


All our checks are done. The ambulance rocks gently from side to side as we glide along empty streets to the hospital. The heater whirrs in the background; Jeanette is tucked up to her chin in blankets; I’ve switched on the smaller overhead spots and turned off the main lights. Jeanette is perfectly awake despite the cosy interior. The light plays across her glasses as she looks around.
‘Yes. Very comfy, thank you.’
‘You’re a good traveller,’ I tell her, putting my clipboard aside.
‘Oh – I’ve done it a few times,’ she says.
‘To hospital, do you mean?’
‘When I worked.’
‘What did you do?’
‘I was an air stewardess. For BOAC. I went all over the world. And when that was that I went into training and took care of the other side of things for a while.’
‘Where were you based?’
‘All over. London mostly. Do you know London?’
‘I was born there.’
‘Were you?’
‘In Pimlico.’
‘Pimlico! Fancy that. Where in Pimlico?’
‘Just off John Islip Street. Near the Tate.’
‘I know it! If I’d had a pound for the number of times I’d walked along Millbank.’
She settles her head deeper into the pillow.
‘We used to go dancing at that place in Victoria. What was it called…?’
She drifts off, the creases and folds of her face smoothed out beneath the spotlights like an actor’s mask left on stage.

I check the ECG and reach over to feel the pulse at her wrist. It suddenly drops down almost to nothing, the merest echo of a pulse from the wrist line of a leather glove waving at the doorway of a DC10 at Nairobi, the trace of an echo behind a wrist watch waving for a cab on the Horseferry Road. But just as I dab about wondering if I can feel it at all, getting up to ask Frank to pull over, the trace on the machine comes back again, quicker and stronger, and the pulse resurfaces beneath my fingers.
She opens her eyes and looks at me.
Where was it?’ she says.

Saturday, January 28, 2012

spelling bee

Orange street lights on frosted tarmac. A crescent moon hooked up in the sky like a suture needle.
I press the button on the intercom, a pause, then the squall of a voice through the speaker.
I lean in.

Mr O’Fallon is standing in his hallway, the subsiding wreck of a fifty year old, propped up against the wall, smiling soggily like a Halloween pumpkin left out in the rain.
‘S’ah. M’gon et ma goh sum’air mate. Eh? S’ah there to, innit.’
‘What’s that?’
He sighs.
‘S’ah. M’gon et ma goh sum’air mate. Eh? S’ah there to, innit.’
‘What’s happened tonight, Mr O’Fallon? Mr O’Fallon?’
He reaches down, grips his left hip, then swipes at the air with his free hand. I prop him back up.
‘Did you fall? Have you hurt yourself?’
He grinds his gums, laughs, then speaks.

When he talks, his Belfast accent, lack of teeth and many cider litres – many years of cider litres – all these things act like the layers of a perverse filtration system: he thinks of a response, pours it in at the top, it filters down through each layer, all the nuances of communication absorbed and lost, until all that’s left to come out of his mouth is a kind of primitive proto-language, the essence of the thing he wanted to say, lukewarm, with just a taint of the original sense.
He says it again.
‘It’s hard to understand what you’re saying,’ I tell him. ‘Seeing as you’re on your feet, shall we get you out to the ambulance and check you over there?’
He makes some sounds. I interpret them as Can you get my jacket? When I fetch his jacket down from where it hangs on the back of the door, he nods as if that wasn’t what he meant but it’ll have to do.
We stagger out to the ambulance.


Mr O’Fallon is sitting on one of the ambulance seats. Frank takes his blood pressure and temperature whilst I try to get the basic details. We’re only round the corner from the hospital, so I need to do it whilst the ambulance is parked up.
‘What’s your first name, Mr O’Fallon?’
He makes a sound.
He makes the sound again, louder.
‘Spell it for me.’
‘Or! F’Orse.’
‘Oh! O!’
‘A’s roi, neh. Or.’
‘Okay. Next letter.’
‘Ay. Ay! Fer Aynjin. Ay.’
‘I. For Indian. I for Indian.’
‘Ay. Ay.’
‘Okay. O, then I. Then what?’
He shakes his head – so hard it almost falls off onto the trolley.
‘Ass! Fer fer’s say. Ass!’
‘Yep. Got it. So that’s O, I and S – then what?’
He frowns. Then immediately raises his eyebrows.
‘On. Fer Nut’n. On.’
‘N! Okay – great. So that makes O.I.S.I.N.’
He shakes his head again, and leans right back in the chair.
‘So how do you pronounce that?’
He laughs, with his awful, craterous, old dog’s mouth.
‘Osheen,’ he says, the name wafting out in a hang of fumes.
He leans forward and slaps me on the knee.
‘Ay ‘us shah boy de Oy Uh Ray,’ he says.
‘You were shot by the IRA?’
Frank takes the cuff off his arm.
‘Well,’ he says. ‘They’re not as patient as us.’

Thursday, January 26, 2012

get cracking, mate

Mr Abbott is lying on the ITU bed, a corrugated tube connecting his mask to the oxygen supply, a tangle of chest leads running out to the ECG monitor, a blood pressure cuff round his arm, a SATS probe clipped to his finger, the ports of a central line dangling from his neck, and a urine catheter running out to a bag on the side of the bed. He is asleep when we roll into the department with our trolley; the nurse wakes him up.
‘Come on, Paul. Shake a leg. We can’t have you lazing around here all day. What do you think this is, a holiday camp?’
He opens his eyes.
‘I’m sure you do it on purpose,’ he says, his dry voice only just distinguishable above all the hushing and beeping and buzzing. ‘What do you do – hide in the cupboard until you see I’ve dropped off, then jump out? You’re a sadist, you are.’
‘Charming. I don’t know why I bother. Just because I wouldn’t give you any of my Kit Kat.’
‘You can keep your bloody Kit Kat,’ he says, then goes to fold his arms. He seems surprised to find that he can’t do it, so lays them down again.
‘Hello, Paul. I’m Spence, this is Frank. We’ve come to transfer you to the other hospital. How are you doing?’
‘Great. Thanks. Bloody marvellous. Who did you say?’
‘Spence and Frank.’
‘There you go,’ says the nurse, stuffing all his notes in a grey plastic bag. ‘I told you they wouldn’t be long. Your own private taxi. How’s that for service?’
We help prep him for the transfer to our trolley.
‘Nice bed you’ve got here,’ I say, looking around. There are two chintzy pictures on the wall facing him – a Thames barge in sail, and a cottage on a country lane. I wonder how long he’s been staring at those pictures, what they’ve come to mean to him.
‘Ready, set – slide.’
‘Now don’t you go complaining too much,’ says the nurse. ‘I know what these guys are like. They’re not nice like me. They’ll fly-tip you in a lay-by.’
‘I only complain when there’s something or someone to complain about.’
But he reaches out to her, and when she puts her hand in his, he squeezes it affectionately.
‘Thanks for all you’ve done,’ he says.
‘Paul – you’re very welcome. Get better soon.’
We wheel him out.
‘And don’t come back!’ she says.


It’s difficult to chat to Paul on the ambulance. The motorway falls away beneath us like a river in flood, and the wind booms around the metal sides of the truck.
‘I suppose you’re retired now?’ I say to him.
‘Retired? Oh god, yes. Years ago.’
‘What did you do?’
‘I was an engineer. Telecoms. I was the guy they use to send in when no-one else could sort it out. I’d pitch up, they’d point me to a big room full of wires and relays and transformers, all higgledy-piggledy, and they’d say “There you go, mate. Get cracking.” And do you know what, when I walked out of that room, everything’d be back in its place and the air would be humming sweetly. And that’s what I did for a living.’
‘Sounds good.’
‘It was good. I went all over the world. Japan, Africa, the Middle East. Always the same thing. “There you go, mate – sort it out.” And I would.’
He pauses, and struggles to adjust his position on the trolley.
‘Are you okay?’
‘I’m all right. I just get a bit – sore, you know?’
I reposition the mask on his face and tuck him up again.

A moment passes.

‘D’you know – there was a woman in the bed opposite me,’ he says. ‘Not good. Not good at all. I’ve no idea what was wrong with her, but it wasn’t good. She’d cry quietly to herself. Felt like hours. I could hear her, especially when it was quiet and the visitors had gone. She had lots of people come to see her. You could tell it was bad because they didn’t say much, just sort of hung about. And when they went she’d cry quietly like that. The nurses did what they could, but it was awful.’
He turns his face to look at me, and his eyes are shining.
‘I couldn’t do nothing,’ he says. ‘What do I know about any of that? All I could do was lie there and listen.’
I hand him some tissue. He wipes his face and blows his nose, then re-settles the mask on his face.
‘And that was the worst thing. I had no idea what was wrong. I couldn’t do nothing. I just had to lie there. And listen.’
The ambulance rocks from side to side. He closes his eyes to compose himself.
We turn off onto the slip road and take the exit towards town.

Saturday, January 21, 2012

haute cuisine

The estate rises around us in the darkness like a ruthlessly illuminated housing machine. Layer upon layer of regularly spaced squares fitfully lit by plasma screens, measured out in a grid of walkways. But despite the scale of the place there’s no-one around, not even a dog walker or a posse from the clubs; no sign of life at all, just a skin of frost over the parked cars and the grass, and here and there faint wisps of steam rising from vents.

Ellie is waiting for us in one of the entrance halls, staring out at us through the scratched Perspex of the front door. Her eyes are so wide and dark they make the hall lights flicker.
‘Can we come in?’
She doesn’t answer, but relaxes her hold on the door and turns to walk back inside.

Her flat is clean and warm, the laminate floor clear of anything but a pair of dog slippers and a scattering of empty pill packets. Ellie goes over to turn off the TV – a cooking competition - and puts her feet into the slippers.
‘My name’s Spence. This is Frank. We were told you might have taken an overdose tonight. Is that right, Ellie?’
She nods, gathers the lapels of her pink towelling robe around her, knots the belt more tightly.
‘Are these the tablets you took?’ pointing to the packets on the floor.
She nods again, and goes to pick them up.
‘It’s all right, Ellie. I’ll get them. Were these all full when you started?’
‘There’s quite a few here. I’ll do the counting up on the ambulance. What we need to do now is take you to hospital for some treatment. Is that okay?’
‘I’ll get my bag.’
‘And your keys? Good. Okay – let’s go.’


She lies back on the trolley, folds her hands neatly across her stomach and closes her eyes. She’s only twenty one; her face is as clear and unmarked as a sleeping alabaster angel in a church.
I calculate the number and size of the pills she’s taken, dropping the counted packets into a spare vomit bowl. The tally is dreadful, a shopping list for the damned. I put everything aside and feel the pulse at her wrist.
‘Did you take any alcohol with these pills, Ellie?’
She opens her eyes.
‘A glass of wine.’
I picture her alone in the flat, sitting on the edge of the sofa, taking little sips with each mouthful, tipping her head back, watching the chefs battle it out on the TV.
‘How long ago?’
‘Half an hour.’
‘Good. And how are you feeling now?’
She rests her head back on the pillow and closes her eyes again.
‘My tummy hurts,’ she says.
We turn up the slope to the department.


The Charge Nurse looks at the name on my sheet and then glances down the corridor to where Frank is waiting with Ellie.
‘Oh yeah. Yep. She was in about a month ago. What’s she taken this time? Whoah!’
She signs the board, hands it back to me, then asks one of the other nurses to come over.
‘Best crack on with this,’ she says. ‘Although why the hell she’s still got all these meds hanging around is beyond me.’
I go back to the trolley to help push her into a cubicle. Her dog slippers are poking out of the bottom of the blanket, so I pull it down a little to cover them.
‘The nurse will be with you very shortly,’ I say to Ellie as we move along. But I can see the nurse is already there waiting for us, smiling, a bottle of charcoal in her hand, shaking it.

Friday, January 20, 2012

double take

Despite Mrs Henty’s thirty-year aversion to doctors, hospitals, medication or intervention of any kind – other than homeopathy – she feels so ill she allows herself to be helped into our chair and carried out to the ambulance. Her daughter is with her, relieved that after two months of these sudden episodes something has changed – serious though it might be – sufficient to force her in to see a doctor. We settle Mrs Henty on the trolley and whizz through our observations.
She has no pain, her oxygen saturations are good, her blood pressure, temperature and so on. But her heart rate is irregular and she looks poorly. When we do a twelve-lead ECG, the result is clear: Mrs Henty is having an anterior MI. We telex the result to the catheter lab, and blue light her in for treatment.
‘Apparently the new protocol is we go to the lab via A&E’ I shout to Frank through the hatch. ‘Last time I went in the old way, but I’m pretty sure I can find it.’

We make it in good time. Mrs Henty’s daughter is a nurse herself – at a different location, but sufficiently au fait with procedure to know what we’re doing and to be useful. She even carries some kit for us as we hurry in through the main A&E doors.
‘Mind your backs! Coming through!’
The department is packed out, as usual, but we bully a passage through to the corridors the other side.
‘Just head for what used to be the medical assessment unit,’ I tell Frank.
But in the six months since I was last there, the department has been reorganised. Partition walls put up, painted and signed for day surgery, a waiting room with lines of pristine blue chairs, posters on walls that used to be open space.
‘Through those doors,’ I tell him.
A porter carrying a rubber mattress is heading in our direction.
‘Is this the right lift for the cardiac catheter lab?’ I ask.
He puts the mattress down on the floor and rests his arm on it.
‘The cath lab?’
‘Uh huh.’
‘Only if it’s an emergency.’
I nod and widen my eyes.
‘Yes, then. Through them doors.’
He picks up the mattress again. But I have a sudden loss of confidence.
‘Can you take us there?’ I ask him.
He puts the mattress down again.
‘To the lifts?’
‘Uh huh.’
He props the mattress against the wall – prodding it a couple of times to make sure it won’t fall – then shuffles ahead of us through the new department. He opens a couple of swing doors, then stands in front of a pair of lifts.
‘Okay?’ he says, sighs, and walks off.
The lift door opens. Inside is an enormous man and woman with an equally inflated toddler in a stroller. In their shiny black PVC puffa jackets they could be a family of gigantic beetles heading out for the day.
‘This isn’t level six,’ he says. The woman frowns.
‘I’m really sorry guys but I’m going to have to ask you to clear the lift. Our patient’s not very well and we need to get her upstairs as quickly as possible. Thanks. Thanks for your help. Sorry. Thanks.’
Reluctantly they leave the elevator. We haul the trolley inside and I push the button to go up.
When the lift opens again we leave quickly and turn left for the lab as we always do.
It’s only then that we realise we’re a floor short, having started from a lower level. But the lift has closed now, so we have to call it again.
A moment later the doors open.
Inside are the family in the puffa jackets.
There’s nothing else to do but brazen it out.
‘Sorry guys. Sorry. I’m going to have to ask you to leave the lift. We’ve got to get our patient upstairs as quickly as possible. Thanks very much. Thanks.’
They shuffle out with a stunned expression and turn to look at us as we pass. As the doors close I see the woman turn to the man, raise a finger to point in our direction and say “Didn’t we just ...?”

We ride the final floor in silence, until Mrs Henty’s daughter shakes her head.
‘I think this is what they call a learning opportunity,’ she says. And then leans forward to read the name on my shirt.

Thursday, January 19, 2012

a cat called keith

Sheila and Deidre became friends sometime in the Cretaceous period. They’ve been friends so long they fit together seamlessly, every nod and smile, every laugh and cough, hair-net pat and handbag hug all slickly co-ordinated, their conversation scooting along like a canoe with two paddles.
‘We didn’t take him in so much as he adopted us.’
‘Barbara up the road’s got five cats and couldn’t handle another.’
‘He just turned up one day and stayed on.’
‘They know the easy life when they see it.’
‘Not like dogs.’
‘Dogs – eurch – crashing about, wanting attention’
‘His name’s Keith.’
‘It was actually Chief but we misheard.’
‘He’s twenty something.’
‘Pick him up, there’s nothing to him.’
‘Just rag and bones.’
‘But he does all right.’
‘He’s got some bad habits.’
‘He likes to sit any old where.’
‘He was on the bread board this morning.’
‘Not very hygienic.’
‘But what can you do?’
‘And vomiting.’
‘From high up.’
‘Apart from that he’s all right.’
‘Yowling. Padding around the place, yowling.’
‘Especially when he wants something.’
‘You put down some biscuits and say “Here you are Keith.”’
‘So he takes a sniff then turns his nose up and walks off.’
‘So we have to give him chicken.’
‘Not a bad life.’
‘He can’t go on much longer.’
‘Bit like me.’
‘Don’t say that, Sheila.’
‘Well, look at me.’

Sheila rests back on the trolley and closes her eyes. After a moment or two Deidre leans forward and reaches out her hand.
‘Just making sure you’re still with us.’
‘We’ve got another cat, of course.’
‘He was already called that when we got him.’
‘Don’t ask.’
‘He must be getting on for eighteen or so.’
‘But you’d never think it.’
‘All his own teeth.’
‘They work in cahoots.’
‘There’s nothing they won’t do for a bit of attention.’
‘He came from Barbara as well.’
‘Can you blame him?’
‘Are we there yet?’
‘Five minutes,’ I say.

Deidre hugs her bag and smiles at me.
‘Do you have any pets?’ she says.
‘Two dogs and a cat. Our cat’s getting on a bit. Same age as Dexter, by the sound of it.’
‘Where did you get her from?’
‘She came free with a sofa. The sales assistant just said it as an afterthought. She was handing us the receipt and she said “I don’t suppose you’d like a kitten as well, would you?” So here we are, eighteen years later. Outlasted the sofa, that’s for sure.’
‘What’s her name?’
‘Kasha. Which apparently is a kind of Eastern European porridge’
‘Kasha. Hmm.’
Deidre closes her eyes on the trolley again.
‘Keith’ she says. ‘Whoever heard of a cat called Keith?’

Monday, January 16, 2012

wolves and eagles

Charlie has been found lying on his side on the pavement. The caller said he’d been fitting, but when we arrive on scene he’s up on his feet and trying to light a roll-up. We help him on to the ambulance to check him over.
‘My son works in IT,’ he says, as we put an inco pad down on the seat and he assumes it happily like we’re laying out a table for him in a restaurant. ‘He had a baby the other week. Which makes me a granddad. Apparently.’
He nods, crosses his legs, hugs his right knee and rocks backwards and forwards on the chair.
‘Yeah. Well.’
His beard is patchy and rough, like he splashed his chin with glue and dipped it in a Hoover bag. Red pock marks crater his skin; there is a grimy fuzz of alcohol about him, and his clothes are waxy and black with dirt.
‘My mum killed herself on the twenty-third of August, nineteen eighty,’ he says, out of nowhere, and formally, like a schoolboy in an exam.
‘I’m very sorry to hear that, Charlie.’
‘She killed herself on my Dad’s birthday.’ He looks down, picks something off his lap and says more quietly: ‘The twenty third of August, nineteen eighty.’
Charlie looks up again.
‘He found the body.’
‘That’s tough.’
‘I haven’t seen him for about ten years. He’s not really that bothered.’
I take the blood pressure cuff from his arm. He rubs the spot for a second then says:
‘I’ve been writing a book.’
‘Oh yes? What’s it about?’
‘It’s called A Consideration of Wolves and Eagles. It’s about the life lessons you can learn by comparing human life with the natural world.’
‘That sounds interesting. Why wolves and eagles, particularly?’
‘Why what?’
‘Why are you writing a book about wolves and eagles?’
‘I don’t tell the others in the hostel about it because I don’t want them to think I’m – you know – clever.’
I test his blood sugar level.
‘So why wolves and eagles?’
‘Wolves?’ he says, sucking the blood from his pricked finger before I get a chance to sample it. ‘I don’t know. They’re just out there, y’know.’ He widens his eyes and grimaces. ‘They’re just wild. And eagles? Someone once said…’ he uncrosses his legs and sits a little straighter… ‘Someone once said: The eagle has landed. Well – it won’t be going anywhere soon.’
‘What do you mean?’
‘Why won’t the eagle be going anywhere soon?’
Because the eagle has probably only landed because it wants something to eat – it’s prey - and if that something happens to be a rabbit - well. Some of those rabbits can be pretty big. And if the eagle isn’t all that, it stands to reason it’s going to be there a while. That’s what I think, anyway. These are some of the things I try to explore in my book.’
‘I see.’
‘Can I go now? Only this thing’s not going to smoke itself.’

Saturday, January 14, 2012

a quiet one

Dragging our sorry tails back to base, exhausted, a long and loveless day of heavy lifts, emotional traumas, disturbed meal breaks, disturbing rumours. But with ten minutes and two miles to go, it’s not looking good. All-calls are spraying out of the radio like spores from a rotten fruit. We’re praying for the night crews to sign on in time to pick them up and get us off the hook, but there are so many calls now we know we can’t possibly make it back on time. I lean back in the attendant’s seat and put my knees up on the dashboard, affecting an ease I do not feel. But the Fates aren’t so easily fooled; the screen lights up at the same time as Control calls us. A choice of two – neither good, but one a mile or so closer.
‘Let’s go.’
Frank dives down a wormhole of flashing blue. We make it in minutes.

A wide, tree-lined street, shining in the wet winter darkness. A woman waiting with her arms folded at the top of the stoop.
She doesn’t smile as we stride up the stairs with our bags.
‘Top flat,’ she says, and leads us up.

Anna’s husband Pavel is naked except for Calvin Klein boxers, face down beneath a coffee table. As we walk in through the door he snorts and thrashes, knocking the table over and scattering little finger bowls of pretzels and nuts across the room. The rug is smeared with dark, brown stains and fresher blood from his abraded knees.
‘This I find from vork,’ she says, lighting a cigarette. ‘With note who say I kill myself. With tablet and whiskey.’
Anna gives me the note, but it’s in Russian, so I hand it back.
‘What’s he taken?’ I ask, squatting down beside him.
She shrugs, and nods at a pile of empty blister packets – anti-depressants, pain killers and blood pressure pills. Pavel is pretty much unconscious, snoring as he struggles to keep his airway open. I tilt his chin up to clear it and open his eyelids to assess his pupils as Frank backtracks to get a chair.
‘Can you write your husband’s name on my form with his date of birth, his doctor and so on? That’d be really helpful.’
She does it, quickly, neutrally, as if she were signing for receipt of a package.
‘Has he done this before?’ I ask, putting in an airway. Pavel gags a little but takes it without vomiting. His SATS are good, but we need to get him in quickly.
Anna shrugs. ‘Once before. But he drink all the time. Is he bad?’
‘Bad enough.’
She blows smoke.
Frank crashes back in with the carry chair and a couple of blankets.
Pavel must be at least six feet tall, heavily built. Strictly speaking it should be a four man lift, but we know that asking for a second crew at this time of night, with so many calls stacking, it would be a while before our back-up came. So we top and tail him into the chair, bundle him up in blankets, and head for the door.
‘Could you put all those pills into a bag?’ I say to Anna, ‘And carry the clipboard down for me? Thanks.’
She follows us as we grunt down two flights and out into the street. When we make the ambulance she puts the bag and clipboard down behind me and watches as we roll him onto the trolley, sort out his positioning, rig him up to the oxygen, the ECG, the BP machine and everything else. A set of obs done we make ready to go.
‘Are you coming?’ I ask her.
She doesn’t say anything, but gives me a look as coldly swept as the street.
Frank slams the door.
We go.


Despite the ASHICE there is no team to meet us. Instead, Carol, one of the nurses, is frantically rearranging trolleys and stuffing used equipment into red bags. She pauses and looks at me, and it could be two doomed sailors on the deck of a sinking ship taking a second to smile at each other, at the hopelessness of it all.
‘It’s been mad,’ she says as I help her move a trolley up. ‘I can’t...’
‘Don’t worry.’
‘Who’s this?’
‘Pavel, thirty eight. OD pills and alcohol. GCS about nine. SATS good on air, fine on O2. Other obs okay. A bit tachy. Past medical history unknown.’
‘Christ – look at him. I’ll get a doctor.’
We slide him over onto the trolley whilst Carol hurries away.
She comes back a moment later and starts connecting him up.
‘The doctor’ll be here in a second,’ she says. ‘Jesus Christ. What a day. We even had to use the quiet room as a temporary morgue.’
Frank is backing out of resus with our trolley.
‘Well,’ he says. ‘ I don’t suppose they’d be noisy.’

Tuesday, January 10, 2012

the pharmacy stairs

There is a handwritten sign taped to the pharmacy window: Closed for staff emergency. Will reopen as soon as possible. Sorry. Barbara unlocks the door without a word and shows me in, determinedly avoiding the frowns of the early morning customers already queuing outside. She quickly closes and locks the door again, and leads me through the empty store to the back, where Jenny is posed in the dispensing zone, standing formally with one hand on the counter and one hand down by her side.
‘Hello, Jenny. I understand you fell down the cellar stairs,’ I say.
She nods.
‘I’m all right. I didn’t want the ambulance. I’m perfectly fine.
‘Would you mind if I had a quick chat, though? Just to make sure everything’s okay? Is that all right?’
She nods again, without shifting her position, as easy as a witness on the stand.
‘Before I go any further, I just have to check a few important things, Jenny. In any long fall, I have to make sure the person hasn’t hurt her neck. If I press here... or here... does that feel okay? Any sharp pains, any discomfort?’
‘And very gently – can you look to this shoulder? Good. And this one. Good. Any pins and needles? Numbness? Visual disturbance?’
‘Were you knocked out?’
She shakes her head.
‘Any pain?’
‘A little – in my shoulder. My leg.’
‘Excellent. And why did you fall, do you think?’
‘I had to go down into the cellar to get some things. I caught my sleeve on the safety gate and fell down.’
‘All the way down?’
She nods.
‘Quite a way, then.’
‘I’m fine. I really didn’t want anyone to call the ambulance.’
‘Why don’t you have a seat, Jenny? I’ll do what I normally do and then get out of your hair? Is that all right?’
She takes a seat and folds her hands in her lap. Barbara moves off, gliding away to tend a shelf of cold remedies. The store manager has been taking a call out back with the area manager, but now that I’m on scene he finishes the call and comes over to say hello.
‘I told you not to ring for the ambulance,’ says Jenny.
‘You fell down the stairs,’ he says, then smiles at me, a terse, precisely ruled affair. ‘You don’t take a fall like that and just carry on as if nothing had happened.’
‘It is a long way, Jenny,’ I say.
‘I’m fine.’


I check her over, take her details.
‘I don’t want to go to hospital,’ she says, rolling down her sleeve.
‘You don’t have to, but it might be as well – just to get checked out by a doctor.’
‘I don’t want to go to hospital.’
‘Fair enough. But if you suffer any of these symptoms – a headache unrelieved by analgesia, persistent vomiting, visual disturbance, pins and needles or other neurological symptoms, blackouts – anything unusual, in other words – then don’t hesitate to get yourself down to the hospital. Or call an ambulance. Just because you don’t want to go in now, doesn’t mean you can’t call us again. It’s not like that.’
She signs the disclaimer.
I pack up the kit and get ready to leave.
‘Nice to meet you,’ I say.
She nods.
I head for the door.
‘Could I have a word – before you go?’ says the manager, striding over from the back of the store, where Barbara is watching with a box of pills in her hand.
‘Oh – okay.’
‘In private.’
He opens a door to a consulting room and when I have stepped inside, follows me in and closes the door.
‘I’m extremely worried about Jenny,’ he says.
‘In what way?’
‘She didn’t fall. I saw the whole thing. She deliberately threw herself down the stairs and said we’d pushed her.’


‘I’ve no idea what to do,’ he says finally, rubbing his hands, a flush of anxiety across his cheeks. ‘She can’t stay in the store. I’m worried she’ll hurt herself – or us. And as far as making up the scripts for the customers...’ He shakes his head. ‘Forget it. It’s just not safe.
‘It’s complicated. If you’re saying you want her off the premises, that’s a police matter. But if you’re saying you’re worried about her mental health, that’s something else entirely. I could persuade Jenny to come to the hospital, and she could talk to someone there. Or maybe you could persuade her to go home and see her doctor. Maybe we should all have a chat about it in the open, so everyone’s clear about the situation. That’s probably the best thing.’
The manager looks unconvinced, but reluctantly opens the door again and stands aside.
‘I’m really sorry,’ he says. ‘I know you’re busy. I know you’ve got better things to do.’
‘Don’t worry. It takes as long as it takes.’
I go with him to the back of the shop again and put my bag on the floor.
She frowns at me.
‘I’m not going to hospital. I’m fine. I’ve told you.’
‘I’ve just been having a chat to Doug, and he’s explained a little about what’s been going on.’
As soon as I start on my preamble, Jenny’s composure dissolves. Her face creases up and her hands come up into a tangle.
‘It’s not fair! I’m perfectly all right! I knew I shouldn’t have said those things. I should’ve just kept quiet about the last seven years, and then maybe none of this would’ve happened. I’m being victimised. Barbara did it. She’s been poking me, laughing at me, calling me names. I’m perfectly fine. All I want to do is work. Please don’t send me home. I’m on a final written warning. If you send me home, what’ll happen next? It’s not my fault. I haven’t done anything. Please. Please just let me carry on. I didn’t mean anything. I shouldn’t have said anything.’
She starts to bow in the middle, rocking backwards and forwards.
‘Please. I won’t go. You can’t make me go. You hate my husband. When he turns up to take me home you say he makes you feel threatened. You’re frightened of my husband and what’s he ever done? All I want to do is work. Please let me work. I promise I won’t say anything more. I promise. Just let me stay.’
Barbara has collapsed onto a step; the manager has folded his arms and is leaning back against the counter. The heat of Jenny’s anguish has melted them away like so many wax figures.
‘It’s not like that, Jenny,’ says the manager, hoarsely. ‘But you’re not well. We just want you to be well.’
In the heavy pause that follows, before I try to sum up and direct proceedings, I look between the three of them, caught in that pressurised, low-ceilinged atmosphere of the little pharmacy, seven years on in a bitter work dispute, an hour behind on the morning’s scripts, a half dozen patients massing outside the shop window, and the stair gate swinging open on the precipitous descent to the cellar.
‘These work situations,’ I say, finally. ‘They’re complicated.’

what happens now

Michael the Scheme Manager is on the phone outside the property. He raises a hand when he sees us turn into the close, then hurriedly finishes his conversation. He is hugging his clipboard as we walk up the concrete path.
‘I got no reply when I did my morning ring-around, so I knew something was up,’ he says. ‘The poor man’s past any help, lads. Even I can tell, and I’ve no experience of these things. This is my first one, in fact.’
He pauses, as if he wanted to say something else. But the thought turns into a deep breath instead; he gives himself a little shake, and turns round.
‘He’s just as I found him,’ he says, and leads us into the maisonette, up a narrow, plainly carpeted staircase onto a bare hallway. He gestures with his clipboard to an open door.
‘Through there.’

Gerry is lying on his back on the bed, the duvet rucked up around his legs. With his half-opened eyes, his slack mouth, his arms crooked up and his hands curled over just below his chin, he could be an old man cruelly mimicking a sad child. But the chilly lack of movement, the waxiness of his skin, the tide line of post-mortem staining – all these things darken the image.
‘He’s been dead a little while,’ says Frank, gently lifting the body at the elbow. The whole body moves, as fixed and frozen as a dummy.

‘Poor fellow,’ says Michael. ‘I’ll get you the folder with the details.’ You can hear his mobile go off as he clumps down the stairs.
‘Hello? Yes – No, I’m afraid not…’

The room is clean but bare, a magnolia cell with flowery curtains permanently pegged over the windows and a naked eco bulb hanging down from the middle of the ceiling, ruthlessly illuminating a varnished pine chest of drawers with a bottle of Irish liqueur, a shot glass and a tidy stack of medication blister packs on top; a small television on a low table with a chair drawn close up in front of it, a pair of glasses resting on a TV guide with the remote control; half a dozen empty beer cans neatly lined up on the floor to the right of the chair, a pair of outdoor shoes and a pair of slippers to the left; four linen shirts next to a couple of black trousers, all on wire hangers hanging from the picture rail, and two round kitchen clocks, both telling the right time, both on the floor and leaning against the wall either side of the chest of drawers.
Michael comes back up the stairs with a yellow folder.
‘I know he hasn’t spoken to his brother in twenty years,’ he says, thumbing through it. ‘All we know is he lives up North somewhere. I don’t know if we’ve even got a number.’
But after a while he stops looking, closes the folder and hands it to Frank.
‘Sorry,’ he says. ‘Here you are.’
He folds his arms back around his clipboard again, and stares at Gerry on the bed. At one point he even rocks on his heels and gives a little nod, as if he was agreeing with something the dead man was saying. But then he draws himself in a little tighter.
‘Shame,’ he says. ‘He was no bother. Anyway. So. What happens now?’

Sunday, January 08, 2012

a golden, laughing boy

Jean is enthroned on a scallop-backed silver chair, her bandaged right leg resting on a footstool, her arms placed either side of her. Her son William, an efficiently thin man of sixty, gives us a prĂ©cis of the action: arrived back at the house after a day out – wind caught the door and slammed it on Jean’s leg – deep cut - walked on it to the house – put a bandage on the wound – elevation and cetera.
‘I don’t want any fuss,’ says Jean. ‘I don’t like hospitals.’
‘Join the club,’ I say, kneeling down in front of her. If she drew a sword and lay it on my shoulder I wouldn’t be surprised.
‘Mum is terribly anxious about being carted off,’ says William.
‘That’s understandable.’
‘I’m ninety two,’ she says. ‘I’m past all that.’
‘Let’s have a look.’
The wound is a full thickness laceration, a brutal laying open of Jean’s calf.
‘I know how you feel about hospitals,’ I say, dressing the leg again. ‘But this is quite a serious injury and you really need to go in.’
‘If you think so,’ she says, ‘but I’m very anxious about it.’
‘Don’t worry. They’re experts at this kind of thing, and if I say you’re worried, they’ll take extra special care.’
‘I’ll follow in the car,’ says William, scooping up the keys from the sideboard.
Jean flinches.


On the ride in to hospital, to take Jean’s mind off the coming treatment, I chat to her about this and that.
‘I couldn’t help noticing the photos on the wall. Who’s that distinguished man in uniform?’
‘My husband, Denis. He was a Major in the army. It was his whole life. Conscripted during the war, stayed on afterwards, retired after forty-odd years. We had such a lovely life together. To be honest, I still can’t quite believe he’s gone.’
‘How long were you married?’
‘Sixty two years. It went so quickly.’
‘That’s amazing.’
‘I was lucky. But then I was always lucky in love.’
‘Well. Sort of. I was married twice.’
‘The first time was to this boy from Devon. One of those golden, laughing boys. We met at a dance and got married about five days later.’
‘So what happened?’
‘He was a merchant seaman and got torpedoed in the North Atlantic the following month. I met Denis just after the war when I was demobbed.’
Jean reaches out to me with her right hand.
‘What will they do to me when we get there?’
‘I’ll tell them you’re worried,’ I say, resting my hand on hers and giving it an encouraging squeeze.
But against the warmth of the blanket, her hand is so cool and slight you’d hardly know there was a hand there at all.

Thursday, January 05, 2012

a villa with a lemon tree

The only thing out of place in Elizabeth’s flat is Elizabeth. She is lying on her left side on the hall floor, her head on a pillow and her body covered with a duvet.
‘She wouldn’t let us get her up,’ says her son. ‘We did try, but she started getting distressed so in the end we thought we’d better err on the side of caution and call you chaps. Sorry to drag you out on such a filthy night.’
Even taking into account the passage of sixty years or so, you would never believe that such a tiny, bird-like woman could ever have given birth to such a vigorous man as Thomas. He fills the hall, a casting director’s dream of a mad professor, the dome of his forehead dangerously close to the ceiling, his bass voice a rumble through the floor.
Thomas gives us space to move and retreats to the sitting room end of the hallway, filling the doorway there, relaying the information so far to his wife, who discretely turns the volume down on Casualty.

Elizabeth is talking in a garbled whisper. Disconnected from the present, she produces a constant, random sequence of words and sounds, the conversational equivalent of pretend writing.
‘Is this normal for your mother?’ I ask Thomas.
‘Yes, I’m afraid so. Ever since her stroke a few weeks back she’s been suffering from confusion and dysphasia. The consultant doesn’t think there’s much chance of a recovery. But she’s ninety-two, of course.’
‘I don’t think she’s injured herself. We’ll get her up and run through a few checks.’
In fact, getting Elizabeth up is as easy as standing up ourselves. Her wizened figure is so slight, you could probably just think about getting her up and she’d rise into the air. She doesn’t show any signs of pain, any loss of mobility; we guide her slowly back into the sitting room, and make her comfortable on the sofa. Thomas’ wife makes space for her there, and retreats to sit on a rocking chair in the corner.

The room is beautifully kept. Along with displays of photos and pictures, there is an ornately carved armoire set in pride of place against the wall.
‘Been in the family generations. My grandfather used to keep his whiskey in it,’ says Thomas, standing next to it, draping an arm across the top and stroking the front. ‘Lovely, isn’t it? Seventeenth century.’

All Elizabeth’s observations are good.
‘Now - what to do?’ I say.
‘We’re in your hands.’
‘I’ll just fill in the paperwork and then we’ll have a chat about the options.’

The TV programme has changed. Now it seems to be a wildlife programme – footage of penguins, and seals, a whale sliding through the blue. To make conversation, I look across to Thomas’ wife and say: ‘You know, when I phoned up my mum the other day and asked her how her Christmas was, she said: Oh – lovely. Mick took us for a ride out to the coast. We walked Kes on the beach, saw the whale, went for a coffee in that funny little cafe ...” and I had to stop her and say “What? What do you mean? You saw the whale?” So she says “Yes – there was a sperm whale washed up on the beach. Quite a crowd – you know. People taking photos. I was a bit worried about Kes taking a bite, so we didn’t stay long.” A whale!’
Thomas’ wife smiles at me, rocking gently backwards and forwards.
‘We went whale watching, once,’ she says. ‘A long time ago now. Nova Scotia.’
I smile, then write some more on the form.
‘Almost done,’ I say.
‘I saw some porpoises once,’ says Frank. ‘I was swimming in the sea in Cornwall, and I saw these lovely black fins breaking the water out in the bay. So I got all excited and when I came back in I said to the lifeguard “Nice porpoises” and he says “What – you mean the triathletes?’ It wasn’t fins – it was the curve of their arms in black lycra.’
‘Can I get you a coffee? Tea? Gin and tonic?’ says Thomas. ‘It’s no bother.’
‘No. Thank you. We’re good to go, now. We just need to figure out what’s to do. I don’t think Elizabeth needs to go to hospital.’
‘I agree. We’re perfectly happy to keep an eye on mum here in the flat.’
He pushes his hair back from his face and takes a breath.
‘ We’ve been staying here ever since mum had her stroke, actually. We live in Portugal now.’
‘We have a beautiful villa out there – you must come and stay sometime.’
‘Thanks. It sounds lovely.’
‘It really is. Lemon trees in the courtyard by the fountain. A pool, a grove of olive trees. Lovely little village down the ways. Heaven, really. We’ve suggested that Mum comes to live with us. She’d have her own little cottage. She’s stayed there before lots of times and really loves it. But her health’s suddenly given out as you can see, and she’s not in a position to make it clear that that’s what she’d like. She can’t speak, she can’t write or even nod particularly if you ask her a question. Which is so frustrating. We’ve been having a health visitor the last few days. He doesn’t do much – mostly just seems to tick boxes on endless forms. Perfectly well meaning but absolutely hopeless. I told him about this plan and he said quite flatly it was out of the question. He said it would be tantamount to abduction. But honestly I don’t know what to do. We can’t stay here indefinitely, but Mum’s too frail to cope on her own.’
‘I think I’d rather live out my last days in a villa with a lemon tree.’ He stands and gathers the bags together. ‘It’s just a crying shame there isn’t a box on his form marked common sense.’

Wednesday, January 04, 2012

perks of the job

The first earthworks were thrown up on top of Allenbury hill two and a half thousand years ago. Now, the only other mounds and dips surrounding the hill are recreational – an eighteen hole golf course, with fine views of the town if the sea frets that haunt the area get blown further inland.
No chance of that today. The spongy mist is flecked with rain; we may as well be climbing out of the ambulance in a car wash.
‘Bloody hell!’ says Frank, gathering his jacket more tightly around him. ‘What hole did they say?’
To make things worse, no one has thought to unlock the height restriction gate. We walk up to the club house, overtaking a couple of golfers like doomed explorers determined to play on despite the polar bears and floes.
‘Aye aye,’ says one, his face as mottled as a chorizo sausage. ‘Someone poorly then?’
‘Not for me, is it?’ chips his friend. ‘I thought I was a bit below par, but I’m not that bad, honest.’
‘You’re off your stroke, mate.’
‘You’re having a stroke, mate.’
We leave them to it and hurry on up to the clubhouse where a man in a pointy knitted hat is smoking a fag.
‘Fourth hole,’ he says, nodding off into the gloom, exhaling a lung’s volume of extra fog.
‘We need the key to open the gate,’ I say. ‘We can’t get in.’
‘Fair enough.’
He grinds out his fag and disappears into the clubhouse.
‘I’ll carry on over to the hole. Can you fetch us out some splints and a buggy to bring him back?’ says Frank.
The man reappears with a key on a giant fluorescent tab of plastic.
‘Don’t lose it,’ he says.
‘Maybe I can use it to guide the helicopter in,’ I say, waving it over my head.
He stares at me grimly. ‘Like I say. It’s our only copy.’

Once I’ve got the ambulance up to the clubhouse, I gather all the kit I think we’ll need and call Pointy Hat out again.
‘I’ll need a buggy,’ I say.
He stares at me. ‘A what?’
‘You know. One of those golf carts.’
He frowns. ‘I don’t know about that. They’re dangerous things, they are.’
‘Really? A buggy?’
No response.
‘I’m used to taking risks,’ I say, slapping my hands together. But it doesn’t warm my hands up any and it certainly doesn’t warm up Pointy Hat.
‘I’ll have to speak to the manager,’ he says, and disappears back inside.
A couple more golfers drag themselves past the clubhouse, toting such a bristling array of clubs I wouldn’t be surprised to see an RPG in there.
‘Lovely weather,’ I say as they pass. They wave and smile with the slightly deranged look of sports addicts everywhere.
‘Use the yellow balls.’ But the fog has already swallowed them up.
Pointy Hat comes back.
‘No,’ he says.
‘Well how do you suppose we’re going to fetch your man in? You know – dislocated knee? Hypothermia.’
‘Have a word yourself if you don’t believe me.’
‘Okay. I will.’
‘Good luck.’
I go into the clubhouse, a haven of overstuffed chairs, shining optics, golfing supplies and Frank Sinatra, with the fog pressed close up against the window like nothing else exists in the world now.
‘Can I speak to the manager, please?’
The barman stops cleaning his glass and gives me a quarter gill look of disbelief.
‘Is she in?’
Unless Pointy Hat has been lying. A man in a hat like that could be capable of anything.
The barman backs away and disappears momentarily out through the bar door. After some hushed whispering he reappears behind an intense looking woman as friable as her hair. She has a sheet of paper in her hand.
‘Nobody told me about this,’ she says. ‘Why wasn’t I told?’
The barman quietly steps to the side and puts the glass down without a sound.
‘Tell me what’s happened,’ she says.
‘As far as I know, one of your golfers has dislocated his knee.’
‘Well how did he do that?’
‘I don’t know. I haven’t spoken to him yet. My colleague has gone on ahead to the fourth hole, but I need a buggy to bring the patient back.’
She frowns.
I picture Frank out in the awful weather. I imagine the language. I feel a surge of annoyance.
‘It’s up to you. The alternative is to drive the ambulance over there. I don’t mind.’
She straightens about a mile and puts the paper down flat on the bar.
‘Neil,’ she says. ‘Please take a buggy and drive this gentleman over to the fourth hole.’
He smiles at me and grabs his jacket.

The seat of the buggy is soaking wet so I put an inco pad on it before I sit down. The splints and blankets go in a carrier on the back and we’re set. He spins the buggy around with the flat of one hand on the wheel, and a second later we plunge off the patio and out across the green.
Neil puts the pedal flat to the floor. At one point he glances a wheel width across the lip of a bunker and almost topples us over. But I lean to counter balance and we rattle on through the mist, passing strange figures that coalesce and diminish in the grey.
‘I’ve never ridden in one of these before,’ I say. ‘It’s like a ghost train.’
‘Perk of the job,’ he says. ‘That and golf.’

Monday, January 02, 2012

big bird

There are three distinct voices coming through the battered black door of the flat. Rae’s modulated appeals; a drunken wail, and a loud, male monotone. We go in and find Rae standing with a middle-aged woman behind a sofa. Rae has her gloved hand on the woman’s arm to hold her upright, whilst the woman – her thick grey hair flattened with blood across one side of her head – furiously points and waves with her hands, almost pitching herself back down on the floor again. The object of both their attention is a thin young man in his twenties, pacing about the room. He has an extravagant mass of curly black hair and as he walks he jabs forwards with the blade of his nose. In his fake fur jacket, scarlet V-neck and drainpipe jeans, he could be a giant, exotic bird scavenging for food. And as he walks, he talks, lurching from affection to spite.
‘You know I love you like my own mother. You know I’d do anything in the world for you, Mary. Anything. You name it, I’ll do it. You know that.’
‘I want you out!’ she says. ‘Get out!’
‘Don’t worry about a thing,’ he carries on. ‘I’ll lock up. I’ll switch off the lights, take care of everything. I’ll even wash up. You don’t have to worry about a thing. I’ll set everything right. Then I’ll come and visit you in the hospital.’
‘Out! Out! I want him out!’
‘Though God knows why I bother, the shit you give me. Nobody else would. Nobody does. You’ll die here alone and no-one will care.’
Frank tries to guide the man out of the flat.
‘You’re not helping, are you? If you really care about Mary you’ll let us get on and treat her. Yeah? Okay – so just get your coat and give us some space.’
‘Don’t you come near me,’ says the man. Beneath the floppy fringe of his hair his eyes are tightly closed, and for a second in the smoky light of the flat it almost seems as if the skin has healed across them. He turns his beak from side to side, sensing the emotional currents in the air. ‘I’m not going until I’ve got all my things,’ he says. ‘I’ve got my dog in the next room. I’m not leaving him here. He’s six months old, a Staffordshire blue if you want to know. I’m not leaving him here all by himself. She wouldn’t look after it.’
‘Okay – so get your dog and go like Mary says. She’s perfectly entitled to ask you to leave, and I think you should respect that.’
‘And I’m not going without my vodka.’
‘That’s my vodka!’ screams Mary. ‘I bought that – for me – with my money.’
‘No. You’re wrong about that. I bought that vodka and I’m not leaving here without it.’
‘Mate – seriously. Just come back another time for the vodka. Mary needs to come to hospital to get her head treated, and you’re just getting in the way.’
‘That’s my vodka. I spent thirty quid on it. A reputable brand. I’m not wasting thirty quid’s worth of vodka on a deadbeat like her. You might as well pour it down the drain. Look at her.’
‘Get out!’ screams Mary.
‘He’s been dreadful,’ says Rae. ‘He picked up the phone, called her son and told him she was dead.’
The man has his eyes firmly closed, but he lifts his head and sniffs the air in Rae’s direction.
‘I hope all your children are still born,’ he says. ‘I hope you get cancer.’
‘Lovely. Thanks for that.’
‘That’s it. Out you go mate,’ says Frank.
But he’ll have to physically grab Joe and throw him out, and even Frank hesitates. I call Control and ask for police back-up.
The man stands there for a second or two more, then grabs a harness off the back of the door.
‘Fine. I love you, Mary. I love you like a son. You’re the mother I never had. So don’t worry about a thing. I’ll make sure the flat’s safe. I’ll lock up for you and keep it nice.’
‘Get out! Get out!’
He opens the bathroom door and a shy little staffy comes out, flicking its eyes around the scene, keeping its head low. The man slips the harness over the dog and stands ready to go.
‘And you can keep the vodka,’ he says to Mary. ‘Why don’t you stick it between your legs, you old witch. You’ve done nothing for me.’
‘Just go,’ says Frank. ‘And good luck for the new year. I think you’ll need it.’
The man strides out of the flat onto the landing, the dog jogging along behind him.
‘Nice,’ says Rae, then: ‘Thanks for getting here so quickly.’
‘Sorry it wasn’t sooner.’
‘Has he gone?’ says Mary. ‘Good. Now – get me my slippers.’