Thursday, April 26, 2012

a quick fix

Still twenty miles out of town and we’re in a queue of traffic so slow we’d have more chance closing our eyes and wishing ourselves home. There must be an accident up ahead, a sink hole or something because this is terrible. We’re surrounded by drivers on their mobiles, frantically re-entering co-ordinates on their Satnavs, or leaning back in their seats and pressing their hands up into the ceiling like prisoners finally losing it in the cell. I’ve had my knees up on the dashboard for the last five miles. It stopped feeling good at three, but I’m too numb to do anything about it now.
‘Gum?’
 ‘Sure.’
 Frank holds out his palm.
The job screen lights up.
‘What? No. No.’
A job way off in the wilds, so far away the scale of the map has to pull back to satellite view to fit the two red markers on the same screen.
‘What is it?’ says Frank, rolling his head left shoulder to right with an audible crack.
 ‘Intoxicated. Can’t get up.’
I call Control and do my best to get out of attending without actually refusing the job. But we’re out of area, out of leverage, out of luck. The Dispatcher fields my call with a chilliness that would make a polar bear grimace.
‘You are the nearest,’ she says.
Not only is it a long way to run, but if the patient needs to go in, we’ll have to head back the way we’ve just come by another ten miles or so, to a hospital renowned for its handover delays. By the time I eventually finish work my kids won’t recognise me. I’ll knock on the door and some teenagers will answer it. They’ll shout over their shoulder: Mum – there’s some strange bearded guy mumbling something about an overrun.
 But we have no choice.
Frank drives so fast the ceramic tiles are stripped from the chassis and the cab starts glowing red. Technically I’m a month younger when we haul up outside the address.

 An elderly woman is standing waiting for us by the garden gate. She waves us over and starts talking the moment we’re in range.
‘I’d better just tell you…,’ she says. Then she closes her eyes, her chin folds upwards and she presses a handkerchief to her face to hide the rest.
‘Take your time,’ says Frank, looking back at the ambulance, gauging the distance. ‘Tell us what’s happened?’
 Eventually she looks at us again.
‘Peter came back a couple of days ago. Well – he had to, you see. A condition of his bail. So he’s been staying with us because he doesn’t have anywhere else to go. But I’m not well, nor his father. We can’t cope. He’s been drinking the whole time. Sleeping on the floor. Carrying on. We had the ambulance out yesterday. They took him to hospital but all they did was put him on a drip or something and then send him straight back. But we just can’t cope. I don’t know what to do.’
‘And it’s Peter we’ve come to see?’
She nods.
‘He’s on the floor again. Eric can’t get him up, not with his back. Do something, would you? It can’t go on like this.’
‘Let’s go in and say hello,’ says Frank.

 Eric waves as we go into the kitchen. By his feet is his son, Peter, a fifty year old man with a face as rough as a pumice stone. He is on his knees on the lino, sipping from a highball glass of vodka.
‘Thank you,’ I say, taking it from him. His head wobbles as he tries to follow me with his eyes.
‘Here… I need that…’
‘Maybe, but it just seems a little too ironic to be called here because of alcohol and watch you carry on drinking. Doesn’t it?’
He shrugs and reaches out his hand to me as if the shrug was all he needed to win the argument.
‘Just a minute,’ I say.
‘Sorry about this,’ says Eric. ‘We didn’t know what to do.’

 Peter hasn’t fallen or hurt himself. We check him over and apart from a little raised blood pressure – not as much as you’d have thought, given his history – he’s fine. Drunk, but fine. We help him onto the sofa. His legs bounce up and down as he folds his arms to see what we’ll do next.
‘Let’s have a chat in the other room,’ I say to the parents.
 ‘He needs to go on some kind of detox programme,’ says Eric quietly. ‘He’s killing himself.’
‘I think you’re right about the detox, but hospital isn’t the place to do it. He needs to be sober, for one thing. They’ll just keep an eye on him and then send him back – here, probably, if you don’t refuse him.’
‘But we can’t cope.’
‘If you want him out and he refuses to go, you can always call the police.’
His mum uses the handkerchief again.
‘We couldn’t do that,’ says Eric.
‘I know it’s hard. But something’s got to give. And if it takes some police involvement to shake him up a bit, maybe that’s not such a bad thing.’
‘He’s had enough of that already.’
‘He’s got to get on top of the drinking, though, Eric. It’s not helping anyone.’
Frank has been writing out the paperwork. He gives me the board to finish off.
‘If Pete’s out of area at the moment, maybe he could see your GP in the morning? What do you think?’
‘It’s worth a shot,’ says Eric. ‘Otherwise I just don’t know.’
‘Don’t forget – if he gets difficult, if you feel threatened in any way, or you really just can’t think what to do next, call the police. Unless he’s unconscious or having a fit or fallen over and hurt himself or something, it’s not really our domain.’
‘Right. Yes. I will do. Thanks.’
He signs the form.
 We leave.
 They watch at the door as we reverse out of the close, practically a handbrake turn.
‘Seatbelt,’ says Frank. ‘Parachute. Gum. Let’s go.’

Thursday, April 19, 2012

raphael

The art deco block sits back from the street behind a pair of substantial iron gates. Rae gets out and rings a number on the entry panel. Eventually the gates swing in. We park up, grab the bags we’ll need and go to the main entrance. There’s no-one there to meet us, so we ring again.
A hesitant voice, sobbing in the background: Yes?
‘Ambulance.’
‘Oh. Yes.’
The door buzzes.
We go through into a wide, bright hallway. Even though the building was converted into flats years ago, the black mosaic floor tiles still reflect the crystal chandelier that hangs from the domed ceiling four storeys above our heads.
A door opens across the hall and a young man waves.
‘Please. Here.’
He goes back inside.

The flat has the conspicuous untidiness of a hotel room, with laptops and keys and fast food cartons on the circular table by the window, and a stack of coats draped over the back of the sofa.
There are two twenty-year-old women sitting at the table, crying and tearing kitchen towel from a roll.
Another, slightly older woman lies unconscious on the sofa.
‘So who’ve we got here then?’ says Rae, leaning over her and taking her hand.
The girls reach out to hold onto each other.
The man says: ‘Repeat, please?’
All the people in the flat are foreign students. The man is the only one who speaks English at all, so we direct our questions to him. It soon becomes apparent that he doesn’t know the patient himself – she’s a friend of his girlfriend, Teresa, staying with them for a few days after splitting up with her partner. But when he relays our questions to Teresa, she’s either too upset or actually not so close to the woman that she can give us much.
‘She is called Luisa,’ he says, flicking the hair out of his eyes and leaning forwards. ‘Teresa say she think she have the low eh-sugar.’
I test her blood. Normal.
The wailing from the two girls increases every time we do any procedure, even innocuous things, like putting on a stethoscope and listening to Luisa’s breathing.
‘What exactly happened with her?’ asks Rae. ‘How did she end up on the sofa like this?’
Raphael spreads his hands wide and shakes his head.
‘She sleepy and very, very sad. She sleep it out for a while before and after we come. I think maybe it is her eh-sugars, yes?’
‘No. But something’s happened. Has she taken any pills you know of?’
Raphael speaks quickly to his girlfriend; still crying, she runs into the bathroom and comes back with a plastic sandwich bag half-filled with yellow and white tablets.
‘She have from Sao Paulo,’ says Raphael. ‘I don’t know for what they are. Teresa say is possible for the heart?’
‘We’ll take them,’ says Rae. ‘And I think we’ll have that chair now, Spence.’
I go back out for it, using my rolled-up gloves to keep the door from closing shut behind me.

When I set it up ready for the transfer from the sofa, Rae goes over the obs she’s made. Everything appears normal, but Luisa’s still flat. Her eyes are half-open, but her pupils scan backwards and forwards like a robot shorting out.
‘I’d put money on an overdose,’ says Rae. ‘Let’s get her out.’
The girls are standing by the window, arms around each other and crying as we strap Luisa onto our chair and manoeuvre her towards the flat door. Raphael hovers around us ineffectively, and has to be guided firmly to open doors, carry bags and so on. Still, he follows us out to the ambulance. I send him back to see if Teresa can find out Luisa’s date of birth at least. Whilst he’s gone and we’re about to transfer Luisa to the trolley, she becomes rigid and starts shaking. Blood jumps and bubbles out of her mouth as she clamps down on her tongue. We keep her positioned so she doesn’t choke, and help her ride out the fit in the chair. It passes quickly; we lift her onto the trolley, clean her face and as Rae preps her for the journey and subsequent fits, I meet Raphael at the door.
‘Teresa thinks Luisa has maybe twenty and four years,’ he says. ‘I’m sorry we don’t know the dates or where she lives, but she make study in London. Her boyfriend also. But she – erm – she came stay for few days because they finish boyfriend girlfriend no more. How is she?’
‘She’s just had a fit. My guess would be she’s taken an overdose of something, but that’s just a guess. We’ve got to get going now, Raphael.’
‘May I come too? Erm – Teresa she ask me to keep with phone and to give people informations at hospital. Is okay?’
‘That’s good of you, thanks.’
‘Okay. No problem.’
He rides with me up front.
‘If she wake, I can translate for you,’ he says.
‘That’s a help. Thanks.’

At the hospital Raphael waits outside making calls whilst we wheel Luisa through to resus. We give the team what we know; I book her in at reception and go outside to tell Raphael what to expect next.

I hop into the back of the ambulance to start tidying up; whilst I’m in there, I hear one of the receptionists come outside to speak to Raphael.
‘Did you come in with that girl? Luisa, is it?’
He lowers his phone, flicks his hair back and leans in, exactly as he did in the flat.
‘Sorry please?’
‘Did you come in with that girl? Only we need her date of birth. Her date of birth? When she was born?’
‘I’m sorry. That is all I have.’
‘So you can’t even tell me her last name?’
‘No. I’m sorry.’
The receptionist lowers her paperwork.
‘Well, what on earth’s the point of you coming in with her then if you can’t even tell me the basics? I don’t know why you bothered.’
The phone rings in his hand. The receptionist gives an irritated little shake of her papers and turns back inside. He pauses, flicks his hair again, uncertainly, then raises his phone to speak.

I go inside to speak to the receptionist.

‘You shouldn’t be so hard on him, you know. He’s only trying to help. He can relay information to us if his friends find anything out, and he’ll be there to translate if she comes round. All that for someone he’s never met before.’
‘Hm,’ says the receptionist. ‘Well. Hm.’

Sunday, April 15, 2012

elvis

Malcolm meets us at the door. A short, perfectly round man in white windcheater and brown slacks, it’s like being met by a giant Christmas pudding.
‘She’s in the sitting room,’ he wheezes, struggling to make himself heard over the homicidal barking of a dog locked away in the kitchen. ‘Poor sow. Probably wants shooting, but you’re the experts.’
He shows us in to his wife Pamela, sitting in an armchair, blood trickling from a gash on the bridge of her nose. She holds her left hand out to the side; the other tragically grips on to a handkerchief whilst her head rests back on a cushion.
‘Oh dear. What’s happened to you, then, Pamela?’ says Frank, walking over.
The dog redoubles its efforts to reach us through the kitchen door, which bows and shudders under the impacts.
‘Elvis! No!’ shouts the man. There is a brief pause. Malcolm smiles and licks his lips. The dog click-clicks away from the door, but then there are dragging sounds, as if it’s coming back with heavy equipment.
‘I fell over, that’s what happened to me,’ says Pamela. ‘Ooh – I’ve never known pain like it.’
‘How come you fell over, Pamela?’
‘I don’t know. I just fell over. I didn’t do it for a laugh, you know.’
‘No – no, I don’t suppose you did. But we need to figure out why you fell. Did you trip? Did you feel dizzy?’
‘I told you. I fell over! I went down, there, in the hall. And I banged my head on the floor and everything.’
‘Were you knocked unconscious?’
‘No – I wasn’t knocked unconscious. I fell over, I banged my head and I cut my nose. It’s bleeding. Can’t you see?’
‘I can see. So it was a trip, then?’
‘Yes. I went dizzy and fell over.’
‘So it was a dizzy spell. And apart from your nose, do you have any other injuries?’
‘What d’you mean, other injuries? I cut my nose. Isn’t that enough?’
‘Yep. We’ll get to the nose in a second. But have you hurt yourself anywhere else? What about if I touch your neck here...’
‘Ow!’
‘And here?’
‘Ow!’
‘So all round that area, then?’
‘And my knee. And my back. And I can hardly move my hand at all.’
‘Do you have any health problems?’
‘Yes. I hurt my hand.’
‘When?’
‘Just now, when I fell over.’
‘No. I mean – do you have any health problems from before the fall? Do you suffer with anything? Heart problems, breathing problems, that kind of thing?’
‘Angina. ‘
‘Okay. I think what we need to do, Pamela, is get you out to the ambulance, clean you up and do some checks, then see what’s best to do after that. Is that all right?’
The dog now appears to be tunnelling his way through the floor.
‘He sounds fun,’ I say to Malcolm. ‘Whatever sort of dog is that, then? Ridgeback?’
‘Elvis? He’s a Bichon Frizz. But you wouldn’t want to get on the wrong side of him.’

Friday, April 13, 2012

identical

Olive answers the door at last, the phone still in her hand.
‘We didn’t think you’d be that quick,’ she says. ‘Come in, boys. Come in.’
She shows us through into the lounge where her ninety-five-year-old identical twin sister Oona is stuck in the chair.
‘I just can’t seem to make it out,’ she says, puffing out her cheeks and scuffing her bandaged legs backwards and forwards. ‘I’ve been trying and trying but I’ve run out of oomph.’
‘Do you have any pain anywhere?’
‘What’dya say?’
‘We’re a bit deaf,’ says Olive.
I lean in and speak more loudly.
‘Do you have any pain, Oona?’
‘Pain? No – no pain. Thank the lord.’
‘Good. Excellent. Have you had trouble like this before?’
‘No – we’re pretty good on the whole.’
‘I mean you, Oona. Have you had trouble getting out of the chair before?’
‘We’re ninety-five,’ she says. ‘What do you think of that?’
‘That’s amazing. I tell you what, Oona. Let’s quickly check you over and see what’s what. Are you desperate for the loo or anything?’
‘I am pretty desperate, yes. That’s why we thought we’d better ring.’
‘Well I’m glad you did. Let me just do this then we’ll get you straight to the bathroom.’
Oona’s problem turns out to be more basic physics than anything else; the soles on her slippers don’t have enough grip, and the armchair is a little too low.
‘I was standing behind holding it still whilst she tried to get up but it wasn’t any good,’ says Olive. ‘I almost went over myself. Sorry to drag you out.’
‘It’s no bother.’
We help Oona out of the chair. Once she has a firm grasp of her trolley, she hurries off in a trunk-legged waddle out of the lounge towards the bathroom with me and Frank either side. Olive helps her settle on the loo, and we tactfully withdraw to the sitting room.

The main wall is covered with a dozen or so family portraits. There is an oval Edwardian print of the mother and father, staring back at the camera with a high-collared, straight-backed expression. The others are mostly of the twins on display in various situations, from their first appearance in prams, to little girls of increasing height standing by a garden wall, in front of an ocean, at a fairground, but always dressed identically, their hair worn the same – more like topiary than hairdressing, a spongy mass of dark curls cut into two circular bunches over each ear like the hat on a Mouseketeer. Even in the recent photos, in increasingly vivid colour, and with more and more people around them, the twins stay side by side at the shoulder, the height decreasing, and the hips spreading, the hair flattening and greying, but the expression essentially the same – sparkling eyes, and a warm and confederate grin.
‘Do you like our rogues gallery?’ says Olive, leading her sister back into the room. ‘You know, our father was a lovely man, but I’m not sure he ever really got over it when we were born. Did he, Oona?’
‘No. He wanted a boy and look what came out instead.’
Olive helps her sister back towards the chair.
‘Maybe I’d better put an extra cushion on it first,’ says Frank.
‘Maybe you could move in,’ says Oona.
After a wicked pause, they both laugh; the sound is exactly the same.

Wednesday, April 11, 2012

the power of mime

A middle-aged figure in denim opens the door to us. There is a rough, buzz-cut angularity to him, as if someone tried to fashion a man out of a block of wood with a chain saw.
‘Shall we have a chat inside for a moment?’ I ask him.
‘Well I’m out now,’ he says. ‘But I’ll sit on the steps if you like.’ He gingerly lowers himself down onto the mosaic tiles. ‘I might not get up again, though. Oof. I want a piss so bad my teeth are floating.’
‘So what’s been happening, Mr Coates.’
He unsnaps the top button of his jeans and shifts uncomfortably.
‘I’ve been passing blood in my piss,’ he says. ‘It’s happened before. Always after sex.’
‘Is your doctor aware?’
‘Oh, yeah. I told her about it four years ago. I’ve had all the tests and dips and whatnot and she’s still not sure. I think I know, though. I had this hernia repair a while ago and I think there’s scar tissue inside. I think when I have rough sex...’ he rocks backwards and forwards on the step with his right arm out in front, a goaty-little mime, something like a galloping jockey, ‘... and all that banging away shakes down a clot or two. And they come out in my piss.’
Frank leans against the balustrade, folds his arms and looks off across the green. With the late afternoon light falling across him like this, he’s the very model of civic forbearance.
‘So why’ve you called us now, Mr Coates?’
‘I can’t piss. I went in the early hours, but only a dribble. And now I’m totally blocked. I think a really big clot must’ve come down and blocked off my pipe.’
Frank looks at me and smiles.
Mr Coates carries on.
‘Not surprised though. I hadn’t had a shag since Christmas and I think I overdid it last night. You know...’
He performs his mime again.
People hurry past in the street.
‘I shouldn’t do that,’ says Mr Coates, grimacing. ‘I might explode. But you get the picture. The other thing I should tell you is if I don’t eat every four hours I can go off.’
‘What do you mean, “go off”? Are you diabetic?’
‘No. Just a high metabolism. But if I don’t have anything to eat I’m liable to collapse.’
‘When did you last eat?’
‘Twelve hours ago.’
‘And why was that?’
The man snorts.
Frank shakes his head.
‘Well,’ says Mr Coates. ‘I had more important things on my mind, didn’t I?’
And he illustrates quite succinctly what they were.

Tuesday, April 03, 2012

mr cooper II

The door to the kitchen opens and two people hurry in. They are both so wiry and active they could have just blundered off-course in an orienteering race. The man has a bristle-top of grey black hair, the leathery skin of his face marked out in lines and folds that radiate direction; his wife, exactly the same except for a block of ice-white hair and discrete, rectangular glasses. They are both dressed in combat jerseys, olive green slacks and mountain-grade trainers. They split when they come in the door, Mr Cooper to his son on the floor, Mrs Cooper to secure the strategically higher ground of the kitchen table.
‘Hello,’ says Mr Cooper to us. ‘Lads,’ to the others. ‘What’s been happening?’
He kneels beside his son, putting a hand lightly on Justin’s shoulder. There is a directness to his touch and to the way that he leans in – the kind of super-sensate economy of movement you might see in a tracker.
‘Justin?’ he says to his son. Moves the hair from his face, then stands up and addresses Frank.
‘What’s the situation here?’ he says.
‘Justin had a bit too much to drink tonight. The guys did their best but called us because they were worried. We’ve checked Justin over and we’re not overly concerned. We’re more than happy to take him to hospital for observation if you’d prefer, but we’d also be happy if you decided to look after him yourself.’
‘I see. Thank you.’
One of the table two chips in.
‘It wasn’t our fault, Mr Cooper. We were just...’
Mrs Cooper holds out her hand.
‘Just a minute, James. We’re talking to the paramedic.’
She doesn’t raise her voice or even look at him particularly, but the effect is the same as if she had picked him up by the scruff of the neck and popped him in a cardboard box.
‘Sorry,’ he says, hiding behind his coffee cup.
‘Right,’ says Mr Cooper, addressing Frank again. ‘That’s good of you. Thank you.’
He turns to the guys on the sofa, who both blanch, trying to blend in with the cushions.
‘Richard. Anthony. Your role in all of this, please?’ he says to them.
‘Erm – seriously, Mr C. We didn’t make him drink all that stuff. He was fine. But then he wasn’t.’
‘He hardly drank anything at all. Honestly, Mr Cooper, it was like - so unusual. That’s why we got worried something might be wrong.’
‘But we took care of him. We lay him on his side like you’re supposed to. We helped him when he was sick. And we cleaned it up when he missed.’
‘I see. Thank you for that.’
Mrs Cooper addresses the second boy at the table.
‘Isaac. When are your parents due back?’
‘Erm – soon. I mean, quite soon. An hour or so? I think.’
‘And what do you think they’ll say when they hear what’s been going on?’
‘I don’t think they’ll be too pleased.’
‘No. I don’t think they’ll be too pleased at all. In fact I’d go as far as to say they’ll be jolly angry.’
‘Yes.’
‘I’m glad you agree.’
Mr Cooper stands in the centre of the kitchen and folds his arms.
‘Thank you so much for coming out to my son,’ he says to me and Frank. ‘It’s good of you.’
The boys in the room all contribute a muted thank you, but with an eye on Mr Cooper to see what he makes of it.
‘We’ll stay here with Justin and make sure he’s all right. We’ll have the place back to normal in no time.’

By the thin set to his mouth and the sudden, appalled silence, I’d put that at five minutes.

Monday, April 02, 2012

mr cooper

Five o’clock in the morning and there are five male students in the farmhouse kitchen – two on the sofa, one either side of the old pine table, and one on the floor, propped on his side with pillows and duvets, a saucepan and some tissues by his head.
Frank asks them how much Justin has had to drink. They all chip in.
‘I don’t know. You don’t really keep track of what other people drink, do you?’
‘Ball park? Embarrassingly little.’
‘Some beer. Wine.’
‘Spirits. Eighty per cent spirits.’
‘What? Eighty per cent proof?’
‘No! Eighty per cent of what he had to drink was spirits. The actual measures ¬¬- well, I wouldn’t have thought they were big enough to account for this horror-show.’
‘We’ve been trying to sober him up for a couple of hours now, but nothing seemed to work. We thought maybe he might choke or something so we called you guys. I hope you don’t mind. I expect you get a lot of this sort of thing, do you?’
The four of them are a pleasant mixture of bored and entertained, poised on a yawn between the Adventure of Justin and the Ambulance, and the prospect of both sets of parents finding out – the ones that own the farmhouse, and Justin’s family.
‘My mum and dad are due to land in a couple of hours. They’ll be here by seven.’
We all check the antique station clock above the fireplace.
‘I phoned Justin’s dad. I told him Justin was unconscious. He told me to call the ambulance and he’d come right over.’
But Justin isn’t unconscious. He’s not even close, batting Frank’s hand away and then rolling himself up more securely in the duvet.
‘We tried feeding him coffee,’ says another friend.
‘We were at our wit’s end.’
‘God knows what Mr Cooper will do when he gets here.’
‘Shoot us, probably.’
‘No. God. Seriously. Like he’d seriously do that.’
‘I’m not even kidding. He’s going to absolutely murder us.’
‘My arse is grass.’
‘He’ll blame us for everything.’
‘No – he’ll blame me for everything. He always does.’
‘He’ll say we made him do it. He won’t care that we’ve been practically like a nanny to him since.’
‘I just don’t understand it.’
‘He didn’t have any more than us. And we’re all sober as judges.’
‘Or magistrates.’
‘Oh my god we are so dead.’
If it wasn’t for the body on the stone flags, you’d think you’d stepped into a glossy feature in a society magazine – four young gentlemen up past dawn, sponsored by Jack Wills.
Frank quickly checks Justin over and everything’s fine.
‘How soon before Mr Cooper gets here?’ he asks.
‘Not long. Any minute now I should think.’
‘I don’t think we’ll be taking Justin to hospital. But we’ll wait for Mr Cooper to arrive, explain the situation and discuss with him what he’d like to be done.’
‘Dispose of the corpse,’ says one.
‘Whose – his or ours?’
‘Don’t even joke about it. Seriously. I’ve seen what Old Man Cooper is capable of.’
‘He’s a legend.’
‘Just don’t even think about it.’
‘Why the hell did you even call him?’
‘What should I have done, then?’
Not call him, maybe?’
Frank sighs, takes a seat at the table and begins writing up his report.
‘Don’t worry,’ he says. ‘You were concerned about your friend. That’s good enough for me, and I’m certain it’ll be good enough for Mr Cooper.’
Justin starts to snore – not the seriously obstructed kind, but the contented nasal song of the casual drunk.
‘He sings in the choir, you know,’ says one of the guys on the sofa. ‘No seriously, he really does.’
‘Tenor or baritone?’
We all listen to the snoring.
‘Baritone.’
Suddenly a car’s lights swing past the kitchen window. There’s a shocked pause, the slamming of a car door, heavy footsteps on gravel heading our way.
The two guys at the kitchen table put down their coffee mugs; the two on the sofa shrink about an inch.