typecast

Mrs Wilson is sitting on a Windsor chair in her kitchen, thoroughly and generously settled in a voluminous rose patterned skirt and a hand-knitted lime-green cardigan. Her arthritic hands rest on the handle of a bamboo walking stick she has planted defensively between her legs, the knees of which are as lumpen and bent out of shape as two great plaited loaves.

‘Oh here they are, the Seventh Cavalry,’ she says, rapping the stick twice on the floor, counting us in. ‘I said it was you and I wasn’t wrong was I, Cheryl? I said it’d be the ambulance. My goodness you were quick, though. I haven’t had time to get a thing ready. Not that there’s much to get ready. Is there, Cheryl? Cheryl’s very good, you know. I don’t know what I’d do without her. Well, I know exactly what I’d do without her. The answer is – Not Very Much. Look. She’s packing my bag. I make it a point never to go anywhere without a good book and some glasses to read them with. You can improvise the rest. What time is it? I seem to have been sitting here for approximately one thousand years.’

Cheryl smiles quietly, drifting around the margins of the room like a breed of domestic ghost. The objects she picks up seem to float in mid-air as she approaches, before silently disappearing into a cat-motif shopping bag.

‘Both pairs please, Cheryl,’ says Mrs Wilson. ‘One for reading, one for looking out on the world.’

Mrs Wilson’s silver hair gleams in the fall of light from a standard lamp. It’s like the hairdresser’s equivalent of a sampler – twists, braids, half a bun and a French plait, all in hair so fine it could be raw silk.

‘I like to talk so put your ear plugs in. And then of course when I’m anxious I talk even more. Cheryl will tell you. It’s this wretched knee, you see. Gave out on me when I got back from the club. I went down like the Titanic and was still crawling in to the kitchen to get to the blaming phone when Cheryl came by for her regular visit and came to my rescue. I’ve had enough, I really have. Just take me out and shoot me. I don’t mind. I’m a horse whose race has run.’

Cheryl appears at her shoulder and gives her a reassuring pat. Mrs Wilson lays her hand on top of Cheryl’s, and the moment passes.

‘Like I say, I love to chat. It’s just my nature. I was fifty years on the stage you know. Local Am Dram. They used to cast me as the maid or the woman in the shop, the comedy headmistress, that kind of thing. I absolutely loved it. Gave me a chance to show off a bit. Do you know what my favourite role was? Madame Arcati. Have you heard of her? Blythe Spirit? The Margaret Rutherford role? Absolutely loved it. Thirty years I was with that company. I’d be there now if it wasn’t for these blessed knees. I had a lovely job as a secretary in a solicitor’s office. So if you ever need your will doing, just give me a call. The thing was, though, they moved to these premises more in the centre of town, a lovely old building, but on the first floor, and really, getting up those stairs was like climbing the Matterhorn, and in the end I just couldn’t manage. So they let me go. It was a damned shame, because I loved that job – the shorthand, the typing, you know. Answering the phone. Chatting to people.’

Cheryl puts the cat bag by Mrs Wilson’s feet, and waits. 

caught

The response car is parked round the back of the block, its engine quietly running, its scene light illuminating the side of the building in a vivid splash of white. We go in through a service door into a cool, bare stairwell. We walk up one flight. On that landing, a door stands open.

‘Hello?’

Stan is lying on his back on the floor of the bedroom. Rae is standing over him.

‘Thanks for coming,’ she says. ‘I’ve been out to Stan a couple of times before. He has trouble with mobility, and sometimes he just misjudges sitting down or whatever and ends up on the floor. Tonight he was heading for the commode when he crash landed. Unfortunately that’s not the only thing he misjudged – so we’ll need to clean him up before we put him back to bed. If that’s okay.’

Stan tries to talk, but it’s almost impossible to make out what he’s saying because he hasn’t got his teeth in, and he’s so dry it makes his tongue seem two sizes too big for his mouth.

‘Don’t worry about it, Stan. Honestly. You’d do the same for us if the situation were reversed, I’m sure,’ says Rae. And then to us: ‘I’ve already got a bowl of sudsy water and a flannel, Spence. If we get him up, are you okay to take care of business?’

‘Yep.’

We help Stan to his feet. His legs are extraordinary, fashioned out of creamy-white driftwood. Whilst Frank and Rae support him between them, I set to with the bowl and flannel. Stan is smeared with fudgy brown excrement from the small of his back down into his withered buttocks. I put a towel over the stains and deposits on the carpet beneath him, then start to wash him down. His legs are so bandy his testicles are easily accessible. I feel like an agricultural worker tending to a bull, dabbing at the pendant scrotum with my flannel.

‘Done,’ I say, dropping the flannel into the bowl again.

We locate a pair of pants and put them on him, then whilst Frank and Rae shuffle him over to the bed, I take the bowl away to empty it in the loo and find some cleaning materials for the carpet.

In the hall there’s a photo of Stan holding an enormous fish. It’s early in the morning – or late at night – and the flash of the camera gives the portrait a hectic, hyper-coloured quality. It flares off the steel frames of Stan’s glasses and the flat black eye of the fish. Stan smiles exultantly into the lens; the belly of the fish sags between his hands.

Back in the bedroom, Stan is neatly propped up, tucked in, sipping from a non-spill beaker. We finish cleaning and tidying. Rae is going to stay and finish off the paperwork, so we leave her to it.

*

Outside, the night has moved on, settling into that deepest, stillest part before the upward movement towards dawn. A winding band of cloud extends from the horizon over the sea towards land. I watch it for a moment before climbing back into the cab.

on the sofa

A man and a woman are sitting on a yellow sofa facing Agnes, a hyper-inflated, twenty-four stone woman sweating quietly in a vast, raspberry coloured dressing-gown.  The woman has a folder resting in her lap, the man has his legs crossed and his hands laced around one knee; both have a glossy aura of control around them. In fact, they are so measured, from the encouraging tilt of their heads and their warm, empathetic smiles, I wouldn’t be surprised to see a camera moving in from the edge of the carpet and a floor manager in headphones urgently pointing at the woman with a pen.

‘Hi Guys!’ the woman says. ‘I’m Amanda, this is Paul…’

‘…Hi…Hi…’

‘Thank you so much for coming.’

‘Really appreciate it,’ says Paul. ‘Good to have you here.’

‘So let me fill you in,’ says Amanda, lacing her fingers together and placing her hands neatly in her lap. ‘We work for the Crisis Outreach Team.’

Paul nods, smiles, discretely checks his watch.

‘We had an appointment to come out to see Agnes today as part of our continuing package of home support – didn’t we, Agnes?’

Agnes nods.’

‘We already knew that Agnes had been up to A and E this morning with a stomach complaint, but the doctors were happy for her to come home with some paracetamol for pain relief. Unfortunately Agnes had a bit of an episode in the early afternoon – isn’t that right, Agnes?’

She nods.

‘To the extent that she decided to take her own life by swallowing all the paracetamol. About forty, all told. Is that fair, Agnes?’

She nods.

‘Of course as soon as we found out what had happened, we all had a chat about it and decided the best thing to do would be to call you guys – the experts – and see what you had to say about it. And here we all are!’

Amanda finishes brightly, rattling her nails on the folder cover as if she couldn’t wait to open it up and share some delicious recipe.

 ‘Do you mind if I sit down?’ I say to Agnes.

She nods.

Amanda and Paul budge up; Amanda pats the cushion next to her. I sit down.

‘Agnes?’

She looks at me.

‘How are you feeling?’

She shrugs.

‘Felt sick? Been sick?’

She shakes her head.

‘The thing is, Agnes, that’s a pretty dangerous dose of paracetamol, as I’m sure you’re aware. We need to get you down the hospital so the doctors can treat you for it. I know it’s a nuisance – given that you were only down there this morning. But it’s just one of those things. How would you feel about coming with us to the hospital?’

She purses her lips and closes her eyes.

‘If I have to go, I have to go,’ she says.

‘Excellent!’ says Amanda.

‘Good. Good,’ says Paul. He leans forwards and looks at me. ‘Good,’ he says again.

‘Okay. So. Do you have everything you need? Phone, keys, slippers?’

She nods.

‘And how would you feel about walking out? Nice and slow – and if anything changes and you feel a bit faint we’ll reconsider our options. But for now – a short stroll out to the vehicle? What do you say?’

Agnes begins rocking backwards and forwards to build enough momentum to break free of her chair. When she stands up, her dressing-gown hangs like a circus tent from the dropping-off point of her chest.

 We stand up, too.

‘Well that’s great!’ says Amanda. ‘I’m glad!’

It’s all so measured and pleasant I half expect the phantom floor manager to gesture with his pen again – And we’re OUT!. Congrats all round. Don’t forget to leave your mikes. Debrief upstairs in five.

Amanda throws her folder behind her on the yellow sofa. It opens to reveal empty pages. Paul rips his earphones out and loosens his tie. ‘I swear if I have to do another overdose…’ ‘Did you hear from your agent yet?’… ‘Where’s my double espresso? Don’t make me ask twice.’

Agnes waits by the door.

coming soon!

A little pre-publicity for the ebook of the blog!

I’ve been working on it for a few months now, and it should be formatted  and published by mid-June, available to download onto Kindle &c from Amazon and maybe some other sites. Priced no more than £1.99, probably less.

I’ve taken a range of blog posts from over the years, edited them to sharpen the writing, then arranged them into chapters reflecting different themes – all within the context of me, Spence, starting work in the ambulance service under the guidance of Frank, a paramedic coming up to retirement.

I’ve written extra material to give more personal context, hopefully building into a more complete picture of what it’s like to work on a front-line, UK ambulance.

If you have any questions, I’d love to hear them. I’ll always answer as honestly as I can, as you know.

With thanks for all your support and encouragement over the past few years

SK

scandal

Eleanor sits in the chair with her head resting back on the cushion, her hands lightly clasping the arm rests. The nurse stands beside her with an open folder, and gives us the low-down.

‘Good morning, gentlemen. This is Eleanor. Eleanor is ninety-five. Eleanor has been with us for rehab and physio since two weeks post mechanical fall one month query fractured pubic rami. Formerly of reasonable health other than an arthritic left shoulder replaced two thousand four, hysterectomy post CA bowel resolved ten years approximately, nothing much else. Independent living, good mobility up until the accident, can weight bear now using the gutter frame here. Unfortunately Eleanor has developed a lower respiratory tract infection seven days, increasing haemoptysis for three, not responding all that well to oral antibiotics. The GP came out and said he wanted her back in the hospital for further review.’

She closes the file, leans in and rests a hand on Eleanor’s shoulder. She opens her eyes.

‘Eleanor, love. These gentlemen have come to take you back to the hospital. Okay?’

The nurse smiles and straightens again.

‘Shall we fetch the trolley in? Plenty of room.’

*

Mid-morning and the clouds have finally cleared. The sunshine has freshened everything, drawing crowds out along the front, the outline and colour of everything suddenly distinct, from the sharp white seagulls turning overhead to the deepening blue of the sea.

‘It’s a shame we don’t have better windows,’ I say to Eleanor, opening the blinds as best I can as we ride along in the ambulance. ‘It’s a beautiful day.’

‘Yes. I thought it might be,’ she says. ‘One can taste it.’

She is in the same position on the trolley that she was in on the nursing home chair, her head resting back and her hands holding on to the rails. But every now and again she lifts her head and turns her face slightly left and right without opening her eyes, as if she was sensing some change in the air, like a hyper-sensitive creature responding to tiny movements or sounds.

‘Are we there yet?’

‘No. About another ten minutes or so, I should think. The sun’s brought the traffic out as well.’

‘Has it? Yes. I expect it has.’

She relaxes again.

‘Have you always lived here?’ I ask her.

‘Me? Goodness, no. I was born in London, but then I moved to South Africa with my husband. My second husband, I should say. Around nineteen forty-nine. That caused quite a shock.’

‘Why? What happened?’

‘Well, I had a cloistered kind of childhood, you know? Quite limiting, and so on. My parents were pretty strict about where I went and who I saw. So consequently I had a small circle of friends, and early on they had fixed ideas about who might be suitable for me to marry. An arranged marriage, really. I was young and didn’t know my own mind, you see. One simply finds oneself in these situations and there you are. So I married Peter. He was a charming man, very considerate, but the awful thing was although I liked him and respected him I didn’t love him. Do you see? Hopeless, really. But it wasn’t long after that Geoffrey came over from Rhodesia. He was a businessman, you know? A distant friend of a friend. And he came over to England to watch the West Indies play, for some reason. Anyway, we met at this party, and silly as it sounds – I just knew. One does. One simply does. You meet someone for the first time and there it is, this shock – of recognition, I would say. Here he is, the person I want to spend the rest of my life with. Of course, we didn’t have long. Just a couple of weeks, in fact. The whole family were up in arms about it. My friends – everyone. Outrage. Calamity. The scandal to end all scandals. But when it happens one simply has to act. Anyway, I think it would’ve been harder not to do anything than to weather the storm and jolly well get on and be happy. So I ran away with him back to South Africa. A beautiful, beautiful country with a beautiful, beautiful man. We got married when the divorce finally came through, and when Geoffrey died a couple of years ago we’d been together almost seventy years. Seventy years!’

She raises her head and opens her eyes to look at me.

‘When did I get so old?’ she says.

notorious

Vera is eighty two.

At least once a week for the past six years or more, Vera has been calling 999 for an ambulance. And getting one.

I’ve been out to Vera a half dozen times, but even though I know her personal details off by heart, her motivation is still as incomprehensible as the voice she puts on – a febrile twittering, strangely at odds with her appearance, like hearing a bulldog squeak instead of bark.

To say she does it for attention doesn’t seem enough. I think there must be something else she gets from the whole procedure, from the pressing of the three nines to the sound of the diesel truck pulling up below her window; from the sound of the lift arriving on her floor to the ringing of the bell and the clunking and fumbling as the key safe is opened; from the sound of heavy boots walking in to the medical shtick of the cuff, the monitor, the SATS probe, the thermometer; from the taking of the history to the collecting together of the drugs, the setting up of the carry chair to the three minute ride to hospital, from the wheeling in through the automatic doors to the pat slide onto the bed – something from all that ritual of fuss, something semi-magical, that feeds her ambulance addiction and keeps her coming back for more.

 Vera obviously doesn’t like the hospital side of things, though. She’s barely half an hour on an A and E bed before she’s bum-shuffling down to the end, hopping off, striding through the department, bad-mouthing the staff as she hurries outside to car-jack a taxi home.

Notorious. Prolific. Loathed or loved, depending on your mood.

It’s not as if I don’t understand the loved aspect. If a crew is dealing with Vera, in her well-kempt flat, they’re temporarily sheltered from the potential horrors of other patients. Vera doesn’t live in a crack house. She’s not drunk and throwing up everywhere. She’s continent, cute, biddable. But just lately I’ve stopped thinking about Vera as a quirky character with lovable ways and started thinking about her as a damned nuisance.

Maybe she’s my bellwether, my emotional compass. Maybe Vera is pointing to the exit. Because now when I read her address on the screen I don’t see a lovable rogue. I see a person who is wasting resources that might be needed for a genuine emergency.

I guess she’s unhappy. I wish I could understand what the problem was so I could help come up with a solution. But probably because there is nothing obviously wrong – her flat is warm and comfortable, the doctors have deemed her mentally competent, her health is reasonable and well-provided for, materially she has everything you could want – because it’s difficult to identify the problem, it’s difficult to come up with a solution. And anyway, there isn’t a procedure for dealing with nuisance callers. They’re treated exactly the same as someone ringing for the first time, which flies in the face of common sense, but stands nonetheless. All in all it amounts to an endless procession of ambulances to this address.

Tonight when I step out of the truck I feel as if a valve has been loosened in my heel and all my patience has run out over the road.

‘I don’t think I can do this any more,’ I say to Frank as we walk up to the main entrance.

‘Yes you can.’

‘No I can’t.’

‘Yes you can. Look. Someone told me this technique for dealing with stuff you find difficult.’

‘I can’t wait.’

‘No. Come on. Listen. What you do – you think about someone you admire already, someone you think of as really cool and competent. Okay? Picture them strongly in your mind. Got it? Now – all you do is, you imagine what they would do if they were here, and you do the same.’

‘Right.’

I tap in the code. We let ourselves into the building. Up in the lift, to the front door, to the key safe.

And into the flat.

Vera is in the living room, artfully placed in front of her armchair, kneeling on one leg, squeaking that her legs have given way.

We help her back into the chair, then I drop myself onto the sofa and throw the board aside.

‘You can’t keep doing this, Vera.’

‘What?’

‘You can’t keep calling the ambulance out.’

‘I’m sick. My legs have gone.’

‘No they haven’t.’

‘They have.’

‘I’m not taking you to hospital, Vera.’

She stares at me.

‘I’ll put in a complaint against you,’ she says.

‘I don’t care. I’ll be in good company.’

‘My legs have gone. I’ve got pain all over. My chest hurts.’

‘No it doesn’t, Vera.’

‘How would you know?’

‘Vera. I want you to be happy and well, I really do. But this can’t go on, can it?’

‘What?’

I get out my phone.

‘What are you doing?’ she says.

‘I’m phoning Control. I’m going to speak to an officer.’

‘I will complain,’ she says. ‘You have to help me.’

Frank sits down on another chair, folds his arms and nods pleasantly.

‘Just a minute whilst we find out what’s happening,’ he says.

When I eventually get through to the Duty Manager he asks me how I’m doing.

‘Not well,’ I say. ‘Not well at all. I’m with Vera.’

‘Yes. I saw.’

‘I hardly know what to say.’

‘It’s difficult.’

‘Seriously. I don’t know what to say. I haven’t the words. I think I’m losing my mind. I simply don’t understand why something isn’t done. I don’t understand why we keep sending ambulances.’

‘Yes, yes. I know what you mean. But we have to be sure everything’s okay, because one day she might really be unwell.’

‘So on that basis I could call the Fire Brigade every day from now until I’m ninety, and they’d be happy to attend because one day there might be a fire.’

‘It’s not like the fire brigade.’

‘Why?’

‘It’s just not that simple.’

‘And whilst we’re tied up here we’re not available to help someone who might really need us.’

‘I hear what you’re saying, Spence. And I sympathise. But our hands are tied. Look. I’ll tell you what. Check Vera over. If she seems okay, don’t take her to hospital. If she calls again, we’ll tell her she’s had her attendance today and she won’t be getting anyone else.’

‘That’s something at least.’

‘All right?’

‘Good.’

‘When you get back to base – if you get back to base – put all this in writing and send it to the COM. It’ll all build into a case of sorts, and then maybe something’ll get done.’

‘I’ll do that.’

Vera is frowning at me as I hang up.

‘What’d they say?’ she says.

I open my bag.

‘Vera? I’m giving you a quick check-up, then we’re leaving.’

‘I want to go to hospital.’

‘I don’t think you need to.’

‘But I want to.’

Her obs are fine.

She squeaks as we close the door.

By the time we’re back in the truck, the radio sounds.

‘Guess who’s on the phone?’ says the Dispatcher. ‘But don’t worry. We’ve put her through to the clinical desk.’

‘Finally.’

An hour later we’re at the hospital, handing over our latest patient.

‘Vera’s been on the phone to Reception and the A&E desk,’ says one of the nurses. ‘She’s wild tonight.’

Back outside, the crew that were here before us clear up and get sent a job immediately.

Vera.

I climb back in the cab, ring Control and ask to speak to the Duty Manager.

‘Hi Spence,’ he says. ‘I bet I know why you’re calling.’

‘It’s just that I notice another crew has gone out to Vera. I thought you said you wouldn’t be sending anyone else tonight?’

‘Well – she kept calling and calling and we kept bouncing her into the long grass. But in the end we thought we’d better send someone just to check nothing’s happened since you were there.’

‘I think we should start sub-contracting these difficult cases out,’ says Frank, passing me a cup of coffee through the window. ‘How far west do you suppose the Mafia reach?’

anywhere but here

Vanessa’s friend Sarah comes out to meet us.

‘Promise me you’ll be discrete.’

‘I promise.’

‘I mean it. You can’t tell a soul. Not anyone – it’s very important. And the other thing is, we can’t possibly go to the local A and E. You have to take her somewhere else. Anywhere but here.’

‘Okay. Shall we go inside and say hello?’

‘She’s a nurse. We’re nurses. There. If they see her being wheeled in she can kiss goodbye to that promotion.’

‘No-one need know.’

‘She wouldn’t have let me call you if she thought you were going to take her there. No way.’

‘Where is she?’

‘She’s had a bad year. Her boyfriend dumped her, restricted practice at work, family things – a holy trinity of shit. So you can’t blame her for hitting the skids. But it’s a blip. It’s not the end of the world. You know what management are like, though.  You can’t trust them to see the big picture. So you’ve got to promise me.’

‘I’m sure we can sort something out. Where are we going?’

Sarah leads us past a giant yucca in the lounge-kitchenette to the closed door of the room out back. She knocks, pauses, pushes it open.

The bedroom is so cluttered we have to pick our way in. Vanessa lies face up on the bed, swaddled in a coverless duvet, surrounded by a scattering of possessions – odd pairs of shoes, empty shoe boxes, clothes, underwear, a Netbook – and, crucially, a bottle of vodka and a few ragged strips of Diazepam. Above everything, the pastel painting of an angel hugging his knees on one wall, a blank TV on the other.

With the amber light filtering through the drapes, it’s like we’ve broken through into a modern version of Tutankhamen’s tomb, except instead of a golden flail she holds a remote control, and instead of a cravat, Frank wears a stethoscope round his neck.

‘Hello Vanessa. How are you feeling?’

Her eyelashes tremble as she struggles to open her eyes against a mess of mascara.

‘Oh Jesus!’ she says when she sees us all standing around her bed. ‘How embarrassing is this?’

theseus and the junkie

The lowest level of the underground car park only has a couple of cars left, huddled up close to the barriers. The rest of the space leads off before us, a strip-lit catacomb, resonantly empty, tiny stalactites of gunge quivering from the joints in the concrete ceiling, dripping into puddles of oily water.

‘We need a ball of string and a sword,’ says Frank, playing his torch ahead. ‘Hello? Ambulance?’

A voice from the other side. ‘Over here mate.’

***

Vince has overdosed on heroin. He lies on his side, taking occasional, deep-brain gasps, the very minimum. His girlfriend Sonia stands over him, swaying from side to side with a beer can in her hand, her long hair hanging down partially obscuring her face. Her words are slurred but she’s still able to tell us what we need to know.

‘Where’s the needle, Sonia?’

‘Don’t worry, mate. I’m good about that shit. I dropped it in the can. Listen.’

She gives it a shake. It rattles.

‘How long’s he been like this?’

‘Twenty minutes or so. I tried pinching him out of it but it didn’t do no good. So then I called you. Sorry. Sorry, mate. It’s a fuss about nothing, I know.’

She kneels down by Vince and shakes him by the shoulder. ‘Vince! Vince, you muppet. You o-deed again. Vince!’

We set him up with an airway and oxygen mask. I support his breathing whilst Frank jabs him in the arm with a shot of Narcan.

‘What’s he like when he comes out of these?’ asks Frank.

She shrugs. ‘All right. He’s all right. I mean to be honest with you he won’t be all that happy about it, but he’s all right. Aren’t you? Hey? Vince?’

After a few minutes Vince starts to show signs of movement. He groans, and finally sits up. I take off the mask as he gags and pulls out the airway. Sonia kneels beside him and hugs his head.

‘Vince, mate. You were so out of it. These guys saved your life, man!’

He curses blindly and pushes her away.

‘I’ll feckin’ do yous’ he says. ‘The feck.’

‘Vince! They saved your life.’

He staggers to his feet, his legs planted more than shoulder width apart, swaying forwards and backwards so violently it’s a miracle he stays upright. ‘The feck are yous,’ he says, drool from his lower lip like one of the stalactites has taken root in his mouth.

‘Vince – ease off, mate. You need to go to hospital so they can keep an eye on you. I think you’ve had some of that strong gear that’s going around.’

Vince takes a swing, but all his movements are so thickened by heroin it’s like he’s fighting underwater. Frank could make a cup of tea in the time he has to side-step the punch; Vince topples forwards onto the concrete again.

‘Vince! What’re you doing, man? They’re here to help you. You were proper out of it.’

But Vince is muttering, grunting like an anaesthetised bull, struggling to get back on his feet to attack us again.

We step aside and try to calm him down from a little way off. He needs to understand that the Narcan will wear off, that he’ll be vulnerable again. Sonia does her best to make him understand but he’s too enraged to listen.

Time passes.

We become distracted by some of the grafitti on the walls this end of the car park. Amongst the tags and crude pictures and phone numbers – a love poem, written in green marker pen, whose closing lines are:

So do me a favour and remember what I said

That girl was everything to me – and she was quality in bed

Sonia comes over.

‘He’s not going,’ she says. ‘But I know what to do. I’ll keep an eye on him.’

‘Are you going to be all right down here?’ I ask her. It’s inconceivable that anyone could spend the night in this place, let alone a young woman on her own.

‘Oh yeah,’ she says. ‘It’s normally just me and the dog.’

shop / drop

Mrs Milgram greets us at the door of the flat with a diffident bob of her shoulders. A tall woman in her late forties, she has the lumpen quality of a giant parsnip, her broad hips tapering down to a pair of tiny feet, her head sprouting with a straggle of wet hair. Her thick glasses water down her eyes, which, along with the puffiness of her face and the droop of her chin, gives her a pale and peculiarly passive expression.

‘Hello. Thanks for coming,’ she whispers. ‘He’s in the living room. I’ll go and finish my hair off if that’s okay.’

She turns and hobbles back into the flat along a narrow corridor, waving us past as she goes into the bathroom. Everything comes off the corridor to the left, except for the living room at the far end. We head that way, squeezing past a clothes horse hung with sagging grey underwear, a cat scratching post, and a stack of lager trays, twenty cans per tray, ten trays tall.

Lennie is crouched at the edge of an L-shaped sofa, his arms folded across his middle. Behind him on a ledge is a crowd of empty lager cans; to his right, with its screen turned discretely away, a laptop. On the other side of the laptop there is a towel draped across the cushion of the sofa; on the other side of the towel is a porn magazine – MILFs and Matures. There are two spangly throws draped across the window on a washing line. The room has the fetid atmosphere of a place that has not seen enough sunlight, or had a window opened in a while, or the litter tray changed frequently enough.

Lennie tells us he’s twenty-five, which is about twenty-five short of what I would’ve guessed. Behind his full beard his face has the waxy yellow tinge of a candle that’s been kept at the back of the cupboard. He is so slight, if it wasn’t for the starch in his clothes he wouldn’t be able to sit up at all.  

‘I haven’t eaten in two weeks,’ he says. ‘I haven’t been outside in five years.’

‘And have you been drinking much?’

‘Twenty cans a day, from when I wake up to when I go to bed.’

‘At the moment, Lennie, your chest is hurting because your heart is running too fast. We need to get you to hospital to have that slowed down. Okay?’

‘Not really.’

‘It’s the only option, mate. If you stay here your heart will become exhausted and eventually pack up. So come on – let’s grab your coat, shoes, phone and be on our way.’

‘Tell mum I need a clean pair of trousers. I’ve messed these.’

‘Fine.’

I unpack the chair and make it ready to carry Lennie out. In the minute it takes for Mrs Milgram to find his clean trousers, Frank says: ‘How do you get all that alcohol if you can’t go out? Presumably your Mum would struggle.’

‘No. It’s easy, really. I just shop online.’

‘Haven’t you seen the advert on the side of the truck, Frank?’ I say, wrapping Lennie in a blanket. ‘You shop, we drop.’

‘Mm,’ says Frank. ‘But not in this case.’

the heebeegeebee range

The night lifted away suddenly, cleanly, without anyone noticing, and now the sky rides above us silver and blue. Outside the station the Born Again Christians have almost finished packing away the trestle tables of their soup and sandwich kitchen; a lorry makes a delivery to the All-Night supermarket, its cages booming off the ramp; a Scarab truck with its slow-flashing orange lamp scavenges litter, and the last of the clubbers stagger home as seagulls shriek and wheel above the road.

An ambulance car is parked by an old railway tenement block. Richard, the paramedic, comes out to tell us what he found.

‘Hi guys. Thanks for stopping by. We got a call from a member of the public who’d found Aimee slumped in the doorway looking distressed. He couldn’t get much sense out of her when he asked if everything was okay, so he called us. I’d put her at GCS fourteen. No sign of trauma or anything amiss in her obs but Aimee must have taken a bath in fairy dust or something guys because her pupils are like dinner plates. She’s off orbiting some alien world, freaking out, yeargh! No idea where she is. Completely suggestible. I asked her if she lived here and she said yes, but no-one knows her of course. No ID. I’d guess she was about twenty or so. Don’t know if I heard her name right, but she seems to respond to it. I think it’s just a case of hospital for safety until she splashes down again. Sorry guys. How’s your night been? Pretty crazy, if it’s anything like mine. I’ll bring her out.’

He goes inside and a moment later re-emerges with Aimee following. With her head down, her long hair hanging over her face, the hospital blanket draped over her shoulders, she could be a hermit being led out of a cave after a twenty-year retreat. Her nose pokes out of the fall of her hair; as she emerges from the gloom of the hallway, she gently hooks the hair away and slowly looks around with an expression of existential terror on her face, a hollow-eyed sadness that things should be as they are. She hesitates, appalled that anyone could expect her to go any further into something so ruined, so terrible.

‘Come on Aimee. Let’s get you in the warm.’

I take her gently by the arm and she drifts along beside me, so lightly I may as well have tied a helium balloon to my elbow, a character shape from the new, grimly-realistic Urban Collection: Bad Tripper, from the Heebeegeebee range.

a big night out

The city changes as the night goes on. The seagulls have the best view, skimming like drones across the upper reaches of the street lights, restlessly scavenging the network. Beneath them, the crowds have thinned along the shopping thoroughfares, clotting and spilling around the usual spots, the late-night bars and clubs. Even as we approach we can see this crowd has an unusual focus, though - a figure lying in the road with an epic triangulation of figures around her, crouching, kneeling, standing with a mobile phone and waving. A guy suddenly wrenches my door open just as I’m hitting the At Scene button.

‘Just slow it down, mate,’ I say to him.

‘She’s fitting.’

‘Let’s have a look.’

But even from here I can tell it’s not an epileptic seizure. There’s an artful focus about the way she flops her arms and legs about, the way she arches and relaxes her spine to bang her head comfortably in the lap of the guy on his knees cradling her. The setting could hardly be more public, and the fact that her skirt and top have ridden up, the way her arms are scuffed and dirtied from the road, all these things give the scene a shocking plausibility.

I’m like a street performer claiming his patch. And if the girl is The patient, I must be The patient whisperer, the figure in green with TV-levels of ability to take control, to sort things out. I’ve played this part before and I know how it goes. I have to get her into the ambulance as soon as possible, with the minimum of fuss. I know that the more direct and authoritative I can be, the more chance I’ll have of success. Conversely, I know that the longer we’re on show like this, the more chance there is the trick will be revealed and the scene become unmanageable.

None of the people with her are related; I identify Isaac as the friend sober enough to help. He stands behind me as I squat down, put one hand at her wrist to feel her pulse and one on her shoulder. She stares up at me, and stops thrashing around to listen for her cue.

‘It’s the ambulance. My name’s Spence. Can I ask what your name is?’

‘Gillian.’

‘Gillian – have you fallen down and hurt yourself?’

She shakes her head.

‘Good. Now. We need to get you on the ambulance where it’s warm and safe. Sit up for me.’

She does.

‘Now bend at the knees – good. That’s it. Hold my arm. And stand.’

She stands.

The crowd parts to give us room as we walk over to the ambulance where Frank waits with the door open and everything ready.

As Frank settles Gillian on the trolley, I tell Isaac to wait outside so we can chat in private. I tell him I’ll be out again in five minutes. He looks crestfallen when I slam the door shut.

***

 Inside, the down-lighters above the trolley are warming and good. Gillian lies covered in a white blanket. She picks strands of hair from her face. Her pupils are saucerous and dark, whilst above her the ECG monitor jumps along at a clip.

‘Have you had any recreational drugs tonight, Gillian? We don’t care – we’re not the police. But we need to know so we can get you the appropriate treatment.’

‘No. Just alcohol.’

It’s hardly worth telling her that a blood test will reveal everything, but I’ll let the nurses at the hospital deal with that.

‘Ever happen to you before?’ I ask, writing down the last of the results Frank calls out.

‘A few. I’ve been for scans and stuff but they still don’t know what causes it.’

‘And how old did you say you were?’

‘Nineteen.’

‘Student?’

She nods. 

‘Psychology. Can Isaac come? I want him with me at the hospital.’

‘Okay. Let’s get him on board.’

***

Isaac seems excited at the prospect of a trip to hospital in an ambulance. He sits forward on his chair, jiggling his legs up and down, his jacket on his lap, mobile phone in one hand, Gillian’s hand in the other.

‘This is wild,’ he says, looking around, his eyes as wide as hers. ‘It’s just like Holby City. How are you feeling, hon?’

She squeezes his hand. ‘Oh – you know.’

‘Who shall I call? Jazzer and Stoofus know already. I’ve told The Arch Meister. Crick says he’ll meet you there later. Ellie says hi.’

Gillian is lit up as much by his attention as by the down-lighters.

‘I’m lucky I’ve got such good friends,’ she says, and smiles at me. ‘God, I need a drink.’

‘You greedy bitch,’ says Isaac, thumbing another text. ‘You nearly died on me and now all you care about is booze. Honestly, girlfriend – you!’

He sends the text then looks at me.

‘How long have you been doing this job, then?’ he says.

‘About seven years.’

‘Like it?’

‘Yeah. It’s interesting.’

‘I bet you see some things.’

‘Oh - you know.’

‘Us for example.’

He laughs, stuffs his phone in his jeans pocket, then holds up the jacket he had on his lap.

‘What do you think of that?’ he says to me.

‘Nice.’

‘I found it. Didn’t cost me a penny. It’s a Ben Sherman.’

‘Excellent.’

‘Do you know, I haven’t actually bought a jacket in years. Every one of the last three have been found. Two by me, one by my sister.’

‘That’s lucky.’

‘That is lucky. Three jackets. And look. Not any old shit.’ He turns the jacket inside out and presses the label towards me. ‘Ben Sherman. That’s quality. Look at the lining. Feel it.’

The ambulance rolls as we turn up the hospital slope.

‘We’re here,’ I say.

Isaac puts the jacket on.

‘Come on, girlfriend,’ he says, standing up and slapping her leg through the blanket. ‘Not the big night out I was hoping for, but whatever.’

hyena tale

Miriam, Jennifer’s carer, periodically widens her eyes to emphasise each dramatic point, like a car going from dip to full beam and back again. A short, dark-haired woman, she is economical with her movements. Once she’s done exactly what she needs to do to help us make Jennifer comfortable on the ambulance trolley, she settles herself into her own chair with a minimal wiggle, clutching Jennifer’s bag of clothes and meds securely on her lap.

‘This is my second home now,’ she says as we move off towards the hospital. ‘I’ve only been here five years but I love it. The freedom! You can step outside your front door without looking over your shoulder first. Believe me, South Africa’s finished. A nightmare. I had a comfortable life, there you wouldn’t believe. I was in computers. I could work when I wanted, how I wanted. I had a beautiful apartment on the twentieth floor overlooking the harbour, a beach house – and I mean a beach house – right there on the beach, with bullet-proof glass to cut out the sound of the sea. They don’t sell double-glazing in South Africa. It doesn’t exist. But bullet-proof glass – well, it’s a good insulator, it protects you from noise. And bullets too, of course.

‘I was attacked three – no, four times. Look at these marks. Know what they are? Teeth. I was going to my car and this guy attacked me. He grabbed my right hand because he knew I carried a pistol in a holster on my right hip. But I still had my left hand free so I whacked him straight in the mouth – like this! Because I’m a brown belt Karate and I will always fight back. So he falls back and lets me go, yah? But just before he runs away to find an easier target he swipes me with his knife – here! Not a deep wound, but what I didn’t realise then was they use poison on their weapons. Herbal magic. Muti, a Zulu thing. All kinds of strange preparations from the bush. Wild garlic and other stuff. So he’d smeared that on the blade. I only found out a couple of days later when I was out with friends and suddenly collapsed in the restaurant. I came round in the ER later that night and the doctors told me all about it.

‘It’s a tribal thing, of course. They migrate down to where the money is, the coastal resorts, and take what they can. It’s understandable really, because there’s such dreadful poverty. I suppose they’re only trying to feed their families, and who wouldn’t? But it’s dreadful, all the same.

‘I thought I was safe up on the twentieth floor. Gated entrance. I even had a police chief living in the flat above me, so I felt pretty secure. Secure enough to sleep with the balcony door open. But one night they abseiled down from the roof, going from balcony to balcony, burning hyena’s tail and other stuff to put us all to sleep. Even the dog went out. Then they were free to take what they wanted. They took the keys to my Audi, but luckily the fuel light was on so they left it and took the police chief’s Mercedes instead. Unluckily for them it had tracking, so a couple of helicopters picked them up down the road.

‘I never wore jewellery. I had a friend who was attacked and they just went kerchup! with the blade when the ring wouldn’t come off first time. I’ve had friends shot in the head, abducted, ransomed, dumped in the bush, stabbed. Ach – it’s not good. Not good at all. The last straw was the beach house getting ransacked. I barely escaped with my life. So next thing you know I’m standing at Heathrow with one suitcase and one dog. It was like getting mugged all over again, the exchange rate was so bad, but what can you do? You can’t put too high a price on security, yah?’