Thursday, June 28, 2012


Mrs Carter is lying on the floor exactly where she landed after sliding out of bed in the early hours. Unable to reach up with her bad shoulder to pull the duvet over her, and with her alerter bracelet where she left it on the far sideboard next to her teeth and jewellery, she resigned herself to a few hours on the floor. She stole the sheep fleece from her dog Poppy’s basket, covered herself with that, and with the added warmth of Poppy herself, waited for her neighbour Derek to come round on his morning visit. Derek did eventually appear, letting himself in with the key from the key safe. When he found Mrs Carter on the floor he made her a little more comfortable with a duvet and pillow, locked Poppy away in the front room as instructed by the call taker on the phone, then waited with Mrs Carter for the ambulance.
She didn’t hurt herself. Although Mrs Carter’s falls are increasingly a problem, and it’s definitely something that needs looking at, for now, she just wants to be put back to bed and have breakfast.
‘So you used the dog blanket to keep warm?’ I say, whilst I transcribe basic information from a previous ambulance sheet.
‘She didn’t mind. She’s a darling. She usually cuddles up on the bed anyway. She’s hardly ever in her basket. It’s just for show, really.’
‘Where is Poppy now? She’s very quiet.’
‘In the lounge. Shall I let her through?’
‘Yeah, go on. I like dogs.’
‘Let her through, Derek. She loves to be where the action is.’
 He goes out.
‘Poppy’s very well behaved,’ I say to her, putting the clipboard down and getting out the thermometer. ‘My dogs would be barking like crazy.’
‘She’s no bother.’
For some reason I’m expecting something small to come round the corner, maybe a Jack Russell or a Shi-Tzu. But there’s a thunderous rumbling along the hallway, and a huge, Apricot-coloured standard poodle crashes into the room. It’s a mad-looking thing, with a wig of frizzy hair, pom-poms on the end of its legs like boudoir slippers and a tail like a frayed piece of rope. The dog launches itself across the carpet, plants two paws in the middle of my chest, presses its nose against mine, and stares at me in extreme close-up, its raisin eyes crossing over with excitement.
‘Down Poppy!’ says Mrs Carter. ‘Get down!’
‘The dog drops back, but then sees my bag and immediately thrusts its snout deep inside. It looks up from time to time with its tongue hanging out as if it can’t wait to hand me a piece of kit.
‘Sorry about Poppy,’ says Mrs Carter.
‘Don’t worry,’ I tell her. ‘It’s just like having a trainee.’


A woman has been standing in the middle of the pavement for an hour or more, gently rocking backwards and forwards with a two pint carton of semi-skimmed in her hand. It’s just as if the film of her trip to the corner shop had been interrupted, some flaw in the mechanism, a glitch – and now she’s stuck, doomed to repeat the same movement over and over and over, trapped in the shadowy space beneath a lime tree and some railings.
‘I hope you don’t mind me calling,’ says a man as we draw level. ‘I’ve been visiting a friend just over the way. I noticed this lady when I went in and I thought it was strange. But then when I came out and saw her still there, exactly the same position – well, there’s something going on. I hope I did the right thing. I asked her what her name was, if she needed help or anything, but she completely ignored me. She’s like one of them zombies.’
‘That’s fine. Thanks for your trouble.’
‘Shall I be going now?’
‘You can if you like. We’ll take it from here.’
‘There’s nothing else you need?’
‘No. That’s fine. Thanks.’
‘Oh, right then, so.’
He walks off.
I approach the woman slowly and quietly, downwind.
‘Hello? It’s the ambulance. My name’s Spence. This is Rae. Can we help you at all?’
She doesn’t even look up, but continues to rock backwards and forwards as before, unblinking, as if she were winding herself up to make a jump. She is a heavily built woman, around thirty, with that puffy, slightly battered look years of medication can inflict. The vest she is wearing exposes her tanned arms, where pale rows of old cigarette burns sit like drops of water on a dusty path.
‘Can I ask your name?’
No response.
‘It’s just that people are worried, seeing you here like this. You must be cold, too. It’s not all that warm today. Can we get you a blanket?’
Rae steps away to fetch one. The woman stares.
‘How are you feeling?’ I say to her. ‘Is there anything we can do. Don’t be frightened. We’re not here to do anything you don’t want to do.’
Rae comes over with the blanket, chin down, advancing as cautiously as a horse whisperer, and slowly drapes it round the woman’s shoulders.
‘There. How’s that?’
It provokes a response. She grasps the blanket around her neck with her free hand and starts to back away from us into the road. We follow her, fanning out either side to stop the traffic, gently herding her until she’s safely over the other side. Eventually she stops under another tree, and looks up and down the street like she’s ready to run.
‘Why don’t you come on board the ambulance for a while? I promise I won’t shut the door. It’ll give you a chance to warm up – and we can make sure everything’s okay. We won’t drive off anywhere. Is that okay?’
She nods, starting to look more aware.
Rae carries on trying to talk to her whilst I go back over the road, fetch the ambulance and drive it across. Once the side door is open, Rae coaxes her up onto a seat, where she sits staring at the carton of milk in her lap.
‘So. What’s your name? What do we call you?’ says Rae.
‘Tracy,’ she says. ‘What’s happened to me? Where am I?’
‘You’re in the ambulance, Tracy. We were called because people saw you standing for ages in the middle of the pavement, looking like you were in trouble.’
‘Where am I?’
‘The ambulance, Tracy.’
What happened?’
‘What’s your past medical history, Tracy? Do you have any problems? Diabetes? Epilepsy?’
She shakes her head.
‘Would you mind if we took a tiny scratch of your finger and checked your blood sugar level? Would that be okay?’
Tracy flashes me a look.
‘What about him?’ she says. ‘Is he going to drive off?’
‘No. Absolutely not. Look – here are the keys. I’ll put them here, where you can see them. Okay?’
She turns and looks back to Rae, then slowly holds out her hand.


Over the next half an hour Tracy becomes more orientated. She gives us her mobile phone so we can talk to her mother, who tells us that Tracy has been suffering with these blackouts for the past few years.
‘She’s been taken home by ambulance and police a few times. To the hospital as well, but she’s had all the tests and there’s nothing they can do. It’s a dissociative state connected with post traumatic stress disorder. She should really wear a bracelet or something. What are you going to do now?’
‘Will she be safe at home?’
‘She should be all right. Put me on and I’ll have a word.’
I hand the phone to Tracy.


Tracy has a basement flat in a gothic building set back from the road. In the narrow gap between the sitting room window and the little back garden, clusters of heavy green leaves spill out over the wall. The flat itself is snug and tidy, smelling of filtered coffee, new carpet, windowlene.
We follow her in to make sure everything’s okay.
‘I’ve only been here a month,’ she says, putting the milk in the fridge.
But her artwork already covers the walls – broad collages of images linked together with fabric and coloured string: photographs, pages from notebooks, letters, squares of maps, vinyl records, buttons, sequins, dried flowers.
‘So tell us some more about this condition you suffer with, Tracy?’
‘They think what happens is I get flashbacks with the PTSD. And the flashbacks kind of short-circuit my usual thinking. I’m surprised it happened during the day today, because it’s usually at night, when I’m tired. But I’ll have one of these flashbacks, and if I don’t manage to use a technique for grounding myself I’ll completely lose track of where I am or what I’m doing. In the past I’ve woken up way over the other side of town with a bag of shopping in my hand, and I’ve sat down and had to go through what I’ve bought, the receipts and whatnot, to try to work out where I’ve been.’
‘It sounds pretty dangerous, Tracy. You’re so vulnerable when it happens. If you’re not aware, anyone could take advantage. And then there’s the traffic issue, of course.’
‘Tell me about it. I’ve been through all this. I’ve had the usual help and I’m a bit stuck. The latest thinking is that therapy will cure me, only they reckon it’ll make the problem worse to begin with. So to have the therapy I need to be kept in a secure unit, only there’s no money for a bed.’
‘But in the short term, what do they suggest? I mean, you’re not exactly safe like this, are you?’
Tracy sits down on the sofa, tucks both her legs under her and reaches down with her right hand to massage a foot.
‘Yeah – well. What can you do? This one guy, he says I should I sew reflective patches on my pyjamas.’

Wednesday, June 27, 2012


James meets us at the door, phone still in his hand. He has a glassy look to him, as if everything – the house, the phone conversation, the ambulance crew bustling in through the door – as if all these things had broken together and cast him head first into a nightmare. He lowers the phone without ringing off; Rae gently takes it from him and tells Control we’ve arrived.
‘I thought he was out,’ says James, pushing his fingers back through his hair and staring at us as we pass. ‘His door was shut. I thought he was out.’
We hurry up the stairs on to a landing where only one door is open. Inside, a man is lying spread-eagled on his back on the bed by the window. Even from here you can tell he is dead. There is a puce tide line of pooled blood along the lower aspect of either arm, and a clump of dried brown vomitus set in his mouth, like he’d fallen asleep chewing a dirty sponge. We give the scene a brief recce, looking for anything that might hint at the cause – a scattering of pill packets, a syringe or a bottle of alcohol – but nothing seems amiss. There is a jacket and a rucksack tossed on an armchair, a mobile phone and a bunch of keys on the dresser by the telly.
‘It looks like he came in, took off his stuff, threw himself back on the bed and just died.’
‘He must have passed out for some reason, aspirated and choked to death.’
We head back down stairs. James is waiting for us at the door to the lounge.
‘I’m afraid Rick has died,’ I tell him.
‘Oh God,’ he says. ‘Died? Oh God.’
He stuffs both hands into his jeans pockets, then almost immediately takes them out and folds his arms, like an actor suddenly overcome with self-consciousness. ‘Jesus. I just thought he was out.’
‘Can we get you anything? A glass of water? Cup of tea?’
‘No. Thanks. I’m good. Do you mind if I smoke? Jesus. I was here all day.’ He stares at us. ‘I thought he was out.’
‘You’d have no reason to think otherwise.’
‘I mean – I’ve been here all day. With Rick – I mean - Jesus!’
He turns back into the living room, a scruffy but comfortable house-share set up, with piles of DVDs by the TV, throws on the sofas, a blanket chest with remote controls, an empty two litre bottle of coke and a glass ashtray overflowing with stubs.
‘So when was the last time you saw Rick alive?’
‘Last night. Well – I didn’t see him. I heard him – come back from the pub. About one.’
‘Anyone with him?’
‘No. He was on his own. Then when I got up about midday, I went to the bathroom, saw his door was shut and thought he’d gone to work.’
‘Had he complained of feeling unwell at all that day?’
‘No. Far as I know.’
‘Is there anything in his past medical history? You know – heart problems, breathing problems, that kind of thing?’
‘Nothing. He was pretty fit. Oh Jesus – I should ring his parents.’
‘Don’t worry about that just for the moment, James. The police are on their way and they’ll help you through that part of things. Just take a few minutes to get over the shock of all this, we’ll get down what information we can, and when the police arrive we’ll take it from there. And don’t worry about them coming. It’s purely routine. Anytime there’s an unexpected death at home, they have to attend.’
He rolls himself a cigarette. When he lights it, there’s so little tobacco in the paper it flares wildly.


A Sergeant and another officer come up the path. I meet them at the door and tell them what we found so far. The Sergeant goes in to the front room to introduce himself to James and explain what happens next. The other hangs around in the hallway with us for a moment.
‘This is beyond a joke,’ he says, rubbing his face. ‘Third today.’
‘Yep. Don’t touch me. You’ll drop down dead on the spot.’
The Sergeant comes out and smiles at us.
‘Lead on,’ he says.
We take them up the stairs into Jack’s bedroom.
‘How long do you think?’ says the Sergeant, leaning over the body.
‘A few hours,’ I tell him. ‘I imagine he died pretty soon after coming home from the pub.’
The Sergeant straightens up.
‘And nothing suspicious, you say.’
‘Nope. Nothing I could see.’
‘What about this whacking great bruise in the centre of his forehead, then?’
‘Whacking great bruise? What whacking great bruise?’
He stands aside and I lean over to look. And it’s true – right in the centre of Jack’s forehead is a flat, circular discolouration the diameter of a teacup.
The Sergeant turns to his subordinate.
‘Get on the blower and tell them we’ve got a sus death, so we’ll need a DI, SOC and the Coroner's Officer. Yeah?’ He turns back to me.
‘And you didn’t touch anything? Move the body? Crack the window, that kind of thing?’
‘Nope. It’s all as was. I can’t believe I missed that mark on his forehead, though!’
‘It’s okay,’ says the Sergeant. ‘Sometimes I think the more obvious it is, the more likely you are to miss it.’
We head back downstairs. The Sergeant puts us in the kitchen.
‘I’m afraid I can’t let you go until you’ve spoken to the rest of the team,’ he says. ‘Is that all right?’
‘Yep. Fine.’
Rae leans back against the kitchen counter. I finish off the paperwork, squeezing in the detail of the bruise, horribly conscious that anyone with a brain could tell it was an after-thought.


‘There’s no way that head injury could account for his death,’ I tell Rae, as a number of heavy feet clump about upstairs, a sequence of progressively important people arrive at the front door and are shown up. ‘No way. I reckon he was a bit pissed from the pub, stumbled and clonked his head against the wall, lay down on the bed for a moment, passed out, aspirated.’
‘Could be.’
‘I can’t believe I missed it, though.’
There is another knock on the door. I wait for someone to come down and get it, but probably because they’re all too busy to hear, no-one does. On the second knock I go into the hallway and open the door.
Standing there is a stooped, unshaven man in a checked shirt and jeans with what looks like a lunchbox on a strap slung over his shoulder. For a moment I wonder if he’s a relative, an electrician, or maybe the landlord. I’m just about to explain the situation and why he might want to come back later, when he raises his eyebrows and nods.
‘Coroner's Officer,’ he says. ‘Can I come in?’
‘Oh. Of course. Hi,’ I say. ‘They’re all upstairs.’
He strolls up. After a second or two I hear mutual greetings, a loose and friendly sound, like a bunch of commuters meeting up in their usual carriage for the ride in to work.
‘Something to do with the Coroner,’ I say to Rae. She yawns, and hugs herself.
‘I wonder if they’ll be taking our boots and uniform,’ she says. ‘That’d be good for another couple of hours, at least.’


Eventually the Coroner's Officer comes back down into the kitchen and leans against the counter with us. He smiles, folds his arms and looks down at his shoes.
‘How are you doing?’ he says.
‘Not bad. You?’
‘Good. I’m good,’ he says. ‘So – what do you think? You found the body, is that right?’
‘Yes – and I’m so embarrassed. I can’t think how I missed that bruise.’
He shrugs. ‘Easily done,’ he says. ‘Well, now. Technically all this counts as unexplained, but I’m guessing our chap bished his head on something when he was coming back from the pub – not in any big way. He lies down, passes out and aspirates. That’s what it looks like. He has an interesting bruise between his thumb and index finger – here – not something you see all that often, but probably where he puts his hand when he falls – like this – a guarding injury, do you see? We’ll establish all this later. For now, I think you chaps are free to go. I imagine we’ve got all your details. The paperwork and such.’
I hand him copies.
‘That’s great. Thank you so much for all you’ve done. I hope the rest of your shift is – less eventful.’
We shake his hand, pick up our bags and head outside.
Just as we reach the door I half expect him to say Just one more thing, but when I turn to look he simply waves goodbye, and then quietly turns and walks back up the stairs.

Tuesday, June 26, 2012


I sit back, open my eyes – and see a row of shops immediately in front of us.
I wrench the steering wheel violently to the left. Both my feet jam down on the pedals.
I brace for impact.
Nothing happens.
Because we’re not moving.
My heart volleys between the back of my spine and the windscreen.
We’re not moving, and the engine is quiet.
Then it comes to me – we’re parked up. We’ve been on roadside standby for ten minutes or so.
I relax my grip on the wheel and look to the side. Rae is breathing softly, curled up in the attendant’s seat, knees up on the dash, arms tucked in and chin down. She groans and folds herself even smaller into her jacket.
I breathe, and check the time.
Four o’clock.
Outside the sky is starting to lighten, a one point increment of blue.
I shift position to feel my feet again.
Suddenly the MDT lights up, along with the horribly urgent sound effect they’ve decided to accompany each job - an electronic Chihuahua raging in a loop of three. I jab it off.
Rae uncurls with a groan.
Man bitten by dog.
I yawn, and turn the engine over.

St Helen street. I don’t know, but I’m guessing St Helen is the patron saint of drunks, deadbeats, users and abusers. There’s probably a shrine to her somewhere: an alabaster figure, head drooping sorrowfully, hands stretched out either side, a needle in the right, a can in the left.
The clubs and bars down this stretch are patrolled weekend nights by a sheriff’s posse of bouncers. But instead of pistols round their waists they have yellow ID bands round their arms. They all seem to come from the same village somewhere in Serbia – probably the same family - and walk in the same way, a casually tough, flat-footed, no-necked waddle, arms out to the sides, ready to draw.
Two of them are with a crowd of people outside The Fox and Hounds. I can see three or four others up ahead, confronting some people, a dog running about. We pull up outside the pub and Rae winds the window down.
‘Hey,’ she says. ‘What’s up?’
One of the bouncers steps over.
‘Yes. Thank you for coming so quick. I have bite to leg. Here. It not bad but I thought maybe ... erm ... injection for ... erm ... infection.’
‘Let’s have a look.’
But just as she goes to get out there’s a sudden roar from up ahead and we see the bouncers and other figures all crash together. It’s a Tex Avery special, a whirlwind of boots and arms -  Oof! Zing! Pow!  – a rangy dog leaping in and out, wind-milling its paws.
The bitten bouncer taps the ambulance. ‘One moment,’ he says, and hobbles off up the street to help. Rae calls for urgent police back-up as I drive forwards to light the scene with the ambulance and maybe get out and help, depending.
But it’s over as suddenly as it started. Now there is a man sprawled face down in the middle of the road with a bouncer on top of him; another man stands over by a shop window holding a dog by the collar, everyone else has gone.
‘Ssh, friend,’ says the bouncer at the head end, holding on to the man’s hand, folded expertly behind his back with one toe-like thumb on the back of his wrist. ‘People sleeping. Quiet now.’
‘You fucking Polish cunt,’ splutters the man underneath him. ‘I hope you die of cervical cancer.’
The bouncer laughs. ‘I am boy, not girl. And anyway I not from Poland.’
‘Sorry. I don’t have anything against the Poles. I’m not racist. It’s just words. I hope you die of testicular cancer then, you bastard.’
The bouncer shrugs and looks up at me.
‘What to do with this?’ he says.
I shine my torch just in front of the man’s face. There is a small puddle of blood there as richly red as a spilled can of enamel paint. I shine the torch on his face – it looks like he cut an eyebrow and bashed his nose when he was taken down.
‘They’re fucking killing me,’ says the man. ‘Get off of me, you Nazi scum.’
‘So what happened here?’ says Rae, pulling on her gloves. ‘Bit of a mess, isn’t it?’
‘I wasn’t doing nothing,’ says the guy on the floor. ‘I was walking by minding my own business and these cunts decided to push me around. So my dog bit one. Next thing you know they’re beating the crap out of me. I want this recorded. I want photographs. Where's Buddy? Is he all right? Who’s got Buddy?’
‘Your friend took him off,’ says Rae. Then, to the bouncer ‘The police are en route.’
‘Good,’ says the bouncer.
‘Just let me sit up,’ says the guy on the floor. ‘I promise I won’t do nothing. Just let me sit up.’
‘No, my friend,’ says the bouncer. ‘We wait till police get here I think.’
‘What’s your name?’ says Rae.
‘Okay, Bill. We’re going to need you to be nice and calm so we can treat your injuries.’
‘Fuck that. I want pictures. I want these cunts prosecuted for brutality.’
He raises his head just enough to spit, a gob of blood that plops out onto the tarmac in front of him. Rae takes a step back.
‘No spitting,’ she says. ‘If you spit we’re not coming anywhere near you.’
‘Sorry. Sorry,’ says Bill. ‘I wasn’t spitting at you, I was spitting at the road. That’s allowed, isn’t it?’
‘The road, yes. Us, no.’
Flashing blue lights, and a police car pulls up. Two police women get out and walk over.
‘Hi guys,’ says the first, as pleasantly as someone introducing themselves at a party. ‘Oh dear. What’s happened here, then?’
‘Oh great,’ says Bill. ‘The fucking filth. More Nazi scum, with your pepper sprays and your batons. Why don’t you fuck off with your Nazi friends here and have a fucking orgy.’
‘That’s not very nice,’ says the police woman. ‘We’re only here to help.’
‘Yeah right,’ says Bill, then spits again.
‘If you spit like that we’ll have to put a hood on you, and I’d really rather not. You’d rather not, too, I expect.’
‘Sorry officer,’ says Bill. ‘I’m just scared. I get scared around the police.’
And he starts to cry, a stagey, extravagantly boo-hoo deal that seems absurdly at odds with his previous demeanour. Bill is a curiously volatile mix, lurching from dreadful curses through swearing and aggressive bravado to self-pitying cries and friendly chat.
‘All right if I sit up?’ says Bill, suddenly reasonable again. ‘Only I can’t breathe all that well at the moment.’
‘Fine,’ says the police woman, moving in. ‘But I’m afraid we’re going to have to cuff your hands behind your back to begin with, just until we know what’s what.’
‘No worries,’ says Bill.
‘And no spitting. Okay? There.’
We help him sit up into a cross-legged position, his hands cuffed behind him. He looks around, the blood from his nose and eye matting his goatee beard.
 ‘Urgh,’ says the police woman to Rae. ‘Any idea of injuries?’
‘Minor. We need to clean him up to see, but minor, I’d say.’
‘Good. Now then. First things first. What do we call you?’
‘Bill what?’
‘Bill the tramp.’
She gets out her notebook and writes it down.
‘Bill – the – tramp. Okay Bill. What’s your date of birth?’
‘One, one, one,’ he says, then spits off to the side.
‘Bill – remember what we said? Okay? No spitting.’
‘I was spitting on the road. Clearing my mouth. Or isn’t that allowed in this country? Like walking your dogs, apparently.’
‘He stand in front and sing bad song, then when we tell him to go away he make dog to bite my friend,’ says the bouncer.
‘Oh dear,’ says the police woman.
‘You fucking Polish nob! You whore! I hope you get a fucking bullet in the back of your head one day, you cunt.’
The bouncer shrugs and smiles at his friend.
‘Polish!’ he says to him. They laugh. The other produces a small bottle of alco-gel and squeezes some onto his friend’s hands.
Suddenly Bill starts howling.
‘Bill! Bill! This isn’t helping, is it?’
‘Sorry. Sorry. I’m just worried about Buddy, that’s all.’
‘Are you going to behave and let the paramedics treat you?’
‘Sure. No problem.’
I approach him warily from the rear, soak a wad of tissue and start cleaning the blood off his face.
‘Can you do my nose?’ he says. ‘There! Just a bit more! Ah! That’s it. There’s nothing worse than having an itch in your nose and not being able to scratch it.’

Monday, June 18, 2012

seven night voices

1.      ‘Shut the door, will you? Only I don’t want the neighbours knowing any of this.... He says he can’t breathe, he can’t get his breath, you know what I mean? It’s freaking me out. He said his heart’s thumping, he’s gone all dry and shaky. Can I give him some water?... About an hour ago he took this Viagra he bought off a friend down the pub. We get all our coke off him, and it’s always good stuff. And the Viagra looked all right – little blue triangles with some white in the middle when you break them open. You know? Didn’t bloody work, though. Absolutely nothing. And then he said he started to feel light headed and peculiar. And these blotches came up all over his body. I phoned my dad and he’s like “Call the ambulance, Shell. He’s having a reaction.” So I did....  the other thing is he went cold turkey on his Citalopram last week, so that’s probably not helping. He’s been a bit stressed out at work. And he’s a type one diabetic and when we did his sugars just now they’d gone through the roof. ... I can’t believe I’m telling a couple of strangers about our sex life. It’s weird. Anyway, he’s just in here. Can I get you a coffee or anything?’

2.      ‘George had an episode about a year or so ago when he ate a cookie and his face swelled up. That’s when they found out he was allergic to  nuts - and melons, for some reason. Not tree type nuts – ground ones, the legume family. Anyway, nothing happened after that. We were always really careful. They gave us an EpiPen just in case and I always carry that. A bottle of Piriteze.... I was making supper and we had a little dish of cashews on the go and George said could he try one and for some stupid reason – I don’t know, I was in a rush, I wasn’t thinking – I said yes and let him have one. He spat it out immediately thank God and then about five or ten minutes later started being violently sick, his face began to swell up again, his eyes and nose running like mad so I gave him some Piriteze and then jabbed him with the pen.... I just can’t believe I was so stupid. I don’t know what came over me. I feel terrible... Whatever kind of mother am I?’

3.       ‘She was all right in the pub but when we got outside,  it all got too much yeah and she was sick just about everywhere and then crashed out in the doorway. I tried cleaning her up because no-one in their right mind would take her like this, would they, hey babe? Would they? But in the end I had to call because I couldn’t think what else to do? I’ll help you lift her up on the trolley if you like? Have you got a blanket because she hasn’t got much on.... But I’ve still got your shoes, Beth? Yeah? Your shoes? That’s the good news, hunny babe. You might have lost everything else but you haven’t lost your shoes.’

4.      ‘It’s my hen night and we’ve all had quite a bit to drink. Kelly was the worse, though. She was completely wasted. She didn’t look all that great, to be honest, so that’s why I called you. But when they said it might take a while I called her boyfriend Grant. So then he turned up he said he’d take her home. So he picked her up and staggered off down the road. But I could see he was struggling a bit and the next thing you know he’s dropped her on her head. I went over and tried to make him leave her where she was and wait for you guys but he wouldn’t listen and he picked her up again. But no sooner had he done it than he dropped her on her head again. Anyway, he still wouldn’t listen, so he picked her up again and staggered off in that direction. I thought I’d better stay here and wait for you. I don’t know where she lives, but it’s somewhere in that direction. Do you think you could have a drive around and see if she’s okay?’

5.      ‘Now and then I bleed myself to help me cope with things. I’ve been pretty good lately but everything started to pile up on me again, you know, so I got one of my cannulas and bled myself over the sink. I did it for quite a while this time, maybe forty five minutes or so? And I don’t feel too bad, to be honest, except I’ve got this terrible urge to open it up again and just keep going. That’s why I called you. I didn’t think I could resist letting it run.’

6.      ‘Poor papa was recently diagnosed with PSP – which isn’t PlayStation, by the way. It’s a bit like Parkinson’s disease, apparently. Progressive Supranuclear Palsy, it stands for. Quite rare. It means his balance is affected and he’s prone to falls. He’s had a pretty tiring day today, which hasn’t helped. He was up at the hospital for more tests, and he’s just started on a new course of drugs, so all in all it’s been quite a harrowing time for him, hasn’t it papa? I don’t think he’s hurt himself, but he’s just too heavy for me to get him up. I’m so sorry to call you out like this. Have you eaten? This is very nice. We call it Dhokla – made with chick pea flour and spices. Mama’s speciality. Try it. And I’ve got some fresh mangoes you might like, also. Very juicy.’

7.      ‘So we were in the hostel common room with Tina for an hour or more. There was no one else about, no numbers to call, nothing. Tina was just sitting there on her own with this big, black and white cat on her lap, and she was stroking it like this, with her head down and her hood up, and she’d listen to what we said and then just say “I’m not going to hospital. I’m not going.” She said she’d only called NHS Direct for advice about the overdose, and they were the ones who’d called us, not her. I can’t tell you, Spence, we were there for ages. We used every angle we could think. Threats about the police, good cop / bad cop, everything. We even used the cat. But absolutely nothing worked. “I’m not going to hospital. You can’t make me.” She just kept on and on she wanted to be left alone to die. So then Claire has an idea and she goes out into the hall and looks in the visitors book. When she comes back in she starts talking about this friend of Tina’s called Vicky, and could we give Vicky a ring and what would Vicky say about all this? Which starts to get a reaction. Turns out Vicky’s four months pregnant, and Tina says it’s too late to ring her. So then I start in about how lovely it’ll be to see Vicky’s baby when it’s born, and how would it make Vicky feel if Tina wasn’t around to help out? Which also seems to get a response. So finally after a bit more of that she shoos the cat off her lap, stands up and says okay, she’s ready to come to hospital. I tell her how pleased I am she’s seen sense. Claire fusses around getting her bags and whatnot. Tina says she only didn’t want to come because they’re so mean to her up at A and E, so I say stuff about it’s no excuse but they get very stressed and it’s difficult to be sympathetic when you’re snowed under with work and how sometimes they’re not aware that they’re coming across a bit harsh. So then I asked her when was the last time she was in A and E. And she says she’s been really good lately and it must be a month or two. So I say that is good and well done and we go in. And it’s only when I handover to the charge nurse and she takes the name that she sighs and says “Not Tina again.” And I say “What do you mean?” “Well,’ she says, “I’m surprised you didn’t know. Tina’s been in every single day this month.”

Friday, June 15, 2012

commode dragons

I feel hot to myself.
I have that buzzing, vaguely hectic feel, and my feet are further away from head than they have any right to be.
I stick the thermometer in my ear.
I check the time.
Half way through the shift.
It’s probably just a case of acute wishful thinking.
I’ll tough it out.

We’re called to a collapse in an old people’s day centre. Rae drives; I sit low down behind my shades, feeling the world rush through me.
‘Are you all right?’ she says.
‘I think I’m coming down with something.’
‘You’ve only just got back from holiday.’
‘I came back too quick.’
‘That’s it, then. You’ve got the holiday bends.’

We pull up outside the church hall. There’s a member of staff in a mauve pinny, waiting.
‘Lola had a funny turn during lunch. She’s just through here.’
She leads us through reception into a bright, vaulted space reverberating with the sound of cutlery on plates and a murmurous hum of conversation that seems to close around us as we walk over to Lola’s table.
Another member of staff is standing behind her chair with both hands on Lola’s shoulders.
‘You couldn’t take over?’ she says. ‘Only I’m stopping her from sliding under.’
I step in, whilst Rae squats down and checks Lola over.
Although she is a sickly grey colour, she’s breathing and just about conscious.
‘We need to lie her down,’ she says. ‘But it’ll be easier if I whizz the trolley in quick and we can scoot her straight over from the chair. Are you okay here for the moment?’
I nod. She hurries out.
Whilst I hang on to Lola, I look around the table. There are five other old ladies, all still busily tucking in to the food on their plates – buttered bread, salad, hard-boiled egg and strips of smoked salmon.
‘Afternoon,’ I say. ‘Mm. You’re making me hungry.’
One of them looks up, shreds of salmon dangling over her chin. It puts me in mind of a Komodo dragon, disturbed at the kill. She takes down the last of the salmon in three snickering snaps of her jaw, then turns her head slightly left and right as if she were smelling rather than seeing me.
‘Get yourself a plate,’ she says eventually. Then leans back in to the egg.
The old lady immediately next to Lola nudges me with her fork arm.
‘She’s never normally all that chatty,’ she says, with a nod of her head that almost puts her wig over her eyes. ‘Hardly says a word. So I can’t say we noticed any difference.’
‘So she’s normally pretty quiet?’ I say. ‘Do you know anything else about Lola? Her past medical history?’
‘Her  what?’ says the old lady. ‘We have lunch three times a week. That’s it. What do you think? I’m her doctor?’
‘No. Quite right.’
They carry on eating. Lola groans in my arms and I look back to the door.
‘Okay, Lola. Trolley’s on its way.’
One of the carers comes over.
‘Can I get you anything?’ she says. 'Tea?'
‘Do you have any details about Lola? Any personal information sheets we could take?’
‘Oh, right. I’ll see.’
‘Great. Thanks.’
She goes back into the kitchen.
Rae struggles back in with the trolley.
I’m amazed there’s not more of a reaction. But despite the loud electric buzz of our trolley, the two figures in green hauling the unconscious old lady out of her chair, the carers collecting bags and belongings, the squawk of our radios and our terse comments to each other, my general impression is that everyone is too busy eating to care. That, or it happens so often they’re used to it.
Either way, we wheel Lola out through the double doors.
There is a sudden loud crash from the hall; I glance back, and I’m not sure, but I think what I see is two Komodo dragons either end of a strip of Lola’s salmon, tugging and fighting and scattering plates.

Wednesday, June 13, 2012

tip top

Mrs Swanley answers the door on her way from the living room to the kitchen.
‘Hello,’ she says, immediately turning away. ‘I’m on a hunt for the dog lead.’
‘Is there a dog on the end of it?’ says Frank.
‘No!’ says Mrs Swanley. ‘If only. He’s gone off on another one of his foolish excursions. Phil next door says he’ll fetch him back and look after him whilst I’m in hospital, but I’ll need to give him the lead before I go. You can’t see it anywhere, can you?’
We go into the house to look.
It should be easy to spot. The place is as spare and clean as a show home; a biscuit crumb would probably trigger an alarm. Mrs Swanley may be eighty-eight, but she still has enough energy to keep her house set to an invisible grid of perfection, and everything in it, from the perfectly plumped, fancy cream cushions on the scallop-backed sofa to the waxy curves of the dining table orchid – everything conforms perfectly to the pattern.
A carriage clock snicks away between a display of ceramic figurines, more like a pacemaker than a timepiece.
‘Found it!’ says Mrs Swanley, shuffling back into the room. ‘On the bread bin, would you believe? Definitely not the full ticket.’
It’s difficult to imagine a dog in this house.
‘What sort of dog is Cecil?’ I ask her.
‘A Jack Russell,’ she says. ‘And a very naughty one. Let me just drop this round to Phil, then we can be off.’
‘When the doctor came to see you, Mrs Swanley, did she leave a note?’
‘No. She said she’d arrange the whole thing by phone. Is that a problem?’
‘No, no. It’s just nice to have a little information beforehand. All we’ve been told was that you’ve been suffering with a headache for a few days.’
Mrs Swanley smiles bravely and drapes her free hand across the top of her head.
‘I wouldn’t say headache so much as fuzziness. And when I look up…’ she looks up… ‘and side to side…’ she rolls her eyes dramatically… ‘I see double. And feel dizzy. Like now. Urgh.’ She sways, and Frank steadies her.
‘Are you sure you ought to be running around like this?’ he says. ‘Here. I’ll give Phil the lead.’
‘You must think I’m an awful fraud,’ she says. ‘There are so many more deserving cases for you to see. I don’t want to take any more of your time than I can help.’
‘Can you give us a quick rundown of the problem, Mrs Swanley? Your past medical history?’
‘Yes, well – the fuzziness has been going on for five days or so. I called the doctor because I was just getting so sick and tired of it, feeling nauseous much of the time, not sleeping. She seems to think it’s worth investigating at the hospital, so I’m sorry to drag you out like this but there you are. As far as my past medical history is concerned, nothing much to report, really. I’ve done remarkably well, considering. A touch of arthritis. You know. Old lady stuff. A certain tendency to drift – the dog lead, for example - but , well… this is hardly front page news. Don’t get old, that’s my advice to you both. It’s no fun. The best thing is just to keel over in the garden when you’re watering the plants, or go to bed and not wake up. But what happens of course is you have to go on and on with everything running down. Ever decreasing circumstances. Sad, really.’
But she smiles, and shakes the lead in the air.
‘Here you are then,’ she says, handing Frank the lead. ‘Phil knows what to do with it.’
I help her on with her coat.
 Just before she takes my arm to walk out of the door, she pauses and touches the top of her head again.
‘Oh yes. And I had a cerebral aneurysm last year. Apart from that – tip top.’

Tuesday, June 12, 2012

nightmare on nice street

‘Oh – come on! I was only here yesterday,’ says Rae, taking down the address off the computer and then tossing the clipboard disdainfully onto the dash. ‘Fucking hell.’
‘This one’s a real pain. A colossal waste of time. I mean – don’t let me prejudice you in any way.’
‘No, no.’
‘But honestly. She needs shooting.’
‘Watch yourself. She’s a nasty piece of work. She’ll turn on a sixpence and her daughter’s no better. What a pair of psychos. Frequent flyers –harpies, more like. They’ve put in loads of complaints against just about everyone you can think of – ambulance, doctors, Mother fucking Theresa, you name it. They’ve got a dreadful reputation. Frank’s actually banned from going there. They said he planted a bag of crack cocaine in the kitchen.’
‘Yeah, well – that’s Frank for you. He’ll always find a way.’
‘I’m amazed you haven’t heard of them.’
‘We’re a bit up-country but yeah - I’m surprised, too.’
‘It’s how it goes. Just bite your lip and keep a low profile. I’ll turn this around as quick as I can. Hopefully she’ll blow and we can run straight out. Jesus Christ. Talk about the grunts of the Health Service, Spence. We just have to go in and deal with this shit regardless.’
I drive steadily.
Rae folds her arms. After a while she leans forwards and spits her gum out into the rubbish.
‘And they never tell you any of the back story. They’re quite happy for you to go in blind. Imagine if you were working on the car and didn’t know,’ she says. ‘At night. On your own.’

I turn into the street. A nice enough place, freshly painted houses a strimmer-swipe back from a line of freshly painted hedges. Caravans on blocks; recycling bins; kids on bikes. A regular, two-up two-down Sunday morning migraine kind of street. The only thing that distinguishes our house from the others is a certain pall of neglect that hangs around it, like the greying glaze on a rotten tooth in an otherwise wide and self-satisfied smile. The windows haven’t been painted or even opened in a while, the hedges are as yellowing as the curtains, and the pebbledash rendering has blown.
As I pull up outside an elderly woman walking past catches my eye and smiles sympathetically. I fully expect to see her cross herself, but she merely shakes her head from side to side in a ‘that’s too bad’ kind of way, and hurries on.
Rae hugs her clipboard and walks up the path to the door.
A shout from inside, a complaint, a vicious curse, another shout – then heavy thumps along the hallway boards. The door flies open.
A lumpen girl in a Nike tracksuit stands staring at us, her face doughy and pale, her hair drawn back in a ponytail so tight it stretches her eyes.
‘Take her away, she’s annoying me now,’ she says, then steps aside.
The house stinks of fags and wet dog.
‘I locked the mutt in the back garden,’ she says, closing the door behind us. ‘He won’t hurt you, though. I told the stupid woman on the phone. I said he’s about a hundred years old, darling. What’s he going to do? Gum them to death?’
‘Through here?’ says Rae.
‘Haven’t you been here before?’ the girl says. ‘I think you’ve been here before. I recognise your face. I’m getting to know them all. Not you though,’ she says to me. ‘You’re new.’
She follows us into the sitting room and throws herself down onto the sofa, holding the position she lands in, legs wide apart and arms right and left along the back. ‘Carry on. Don’t mind me.’
Her mother is sitting on an armchair in the bay window. With her swollen feet planted in a pair of decaying slippers, her legs pushed aside by the swollen mass of her belly and her hands placed on either knee, she could be a statue of the laughing Buddha, except for the expression on her face, the chilling opposite to celestial joy.
‘I’m not going to hospital,’ she snarls. ‘So now what are you going to do?’
‘Hello, Rita,’ says Rae. ‘I was out to you just yesterday. Something about some gastric pain, wasn’t it?’
‘Oh yes. I remember,’ says Rita, with a ghastly smile. ‘You said the doctor would be in touch.’
Rae looks at me.
‘Rita’s been having this pain for a few months. Yesterday when I came I tried to persuade Rita that she should come to hospital to have it investigated there, but she refused. So I referred her on to her GP.’ She turns back to Rita. ‘That’s right, isn’t it?’
‘GP!’ says Rita. ‘He says he never wants to see me again. He says he couldn’t care less if I died. He says I’m a rude and aggressive person – rude and aggressive! Me!’
‘You’re the third ambulance today,’ says the daughter from the sofa, reaching for a cigarette.
‘Do you have any of the ambulance sheets?’ says Rae.
‘Take your pick, luv,’ says the daughter, nodding over to a sideboard, where a bundle of PRF’s have been stuffed into a letter rack. I take them out whilst Rae carries on talking to Rita.
‘So when did the last ambulance come out to you?’
‘I told you. About an hour ago.’
‘And was that for stomach pain, too?’
‘It’s all about stomach pain, dear. I’ve got stomach trouble. It’s what I suffer with. The doctor knows. He’ll tell you all about it – if he can be bothered. Which he can’t. He says he never wants to see me in his surgery again. Which makes life a bit difficult, don’t it? I need a camera down me to see what’s what. How am I going to get a camera down me if the bleeding doctor won’t even come out?’
I turn to the daughter.
‘Would you mind not smoking whilst we’re here?’ I say to her. ‘Only we’ll stink of fags the rest of the shift.’
There’s a dangerous pause, but luckily the moment passes and she seems to accept the request.
‘Oh. Excuse me,’ she says, putting the cigarette back in the packet. ‘I wouldn’t have done it if I’d known. You see I’m not like some. I fully respect people’s human rights. I know it’s not nice to breathe in someone’s smoke if you’re not a smoker yourself. I never would’ve gone to light up if I’d known. We’re not like that, Mum and me. We respect people’s rights. Don’t we, Mum?’
Rita nods.
‘Yes we do,’ she says. ‘And I know mine. I know that doctor has no right to refuse me a visit. I’m going to get him struck off. How else am I supposed to get this sorted?’
Rae takes one of the forms and quickly scans through it.
‘It says here you had an appointment for an endoscopy earlier in the week. Didn’t you go?’
She looks down and picks fluff off her knee.
‘Why not?’
‘I missed the transport.’
‘How did you miss the transport, Rita?’
The daughter sits up.
‘She couldn’t just leave me here on my own, could she? I’m agoraphobic and I get panic attacks. I’ve been diagnosed with acute anxiety disorder and chronic depression, irregular periods and irritable bowel syndrome. I can’t just be left. And I can’t just go out into the street, neither. I’d fucking keel over, mate.’
Rae turns back to Rita.
‘So couldn’t you arrange for someone to stay here with your daughter whilst you went up the hospital? A friend or relative or someone?’
‘Who? Who can I trust?’
‘I don’t know, Rita. But otherwise we’re all at a bit of a stalemate.’
‘No. It’s not a bit of a stalemate. It’s up to the doctor to sort out a treatment that’s right for me and my circumstance. I can’t be expected to think of everything.’
‘You can’t very well have an endoscopy at home, Rita.’
‘You have to go to the hospital.’
‘Which is something the doctor has to sort out.’
‘But he did already sort it out, Rita. It’s just you missed the transport.’
‘He says he won’t see me any more because I’m rude and aggressive. He says he wants me to fuck off and die.’
‘I’m sure he didn’t say that, Rita.’
‘That’s what he meant.’
Rae looks at me and sighs. Then she looks back at Rita.
‘So what are we going to do with you? As an ambulance crew we’re a bit limited. We can either take you to hospital or refer you to your GP. We’re quite happy to do either of those things. But what you can’t do is just keep refusing hospital, sending crews away and then ringing treble nine again.’

Both Rae and I know that if Rita sends us away and we tell Control exactly what the situation is – that Rita is in dispute with her surgery, that she is repeatedly calling 999 specifically to cause a nuisance – we both know full well that if she calls again, another ambulance will be sent without question, and even more resource will be wasted.

‘No?’ says Rita. ‘Well what else am I supposed to do, if the doctor won’t see me?’
‘Rita? I’ll ask you again. Are you going to come to hospital with us?’
She narrows her eyes and studies us.
Eventually she says: ‘Do you know where Marston House is?’
‘Yes. I do.’
‘Then I’ll come with you on one condition.’
‘What’s that?’
‘You drop by there and pick up some legal papers I’m waiting on from my no-good cousin. If you do that, then I will come to hospital with you.’
‘What about Amy?’
The daughter jumps up.
‘I’ll get me coat,’ she says.