out of joint

Duane is standing on the corner by a blue holdall, smoking a roll-up, casting his eyes up and down the street, shuffling from foot to foot, his right hand stuffed into his open shirt, his right shoulder lower than the left. When he sees us approach he takes a last hit of smoke, drops the fag, waits by the bag, cradling his arm.

‘They jumped me on the beach,’ he says, scurrying up the steps as soon as I open the side door. ‘Got me from behind so I wasn’t ready. Bastards. But I’ll be ready for them next time. They’ve put me shoulder out, haven’t they? Can you fix it quick so I can get back down there? I know you’ve got your tricks.’

I pull out a chair for him and he sits. We help him out of his shirt. His torso has a reduced, tautly feral look, patches of dirt on creamy muscle, smelling of sweat, and vodka, and wet concrete.

‘I walked down from Middlesbrough,’ he says. ‘Look at my shoes. You can tell by my shoes.’

I look down. Maybe he’s forgotten that his shoes fell apart and he recently got new ones, but these trainers are shop-clean.

‘That’s a long way,’ I say. ‘Middlesbrough.’

‘It’s a fuck of a long way. Motorways...’ he trails off, tenderly prodding his shoulder. ‘Pop it back in, mate,’ he says. ‘Come on. I know you’ve got the moves.’

‘It’s not as easy as that, Duane. You need to see a doctor. They’ll probably want to take an x-ray, to see exactly what the damage is. Then they’ll give you some medication and put it back.’

‘Come on, man. Just put it back in and I can be about my business.’

‘You just don’t want to cause any more damage, you see, Duane.’

I give him Entonox to help with the pain. He draws it down enthusiastically, like a scuba diver working hard underwater.

‘Nice gear,’ he says after a while, pointing at me with the mouthpiece, then putting it back in his mouth and clamping it between his grey teeth.

We move off.

I put the clipboard aside.

‘So what brings you down this way? I can’t believe you walked it.’

‘Yeah,’ he says, inspecting the mouthpiece and raising his eyebrows. ‘Whatever.’

‘Have you got family up North?’

‘Yeah. But I’m like one of those missing persons, like. I hardly know what I’m doing one minute to the next. They said I had post traumatic whatever, but I ‘ent never been a soldier.’

‘It’s not just soldiers who get PTSD. I think anyone who had a bad experience can get it.’

‘Yeah?’ he says, then puffs some more on the Entonox, thinking about that.

‘Does your family not know you’re here, then?’

He shrugs, then groans and leans over to his right. ‘I rang the wife last night,’ he says. ‘She didn’t say much.’

He closes his eyes. I adjust the sling and the cushion. Then he says: ‘Just whack it back in, mate. Go on. I know you’ve got your moves.’

*

The A&E department is as busy as ever. We sit Duane down on the only available space – a blue plastic chair next to the PathLab specimen duct. There is an elderly woman on a trolley in front of us, and the family with her shift uncomfortably when I sit Duane there. They sneak appalled glances in our direction, and close protectively.

Rae goes to handover to the charge nurse whilst I wait with Duane.

‘Come on, mate,’ he groans. ‘Don’t fuck about. Shove it back for us – or I’ll do it myself.’

‘It won’t be long, Duane. I know it’s painful but you’ve got to be patient. Honestly, mate – you don’t want to cause any more damage to your shoulder than you already have.’

‘I don’t care,’ he says. ‘I just want it back in so I can get after them. This is nothing to what I’m going to do to them, mind. I’m gonna tear them to pieces.’

The department is crowded to destruction, porters moving beds and equipment, a student doctor in flat shoes shuffling through with her head down, hugging a bundle of notes, a health care assistant cheerfully wheeling his cannulation trolley like he’s selling sweets, a radiographer grimly backing out of resus with her mobile x-ray machine, a cleaner working his broom in meditative swirls, patients wandering round, visitors asking directions, nurses hurrying off to break, dragging themselves back in, and at the centre of it all, the trading floor activity of the doctors and nurses in the central station with its phones, screens and white board of names, dates, states of play – everyone, the whole department at that moment, each facet of it in its own way frantically servicing the cubicles and the beds inside them like bees in a rambling, stuffy blue hive. But every now and again something happens to still the noise and bring it all together, something that gets a common response. It could be a cubicle alarm, a shout of pain, or just one of those unaccountable silences that suddenly drop across a crowded room when one person talking becomes the focus. Right now that person is Duane, standing up and saying: ‘Fuck!’

  If he notices the change in the air around him he doesn’t show it. He has just two points of interest: the pain in his shoulder and the people who did it.

 ‘Where are you going, Duane?’

‘I’m off outside to do it me’seln.’

‘Seriously, Duane. Just take a seat. The doctor’ll be with you in a minute.’

‘Nah! That’s it. I can see you’ve got better things to do.’

He walks off, a shuffling kind of lope like a wounded ape, and everyone takes a step back to let him go.

I wave to Rae to get her attention, then follow him outside, but in the time it takes me to do that, Duane has taken a run and driven the point of his right shoulder into the wall. I meet him staggering back in through the double doors, his shoulder hanging a few inches lower.

‘Nah!’ he sweats. ‘You’re gonna have to do it.’