never say never

If twelve hours is a long time, by the end of the fourth shift, it feels eternal.

We’ve managed ten and a half, and the end’s in sight, but the prospect of a prompt finish diminishes as we take a call to a non-injury fall at home. As we make our way over to the address, we hear several other calls going out for jobs with no vehicles to assign.

‘We’ll have to pace this one,’ says Rae.

But everything’s fine. I’ve been to this address before. Errol, ninety-eight, a charming old man in a little cottage overlooking the sea, set back from the cliff road amongst a huddle of laurel and hawthorn, dark steps from the gate to the patio door, the key safe on the wall by the flagpole, a strew of interesting drift wood, holed stones strung on lines, weathered wooden sculptures. It’s been an unsettled day; the night has settled in with a scrub of cloud across the moon and a salt chill to the air.

We fiddle with the key safe and let ourselves in.

‘Hello? Ambulance?’

Errol’s mobility has decreased since I saw him last. He’s no longer able to manage the stairs, so the OTs have set him up with a sweet little electric bed in the living room. He’s lying on the floor at the foot end, and gives a little wave as we put our bags down and go over.

‘I’m fine! I’m fine! I haven’t hurt myself – and I can confidently say that everything works as it should. I just can’t blasted well get up. Sorry for the language.’

We help him up, and make sure he’s okay walking to his tilt-armchair in the middle of the room.

‘Would you like a cup of tea, Errol?’

‘I would love a cup of tea. That’s so kind of you. And please – make one for yourselves. Are you all right with Assam? And I rather think there may be a biscuit or two in the tin by the folders. Please, whatever you’d like.’

I settle myself onto one of his carved mahogany chairs and prepare to write out the report form in immaculate – and slow – detail.

He watches me, and smiles when I look up.

‘These wretched legs,’ he says, crossing them. ‘Can’t do a thing  with ‘em. You wouldn’t believe I used to swim for the county, would you? Before the war, of course. Before the war.’ He scratches his forehead, as if the thought was a perplexing itch.

He looks up again.

‘That’s how I met my wife.’

‘In the water?’

‘Sort of. She was... erm... she was on the beach.’

‘She liked the cut of your jib?’

‘Something like that. She was rather cool about the whole thing, actually, but that’s what they’re like, you know... erm... from the Black Forest. They don’t like to give too much away, you know.’

‘Probably just as well.’

‘Of course that’s one of the reasons we got married. They were rounding up all the Germans over here and patching them off to the Isle of Man. I wanted to make sure she was protected before I went off to fight. So we got married. That wasn’t the only reason of course, but it was one of them. And to think I didn’t see her again for another five years.’

Rae comes in with the tea, and a plate of chocolate biscuits.

‘I don’t know if it’s exactly true or not,’ I tell him, dunking my biscuit, ‘but the family story goes that my uncle John went off to fight, got captured and put in a POW camp in Italy, escaped, and ended the war fighting with the partisans. But in the meantime, auntie Ollie was told he’d been killed. So she made the best of it, took up with a GI, and got engaged. But then a day or so before the wedding, John turned up.’

‘Oh my goodness! She must’ve thought it was a ghost!’

‘I can’t imagine! So there was this big reunion and everything, except the GI wasn’t too pleased. Apparently he climbed up on the parapet of Westminster Bridge and threatened to throw himself in. Don’t know if he did or not. Probably not.’

‘Well. It just goes to show. Never give up hope. Never.’

‘Never say never.’

Errol takes a shaky sip of his tea, then rattles the cup back on the saucer.

‘It’s like I’ve always said,’ he says, ‘when you find yourself a good woman, you hold onto her no matter what.’

Then he glances over at the faded black and white picture on the wall just across from him: a young woman in a panama hat, tipping the brim of it, frowning playfully into the lens.

the waiting room

The cancer centre is all locked up, the reception area beyond the glass dimly, economically lit. There’s no buzzer; when we knock nothing happens, no-one comes. The rain is just starting in now after threatening all evening. We shelter as best we can in the overhang. I call Control to check whether we’re in the right place. They eventually get back to say that someone is coming to let us in.

‘Sorry about that,’ says a nurse as the door opens. ‘We don’t normally run this late. Mr Rogers has just got another ten minutes to go. Is that okay?’

She shows us to the threshold of a deep and empty waiting room, and hits a switch. The overhead lights blink on, nearest first, then off in two lines into the distance.

‘Make yourselves at home,’ she says.

The chairs around the perimeter of the room are high-backed, generously padded, pastel mauve, pink and yellow. On the low, white tables in the centre of the room are tidy stacks of magazines: House & Home; Elle; Cosmopolitan; Red; Gardener’s World.

Amazing before & afters.

Your Spring must-haves.

How normal is your sex life?

Boost your energy in a week.

Public enemy no.1.

And today’s paper, folded to the crossword, half-done. A small bookshelf on wheels with a stack of thrillers, a slotted pot for contributions. Nicely organised notice boards, bright adverts for contact groups, names and numbers, a fundraising spread with people running through ribbons with their arms in the air, smiling in a huddle round a giant cheque.

Rae gets herself a cup of water from the cooler and stands there, sipping it, looking around.

Outside, the rain rattles coldly against the black glass.

‘Here we are!’ says the nurse, pushing Mr Rogers in a wheelchair.

He waves an emaciated hand in the air and smiles broadly as they come to a stop.

‘Thank you so much for waiting,’ he says. ‘Sorry to keep you.’

last of the helmstone hyenas

After a brief pause we’re buzzed in to the lobby. An elderly man is standing by the nearest flat door; I assume it’s flat number one.

‘Hello,’ I say. ‘Who’ve we come to see, then?’

He frowns. ‘I don’t know,’ he says. ‘That’s what I was wondering.’

For a second I think this must be an aspect of the job, but Rae sees how the numbers are running.

‘This is flat eight,’ she says.

The man takes a trembling step out further towards us.

‘Yes. Flat eight. But I saw your ambulance and I wondered what all the fuss was about. Who did you want?’

‘One.’

He thumbs us further down the hall.

‘Out the back. Let me know if you need anything,’ he shouts after us.

The corridor seems to extend forever without any logic to the numbers or leading anywhere in particular. We’re just about to radio for more information when a door to a hidden stairway at the far end cracks open and a friendly-looking woman in her seventies puffs out onto the landing.

‘This way,’ she wheezes. ‘I told your people we were round the back.’

‘Oh. I thought where we parked was the back.’

‘No, that’s the front. But it’s confusing,’ she adds, generously. ‘Follow me.’

She tells us what’s happened as she walks, marking out the dreadful progress of the whole thing in her padded slippers: Stan eventually got diagnosed with terminal cancer a couple of months ago. He doesn’t like doctors, he put it off too long. They haven’t been able to sort the care package out mostly because of Stan’s cussedness. But he’s much, much weaker now. The speed of it’s taken everyone by surprise. The last few weeks have been difficult; the last few days have been disastrous.

‘He won’t even talk to the doctor anymore,’ she says. ’I’m at my wit’s end. I just can’t manage.’

She shows us into the flat, a tiny but comfortable place with a wooden baby gate in the hallway.

‘For the dog. When we had it. Excuse the mess.’

Stan is lying in bed. The cancer has robbed everything from him but the shine in his eyes. Every ridge and scoop of his skeleton is readable through the skin; it’s a shock to see him breathe, like seeing signs of life in a mummy.

‘He won’t eat or drink. He hasn’t had anything the last few days. I spoke to the doctor again but he just pointed me back to the cancer trust. They’ve done their best but it’s reached the point now when I just don’t know who to call or what to do.’

She reaches out and rubs the back of his hand.

‘There’s a Do Not Resuscitate thingy for him. I know he’s dying, but the doctor said maybe three months. He won’t go into a hospice and I don’t know what to do. We haven’t got the room. It’s not like I can even be in the same bed with him anymore.’ She looks down at him with a numb statement of fact. ‘I just can’t.’

‘Do you have a care folder we could look at, Deidre?’

‘Care folder! I’ve got a phone number somewhere, but it’s not twenty-four hours. I thought maybe you’d have some ideas.’

But just as I start to review the options – including taking Stan to hospital, although in his condition that obviously wouldn’t be the best place – when Stan suddenly turns over in bed, grabbing the sheet with an emaciated hand and dragging it over his head as he goes. It’s an unexpected, peevish kind of movement, like someone bothered by all the fuss.

Rae goes round the other side to look at him.

‘Agonal,’ she says after a moment.

Deidre lays both her hands on her heart.

‘What does that mean?’ she says.

‘I’m afraid Stan’s dying,’ I tell her. ‘These are his last breaths.’

Deidre has to leave the room, but one of Stan’s niece’s had been visiting the family. She sits with her uncle and holds his hand as he dies.

‘Would you like some tea?’ says Deidre, bustling about in the kitchen. ‘Milk and sugar?’

*

There are quite a few family members in the area. We’re still finishing off the paperwork and organising the next step as they arrive. It’s a friendly bunch – there are gasps and tears, but it all soon settles down into a kind of scratch wake, tea and biscuits, old photos coming out. His brother hands me a framed black and white picture of a hockey team, lined up with their sticks.

‘Here’s Stan in the Fifties. That’s him, there. The Helmstone Hyenas. County champions. You should’ve seen them.’ He taps the glass, and then wipes it with the edge of his hand. ‘That’s why I’m not too sad about what’s happened tonight. That wasn’t Stan in there. He’d already gone. I saw him a couple of days ago and we had a good chat about things.’

I hand him back the photo.

‘The last of the Helmstone Hyenas,’ he says. ‘And if you look at that picture over there...’

He points to a wedding photo, Deidre and Stan arm in arm striding out of the church. I’d noticed it before a few minutes ago, but there’s something I missed, a foreground detail – an arch of raised hockey sticks for the young couple to walk through.

what to do

Georgina is sitting on the floor where she fell, her oedematous legs splayed out in front of her, rolling in folds at the ankle and knee, punished by cellulitis, venous insufficiency, heart failure, age. One of the residential nurses, a woman in her twenties, as dark and slim as Georgina is pale and plump, squats down next to her with an arm round her shoulders. She adjusts the blanket round Georgina’s shoulders and points to us as we come in through the door.

‘Here they are,’ she says. ‘The cavalry.’

Georgina hasn’t hurt herself, but the likelihood is she’s septic, which was probably a factor in the fall.

‘I’m afraid it’s a trip up the hospital,’ I tell her.

‘Oh for God’s sake! What’s the point? Just let me die,’ she says. ‘I’m ninety-seven. I’ve had my time. Let me go.’

‘Hey! Come on, Georgie!’ says the nurse, giving her a hug. ‘You’ll be back in no time. Don’t worry about it. These guys’ll take care of you.’

‘I wish they would take care of me.’

But by the time we’ve got the trolley into the room and sorted things out, she’s cheered up a bit. She jokes with us about this and that, trades affectionate squeezes with the nurse, and generally seems to be building herself up for the trip. We make her snug with blankets and are just getting ready to go when she sighs.

‘I really miss my mother,’ she says. ‘And she’s been gone seventy years.’

She folds her arms on top of the blankets, thinks a moment, and then looks at me.

‘She’d have known what to do,’ she says.

the chances

‘Sorry it’s taking so long to handover. The hospital’s busy today.’

‘I can see.’

‘Still pain free?’

‘A little discomfort, but nothing I can’t handle.’

‘Good. Anyway. Shouldn’t be much longer. I expect your husband will be here soon.’

‘I hate to worry him.’

‘He seems to be coping pretty well.’

‘He’s used to me now.’

‘Finally.’

Molly rearranges the carrier bag of medication and things on her lap, then settles back again.

‘This is so unexpected,’ she says. ‘And so unfair. I go swimming with my daughter twice a week. Forty lengths! An Olympic-sized pool! You’d think after all that I’d be a bit healthier.’

‘Twice a week’s impressive.’

‘I think Katie gets a bit frustrated with me, though. She could probably do twice as many lengths in half the time, but she humours me.’

‘How old’s Katie, then?’

‘Forty-eight.’

‘Forty-eight?’

Molly is only sixty-five. I quickly do the maths – but she pre-empts me with a generous smile.

‘I had Katie when I was seventeen,’ she says. ‘I told your colleague all about it on the way in. I know, I know. Young and stupid. But these things happen - in our case, about six months after we got married. Seventeen’s too young, really, but it worked out for the best. I’ve even got a great-grandchild now, which doesn’t sound right at all, but there you are.’

We get the signal from Rae, and move towards a cubicle.

‘Thanks for all you’ve done,’ she says.

*

Afterwards, whilst we’re tidying up the back of the ambulance, I tell Rae about my chat with Molly.

‘It’s amazing to think she had a child when she was seventeen, and here they are now, forty-eight years later. I mean, what are the chances of staying married for so long after a start like that?’

‘They didn’t.’

‘What do you mean, they didn’t?’

Rae starts folding a blanket.

‘You missed the best part. They got divorced just after the daughter was born, lost touch, she brought Katie up on her own for a while and then eventually re-married. They only got back together again last year.’

‘Last year?’

‘Yep.’

She drops the folded blanket onto the trolley. ‘Like you say – what are the chances?’

nile street

There’s a Nile Street in every British town. Running up to the railway station. A newsagent, pizza delivery, pawnbrokers, second-hand clothing shop and tattoo parlour, a semi-derelict, permanently open pub with green tiles on the front to make hosing down a little easier. A small square of public garden with high-railings all around like an exercise yard, with benches, bins, and plane trees. But if the street was named after a brilliant Nelson victory, the echoes of that particular cannonade have long since segued into the low-grade rumble of traffic endlessly passing across the bottom of the street on the main drag.

The area is something of a street-drinkers’ ghetto. There’s already a groundswell of public protest about the level of deprivation, the drug users and NFAs that have colonised the area, and no doubt a time will come when enough fuss is made to initiate some kind of clearance, a zero-tolerance approach that will finally bring in the developers. And of course the net result will be to shift the drinkers and the users to another part of town, to start the whole process over.

But for now, it’s the usual faces in the usual places.

Garry, a bandage round his head, sitting with his back against the pizza place, a puddle of blood off to his left marking the spot where he fell.

Because of the one-way system here, we’ve had to park the ambulance a little way up Nile Street and walk back. Greg ,the paramedic first on scene, is crouching next to Garry as we approach. He’s writing something on his form, so we don’t say anything, but stand slightly off to the side with our blue gloved hands folded respectfully in front of us.

Eventually Greg stands up, sighs and looks off to the right, in the direction he’s expecting us to arrive from. The fact that he doesn’t appear to have noticed us standing there is so extraordinary we don’t say anything, wondering how long it’ll be before he notices. At one point he actually turns and looks past us, but still doesn’t register we’re there. Eventually I cough and say: All right, Greg. He flinches and jerks back a little.

‘Fucking hell where did you come from?’

‘Erm...’

‘How long have you been there?’

‘A minute or two.’

He looks utterly lost for words – and, for a moment, we are, too.

Garry shifts his position on the ground.

‘Shall I get up now, guys?’ he says.

‘Yep. Hang on a minute, I’ll just tell these guys the story.’

He says Garry doesn’t know how he ended up on the ground. He may have been assaulted or may have had an alcoholic blackout – either way, he has a cut to the back of his head that needs attention at the hospital. He hands us the form.

‘I can’t believe I didn’t see you,’ he says, seeming more white-faced and shaken up than Garry with the head injury. ‘I need a break.’

We help Garry up and all walk together up Nile Street to the ambulance.

Incredibly, a beautiful young woman in a white coat comes running over from the pharmacy on the opposite corner.

‘Garry!’ she says. ‘Are you all right?’

‘Yeah,’ he grins, revealing a mouthful of dreadful teeth. ‘I bashed my noggin, love. It’s okay, though.’

‘He was fine when he came in for his scrip about an hour ago,’ the woman says, touching him lightly on the arm. ‘Weren’t you, babe?’

‘Yeah! I’m always fine, me.’

‘Well you take care,’ she says, then turns to us. ‘Is there anything I can help you with?’

‘No, no. We’re good, thanks.’

She hurries back in the direction of the pharmacy.

‘She’s nice,’ I say to Garry.

‘Yeah! She’s all right, she is. Everyone’s all right.’

A shambling figure intercepts us as we pass the entrance to the park, a filthy figure in ragged combats and trainers so rotten you’d double wrap them before you threw them in the bin.

‘Garry mate,’ he drawls. ‘Wha’sappened?’

‘Wriggles,’ I think he says. ‘Mate – I’ve smashed me ‘ead and I need to go up the hospital.’

‘N’ah mate. Really? Who done that t’you?’

Garry shrugs. ‘Someone. Maybe no-one.’

Wriggles hands him a roll-up.

‘There you go, mate.’

Garry puts it in his mouth and stands there whilst Wriggles lights it.

‘I don’t think we’ve really got time to stand here and smoke,’ I say. ‘We’ve got to get your head seen to.’

Garry nods, but makes no effort to move.

It’s as if this whole incident and our presence here has released something into the air. Wriggles was the first to respond, but now others are coming over, irresistibly drawn by a trace pheromone of scandal. One guy, a decrepit figure of indeterminate age lopes across the road and joins us.

He pulls his hand out of his pocket and shows us a couple of silver bracelets.

‘Where can I sell these?’ he says.

Wriggles nods in the direction of a tiny jewellers shop further up the hill.

‘What about there?’ he says. ‘The old guy there’s taken stuff before.’

‘Nah,’ says the man. ‘That’s where I nicked ‘em from.’

twinset and hearing aids

The scaffolding is finally down at Blenheim Court. It rises up on the corner of the street as fresh as an architect’s model, every Art Deco detail – the curving, metal windows, the kinked brass fittings, the epic marble friezes of Achievement, Reward, Industry – everything sandblasted free of a hundred years of grime.

It’s a windy night, cloudless, half a moon. The wind has been picking up the last hour or so; the block is so exposed here, maybe the scaffolding was simply swept away, the last traces of dirt lifted from the bricks, the corners of the building rounded off.

No-one answers the intercom.

I’m just about to call Control to ask them to get back to the caller when the intercom crackles.

‘Ye-es?’

‘It’s the ambulance.’

After a long pause the door clicks, letting me in to a small atrium with another, identical door and intercom just ahead.

I walk up the marble steps and buzz again.

‘Ye-es?’

‘It’s the ambulance.’

Who else do they think it might be?

Another pause.

The original door buzzes.

I push the second door - still locked.

I buzz again.

Pause.

‘Ye-es?’

‘Could you let me through the second door, please?’

Pause.

Buzz.

In my haste to get in I pull instead of push, and then in a panic to get it open before the buzzing stops I crash against it, almost demolishing a panel in the process, stumbling through.

The interior lobby is eerily vacant. The renovation has swept through the place so thoroughly, everything hangs in a strangely indeterminate state, as if the building had been newly built and then dropped through a wormhole into the next century.

I follow the golden arrows on the lacquered wooden signs to number ten, put my bags down and knock.

Another pause, the door opens.

‘Ye-es?’

‘Hello. It’s the ambulance. Are you the patient?’

‘You want my sister, Vivien. She’s just through here.’

She turns and leads me through.

Even though Barbara is as old as the building – was born in this flat – sadly, the renovation process has passed her by. She is sweetly decrepit, lavender talc and peppermints, the ropes of her neck rising out of her dressing gown in frank, anatomical cables. Her skin is as fragile as a parchment map marked out with liver spots, scars, moles, bruise-patches. She’s wearing a hairnet and curlers, the whole thing like some mad professor’s prototype –  a machine for dreaming yourself young.

Barbara shuffles ahead of me down a hallway into the sitting room where her twin sister Vivien is sitting on the couch.

‘Vivien?’

‘Hey?’

‘Vivien?’

‘What?’

‘It’s the ambulance.’

‘Who?’

‘The ambulance.’

‘What?’

‘She’s deaf, you know,’ says Barbara, straightening up and patting her hairnet.

‘So what happened tonight?’

‘She got up and came in here. When I followed to find out what was wrong she said she couldn’t breathe, so I called 999.’

I crouch down next to Vivien.

‘How are you feeling?’

‘What?’

‘How are you feeling?’

‘How am I what?’

‘Your breathing. Do you feel short of breath?’

Vivien turns to her sister.

‘What’s he saying?’

She leans in and touches her on the shoulder.

‘Your breathing, Viv.’

‘My what?’

‘Your breathing. You said you couldn’t breathe.’

‘I can’t hear a word you’re saying. My what?’

‘Does Viv have a hearing aid?’ I ask Barbara.

‘No, but she ought to.’

The SATS probe on Viv’s finger supports what’s apparent anyway – Vivien is not having trouble breathing. In fact, she looks better than her sister.

Barbara leans in again and shouts in her ear.

‘You said you were having trouble breathing, Viv.’

‘When?’

‘When you got up.’

‘I had trouble sleeping.’

‘What?’

‘Sleeping. I had trouble sleeping.’

‘Oh,’ she says, sighing, and then burying her hands in the deep pockets of her dressing-gown, she turns to me and says: ‘I see.’

toblerone

Frieda Allenstein is ninety-six years old next Thursday, but she’s the only one here who doesn’t know it. Frieda has dementia. She’s being cared for in her own flat by a combination of live-in carers and her family who live nearby. It’s a loving remedy for a cruel disease that in the last few years has robbed Frieda of her independence, her orientation in the world, her identity.  She is curled up on her side on the bed, her head cradled in the crook of her arm, staring at the sunlight pouring in through the window.

‘Listen to them talking,’ she mutters. ‘Lies. All lies.’

When I lean over to look at her, her eyes are glittering and hard.

The EMI outreach team have changed Frieda’s meds and that’s perhaps one reason why she’s shown a decline this last week. She’s fallen a couple of times – non-injury, but her confidence is shaken and she’s withdrawn to bed. She’s refusing to take any of her pills, and becoming increasingly aggressive to Marta, the live-in carer.

‘I can do nothing,’ she says, standing in the doorway as we gently coax some observations from Frieda. ‘First she is with the biting and now with the slaps.’

Frieda’s son-in-law, Jacob, a rounded and friendly man in his late sixties, sits on an Ottoman with his hands placed either side, as if he were ready at a moment’s notice to spring up and be helpful.

‘My wife’s away on business till Monday,’ he says. ‘What do I tell her? Should we get her back early?’

‘Let’s have a talk first about the options. I don’t think we need to be rushing off to hospital. I think there’s a good chance we can manage this at home with a little extra help.’

I make a couple of phone calls, wait for a ring back.

Jacob makes us tea, and we drink it next door in Frieda’s living room, a bright and lovely room crowded with paintings and photos and the collected ephemera of her life.

‘She’s accomplished so much,’ he says, cradling his cup. ‘So much. It’s tragic she should suffer this thing, but then I suppose she’s had ninety odd years of good health. It’s only in the last couple she’s gone downhill, so that’s a blessing.’

‘It is.’

‘You know – my son jokes with me. He says “Dad, when you start to go like that, let’s take you to Switzerland.” So I say “What do you mean, Switzerland? You want I should go to that dreadful clinic and be finished off?”  And you know what he says? He says: “You know it’s for the best, Pops. Everybody wins. You get to avoid all this mess, and we get to eat Toblerone on the flight back.”’

crane man

‘It buckin’ hurts, mate! Naawwww! Buckin’ ‘ell! Cheysus Kay-Ryst!!’

Mr Layton carries this on at top volume the whole time. It’s so emphatic, in a Carry On Cockney kind of way, it would make you laugh, except the contrast with his dreadfully debilitated state brings you up short. Mr Layton has cancer. We’ve been called out in the early hours because he’s hit a rocky patch, some kind of sepsis no doubt, with low blood pressure, high temperature, tachycardia, and pain despite a container of meds. His cancer is an aggressive form; it’s taken hold quite recently, and an appropriate care package isn’t fully in place.

Mr Layton’s daughter Chrissie is sitting just slightly back from him on a low stool. She’s smiling,  but when she catches my eye she presses her lips together, shakes her head slowly from side to side and mimes the word terminal.

‘Has there been any Macmillan involvement?’

Barry, the son, a gigantic man dressed in a roughly stitched sheepskin coat and blockish loafters – like a friendly ogre the villagers dressed in whatever building materials they had to hand – takes a sip from a mug of tea the size of a vase and grimaces.

‘Yep. They were round today.’

‘So what did they say about this sort of thing happening?’ says Rae, flicking through the folder.

‘I don’t think they got that far, mate.’

‘And what about hospices? Did they...?’

Barry tugs her elbow, frowns and shakes his head.

‘Don’t go there,’ he says, barely moving his lips. ‘He don’t want that.’

Rae puts the folder aside.

‘Obviously we’d do anything to keep your dad out of hospital, but I’m not sure what else we can do here, especially if – erm – that other option isn’t on the table.’

Barry shakes his head again and buries his face in the mug.

‘Buckin’ ell! Cheysus Kay-Ryst! It ‘urts! It buckin’ urts!’

‘At least we’ll be able to get on top of this infection, sort the pain control out and get you back home as soon as possible.’

‘That sounds good,’ says Chrissie, squeezing his hand. ‘Let’s take a nice little trip up the hospital. Shall we, Dad? Hey?’

*

I wait with them whilst Rae goes to handover.

Mr Layton’s shouting has subsided into a delirious, low-grade kind of fuss. He plucks at the blankets on his lap and carries on a conversation only he can follow. Chrissie stands next to him, rubbing his shoulder; her brother stands at the foot of the trolley, his hands in his pockets, his legs planted left and right, shifting his weight only occasionally as if to take the load better.

‘I’ve only just come down from a job up north,’ he says. ‘I’m knackered.’

‘Oh? What do you do, then?’

‘I’m on the cranes.’

He’s so enormous I imagine him passing up wheelbarrows of cement in his bare hands, the BFG of the construction industry.

‘They put a crane up on a site near where I live,’ I tell him. ‘It was so impressive to see it go up. And then one morning I was out walking the dog, and it was really foggy, and there was this banging coming from overhead. When I got a bit closer I could just make out a guy in a yellow jacket standing right out on the end of the boom, whacking something with a hammer. It made my legs weak to see him standing like that, right out on the end, bent over that drop, banging away. And the fog just made it worse.’

Barry nods.

‘Yep. We’ll do that,’ he says.

‘I don’t think I ever really thought about cranes before that. Simple things, like where you put it up. How much of the site you’ll have to cover. Practical things.’

‘It’s how you take ‘em down at the end of it that’s more of a problem,’ says Barry. He leans forward a little and widens his eyes at me. ‘How are you gonna get your crane out when the building’s done?’ he says.

What would you do? Put up a crane to take out the crane? Then what about that crane? There’d be no end to it.

I shrug.

Barry shifts his weight again.

‘What do you call a big hole that runs through a building?’ he says.

I think about it, then shrug again.

‘A window?’

‘A lift shaft!’ he says. ‘You put your crane up where the lift shaft is going to go. Your forty-foot boom covers the site. And when you’re done, you take the crane away, and there you are!’

‘Buckin’ cranes!’ says Mr Layton, shifting up straight on the trolley and gripping the rails. ‘Cheysus buckin’ Kay-Ryst!’

Barry taps me on the shoulder, grins and points an index finger up. ‘Scared of heights,’ he says. ‘Aren’t you, pops?’

four by twos

1. We haul our heavy bags up four flights to the top flat. A smart middle-aged man is waiting for us by an open door.

‘That’s a long way up!’ I puff, pleasantly.

‘It’s because you’re fat,’ he says.

He turns and goes inside.

A scrupulously clean flat, laminate flooring, size-ordered books, tasteful prints, and on a clear section of wall a gleaming Fender Stratocaster, hung on a peg.

His partner Janice is sitting over by the window.

‘Can I get you a cup of tea?’ she says.

‘No, no. We’re good, thanks. How are you feeling, Janice?’

‘I really don’t mind,’ she says. ‘Are you sure you don’t want one? You look as if you could use something.’

The man comes and stands by my shoulder.

‘Make sure you tell them everything,’ he says. And then to me: ‘Janice has a habit of glossing over the truth. God knows why.’ He stares at her a moment then says: ‘I want you to tell these people the whole story.’

Janice is brittle, watchful.

When the man turns to fetch a glass of wine from an antique table, she mouths: I don’t want him here.

When he turns back I say to him: ‘Would you mind if we had a chat to Janice on her own? Is that okay?’

I prepare myself for his response, but eventually all he says is: ‘Make sure you tell them about the overdose.’

When he leaves the room, he shuts the door slowly and quietly.

2. Zak limps as he helps Ellie up the steps of the ambulance.

‘What’s the matter with your foot?’ I ask him.

‘I kicked a wall when she said she weren’t going to hospital. But I can book myself in and get it looked at when we’re up there.’

‘Good idea.’

Ellie throws herself onto the trolley and curls up. Zak takes a seat, but then leans forward and drapes himself over her.

‘Stay with me, babe,’ he says. ‘I love you, yeah? You know I do.’

But Ellie is so drunk she doesn’t appear to notice or care. She pulls her jacket further over her head and draws her knees up.

‘Sorry to call you guys out,’ says the paramedic on the car. ‘It was initially an abdo pain, and I was going to take her up, but then she said she didn’t want to go, took a few steps down the road and collapsed. Non-injury. I think alcohol’s the deal here, but who knows. She changed her mind and said she did want to go to hospital, so I didn’t really have much of a choice. I’m really sorry. Here’s what I got on the form. See you later.’

Rae is attending.

When I ask if she needs anything she bats the air sleepily so I leave them to it.

I drive us up the road.

At the hospital I wait with Zak and Ellie whilst Rae goes to handover to the nurses.

Zak goes off to book himself into the minor injuries department.

I’m still waiting when he hobbles back through the double doors towards us.

‘Mate - help me roll her over,’ he says.

‘It’s okay,’ I tell him. ‘She’s not unconscious, and actually this quite a good position for keeping her airway clear.’

‘What?’ he says. ‘Her tobacco’s in the other pocket and I need a smoke.’

3. The woman is lying back on the ambulance trolley breathing as deeply and noisily through the Entonox regulator as a panicked scuba diver. Her partner, a blank faced kid with stripes shaved in his eyebrows leans forward and taps her leg.

‘Off your nut yet?’ he says.

She takes the mouthpiece out for a second. ‘Fuck off,’ she says.

He smiles and sits back. ‘That’s a yes, then.’

I read through her notes. She’s young, but already has three children. At twenty-two weeks these abdo pains look dangerously like contractions.

But her partner seems oblivious. He carries on talking to me about the mini-moto scrambler he’s thinking of buying the four-year-old. He shows me a picture on his phone.

The woman takes the mouthpiece out again.

‘I’m worried it’ll be like my cousin, come out too soon and dying in one of them incubators,’ she says.

He looks up.

‘No it won’t,’ he says. ‘I won’t let it.’

‘How’re you gonna do that, then?’ she says, before wincing and taking several more drags on the mixture.

‘I’ll crawl up your cunt and push it back, all right?’ he says. Then he elbows me and holds out his phone again. ‘Look at that! Wha’dya think?’

4.  Mal is a mean drunk. He lies back on the ambulance trolley, bunching his fists and raising himself up anytime anyone asks him the simplest question. His grey goatee is neatly trimmed; that, along with his sharp blue eyes are the only clean thing about his face, liberally fouled with the blood from his head wound.

‘Ya’ filthy bitch,’ he says to the police woman.

‘What have I told you about using language like that?’ she says. ‘Carry on in that vein and I’ll arrest you for drunk and disorderly and take you down the nick.’

‘Ssh. Ssh,’ he says, smiling and lying back down again.

‘So let’s have your address,’ she says.

‘Why should ah?’

She sighs and taps her notebook with her pen. Her colleague is outside the ambulance on the radio, listening to the roll-call of Mal’s previous convictions; he looks round the door and nods to us.

It’s been going on like this for half an hour or more. Mal was found on his back in the gutter by a lovely couple who tended to him despite the foul language and temper. They stayed until we arrived. I had to tell the woman she had blood on her trousers from where she’d knelt down beside him.

‘Don’t worry about that,’ she said.

It was a battle from then on to get Mal to accept any treatment – something we felt obliged to do, though, as he had a significant head injury, and no evidence of capacity to refuse. The police arrived; between us we got him on to the vehicle, but if anything his hostility grew. The police managed to get the name of his wife from him, though; it appeared she lived nearby. They rang her on Mal’s phone. She said she’d come out and meet us.

When finally she steps up onto the ambulance in her heavy lavender coat and trim hat, she should be stepping up onto a dais at the Guild flower show to award prizes, not taking her seat next to a late-night derelict like this.

‘Oh Malcolm,’ she says.

‘Fuck yous,’ he says. ‘Le’me lone.’

She smiles tearfully at the police woman.

‘I hope he hasn’t been too much of a bother,’ she says.

‘Oh. You know,’ says the police woman.

Rae slams the door and we move off.

delicate orchids

I’m struggling to open the gate of the ramshackle little bungalow when the porch light comes on and an elderly man steps out. His hair and beard are so full they’d make a passable mane – the kind of mane you might see on a lion that didn’t get out much.

‘Let me help you with that,’ he says, coughing in the chill night air and shuffling up the path towards me. ‘We keep it bolted. Neighbourhood kids, you know.’

Then he turns and leads us back down the path, eventually ducking through the back door into a house so filthy our boots make an audible crickle-crackle sound as we walk through. The smell is dreadful; I don’t know whether it’s better to breathe through my nose or my mouth, but in the end the sensation is the same – like eating.  

‘You keep it hot in here,’ I say, struggling to find somewhere to put my bag and board.

‘Delicate orchids,’ says Eric, lowering himself into a fossilised armchair with soiled towels draped front and back. He reaches for his cigarettes.

‘Would you mind not smoking until we’ve finished?’ I ask him. ‘Sorry if it sounds bossy, but we’ll stink of fags all night, otherwise.’

Like it’ll make any difference. But the act of asking makes the rest of it seem a little more palatable, somehow.

‘Right you are, Chief,’ says Eric, putting the fags back.

His partner Simon is sitting on the carpet where he fell. Simon is pretty much as hairless as Eric is wild, excepting a splurge of whiskers around his muzzle. Although Eric is dressed in the mortal remains of a three-piece suit, all Simon is wearing is a pair of grey boxers, the fly gaping horribly. His legs are stretched out in a flat V; he has both hands planted on the floor at either hip, and he rests with his back against the sofa. Between the sofa and the armchair is a scattering of empty vodka bottles.

‘How did you end up on the floor, Simon?’

‘A simple error of judgement,’ he says. ‘I’ve done it before. I used the back of that stupid chair to help me stand up, but it wasn’t sufficiently steady and I tipped over. I landed on my bottom where you see me, and I just haven’t been able to get up.’

‘Have you hurt yourself?’

‘Nope. No. My back is agony, but then it always is. I don’t suppose you have your magic cushion to hand?’

Rae goes to fetch it.

‘When was the last time this happened, Simon?’

‘Last year, was it, Eric? Yes, I think last year.’

There’s a Christmas tree in the corner of the room, decorated with a vomit of baubles and tinsel.

‘I see you’ve got your tree up early,’ I say.

Eric struggles out of the armchair again.

‘Do you like it?’

‘Very nice.’

‘I’ll turn it on if you like.’

‘Okay.’

He follows the green wire, scattering the vodka bottles, excavating down through layers of rubbish to a plug behind the sofa. There’s a click, the tree gives a lurch, glows red and purple, starts grinding round in a precariously off-centred way.

‘We like it so much we keep it up all year,’ he says, stepping back.

‘Saves taking it down and putting it up again,’ says Simon, reaching in to scratch himself through his boxer fly.

Over on the windowsill, in the one clear space amongst the unutterable clutter and junk, is a black and white photograph in a frame. An old, three-quarter length portrait of a barrister in wig and gown.

‘Who’s that?’ I ask them.

‘Have you heard of Marshall Hall?’

‘Yes! I think I have!’ But then I doubt myself. Maybe I’m thinking of martial law. ‘Relative of yours?’

‘Can you see a resemblance?’

He smiles up at me – a dreadful gurn, like a walrus breaking surface smelling mackerel.  

‘Erm....’

He leaves me a while then closes his eyes and says: ‘Silly boy. We just like the photo.’

‘Ah.’

Rae comes in with the inflatable cushion.

‘Have you used this before, Simon?’

‘Yes, I’ve ridden the cushion many times.’

Eric snorts.

Simon holds out his hand.

‘To stabilise me,’ he says, batting the air between us. ‘Don’t worry. I’m not getting fresh.’

TMI

Stephen meets us at the door. A middle-aged man with long, reedy hair and a face as rumpled as his moccasins, he stands at the bottom of the stairs with one hand on the banister, making no move to let us up to the patient.

‘Thanks for coming. This is quite a strange one – although I don’t know, maybe you see this all the time. But I must admit it’s thrown me. It’s all a bit of a shock. So – let me tell you what happened. I wasn’t supposed to come over today. I was meant to be going over to see Jean, but Jean’s had trouble with her eldest and was called into school unexpectedly, which left me the morning free. So I came round to see Dad, and let myself in with my spare key when he didn’t answer the door. He wasn’t downstairs and I thought maybe he’d gone out shopping or something. Like I say, I wasn’t expected. But then I heard a noise upstairs and I thought – Dad? And that’s where I found him. In the bath. I mean literally in the bath. He’d fallen backwards into it sometime early this morning and hadn’t been able to get himself out again. He’s been there about five hours or so. Initially I thought I’d be able to get him out on my own, but he’s a large chap as you’ll see, and I realised I wouldn’t be able to do it on my own. He doesn’t appear to have injured himself all that much – just on his back, some bruising and minor lacerations from the taps, I think.’

Listening to Stephen talk is like witnessing the relentless spread of a fractal pattern, an endlessly expanding thing, each word suggesting five more. The only way we can break the spell is by talking across him.

‘Can you show us where your Dad is, then?’

‘Yes. Of course. I have no idea how you’re going to get him out, but I’m guessing you have specialist equipment. Just up here. I don’t know why he ended up like this. His mobility hasn’t been great lately, but not all that bad, either, considering his advanced age. He doesn’t take many pills. And he’s pretty active. Jean and I are round as often as we can. Only last week we took a trip out to a lovely country pub for a family lunch. The weather wasn’t great but that’s not the most important thing. You know - I hope I’m as hale and hearty as Dad when I’m eighty-five. Or eighty-six. No. Yes. Eighty-five. Mum died a few years ago now, so he lives here on his own. But like I say he has plenty of people round. I only live across town. Five minutes if the time’s right. Twenty at rush hour, but I’m lucky in that I work from home so I I’m pretty flexible. Jean is closer but then she’s busier, so she doesn’t get over quite so much. Here we are. My father.’

He pushes open the bathroom door.

‘Dad? Some people to help.’

James is lying on his back in the empty bath, his head at the tap end. There’s a bunched-up towel to cushion his shoulders, and an old blue dressing-gown draped over his knees. His face has such a jowly hang to it, his eyes weighed down so mournfully, he could be a gigantic, hairless basset hound scrutinising the latest disappointment.

Unlike his son, he barely says a word.

Rae starts checking him over and asks if I’ll fetch the inflatable cushion and a slide sheet.

‘That sounds promising,’ says Stephen – and carries on from there as I head back down the stairs to the truck.

*

‘Right. Now. I’ve put your watch and your wallet in the big brown holdall. I’ll put today’s paper in there, too, so you’ve got something to read. I have to go home for childcare duties but once Lisa’s home we’ll sort something out and I’ll meet you down the hospital. Okay? I can’t think of any other way of doing it, but you’ll be fine. I expect the first couple of hours you’ll sleep anyway, after all the long trauma of the bath. Once you get on one of those comfortable hospital beds you’ll be away. And then when you wake up, I’ll be there to keep you company. The important thing is we get you checked out, and get to the bottom of why you fell. You’ll be home before you know it, Dad. I’ll make sure all the lights are turned off, the windows closed and the back door locked. It’s landfill bin today, so I’ll put that out, too. Jean says she can probably make it over sometime after six if you’re still there, but hopefully they’ll have you discharged home before then. We can all reconvene here in the evening. The girls have got tap and karate. Mae’s got that show coming up and Ellie’s got a grading, but don’t worry, we’ll sort it out.’

And on and on, like some benign species of domestic spider, playing out an endless spool of detail. James sits impassively in the carry chair, swaddled in our blankets. He doesn’t say a thing.  I give Stephen some tasks – bringing out the equipment for us, the bags and so on. It means we won’t have to come back in to get them, and I’m also hoping it might act as a distraction. But his facility for talking is such a separate thing, I’m sure he could do three things concurrently and still be able to chat.

Once we have James on the ambulance trolley, we store the gear and make ready to go.

Stephen stands looking in, continuing his monologue, still without any sign of stopping.

In the end, despite trying to steer things to a gentler conclusion, I have to close the door on him. I do it as slowly and respectfully as I can, nodding and smiling the whole while, but even so, Stephen manages to squeeze a hundred more words through the closing gap before the door clicks shut.

I take my seat next to James as we move off.

‘Takes after his mother,’ he says, then shuts his eyes.

anxiety

As we turn into the road, three children and a dog have been standing look-out. They catch sight of us and run ahead along the pavement, the terrier barking furiously, pushing itself forwards on the lead with such force it’s like they’re holding a rabid dog at the end of a pole. Groups of people stop to stare as we pass. Windows open, people lean out,  all with the same expression. In fact, everyone’s so interested it makes us nervous. Maybe they don’t like visitors. Maybe they’ll kill us, stuff us, and hang us on the end of terrace display along with the other trophies: the milkman, the postman, the Jehovah’s Witness.

Two men in shiny black puffa jackets smoke and stand guard by the gate of the house we want; a large woman with an unfeasibly contoured figure waves and carefully lowers herself down a step.  A couple of seagulls land on the roof – it’s like the whole world has been alerted.

The two men stand aside; one of them holds the gate open for us and grunts as we pass.

Half-way up the steps, the woman gasps: ‘It’s John. It’s John’s heart.’

The little front garden is crapped-up with rubbish, heaped up around the threshold like the house spat out any junk it couldn’t eat through the battered front door.

‘John? John? It’s the ambulance, John.’

There are shouts and screams like there’s a fight going on upstairs. But the woman doesn’t seem to pay it any mind, so we don’t ask.

John is sitting on the sofa, his hands spread on his knees in a position of studied calm only undercut by his rapid breathing and a flush of panic on his face.

‘Anxiety,’ he says. ‘Sorry.’

Suddenly a teenage boy as large as the woman stomps into the sitting room; John looks up and tries to smile reassuringly  but it doesn’t work.

‘What the fuck...?’ says the boy. He seems angry. He rolls his eyes about the room like a wounded lion looking for something to bite. His paws are bunched into fists.

‘It’s okay, Josh,’ says John. ‘They’re paramedics. Mum was worried ... about my heart.’

‘Yeah?’ he says, ‘Yeah?’ - and stands over us for a second, breathing hard. But he thinks better of it and suddenly turns and crashes back out of the room.

‘Oh my God! Oh my God!’

It’s like tag-interruption. The boy goes out and a woman comes in, one hand over her mouth and the other reaching out to touch John on the side of the face. ‘What is it, John? What’s wrong?’

‘Nothing, Jean, nothing. I just had some bad news, that’s all. I’ll be all right.’

‘Are you sure, doll? Are you sure?’

‘Perfectly sure.’

She turns to us.

‘You take good care of him,’ she says. ‘He’s very precious to us. Check his heart, and everything. Okay? I don’t want him to die on us.’ She turns back to John. ‘Don’t you dare. Will you? You promise? You won’t die on us? Please, god.’

John smiles but looks tearful.

‘Could you just wait outside for a bit?’ I ask the woman. ‘Sorry. Only we just need a little space – and quiet – so we can get the whole picture. Is that all right?’

The woman sighs and fishes a cigarette out of her pocket.

‘I’ll make some tea,’ she says, the fag bobbing up and down in her mouth. ‘Shall I make some tea, pet?’

John nods.

‘I’ll make it just how you like it.’

She goes out and starts crashing around in the kitchen, swearing.

We sit down either side of John on the sofa.

‘There. That’s better. Now. How are you feeling, John?’

‘Better. I’m better, thanks. It was definitely anxiety. I’ve had the attacks before. I know what to look for, all the signs. It’s just – I had some bad news – very bad news. I think what with that and everything else it just took me by surprise.’

Suddenly the sitting room door bursts open again and another guy rushes in.

‘What’s wrong, John? They said you was having a heart attack. Are you all right? I saw the ambulance and I thought fuck – he must be dying. Are you okay?’

John holds his hand up to stop him.

‘I’m okay, mate, yeah – thanks. Don’t worry. Let me just talk to these guys and I’ll tell you all about it.’

But this last interruption has breached the dam wall. Everybody pours in - the two guys from the garden, John’s wife, the kids with the terrier, and finally the woman from the kitchen, who starts shouting for everyone to be quiet and spills half the cup in John’s lap.

John leans past me to get a cloth.

‘I think you’ll be the one needing a paper bag in a minute,’ he says.