Saturday, April 27, 2013

almost there

Ellen is sitting on a chair just outside the en suite bathroom, leaning over to the right. She has pain in her left hip from where she slipped over an hour ago, landing heavily on her bottom.
‘Osteoporosis,’ she says. ‘ I just know I’ve done something.’
Her daughter-in-law Stephanie is waiting by the bedroom door hugging an armful of coats.
‘We’re getting to be regulars,’ she says. ‘We had another nice crew out last week. For Ellen’s diabetes.’
Even though she’s thirty years younger, Stephanie looks more tired than Ellen.
‘I’ve phoned Richard,’ she says, waving her mobile in the air then dropping it into her bag. ‘He says he’ll meet us up there.’


‘I came down this way for work twenty years ago and never went back,’ says Stephanie. ‘Funny – the places you end up. Left one long-distance relationship, then a few weeks after I got here, went straight into another. Mind you, we’ve been together ever since. Two grown up boys. Lovely house. And now Ellen’s moved in.’
Ellen smiles at her from the trolley, then winces a little as she adjusts her position.
‘Okay?’ says Stephanie. ‘All right?’ She reaches over and pats her on the arm. ‘Almost there.’
She settles back in her chair again, and rearranges the coats on her lap.
‘The boys have all grown up now,’ she says. ‘They’ve gone their own way, done their own thing. Mark’s training to be an engineer. John’s travelling a bit before his law degree. So they’ve both turned out all right. I suppose I could’ve gone to university but it just never really happened, if you know what I mean? Maybe I should’ve done something? Then who knows where I might’ve ended up? Some far flung place. I might’ve met someone else. Had a whole other life.’
She stops, like someone who’d been rummaging through a box of photos and unexpectedly caught themselves on something sharp. In an effort to cover it, she leans forward again and touches Ellen on the hand.
‘But you know what Richard’s like,’ she says.
Ellen nods.
‘Almost there,’ says Stephanie again. And settles back with the coats.

Thursday, April 25, 2013


Mr Warding, BEM, DCM, DL, is sitting on a rich leather sofa in the lounge, one arm in a blood pressure cuff and the other on the armrest, wired up for an ECG, his shirt unbuttoned to the navel, his velvet-lined jacket slung neatly across his lap. Two of the residential home staff hang back, one with a folder of notes, the other with a bag of medication. Stephen, the first paramedic on scene, is just finishing his examination; he introduces us to Mr Warding, then carries on.
‘So - to re-cap for these guys,’ he says, ‘you’d just finished lunch, you felt a bit swimmy, you were helped to the sofa where it looks like you may have passed out for a minute or two. At no time did you have any chest pain, and you don’t have any now. Is that right?’
‘Ye-es. That is correct. Now look here. What’s going to happen to my wife when I go in to hospital? She has some significant health problems of her own, as you no doubt have been informed by these good people here to my left and my right. I am her main carer, although to be frank my responsibilities are pretty light, limited to a few words of conversation, perhaps a little push around the gardens in her wheelchair. But you see even that is rather too much for me these days. I’m interested to know what you recommend we do about this?’
Mr Warding speaks slowly and precisely. Whenever he needs more air he stops, squeezes his eyes shut and pulls a peculiar expression, a cute and animal thing, a cross between a smile and a stifled sneeze. With his hanging jowls, great, fleshy paws and stubby legs, he could be a gigantic species of mole, ninety-five years old, reminiscing about the lawn.
‘Has something like this ever happened to you before?’ asks Stephen, writing down the last of his observations, then putting the board down, unwrapping the cuff, disconnecting the leads.
‘Well in actual fact it has. (Smile). It was very much the same circumstance, a post-prandial fainting fit, barely a week ago. (Smile) I was assisted to this sofa, made comfortable with cushions and so forth, water and the like. An ambulance was dispatched and duly arrived (Smile) They trussed me up with wires and so on, as indeed you have, and they found absolutely nothing wrong with me at all. (Smile). They recommended I travel with them to the Accident and Emergency department of the local hospital, and I followed their advice. (Smile) As one should. (Smile) More tests, more collective scratching of heads. I was there quite some hours. It was dark when I was finally delivered back to my room, with no more insight into my condition than before.’
Stephen has packed away all his things and looks about ready to force a decision.
‘So, Mr Warding. All things considered I would imagine you had a simple faint. I don’t think it’s your heart, but of course that’s just a guess.’
‘A guess? Well, now, I’d like a little more than guess work, if you wouldn’t mind. (Smile) What I’m really after are some definitive answers. Something I can hang my hat on. I can’t very well carry on like this, you know. Collapsing about the place for no good reason.’
‘When I say guess,  I mean an educated guess.’
‘An educated guess. Yes. I see.’
‘Based on what I’ve found. Which is nothing, to be blunt. But obviously I can’t do blood tests, and I’m not a doctor.’
‘You have plenty of carers around you, Mr Warding. One of your options would be to stay here at the home and see how you go. If anything changes, you can always call us back again. Or else you can go to hospital with these guys, and go through some more tests. And see a doctor, of course.’
‘Well, now, that’s most interesting,’ says Mr Warding, ‘Thank you.’ He fiddles with his gold cufflinks. I’m amazed he can handle such small things with those paddle-sized fingers, but he seems to manage okay. With his sleeve restored, he carries on.
‘You think I should go to the hospital and see a doctor? Well – of course my over-riding concern would be my wife. Who would be there to take care of her whilst I’m away seeing these doctors and having all these tests?’
‘Or you could stay here with the care staff and see how you go.’
Both women step forward. I half expect to see them curtsey.
‘We’ll keep a close eye on you, Mr Warding. And Mrs Warding.’
He glances at them both, then sighs, and sinks about a foot further into the chair.
‘It’s not as if she does all that much,’ he says. ‘Dementia, you know. A terrible business. Mostly she just sits there, staring. But then again, often she carries on awfully, crying out, you know? Making a dreadful show of it. I don’t know what to do. I simply don’t know what to do.’
Stephen has shouldered one of the bags and has the other in his hand. He stands over Mr Warding, willing him to make a decision.

A grandfather clock gently tings the quarter.

A blackbird chip-chip-chips out in the garden.

‘Now then,’ says Mr Warding. (Smile)  ‘What are my options?’

Sunday, April 21, 2013

some like it very hot

We’re met at the door by William, a portly, middle-aged man in a Hawaiian shirt, khaki shorts and espadrilles.
‘Simon’s on the floor but don’t blame us,’ he says, beaming. ‘It wasn’t our cooking – at least, I don’t think it was. He didn’t even have the salmon. Anyway, what happened was – we’d just finished the main course. Malcolm, my partner, was clearing the plates. Stephanie, Simon’s wife, asked him if he was feeling okay – which he clearly wasn’t, as he’d gone whiter than his napkin. He mumbled something or other – I don’t know what – got up, took a few steps in the direction of the sofa, then just sort of collapsed in a heap. Didn’t hurt himself, luckily. Lay there a minute, eyes rolling...’
William mimes the faint, turning his eyes up towards his forehead and describing a circle with his head.  ‘...then Malcolm put him in the recovery position and Stephanie phoned for the ambulance.’
William stares at us for a moment, his eyes diluted by his glasses. ‘Well. There you are. That’s it. I suppose you’d like to meet the poor unfortunate? This way.’
He leads us through the hallway into the dining room, a tastefully-furnished room of palms, blond wood, botanical prints, white bookshelves of art, cinema, architecture, with the only thing to disrupt the Sunday supplement air being Simon, buffered into position on the Turkish rug by an array of plump velvet cushions.
‘I was just feeling a bit hot,’ he says. ‘And then I came over all faint.’
His wife Stephanie, dressed in a flapping black caftan decorated with a pattern of gold and silver orchids, moves between us all like a large but harmless variety of moth.
‘It’s so kind of you to come, so quickly,’ she says, hurrying around her supine husband to come and lay a hand on my arm. ‘We’re not always such flakes.’
‘Speak for yourself,’ groans Simon. And then, weakly: ‘I’m feeling better, you know.’
But when he goes to sit up, what little colour that had returned to his face visibly drains. We lay him back down again.
‘Let’s get you out to the ambulance and do an ECG there,’ I say. ‘We can decide what to do after that.’
Rae goes outside to get the chair.
‘But you can’t leave before dessert,’ says Malcolm, standing in the kitchen doorway with his arms folded and a flowery tea towel over one shoulder. ‘It’s Eton Mess.’
‘Well you’ll simply have to make it a mess to go,’ says Stephanie. She sighs, knocks her head against mine and whispers: ‘But oh! If there’s one thing I love, it’s meringue.’


Outside on the truck, Simon has picked up considerably.  He sits comfortably, his arms folded, blinking around at all the equipment in the cabin like he’s admiring someone’s shed.
‘You’ve got some gear, haven’t you?’ he says.
‘It pays to be prepared,’ I say.
‘Well I’m glad someone is,’ says Stephanie.
We do a twelve-lead ECG, and it comes out clear. All his other obs seem to have normalised, too.
‘Great,’ I say. ‘Right. A few more details. How old are you, Simon?’
Stephanie cuts in.
‘You’ll never guess what year we were married.’
I make an attempt to be flattering.
‘Well I’m guessing you were a teenage bride.’
 ‘A teenage bride! We like this one, don’t we, Simon? Can we keep him?’
He nods, goes to button up his shirt, and seems startled to find the chest leads won’t let him.
 ‘Let me get those for you,’ I say. ‘So – anyway. I reckon this was probably just a faint, Simon. It’s quite common after a big meal, especially if the room’s hot.’
‘They always have the room hot,’ says Stephanie. ‘Don’t they, Simon? Very hot. And there’s a good reason for it.’
She leans in. ‘Naturists. They normally wander round the flat completely starkers. We’re used to it, but when they heard you were coming they threw something on.  Lovely couple. Great cooks. But my word they like it hot.’

Thursday, April 18, 2013


He should be easy to spot.
Male, 50. Chest pain. Beneath the town clock.
And there he is, a hunched figure on the shallow steps around the base.
I pull the car over half on and half off the pavement, and leave it running for a quick getaway.
There is a group of clubbers sitting on one of the benches in the little landscaped island of the square. I nod hello, expecting them to point or say something, but they ignore me.

John is so fattened out by all his layers he looks like some kind of spaceman – except, instead of a shiny white suit and survival pack he has a shiny black parka and carrier bag.
‘Hiya mate,’ he says, looking up as I approach. He keeps one hand clutched to the centre of his chest, the other on the stretched handles of the bag.
‘How are you doing?’
‘Not good, mate. Not good.’
‘What’s happened, then?’
‘I don’t know. I got this pain in my chest, like. Right here. And it hurts like a bastard when I cough.’

It’s been a busy night. I know that if I wait here for an ambulance the hands on the clock above us will have travelled all the way round before anything pitches up. I can’t do an ECG on the street or in the back of the car. So I decide to take him in myself.
‘Are you okay sitting in the front?’
‘No worries, mate. Sorry to bother you. It wasn’t me that got you out.’
‘Oh? Who did?’
‘Well I coughed and the pain was so bloody sharp I kind of doubled over. Some kids were going passed and I think one of them called you.’
‘Fair enough.’
When he’s in the front and I’ve climbed into the driver’s seat, I grab the clipboard off the dash. When I ask him his address he hesitates, then gives me the name of a road. I can tell he’s made it up, so instead I leave that field blank. A couple more questions and we’re good to go.
‘Sorry to mess you about,’ he says. ‘I mean, I’m fifty years old, for Chrissake. I should be big enough and ugly enough to take of myself.’
Then he coughs. It sounds like his lungs are filled with tacks.


At the hospital, the foyer is as crowded as ever. I help John into a chair and do some basic obs there whilst we’re waiting for the triage nurse. We’re surrounded by the usual casualties of a weekend night – overdoses, drunks, somebody in a vacuum mattress waiting for a log-roll, an abdo pain. It’s a disparate catch, like a trawler has passed over the town and dragged up a dozen cases for sorting at the dockside.

Eventually, Raoul the triage nurse makes it round to us. Raoul needs a break – a sabbatical, actually. He’s doing that thing where he seems to be listening but he’s actually only ten percent there. The majority of his brain is somewhere else, scanning the scene around him, an agitated snow globe of beds, times, x-ray requests, in-comings, out-goings. It’s an impossible, thankless task. I don’t know how he stays as calm as he does.
He listens to the story of John, distilling it down to a scrawl of numbers, acronyms, abbreviations. After the age and date of birth, he comes to the address.
‘And where do you live?’ he says.
‘Whiston Road.’
‘What number Whiston Road?’
‘Ahm…. thirty.’
‘Thirty Whiston Road?’
‘Something like that.’
‘What do you mean, something like that?’ Raoul sighs and carries on looking around. He talks without malice, and without even seeming to address anyone in particular. It could almost be part of an internal monologue, the story of his night, which is the story of the continuing struggle of the department to keep its head above water.
When John doesn’t say anything, Raoul directs his attention back to him.
‘Come on. You must know your address,’ he says, sighing and tapping the form with his pen. He looks at John, hunched forward on the wheelchair, gripping on to his carrier bag, really seeing him for the first time.
‘NFA,’ John says quietly. ‘Just put NFA.’
Raoul hesitates. He writes NFA, then clicks his pen shut.
‘Sorry John,’ he says. Then brightens again. ‘We’ll sort you out with a bed just as soon as we can.’ He touches him lightly on the arm. And hurries away.

Tuesday, April 16, 2013


Mr Weston lies on his back on the trolley, staring up at the lights in the hospital ceiling as we wheel him through. A large, fleshy man in his seventies, he’s been here a couple of days post-fall; now we’ve been asked to transfer him to a specialist neurological centre.
Just before we go into the lift, a woman and her young son appear in the lobby.
‘Is it all right if we…?’
‘Plenty of room.’
She hesitates, but everyone knows how slow these lifts are; it’ll be a while before the next one. She comes on, hugging the boy to her, occupying as little space as possible up near the buttons.
Suddenly, for the first time since loading him on the trolley, Mr Weston stirs.
‘…and the trajectory of the bullet was such that enormous trauma was experienced…. given the size and velocity of the round… massive cavitation….fully investigated, of course…’
The woman hugs her boy, one arm round his body, one round his head to cover his ears. I try to catch her eye, to reassure her they’ll be all right, but actually I’ve no idea what Mr Weston will say next.
She keeps her head down, staring at the floor as we descend.

Mr Weston is in a strange, dreamlike state. If you ask him a direct question he’ll answer, but then quickly trail off into some ongoing lecture about ballistic trauma.
‘Were you in the army before you retired?’ I ask him.
He rolls his eyes, his fattened senses trying to locate the source of the question. Without actually seeing me, he smiles and lifts a heavy hand.
‘Yes, sir. Twenty-five years a soldier.’
He moistens his lips, then sinks again.
‘…but then after the impact, the collateral damage… of course subsequent studies have borne this out… trauma volumes, kinetics…  the pathways aren’t always easily anticipated, the geometry of these things is often complicated…’

 It’s late at night. I wait with Mr Weston as Rae ducks outside to the ambulance to put the ramp down and open the doors. The wind cuts around her, barrelling through the great artificial valley of these hospital buildings; when we wheel Mr Weston out, the blankets we’ve so carefully tucked around him are pulled aside.
‘Soon have you in the warm.’
‘Yes. Of course,’ he says. ‘This is the problem.’


Mr Weston is lulled by the gentle rocking of the ambulance and the low-lit cabin. Now and again his eyes flicker open and he frowns, as if he’s mildly surprised to find himself on his back. I read his notes, make some observations, but with everything stable and not much to do, the warmth of the cabin, the gentle light and the hushing and splashing of the tyres along the wet road, it’s a struggle not to fall asleep myself. At one point the ambulance seems to jolt, and when I put my hand out I’m temporarily disoriented. Did the ambulance go over a bump, or was it me jerking awake?
Mr Weston has his eyes open as well. He makes vague alterations to his blankets as he stares up at the ceiling.
‘Almost there,’ I say. ‘Not long now.’
‘I was a teacher,’ he says, unexpectedly. ‘In civvy street.’
‘Oh? Really? What was your specialty?’
He pauses, then seems to melt away into the word:

Thursday, April 11, 2013


Marissa is crying because her back is hurting again. It’s a long-term problem, and really the meds she’s been prescribed should help. She’s borne the discomfort of this episode as long as she could from the small hours of the morning, hanging out for when her doctor’s surgery opened. But it’s all got too much, she’s called the non-emergency number for advice, and for some reason they’ve bounced it on to us.

She’s perched on a huge brown sofa at one end of a living room so vast it could be the deck of an aircraft carrier. And in fact, Marissa’s three-year-old daughter Kate is busy trying to take off, showing us how fast she can travel on her scooter from one end to the other.
‘Be careful on that sweetie,’ says Marissa, just as she crashes into Rae’s para bag.
‘Oops! Are you okay?’
She nods, then climbs up next to her mum, who anxiously tries to guard her posture.
‘You’ve got your hands full,’ I say to her.
She snorts, and winces.
‘Wait till the twins are up,’ she says.
And exactly on cue, there’s a sudden rumbling sound overhead; a harassed male voice, then a hurried lump of footsteps along a hallway and down the stairs. From the chaotic tumble of it all you’d think they kept goats upstairs, but the baby gate crashes open and two tiny boys gambol in.
It’s impossible to tell one from the other. Both have identical Peppa Pig pyjamas; both have tangled black hair; both have pointy little chins and bright gray eyes, tiny rows of teeth like porpoises on the lookout for fish and mischief; both catch up short when they see the two huge visitors in green. They hold on to each other, then do a comedy creep over to where Marissa is semi-cuddling Kate.
‘Go easy, boys,’ she says, then sighs: ‘You wouldn’t believe how much energy they have.’
Marissa’s husband Dave follows them into the room. He already looks exhausted. He sits down on the carpet, leans against the wall, and watches the whole scene unfold in front of him as if it was a continuation of a particularly vivid dream he’d been having.

There’s not much for me to do. I write down a few observations as Rae calls them out, the full address, date of birth, telephone number and such, but after that it’s more down to Rae to take an overview and decide what to do next. My job seems to be keeping the twins amused. They’re wary at first, circling at a distance, disappearing for a few seconds and then popping up behind me, behind the bag, behind the curtains, giggling and carrying on. Whenever I spot them and pull a monster face they shriek and run away.  When they come back they start to bring various toys: a fluffy dog, a fluffy chicken, a fluffy rabbit. One of them comes and sits next to me, whilst the other one throws himself head first into the only other available space on the sofa.
‘Careful, Billy,’ says Marissa. But instead of being careful, Billy rights himself and immediately starts rocking violently backwards and forwards, slamming his head into the cushions.
‘He’s a bit of a head banger is our Billy,’ she says.
Kate watches everything from the seat next to her mum.
Meanwhile, Billy’s brother Jack is staring at me, willing me to do something.
I pick up the rabbit, point it at him, and work its paw so it’s waving.
Hello Jack. How are you?
He frowns.
You know what I’m going to do, Jack? I’m going to SIT ON YOUR HEAD!
I put the rabbit on Jack’s head.
But instead of sitting still so the rabbit can balance there, Jack gives a convulsive jerk of his body and tosses his head – so much so that he plunges straight back off the sofa onto the carpet, his bare feet flying up in the air and his hands making a mad grab for anything as he falls.
‘Oh my god!’ shouts Marissa, turning and holding her back at the same time.
‘Hmm? What?’ says David, opening his eyes.
Rae stops writing and looks at me.
Billy bangs backwards and forwards, screaming with laughter.
I help Jack up.
Kate says: ‘Again!’

Monday, April 08, 2013

the miracle of birth

We’re standing in the courtyard of an old, C-shaped, ten-storey apartment block, the simple, black metal gantry of its internal stairways and gangways rising up around us like we’re on the set of some seedy 1940s drama set in New Orleans. Except it's freezing cold, and the tree in the middle of the courtyard in its plain, red brick planter would only bear fruit if you tied it on with string.
We’ve been called to a woman about to give birth in flat number one, but the woman in flat number one is past childbearing age. In fact, so far past childbearing age she takes a full five minutes to make it to the door with her frame.
‘Who did you say you wanted?’
‘Sorry to have bothered you.’
‘That’s all right, son. I’ve enjoyed it.’
She closes the door and we head back out into the courtyard.
I’m tempted to lean back and shout out.
Or whatever the patient’s name is. But Rae calls Control, and they tell us they’ll check the address.
Four guys walk past, looking so rough it would make a pirate blush.
‘Evening,’ says one. The others don’t say anything but grunt and grin and stroke their cutlasses.
‘Did someone die?’
‘Or hang the’selfs.’
‘I hope not.’
‘Yah. Me too, bro.’
They laugh and carry on. I hear one of them say something surprisingly pettish, about how there’s always an ambulance here. He’s not far wrong, though. It’s definitely a hotspot.
Control calls back.
Right name, but it should be House, not Lodge. The House version is just next door.
We pick up our bags and head that way, high-stepping over a low, chain-link fence to save time.


Sky opens the door to us. A tall, sleepy looking guy in his twenties, he has a clumpy black afro that looks like someone used it to unblock a chimney. He scratches up his jeans and steps aside for us to come in.
‘Yo,’ he says. ‘She’s thru’ there on the sofa.’

Jelly is propped up on cushions, her legs drawn up, puffing through the next contraction with her face screwed up. But the strange thing is, no sooner has the contraction ended then she is bright and alert, laughing that Sky didn’t even know where they lived.
‘You’re incredible,’ she says.
‘Fanks. You’re not so bad yourself.’
Jelly tells us she’s thirty-two weeks pregnant.
‘I’ve been having contractions every few minutes. I had them a couple of days ago and went in to hospital, but they didn’t say whether the baby was coming or not. They told me if I started getting them again, to give you guys a ring.’
Another contraction. She draws her legs up and rides it out.
When it’s passed, she’s perfectly relaxed again.
‘It’s been all right up till now,’ she says, taking a sip from a carton of apple juice. ‘No worries. Not like the last one. I was in labour for a week.’
‘Man – I’m glad I wasn’t around for dat party,’ says Sky, zipping his hoody up to his chin.
‘How old’s your other child?’ I ask her.
‘And where is he tonight?’
‘With his dad. Ooh – here it comes again.’
Sky does a hopeless Michael Jackson kind of spin on the spot and then smiles at me. ‘I suppose we’re off to the hospital then?’ he says.
‘Yep. Can you get Jelly’s things together?’
‘What like, man?’
‘You know – notes, phone, keys, money. Whatever she might need.’
‘I don’t know what she might need. What do you mean, notes?’
‘Notes. You know. Maternity notes.’
I draw the shape of it in the air.
‘Oh. Notes.’
He starts rummaging through a pile of things.
‘You know – they asked me some crazy fucked up shit on the phone before you got here,’ he says.
‘What like?’
He straightens up.
‘Like they asked me to take a look and see if the baby’s head was coming. The baby’s head! I mean – what’s that about?  It’s crazy!
He pulls a face, and then carries on searching. After a second or two he stops.
What am I looking for?’ he says.

Sunday, April 07, 2013

what she wants

Rae reads the screen and groans.
‘Oh God! This is Anna-Beth. I can’t cope with Anna-Beth tonight.’
It turns out Anna-Beth is a frequent flyer. A woman in her early twenties, she calls about twice a month, sometimes more, always with back and neck pain. The suspicion is she’s a morphine chaser, but so far there hasn’t been any official line on that. I’m amazed I haven’t met her before, but I suppose it’s mathematics rather than luck.
‘The last time I went there we had a row. I don’t suppose you could attend this one, could you? I’ll buy you a coffee. Pleeease? I’d better just hang in the background.’
‘Fair enough.’
‘She’s got this hulking great boyfriend, so watch out. No doubt he’ll try to get us to carry her out as well as give her drugs.’

The boyfriend is standing waiting for us in the doorway, backlit by the strip lit hallway, the silhouette of a nub-headed bouncer with a frown like a crimp in a metal bucket.
‘Through here,’ he says, turning and leading us through.
Rae hangs way back.

Anna-Beth is lying on her back on a wide leather sofa in a onesie decorated with cute doggies in pink bows. Behind her head on a shelf is a cage of tiny orange and white rats. One of them jumps up onto a shelf and scrutinises me with the same button-eyed level of attention as Anna-Beth.
‘It’s my back,’ she says.
I put my bag down.
‘I understand this is part of an on-going problem.’
The boyfriend shuffles forwards.
‘It’s about time this was sorted out, mate’ he says. ‘It’s been going on too long. She’s in agony. Look at her.’
But in truth, Anna-Beth looks pretty comfortable.
‘What pain meds have you been prescribed?’
The boyfriend produces a shoebox and drops it on the coffee table. ‘They’re all there,’ he says. ‘And none of them even touch the sides.’
A quick glance in the box reveals an impressive arsenal of pain meds.
‘These are pretty strong,’ I say. ‘Have you taken what you should today?’
She nods.
‘But you’re still in pain?’
‘Yes. And my neck – which is a new thing.’
When I ask her what advice she’d been given about managing her condition, she says they told her to stay mobile and keep taking the meds. But apparently this hasn’t worked today.
‘I phoned the out of hours number and they told me to call 999. I wouldn’t have bothered you otherwise.’
‘She puts up with a lot,’ says the boyfriend. ‘Too much, if you ask me. What are you going to do about it?’
‘Well obviously there’s not much we can do for you other than take you to the hospital. But I understand you’ve been up there a lot...’
‘Her pain meds aren’t working,’ says the boyfriend. ‘What else is she going to do?’
‘You may be right. Maybe hospital is the only option tonight. Either that or having a doctor come out to see you.’
‘The doctor won’t do anything. He’s hopeless.’
‘An out of hours doctor, not your GP.’
‘They’re all the same.’
‘Oh. Okay.’
The rats have become even more active, maybe sensing an audience, or the prospect of more food. They’ve started hopping about from shelf to swing to straw to shelf again, tumbling over and over and whipping their nude pink tails about.
‘You know what’s likely to happen at the hospital though, don’t you?’ I say, struggling to concentrate and not be drawn into watching the rats instead. ‘A long wait. Probably a referral back to your GP. Wouldn’t you rather stay at home in comfort and see how you go?’
Again – the boyfriend: ‘She’s tried that. What else can she do?’
‘Anna-Beth? This is your decision. I need to hear it from you.’
‘I’ll go to the hospital.’
‘Okay. Well – you’ve been walking around today. So we’ll take a slow walk out to the ambulance. No rush. Have you got everything? We’ll need those meds in a bag for starters.’
The boyfriend steps in massively and helps Anna-Beth move her legs off the sofa, sit up straight, stand, then walk to the door, all the while flashing us looks even sharper than the rats.


When I go to book Anna-Beth in I ask Linda, one of the Receptionists, to bring up Anna-Beth’s attendance sheet. After a few seconds it appears on the screen, a long, scrolling list of dates, all with the same complaint: back & neck pain.
‘She obviously likes it here,’ says Linda. ‘And I mean a lot.’


Back out on the truck and Rae is sitting texting in the attendant’s seat.
I chuck the clipboard onto the dash and climb in next to her.
‘You were right about the boyfriend,’ I say. ‘What a piece of meat.’
‘Oh him? That was a different one.’
‘A different one?
‘Yeah. The other one must’ve seen the light. She can’t have had this one more than a couple of weeks. But what gets me is – he looks exactly the same.’
She finishes the text , puts the phone back in her pocket and starts writing out a new sheet.
‘Maybe there’s a website,’ she says. ‘Chuffing Great’

Monday, April 01, 2013

three in one shift

#1: Stella, 93

Lying in bed, the covers pulled up to her chin. Her eyes half-closed, as if the bright rectangle of sunlight angling in through the window was a little too much.
‘Is she ...?’
‘Yes, I’m afraid your mother is dead. Sometime in the night, I’d say.’
‘I left her alone when I came in this morning. I thought she was asleep. I was making her breakfast. Then it just felt – wrong.’
Stella’s son stands uncertainly the other side of the bed. It hardly takes an effort to imagine his mother closing her mouth and turning her head to see what on earth all the fuss was about.
‘I came early this morning because I was worried. I’ve spent the last couple of days trying to coax her out of bed. It wasn’t like her, to just lay herself away like that.’
‘We’ve got some paperwork to do.’
‘Come into the lounge, then. Would you like some tea?’
‘That’d be great, thanks.’
We follow him out of the room.
‘What do I now?’ he says, filling the kettle.
‘Well – because it wasn’t what they call an expected death, and Stella’s GP hasn’t seen her in the last couple of weeks, we contact the police and they attend. Don’t worry about them coming – it’s just a formality. And then they’ll guide you through the next bit, which is the Coroner’s Office people coming to collect your mother, and a decision being made about a post mortem and so on. But they’re the experts. They’ve got all the information.’
He finds three mugs and puts them out in a line, reaches up for the tea caddy. He opens it, then tosses a bag into each cup before pausing at the last one.
‘Do you think she suffered?’ he says.
‘I don’t think so. It looks to me like she died peacefully in her sleep.’
‘That’s something then,’ he says. He drops the last bag into the mug, picks up the kettle and pours out the water. ‘Stella was ninety-three you know. Good as gold up till the last few weeks. But that fall she had shook her up a bit.’
‘Oh? When was that?’
‘Last month. She goes down the casino every Wednesday to play roulette. Except last week she caught her foot and fell out the taxi.’

#2: Peter, 24

There are two police cars outside the house. We park where we can and hurry into the house. A middle-aged woman is standing in the hallway.
‘He’s up in his room,’ she says, tonelessly, moving to one side. ‘Excuse the mess.’
I want to say something more but there isn’t time. We hurry up the narrow stairway. Muted voices ahead of us. The landing cluttered, difficult to negotiate. A police officer opens a door and comes out, gesturing for us to go on past him.
‘I hate this shit,’ he says.
The room is a chaos of stuff – DVDs, games and devices, fast food cartons, discarded clothes, Coke bottles, scarcely room to move without treading on something; what space there is on the carpet is covered with a scattering of empty blister packets.
Peter is over in the corner under the attic window, curled up on his side. The flowery quilt that was over him has been pulled aside;  even from here we can see the unmistakable tide line of pooling blood. One of the officers draws our attention to a sheet of paper blu-tacked to the wall above Peter’s head. A neatly typed letter. To whoever finds me it reads. I couldn’t go on ... just too much ... tired trying ... nothing left. And then along with the signature, an afterthought written in the same blue pen: Sorry mum.

‘Are you okay after that one?’ says Control when we radio clear.
‘Yep. We’re fine.’
‘Back to base for a cuppa,’ she says. ‘I think you’ve earned it.’

#3: Viktor, 70

Viktor says he wants to go to the toilet before we leave for hospital. He’s a little unsteady, but manages to take himself into the bathroom.
‘I think we’d better have the carry chair,’ Rae says.
I take all our bags back down in the lift, out to the ambulance, stow them away, make the trolley ready, put the ramp down. Whilst I’m pulling the carry chair out of its cupboard, Viktor’s middle-aged daughter Rachel suddenly appears next to me.
‘Your colleague says can you give her a hand.’
For a second I wonder if I should take all the bags back up again. But to be quick I decide just to go with the chair.
As we ride up in the lift together, Rachel tells me about her father’s fifty-odd years of binge drinking, his years of self-imposed isolation, how she and her husband finally got through to him, persuaded him to leave his dreadful place and move nearer to them, so they can look after him and keep him on the straight and narrow.
‘You should’ve seen it,’ she says. ‘We had to have it de-verminated.’

When we come into the flat the bathroom door is open and Rae is struggling to support Viktor on the toilet.
‘He’s arrested,’ she says.
I put the chair down and hurry in. Together we get him on the floor, start compressions, take stock.
‘I’ll wait in the sitting room,’ says Rachel, and goes through.
I carry on compressions whilst Rae goes back down to the vehicle to get the bags and call for assistance. Luckily, another paramedic is passing on his way back to base; the two of them come back into the flat together.

We work on Viktor for an hour.

Half-way through, Rachel’s husband Mark arrives. An ex-policeman, he’s been to his share of these things.
‘If there’s anything you want doing, any fetching or carrying, I’m your man,’ he says. ‘How’s it looking?’
But he spares us having to come up with the words; he nods gravely, then goes to be with Rachel whilst we carry on.

Nothing works. We end up in one last review of the situation, kneeling amongst all the detritus of the resus, the ripped adrenaline cartons, drained bags of fluid, the wrappers and packaging, the changes of gloves, the bloody towels and roughly-cut clothing – and in the middle of it all, Viktor, flat and lifeless as the line on the screen.

We go through to tell Rachel her father has died. We give them some space whilst we go back to tidy up the hallway and bathroom. I retrieve Viktor’s false teeth from the corner where they somehow ended up, rinse them clean under the tap and place them on the side of the sink. I have one last wipe around the area, then head back down to the truck to fetch the scoop stretcher. Together we use it to carry Viktor into the bedroom, temporarily tying his arms with a bandage to stop them flopping over the side.

Mark comes into the bedroom to help us settle Viktor in, moving cushions and covers, arranging furniture.
‘Thanks for all you’ve done,’ he says, and then: ‘I’ve made some tea.’
We follow him back into the lounge to drink it.