Saturday, May 31, 2014

tights or no tights

It’s been such an incredibly busy night, I hardly know what to do with myself. I feel punch-drunk, brutalised. No sooner did we clear up than another job came through, everything from the most serious to the most trivial, from a young guy with a life-threatening head injury to a drunk teenager vomiting all over the place. The fact that there was only patchy cover made it worse, especially late on in the shift. Everyone was out of sync, off patch. We ended up travelling distance to get to jobs, twice out to a town east of the city. And now, just before the end of our shift, with the relief crews almost on base ready to take over, another call comes through, back to that same town. We’ve already asked if there was anything Control could do to sit on the job for a few minutes until someone fresh could go. It’s a low priority job, after all. The Dispatcher was sympathetic, but her hands were tied. The only reason for us not to respond would be if we booked sick. But if we did, the whole shift would be marked absent. Given the level of work, that would feel like a major sacrifice.

‘Mobile,’ I say, pushing the button.
Never has that word or that action felt so wretched.

*

Rae drives smoothly and quickly. I try to shrug it off, this feeling in my chest, an ugly grey weight of exhaustion and resentment. Rae feels the same, but we talk each other up. After all, how bad could it be? Here we are at the top of the day, the morning fresh, the sea running clear and bright. There’s a fishing boat out there, gathering lobster pots. I imagine what it must be like on that boat. I wonder if he notices us, the tiny ambulance on the distant shore, racing along the coast road.

*

Helen is sitting on the side of her bed, anxiously turning the hem of her nightie over and over in her hands.
‘I don’t know what to do,’ she says. ‘I don’t know what to do. Shall I get dressed before I have a wash, or after?’
Rae spots an ambulance sheet on the sideboard.
‘Did you have an ambulance out earlier on?’ she says.
‘I’m not in trouble am I?’ says Helen.
‘No, no. We just want to make sure you’re okay.’
‘Same thing,’ says Rae, reading the form. ‘Anxiety.’ Then she points to a folder on a table, stuffed full of ambulance sheets.
‘Quite a collection,’ she says.
‘I’m sorry, I’m sorry,’ says Helen. ‘But I didn’t know what to do. I’m going to the Day Centre this morning. They’re picking me up at nine thirty. Do you think I should go? I haven’t got my tights on. Should I put my tights on, do you think? I can’t breathe.’
‘You can breathe, Helen. You’re talking to me perfectly fluently, your SATS are fine, there’s nothing physically wrong with you. I think you’re just getting a bit het up. Don’t you think? Has that been a problem for you lately?’
‘I’m not getting into trouble, am I?’
‘No. Like I say, we just need to make sure you’re okay and have everything you need. Maybe it’ll be worth having a word with your doctor later today. What do you think?’
‘I don’t know. I don’t know what to do. Please help me.’
‘Have you had your medication this morning? I can see here you take some pills to help calm you down.’
‘I can’t have them before I eat.’
‘Shall I make you some toast and a cup of tea? Then you can take your meds.’
‘I haven’t had a wash yet.’
‘Maybe you could have something to eat first, have some pills to help calm you down, then have a wash and get dressed. What do you think?’
‘Oh. I don’t know. I haven’t got my tights on.’

Helen is such a lightning rod of anxiety, she seems to draw it out from everything, to feed on the latent fuss around her, from the heavy brown furniture, the soft toys in their plastic wrappings, the cluttered pictures and plates, the trinkets piled up around the place – and weirdly, out of me, too. Because for whatever reason, the more time I spend with her, the more my own anxiety and exhaustion seem to lift. Her distraction is cancelling out my own.
‘You’re going to be fine,’ I say, squeezing her hand. ‘Everything’s fine.’
‘What about my tights?’
‘You can put them on if you want, Helen, but it doesn’t matter if you don’t. It’s up to you. Whatever way, tights or no tights, it’s going to be fine.’

Thursday, May 29, 2014

major incident

‘Quite why I said I’d cook dinner I don’t know. Especially as we’ve just moved  in. I’m not saying I’m the best cook in the world but I’m not bad, and anyway, even Nigella Lawson would’ve had a nervous breakdown. I had to use that rubbishy old cooker and dishwasher they left us – well, fly-tipped would be nearer the truth. Half-electric and half-gas and none of it working properly.’
Angie, one of the receptionists, talks as she inputs, the pop-up screens opening and falling away in front of her on the screen like zombies shot down in a computer game. She taps the return key one last time and spins round on her chair with a bundle of papers and straightens them up on her knee.
‘So obviously it was a complete disaster.’
 The reception staff have been doing the job for so long, subject to such intense pressures of work, they’ve developed extra-sensory coping skills, quite capable of answering calls, handing out pens and forms, inputting client data, fixing the photocopier, finishing off the tea and chatting about the latest scandal. If they had four arms apiece they’d be no quicker.
‘I kept it simple,’ she says, filing the papers and drawing out another stack. ‘I did baked potatoes with chilli con carne and ice-cream for dessert. But the oven was cooler than I thought, so the potatoes took forever and turned out like rocks with a soft potato centre. And then because the potatoes needed about a year the chilli was cooked to a crust. And as if that wasn’t bad enough, I’d cleaned the desert plates in the dishwasher because they’d been in the packing crates a while. When I served the ice cream Sarah took a spoonful then screwed up her face and said Urgh! God! What flavour’s this, Mum – rinse aid? And it turns out the dishwasher had stopped half-way through the cycle.’
‘Ange?’ says Lola, leaning over her to take my patient forms. ‘Don’t take this the wrong way, but you can cancel my booking on the fifth.’

Monday, May 26, 2014

sixty-five years

‘You see, what happened was, the old fool was moaning as usual about not being able to get to sleep. I couldn’t stand much more of it, so I said why don’t you take one of my sleeping tablets? Well, the truth is, he’s just not used to them. The next thing you know, he’s gone back into his room, left all the lights on, and started mumbling away in there like a madman. I thought he was having a stroke, so I got out of bed to go and see about it, and switch all the damned lights off. And that’s when I fell over. It’s my hip, you see. It’s just no good any more.’
We’ve already got Mrs Darlington off the floor. She’s propped up on a pile of cushions on the bed, a little scuffed and bloodied, but otherwise okay.
‘What a nuisance!’ she says, dabbing at her nose with a handkerchief. ‘I only had my hair done yesterday, and now look at me. I must look a fright.’
But in fact her hair wouldn’t look out of place on a punkish model, artfully teased out in spikes and curls and dyed a silvery purple.
‘You look lovely,’ says Mr Darlington, watching the whole thing from his vantage point at the foot of the bed, propped against the wall with a walking stick. ‘Shocking really,’ he says. ‘When you get to our age, falling over and wandering around aimlessly at night. When I rang I thought they might send someone round to shoot us.’
‘Shoot you, maybe’ says his wife. ‘You old fool. It was your fault for leaving the lights on. And being so hopeless about sleeping pills.’
‘Well they didn’t work. I’m wide awake now.’
‘Yes. You are – you and the rest of the block. It’s a wonder they’re not all standing outside the door with pitchforks.’
‘I went all through the war,’ sighs Mr Darlington. ‘Joined up at sixteen, served my time on the Atlantic convoys. Sunk twice, once by U-boat, once by plane. And now this.’
‘Oh don’t start blowing that old trumpet,’ says his wife, shaking her head. ‘We’ll be here all night.’
 I start cleaning Mrs Darlington up.
‘For a minute there I thought you were getting into bed with me,’ she says when I sit next to her to examine her knee. ‘Don’t worry about that old duffer. He’s deaf as a post and half-blind.’
‘I see well enough,’ says Mr Darlington. ‘And so can he.’
He adjusts his position.
‘Why don’t you sit down, Mr Darlington?’ says Rae, moving some stuff off a chair.
‘Yes, before you fall down,’ says his wife, wincing a little when I dab at her knee with some gauze and sterile water.
‘That’s your department,’ he says. ‘Oh. Well. I might just rest a little. It’s so damned late.’
After a while he says: ‘Sixty-five years we’ve been married.’
‘You’d never guess,’ says Mrs Darlington. ‘But we’ve had some nice times, haven’t we, Henry?’
‘Oh ye-ess. When I finally made it back from the sea. Out dancing. Carrying on. You know. Or maybe you don’t.’
‘I must say it’s nice having a young man in bed with me again,’ says Mrs Darlington.
‘Don’t flatter yourself,’ he says. ‘Shooting. That’s what we really need.’
He laughs, shakes his head, then pushes himself back onto his feet with his stick.
‘Now then,’ he says. ‘Who’s for tea?’

Sunday, May 25, 2014

safe

There was rain last night, but the sky cleared by mid-morning and Ken thought the park looked dry enough for a kick-about. His twenty-year-old son Rio was staying with him for the weekend, so they both got dressed in their Man United gear and headed out.
It didn’t last long.
When Ken dropped the ball to punt it out, his left leg slipped from under him and he landed flat on his back. And even though the ground was soft, still it was enough of a jolt to aggravate an existing weakness, and he lay there, groaning, unable to get up.

Jill, the paramedic first on scene, has already given him as much morphine as he can take, topped up with Entonox, which Ken sucks down in workmanlike bursts, like a diver negotiating a hazardous wreck.
‘Please help my Dad,’ says Rio.
‘We’ll do our best.’
Even though Rio looks like any other urban twenty-year old – buzz-cut hair, low-trousered slouch, mobile phone permanently in his hand – there’s something different, a blunt and unfocused quality that makes you take a little more care of him than you otherwise might.
Jill says she thinks the trolley will just about make it over the grass. With a scoop stretcher, we should be able to lift Ken up without disturbing him too much, and take it from there.
‘Other than the pain he doesn’t have any concerning symptoms, no neurological deficit or anything,’ she says. ‘The mechanism of injury wasn’t all that, so all in all I think we just have an exacerbation of chronic back problems.’
Ken groans, toots on the Entonox.
‘Almost there,’ she says to him, patting him on the shoulder. ‘We’ll soon have you off this wet grass.’
‘Is he gonna be all right?’ says Rio.
‘Yep. He’s going to be fine.’
Rio feels a text arrive, and turns round to answer it.

*

It’s a long ride to the hospital. Ken is as comfortable as we can make him, supported with blankets and pillows, only groaning when the bumps in the road are deep enough to shake through his generous buffering of analgesia.
‘Why’s he making that noise?’ says Rio, licking his lips.
‘It’s still painful for him, but he should be fine.’
‘Yeah? But that’s not wot I aksed you. I aksed you why he’s making that noise.’
‘He’s got some pain in his back, and he’s feeling all the bumps and shakes.’
‘So why does the ambulance shake like that?’
‘It’s these god awful roads, Rio. It was a hard winter, and they got broken up. These ambulances weren’t all that comfortable to begin with.’
He stares at me with his mouth half open.
‘It’s the weight distribution. It’s got a heavy tail lift on the back, so that makes us see-saw…’ I do the motion with my arms. ‘And then we’ve got some big gas cylinders on the right, so that makes us rock from side to side. And then of course it’s quite a tall cab, so...’
No reaction.
‘…so all in all, what with the terrible state of the roads, it makes it a rougher ride than we’d like.’
He looks upset.
‘But don’t worry. He’s perfectly safe, and I think the pain-relief is helping.’
Rio flares.
‘If something happen to my Dad, yeah, I’d go fucking special.’
‘Yeah, but nothing’s going to happen, Rio. You’ve got to help your Dad by staying as calm as you can.’
‘Cos’ it’s my Dad, yeah?’
‘Absolutely, and of course you’re worried. But it’s all going to be fine. The fall hasn’t affected his spinal cord or anything. It was soft earth, not concrete. And quite low down. Honestly, Rio, it’s all going to be fine.’
‘It’s my Dad, you get me?’
‘And we’re taking care of him.’
Rio settles back into his chair and starts thumbing through his phone.
We pass the next mile in silence.
‘Do you often play football with your Dad, Rio?’ I ask him at last. He answers without looking up.
‘Yeah. I come over sometime and we go out, like. Football and dat. I’m proper hectic, innit. What team d’you go wiv?’
‘Me? No-one really. When I was younger I liked Arsenal, but that was a while ago.’
‘The Arsenal?’
‘Yeah. Charlie George.’
‘What the fuck is Charlie George?’
‘A cool footballer with sideburns who used to play for Arsenal in the seventies.’
‘Charlie George? What kinda name is dat? It’s like two names.’
‘I never thought about it.’
‘I support Man You.’
‘Yeah?’
‘Yeah. They’re sick.’
‘You’re right. They haven’t been winning much lately.’
Rio looks at me, his eyes perfectly small and round.
Luckily, Ken interrupts with a groan, slowly letting the Entonox mouthpiece drop to his side.
‘What’s he doing that for?’ says Rio.
‘He’s resting. It’s pretty tiring, being in pain.’
‘Is he dead?’
‘No. Just resting.’
‘How can you tell?’
‘You can see him breathing. Look.’
No-one could miss it, the great curve of his belly rising up and down.
‘He’s fine, Rio. Don’t worry. We’ll be there in a minute.’
‘What will they do?’
‘Well – the doctors will take a look at him. They’re the experts. They might X-ray his back, I don’t know. But they’ve got all the equipment they need to figure out what the problem is. And then they can think about how to treat it.’
‘What d’you mean, treat him?’
‘It could be different medication. It could be a referral to physiotherapists to give him exercises that might help. There are lots of things they can do, Rio. As soon as we get to hospital they’ll start helping your Dad to get better.’
‘Cos I don’t like this.’
‘No. I know. It’s not nice.’
‘I don’t like this at all, ya get me?’
‘No. I think you’re handling it very well.’
‘Huh?’
‘I said I think you’re handling it very well.’
He rubs his hands on his knees and bites his lip, and the rest of the journey he rides in tortured silence.

*

 The transfer from our trolley to the hospital bed is as smooth as we can make it. I try to involve Rio as much as possible, even though he gets in the way and makes things more difficult. It’s a relief when Ken is safely across, and officially handed over.
Rae says goodbye and wheels our trolley out of the cubicle. I’m just about to follow her when Rio says ‘Hey!’ with such an aggressive bark, his right hand drawn back over his shoulder, I can’t help flinching a little. But then I realise he just wants to do one of those street handshakes. We bump fists (which I fluff, of course), then he throws his left hand round my back and draws me to him.
‘Safe, man,’ he says, slapping my back. ‘Safe.’

Thursday, May 22, 2014

singers & writers

Doris’ son Malcolm raised the alarm. He was worried about a call he’d had from his mother. But when he answered there was no-one on the line, and when he tried to call back it was permanently engaged. Welfare check read the message on our screen.

Three o’clock in the morning, and the streets run cold beneath a deep blue vacancy that makes you ache for bed. Outside the block we wait at the front door for the Care agency to reply to our call and let us in. It’s one of those intercoms that makes a series of penetrating screeches between each phase of the conversation.
‘Where are they based? says Rae, yawning and leaning back against the wall  ‘The moon? What if this was a real emergency?’
There’s nothing to say it isn’t, of course, except experience. The last welfare check I made, I almost gave the old woman a heart attack. When I let myself in she had her back to me, slumped forwards in a chair. I thought she was dead, but when I touched her on the shoulder she leaped about a foot. Turns out she was just deaf, peeling a pear.
Letting you through now says the voice. Beep. Howl. Scratch. Crackle.
Eventually the door clicks and we go through to the lobby. Once the door closes behind us we hear the voice come back on the intercom. Are you in? it says. But of course they couldn’t hear us if we answered. I don’t know why they needed to ask, because we have to pull another cord to be given access to the safe that holds all the keys.

Again, the same screeching delay.

Rae assumes the neutral face and posture of a Shaolin monk, composed and philosophical, but capable of violence. Me, I drop into a padded chair and start grazing through the lifestyle magazines fanned out on the coffee table. It seems to me at this thin and unpromising hour of the night, lifestyle is something I could really use. The glossy pictures don’t help, though. In fact they just exacerbate my feeling of disconnection. I’m like a sick robot in a waiting room, idly wondering how to be human whilst the engineers argue in the workshop about the strange dreams I’ve been having.
‘Let’s go,’ says Rae, rattling a gaoler-fat bunch of keys in my face.
‘Oh. Okay.’
I may actually have fallen asleep.

The landing on the fifth floor is thickly carpeted with silence.
Rae knocks on Doris’ door.
Nothing.
We put our ears to it.
Nothing.
She puts the key in the lock.
‘Ambulance’ she says, turning the key, leaning in.
Resistance.
She pushes a little harder, making enough of a gap for me to peer inside.
It’s completely dark, so I reach in along the wall and feel around for a switch.
A dim overhead light comes on.
There’s something lying on its side across the bottom of the door.
An aluminium step-ladder.
I feel a sudden chill.
Has she hanged herself and kicked it over? Is that why she rang her son?
There are other things piled up against the door, too. A sewing-machine, and a pair of jeans, rolled up and stuffed into the gap between the floor and the bottom of the door.
I push the door a little harder and make more of a gap. It’s only then that I see there’s an internal door immediately facing this one. A door with two rectangles of glass in the middle. In the right hand pane is the face of an elderly woman, her wiry hair shocked out in a halo of white, her eyes and face slack.
‘Hello! Doris? It’s the ambulance,’ I say, trying to sound composed. ‘Can we come in? Malcolm’s worried about you?’
She doesn’t answer, but clutches her nightie to her throat and withdraws into the shadowy room behind her.
I reach round, move the things as best I can.
We go in.
I open the second door and turn some more lights on.
Doris is standing in the middle of the room.
‘Who are you?’ she says. ‘What do you want?’
‘We’re the ambulance, Doris. Look…’ I say, pointing to the badge on the left of my shirt, then to the blue and white NHS logo on the right.
She peers closer to look.
‘Are you okay, Doris?’
Rae puts on more lights.
The room is warm, comfortable, orderly.
‘Why don’t you have a seat, Doris?’ she says, plumping some cushions in what must be Doris’ favourite chair.
Doris walks over and settles into it; Rae kneels down next to her. I sit opposite.
‘Do you mind if we check you over and make sure you’re okay?’ says Rae, flipping her open the lid of her obs bag. ‘Malcolm asked us to come over. He was worried because he got a late night call from you but when he answered there was no-one there.’
‘No-one there? Who called him if there wasn’t anyone there?’
‘Did you call him?’
‘Who?’
‘Malcolm.’
‘I’m always calling Malcolm, poor boy. He must be sick and tired of it.’
‘But did you call him tonight?’
‘Probably. I can’t remember. What a fool I am.’
She shrugs and folds her arms contentedly.
‘I’m sorry to put everyone out,’ she says. ‘I know you’ve got better things to do than chase round town after crazy old women.’
‘Malcolm was worried.’
‘Was he?’
I can see from here that the phone is off the hook, so I go over to replace it. It’s one of those Land of the Giants-style phones, with buttons big enough to sit on. There are a line of blank, speed dial buttons down the right hand side. Three of them have tiny portrait photos on them.
‘Is that Malcolm?’ I ask her, pointing to the face at the top.
‘Ye-es,’ she says. ‘Oh, I lead him a merry dance.’
‘Do you mind if I give him a quick call, to let him know everything’s okay?’
‘Be my guest,’ she says. ‘Can I get you anything? A cup of tea?’
‘That’s very kind. But don’t worry. I’ll just give him a quick call to let him know everything’s okay, then I’ll make you one.’
‘Oh lovely,’ she says. ‘Two sugars. The milk should still be all right.’ And she holds out her arm for Rae to put on the blood pressure cuff.

Malcolm answers after one ring. He tells me his mother has been having some hallucinations recently, which explains the furniture. She’s having tests, so it’s all in hand. Normally when she rings he’s able to reassure her everything’s fine, but this time when she didn’t answer he was worried she’d had a fall or something. He apologises, says he’d have taken care of it himself but his situation at home tonight meant he wasn’t free to come out.
‘Thanks for all you’ve done,’ he says. ‘I’m so sorry you got called.’

‘All fine,’ says Rae, folding up her steth and stowing it in her bag. ‘A clean bill of health.’
‘Lovely,’ says Doris. ‘Sorry to drag you out for nothing. And I’m sorry if I gave you a bit of a fright. But you see, I thought it was the singers again. That’s why I put all those things against the door.’
‘What singers?’
Singers. The three of them. They stayed a week last time. I couldn’t get rid of them.’
Doris takes a shaky sip of tea.
‘So – who do you think these singers are?’ I ask her.
‘Just people who go around. You’ve seen them, no doubt. I just didn’t like the fact they came in and stayed all that time. They drove me bananas.’
‘What were they singing?’
‘Oh you know. Numbers. Words. That kind of thing. They wouldn’t shut up. In the end I had to trick them outside and then lock the door. I rang my policeman friend about it, but I’m worried he’s getting sick of me, too. He’s so tiny,’ she says, putting her cup back on its saucer with a worrying rattle. ‘He’s only this big (thumb over forefinger – about an inch). I thought they had to be taller than that, but apparently they relaxed the entry conditions.’
She leans forward and puts the cup and saucer on the table, then settles back in the chair again.
‘Oh my goodness, look at him!’ she laughs, tapping Rae on the shoulder and pointing at me. ‘Taking mental notes. He thinks I’m completely doolally.’ She leans in to Rae for a pantomime whisper.
I bet he’s going to write it all down and publish it!

Tuesday, May 20, 2014

mr & mrs

‘She had a bad night,’ says Mr Ellery, shuffling back along the corridor, like an ancient oak that’s somehow managed to pull up its roots and drag itself across the common. ‘We both have. Mind your feet. I’ve cleared the worst of it. Eric said he’ll be over to get the rest. I don’t know.’
He’s bare-chested, and every year of his great age is displayed in the sags and valleys of his skin, the moles and scars, the faded tattoos and tufts of wiry grey hair.
He hitches up his trousers that are sagging below the line of his inco pants, then rubs his chin.
‘I haven’t even had a shave yet,’ he says ‘Anyway - she’s through here.’
Mrs Ellery is in bed, holding the duvet up to her chin with both hands.
‘It poured out of me,’ she says.

Despite the unpleasantness of the episode, nothing else seems to be amiss. She’s had an acute bout of diarrhoea, but then she’d been constipated for a few days and Mr Ellery had given her a big dose of laxatives to help things along.
He watches over us as we examine Mrs Ellery, scratching his head and offering encouraging remarks.
‘Sixty-five years we’ve been married,’ he says. ‘Who’d have thought it.’
‘I’ll have to live to a hundred and three before I can say that,’ I tell him.
‘Don’t wish it on yourself,’ he says. ‘I mean – look at us. You’d never think we used to go dancing three times a week. And go on cycling holidays. On a whatsit. On a tandem.’
‘A tandem? What did you do when one of you wanted to go left and the other one right?’
‘Never happened. We never used to argue. We saved up all our arguments till now.’
The phone rings.
‘That’ll be Eric,’ he says, giving a little start and then hobbling over to the sideboard. ‘Hello? Eric?’
The two of them have a shouty conversation about the state of the carpet and when Eric can make it over to sort it all out.
‘Righto,’ says Mr Ellery. ‘Thanking you.’
He puts the phone down, staggers back to the bed and sits on the end of it after first prodding to see where Mrs Ellery’s feet are. She clutches the duvet more closely to her chin.
‘That was Eric,’ he says. ‘Lovely chap. How are we getting on here?’
‘We’re going to get the doctor over to make sure everything’s okay, and see you’re getting all the help you need. I don’t think hospital’s the right place this morning.’
‘No. I don’t think so. Right. Now then – I must put my teeth in.’
‘I thought you had them in.’
‘The upper set,’ he says, drawing his lips back and exposing one solitary yellow tooth in the corner of his mouth.
‘What’s that one for?’ I ask him. ‘Spaghetti?’
‘No,’ he says. ‘That’s for spearing pickles.’

Friday, May 16, 2014

the other side of the wall

We’re waved over to the corner of one of the busiest intersections in town. A woman puts her phone away as we pull alongside and nods just behind her to the left. It’s only then that I see the patient, a man in a white shirt, lying behind the low wall of a private car park.
‘I think he’s probably just drunk, but I wanted to be sure,’ she says.
‘No worries.’
I hop over the wall and take a look. A heavy-set man in his fifties lying almost prone, his face pressed into his left arm, which stretches out along the bottom edge of the wall, terminating in a sherry bottle. ‘Hello!’ I say, reaching over and squeezing him on the shoulder. ‘It’s the ambulance. How are you doing?’
He shrugs irritably, like he’s trying to shake off a worrisome bird.
‘It’s the ambulance. Have you hurt yourself?’
He mumbles something.
‘Listen. I don’t want to bother you, but people see you lying here like this and they think you’ve had a heart attack or something. Can you sit up for me and let me see that you’re all right?’
He groans and swears, but eventually makes an effort to sit up after carefully putting the bottle onto level ground.
‘There! That’s better. Now – are you ill in any way? Do you need our help?’
‘No. I’m grand. I’m just having a sleep, s’all.’
‘Why don’t you nip over the road into the church gardens, then? It’s a lovely day. You could stretch out on the grass nice and comfy and no-one would bother you. If you lie down here they’ll just call the ambulance again.’
‘I’m fine. Leave me alone.’
‘Come on. I need you to get up and walk somewhere a bit more sensible. Yeah? Can you do that?’
‘Give me a minute.’
‘Okay. Fine. But make sure you make a move though. You can’t stay here.’
I take his name, thank the woman who called us, then go back to the ambulance.

Five minutes later, I’m writing out the form when a young woman wheeling a bike comes up to the window.
‘Did you know there’s a man collapsed by that wall?’ she says.
‘Yeah. He’s okay, just a bit drunk. But I’ll go back and have another look.’
She smiles and carries on.

He’s slumped back in the same position.
I pinch his shoulder again.
‘Hey! Gary! Sit up for me.’
‘Whaaat?’
‘You really can’t sleep here, mate. We’re going to get called back.’
‘Leave me alone.’
‘Come on. Sit yourself up and take a walk over the road to the park. Seriously, Gary. You can’t just lie down anywhere. People think you’re dead.’
He pushes himself back up into a sitting position, his hair sticking out all-angles, his face puffy and red and mottled from where the gravel of the car park pushed into his cheek.
He reaches out for the sherry bottle, cradles it in his lap, and stares out at all the people hurrying along the pavement the other side of the wall.
‘Give me a minute,’ he says. ‘I just need a minute.’

Thursday, May 15, 2014

a family film

Robert leans forwards in his chair and rolls up his sleeve for the blood pressure cuff. There’s an intricate tattoo on the inside of his forearm: Live your dream, spookily inked in blues and blacks, ivy and lilies and roses.
‘It’s the drink, Spence. I know it’s the drink. What’s to be done with me, ay? What’s to be done?’
‘Have you ever been on a detox programme, Robert?’
‘Yeah. Once. A while ago.’
‘And how long did you stay sober?’
‘’Bout a couple a year.’
‘That’s pretty impressive. You’ve done it once, you can definitely do it again. Don’t you think?’
He stares at me as I put the steth in my ears and pump up the cuff.
‘It’s the drink,’ he says again, his head wobbling from side to side. ‘D’ya get me?’
His mobile phone rings.
‘Hey! Dad! How’s it going? I’m jes’ with the paramedics, Dad. Yeah. D’ya wanna word with them?’
He hands me the phone.
‘It’s me dad,’ he says.
‘Hi,’ I say to him. ‘My name’s Spence. We got a call out to Robert this morning because he felt unwell and thought he might have a fit.’
Hello there, Spence. Yeah – well – he hasn’t fitted with his drinking in the past, but sometimes he gets wound up when he’s been overdoing it. Do you know about Jack, the guy he shares the house with?
‘Yep. He told us Jack went in for some kind of heart op.’
That’s right, yeah. I think that hasn’t helped matters.
‘Sorry?’
I say that can’t have helped.
‘No, absolutely. Look – I’m sorry, but this phone line’s terrible. It sounds like you’re being attacked by a giant squid.’
No, no. I’m on the bus. So what are you going to do? Are you taking him to hospital?
‘I don’t think he needs to go. He’s not that bad. I’ve made him an appointment to see his GP this morning, to talk about getting on another detox programme.’
Okay, mate. Fair enough. Thanks for all you’ve done.
‘No problem. I’ll hand you back.’
Robert takes the phone and chats on with his dad whilst I finish off the paperwork.
It’s a lovely house, one of those warm and chaotically interesting places, prints and pictures on the walls, family photographs spanning the years, books on the bookshelves, and bright sunlight filtering in over the back of a huge sofa through the bay window and the straggling rosemary bushes outside – in fact, the kind of place you could happily lose a few hours browsing.
Robert says goodbye to his dad and puts the phone on the table.
‘Me dad,’ he says. ‘He’s a good man, he is. Deserves better’n me, tha’s for sure.’
‘So Robert? You managed to stay sober for two years. What was it that started you drinking again?’
‘Me? I made a film.’
‘A film?’
‘Yeah. A film. With me dad.’
‘What kind of film?’
He shrugs, a loose, Vodka-driven movement that rides up from the small of his back to the top of his head like a wave.
‘I can’t remember, mate. Sorry. It’s gone. A film type film.’
‘Thriller? Comedy?’
‘Dunno.’
‘Who else was in it?’
‘Jes’ me and me dad. Yeah. It was dead good. I loved it.’
‘But it started you drinking again?’
‘Yeah. Well. It would, wouldn’t it?’

Wednesday, May 14, 2014

barney

The update from Control is unexpected.
Pt says she is dying. Has punched dog. Stand-off for police
I park up outside the block and turn the engine off.

It’s still early. Above the cooling and clicking of the engine, the sounds of sparrows squabbling in a tangle of shrubs by the roadside. The air through our open windows is super-fresh, the sky through my sunglasses mega-blue. Even the vapour trail of that plane could not be whiter or more perfectly formed.
A few minutes later, the computer screen buzzes again.
Patient not aggressive on phone. Safe to approach.
‘Hmm,’ says Rae, grabbing a pair of gloves.

The block is such a wretched slab of seventies planning even a morning like this couldn’t ease the pain. Refurbishment would only prolong the agony; razing to the ground is the only option.
Just as we stand at the intercom to buzz, a man in a helmet and biker jacket opens the door.
‘Good timing!’ I say to him, but he just shakes his head as he lets us through. I’m confused by his body language. Does it mean there’ve been calls to Sheila before? He didn’t want to let us in? Or he actually enjoyed the moment? But in his tinted visor and biker’s gear, I may as well try to second-guess the motivation of a robot. He slams the door behind us.

We walk a short way along a crapped-up balcony to Sheila’s flat, where the door stands open.
A plump Jack Russell waddles out, his tail crooked but wagging at least, his one good eye fixed up on us. With a wheezy bark that’s like a back-firing model steam engine, he clatters around our legs demanding attention.
‘Hello?’ says Rae, knocking on the door and pushing it wider.
The dog skitters ahead of us, round a corner.
‘In here. You can come in.’

The flat is a terrible mess, tossed papers, cans, unopened letters and scattered clothes, a whole bag of dog biscuits tipped onto a dirty plate, with a metal bowl of water beside it. Sheila is slumped against the far wall on a filthy mattress, as discarded as everything else here, her knees drawn up, her hands either side.
‘I’m surrounded by vigilantes and murderers,’ she says. ‘I’m dying of cancer. The drink is eating me up and I haven’t got long . That’s why I want Barney taken away. It don’t matter if I die in a flat with shit on the floor but Barney deserves better. He needs a walk and I just can’t do it. I’m dying, d’you see? Look at me. I’m Bi-Polar. I’m not the same person two minutes running. Barney can’t live like that no more. He just can’t. So take him away. Can you?’
Just at that moment Sheila’s phone rings. When she sees who it is she grimaces and passes it to Rae.
‘Brenda, my CPN,’ she says. ‘You talk to her. She’ll tell you all about it.’

Brenda says that Sheila is alcohol dependent. She’s been bad for a while, but lately she’s fallen off the edge, a serious decline, mental and physical. They’ve been trying for a while to get things sorted, but so far Sheila has resisted any help. Brenda says the situation is known about, though, and things are happening. She asks if we’d mind contacting the RSPCA to have Barney collected; Brenda will be making arrangements to treat Sheila a little later in the day.

I step back outside onto the balcony to make the call.

The RSPCA switchboard takes a while to answer, but when it does they take Barney’s details with a brisk but sympathetic manner that makes me think they’ve done this before. I describe the situation, Sheila’s problems, the appalling living conditions.
‘And you say she attacked the dog?’ says the operator.
‘That was what she told Control. But I can’t see any obvious signs. Barney has a damaged eye and a crimp in his tail, but they look like old injuries to me. He seems quite content in himself. He’s got food and water.’
‘Bless,’ says the operator. ‘And has Sheila said to you she wants him taken away, that she can’t cope?’
‘Yep. She was quite clear about it. Her CPN thinks it’s a good idea, too.’
‘Poor love. We’ll get someone out as soon as we can. Will Sheila be there to let us in, do you think?’
‘She says yes.’
‘Okay then. Thanks for your call.’
I go back inside and hand Sheila the phone back.
‘Thanks,’ she says. ‘I like men. You’re so – stubborn.’

Barney jumps up on the mattress next to her and she strokes his side.
‘I’d never be without him,’ she says. ‘I take him down the offie and he waits for me outside. I don’t tie him up, so he could run away. But he doesn’t. He just sits there and waits for me to come out. Everyone round here knows him.’
She looks up at us and winks. ‘That’s got to be worth something. D’ya think?’

Monday, May 12, 2014

out of the rain

I park the ambulance as close to the EMI unit as possible so we don’t have far to walk in this downpour, but by the time we’ve pulled all the equipment we need out of the back of the truck and jumped across all the puddles in the driveway, we’re soaked.
‘God that’s awful!’
‘Bloody hell!’
We take what shelter we can from the little canopy over the door, until one of the care staff opens up for us.
‘Follow me,’ she says. ‘Stella has a DNAR.’
She leads us through a couple of security doors, then down a corridor with a carpeted floor that gives a little and creaks as we walk. Past closed doors with colour-copied pictures of each resident sellotaped below the number; past the nurses’ station, the sluice, the laundry. Past the games room, where a number of residents are sitting in small groups quietly playing cards or board games, or painting pictures. They don’t look up as we pass.
‘Here we are.’
The carer knocks and shows us in.

Stella is lying on her back on the bed, making feeble, agonal gasps. She’s terribly emaciated, her arms and legs drawn up, all the hollows of her body accentuated, the mortal structure of it, the iliac crest of her hip pushing up beneath a meagre covering of skin.
‘Could we see that DNAR please?’ says Rae. The manager – a small, powerfully-built man with the air of someone more used to receiving forms than handing them out – passes her the red-margined document.
‘Dated and signed,’ he says. ‘As you can see.’
‘Fine. Thank you.’
Stella’s gasps fade to nothing as the arrest proceeds.
‘Shall we sit her up?’ says one of the carers.
‘No. I don’t think so,’ says Rae.
She feels for Stella’s pulse, then takes out her stethoscope and listens to her chest. I stick on some ECG dots and watch the line run flat on the printout, clear and unequivocal.
After a moment or two, Rae says: ‘Stella has died now.’
I write the time down.

Rae questions the staff about the sequence of events whilst I tidy up the equipment and start filling in the ROLE form.
The room is stuffy and foul-smelling. Stella collapsed on the toilet, and the faecal smell, along with the heat from the radiators and the heavy, plaid curtains drawn across the windows, gives the room an unpleasantly closed-in feel.
‘Let’s finish this paperwork in the office,’ says Rae. We leave the carers to clean Stella up, and follow the manager out into the corridor.
He leads us back to the nurses’ station, where Rae rests on the counter to finish up.
‘Would you like a cup of coffee?’ says the manager.
‘That’s very kind, but we’re fine, thank you.’
‘You’re sure?’
‘Yep. Thanks. Almost done.’
The station is just a long, narrow recess with a series of windows along the back that look out onto an overgrown garden. Even though the rain is still coming down hard, there must be a break in the cloud, because the room is suddenly swept with a clear, hard light – so intense, that every detail in the office stands out, like a painting on a broad canvas: the browning tips of a potted dracaena, a black SuperDry jacket and black nylon satchel hanging on a hook; an old style fax machine with a note that says: Feed sheets separately; a drugs company calendar with a cute quote about doctors for May; a shelf above a low filing cabinet with a bag that says in big red letters: Emergency Bag, and underneath, taped to the front of the shelf, another sign, saying Emergency Bag, in blue, with an arrow pointing straight up.
The burst of sunlight passes, and the room becomes dim again.
Rae finishes the paperwork.
She hands him the forms.
‘Thank you. We’ll notify the doctor,’ says the manager. ‘I’ll show you out. You need the code.’
We follow him back along the corridor.

Everyone in the games room is sitting as before, the patients absorbed in their games, the staff encouraging them. One of them looks up from his hand of cards as we pass.
‘Thanks again for all you’ve done,’ says the manager, holding the front door open for us.
It’s pouring outside.
We move as fast as we can, but our gear slows us down. We stow the bags, slam the doors, squeal as we jump in the cab.
‘Jesus!’
‘Christ!’
But we’re safely out of the rain now, the wonderful, tumultuous rain, roaring and rattling a few inches above our heads, on the roof.

Sunday, May 11, 2014

hilda's tiger

Hilda is still on the phone to ambulance Control as we walk in the door.
‘Just a minute’ she says, holding up a gnarly old digit more like a twig than a finger.
‘It’s okay, Hilda. You can hang up now.’
Hilda frowns, makes an impatient gabbling noise and puts her finger up again.
‘What’s that you said? Someone was talking to me.’
‘Hilda? You can hang up. We’re here now.’
She stares at us, then speaks loudly into the phone again. ‘They say I’m to hang up.’ She does, then rests her head forwards on the table and closes her eyes.
‘I just want to sleep,’ she says.

*

Hilda is ninety-four, and so resolutely independent she may as well be living in a stockade.
‘I’ve outlived everyone I knew,’ she says. ‘I’ve got to shift for myself.’
The chest pain she called us out for looks muscular in origin. Yesterday Hilda tried to drag an old tumble drier from the pantry; she’s had sharp twinges in her left side ever since.
‘Ooh, I had a bad night last night,’ she says.
‘Was that the pain keeping you awake?’
‘What? No. It was windy. Didn’t you hear it?’
‘Yep. Now that you mention it.’
‘If I could only sleep it’d all come right.’
Hilda is adamant that she doesn’t want to go to hospital, but she’s not safe to be left alone like this.
To buy us a little more bargaining time, I offer to make her a cup of tea.
‘Through here, is it?’
The little kitchen is cold and dimly lit, its fifties’ work surfaces only clear in small patches where some minimal activity has stopped the detritus from settling. Here and there the ruins of previous meals are composting into richly-colored patterns of mould. The fridge has one ready meal and a packet of ham, the milk busily converting to solid through four stages of lactic horror. But there is some edible food here, in two neatly stacked columns of boxes – fondant lemon fancies to the left, chicken and mushroom cup-o-soup to the right. When I manage to locate a cup and saucer in the sink – exhuming them carefully, at gloved fingertip – the Spode tea cup and saucer are actually so cute they wouldn’t look out of place in a chintzy cake shop (once you bead-blasted the tannin).

‘There you go,’ I say, giving her the tea. ‘Sorry it’s black. Who gets your shopping for you?’
‘Who does what, dear?’
‘All your cakes and things. Who buys them for you?’
‘My lovely next door neighbour, whenever he goes down Morrison’s. But he’s on holiday at the moment so I don’t know when I’ll see him next. He got me plenty last time, though, so I think I’m all right.’
I don’t think the neighbour could ever come in with the shopping, though. Anyone who saw the state of that kitchen would back out slowly and reach for the phone.
‘I really think you should come with us to hospital, Hilda,’ says Rae. ‘You’re obviously in some pain from your side, you say you get dizzy when you stand up, and there’s no-one here to keep an eye on you.’
‘I shall be all right, love. I’ve got my tea.’
‘But what if you fall over, Hilda? You’ll only hurt yourself and end up having to stay even longer in hospital. Why don’t you come in with us now, let the doctors have a look at you, sort you out, and then maybe think about getting you some help at home. You’re ninety-four, Hilda. I think you’ve earned a rest.’
She doesn’t say anything, but carries on drinking her tea.
Propped up on top of the TV is a paint-by-numbers picture of a tiger, its head slightly tipped back, looking down its nose. Whether it’s the fault of the design or the way the painter followed the pattern, but the tiger has a strange expression, like a cross-eyed clown who just remembered where he left his hat.
‘I like your tiger,’ I tell her. ‘Did you do it?’
‘Did I what?’
‘Did you do the tiger?’
She carefully puts her cup down on the saucer.
‘No,’ she says.

Saturday, May 10, 2014

bogeymen

Clancy has been on the floor all night. There’s an abraded patch of red skin on the side of his face where it was pressed into the lino, and a few lank strands of hair sweated across it. Luckily he didn’t break anything when he fell, so we pick him up as gently as we can and set him down in his armchair. Clancy is an artist. All around his chair, hanging on the walls, or stacked up in tidy piles next to boxes of pastels and tubes of acrylic paint, there are canvases and boards and sketch books, all of them covered with such explosive bursts of colour it’s like they’ve been pegged outside in the middle of a paint storm.
‘I used to drink a great deal,’ he says, running his fingers through his hair. ‘I was stupid, but there you are. Haven’t touched a drop in years, mind.’
‘Yeah! He’s good,’ says Isaac, fiddling with his outsize headphones, signing the care folder, getting ready to go. ‘Sorry Clance, mate. I’m late for my next appointment. You’ll be all right with these guys, yeah?’
‘I’ll be fine, thank you, Isaac. Thanks for everything you do.’
‘No worries. Sorry I couldn’t pick you up myself.’
‘Quite right. You have to take care of your back, Isaac. I wouldn’t want to lose you now. But look at me. Look at the state I’m in. What’s to be done? Hmm? What’s to be done?’

Clancy’s obs are okay, but he can only just weight bear and would fall again if we let go of him, so Rae goes out to make the truck ready and fetch the chair.

‘Four men came into the room last night,’ says Clancy, just as Isaac picks up his bag.
‘What four men?’
‘I didn’t ask their names. I was too afraid. They were quiet, serious men, and they wouldn’t look me straight in the face. I told them to get out but they just ignored me. They forced me down on the floor, and then stood around watching me for hours, like it was some kind of game, until eventually they got bored and left me to it. Who do you think they were?’
‘Bogeymen, Clance,’ says Isaac, shouldering his bag. ‘I think you’re away with the faeries, mate.’
‘Am I? D’you think so?’
‘Well I’m not the medic, but what else could it be? There’s no sign of any break in. I had to use the key safe to get in this morning, and everything looked okay.’
‘What do you think?’ says Clancy, turning to me. ‘I couldn’t just imagine something like that, could I? They were standing right in front of me, as real as you are now.’
‘Have you suffered with hallucinations before?’
‘Never! So you definitely think I’m seeing things, do you?’
‘I think it’s the most likely explanation, Clancy. It’s another good reason to take you down the hospital.’
He puts his face in his hands.
‘But I haven’t touched a drop!’ he says. ‘Why would I start seeing things now? It doesn’t make sense.’
He moans a little, then eventually straightens up and looks directly at me again.
Who sent you?’ he says.

Friday, May 09, 2014

the apprentice

The big screen at the back of the burger restaurant is playing Van Wilder. The place is empty, near to closing, and it’s strange to see this cavernous room, as high and square as a power station, utterly devoid of life. The characters up on the screen are having some hilarious, high-definition relationship problems, but we don’t take a seat to watch. Instead we carry on to the back of the room, to the security pad at the side of the toilet door, where Rae taps in the numbers.

Janine is doubled over in a cubicle, hyperventilating. Her boyfriend Tom is standing next to Clara, the paramedic first on scene. A tall, red-faced young man with a mild expression, Tom looks pleasantly embarrassed, like someone who’d just been asked up on stage to help a magician. He smiles at us as we introduce ourselves, swinging Janine’s bag from side to side in a diffident kind of way.
‘I’ve been trying to coach Janine’s resps back to normal but not having a great deal of luck so far,’ says Clara, straightening up. ‘Let’s get you out of here onto a chair at least,’ she says to Janine, who has started making dramatic gasping noises, sucking in her cheeks and cupid-bowing her mouth like a cartoon fish. ‘Try to remember what I said – in through the nose, hold it a little, out through the mouth… that’s it… you hold the key to feeling better, Janine. You’re perfectly safe. Come on. Take my hand…’

Back out in the restaurant and there’s an advert break playing. Loud, fast images, shaky zoom shots, white teeth, laughter and overflowing drinks, cars and crowds and perfect sunsets, the whole thing thumping over our heads into the void of the empty restaurant.
‘I – can’t – tell my – dad. He’s had a – stroke. This’ll – kill him.’
‘No-one’s telling anyone anything, Janine. Don’t worry about that now. Let’s just focus on getting your breathing right. When you’re feeling better we’ll see about the rest.’
‘But – my dad!’
She takes a few more deep breaths, then slumps across the table.
‘She’s been doing this a fair bit, too,’ says Tom, blushing. ‘What is it? Has she fainted?’
‘Well – you see it sometimes with anxiety attacks,’ says Clara. ‘Don’t worry. She’s not unconscious or anything. I think it’s just emotionally exhausting for her. Plus over-breathing like that makes you dizzy. But she hasn’t passed-out as such. Have you – hey? Hello!’ Clara hooks the hair away from Janine’s face, who immediately arches her back and starts breathing rapidly again.
‘Come on. Let’s get you out to the ambulance. I can’t hear myself think in here,’ says Clara. ‘And it’s making me hungry.’
We all get up and make our way out to the truck.

There are two customers in the front part of the restaurant by the doors. The one facing me stares as we pass, a cluster of fries poised in front of his mouth. I nod at him and raise my eyebrows, which seems to work, because he suddenly reanimates, cramming the fries in by turning his hand from side to side, and then pouting up to a drinks straw to wash it all down.

*

‘I’m afraid I can’t tell you anything about her,’ says Tom. ‘Her name and where she lives. But that’s it. This was our first date.’
‘Your first date?’
‘I know! I thought it was going pretty well. We went for a few drinks in the pub, nothing crazy. In fact, she said she was going to drink me under the table. But we hardly had anything and then it all kicked off. So – not much of a competition, as it turns out.’
‘I think you’re being incredibly supportive, Tom. Janine’s lucky to have met you.’
‘You think? It doesn’t look good though, does it? A panic attack on your first date. I didn’t think I was that bad.’
He checks his phone.
‘Sorry. I’ve got to keep an eye on the time,’ he says. ‘If I miss the last bus I’ve got a long walk home. It’s a college day tomorrow.’
Janine vomits noisily into a bowl. I tuck her hair away from the mess, give her some tissues and replace the bowl with a fresh one.
‘There! Better?’ I say.
But she groans and starts hyperventilating again, slumping forwards to press her forehead onto her knees.
‘You’ll feel better if you sit up straight, Janine. Come on. Open your eyes for me. Think about slowing that breathing down. In through the nose, hold it, out through the mouth…’
Tom checks his phone again.
‘What are you studying at college?’ I ask him.
‘Plumbing and stuff.’
He puts Janine’s bag on the end of the trolley and then stands at the back door.
‘One thing’s for sure,’ he says, as Rae opens it for him. ‘Boilers are a lot easier to figure out than people. Anyway – catch you later.’
And he hurries off into the night.