Sunday, November 30, 2014


Lea is lying in the middle of the dance floor, star-fished tragically like she spun out of a fast move, slowed up and stayed there. Her eyelashes are flickering with the effort of keeping her pupils rolled up zombie style. The rest of the club is jumping around as normal, but Lea has created a little cell of attention around her: two friends, one crying on the other’s shoulder, some others leaning in, struggling to be heard over the bass beats – something about a spiked drink, a fall, a fit – and a couple of bouncers trying to keep the area clear.
Did she hurt herself when she fell?
Did she go down boom with a clatter?
No. She just kinda went.
We need to get her out of the club as quickly as possible. I crouch down next to her and shout her name in one ear, whilst surreptitiously pressing my finger in the space behind the other. She gasps, sits up and pats my hand away.
Lea. We need to get you somewhere safe. Let’s stand you up and help you out to the ambulance. It’s quieter there. More comfortable. Yeah? Ready?
With Rae one side and me the other we walk her towards the entrance, the bouncers carrying our bags, ploughing relentlessly through the crowds like two carthorses in frockcoats communicating with the farmer by chin-mic.
Outside on the forecourt, the air is deliciously fresh. Lea bends forwards and vomits. We wait for that to pass, then carry on walking.
Clubbers lean in, laughing and cheering and comic-swerving the mess as we head up to the truck.
Inside – doors shut, the whirring of the heater, the bright downspots of the cabin lights – the whole thing feels nothing less than sanctuary.

‘Right. That’s better.’

Lea’s twenty, a student at the university. A tall, gawky twenty year old in Gothic clothes, a pentagram pendant, black nail polish, black PVC trousers, pixie boots. When I roll the sleeves of her black lace top up to put the BP cuff on, there are a series of parallel pale scars on her forearm.
Talking to her is difficult. She’s perfectly lucid, but now and again she flops her head to the side and appears to go unconscious. Ella, the first friend, is upset by this; Chloe, the other, has lost interest, distracted by the novelty of being on an ambulance, looking around and saying cute things about the equipment.
‘She collapsed and had a fit last year,’ says Ella, blowing her nose on some tissue Rae gives her. ‘They did all kinds of tests but couldn’t find what was wrong. What do you think it is? We’ve got to find a cure! We can’t go on like this! Oh my God! Shall I call her mum?’
‘Well – it’s four in the morning. Why don’t we find out exactly what’s happening and then maybe give her a call a little later.’
Lea groans, opens her eyes and looks between us all, her confused face as off-the-peg as her unco face.
‘Hi Lea! How are you feeling?’
‘Wha’?’ she says.
‘You collapsed in the club, for some reason. Tell us about last year, Lea. What happened then?’
She puts her free hand over her face.
‘The nurse said I was faking it. The bitch.’
‘But they ran some tests did they? An EEG for example?’
She shrugs, then lowers her hand and makes a grab for the vomit bowl.
‘Is this like – for zapping dead people?’ says Chloe. Whilst Lea vomits into the bowl, Chloe strokes the screen of the Lifepak. ‘Clear!’ she says.
‘Chloe – don’t!’ says Ella. ‘Lea’s had a fit or been spiked or something and you’re clowning around like you don’t care.’
‘I do care, El, but they obviously don’t think it’s anything.’
‘How much have you had to drink tonight, Lea?’ I ask her, writing stuff down on the clipboard.
‘Not much,’ she says, wiping her mouth with some tissue. ‘Not as much as I normally do. I know it’s not the drink.’
‘But sometimes you can lose track of what you’ve had. And other times your body doesn’t tolerate it quite as well.’
She shakes her head, then apparently without anything else to do, collapses into unconsciousness again.
‘Lea! Lea!’ shouts Ella, throwing her arms around her.
‘It’s okay, Ella,’  I tell her. ‘Don't worry. She’s ... erm... resting.’
‘Students, eh?’ says Chloe, sounding as war-weary as a ten year paramedic. She straightens the blanket over Lea’s feet. ‘You gotta love ‘em.’

Saturday, November 29, 2014


Six-fifteen in the morning and exhaustion powers us, a darkly inverse propulsion system that feeds not on potential but the absence of potential.  Not only does it pick us up and walk us back out to the truck, it also gives us the preternatural ability to see how things are – the tactical spread of work at this hour, and how we’ll need to play things to be in with a chance of finishing on time. Because if we don’t, after such a demanding night, I will surely die on the spot, an EMT vampire staked through the heart with a rolled-up patient report form.
It’s tricky. An elderly woman fourteen miles out of town who can’t get out of bed to take her meds. The fact we’re being sent so far out means there are no resources in that sector. It also means we’re highly likely to get stood down from this job to attend a higher category call. If we can reach this patient and book at scene, we’ll be safe, but we’ll need to take her to hospital,  because if we leave her at home we’ll almost certainly be given another job in that area; if it’s serious, it’ll have to go to the main hospital ten miles further east, leaving us with an overrun of approximately one million years.
Rae drives like a winged angel of death. We arrive marginally younger than when we started.
Agnes is lying in bed.
‘You took your time,’ she says.
‘Hello! Agnes! What seems to be the problem this morning?’
‘I need to take my five o’clock pills but I can’t get out of bed.’
I don’t say anything about the fact her pills are neatly positioned on a little pine table right next to the bed. She could turn her head and pick them up with her teeth if she wanted.
‘Can you normally get out of bed?’
‘Why can’t you now?’
‘My legs don’t work.’
We examine her. There doesn’t seem to be anything the matter with her legs. She’s FAST negative, nothing seems amiss.
‘Do you have any pain anywhere?’
‘I always have pain.’
‘Where, in particular?’
‘All over.’
‘In your chest?’
‘All over.’
‘Well – given that you say your legs don’t work and you have pain all over I think we should run you down the hospital for a check-up.’
‘I want my daughter to come with me.’
‘We can give her a call and she can meet us there.’
‘I want her to come with me.’
‘Where does she live?’
Agnes mentions a town about an hour away.
‘I really think the best thing is for us to give her a call and get her to meet you there. Okay? Shall we help you into the chair?’
‘Oh! Your hands are cold’
‘Yep – but warm heart, as they say.’
‘Who does?’
‘I don’t know. People.’
She tuts as we help her into our chair. She weight bears perfectly well.
‘This seat’s all sticky.’
‘Shouldn’t be. We clean it regularly.’
‘Where are my pills?’
‘We’ve got them.’
‘I need to take them.’
‘Let’s do that on the ambulance, shall we?’
She frowns as I wrap the blanket around her.
‘Someone’s got out of the wrong side of bed this morning,’ she says.
‘I haven’t actually been to bed, Agnes. I’ve been working all night.’
‘Oh. I ‘spect your tired then. Never mind the rest of us.’
‘I am, tired, Agnes. I am. Now then – don’t worry, you’re perfectly safe. Here we go.’
We wheel her out to the ambulance.
‘I need my bag and my glasses.’
‘I’ll come back for them.’
‘And lock the back door. And make sure the kitchen window’s closed. And put the key back in the keysafe.’
‘Yep. Okay.’
We wheel her onto the ramp.
‘Blimey! That’s a bump,’ she says.
‘Sorry, Agnes. There’s no easy way to do it.’
‘If I wasn’t ill before I am now.’
‘If I’d known how rough you were going to be I’d never have come.’
‘Let’s get you over onto the trolley, Agnes.’
‘Don’t you have heaters on these ambulances?’
‘Yep. It’s just the door’s been open and all the heat’s gone out. It’ll soon warm up again.’
‘I hope it does or I’ll freeze to death. Is my daughter coming?’
‘We’re going to call her en route. Do you remember?’
‘It smells in here.’
‘It smells of disinfectant.’
‘Well there are worse things.’
‘What like?’
‘I don’t know. Things.’
‘Where are you taking me?’
‘To the hospital.’
‘Because you can’t move your legs.’
‘I know I can’t.’
‘So why are you taking me to hospital?’
‘Well, if you can’t move your legs, what’ll you do when you need the toilet?’
‘I don’t need the toilet.’
‘But when you do.’
‘I have a girl comes in.’
‘But what if you need to go before she arrives?’
‘I don’t.’
‘And anyway, there’s all this pain you’ve been having.’
‘Oh, you’re right there. I suffer terrible with the pain.’
‘So that’s another good reason to go to hospital.’
‘I’m ever so thirsty. Can I have a drink of water?’
‘Just a tiny bit to wet your mouth.’
‘What d’you say?’
‘I say don’t drink much. Just enough to wet your mouth.’
‘But I’m thirsty.’
‘The nurses don’t like you to drink before they see you. In case you need an operation.’
‘What operation?’
‘I don’t know.’

The ambulance moves off.

‘It isn’t half bumpy.’
‘I know. It’s the roads.’
‘I feel sick.’
‘Here’s a bowl, just in case.’
‘Where are we going?’
‘To the hospital’
‘I don’t think much of her driving.’
‘She’s a very good driver.’
‘I don’t think so. Oh – this is an absolute shocker! Where’s my daughter?’
‘She’s meeting us there.’
‘Is she?’
‘Well I’ll phone her and see.’
I take my phone out, drop it, the case springs off and the battery flies under the trolley.
‘Butterfingers’ says Agnes.

Friday, November 28, 2014

the four bikemen

There are four kids hanging around the entrance to St George’s Rise, slouched over the handlebars of their bikes, hoods up, faces so deep in shadow when they turn to watch us walk to the door with all our bags, I could swear they didn’t have faces at all.
You’d know it was a tough block, even if it didn’t have a posse of dark knights guarding the entrance. The lift feels like a reinforced coffin, with anti-graffiti panels, an armoured security camera in the top corner, and the whole thing lit with an unearthly blue light to make shooting-up difficult.
Up in flat fifty-four, Jake is on the floor with Mick pumping up and down on his chest. We take over, whilst Mick gets his breath back on the sofa.
It turns out Jake smoked heroin half an hour before and eventually went into respiratory arrest. We protect his airway, support his breathing, give him narcan to reverse the effect of the opiates. Ten minutes later he’s sitting in our carry chair, pulling the plastic airway out of his mouth, and looking up at us with eyes as wide as if we were green angels from hell come to collect his soul.
We try to reassure him.
‘So I died?’ he says. ‘You mean like – dead died?’
‘You would’ve if Mick hadn’t stepped in to save you.’
Jake closes his eyes, and needs a shake to bring him back into focus. His hair is spiked with sweat. Now and again he grimaces, coughs and spits a glob of bright red blood into the bowl.
‘What’s this?’ he says, lifting up the bowl.
‘I was just doing what they said,’ says Mick.
When Mick came out of the bathroom and found Jake collapsed he called 999. They told him to put Jake on the floor and start CPR, because it must have sounded like cardiac arrest to them.
‘You saved my life then, yeah?’
‘I dunno. I just did what they said.’
Mick looks at me.
‘Did I do right?’ he says.
‘Absolutely, you did. Jake was definitely heading south.’
‘But all that blood. Have I hurt him?’
‘It’s possible you might have broken a rib and nicked his lung a bit.’
‘Oh god!’
‘But hey – full marks for getting down and dirty.’
‘I can’t believe you saved my life’ says Jake, then coughs again, clutching his chest and grimacing. He dredges up some more blood and spits it into the bowl.
‘Put the mask back on, Jake, and we’ll set off for hospital.’
‘Hospital, yeah? You think I need to go?’
‘All things considered, I do, yeah.’
‘I don’t like hospitals.’
‘No. No-one does.’
‘I can’t come,’ says Mick. ‘I’ve got things to do.’
‘What? Like saving more lives?’ says Jake.
‘Seriously, Jake. You’ve got to stop smoking that shit,’ says Mick. ‘I’m not going through that again.’


Back downstairs and the gang of kids on bikes have migrated to the ambulance. They watch in silence as I stow the bags, put the back down ready for the chair and prep the trolley.
‘Has someone died?’ says one, eventually moving in closer and looking round the cabin.
‘No. Not today.’
‘What did he say?’ says another.
‘He said no.’
‘I called an ambulance once,’ says one of the kids sitting further back.
‘Who for?’
‘My mum.’
'Yeah?’ laughs the other. ‘Mate - it’s always your mum.’

Wednesday, November 26, 2014

lucky slippers

Antoine had a fight with his girlfriend, left the house in his slippers, walked round to his friend Terry’s house. They smoked a bit, had a few cans, played Call of Duty, until he reckoned things had calmed down enough for him to go back. It was three a.m.
Almost outside the front door, Antoine trod on a broken bottle. A fragment of glass pushed up through the sole of his threadbare slipper into his left heel. He hopped inside and banged on the flat door. Siobhan opened it long enough to throw him a towel to staunch the bleeding, then slammed the door again.
He called 999.


Antoine sits on chair with his bandaged foot up on the trolley.
‘I can’t believe this,’ he says, wiggling his toes and watching them work from his great, smoked-up distance. ‘Thems supposed to be mah lucky slippers.’
With his dreads spilling out of his hat, a wide, warm smile, and an ee-zee way of talking as wispy as his beard, Antoine would make Bob Marley look like a City Trader.
‘Ah don’ think Siobhan’s gonna get over this one in a hurry’ he says, taking a sip from his Evian bottle. ‘The way she threw that towel at me, man. Ah’m surprised it weren’t a knife.’
There’s not much else to be done about his injury, so we chat about places he’s been, things he’s done, this and that.
He takes another sip of Evian.
‘See this?’ he says, tapping the label. ‘Do not store next to strongly flavoured food. Why would they even say that?’
‘I don’t know. Do not keep in the cheese cupboard. You wouldn’t want cheesy water.’
‘Nah mate. Cheesy water? You can keep it.’
He laughs and turns the bottle round in his hands.
‘I love it when they give you all that shit, man. It’s a bottle of water! Drink and enjoy! Thassit!’
Do not drink and drive.’
Yeah! This is not a toy.
Single use only.
Stop when bottle is empty.
Do not drink and swim.
Do not drink and walk in slippers.
He shakes his head, takes another sip, then screws the cap back on and relaxes back on the chair. He studies his foot again.
‘Siobhan, she’s really gonna kill me this time’ he says, wiggling his toes.

Sunday, November 23, 2014


Tito’s chest is full of dinks and rumbles and squeaks and rasps. I might as well have put my steth against the engine cover of an old tractor, cranked into life after twenty years at the bottom of a ditch. He needs anti-biotics, steroids, pain killers. More than all of these, of course, he needs a place to live. Sleeping in a shop doorway night after night would be tough on anyone; for a man in his fifties with corrupted lungs, it’s tantamount to a death sentence. Still, he’s sanguine enough. He settles into the trolley, happy in the moment, with the warmth and the light, and the novelty of a sense of direction. The stench from his sodden trainers is truly appalling. You could track him blindfolded, across the wastes of Alaska, without dogs. For now, I’m just grateful he doesn’t have a foot injury I’m supposed to examine. Instead, I fix him up a neb, adjust the blanket, and he snuggles in for the ride.
I’m writing a few things down on the form when he taps me with his newspaper, the free one they give away outside the railway station.
He lifts the hissing neb mask.
‘Have you seen this?’ he says.
He points to a story just inside.
He puts the mask back on whilst I have a look.
A fossil of the world’s largest dinosaur has been discovered in Patagonia. A plant-eating Titanosaur, it was as big as seven T-Rexes. Sixty-five tonnes, thirty-seven foot neck, weaponized tail. Dreadnoughtus schrani.
‘Amazing!’ I tell him.
He pulls the mask aside again.
‘Can I turn this off, mate?’
‘Sure. You don’t have to wear it if you don’t want.’
‘Nah. It makes me nose all sweaty.’
I turn the oxygen off and sit back down.
‘You like dinosaurs then?’
‘Depends what you mean by like. I like looking at pictures and all that, thinking about how things used to be. I don’t know’s I’d want to keep one as a pet.’
‘It’d make one helluva mess of your garden.’
‘Aye, no doubt it would. And the whole street, come to that. I mean – look at the size of the thing. Why’d it get so big, d’you think? What’s the point in that?’
‘I don’t know. I remember seeing this programme about Apatosaurus once. It said they had long necks because they’d walk to a good position then stay there, grazing everything around them up and down without having to move. Apparently it was more efficient that way.’
‘Yeah? I’m a bit like that myself. I don’t like to move much when I’m feeding.’
‘Maybe in a few million years your relatives’ll all have very long necks.’
‘I wouldn’t mind. I think I’d look pretty good. Although it’d be a stretch putting my beanie on in the morning.’
He closes his eyes and seems to fall instantly asleep. Maybe it’s the unaccustomed heat in the back of the truck. I turn the dial down a bit and finish off the paperwork. After a few minutes he yawns and opens his eyes again.
‘What gets me is the names they come up with,’ he says, as if there’s been no pause in the conversation at all. ‘See this one they found? Dreadnoughtus here? After one of them big battleships from the first world war? Well, no surprises there I suppose. But you know what? If it was up to me I’d call it something else. A Humungasaurus. And whilst I was there I’d rename a few others. Your T-Rex? You know what I’d call him?’
‘A Meanmuthafuckasaurus. And if he were here now, chasing us down the street, no doubt you’d see my point.’

in the zone

Just a couple of years ago there were fields and trees here. Now, after an overnight shower, a small village has sprung up, so complete – with a central square, a village hall, a playground, a jogging track, and a variety of building styles from faux-thatch to balconied apartment to terraced house – you’d think the whole thing was designed on a computer and printed out brick by beam in a giant warehouse. Even the street names sound google-generated. Middle Way; Church Close; Woodvale Mead; Upton Hill.  The name of the village is spelled out on the access road in a line of fibreglass standing stones. Aligned with the city, no doubt.
I always get lost here. SatNav gives up, dumping its arrow in the middle of an approximate grey, marked Erewhon. When I stop to ask a postman, even he looks round, scratching his chin.
Pine Tree Close actually has three Rowans, still with their labels attached, planted in a raised central bed in the middle of a courtyard. There are six bunaglows arranged round them in a C-shape, the whole thing railed off, with access by a ramp left and right or a series of shallow steps up the centre.
I’ve been called to number three. A cause for concern. Apparently someone rang 999 asking for help, but hung up when the call-taker started asking questions. They hadn’t answered when the call-taker rang back, so could I go and check out the address?
I knock on the door. A young woman answers, smiling, but obviously a little alarmed to see me.
‘Sorry to bother you. We took a treble nine call from this address about ten minutes ago. I’ve no idea what the problem was or who called. They hung up before we got any more information and didn’t answer when we tried to ring them back.’
‘Really? Well there’s just me and my husband here, and we haven’t made any calls.’
Her husband appears behind her, cuddling a baby in a stripy baby-grow.
‘Everything all right?’ he says. The baby wobbles its head round to look.
‘He says someone called 999 from this address.’
‘I don’t think so,’ says the man. ‘Why? What did they say was wrong?’
I shrug.
‘I don’t know any more than that. It was a landline...’ I read out the number.
‘Nope. Never heard of it. We haven’t even got a landline. We just use our mobiles.’
‘Okay. Definitely not here, then.’
‘Maybe it’s a hoax.’
‘Could be. It’s strange that the number tracked here though. I’ll get back to Control and let them know.’
‘Do you think it could be Janet, the old woman who lives next door? She’s had the ambulance out a few weeks ago.’
‘Really? I’ll nip next door and give her a knock. Sorry to disturb you.’
‘No, that’s okay. It’s all a bit mysterious, isn’t it?’
They stand under the porch and watch me go next door.
I knock and wait. Ring the bell. Knock again.
‘No answer!’ I say to the young couple.
They smile and shrug.
The elderly woman from number five comes outside.
‘Whatever’s the matter?’ she says.
I tell her.
‘Well Janet’s not there. She’s been in hospital for the last six weeks with her hip. I don’t think it’s her. Unless she took her emergency button thingummy with her and pressed it by mistake.’
‘That wouldn’t account for the odd phone number, though.’
‘No. Well. I’m a bit stumped. And before you ask it definitely wasn’t me.’
‘Don’t worry. I think I’ve tried all the options.’
‘What about Mrs Duckworth? She’s not had the ambulance before, but I know she had a dose of the whatsits last week. Maybe she got into trouble. I’ll go and have a look.’
A man in one of the bungalows immediately opposite comes to his door.
‘What’s going on?’ he says. ‘Can I help?’
‘Someone’s had an emergency and we can’t find out who,’ says the elderly woman. She starts thumping on Mrs Duckworth’s door, then peering through the side window.
‘Is everything all right?’ says the man’s wife, appearing behind him with a vegetable peeler in one hand and a potato in the other.
I walk into the centre of the courtyard so I can talk to them all at once.
‘Someone rang 999 – don’t know why or what’s wrong – then hung up before we could find out anything else. The number apparently tracked to number three..’
‘It’s not us,’ says number three.
‘We’re fine,’ says the husband. ‘Aren’t we?’ (holding the baby up as proof).
‘I’ll give Roisin a call to see she’s okay’ says the man.
‘Oh, yes. You’d better. She had that thing not so long ago.’
He knocks on Roisin’s door.
‘She’s probably still at work’ says the man, knocking on the window. ‘Do you want me to go round the back and check there?’
‘If you like. I shouldn’t think it is her, though. I’m just waiting for Control to get back to me with more information. I expect it’s all just a technical glitch.
They all nod. It seems to be a popular explanation.
‘You don’t like to think of someone being in trouble like that,’ says the elderly woman at number five.
‘But they hung up. You wouldn’t hang up if you were really in trouble. Would you?’
‘Maybe the battery on their phone packed up?’ says the woman with the potato and peeler. ‘Our one’s pretty rubbish.’
My radio buzzes. I wave it in the air a little as if to say: Here we are. This’ll tell us.
I describe what I’ve found to Control, saying rather dramatically that I’ve knocked up everyone in the close but had no luck. The Dispatcher tells me that they’ll mark it as nothing found, and refer it to police to see if they’ve got anything to add. She stands me down. I clip the radio back on my belt.
‘Well! That’s it! Thanks for all your help!’
I pick up my bag and do a little turn in the middle of the courtyard, like I’m waving goodbye on a revolving stage.
‘Nice to meet you all.’
‘You too.’
‘Hope the rest of your shift is less eventful.’
‘I hope you find your next patient’
I walk down the central stairs, put my bag back in the ambulance car, and finish writing the paperwork.
Half-way through, the radio buzzes again.
‘The number definitely maps to that address’ says the Dispatcher. ‘Are you sure the patient wasn’t there?’
‘Positive. It’s a happy, healthy young family. They don’t even have a landline.’
‘Oh well. If you’re sure.’
‘Unless I’m in The Twilight Zone and everyone here’s an actor or something.’
‘Right’ says the Dispatcher. ‘Twilight Zone. I’ll make a note. Okay. Back to base.’
‘Wherever that is.’
And of course, even though I concentrate and try really hard to simply retrace my steps back out of the village, I end up getting lost.

Saturday, November 22, 2014

not long

Ted is ninety-three. Five years ago he had a serious stroke that left him bed-bound, unable to speak, incontinent, swallowing problems and so on. The best he can do is intimate pain – everything else is subject to the attention and good offices of the nursing home staff. He’s padded and catheterised, spoon-fed pureed food. He takes a dozen meds including prophylactic antibiotics for urine and chest infections. Every morning after breakfast Ted is hoisted out of bed to a wheelchair, bolstered with cushions, then pushed through to the lounge where he sits with his back to the window, facing the TV. There is no DNAR.
The last couple of days Ted has stopped eating and drinking. There’s a suggestion that he may have had another stroke but of course it’s difficult to say. The doctor was informed over the phone. After reviewing the situation he arranged for Ted to be collected by ambulance and brought to hospital with a view to fitting him with a PEG – a tube that passes through the abdominal wall to the stomach.
He’ll be admitted via A&E, pending an available bed further up the chain.
Ted’s daughter Fiona arrives. We tell her how things stand at the hospital, the delays, the queues in the triage area. She’s quite stoical about it. She says she faced a similar ordeal a few months back when he was admitted with his breathing.
She rests a hand on his shoulder and leans in to shout in his ear. Don’t worry Dad. I’m coming with you.
He stares ahead, his mouth hanging open.
The nursing staff hoist him onto our trolley. We collect his notes, his medication, his personal effects. We head out of the lounge to the lift.
‘Going on a trip?’ says one of the nursing staff, holding the lift door for us. ‘Have a good one!’
We ride down, the bright down spots of the lift casting all our eyes in shadow.
Fiona pats Ted on the hand, fusses with his blankets.
We wheel the trolley through the lobby, passed a potted fern, a couple of soft focus canvases, four leather armchairs round a glass table displaying a circle of leaflets.
Fiona takes a call on her mobile, makes arrangements.
An assitant in the lobby keys a sequence into a pad and the doors slide open. The wind out in the car park hits us cold, blowing in from the sea across a swathe of dark, freshly-tilled earth.
‘Won’t be long now,’ says Fiona.
There’s no reaction.

Wednesday, November 19, 2014


Mark lies back on the trolley, staring up at the cabin spotlights. Every now and again he runs the tip of his tongue over his lips in a circular sweep.
‘They don’t half dry you out, them tablets,’ he says.
Mark had a sub-arachnoid haemorrhage five years ago. One of the side effects was short term memory loss. The majority of his meds are in a blister pack, but for one reason or another the Quetiapine was sent to him in a separate box. He overdosed last night. His CPN has sent him in for treatment.
All Mark’s obs are fine, but he’s told us about some hallucinations.
‘Are you having them now?’
‘Oh, all the time,’ he says. ‘It’s nothing to do with the meds. It’s just another side-effect of the bleed.’
‘How would you describe these hallucinations?’
He rubs his face with his hands, then turns to look at me.
‘Sometimes it’s just these big, shimmering spiderwebs. All colours – draped everywhere. And then other times, like now, it’s dead people.’
‘Dead people?’
‘Yeah. As real as you sitting there. A big crowd, hundreds, all huddled up. So close you can only see this much...’
He makes a frame with his hands, thumb and forefinger at right-angle, right over left, showing his eyes and nose. He stares at me like that for a moment, then relaxes his hands again.
‘That’s it. They don’t do much. You know what? I wish there was some machine I could plug into, like a PS4 or something. Then maybe we could touch hands and you could see what I see.’
‘I think I’d freak out.’
‘Yeah? Well. Maybe you would.’
He relaxes back on the trolley and licks his lips again.
‘I did, to begin with,’ he says. ‘You get used it.’

Sunday, November 16, 2014

ten minutes

Elizabeth is waiting for us in the conservatory. A tall, powerfully-built woman in her seventies, she has the worn, slightly bewildered demeanour of an athlete who threw a javelin so hard it never came back to earth.
‘David’s in the bathroom,’ she says, pushing the silvery strands of her hair back and showing us inside. ‘He didn’t fall with a terrible clatter or anything, but he’s rather unsteady on his feet and a little reluctant to bend in the middle. I tried to get him up myself, but I’m afraid I couldn’t quite manage it. He’s had problems with his back for years. The other thing is a touch of dementia, but we rub along, you know? So sorry to call you out like this.’
The house is tastefully decorated, landscape watercolours on the walls, silver photoframes on highly-polished furniture, the whole place as neat and perfect as an illustration in a country catalogue. A chair lift snakes round the balustrade up to a sunlit landing and the mosaic-tiled wet room where David is lying on his back, surrounded by cushions. He’s as olympian as his wife, except his health has taken more of a battering. His eyes are a pearlescent gray, and his hands shake when they reach out to us, flailing around without focus when we manipulate him into a better position.
We use our inflatable cushion to get David up from the floor. He can weight bear, but paddles his feet in a dangerously unstable way. We fetch a chair for him to sit on, and stand close in to keep him there whilst we consider our options.
‘Is this shaking new?’
‘No. They think it’s benign, though. Not Parkinson’s. Look – before you say anything – I just want you to know that hospital’s not an option. We’ve had a rotten time of it these last few months. David simply cannot go back there. I hope you understand. It may take some time to get him down the corridor and back to bed, but if you wouldn’t mind bearing with us I’d be terribly grateful.’
In the end we have to wheel him there on a commode. Even alongside the bed, David doesn’t seem able to make the transition. We help him to stand as positively and simply as we can, but at the last minute he loses confidence, relaxes his knees, and we have to sit him back down again. He’s easily distracted, and struggles to understand our instructions.
‘Come on darling,’ says Elizabeth, stroking his silver hair flat and kissing the top of his head. ‘There’s a good boy. We’ll get you to bed. You’ll be comfortable there. You can watch Countryfile. You know how much you enjoyed that last time.’
When she looks up at us she starts to cry.
‘He wasn’t always like this,’ she says. ‘He could do the Times crossword in ten minutes flat. Couldn’t you, darling? Ten minutes?’
She kisses his head again. He turns his head from side to side, like he’s struggling to pinpoint something he can hear in the distance.
‘Not the quick crossword. The cryptic one, you know? The difficult one.’ Then ‘Come on, David. You can do it. You’ve got to do it. One last try.’

Saturday, November 15, 2014


We walk along a corridor bathed in an unearthly blue light through to the living room where Gillian is waiting, sitting on a leather sofa with a German short-haired Pointer by her side. On the wall opposite is a giant plasma screen sectioned into six, each segment the feed from a different security camera – views of the front of the house, the back, the garage, even the roof. There’s a server in one corner of the living room, a couple of laptops, only one open and on. Behind the sofa is an exercise bike, still in its wrapping. Apart from a large cage for the dog, the room is bare.
The Pointer looks up as we come in; Gillian does not.
I make the introductions; she quietly acknowledges.
‘I understand you’ve been feeling depressed tonight and cut yourself with a razor. Is that right, Gillian?’
She rolls up her sleeve and shows me the wound, a superficial scrape.
‘Have you done anything else to hurt yourself? Taken any pills?’
‘No. Just this.’
‘Your boyfriend called us…’
‘He said you sent him a text with a picture of you cutting yourself.’
She shrugs.
‘And words to the effect you were thinking of doing more.’
‘Yeah? Well – I didn’t.’
Rae dresses the wound. The dog jumps off the sofa to help. We have a laugh about that.
Gillian says she got angry when her boyfriend said he didn’t believe in her business. He should be more supportive. He doesn’t understand what she’s had to go through to get this far. He doesn’t know what she’s up against.
‘What are you up against?’
‘Oh. You know. Competitors.’
The dog has lost interest in the contents of Rae’s dressings bag. He walks over to his cage, turns round a couple of times, collapses in a compact heap.
‘I’m not going to hospital,’ Gillian says. ‘I didn’t even call you.’
We tell her it’s important she speaks to someone about what happened here tonight. Perhaps she could see her GP in the morning?
Gillian snorts.
‘I don’t think so,’ she says. ‘He just wants to get me medicated, but I’m like – no way. I don’t even smoke cannabis anymore.’
‘It doesn’t necessarily mean medication, Gillian. He could refer you on for some therapy. It might help to talk things through with someone.’
‘Yeah? Well – I tried all that and look how far it got me. I just want to be left alone to focus on the business. It’s a difficult time. Everything else, it’s just…’
She looks around, at the screens, the dog, the computers. Us.
‘…I don’t know… noise.’

Thursday, November 13, 2014

spelling ebe

The notes that come through on this job are comprehensive in the extreme. Update after update comes through. I scroll down, reading it all out to Rae as she drives, the medical history, social aspects, interventions made, comments from the community health team, latterly the doctor.
‘Hat size?’ says Rae, turning into the street. ‘Star sign?’
‘Doesn’t say.’
She tuts.

There are so many people of different ages outside in the garden or inside, milling around the various rooms, it feels like we’re crashing a family party. From the accents and skin tones I would guess they’re of North African origin. Everyone’s pleased to see us, thanking us profusely – so much so you’d think we were taking the patient away for good rather than a routine admission to hospital.
A way is cleared for us to the front room where the patient is sitting in an armchair waiting. He has enormous gravitas. In his bright, orange print shirt and purple trousers, he looks like the elder statesman of the family. Even though he’s quite frail, he still manages a welcoming smile as I introduce us and crouch down in front of his chair. I half-expect him to lay a hand on my shoulder and the crowd that has gathered in the doorway behind us to applaud.
‘So – hello!’ I begin with a flourish. ‘We’ve been told quite a bit already – the reason we’re taking you to hospital, the history of this and that. But first things first. How do we pronounce your name?’
He carries on smiling, but frowns a little.
‘Aleef? Aleef-ay? I’m not sure. How do you say it?’
The smile straightens out. The patient looks off to the side, to an elderly woman who’s standing there with a carrier bag of meds. She comes forward and lays a reassuring hand on his shoulder.
It’s an unexpected turn of events, and early on, too.
‘Look. Let me show you.’
I hold out the clipboard, and point out the name I’ve written in caps on the report sheet, copied down from the notes control sent through. I spell it out.
‘A-L-I-F-E. How do you pronounce that?’
The patient stares at the form, then at me.
‘Alfie’ he says.

Wednesday, November 12, 2014


There are half a dozen pigeons sheltering in the lee of the sandwich bar. They’re huddled up in an orderly line, perched as best they can on a ledge out of the rain. They only blink as we pass.
The guy in the sandwich bar stands behind the counter with a half baguette in one hand and a buttered knife in the other, fifty-fifty whether he feeds us or stabs us to death. No, there hasn’t been anyone in asking for help. No, I haven’t heard anyone saying they’re depressed. Everyone’s depressed. I’m depressed. Look outside. What else you gonna be?
We thank him for his time and back away.
The sandwich bar sits on the street side of a small green space, an iron-railed square of lawn with a couple of benches, a few maple trees – just enough room to swing a baguette, make a phone call, call an ambulance. On a sunny day, maybe. Today, a kingdom of cloud has fallen to earth, and nothing that isn’t desperate, waterproof or a good swimmer is abroad.
We call Control and tell them we can’t find our patient. They tell us to stand by whilst they try to get more information.
We retreat back to the cab.
The notes are pretty specific, if badly typed.
Male, thirty-two / hx bipolar and dpressin / meds not wowking / worried will loose control / was watching tv prog about war / now in sandwwch bar.
We sit in the cab and wait.
The high street traffic shushes by in super-wet slo-mo, headlights on in the middle of the day. Those people who absolutely have to be out are walking quickly, hunched forward, prisoners exercising in a yard.
We both take something out of our lunchboxes and eat quietly, watching it all, listening to the radio. Gotye: Somebody that I used to know.
Rae turns it up. There’s something peculiarly fitting about that xylophone riff, something darkly comic, like a toy robot wound up and set walking towards a drop.
Control call us back.
Stand down higher priority.
We move off into the traffic.

Tuesday, November 11, 2014

half way back

The fireplace has been ripped out, the hole boarded up and crudely plastered. Standing in front of it on what used to be the hearth is a medium-sized fish tank supported on a plain wooden side table. The fish tank is full, with a layer of coloured stones, a bunch of floating weed, but no fish. Aside from the tank and table, the only pieces of furniture in the room are a TV and a brown, two-seater sofa. The floorboards are bare and untreated. There are no pictures on the wall. Hanging in front of the windows are four or five lumpish crystals of different colours, suspended on crocheted lines thumb-tacked to the ceiling. The back door is visible from here, a chair leant back under the handle, a couple of brooms wedged between the floor and the middle section, a tangle of rope wrapped around everything and running up and back to a curtain rail. The doors to the other rooms coming off the hall are closed. The hall is dark.
Barbara is sitting on the sofa, her hands neatly folded in her lap. She’s wearing a heavy tweed coat, a dark cashmere scarf and a furry, pointy-eared balaclava. She seems dazed, disconnected, like I’m talking to a woman who’d been turned into a bear and was only half-way back.

 ‘I knew there was something wrong as soon as I come out of the restaurant. My head was all swimmy. I couldn’t hardly put one foot in front of the other. I felt like I was drunk. How I made it home I don’t know. It was definitely something they’d put in it. I only had one mouthful and I knew something was up. And when I looked in the burger there was all this slimy stuff. I should’ve thought when I went in they’d try something.
‘I’ve been all right lately. Not too bad. I used to drink a lot but not so much now. I’m much better than I was. A few years ago I had some rushing sensations in my heart – you know? – had all kinds of tests. They couldn’t find nothing and nothing much happened.
‘I take care of myself, though. I’m careful what I eat. I always check things. Like if I open a yogurt and there’s all that watery stuff I throw it away and open another. God knows why they do that. Do you?
‘The only thing I can think is I’m not sleeping as good as what I normally do. Normally I try to get eight hours solid. I know about it if I don’t. These last few months I haven’t really been sleeping much. I have all these thoughts going round my head and I have to get up and watch telly or something. Have a cup of tea.
‘I’ve had these people breaking in all the time. That’s why I’ve had to double bolt the windows and prop them things up against the back door. Not that it does any good. They still get in. I had to tape up the letterbox because they were climbing in through that, but as I say, nothing seems to work. I hung them crystals in the window ‘cos I thought the light shining through might put them off. We’ll see. We’ll see.
‘Not that they do all that much when they’re in. Last night they put a dab of paint on the curtains. The night before it was just a bit of straw lying in the middle of the floorboards. Still, I don’t like them being around. It’s quite upsetting, really.
‘What’s wrong with me?
‘I bet you think I’m crazy. Is that what you think? But I’ve told you what’s going on. You can see for yourself what I have to put up with. And if that sounds crazy, I’m sorry.
Does it sound crazy?
‘Well, does it?’

Wednesday, November 05, 2014

little zombie

I’ve met Sophie before. Her case is certainly unusual – subject to fugue states, she’s been known to wander out of the house at night, where she’ll be found by the police, standing motionless in the middle of swerving traffic, or at a supermarket checkout, surrounded by staff and security, or half frozen to death under a tree in the park. She’s tagged, so any unauthorised exiting of her flat will alert the various agencies, including the police, that are currently assigned to her care. Often these fugue states will be preceded by mini-absences; the guidance is that if Sophie reports any of these during her morning or afternoon safety calls, an ambulance will be sent to check her over and co-ordinate anything else that might need to be done.
This morning she seems perfectly rational, though
‘I’ve had two absences’ she says, smoking a tiny roll-up pinched between the tips of her thumb and first finger. ‘I don’t feel safe.’
We call her key worker and describe what we’ve found.
She needs to be in a place of safety. Can you take her to hospital? We’ll liaise there.
Sophie has no feelings either way.
‘I don’t care. Let me just finish smoking this.’

We walk out with her to the ambulance. A sharp, blue autumn morning.
‘This is such a waste of time,’ sighs Sophie, looking down at her feet crunching through the leaves like a bored driver looking down from the bridge of a walking machine. ‘Just ‘cos I have these absences, doesn’t mean anything’ll happen.’
I shrug and stand aside as she steps up onto the vehicle.
‘I know,’ I tell her. ‘But at least there’ll be someone to keep an eye on you and keep you safe the rest of the day.’
When she’s taken a seat I help her put the seatbelt on. She frowns as I click it into place.
‘Okay?’ I say to her, taking a seat opposite.
She doesn’t answer.
‘Ready when you are, Rae’ I shout back through the hatch. We move off.
‘Such a lovely day today,’ I say, settling back into my own seat.
Sophie is perfectly silent now, the frown still holding.
‘Shame we can’t see out all that much. But I could turn the blinds if you’d like’
‘I love all the artwork in your flat. Is some of it yours?’
No response.
‘It’s okay if you don’t want to talk,’ I say to her. ‘I don’t mind.’
I pick up the clipboard again and write some other stuff down – for something to do more than anything else.

Ten minutes into the journey we meet heavy traffic.
‘All these roadworks,’ I say to Sophie.
Suddenly she reaches down to her right, unsnaps the seatbelt and makes a lunge for the back door.
She’s flung it open by the time I have made the distance and grabbed her round the waist. Even though she’s small she’s quite a handful, and it’s all I can do to stop us both pitching out onto the road. For a moment the two of us hang there, half-in and half-out of the ambulance. I’m dimly aware of a couple of guys on a nearby pavement pointing and laughing. By this time Rae has put the hazards on and come to a stop. She jumps out, runs round, and together we manhandle Sophie back inside.
We manage to put her back in her seat and for the moment she stays there, breathing hard, her cheeks flushed, but otherwise unemotional.
‘Will you be all right back here on your own?’ says Rae. ‘We could always call for help.’
‘No. It should be fine. We’re pretty close to the hospital. Probably best if you lock the doors from the front, though.’
We set off again.
No sooner are we moving than Sophie tries another escape. She manages to unclip the seatbelt again, and I spend the rest of the journey corralling her in place with my body.
At the hospital the opposite becomes true. She puts herself on the floor of the ambulance and won’t come out. We have the back doors open and a trolley standing by as we try everything we can to tempt her out. Finally, though, after about twenty minutes, for no discernible reason, she sits up, walks out, and lies down on the trolley.
We wheel her into the department. 


Later that day Ella, the triage nurse, grabs me in the lobby.
‘Thanks for bringing Sophie in!’ she says. ‘Thanks a bunch!’
‘Why? What happened?’
‘She spent the whole morning causing absolute chaos. She kept wandering out of her cubicle and standing in front of the desk or other people’s trolleys just staring, without speaking. She put the willies up everyone, including the consultant. He wanted to know who brought the little zombie in and d’you know what? I was that ticked off I almost told him.’
‘It wasn’t our fault. I spoke to the mental health team and they said she had to come in.’
 ‘Yeah? Well next time call me. Give me a five minute warning or something. That way I’ll know to go sick and be on the next bus outta here.’