Monday, March 30, 2015


Mark flinches when I wrap the blood pressure cuff round his arm.
‘Sorry it’s cold,’ I tell him.
‘It’s fine. It’s fine,’ he says.
He’s holding his arm straight out in front of him. I rest my hand on his wrist to ease it back down; he’s so tense it’s like positioning the arm on one of those jointed artist’s dolls.
‘Just relax it on your lap, Mark. Like that.’
‘Okay. Yep. Right.’
He stares at me as I work the bulb of the sphyg – so intensely it feels as if it’s not just the cuff I’m pumping up.
‘Is it high?’ he says.
‘It is high, yes. Do you suffer with that?’
‘No. Is it dangerous, do you think?’
‘I think you’re stressed at the moment and that’s putting it up. We’ll do it again in a little later and see if it’s come down.’
‘What if it doesn’t?’
‘Let’s just see how it’s doing ten minutes from now. I’m sure it’ll head south again.’
‘If you think.’
‘Absolutely. Yes.’
Along the corridor in the kitchen I can hear Rae talking to Mark’s wife, in low, serious tones. I know the kinds of things she’ll be asking. I wonder if he can hear them, too.
‘I understand you called the police earlier, Mark?’
‘Yes. Yes, I did. Earlier, yes.’
‘Why? What was that about?’
‘It was stupid, really. I know it was stupid. I had a bad night. I was restless. I’ve got a lot on my plate. What with the redundancy and one thing and another. I just couldn’t settle. My mind – my mind was whirring round and round. I couldn’t make sense of it all.’
‘So you called the police?’
‘What about?’
‘The dog. I called them about the dog. I know it sounds stupid. But I got it into my head the dog was in danger.’
His jaw trembles and I know he’s about to cry.
‘I can see it’s been really stressful for you lately, Mark.’
He nods, wets his lips.
‘I think a lot of people get fixated on odd things when their mind’s in turmoil like that – especially in the early hours.’
‘I don’t want to worry anyone. I don’t want to worry my wife. Things are difficult for her, too.’
‘Are you looking after yourself, Mark? Eating, drinking okay? Getting enough exercise? You seem in pretty good shape.’
‘I cycle a lot. Run. Walk the dog.’
‘Where is the dog? She’s very well behaved, considering all the strange voices in the house.’
‘She’s upstairs in her crate. She’s a good girl.’
‘Why don’t you let her down? We’re fine with dogs.’
He goes out of the room. A few moments later there’s a thundering sound on the stairs and a Springer Spaniel charges in, wagging her tail, clambering over my bag, shoving her nose into it, then up into my face, leaping onto the sofa and immediately off again, overwhelmed by it all.
‘Meg! No!’ shouts Mark, following her into the room. He strides over to the sofa and she slinks after him, plumping herself down at his feet and then staring up at him, panting. He sits next to her, slowly, stiffly, holding his eyes closed for a moment or two, then taking a breath, and flicking them open again.
‘Do you want to check my blood pressure?’ he says, holding out his arm.

Sunday, March 29, 2015

wound care

Despite the late afternoon sunshine, all the curtains and blinds in the Baxter’s flat are drawn. Mrs Baxter is standing in the hallway as we come in, her arms down by her sides, strands of hair frizzling out around her head like static. She doesn’t respond to hello or through here? but watches us as we walk into her son’s bedroom.
John is sitting on the edge of his bed in the greasy, airless room. A heavy man in his late twenties, as inert and fleshy as a mushroom, he has a disconcerting habit of closing his eyes when he looks at me, and then opening them again when he looks away, like he was using some other, deeper sense to gauge any response.
His left leg is markedly swollen, tightly bound in a discoloured bandage, his foot covered in a filthy sock. He obviously hasn’t changed anything in weeks. Unwrapping his leg is an appalling prospect.
‘Basically what I want is some advice,’ he says, his voice rapid and flickering. ‘Because I have to say thus far I’ve had conflicting information. Let me explain. Basically, and for reasons that haven’t been satisfactorily explained to me thus far, I developed a pain in my left calf muscle, which gradually, over-time turned into some kind of blister. Eventually, this blister grew bigger, burst, and left me with something of a crater, which then proceeded to grow wider. I was quite concerned, so I went to my doctor. My doctor told me that it was a venous ulcer, gave me some cream to use, and emphasised the importance of keeping the wound clean, all of which I have done. Unfortunately, after a week or two, the ulcer became quite a bit deeper and wider. I really was quite concerned by this point, so I saw another doctor, who said the ulcer would almost certainly start to heal soon, and that I should carry on keeping the wound clean and dry. I didn’t mention the cream, he didn’t say anything, so I wasn’t sure whether I was supposed to use it or not. Anyway, I’ve left it alone for a week or so, now, but last night I started feeling quite unwell, so I phoned for further advice. Things are a little complicated at the moment. We’re between surgeries, and I wasn’t sure who to turn to. What do you think I should do now? Use the cream? Or carry on keeping it clean and see what happens?’
There’s such a disparity between what he’s saying and the evidence of our eyes – and noses - it’s hard to know how to begin.
‘So no-one’s had a look at your leg in a week or so, John?’
‘No-one. I thought it best if I let it rest for a while.’
‘When did you last change your socks?’
‘My socks? Well – I would say about the same time.’
‘Your leg looks quite swollen.’
‘Yes. Yes, I suppose it does. It’s not painful anymore though. I just feel quite sick and dizzy most of the time. I do suffer with acid reflux, but this feels more like the flu.’
‘Would you mind if we cut the bandage off and had a look?’
‘If you feel you must,’ he says.
We dampen the bandage with saline to stop it sticking to the wound. Even so, cutting it is like breaking the skin of some malign fruit. Of course, the ulcer beneath it is horribly infected, a palm-sized crater so vibrantly coloured and textured you could be looking at the aerial photo of a coral island, blooms of scarlet and black in a darkening sea of green.
John looks down at it, too.
‘Is that good?’ he says.
‘Not really,’ I tell him. ‘It’s badly infected. We need to take you to hospital.’
‘To hospital?’
‘That’s not what I was expecting,’ he says. ‘I just wanted advice.’
I finish re-dressing the leg.
When I turn round to throw the waste in the bag I see Mrs Baxter, standing in the doorway, staring at me. She has the same expression as before, but this time she has her hand up to her mouth and nose.
‘Are you coming with us?’ I ask her, as brightly as I can. ‘We’ll be a little while getting John settled on the ambulance, so you’ve got five minutes or so to get whatever you need together.’
She doesn’t say anything, but turns, and quietly walks away.

Saturday, March 28, 2015

happy wednesday

Ralph is sitting on a bench in the garden, his hand raised in the air, wrapped in a bloody tea-towel.
‘Hey! I think I hit an artery,’ he says, lowering his hand and starting to pull the towel free.
‘Just a minute. Keep it up until we’re ready.’
‘It was squirting all over the place. I’ve made a right old mess.’
‘How did you do it?’
‘I was slicing up the chicken and I slipped and did my hand instead.’
‘Show me on my hand where you cut yourself.’
I hold out my gloved hand. He traces a line from the base of my thumb to the root of the index finger.
‘It’s deep,’ he says. ‘I got a new knife out of the packet and it was sharper than what I thought.’
‘Are you on any medication for anything, Ralph?’
He shakes his head.
‘Fit and well?’
‘I wouldn’t go that far.’
‘Let’s have a look at this hand, then.’
Rae unwraps the towel whilst I stand by with a dressing.
It’s a deep wound. Blood starts running out so I wrap it quickly and supplement the dressing with a few gauzes, tying the whole thing off to apply pressure.
‘We need to keep it elevated, Ralph. So look – we’ll use this triangular bandage... There! Can you feel me touching your fingers? Give them a wiggle. Excellent. Okay. I think we’re good to go. How much alcohol have you had this afternoon, Ralph?’
‘Dunno. About seven pints.’
‘Is that a normal amount for you?’
‘Depends what you call normal.’
‘Special occasion?’
‘Yep. Definitely.’
‘What were you celebrating?’
He trudges up the steps and sits down in the seat we’ve made ready.
‘It really stings,’ he says.
‘I bet.’
‘I can’t afford to lose my hand.’
‘No. Are you right or left handed?’
He holds up the good hand.
‘That’s something, then.’
‘Yeah,’ he sighs. ‘That’s something.’
A quick round of obs and we’re ready to go. Rae shouts the leaving scene time back through the hatch and we set off.
‘What were you cooking?’
‘Fresh or frozen?’
‘Well I weren’t chasing it round the yard or nothing.’
He pulls an angry face – Yargh! – and raises his good hand like he’s waving a cleaver. Then laughs, and settles back again.
‘Nah, mate. I just got it out the freezer. I was slicing it up for a stir fry.’
‘Alcohol and cooking. A deadly combination.’
‘Tell me about it.’
‘I cut the top of my finger off, once.’
‘Did ya?’
‘I was showing my eldest daughter how to make an omelette. I was chopping the bacon and she was breaking the eggs. I just glanced over to say careful you don’t get egg on the floor when I sliced the tip of my finger off.’
He laughs.
‘So you know all about it, then?’
He blinks, thickly, with the buffered precision of several pints, then rests his head back on the seat.
After a while he says: ‘Am I gonna die, d’you think?’
‘Well. Yep. One day, Ralph. But probably not from this.’
He turns his head and glares at me.
‘Great. Thanks, mate. Cheers for that,’ he says. ‘I hope I get better treatment at the hospital. Although knowing my luck, they’ll probably mix me up with someone else and cut me leg off.’
‘Only if they’ve been drinking, too, Ralph.’
‘Yeah. Well,’ he says, closing his eyes again. ‘Like I say. I was celebrating.’
‘Happy Wednesday, Ralph.’
‘Happy Wednesday to you, too. Wake me up when we’ve landed.’

Monday, March 23, 2015

urban fairy story

‘What did you use to cut yourself?’
‘A knife I got from the kitchen.’
‘Have you still got it on you, or...?’
‘I chucked it. Listen to me, yeah? You don’t understand what it’s like. I’m having a mental breakdown. I just can’t cope with it no more. If I don’t get some help, trust me, I’m going to do something. I’m going to throw myself under a bus.’
‘I can see you’re under a lot of stress.’
‘Stress? Jesus Christ! You don’t understand what it’s like. I mean, I can’t.... I haven’t....’
Cherie chokes down on her tears, sobbing uncontrollably by the side of the road for a moment.
‘If you think you’ll be all right in the car...’ I say to her.
She presses a wad of tissue to her eyes.
‘...I can drive you to the hospital where you can talk to someone about how you’re feeling. How does that sound?’
She nods, picks up her handbag, and follows me to the car.
‘’Scuse the mess,’ I say, grabbing the box of gloves, lunchbox, spare sheets, the clipboard from the front seat, and throwing them all in the back.
‘Don’t worry about it,’ she says.
I shut her door, and climb in the other side.
‘I’m not a bad person, yeah?’ she says. ‘They’re trying to make out I am but I’m not. I’ve tried, you know? I’ve tried so hard. My mum says I do too much for him and she’s right. But I wanted to make a home for us both. I shouldn’t have given up what I did and now I’ve got nothing. I let my friends go ‘cos he was jealous. I let my place go in town. You don’t understand what it’s like. And now he’s gone off down the gym, and he’ll be drinking with his mates, and I won’t see him till later, all pissed up. And we haven’t even got a telly.’
Cherie is strikingly pretty, with long, auburn hair and dark eyes. If Disney ever thought of casting a gritty, urban version of Aladdin, she’d be a shoe-in for Princess Jasmine. With Jeremy Kyle as Jafar.
I pass her more tissue.
‘D’you know what?’ she says, blowing her nose and then sighing – a deep and shuddering thing – before tearing the damp tissue into shreds. ‘His family, yeah? His family have got it in for me, big time. Ever since my Dad came round and punched him in the mouth. That’s when my Mother-in-Law jumped on top of me and bit my arm. She took such a chunk out they had to do skin grafts. So she goes down for ABH, yeah, and then his brothers go round and put my Dad in hospital. So now he’s cut me off, and I ‘aint got no-one. You don’t understand what it’s like. I’m stuck in that flat with no electric, no friends, no money. No family anymore. I’m going out of my head. Do you know what I’m saying? If I don’t get some help today I’m going do something. I want to get that knife, stick it in my chest and let all the pressure out. It’s all too much. I can’t bear it. I can’t.’
She starts crying again. But whether it’s the movement of the car, the feeling that something is finally happening, or the fact she’s been able to vent some of her frustration, she seems to calm down, and her tears gradually subside.
Suddenly she sits up straight and slaps me on the shoulder.
‘Have a look. Over there,’ she says, leaning forward, her voice hard and glittering. ‘That’s where I live.’
She follows it as we pass, then settles back in the seat and flicks her hair back.
‘What a fakkin’ dump,’ she says. ‘Scuse the language.’

the invisible man strikes again

The next day – the second of two car shifts – I’m called to a twenty-three year old male collapsed in the street with a presenting complaint of back given out.
It’s Ricky again. A different part of town, but just as public.
He’s sitting in the middle of a pedestrian precinct, calmly rolling a cigarette whilst two police community support officers in yellow jackets stand over him, one on the radio, one writing in a notebook.
‘Ah! Here we are!’ says the one with the notebook, putting it away.
‘Hello!’ I say, dropping my bags down. ‘Hello, Ricky!’
‘You know this one?’
‘Yep. I met him yesterday. Similar deal. Although he’s looking a bit brighter this morning. How are things, Ricky?’
He ignores me, and concentrates on the cigarette.
‘It was a call from a member of the public,’ says the first PCSO. The other one has finished on the radio, and stands there with her arms folded, on guard, looking around.
‘Ricky wasn’t seen to fall or anything. He just decided to sit down. We were only round the corner. When we asked him what was wrong he said his back had given out.’
‘Is that right, Ricky? Is it back pain today?’
He shrugs, lights his fag.
‘Do you normally suffer with that?’
‘I’ve got complex mental health needs,’ he says, spitting a strand of tobacco off to the side.
‘How did you get on at the hospital the other day?’
‘They kicked me out.’
The second PCSO leans in.
‘I understand that Ricky was asked to leave by security. Isn’t that right?’
He looks in the other direction.
‘Well. I don’t think you need go to hospital today,’ I tell him. ‘There’s a Walk-In Health Centre just around the corner – I mean, literally, fifty yards...’
I point it out.
‘ what you could do is walk over there and talk to someone about your back. How’s that sound?’
‘You haven’t checked me over or anything. You don’t know me.’
‘Do you want checking over, then? I’d have to call an ambulance again. Or do you think the Walk In centre might be better?’
‘I’m not going there. It’s full of people. I’d have to wait.’
‘Yes – well – I’m afraid that’s a bit of a national problem, Ricky. It’s been in all the papers. It’s no different at A and E. In fact, I’d say it’s worse.’
He closes his eyes and carries on smoking.
‘We can deal with this if you need to get off,’ says the first PCSO.

Our group is a little island of incident in the centre of the busy precinct. The crowd flows around us, anonymous, unstoppable, hardly giving a second look. You’d think we’d be safe in our yellow jackets, but still a woman almost crashes into us. She’s talking on her phone, not watching where she’s going. The second PCSO sees her coming, though, and gently guides her round. For a moment the woman looks up, as shocked as if the air had unexpectedly crystallised in front of her. Ricky isn’t bothered. He carries on smoking, as calmly as before.
I’m squatting down next to him. And just for a second I can see things from his angle. Despite everything, despite the wild, Rasputin beard, the extravagant headphones and the filthy parka jacket, despite the over-stuffed rucksack and the tatty bedroll, despite the focused and hostile detachment, plumped down here on the pavement in the middle of the day, in the middle of everything – despite all this, Ricky is effectively invisible. He just doesn’t figure. No one meets his eye – and if by accident they do, they quickly look away.
And it strikes me that Ricky’s high-profile collapses are just a crude way of testing the limits of his invisibility, a way of proving to himself he still exists.
Of course, he brings me crashing back to pavement level, leaning over and grinding out my empathy as ruthlessly as his cigarette.
‘I’m gonna have you struck off for not caring,’ he says.

the twenty pound stand

It’s lunchtime, and the square is filling up. A company has set up an advertising display in one corner, with a car and banners and beautiful women in heels and smiles handing out leaflets. Office workers are emerging into the bright sunshine to forage for lunch, but the place many of them would sit to eat their wraps and crisps, the curvy public artwork that usefully doubles as a bench, is curiously empty. The reason is obvious, though.  An NFA is sitting and smoking on one end; at the other, stretched out on his back on the floor, is Ricky.
I’m on the car, so I’m relieved to see it’s not a resus. An ambulance has also been dispatched to this, so I shouldn’t be on my own for long.
‘Hello? Ricky? Open your eyes for me.’
I pinch his shoulder. He snarls.
‘Don’t. All right?’
He closes his eyes.
‘Come on, Ricky.’
Another pinch.
‘What’re you doing that for?’
‘I need you to sit up and talk to me.’
He shuts his eyes again and lies still.
A thick-set guy in his early twenties with a full, black beard and a pair of Beats headphones, he looks like a monk DJ who hit the skids.
‘Come, on, Ricky. You can’t just lie here all day.’
‘People will think you’re ill and call the ambulance.’
He ignores me. I poke him again.
‘Fuck off!’
‘Sorry, Ricky. All you have to do is sit up. We’ll have a chat and then I’ll leave you alone.’
The other NFA grins and nods and shouts out drunken advice. I give him a wave and then help Ricky sit up, propping him back against the sculpture. But no sooner is he upright than he starts slumping forwards again.
‘Have you taken anything today, Ricky?’
He slurs something that sounds like the name of an anti-epileptic medication.
‘Have you taken more than you should?’
I have to prod him for an answer. He jerks awake and sneers at me, his eyes half-closed.
Meanwhile, the other NFA has come over. He stands in front of me, hardly able to stay upright himself.
‘He’s a dead fucking loss, that one,’ he says. ‘Aint you, Ricky old son? Hey! D’you want ta see if he ken stand up?’
‘There’s a truck coming in a minute so we’re good till then, I think.’
‘Nah! I know how ta do this. S’easy. Watch me.’
He leans in to Ricky.
‘Hey! Ricky, me ol’ mate. See there – that twenty pound note? Is that your’n? I think it’s come out o’ yer pocket! Look! A twenty pound note, son.’
Ricky frowns and waggles his head from side to side.
‘A twenty pound note, man! Jes’ there, hanging out ya pocket! Yer sittin’ on it.’
Ricky jerks upright, hauls himself to a stand, then sways hopelessly from side to side, like a marionette with its strings in a muddle.
‘There ya go!’ says the NFA. ‘The twenty pound note test.’
He taps the side of his nose, winks and then points to me.
‘That one’s on the house,’ he says. Then laughs, and staggers off.

Friday, March 20, 2015

belts and biscuits

‘What’re you doing here?’
Michael leans forward on the hospital bed.
‘I thought you was dead,’ he says. Then he settles back again, finishes off the biscuit he was eating and slaps his hands crumb-free. ‘Maybe you are. Maybe you aren’t. That’s for another day. Now then. Who’s had it away with my tea?’
‘Here you are, Mike.’
‘I thang’yor.’
The nurse comes in with Michael’s notes and gives us a handover. Referred to the vascular team query TIA. History of dementia, CVA, a few other things. Plenty of medication. Social history.
Michael pulls a face.
‘I hope you’re paying attention’ he says to me.
‘Oh yeah.’
‘Good. ‘Cos I’m not.’
He has an early-onset form of dementia, which, judging by his neatly-clipped, silver goatee and moustache, seems to involve a gradual transformation into Colonel Sanders – at least, a Cockney music hall version of the chicken magnate, whose schtick involves making anything you say sound ridiculous.
‘Look at that!’  he says, leaning forwards again and pointing to my middle.
‘I know. I’m carrying a little holiday weight…’
‘No! That!
‘What d’you mean – my belt?’
‘Ye-es! Your belt. And now look at that.’
He points to Rae’s belt.
Hers is ambulance issue, with a decorated buckle.
‘M&S’ finest,’ I say, slapping mine, and then taking the opportunity to tuck my shirt in.
‘Say who?’
‘Marks & Spencer.’
Marks and Spencer. Of course. Tsch, tsch, tsch.’
He raises his eyebrows and stares at me.
‘Well it’s better than string,’ I say, shrugging. ‘It gets the job done.’
‘What job?’
‘Keeping my trousers up.’
‘Oh! Your trousers!’ He shakes his head, like this is the craziest thing he’s ever heard, and then he turns his attention to the table again, and carefully extracts the second biscuit from the packet of three.

Thursday, March 19, 2015

henry's war

‘We had this new Captain take over ‘cos the other one got killed. My mate said “Have you seen him? He’s an old fucker”. D’you know how old he was? Forty! Goes to show how young we all was then.’
Henry laughs, not an active thing, more like the gentle release of a deep bubble of humour. It’s a cold night, so we’ve bundled him up on the ambulance trolley under a pile of white blankets, the grave and liver-spotted bulk of his head vividly illuminated under the bright cabin lights.
Henry’s accent is so strong, his mouth so toothless and collapsed, the journey in to hospital so noisy, I have to lean in to hear him – and even then there’s a delay between Henry speaking and the sense of it percolating through.
‘I went through the lot. D-Day. I was there. It didn’t start all that good. We went aground in our landing craft. Bullets and bombs flying all over the place. So they says “Jump out quick lads. We’ll hev’ to walk the rest of the way.” Which would’a been fine ‘cept we were in about five foot o’ water. Carrying about seventy-five pound a kit. ‘Course, quite a few drowned. How I made it in I’ll never know. ‘Cept I was young then, and when yer young you can do a thing as soon as think it, eh? Anyways, a day or so later, when we was all set-up on the beach, like, they had these tractors with forks going up and down. And Billy says: “What’re they havin’ now, d’you think? A ploughin’ match? But it weren’t that. They was collecting all the drowned lads, you see? Scooping ‘em up and dumping them in a pile. A’ter that they put us on a forced march. D’you know what a forced march is? Five miles you run, five miles you walk. No change of clothes. Yer pockets and your boots full of water. Full of blood half the time. But you dried out, course. And you took yer ease where you could.’
‘I met ‘em all. The Belgians. The Poles. The Dutch were all right. The French were grateful but you couldn’t trust ‘em. The Russians were just fixed on revenge. The Americans were fine in ones and twos but when you got ‘em in a crowd they was a blasted nuisance. We used to hev’ fights with ‘em now and again. Depends where we was and what else there was to do. And the funny thing was, d’you know who we got on the best with? The Germans. You know where you are with your German. It’s all there and out in the open, if you know what I mean. Personally I don’t think Hitler was as bad as he was made out. I think he had some good ideas – and he certainly got the country going again, didn’t he? Trouble was, he was surrounded by some very strange characters. Goering, Himmler, Hess – they was all a bit weird. I don’t think Hitler was strong enough to resist what they was saying to ‘im.’
‘Anyway. Difficult days. A long time ago. I lost a lot of mates. And you know what?’
He turns his misty eyes in my direction.
‘I wouldn’t ‘a missed it for the world.’

Tuesday, March 17, 2015

driving the general

George is wearing so many layers it’s difficult to get to his arm for the blood pressure. And the more layers he sheds, the more the ambulance is filled with his body odour, a mature and seamy fug that speaks of airless rooms, empty cupboards, spotted curtains, damp corners.
For some reason he has an elastic band around his wrist.
‘What’s that for, George? To remind you of something?’
He stares at me, his face pale and slumped with the shock of it all.
‘Seventy years I’ve been driving and never had an accident. Seventy years and now this.’
He looks at me, his eyes watery and preternaturally large behind the thumbed lenses of his spectacles.
‘If you’d told me this morning what was going to happen I wouldn’t have bothered.’
‘Where are you living these days, George?’
‘I’ve got two places and that’ s half the trouble. One of them’s what you might call my old address where I keep all my stuff, and the other is where I live most of the time, where my post goes, so I suppose you’ll want that?’
‘Sounds good.’
‘My nephew’s always on at me to sell ‘em both. I  know he just wants to put me away so I can die and he can have the money. And now this. I suppose you’ll take me to hospital, then they’ll put me in a home, and that’ll be that. Still, I suppose it had to happen sooner or later.’
He grips my arm.
‘Why now, though?’
‘One thing at a time, George. There – just relax your arm.’
We run our tests. Everything checks out. He’s still pretty shaken after the accident, though, and there are concerns about his overall state of health.
‘Anything else you want out of the car before we go?’ I ask him.
‘Just my bag,’ he says. ‘It’s got my phone and keys.’

The traffic is starting to clear now. The first ambulance on scene has taken the other patient, and the police have moved George’s car to the side.
‘Look at the state of it,’ says the officer. ‘I bet he’s been sleeping in there.’
‘I wouldn’t be surprised.’
‘Are you taking him to hospital?’
‘Yeah. He’s pretty shaken up.’
‘Not as much as the pedestrian,’ says the officer, nodding to the bullseye on the windscreen. ‘Apparently he ended up doing a cartwheel over the bonnet.’
‘Yep. George drove straight through a red light. Poor guy didn’t stand a chance. Scary, when you think of it. All those Georges out there.’
The officer follows me back onto the ambulance and pulls a breathalyser out of his pocket.
‘Now then!’ he says.
George stares at him with the same slack expression he’s had the whole time.
‘Seventy years I’ve been driving,’ he says. ‘I learned in the army. And I was so good, I ended up on staff, driving the General about.’
‘Driving the General?’ says the police officer, snapping the mouthpiece onto the breathalyser. ‘Well that sounds – a long time ago.’

Saturday, March 14, 2015


‘They kept asking me all these stupid questions. I told them I had to see to Mike, he was bleeding, but they wouldn’t listen. They just kept on and on. Is he breathing? Is he this? Is he that? I couldn’t talk to them anymore. I mean, look!’
Mike is slumped on the edge of the bed. There’s blood around his nose and mouth, blood on the towel she’s used to staunch the bleed, blood over his pyjama bottoms, the duvet, and a patch on the floor where he fell.
‘Why did you fall?’ Rae asks him.
Sheila answers.
‘He’s not well. He’s got cancer of the liver that’s spread, and it’s making him weak.’
‘So what happened?’
‘I don’t know. Mike got out of bed to go to the loo and just pitched forward onto his face. I think he must’ve caught his foot in the rug or something. You can see where he landed.’
She starts crying again, one hand pressed to her face, the other reaching out to pick some strands of hair away from Mike’s face.
‘Were you knocked out, d’you think?’ asks Rae, resting a hand on Mike’s shoulder.
He shrugs.
‘What about your neck? Any pain here, where I’m pressing?’
He grunts.
Rae pauses, then squats down in front of him to look into his face.
‘How are you feeling?’ she says.
He mumbles and drools.
‘Give my fingers a squeeze,’ says Rae, taking hold of his hands.
After a moment she stands up.
‘Weak on the right,’ she says. ‘How’s Mike’s speech sound to you, Sheila?’
‘I don’t know. Say something, Mike.’
He mumbles again.
‘No. That’s not right,’ says Sheila. ‘Do you think he’s concussed?’
‘I think he might have had a stroke,’ says Rae. ‘What kind of treatment is Mike getting for the cancer? Is there a care plan?’
 ‘They said they can’t do anything for him. It’s still early days.’
‘Any Macmillan involvement? Cancer nurses, palliative care team?’
‘Just the doctor for pain relief. Mike doesn’t want to go to hospital.’
Mike lies back on the bed and stares up at the ceiling. He’s wearing a black and white motorcycle t-shirt. Triumph.
‘He’s got blood on that, too,’ says Sheila. ‘He loves his bikes. It’s how we met.’
‘If it is a stroke, we’ll have to act quite quickly,’ says Rae. ‘Every minute counts.’
‘Shall I show you what pills he takes?’ says Sheila. ‘Excuse the nightie. I didn’t have time to get dressed.’
‘That’s okay.’
‘I’ll go and get a chair,’ I say.
I follow Sheila downstairs into the front room, where she starts searching through drawers for the medication.
‘It’s here somewhere,’ she says. ‘Do you want to read some of his treatment letters? Where did I put them...?’
‘Anything that comes to hand, but don’t worry too much. Put it in a bag so we’re good to go. I’ll be back in with the chair in a second.’
Sheila straightens and stares at me.
‘He’s not going to hospital, is he? It’s just a nosebleed.’
She stands in the middle of the room, her arms by her sides, her hair wild on her shoulders, the rapid beat of her heart trembling through the silk of her nightie.
‘Sheila? I know this is really hard and upsetting, but we need to be clear. We think Mike fell out of his bed because he’s had a stroke. If he has, the sooner we get him to hospital and scanned, the sooner we can do something about it. If we don’t – worst case scenario – he could die. Sorry to be so blunt, but you need to know.’
‘So, look. I’ll go outside and fetch in our special chair so we can carry him out. Don’t worry about the medication or anything. Just take the next five minutes to put some clothes on and get yourself ready, then we’ll all go to the hospital together. How does that sound?’
She nods, but continues to stand there.
‘Because you know – we need to get going.’
She nods, and starts to cry again.
‘Try not to worry, Sheila. We’ll take good care of him.’
I give her a squeeze on the shoulder in passing, then carry on outside to fetch the chair.

Outside the air is crisp and cold. The early morning sun holds everything in a moment of sharp relief –a vapour trail thinning across the sky, heavy traffic on the top road, people walking quickly in one tidal direction, to work, to school – the activity and business, the community of everything, the life.
The cold on my bare arms feels good.
I take two blankets with the chair and head back inside.
Sheila holds the door.

Friday, March 13, 2015

sleeping beauty

The van is easy to spot. Stopped at the junction with three guys standing round the driver’s door, one of them on the phone, one of them waving. I can see from here it’s not actually a cardiac arrest, but the young guy certainly looks unwell, slumped forwards over the steering wheel.
‘At least his handbrake’s on,’ says one of the bystanders. ‘He doesn’t look all that clever, though.’
The door is locked, but luckily the window is half-way down so I can reach in and give him a shake.
‘Hello!’ I shout. ‘It’s the ambulance! How’re you doing?’
He throws himself back into the seat, pressing his hands to his sweating face, then reaching out in a panic to grab the steering wheel and turn the ignition, which grinds in protest.
‘Sorry. Sorry,’ he says. He’s flushed and sweating, and his movements uncoordinated.
‘Can you open the door for me?’
‘Yep. Yep. Absolutely.’ He tries turning the engine over again, and goes to take the handbrake off.
I reach through the window, unlock the door, open it, turn the engine off and pull the keys.
‘Are you all right?’ I say to him. ‘What’s going on?’
‘No. Yep. Sorry,’ he says. ‘I’m fine. I’m just a bit tired.’
‘Would you mind coming on board the ambulance so we can have a chat and check you over? You don’t look all that well.’
‘I’m fine. Honestly. Just tired...’
And like a robot that’s been pulled at the plug, his chin suddenly sinks forward onto his chest, and he falls instantly asleep.
I shake him by the shoulder.
It takes a firm pinch to rouse him – and suddenly he’s back, kicking his legs, paddling forwards with his hands and turning his head rapidly from side to side.
‘Hey! Easy! Come on, now – let’s get you onto the ambulance and make sure everything’s okay.’
‘It’s fine. I’m fine. I just need to go home and sleep it off.’
‘Come on.’
We help him out. He’s bare-foot, soaked in sweat. He follows us onto the ambulance, and no sooner has he sat down than he falls asleep again.
We take advantage of his quiescent state to run a set of obs and an ECG, although you could see the effects of the drugs he’s taken from across the road.
‘What have you taken today?’ I ask him when he picks up again.
‘Nothing. I haven’t had nothing.’
‘You can tell us. We don’t care. Except we need to know for your treatment. You’ve obviously taken something.’
‘I haven’t. I’m just tired. Can’t I just go? You’re not gonna stop me, are you?’
Rae’s already called for police. They arrive a moment later – two traffic cops, one straight out of university, the other straight out of prison, by the look of him.
‘Oh dear oh dear,’ says the old cop, the ambulance dipping to the side as he steps on. ‘A bit early for this shit, innit?’

They get him to blow into a breathalyser, which comes out clear.
‘So far so good,’ says Old Cop. ‘Now then...’
He produces a drug kit.
‘Wet your mouth,’ says Old Cop. ‘Get it nice and moist. That’s it. Now. This’ll show us if you’ve had any cannabis or cocaine. And if you’re pregnant.’
He wipes it on the patient’s tongue, then snaps the scraper into place.
‘Cooking time eight minutes,’ he says. ‘Meanwhile, I’ll have a little shufty round your van if I may. Give us the key.’
Whilst he’s gone, the patient falls asleep again; Uni Cop makes some notes.
‘The way he’s behaving looks like a legal high,’ I tell him. ‘This mad on-off thing. I don’t think it’ll show on your kit.’
‘No. Just cannabis and cocaine. I’m not even sure a blood test would do a legal high. Depends what it was.’
‘Will he be prosecuted? I hate to think of him being on the road like this.’
‘Well, it’s difficult. I don’t think  it’ll fly with the CPS. He wasn’t actually driving...’
‘He was sitting at the wheel with the engine running at a junction. Surely that’d count?’
‘You’d think. But he was stationary with the handbrake applied. You could argue he was parked. As I’m sure he will.’
‘Can’t you do anything then?’
‘Oh yeah. He clearly has an impairment to drive.’
Old Cop comes back on board.
‘A few documents that might be of interest,’ he says, dropping them on the trolley. ‘Some antibiotics, nothing else. Looks like he might be living in there. How are we doing?’
He picks up the drugs kit.
‘Yep. There we go. Smiley faces for cocaine and cannabis.’
He shows us the stick and the two discreet lines.
The patient wakes up again.
He goes through another round of uncoordinated jerks, bending forwards, throwing himself back, slapping his face. Then settles in the chair and rests there, panting.
‘I’m just tired,’ he says.
‘Well – mate!’ says Old Cop. ‘I get a bit fidgety when I’m knackered, but this is something else. Look. Let’s cut the crap. We know you’ve taken drugs.’
‘I haven’t...’
‘Honestly, mate – the time for fucking about is over. We’re all professionals here, so don’t waste your breath.’
‘But I haven’t...’
‘Listen to me. Okay? Let me tell you what’s going to happen. I’m going to park your van up, and you’re going to go to the hospital with these lovely people. Because despite what you might think, my partner here is a deeply caring individual.’
Uni Cop shifts uncomfortably in his seat.
‘I’m also going to contact the DVLA. They will be pulling your licence – okay? – and it’ll be up to you to prove to them over the course of the next year or so that you’re fit to drive. Are we clear?’
Old Cop looks at me. ‘I hope you don’t mind,’ he says. ‘But really – it’s pointless taking him down to custody. The state he’s in, they’re guaranteed to send him to hospital. This way’s quicker and cuts out the middle man.’
The patient has fallen asleep again.
Old Cop looks at him and shakes his head.
Uni Cop closes his notebook and gets ready to go.
‘Are you all right on your own with him?’ says Old Cop to me. ‘He doesn’t look like he’ll be any trouble.’ He picks up the drugs kit and puts his hat on. ‘My advice? Let Sleeping Beauty dream on. Time to go, Starsky. The city needs us.’
The ambulance rises a clear foot when he steps off.


The house has an up-to-the-edge perfection that makes me conscious of my boots. A colour scheme of white and cream, two vases of teasels and twigs left and right on the mantelpiece beneath a winter woodland scene; Lily-of-the-valley diffusers, down lights, corner lights, a polished and clutter free oak table, plumped cushions angled symmetrically on a sofa so sharp it could be chiselled chalk. Maggie is sitting in the middle; her husband Jim is standing behind her.
‘Hello,’ she says. ‘Sorry about the mess.’
Maggie has had chest pain since the early hours. She’s tried antacids, paracetamol, breathing exercises, but the pain has settled in and her left arm feels numb.
‘I know that can be a sign,’ she says, tailing off and staring down at the tissue in her hands. ‘I’m just worried about Jim.’
Jim has Alzheimer’s. He’s only been diagnosed a few months, and together they’ve been coping pretty well. The disease isn’t so far advanced that Jim is a danger to be left alone. He gets confused though, and it’s better if he has company.
‘My sister is on her way over. She might be a couple of hours,’ says Maggie.
‘Will Jim be okay until then?’
She nods, then turns round and smiles at him. ‘I think so. Won’t you? You’ll be all right?’
‘Oh yes,’ he says, smiling and folding his arms. Maybe it’s the contrast with the rest of the room, but his eyes seem incredibly blue. ‘I’ll be fine.’
Maggie is feeling dizzy, so she sends Jim upstairs to the bedroom to fetch down a few things – the t-shirt and sweat pants draped on the back of the dressing table chair, and a pair of knickers out of her drawer.
‘Any pair,’ she says. ‘Nothing too fancy.’
He walks out of the room and up the stairs.
A moment or so later Maggie says: ‘Would you mind going up and seeing he’s okay?’
‘Of course.’

Jim is standing at the foot of the bed. He’s opened all the dresser drawers and strewn the contents across the counterpane – tights, socks, knickers, camisoles. When I come into the room he’s standing with a belt in one hand and a bra in the other. He smiles at me, a little upset but still, on the surface, quite serene, his blue eyes bluer than ever.
‘There was something,’ he says. ‘I’m not sure...’

Wednesday, March 11, 2015

snowballs aren't cool

To begin with, side entrance to railway station isn’t a helpful direction. Front or back?  Left as you look at it or right as you come out? Control says the patient isn’t answering his phone to tell us more.
I step out of the ambulance and look around.
The evening commute is in full flood, people hurrying in and out, queues at the coffee concessions, workmen banging and shouting overhead, taxi drivers out of their cabs in twos and threes, stretching, smoking, looking over the chaos with a pouchy kind of stoicism.
A guard in a yellow jacket hurries over.
‘We haven’t been told nothing,’ he says, unclipping his radio. ‘Just give us a minute and I’ll find out for you.’
I look back at the cab. Rae has draped herself over the wheel, one hand under her chin. It’s been a long day and we’re both tired. The fact that this drugs overdose / chest pain called 999 himself is reassuring, for some reason, and anyway, these things have a way of playing out in their own particular time.
The security guard catches my attention and then waves with his radio in the direction of the left-hand side of the station, by the pedestrian crossing.
I jump back in the cab. Rae swings the ambulance round and we head over.

If we’d approached from that side, Lee would’ve been impossible to miss. A blond, bare-chested man in his twenties, he’s sitting on the pavement, eyes closed, a smashed mobile phone in one hand by his side, leaning back against the traffic lights with his legs stretched out. No-one’s kneeling by his side or standing over him. Whether this is symptomatic of the blinkered focus of the commuter traffic, or whether it’s because Lee looks so rough, it’s hard to say. We’re here now, though. The rush continues around us, with barely a horrified glance.

Once I’ve established he’s conscious, hasn’t fallen and hurt himself, and can feasibly stand up with some help, we get him onto the ambulance. It feels good to shut the door behind us.
‘Sanctuary,’ I say, as Lee throws himself down onto the trolley. ‘Good. Now. What’s been going on today?’, wiring him up as we talk.
‘I took a few snowballs this afternoon.’
‘Snowballs? What are they?’
He squints at me. After a pause just long enough to evaluate his situation, who I am, what I know or don’t know, what kind of risk I might be, he says: ‘A mix of heroin and crack.’
‘And what – do you inject that or smoke it?’
‘Okay. And then what happened?’
He winces and rubs the centre of his chest.
‘I felt terrible, like my heart was gonna bust out of my chest.’
‘Have you felt like that before?’
‘Never. I’ve done this shit loads of times and it’s never been that bad.’
‘Well your ECG looks pretty normal. A bit fast, but nothing major. Everything else is checking out. Have you still got that feeling in your chest?’
He nods.
‘It’s difficult, isn’t it, Lee? I mean – who knows what was in that stuff. You might have taken it before, but it could’ve been a rogue batch. He might be the most reliable dealer in the world but he’s not always going to know if it’s been cut with something weird.’
‘I think the safest thing is to come to hospital with us so they can run some more tests and keep an eye on you.’
Lee sits up.
‘Can I have a sip of water?’ he says.
Rae gives him a carton.
He empties it with one tip of the head, then hands me the carton and starts pulling off the ECG dots, grimacing and yelping as the hairs on his chest and arms come off with them. When he’s done he hands me the discs, then swings his legs over the side of the trolley.
‘Thanks, yeah?’ he says.
‘Will there be anyone to keep an eye on you for the next few hours.’
He grunts and nods vaguely over his right shoulder.
‘Up the road,’ he says.
‘Okay. Sign here, then. It’s just to say that you’ve decided not to go to hospital, against our advice.’
He signs, Rae hands him his top and he pulls it on.
‘And just remember,’ she says, in a put-on voice. ‘Snowballs aren’t cool.’
Snowballs. You know. Made of snow. But .... erm ... just take it easy,’ she says.
I hand him his smashed phone.
‘It was like that already,’ I tell him.
‘Yeah,’ he says. ‘I know.’

little green wheelbarrows

Maureen, Jeff’s neighbour, leads us up the stairs, deeper into the gloom.
‘Connie died a few years ago and ever since he’s been on a bit of a slide,’ she says. ‘Excuse the strange dress and boots combo. They were the first things that came to hand. I’m supposed to be at work in half an hour.’
It’s a bright, blue day outside, but all the curtains are drawn, the air is chill, and the house feels retiring, the final point of retreat for the night just gone. There’s a pile of suitcases on the landing in size order, books neatly arranged in stacks, anonymous boxes draped in layers of clothes. If it wasn’t for a few portraits on the walls and a display of souvenirs and knick-knacks on the shelves you’d think someone was either moving in or moving out.
Jeff is sitting on his bed, fully-clothed, a white throw over his shoulders.
‘Oh! Hello! Well! I didn’t expect any of this!’
‘Do you mind if I get back?’ says Maureen. ‘Only I really can’t be late today.’
‘No, no. You carry on, Mo. Thanks for your help.’
‘All the best,’ she says, reaching over and touching him on the shoulder.
He laughs and nods his head.
‘I’ll be fine,’ he says.
She grimaces and shakes her head as she hurries out.
‘It’s cold in here, Jeff,’ I tell him.
‘I can’t risk having the boiler on. It’s on its last legs, you see, and I can’t afford to have it replaced. That’s why I’m wearing all my clothes. Sorry if I smell, but I expect you’ve seen worse.’
‘Yes. We have. We’ve seen better though. You poor thing. We’ll have to get something done about your heating.’
He laughs.
‘Good luck,’ he says. ‘Anyway, I can’t get undressed because of this blasted hip. I can’t get the angle of it. I manage to hobble back’ards and for’ards to the toilet, but that’s about it.’
‘Have you had a fall recently?’
‘We-ell, not what you might call a fall. I jarred me’self when I stepped off the pavement and my hip hasn’t been the same since. The doctor knows about it. I’m supposed to be having an x-ray sometime soon, but I haven’t heard. This morning it just felt too bad, so I rang Mo – she’s so good – I don’t know what I’d do without her – starve, probably – so there we are.’
He’s an extraordinary figure. Cruelly reduced in his clothes, a life-sized scarecrow, topped with a blast of fine white hair.
‘I can’t believe any of this,’ he says, hugging the throw around him. ‘If you’d told me thirty year ago I’d be sitting here like this I’d have said – well – I don’t what I’d have said. I was a grafter in them days. A shop-fitter. We was a hard-working gang. We’d get the call – day or night – and we’d have forty-eight hours to get it done. And we’d work it, straight through. And then we’d get in the van and hit the town. All night bars – it’s all a bit hazy. And then loft conversions in the city. That was the best. We’d be up in the loft, knocking through the roof to build the dormer. No scaffolding, mind. Five, six floors up sometimes. Just a roof ladder between you and certain death. You didn’t used to worry about how bad you’d be hurt because you knew if you went you’d be dead and that’d be that. But it was great. Standing on the roof looking out over the city. King of the world. ‘Course, I settled down a bit when I met Connie, but I still worked hard. And then when I retired I got into making wooden toys. All sorts. Locomotives, doll’s furniture, jewellery boxes, you name it. I won awards. I used to make these little green wheelbarrows, painted red on the inside. We used to sell them at craft fairs, me and Connie.’
He bends over and starts to cry, pressing the corner of the throw into his face. His wrists are wide, square-cut, and his hands look unusually large, the two together an indication of how strong he used to be.
‘Have some tissue, Jeff,’ says Rae, handing him a scrunch and resting her hand on his shoulder.
‘Thanks,’ he says, blowing his nose. ‘Sorry. I haven’t been myself since Connie went.’
‘How long’s it been now?’
‘Eight years. But if you said eight minutes I wouldn’t believe you.’
He brightens and takes a deep breath.
‘Anyways,’ he says. ‘That’s that. Once I get the garden sorted I can build myself a little workshop. The front of the house has always been in the shade but the back gets a nice lot of sun. That’s what I’ve got to do. Build myself a workshop. I’ve got the tools somewhere. And I’ll put windows all round it to let in the sun, and then I’ll get going on the toys again. I’ll be all right. Hey? What d’you think?’

Thursday, March 05, 2015


The call has been passed from another ambulance service. A man rang to say his friend, Jez, had taken an overdose, so we’ve been dispatched to investigate.

We know the hostel. I’ve been here several times over the years – the  last, to a woman threatening to throw herself out of a first floor window. Rae had coaxed her away from the ledge by talking about Barbra Streisand.
‘We might have to use something else on Jez, though. What d'you reckon? BublĂ©?’

It’s  an awkward call. The hostel doesn’t have any night-time staff. Each of the ten or so residents has their own room,  five upstairs, five down, shared use of bathroom, kitchen and lounge. Even to get in to the building means we’ll have to ring the front door bell and wake someone up. At half-past three on a freezing morning, that’s a risky thing.
‘If they’re not psychotic they soon will be,’ says Rae, zipping her jacket as far under her chin as she can, leaning back and looking up at the moon. The freezing air draws her breath up in a cloud.
I ring the bell, knock loudly, repeat.
Nothing happens.
We radio Control for guidance. They say Jez’ phone is going straight to voicemail, so could we make every effort to gain access.
I ring and knock some more.
A light goes on in the lounge. Rae climbs on to a low wall to look in.
‘Oh my God it’s Barbra Streisand,’ she says.
‘What’s she doing?’
‘Just standing there, staring. Go on – ring again.’
A few minutes later, the hall light goes on and a blurry figure shuffles towards the door.
‘I’m so, so sorry for bothering you – Jane, isn’t it? Anyway, sorry for disturbing you, but we’ve been told one of the residents here has taken an overdose. A guy called Jez. Do you know him?’
Jane stares at me, a thin line of drool dangling from her mouth. She coughs, once, a thick and corrupted growl.
‘Oof! That sounds rough,’ I say. She carries on staring at me.
‘Anyway, erm… do you know if there’s a guy called Jez staying here?’
She moves to the side and slowly raises her hand to point up the stairs. What with the early hour, the full moon, the dark circles under Jane’s eyes, her eerie silence, it’s like being shown something  by the Ghost of Christmas Future.
‘Oh! Great! Any idea which room…?
She shakes her head from side to side, keeping her eyes fixed on me.
I close the door quietly behind me and we head upstairs. Jane watches us go.

Unfortunately, once we’re upstairs on the landing we’ve still got to find out which is Jez’ room. I pick the nearest and knock.
‘Hello? Ambulance?’
Some grunting from inside, but nothing intelligible. I knock again.
‘Sorry to disturb you,’ I say through the door. ‘It’s the ambulance. We’re looking for someone called Jez.’
Heavy footsteps, the door thrown open.
A heavy-set, hairy-backed man in saggy pants, frowning so hard it’s like his forehead has subsided onto the bridge of his nose.
‘Hi! Sorry. Sorry. We’re the ambulance. We’re trying to find someone called Jez. There aren’t any names on the doors or anything, so…’
‘That one!’
We cross the landing and knock.
I try the handle.
‘Hello? Jez…?’

He’s lying on his bed, surrounded by pill packets. Jez is probably eighteen stone;  we’re lucky he’s rousable enough to walk with help down the stairs, otherwise we’d have to call for help, and things are so stretched tonight the moon is closer than the nearest available crew.

When we reach the lobby Jane is still there. She opens the door for us and stares blankly as we pass.
‘Thanks!’ I say to her. She doesn’t reply.


We’re just about to clear up at the hospital when the radio buzzes.
Strange thing – but I don’t suppose when you were at that last address you noticed a middle-aged woman…?
- Yep. She let us in.
I don’t suppose you couldn’t do us a favour, could you?
- Go back and pick her up?
‘Fraid so. When you’re ready…
Rae brings out some coffees.
‘What did they want?’ she says, handing me one.
‘Well –seeing as you seem to know so much about Barbra Streisand…’