Mrs Elswick is stretched out on the bedroom carpet between the second of the two single beds and the wall. She is neatly arranged; someone has put a pillow under her head and a duvet on top. She lies there looking up at us, her jaw springing up and down like a ventriloquist’s dummy on the back seat of a car.
‘I fell off the edge of the bed,’ she chatters.
Frank checks her over. There are two community responders in the hallway talking to Mr Elswick, a worn and rounded man with a habit of staring fixedly then blinking twice as an afterthought. He is standing in front of a long wall mirror; the effect is of someone split down the middle.
‘The very same thing happened yesterday,’ he says. ‘I just don’t know what to do.’
‘We’ll have a chair please, Spence,’ says Frank.
Out on the truck we run through our medical shtick.
‘We’ll be coming at you from all angles,’ says Frank, hauling out the ECG leads. ‘Like a pit stop at the Formula One.’
‘Ooh yes,’ says Mrs Elswick.
‘I’ll do your tyres,’ I say.
She doesn’t hear me.
Frank towers above the scene, his hands working with the easy autonomy that comes with repetition. If I looked into his eyes now I would catch him slouched back with his feet up on his brain’s console, flicking through a magazine.
‘Erm - one of the community responders told me not to call you Ruby,’ he says, peeling open the ECG dots, flipping the clear plastic circles into a vomit bowel and sticking her up. ‘Why’s that, then?’
‘Ruby’s my middle name,’ says Mrs Elswick, her jaw working up and down.
‘So what do you like being called?’
‘Ruby.’
Frank switches on the ECG monitor and feels her pulse.
‘I don’t get it. We’re not to call you Ruby, but it’s your middle name, and it’s what you like to be called.’
‘Yes.’
‘I’m missing something.’
Mrs Elswick rolls her eyes upwards in an exaggerated expression of teacherly despair, but any fine motor function is difficult whilst her jaw springs up and down as it does.
‘My middle name’s Ruby, but my Father said I shouldn’t ever use it. He said it was a tart’s name.’
‘What nonsense,’ says Frank, poking a thermometer in her ear and sniffing at the result. ‘Now - rhubarb. That’s a tart’s name.’
We are all laughing when I open the door to Mr Elswick.
He blinks up at us, twice, with great precision.
Thursday, May 14, 2009
Monday, May 11, 2009
who will be there?
‘Are you the man who stole my chairs, my carpets and my pictures?’
‘No. My name’s Spence and this is Rae. We’re from the ambulance.’
‘Are you sure?’
‘Yep. Your neighbour, Sheila, has called us because she’s worried about you.’
‘Every last stick of furniture gone, the carpets, everything. It’s an absolute scandal. Are you sure it wasn’t you?’
Margaret leans forward and scans me with eyes so ancient they carry only a memory of blue. She is sitting in her coat, buttoned up, ready for the off, her battered old brown handbag clasped on her lap. Sheila is standing next to her with one hand on her shoulder, as if she is posing for a plate photograph.
‘She’s not herself,’ she says.
Out on the ambulance, Margaret settles into the seat and brightens.
‘Are you taking me home?’
‘Where is your home, Margaret?’
She gives the address we have just led her out of.
‘Do you know why we’re here today, Margaret?’
‘I haven’t the faintest idea,’ she says, drawing her handbag closer to her. ‘All I know is that some man came and took my furniture and he had no right to it. I think it was you. I think this is all part of your stupid game.’
‘The reason Sheila called us out was that you don’t seem yourself. She says you’ve been very confused these past few days.’
‘Confused? My dear, I was fifty years in the government. I think you’ll find I know precisely what day of the week it is.’
Her eyes bore into me, two topaz stones set in a weathered mask.
‘And I want my furniture back.’
Later in the journey she asks me again where we are taking her.
‘To the hospital,’ I say. ‘You need to see a doctor.’
She pauses. A confusion settles on her, then lifts, then settles again.
‘Will my parents be there?’ she says. ‘My elder brother Jeremy?’
‘How old is Jeremy?’ I ask her, as gently as I can.
‘Forty,’ she says.
Then she looks at me, and smiles, as the ambulance floods with time.
‘No. My name’s Spence and this is Rae. We’re from the ambulance.’
‘Are you sure?’
‘Yep. Your neighbour, Sheila, has called us because she’s worried about you.’
‘Every last stick of furniture gone, the carpets, everything. It’s an absolute scandal. Are you sure it wasn’t you?’
Margaret leans forward and scans me with eyes so ancient they carry only a memory of blue. She is sitting in her coat, buttoned up, ready for the off, her battered old brown handbag clasped on her lap. Sheila is standing next to her with one hand on her shoulder, as if she is posing for a plate photograph.
‘She’s not herself,’ she says.
Out on the ambulance, Margaret settles into the seat and brightens.
‘Are you taking me home?’
‘Where is your home, Margaret?’
She gives the address we have just led her out of.
‘Do you know why we’re here today, Margaret?’
‘I haven’t the faintest idea,’ she says, drawing her handbag closer to her. ‘All I know is that some man came and took my furniture and he had no right to it. I think it was you. I think this is all part of your stupid game.’
‘The reason Sheila called us out was that you don’t seem yourself. She says you’ve been very confused these past few days.’
‘Confused? My dear, I was fifty years in the government. I think you’ll find I know precisely what day of the week it is.’
Her eyes bore into me, two topaz stones set in a weathered mask.
‘And I want my furniture back.’
Later in the journey she asks me again where we are taking her.
‘To the hospital,’ I say. ‘You need to see a doctor.’
She pauses. A confusion settles on her, then lifts, then settles again.
‘Will my parents be there?’ she says. ‘My elder brother Jeremy?’
‘How old is Jeremy?’ I ask her, as gently as I can.
‘Forty,’ she says.
Then she looks at me, and smiles, as the ambulance floods with time.
Thursday, May 07, 2009
scoot the merciful
The notes tell us we will be met.
As we push through the revolving doors into the hotel lobby there is a fierce haircut of a man in white shirt and red waist coat standing in the centre spot of the circular parquet floor, his legs apart and his hands lightly clasped in front of him. He makes no gesture of recognition, or sign of any kind.
It hardly needs saying, but: ‘Ambulance.’
Without moving anything other than his lips, he says:
‘This way.’
Then with a lean limbed economy, pivots and strides off up the main staircase.
‘So what’s happened here tonight?’
‘They tell you.’
‘Okay. Good.’
He leads us onto the first landing where a young girl is lying in the recovery position. A select audience of hotel staff have lined themselves up in order of seniority along the opposite wall, from Chamber Maid to Manager. I could be a detective entering a murder scene. I should be saying: ‘Nobody leaves until I say so,’ but instead begin with the usual: ‘What’s happened?’
The Manager, a Praying Mantis in a stripy three piece and shiny shoes, steps forward.
‘My security staff were alerted to a disturbance in room 44, this lady’s room. People had heard loud voices, crashing noises, and so on and so forth. My staff had to force their way into the room, found this lady on the bed and her partner in the bathroom. When they helped the lady out of the room, she complained of feeling dizzy, so they assisted her to the floor, which is where you find her now.’
‘And did anyone call the police?’
‘I am assured they will be here soon.’
I kneel beside the patient. A heavy set girl in her early twenties, her age weighs more heavily in her face than it should. She seems embarrassed rather than distressed, reluctant rather than unable to talk. No apparent injuries. We sit her up.
She puts one hand to her face as if she is trying to remember something, then suddenly stands up decisively.
‘Let’s go to the ambulance,’ she says.
The manager and his staff almost applaud.
The ambulance sits outside the hotel, a cosy box of light amongst the feral noises of a Saturday night, flowing round us, moving on.
Leila says he’s attacked her before. Last time with a knife. Leila shows us a tiny scar just underneath her chin. Tonight they were arguing, she doesn’t remember what about. He grabbed her, threw her against the wardrobe, bruised her arms where he held her, scratched her breasts. She tells us this with a muted attention to detail that would seem casually conversational were it not for the context.
There is a knock on the door.
I let a policewoman on board.
‘Could one of you go back up and have a look at Ken, the other party? He’s had a bash to the head and an eye injury.’
En route to the hospital. Leila is back at the hotel being questioned by the police, Ken is on the ambulance, a head wound from an ashtray and an eye that’s been poked with a fingernail.
‘This is shit, man,’ he says.
The policeman riding with us says nothing. He looks exactly like the guy who met us in the lobby at the beginning. How could that be?
He smiles.
I hand in the paperwork at reception.
‘Is Scoot still there?’ I ask Zoe.
‘Yeah – come on.’ She opens the door and lets me in.
Scoot is exactly where he’s been all night, bundled up in blankets beneath the desk in the storeroom.
‘Hey Scoot. What d’ya say, what d’ya know?’
He looks up, gives my hand a sniff, then grants a dab or two of his head.
‘I dunno, Scoot. People, ay?’
Suddenly Scoot looks up, as if he is listening to a command from far away. But then he relaxes again as the impulse fades, gives a jaded smack of the lips, and settles himself back down amongst the blankets.
Scoot the Merciful at peace again, the fluorescent lights of the A&E department burning on through the night around him.
As we push through the revolving doors into the hotel lobby there is a fierce haircut of a man in white shirt and red waist coat standing in the centre spot of the circular parquet floor, his legs apart and his hands lightly clasped in front of him. He makes no gesture of recognition, or sign of any kind.
It hardly needs saying, but: ‘Ambulance.’
Without moving anything other than his lips, he says:
‘This way.’
Then with a lean limbed economy, pivots and strides off up the main staircase.
‘So what’s happened here tonight?’
‘They tell you.’
‘Okay. Good.’
He leads us onto the first landing where a young girl is lying in the recovery position. A select audience of hotel staff have lined themselves up in order of seniority along the opposite wall, from Chamber Maid to Manager. I could be a detective entering a murder scene. I should be saying: ‘Nobody leaves until I say so,’ but instead begin with the usual: ‘What’s happened?’
The Manager, a Praying Mantis in a stripy three piece and shiny shoes, steps forward.
‘My security staff were alerted to a disturbance in room 44, this lady’s room. People had heard loud voices, crashing noises, and so on and so forth. My staff had to force their way into the room, found this lady on the bed and her partner in the bathroom. When they helped the lady out of the room, she complained of feeling dizzy, so they assisted her to the floor, which is where you find her now.’
‘And did anyone call the police?’
‘I am assured they will be here soon.’
I kneel beside the patient. A heavy set girl in her early twenties, her age weighs more heavily in her face than it should. She seems embarrassed rather than distressed, reluctant rather than unable to talk. No apparent injuries. We sit her up.
She puts one hand to her face as if she is trying to remember something, then suddenly stands up decisively.
‘Let’s go to the ambulance,’ she says.
The manager and his staff almost applaud.
The ambulance sits outside the hotel, a cosy box of light amongst the feral noises of a Saturday night, flowing round us, moving on.
Leila says he’s attacked her before. Last time with a knife. Leila shows us a tiny scar just underneath her chin. Tonight they were arguing, she doesn’t remember what about. He grabbed her, threw her against the wardrobe, bruised her arms where he held her, scratched her breasts. She tells us this with a muted attention to detail that would seem casually conversational were it not for the context.
There is a knock on the door.
I let a policewoman on board.
‘Could one of you go back up and have a look at Ken, the other party? He’s had a bash to the head and an eye injury.’
En route to the hospital. Leila is back at the hotel being questioned by the police, Ken is on the ambulance, a head wound from an ashtray and an eye that’s been poked with a fingernail.
‘This is shit, man,’ he says.
The policeman riding with us says nothing. He looks exactly like the guy who met us in the lobby at the beginning. How could that be?
He smiles.
I hand in the paperwork at reception.
‘Is Scoot still there?’ I ask Zoe.
‘Yeah – come on.’ She opens the door and lets me in.
Scoot is exactly where he’s been all night, bundled up in blankets beneath the desk in the storeroom.
‘Hey Scoot. What d’ya say, what d’ya know?’
He looks up, gives my hand a sniff, then grants a dab or two of his head.
‘I dunno, Scoot. People, ay?’
Suddenly Scoot looks up, as if he is listening to a command from far away. But then he relaxes again as the impulse fades, gives a jaded smack of the lips, and settles himself back down amongst the blankets.
Scoot the Merciful at peace again, the fluorescent lights of the A&E department burning on through the night around him.
Wednesday, May 06, 2009
scoot
A&E reception stands guard over the entrances to the Walk-In minors, GP out of hours and major zones. It is a foursquare, plexiglass temple to Admin Kali, the multi-tasking Mother of Process and Information, Creator of Record, Taker of Number, Keeper, Caller, Confessor. Zoe and Claire are two of her acolytes. I imagine they were free administrative spirits haunting a grove here on this hill a thousand years ago, and the hospital was built around them. Now they are caught within these walls, and the years have stacked up, and the ambulance crews come and go, endlessly bowling in through the magic doors with snow in their hair or rain on their shoulders or sunshine on their backs, a relentless train of pilgrims wheeling past the windows, surrendering their paper tributes, bothering them for pens.
Today as Rae and I hand in our patient report form Zoe stands up and smiles.
‘Come round and have a look at what we’ve got,’ she says. ‘You’re going to love it. Come on.’
She slides the hatch closed and then comes round to let us in through the security door.
‘Have a look in there,’ Zoe says, pointing in to their little storeroom.
Under a desk there is a dog curled nose to tail in a nest of blankets. It looks up.
‘His name’s Scoot.’
Scoot is a Springer Spaniel, a ragged brown and white scrap of a dog whose black eyes seem to make up four fifths of his body. His expression is so desperately mournful even Disney would have blushed. It fells us both, bringing us to our knees beside the nest.
Claire appears in the doorway behind Zoe.
‘What do you think of our new assistant?’ she says.
‘He’s so-o-o cute,’ says Rae, mussing the dog. ‘I want him.’
‘Well what he wants is another Cheddar biscuit,’ says Claire. She produces half a packet. It makes its way along the line to Rae, who taps one out and presents it to the dog. But Scoot’s either eaten his fill or he’s too overcome with depression – a condition which, judging by his expression, he has learned to live with. He gives the biscuit a disappointed sniff and then plumps himself back down again.
‘How did you get Scoot?’
‘He came in with a woman who’s taken an overdose. Nothing too serious, but they’re keeping her on CDU for a little longer. It’s not worth calling the RSPCA ‘cos she’ll probably be discharged tonight. So we offered to look after him. And he’s no bother at all – are you? Are you?’
Scoot raises his eyebrows in our direction, then carries on staring at his front paws.
‘Trouble is, we’ve just heard matron is coming on at seven, and she’ll have us all taken out and shot.’
‘She never comes in at that time!’ says Claire, kicking the door frame. ‘Why now? It’s so typical of her.’
‘I don’t think even Matron would mind about Scoot, though,’ says Rae. ‘I mean, look at him!’
We all look at him.
Scoot gives a professional sigh, and wriggles down further amongst the blankets.
Outside, a crew wheels past the serving hatch with a man strapped and groaning on a spinal board.
Rae places the cheddar biscuit next to the vomit bowl filled with drinking water, gives Scoot a last, loving fuss, then stands up. Her knees give an audible crack and she staggers slightly.
‘You’re worse than me,’ says Zoe, offering her one of the biscuits. ‘You’re falling to bits.’
‘I don’t think I’ll do anything else tonight,’ says Rae, snapping down the biscuit in two bites and smacking the crumbs from her hands. ‘I think I’ll just curl up under the desk with Scootie pie. And if Matron comes in and makes a fuss, well then I’ll just have to bite her bony butt. We don’t care, do we Scoots? We don’t care.’
But the dog is already asleep.
Today as Rae and I hand in our patient report form Zoe stands up and smiles.
‘Come round and have a look at what we’ve got,’ she says. ‘You’re going to love it. Come on.’
She slides the hatch closed and then comes round to let us in through the security door.
‘Have a look in there,’ Zoe says, pointing in to their little storeroom.
Under a desk there is a dog curled nose to tail in a nest of blankets. It looks up.
‘His name’s Scoot.’
Scoot is a Springer Spaniel, a ragged brown and white scrap of a dog whose black eyes seem to make up four fifths of his body. His expression is so desperately mournful even Disney would have blushed. It fells us both, bringing us to our knees beside the nest.
Claire appears in the doorway behind Zoe.
‘What do you think of our new assistant?’ she says.
‘He’s so-o-o cute,’ says Rae, mussing the dog. ‘I want him.’
‘Well what he wants is another Cheddar biscuit,’ says Claire. She produces half a packet. It makes its way along the line to Rae, who taps one out and presents it to the dog. But Scoot’s either eaten his fill or he’s too overcome with depression – a condition which, judging by his expression, he has learned to live with. He gives the biscuit a disappointed sniff and then plumps himself back down again.
‘How did you get Scoot?’
‘He came in with a woman who’s taken an overdose. Nothing too serious, but they’re keeping her on CDU for a little longer. It’s not worth calling the RSPCA ‘cos she’ll probably be discharged tonight. So we offered to look after him. And he’s no bother at all – are you? Are you?’
Scoot raises his eyebrows in our direction, then carries on staring at his front paws.
‘Trouble is, we’ve just heard matron is coming on at seven, and she’ll have us all taken out and shot.’
‘She never comes in at that time!’ says Claire, kicking the door frame. ‘Why now? It’s so typical of her.’
‘I don’t think even Matron would mind about Scoot, though,’ says Rae. ‘I mean, look at him!’
We all look at him.
Scoot gives a professional sigh, and wriggles down further amongst the blankets.
Outside, a crew wheels past the serving hatch with a man strapped and groaning on a spinal board.
Rae places the cheddar biscuit next to the vomit bowl filled with drinking water, gives Scoot a last, loving fuss, then stands up. Her knees give an audible crack and she staggers slightly.
‘You’re worse than me,’ says Zoe, offering her one of the biscuits. ‘You’re falling to bits.’
‘I don’t think I’ll do anything else tonight,’ says Rae, snapping down the biscuit in two bites and smacking the crumbs from her hands. ‘I think I’ll just curl up under the desk with Scootie pie. And if Matron comes in and makes a fuss, well then I’ll just have to bite her bony butt. We don’t care, do we Scoots? We don’t care.’
But the dog is already asleep.
Friday, May 01, 2009
two old friends
Geoffrey is the very ambassador of punctuality. If he says he’ll be there at nine he’ll be there a minute before, pressed, polished, clipped, buttoned, straight-backed and smiling, a crisply folded newspaper under his left arm, his right reaching out for the measured handshake that will fade on the ninth stroke of the clock.
Which is why James knows something is wrong.
Usually the two of them catch the bus into town early every Saturday and stay until lunch, but James needs to pick up some shoes that have been re-heeled and Geoffrey needs to organise a present for his granddaughter’s wedding. So they arranged a special mid-week trip. Geoffrey was to call round for James as his flat is nearest to the bus stop.
The two flats – economical, sensible, self-contained – stand as well-appointed symbols for the position in life both men have reached. Retired professionals – James from the print trade (high-end catalogues and diaries for museums and art galleries), Geoffrey from the Royal Fleet Auxiliary and latterly the Civil Service – James has been married and divorced with one son in Australia, Geoffrey has two daughters at either ends of the country and a wife laid to rest in the local churchyard. Both men have been retired so long the memory of their working lives hangs in the air as abstracted and strangely coloured as the gilded photos on their walls. Shopping trips, bridge parties, family excursions, the Horse and Hounds and the Ten O’clock News - this is the comfortable currency of their lives now, and they spend a good deal of it in each other’s company.
But today is different.
James stands with the phone in his hand, picturing the little iron and glass table in the hallway the other end, hearing exactly the sound the phone would be making on it, every unanswered ring another reason why Geoffrey might not be able to answer: he’s forgotten the appointment and made other plans, he’s been called away on urgent business, he’s ill. But like little waves running out to a bigger, more destructive mass, the conviction grows in him that the reason Geoffrey is not answering is that he has collapsed on the floor.
James hangs up, then after a moment presses the green button again and dials 999. But then before that call is answered he replaces the handset in its cradle. He should go round himself and see what the problem is. Maybe he is the one who has got things mixed up.
He hurries round to his friend’s flat. He checks the windows from the road as he turns up the path. The curtains are open in the lounge. He walks towards it as quickly as he can, strides up to the door and knocks brightly three times. No reply. He knocks again, a different pattern, not his usual, and presses the bell for good measure. After a little while he walks round through the curved red-brick arch and checks the bedroom window. The curtains are still drawn there. On an impulse he knocks on the window, too, but immediately feels foolish. As he walks back through the archway he pulls out the spare key that he has been turning absently round and round in his raincoat pocket. He puts it into the lock and opens the door.
‘Hello? Geoffrey?’
The silent interior draws him in. He looks into the lounge. Empty. He looks into the bathroom. Empty. He comes to the bedroom and steps inside.
Geoffrey had been sitting up in bed with a breakfast tray on his lap, reading the newspaper. Now he is sprawled face down, his glasses squashed cruelly into his face, one hand stretched out and over the side of the bed, a GTN spray on the carpet a few feet away. The contents of the tray – a hard-boiled egg, a slice of toast, a glass of juice and a cafetiere of coffee, are scattered around him on the counterpane. James reaches out and gives his shoulder a little push. It might as well be wood.
***
When the ambulance arrives, James watches them park down on the road. He waves as they look up towards the block so they know which entrance to come to. They collect their bags from the back of the truck, slam the door and make their way up to him. When they’re within hailing distance he says:
‘I think he’s gone.’
One of them says: Can you show us where to go?
He’s not altogether sure he can.
Which is why James knows something is wrong.
Usually the two of them catch the bus into town early every Saturday and stay until lunch, but James needs to pick up some shoes that have been re-heeled and Geoffrey needs to organise a present for his granddaughter’s wedding. So they arranged a special mid-week trip. Geoffrey was to call round for James as his flat is nearest to the bus stop.
The two flats – economical, sensible, self-contained – stand as well-appointed symbols for the position in life both men have reached. Retired professionals – James from the print trade (high-end catalogues and diaries for museums and art galleries), Geoffrey from the Royal Fleet Auxiliary and latterly the Civil Service – James has been married and divorced with one son in Australia, Geoffrey has two daughters at either ends of the country and a wife laid to rest in the local churchyard. Both men have been retired so long the memory of their working lives hangs in the air as abstracted and strangely coloured as the gilded photos on their walls. Shopping trips, bridge parties, family excursions, the Horse and Hounds and the Ten O’clock News - this is the comfortable currency of their lives now, and they spend a good deal of it in each other’s company.
But today is different.
James stands with the phone in his hand, picturing the little iron and glass table in the hallway the other end, hearing exactly the sound the phone would be making on it, every unanswered ring another reason why Geoffrey might not be able to answer: he’s forgotten the appointment and made other plans, he’s been called away on urgent business, he’s ill. But like little waves running out to a bigger, more destructive mass, the conviction grows in him that the reason Geoffrey is not answering is that he has collapsed on the floor.
James hangs up, then after a moment presses the green button again and dials 999. But then before that call is answered he replaces the handset in its cradle. He should go round himself and see what the problem is. Maybe he is the one who has got things mixed up.
He hurries round to his friend’s flat. He checks the windows from the road as he turns up the path. The curtains are open in the lounge. He walks towards it as quickly as he can, strides up to the door and knocks brightly three times. No reply. He knocks again, a different pattern, not his usual, and presses the bell for good measure. After a little while he walks round through the curved red-brick arch and checks the bedroom window. The curtains are still drawn there. On an impulse he knocks on the window, too, but immediately feels foolish. As he walks back through the archway he pulls out the spare key that he has been turning absently round and round in his raincoat pocket. He puts it into the lock and opens the door.
‘Hello? Geoffrey?’
The silent interior draws him in. He looks into the lounge. Empty. He looks into the bathroom. Empty. He comes to the bedroom and steps inside.
Geoffrey had been sitting up in bed with a breakfast tray on his lap, reading the newspaper. Now he is sprawled face down, his glasses squashed cruelly into his face, one hand stretched out and over the side of the bed, a GTN spray on the carpet a few feet away. The contents of the tray – a hard-boiled egg, a slice of toast, a glass of juice and a cafetiere of coffee, are scattered around him on the counterpane. James reaches out and gives his shoulder a little push. It might as well be wood.
***
When the ambulance arrives, James watches them park down on the road. He waves as they look up towards the block so they know which entrance to come to. They collect their bags from the back of the truck, slam the door and make their way up to him. When they’re within hailing distance he says:
‘I think he’s gone.’
One of them says: Can you show us where to go?
He’s not altogether sure he can.
Wednesday, April 29, 2009
contents of a fridge
After the death of Mrs Dorothy Cheeseman’s husband Harold following a brisk but inelegant struggle with prostate cancer; and after an efficient funeral on an averagely sunny day in a square-cut crematorium with adequate attendance and foliage, undercut somewhat by a vicar who could not pronounce his R’s and A Nightingale sang in Berkley Square (Harold hated London); and after six months had fallen from the calendar like so many dead leaves; and after the health insurance that Harold had arranged with his usual prescience had fattened up the joint account overnight, Mrs Dorothy Cheeseman – acting on the instructions of their only daughter, Claire, a woman who had obviously hooked all her genetic ducks from Harold’s ancestral pond, especially a talent for organisation and a thin-lipped approach to problem-solving, (but Claire’s edginess in company could only have come from Dorothy, whose own particular terrors had grown exponentially since she was eight years old at her father’s Christmas work’s do, 1948, when she was pushed up first on stage to collect her present from Father Christmas and threw up three bottles of apple pop and a crab-paste sandwich into his sack) – Mrs Dorothy Cheeseman, widow, sold the family home and moved into the manageable, one bedroom flat Claire and her silent partner Ben had arranged for her just a simple bus ride away from their front door on the other side of town.
And now her sciatica was playing up.
She had been sitting on the sofa looking out at the newly planted communal lawn for a few hours. The washing line had one plain white tea towel fluttering there, but no-one seemed bothered to add any more or take this one down. She watched it for hours. The sun moved across the grass and changed the angles of its shadows at the edges, until the ache in her leg – a cramp that spread from the root of her hip to the heel bone – forced her to get up, move about, find an aspirin. She swallowed the pill with a glass of warmish tap water, then suddenly picked up the phone and dialled 999.
She let the ambulance people in via a short struggle with the entry phone, then sat back down on the sofa.
When they came in they seemed to fill the room completely with their bags and their bulky jackets and their overloud characters. Mrs Dorothy Cheeseman wished she had not bothered.
One of them, the older of the two, a man who reminded her of Harold’s German business associate Klaus, with the same squashy features and crooked teeth, except Klaus was always on the verge of clasping her round the shoulders to draw her to him, and smelled of yeast and pipe smoke. But this man only touched her lightly round the wrist, and smelled of disinfectant. The other ambulance man, a squared-off chap who looked as if he should be outside sawing logs, drew up a stool and sat quietly.
‘I bet they think I’m a fool,’ she thought.
She told them about her leg. And, no, she hadn’t been to a doctor because she had only just moved here and these things were not easy to sort out.
She looked about the room and realised with a low-down stumbling feeling that she had not made the bed. In fact, all her clothes were strewn about the floor. She had been meaning to have a tidy up. What would they think?
‘I’m so hungry,’ she said to them. ‘I haven’t had a thing to eat in days. And I can’t go shopping because of my leg.’
She had been expecting to be scooped up and rushed to the hospital, but the men in green did not appear to be in any kind of rush. Were they always this slow? The old one carefully wrote down the facts and figures whilst the short one fussed about with blood pressure cuffs and thermometers and blood sugar kits – though what all this had to do with a leg she could not possibly say. Suddenly the short one seemed to be finished with all that. He packed his kit away, stood up and asked if she would like a cup of tea, then wandered off into the kitchen to get it. Dorothy tried to listen to the old one talking on in a quiet voice about options and such, but her attention was really focused on the kitchen.
‘I haven’t any food at all,’ she suddenly shouted out to him. ‘Not a thing.’
But when he looked in the fridge for the milk, Dorothy knew exactly what he would see: two spotted rashers of bacon, a tub of marge, and a dried-out slab of Leicester cheese.
And now her sciatica was playing up.
She had been sitting on the sofa looking out at the newly planted communal lawn for a few hours. The washing line had one plain white tea towel fluttering there, but no-one seemed bothered to add any more or take this one down. She watched it for hours. The sun moved across the grass and changed the angles of its shadows at the edges, until the ache in her leg – a cramp that spread from the root of her hip to the heel bone – forced her to get up, move about, find an aspirin. She swallowed the pill with a glass of warmish tap water, then suddenly picked up the phone and dialled 999.
She let the ambulance people in via a short struggle with the entry phone, then sat back down on the sofa.
When they came in they seemed to fill the room completely with their bags and their bulky jackets and their overloud characters. Mrs Dorothy Cheeseman wished she had not bothered.
One of them, the older of the two, a man who reminded her of Harold’s German business associate Klaus, with the same squashy features and crooked teeth, except Klaus was always on the verge of clasping her round the shoulders to draw her to him, and smelled of yeast and pipe smoke. But this man only touched her lightly round the wrist, and smelled of disinfectant. The other ambulance man, a squared-off chap who looked as if he should be outside sawing logs, drew up a stool and sat quietly.
‘I bet they think I’m a fool,’ she thought.
She told them about her leg. And, no, she hadn’t been to a doctor because she had only just moved here and these things were not easy to sort out.
She looked about the room and realised with a low-down stumbling feeling that she had not made the bed. In fact, all her clothes were strewn about the floor. She had been meaning to have a tidy up. What would they think?
‘I’m so hungry,’ she said to them. ‘I haven’t had a thing to eat in days. And I can’t go shopping because of my leg.’
She had been expecting to be scooped up and rushed to the hospital, but the men in green did not appear to be in any kind of rush. Were they always this slow? The old one carefully wrote down the facts and figures whilst the short one fussed about with blood pressure cuffs and thermometers and blood sugar kits – though what all this had to do with a leg she could not possibly say. Suddenly the short one seemed to be finished with all that. He packed his kit away, stood up and asked if she would like a cup of tea, then wandered off into the kitchen to get it. Dorothy tried to listen to the old one talking on in a quiet voice about options and such, but her attention was really focused on the kitchen.
‘I haven’t any food at all,’ she suddenly shouted out to him. ‘Not a thing.’
But when he looked in the fridge for the milk, Dorothy knew exactly what he would see: two spotted rashers of bacon, a tub of marge, and a dried-out slab of Leicester cheese.
Sunday, April 26, 2009
daniels then and now
Daniel then
I was born into this world on the thirteenth day of March, 1770, may it please you, received into the sure and respectable arms of the Lambert family senior, in the county seat of Leicester. My father, John, in stature and in public life a substantial and hospitable man, keeper of the Bridewell jail, redoubtable servant of the county of Leicestershire, breeder of dogs and fighting cocks, held me to his heart a boy of grace and opportunity, heir designate to the modest fortunes he had so assiduously acquired. I grew strong like him, swimming in the Stour, hunting and fishing, taking all of life that I could with an appetite born of a naturally expansive mind and a temperament which demanded of all experience the simple necessity of sampling as much of it that I could. By virtue of this temperament, in the most part the result of an indulgent heritage, by which I mean a father who wished me all the things he was denied in his youth, and a mother for whom bread and game, pies, puddings and pitchers of ale marched on through the household as like the very blood of the body Lambert – by virtue of this temperament, as I say, the weighty proclivities I was born with, and the idiosyncrasies I can only claim for myself, I grew in circumference as much as in height. The love people bore for me, my family and friends, indeed the very prisoners who were given into my charge when I succeeded my father as president of the gaol, all the love that orbited me in my heavenly path through life, seemed to act on me in much the same way as food.
By the time I was pensioned from my job in 1804, I was of considerable girth, my clothes specially made, and the furniture in my house reinforced by craftsmen without whose skill and ingenuity my comfort would have been in jeopardy. I grew to be such the celebrity in my home town that I would be followed about by crowds of rowdy boys, riding in my wake like so many bottles bobbing about behind the progress of a ship. Without work to maintain me, and with a pension grown exhausted by the demands placed upon it, I thought about the ways in which I might earn an extra sixpence or two, and struck upon the idea of charging admission to look upon me, five shillings per person, with a reduction for large parties. Though it pained me to exhibit myself in this way, it allowed for the fitting of a special carriage, and sundry other life essentials.
On the twenty first of July, 1809, I had repaired to the races at Stamford, and taken up lodging at an Inn in that fair town. It was there that my heart and my life finally acceded to the strains placed upon them. I fell asleep, and did not open my eyes on this world again.
The inn keeper and his men looked at the situation all of the morning and some of the afternoon, scratching their heads and pacing the circumference of my bed, taking measurements, gauging material strengths, angles and probabilities. Finally it was decided that the only way to remove my mortal remains was to take out the window adjacent to the cot, partially demolish the attendant wall, apply planks of wood as a bridge to a waggoner’s cart judiciously parked in the courtyard, and slide me out by means of ropes.
At my funeral, twenty pall bearers bore my coffin into the ground, and there it was, dear reader, my life’s adventure found its end.
Daniel now
We hear an obstructed rattle from the front room as the son leads us in to his father.
'He was like this yesterday, maybe not quite so bad,’ he says, pushing open the door.
A glutinous landslip of a figure, Daniel is not so much sitting in the huge electric chair as spilling out of it, his massive legs planted either side of a belly so enormous it would take a team of tailors with ladders to clothe it; as it is, he seems to be wearing a shower curtain as a nightshirt. The cupid features of his face float on an indeterminate mass of mottled flesh, the lips tinged with blue. I take up the controls to the chair and adjust his position, tipping him back enough to open his airway and stop him snoring. The cyanotic mottling gradually fades, his level of consciousness rises, but there is a crackle from his lungs.
‘How long’s his chest been like this?’
‘A few weeks. He normally has problems with his breathing, but it’s getting worse.’
We put an oxygen mask on him, check him over. His sats come up to an acceptable level, but he seems to be running a temperature, and his breathing is obviously compromised by infection. There is no blood pressure cuff available outside of London Zoo that would fit around his arm, but at least he has a good radial pulse.
The son stands watching us, his hands hooked in the back pockets of his jeans. He seems nervous, scooped out by things. I wonder when he ate last.
‘Normally with a chest infection like this we’d simply take your dad to hospital,’ I tell him, putting the clipboard to one side.
‘I don’t want to go to no bleedin’ hospital. I hate them places,’ wheezes Daniel, pulling off our mask and putting on his own nasal cannula instead. ‘They’re full of sick people.’
‘He won’t go if he doesn’t want to. He’s a stubborn old git.’
‘The thing is, even if he did want to go, it wouldn’t be an easy thing, given his weight. What – about thirty two stone, would you say?’
‘Charming,’ Daniel says, adjusting the cannula.
There is a knock on the side of the open door and a bright young woman hellos her way into the room.
‘Hi Keith. Everything all right? I saw the ambulance.’
‘Yeah. Thanks Jean. Dad took a bit of a turn’s all. We’re just figuring out what to do with him.’
‘Send me to the knackers,’ says Daniel. ‘Make a bit of money.’
‘Oh you,’ says Jean. ‘Well – just thought I’d check in. If there’s anything you need…’ And she goes.
‘It’s just a logistical problem, that’s all,’ I say to Daniel. ‘We’d need at least a second crew here to help with the lift, but then you won’t fit on our trolley anyway. So we’d have to arrange for a special truck to come out, and I’m not sure how soon that could be. I think the best thing is for the doctor to come out and have a look at you here – which is what you probably want anyway. See if this chest infection can be handled at home. And if the doctor thinks a trip up the hospital is definitely needed, then at least we’ve got a bit more of a run up to organise things. I’ll call Control and give them a heads up. What do you think?’
Keith sits on a stool, fishes a pack of cigarettes and a lighter out of his top pocket, then hands me across the phone.
‘They know us there,’ he says. ‘It’s on speed dial 3. Tell him I’ll be here all day to let him in.’
I was born into this world on the thirteenth day of March, 1770, may it please you, received into the sure and respectable arms of the Lambert family senior, in the county seat of Leicester. My father, John, in stature and in public life a substantial and hospitable man, keeper of the Bridewell jail, redoubtable servant of the county of Leicestershire, breeder of dogs and fighting cocks, held me to his heart a boy of grace and opportunity, heir designate to the modest fortunes he had so assiduously acquired. I grew strong like him, swimming in the Stour, hunting and fishing, taking all of life that I could with an appetite born of a naturally expansive mind and a temperament which demanded of all experience the simple necessity of sampling as much of it that I could. By virtue of this temperament, in the most part the result of an indulgent heritage, by which I mean a father who wished me all the things he was denied in his youth, and a mother for whom bread and game, pies, puddings and pitchers of ale marched on through the household as like the very blood of the body Lambert – by virtue of this temperament, as I say, the weighty proclivities I was born with, and the idiosyncrasies I can only claim for myself, I grew in circumference as much as in height. The love people bore for me, my family and friends, indeed the very prisoners who were given into my charge when I succeeded my father as president of the gaol, all the love that orbited me in my heavenly path through life, seemed to act on me in much the same way as food.
By the time I was pensioned from my job in 1804, I was of considerable girth, my clothes specially made, and the furniture in my house reinforced by craftsmen without whose skill and ingenuity my comfort would have been in jeopardy. I grew to be such the celebrity in my home town that I would be followed about by crowds of rowdy boys, riding in my wake like so many bottles bobbing about behind the progress of a ship. Without work to maintain me, and with a pension grown exhausted by the demands placed upon it, I thought about the ways in which I might earn an extra sixpence or two, and struck upon the idea of charging admission to look upon me, five shillings per person, with a reduction for large parties. Though it pained me to exhibit myself in this way, it allowed for the fitting of a special carriage, and sundry other life essentials.
On the twenty first of July, 1809, I had repaired to the races at Stamford, and taken up lodging at an Inn in that fair town. It was there that my heart and my life finally acceded to the strains placed upon them. I fell asleep, and did not open my eyes on this world again.
The inn keeper and his men looked at the situation all of the morning and some of the afternoon, scratching their heads and pacing the circumference of my bed, taking measurements, gauging material strengths, angles and probabilities. Finally it was decided that the only way to remove my mortal remains was to take out the window adjacent to the cot, partially demolish the attendant wall, apply planks of wood as a bridge to a waggoner’s cart judiciously parked in the courtyard, and slide me out by means of ropes.
At my funeral, twenty pall bearers bore my coffin into the ground, and there it was, dear reader, my life’s adventure found its end.
Daniel now
We hear an obstructed rattle from the front room as the son leads us in to his father.
'He was like this yesterday, maybe not quite so bad,’ he says, pushing open the door.
A glutinous landslip of a figure, Daniel is not so much sitting in the huge electric chair as spilling out of it, his massive legs planted either side of a belly so enormous it would take a team of tailors with ladders to clothe it; as it is, he seems to be wearing a shower curtain as a nightshirt. The cupid features of his face float on an indeterminate mass of mottled flesh, the lips tinged with blue. I take up the controls to the chair and adjust his position, tipping him back enough to open his airway and stop him snoring. The cyanotic mottling gradually fades, his level of consciousness rises, but there is a crackle from his lungs.
‘How long’s his chest been like this?’
‘A few weeks. He normally has problems with his breathing, but it’s getting worse.’
We put an oxygen mask on him, check him over. His sats come up to an acceptable level, but he seems to be running a temperature, and his breathing is obviously compromised by infection. There is no blood pressure cuff available outside of London Zoo that would fit around his arm, but at least he has a good radial pulse.
The son stands watching us, his hands hooked in the back pockets of his jeans. He seems nervous, scooped out by things. I wonder when he ate last.
‘Normally with a chest infection like this we’d simply take your dad to hospital,’ I tell him, putting the clipboard to one side.
‘I don’t want to go to no bleedin’ hospital. I hate them places,’ wheezes Daniel, pulling off our mask and putting on his own nasal cannula instead. ‘They’re full of sick people.’
‘He won’t go if he doesn’t want to. He’s a stubborn old git.’
‘The thing is, even if he did want to go, it wouldn’t be an easy thing, given his weight. What – about thirty two stone, would you say?’
‘Charming,’ Daniel says, adjusting the cannula.
There is a knock on the side of the open door and a bright young woman hellos her way into the room.
‘Hi Keith. Everything all right? I saw the ambulance.’
‘Yeah. Thanks Jean. Dad took a bit of a turn’s all. We’re just figuring out what to do with him.’
‘Send me to the knackers,’ says Daniel. ‘Make a bit of money.’
‘Oh you,’ says Jean. ‘Well – just thought I’d check in. If there’s anything you need…’ And she goes.
‘It’s just a logistical problem, that’s all,’ I say to Daniel. ‘We’d need at least a second crew here to help with the lift, but then you won’t fit on our trolley anyway. So we’d have to arrange for a special truck to come out, and I’m not sure how soon that could be. I think the best thing is for the doctor to come out and have a look at you here – which is what you probably want anyway. See if this chest infection can be handled at home. And if the doctor thinks a trip up the hospital is definitely needed, then at least we’ve got a bit more of a run up to organise things. I’ll call Control and give them a heads up. What do you think?’
Keith sits on a stool, fishes a pack of cigarettes and a lighter out of his top pocket, then hands me across the phone.
‘They know us there,’ he says. ‘It’s on speed dial 3. Tell him I’ll be here all day to let him in.’
Friday, April 24, 2009
the piano tuner
I can imagine this crowd foraging through bargains in a Church hall. They have the same good-humoured competitiveness, the same restless sense of purpose. It is a disparate mix: mothers, office workers, middle-managers and students, all dressed militia-style in a haphazard kit of army surplus jackets, scarves, disposable charity shop t-shirts and good boots.
The two policemen shut the holding bay door behind us with a clunk and survey the scene.
‘Her name’s Marge. She’s been arrested under suspicion of trespassing and criminal damage. She’s sitting over there, in that corner,’ one says.
We follow him through to a middle-aged woman sitting on the bench that runs the length of the bay. She has her right hand wrapped up in a dirty white t-towel and held up in the air. She smiles pleasantly at us. I expect her to say: ‘How much for this?’ but instead she says: ‘I’m so sorry to bother you. It’s all a bit embarrassing.’
‘What’s happened?’
‘Well, there’s a fair bit I have to be careful telling you, apparently. But the gist of it is that I was climbing over a fence and hurt my finger. A friend of mine who’s a nurse did a makeshift dressing because we didn’t have time for much else. And the police called you when I – erm – got here because they were very sweet and they thought I’d better have it looked at. I’m sure it’s nothing.’
We help her up and lead her back through the crowd to the ambulance parked outside. A few people pat her on the back, wish her well. A young guy in a jacket sprouting all over with badges punches the air and cries out ‘Go Margie! Go Margie!’ but no-one joins in. The unexpected silence closes over him, and the door slams shut behind us.
With the patient sat comfortably on the ambulance, the two policemen waiting just outside, I set to work unwrapping her hand.
‘I’m a bit squeamish,’ she says, tugging off her woolly hat and shaking out a hedge of steely grey hair. ‘It doesn’t hurt though.’
In fact she has no sensation in her hand at all.
As I work my way through the extemporary bandaging, Marge tells us a little more.
‘We were at a laboratory that experiments on animals. Breaking in, actually. I mean, here we are, chatting like this, and there are dogs just the other side of town with disinfectant being dropped into their eyes. Did you know that? Disinfectant. You have to do something.’
She loosens the scarf around her neck.
‘Anyway. I was climbing over this horribly pointy fence and I got caught up. It was tricky and of course I’m not the world’s most athletic commando. I think I must have slipped back and got my hand caught. So I hung there for a moment until lovely Jake hoiked me up from below and someone else worked my hand free. We didn’t have time to hang around – no pun intended. We had to get in there and – well – complete the mission. Which we did. Hurrah.’ She smiles at me. ‘Down to it, yet?’
The inner layers of the dressing are crusty with dried blood.
‘How long ago did this happen would you say?’
‘I don’t know. Three, four hours?’
‘We’ll have to soak this lot off.’
‘Sorry to be a nuisance.’
I fill a bowl with saline and she dips her hand in it. A cloud of red slowly spreads outwards into the water. After a moment or two we ask Marge to hold her hand back up, and then with a large syringe filled with more saline I unwrap the inner layers, gently hosing underneath to loosen the dried blood and release the skin caught up underneath.
Rae is poised next to me with a large, damp gauze.
Marge looks off to the side.
The dressing comes away.
In the brief instant before squirts of blood arc delicately into the air and Rae leans in with a dressing, I catch a view of the injury: Marge’s ring and middle fingers have been partially de-gloved, the flesh and skin of both ripped at the root and slid upwards.
‘How is it?’ she says.
‘It’s quite a serious injury,’ I tell her. ‘And the delay hasn’t helped. We need to get you to hospital as soon as we can to get it repaired.’
‘It hurts a bit now.’
I clean the area as best I can, re-bandage the wound and put her arm in a sling. I tell the policemen waiting outside that Marge needs to go to hospital right away, and we’ll be driving on lights and sirens. Whilst they make arrangements, Rae jumps out and goes to the cab to call the job in .
‘It’s really quite a deal then,’ Marge says quietly. She rubs her nose with the back of her good hand and looks clear into me.
‘I’m a piano tuner,’ she says.
The two policemen shut the holding bay door behind us with a clunk and survey the scene.
‘Her name’s Marge. She’s been arrested under suspicion of trespassing and criminal damage. She’s sitting over there, in that corner,’ one says.
We follow him through to a middle-aged woman sitting on the bench that runs the length of the bay. She has her right hand wrapped up in a dirty white t-towel and held up in the air. She smiles pleasantly at us. I expect her to say: ‘How much for this?’ but instead she says: ‘I’m so sorry to bother you. It’s all a bit embarrassing.’
‘What’s happened?’
‘Well, there’s a fair bit I have to be careful telling you, apparently. But the gist of it is that I was climbing over a fence and hurt my finger. A friend of mine who’s a nurse did a makeshift dressing because we didn’t have time for much else. And the police called you when I – erm – got here because they were very sweet and they thought I’d better have it looked at. I’m sure it’s nothing.’
We help her up and lead her back through the crowd to the ambulance parked outside. A few people pat her on the back, wish her well. A young guy in a jacket sprouting all over with badges punches the air and cries out ‘Go Margie! Go Margie!’ but no-one joins in. The unexpected silence closes over him, and the door slams shut behind us.
With the patient sat comfortably on the ambulance, the two policemen waiting just outside, I set to work unwrapping her hand.
‘I’m a bit squeamish,’ she says, tugging off her woolly hat and shaking out a hedge of steely grey hair. ‘It doesn’t hurt though.’
In fact she has no sensation in her hand at all.
As I work my way through the extemporary bandaging, Marge tells us a little more.
‘We were at a laboratory that experiments on animals. Breaking in, actually. I mean, here we are, chatting like this, and there are dogs just the other side of town with disinfectant being dropped into their eyes. Did you know that? Disinfectant. You have to do something.’
She loosens the scarf around her neck.
‘Anyway. I was climbing over this horribly pointy fence and I got caught up. It was tricky and of course I’m not the world’s most athletic commando. I think I must have slipped back and got my hand caught. So I hung there for a moment until lovely Jake hoiked me up from below and someone else worked my hand free. We didn’t have time to hang around – no pun intended. We had to get in there and – well – complete the mission. Which we did. Hurrah.’ She smiles at me. ‘Down to it, yet?’
The inner layers of the dressing are crusty with dried blood.
‘How long ago did this happen would you say?’
‘I don’t know. Three, four hours?’
‘We’ll have to soak this lot off.’
‘Sorry to be a nuisance.’
I fill a bowl with saline and she dips her hand in it. A cloud of red slowly spreads outwards into the water. After a moment or two we ask Marge to hold her hand back up, and then with a large syringe filled with more saline I unwrap the inner layers, gently hosing underneath to loosen the dried blood and release the skin caught up underneath.
Rae is poised next to me with a large, damp gauze.
Marge looks off to the side.
The dressing comes away.
In the brief instant before squirts of blood arc delicately into the air and Rae leans in with a dressing, I catch a view of the injury: Marge’s ring and middle fingers have been partially de-gloved, the flesh and skin of both ripped at the root and slid upwards.
‘How is it?’ she says.
‘It’s quite a serious injury,’ I tell her. ‘And the delay hasn’t helped. We need to get you to hospital as soon as we can to get it repaired.’
‘It hurts a bit now.’
I clean the area as best I can, re-bandage the wound and put her arm in a sling. I tell the policemen waiting outside that Marge needs to go to hospital right away, and we’ll be driving on lights and sirens. Whilst they make arrangements, Rae jumps out and goes to the cab to call the job in .
‘It’s really quite a deal then,’ Marge says quietly. She rubs her nose with the back of her good hand and looks clear into me.
‘I’m a piano tuner,’ she says.
Sunday, April 19, 2009
beneath the cherry tree
A man has collapsed and died from a suspected heart attack in a local park. Two paramedic crews attended the scene but were unable to revive him. A popular family man in his mid-forties, he was a well-known character in the area, active in local charities and a familiar figure at the local pub. Friends and acquaintances described him as a friendly, witty man with an encyclopaedic general knowledge, always willing to put himself out for others and ready to help wherever possible. An Inquest is scheduled for later in the week.
I flatten the paper, push it across the table to my wife and tap the paragraph.
‘That’s the guy we went to.’
***
The cherry tree is out in blossom, its branches freighted with thick masses of light pink flowers.
A man is spread out on his back beneath it, his legs and feet stretched across the little tarmac pathway and the rest of him on a grass verge, the clothes cut away from his chest, a paramedic kneeling beside him with her arms locked, rocking up and down on his chest, and another paramedic with a mask clamped to the man’s face, rhythmically pressing oxygen into him. We duck beneath the blue and white police tape stretched across the path.
‘Hi guys. Thanks for getting here so quick,’ says the paramedic on the mask.
We take over their positions whilst they give us the story.
‘Okay guys. This man had been seen sitting under the tree by various people around lunchtime, nothing obviously wrong. A guy who works in that hardware store over there had passed him on his way back from the sandwich shop, slumped forwards and snoring, thought he was just the worse for drink. That was about one twenty. The guy came back outside the shop for a smoke at about one forty, noticed the guy flat on his back halfway across the path. He called the police to report him as drunk. The police responded on low priority to a D&D, getting here just on two. Found him apparently dead. We got here about five or eight past. So unfortunately no CPR attempted at any point until then, which must be at least half an hour, probably more. The guy’s asystole but warm, pupils fixed – but he’s young, so we went for it. What’s the time now?’
We carry on for another twenty minutes, bustling through a resus protocol that lacks for nothing but the one thing that would have made a difference: timeliness. Nothing changes, and nothing we can do can stop the man from riding out beneath us on a relentless line of asystole. We stand up, stretch the cramp out of our legs. Clear away the empty tubes, the oxygen line, airway adjuncts, pads and empty cartons, stuffing it all into clinical waste bags.
Two policemen come over to take details and discuss the next phase. They have his wallet and phone. They have numbers to call.
A scattering of cherry blossom drifts down across all of us, catching in our hair like confetti.
I flatten the paper, push it across the table to my wife and tap the paragraph.
‘That’s the guy we went to.’
***
The cherry tree is out in blossom, its branches freighted with thick masses of light pink flowers.
A man is spread out on his back beneath it, his legs and feet stretched across the little tarmac pathway and the rest of him on a grass verge, the clothes cut away from his chest, a paramedic kneeling beside him with her arms locked, rocking up and down on his chest, and another paramedic with a mask clamped to the man’s face, rhythmically pressing oxygen into him. We duck beneath the blue and white police tape stretched across the path.
‘Hi guys. Thanks for getting here so quick,’ says the paramedic on the mask.
We take over their positions whilst they give us the story.
‘Okay guys. This man had been seen sitting under the tree by various people around lunchtime, nothing obviously wrong. A guy who works in that hardware store over there had passed him on his way back from the sandwich shop, slumped forwards and snoring, thought he was just the worse for drink. That was about one twenty. The guy came back outside the shop for a smoke at about one forty, noticed the guy flat on his back halfway across the path. He called the police to report him as drunk. The police responded on low priority to a D&D, getting here just on two. Found him apparently dead. We got here about five or eight past. So unfortunately no CPR attempted at any point until then, which must be at least half an hour, probably more. The guy’s asystole but warm, pupils fixed – but he’s young, so we went for it. What’s the time now?’
We carry on for another twenty minutes, bustling through a resus protocol that lacks for nothing but the one thing that would have made a difference: timeliness. Nothing changes, and nothing we can do can stop the man from riding out beneath us on a relentless line of asystole. We stand up, stretch the cramp out of our legs. Clear away the empty tubes, the oxygen line, airway adjuncts, pads and empty cartons, stuffing it all into clinical waste bags.
Two policemen come over to take details and discuss the next phase. They have his wallet and phone. They have numbers to call.
A scattering of cherry blossom drifts down across all of us, catching in our hair like confetti.
Saturday, April 18, 2009
Fiona in greens
Bear Court. Sounds more like a headline than an address. Fiona looks it up in the map book whilst I machete my way through the early evening traffic. This is perfect timing for a call; surely our last of the day, and the last that Fiona will do for the next six months until her baby is born.
She points the address out on the map. Perfect. And there’s a car on scene already, so the paperwork should mostly be done. We wave at the traffic like crazy royals as it falls away before us.
Bear Court. A great, sandstone cube landed amongst some trees. I drive into the car park past a wide, white sign and its logo: a bear, rearing up, with a sash. There’s a path and a run of stubby black path lights leading up to a door. You could swivel the building through ninety degrees and find no difference. The only thing that suggests that this is indeed the front is the fact that the RRU is parked here. I grab the chair out of the truck and we walk up to the building.
Bear Court. No wonder the bear in the logo is angry. A rage born of confusion, no doubt. This is the rear of the building. We walk back to the truck and drive round to the front (looks like the back, has poorer access). I park. We walk up to an identical door.
Inside, the building is run through with a blue carpeted corridor that seems to extend as we walk along it. About five miles further on we see that one of the thousand doors here is open. We can hear voices, and as we get even nearer, a formidable figure steps out and waves to us.
A woman as square as the building, she is contained by a quilted floral dressing gown and a hair net, utterly in keeping with her environment, somehow, like she’s not so much a resident as an architectural extension.
‘Over here!’ she calls, and we gradually make the distance.
Inside, the flat is as bustling as the rest of the building is dormant. Frank is on the car today. He’s kneeling down beside a rumpled bed where an elderly woman is sitting propped against a dressing table. Two more elderly women are fussing around in the room, laughing and giving each other playful little slaps on the shoulder.
‘Ooh, here comes the cavalry,’ one of them says. Then: ‘We’ll get out of your way.’
‘Watch from the cheap seats.’
‘You’ll be alright, Eth. You’ve got the A Team.’
‘Mine’s the one in green.’
‘They’re all in green. Even the lady.’
‘Well I’m not fussy.’
‘Oh you.’
Slap.
Frank looks at me. If I ever came across a cow lost in a shopping centre I would expect to see the same expression: a lugubrious and silent plea to be led back to the fields.
‘Sorry I didn’t move the car, guys,’ he says. ‘I couldn’t face hauling all those bags back to the car, so I came up some steps at the side. Anyway. This is Ethel. Ethel has been feeling nauseous on and off today. Took herself to bed. Found herself on the floor. Looks like she passed out for a minute or two. Was sick. No pain, obs okay – blood sugar slightly high but nothing major. Had a similar episode a month ago, nothing found.’ He pats her on the hand. ‘How are you feeling now, Ethel?’
‘Okay,’ she says, with a washed-out smile. ‘Don’t fancy a trip up to hospital. Don’t like hospitals.’
‘Who does. I’m allergic to them,’ Frank says, taking off his stethoscope. ‘All yours, chaps.’
We help her into our chair and wrap her in blankets. I am at the business end of the chair and reverse out of the flat. Frank and Fiona walk off down the corridor to call the lift, leaving me surrounded by a flap of nightgowns as heavily made-up and frenetic as clowns at the circus, pushing each other around in some elaborate and incomprehensible piece of shtick involving keys, slippers, cats, scrawled phone numbers on scraps of paper. They seem never to have come across the concept of ‘a door on the latch’ and struggle to close it.
I look ahead into the distance to where the tiny figures of Fiona and Frank talk nonchalantly by an opened lift.
I will never make it there. I will live out the rest of my life here by this door.
***
Ethel lies back on the ambulance trolley looking as white - and flat - as the sheet. But her blood pressure is fine, everything seems okay. The ECG is ticking along nicely.
‘Ready to go,’ I say to Fiona.
‘Yep. Let’s head on out.’
I jump down, shut the door. Climb in the front.
The sun is low in the sky but it’s still warm. It’ll be a lovely summer. I put the radio on. Call our leaving time through the hatch, and set off.
Just as I’m pulling out of the car park, I hear Fiona call out: ‘She’s gone.’ Followed by a crashing noise. I stop the ambulance and hurry back round.
‘She went bradycardic, then asystole,’ she says as I climb back inside. ‘I dropped the back of the trolley and it shocked her out of it.’ She squeezes her shoulder. ‘Ethel?’ She opens her eyes and moves her head feebly from side to side, muttering. ‘Are you with us, Ethel?’
I look at the printed strip. Flat line for a few seconds. Incredible.
Ethel begins to retch, so we turn her on her side. She vomits a little into the bowl I hold for her.
After a while she settles down. She says she still has no pain. Nothing untoward shows on the ECG. Everything seems fine – but that period of asystole sits heavily on the paper in front of us, a resonant mark of doom. I go back round to the cab, call the job in, and head off through the traffic on lights and sirens.
I look in the rear view mirror. Fiona leaning forward, attending to Ethel.
Fiona with the baby growing inside her. Fiona in Greens, Provider and Protector.
Cars pull over to let us through.
She points the address out on the map. Perfect. And there’s a car on scene already, so the paperwork should mostly be done. We wave at the traffic like crazy royals as it falls away before us.
Bear Court. A great, sandstone cube landed amongst some trees. I drive into the car park past a wide, white sign and its logo: a bear, rearing up, with a sash. There’s a path and a run of stubby black path lights leading up to a door. You could swivel the building through ninety degrees and find no difference. The only thing that suggests that this is indeed the front is the fact that the RRU is parked here. I grab the chair out of the truck and we walk up to the building.
Bear Court. No wonder the bear in the logo is angry. A rage born of confusion, no doubt. This is the rear of the building. We walk back to the truck and drive round to the front (looks like the back, has poorer access). I park. We walk up to an identical door.
Inside, the building is run through with a blue carpeted corridor that seems to extend as we walk along it. About five miles further on we see that one of the thousand doors here is open. We can hear voices, and as we get even nearer, a formidable figure steps out and waves to us.
A woman as square as the building, she is contained by a quilted floral dressing gown and a hair net, utterly in keeping with her environment, somehow, like she’s not so much a resident as an architectural extension.
‘Over here!’ she calls, and we gradually make the distance.
Inside, the flat is as bustling as the rest of the building is dormant. Frank is on the car today. He’s kneeling down beside a rumpled bed where an elderly woman is sitting propped against a dressing table. Two more elderly women are fussing around in the room, laughing and giving each other playful little slaps on the shoulder.
‘Ooh, here comes the cavalry,’ one of them says. Then: ‘We’ll get out of your way.’
‘Watch from the cheap seats.’
‘You’ll be alright, Eth. You’ve got the A Team.’
‘Mine’s the one in green.’
‘They’re all in green. Even the lady.’
‘Well I’m not fussy.’
‘Oh you.’
Slap.
Frank looks at me. If I ever came across a cow lost in a shopping centre I would expect to see the same expression: a lugubrious and silent plea to be led back to the fields.
‘Sorry I didn’t move the car, guys,’ he says. ‘I couldn’t face hauling all those bags back to the car, so I came up some steps at the side. Anyway. This is Ethel. Ethel has been feeling nauseous on and off today. Took herself to bed. Found herself on the floor. Looks like she passed out for a minute or two. Was sick. No pain, obs okay – blood sugar slightly high but nothing major. Had a similar episode a month ago, nothing found.’ He pats her on the hand. ‘How are you feeling now, Ethel?’
‘Okay,’ she says, with a washed-out smile. ‘Don’t fancy a trip up to hospital. Don’t like hospitals.’
‘Who does. I’m allergic to them,’ Frank says, taking off his stethoscope. ‘All yours, chaps.’
We help her into our chair and wrap her in blankets. I am at the business end of the chair and reverse out of the flat. Frank and Fiona walk off down the corridor to call the lift, leaving me surrounded by a flap of nightgowns as heavily made-up and frenetic as clowns at the circus, pushing each other around in some elaborate and incomprehensible piece of shtick involving keys, slippers, cats, scrawled phone numbers on scraps of paper. They seem never to have come across the concept of ‘a door on the latch’ and struggle to close it.
I look ahead into the distance to where the tiny figures of Fiona and Frank talk nonchalantly by an opened lift.
I will never make it there. I will live out the rest of my life here by this door.
***
Ethel lies back on the ambulance trolley looking as white - and flat - as the sheet. But her blood pressure is fine, everything seems okay. The ECG is ticking along nicely.
‘Ready to go,’ I say to Fiona.
‘Yep. Let’s head on out.’
I jump down, shut the door. Climb in the front.
The sun is low in the sky but it’s still warm. It’ll be a lovely summer. I put the radio on. Call our leaving time through the hatch, and set off.
Just as I’m pulling out of the car park, I hear Fiona call out: ‘She’s gone.’ Followed by a crashing noise. I stop the ambulance and hurry back round.
‘She went bradycardic, then asystole,’ she says as I climb back inside. ‘I dropped the back of the trolley and it shocked her out of it.’ She squeezes her shoulder. ‘Ethel?’ She opens her eyes and moves her head feebly from side to side, muttering. ‘Are you with us, Ethel?’
I look at the printed strip. Flat line for a few seconds. Incredible.
Ethel begins to retch, so we turn her on her side. She vomits a little into the bowl I hold for her.
After a while she settles down. She says she still has no pain. Nothing untoward shows on the ECG. Everything seems fine – but that period of asystole sits heavily on the paper in front of us, a resonant mark of doom. I go back round to the cab, call the job in, and head off through the traffic on lights and sirens.
I look in the rear view mirror. Fiona leaning forward, attending to Ethel.
Fiona with the baby growing inside her. Fiona in Greens, Provider and Protector.
Cars pull over to let us through.
Sunday, April 12, 2009
anatomy of a slap
Viren has only been at the EMI unit for a couple of hours, not that he could tell you. He lies back on the bed, heavy glasses on a wide and leathery smile, nodding and muttering and seemingly oblivious to the small crowd of people invading his room.
‘We find blood in pads,’ the nurse says, flicking through his notes with a sniff. ‘The first time we come to change we find blood in pads. From penis. I haven’t more, unfortunately. His name is Viren. V-I-R-E-N. Viren. There.’
She hands me the notes. ‘Wife will meet at hospital.’
I introduce myself and Rae. Viren produces a hand as padded and massive as a baseball mitt, wraps it round mine, then rattles on through a low and loose knit of words. I shake his hand and tell him what to expect. The nurse and her assistant stand to one side and dispatch an orderly for the hoist.
‘The notes say here that he can be violent. Have you found that?’
‘Like I say, he came two maybe three hours. I could not say. He’s fine.’
I look at Viren and smile, then go back to the paragraph describing his history. Vascular dementia. Wife sole carer. Some kind of incident on a bus when he refused to leave and became aggressive. Banging on the window. Police etc. Wife at risk. Having him put into respite care whilst longer term provision found.
‘How are you feeling, Viren?’
His reply could be anything.
‘We think UTI, maybe kidney. He has swollen abdomen. He has temperature.’
I run through the basic obs whilst Rae goes to fetch the trolley. I make notes on my form, interspersing each procedure with reassuring smiles, squeezes and words. Viren seems happy and calm, even when I examine his abdomen.
‘He prefer men,’ says the nurse. ‘Girl – not so much.’
When the trolley comes through we position it so that the hoist will have room to operate. The sling seems to be a sheep’s fleece with straps.
‘I’ve never seen such luxury, Viren,’ I say. He smiles and tries to pull my shirt.
The lift over onto the trolley is uneventful. At one point Viren is swinging in mid-air, his legs spread and his hands fluttering in the void like gross, featherless birds.
‘Here. Hold on to this,’ we say, directing his hands. But he flaps awkwardly until we land him.
We tuck him up, raise the trolley, make our farewells, and leave.
***
A&E on a Monday. Crammed with doctors’ urgents. People have had the weekend to fall ill, present themselves at their surgery and be referred on to the hospital. Accident and Emergency is transformed into some ghastly portal. Trolleys line the corridors; the status board is as scrawled and hectic as a race meeting tote. Walking in through the automatic doors I expect to see a gothic sign inscribed in slate: Abandon Hope All Ye Who Enter Here. But I give Viren’s hand another squeeze and excuse my way through to the charge nurse to handover my patient.
After twenty minutes I come back. Rae is a fossilised yawn.
‘We’re going into space nineteen,’ I say to them. And then specifically to Rae ‘I’ll get some half boards.’ I figure that Viren won’t tolerate being laid flat.
When I return with the boards I look around for someone to give us a hand with the transfer. Viren is a tall man and I don’t want his legs getting snagged on the foot bar as we go across.
Luckily, Erik the Viking is standing with a patient just behind us, and if there is one person in the wide ambulance world who is good for a smooth transfer, it is Erik the Viking. A tree-sized, red-faced man, in earlier times he would have looked at home standing at the prow of a longboat, squinting through a helmet with an axe across his chest, but these days he simply looks mighty in greens.
‘Help with a transfer, Erik?’
‘Sure.’
He clumps across.
‘This is Viren. Viren has dementia, but apart from being a bit grabby, hasn’t been too much of a problem. Viren has some bleeding from his penis, so it’s query UTI or other infection. Otherwise okay.’
‘Fine’
‘I’ll take the legs if you’re happy with the middle.’
‘Yep.’
He smiles at Viren.
‘Just put your hands across your chest and let us do all the work,’ he says pleasantly. Viren smiles and looks around. I place his hands for him. ‘Keep them on your chest,’ I say.
We lean him to his right and slide the boards into position. He accepts this indignity without any trouble.
‘Ready to slide – and – slide.’
His right arm shoots out and grabs the edge of the board, stopping him moving.
‘What are you doing?’ he screams.
‘Viren. It’s okay. Just relax and let us get you over.’
‘Help! Help!’
I unclasp his hand. ‘Let’s get him over,’ I say. We slide him all the way.
‘What are you doing to me?’
‘All done now. All done,’ says Erik. He goes to roll him up a little to give me room to slide the boards out.
Viren draws his hand back and slaps him round the face.
When he pulls back to hit him again, Erik catches his hand.
‘You do that again and you’ll be in hospital for a lot longer,’ he says.
I know that the shock of the slap has jolted Erik into war mode, but it’s a truly dreadful picture, framed by the sudden thrill of attentive quiet that has flashed through everyone in the vicinity.
Whilst Erik controls Viren – who stares up at him with a look of whitened terror – Rae and I pull up the safety bars and arrange his blankets. Erik releases Viren’s hands.
‘I’m so sorry about that, Erik,’ I say to him. ‘That came out of nowhere. He was a bit grabby when we picked him up, but that was it.’
‘No worries,’ says Erik, but he looks about to blow. ‘I’m used to it.’
We put Viren into position. I tell the charge nurse what happened.
‘Oh great,’ she says, ‘that’s all we need. Thanks a lot.’
I go to the kitchen, make a round of tea and carry it outside on a plate. Erik is there, smoking. I hand him a cup.
‘I feel so embarrassed,’ I tell him. ‘The notes said he was aggressive, but he was so good it just went clean out of my head.’
‘Don’t worry about it.’ He adjusts his position against the railing. ‘It’s happened to me before. It’ll probably happen again. I can take it.’
Rae joins us. We drink our tea. Erik smokes.
I can feel the stress tonight. I can see its stealthy mycelia threading out beneath the A&E doors, along the tarmac and up to my boots, up my legs, over my chest, my arms and my hands, into the tea, into me.
I gave up smoking seven years ago but I could do with a cigarette tonight.
‘We find blood in pads,’ the nurse says, flicking through his notes with a sniff. ‘The first time we come to change we find blood in pads. From penis. I haven’t more, unfortunately. His name is Viren. V-I-R-E-N. Viren. There.’
She hands me the notes. ‘Wife will meet at hospital.’
I introduce myself and Rae. Viren produces a hand as padded and massive as a baseball mitt, wraps it round mine, then rattles on through a low and loose knit of words. I shake his hand and tell him what to expect. The nurse and her assistant stand to one side and dispatch an orderly for the hoist.
‘The notes say here that he can be violent. Have you found that?’
‘Like I say, he came two maybe three hours. I could not say. He’s fine.’
I look at Viren and smile, then go back to the paragraph describing his history. Vascular dementia. Wife sole carer. Some kind of incident on a bus when he refused to leave and became aggressive. Banging on the window. Police etc. Wife at risk. Having him put into respite care whilst longer term provision found.
‘How are you feeling, Viren?’
His reply could be anything.
‘We think UTI, maybe kidney. He has swollen abdomen. He has temperature.’
I run through the basic obs whilst Rae goes to fetch the trolley. I make notes on my form, interspersing each procedure with reassuring smiles, squeezes and words. Viren seems happy and calm, even when I examine his abdomen.
‘He prefer men,’ says the nurse. ‘Girl – not so much.’
When the trolley comes through we position it so that the hoist will have room to operate. The sling seems to be a sheep’s fleece with straps.
‘I’ve never seen such luxury, Viren,’ I say. He smiles and tries to pull my shirt.
The lift over onto the trolley is uneventful. At one point Viren is swinging in mid-air, his legs spread and his hands fluttering in the void like gross, featherless birds.
‘Here. Hold on to this,’ we say, directing his hands. But he flaps awkwardly until we land him.
We tuck him up, raise the trolley, make our farewells, and leave.
***
A&E on a Monday. Crammed with doctors’ urgents. People have had the weekend to fall ill, present themselves at their surgery and be referred on to the hospital. Accident and Emergency is transformed into some ghastly portal. Trolleys line the corridors; the status board is as scrawled and hectic as a race meeting tote. Walking in through the automatic doors I expect to see a gothic sign inscribed in slate: Abandon Hope All Ye Who Enter Here. But I give Viren’s hand another squeeze and excuse my way through to the charge nurse to handover my patient.
After twenty minutes I come back. Rae is a fossilised yawn.
‘We’re going into space nineteen,’ I say to them. And then specifically to Rae ‘I’ll get some half boards.’ I figure that Viren won’t tolerate being laid flat.
When I return with the boards I look around for someone to give us a hand with the transfer. Viren is a tall man and I don’t want his legs getting snagged on the foot bar as we go across.
Luckily, Erik the Viking is standing with a patient just behind us, and if there is one person in the wide ambulance world who is good for a smooth transfer, it is Erik the Viking. A tree-sized, red-faced man, in earlier times he would have looked at home standing at the prow of a longboat, squinting through a helmet with an axe across his chest, but these days he simply looks mighty in greens.
‘Help with a transfer, Erik?’
‘Sure.’
He clumps across.
‘This is Viren. Viren has dementia, but apart from being a bit grabby, hasn’t been too much of a problem. Viren has some bleeding from his penis, so it’s query UTI or other infection. Otherwise okay.’
‘Fine’
‘I’ll take the legs if you’re happy with the middle.’
‘Yep.’
He smiles at Viren.
‘Just put your hands across your chest and let us do all the work,’ he says pleasantly. Viren smiles and looks around. I place his hands for him. ‘Keep them on your chest,’ I say.
We lean him to his right and slide the boards into position. He accepts this indignity without any trouble.
‘Ready to slide – and – slide.’
His right arm shoots out and grabs the edge of the board, stopping him moving.
‘What are you doing?’ he screams.
‘Viren. It’s okay. Just relax and let us get you over.’
‘Help! Help!’
I unclasp his hand. ‘Let’s get him over,’ I say. We slide him all the way.
‘What are you doing to me?’
‘All done now. All done,’ says Erik. He goes to roll him up a little to give me room to slide the boards out.
Viren draws his hand back and slaps him round the face.
When he pulls back to hit him again, Erik catches his hand.
‘You do that again and you’ll be in hospital for a lot longer,’ he says.
I know that the shock of the slap has jolted Erik into war mode, but it’s a truly dreadful picture, framed by the sudden thrill of attentive quiet that has flashed through everyone in the vicinity.
Whilst Erik controls Viren – who stares up at him with a look of whitened terror – Rae and I pull up the safety bars and arrange his blankets. Erik releases Viren’s hands.
‘I’m so sorry about that, Erik,’ I say to him. ‘That came out of nowhere. He was a bit grabby when we picked him up, but that was it.’
‘No worries,’ says Erik, but he looks about to blow. ‘I’m used to it.’
We put Viren into position. I tell the charge nurse what happened.
‘Oh great,’ she says, ‘that’s all we need. Thanks a lot.’
I go to the kitchen, make a round of tea and carry it outside on a plate. Erik is there, smoking. I hand him a cup.
‘I feel so embarrassed,’ I tell him. ‘The notes said he was aggressive, but he was so good it just went clean out of my head.’
‘Don’t worry about it.’ He adjusts his position against the railing. ‘It’s happened to me before. It’ll probably happen again. I can take it.’
Rae joins us. We drink our tea. Erik smokes.
I can feel the stress tonight. I can see its stealthy mycelia threading out beneath the A&E doors, along the tarmac and up to my boots, up my legs, over my chest, my arms and my hands, into the tea, into me.
I gave up smoking seven years ago but I could do with a cigarette tonight.
Thursday, April 09, 2009
a bag of nuts
The satnav has failed but I recognise the street from a siege last year. A burglar with a knife had been disturbed, chased by police and gone to ground in one of the terraced houses there. After a time, a police dog handler had arrived. The crowds taped off at the end of the street had been parted to let this new and terrifying apparatus through. The dog handler had parked in front of the house, stepped to the back of the van, and opened the door with the gravitas of an executioner. At a snap from his fingers out leaped a dog that, from where we stood, looked one part Alsatian, three parts grizzly bear. It sat in front of him, he gave it some instructions – which the dog seemed to understand and enjoy – then they padded off through the front door, and as far as I understand it, the burglar ran out the back into a big net. Anyway, it was a sunny, do-nothing standby, with people leaning out of car windows, looking on with folded arms, comparing mobile phones, cleaning their sun glasses on their shirts, or passing time with the easy, expansive chat that breaks out when anything cuts across the norm; a mixed crowd of sudden sociability, from the stab-vested police and evacuated neighbours to the local press, TV crews and any one of the hundreds of commuters drifting past on homeward currents, stopping to have a look.
The street is different now. The lamps have all failed, and the only illumination is the yellowy overspill from the railway station and a full moon hangs above us like a hub cap. The house numbers are difficult to read. But just as I go to pull a torch out of the rack to have a closer look, the truck headlights pick out a policewoman emerging from the gloom at the top of the street. Rae drives up and I climb out.
‘We weren’t told you’d be here,’ I say. ‘The job came through as a sick elderly woman.’
The policewoman smiles and comes up close.
‘Her name is June – we think. She was found wandering in someone’s garden, very confused. They took her in and called us. She says she lives in one of the cottages backing onto the alley, but doesn’t have a key, the people looking after her have never seen her around before, and well – it’s difficult to figure out quite what the story is. Come and see what you think.’
She leads us back up to the top left corner of the road and turns confidently into what would seem to be a high wall. But the thicker darkness there is actually the entrance to an alleyway I would never have guessed existed, a twitten tucked away as neatly as a secret compartment in a Georgian writing desk. A few yards along it we come across another policewoman standing by an arched trellis. She shows us through into a pocket-sized courtyard and the front door of a narrow cottage in front of which stands a figure who appears in the shadows to be a speaking facet of the rough flint wall.
‘Oh no. What now? Who’s this?’ she says.
I resist the urge to switch my torch on. The beam would blind us all, and the woman is so insubstantial it feels as if she would simply disappear.
‘Hello, June. My name’s Spence and this is Rae. We’re with the ambulance service.’
‘The ambulance service? Well for goodness sake! No-one’s sick, are they?’
‘That’s what we’re here to find out. How are you feeling?’
‘How am I feeling? Why do you want to know that?’
‘Because people are a little concerned about you, June.’
‘Are they? Who? Why are they concerned about me?’
‘June – it’s pretty cold and dark out here. Would you like to come and sit on the ambulance and chat to us there? It’s so much warmer and more private. We can sit down in comfort, have a chat and get to the bottom of this mystery.’
‘What mystery?’
‘Exactly. Will you do that, June? Come on, just for a minute or two. We won’t drive off anywhere, or do anything you don’t want to do.’
‘All right, if you think it’s absolutely necessary. One must always trust those in public positions of responsibility. But I have to say it all seems rather a nonsense. Who are you, do you say?’
‘The ambulance service.’
‘And why are you here?’
I take her by the hand. Even that small movement is enough to disturb an unsettling odour from her. It spreads out around us, a seamy musk of neglect.
‘Follow me.’
I lead her back along the alleyway to the ambulance. We sit her in a forward seat, close the door and settle in as pleasantly as we can.
‘And this is an ambulance, you say?’
June looks around like some visiting dignitary making conversation. Her silver hair is scraped neatly back into a black scrunchy, and her jacket and trousers have a smart line to them. But it looks as if she has been wearing the same clothes for some time now. They have a hazy, forgotten look about them.
June has a wide face, with an asymmetric twist to her mouth that would have been terrifying in middle age. Now it seems somewhat disconnected from her eyes, which flicker dully around her surroundings.
‘Would you mind if we did a few very basic tests, June, just to make sure everything’s okay?’
‘Of course everything’s okay. Why the fucking hell would they not be okay?’
‘Try not to get upset, June. Let me explain what the problem is.’
‘I wish you would. And don’t bamboozle me with jargon. Speak plainly and simply. I am not a fool and I will not be treated as a fool.’
‘Absolutely. Okay. Here’s the thing. Some people who live near here found you wandering in a confused state in their garden. They were worried about you, so they called the police. The police called us because they thought there might be something wrong with you.’
‘Something wrong with me? Like what?’
‘A urinary tract infection, for example. That can make you confused.’
‘Who’s confused?’
‘You seem confused.’
‘About what?’
Rae joins in. Whilst we give her a quick health screen, we try different approaches to find out the facts of her situation – where she lives, who she lives with, where she has been today and what she thinks of this whole situation. Her vital signs are fine, but although she is articulate and forceful, she seems to lack any reasonable insight into her predicament. And by the simple expedient of repeating isolated phrases back to us, she starts to make it seem as if we are the ones in need of focus.
‘Please. This is not amusing in the slightest – although I don’t doubt this fellow thinks it’s a hoot. I worked fifty years for the foreign office in Africa, and believe you me I know my way around the garden. I’ve put up with worse antics than you. I know what you’re about.’
‘June, let me try to explain again what the problem is.’
‘Please do. All ears.’
‘We’ve never met you before. We have no way of knowing what is normal behaviour for you and what is not. We can only go by what we see, the facts of the case.’
‘And they are?’
‘An elderly woman found wandering in the cold and dark, unable to give an account of where she has been or what she intends to do next. No key to get in, and no plan of action.’
‘What key? What are you talking about?’
‘June – do you live in the house you were standing in front of?’
She screws up the handle of her black bag.
‘Oh this is fucking ridiculous. Here you are talking about keys and confusion. You and your fancy equipment. Your mumbo jumbo.’
‘Okay. June. Do you have a key to that house? Would you mind looking in your bag?’
‘For what?’
‘For a key.’
She opens up the bag and rummages around. It flops about emptily, until suddenly she pulls out an unopened bag of salted peanuts.
‘Would you like a peanut? They’re very good for you, apparently.’
‘No thanks, June.’
‘How about your lovely colleague? Can I pass you a nut, dear?’
‘No thanks, June.’
There’s nothing else in the bag other than a two pence piece and a dirty handkerchief.
‘I don’t suppose you have the key on a string round your neck?’
June stares at me.
‘And why on earth would I have a key round my neck? Do you take me for an imbecile?’
‘June. Our duty first and foremost is to make sure that you’re okay.’
‘Good. Yes. You must do your job.’
‘Yes. It’s our job to make sure that no harm comes to you.’
‘I see.’
‘As things stand, we have no way of knowing if you actually live there, and no way of knowing what you will do next. What would you do if we dropped you off in the street now?’
‘I’d go home.’
‘And where is home?’
‘You know where my home is. I’m tired of these stupid questions.’
‘It’s cold and dark, and we couldn’t possibly just let you wander off. So here’s my plan. Come to hospital with us. It’s warm and safe there. You can see a doctor, just to make absolutely sure there’s nothing physically wrong with you. And there are people there who can help figure out what to do next. How does that sound?’
‘You must do what you must do. But I think the whole thing is a colossal waste of time.’
Rae climbs out to tell the policewomen what is happening. Then she calls back the leaving scene time through the hatch, and we set off for the hospital.
‘This is a rickety old charabanc,’ June says, sniffing and twisting her lips, hugging her bag to her on her lap. And then: ‘What an absolutely fucking ridiculous end to the day.’
The street is different now. The lamps have all failed, and the only illumination is the yellowy overspill from the railway station and a full moon hangs above us like a hub cap. The house numbers are difficult to read. But just as I go to pull a torch out of the rack to have a closer look, the truck headlights pick out a policewoman emerging from the gloom at the top of the street. Rae drives up and I climb out.
‘We weren’t told you’d be here,’ I say. ‘The job came through as a sick elderly woman.’
The policewoman smiles and comes up close.
‘Her name is June – we think. She was found wandering in someone’s garden, very confused. They took her in and called us. She says she lives in one of the cottages backing onto the alley, but doesn’t have a key, the people looking after her have never seen her around before, and well – it’s difficult to figure out quite what the story is. Come and see what you think.’
She leads us back up to the top left corner of the road and turns confidently into what would seem to be a high wall. But the thicker darkness there is actually the entrance to an alleyway I would never have guessed existed, a twitten tucked away as neatly as a secret compartment in a Georgian writing desk. A few yards along it we come across another policewoman standing by an arched trellis. She shows us through into a pocket-sized courtyard and the front door of a narrow cottage in front of which stands a figure who appears in the shadows to be a speaking facet of the rough flint wall.
‘Oh no. What now? Who’s this?’ she says.
I resist the urge to switch my torch on. The beam would blind us all, and the woman is so insubstantial it feels as if she would simply disappear.
‘Hello, June. My name’s Spence and this is Rae. We’re with the ambulance service.’
‘The ambulance service? Well for goodness sake! No-one’s sick, are they?’
‘That’s what we’re here to find out. How are you feeling?’
‘How am I feeling? Why do you want to know that?’
‘Because people are a little concerned about you, June.’
‘Are they? Who? Why are they concerned about me?’
‘June – it’s pretty cold and dark out here. Would you like to come and sit on the ambulance and chat to us there? It’s so much warmer and more private. We can sit down in comfort, have a chat and get to the bottom of this mystery.’
‘What mystery?’
‘Exactly. Will you do that, June? Come on, just for a minute or two. We won’t drive off anywhere, or do anything you don’t want to do.’
‘All right, if you think it’s absolutely necessary. One must always trust those in public positions of responsibility. But I have to say it all seems rather a nonsense. Who are you, do you say?’
‘The ambulance service.’
‘And why are you here?’
I take her by the hand. Even that small movement is enough to disturb an unsettling odour from her. It spreads out around us, a seamy musk of neglect.
‘Follow me.’
I lead her back along the alleyway to the ambulance. We sit her in a forward seat, close the door and settle in as pleasantly as we can.
‘And this is an ambulance, you say?’
June looks around like some visiting dignitary making conversation. Her silver hair is scraped neatly back into a black scrunchy, and her jacket and trousers have a smart line to them. But it looks as if she has been wearing the same clothes for some time now. They have a hazy, forgotten look about them.
June has a wide face, with an asymmetric twist to her mouth that would have been terrifying in middle age. Now it seems somewhat disconnected from her eyes, which flicker dully around her surroundings.
‘Would you mind if we did a few very basic tests, June, just to make sure everything’s okay?’
‘Of course everything’s okay. Why the fucking hell would they not be okay?’
‘Try not to get upset, June. Let me explain what the problem is.’
‘I wish you would. And don’t bamboozle me with jargon. Speak plainly and simply. I am not a fool and I will not be treated as a fool.’
‘Absolutely. Okay. Here’s the thing. Some people who live near here found you wandering in a confused state in their garden. They were worried about you, so they called the police. The police called us because they thought there might be something wrong with you.’
‘Something wrong with me? Like what?’
‘A urinary tract infection, for example. That can make you confused.’
‘Who’s confused?’
‘You seem confused.’
‘About what?’
Rae joins in. Whilst we give her a quick health screen, we try different approaches to find out the facts of her situation – where she lives, who she lives with, where she has been today and what she thinks of this whole situation. Her vital signs are fine, but although she is articulate and forceful, she seems to lack any reasonable insight into her predicament. And by the simple expedient of repeating isolated phrases back to us, she starts to make it seem as if we are the ones in need of focus.
‘Please. This is not amusing in the slightest – although I don’t doubt this fellow thinks it’s a hoot. I worked fifty years for the foreign office in Africa, and believe you me I know my way around the garden. I’ve put up with worse antics than you. I know what you’re about.’
‘June, let me try to explain again what the problem is.’
‘Please do. All ears.’
‘We’ve never met you before. We have no way of knowing what is normal behaviour for you and what is not. We can only go by what we see, the facts of the case.’
‘And they are?’
‘An elderly woman found wandering in the cold and dark, unable to give an account of where she has been or what she intends to do next. No key to get in, and no plan of action.’
‘What key? What are you talking about?’
‘June – do you live in the house you were standing in front of?’
She screws up the handle of her black bag.
‘Oh this is fucking ridiculous. Here you are talking about keys and confusion. You and your fancy equipment. Your mumbo jumbo.’
‘Okay. June. Do you have a key to that house? Would you mind looking in your bag?’
‘For what?’
‘For a key.’
She opens up the bag and rummages around. It flops about emptily, until suddenly she pulls out an unopened bag of salted peanuts.
‘Would you like a peanut? They’re very good for you, apparently.’
‘No thanks, June.’
‘How about your lovely colleague? Can I pass you a nut, dear?’
‘No thanks, June.’
There’s nothing else in the bag other than a two pence piece and a dirty handkerchief.
‘I don’t suppose you have the key on a string round your neck?’
June stares at me.
‘And why on earth would I have a key round my neck? Do you take me for an imbecile?’
‘June. Our duty first and foremost is to make sure that you’re okay.’
‘Good. Yes. You must do your job.’
‘Yes. It’s our job to make sure that no harm comes to you.’
‘I see.’
‘As things stand, we have no way of knowing if you actually live there, and no way of knowing what you will do next. What would you do if we dropped you off in the street now?’
‘I’d go home.’
‘And where is home?’
‘You know where my home is. I’m tired of these stupid questions.’
‘It’s cold and dark, and we couldn’t possibly just let you wander off. So here’s my plan. Come to hospital with us. It’s warm and safe there. You can see a doctor, just to make absolutely sure there’s nothing physically wrong with you. And there are people there who can help figure out what to do next. How does that sound?’
‘You must do what you must do. But I think the whole thing is a colossal waste of time.’
Rae climbs out to tell the policewomen what is happening. Then she calls back the leaving scene time through the hatch, and we set off for the hospital.
‘This is a rickety old charabanc,’ June says, sniffing and twisting her lips, hugging her bag to her on her lap. And then: ‘What an absolutely fucking ridiculous end to the day.’
Sunday, April 05, 2009
keep the change
Frank steps up to the bank of flat buzzers and presses number ten. We wait a while, and then just as Frank steps up to press again, a voice crackles something unintelligible, the lock thrums, and we push the door open.
From outside there is nothing to give away the fact that this is a care in the community hostel, but inside the institutional roots of the place are apparent. Along with the pin board covered in departmental posters and leaflets, illuminated exit signs fixed above every doorway, fire extinguishers hanging on brackets and a large grey alarm console winking over the stairway, there is a functional air about the hallway, a brisk, sanitary aura that smacks of observation and control.
A cadaverous man in a jacket suit and trousers – but not from the same suit – steps out of his flat and confronts us in the hallway.
‘Who’re you here for?’ he says.
‘Number ten.’
‘Number ten? Ah. Upstairs. Is he going to die?’
‘Let’s hope not. Thanks for your help.’
He studies us as we climb the stairs, but when we look back down to wave he hurries inside his flat.
The door to number ten stands open. I knock and push it open further.
‘Hello. Ambulance.’
The room is filled with cigarette smoke. Our patient, Michael, sitting bare-chested on a low stool in the middle of it all like a sumo wrestler in a steam room, nods for us to come in.
‘It’s a bit smoky, Michael,’ I say to him. ‘Are you able to come out here and talk to us? Only it’s the beginning of our shift and we’ll absolutely stink of fags if we spend much time in here.’
‘The window’s open,’ he says. But the yellowing net curtains hang straight down, the nicotine equivalent of stalactites.
‘Still – if you wouldn’t mind.’
He sighs, stands and walks out onto the landing. I sit him down on the stairs.
‘So what’s the problem, Michael?’
‘I’m depressed.’
‘We were given the call as an abdo pain. Do you have any pains around there?’
‘This morning. But it’s gone now.’
‘Any other pain anywhere?’
‘No.’
‘Any unusual feelings? Sickness? Dizziness? Shortness of breath?’
A fog bank of fag smoke is sliding out of the flat towards us.
‘No. I feel okay.’
‘So what’s the main reason you wanted an ambulance tonight?’
‘Like I said. I’m depressed.’
‘And is this a new thing?’
‘No. I’m always depressed.’
‘Are you on medication for it?’
‘Yep. These.’ He pulls out a scrip, a comprehensive list of anti-psychotics.
‘You see, Michael, the best person to talk to about these feelings of depression are your doctor. They know you. They’ve got all your notes. If you saw an out of hours GP tonight, they’d be hard pushed to give you anything you’re not currently taking – and they’d be loathe to do that, anyway. My advice would be to get some rest tonight and see your GP in the morning. How does that sound?’
‘Fine.’
A young woman is coming up the stairs. Dressed in a tracksuit top with the hood pulled over her head, she has a stealthy, predatory hunch to her. In this harsh hallway light I expect to see a Nosferatu shadow thrown against the wall. But half way up towards us she stops and calls:
‘Mickey? Are you all right, Mickey?’
‘Yeah. I’m fine. Listen – Leila. Come up here a minute, can you?’
She pads cautiously towards us. When she puts down her hood, her face is a disconcerting mix of ages; she has the eyes of a young teenager, but the skin and hair of a woman in her thirties.
‘Leila? If I give you this money, will you go to the shops and get me some Chinese chips and a bottle of lemonade?’
‘Yeah. Course.’
‘But I want the change. You can’t keep the change.’
‘I won’t keep the change.’
‘You promise you won’t keep the change?’
‘I promise I won’t keep the change.’
Frank looks at me. His face is impassive, but I can feel the power of his impatience trembling in my pen.
‘I’ll just finish this paperwork and we’ll be off.’
‘Yeah. Okay,’ says Mickey, scratching the sparse black hair between his breasts.
Leila leans in to study the two of us.
‘I dated Frank Sinatra. Do you know Frank Sinatra?’
‘Frankie. Oh yes,’ says Frank.
‘What’s your name?’ She squints at his name badge. I can see that he wants to cover it up with his arms, but he reluctantly pulls aside his jacket so she can read it.
‘Frank!’ she says. ‘Frank Sinatra!’
I’m writing as fast as I can.
‘Do you know anything about the shooting in the pub at the end of the road, Frank?’ Leila says to him, moving even closer.
‘No. What shooting?’
‘There was a man shot there.’ She leers horribly and puts two fingers to her temple. ‘Right through the brains. Dead.’
‘Oh. When was that?’
‘I don’t know,’ she says, suddenly dropping her fingers and her tone. ‘Ten years ago? Can I see you again?’
‘Just sign here,’ I say to Mickey, and he takes my pen
‘I’m sure our paths will cross,’ says Frank, picking up the bag and turning to go.
‘But who do I call?’
‘The usual numbers,’ says Frank, helpfully, and starts off down the stairs. I tear Mickey off a copy of the patient form and follow on. At the bottom of the stairs cadaverous man steps out again.
‘What’s happening now?’ he says.
‘Nothing,’ says Frank. ‘Everything’s fine.’
‘So how much does an ambulance man get paid?’ says the man, as Frank hauls open the door.
‘Not enough, mate’ - and he is in the truck with the keys in the ignition before I’ve shut the door behind me.
From outside there is nothing to give away the fact that this is a care in the community hostel, but inside the institutional roots of the place are apparent. Along with the pin board covered in departmental posters and leaflets, illuminated exit signs fixed above every doorway, fire extinguishers hanging on brackets and a large grey alarm console winking over the stairway, there is a functional air about the hallway, a brisk, sanitary aura that smacks of observation and control.
A cadaverous man in a jacket suit and trousers – but not from the same suit – steps out of his flat and confronts us in the hallway.
‘Who’re you here for?’ he says.
‘Number ten.’
‘Number ten? Ah. Upstairs. Is he going to die?’
‘Let’s hope not. Thanks for your help.’
He studies us as we climb the stairs, but when we look back down to wave he hurries inside his flat.
The door to number ten stands open. I knock and push it open further.
‘Hello. Ambulance.’
The room is filled with cigarette smoke. Our patient, Michael, sitting bare-chested on a low stool in the middle of it all like a sumo wrestler in a steam room, nods for us to come in.
‘It’s a bit smoky, Michael,’ I say to him. ‘Are you able to come out here and talk to us? Only it’s the beginning of our shift and we’ll absolutely stink of fags if we spend much time in here.’
‘The window’s open,’ he says. But the yellowing net curtains hang straight down, the nicotine equivalent of stalactites.
‘Still – if you wouldn’t mind.’
He sighs, stands and walks out onto the landing. I sit him down on the stairs.
‘So what’s the problem, Michael?’
‘I’m depressed.’
‘We were given the call as an abdo pain. Do you have any pains around there?’
‘This morning. But it’s gone now.’
‘Any other pain anywhere?’
‘No.’
‘Any unusual feelings? Sickness? Dizziness? Shortness of breath?’
A fog bank of fag smoke is sliding out of the flat towards us.
‘No. I feel okay.’
‘So what’s the main reason you wanted an ambulance tonight?’
‘Like I said. I’m depressed.’
‘And is this a new thing?’
‘No. I’m always depressed.’
‘Are you on medication for it?’
‘Yep. These.’ He pulls out a scrip, a comprehensive list of anti-psychotics.
‘You see, Michael, the best person to talk to about these feelings of depression are your doctor. They know you. They’ve got all your notes. If you saw an out of hours GP tonight, they’d be hard pushed to give you anything you’re not currently taking – and they’d be loathe to do that, anyway. My advice would be to get some rest tonight and see your GP in the morning. How does that sound?’
‘Fine.’
A young woman is coming up the stairs. Dressed in a tracksuit top with the hood pulled over her head, she has a stealthy, predatory hunch to her. In this harsh hallway light I expect to see a Nosferatu shadow thrown against the wall. But half way up towards us she stops and calls:
‘Mickey? Are you all right, Mickey?’
‘Yeah. I’m fine. Listen – Leila. Come up here a minute, can you?’
She pads cautiously towards us. When she puts down her hood, her face is a disconcerting mix of ages; she has the eyes of a young teenager, but the skin and hair of a woman in her thirties.
‘Leila? If I give you this money, will you go to the shops and get me some Chinese chips and a bottle of lemonade?’
‘Yeah. Course.’
‘But I want the change. You can’t keep the change.’
‘I won’t keep the change.’
‘You promise you won’t keep the change?’
‘I promise I won’t keep the change.’
Frank looks at me. His face is impassive, but I can feel the power of his impatience trembling in my pen.
‘I’ll just finish this paperwork and we’ll be off.’
‘Yeah. Okay,’ says Mickey, scratching the sparse black hair between his breasts.
Leila leans in to study the two of us.
‘I dated Frank Sinatra. Do you know Frank Sinatra?’
‘Frankie. Oh yes,’ says Frank.
‘What’s your name?’ She squints at his name badge. I can see that he wants to cover it up with his arms, but he reluctantly pulls aside his jacket so she can read it.
‘Frank!’ she says. ‘Frank Sinatra!’
I’m writing as fast as I can.
‘Do you know anything about the shooting in the pub at the end of the road, Frank?’ Leila says to him, moving even closer.
‘No. What shooting?’
‘There was a man shot there.’ She leers horribly and puts two fingers to her temple. ‘Right through the brains. Dead.’
‘Oh. When was that?’
‘I don’t know,’ she says, suddenly dropping her fingers and her tone. ‘Ten years ago? Can I see you again?’
‘Just sign here,’ I say to Mickey, and he takes my pen
‘I’m sure our paths will cross,’ says Frank, picking up the bag and turning to go.
‘But who do I call?’
‘The usual numbers,’ says Frank, helpfully, and starts off down the stairs. I tear Mickey off a copy of the patient form and follow on. At the bottom of the stairs cadaverous man steps out again.
‘What’s happening now?’ he says.
‘Nothing,’ says Frank. ‘Everything’s fine.’
‘So how much does an ambulance man get paid?’ says the man, as Frank hauls open the door.
‘Not enough, mate’ - and he is in the truck with the keys in the ignition before I’ve shut the door behind me.
Tuesday, March 31, 2009
misunderstanding
Stanley opens the door so quickly he must have been standing right by it. Half past five in the morning but he looks as if he has been up an hour or more. There is an air of silence about him, hanging from his shoulders as thickly as the dark green cardigan he wears. He stands in the doorway with one hand clutching the frame and one hand fiddling with a top button I’m not sure is actually there.
‘Hello. It’s the ambulance. Shall we go inside and have a seat?’
He stares at me slackly.
‘Just for a moment, so we can find out what the problem is.’
He turns and drops back inside the house. We follow him into the sitting room, a gloomy parlour crammed with paintings of racehorses, a trophy cabinet, family portraits. It feels more like a memorial to a former jockey than a place anyone might live. Stanley plumps himself down in a high-backed chair and laces his fingers together.
‘What’s the problem?’
‘I’ve been getting rather a sore throat.’
He makes a tired little stroking movement with one hand up and down his neck.
‘And how long has this been going on?’
‘A few days. I don’t know.’
‘Any other pain?’
‘My knee, but that’s old and best forgotten about.’
‘Dizziness? Shortness of breath?’
I fish about for a while, making sure that Stanley is not in fact having the chest pain described in the message.
‘No. Just this sore throat.’
Stanley has recently been cleared of prostate cancer, still has problems urinating, but other than that seems in remarkably good shape for a man in his mid-eighties. It does look as if he needs to go to hospital, but I want to do an ECG to make sure it isn’t cardiac, so I ask if Stanley will come with us out to the ambulance.
‘I’m sorry to have troubled you,’ he says. ‘If you think it’s nothing then I’ll say no more about it.’
‘Let’s go on the ambulance and do a few more checks, just to be on the safe side.’
I help him up, and guide him out to the vehicle. On the way he coughs a few times, a dry, half-hearted affair, like someone clearing their throat in church.
‘How long have you had that cough?’ I ask him.
‘A few days. I don’t know.’
We settle him onto the trolley, and begin our round of observations. Whilst I’m sticking some dots on him I have to excuse myself and hurriedly turn to the side to sneeze.
‘Oh – look at me!’ I say, pressing my nose with the back of my blue-gloved hand. ‘I think we’ve both got a touch of the sniffles.’
Stanley gives a little jolt and straightens an inch.
‘If you think I’m wasting your time then please say so and I’ll go back inside. I didn’t know what to do. I have no one to ask. My wife’s in a home with Alzheimer’s, my daughter’s in Spain. It’s not easy you know, living alone like this. But I don’t want to be a nuisance. If you think all I have is a cold, then fine, help me up and I’ll get about my business. I will not be a burden and I will not waste anyone’s time.’
‘Stanley! Stanley!’ I say, as shocked by his outburst as if a teddy bear had suddenly reared up and bitten me. ‘That’s not what I meant at all! I don’t think you’re a burden!’
‘If you think all this is just a waste of time then tell me and that’ll be the end of it.’
‘Stanley! It was just that I sneezed – and you were coughing – and I thought we both might have a cold. But I don’t think you’re wasting our time. We’re more than happy to come round this morning and make sure you’re okay. More than happy.’
But Stanley avoids my eyes. Instead, he keeps his head up, uncomfortably looking around the ceiling and overhead lockers, like a tired old donkey sniffing the sky for signs of rain.
‘Hello. It’s the ambulance. Shall we go inside and have a seat?’
He stares at me slackly.
‘Just for a moment, so we can find out what the problem is.’
He turns and drops back inside the house. We follow him into the sitting room, a gloomy parlour crammed with paintings of racehorses, a trophy cabinet, family portraits. It feels more like a memorial to a former jockey than a place anyone might live. Stanley plumps himself down in a high-backed chair and laces his fingers together.
‘What’s the problem?’
‘I’ve been getting rather a sore throat.’
He makes a tired little stroking movement with one hand up and down his neck.
‘And how long has this been going on?’
‘A few days. I don’t know.’
‘Any other pain?’
‘My knee, but that’s old and best forgotten about.’
‘Dizziness? Shortness of breath?’
I fish about for a while, making sure that Stanley is not in fact having the chest pain described in the message.
‘No. Just this sore throat.’
Stanley has recently been cleared of prostate cancer, still has problems urinating, but other than that seems in remarkably good shape for a man in his mid-eighties. It does look as if he needs to go to hospital, but I want to do an ECG to make sure it isn’t cardiac, so I ask if Stanley will come with us out to the ambulance.
‘I’m sorry to have troubled you,’ he says. ‘If you think it’s nothing then I’ll say no more about it.’
‘Let’s go on the ambulance and do a few more checks, just to be on the safe side.’
I help him up, and guide him out to the vehicle. On the way he coughs a few times, a dry, half-hearted affair, like someone clearing their throat in church.
‘How long have you had that cough?’ I ask him.
‘A few days. I don’t know.’
We settle him onto the trolley, and begin our round of observations. Whilst I’m sticking some dots on him I have to excuse myself and hurriedly turn to the side to sneeze.
‘Oh – look at me!’ I say, pressing my nose with the back of my blue-gloved hand. ‘I think we’ve both got a touch of the sniffles.’
Stanley gives a little jolt and straightens an inch.
‘If you think I’m wasting your time then please say so and I’ll go back inside. I didn’t know what to do. I have no one to ask. My wife’s in a home with Alzheimer’s, my daughter’s in Spain. It’s not easy you know, living alone like this. But I don’t want to be a nuisance. If you think all I have is a cold, then fine, help me up and I’ll get about my business. I will not be a burden and I will not waste anyone’s time.’
‘Stanley! Stanley!’ I say, as shocked by his outburst as if a teddy bear had suddenly reared up and bitten me. ‘That’s not what I meant at all! I don’t think you’re a burden!’
‘If you think all this is just a waste of time then tell me and that’ll be the end of it.’
‘Stanley! It was just that I sneezed – and you were coughing – and I thought we both might have a cold. But I don’t think you’re wasting our time. We’re more than happy to come round this morning and make sure you’re okay. More than happy.’
But Stanley avoids my eyes. Instead, he keeps his head up, uncomfortably looking around the ceiling and overhead lockers, like a tired old donkey sniffing the sky for signs of rain.
the gravity of the situation
An old house in an old part of town. A young girl stands framed in the enormous doorway, an elegant fan light spread above her, two broad steps inlaid with a multi-coloured mosaic pattern leading up. She leans back against the doorframe and smiles shyly, her teeth wired into line by a stout wire gantry. I wave, help Rae pull the resus bag, drugs bag and carry chair out of the back of the truck, then foot the door shut and head up towards her.
I think: I’ll be surprised if this really is a Category A unconscious.
But say: ‘Hello. Where’re we going, then?’
The girl blushes and points up at the sky.
‘Top flat. And no lift,’ she adds pleasantly, shrugging her shoulders, as if the Georgian architect had decided against installing one out of sheer cussedness.
We haul ourselves up the steep staircase, mindful of the rucks and folds of the carpet.
‘We’ll be needing oxygen soon,’ Rae says, repositioning the heavy yellow bag.
‘Not far now,’ laughs the girl from above us, her braces glinting in the light from a tiny landing window.
Another two flights and we step onto a sunny hallway with three doors leading off. One of them stands open, and the girl leads us into a bright bedsitting room, ordered in an ingenious, below-decks fashion, with every space and surface adapted to serve at least two functions, and every article folded, marked and stored neatly away. There are two sofa-beds in the room, but one of them is still in use from the night before. A middle aged woman is sitting on the side of it, her hands placed either side of her and her long black hair hanging straight down like black water from a pump.
‘This is Momma. Momma doesn’t speak English, so I’ll translate.’
The family is from Slovakia. The mother, Emilia, is working as a cleaner; Sara, the daughter, is studying at a local secondary school. Sara called a helpline number for advice when her mother fell ill with a temperature and a headache last night and still felt bad this morning. The helpline advised calling for an ambulance. We examine her carefully, but nothing Emilia says – earnestly reported back via her daughter – and nothing in her observations suggests anything more serious than a viral infection of some sort. The mother had not taken any pain medication, so we give advice about this, along with a recommendation to see her GP if there is still no improvement over the next twenty four hours.
Sara helps with the translation and gives us the information we need with a warmth that does not diminish even when we say that we think she should stay with her mother to keep an eye on her for the rest of the day.
‘Of course,’ she says, tapping her notebook. ‘There’s plenty for me to do.’
We complete the paperwork, pick up the bags and chair, and leave.
Half way down the stairs I turn to Rae and say: ‘At last - gravity working for us, for a change.’ And immediately trip on the carpet.
Instinctively I fling the bags ahead of me and flatten myself against the wall to stop myself toppling head first down the staircase. Amazingly I manage to avoid a catastrophic swallow dive onto my head, and instead end up my arse with my legs pointing upwards, one arm spread up the wall and the other out to the side, five or six steps below Rae. She looks down at me.
‘Are you okay, Spence?’
I flex a couple of things. Everything seems to work. ‘Yep. I think so.’
She looks down at me, sniffs and says: ‘Yep. That’s gravity for you, mate.’
I think: I’ll be surprised if this really is a Category A unconscious.
But say: ‘Hello. Where’re we going, then?’
The girl blushes and points up at the sky.
‘Top flat. And no lift,’ she adds pleasantly, shrugging her shoulders, as if the Georgian architect had decided against installing one out of sheer cussedness.
We haul ourselves up the steep staircase, mindful of the rucks and folds of the carpet.
‘We’ll be needing oxygen soon,’ Rae says, repositioning the heavy yellow bag.
‘Not far now,’ laughs the girl from above us, her braces glinting in the light from a tiny landing window.
Another two flights and we step onto a sunny hallway with three doors leading off. One of them stands open, and the girl leads us into a bright bedsitting room, ordered in an ingenious, below-decks fashion, with every space and surface adapted to serve at least two functions, and every article folded, marked and stored neatly away. There are two sofa-beds in the room, but one of them is still in use from the night before. A middle aged woman is sitting on the side of it, her hands placed either side of her and her long black hair hanging straight down like black water from a pump.
‘This is Momma. Momma doesn’t speak English, so I’ll translate.’
The family is from Slovakia. The mother, Emilia, is working as a cleaner; Sara, the daughter, is studying at a local secondary school. Sara called a helpline number for advice when her mother fell ill with a temperature and a headache last night and still felt bad this morning. The helpline advised calling for an ambulance. We examine her carefully, but nothing Emilia says – earnestly reported back via her daughter – and nothing in her observations suggests anything more serious than a viral infection of some sort. The mother had not taken any pain medication, so we give advice about this, along with a recommendation to see her GP if there is still no improvement over the next twenty four hours.
Sara helps with the translation and gives us the information we need with a warmth that does not diminish even when we say that we think she should stay with her mother to keep an eye on her for the rest of the day.
‘Of course,’ she says, tapping her notebook. ‘There’s plenty for me to do.’
We complete the paperwork, pick up the bags and chair, and leave.
Half way down the stairs I turn to Rae and say: ‘At last - gravity working for us, for a change.’ And immediately trip on the carpet.
Instinctively I fling the bags ahead of me and flatten myself against the wall to stop myself toppling head first down the staircase. Amazingly I manage to avoid a catastrophic swallow dive onto my head, and instead end up my arse with my legs pointing upwards, one arm spread up the wall and the other out to the side, five or six steps below Rae. She looks down at me.
‘Are you okay, Spence?’
I flex a couple of things. Everything seems to work. ‘Yep. I think so.’
She looks down at me, sniffs and says: ‘Yep. That’s gravity for you, mate.’
Thursday, March 26, 2009
blown away
These air molecules, responding to a steady change in pressure between this stretch of land and the sea, flow down the steepening gradient, and eddy and rush according to the spinning of the earth, and the rising and falling away of the Downland rucks and rills, blindly flow on across the County, hurtle through stands of beech and sycamore, hawthorn, gorse and rhododendron, around the flints of a farmhouse wall, through broken fence slats, between the legs of these cows standing in the field and over the back of this one lying down, and on, through and across towards the town, scythe through an industrial estate, snatch up a strip of pallet wrap, ruffle the hair of a man on a fork lift, nip round the beeping end of a lorry backing up, rattle across the corrugated surfaces of doors and roofs, and then barrel on up a steeply inclined pathway to a group of three old cottages huddled at the top.
The door of the first cottage bangs in its frame.
‘Get that, would you?’
Malcolm, the eldest son, takes the door off the latch, closes it firmly, then rejoins the group in the living room.
‘Here’s a list of the medication she’s on.’
Stephanie, Malcolm’s wife, hands one of the ambulance technicians a prescription sheet. He skims it and nods, then turns his attention again to the old woman sitting in the chair.
‘How are you feeling?’ he says.
She looks at him, then away over his shoulder to the faces of the people standing around.
‘Where’s Barry?’ she says.
‘Barry’s here, Mum. He’s just here.’
Malcolm has his hand on Barry’s shoulder. Barry passively absorbs the attention. He has thick glasses, and his hair looks combed and wetted by someone else.
‘I want Barry,’ says the old woman.
Malcolm leads Barry over to the chair and stands him between the old woman and the fireplace.
‘Barry’s okay, Mum,’ he says.
Stephanie reiterates what the doctor found on his visit earlier that day. Suspected urinary tract infection on top of an existing chest infection, possible renal insufficiency – a general deterioration, not entirely out of keeping in a woman of eighty nine.
‘She was right as rain up until last week. Did everything for herself. Didn’t you, Molly?’
Molly sits at the centre of all this concern, desiccated and pale, her spindly legs drawn up and her arms around them, looking down on the scene like an ancient spider tucked up in the corner of a room.
Malcolm takes the ambulance technician to one side.
‘Of course we have two problems here. One is Mum and her well-being. The other is Barry. Mum's been the main carer for Barry ever since he was born brain damaged, and we simply don’t know what’ll happen to him if it turns out she can’t cope at home any more. We’ll take him for the time being, but after that...’ Malcolm takes off his glasses and cleans them on his t-shirt. ‘It’ll kill Mum to have him put in a home, but honestly – she can’t cope here any more. It’s been coming for some time. We’ve just been putting it off.’
The technician nods. It is a difficult situation, he says, one that will have to be resolved between the hospital, social services and the family doctor. For now the focus is on getting Molly better. The rest will have to follow.
Malcolm puts his glasses back on and thanks the technician for coming out. He asks him if they can all ride with Molly to the hospital.
‘We’ll just about fit you in,’ says the technician. His colleague goes outside to get a carry chair and blankets. As soon as the door is opened, the wind rushes in.
‘Hark at that,’ says Stephanie, wrapping her cardigan tightly around her. ‘We’re all going to get blown away.’
The door of the first cottage bangs in its frame.
‘Get that, would you?’
Malcolm, the eldest son, takes the door off the latch, closes it firmly, then rejoins the group in the living room.
‘Here’s a list of the medication she’s on.’
Stephanie, Malcolm’s wife, hands one of the ambulance technicians a prescription sheet. He skims it and nods, then turns his attention again to the old woman sitting in the chair.
‘How are you feeling?’ he says.
She looks at him, then away over his shoulder to the faces of the people standing around.
‘Where’s Barry?’ she says.
‘Barry’s here, Mum. He’s just here.’
Malcolm has his hand on Barry’s shoulder. Barry passively absorbs the attention. He has thick glasses, and his hair looks combed and wetted by someone else.
‘I want Barry,’ says the old woman.
Malcolm leads Barry over to the chair and stands him between the old woman and the fireplace.
‘Barry’s okay, Mum,’ he says.
Stephanie reiterates what the doctor found on his visit earlier that day. Suspected urinary tract infection on top of an existing chest infection, possible renal insufficiency – a general deterioration, not entirely out of keeping in a woman of eighty nine.
‘She was right as rain up until last week. Did everything for herself. Didn’t you, Molly?’
Molly sits at the centre of all this concern, desiccated and pale, her spindly legs drawn up and her arms around them, looking down on the scene like an ancient spider tucked up in the corner of a room.
Malcolm takes the ambulance technician to one side.
‘Of course we have two problems here. One is Mum and her well-being. The other is Barry. Mum's been the main carer for Barry ever since he was born brain damaged, and we simply don’t know what’ll happen to him if it turns out she can’t cope at home any more. We’ll take him for the time being, but after that...’ Malcolm takes off his glasses and cleans them on his t-shirt. ‘It’ll kill Mum to have him put in a home, but honestly – she can’t cope here any more. It’s been coming for some time. We’ve just been putting it off.’
The technician nods. It is a difficult situation, he says, one that will have to be resolved between the hospital, social services and the family doctor. For now the focus is on getting Molly better. The rest will have to follow.
Malcolm puts his glasses back on and thanks the technician for coming out. He asks him if they can all ride with Molly to the hospital.
‘We’ll just about fit you in,’ says the technician. His colleague goes outside to get a carry chair and blankets. As soon as the door is opened, the wind rushes in.
‘Hark at that,’ says Stephanie, wrapping her cardigan tightly around her. ‘We’re all going to get blown away.’
Wednesday, March 25, 2009
mother's day
The Receptionist, a tall, closely clipped man in his early twenties, stands with his hands planted either side of him on the cherry wood desk, scanning the hall with the proprietary smirk he has developed over the years along with his excellent customer service skills. It is quiet for a Sunday. There is an elderly couple sitting over by the window, studying the drinks menu so closely you would think they were going to be examined rather than asked to place an order. A poor advert for the hotel, he thinks. He must have a word with Gerry about reading the clientele and political steerage vis a vis seating arrangements. And then over in the palm zone, hiding himself amongst the foliage, his business raincoat draped over his business bags, a business man abstractedly tapping a Blackberry on his knee.
A woman appears on the other side of the revolving door. The Receptionist watches as she stands there staring through. Has she not used a revolving door before? This should be good. Although he can see she only has a small holdall – rather masculine, he thinks. Probably her husband’s. Where’s he, then?
As she pushes the door round and makes her way inside, the Receptionist runs a finger down the Expected list and taps it at the likely candidate. Single female, two nights paid, debit rather than credit card. He powers up his welcome smile as she approaches the desk.
**
The basement steps are dark and steep. The two ambulance technicians pause for a moment at the gateway. The one in front pulls a small torch from his jacket pocket, and slinging the bag over his shoulder with his left hand, lights both their way down with his right, until they find themselves in a little square courtyard, crowded with spilling bins and tangled piles of rubbish.
There is a door standing partially open, but the only light visible around it is from deep inside the flat; there is no hall light, and no sounds of life inside.
The first technician puts his foot out to swing the door fully open, but just as he does so his torch illuminates a policeman coming towards them.
‘Whoa!’ the policeman says, putting his hand up against the beam. The technician lowers it. Then: ‘Great. That was quick. Basically, what we’ve got is a forty something guy, very suicidal. He took some heroin today, a bottle of vodka. He’s emotional but not violent. We wondered if you’d mind coming and having a look, see what you think?’
The technicians follow the policeman into the flat, the diffuse circle of light from the torch playing around the hall floor.
‘Sorry about this,’ the policeman says. ‘He’s only got a lamp in the back room for some reason. It’s a dump, basically.’
Walking along the hallway is like walking through a cored, rotten apple, the air mealy with neglect. At the far end the policeman pushes open a door and shows them into a boxy room sparsely furnished with a low sofa, coffee table and a CD radio combo on the floor. The kitchenette that adjoins the room is as chaotic as the bins in the courtyard; in fact, it would be difficult to chose which one would be the safer place to prepare food. Lit as it is by a single standard lamp, the room is a vision of inhumanity. The shadows that rear up from every surface seem more an expression of shock than light.
In the middle of the room there is a man standing, sucking on a tiny, hand rolled cigarette. A powerfully built man, standing rooted in his big black boots, wearing a combat jacket with bulging pockets, at first glance he seems like a workman taking a break. But his mouth is pulled down by the gravity of something lost, and his eyes are rimmed with exhaustion.
**
‘Welcome to the Excelsior, Mrs Plunknett. I do hope you have a pleasant stay. Of course, if you have any questions about the hotel, its services or facilities, or indeed any aspect of your stay with us here today, do please let the desk know, either by using the little white phone in your room or indeed asking down here directly. There’s also lots we can help you with regarding the town, places to go, what’s hot and what’s not…’
The Receptionist nods forward and raises his eyebrows at this point, implying that they both know that what is hot is not at the top of Mrs Plunknett’s agenda. She smiles in a heavy-faced manner. Some people. He remembers with a shudder what it was like when he was holiday rep at that resort, chivvying along the cow-like hordes.
‘O-kay. Breakfast is from half past seven until nine thirty. Between then and throughout the day you’ll find a wide selection of snacks – healthy or otherwise – available from Gerry, our wonderful Bar manager. Gerry’s ham baguettes are world class - and his Banana Daiquiris aren’t bad, either.’
The Receptionist smiles. If it was an attractive woman the other side of the counter, he would say Screaming Orgasm. He is a professional, though. He understands the need for tact.
‘The Silver Leaf Restaurant is open from six thirty with a full a la carte service. I recommend the Fruits de Mer. I would also recommend an early booking, though – particularly today, Mother’s Day … ‘
That was a risk, though. He studies her face to see how she took it. Was she a mother? She was old enough, but what did that mean? He hopes she isn’t here to bury any of her brood. These things happen. He ought to be more careful.
He waits for her to say something. Again she comes back with a lumpy smile.
‘I’m sure you must be very tired and ready to jump in the shower. I see you’ve come from…’ He makes a show of reading her booking entry, but the woman says: ‘Liverpool’
‘Ah – Liverpool.’ He struggles to think of something to say. ‘That’s – a long way.’
‘Yes it is. Thanks.’ She sweeps the room card from the desk and walks off across the lobby towards the lifts. He studies her as she goes, but whilst she waits for a lift to descend she unexpectedly turns to look back in his direction. He lowers his eyes and pretends to be reading something, and when he looks up again she has gone.
**
Richard is sitting on the forward ambulance chair, staring down at his hands as the fingers pick and work at each other.
‘I’ve had enough,’ he says. ‘I’m forty five years old and I’m finished. I just don’t have the energy to carry on. I’d kill myself, but on top of everything else I’m a coward. I can’t even do that right.’
He has been clean of heroin for seven years. He took some training, learned carpentry. Got himself some tools and a job first fixing, got himself a nice little place – not this one. But then work started drying up, he fell in with the old crowd. Took a hit and it all started up again. Today he tried to kill himself with an OD and a bottle of vodka, but incredibly, woke up to hear someone banging on the door.
‘I thought I’d taken enough,’ he says. ‘What have I got to do?’ He looks at the two ambulance people as if they are representatives from an alien civilisation he has no connection with.
‘Throw myself off something, I suppose,’ he says. ‘But how do you do that? Jesus – what a fuck up.’
‘Who called the police?’
‘My mum. She got me on the mobile. She said she was going to come down and see me. From Liverpool. And she’s not well. I’ve fucked her life up and I just keep doing it. I’m no good. Just let me go, guys. I’ll take myself away and no one need ever know.’
The technicians talk to him some more, persuade him to go with them to the hospital to talk to someone there. One last chance. For his mother’s sake if no-one else.
‘I’ll go. But there’s nothing anyone can do. And I don’t want to see my Mum,’ he says. ‘I couldn’t bear it.’
The policeman says he will contact the mother at the hotel and at least let her know that Richard is safe, in the hospital, but doesn’t want to see her just yet.
‘I just don’t have the energy to start over,’ he says.
He looks at the technician, sitting there with his clipboard spread across his knees, surrounded by equipment, light and direction.
‘I just don’t have the energy,’ he says.
A woman appears on the other side of the revolving door. The Receptionist watches as she stands there staring through. Has she not used a revolving door before? This should be good. Although he can see she only has a small holdall – rather masculine, he thinks. Probably her husband’s. Where’s he, then?
As she pushes the door round and makes her way inside, the Receptionist runs a finger down the Expected list and taps it at the likely candidate. Single female, two nights paid, debit rather than credit card. He powers up his welcome smile as she approaches the desk.
**
The basement steps are dark and steep. The two ambulance technicians pause for a moment at the gateway. The one in front pulls a small torch from his jacket pocket, and slinging the bag over his shoulder with his left hand, lights both their way down with his right, until they find themselves in a little square courtyard, crowded with spilling bins and tangled piles of rubbish.
There is a door standing partially open, but the only light visible around it is from deep inside the flat; there is no hall light, and no sounds of life inside.
The first technician puts his foot out to swing the door fully open, but just as he does so his torch illuminates a policeman coming towards them.
‘Whoa!’ the policeman says, putting his hand up against the beam. The technician lowers it. Then: ‘Great. That was quick. Basically, what we’ve got is a forty something guy, very suicidal. He took some heroin today, a bottle of vodka. He’s emotional but not violent. We wondered if you’d mind coming and having a look, see what you think?’
The technicians follow the policeman into the flat, the diffuse circle of light from the torch playing around the hall floor.
‘Sorry about this,’ the policeman says. ‘He’s only got a lamp in the back room for some reason. It’s a dump, basically.’
Walking along the hallway is like walking through a cored, rotten apple, the air mealy with neglect. At the far end the policeman pushes open a door and shows them into a boxy room sparsely furnished with a low sofa, coffee table and a CD radio combo on the floor. The kitchenette that adjoins the room is as chaotic as the bins in the courtyard; in fact, it would be difficult to chose which one would be the safer place to prepare food. Lit as it is by a single standard lamp, the room is a vision of inhumanity. The shadows that rear up from every surface seem more an expression of shock than light.
In the middle of the room there is a man standing, sucking on a tiny, hand rolled cigarette. A powerfully built man, standing rooted in his big black boots, wearing a combat jacket with bulging pockets, at first glance he seems like a workman taking a break. But his mouth is pulled down by the gravity of something lost, and his eyes are rimmed with exhaustion.
**
‘Welcome to the Excelsior, Mrs Plunknett. I do hope you have a pleasant stay. Of course, if you have any questions about the hotel, its services or facilities, or indeed any aspect of your stay with us here today, do please let the desk know, either by using the little white phone in your room or indeed asking down here directly. There’s also lots we can help you with regarding the town, places to go, what’s hot and what’s not…’
The Receptionist nods forward and raises his eyebrows at this point, implying that they both know that what is hot is not at the top of Mrs Plunknett’s agenda. She smiles in a heavy-faced manner. Some people. He remembers with a shudder what it was like when he was holiday rep at that resort, chivvying along the cow-like hordes.
‘O-kay. Breakfast is from half past seven until nine thirty. Between then and throughout the day you’ll find a wide selection of snacks – healthy or otherwise – available from Gerry, our wonderful Bar manager. Gerry’s ham baguettes are world class - and his Banana Daiquiris aren’t bad, either.’
The Receptionist smiles. If it was an attractive woman the other side of the counter, he would say Screaming Orgasm. He is a professional, though. He understands the need for tact.
‘The Silver Leaf Restaurant is open from six thirty with a full a la carte service. I recommend the Fruits de Mer. I would also recommend an early booking, though – particularly today, Mother’s Day … ‘
That was a risk, though. He studies her face to see how she took it. Was she a mother? She was old enough, but what did that mean? He hopes she isn’t here to bury any of her brood. These things happen. He ought to be more careful.
He waits for her to say something. Again she comes back with a lumpy smile.
‘I’m sure you must be very tired and ready to jump in the shower. I see you’ve come from…’ He makes a show of reading her booking entry, but the woman says: ‘Liverpool’
‘Ah – Liverpool.’ He struggles to think of something to say. ‘That’s – a long way.’
‘Yes it is. Thanks.’ She sweeps the room card from the desk and walks off across the lobby towards the lifts. He studies her as she goes, but whilst she waits for a lift to descend she unexpectedly turns to look back in his direction. He lowers his eyes and pretends to be reading something, and when he looks up again she has gone.
**
Richard is sitting on the forward ambulance chair, staring down at his hands as the fingers pick and work at each other.
‘I’ve had enough,’ he says. ‘I’m forty five years old and I’m finished. I just don’t have the energy to carry on. I’d kill myself, but on top of everything else I’m a coward. I can’t even do that right.’
He has been clean of heroin for seven years. He took some training, learned carpentry. Got himself some tools and a job first fixing, got himself a nice little place – not this one. But then work started drying up, he fell in with the old crowd. Took a hit and it all started up again. Today he tried to kill himself with an OD and a bottle of vodka, but incredibly, woke up to hear someone banging on the door.
‘I thought I’d taken enough,’ he says. ‘What have I got to do?’ He looks at the two ambulance people as if they are representatives from an alien civilisation he has no connection with.
‘Throw myself off something, I suppose,’ he says. ‘But how do you do that? Jesus – what a fuck up.’
‘Who called the police?’
‘My mum. She got me on the mobile. She said she was going to come down and see me. From Liverpool. And she’s not well. I’ve fucked her life up and I just keep doing it. I’m no good. Just let me go, guys. I’ll take myself away and no one need ever know.’
The technicians talk to him some more, persuade him to go with them to the hospital to talk to someone there. One last chance. For his mother’s sake if no-one else.
‘I’ll go. But there’s nothing anyone can do. And I don’t want to see my Mum,’ he says. ‘I couldn’t bear it.’
The policeman says he will contact the mother at the hotel and at least let her know that Richard is safe, in the hospital, but doesn’t want to see her just yet.
‘I just don’t have the energy to start over,’ he says.
He looks at the technician, sitting there with his clipboard spread across his knees, surrounded by equipment, light and direction.
‘I just don’t have the energy,’ he says.
Monday, March 16, 2009
ute
Ute is sitting on the floor, half in and half out of the kitchen, a baggy black felt bathrobe plumped up around her.
‘I’d have helped her up but she told me not to. She didn’t want me to see her naked.’
The meals on wheels guy is standing in the hallway looking on as Frank and I squat down beside her. ‘She passed the key through the letterbox.’
‘I tell you I want women ambulance only,’ Ute says in a trembling Germanic accent. ‘Where are the women I had last time?’
‘Ute – have you hurt yourself? Are you in pain?’
She rubs her shin. ‘There perhaps. Here – not so much. My bottom, where I’ve been sitting.’ She looks up at us. ‘And who did you say you were?’
‘The ambulance, Ute. We’ve come to get you up off the floor and see how you are.’
‘I’m not going to hospital. They’ll put me straight in the loony box.’
We help her into a chair, but as soon as she’s settled she says she wants her teeth.
‘I’ll get them for you. Where are they?’
‘In a cup in the bath.’
The flat could not be tidier if it were laid out on a grid. There is a measured distance between the Ercol chairs, the salt and pepper cruet and commemoration tankard, the oil painting of a barge on the sea at sunset, that group of cherubs flying in blessed formation over the gas fire.
Her teeth are where she said they would be, stewing at the bottom of an orange tumbler in the bathtub. The arrangement of teeth seem strangely chaotic; have they worn away into those positions, or did she have an irregular set made for authenticity? Either way, they don’t fit. When she stuffs them into place and tries to talk, she may just as well have crammed a handful of Lego into her mouth.
‘Do what you will – but I’m not going to hospital.’
We thank the meals on wheels man for his help.
‘What would’ve happened if you’d not come round when you did?’ I say to him.
He slaps me on the shoulder.
‘Roast pork and vegetables, Apple pie and custard,’ he says to Ute. ‘See you tomorrow. And stay off the floor.’
‘What did he say?’
‘Roast pork and vegetables,’ says Frank. ‘And if you don’t want it I’ll have it.’
‘Oh.’ She smiles, and her teeth almost pop out.
‘We’ll just give you a check up to see everything’s okay.’
‘Come on then.’ She bunches up her bathrobe.
As I’m taking her blood pressure, she straightens in the chair and points at the door.
‘Who’s that coming in?’
‘No-one. The door’s on the latch and it’s blown open a little.’
‘Oh.’
She settles back as I pump up the cuff. Then she says:
‘I thought it was the nuns.’
‘Nuns? What nuns?’
‘But they only come out at night, so it couldn’t be them.’
Frank brings over Ute’s care folder and points at a section that describes her hallucinations. The list of medications alone are testament to her on-going mental health problems.
‘Where are you from, originally?’
‘Vienna. I came to this country in 1948.’
‘My mother-in-law’s German, too. Prussian.’
‘Really? What part?’
‘Stolp. Of course it’s Poland now.’
‘Ah.’
She frowns at me.
‘Your blood pressure’s absolutely fine, Ute. Everything’s looking good.’
‘Good.’
I roll up the sphyg and pack it away.
‘Yes. She escaped with her life in 1939. She’s Jewish. She just made it out. The British borders were already closed by then, so she ended up in Northern Rhodesia. What’s now Zambia.’
Ute leans forward.
‘Are you Jewish, too?’
‘Me? No.’
‘Of course, Hitler was quite mad, you know,’ she says finally, easing back in the chair. ‘Quite, quite mad.’
Frank writes out the form whilst I make Ute a cup of tea.
‘Thank you,’ she says as I place it on the little wooden table by her side. ‘You’ve even matched the saucer.’
Just behind her on the sideboard is a large old ceramic: an elephant with a tiger on its back. The elephant must have held that expression of terror now for a hundred years or more. Next to it is a small silver picture frame: a man in a yellow t-shirt, grinning massively behind a curly red beard.
‘My son,’ says Ute, replacing the tea cup onto the saucer with barely a click. ‘I haven’t seen him in ten years. Disappeared. Gone. The Salvation Army say he might never be back.’
‘So what happened?’
‘Drugs. The spoon and the candle. And then one day – poof! Not a trace.’
She picks up the tea again.
‘A nice colour, too. You really are kind. I don’t mind a bit you were not women.’
Back outside in the truck, we’ve just closed the door when we hear Rae come on the radio, somewhere the other side of town, updating Control on the outcome of the job they were sent on:
‘The patient was very drunk, abusive, aggressive, declined all assistance, told us to Foxtrot Oscar in no uncertain terms. He’s headed off in the direction of the shopping centre shouting and swearing, and we wondered if you could make the police aware.’
‘Roger to that. Could you pass a description?’
‘Yep. Can’t really miss him. Sixty year old male, big white beard, red skirt, wellington boots, carrying a basket with a toy fox in it.’
‘I’d have helped her up but she told me not to. She didn’t want me to see her naked.’
The meals on wheels guy is standing in the hallway looking on as Frank and I squat down beside her. ‘She passed the key through the letterbox.’
‘I tell you I want women ambulance only,’ Ute says in a trembling Germanic accent. ‘Where are the women I had last time?’
‘Ute – have you hurt yourself? Are you in pain?’
She rubs her shin. ‘There perhaps. Here – not so much. My bottom, where I’ve been sitting.’ She looks up at us. ‘And who did you say you were?’
‘The ambulance, Ute. We’ve come to get you up off the floor and see how you are.’
‘I’m not going to hospital. They’ll put me straight in the loony box.’
We help her into a chair, but as soon as she’s settled she says she wants her teeth.
‘I’ll get them for you. Where are they?’
‘In a cup in the bath.’
The flat could not be tidier if it were laid out on a grid. There is a measured distance between the Ercol chairs, the salt and pepper cruet and commemoration tankard, the oil painting of a barge on the sea at sunset, that group of cherubs flying in blessed formation over the gas fire.
Her teeth are where she said they would be, stewing at the bottom of an orange tumbler in the bathtub. The arrangement of teeth seem strangely chaotic; have they worn away into those positions, or did she have an irregular set made for authenticity? Either way, they don’t fit. When she stuffs them into place and tries to talk, she may just as well have crammed a handful of Lego into her mouth.
‘Do what you will – but I’m not going to hospital.’
We thank the meals on wheels man for his help.
‘What would’ve happened if you’d not come round when you did?’ I say to him.
He slaps me on the shoulder.
‘Roast pork and vegetables, Apple pie and custard,’ he says to Ute. ‘See you tomorrow. And stay off the floor.’
‘What did he say?’
‘Roast pork and vegetables,’ says Frank. ‘And if you don’t want it I’ll have it.’
‘Oh.’ She smiles, and her teeth almost pop out.
‘We’ll just give you a check up to see everything’s okay.’
‘Come on then.’ She bunches up her bathrobe.
As I’m taking her blood pressure, she straightens in the chair and points at the door.
‘Who’s that coming in?’
‘No-one. The door’s on the latch and it’s blown open a little.’
‘Oh.’
She settles back as I pump up the cuff. Then she says:
‘I thought it was the nuns.’
‘Nuns? What nuns?’
‘But they only come out at night, so it couldn’t be them.’
Frank brings over Ute’s care folder and points at a section that describes her hallucinations. The list of medications alone are testament to her on-going mental health problems.
‘Where are you from, originally?’
‘Vienna. I came to this country in 1948.’
‘My mother-in-law’s German, too. Prussian.’
‘Really? What part?’
‘Stolp. Of course it’s Poland now.’
‘Ah.’
She frowns at me.
‘Your blood pressure’s absolutely fine, Ute. Everything’s looking good.’
‘Good.’
I roll up the sphyg and pack it away.
‘Yes. She escaped with her life in 1939. She’s Jewish. She just made it out. The British borders were already closed by then, so she ended up in Northern Rhodesia. What’s now Zambia.’
Ute leans forward.
‘Are you Jewish, too?’
‘Me? No.’
‘Of course, Hitler was quite mad, you know,’ she says finally, easing back in the chair. ‘Quite, quite mad.’
Frank writes out the form whilst I make Ute a cup of tea.
‘Thank you,’ she says as I place it on the little wooden table by her side. ‘You’ve even matched the saucer.’
Just behind her on the sideboard is a large old ceramic: an elephant with a tiger on its back. The elephant must have held that expression of terror now for a hundred years or more. Next to it is a small silver picture frame: a man in a yellow t-shirt, grinning massively behind a curly red beard.
‘My son,’ says Ute, replacing the tea cup onto the saucer with barely a click. ‘I haven’t seen him in ten years. Disappeared. Gone. The Salvation Army say he might never be back.’
‘So what happened?’
‘Drugs. The spoon and the candle. And then one day – poof! Not a trace.’
She picks up the tea again.
‘A nice colour, too. You really are kind. I don’t mind a bit you were not women.’
Back outside in the truck, we’ve just closed the door when we hear Rae come on the radio, somewhere the other side of town, updating Control on the outcome of the job they were sent on:
‘The patient was very drunk, abusive, aggressive, declined all assistance, told us to Foxtrot Oscar in no uncertain terms. He’s headed off in the direction of the shopping centre shouting and swearing, and we wondered if you could make the police aware.’
‘Roger to that. Could you pass a description?’
‘Yep. Can’t really miss him. Sixty year old male, big white beard, red skirt, wellington boots, carrying a basket with a toy fox in it.’
Thursday, March 12, 2009
standby
Standby in the supermarket car park, four o’clock in the morning.
One day I’ll paint this. One day I’ll hang a wide, windscreen-shaped canvas on the living room wall so any time of day or night I could put myself back in this seat and wallow in the desolation of the scene – the recycling bins, the advertising hoardings, the pay-at-the-pump petrol station, the blasted saplings, the factory units beyond the hedge. But where would you buy the colours you’d need? And if you had them, how would you mix them, how would you spread them out, to even hint at the leached-out, down-lit, washed-up inhumanity of the place?
A car pulls over at the recycling bins. An elderly man gets out and begins popping bottles and cans through the correct holes.
Who does that at four in the morning?
We watch him from the cab. He folds the carrier bags as they become empty and piles them up on the roof of his car. He couldn’t do that if it were windy, I think. What would he do if it were windy? He finishes, rolls the bags up, secures them with an elastic band, stows them in the boot.
He drives off.
The car park is empty again.
Busy? Jesus – worst ever! Non-stop all day, every one a proper job. The last one was an arrest in the street outside a shopping centre. I was on my own for about five minutes until Chas came by off duty and pitched in, thank God. Then a crew turned up, so that was a relief. There were a couple of PCSO’s on scene, but I might as well’ve grabbed two shop dummies out of the window, stuck a yellow jacket on them and stood them up next to us all the crowd control they did. Honestly, there must’ve been about two hundred people milling about. The crush was so bad our bags were getting kicked over. One woman was right at the front with her hand over her mouth like this, like she was going to chuck. I said to her: You don’t have to watch this, love. Why don’t you just fuck off and let us do our job? But anyway – we got a few shocks in, he went down the usual PEA – Asystole route. We collared and boarded him in the end because – that was the other thing – he’d whacked his head on some railings as he went down and had this horrible boggy mass at the back of his head. We ran him in, but it was academic. Resus was crammed when we got there. We were coming in the door just as the porters were coming out with that lovely box trolley they have with the green tarp. I wouldn’t have been surprised if they’d been wheeling a handcart. But it cleared a space for us, and the team were nicely warmed up. Honestly – a fucking war zone.
The radio twitters and beeps. An all-call for a Category A breathing problem. Miles away. I hit the mute button and the cab’s silent again. Rae is slumped forward on the wheel, using her arms as a pillow. There’s a scene in that fifties film of The Time Machine where Rod Taylor is powering forwards through time. Slowly at first, the moon and sun chasing each other across the glass roof of the conservatory, and then more quickly, his house falling away around him as the dial spins on the dashboard and hundreds of years fly past, the scene changing constantly and quickly until suddenly a mountain rises up around the machine and he’s locked deep inside the rock, and it’s dark and cold, and he despairs that it’s his fate to be trapped like that forever, as the dial spins through tens of thousands of years until at last the mountain is eroded away and he’s back in the air again.
I check my watch. We’ve been here twenty minutes.
We had an elderly woman burned up in a fire. Fell asleep in her chair, smoking a fag. Dot dot dot. Trumpton were there and they pulled her out – no mean feat, considering her size. Twenty stone, at least. But there was nothing to be done. She was pretty comprehensively cooked. We took her on the vehicle, out of the public gaze, and then it was down to the mortuary. I had to bin my uniform. That’s our truck out front, all the doors open. I wouldn’t take that one for a while.
The car park seems to stretch on forever, following the curve of the planet. There surely cannot be enough cars in the world to fill all these marked out spaces. Where are the people to drive those cars? Where do they live? Instead of cars I watch as each space fills with people lying down asleep. Fragile, lucent figures, arriving alone and in family groups, drifting along, following the arrows, finding a gap, lying down. The petrol pumps unhook themselves and blow a peppermint scented mist across them. Birds fly over with messages held in their claws. One of them swoops down and in through the open window of the cab. It grabs me by the shoulder and begins to rock me backwards and forwards. I look up. Rae is shaking me. I was snoring.
I’ve never seen so much blood – and I’ve been to a few bloody ones. The kitchen was like a paddling pool. The poor old thing was lying on her back, one leg up on a stool. I thought they’d been a murder with a chainsaw or something, but what it was - she’d tripped as she’d come in from the garden and snagged a varicose vein on the concrete step. Amazing she was still alive, the blood she’d lost. And the air – it had a metally twang I’ve been tasting on and off all day. We were off the road for a good hour cleaning up the truck after that one. And the very next job we get? Breech birth infant resus. I’ve never been so tested in all the years I’ve been here. What can I say? That new kid I was on with? What a Jonah.
Rae hits the call button on the radio. After an age of static, Control gets back to us.
‘Vehicle calling, go ahead.’
‘We’ve been here about a thousand years, Control. Can we request an RTB?’
Another pause. Either end of the conversation studying the clock. We’ve been here forty minutes. They could insist we stay the hour.
But: ‘Return to Base, then. Thank you for your help.’
‘No problem.’
She replaces the handset on the little hook, grips the wheel and stares out across the car park.
‘Much as it pains me to leave this place,’ she says. Then starts the engine.
Movement.
I never appreciated how sweet movement is until now.
One day I’ll paint this. One day I’ll hang a wide, windscreen-shaped canvas on the living room wall so any time of day or night I could put myself back in this seat and wallow in the desolation of the scene – the recycling bins, the advertising hoardings, the pay-at-the-pump petrol station, the blasted saplings, the factory units beyond the hedge. But where would you buy the colours you’d need? And if you had them, how would you mix them, how would you spread them out, to even hint at the leached-out, down-lit, washed-up inhumanity of the place?
A car pulls over at the recycling bins. An elderly man gets out and begins popping bottles and cans through the correct holes.
Who does that at four in the morning?
We watch him from the cab. He folds the carrier bags as they become empty and piles them up on the roof of his car. He couldn’t do that if it were windy, I think. What would he do if it were windy? He finishes, rolls the bags up, secures them with an elastic band, stows them in the boot.
He drives off.
The car park is empty again.
Busy? Jesus – worst ever! Non-stop all day, every one a proper job. The last one was an arrest in the street outside a shopping centre. I was on my own for about five minutes until Chas came by off duty and pitched in, thank God. Then a crew turned up, so that was a relief. There were a couple of PCSO’s on scene, but I might as well’ve grabbed two shop dummies out of the window, stuck a yellow jacket on them and stood them up next to us all the crowd control they did. Honestly, there must’ve been about two hundred people milling about. The crush was so bad our bags were getting kicked over. One woman was right at the front with her hand over her mouth like this, like she was going to chuck. I said to her: You don’t have to watch this, love. Why don’t you just fuck off and let us do our job? But anyway – we got a few shocks in, he went down the usual PEA – Asystole route. We collared and boarded him in the end because – that was the other thing – he’d whacked his head on some railings as he went down and had this horrible boggy mass at the back of his head. We ran him in, but it was academic. Resus was crammed when we got there. We were coming in the door just as the porters were coming out with that lovely box trolley they have with the green tarp. I wouldn’t have been surprised if they’d been wheeling a handcart. But it cleared a space for us, and the team were nicely warmed up. Honestly – a fucking war zone.
The radio twitters and beeps. An all-call for a Category A breathing problem. Miles away. I hit the mute button and the cab’s silent again. Rae is slumped forward on the wheel, using her arms as a pillow. There’s a scene in that fifties film of The Time Machine where Rod Taylor is powering forwards through time. Slowly at first, the moon and sun chasing each other across the glass roof of the conservatory, and then more quickly, his house falling away around him as the dial spins on the dashboard and hundreds of years fly past, the scene changing constantly and quickly until suddenly a mountain rises up around the machine and he’s locked deep inside the rock, and it’s dark and cold, and he despairs that it’s his fate to be trapped like that forever, as the dial spins through tens of thousands of years until at last the mountain is eroded away and he’s back in the air again.
I check my watch. We’ve been here twenty minutes.
We had an elderly woman burned up in a fire. Fell asleep in her chair, smoking a fag. Dot dot dot. Trumpton were there and they pulled her out – no mean feat, considering her size. Twenty stone, at least. But there was nothing to be done. She was pretty comprehensively cooked. We took her on the vehicle, out of the public gaze, and then it was down to the mortuary. I had to bin my uniform. That’s our truck out front, all the doors open. I wouldn’t take that one for a while.
The car park seems to stretch on forever, following the curve of the planet. There surely cannot be enough cars in the world to fill all these marked out spaces. Where are the people to drive those cars? Where do they live? Instead of cars I watch as each space fills with people lying down asleep. Fragile, lucent figures, arriving alone and in family groups, drifting along, following the arrows, finding a gap, lying down. The petrol pumps unhook themselves and blow a peppermint scented mist across them. Birds fly over with messages held in their claws. One of them swoops down and in through the open window of the cab. It grabs me by the shoulder and begins to rock me backwards and forwards. I look up. Rae is shaking me. I was snoring.
I’ve never seen so much blood – and I’ve been to a few bloody ones. The kitchen was like a paddling pool. The poor old thing was lying on her back, one leg up on a stool. I thought they’d been a murder with a chainsaw or something, but what it was - she’d tripped as she’d come in from the garden and snagged a varicose vein on the concrete step. Amazing she was still alive, the blood she’d lost. And the air – it had a metally twang I’ve been tasting on and off all day. We were off the road for a good hour cleaning up the truck after that one. And the very next job we get? Breech birth infant resus. I’ve never been so tested in all the years I’ve been here. What can I say? That new kid I was on with? What a Jonah.
Rae hits the call button on the radio. After an age of static, Control gets back to us.
‘Vehicle calling, go ahead.’
‘We’ve been here about a thousand years, Control. Can we request an RTB?’
Another pause. Either end of the conversation studying the clock. We’ve been here forty minutes. They could insist we stay the hour.
But: ‘Return to Base, then. Thank you for your help.’
‘No problem.’
She replaces the handset on the little hook, grips the wheel and stares out across the car park.
‘Much as it pains me to leave this place,’ she says. Then starts the engine.
Movement.
I never appreciated how sweet movement is until now.
Tuesday, March 10, 2009
falling
The blond woman who took an overdose is not where she is supposed to be. No one down on the beach or the promenade seem to know anything about her, who made the call, where she might have gone, who she is, whether she ever existed. A slow, weekend river of people slips around us, absorbing our fluorescent jackets and over-stuffed bags, casually feeling out the potential for drama in this scene, and then moving on with a shared nod or smile, or an innocent re-pocketing of a camera phone, without dropping a step or a word of conversation, on to the next thing.
I feel like a bad street performer failing to drum up custom. We look east and west along the promenade, but there are no signs of anything going on, any concerned groups, any fallen figures. She really could be anywhere.
Someone taps my shoulder. A soupy-eyed woman leans in close, smelling of vinegar chips and a polo mint.
‘Sorry to intrude,’ she says, ‘but are you looking for an elderly man who’s fallen down some steps?’
‘No – but..’
‘Well, just in case you’re interested, he’s over on the steps of the museum. Just thought I’d let you know. No harm done. Goodbye to you.’
And she’s off before I can ask her any more.
Two policemen, their trousers tucked into their combat boots, appear from out of the crowd and plant themselves in front of us.
‘Blond woman? OD?’
‘Yep.’
They lean back, buttressed by their huge black boots, studying the crowd. It feels as if they should be carrying guns, but it’s just their hands tucked into the little front pockets of their flack jackets.
‘We got that too. But no-one seems to know a thing.’
‘Who made the call?’
‘Third party. Absconded. Hoax? You decide.’
‘We’ve got something else going on over by the museum. I think we’ll head over there and see what’s what. We’re not accomplishing much here.’
‘Later, mate.’
Whilst the blond woman was impossible to spot, this patient may as well be carrying a placard saying: Help Required Here. He is still on his feet, but he clutches on to the black iron railings beside him with the grip of someone who has suddenly lost all faith in the predictability of the world. An elderly woman stands beside him with one hand on his shoulder. With her other hand she raises up her handbag as we approach along the pavement.
‘It’s my fault,’ she says, breathily. ‘I lost my footing and pulled Malcolm down with me.’
Malcolm stands unsteadily, his frame rattling beneath his suit. But it seems they only stumbled down a couple of steps; Malcolm has a graze on his hand and shin, is in no pain.
‘Shall we take a slow walk to the ambulance,’ I tell him.
His eyes are scanning the crowd for something, recognition, direction, I don’t know, but when I repeat my question, he suddenly rests his eyes on me, as if he’s surprised that a response would come from something so close by.
‘We can’t miss the coach,’ his wife says. ‘How’ll we get back to the hotel?’
‘Let’s worry about that in a minute,’ I say. ‘Most important thing is to get Malcolm checked out, so we can be sure everything’s okay.’
‘There’s nothing wrong with him. It was my fault. I tripped and pulled him down.’
‘Let’s just take a minute or two on the vehicle, do all the usual checks, and then we’ll see.’
He takes my arm, and we head for the truck.
Malcolm is lying on the trolley with his chest laid bare and dotted up. There is a great knotted scar running down his sternum where the surgeons cracked his chest and performed a coronary artery bypass last year. Implacably the ECG rolls out its lines and numbers as Malcolm takes a minute to cry out the tears he was restraining on the steps. His wife sits on the seat behind him, looking at her watch, kneading her handbag strap.
‘I’m sorry,’ he says. ‘This is all so stupid.’
‘But it’s my fault,’ his wife says. ‘I’m the one who should be in tears.’
‘Why are you so upset, Malcolm?’
‘It was the fall. I felt myself going and – well, I know it wasn’t far – and it all happened so quickly - but just when I started to go and couldn’t stop myself I felt like I was falling into a great big pit, and when I reached the bottom I’d smash into pieces, I’d just fall apart down the middle, whack, and that would be it.’
He cries into the tissue I give him.
We talk about pragmatic things, grounded things, strategies for getting the couple back to their hotel, numbers we could call, whilst Malcolm gathers himself at the centre of all this, dabbing at his face with a wad of tissue, wired up to our machines, falling into the pit again.
I feel like a bad street performer failing to drum up custom. We look east and west along the promenade, but there are no signs of anything going on, any concerned groups, any fallen figures. She really could be anywhere.
Someone taps my shoulder. A soupy-eyed woman leans in close, smelling of vinegar chips and a polo mint.
‘Sorry to intrude,’ she says, ‘but are you looking for an elderly man who’s fallen down some steps?’
‘No – but..’
‘Well, just in case you’re interested, he’s over on the steps of the museum. Just thought I’d let you know. No harm done. Goodbye to you.’
And she’s off before I can ask her any more.
Two policemen, their trousers tucked into their combat boots, appear from out of the crowd and plant themselves in front of us.
‘Blond woman? OD?’
‘Yep.’
They lean back, buttressed by their huge black boots, studying the crowd. It feels as if they should be carrying guns, but it’s just their hands tucked into the little front pockets of their flack jackets.
‘We got that too. But no-one seems to know a thing.’
‘Who made the call?’
‘Third party. Absconded. Hoax? You decide.’
‘We’ve got something else going on over by the museum. I think we’ll head over there and see what’s what. We’re not accomplishing much here.’
‘Later, mate.’
Whilst the blond woman was impossible to spot, this patient may as well be carrying a placard saying: Help Required Here. He is still on his feet, but he clutches on to the black iron railings beside him with the grip of someone who has suddenly lost all faith in the predictability of the world. An elderly woman stands beside him with one hand on his shoulder. With her other hand she raises up her handbag as we approach along the pavement.
‘It’s my fault,’ she says, breathily. ‘I lost my footing and pulled Malcolm down with me.’
Malcolm stands unsteadily, his frame rattling beneath his suit. But it seems they only stumbled down a couple of steps; Malcolm has a graze on his hand and shin, is in no pain.
‘Shall we take a slow walk to the ambulance,’ I tell him.
His eyes are scanning the crowd for something, recognition, direction, I don’t know, but when I repeat my question, he suddenly rests his eyes on me, as if he’s surprised that a response would come from something so close by.
‘We can’t miss the coach,’ his wife says. ‘How’ll we get back to the hotel?’
‘Let’s worry about that in a minute,’ I say. ‘Most important thing is to get Malcolm checked out, so we can be sure everything’s okay.’
‘There’s nothing wrong with him. It was my fault. I tripped and pulled him down.’
‘Let’s just take a minute or two on the vehicle, do all the usual checks, and then we’ll see.’
He takes my arm, and we head for the truck.
Malcolm is lying on the trolley with his chest laid bare and dotted up. There is a great knotted scar running down his sternum where the surgeons cracked his chest and performed a coronary artery bypass last year. Implacably the ECG rolls out its lines and numbers as Malcolm takes a minute to cry out the tears he was restraining on the steps. His wife sits on the seat behind him, looking at her watch, kneading her handbag strap.
‘I’m sorry,’ he says. ‘This is all so stupid.’
‘But it’s my fault,’ his wife says. ‘I’m the one who should be in tears.’
‘Why are you so upset, Malcolm?’
‘It was the fall. I felt myself going and – well, I know it wasn’t far – and it all happened so quickly - but just when I started to go and couldn’t stop myself I felt like I was falling into a great big pit, and when I reached the bottom I’d smash into pieces, I’d just fall apart down the middle, whack, and that would be it.’
He cries into the tissue I give him.
We talk about pragmatic things, grounded things, strategies for getting the couple back to their hotel, numbers we could call, whilst Malcolm gathers himself at the centre of all this, dabbing at his face with a wad of tissue, wired up to our machines, falling into the pit again.
Wednesday, March 04, 2009
running on empty
Bill does not so much stand in the room as continue to remain upright, like a condemned tower overdue for demolition. With a series of jerky little corrections to the vertical, his eyebrows raised and his eyelids half-lowered - the Stan Laurel School of Concentration - he tightens the cord of his towelling robe and sniffs around the perpendicular a few minutes more.
‘Bill? Hello – it’s the ambulance. How are you feeling, mate?’
An absent, smacking of the lips, the effort of which shutters down his eyelids even further.
‘Do you know where you are?’
The question soaks away without effect. But suddenly he says: ‘Bill.’ And then tightens the belt some more.
‘When we got here, he was standing in the hallway, naked. There’s something very wrong.’
The District Nurse is an active, busily thin woman who leans forward as she talks, whiskering out levels of dedication as vital as her own. She has an assistant, a fleshy faced young guy as squashy as she is sharp edged. He smiles, his ginger hair sticking out all angles, and shows us the blood sugar test he has just taken: normal.
The District Nurse tells us what’s happened.
‘Bill was discharged yesterday following investigations for oesophageal varices. There was also some mention of Korsakoff’s syndrome – you know, that dementia-like thing when heavy drinkers don’t get enough thiamine and lose brain function. But other than that, I don’t have much else to tell you, I’m afraid. I must say it looks as if he was discharged without too much thought to his living situation. It’s weird. He’s lined up all his TTOs on the kitchen table, but he’s thrown all the bedclothes off his bed into the corner. I can’t make it out. And he’s not saying anything to help. He doesn’t smell of drink. His obs are okay. I don’t think he’s had a stroke.’
Bill stands in the middle of all this, as massively absent as before.
‘Do you know who we are, Bill? You see our green uniforms? Who are we, do you think?’
I reach up and tap him on the shoulder. He opens his eyes, tightens his belt.
‘Bill,’ he says.
He does have a slight tremor underneath his eyes, the kind of twitch you get after a few late nights or a stressful difficult weekend. He doesn’t seem to respond to pain in the usual fashion, though, so this, in combination with his lack of orientation, has us mark his GCS down.
‘Let’s see if we can walk him down to the vehicle.’
‘Well this I must see.’
Bill is six feet something, a great hairless bear of a man, and his flat is on the third floor. It will take a second crew to help with the lift if we need to carry him out.
‘Come on, Bill. One foot in front of the other.’
I give him a gentle tug on his robe; the distribution of his weight changes, and somewhere deep inside him, some primitive place intact enough to be able to register gravitational shift and make appropriate compensations, sparks off a message to his left leg. It swings forward. Another tug and another step towards the door. In this way we operate him down the staircase.
When we reach the hallway, Rae goes on ahead to reverse the ambulance nearer to the door, fetch the trolley out and position it at the bottom of the concrete steps.
We step outside the front door. It’s like stepping onto the threshold of a vast world of perspective and movement. The early morning flaps about us; the trees in the park lean over, and volleys of birds don’t fly so much as tumble chaotically through the air. Bill stops and grips hold of the iron banister.
‘Harraph.’ He leans forward, supports himself on his left knee. ‘Harraph.’
We have just enough time to stand further round to the side when he empties his stomach. The watery vomitus splatters down the steps. Holding onto his arms, both me and the District Nurse peer into the mess as if we might divine an answer there. Rae comes hurrying up with a bowl and a wad of tissue paper.
‘Let’s get you on board, Bill.’
We move him down the steps, a machine called Bill, running on empty.
‘Bill? Hello – it’s the ambulance. How are you feeling, mate?’
An absent, smacking of the lips, the effort of which shutters down his eyelids even further.
‘Do you know where you are?’
The question soaks away without effect. But suddenly he says: ‘Bill.’ And then tightens the belt some more.
‘When we got here, he was standing in the hallway, naked. There’s something very wrong.’
The District Nurse is an active, busily thin woman who leans forward as she talks, whiskering out levels of dedication as vital as her own. She has an assistant, a fleshy faced young guy as squashy as she is sharp edged. He smiles, his ginger hair sticking out all angles, and shows us the blood sugar test he has just taken: normal.
The District Nurse tells us what’s happened.
‘Bill was discharged yesterday following investigations for oesophageal varices. There was also some mention of Korsakoff’s syndrome – you know, that dementia-like thing when heavy drinkers don’t get enough thiamine and lose brain function. But other than that, I don’t have much else to tell you, I’m afraid. I must say it looks as if he was discharged without too much thought to his living situation. It’s weird. He’s lined up all his TTOs on the kitchen table, but he’s thrown all the bedclothes off his bed into the corner. I can’t make it out. And he’s not saying anything to help. He doesn’t smell of drink. His obs are okay. I don’t think he’s had a stroke.’
Bill stands in the middle of all this, as massively absent as before.
‘Do you know who we are, Bill? You see our green uniforms? Who are we, do you think?’
I reach up and tap him on the shoulder. He opens his eyes, tightens his belt.
‘Bill,’ he says.
He does have a slight tremor underneath his eyes, the kind of twitch you get after a few late nights or a stressful difficult weekend. He doesn’t seem to respond to pain in the usual fashion, though, so this, in combination with his lack of orientation, has us mark his GCS down.
‘Let’s see if we can walk him down to the vehicle.’
‘Well this I must see.’
Bill is six feet something, a great hairless bear of a man, and his flat is on the third floor. It will take a second crew to help with the lift if we need to carry him out.
‘Come on, Bill. One foot in front of the other.’
I give him a gentle tug on his robe; the distribution of his weight changes, and somewhere deep inside him, some primitive place intact enough to be able to register gravitational shift and make appropriate compensations, sparks off a message to his left leg. It swings forward. Another tug and another step towards the door. In this way we operate him down the staircase.
When we reach the hallway, Rae goes on ahead to reverse the ambulance nearer to the door, fetch the trolley out and position it at the bottom of the concrete steps.
We step outside the front door. It’s like stepping onto the threshold of a vast world of perspective and movement. The early morning flaps about us; the trees in the park lean over, and volleys of birds don’t fly so much as tumble chaotically through the air. Bill stops and grips hold of the iron banister.
‘Harraph.’ He leans forward, supports himself on his left knee. ‘Harraph.’
We have just enough time to stand further round to the side when he empties his stomach. The watery vomitus splatters down the steps. Holding onto his arms, both me and the District Nurse peer into the mess as if we might divine an answer there. Rae comes hurrying up with a bowl and a wad of tissue paper.
‘Let’s get you on board, Bill.’
We move him down the steps, a machine called Bill, running on empty.
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