notes on a drowning

A kitchen brittle with light, its neat domestic scene laid open in the afternoon, bright aluminium and white ceramic. Raw wood.
‘I drained the water from the bath,’ the husband whispers as we hurry through. One of my bags hooks a stool over; it crashes to the tiled floor.
‘Don’t worry,’ he says. ‘I’ve got it.’
His wife is lying dead in the emptied bath, legs hooked up on her right side, feet and hands wrinkled and grey from the water, eyes half opened, like someone figuring distance. Her teeth are clamped shut, her lips grey blue, drawn back.
I lean over, grab her under the arms and lift her up into a sitting slump.
Rae gives me her wrists, then hooks her under the legs.
We top and tail her out onto the laminate flooring. The flopping, landed lump of her. Her head bops back on the floor. I start compressions. Her ribs crack for the first three or four. Bloodied water pumps out of her nose.
The Community Responders go into the kitchen to talk to the husband, replaced by an ECP and another paramedic. Some more of the family have gathered in the kitchen. We hear them as we work.
Tubes and pads and cannulas, blankets and inco pads, torn boxes, plastic lids flipped and thrown. Lines and leads everywhere.
Time passes. Someone takes over the compressions so I can pick my way over the chaos and out to organise the exit. I have to go through the kitchen. I want to touch the husband on the shoulder as I pass but he shrinks back from me. They all do. I am death passing through their kitchen. I feel them close back around my absence.

I figure that the best route is through the french windows in the living room and out through the garage. No other angle will work for the scoop. I make the ambulance ready, take the trolley down on the lift, put it into position and then go back inside along that route to make sure everything is clear and ready for the move.

I hear the defib metronome counting out compressions in the bathroom, tagging the seconds as they flow implacably through the house.

Beep, beep, beep goes The Little Red Beacon in the Void.

Beep, beep, beep.

We parcel her up and carry her out.
The second ambulance takes the husband.
I do compressions en route.

The ECP in the back with me manages the airway.
‘It’s been a lovely day today,’ he says, holding the suction catheter with the insouciance of a dentist. ‘Nice and hot.’
He smiles up at me. I shake my head to clear my face of sweat. The sunglasses I had pushed up onto my hair and forgotten about, clatter off into some corner.
The aspirator jug bubbles with bloody water.
‘Good compressions,’ he says. ‘You’re clearing her lungs nicely.’
The ambulance barrels on.

**

As I’m coming out of the resus room I see an elderly couple standing hesitantly by the main doors. The husband’s parents. I take them with me to the relatives’ room, where the husband is waiting. The elderly man lags behind, bewildered, stopping and looking around.
‘Don’t let’s lose Bob. He’s ninety-two, you know,’ she says.
She takes his hand, I take hers, a chain of us through the department to the relatives’ room.
The husband stands up as we come to the open doorway. The foam seats around him in the room are so brightly purple it looks more like a children’s soft play area. But there are leaflets in a rack, a print on the wall, flowers on the table.
‘Can you tell us? Is there any hope?’ the elderly woman says to me as I let go of her hand. The husband looks at me. The question he dared not ask.
I know the woman has been declared dead already, but I say: ‘The doctor in charge is on his way. Let me get him for you.’
Back in the resus room, the doctor is having an earnest discussion close in with a junior doctor.
‘Ah,’ he says to me. ‘Just two things: patient’s name, husband’s name.’
I tell him. He rehearses them, then slaps the junior doctor on the arm.
‘Come on,’ he says, ‘This way.’ And they walk out together, shoulder to shoulder.

hair

Frank answers the phone. He listens to the dispatcher, and after a second turns to look at the seven o’clock crew, star-fished in their chairs watching Top Gear.
‘Mrs Focaccia, he says. ‘Yes – I have heard of her.’
The sevens straighten up. One of them guffaws and claps his hands. ‘Yes!’ he says, and punches the air.
‘Who’s Mrs Focaccia?’ I ask him.
‘She’s a big loaf,’ he says. The other one says: ‘Oh my God!’
Frank replaces the receiver.
‘We’ve got Focaccia.’
‘Who is Focaccia?’
Laughter round the room.

Half an hour later Frank is parking up outside the house we want, a building as ruthlessly square, grey and anonymous as all the others in the street, the only difference being the lack of a wrecked car on the front patch and a concrete ramp up to the door. The architect must have a castle fetish. Even the windows look more suited for shooting arrows than letting in sunlight.
Frank has given me the SP on Mrs Focaccia on the way here. Twenty stones of pure awkwardness and a partner who both in looks and demeanour would seem more at home in an illustration by Cruickshank.
‘Registered blind, but spends his life on the computer,’ says Frank, locking the door. ‘You’ll see.’
I walk up the ramp and knock on the door. A thousand dogs bark close by and far off into the night.
After a pause, bolts are thrown back and the door opened.
Mr Focaccia stands silhouetted in the fierce hall strip light. At first glance he seems to be a tall, middle-aged man surrendering to the effect of gravity. He curls forwards at the belt buckle, and his long, curly black hair hangs down in front of him like a fraying plumb line.
‘Yeah?’
‘It’s the ambulance. Hello. We’ve erm – come for Mrs Focaccia.’
‘This way.’
He swings round and we pick our way through the cluttered hallway after him. He leads us through into the living room.
‘They’re here. Again.’
Mrs Focaccia is lying on her side on a double bed, scrunched up in the far corner. There is a low bookshelf along the nearside of the bed that acts as a partial screen; the foot of the bed has a hospital-style table, and the walls all around the bed are fixed with shelves. Every available surface is piled high with clutter, and any spare inch of wall not given over to storage is blu-tacked with computer printouts. There are some grey-looking sheets rucked up at the foot of the bed; that area of mattress not occupied by Mrs Focaccia is given over to a tideline of wipes, cotton buds, tissues, pill packets, marshmallow cup cakes, cream pots, an ashtray and a pile of newspapers high as Friday.
‘Hello Mrs Focaccia.’
She gives a yelp.
‘We understand you have a back problem.’
Lying as she is on her right side, her right arm tucked up under her head, she looks like the kind of massy abstract sculpture you might find in a park. The mattress craters dangerously around her.
‘So what’s happened?’
Mrs Focaccia tells us the story. History of spondylitis. Wheelchair bound. Coming down the ramp of a taxi a few days ago, wheels rode off the edge, flung forwards, slid down on to foot plates. Pain since. Ambulance at home next day – said to see if any improvement with Ibuprofen. No good at all. Ambulance earlier today – not helpful. Recommended a GP home visit. Said it would be better if the doctor could assess and then arrange for her to go straight to an assessment ward rather than through A&E. GP came. Said just that.
I picture a line of people all pulling off their gloves.
‘I’ll get the trolley out and up to the door,’ says Frank.
‘The first thing we need to do is clear the immediate area. Because of your back injury, we’re probably going to have to put you on a vacuum mattress to keep you nice and straight.’
‘No! No! You can’t clear the bed! I know where everything is. I’ll be helpless if you do that.’
‘But we won’t be able to get you out like this.’
‘No! Gary will do it. Gary’ll get me out.’
Mr Focaccia sighs, rattles through one last email, closes down the computer, sticks a pen behind his ear, stands up and starts foraging for the supplies they’ll need. It may be that my impressions have been tainted by what I’ve already been told, but he seems to gives me a sideways look before crashing awkwardly back into the bookcase as if he misjudged the distance.
‘Oops,’ he says.
‘You can’t do this to me,’ Mrs Focaccia says from her corner.
‘Try not to worry yourself,’ I say.

For the first time I see what makes up most of the clutter around the room. Victorian dolls, forty or fifty of varying size, each shelf like a crowded school photograph, layers of dusty crinoline and lace, row upon row of the same porcelain face, stupefied with paint, each with an abundant crown of curly hair. And then it strikes me that the pictures on the wall are all of the same thing: head shots of Gabrielle Drake, in UFO, her hair a severe purple wig. And then leading across from the pictures, another, deeper shelf facing the bed, also crowded with dolls. But these are bigger, and every one has its hair combed forwards, completely obscuring the face.
Frank suddenly reappears behind me.

‘How are we getting on?’ he says brightly.

I have no idea.

difficult questions

‘Listen. I’ve lived here all my life. I was born here, about a thousand years ago, I should think. Hrmph! So if anyone’s heard of The Old Coach House, I’ve heard of it.’ He frowns. ‘And I’ve certainly never heard of it.’ He grips with both hands on to Ellen’s open window as if he’s tethering the basket of a runaway balloon. He blinks, heavily, and it seems to carry on into a little sleep. Ellen touches him on the arm and he opens his eyes again with a start.
‘Okay? So there you are. Good. I don’t believe it exists, sir. Madam - of course.’
He releases his grip and tries to stay upright.
‘So I suggest you get straight on to Mission Control and check your facts. Good luck.’
He takes a catastrophic step backwards that almost puts him in a hedge, recovers himself, and waves us on. I expect to see him saluting in the rear view mirror.

I drive out of the lane and pull over at the top whilst Ellen calls Control to get a better fix. It’s only then that we see the painted white sign: The Old Coach House, on an opened wooden gate between two high flint walls. Ellen hits at scene and we jump out.

A moment later we’re waiting at the door with all our bags.
A figure appears behind the frosted glass.
‘Just a moment,’ she says, struggling with a top bolt and then turning the lock. The door swings open and an elderly woman stands there, dressed in a heavy brown tweed skirt and jacket, looking so much a part of the house you would think she was struck from the quarry along with the weathered old stones of the walls.
‘Thank you for coming so quickly,’ she says. ‘My eldest daughter Karen’s upstairs. She’s fallen out of bed and I can’t get her up.’
She shows us through the house and up the stairs.
‘I’m afraid my poor darling has cancer very badly. She was discharged from hospital a couple of weeks ago to spend her last days at home, and she seems to have taken rather a turn for the worse.’
‘What’s your name?’
‘Edie. My other daughter is on her way over, but she’s had to come quite some distance.’
‘And how old is Karen?’
‘She’ll be fifty-eight in October.’
Edie stands aside at the entrance to a bedroom simply furnished with two single beds, and waves us in.
There is a woman on the floor, lying on her side between the beds, her knees drawn up, with some of the bedclothes dragged down over herself.
‘Karen – it’s the ambulance.’
She groans. Her legs poke out from under the bedclothes with the waxy white skin tones of a mannequin. There is a dreadful metallic smack beneath the otherwise soft herbal scents of the room. When we get closer we see that Karen has vomited copiously, a quantity of foul, black blood that sticks her hair to her face, stains her mouth, nose and chin, and pools out around her on the carpet. Her lips are drawn back from her teeth, and she stares up at us with eyes so round and deep and lightless it’s like looking through a window onto the abyss. She grabs my arm and tries to talk.
‘I’m dying,’ she gasps. ‘Let me die.’
‘Just hold still, Karen.’
Ellen chucks me a towel and I wipe her mouth and face clear. She clutches on to me, her breath coming in spasmodic gasps
‘Karen’s extremely ill,’ I tell Edie. ‘We need to get her to hospital right away.’
‘Oh no, please don’t take my darling away. If she’s dying I want her to die here with me. That’s what she wants. Please don’t take her.’
Ellen passes me an oxygen mask and I put it around Karen’s face.
‘I have to ask you some difficult questions,’ I say to Edie. She sits down on a low wicker stool.
‘Yes?’
‘Does Karen have a DNAR in place?’
‘What’s that?’
‘A DNAR – Do Not Attempt Resuscitation.’
‘I don’t know what that is. These are her notes.’
She hands Ellen a file.
‘District Nurse, Doctor, discharge home,’ says Ellen, rifling quickly through the file, trying to make sense of the information there. ‘Can’t find a DNAR – but there’s a section here: Karen understands the extent of her condition and wants to spend her remaining days at home with her mother.’
Whilst Ellen is reading this out, Karen stops breathing. I feel for a pulse at her neck.
‘She’s arrested,’ I say, then give her a quick thump in the chest. Ellen hands the file back to Edie, comes over to pull the bedclothes away and to cut off Karen’s nightdress whilst I compress her chest.
‘Oh, please, don’t,’ says Edie.
At once Karen is groaning again. Even before Ellen manages to put the defib pads on, she has a pulse and is breathing. I push the hair back from her face. She claws feebly at the oxygen mask, trying to pull it away.
‘Please, don’t do anything more,’ Edie says.
Ellen and I both know that without a DNAR we should make all due effort. We should be making ready to get Karen out to the ambulance, stabilising her as best we can, putting in an ASHICE to the hospital, the scenario playing itself out before us with wretched inevitability.

We have to make a decision.

The progress of her cancer is plain to see. This is a warm and loving environment. Far better to die here with her mother by her side than on a brightly lit resus trolley.

‘What do you think, Ellen? Shall we make Karen comfortable?’ I say.

We arrange things so she can rest comfortably against the bed, surrounding her with cushions and rolled up duvets. We unplug the defib, and then cover her up with soft blankets from the other bed. Edie gives us a box of tissues and a wet flannel so we can clean her face. Ellen brings the wicker stool over so Edie can sit next to Karen and hold her hand. She strokes it and presses it to her cheek.
‘This is all wrong,’ she says. ‘It should be me. It should be me. My poor darling.’
Karen seems calmer. Her breath comes in short, periodic gasps. Her head relaxes backwards and Edie strokes her forehead.

We have no way of knowing how long it may take for Karen to die. I phone Control to ask for an out of hours doctor, an ECP or paramedic practitioner to attend, but there are none available. The Dispatcher tells me he’ll get a senior manager to ring back to talk over aspects of the job as soon as possible. By the time the phone rings a few minutes later, Karen has stopped breathing again.
‘Has she gone?’ says Edie. ‘She’s gone, hasn’t she?’
Ellen checks for a pulse. After a few moments she shakes her head.
‘I’m afraid so.’
‘My poor, poor darling.’
‘Are you there?’ the manager says on the phone.
‘Sorry. It’s academic now.’ I tell him.
He says he’s logged everything. He understands the predicament, is sympathetic, says he might well have done the same.
I ring off, then contact the police number for a death at home.

I tell Edie that we’ll put Karen back to bed.
‘Would you like some tea?’ Edie says.
‘That would be great.’
I help her down the stairs, then go out to the vehicle to fetch the scoop stretcher.
‘Don’t worry,’ I say to Edie in the hallway. ‘It’s just something to help us lift Karen off the floor.’

The other daughter arrives whilst we’re finishing the paperwork in a spare room. We hear her crying along the hallway.

Later, she comes into the room and shakes our hands. She says she would’ve punched me had I carried on down the other route. She smiles when she sees the cup of tea Edie made us, asks us if we’d like another.

When the police arrive Ellen and I have to give statements. Without a DNAR this is not a straightforward death at home. We’re asked to hang on for a senior officer to come over from the station. We tell him we’ll be waiting outside in the ambulance.

We say goodbye to Edie and her daughter, and take the last of our bags out with us.

The evening has deepened into night. We sit in the cab, and wait, with only the occasional passing car and the moon to light us by.

feeding the poor

When I last saw Zachary he was held between two policemen, blood on his face, his chest bare, the samurai sword he’d fetched from his flat to attack his neighbour with lying on the back seat of the patrol car. Now he is sitting quietly on his own at a table for two in a gastro pub, a fluorescent Little Monkeys baseball cap pulled down low, one hand on his lap and the other draped across a chess board.

One of the bar staff points in his direction and waves us over. The pub has been open half an hour, but even though it only has a scattering of customers, there is a strong sense of margin around this particular section of the bar.
‘Hello Zachary,’ I say. ‘We met a few days ago. You’d been in a fight.’
‘Fight? I’d hardly call it a fight.’ He bobs his head and smiles with a patronising stretch of the mouth. ‘A fight is when two warriors come together for the purpose of practising their art. A fight is a mutual exchange of physical power. I was engaged in a struggle for my very existence on this so-called planet. For some reason – and I’ve studied the problem at a very high level for many years, my friend – as I say, for some reason, there are forces in this world that simply do not want me to live. Can not allow me to live.’
‘Would you like to come with us out to the ambulance, and then we can see what we can do to help?’
‘Of course. Could you just help me with my chess board – careful! It’s a thousand years old, almost certainly the most valuable object in town today.’
He hands me a crudely knocked up article in pine with a chipped walnut veneer and a rickety drawer slung underneath.
‘Oops! Looks like the drawer’s coming off.’
‘It’s a thousand years old. What do you expect? Be very careful my friend.’
The barman smiles and waves.

Outside on the ambulance Zachary lowers himself carefully into one of our chairs, and I sit opposite him on the trolley. I put the chess board down next to me.
‘It’s an exquisite object,’ he says. ‘I acquired it in my travels. Hand built by one of the sacred knights of El Cid. I expect you’ve seen the film. Have a look at the figures. Incredible craftsmanship.’
The drawer has lost its ability to slide out. You have to lift the board up to get to the pieces – a throw of roughly cast nickel figures. I hold up the king. His beard looks like a glob shaken off a soldering iron.
‘I had to come in to town to find food and water. I have no “money”, so I brought something to trade with. You’d think that I could swap a thousand year old chess set for something to eat and drink, but this world has no honour, no love, nothing for me or my kind.’
I put the king back.
‘So how can we help today, Zachary?’
‘I need to go to Southview and talk to the medical experts there. It’s been a difficult time for me and I need some help.’
‘We can certainly take you down the hospital and find you someone to talk to, if that’s what you’d like?’
He winces and bends at the waist.
‘I have pain all over. Chest pain, stomach. My arms and legs are full of cramps.’
‘I’m sorry to hear that.’
He takes off his baseball cap and lobs it onto the trolley. He has dyed his stubby Mohican purple and orange. It runs back to front along the crown of his head like a strip of carpet, whilst around it the scarred and lumpen skin of his skull rises and falls, features on a raised-relief map, the hard ground beneath his shifting monologue.

‘I'm a samurai - but you know that. Since I saw you I’ve had three fights in the temple. Training fights, I can’t say much. But I’m sorry to say that I've been thrown out. Yakumoja has spoken. He has said, and I quote: “You have chosen the way of the fool and not the way of the wise man.” I think that was from Lord of the Rings. Saruman vs. Gandalf. Christopher Lee vs. Ian Holm - or Ian Mckellen, I can never remember which. One of them is gay. Don't know about the other one.’

The ambulance lurches off the pavement. Zachary groans, but quickly recovers himself.

‘I'm a genius. It may sound big headed to say it. Maybe it doesn't. But a fact’s a fact. Anyway, it's not my judgement. Mr Stephen Fry has met five Prime Ministers, and he has put it on record that not one of them could stand toe to toe in the grid against me.’

‘My daughter is amazing. She’s confounded all the experts. She's like Mahatma Gandhi, Britney Spears, Michael Jackson, Barack Obama and Jesus Christ all rolled into one. Elvis Presley himself would not have a thing on her. She's incredible, remarkable. Maths, Physics, Cookery, The Arts. So why society has such a problem with us, won't let me be with her, won't allow me to live .. I don't know.’

‘We're going on a world trip. We’re getting out of this place. Europe, Africa, South America. Perhaps I'll meet ambulance people in those countries. Or maybe not. Hopefully we'll just be travelling around, quietly and anonymously, following The Code, learning, teaching, observing.’

Zachary stares through the slats of the window at the busy afternoon crowds, gently spidering his fingers backwards and forwards along the multi-coloured strip of hair.

‘Feeding the poor,’ he says.

that woman upstairs

It’s a substantial front door, all right. A heavy black affair, panels studded with thickly painted iron rivets, the kind of thing you might see recessed in a castle wall.
‘But we don’t need to force this one. We can get one of the other flats to let us in.’
Three in the morning, and we stand on the steps reviewing our options. The windows off to our right would break open without much problem, but below them is a drop of fifteen feet or so down into a dark basement. Blondin would blanche.
I push the buzzer to flat number one and we wait. A couple of minutes later I push it again. Another couple of minutes, the hall light goes on, a bolt is drawn back and the door swings open.
‘I’m so sorry to drag you out of bed at this ungodly hour…’
‘It’s Vera, isn’t it? She’s fallen again, hasn’t she?’
‘Is there access round the back?’
The woman stands swaying slightly, yawning and rubbing a finger into the corner of her right eye, grubbing out the sleep crust. She drops her hand and looks at me, as if she really expected to have rubbed me out at the same time.
‘We’re really sorry to have got you up like this. We couldn’t think what else to do.’
She gathers her nightgown more tightly across her chest.
‘Why the hell she won’t give us a key I don’t know. Or get one of those little black boxes for the outside. This is the third time this year. You’re going to have to call for a locksmith, maybe even the fire brigade. Last time they needed ladders to get in. You won’t be able to kick the door down. It’s got special locks on it. She’s very suspicious.’
She stands aside and we troop in.
Vera’s door is right in front of us, narrow and solid looking, not an obvious candidate for a swift kicking. I foot it speculatively and it gives at the bottom, but the rest of it seems to have a number of locks.
‘It might go,’ I say, putting my bag down.
‘It won’t,’ she says. ‘You’ll have one hell of a job.’
‘Stand back, anyway. I’ll give it a try.’
‘He likes doors,’ says Rae to the woman. They watch me from the stairs.
I draw myself back and then land a heavy kick squarely on the door just below the Yale lock. My pelvis almost flies backwards out of my trousers.
‘Told you,’ the woman says. ‘I’d call a locksmith if I were you.’
‘I’ve got one more thing I can try,’ I say, trying not to hobble. I unroll our tool kit and pull out a crowbar. I want to say: Say Hello to my leetle friend… but the woman looks at me with such a flat expression I just say: ‘This may make a bit of noise.’
I slam the flat end in the gap between the door jamb and the door, and then lever it back a couple of times as hard as I can. The wood splits, the door booms and shakes, and on the third pull I feel it give enough to stand back, take another big kick and the door flies open in a shower of splinters and unseated screws.
‘Who needs locksmiths?’ I say, dropping the crowbar back onto the roll.
‘Well you certainly do now,’ the woman says. ‘I’ll be upstairs if you need me.’

We go into Vera’s flat.
‘Hello? Ambulance?’
Vera is sitting on the floor of the bedroom, comfortably arranged with her legs stretched out in front of her, leaning back on the bed, talking on the telephone.
‘Yes, yes,’ she says. ‘That was them. They’re in now. Thank you. Goodbye.’ She gently places the handset back in the cradle, and turns her face up to look at us.
‘I slipped out of bed and couldn’t get up.’
Vera has a way of talking that seems as doughy as the rest of her, an air of lumpish passivity that makes her many years older than her given seventy seven.
‘Is that woman from upstairs still there?’ she says. And then: ‘It’s my knee. If you could just give me a hand up.’
We help Vera to her feet and get her back to bed. I check her over whilst Rae arranges for an emergency locksmith to come and fix up the door.
‘I’ll need to be able to let them in the front door,’ Vera says. ‘Perhaps I’d better wait in the living room.’
She hauls herself up and then moves slowly and carefully but without too much difficulty with a couple of sticks through the flat to the living room.
‘That woman upstairs is so stuck up,’ she says as she goes, her words fogging out around her in a monotonously soft and strangely sapping cloud. ‘When she first moved here and I fell over she was around straightaway, of course. Looking at her watch. Saying she had to get back to bed ‘cos she was due in court that day. So I said she shouldn’t worry about things like that. It’s like my husband always used to say: There’s no sense worrying about things that haven’t happened yet. You’ve got to wait until they do happen, because it’s never what you imagine, and never as bad as you think it’s going to be, so all that worrying would’ve been for nothing, and wouldn’t have helped you with what the problem really was in the first place. If you follow me. He put it better. But do you know what she said? She said: Well I’m due in court Vera because that’s my job. I’m a lawyer. Stuck up cow. ‘Scuse my whatsits. But there you are. I take people as I find them and expect them to do the same. Doesn’t always work, though, does it? Shall I put the kettle on and we’ll all have a nice cup of tea?’
‘I’m afraid we have to be going soon,’ I say. ‘Vera? We need to arrange for the Falls Team to visit you. Check the flat out. See what can be done to make things easier. Get a Key Safe put outside, so we don’t have to keep busting your door down in the early hours.’
‘That would be nice. You do that.’
‘We have to be going now.’
‘Look. That’s me when I was a little girl. Scrappy little thing, wasn’t I?’
Perhaps its the early hour, or perhaps the subject moved slightly just before the picture was taken, but the image is smudged and unreal, a hoax ghost, or someone standing off to the side whilst you look straight ahead.
‘Cute,’ I say, struggling to find anything else. I hand her back the picture.
‘I’m sorry Vera. We really have to go.’

Splinters of wood crunch underfoot as we pass back through the hallway.

taking away the power

End of the day and the sky is a ringing, Wedgewood blue. There are two ambulance men standing outside the station, the younger one leaning back against the bonnet of an ambulance, smoking, left arm crooked under the right, the short sleeves of his green shirt rolled up an extra inch to emphasise his bicep, a Maori pattern tattoo stretching and shrinking with the regular backwards and forwards of the cigarette. The other guy, an older figure, a curious mix, peat-digger crossed with primary school teacher, stands with his legs planted shoulder-width apart and his lumpish hands linked together on top of his head.
The younger guy blows out a stream of smoke.
‘We had a hanging today.’
‘Oh yeah? What was that, then?’
‘Young girl. Dressed all in black. Strung herself up in the woods. There was a note in her bag, explaining everything. Why she’d done it. Addressed to her family. All very organised. She’d been there a few days. We heard the buzzing before we saw her.’
The older guy unlaces his fingers, moves his hands down from the top of his head to his forehead, gives it a rub, then folds his arms and looks off into the chestnut trees growing along the front of the station.
‘Pretty bad.’
‘A dog walker found her.’

There is a brief pause, and then a shift in the conversation, a distinctive lurch, like a handle being thrown on some battered old machine.
‘It’s always a dog walker.’
‘Always the same dog walker.’
‘Excuse me sir. I just need to ask you and your dog a few questions. How is it that you decided to go for a walk in this particular neck of the woods, pardon my French?’
‘We just had a feeling. Or rather, the dog did. He got the map out, put a paw on it and started whining.’
‘I see. And that’s the tenth time this week?’
‘Eleventh.’
‘And it’s only Monday.’
‘I know. Jeez! What d’ya gonna do?’
‘What sort of dog might this be, sir?’
‘He’s a Corpsehound. Part Bloodhound, part vulture.’
‘And what do we call it? Damien? Old Nick?’
‘Zoltan.’
‘Very nice, sir. Very nice. I especially like the red eyes. Glowing like coals, I see. Healthy.’
‘It’s all those walks. There’s a lot of ground to cover.’
‘What do you feed him on?’
‘Well, there’s a saving right there, officer. He’s been dead a thousand years.’
‘One last question sir – sir?’
‘But there was no-one there, nothing but a black cape lying on the ground and some cackling in the trees.’
‘You can’t beat a nice bit of cackling.’

The younger guy flicks his cigarette off towards the grass verge.
‘That’s me,’ he says, arching his back. ‘I hope you have a quiet one, mate.’
He picks up his kit, and slouches off towards his car.

pam penistone vs. the covenant

The police have taken Zachary’s samurai sword from him. It lies sheathed on the back seat of the squad car, whilst Zachary stands between the two officers, hunched over and groaning, his bloodied green shirt unbuttoned to the waist. As they lead him to the back of the ambulance he stumbles and winces and holds the sides of his chest. When he reaches the steps he swears bitterly, slows up, but eventually makes the climb and settles himself back on the trolley, one hand up to shield his eyes from the light.

He has been beaten up. His nose is broken, and there is an s-shaped gash in the centre of his forehead; the blood from both injuries has fanned down across his face and dried into an inverted V.

He has shaved his head to the skin except for a strip of hair along the middle. His eyebrows are gone, too, and beneath the crusted blood you can just make out a minutely shaved goatee beard tracing the outline of his lips and mouth. Zachary’s head has a dreadful topography; his face is something crudely sketched onto the edge of a monstrous broad bean, the forehead overhanging the eyes which glitter in the shadows beneath it. The wide spread of his skull seems soft, swelling in unexpected places, almost as you look at it, like someone squeezing a water-filled balloon. And when he talks, the pressure of that invisible hand seems equally present in his words. They patter out quickly and quietly, hissing little rushes of violence that whistle out through his teeth.

At the end of each phrase, he purses his lips and gives his head a little sideways wobble, as if the terrible injustice of his case hardly needs repeating. But he needs his audience to be quiet. If I say anything, he looks in my direction only for as long as it takes to gauge the distance between us.

‘Pam Penistone. Bitch witch. May she rot in hell for all eternity. As if the Devil would want her down there. He’d never get the stench out.

‘I am an incredibly educated man. I speak ten languages. I can do any accent there's ever been. I can quote Shakespeare, the Greek philosophers, the Bible. And yet that maggot-ridden hag Pam Penistone and her halfwit boyfriend Tony think I'm nothing but a bag of shit to kick to the floor. Do they think I have no power? Do they think I don’t know what they’re about?

‘I’ve had the country’s best psychiatrists working on my case. They don’t know what to make of me. I can sing any opera that’s ever been written. (whistles a snatch of the Toreador’s March.) Carmen by Bizet is as Spanish as the Champs Elysee.

‘My daughter is the only thing worth living for. But Pam Penistone, the Poisonous Minge has taken her over, turned her against me, her and that retard boyfriend of hers. But she knows who I am and what I’m capable of, even if they don’t.

‘I’m not a samurai. I wouldn’t put myself in the same class as those mythical warriors of old. I have too much respect for who they are and what they can do. There is a code that needs to be observed. But I’m not giving too much away if I tell you that I am a member of a secret and highly trained covenant. There's an underground army of warriors I can call on at any time to do my bidding. And I’m certainly going to instruct them to kill that whore Pam Penistone and Tony, her worm of a sidekick.

‘I'll have them killed. Or maybe not killed, but forced to suffer each other for a thousand years. That would be punishment enough. A thousand years to roll around in each other’s shit. And then be killed.

‘When I married the Witch Penistone I was desperate to leave home. I was being abused. I didn’t know the first thing about anything. But that first night we slept together, when she was sleeping, I looked inside her knickers. And you know what? They were caked in shit.

‘I didn't know then what I know now. I’m an expert on the classics. I'm like Achilles, or Hector. She could've been my Helen, Helen of Troy. But if the thousands of ships had any idea what they were really sailing towards, they would have turned round and come straight back.

‘I’ve studied military history. I used to have a set of Napoleonic soldiers. A thousand pieces, worth ten thousand pounds. But that whore Pam Penistone stole it. She stole it whilst I was in hospital last time. When I came out I couldn't prove it but I knew she'd done it. I'll have my justice, though. I'll see she pays. I'll make it my dying wish. My one true aim in life.

‘See these scars on my chest? I did those. I don't choose to call it self-harm. That's someone else's label. I don’t live by labels. These are simply the marks I make on myself to remind me of all the times I've let my daughter down. To remind me not to be late in future.

‘Tony was a gentleman to begin with. Pam Penistone led him on, she forced him to act like a monster. He's a trained killer. He respects what I can do. But just then I chose not to take action. I just stood there and let it come. He could've killed me, but he saw what I was about and held back out of respect. He knows. But Pam Penistone has her claws into him too deep.

‘I've had forty five of the top psychiatrists in the land. They call me a genius – well, that's just their words, their understanding. Genius? No - just someone with special powers who's been shat on for so long he can't take any more.

‘I kicked the drugs and the drink. I only used to smoke because I liked to see the little red point of light at the end. I'd take a drag - see it glow and think - ooh, what's that? - then - here, you take it. Not bothered. Done. Kicking the drink was harder than kicking the drugs. Legal drugs.

‘This world is fucked up, my friend. Fucked up and finished. There's no honour or love any more.

‘I just feel sorry for them. They don't have the love that I do. So I’ve decided I’m going to handle this all legal and above board. I don’t seek vengeance. That is not the way of the Covenant. But I do seek justice, and I do seek punishment. And if I don’t see justice, and I don’t see punishment, let me give you all fair warning, you and your newspapers. Write this down. There’s a bloodbath coming the likes of which this world has never seen.’

four sitters

#1: Man, thirty. On the end of an empty row of sculpted blue plastic seats in the town’s new walk-in centre. White shirt, wide grey fabric braces, khaki trousers, heavy walking boots, everything muddied, as if he’d just walked in from an eighteenth century harvest. His face is long and dusky, pointed at the bristled chin like an ant in close-up, his hair tangled, desiccated. When I ask him his name he smiles efficiently, watching me closely.
‘I don’t believe in possessions. I suffer from Dextroprodesiacondraplasia. Hah! Spell that! I suffer from Memory Ankylosaurusemia. Second formation. You’d know. Something like. Mmm. And in the evenings I’m surrounded by voices. Etcetera. But you don’t want to hear about them.’

#2: Woman, ninety. On a rustic wooden chair in a bright blue hallway furnished like an art gallery with framed ceramic tiles of fish and farm animals, broad abstract oil paintings and delicate swatches of Chinese silk. She is wearing a simple white robe gathered loosely around her waist, open at the chest, one leg tucked in to her and one off to the side, an arm draped over the back of the chair, in a pose you might expect from an artist’s model.
‘Fallen on the floor? What nonsense. I’m absolutely fine,’ she says. ‘Who called you? I’m simply waiting for my carer.’

#3: Man, forty. Sitting on the edge of an unmade bed, his arms close in to his sides to keep him propped upright, legs apart to make room for his grossly distended belly, a veined and vegetable thing, laparotomy scar zipped up from groin to middle like the linea nigra of a pregnant woman.
‘It’s the ascites again. I’ve been a silly boy. Drinking all week. Totally my own fault. I expect I’ll have to go in again for another drain.’

#4: Man, twenty. Sitting bare-chested in a dark shop doorway, his face and body smeared with the blood that has run down from the cut on the crown of his shaved head and the split on the bridge of his swollen nose. He has his legs drawn up, resting his hands on either knee. He looks like a wounded hunter, staring out into the crowds, wondering where his prey could have gone.

There is another young man standing leaning over him. His arms and hands are covered in blood, too, the hunter’s blood. He is shouting down at him to go on to the ambulance to get some help. An ambulance man taps him on the shoulder and asks him to stand to one side; he tells him to be careful about getting the wounded man’s blood on him; there are antiseptic wipes and gel on the ambulance if he’d like to get cleaned up. The man says he doesn’t care. He says if he saves one life tonight and dies as a result it will all have been worth it.

The hunter jumps up, pushes the man aside and runs off down the street.

bear knows best

‘I really don’t know what he wants with me. I think he thinks I’m gaga.’
Deidre loons at us through her glasses and taps the side of her head, missing with the last tap and almost falling out of her arm chair with the momentum of it. ‘But it’s all there,’ she says, righting herself. ‘I just wish I could find my glasses.’
Frank looks up from his clipboard.
‘You’re wearing them, Deidre,’ he says, then carries on writing.
Deidre makes a whooshing noise.
‘Not these glasses, silly,’ she says, taking them off, waving them around, then holding them at arms length and frowning. ‘My other glasses. The ones that help me see.’
Frank sighs.
‘As you have probably worked out, Deidre has been drinking this afternoon.’
‘I like a drop of whisky and I don’t care who knows it,’ she says, straightening up and scrunching her face into a dreadful mug of indignation. But just as suddenly she deflates onto her right arm which struggles to keep her propped up. ‘What on earth does he want with me?’
There is half a bottle of Teacher’s by the side of her chair, and the mahogany sideboard opposite is bright and clink-full of spirit glass. Deidre’s flat is an overheated, lace-edged box of disorder, just one neatly arranged bookshelf of hardback first editions standing like a last stockade of sobriety and reason.
‘I found her crashed out on the landing,’ says Frank, clicking his pen shut. ‘I woke her up and helped her walk into the flat. There doesn’t appear to be anything wrong, so would you mind if I push off now? I finish in quarter of an hour.’
Deidre reaches out to tug at his elbow.
‘I know you,’ she says, wagging her finger at him. ‘I’ve seen that handsome face before.’
Frank takes her hand.
‘Deidre. Take care of yourself. Don’t drink too much and don’t go worrying the residents by falling asleep in the hallway.’
She stares at him, focuses, then splutters into a laugh.
‘I love you when you’re cross,’ she says. ‘I absolutely love you, pet.’
Frank shakes her hand.
‘I love you too, Deidre. But I have to be going.’
Suddenly she wraps her other hand around his, and Frank struggles to pull away, caught like a careless diver in a giant clam.
‘What have you done with my glasses?’ she says.
‘These lovely people will help you with that,’ he says, and smiles across at Rae and me. ‘Won’t you?’
I sit down on the sofa and grab a teddy bear onto my lap.
‘I’ll find your glasses, Deidre,’ I make it say. It leaps off my lap and stomps off around the edge of the sofa.
‘Look at that silly bear,’ she laughs, throwing her hands up to clap them together, allowing Frank to go free. ‘He hasn’t got a clue. As if I’d have dropped them down there.’

last delivery

The garden centre is on the outskirts of town, high on the edge of a ruck of ground, its pointed canopies dark against the sky.

Man collapsed. This has to be a member of staff. The place won’t have opened yet.

Rae swings the ambulance round into the broad and empty car park, up towards the glass frontage of the building. There is a man standing just off to the right of it, and he points with a straight arm off to his left, to a track that runs around the side of the building.
‘He’s in the loading bay,’ he says as we draw level. The only way to get there is to go back out of the car park and drive round, but that’ll take a while, so I jump out, grab the resus bag from the back, and tell Rae I’ll see her there.
‘We’ve been unloading the lorries this morning,’ the guy says as we walk quickly, side by side. ‘This was the last delivery. The driver fell asleep in the cab and we can’t wake him.’
There’s one lorry parked with its cab towards us at the end of the track. I can see the driver high up behind the wheel, leaning back in his seat with his head resting to the side against the window, his eyes closed and his mouth slack.
‘We don’t know anything about him. He’s not a regular.’
I open the passenger door and climb up into the cab. Before I even touch him I know he’s arrested. I brace myself between the steering wheel and the chair, give him a thump in the centre of his chest, and start compressions as best I can in that position. He’s a heavy man, probably twenty something stone. The cab is about six feet off the ground. The man who brought me here is looking in through the passenger door.
‘We’re going to need you and a couple of your mates to get him down onto the ground. Quick as you like.’
But Rae is here now and a couple of other centre workers have come out by themselves. Rae tells them to grab hold when I open the door. I pull the latch, the driver sinks out head first into the open air and is handed down in a lurching descent to the ground. The workers step aside. I get back on his chest.
‘Anybody know anything about him?’
‘He’s from up North.’
‘How long do you think he was like this?’
‘Fifteen, maybe twenty minutes. Not much longer.’
A second ambulance arrives.
We follow the protocol, but get nothing.
I check the man’s pockets. A handful of coins, some keys. I ask one of the garden centre workers to look for ID in the cab. He comes back with a wallet and a mobile phone. I read out the man’s name from his driving licence.

We can’t do any more here, but the patient is still well perfused.
We scoop him onto our stretcher and run him off to hospital.

There is a crash team waiting for us in resus. I call out the story as we slide him from our trolley onto theirs.

When the team are well into their run, I leave the room to go and book the patient in and start on the paperwork. I’m half way through when one of the crash nurses comes out to me.
‘They’ve called it,’ she says. ‘Someone has to ring the family.’
And she taps his mobile phone gently, absently, in the palm of her opened hand.

sleeping it off

The early hours, thick and blue with the threat of more rain. The storm never did come, and these showers have done nothing to clear the air. I feel cut out of the sticky atmosphere, a jigsaw shape man forcing a path through the picture.

We see our patient. She lies curled on her side in front of a department store window and its display of partying mannequins. They hold their gorgeous poses, plastically fabulous, perfectly removed from the life on the pavement just the other side of the window.

Three taxi drivers from the rank opposite point in the woman’s direction. With the ragged groups of clubbers laughing and pushing each other, the street cleaners making a start on their rounds, the rough sleepers arranging their nests in shop doorways and the delivery drivers leaning out of their windows, the whole scene is like some epic Dutch canvas, each component part a drama in itself, but somehow contributing to the drift of attention that leads the eye across the road and beyond the taxis to the woman lying on the pavement, lit by the shop window.
‘It’s Sonia,’ says Rae.
Sonia is a regular caller, her MO being pseudo-fits and feigned unconsciousness.
‘Hello Sonia,’ I say, squatting down beside her and lighting up her face with my torch. ‘It’s the ambulance.’
One of the taxi drivers – maybe the one who called – takes a few steps closer and leans in.
‘You know this lady?’
‘Yes. I’m afraid so.’
‘What’s the matter with her?’
‘Actually nothing. She just does this now and again.’
‘Why? Is she crazy?’
‘You’d have to ask her.’
He turns and walks back to his colleagues. One of them laughs. Some clubbers shout encouragement to us. I think they want to see some ER action. But instead of masks and tubes and cylinders, I just give Sonia a discreet squeeze.
‘Come on Sonia. We know you’re not unconscious.’
She opens her eyes and looks at me.
‘What are you doing down there?’ I ask her. ‘People are worried about you.’
‘I’m sleeping,’ she says. ‘Fuck off.’
‘You can’t sleep here on the pavement like this. People think you’re sick or hurt.’
‘I don’t care.’
‘Well you should care, Sonia. If you don’t get up and find somewhere a bit more sensible to sleep, we’ll get the police running.’
Her eyes widen and her mouth tightens into a scowl that reminds me of Popeye when he’s reached the fighting point.
‘If you’d had four cans of lager, four cans of cider and a half bottle of vodka, you’d have trouble standing up and finding a nice place to sleep.’
‘You’re absolutely right about that, Sonia. I’m a notorious lightweight. All I’m saying is that you have to find somewhere a bit more out of the way to sleep it off. You’re not getting a ride up to the hospital. We’re going back to the ambulance now, and I’ll tell the police that you’re here. So you’ve got about ten minutes before they arrive.’
‘Fuck you.’
‘Okay. Bye then, Sonia.’

We walk back to the ambulance.

A group of three clubbers making for the taxi rank step aside as we pass. One of them, a radiantly blond young woman who looks as indestructible as one of the mannequins in the window, shakes her head and frowns at us. I want to tell her that the woman we’re so callously leaving on the floor is very well known to us, that she’s drunk, abusive and a disproportionate drain on public resources. But I don’t say anything. I simply grimace and nod and pull off my gloves with the shamefaced snap of a cut-price surgeon hurrying away from his latest crime.

curtain call

There is a dense strangle of vegetation either side of the track that leads up to the allotments; ferns and nettles, cow parsley, brambles, buddleia, bindweed and spindly grey willow – only the backwards and forwards of vans and cars keeps the track clear. Just a week without a visitor in these fertile days of warm sunshine and drenching rain, and the track would be completely lost.

Now, there are two cars stopped at the far end of the track one behind the other, their drivers out and leaning over a man lying on his back across the path. The people look quite content. The man is breathing, the sun is shining, the ambulance has come quickly. A woman in huge wrap-around shades smiles at us as we approach.
‘No rush,’ she says, and begins rolling a cigarette.

The man on the ground has long ropes of tangled hair and his jeans are ripped in several places. He seems as wild as the vegetation around us; in fact, you could easily believe some strange plant at the margin had just come into fruit and spilled him onto the track. When I lean over him and lift his eyelids, his washed grey eyes have pupils so pinpoint and alien he must either be a fallen woodland divinity or a user smacked out on heroin. Either way we decide to give him some Narcan.

The magic works.

Within five minutes he is sitting up, apologising, politely telling us his name is Marshall. He says he doesn’t want to go to hospital, but we persuade him to come onto the ambulance so we can move out of everyone’s way and have a chat. He only agrees to come on board if we promise we’ll leave the door open. We help him to his feet, up the little side steps, reverse back down the track to a passing point, and the other cars move on.

‘I’m not a user,’ Marshall says, almost falling off the chair as he rolls up the sleeves of his shirt to prove it. ‘I haven’t got a Roger Rabbit.’ Although there are only a couple of needle marks in one arm, both wrists carry stripes of scar tissue testifying to another kind of history.
Suddenly he says: ‘I’m gonna be sick.’
Before I can grab a bowl he has stumbled back down the steps and, leaning against a rough wooden fence by some compost heaps, empties his stomach onto the ground.
‘Sorry,’ he says as Rae hands him some tissues. ‘Sorry about that.’
We tell him we’d like him to come to hospital so someone can keep an eye on him. The Narcan will wear off. He’ll fall unconscious again. Maybe no-one will find him. He could die.
‘Don’t care if I do,’ he says. ‘I’ve had enough. I’ve tried really hard but I just can’t seem to get anywhere.’
He frowns at us, as if before this point we were strange, translucent figures of green who are only now beginning to take on a human form.
‘I’m a poet,’ he says. ‘Would you like to hear one?’
So Marshall stands by the fence, suddenly taller and more centred. He starts in on his poem, leaning into the lines, jerkily moving his legs and his hands like a market trader marionette, relishing the tricky skips of his words, riding the performance to the end.
He gives us a modest little bow when he’s done.
We both clap.
‘That’s fantastic, Marshall.’
‘Thanks. Thanks a lot.’
He rubs his nose and seems to fade again. He tells us about his website. His stage fright. His partner and her unsympathetic friends.
We ask him if he’ll come with us to hospital.
‘I can’t. They’re all back at the flat waiting for me to watch Billy Elliott. They’ll wonder where I am.’

We stand there by the fence.

A young family walks by and I nod to them but they’re confused by the scene and hurry past.

Marshall pushes his hair back from his face. He looks pinched and pale, like a child suddenly grown old, or an actor who started his performance in a packed theatre only to find that by the time he reached the curtain call, the walls and roof had disappeared and been replaced by a jungle.

musketeer

Ella Mae.
More an ululating cry than a name.
Ella Mae.
With a name like that you’d expect a Southern American dowager cooling herself beneath the frangipani with a cheroot and a banana daiquiri. What you get is a crazy old nurse - piratical eye patch, wide-brimmed hat - hunched on a mobility scooter, hooking at the scenery with a nicotine-dipped finger.

The latest job Control sends through to us is to Ella’s address. Before Rae even acknowledges receipt, she calls up the dispatcher.
‘Can’t she be dealt with over the phone?’
‘The line went dead, so I’m afraid we’ve got to attend.’

Ella Mae lives in a house that must once have been part of the old chapel next door. Perhaps a sexton lived here, simply and devoutly, rising with the sun every day to oil the pews, dust the books, water the stone planters and wash the steps. But the chapel has long since surrendered its prayerful space to mezzanine floors, sofa beds and plasma screen TVs. And if the adjoining house ever maintained a quiet devotion, that energy has been abstracted now into something altogether more fallen, more tragically human.
The stone planters are filled with lurid plastic flowers and wired bees, fragments of mirror, twirling seaside windmill sticks, dolls and damaged plaster birds. There are notices taped to the glass in the door, written in a cramped and furious hand, threatening actions, offering warnings, describing on-going litigations. Amongst the notices are random postcards faded with age: Puffins on the Gower Peninsula; Greetings from Hawaii. Public safety announcements from the national press. Black and white photographs arching back from the glass as they curl in on themselves.
Rae raps on a glass pane.
‘She gets exactly one minute.’
But Ella Mae has been staking out the door. The filthy net curtain that hangs behind all the paper in the window is immediately hooked aside, and her gaunt face looms out.
‘Who is it?’
‘The ambulance, Ella. Open up.’
‘What do you want?’
‘Well that’s exactly what we’d like to know from you. Open the door please.’
We hear a crash as she reverses her scooter.
Rae turns the handle and pushes the door aside.
A caustic fug of smoke envelopes us.
‘Put your cigarette out, Ella. We’re not coming in until you do. In fact, not even then. We’ll stand here in the fresh air whilst you tell us why you called the ambulance.’

It’s difficult to understand her when she talks. Even if her false teeth – glitteringly grey and black, like the scales on a mackerel – actually fit her mouth; even if she hadn’t ripped up her voice with an unbroken chain of cigarettes stretching tip to tip from VE day to this knock on the door; even if she hadn’t drunk a bottle and a half of vodka tonight, her thoughts are so whirled around and mixed into each other it’s almost impossible to follow what she is saying. The only thing you can do is let your mind roam freely through her speech, picking up odd scraps of sense and laying them down jigsaw-style until a pattern emerges.
‘So nothing new has happened tonight?’
This seems to be the case.
‘We’ll be going then, Ella Mae. You know you’re not allowed to do this. You know you’re wasting time and stopping someone else from getting help, someone who might really need it. You used to be a nurse. You should know these things.’

But Ella seems to be saying that there is someone else in the house.
Someone called Musketeer.
‘Do they need our help?’
Ella nods as if we were idiots, then reverses further into the living room, a space so junked she really could do with a bucket on the scooter, like a mini-JCB.
‘Hello?’ shouts Rae, then we wait and listen. ‘Hello? Anyone there?’

After a pause, which Ella takes advantage of to light another cigarette, Rae says:
‘This is ridiculous. Ella. We’re off. Please don’t call again.’

But just as we turn to go, we hear it.
A faint call from deep inside the house.
‘Hello? Anyone there?’
That call again.
Ella sits puffing on her cigarette, staring at us triumphantly.
‘Musketeer,’ she says.
We brave the smoke and follow the scooter-width track through the junked up space of the living room out to the hallway. Incredibly, there is an elderly man nesting in a space he has made amongst all the books and magazines that completely obscure the bottom of the stairs. He is wrapped in a blue quilted sleeping bag.
‘Hello,’ he says.
‘Are you Musketeer?’
He smiles and tries to smooth down his wild, white hair.
‘Don’t listen to her,’ he says, then mimes someone sipping from a glass. ‘All night,’ he adds as a rider. ‘Crazy.’
‘So you’re okay, are you?’
‘I’m fine. Just trying to get some sleep, you know?’
Ella has made it through to the hallway, too.
Now she is saying there is something in the bathroom, too.
We look at Musketeer.
‘Oh, there is,’ he says, with a simple smile. ‘Take a look for yourself.’
This is the furthest either of us has made it into Ella’s lair. The light doesn’t seem to work here. I hold my torch up and we take careful steps towards the bathroom door, a slide-aside affair, half off its tracks and revealing an awful looking cavern beyond. I push the door more firmly aside.
The bathroom is as junked as the rest of the house.
I prod around with the torch throwing ghastly shadows against the walls until Rae finds a light chord and snaps it on.
There is a foetid smell coming from the bath.
We go over to it.
For a moment it looks as if there is someone in there, hiding under a clothes horse that has been dumped across the top and then covered with rags. But when I reach down to touch it, the shape is revealed as a bundle of filthy clothes.
‘I want a report made of this,’ says Ella from the hallway. ‘An official report.’
From his nest back in the hallway, Musketeer gives a low, appreciative laugh.
‘I’ll never get to sleep at this rate,’ he chuckles.

junk abraham

This playground has a post-Apocalyptic feel. Set up some years ago on a rise overlooking the great grey spread of the city, now the damaged seats of its swings rock gently backwards and forwards, worked by the ghosts of children long since grown up and gone. Mature weeds thick as trees rise up around the margins; the yellow slide stands water-stained and peeling; even the roundabout seems more like an abandoned instrument of torture than a plaything.

There is a cratered path that leads up alongside the playground, eventually widening into a patch of open ground and a signposted footpath to the downs. A woman with a child in a red buggy waves us along in that direction, then hurries off, the buggy wheels skittering on the grey granite chippings, the child leaning out to look backwards and see what the mother is so afraid of.

We come to a battered blue car with the driver’s door standing open.

A man is lying flat on his back on the ground, at right angles to the car, his arms spread out either side of him. There is another man kneeling beside him. He puts his mobile phone away as I jump out of the cab.
‘My brother,’ he says.
‘He’s got a pulse but he’s not breathing,’ I say to Rae. As she pulls out the resus and drugs bags I crouch down at the unconscious man’s head, lift his chin forwards to open his airway, and prise open his eyelids to check his pupils.
‘When did he take the heroin?’ I ask the man. He raises his eyebrows, smiles and shrugs, turning the palms of his hands towards me in the internationally accepted mime for: I’d like to help you, but…
‘We’re not the police. We just need to know so we can treat your brother. What’s his name?’
‘Rich.’
‘Did he smoke or inject?’
The man scratches his head roughly, then says:
‘Inject.’
‘When?’
‘Fifteen minutes ago.’
An ambulance car wallows along the pathway and scrunches to a stop next to us, kicking up a cloud of dust that’s snatched up by the wind and carried off towards town.
Rae hands me an airway which I put into Rich’s mouth, and then the BVM and oxygen so I can start bagging him. Frank is with us now. I ask him to draw up a syringe of Narcan. But just as he gets the kit together, Rich makes a sudden convulsive gagging motion, reaches in to pull out the airway, and sits up.
‘You see the effect I have?’ says Frank.
‘Hello, Rich. You were a little bit flat, mate,’ I say. He sits staring vacantly at the car, turns to look at me, then back to the car, like a man who has woken up inside a dream but doesn’t yet know how to influence what happens next.

A woman walks past with a black and white collie.
‘Morning!’ she says brightly, hauling on the dog’s lead, striding off towards the footpath. ‘Lovely morning!’ The dog regards us with fierce yellow eyes.
‘How are you feeling now, Rich?’
He grunts.
His brother gives him a push on the shoulder.
‘You were blue, mate. Honestly. You were so gone.’
Rich studies him with the expression we just saw on the collie dog.
‘What?’
‘Come and sit on the ambulance so we can check you over.’
We help him up.
As he leans forward and his t-shirt drops back, I notice he has a tattoo at the angle of his neck: a pair of angel wings either side of an Egyptian eye.

He sits up on the ambulance and submits to an examination. We leave the door open. The sky is overcast, but now and again the sun breaks through and touches a tiny row of houses way off on the far side of town with a gilding splash of light.
‘I’m supposed to be at work today,’ he says, rubbing his face. ‘I’m a Painter and Decorator.’
‘I can’t imagine getting smacked up can do much for your roller technique,’ says Frank, leaning against the door jamb, smoking a roll-up.
Rich looks at him. ‘I can’t help it.’
‘It must cost you a fair bit.’
‘Sixty pounds a day.’
‘Sixty? That’s a lot of paint.’
‘You could say.’
Rich’s brother has been back over at the car, but he comes back carrying a little white puppy.
‘Look what we bought yesterday,’ he says, holding it up in the air. Wrinkled and fat, its paws spread helplessly either side of the man’s encircling hands, the puppy could pass for the Lamb of God, hoisted up on a mountain top, hairless and helpless and utterly subject to the vagaries of a world it knows nothing about.

forty quid

The window of the All Night store is heaped with a selection of goods you can expect to find inside. Jumbled and incoherent, it looks like the window dressing equivalent of a supermarket dash, a bored employee given sixty seconds to swipe as much as they can from the shelves and throw it in the window. And if this is a representative sample, what’s mostly on sale in this shop is beer and spirits. Dusty pyramid piles of bottles and cans rise up precariously against a background of dessicated celebrity magazines, boxes of sanitary products and a toy ambulance standing by in a yellowing plastic bubble. The whole scene is back-lit by the strip-lighting from within, and a purple neon sign that flashes on and off throughout the night and day: 24… Hour… Off… Licence.
Next to the store is a battered black doorway. It stands open to reveal a cavernous hallway with letters on the floor, as if the postman had thrown them there, too scared to go any further. A flight of stairs rises steeply upwards at the back of the hall. We step inside and walk up.
‘Hello? Ambulance?’
‘Up here.’
Short stubs of staircase switch back on themselves seemingly without logic, following the hidden architectural demands of the shop underneath. But eventually they lead us up to a large sitting room where two men hang back against the far window and a young blond girl lies motionless on her back on a wide, dark green tartan bed.
‘Help her, man. She gone. I think she dead.’
‘Yeah. Help her.’
The two of them have an enervated watchfulness about them, like husbands on a shopping trip outside a changing room. The difference between this girl being alive or dead is another tedious distraction.
‘She owe us forty quid.’

I can see from here that the girl is not dead. She’s not even unconscious. Her breath rises and falls evenly, her pulse beats in her neck and tummy, and her eyelids flutter as she resists the urge to sit up and look at us as we come closer around the bed.
‘What’s her name?’
‘I don’t know, man. We only met her tonight. At a club. Y’understand?’
‘So what can you tell me about her?’
‘Nothin’. She say she want coke. We come back here and get her some. She put it up her nose then gets well freaked and crashes out on us, man. What’s the matter with her? I swear no more. Last time.’
‘Anything other than coke?’
He tips his head back.
‘What’ya mean?’
‘It doesn’t make any difference to us. We’re not the police. We just need to know what she took so we can figure out what’s the matter.’
‘Ya listen ta’ me. Nothin’. A little bit a’ coke, vodka and the Bull. Thassit.’
‘The name on her credit card is Christina,’ says Frank, holding her shiny black purse.
I call her name, and when that doesn’t work, apply some painful stimuli. When she opens her eyes she starts to cry.
‘What’s happened to you, Christina?’
‘I don’t know,’ she sniffs. ‘I want my mum.’
‘I want my forty quid.’
‘I tell you what we’ll do. We’ll go down to the ambulance, check you out there and then decide what we’re going to do. Okay?’
She nods, her bottom lip clenching upwards as she cries, making her look like an eight year old caught in her older sister’s party clothes.
‘Come on. Take my arm.’
The second guy steps towards us.
‘What about our money?’
‘We just need a few minutes to ourselves on the ambulance, then we’ll let you know.’
‘Huh.’
The two men study us as we lead Christina down the stairs. She goes barefoot, hanging onto my arm, with Frank following behind carrying the response bag and a pair of black stiletto shoes.

‘Who are those men?’ I ask her as I wrap the blood pressure cuff around her arm.
‘I don’t know,’ she says. ‘I don’t like them. I was with some friends at a club. We got chatting to them. They said did I want some cocaine, so I said yes. We all started out together but somehow we got separated. I ended up in their flat. And when I took the cocaine, it made me feel bad. I felt all choked up and panicky. Then I must’ve collapsed. And when I came too they were standing over me, staring down, and I was scared.’
Frank gives her a roll of tissue to wipe her face. She looks at us.
‘Please don’t tell my mum.’
‘How old are you?’
‘Twenty one.’
‘Then it’s up to you whether you tell her or not. But I think you should come with us to the hospital and give yourself space to think about what to do next. I don’t think you’re safe here with these guys.’
‘No.’
She blows her nose.
‘Frank? I think we’re about ready to go. And if you see the guys outside…’
‘Yep. I know,’ he says. ‘Leave it to me.’

blood and flowers

Any more calls to this hostel and they could usefully introduce valet parking for the ambulances. I swim through the late night traffic and we’re out of the cab even before the caller has hung up. He stands lookout at the end of the flagstone alley that leads to the side entrance, and waves his arms Help style when he sees us.
‘There’s a guy on the floor just up there,’ he says, breathlessly. ‘I think he’s cracked his head. My girlfriend’s with him.’
‘Lead on, Macduff,’ says Frank.

A young woman in a tiny club dress and white jacket has taken off her heels to crouch down by the side of a man squashed against the hostel wall. Her right arm is around the man’s back whilst her left hand strokes his face.
‘Come on!’ she says, leaning in closer, the party sparkles in her crimped blond hair twinkling in the beam of Frank’s flashlight. ‘Some amazing people are here to take care of you now, Jim. Jim? The help you need has come, darling. But don’t worry. I’ll be here. I’m not going to leave you.’
She looks up at us, but hangs on to Jim.
‘He’s hurt and alone. I don’t know what to do. Please do your best.’
The man who led us down the alley stands slightly back from his girlfriend. The hostel warden is leaning against the doorway, taking in the cool night air through a cigarette.
‘All right, gents?’ he says, considerately flicking the ash downwind. ‘I think Jim must’ve taken a tumble outside. He seems okay, but you’re the boss.’
Jim has a small cut and swelling above his right eye, and the blood has run down the side of his face.
The contrasts between the blinding sweep of Frank’s torch and the deep shadows and pools of darkness in the alleyway are marked, but even so you can figure by the shine of Jim’s coat and the dull glint of the bottle next to him that he’s a street sleeper with a drink problem.
‘He needs the best medical attention – and plenty of hugs,’ the woman says, giving Jim another squeeze. Frank looks at me. We’re quite prepared to touch Jim with our gloves on, but hugging? We’d need to be suited up like Dustin Hoffman in Outbreak.

‘Let’s have the trolley out, Spence,’ says Frank.
I know he wants to get Jim away as quickly as possible – for the woman’s sake as much as anyone.

When I come back with the trolley, she’s still giving Jim affectionate rubs on the arm and strokes of the face.
‘Be careful,’ I say to her. ‘He’s got blood on him.’
‘Oh I don’t mind about that,’ she says. ‘I just want what’s best for him.’
She gives him another squeeze, radiating love with as much chemical intensity as the product in her hair. Her partner is less committed. He hangs back from the scene, flipping his phone as if there were other calls he’d like to make.

We help Jim onto the trolley and rattle back up the alley to the ambulance.

‘You’re in the best, most expert hands the city can employ,’ she says. ‘They really are angels from heaven. I know you’re going to be fine, Jim. You’re going to be absolutely fine.’ She has a hold of his left hand, but he tries to pull it away and pillow his head. Like an irascible old terrier, Jim has had enough fuss and just wants to curl up for a while.

We load the trolley onto the vehicle. The woman wants to come on, too, but I stop her.
‘Thanks for your help,’ I say. ‘Do you want some alcohol gel for your hands?’
‘No. Thank you. I just want to know what I should do next?’
‘I think you’ve done as much as anyone could. We’ll take him to hospital and get him checked over. But he seems fine. Just a minor head injury. They often bleed quite a bit.’
I notice a long, diffuse smear down the right side of her jacket.
‘I’m afraid you’ve got blood on you.’
‘Have I?’
And for a moment something sudden and new seems to drop down around us in the night, like an unexpected scene change in a play. She stares at her hands. I give her some alcohol gel. Whilst she rubs the liquid between her fingers, her partner touches her on the shoulder.
‘Come on,’ he says.
She studies him silently for a moment, then turns back to me.
‘Can I send flowers?’ she says.

room 43

Mrs Elizabeth ‘Betty’ Wilson, ninety-one not out, sits with her hands cupped in her lap, neatly perched on the edge of a plump and flowery sofa, her head wrapped in a bandage. She fell over in the bathroom and cut the back of her head; the bandage is there to hold a dressing in place whilst we wait for the paramedic practitioner to glue the wound here at home and keep Betty out of hospital. As the wound is right at the back of her head, the bandage has to take a couple of turns under her chin, too, otherwise the whole thing would gradually slide upwards.
‘You look like a proper Mummy,’ her son Jeremy says. ‘Or Marley’s ghost.’
Then he slaps his knees to spur himself into action, and goes off into the kitchen to make us all a cup of tea.
‘I saw a ghost once. Twice, actually,’ Betty says, leaning forwards and squeezing her eyes shut, smiling indulgently like a tipsy nun. ‘I used to work in an old hotel, a very, very old hotel. A coaching hotel, in fact. I looked after the linen. Well, I had a little office in the oldest part out the back, and I was out there one night doing the books, when I felt something strange in the air. Nothing frightening. Just different. Out of the ordinary, you might say. And when I looked up, I saw a man walk across the room and go up the stairs.’
She sits back up straight again and looks at us. After a pause, in which the only sounds are the heavy rain thrumming against the windows and Richard clinking cups in the kitchen, I ask:
‘So - how did he look?’
‘Just odd. Completely different.’
Frank wades in.
‘How do you know he was a ghost and not just some geezer staying at the hotel? Was he transparent? Head under his arm?’
‘Oh no. Nothing like that. He just looked - extraordinary. The outline of a person. All ripply. But I wasn’t afraid. Things like that don’t scare me. Why should they? It’s just the way things are. Like the clouds, or the rain. When my husband died he came back to me about a month later. He was just a smiling face, drifting across the room when I opened my eyes one night. He was saying: Don’t worry, Betty. Everything’s going to be fine.’
Jeremy comes in with a tray of tea, and takes up his seat again on a matching flowery pouffe at Betty’s side. We sit sipping our tea in a semi-circle, the rain booming down outside. Betty’s bird song clock suddenly cuckoo’s the half hour.
‘I heard a good one from some guys at another station,’ says Frank, replacing the delicate, rose-patterned cup on its matching saucer with the self-conscious precision of a navvy in a china shop.

‘They turn up to a resus in a hotel. They charge into the lobby and a guy on the desk says Room 43 – which was what they’d been told anyway. So they pile up the stairs to the first floor, find the door to Room 43 and knock on it. A guy comes to the door and says: “What do you want?” and they say: “We’ve been told there’s a sick person here.” And the man turns round and says: “I think you have the wrong room, mate. There’s no-one like that here.” So of course they say sorry and all that, the guy shuts the door, and one of them gets on the radio to ask if Control can check the address. Meanwhile, the manager appears at the end of the corridor and says: “Thanks for coming so quickly. I’ve got the key.” And they say to him: “Well it’s not Room 43. The guy there says he doesn’t know anything about it.” So the Manager gives them a funny look, leans past them, swipes his key card and pushes the door open. The same guy who answered the door to them just a minute ago is lying on the floor, and he’s been dead at least twelve hours.’

‘That’s a good one,’ laughs Jeremy, taking a swig of his tea. ‘I like that one.’
‘I know what you’re thinking, but they’re stand up guys, those two’ says Frank.
‘Stand up comedy, more like.’
‘All I’m saying is, there’s more to life than just what you see on the surface,’ he says, sitting back on the chair and looking round the room, as if the framed photos and needlepoint pictures could be covering something altogether more terrifying than a floral print wall.

There’s a sudden, urgent rapping on the door.

‘That’ll be the paramedic practitioner,’ I say, getting up to answer it.

‘You think?’

scusstin cat

The side of this new ambulance is blazoned with stroke information but I think it should carry advertising for beer. At least that way we could generate some income and buy a few more of these trucks, which make the rest of the fleet look like hand carts.
And after all, beer is the motive force behind the majority of the jobs we’ve been hit with tonight. Drunken assaults, assaulted drunks, unconscious drunks, drunken falls, self-harming (with a bottle opener), spiked drinks, and a man – drunk - wanting his hip operation bringing forward at eleven o’clock on a Saturday night as he was tired waiting on the list.
I need a drink. But I have to settle for a Diet Coke down on the seafront as the sun drags itself above the horizon and survivors of the Saturday night apocalypse clatter home.

One last call – a psychiatric / suicide. Patient given as slightly violent, which I query with Control. Should we stand off a touch? It’s up to us. Police have been assigned, no ETA. There’s a grey wash of exhaustion in the air. Even the seagulls are gliding smack into buildings.
Frank takes the ambulance round the corner and into the street. There is a young girl standing outside a house with a mobile phone. She waves to us, it all seems calm, so we park up and introduce ourselves.
‘Mel’s upstairs,’ she says. ‘She’s taken about a dozen of these pills and says she wants to kill herself.’
She hands us an empty blister pack of Citalopram.
‘Is that everything she’s taken?’
‘I think so.’
We follow her up the stairs of a sparsely furnished student house towards a bedroom on the landing where a girl is being comforted on an unmade bed.
‘I just want to kill myself,’ she chokes. ‘I’m worthless and no good and everyone’d be better off if I was dead.’
All three girls are spilling out of ultra-short club dresses, the glossily sweet aromas of their make-up and perfume cut with smoke and sweat and alcohol. They are hyper-sexed figures from a Manga strip struggling in the grim dimensions and gravity of this room.
‘Kill me. Just kill me and walk away,’ Mel says.
At some point in the night someone has drawn a cat nose and whiskers on her face. ‘I’m scusstin. I’m a scusstin person and I want to die.’
Frank and I sit down on the other bed in the room. I put the clipboard on my lap. It’s an intolerable temptation to kick off my boots, lie down on this bed and go to sleep, and for a moment I wonder if that might actually help. Maybe it would be a calming influence. I remember reading an article about the psychiatrist R D Laing. If a patient was having a psychotic episode and was crouched on the floor with their hands over their heads, he would crouch down next to them and do the same. I bet R D Laing would’ve had no problem lying down. The shock factor. The distractingly idiosyncratic move. I could wake up after an hour or two, Mel would have straightened out, I could go home.
Instead I say: ‘What’s happened tonight to spark this off?’
Mel starts banging her head against the wall and her friend hugs her to stop it.
‘Nothing,’ the friend says, stroking away the strands of blond hair that are sticking to Mel’s face. ‘We had a nice time, came home, then this. She’s been like it before, but never as bad.’
Mel starts scratching at her legs, but her nails are all bitten back, so it doesn’t cause any damage.
‘Can’t you just give me an injection to kill me?’ she says.
There is a knock on the door downstairs and two policemen come thumping up the stairs.
I explain the situation to the first of them, a tall, buzz-cut guy whose blue eyes are no doubt capable of projecting his CV onto the wall.
Meanwhile, Frank says to Mel: ‘Do your family live nearby?’
‘They’re all miles away and I bet they’re glad about that.’
‘Brothers? Sisters?’
‘A little sister.’
‘What’s her name?’
‘Claire.’
‘Imagine if Claire came to you and told you she was really sad and wanted to kill herself. What would you say to her?’
‘I’d say don’t be stupid.’
‘Would you tell her she wasn’t thinking straight? She was being too hard on herself?
‘Maybe.’
There is a pause. The policeman has tucked his hat under his arm; his colleague stands behind him on the hallway discretely studying his watch.
Mel suddenly snatches up the empty packet of Citalopram and shakes it in the air.
‘These are meant to be happy pills but they don’t fucking work.’
She starts trying to bang her head on the wall again.
The policeman steps into the room. We make room for him on the bed.
‘Now Mel,’ he says. ‘Don’t do that or I’ll have to restrain you.’
He puts his hat on the windowsill, sits down between us then leans forwards to take her hands. For a moment they sit like that, Mel cradled in her friend’s lap, both her hands held by the policeman.
‘I’m scusstin,’ she whispers. ‘I’m a scusstin person and I have to kill myself.’
‘You’re not disgusting, Mel. I’ve only known you a few minutes but I would say you’re a well loved young woman who just feels a bit under the weather at the moment. Why don’t you come with these guys to the hospital and speak to someone about how you feel?’
‘A little ride in the ambulance, Mel,’ I say, sounding like a poor salesman. ‘The pills you’ve taken won’t cause you any harm, but the fact you took them is a worry. We need to make sure you’re safe. So why not come with us to the hospital and we can find someone for you to talk to? Otherwise, I’m afraid it’ll mean a trip to the cells.’
The policeman gives me a slantways look.
‘I don’t think that’ll be necessary,’ he says. ‘I know Mel’s going to be sensible about this.’
Ten minutes later, he leads her down the stairs and into the ambulance. The policeman explains to her why he believes she is a worthwhile person. I chat to her friend about her studies.
Mel moans and pulls her hair. ‘I’ve done bad things, scusstin things. I’ve had sex with boys to make them like me.’
‘When?’ says her friend.
‘All the time. I don’t tell you ‘cos I think you’ll hate me.’
She starts scratching and slapping at her legs.
‘Don’t make me have to restrain you,’ says the policeman, reaching out to take hold of both her hands again.
She stares at him, a smudged and bedraggled, scusstin cat, paw to paw with the long arm of the law in the early hours of the morning.

trouble sleeping

As we climb out of the cab, the heat of the afternoon lays down heavy on our backs. In just the few seconds it takes to pull out our bags, open the little iron gate and walk up the path, our delicious, air-conditioned frosting is burned clean away.
I ring the bell.
Dogs furious. Commanding words, and a door firmly closed inside. A pause, and then a white shirted figure moves into focus behind the leaf patterned glass of the front door. An elderly man, trim and precise, waves us in.
‘She’s just through here,’ he says, turning and leading us through into the curtained bedroom where his daughter died last night.

She is lying on her back on a single bed, the counterpane neatly rolled and folded at the end, and even the single sheet she had been lying under drawn across and to the side in a wide triangular fold. She looks asleep, her arms out to the sides, palms up, a martyr to the night’s heat who found respite in the early hours.
I touch her forehead, but the dark staining along the lower edges of her arms and legs tells the story well enough.
‘I’m very sorry to say that your daughter has died, George.’
‘I thought so. They said to put her on the floor before you arrived but I knew it would do no good.’
‘It’s not much comfort I know, but at least there are no signs of distress. I don’t think she could have suffered at all.’
‘Right.’
He leads us out of the room and into the sitting room. Dogs barking and scratching even more frantically behind the kitchen door.
‘We don’t mind if you let them out, George. We’re okay with dogs.’
‘If you’re sure. They like to know who’s here and whatnot.’
The moment the door is opened two small black and white mongrel terriers bowl across the carpet in a frenzy of wagging and sniffing. The smaller of the two immediately launches into a campaign to jump up on the sofa. The other seems more wary, running in and out and around until she’s sure she knows how many there are of us and what we might do.
‘Nutmeg is an absolute pain,’ George says. ‘She knows she’s not allowed. Jenny will settle eventually.’
And she does, taking up position between his legs. Nutmeg inspects my boots.
‘I don’t know what’ll happen to them,’ he says. ‘They’re rescues. They were everything to Mary. But they’ll have to go back.’
I make a start on the paperwork. George strokes Jenny’s head and scrunches her ears as he answers my questions. He spoke to Mary last night before she went to bed. Everything seemed fine, nothing out of the ordinary. They were due to go shopping this morning. She didn’t show. She didn’t answer the phone. He drove round and used his spare keys to let himself in.
I tell George that I need to make a phone call to the police, the next stage of the procedure for a death at home. George says he knows.
‘I went through it all when my wife died a few years back. Don’t worry.’
His face is flushed and damp with sweat.
Rae bats Nutmeg away and leans forward to touch George gently on the shoulder.
‘Can I get you a cup of tea? Anything at all?’
‘No. I’m fine,’ he says, taking off his glasses and wiping his face with a handkerchief. ‘I’m fine. But I don’t know how the boys will take it.’

When the police arrive, Rae helps George put Jenny and Nutmeg back into the kitchen as I answer the door. I tell them what has happened, and take them into the room to see the body. They put on latex gloves and make a quick inspection for themselves, then I hand them the paperwork.
Back out in the hallway, George is standing with Rae.
‘We’ll be going now,’ I say to him. I shake his hand. ‘I’m very sorry for your loss.’
He thanks us for coming.
We pick up our bags, one of the policewomen holds the door open for us and smiles. We step back outside.
It’s so bright I can hardly open my eyes.

who had what

The brickwork of these old dock workers’ cottages still manage to radiate something rooted and forbearing through the thick masonry gloss of their recent refurbishment. They seem to hang back from the margin of the main road and the commercial brutalities of the rest of the area, everything having been ripped out years ago, replaced with factory units, DIY outlets and scrap metal yards. But the cottages have lasted, still keeping a look-out over the busy quays and sheds below them on the other side, the dark rectangular strips of deep water, and the sea, constantly pressing in on the other side of the harbour wall.

The door to the last of these cottages is open, spilling a light of a friendlier, more domestic hue than the points of fierce magnesium that blaze over the cargo ship fifty feet below, loading timber.

A man is standing in the doorway. Silhouetted as he is, arms folded and feet planted either side, he could be a security guard guarding the entrance to a club. But up close, we see that the stab vest is actually a soft sleeveless jacket, the frown is apprehensive not aggressive, and the arms are folded out of a need for reassurance.
‘He’s just through here,’ he says, letting us in through the tiny hallway and into the main living area, so neatly furnished and colour co-ordinated it feels as if we are walking into a feature in Country Living. But a man is lying on his side on a patterned cream rug, dressed in a white cotton wrap, his head surrounded by a messy red halo of regurgitated mousakka.
He feebly raises his head.
‘Who’s this?’
‘The ambulance, John. You’ve had me so worried.’
‘I didn’t want you to call an ambulance.’
‘Just lie still and let them look at you.’
‘So what’s happened here?’
‘We were at a restaurant celebrating a friend’s birthday. Nothing big, nothing wild. We had less than half bottle of wine each, absolutely nothing out of the ordinary. Then we caught a cab home. We’d only been back a minute or two. John had gone into the bathroom, undressed, and was walking out tying his robe when he took a step or two into the living room and – bam! – he was spark out on the floor, pretty much where you see him now. He was just gray and awful and there was nothing I could do to bring him round.’
‘I was not.’
‘I’m sorry but you were, John. What would you know about it? You were unconscious. Then when he did come round he threw up, and I was so out of my mind with worry I called you.’
John moans from down on the rug.
‘I’m so embarrassed,’ he says. ‘I’ll be fine. It’s just one of those things.’
‘One of those things,’ says Peter. ‘Oh – right. One of those “drink half a bottle of wine and fall unconscious” things? I don’t think so.’
‘I’m so embarrassed.’
‘Let’s have a look at you.’
Rae checks him over, then we help him sit up and re-arrange his robe.
‘Urgh! I can’t believe I did this,’ he says, staring down at the mess on the rug. ‘It’ll never come out.’
‘Who cares about that? The most important thing is that we find out what happened to you?’ says Peter, putting both his hands on John’s shoulders as if he were reasoning with a child.
‘Well I don’t need hospital. What will they do for me there? Oh. I know. See a doctor. Have a CT scan. Find I’ve got a brain tumour. Game over. I know. We both work for the NHS, for God’s sake.’
Rae gives me a look.
‘Let’s not get too carried away, John. But I think Peter’s right. I think you do need to come to the hospital for a check over. It’s certainly not normal behaviour, passing out after half a bottle of wine with no warning.’
He wipes his mouth on the kitchen towel and stares at the result with disgust.
‘Well. I’m getting dressed first.’

Even though we tell him that he’s fine as he is, that he’ll only have to undress again and put on a hospital gown as soon as he gets there, John insists. He spends the next ten minutes struggling to put together an outfit, knocking things over in his search for flip-flops, staggering around trying to push his head up into the arm of his t-shirt.
‘John! Please!’ says Peter.
‘If I didn’t know any better, I’d say John was simply very drunk.’
‘But he’s had the same as me. Absolutely nothing at all. Trust me - this is completely uncharacteristic. When he fell backwards on the rug, I thought he’d died.’
We watch as John bends down to put on a flip flop and rolls backwards onto the sofa.
‘So what do you do in the NHS?’
‘I’m a nurse on an orthopaedic ward, he’s a radiographer.’

Finally, after some firm intervention, John has some clothes on, a mobile phone and a bunch of keys.
‘I don’t want to go,’ he says. But shuffles out anyway.

As I’m driving to the hospital, I catch sight of Rae in the mirror, raising the feet of the trolley up, leaning over and shouting ‘John? Come on, John.’ Then to me, through the hatch. ‘He’s gone off on me.’
‘Shall I pull over?’
‘No. I’m not sure about it. Just keep going and I’ll let you know.’
Further down the road, I can tell from the tone of her voice that John has come round.
‘It’s not funny, John,’ she says. ‘I don’t know why you’re doing this.’
I see Peter’s reflection in the mirror, leaning forwards, his face blurred with anxiety.

When we arrive at the hospital, Rae tells me that John seemed to have a curious kind of fit – not the usual phonus-bolonus, pseudo-fit we often see, but more like a partial seizure. His breathing had changed in character, becoming shallower and faster, and his heart had pounded out an irregular one forty plus.
‘I’m really not sure about this one,’ she says to me in secret, just before she goes to handover.
I wait by the trolley in the corridor. John seems genuinely embarrassed.
‘God. If anyone recognises me,’ he says. ‘I feel so bad about all this. I’m so sorry to waste your time.’
‘You’re not wasting anyone’s time,’ Peter says, pushing the fringe back from John’s forehead. ‘You mustn’t think like that.’ Then he looks at me and says: ‘What do you think it is?’
‘A brain tumour,’ says John.
‘Don’t say that,’ says Peter. He looks exhausted. ‘Don’t say such things.’
Rae comes back with a cubicle number. We wheel him into position.
Just as we do this, John seems to go off again, staring vacantly up into the ceiling, breathing rapidly, his pulse racing.
‘Has John taken any kind of recreational drugs tonight?’
‘No. Never. We don’t touch them.’
A doctor comes over and has a quick look.
‘Mm,’ he says. ‘Let’s do another ECG.’

Later that night we check in on John’s progress.
‘They’ve just gone up to the CT suite,’ says the nurse.

An hour later still, and we’re back in A&E again. I’m sipping coffee out by the ambulance when Rae comes through the double doors looking like she has something.
‘Well?’
‘I spoke to the nurse again. They’ve just got bloods back from our mate John,’ she says. ‘He’s absolutely loaded. Half a bottle of wine? Yeah, right – and Oliver Reed had a diet Coke.’

sea breeze

The night has rolled on, thinning to a scrape of heels on concrete, a shriek in an alleyway, bass notes spilling from a passing car. The pier has closed finally, shutting down its multicoloured circuits for the night, leaving just a workshop window illuminated, tucked beneath the dark boardwalk. There’s a barely discernible silhouette moving about in there, like an ant caught in a light box. Meanwhile, the moon leans down low and bright, scrying our fortunes in the polished black surface of the water.

Karol is sitting in a wheelchair by a tall, open window that overlooks the sea. He grips the armrests, leaning forwards with his chin up, his face whiter than the net curtains, breathing like he’s just been running a race.
‘Please.’
His wife is holding on to one of the rear handgrips, either to keep herself upright or her husband in the chair, it’s hard to tell. She smiles at us as we haul our gear into the room – her smile, like her hair, thinning and untended.
‘Can’t you help him?’
Karol is a cancer patient of a year or so, the tumours slowly metastasising from where they first laid root in the right lung, creeping on through the rest of his body despite the drastic treatments called down on them. He manages his condition at home and at the local hospice, with a bottle of Oromorph to supplement the other pain relievers when things get too difficult.

The problem tonight, though, is that Karol is hyperventilating. He nods to say he understands what that means.
‘Don’t - leave me - until I’m better,’ he says.
‘We promise.’

I coach his breathing to bring it back down to a normal rhythm. He gradually relaxes his grip on the chair. His wife comes round to sit on a facing stool.
‘All day he’s been worrying that the cancer will stop him breathing,’ she says, rubbing his knee. ‘The doctors are happy with the way things are at the moment, and everything seems to be holding, but now and again Karol gets a bit – well - worked up.’
‘I think I tripped out on all the meds,’ he says, his breathing levelling out and his shoulders relaxing. ‘I grew up in the sixties. You’d think I could handle that.’ He laughs, but then his face seems to slacken again with a dreadful kind of existential sweat.
‘The walls just seemed to be bearing down on me,’ he says, wiping his forehead with the back of his hand. ‘I just couldn’t seem to get my breath.’
‘That’s why we came to the window,’ says his wife. ‘The ozone.’
‘It’s got to help.’

I make a phone call to request a home visit from the out of hours doctor. Karol could do with some lightweight sedation tonight, to see him through to a visit from a Macmillan nurse in the morning and a thorough-going review. A trip to A&E would only make things worse.

‘Karol is an artist. He did all these paintings,’ she says. ‘Look.’

We scarcely noticed them as we came into the room at first, but now things have calmed down we’re able to take in our surroundings. There are huge, square canvases hung around the room, vigorously painted, intensely coloured images of pelicans jostling on flaming yellow and blue beaches, a naked woman reclining on a leaping zebra, a cascading forest of orchids and tigers. And then, just by the door, an abstract canvas, the biggest of all of them, strung from ceiling to floor – a massing cloud swirl of ochre, burnt earth, carmine and terracotta.

‘I tried to get down how it felt to be told I had cancer,’ he says. ‘How it feels.’

We all look at the painting, as the net curtains gently bow and snap in the cool sea breeze.