born before arrival

There’s a woman standing by the side of the road with a phone to her ear; she waves as we approach, then hurries back inside. The street is quiet and dark. A fox glides out of a garden ahead of us, hesitates in an isolated pool of light thrown down by a streetlamp, then hurries on into the darkness on the other side.

I grab an obs bag and maternity pack; Rae fetches the Entonox.

Stacy’s house is up on a shallow rise, all its lights blazing. It’s not immediately clear where the front door is, but the sounds of a woman crying out in pain leads me round the back.

Stacy is on all-fours in the living room, surrounded by a hasty scattering of towels. Her sister Kate has hung up the phone and is down on the floor supporting her; Stacy’s husband Richard hangs back near the kitchen, one hand flat on the top of his head like he’s trying to stop it blowing away. He looks at me as I come in with my bags, desperate for me to help.

As I say hello and ask a few questions, I’m unzipping the maternity case, unpacking the kit, setting it on a nearby sofa, pulling on my gloves and then crouching down to see how far advanced she is. What I find is nothing I’ve ever seen before, something like a pale, prolapsed balloon, tight with fluid, extending out of Stacy’s vagina. There’s no sign of the baby’s head, but Stacy’s contractions are powerful and quick and there’s no doubt she’s ready to deliver. Richard tells me they were up at the hospital earlier that day. He said she’d had a scan, but apart from showing that the baby was back-to-back, everything else was fine. Today is her due date. Stacy’s had two other children, neither with any complications. Her health is good.

This balloon-like structure must be the amniotic sac. But is there any chance the placenta could’ve been dragged out of position to block the cervix? In a couple of hours? I don’t think it’s likely, but I’m no expert. And anyway, even if it is the amniotic sac, could it obstruct the birth? Is the foetus in distress right now, struggling to be born, the cord compressed?

It’s only been a minute or two since we came in the door but it feels longer. I’m horribly aware that all the time I’m hesitating the baby might be struggling.

I decide to rip the sac. It tears without much effort. There’s a rush of clear liquid over my gloves and up my arms. Almost immediately I can see the dark hair of the baby’s head as it emerges. I get Stacy to pant as the head crowns and is born. The baby’s face is puce, all bunched up in that way newborns have. I check round its neck, which feels clear of the cord.  

Rae is next to me with a clean, white towel. She’s ready to help me catch the baby.

‘Okay, Stacy. One  more push and we’re out,’ I tell her. ‘Whenever you’re ready. One last push.’

She bears down. The baby emerges, shoulders, body, legs, flopping out into our blue gloved hands in a splattering of bloody discharge, mucus and amniotic liquor.

‘It’s a boy!’

I hold him whilst Rae clears first his face then his body. Almost immediately the baby opens it eyes, squashes his tiny face up and lets out a great, squalling cry that fills the room with a sense of relief, and release.

He pinks up quickly, beautifully.

We wrap him in another clean towel and whilst Richard holds him, we help Stacy turn over and sit on the floor, resting against the sofa.

‘The midwife can cut the cord,’ I tell them. ‘There’s no rush.’

And as if I’ve summoned her by using her name, here she is, backing in through the door with a drag-along suitcase of maternity things, looking as smiling but exhausted as a woman who’s just landed at the airport.

‘Is that baby I can hear?’ she says. ‘Congratulations. What did we have? A he or a she?’

*

 When we’ve drunk the tea Stacy’s sister makes us, seen the placenta delivered safely and everything good, the midwife happy for mum and baby to stay at home, said our goodbyes and congratulations again, we head back down the drive to the ambulance.

Above us the sky is brilliantly clear, a dizzying throw of stars, stars on stars on stars, leading out into the unfathomable deeps of space. It’s strange to think of that tiny life emerging, in that chaotic, warm, brightly lit room, with a sky like this above it.

*

The rest of the shift passes without incident. Half an hour before we finish and we’re back on base. The morning is already so well established our night feels like ancient history.  I’m so tired I wonder how I’ll make it home through the rush hour traffic, but the thought of going to bed, pulling the duvet over my head and diving into sleep is so wonderful I’d risk anything to make it happen.

Dermot arrives for the start of his shift. He’s been a paramedic for about a thousand years, so I tell him what happened.

‘Sounds like the amniotic sac,’ he says, yawning. ‘There’s that expression – born in the caul. It’s quite rare. I’ve only seen it once. They’re okay being born like that without having to tear the sac. Nine times out of ten it’ll tear as the head comes out, but if it doesn’t, you can wait till the baby’s born. A lot of doctors tear early, of course. They like their interventions. But either way’s fine, I think. There are arguments for and against. And there’s that superstition thing, of course. Your little man won’t ever drown, so it goes. In the past the midwives used to frame the caul and sell it as a good luck charm to sailors.’

He yawns again, then stretches as he stares out of the window into the car park.

‘I had a different birth experience the other day,’ he says. ‘Not quite so nice, though. Twenty weeks old.’

He holds his hand out and looks at it.

‘A perfect little thing, this big,’ he says, drawing an imaginary outline in his palm with the forefinger of his other hand. ‘And it was making these tiny little gasps.’ He pauses, then closes his hand. ‘Twenty weeks – I mean, that’s got no chance. But we thought – well, maybe they got the dates wrong. And the way things were, we couldn’t just stay there. So we took it in, wafted a little bit of oxygen its way. Foregone conclusion, though. They didn’t do anything in resus. I knew they wouldn’t. Just gave mum some privacy whilst it faded away.’

aspects

Mrs Grayling has died, sometime in the night. She lies on the bed with her eyes half-open and her jaw slack. The sliding door to a narrow conservatory adjoining the bedroom stands open, and the garden door beyond that. A gust of fresh spring air moves through.

Her son Graham is sitting at the kitchen table with his face in his hands. He looks up as we come in and finds a tired smile.

‘She’s dead, isn’t she?’

‘Yes, I’m afraid she is.’

‘I knew it. Sorry to drag you out like this. Would you like some tea?’

He stands up, steadies himself at the table, and then starts getting things together, filling the kettle, setting out the Spode tea cups, the jug of milk, a saucer of custard creams. I ask him about his mum’s health these past few months. He says she’d been fine until just a couple of weeks ago. Ninety-three and still independent. But she’d developed a chest infection. It knocked her sideways. She’d taken to bed. The doctor wasn’t optimistic.

‘I think I need some time to myself,’ says Graham. He hesitates and stares out of the window at the garden. ‘It’s such a nice day,’ he says. ‘Mummy’s favourite time of year. Maybe what I need is a nice long walk. A nice long walk by the sea, with a cup of coffee at the end of it. Hell – a pint of beer. Why not?’

He gathers himself together again, finds a tray.

‘An odd thing to ask,’ he says. ‘But could you do me a favour and cover her face?  I said goodbye to her last night. I don’t need to see her again. Not – like that.’

‘Of course.’

‘Sorry to ask.’

‘It’s no bother.’

‘I’ll bring your tea through when it’s ready.’

‘Thanks.’

There are two carers in the house. The first discovered the body; the second hurried over to give her support. They’ve come together in the sitting room, shoulder to shoulder, blowing their noses, fussing through folders, unsure what to do next. They’ve known Mrs Grayling for years. It’s a terrible shock.

When we join them in the lounge, they take a hesitant step towards us, and talk quietly, overlapping each other.

‘Is he okay?’

‘What’s he doing in there?’

‘Upset – you know.’

They blow their noses again.

‘Someone should tell his sister.’

‘He won’t.’

‘They fell out.’

‘Big time.’

‘She wasn’t – supportive.’

‘You’re telling me.’

‘But she needs to know.’

‘I don’t mind telling her.’

‘She’s not on our list.’

‘I’ll ask him if he wants me to ring her. Someone’s got to.’

They stare at me. I shrug and nod. The second one goes into the kitchen.

After a little pause, the second carer comes back, followed by Graham, holding a tea tray.

‘It’s very kind of you. Really,’ says Graham. ‘But don’t worry. I’ll talk to the GP about – that aspect of things.’

He sets the tea tray down, and goes back into the kitchen.

I take a cup and look around the room.

There is a series of framed paintings on the walls. Two watercolour still life studies of the same thing – a vase of daffodils and a bottle of wine. And three collages – a duck, a chicken and a pheasant. The collages have been put together from odd scraps of hessian, cotton, velvet, silk, satin and lace, with an assortment of buttons, pieces of glass and other scavenged material. The bird pictures are so lively, if it wasn’t for the glass covering them, they’d be clattering around the room and out the window.

‘Did Mrs Grayling do these?’

‘Loads more.’

‘She was quite an artist.’

‘All up the stairs.’

‘It’s like a gallery.’

‘Always tinkering.’

‘Terrible to think she’s gone.’

‘Terrible.’

‘I don’t know how he’ll cope.’

‘I don’t know what he’ll do.’

‘Or his sister.’

‘When she finds out.’

They stare at me.

We all take another sip of tea.

have a nice day

The long and the short of it was, we fell out with Control.

A tone of voice thing, I suppose. A misinterpretation. These things are always worse when you can’t actually see the person in front of you. But whatever the reason, after the disagreement, you could almost hear the scritch scritch scratch of the black swan’s quill as our name was written into the ledger.

Sure enough, the very next job, we’re sent on a long-distance mental health transfer, one that almost guarantees us a late finish. We check the details, the times. A non-urgent job that could happily wait all afternoon; they’ve given it to us almost as soon as it came in. They’ve stitched us up.

‘Is there no-one else who could take this one?’ I ask. ‘Wouldn’t it suit a link crew better?’

‘Yep. I know where you’re coming from. But the police say they’re worried about this chap and want him out of the cells asap. Sorry.’

I put the radio back in its clip, but really I want to rip it off the dash and throw it out the window.

*

Buzzed through into the custody suite, the heavy steel doors clunking shut behind us. The broad circular sweep of the raised dais that dominates the centre, its segmented stations like the compartments on a gigantic roulette wheel, with a computer terminal and officer perched where the number would be written. It’s as busy as ever. Police officers checking people in, checking them out, administrators moving about up on the stage with bundles of paper, ziplocked clear plastic personal possession bags with yellow security tags, phone calls, shouted requests, jokes. We catch the eye of the Custody Sergeant who smiles and asks if we’ve come for Jack. He buzzes through and asks for Jack to be brought out.

‘What’s the score with Jack, then? We haven’t been told much.’

‘A Section Two, but he’s good as gold. A bit confused – well, very confused, actually, but no trouble.’

‘Just out of interest, did you put in a request to have Jack taken out as soon as possible?’

The Sergeant looks nonplussed.

‘Well. It’s nice to have these things taken care of in good time. But nothing especially pressing, I don’t think.’

I look at Rae and sigh.

The Sergeant pulls out the Section papers.

‘It says here Jack was found wandering the streets with a bread knife...’

‘A bread knife?’

‘Yeah. I know. But he wasn’t ... like ... ‘ He widens his eyes and performs the universal mime for psycho. ‘More that he wandered out of his house half-way through slicing some bread. Anyway, Jack’s at risk to himself and possibly others – only possibly. Needs assessing. Probably dementia but there’s no diagnosis yet. Okay? Happy with that? I really don’t think he needs an escort.’

‘Fine.’

Jack is led out by a police officer. A sallow, slack-faced man in his late seventies, Jack looks like he’d just been woken from a long and troubling sleep. He shuffles forwards, looking around him with filmy grey eyes, both hands clutching the waistband of his tracksuit bottoms, his bare feet making a gentle slapping noise on the marmoleum.  

‘This way, Jack,’ says the police officer. ‘Shall we put your slippers on?’

He starts to take them out of the bag, but then finds that one of them is soiled.

‘Or maybe you’ll be all right out to the ambulance,’ he says, then hands me the bag.

Together we lead him out.

*

Rae’s the attendant on this one. All I have to do is drive. It’s a resonantly blue day, the sky swept with tails of thin white cloud. I think about the misunderstanding we’ve had with Control. It still rankles; we’ll be way off patch just a couple of hours before we finish, with the likelihood of a long overrun. It gives me a twist of frustration to think of the corner we’re in with nothing to be done about it. I go over all the ways we could get our own back, but it only seems to make the frustration tighten a notch. So instead I try to disengage from the whole stupid scene, to think about all those things beyond Control’s control, which really, is everything – certainly everything of importance. I try to put into action the old dictum that it’s not the things that other people do that make you angry, it’s your response to those things. If you decide not to respond in an angry way, you’ve won.

It works a little. Not much like a victory, it has to be said, but an easing, at least. I put the radio on, and the music helps, too. The roads are pretty clear. We make the hospital in good time.

*

The nurse who receives us is so warm and caring, Jack almost floats inside. At one point he lets go of his trackie bottoms and they slide down to his ankles.

‘Oops! Let’s just restore those for you. There! Onwards!’

The ward seems to be filled with Jack-a-likes: elderly men wandering round, randomly trying door handles, picking at the artwork on the walls, or staring out of the window at the daffodils. Two of them latch on to us as we go along the corridor, but again, quite aimlessly, as if they were responding to a curious thickening of the air rather than a new visitor.

Another nurse comes out of the office and takes Jack off to his room to get settled.

The first nurse asks us if we’d like some tea. She shows us out to the veranda, then goes back inside to make it.

We sit there in the sunshine, tipping our heads back to drink in the sky through our sunglasses.

A hawk circles overhead, harried by crows.

The  sunshine leans in through the branches of the horse chestnut whose leaves are just starting to burst out now, plump with potential.

Just to the side of my seat is a little flowerbed, part herb patch, part daffodil bed. At the end of it someone’s stuck a strange little scarecrow, only about a foot high, made of sticks. They’ve taken a lot of trouble to make it a pair of dungarees with little brass buttons and fastenings, a check shirt, with bits of straw sticking out the sleeve ends. They haven’t given it a face, but in some ways it looks all the happier for it. A face would only get in the way.

There are big, laminated signs on the windows of the various rooms: TV Lounge, Kitchen, Games. On the locked cover of the gas meter beneath one of the windows someone has written some graffiti. It takes me a while to figure out what it says from here, because the letters are so rough. But eventually, by relaxing my eyes, I think I can tell what it says.

Have a nice day. 

a dog, some fish

A narrow country lane, trees banked up either side. You’d hardly know there were houses here at all, but there are, a select few, an occasional flash of something glassy and architectural a safe driveway’s distance back from the road. There’s so much space between each plot if you lived here you’d scarcely guess you had neighbours at all.

Some additional notes now: Use the tradesmen’s entrance.

The satnav has switched to approximate, its little chequered flag stuck out in the middle of nothing. But it seems we’re almost there, wherever there is.

‘Up ahead’

A young, smartly dressed guy, standing in the middle of the lane. He waves once, then moves back to the side, by a pair of high, dark gates.

I wind the window.

‘Just follow the drive round, past the house to the estate manager’s office,’ he says.

I smile and say something about how lovely it is out here. He doesn’t react. I’d be better off passing time with the gate.

‘What’s this place, then? A cult?’ says Rae, driving through the gates, down along a perfect, yew-lined path.

A Tudor manor house slides into view, arches, cupolas, stained glass casements, wisteria, a perfect stretch of lawn in front and a landscaped vista beyond. Everything clipped and curiously flat, like we’re driving through a hyper-real painting.

Round and down, to a cluster of ancient stables and outbuildings. If they kept horses in the past, they’ve made way for Land Rovers, sports cars, gleaming collectibles. The Estate Manager’s office is an elegant building that presides over the quadrangle with a simple clock tower rising up from the middle of its roof. A wide array of swept stone flags leads up to the front door, guarded left and right by two olive trees in lead planters. There’s a little dog waiting for us there, a strange hybrid, like a Corgi crossed with a Chihuahua. It’s so fat it doesn’t walk so much as rock from side to side, allowing just enough clearance to swing each leg forward. Its black eyes bulge, probably a mark of the breed, but maybe just the pressure of fat making them pop.

Our patient is sitting on one of the office chairs inside. He’s embarrassed to see us. He rang the new, non-emergency number for some advice and they’ve forwarded it to 999. We stay long enough to makes sure everything’s okay, then leave. The dog follows us out, its claws clacking on the flags.

I Google the place as we drive away.

‘It’s a billionaire’s UK home,’ I tell Rae. ‘Apparently there used to be an eighteen hole golf course here as well, but he hurt his back so it’s been left to grow wild.’

*

I was only at this block last week, a Jenga version of the seventh circle of Hell.

As we wait at the buzzer console for an answer, the automatic front door swings opens and a woman shuffles out, so ravaged by life she could be any age from thirty to sixty. She stops and does a double-take, hooking her long, lank hair back from her face. Then she grunts, and carries on.

‘In fact - she was the one I came to,’ I say to Rae.

We take the lift up.

Our patient is doubled up in pain on a put-you-up in the living room. His brother is there too, along with their mother, a cadaverous figure shivering on the edge of the sofa.

‘Mum is staying with me whilst they sort her cancer out,’ the brother says. ‘And Rich is only staying since he got sick, too. As you can see, it’s a bit cramped.’

There’s a glass globe of goldfish on a stand next to the telly. The goldfish have outgrown the bowl; there seem to be too many of them, really. They float about in a kind of waxy stupefaction, knocking into each other, drifting against the side of the glass where they momentarily press their eyes, as if they’re struggling to understand what it is they’re seeing, the space beyond the glass, and why it’s denied to them.

standby for terror

It’s haunted.

I might believe it, too, if I didn’t know just how buggy these new vehicles are. For whatever reason, the scene lights come on spontaneously, the doors lock and unlock independently, the interior lights cut out, and – most embarrassingly – the bull horn sounds on its own, when you’re waiting in traffic, or maybe waving an elderly pedestrian to cross.

I suppose if there were any place that should be haunted, it’s an ambulance. But there’s something so utilitarian about them, so ruthlessly lit up, that along with all those other liminal places – the operating theatre, the resus room, the mortuary – they all feel about as free of earth-bound spirits as they are of pets. I wouldn’t take a nap in the back of an ambulance, but that’s not because of the things that have happened there, more the long gaps between each deep clean.

Apart from this haunted ambulance, and that episode when two paramedics were called to an exorcism and a sofa flew at them across the room, there’s The Story of The Haunted Standby Point.

It’s a lonely place to the east of the city, a bleak little parking area between a stretch of woodland and an ancient pond. Apparently two ghosts favour this spot – a woman who was killed in a motorcycle accident and a woman who drowned herself in the pond. I’ve not seen either, but apparently The Ghostly Motorcyclist lies by the side of the road and then disappears when anyone stops to help, and The Drowned Woman rises up from the tangled shore of the pond with her arms raised out Scooby-Doo style. It’s tempting to think maybe the motorcyclist was killed swerving to avoid The Drowned Woman, but there’s no way of knowing, except to say that The Drowned Woman is wearing a voluminous Victorian dress, and The Ghostly Motorcyclist helmet and jeans, so the one obviously predates the other. On the other hand, maybe the only connection is that the standby point is in some kind of geographical/spiritual anomaly, some little kink of gravity that encourages the retention or production of ghosts. It certainly feels ghost-friendly, especially in the early hours, with a mist hanging over the surface of the pond, and crows rawking overhead. There’ve been so many sightings now that no-one will go there. Control have given up trying to enforce it, and removed it from the list.

Whether it’s true or not, it’s a satisfying kind of victory that at least one roadside standby point has gone. And even more satisfying that the reason is so extraordinary. It’s given me hope I could start a rumour about another standby point we hate.

The ambulance trust hires the lobby of a charity in a tiny terraced office in an old part of town. We get sent there at night if there’s no work, which these days is pretty rare. It can be creepy on your own in that building, especially when the robotic door closures take so long to work. If you use the toilets deep in the building, and then come back into the lobby to sit down, it’s a full five minutes before the inner doors slam shut. It wouldn’t take much to conjure up a restless spirit, whose torment these past hundred years or more has been to wander around an empty building at night randomly slamming doors.

Taking a practical view (which I have to do whenever I freak myself out with these things), surely there can’t be many spots that haven’t experienced a death of one sort or another. If a ghost was created every time there was a death, there’d scarcely be time to scream before you turned round, drew breath and screamed again. Ghosts would be everywhere, and they’d have to work a lot harder to get our attention.

Maybe they are everywhere, but only certain sensitives can see them, like Derek Acorah, or our dog, Buzz, who’ll suddenly bark for no reason, as if something’s snuck in the room while you were dozing off and vulnerable.

Anyway, the point is, never, ever leave your keys in this truck. Which is probably good advice, ghost or no ghost.

And don’t do standby at night.

almost there

Ellen is sitting on a chair just outside the en suite bathroom, leaning over to the right. She has pain in her left hip from where she slipped over an hour ago, landing heavily on her bottom.

‘Osteoporosis,’ she says. ‘ I just know I’ve done something.’

Her daughter-in-law Stephanie is waiting by the bedroom door hugging an armful of coats.

‘We’re getting to be regulars,’ she says. ‘We had another nice crew out last week. For Ellen’s diabetes.’

Even though she’s thirty years younger, Stephanie looks more tired than Ellen.

‘I’ve phoned Richard,’ she says, waving her mobile in the air then dropping it into her bag. ‘He says he’ll meet us up there.’

*

‘I came down this way for work twenty years ago and never went back,’ says Stephanie. ‘Funny – the places you end up. Left one long-distance relationship, then a few weeks after I got here, went straight into another. Mind you, we’ve been together ever since. Two grown up boys. Lovely house. And now Ellen’s moved in.’

Ellen smiles at her from the trolley, then winces a little as she adjusts her position.

‘Okay?’ says Stephanie. ‘All right?’ She reaches over and pats her on the arm. ‘Almost there.’

She settles back in her chair again, and rearranges the coats on her lap.

‘The boys have all grown up now,’ she says. ‘They’ve gone their own way, done their own thing. Mark’s training to be an engineer. John’s travelling a bit before his law degree. So they’ve both turned out all right. I suppose I could’ve gone to university but it just never really happened, if you know what I mean? Maybe I should’ve done something? Then who knows where I might’ve ended up? Some far flung place. I might’ve met someone else. Had a whole other life.’

She stops, like someone who’d been rummaging through a box of photos and unexpectedly caught themselves on something sharp. In an effort to cover it, she leans forward again and touches Ellen on the hand.

‘But you know what Richard’s like,’ she says.

Ellen nods.

‘Almost there,’ says Stephanie again. And settles back with the coats.

options

Mr Warding, BEM, DCM, DL, is sitting on a rich leather sofa in the lounge, one arm in a blood pressure cuff and the other on the armrest, wired up for an ECG, his shirt unbuttoned to the navel, his velvet-lined jacket slung neatly across his lap. Two of the residential home staff hang back, one with a folder of notes, the other with a bag of medication. Stephen, the first paramedic on scene, is just finishing his examination; he introduces us to Mr Warding, then carries on.

‘So - to re-cap for these guys,’ he says, ‘you’d just finished lunch, you felt a bit swimmy, you were helped to the sofa where it looks like you may have passed out for a minute or two. At no time did you have any chest pain, and you don’t have any now. Is that right?’

‘Ye-es. That is correct. Now look here. What’s going to happen to my wife when I go in to hospital? She has some significant health problems of her own, as you no doubt have been informed by these good people here to my left and my right. I am her main carer, although to be frank my responsibilities are pretty light, limited to a few words of conversation, perhaps a little push around the gardens in her wheelchair. But you see even that is rather too much for me these days. I’m interested to know what you recommend we do about this?’

Mr Warding speaks slowly and precisely. Whenever he needs more air he stops, squeezes his eyes shut and pulls a peculiar expression, a cute and animal thing, a cross between a smile and a stifled sneeze. With his hanging jowls, great, fleshy paws and stubby legs, he could be a gigantic species of mole, ninety-five years old, reminiscing about the lawn.

‘Has something like this ever happened to you before?’ asks Stephen, writing down the last of his observations, then putting the board down, unwrapping the cuff, disconnecting the leads.

‘Well in actual fact it has. (Smile). It was very much the same circumstance, a post-prandial fainting fit, barely a week ago. (Smile) I was assisted to this sofa, made comfortable with cushions and so forth, water and the like. An ambulance was dispatched and duly arrived (Smile) They trussed me up with wires and so on, as indeed you have, and they found absolutely nothing wrong with me at all. (Smile). They recommended I travel with them to the Accident and Emergency department of the local hospital, and I followed their advice. (Smile) As one should. (Smile) More tests, more collective scratching of heads. I was there quite some hours. It was dark when I was finally delivered back to my room, with no more insight into my condition than before.’

Stephen has packed away all his things and looks about ready to force a decision.

‘So, Mr Warding. All things considered I would imagine you had a simple faint. I don’t think it’s your heart, but of course that’s just a guess.’

‘A guess? Well, now, I’d like a little more than guess work, if you wouldn’t mind. (Smile) What I’m really after are some definitive answers. Something I can hang my hat on. I can’t very well carry on like this, you know. Collapsing about the place for no good reason.’

‘When I say guess,  I mean an educated guess.’

‘An educated guess. Yes. I see.’

‘Based on what I’ve found. Which is nothing, to be blunt. But obviously I can’t do blood tests, and I’m not a doctor.’

‘No.’

‘You have plenty of carers around you, Mr Warding. One of your options would be to stay here at the home and see how you go. If anything changes, you can always call us back again. Or else you can go to hospital with these guys, and go through some more tests. And see a doctor, of course.’

‘Well, now, that’s most interesting,’ says Mr Warding, ‘Thank you.’ He fiddles with his gold cufflinks. I’m amazed he can handle such small things with those paddle-sized fingers, but he seems to manage okay. With his sleeve restored, he carries on.

‘You think I should go to the hospital and see a doctor? Well – of course my over-riding concern would be my wife. Who would be there to take care of her whilst I’m away seeing these doctors and having all these tests?’

‘Or you could stay here with the care staff and see how you go.’

Both women step forward. I half expect to see them curtsey.

‘We’ll keep a close eye on you, Mr Warding. And Mrs Warding.’

He glances at them both, then sighs, and sinks about a foot further into the chair.

‘It’s not as if she does all that much,’ he says. ‘Dementia, you know. A terrible business. Mostly she just sits there, staring. But then again, often she carries on awfully, crying out, you know? Making a dreadful show of it. I don’t know what to do. I simply don’t know what to do.’

Stephen has shouldered one of the bags and has the other in his hand. He stands over Mr Warding, willing him to make a decision.

A grandfather clock gently tings the quarter.

A blackbird chip-chip-chips out in the garden.

‘Now then,’ says Mr Warding. (Smile)  ‘What are my options?’

some like it very hot

We’re met at the door by William, a portly, middle-aged man in a Hawaiian shirt, khaki shorts and espadrilles.

‘Simon’s on the floor but don’t blame us,’ he says, beaming. ‘It wasn’t our cooking – at least, I don’t think it was. He didn’t even have the salmon. Anyway, what happened was – we’d just finished the main course. Malcolm, my partner, was clearing the plates. Stephanie, Simon’s wife, asked him if he was feeling okay – which he clearly wasn’t, as he’d gone whiter than his napkin. He mumbled something or other – I don’t know what – got up, took a few steps in the direction of the sofa, then just sort of collapsed in a heap. Didn’t hurt himself, luckily. Lay there a minute, eyes rolling...’

William mimes the faint, turning his eyes up towards his forehead and describing a circle with his head.  ‘...then Malcolm put him in the recovery position and Stephanie phoned for the ambulance.’

William stares at us for a moment, his eyes diluted by his glasses. ‘Well. There you are. That’s it. I suppose you’d like to meet the poor unfortunate? This way.’

He leads us through the hallway into the dining room, a tastefully-furnished room of palms, blond wood, botanical prints, white bookshelves of art, cinema, architecture, with the only thing to disrupt the Sunday supplement air being Simon, buffered into position on the Turkish rug by an array of plump velvet cushions.

‘I was just feeling a bit hot,’ he says. ‘And then I came over all faint.’

His wife Stephanie, dressed in a flapping black caftan decorated with a pattern of gold and silver orchids, moves between us all like a large but harmless variety of moth.

‘It’s so kind of you to come, so quickly,’ she says, hurrying around her supine husband to come and lay a hand on my arm. ‘We’re not always such flakes.’

‘Speak for yourself,’ groans Simon. And then, weakly: ‘I’m feeling better, you know.’

But when he goes to sit up, what little colour that had returned to his face visibly drains. We lay him back down again.

‘Let’s get you out to the ambulance and do an ECG there,’ I say. ‘We can decide what to do after that.’

Rae goes outside to get the chair.

‘But you can’t leave before dessert,’ says Malcolm, standing in the kitchen doorway with his arms folded and a flowery tea towel over one shoulder. ‘It’s Eton Mess.’

‘Well you’ll simply have to make it a mess to go,’ says Stephanie. She sighs, knocks her head against mine and whispers: ‘But oh! If there’s one thing I love, it’s meringue.’

*

Outside on the truck, Simon has picked up considerably.  He sits comfortably, his arms folded, blinking around at all the equipment in the cabin like he’s admiring someone’s shed.

‘You’ve got some gear, haven’t you?’ he says.

‘It pays to be prepared,’ I say.

‘Well I’m glad someone is,’ says Stephanie.

We do a twelve-lead ECG, and it comes out clear. All his other obs seem to have normalised, too.

‘Great,’ I say. ‘Right. A few more details. How old are you, Simon?’

Stephanie cuts in.

‘You’ll never guess what year we were married.’

I make an attempt to be flattering.

‘Well I’m guessing you were a teenage bride.’

 ‘A teenage bride! We like this one, don’t we, Simon? Can we keep him?’

He nods, goes to button up his shirt, and seems startled to find the chest leads won’t let him.

 ‘Let me get those for you,’ I say. ‘So – anyway. I reckon this was probably just a faint, Simon. It’s quite common after a big meal, especially if the room’s hot.’

‘They always have the room hot,’ says Stephanie. ‘Don’t they, Simon? Very hot. And there’s a good reason for it.’

‘What?’

She leans in. ‘Naturists. They normally wander round the flat completely starkers. We’re used to it, but when they heard you were coming they threw something on.  Lovely couple. Great cooks. But my word they like it hot.’

nfa

He should be easy to spot.

Male, 50. Chest pain. Beneath the town clock.

And there he is, a hunched figure on the shallow steps around the base.

I pull the car over half on and half off the pavement, and leave it running for a quick getaway.

There is a group of clubbers sitting on one of the benches in the little landscaped island of the square. I nod hello, expecting them to point or say something, but they ignore me.

John is so fattened out by all his layers he looks like some kind of spaceman – except, instead of a shiny white suit and survival pack he has a shiny black parka and carrier bag.

‘Hiya mate,’ he says, looking up as I approach. He keeps one hand clutched to the centre of his chest, the other on the stretched handles of the bag.

‘How are you doing?’

‘Not good, mate. Not good.’

‘What’s happened, then?’

‘I don’t know. I got this pain in my chest, like. Right here. And it hurts like a bastard when I cough.’

It’s been a busy night. I know that if I wait here for an ambulance the hands on the clock above us will have travelled all the way round before anything pitches up. I can’t do an ECG on the street or in the back of the car. So I decide to take him in myself.

‘Are you okay sitting in the front?’

‘No worries, mate. Sorry to bother you. It wasn’t me that got you out.’

‘Oh? Who did?’

‘Well I coughed and the pain was so bloody sharp I kind of doubled over. Some kids were going passed and I think one of them called you.’

‘Fair enough.’

When he’s in the front and I’ve climbed into the driver’s seat, I grab the clipboard off the dash. When I ask him his address he hesitates, then gives me the name of a road. I can tell he’s made it up, so instead I leave that field blank. A couple more questions and we’re good to go.

‘Sorry to mess you about,’ he says. ‘I mean, I’m fifty years old, for Chrissake. I should be big enough and ugly enough to take of myself.’

Then he coughs. It sounds like his lungs are filled with tacks.

*

At the hospital, the foyer is as crowded as ever. I help John into a chair and do some basic obs there whilst we’re waiting for the triage nurse. We’re surrounded by the usual casualties of a weekend night – overdoses, drunks, somebody in a vacuum mattress waiting for a log-roll, an abdo pain. It’s a disparate catch, like a trawler has passed over the town and dragged up a dozen cases for sorting at the dockside.

Eventually, Raoul the triage nurse makes it round to us. Raoul needs a break – a sabbatical, actually. He’s doing that thing where he seems to be listening but he’s actually only ten percent there. The majority of his brain is somewhere else, scanning the scene around him, an agitated snow globe of beds, times, x-ray requests, in-comings, out-goings. It’s an impossible, thankless task. I don’t know how he stays as calm as he does.

He listens to the story of John, distilling it down to a scrawl of numbers, acronyms, abbreviations. After the age and date of birth, he comes to the address.

‘And where do you live?’ he says.

‘Whiston Road.’

‘Number?’

‘Sorry?’

‘What number Whiston Road?’

‘Ahm…. thirty.’

‘Thirty Whiston Road?’

‘Something like that.’

‘What do you mean, something like that?’ Raoul sighs and carries on looking around. He talks without malice, and without even seeming to address anyone in particular. It could almost be part of an internal monologue, the story of his night, which is the story of the continuing struggle of the department to keep its head above water.

When John doesn’t say anything, Raoul directs his attention back to him.

‘Come on. You must know your address,’ he says, sighing and tapping the form with his pen. He looks at John, hunched forward on the wheelchair, gripping on to his carrier bag, really seeing him for the first time.

‘NFA,’ John says quietly. ‘Just put NFA.’

Raoul hesitates. He writes NFA, then clicks his pen shut.

‘Sorry John,’ he says. Then brightens again. ‘We’ll sort you out with a bed just as soon as we can.’ He touches him lightly on the arm. And hurries away.

engineering

Mr Weston lies on his back on the trolley, staring up at the lights in the hospital ceiling as we wheel him through. A large, fleshy man in his seventies, he’s been here a couple of days post-fall; now we’ve been asked to transfer him to a specialist neurological centre.

Just before we go into the lift, a woman and her young son appear in the lobby.

‘Is it all right if we…?’

‘Plenty of room.’

She hesitates, but everyone knows how slow these lifts are; it’ll be a while before the next one. She comes on, hugging the boy to her, occupying as little space as possible up near the buttons.

Suddenly, for the first time since loading him on the trolley, Mr Weston stirs.

‘…and the trajectory of the bullet was such that enormous trauma was experienced…. given the size and velocity of the round… massive cavitation….fully investigated, of course…’

The woman hugs her boy, one arm round his body, one round his head to cover his ears. I try to catch her eye, to reassure her they’ll be all right, but actually I’ve no idea what Mr Weston will say next.

She keeps her head down, staring at the floor as we descend.

Mr Weston is in a strange, dreamlike state. If you ask him a direct question he’ll answer, but then quickly trail off into some ongoing lecture about ballistic trauma.

‘Were you in the army before you retired?’ I ask him.

He rolls his eyes, his fattened senses trying to locate the source of the question. Without actually seeing me, he smiles and lifts a heavy hand.

‘Yes, sir. Twenty-five years a soldier.’

He moistens his lips, then sinks again.

‘…but then after the impact, the collateral damage… of course subsequent studies have borne this out… trauma volumes, kinetics…  the pathways aren’t always easily anticipated, the geometry of these things is often complicated…’

 It’s late at night. I wait with Mr Weston as Rae ducks outside to the ambulance to put the ramp down and open the doors. The wind cuts around her, barrelling through the great artificial valley of these hospital buildings; when we wheel Mr Weston out, the blankets we’ve so carefully tucked around him are pulled aside.

‘Soon have you in the warm.’

‘Yes. Of course,’ he says. ‘This is the problem.’

*

Mr Weston is lulled by the gentle rocking of the ambulance and the low-lit cabin. Now and again his eyes flicker open and he frowns, as if he’s mildly surprised to find himself on his back. I read his notes, make some observations, but with everything stable and not much to do, the warmth of the cabin, the gentle light and the hushing and splashing of the tyres along the wet road, it’s a struggle not to fall asleep myself. At one point the ambulance seems to jolt, and when I put my hand out I’m temporarily disoriented. Did the ambulance go over a bump, or was it me jerking awake?

Mr Weston has his eyes open as well. He makes vague alterations to his blankets as he stares up at the ceiling.

‘Almost there,’ I say. ‘Not long now.’

‘I was a teacher,’ he says, unexpectedly. ‘In civvy street.’

‘Oh? Really? What was your specialty?’

He pauses, then seems to melt away into the word:

‘Engineering…’

again

Marissa is crying because her back is hurting again. It’s a long-term problem, and really the meds she’s been prescribed should help. She’s borne the discomfort of this episode as long as she could from the small hours of the morning, hanging out for when her doctor’s surgery opened. But it’s all got too much, she’s called the non-emergency number for advice, and for some reason they’ve bounced it on to us.

She’s perched on a huge brown sofa at one end of a living room so vast it could be the deck of an aircraft carrier. And in fact, Marissa’s three-year-old daughter Kate is busy trying to take off, showing us how fast she can travel on her scooter from one end to the other.

‘Be careful on that sweetie,’ says Marissa, just as she crashes into Rae’s para bag.

‘Oops! Are you okay?’

She nods, then climbs up next to her mum, who anxiously tries to guard her posture.

‘You’ve got your hands full,’ I say to her.

She snorts, and winces.

‘Wait till the twins are up,’ she says.

And exactly on cue, there’s a sudden rumbling sound overhead; a harassed male voice, then a hurried lump of footsteps along a hallway and down the stairs. From the chaotic tumble of it all you’d think they kept goats upstairs, but the baby gate crashes open and two tiny boys gambol in.

It’s impossible to tell one from the other. Both have identical Peppa Pig pyjamas; both have tangled black hair; both have pointy little chins and bright gray eyes, tiny rows of teeth like porpoises on the lookout for fish and mischief; both catch up short when they see the two huge visitors in green. They hold on to each other, then do a comedy creep over to where Marissa is semi-cuddling Kate.

‘Go easy, boys,’ she says, then sighs: ‘You wouldn’t believe how much energy they have.’

Marissa’s husband Dave follows them into the room. He already looks exhausted. He sits down on the carpet, leans against the wall, and watches the whole scene unfold in front of him as if it was a continuation of a particularly vivid dream he’d been having.

There’s not much for me to do. I write down a few observations as Rae calls them out, the full address, date of birth, telephone number and such, but after that it’s more down to Rae to take an overview and decide what to do next. My job seems to be keeping the twins amused. They’re wary at first, circling at a distance, disappearing for a few seconds and then popping up behind me, behind the bag, behind the curtains, giggling and carrying on. Whenever I spot them and pull a monster face they shriek and run away.  When they come back they start to bring various toys: a fluffy dog, a fluffy chicken, a fluffy rabbit. One of them comes and sits next to me, whilst the other one throws himself head first into the only other available space on the sofa.

‘Careful, Billy,’ says Marissa. But instead of being careful, Billy rights himself and immediately starts rocking violently backwards and forwards, slamming his head into the cushions.

‘He’s a bit of a head banger is our Billy,’ she says.

Kate watches everything from the seat next to her mum.

Meanwhile, Billy’s brother Jack is staring at me, willing me to do something.

I pick up the rabbit, point it at him, and work its paw so it’s waving.

Hello Jack. How are you?

He frowns.

You know what I’m going to do, Jack? I’m going to SIT ON YOUR HEAD!

I put the rabbit on Jack’s head.

But instead of sitting still so the rabbit can balance there, Jack gives a convulsive jerk of his body and tosses his head – so much so that he plunges straight back off the sofa onto the carpet, his bare feet flying up in the air and his hands making a mad grab for anything as he falls.

‘Oh my god!’ shouts Marissa, turning and holding her back at the same time.

‘Hmm? What?’ says David, opening his eyes.

Rae stops writing and looks at me.

Billy bangs backwards and forwards, screaming with laughter.

I help Jack up.

Kate says: ‘Again!’

the miracle of birth

We’re standing in the courtyard of an old, C-shaped, ten-storey apartment block, the simple, black metal gantry of its internal stairways and gangways rising up around us like we’re on the set of some seedy 1940s drama set in New Orleans. Except it's freezing cold, and the tree in the middle of the courtyard in its plain, red brick planter would only bear fruit if you tied it on with string.

We’ve been called to a woman about to give birth in flat number one, but the woman in flat number one is past childbearing age. In fact, so far past childbearing age she takes a full five minutes to make it to the door with her frame.

‘Who did you say you wanted?’

‘Sorry to have bothered you.’

‘That’s all right, son. I’ve enjoyed it.’

She closes the door and we head back out into the courtyard.

I’m tempted to lean back and shout out.

Stella!

Or whatever the patient’s name is. But Rae calls Control, and they tell us they’ll check the address.

Four guys walk past, looking so rough it would make a pirate blush.

‘Evening,’ says one. The others don’t say anything but grunt and grin and stroke their cutlasses.

‘Hello.’

‘Did someone die?’

‘Nope.’

‘Or hang the’selfs.’

‘I hope not.’

‘Yah. Me too, bro.’

They laugh and carry on. I hear one of them say something surprisingly pettish, about how there’s always an ambulance here. He’s not far wrong, though. It’s definitely a hotspot.

Control calls back.

Right name, but it should be House, not Lodge. The House version is just next door.

We pick up our bags and head that way, high-stepping over a low, chain-link fence to save time.

*

Sky opens the door to us. A tall, sleepy looking guy in his twenties, he has a clumpy black afro that looks like someone used it to unblock a chimney. He scratches up his jeans and steps aside for us to come in.

‘Yo,’ he says. ‘She’s thru’ there on the sofa.’

Jelly is propped up on cushions, her legs drawn up, puffing through the next contraction with her face screwed up. But the strange thing is, no sooner has the contraction ended then she is bright and alert, laughing that Sky didn’t even know where they lived.

‘You’re incredible,’ she says.

‘Fanks. You’re not so bad yourself.’

Jelly tells us she’s thirty-two weeks pregnant.

‘I’ve been having contractions every few minutes. I had them a couple of days ago and went in to hospital, but they didn’t say whether the baby was coming or not. They told me if I started getting them again, to give you guys a ring.’

Another contraction. She draws her legs up and rides it out.

When it’s passed, she’s perfectly relaxed again.

‘It’s been all right up till now,’ she says, taking a sip from a carton of apple juice. ‘No worries. Not like the last one. I was in labour for a week.’

‘Man – I’m glad I wasn’t around for dat party,’ says Sky, zipping his hoody up to his chin.

‘How old’s your other child?’ I ask her.

‘Five.’

‘And where is he tonight?’

‘With his dad. Ooh – here it comes again.’

Sky does a hopeless Michael Jackson kind of spin on the spot and then smiles at me. ‘I suppose we’re off to the hospital then?’ he says.

‘Yep. Can you get Jelly’s things together?’

‘What like, man?’

‘You know – notes, phone, keys, money. Whatever she might need.’

‘I don’t know what she might need. What do you mean, notes?’

‘Notes. You know. Maternity notes.’

I draw the shape of it in the air.

‘Oh. Notes.’

He starts rummaging through a pile of things.

‘You know – they asked me some crazy fucked up shit on the phone before you got here,’ he says.

‘What like?’

He straightens up.

‘Like they asked me to take a look and see if the baby’s head was coming. The baby’s head! I mean – what’s that about?  It’s crazy!’

He pulls a face, and then carries on searching. After a second or two he stops.

‘What am I looking for?’ he says.

what she wants

Rae reads the screen and groans.

‘Oh God! This is Anna-Beth. I can’t cope with Anna-Beth tonight.’

It turns out Anna-Beth is a frequent flyer. A woman in her early twenties, she calls about twice a month, sometimes more, always with back and neck pain. The suspicion is she’s a morphine chaser, but so far there hasn’t been any official line on that. I’m amazed I haven’t met her before, but I suppose it’s mathematics rather than luck.

‘The last time I went there we had a row. I don’t suppose you could attend this one, could you? I’ll buy you a coffee. Pleeease? I’d better just hang in the background.’

‘Fair enough.’

‘She’s got this hulking great boyfriend, so watch out. No doubt he’ll try to get us to carry her out as well as give her drugs.’

‘Okay.’

The boyfriend is standing waiting for us in the doorway, backlit by the strip lit hallway, the silhouette of a nub-headed bouncer with a frown like a crimp in a metal bucket.

‘Through here,’ he says, turning and leading us through.

Rae hangs way back.

Anna-Beth is lying on her back on a wide leather sofa in a onesie decorated with cute doggies in pink bows. Behind her head on a shelf is a cage of tiny orange and white rats. One of them jumps up onto a shelf and scrutinises me with the same button-eyed level of attention as Anna-Beth.

‘It’s my back,’ she says.

I put my bag down.

‘I understand this is part of an on-going problem.’

The boyfriend shuffles forwards.

‘It’s about time this was sorted out, mate’ he says. ‘It’s been going on too long. She’s in agony. Look at her.’

But in truth, Anna-Beth looks pretty comfortable.

‘What pain meds have you been prescribed?’

The boyfriend produces a shoebox and drops it on the coffee table. ‘They’re all there,’ he says. ‘And none of them even touch the sides.’

A quick glance in the box reveals an impressive arsenal of pain meds.

‘These are pretty strong,’ I say. ‘Have you taken what you should today?’

She nods.

‘But you’re still in pain?’

‘Yes. And my neck – which is a new thing.’

When I ask her what advice she’d been given about managing her condition, she says they told her to stay mobile and keep taking the meds. But apparently this hasn’t worked today.

‘I phoned the out of hours number and they told me to call 999. I wouldn’t have bothered you otherwise.’

‘She puts up with a lot,’ says the boyfriend. ‘Too much, if you ask me. What are you going to do about it?’

‘Well obviously there’s not much we can do for you other than take you to the hospital. But I understand you’ve been up there a lot...’

‘Her pain meds aren’t working,’ says the boyfriend. ‘What else is she going to do?’

‘You may be right. Maybe hospital is the only option tonight. Either that or having a doctor come out to see you.’

‘The doctor won’t do anything. He’s hopeless.’

‘An out of hours doctor, not your GP.’

‘They’re all the same.’

‘Oh. Okay.’

The rats have become even more active, maybe sensing an audience, or the prospect of more food. They’ve started hopping about from shelf to swing to straw to shelf again, tumbling over and over and whipping their nude pink tails about.

‘You know what’s likely to happen at the hospital though, don’t you?’ I say, struggling to concentrate and not be drawn into watching the rats instead. ‘A long wait. Probably a referral back to your GP. Wouldn’t you rather stay at home in comfort and see how you go?’

Again – the boyfriend: ‘She’s tried that. What else can she do?’

‘Anna-Beth? This is your decision. I need to hear it from you.’

‘I’ll go to the hospital.’

‘Okay. Well – you’ve been walking around today. So we’ll take a slow walk out to the ambulance. No rush. Have you got everything? We’ll need those meds in a bag for starters.’

The boyfriend steps in massively and helps Anna-Beth move her legs off the sofa, sit up straight, stand, then walk to the door, all the while flashing us looks even sharper than the rats.

*

When I go to book Anna-Beth in I ask Linda, one of the Receptionists, to bring up Anna-Beth’s attendance sheet. After a few seconds it appears on the screen, a long, scrolling list of dates, all with the same complaint: back & neck pain.

‘She obviously likes it here,’ says Linda. ‘And I mean a lot.’

*

Back out on the truck and Rae is sitting texting in the attendant’s seat.

I chuck the clipboard onto the dash and climb in next to her.

‘You were right about the boyfriend,’ I say. ‘What a piece of meat.’

‘Oh him? That was a different one.’

‘A different one?’

‘Yeah. The other one must’ve seen the light. She can’t have had this one more than a couple of weeks. But what gets me is – he looks exactly the same.’

She finishes the text , puts the phone back in her pocket and starts writing out a new sheet.

‘Maybe there’s a website,’ she says. ‘Chuffing Great Lunks.com.’

three in one shift

#1: Stella, 93

Lying in bed, the covers pulled up to her chin. Her eyes half-closed, as if the bright rectangle of sunlight angling in through the window was a little too much.

‘Is she ...?’

‘Yes, I’m afraid your mother is dead. Sometime in the night, I’d say.’

‘I left her alone when I came in this morning. I thought she was asleep. I was making her breakfast. Then it just felt – wrong.’

Stella’s son stands uncertainly the other side of the bed. It hardly takes an effort to imagine his mother closing her mouth and turning her head to see what on earth all the fuss was about.

‘I came early this morning because I was worried. I’ve spent the last couple of days trying to coax her out of bed. It wasn’t like her, to just lay herself away like that.’

‘We’ve got some paperwork to do.’

‘Come into the lounge, then. Would you like some tea?’

‘That’d be great, thanks.’

We follow him out of the room.

‘What do I now?’ he says, filling the kettle.

‘Well – because it wasn’t what they call an expected death, and Stella’s GP hasn’t seen her in the last couple of weeks, we contact the police and they attend. Don’t worry about them coming – it’s just a formality. And then they’ll guide you through the next bit, which is the Coroner’s Office people coming to collect your mother, and a decision being made about a post mortem and so on. But they’re the experts. They’ve got all the information.’

He finds three mugs and puts them out in a line, reaches up for the tea caddy. He opens it, then tosses a bag into each cup before pausing at the last one.

‘Do you think she suffered?’ he says.

‘I don’t think so. It looks to me like she died peacefully in her sleep.’

‘That’s something then,’ he says. He drops the last bag into the mug, picks up the kettle and pours out the water. ‘Stella was ninety-three you know. Good as gold up till the last few weeks. But that fall she had shook her up a bit.’

‘Oh? When was that?’

‘Last month. She goes down the casino every Wednesday to play roulette. Except last week she caught her foot and fell out the taxi.’

#2: Peter, 24

There are two police cars outside the house. We park where we can and hurry into the house. A middle-aged woman is standing in the hallway.

‘He’s up in his room,’ she says, tonelessly, moving to one side. ‘Excuse the mess.’

I want to say something more but there isn’t time. We hurry up the narrow stairway. Muted voices ahead of us. The landing cluttered, difficult to negotiate. A police officer opens a door and comes out, gesturing for us to go on past him.

‘I hate this shit,’ he says.

The room is a chaos of stuff – DVDs, games and devices, fast food cartons, discarded clothes, Coke bottles, scarcely room to move without treading on something; what space there is on the carpet is covered with a scattering of empty blister packets.

Peter is over in the corner under the attic window, curled up on his side. The flowery quilt that was over him has been pulled aside;  even from here we can see the unmistakable tide line of pooling blood. One of the officers draws our attention to a sheet of paper blu-tacked to the wall above Peter’s head. A neatly typed letter. To whoever finds me it reads. I couldn’t go on ... just too much ... tired trying ... nothing left. And then along with the signature, an afterthought written in the same blue pen: Sorry mum.

‘Are you okay after that one?’ says Control when we radio clear.

‘Yep. We’re fine.’

‘Back to base for a cuppa,’ she says. ‘I think you’ve earned it.’

#3: Viktor, 70

Viktor says he wants to go to the toilet before we leave for hospital. He’s a little unsteady, but manages to take himself into the bathroom.

‘I think we’d better have the carry chair,’ Rae says.

I take all our bags back down in the lift, out to the ambulance, stow them away, make the trolley ready, put the ramp down. Whilst I’m pulling the carry chair out of its cupboard, Viktor’s middle-aged daughter Rachel suddenly appears next to me.

‘Your colleague says can you give her a hand.’

For a second I wonder if I should take all the bags back up again. But to be quick I decide just to go with the chair.

As we ride up in the lift together, Rachel tells me about her father’s fifty-odd years of binge drinking, his years of self-imposed isolation, how she and her husband finally got through to him, persuaded him to leave his dreadful place and move nearer to them, so they can look after him and keep him on the straight and narrow.

‘You should’ve seen it,’ she says. ‘We had to have it de-verminated.’

When we come into the flat the bathroom door is open and Rae is struggling to support Viktor on the toilet.

‘He’s arrested,’ she says.

I put the chair down and hurry in. Together we get him on the floor, start compressions, take stock.

‘I’ll wait in the sitting room,’ says Rachel, and goes through.

I carry on compressions whilst Rae goes back down to the vehicle to get the bags and call for assistance. Luckily, another paramedic is passing on his way back to base; the two of them come back into the flat together.

We work on Viktor for an hour.

Half-way through, Rachel’s husband Mark arrives. An ex-policeman, he’s been to his share of these things.

‘If there’s anything you want doing, any fetching or carrying, I’m your man,’ he says. ‘How’s it looking?’

But he spares us having to come up with the words; he nods gravely, then goes to be with Rachel whilst we carry on.

Nothing works. We end up in one last review of the situation, kneeling amongst all the detritus of the resus, the ripped adrenaline cartons, drained bags of fluid, the wrappers and packaging, the changes of gloves, the bloody towels and roughly-cut clothing – and in the middle of it all, Viktor, flat and lifeless as the line on the screen.

We go through to tell Rachel her father has died. We give them some space whilst we go back to tidy up the hallway and bathroom. I retrieve Viktor’s false teeth from the corner where they somehow ended up, rinse them clean under the tap and place them on the side of the sink. I have one last wipe around the area, then head back down to the truck to fetch the scoop stretcher. Together we use it to carry Viktor into the bedroom, temporarily tying his arms with a bandage to stop them flopping over the side.

Mark comes into the bedroom to help us settle Viktor in, moving cushions and covers, arranging furniture.

‘Thanks for all you’ve done,’ he says, and then: ‘I’ve made some tea.’

We follow him back into the lounge to drink it.