film night

Stephen is being sent to a psych unit in another town because there are no beds here.

‘Sorry it’s such a long way,’ says Rae. ‘And so late.’

‘It’s not your fault,’ says Stephen, hauling an enormous black sports bag onto his shoulder.

‘Can we help with that?’

‘No. Thanks. I’m fine.’

A nurse comes over with a file of notes, but it turns out they’re the wrong ones –Steven, not Stephen. She tuts and goes away again.

The idea that we might take the wrong person hangs unspoken on the air between us. We make other, safer comments.

The nurse comes back, apologises – she has to go to the office to do some photocopying.

Stephen puts his bag down again.

The person in the opposite bed has been staring at us all this time; he doesn’t acknowledge me when I nod in his direction. I wonder if it’s Steven.

Stephen pushes his huge steel glasses up his nose, tips his head back slightly, and stares in the direction of the nurses’ station. Picks his bag up, puts it down again.

*

A long drive out, but easy enough. After midnight, and this busy commuter route has been cleansed of traffic. The moon is low and full, more like a ghostly sun. Its light has a strange effect on everything, on me.

I’m dreaming about driving.

I open the window and take deep breaths.

I’ve not been to this unit before. Even the sat nav seems vague. But after some last minute adjustments, I pull up outside.

The lobby is empty, hard-lit. When I buzz the ward there’s a long wait before anyone comes to let us in. Stephen waits anxiously between us.

‘It’s a long way for anyone to come and visit,’ he says.

‘Sorry.’

‘It’s not your fault,’ he says again. And then: ‘I’m a bit nervous. I don’t know what to expect.’

‘That’s natural,’ says Rae, looking around. ‘But it looks like a nice place.’

*

Two women come down to greet us, both in their early twenties, both dressed in jeans and t-shirts. They introduce themselves, shake Stephen’s hand, lead us back upstairs. In the ward itself one of them shows Stephen to his room whilst the other asks us if we want a coffee. She swipes us into a room, and goes off to make it.

The room has a stack of chairs in one corner, a bookshelf of DVDs, and a wide, beech veneer conference table in the centre. Rae sits one side of it, I sit the other. I put my feet up on a chair.

‘Thanks for coming,’ I say. ‘Shall we begin?’

The chair cuts into my back so I put my feet down again.

How are you feeling? she says.

The outside windows are more like panels in an aquarium – thick Perspex panels secured with rivets.

The nurse comes back with two plastic cups of coffee.

‘Take your time,’ she says with a smile, and goes out again.

We sip our coffee, yawn, chat.

Suddenly Rae nods at something she’s seen behind me.

I turn round and see someone pressed up against the security glass, a middle-aged man in a zipped-up top. Because he’s standing so close to the glass, and because his hood is pulled low over his forehead, I can only make out the smallest fragment of light reflected in his eyes. He doesn’t acknowledge that we’ve seen him. His breath mists up the glass.

After a moment, I turn back to Rae. Raise my eyebrows. Finish my coffee.

The man has gone when the nurse returns to let us out again.

Suddenly there are screams and ripping sounds from a room across the way.

‘Don’t worry,’ she says. ‘Film night.’

nappies

‘It’s dead boring, mate. The same fookin’ questions over and over and over. For what? For the paperwork, thassall. And you get treated like shit as soon as they find out you used to do a little gear. You can see it when they read them fookin’ letters: I V D U. Snigger. Point. Yeah? But that was years ago. I’m clean now, man. I’ve not touched the stuff in ten years. That’s what you get though. That’s what you get for being different.’

Alex is different. You can see it in the jaundiced glow of his face, like a solarised photo; you can see it in the way he walks, crabwise, jabbing at the ground with a stick, crooked over to one side with the drag of a leg that was damaged when gangrene set in from a filthy injection; you can feel it in the drum-tight swelling of his belly; you can hear it in his accent, a tight, Mancunian drawl, case-hardened in smoke and rage, and you can see it in his eyes, when he opens them wider than a slit. Pinned through Subutex.

‘Look at them porters,’ he says. ‘Loafing around. You can’t tell me that’s work. Skivers, plain and simple. And them nurses are no better. I’ve seen smarter monkeys. Fookin’ ell  – I can’t sit here much longer, pal. I’m off outside for a fag. Eh? In fact I think I’ll just fook off. There’s nowt for me here. Just hours and hours of hanging around – for wha? They can’t do nothing, mate. They do nothin’ for me. I’m fit for the knackers, that’s all there is to it. But I tell you one thing for free – when the time comes, I’m not going to be wearing no fookin’ nappy. That’s it. That’s the truth. No-one’s putting no fookin’ nappy on me.’

completing the circle

Mary isn’t being straight. Not with her doctor, not with her friend, certainly not with us. Even her cat Bob takes the long way round to the kitchen.

‘No. I haven’t had a drink tonight? What do you take me for?’

‘It’s just that your speech is a bit slurred, Mary. And there’s a carrier bag of empty vodka bottles just inside the door.’

‘Yes, well, I gave up drinking a long time ago, thank you very much. An’ the reason I might possibly-be-slurring....’ (she exhales down the three words with her eyes half closed) ‘... is because I’m very, very tired. Okay? Officer? I’ve had a busy day, what with one thing or another. Now then. What are you going to do about my back?’

Mary’s next door neighbour Janet came round as soon as she got in from work and picked up the message on her answer machine. She’s still got her coat on, and the spare set of keys in her hand. Caught between wanting to help Mary and wanting to go home, she sits perched on the edge of the armchair, periodically glancing at the door.

‘Mary’s had trouble with her back before,’ she says. ‘Haven’t you, Mary? She saw the doctor last week and he gave her some different pills, but they haven’t really agreed with her. And then of course she had that fall.’

‘When did you have the fall, Mary?’

She shrugs. ‘Last week.’

‘Did you see anyone about it?’

‘The doctor! Keep up.’

She tuts and closes her eyes.

‘And what did the doctor say?’

‘He gave me some more pills.’

Janet hands me a paper bag.

‘I think this is everything.’

It’s obvious from the blister packs that Mary hasn’t taken her full complement.

‘It’s no wonder you’ve got pain if you’re not taking your meds,’ I say to her.

‘You don’t like me, do you?’ she says.

‘Do you know, you’re the second person who’s said that to me recently.’

‘Oh? Coincidence, you think?’

‘Maybe. Maybe not. But that’s beside the point. Let’s see how we can help you tonight. Are these the only meds you take?’

‘She has diazepam, too,’ says Janet.

‘Really? So where are they?’

‘I told you, Janet. I don’t like taking them things. They make me go funny in the head.’

‘But were they prescribed for your back pain?’

She nods.

‘I don’t like them.’

She starts to cry.

Janet sighs.

Bob looks in from the kitchen, hesitates, then turns and goes out through the flap in the back door. I have a strong urge to follow him, but I take a steadying breath and carry on.

We’re there some time.

We refer her to the out of hours.

*

Much later, we get a call to an elderly fall. I’ve been to this address before – some time ago, but I know the ambulance makes frequent visits here. Agnes is ninety something, unsteady on her feet, but still living with her husband Norman, who has Parkinson’s.

We use the keysafe to gain entry and find Agnes sprawled half on and half off the bed. Agnes has activated her careline button – not so much because of her position on the bed, but because of Norman – and I can see why. He seems flushed and confused, wandering about the bungalow on some obscure mission. We can see from an ambulance sheet that a crew’s already been out tonight. All things considered we can’t leave them alone. We take them both in, as a job lot.

*

I park alongside another ambulance at the entrance to A&E. Dermot is round the back of his truck, putting the ramp up.

‘We just brought in someone you know,’ he says.

‘Oh? Who’s that?’

‘Mary.’

‘No!’

‘Yep. The out of hours went round, saw her slumped on the sofa, banged on the window but got no response, so he called the police who smashed down the door with their big red key.’

‘Is she all right?’

‘Pissed, is all. Complaining of back pain but we couldn’t get much sense out of her so we brought her in.’

I start to open the back of our truck.

‘Funnily enough, we’ve got one of yours.’

‘Oh? Who?’

‘Agnes.’

‘Agnes! So what about...?’

‘Yep. Norman, too.’

I swing the door open to reveal the bright interior, Agnes on the trolley, Norman on a side seat. They both look out, see Dermot, and wave.

He waves back.

‘And so the circle is complete,’ he says, in a mock heroic voice. ‘Our work here is done.’

a wash and brush-up

Mr & Mrs Taylor live in a house on a hill served by a system of concrete stairs so complex you’d think you’d blundered into a landscape by Escher. We go up to go down to go up again. None of it makes sense.

‘And I bet he’s upstairs,’ says Rae.

Early morning, last hour of the night shift. A heavy lift will probably kill us.

I ring the bell.

An elderly woman shuffles to the door with her zimmer.

‘Can you come in and help him, please?’ says Mrs Taylor. ‘Only I can’t get him up. I’m not good myself.’

Stan is sitting scrunched up on the floor of the little downstairs bathroom. He fell over when he went to spend a penny at eleven o’clock at night, and he’s been there ever since. But Stan is a heavy man; at least eighteen stone, his torso a great conical lump with a couple of stringy legs hanging from the base.

‘Get me back to my chair’ he says, puffing and blowing.

We have to slide him backwards to give ourselves some room. He yelps and swears.

‘Where’s that hurting?’ I ask him.

But he ignores the question and waves his hands speculatively in the air.

‘Why won’t you put me back in my chair?’

‘Oh, no, don’t put him back in his chair,’ says Mrs Taylor, watching from the sitting room doorway. ‘He’s stuck in that thing all day, all night. He won’t even use the bathroom. He just sits there and wets.’

‘Get me back to my chair,’ says Stan.

‘I can’t cope,’ she carries on. ‘I can’t. He won’t have the doctor in. He won’t take his pills. He won’t use his frame. He just sits and sits and sits. And wets. I think he’s going a bit...’ she taps her forehead with a bony finger. ‘You know.’

‘I’m not going to hospital,’ Stan puffs. ‘Just get me up, will you? What are you waiting for?’

‘You feel hot to me. Are you hot, Stan?’

‘Why are you leaving me on the floor? Why don’t you help me up?’

Rae comes back in with the Mangar inflatable cushion.

‘What’s that?’ says Stan.

‘It’s a device for getting you off the floor. You’re too big for us to just pick you up.’

‘Am I?’

‘Unfortunately, yes. But this is good. Look. It goes under here – if you could just shuffle backwards a bit...’

He yelps and screams again.

‘What’s up, Stan? Where’s that hurting?’

He grumbles, but doesn’t tell us.

We start to inflate the Mangar. Despite warning him what to expect and what he has to do as the cushions inflate, he reacts to the whole business with the same level of uncoordinated, hoofing panic you might see in a cow being hoisted out of a ditch. With a great deal of counterbalancing and bracing, we manage to inflate all four cushions without Stan falling off, and then help him to stand. He clutches on to the door of the bathroom, his spindly legs buckling.

I fetch a wooden chair in from the sitting room.

‘I took the cushion off,’ says his wife. ‘He’ll just wet it.’

‘I’m not going to hospital’ Stan says, collapsing back into the chair. ‘Why have you put me in this thing?’

‘Because you obviously can’t walk through to the sitting room and I don’t want you falling over again.’

‘Just help me up and I’ll be all right. I’m not going to the hospital.’

‘We can’t very well leave you here like this, Stan. Now – if you can prove to me that you can get yourself up and walk through to the sitting room, fine, I’ll leave you alone. If not, it’s the hospital and no question about it.’

He tries to stand up again, but his legs will not support him. He keeps a grip on to the doorframe, though, and looks at me to see that I’ve understood.

It’s looking increasingly as if we’re going to be stuck here for hours, and we’re off duty in a few minutes. Rae calls Control and asks for a second crew. We’re going to need help lifting Stan up and down those concrete stairs – and then they can take him to hospital whilst we clear up and hurry back to base.

‘They’re sending a reserve crew,’ she says, hanging up.

‘A what?’ says Stan. ‘I’m not going to hospital.’

‘You go with these nice people!’ says his wife, glaring at him from her zimmer frame, as homicidally furious as Davros of the Daleks. ‘You can’t go on like this, Stan. You can’t!’

There’s the sound of boots on the concrete steps outside.

The fight seems to go out of him.

I slap him reassuringly on the shoulder. ‘Don’t worry, Stan. It’s only for a check-up. I reckon you’ve got a little urinary tract infection and it’s making you weaker than normal. You need a thorough-going overhaul. Wash and brush-up ,tuppence. Maybe they can get someone in to look at the house, and see if there’s not stuff that can be done to make it easier for you generally. With any luck they’ll discharge you later today. But you absolutely have to go, Stan, because to be honest – you’re so weak, if I left you now you’d fall over again and then where would you be?’

‘On the floor,’ he says.

A knock on the door. A friendly face.

‘Hello! Who’ve we got here, then?’

Stan submits to the carry-chair, and we all struggle outside to the truck. 

the cuddly toy conspiracy

Sienna is sitting on the edge of her bed, crying into the phone, whilst two of the other hostel residents look in at the door.

‘I’ve made too many mistakes,’ she sobs. ‘I just can’t cope anymore. I can’t cope.’

Along with a packet of tobacco and an asthma inhaler, there’s a neat mound of empty blister packs beside her.

When we’ve chatted to her for a while, calmed her down, established that yes, she will come with us to the hospital, Rae asks if she has everything she needs. Phone, keys, money for the taxi home?

‘Humphrey,’ says Sienna, reaching for a tatty owl that’s reclining on her pillow. She stuffs it in her handbag along with the rest of her medication.

I carry the bag and her coat so she has her hands free to support herself as she goes down the stairs.

The owl stares up at me from the bag as we descend.

*

Waiting with Sienna in the triage area of the A&E department.

Another crew comes in, pushing a young man in a wheelchair. He’s slumped forward over something; at first I think it’s a vomit bowl, then I see a little more of it and think it must be a furry hat, but when they park themselves next to us I can see that it’s actually a little toy fox. He moans slightly, and strokes the head of it.

When the triage nurse comes over to them, the attendant smiles and waves a little bundle of empty blister packets in the air.

*

Giles buzzes us into the flat. A twenty year old man, he has the bland and fleshy complexion of celery forced in the dark.

‘I took all my meds at once and went to sleep. I’m a bit disappointed I woke up, to be honest.’

Have you got everything you need to go to hospital, Giles? Phone, keys, money...?

He hands me a canvas bag whilst he pulls on a Slipknot hoodie.

And yep, there in the bag, just visible beneath the headphones, the magazine, the drink bottle and cigarettes, a cuddly little toy hedgehog, staring up at me with an off-centre kind of smile, as if to say: Sssh! Don’t say anything. I’m hiding.

charles and emma

The door stands open. I knock and push it open even further. A dark hallway, with dull light spilling down from a first floor landing, over photos and pictures, a narrow shelf of souvenirs, a chair-lift track with the chair upstairs. I say Hello, but there’s no reply, no sound.

Ambulance?

Nothing.

We go in, head up towards the light.

Hello? Ambulance?

Charles Westinghouse is fussing over his wife in the main bedroom he’s adapted for her. Everything has been cleared out except the basics – a hospital bed, a hoist, a commode, an electric armchair by the window, and another, simpler chair nearer the door. Emma Westinghouse is lying in bed with the back fully in the upright position. Her wasted arms are along by her sides, the right one under the duvet, the left on top. She doesn’t wear teeth anymore; as a consequence her mouth is a puckered crater. A PEG tube winds out to the left, a catheter tube to the right. Her skin has the waxy pallor of the profoundly inert, someone whose main experience of movement over the past eight years has been the hoist or the body roll, and of the outside world, sunshine filtered through curtains, and traffic passing in the street. Apart from the rise and fall of her chest and a certain flickering of her eyes – which, for all the low light and late hour, seem sharp and blue – she is absolutely still. Surrounded like this by all the details of her care, utterly immobile, she could be the centre of a tough new display by Tussauds, something to bring the collection up to date, Domestic Trials and Tribulations, sponsored by the NHS.

‘Oh! There you are!’ says Charles, straightening up and pushing his thick grey hair back. ‘Sorry to drag you out like this.’

He called because Emma had started grunting in a new way, something that suggested pain. There’s no sign of it now, though. All her observations are within range.

‘We’ll be guided by you, Charles. We’re more than happy to take Emma to hospital. The other option is to see how you go tonight and get the GP involved tomorrow morning – on the understanding that if anything changes you give us a call back.’

‘Will do. Just give us a hand to make her more comfortable.’

Whilst we’re doing that, Emma stretches her face a little more, making strange little panting noises, her eyes flashing.

‘Is that what she was doing?’ I ask him.

‘No. She laughs at me sometimes. I think it’s when I bend over her and my stupid hair flops forwards. Is that it, Em? Is it my hair again?’

We lower the back of the bed.

And slowly, like a doll whose weighted eyes gently close when you lie them down, she drifts off to sleep.

definitely dumped

Five o’clock in the morning, and dawn’s a spill of ink. Clubbers clacking and scraping in the direction of taxis, or anything that looks like a taxi.

There’s a guy standing outside The Spur Hotel, his hands planted deep in the pockets of his parka. I nod to him as we pull up, but he doesn’t respond.

‘Did you call the ambulance?’ I ask him as I climb out.

‘Me mate? No mate?’ His face cracks into a dreadful, stumpy grin. ‘Why – someone dying?’

‘Well I couldn’t possibly say.’

He watches me as I pull out my bag; Rae locks the vehicle behind us as we go up to the revolving doors. I glance behind as we push through; he’s still watching.

Our boots don’t make a sound on the thick blue carpet. We cross the vestibule, walk up a shallow staircase and approach the reception desk, spot lit at the far end of the atrium. The hotel rises up around us like a renovated prison – layers of identical rooms forming the four sides of the atrium, with the dining room and bar in the middle. The silence is overwhelming, accentuated by the empty dining tables all dressed for breakfast, the jardinières, the fans, the fish tanks.

A red-eyed, puffy faced receptionist is waiting for us at the desk, his arms spread left and right along the desk as if he’d been flat on his face when the call came through.

‘Room two three two,’ he says. ‘Come. I show you.’

‘So what’s the story?’

‘Well – a man and his girl, they got back from club about an hour ago. He was propping her up, you know – like this?’ He smiles at me, does the mime. ‘I thought it was the vodka.’ He shrugs.  ‘It happen lot.’

The lift puts us out on the fourth floor, an identical floor to the one we’d just left. Without even looking up, the receptionist pads ahead of us along an endless corridor, turns at the end, then along another, turns at the next end, then two doors down stops and swipes the lock.

‘Hello ambulance peoples’ he says, rapping with his knuckles on the door before he opens it.

Lying on the tiles of the en suite bathroom is a young woman, her head underneath a melamine shelf containing twin sinks and a dressing mirror. Kneeling by her side is a heavily built guy in his twenties.

‘That’s fine now,’ I say to the receptionist, who is soaking up the scene from over my shoulder. ‘We’ll let you know if we need anything else.’

‘Okay, my friend,’ he says. He nods to the boyfriend, and quietly withdraws.

‘So what’s been going on?’

Craig tells us what happened. They’d come away for the weekend. Been to a club. Not drunk all that much. Not taken any drugs. Natalie had become anxious and wanted to leave. She’d collapsed on the bathroom floor when they got back.

Natalie starts to hyperventilate, but in a non-committal, stagey kind of way. I coach her resps back.

‘Have you ever had a panic attack before?’ I ask her. She nods. ‘Okay. So you’ll know how over-breathing can make you feel.’ She nods again.

In between encouraging the breath control, I ask Craig about Natalie’s medical history.

‘I wouldn’t know,’ he says. ‘I’ve only known her a month.’

Natalie lifts her head.

‘You’re going to dump me,’ she says.

‘I’m not going to dump you. Don’t be silly.’

But Natalie drops her head back to the floor and starts breathing quickly again – and too soon after for it to be at all credible, passes out.

‘She’s not unconscious,’ I say.

I show him how I can tell.

Over the next half an hour, and despite all our efforts, Natalie carries on as before, small bursts of hyperventilation followed by unconvincing faints. Rae and I play Good Cop, Bad Cop, but nothing works. We try to encourage Natalie to stand up and move to the bed where she’ll be more comfortable, but Craig intervenes, physically picks her up, carries her through.

‘Watch your back,’ I tell him.

He shakes his head and staggers with her into the bedroom. As soon as she lands on the bed she throws herself flat and pretends to pass out again.

‘Why’s she doing this?’ he says, red in the face.

‘I don’t know. Natalie? Come on. Let’s sit you up and have a chat about how you’re feeling. We’ve just got to reassure ourselves that everything’s okay, then we can leave you alone.’

She sits up and stares at me for a moment.

‘Natalie? How are you feeling? How can we help?’

She holds out her hand to Rae without taking her eyes off me.

‘You don’t like me, do you?’ she says.

‘It’s kind of immaterial whether I like you or not, Natalie. We’re here to help and that’s what we’re trying to do.’

Suddenly she jumps up and runs out of the room.

Craig follows her, shouting over his shoulder: ‘I’ll be okay from here in, guys. Thanks for your help.’

We stand outside the room and watch Natalie run down the corridor, followed by Craig. Right at the end, where the corridor turns to the right, she stops, and after hesitating a moment, neatly puts herself on the floor.

Wearily, we walk up to meet them.

Craig is kneeling beside her, stroking her hair; amazingly, he nods at us in a friendly way.

‘All right?’ he says.

I check Natalie over.

She’s feigning unconsciousness again, only coming out of it to look up at Rae and say: ‘I like you. You’re all right.’ Then lapsing back into a little fast breathing again.

‘Try to encourage her back to the room, Craig. I think you’re doing a great job. But obviously she can’t stay like this all night. The hotel security might get involved. I don’t think Natalie needs to go to the hospital, but if anything changes later or you become concerned, you can always call us again.’

‘Thanks,’ he says. ‘Sorry to have wasted your time.’

‘It’s no bother.’

We leave them to it.

Back down in the atrium, the receptionist has resumed his position on the desk.

‘What was matter?’ he says, looking up from an early edition of the newspaper. ‘Vodka?’

‘She’s not too bad,’ I tell him. ‘Lying in the corridor at the moment, but hopefully they’ll be back in their room soon.’

‘Okay chief. I keep eye on this business.’

Back outside on the pavement, the strange guy hasn’t moved.

‘No good?’ he says. ‘Nothing doing?’

‘Another life saved.’

He watches us stow the bags and get back in the cab.

‘One month in,’ says Rae. ‘Good god. If I was him I’d be running in the other direction.’

‘Dumped,’ I say. ‘Definitely dumped.’

We clear up, take another job.

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.