dumped

We walk down the slope to the club, towards the epicentre of the thumping, subterranean rhythm. The club's neon sign punches out a lurid pink hole in the darkness; beneath it, drawn from the deep hollows of the night like exotic moths, clubbers are massing. One girl is draped upside down on a barrier, looking like a strangely animated piece of discarded clothing. She is shouting into a mobile phone, but she’s not our patient. We excuse our way to the head of the queue and catch the eye of the doorman, who nods an acknowledgement, then tosses the nod across to another doorman, who immediately pushes through to us. He is massive, constructed rather than born, his head as square as his shoulders, and his eyes drilled in deep.
‘She’s over there on a bench with her brother. My opinion? Too much to drink. Some ecstasy, she says. Nothing, really. Emotional, that’s all. Pain in the arse. Want a look?’
I ask him if she’s able to walk, and if so, will he bring her over to us, as we won’t be able to hear or do much over where she is at the minute. He accepts this without any change in expression; in a moment, like a big black dog retrieving a fallen bird, he’s back, gripping a slumped woman by the arm. A man stands touching her other arm. He is a brittle looking guy of about thirty, well-dressed in expensive leather jacket and jeans, but his eyes are puffy; he stares at us gloomily like we’re the next goddamned thing to happen.
‘Whilst she’s on her feet, let’s get her up to the vehicle,’ I shout, taking advantage of the momentum of events. The doorman straight away marches her back up the slope with the woman almost losing her shoes as she drags herself along by his side, trying to keep up.
‘What’s the story, then?’
‘This is my sister Susie, yeah? She got a bit down tonight, you know? She’s had a little bit too much to drink, taken half an e and some charley up the nose, but nothing to write home about. It’s all just proved too much for her. Can you help us?’
At the back of the ambulance the doorman shrugs off any help, dumps the woman on the trolley, turns round and says: ‘Call sign?’
I give it to him. Before I can really thank him for his help he’s marching back down the slope.
‘Right. Let’s get to the bottom of this.’
Susie has immediately adopted the same posture on the trolley as the clubber on the rails, hanging upside down. She makes a sudden, cat-like heave, and I only have two seconds to get a bowl beneath her mouth before she starts emptying her stomach.
‘And you’re sure she’s had nothing else tonight?’ I ask the brother.
‘God’s truth,’ he says, rubbing his eyes. ‘I’ve never seen her like this before.’
But after we’ve taken a round of observations including an ECG, and talked to Susie – who is perfectly able to talk to us – it looks increasingly as if the doorman was right, that the only thing wrong with her is that she’s had too much to drink and isn’t coping well.
The vomiting has settled her, though. She rights herself on the trolley and starts to talk to us in more detail.
‘You don’t understand. You don’t understand what it’s like.’
‘What what’s like?’
‘Being dumped.’
She looks up at me through a mess of makeup, her face a twist of dreadful anguish.
‘We were supposed to be getting married in four weeks. Four weeks. And now he’s dumped me.’
‘That must be very difficult for you.’
‘I can’t believe he just dumped me. In the street!’
‘Well you know what I think,’ says the brother, rubbing his face in his hands. ‘You’re better off out of it. He’s done you a favour. Tosser.’
‘Four weeks!’
Rae keeps Susie supplied with paper towel whilst I finish off the paperwork. Eventually we reach the stage where we have to decide what happens next. I know this is going to be difficult.
‘Now, Susie – there’s nothing medically wrong with you, so I don’t think you need to go to hospital.’ They both nod, which is a good start. She blows her nose, then lies back on the trolley, rolled flat by nausea, and broken plans, and other people.
‘I think – all things considered – the emotional upset, the drink and the drugs that you’ve taken – I think the best thing would be to get yourself home, sleep it off and figure out what to do next when you’re fresher in the morning.’
‘Can you take us home, then?’ asks the brother. Susie opens her eyes and looks up at me again.
‘Unfortunately that’s not what we’re here for. We can only take you to hospital, and like I say, that’s not the best place for Susie at the moment. Especially when you consider that it’s a Friday night, and A&E will be looking like a war-zone. No. What I suggest is that you get yourself a taxi and make your own way home.’
‘What taxi is going to accept her in that state?’
‘You’re right. Most taxis won’t even think about letting anyone on board who they think might throw up on their seats. So what I suggest is that – Susie – you make a big effort to walk over to the taxi rank looking as sober as you possibly can. You haven’t got far to go. They’ll take that into account, too.’
Susie stares at me.
‘You want to dump me, too,’ she says. ‘You want to throw me out in the street.’
‘No, no. It’s not like that. We’ve just got to think about what’s best.’
‘I’ve paid my national insurance. All these years I’ve worked, I’ve coughed up. Why can’t you take me home?’
‘Because we’re an ambulance, not a taxi.’
‘But a taxi’s not going to take us home.’
‘Sorry, Susie. But the only other thing I can do is take you to hospital – which I will do if you insist, even though there’s nothing wrong with you. But then you’ll be further from home than you are now, it’ll cost you more, and it’ll delay you getting home to your own bed and all the comforts that you need right now.’
‘Great,’ she says, balling up another tissue and throwing it into a corner. ‘Fucking hell. I can’t believe you won’t take us home.’
The brother stands up.
‘Come on, Susie,’ he says. ‘This is a waste of time. Just try to walk straight and look decent.’
We help her off the vehicle, discretely giving her another vomit bowl to hide under her jacket.
‘Thanks for your help,’ says the brother, but it doesn’t sound sincere.
‘You’re welcome. Good luck with the taxi.’
They don’t answer, but draw themselves up to cross the road. She looks fine from here.

four out of ten

[Eight in the evening. A fifteen year old girl is having her head wound cleaned in the back of the ambulance]

‘What the fuck was all that about? I have no idea why that happened. We were walking along the street, feeling merry. I had my iPod on and I was singing away to something – I don’t know – being stupid – being happy. Then this girl’s face appears out of nowhere and she’s like “I don’t want you singing no more” and I’m like “Excuse me. I’ll sing if I want to” and she’s like “Do you know who I am?” and I’m like “No” but my friend pulls me by the arm and says she’s one of the Brookses, one of the hardest families in town. I mean, everyone’s heard of the Brookses. And I’m like “I was only singing”. The next thing, she smashes me over the head with a bottle, and then walks off. I mean – why the fuck did she do that? Why would you do something like that? But then the worst thing was, she came back about five minutes later and put her arms round my shoulder and starts to make out like she’s sorry and wants to take care of me. What kind of psycho would do that? Saying she wanted to know I was all right, she had things going on –family things. Well, I mean, I don’t give a fuck if she’s having a hard time at home. I just want her to leave me alone. She had her arm round me, started dabbing at my head with a hankie. And I’m so terrified I’m sort of just quivering and letting her do whatever she likes because all I want her to do is go away and leave me the fuck alone.’

***

[Midnight. A man is lying in the middle of a busy street, police cars in the fend off position to protect him, a small bunch of people trying to help and keep him still]

‘I’d had a few drinks, it was getting on, I thought – I’ll go and see my girlfriend at The Beggar. Brilliant. Impress her, impress her friends, impressive. Yah! So I start to cross the road, waving and that, and I get run over. By a taxi. Was it a taxi? How cocking stupid is that?
[We fit him with a collar]
There’s nothing wrong with my neck, mate. I feel fine. Fuck me. Who’d have thought getting run over would be so complicated?
[We log roll him onto a spinal board and strap him down]
Hey! What’s all this for? I’m fine. It’s just my knee. Jesus fucking H Corbett. How embarrassing. And I bet they’re all outside the pub looking.
[We lift him onto a stretcher].
Well. I suppose it’s not that big a deal, being hit by a taxi. Was it a taxi? Fucking taxis. Where am I?
[We load him onto the ambulance]
If I don’t show up to work tomorrow they’ll let me go. It’s tough in the building trade these days. You’ve no idea. Any old excuse.
[We examine him more closely]
Honestly mate. I couldn’t be better. Considering. I can’t believe it. Run over. By a taxi, yeah? How pathetic is that?

***

[Five in the morning. A middle-aged man is talking in the back of the ambulance]

‘I came home from the pub and I was feeling a bit hungry, so I had a look round for something to eat. There wasn’t anything in the flat except this one bag of pasta, and I’m no cook – I mean, I usually just have those microwaveables. But I was that hungry I thought I’d chance my arm and try a bit of cooking. How hard can it be? So I got half a pack of butter, stuck it in a pan, fried up the pasta in that. Well tasty. But I was stirring it round and round for hours and it wasn’t getting any softer. It really hurt my gums. And then all that beer started to catch up on me. So I lay down on the sofa for a bit. Next thing I know, the room’s full of smoke, there’s banging on the door, sirens out in the street, God knows what else. But I’m okay. The landlord says he won’t let me back in the building until I’ve been to the hospital for a check up, but that’s my business, isn’t it? I feel fine. Tired and that, but okay. I normally wheeze a bit. Nothing new there. I just need some sleep. God knows I won’t be doing any cooking any more.’

***

[Six in the morning. A young guy has propped himself up against a wall and is talking into a mobile phone. The left side of his face is covered in vomit.]
‘The ambulance is here. Are you the ambulance? Yes. They say they are the ambulance.
[He holds out the phone]
She wants to talk to you.
[I tell him I’m not speaking on his phone because it’s covered in vomit]
He says he doesn’t want to talk to you because the phone’s covered in vomit. She says what hospital are you taking me to?
[Are you injured or sick in any way?]
No. I didn’t call you. Someone else must have. I’m on my way home.
[Were you lying in the street at some point?]
Maybe. Resting. It’s quite a long way home.
[That’s why we were called, then. Someone saw you and thought you were in trouble]
Well, I didn’t call you. Hang on. She says she wants to know what hospital you’re taking me to.
[We’re not taking you to hospital. You don’t need hospital. You just need to get yourself home.]
Okay. All right, mate. Whatever.
[Into the phone]
I’m coming home now.
[Stuffs the phone in his pocket, staggers off up the street]

the crumpled cigarette

The main shopping thoroughfare may be free-flowing with buses and taxis and people, but the discrete little stubs of pavement, alleyways and back entrances that serve it are so clogged with utilitarian chaos, and there are so many office workers lunching in the sunshine outside obscure new cafés, Rae is forced not so much to drive the ambulance as to insinuate it through to the location given for our next patient.
Eventually we make out the likeliest candidate, a down-at-heel, middle-aged man sat flatly on his arse on a stretch of bare concrete behind a smart little mews garage, his legs crooked up, his arms on his knees, and his face propped on the right hand whilst the left serves his mouth with a cigarette. With the cans of lager around his feet, and his relaxed, relentless smoking, he looks like some weary philosopher, taking his ease whilst the world goes to hell.
Just next to him is a sweating businessman, urgently talking into a mobile phone. He nods to me – a cursory little tip of the head, as if he’s acknowledging one delivery whilst negotiating another – then takes a step to the side. I climb out of the cab and walk over to them whilst Rae manoeuvres the vehicle into a better position.
I squat down next to the patient, but before I have a chance to say anything, the businessman clips the phone shut then taps me on the shoulder with it.
‘For God sake, let him finish his cigarette,’ he says.
‘Hold on. Are you a relative?’
‘I called you,’ he says, showing me the phone, then stuffing it in his trouser pocket. ‘I called you. Is he going to be all right? I hate to see this. It just kills me to see stuff like this. I’m sorry if I’m a bit – emotional. My twin sister committed suicide two weeks ago and I’m not over it yet.’
‘Well I’m very sorry to hear about your sister,’ I say, squinting up at him, gauging whether I should stand and take a step back. Instead, I opt for the neutral calm I’d try to show before an angry dog. ‘That must be tough. Look. Thank you very much for calling us out to see this guy. But - I just need to ask him a few questions to see what the problem is. Okay?’
‘I mean – just look at him. He’s terribly, terribly sick. You must help him.’ But I study the businessman instead. His face is a more ghastly colour than the stripes on his tie. Booze fumes roll from him like scent from a cheap odouriser; he seems to be on the verge of tears.
‘If you’d like to step to one side – for one moment? Then I can get on and see exactly what this guy needs from us. Okay?’
‘Sorry. Sorry. I just – well, my sister dying like that. I see the ambulance. I see the guy lying there. And it’s just – well, you do what you can for him. I know you will.’
But instead of moving aside, he kneels down on the concrete next to the patient, who becomes slightly more alert, but not much. He takes his right hand in between both of his – which obviously inconveniences the patient, as he now has to support his head on his neck – and squeezes affectionately. The patient stares out at him from behind his heavy eyelids.
‘Get better, mate. Please. You’re in good hands now.’ The businessman releases his grip, produces a cigarette and puts it in his mouth. I have to tell him it’s the wrong way round.
‘These guys really know what they’re doing,’ he says, as if that just proved it. Distractedly, he stuffs the cigarette into his breast pocket. ‘They’ll do their very best for you, mate. Don’t worry. I’m sure the worst is over.’
I tell the patient that I’d like to talk to him on the ambulance so we can take a few details in private. He stands up with a little help, and I walk him to the back of the vehicle. The businessman tags along.
‘Are you taking him to the hospital?’ he says.
‘Well, that’s certainly one option. But anyway – thank you very much for all your help. I think we’ll be okay now.’
‘I’ll wait just over here. Let me know what happens,’ he says, pulling his phone out again.

Safe inside the vehicle I talk to the patient. He’s not unwell, simply worn down by his life, as drunk as he needs to be at this time of day, waiting on yet another appointment with the alcohol dependency team, the community psychiatric nurse, the housing support worker. He thanks us for coming out, apologises for wasting our time. He stumbles back off the ambulance.
Outside, the businessman closes in again.
‘What? What are you doing? Aren’t you taking him to hospital?’
‘No. He doesn’t need to go. He doesn’t want to go,’ I tell him.
Whilst the patient goes to sit back down on the concrete, the businessman follows me round to the cab.
‘Sorry if I’ve been a bit – emotional,’ he says, then gives a big, deflationary sigh. He pats himself down for a cigarette, eventually alighting on his breast pocket. ‘This thing with my sister. My twin, you know.’ He hauls out the crumpled cigarette and holds it up in front of him. We both stare at it, and his eyes seem to fill, as if he’s focusing on the remains of something vital he’d momentarily overlooked.

tea

‘Look at me.’ Jonty holds both her hands out in front of her, zombie-style. ‘I’ve got the bloomin’ DTs. Do you know what that means? The DTs? It means I’m desperate for a tea. That’s the only thing that’ll sort me out. Just look at me.’ She laughs, a sweetly burbling, schoolgirl laugh. Her hands are not the only part of her jiggling about. Her jaw waggles up and down as if she’s eating a hot potato; only her hair has peace, rolled up in curlers and tightly bagged in a lincoln green scarf. ‘What a misfortunate article I am. Would you like some tea?’

We’ve just picked Jonty off the floor and helped her back into her favourite chair. Behind her through the window a beautiful blue stretch of sea and sky.

‘Do you know they want to make you pay more for a sea view? Add it on to your rates? I said not likely. I said you’ll have a Class A fight on your hands, mister. They don’t know what I’m like when I get going.’ She makes her hands into fists and holds them at eye level. ‘Pow! I can deal ‘em out when I need to. Mind you, my right shoulder’s frozen, and I can only lift my arm so high. I haven’t got the swing I used to have. And my husband died twenty years ago, so I’m out of practice.’ She gives me an elaborate stage-wink, and pats me twice on the hand. ‘But don’t worry. You’re safe with me. For now.’

The familial branches from Jonty’s ninety six years have spread across the walls story-board style: glasses raised at a work do, a man fishing, assorted bridal compositions by cake, by tree, by registry book; babies paraded to camera; gap-toothed children segueing into gowned adults; an inflated woman in shorts and sunglasses waving briskly from a summer garden a thousand miles and fifty years distant. And then amongst all these photos, Jonty has sellotaped up pictures of tigers torn from magazines.

‘Oh, do you like my tigers? I love my tigers. Here. Stroke this.’ She fetches out a stuffed tiger from behind a colourised photo of a soldier and a vase of plastic ox-eye daisies. ‘He likes his back roughing up - like this.’

I play with the tiger a little – ‘No! Really rough it up! Use your knuckles, man.’ I hand it back to her. She kisses it, then carefully places it back behind the photo – a man in a scarlet dress uniform and gold buttons, embalmed by a heavy-handed studio assistant.

‘My father. What a wonderful man. Looked after seven kids and had a job in the city. I don’t know how he did it. Mother had a heart condition, in hospital most of the time. He did have a woman who helped a bit with cleaning and chores, but mostly he’d come home from work and get straight down to it. Wonderful cook. Grew vegetables. Taught me to march around the garden – Boom! Bosh! Bosh! Just like him.’

We ask Jonty if she would like to go to hospital.

‘Would I like to go to hospital? Why? Whatever for? I’ve been in this body ninety six years. I think I should know by now when it’s not working properly. All I need to do is sit down, watch some boats, drink some tea. Okay?’

Her jaw works up and down, her head nods, every part of her not stabilised by an aspect of the chair trembling and ticking, as that ancient body like a vintage Bugatti gradually shakes itself out of whack. She pats my hand again as the home help brings her over a cup of tea and places it next to her on the trolley. I have no idea how she will manage to drink it.

‘Thank you dear,’ she says, then gives me a wink.

‘I just couldn’t get up off the floor, that’s all. ’

montage

#1: A cluttered room with an unmade bed in one corner, book shelves stuffed with cups, boxes, magazines and newspapers, the occasional book. A bulky old TV weightily sat on a stack of three: VCR, DVD, Sky. An occasional table with a pint glass three-quarters full of whisky. A floral sofa, shiny with dirt at the usual places of contact. Sitting on the sofa, the corpse of a hyper-inflated, naked man, his head angled to the left, his eyes and mouth closed, the lower surfaces of his body marbled with post-mortem staining, the remote control in his right hand partially subsumed by the rolling tympanic volume of his abdomen. A technician holding a clipboard and prescription sheet with one hand, pen in the other. A paramedic pulling back a grey net curtain and reaching through to open a window. A housing warden with a mobile phone to one ear, checking his watch.

#2: A gaunt man in a light blue windcheater and silver glasses, propped up against a low wall in the street, his bald head glazed by the sun. He is smiling bravely at the technician kneeling beside him, holding his wrist. There is a paramedic standing next to a line of three young women, all with their arms folded, looking down at the man like the chorus in some new, street adaptation of a classic Greek play.

#3: The strip-lit lobby of a dark block of flats. The lift is open, and four people are striding out: a technician with a baby in his arms, a woman in a light pink tracksuit and a paramedic carrying a red response bag and a cylinder of oxygen. The baby is wearing an unbuttoned white sleep suit; its arms and legs thrown out to the side and its head tipped back in the classic falling posture of the startled newborn.

#4: A silver saloon car outside a pub, its hazards on and all its doors open, no one there. An ambulance alongside it, headlights wig-wagging and blue lights sparkling, the back door open and the step down. Four men in blue football shirts walking into the pub, passing behind the vehicles. The second one is slapping or pushing the first one on the shoulder, but neither have turned to look inside the ambulance. The third one has his hands in his pockets, looking at the tarmac. The last and youngest one has his face turned to the dark interior of the ambulance; the compulsion to know holds his expression like a mask.

what's out there

‘I’ve got three accountancy exams next week,’ Paul says, moving his eyes up to look at me. The eyes are about the only things he can move, trussed-up as he is on our spinal board. His head is between two blocks, strapped across the forehead and chin; his neck is in a cervical collar; his torso is held crossways over both shoulders and over the hips, and his legs by a loop around the ankles.
‘That sounds tough,’ I say.
Paul had been round at a friend’s house until the early hours, when he’d accepted a lift home. Within two minutes of finishing the last round of Grand Theft Auto he was sprinting outside through a sudden downpour to the front passenger seat; within five he was spinning out of control into a flint wall on the main coast road.
Paul wriggles his toes on the board. His Timberlands have been cut through the laces, taken off and placed backwards on top of his legs. It’s like the street version of the cavalry officer’s funeral, reversing the empty boots in the stirrups, but I keep that one to myself. Instead I ask Paul what he remembers about the accident.
‘We were going round and round and round and I was holding on thinking “I’m dead” – then there was this crunching mess – and everything closed right in – and slowed – and then silence. I really thought that was it. But after a bit of just hanging there thinking “shit, shit, shit” I kind of checked everything off mentally, and it all seemed to work. And I looked Sye over, and he seemed worse, but alive at least. Then I climbed out, and some people were there saying the fire brigade were on their way. And that was that.’
The car was such a beaten wreck, it seemed inconceivable anyone could climb out unaided. But apart from a bloody nose and some lower leg pain, Paul seems remarkably intact. Sye has suffered more, though. Cut out of the car and taken on ahead by the first crew on scene, he is being assessed by the trauma team in resus whilst we wait our turn in the corridor outside.

Three o’clock in the morning and it’s the busiest the department has been all night. First up ahead of us, cued up on the runway for inspection, is an old man in such an advanced state of decrepitude the son who stands by him at the trolley is himself a livery retiree. He stands clutching a plastic bag and a jacket, nodding and smiling around him like some benign school inspector having a lucid dream. Next to them on a trolley is a woman with her face buried in a vomit bowl. She gives a cat like heave every once in a while, but is otherwise silent in her misery.
Some of the crews here I haven’t seen in a long while. In between glib interactions with our clients, circus performers spinning the plate once in a while, we catch up with the latest. Richard’s industrial goth punk sado-metal band is doing well – they’ve just finished another recording session. He’s also a paramedic now, but it took months for his registration to come through. Mike seems unusually quiet, and it’s only when I ask him how Maria is he tells me he wouldn’t know, she kicked him out two weeks ago.
‘Taxi for Mr Kennedy,’ says Richard, jamming his hand into his mouth, the clown.
Another crew arrive. Their patient, a woman in her forties, is screaming in pain as they come through the doors. It is the kind of excoriating howl that rips through everything, that stops up all normal activity for a second and lays everything completely still. They go to the front of the queue, and are taken off to a cubicle. Rae goes to help them with the transfer. I chat to Paul some more to take his mind off her screams. I can guess how awful it must be to hear something like that without being able to turn your head and look.
‘So – is that what you want to go into? Accountancy?’
‘I don’t know. Maybe. Maybe not. I’m also doing Business Studies. But I think after these exams I’ll take a couple of years off. Do some travelling. See what’s out there.’
‘Good idea. There’s plenty of time.’
The doors to the resus room swing open, and a nurse gives us a nod.
‘RTC?’ she smiles. ‘This way.’
‘Come on then, Paul,’ I say, as we wheel him in. ‘Try not to worry.’
The team close round him with their scissors and their needles and their questions.

mrs dacre's cat

On standby at our regular cliff-top haunt. The sea is a great curve of smoky grey glass glittering below us and out to the edge of the world. We are at the top of the sunniest day so far; we sit slumped like coastguards filleted by the heat as squadrons of seagulls waggle their little orange feet, zooming up on the cliff thermals. Dog walkers nod and smile or sneak disapproving looks, or both. We know that many of them think we’re hiding out here to avoid work. I wonder if we should have a sign to put in the cab window: On Standby. Ring this number for more information. Rae yawns, again. I worry that if I yawn, too, I’ll actually dislocate my jaw. I check my watch – incredibly, it’s only been fifteen minutes.

The terrafix suddenly beeps with a job: voluntary admission to a psychiatric unit further along the coast. I write the address and Mrs Dacre on my sheet as Rae hauls herself into consciousness and puts the ambulance into gear.


The satnav hates this area. You would think by the way it gets the layout so completely wrong that the residents sneak out at night to re-arrange the one way systems and dead ends. But then, there is so little to do here, it wouldn’t surprise me if that were true. So we ignore the crisis of arrows on the screen, and I direct Rae in using the map book.

We pull up outside what must be the house, working on the assumption that the numbers are following a logical progression. It’s impossible to visually check that this is the house we want, though, as it is surrounded by a hedge so impenetrably tangled it seems not to have been grown, but conjured by a vengeful witch. Luckily there is a gap that suggests an entrance. We walk through it, and suddenly the house rises up in front of us, a dirty, doomed hulk, its guttering clogged with grass and its windows obscured by ragged curtains. A scatter of desiccated plant remains hang out of pots stacked either side of the concrete stairs that lead up to the front door, a slab of wood artfully distressed with what could only have been an axe.
‘Nice,’ says Rae.
‘You knock.’
‘No, you knock. It’s your patient.’
I step up and knock. Wait. Knock louder. Look through the letterbox. Inside, a small hallway crammed with cardboard boxes, seed trays, telephone directories and – worryingly – a chain saw. Rae has a look, too.
‘Psychopath,’ she says, expertly.
‘It looks quite new. Maybe they bought it for the hedge.’
‘Or the next visitor.’
The heat of the day seems to have no power here in the lee of this hedge. A chill seems to settle around our shoulders.
‘We’d better just have a look round the back,’ I say.
‘Great,’ says Rae. She makes a lame, slasher movie-style face. ‘Yaah!’
‘I’m not worried. Are you worried? I’m not a bit worried.’
We walk around the side of the house, Hansel and Gretel style.

The only thing that makes the back door slightly more prepossessing than the front is the enormous chocolate coloured cat draped over an abandoned washing machine. It barely opens an eye as we crunch up to it from round the corner.
‘Hello,’ says Rae, offering the cat a sniff of her outstretched hand. The cat opens the other eye. ‘How did you get out here?’ There is a small window open on a latch above us, but surely the drop is too high (and the cat too round) to have made use of it. ‘Who’s a cheeky thing, then?’ she carries on, but the cat has seen and heard enough. A disgusted shiver runs through it from its whiskers to its tail; it hauls itself up and off the washing machine, and lumbers off into the undergrowth.
‘Oh.’
I knock on the back door, a resoundingly official rap, but again, no reply. ‘Ambulance’, I shout, but it’s looking hopeless. I notice that there is a small gap to the side of the curtains hung across a window to my right, so I step over some rubbish and peek inside. In the gloom I can make out a mattress on the floor, some heavy black furniture – is there a foot in that trainer…?
And suddenly there are two eyes staring straight into mine.
I start back and almost fall over. A face in the window, tangled hair, beaky nose, frown.
‘Hello. Mrs Dacre? It’s the ambulance. Can we have a word?’
Her expression does not change, but she drops the curtain. A few seconds later and the back door rattles as some bolts are drawn back. It opens, and a thin woman in her early forties steps hesitantly into the light.
‘What do you want?’
Apart from her bushy hair she is dressed cleanly, and talks in a well-modulated voice. Whether in another context she would strike me as perfectly normal, I don’t know. But here, in this house, and with our instructions, her reticence feels more like the synthetic, outward shell of something altogether more volatile.
‘Are you Mrs Dacre?’
‘No.’
‘Does Mrs Dacre live here?’
‘Yes.’
‘Oh. Is she in?’
‘No.’
‘You see – we’ve been asked to come here to take Mrs Dacre to, er…’
For some reason I baulk at using the word ‘psychiatric’.
‘…a hospital appointment.’
‘She doesn’t know anything about that.’
‘And you would know? If she knew? About the appointment?’
I really want to ask this woman quite plainly if she is, in fact, Mrs Dacre. But this is supposed to be a voluntary admission, and I would guess that pretending you were not the patient amounts to a refusal to travel.
‘I would certainly know. And I can tell you quite categorically that she doesn’t know.’
‘Okay. Well. It’s a mystery.’
‘Yes it is.’
‘In that case – sorry to have disturbed you.’
She nods once, grimly acknowledging the disturbance, then retreats back behind the door. The bolts clunk to.

I call Control to tell them what happened. The dispatcher is nonplussed, says he’ll get back to me. After a while my phone rings. He tells me that the social worker will be contacting the patient to make other arrangements, and that we can return to base.

‘Lovely cat,’ says Rae, nosing the ambulance back through the maze of streets and out on to the main drag. I have a vision of Mrs Dacre pushing it out of the tiny window with a broom handle.
‘Imagine getting that call at night, though.’
I wind down the window, and warm air floods the cab.
‘Honestly wouldn’t bother me,’ I say. And yawn.

the drop zone

Jozef is sitting hunched over on the side of the bed, his hands either side of him, kneading at the bed clothes as he struggles to breathe.
‘Oh God,’ he says, throwing us a desperate look. ‘This is worse than last time. Worse and worse.’
Jozef took some paracetamol in the early hours but the pain has progressed until now he says it’s like horses trampling across his chest. Rae puts the chair up whilst I fix up some oxygen, trying not to let the urgency of the situation infect the tone of our voices.
‘Poor Jozef,’ says the house manager, handing us his medical summary. ‘He’s not been right since his last heart attack. I’ll bring his stuff out to the ambulance.’
He pulls aside the hissing mask to say: ‘Please. My shaving bag. A change of clothes. My book.’
‘Yes, yes, Jozef, don’t worry about that. You just concentrate on getting better.’ She gives him a reassuring chuck under the chin. ‘He’ll be ninety one soon. You’d never think it, would you?’
We strap him into the chair, and then she leads us out to the lift.

On board the ambulance and the ECG is telling us what is obvious from his ghastly pallor and from the feeling of dread that seems palpably to crawl all over him – Jozef is suffering a heart attack.
‘Help me,’ he says, wrenching the mask aside. I spray him under his tongue with GTN, give him an aspirin to chew. He takes it like communion wafer. ‘My God,’ he moans. ‘This is worse than my wound at Arnhem, even.’
Rae is in the middle of cannulating his arm when he suddenly he seems to relax slightly.
‘Jozef?’
‘I’m afraid this is it for me,’ he says, simply, then crumples in on himself with a gurgling exhalation.
I drop the back of the trolley down, snatch the pillow away. Rae punches him in the chest then begins CPR whilst I put some pads on him.

Over the next hour the early morning commuter traffic rises and flows around the ambulance as inside our grim little protocols are acted out. But the scattering of ripped packets, empty drug phials and upended kit bags, the convulsive voltages and broken ribs, all peter out, seem to fade in conviction along with the readout on the ECG, until, in the telescoping daze of these things, we find ourselves in resus back at the hospital, watching from the outskirts of the crash team as the registrar peels off her gloves and calls out a time.

Back outside, the ambulance cleaned and prepped, a cup of coffee, and the air is crisp and bright. Another ambulance parks alongside to offload.
‘All right, Spence. Rae’ says Frank. I can imagine him getting off a horse in the same trail-beaten way, tipping his hat back with a rangy forefinger. He stretches, there is an almost audible crack, then he makes his way to the back. ‘Working hard? Or hardly working.’

The coffee is strong and wonderful. I look at my watch, but it’s still too early to call home.
Rae asks me what Jozef meant by Arnhem.
‘I think it was something to do with an operation to capture some bridges in Holland toward the end of the war in Europe. It was what the film ‘A Bridge Too Far’ was all about.’
‘Never heard of it.’
‘Paratroopers. In by gliders. I think a lot of them were killed or captured.’
‘Oh.’
We climb back into the ambulance cab and clear up for the next job. Rae offers me a stick of gum. I try to imagine what it would have been like on the glider. I wondered who Jozef sat next to all those years ago as the flimsy aircraft shivered and cracked in the darkness, as they clutched their rifles, approaching the drop zone.

falls diorama

Three rows of dog design plates on the wall, four to a row. Newfoundland, Alsatian, Labrador, others.

A partially collapsed bookcase, a precarious herring-bone of spines: David Attenborough’s Life on Earth; A History of the Second World War; The RHS Horticultural Encyclopaedia; tatty romantic novels; three bronze darts trophies.

A watercolour – country scene – slipped askew in a chipped, cheap gold-leaf frame of flowers and leaves.

A slate mantelpiece where, amongst the piles of papers and letters, two bronze horses, one grazing, one rearing up, either side of a four-by-six colour photo where the tones have all leached away over the years. A man and a woman? Sitting at a table, looking up into the lens with their heads together, smiling. One of them may be wearing black glasses; the rest is lost.

A series of six plaster of Paris heads at an angle either side of the mantelpiece, three US Cavalry on the left, three Indians on the right. The Indian Chief is snarling; the Cavalry Captain is shouting.

A TV stacked-about with videos and cases. A stubby bronze candle holder, doubling as an ashtray, resting on the top.

Black bin liners splitting open with books and magazines.

A flowery sofa, partially buried beneath a drift of letters, calendars, free newspapers, shopping lists, prescription sheets, boxes of old electricals, two more bronze horses with their legs sticking in the air, a slipper.

Behind the sofa, a three feet long toy panda lying on its back, staring up beneath the dust with a glassily over-stuffed expression.

A pale pine sideboard. On the surface, amongst more anonymous clutter, a bronze tyrannosaurus rex rearing up behind a bronze man on a motorbike, souvenir of the TT 1962.

An elderly woman lying on her back, gradually waking up at the foot of the stairs where she exhausted herself trying to make the hallway phone.

feet

one

At the top of the road that leads up to the railway station we can see a frenetic chain of flashing blue lights: transport police, a response car and the first ambulance on scene that we have been sent to back up. Many of the people who live in the houses along this road have been drawn outside to watch. I am aware of their collective focus as Rae jumps out and goes to grab her paramedic response bag. I turn on the KRS to leave the engine running whilst taking the keys with me. We both stretch on our blue rubber gloves as we stride over to where a couple of police stand guard to the platform entrance.
‘Follow the stairs, you’ll be directed at the top,’ says a female officer, and smiles encouragingly, like a stage manager to the next actors out.
Up the stairs, and we emerge onto a platform of bright sunlight and a small crowd of fluorescent jackets, mostly rail staff, waving us on.
‘Just over there a bit and down on the track. Don’t worry – power’s off.’
‘But don’t stand on any rails, just in case,’ adds another.
We recognise two of our colleagues in an ambulance huddle around the figure of a woman lying across the rails: Frank, holding her head still, and Kent, busy dismantling a scoop stretcher. We jump down to join them. Richard, the officer on scene, lays out the story so far. We listen, whilst at the same time registering the bloody devastation to the woman’s lower legs. They have been rendered to a butchery mess along the shining rail, but elsewhere there is a curious absence of trauma. The only other potentially dangerous sign seems to be the worrying way in which her arms are crooking up and inwards. Head injury? It would be inconceivable to escape without one.
’Guys. This lady jumped in front of the train as it passed through the station and was rolled underneath it. She’s suffered massive trauma to her lower legs, has good, bi-lateral air entry, is conscious but GCS eleven, if that.’
We are all aware of the need to get things moving quickly now. We set to work, following Richard’s direction: Rae attempts to cannulate the woman around the rest of us as we manipulate the scoop stretcher beneath her. The left foot is nowhere to be seen; a policeman is dispatched to locate it. The right one is attached by the merest strip of flesh. I have to pick the remaining oil-blackened foot up so that the stretcher can be clicked shut either end; it feels cold and heavy in my hand. The extent of the trauma to the woman’s legs is so awful that despite our efforts, some fatty tissue snags in the mechanism. Rae cannot get the cannula in as the woman is moving her arms too much, but by this time we are ready to raise her off the rails and up onto the spinal board placed on the platform just above us. Once on, we secure the straps and then climb up ready to go. I take the foot end, Kenton takes the head, the others around the middle, and we all set off back along the platform towards the exit.
As we go backwards down the stairs, a sudden gush of blood pours down the front of my trousers and splashes onto my shoes.
As Rae and Richard put a line up in the ambulance, I make an attempt to bandage up the woman’s legs. I cut away the remains of her trousers as best I can, tangled as they are amongst the splintered bone. There is surprisingly little blood; the major vessels seem to have retracted, reducing the flow. I improvise a bandage from an incontinence dressing, then, after checking that there is nothing more for me to do, I rip off my gloves and jump out to move my ambulance out of the way and clear the exit.
A man is running up towards me.
‘My wife!’ he says. ‘It’s my wife in there, isn’t it? Please. Let me on. Let me be with her.’
I glance behind me into the ambulance and Kent is shaking his head vigorously. So I put my arms out to the man. I am aware of Kent shutting the door as I start to say to that there are too many people on board the ambulance, that everything possible is being done, that he can come with me to the hospital and meet his wife up there. He pushes past and tries to force his way round and on to the vehicle through the side door. Two policemen standing there hold him back, but after a second or two of rapid negotiation he is allowed to kiss his wife, then taken into a police car to follow the ambulance up.
It leaves on lights and sirens, along with the police car.

After I’ve turned the ambulance around, I drive away from the scene normally, calming myself down, radio on, windows open to let in the fresh air. I wave to the woman who lets me out at the end of the street, and she gives me a friendly wave right back. I start to think about what I need to do now. Change these trousers, for one.

two

Later that afternoon we’re called to an elderly man who has a laceration to his foot. We are met outside the block of flats by a round-faced, pleasantly smiling man with a plastic washing basket.
‘He’s inside, the old fool. He’s been walking around without anything on his feet, he’s trodden on something and his foot has bled. There. I tell him, but what’s the use? He bled quite a lot. Such a mess. But I’ve cleaned it up. Anyway. How are you? Lovely day. Thank you so much for coming out. I hate to trouble you when I know you’ve got better things to do.’
He leads us inside. The heat in the hallway, the dull light and the man’s sugary chatter combine to make me feel a sudden, crushing burden of sleep. When he introduces us to the patient, it’s all I can do to stop myself grabbing a cushion and lying down on the carpet. But with a lurch of consciousness, I force myself to see that the patient is a semi-naked, bulgingly fat man sitting in an easy chair with one foot up on a red, rattan stool. He smiles down at me as I kneel before him. I pull out my little black torch and inspect the foot. There is a little dried blood on the sole and around the toes, but no obvious cuts. Rae helps me open up a sachet of sterile water, and together we clean his foot. The only thing I can see is perhaps a tiny wound, almost like a paper cut, along the crease of one of his toes. But nothing serious. I push and prod his foot.
‘How’s that? Feel anything?’ He continues to smile down at me, happy with the attention. His friend still hugs his washing basket.
‘You should have seen the blood,’ he says.
‘How about that?’ I ask the patient, prodding his foot some more. No reaction.
‘A bit of shiatsu,’ I say. ‘No extra charge.’ Then I look at Rae and say ‘I think I’ve had enough feet today.’ And I have a clear vision of the policeman wandering slowly off along the track like a beachcomber in the sunshine.
‘You’re fine,’ I say, squeezing the man’s big toe. ‘But get yourself some slippers.’

the fantastic fusiliers

‘I got stationed to Berlin. The west of it. Nineteen forty eight. Christ, what a mess. It was the Russians, see? They came in. They looked at the map, at their bit. They thought Right – that’s got to go, and that, and that. Flattened the lot. Drew a ring around the rest, nothing in or out without their say so. We had to fly supplies in. Or come in on a train – which of course the Russians stopped, and searched, front to back. They were young, a lot of them Russians. boys really. They would look at you – stare at you – like this… not say a word. But we was all cockney boys. We were just the same. We stared right back at them – like this…. So it went on. Funny, really. The Fusiliers. Fantastic.

‘When I came back, I got a job working the railways, but then Margaret Thatcher came along and that was that. The only job I could get then was at the Coroners. People thought I was a policeman, with the black suit and everything, but no – I was a glorified usher, I suppose. I met a lot of famous people. (…) came up to me and said “I must say you’re looking good after that fight” and I said “What d’ya mean? What fight?” and he said “That fight. You’re whatsisname aren’t you? What you doing here, anyway? I didn’t know you knew (…)” And I realised he thought I was (…)

‘My wife met a lot of famous people when she was younger, you know. That’s her in the photo. What a looker. She was an usherette at the Academy. All the famous film stars would come in for the first night and what have you, and she’d be the one who’d hop on stage and give them a bunch of flowers. Oh yes. She met them all.

‘Sixty years we’ve been married. Well, this year – sixty years. One child, Peter, but he’s gone now. We could only have the one, you see.

‘And of course, since she got ill, it’s been difficult. For both of us. You know, she’s been stuck in this flat six years. Six years. Not even down the stairs for some bingo. It’s her nerves, mostly. She gets all het up, it’s a job to know what to do. Things play on her mind, especially at night. When she’s reading the paper or watching the telly, she’s all right. But when she’s finished doing that, she just kind of sits and stews. But you do your best – what else can you do? It’s difficult, though. No question about it.

cute

We pull into the long drive that winds like a river through this bleak canyon of housing blocks. Rae switches off the blue lights; this is an area you would turn on your cloak of invisibility if you could, an estate we know well, though mostly at night. An area on the map that could well be marked here be dragons, except instead of a coiled serpent there would be a can of lager and a syringe. The message says birth imminent, and Control assures us that a midwife has been dispatched. I point out the doorway with the right numbers, we lock the vehicle, and, watched by a small gang of kids who should really be in school, we give them a nod, ignore their questions, and hurry in with a maternity pack and some Entonox.
A man paler than his tracksuit top opens the flat door to us and steps aside.
‘Come in. She’s on the bed through there.’
I would guess he was about twenty, but with his gelled fringe, his spotted face and his spotless trainers, he looks like he should be outside kicking a ball against a wall. He shows us into an encouragingly warm and bright flat, though, and just before we go into the bedroom – where we can hear groaning – the girl’s mother comes out, a brisk, trim woman with lipstick as bright as her manner.
‘Hello. I’m Trish. I think Sandra’s about ready to give birth. They told us to get up to the centre when the contractions were about five minutes apart, but they started coming on fast and strong when she was on the phone. Her waters have broken and she wants to push. Her last baby was pretty quick.’
She gives us a wide smile and says: ‘I hope you’ve done this before.’
I match the smile and say ‘Hell, yes – at least three,’ which is true, but I omit to say that this was in the capacity of fetcher and carrier. I know Rae has actively delivered a couple, though.

Sandra is naked and on all fours.
‘I can’t do this! I can’t do this,’ she gasps, and grips her mother’s hands when she rejoins her on the bed. Trish kisses her forehead and rubs her back with her free hand. I tell her about the gas and air – she says she had some last time. I hand her the mouthpiece for her to use as she needs, then make things ready for delivery.
After this latest contraction passes, Trish tells us that Sandra already has a little girl of two. That birth went quickly and without problem, and all her current ante natal checks have been fine. But without changing her expression she says that there were some problems the very first time Sandra was pregnant, but only after the baby was actually born. Hours later it had stopped breathing and died. Sandra gasps again and says ‘Don’t’, and her mum grips her hands even tighter. I look over to her partner, standing in the doorway, and he shifts his weight slightly. I think he might cry.
‘Are you okay?’
‘Yeah. I just don’t like to see – you know.’
‘Could you get some clean towels? It’ll be good to have something to wrap the baby in when it comes. Which won’t be long now. Are you okay with that?’
He nods.
‘Don’t worry. It’ll be fine.’
Sandra starts to cry out with a low-down, animal conviction, and her perineum starts to bulge. The top of the baby’s head appears, its wet black hair a glistening whorl. I place my right hand to control it.
‘The head is crowning now. I don’t want you to push. I want you to pant – like this. It mustn’t come out too quickly or you’ll tear.’
After about three contractions the baby’s head is delivered, slowly squeezing out with an intensely squashed-up expression. There is a pause. I feel round the baby’s chin and ear for any sign of a cord, but thankfully – am I right? – it all seems free there.
‘That’s the worst bit over,’ I say, conscious of the fact that I have no actual idea what any of this might feel like. ‘The rest of the baby will come with the next couple of pushes.’
My words sound typed-out and unconvincing; but despite all this, despite these clunking interactions and interventions, the event advances as it will always try to through time, blindly working out another link in the chain, bloody, pure and remarkable.

I know that we should aim to have the baby delivered within about three contractions, or it might be that the shoulder is stuck. But after just two more pushes the baby slips out in a gloopy rush and I guide it up and out.
Together with Rae we clean it and check it over quickly. It cries, and I realise that I’ve been holding my breath for a little while, too. It’s like breaking the surface after a length underwater.
‘It’s a boy – and he’s absolutely fine.’
Sandra turns onto her back. We bundle him up in a couple of towels, then Sandra receives him on to her breast where he blindly smacks his tiny cupid mouth and waves his fingers in front of his face.
There is a knock on the door. The midwife hellos and enters.
‘How we doing?’ she says. I’m almost as happy to see her as I was to see the baby.

**

After the midwife has used syntometrine to bring on the birth of the placenta, checked it over and satisfied herself that everything’s fine, she says we can go.
Trish gives us a hug.
‘Maybe we should call the baby Spence,’ she says.
‘Poor little thing! I wouldn’t wish that on anybody,’ I tell her. ‘Congratulations. He’s beautiful.’
Sandra gives us a wave from the bed where she sits suckling the baby; her partner comes over and shakes our hand. ‘Thanks for everything.’
We walk outside with the remains of our equipment and give the gang of kids outside a bigger, brighter and altogether more confident smile than when we went in.
‘What happened?’ one of them says, about eight years old, leaning forward on the bars of his bmx like Marlon Brando in The Wild One.
‘A baby boy,’ I tell him. ‘A lovely baby boy happened.’
‘Ahh. Cute,’ he says. And then one of the girls next to him laughs and tries to push him off.

the whole picture

This area of town has been struggling for some years now. Of the surviving shops on the main drag, only a newsagent slash off licence and a tatty convenience store survive to filter-feed the meagre streams drifting along the pavements, but there’s not much business to be had. They open early, close late, then bolt down shutters so battered with graffiti they make the shops look like embattled settlements on an angry planet, violent paint storms descending every night.

Control tells us to stand off whilst they clarify the job, something we’re all too happy to do. Eventually they give us the nod, and we pull round the corner into view.

A woman is standing on the pavement, smoking. She grinds her fag out underfoot when she sees us, and waves us over. Rae climbs out of the cab, and in the moment it takes me to grab a torch and lock the vehicle, the woman is talking close-in to Rae as if they’ve known each other for years.

‘His name’s Michael. He’s a lovely boy, smack head, obviously, but you can’t have everything. We’re worried about him ‘cos he’s taken a load of methadone – his eyes are like this…’ (she rolls up the forefinger and thumb on each hand and holds them in front of her eyes like tiny spectacles, then speaks in a robot voice: I can not see you. I am a smack head.). She drops the voice, the pretend specs, carries on.
‘…then he’s well grouching out. Every now and then he’ll slump forward and stop breathing, and we’ll have to give him a poke. Hey, Michael,’ she acts out for us, ‘don’t die on us mate! Keep it going!’ She smiles at us, affectionate as a holiday camp entertainer on speed. ‘Ahh. Anyway – thanks for coming. I suspect you have better things to be doing. Bank holiday and everything. Eh, Spence?’ she says, giving me a dig in the shoulder and checking my name tag. ‘My name’s Lilly, but you can call me Lil. If you like. Or not. Anyway, he’s this way. Okay with dogs?’

She leads us into an abandoned shop, permanently boarded up but the door pushed through. There is no light; our flashlights pick out elements as we thread our way through the junked space – the old counter still standing at one end, polystyrene tiles hanging from the ceiling, wires and rubble, a pool table with a game half played – then up some wormy stairs. As soon as we touch on the first tread, some savage barking erupts above us.

‘Clancy! Cindy! Shut it!’ she yells overhead into the darkness, but it only seems to make them worse.

‘You are okay with dogs, aren’t you?’ Lil asks us. ‘They’re – how shall we say – enthusiastic? But they won’t do you any harm. Not whilst I’m here, they won’t.’ She gives a strange, low-down laugh from her belly, and with a slap on the shoulder we carry on in.

Clancy and Cindy are waiting at the top of the stairs, driven into a paroxysm of aggression by the numbers of feet coming towards them and the waving torches.

‘No! NO! Don’t you dare!’ Lil shouts at them. But the only thing that actually helps is when she grabs them by a collar apiece as they make an early lunge for our throats.

‘In you go!’ she says, hurling them both like bowling balls into a side room and slamming the door shut. She smiles at us in the gloom. ‘Just through here.’

She leads us into an oppressively smoky room lit only by a camping hurricane lamp. The light from this plays across a bare-chested man in his late fifties, sprawled on a mattress with a can of lager resting on his belly and a fag rising and falling to his slack face. He has long hair and a moustache that could be a set-piece from a fancy dress shop, over in The Sixties section. He raises the can in acknowledgement. Nearer the lamp and more thoroughly illuminated is a younger man, arms either side on the armrests of the easy chair, slumped forward with his baseball cap over his face.

‘Michael,’ says Lil, giving him a shake, then even louder ‘Michael!’ When he doesn’t respond she knocks off Michael’s cap, turns to the man on the bed and throws it at him. ‘You toss bag. You said you’d keep an eye on him.’

‘I did. He’s alright. Michael – come on now, son. Play the game. The ambulance is here for you now.’

Michael gives a jerky nod then sits up, just like someone falling asleep on a train and catching themselves awake one stop too late.

‘Shit. Sorry. Yes. What?’

‘Michael. The ambulance is here.’

‘Well what do they want?’

‘I called them. We’re worried about you.’ Lil turns to us again. ‘I had a friend like this – in just this state. In and out, in and out. Then she was out and out. I mean she was dead. That wasn’t so long ago, either.’ Back to Michael. ‘You little shit. You’ve taken way too much methadone and you’re going to croak on us.’

Rae sits down with Michael. She explains that everyone thinks it best if he come to the hospital so the nurses there can keep an eye on him. She says that the worry is that if he’s left to his own devices, he might well pass out and the opiates reduce his breathing to nothing.

Michael soaks up the concern with a drug-fattened detachment. He does agree to come in with us, though. Lil retrieves his cap from the man on the mattress, and between us all we manage to get him out to the vehicle.

***

At the hospital, we put Michael into a chair, and whilst Rae goes over to the desk to talk to the charge nurse, Lil and I stand either side of him.

‘Now you tell these good nurses everything. Don’t hold back. They don’t mind about the drugs – do they Spence? Look at Spence. Does he look like he cares? He doesn’t mind a bit. Do you Spence?’

I tell them that I don’t mind. I say we’re not the police. We’re just need to know exactly what’s been taken so we can take the right action.

‘See what I mean?’ she says to him, standing over him with one arm round the back of the chair, like an over-interested aunt. ‘It’s all good stuff.’

Lil straightens up and looks around, watches Rae at the desk for a bit, then looks at me and smiles.

‘So – are you two always together, then?’
‘Mostly. We change around sometimes.’
‘Are you – er – are you an item?’
‘No. I’m married with two little girls.’
‘Ah. That’s nice. Nice that you’ve got two little girls. And nice you feel able to tell me all these personal things. Some people wouldn’t. With some people it’s like – whoa!’ – she flattens both hands out in front her, like a wall. ‘But no – I appreciate that, Spence.’
She looks around her a bit more, straightens Michael’s cap, then says: ‘I didn’t know if you were gay or not. Not that that matters. Who cares? Not now. Not ever!’ She pulls off his cap again and gives it a tap against her thigh. For the first time I notice that Michael has a bald patch on the top of his head, like a monk.
‘It’s nice to get the whole picture, once in a while,’ says Lil.
Rae waves us over, and we wheel Michael into a cubicle.

travelling companions

‘Thanks for coming.’
Standing in the open doorway of the caravan, in the thickly shadowed darkness of this derelict office forecourt, the man looms above us like an urban warlord, big hands reaching down to us, glints of metalwork in his mouth, ear and lips, a roughly-worked, stubbled head. A dog – the magician’s familiar – jumps down with a muscled thump and sniffs us thoroughly.
‘Don’t mind him. He’s okay. Watch yourself as you step up. I’m afraid it’s all a bit – temporary.’
He helps us into the caravan as we step up using the lorry tyre that’s been put there.
Even by the light of the solitary candle you can tell that Kat is exhausted. She sits with her legs drawn up on the bed-shelf, stroking her pregnant belly with one hand and her forehead with the other. Just along from her on the shelf a child is sleeping in a nest of duvets, towels and such. You can just make out a messy heap of hair on the pillow. The dog follows us in, jumps up beside the little boy, sighs heavily and curls up.
Kat tells us that she went to stand up and felt a tearing pain in her right side. She’s never had anything like it before; it made her vomit, and cry out. It lasted for about an hour, full on, nothing helped. It’s fading now. She tells us that she’s twenty two weeks pregnant, everything’s going well, but she did have a difficult time of it with her last pregnancy. Non-identical twins. But just as she went into labour they discovered that one of them had died, so they delivered by emergency c-section and found that there had been a problem with one of the placenta.
Although her initial obs are normal, I tell them that – with all she’s said about the pain and her past medical history – it’s inevitable I’ll be recommending a trip into hospital for a check up. She says she’s okay to walk out to the ambulance. We help her up.

This interior seems insanely bright and organised; Kat quietly grips the arms of her seat as we lurch off the site, but she is as safely stowed as all the clinical stuff that surrounds us. Despite her scavenged clothes and matted hair, she has the resonantly clear complexion and expression of a child.
‘I’m tired,’ she says. ‘I want to settle down and find a flat, but it’s not happening. They say I’ve got to go back home to my parents, but there’s nothing there for me. I don’t want to stay with Mike, though. I don’t know how I ended up there.’
She pauses, staring into the window and the reflection that stares straight back at her.
After a moment she says: ‘He’s nice enough, and he’s great with Jez, but – I think I’ll miss the dog more.’

alexandria

Eleni, the ninety three year old Greek-born resident of these flats, sits on the floor, propped up against an armchair with her withered legs drawn up. Her cream dressing gown is patterned with splotches of blood. She looks across at us as the warden, James, shows us into the room, and she raises a hand feebly in acknowledgement.
‘Ninety three and steady on her pins,’ he says, proudly showing off his favourite, but in the pause that follows no one could be in any doubt that times have moved on.
‘Then again, she has started falling over a little bit these past few weeks.’
She tuts, and shakily tries to pluck away some hair sticking to her face.
‘Eleni has cerebral atrophy,’ says James, ‘which means she has difficulty remembering things sometimes. And her English was never that good to begin with.’ He steps aside with a red-faced flourish. ‘Over to the professionals. I’ll go and make a few calls.’
‘No hospital,’ she snaps up at us, grumpily.

It seems Eleni has fallen over in her little kitchenette sometime in the last three hours, an event born out by the dried blood on her face, and the way the wound’s edge has curled back on itself. She has knocked a sixpenny sized hole into her head just above her left eye; beneath the congealed lumps you can just make out the dull glimmer of bone.
‘Toilet,’ Eleni says, gripping my hand. ‘Bring me.’
We give her a quick assessment for other injuries, then ask James to bring the commode over so we can lift her straight onto it. I give her a few moments privacy to relieve herself, then start in with the cleaning of the wound.
‘This will need a trip up to the hospital, I’m afraid,’ I tell her. She narrows her eyes at me and hisses. ‘This is a nasty wound, Eleni. We can’t just treat it here. It needs some specialised attention.’
Eleni seems to whince more at the prospect of a trip up to the hospital than my dabbing clean of the area. I do what I can, then tie a dampened bandage to her head. From where we stand around her we can see into the kitchenette, the smashed plate of food on the floor, cold ratatouille mixed with blood and a pair of broken glasses on the top like some tragic garnish.
James comes back into the room.
‘I’ve spoken to Henry,’ he says, bending close-in to Eleni and speaking loudly. ‘He’s going to set off right away, says he should be up the hospital by close of play today.’ James rubs her shoulder affectionately then straightens up and says to us: ‘Her son, Henry. Well – I say son – he’s seventy odd himself. He’s a consultant at a hospital somewhere up north a-ways. He’ll be retiring himself, soon.’
We move with Eleni out of the room, and as I wait for James to open the door, I notice a beautifully framed, formally posed photograph on the wall – a young nurse sitting down, and a young man in a uniform standing behind her, one hand on her shoulder, the other by his side. James catches me looking at it.
‘Eleni’s husband. Flight lieutenant Frank Clements. Shot out of the skies over Alexandria in forty one.’ Then to Eleni: ‘See you soon, Trouble,’ and leads us all to the lifts.

a slow drive out

‘Apparently you’ve got a transfer to Southview for us. A patient Beauregard?’
The charge nurse suddenly looks up at me with a thousand watts of attention. Worryingly, she stands, walks around the desk, grabs me by both shoulders and holds me at arms length.
‘God. Jesus. Yes. Thank you so much. Now then. She’ll tell you she’s injured but she’s not. She’ll tell you she’s been in umpteen traffic accidents but she hasn’t. She says she can’t move, but even though she’s perfectly mobile, please, please, please treat her as if she can’t and pat slide her slowly onto your trolley. She’ll throw herself on the floor if you don’t. She’s had all her medication – don’t listen to her. Her brother Ken’s with her and he’s okay, so follow what he says. She’s taken everyone’s name in here, threatened us all with the police, so don’t worry about that. She’s very volatile and she may well try to pinch or slap you, but I don’t think she needs a police escort. Ken seems to have things in hand. Follow him. Strap her into the trolley. Drive slowly. God. Thank you so much for taking her off our hands.’
‘Is this a compulsory section?’
‘No – it’s voluntary. But best not talk about it overmuch.’
The charge nurse leads us to a cubicle with all its curtains drawn. She gives me a preparatory over-the-shoulder look – one part showman, two parts executioner – then draws the curtain back.
‘Ah. There you are. Look. I’m really not at all comfortable. My legs are swelling up. I have dangerous sensations in my arms and my back is an utter nightmare. Why aren’t you giving me the medication I need? Why are you torturing me like this? I don’t think you can be aware of the extent of my condition.’
Mrs Beauregard reminds me of one of my primary school teachers. She has the same high manner, the same great jowls of indignation, but behind the lenses of Mrs B’s thick glasses, her eyes seem painted and flat.
‘This is the ambulance crew who have come to take you to the other hospital we talked about.’
Mrs Beauregard scans us vaguely, then plucks at her blankets.
‘That’s all very well – and I’m happy to meet you – but this isn’t addressing the central question. I am suffering. I am in considerable pain. And you don’t seem in the least bit interested to do anything about it. I know what your name is and I know what you’re up to. I’ve taken note of everything that’s happened here today, and I shall be contacting the police, my MP, the papers. It pains me to say it but your career is effectively over.’
‘Obviously you are entitled to say whatever you like about the treatment you’ve had from us today. I’m confident that it will show a proper level of care.’
The charge nurse introduces me to Ken, who is sitting surrounded by bags on a hospital chair. As he stands up, it seems inconceivable that he is related to the woman in the bed. The vigour of his handshake, the warmth in his eyes, even the care evident in his closely-trimmed white beard – whilst her illness has leached something intangibly connected from Mrs Beauregard, her brother looks at us with a grounded smile.
‘Hello,’ he says. ‘Thanks for coming so quickly.’

Despite taking as much care in the transfer from the hospital bed to our trolley as we would for a critically injured patient, Mrs Beauregard provides an awful soundtrack of yelps, shrieks, urgent instruction, threats and pleadings.
‘My back! My back! Good God Alive! You’ll paralyse me! Don’t you care? Can you be so cruel?’
Once we have her on the ambulance trolley, and Ken collects all the bags together ready to go, Mrs B gives us some more information.
‘I don’t know if you’ve been made aware,’ she says, placing her hand on my arm, ‘about my eye condition? As a result of the last road accident, my retinas have become detached, and pressure has built up dangerously behind the eye. It’ll be in my notes. Is it in my notes?’
I look across to Ken and he raises his eyebrows.
‘Let’s have a look at that on the vehicle,’ I say to her. ‘The sooner we make a start, the sooner we’ll be there and you can have a rest.’
‘No. You don’t understand. Why should you? The nursing standards here are execrable. No. Listen to me – and do not move until you have this perfectly understood. My eyes are in a fragile state. The slightest wrong move and I will be plunged into darkness. I cannot be subject to any untoward movement. I cannot be driven above twenty miles an hour. Any faster and I will jump out of the vehicle. Do you understand? I shall go blind.’
Ken puts the bags back down and steps over to his sister.
‘Dorothy,’ he says, stroking her forehead. ‘Dorothy. Try to relax. This is an experienced crew. They know what they’re doing. Let’s just get going and make the best of it.’
‘I hope they do know what they’re doing,’ she says, releasing my arm. ‘If they do, it’ll be a first.’

The journey to Southview is an extended version of the transfer from bed to trolley. Mrs Beauregard instructs and screams and threatens and reaches across to slap me, whilst Ken does what he can to pacify his sister. At one point, in an effort to introduce some rational understanding of her situation, I decide to see if Mrs B knows where she is going; this is supposed to be a voluntary admission, after all.
‘Dorothy? Do you know much about Southview?’ But when I glance at Ken, he shakes his head discretely. I decide not to pursue that particular line, and settle back into my seat.
‘How can you be so cruel?’ says Dorothy, fixing me with a watery stare. ‘When I first saw you I thought you seemed kind, but now I see you for what you are. A cruel and petty man.’

At Southview we are faced with a practical dilemma. The trolley will not fit into the lift, and there are no chairs. Mrs Beauregard can barely interrupt her monologue of threats to think about the problem, so I leave her with Rae and Ken and set off to muster some help from the ward.
The psychiatric nurse who comes down with me listens to my description of Mrs Beauregard with a battle worn air of detachment.
‘We don’t need a chair,’ she says. ‘Come on. We’ll do this quickly.’
I’m encouraged; she seems a formidable ally, with her pile of henna red hair and her orange lipstick, a vivid specialist who’ll know how to trot this one out.
Unfortunately, back down in the lobby, it appears she has no magic formula. We’re left to wrap Mrs Beauregard in blankets, slide her onto the ambulance carry chair, and wheel her up to her bare little room, all within a storm of sound that echoes about the resoundingly empty corridors.

Whilst the psychiatric nurse and an orderly settle Mrs Beauregard into her room, Ken steps outside and thanks us for our help.
‘Don’t worry about anything she said to you. It doesn’t mean anything. It’s just her illness.’
For the only time that night I’m able to ask him a little about the situation. He tells me that he has two sisters. The eldest sister is already in a special unit; Dorothy started showing similar symptoms about a year ago, but this is an acute deterioration. In neither case can the doctors pinpoint an organic cause, and there’s no history of it in their parents or other relatives. Ken lives abroad, and flew back yesterday to oversee things.
‘Good luck with everything,’ I say to him as we gather up our chair and blankets. ‘I hope it all works out.’
He waves to us from outside the room, steps back inside, and the door closes on Dorothy’s booming complaint.

We wait by the security door to be buzzed out.

baby bird

The girl is star-fished on the sofa, asleep, but there are several details in the room that undercut the peaceful image. Two policemen make room for us as we come in the door, the radios on their shoulders emphasising their darkly official presence; the other detail is the two raddled looking women, one in a puffa jacket with her arms folded, the other in a dressing gown smoking a cigarette. She gives us a thin smile about one degree cooler than murderous. The next thing I notice – initially as a winy smell, then as slipperiness - is that the laminate floor we’re standing on is awash with vomit.
‘Paula came back with her mate, Francie. They went upstairs for a couple of hours, then Francie left. That was it, as far as I was concerned. Then she came downstairs, and she’s like this.’ Paula’s mother takes another drag on her cigarette. ‘I can’t understand it. What’s wrong with her?’
‘Francie came home about an hour ago and she seemed absolutely fine. Went to bed early. Zonko. Good as gold.’
It looks as if the two women have been dragged together in the wake of their two thirteen year old daughters, but the cigarette smoke coming from Paula’s mum looks like steam escaping from an overheating boiler, and from here, between these two policemen, it certainly feels as if this particular teen-parent coalition is set to blow.

I go over to Paula and try to rouse her. With one little shake of her shoulder she suddenly sits up. She opens her eyes, and though the pupils are massively dilated, she doesn’t seem to register anything. Then she opens her mouth, stretches out her tongue, and lets out a dreadful, mewling scrape of a noise, sounding in her distress like a baby bird chewed by a cat. She doesn’t respond to any questions, just shakes her head from side to side, and spits little white saliva-balls into the air.
‘It’s pretty obvious that Paula’s had a fair bit to drink tonight, but do you think she might have had some drugs?’
‘No. She’s a good girl,’ she says, looking at Francie’s mum. ‘She’s never done anything like that.’
‘Francie is on Ritalin, for her behaviour problems,’ says her mum helpfully. ‘Could Paula have taken some of her medicine?’
‘It’s possible. I’d have to look it up in the BNF. But whether she’s taken that or something else, she’s in a pretty poor state and I think she should go into hospital for a doctor to have a look at her.’
‘I’ll put some clothes on.’

Getting Paula onto the vehicle is a problem – essentially an exercise in how to handle an uncoordinated, uncooperative, stinking mess that screams horribly and spits a great deal. The spitting we control by putting an oxygen mask on her; the rest we look to cover with some discrete blanketing and a speedy removal to the safety of the trolley. Once on the vehicle and in the recovery position, her screams gradually subside again into a slack-mouthed sleep. She breathes slowly and heavily. Despite having vomited many times there are still traces of pearlescent peach lipstick on her lips, but the mascara round her eyes has pretty well all run off and down her cheeks in thin, dark rivulets.
I open the back door to tell her Mum that we’re ready to go. She scrunches out another cigarette and hauls herself up the step.

‘Kids’, she says.

***

When we’re cleaned up and ready to go at the hospital, we get another job immediately. The house next door to the house we’ve just been to. Thirteen year old girl, drunk, acting strangely.
No need to consult the satnav. We’re there in record time. The police have gone, but the mother in the puffa is standing outside to wave us in. She looks closely in at the cab to see who the crew is, and visibly flinches when she sees it’s us.
‘Well – it finally caught up with her,’ she says as we walk down the path. ‘I found two bottles of Lambrini they’d thrown out of the window into the garden.’
Francie is sitting with her head in her hands at the bottom of the stairs. She doesn’t have the enthusiasm to look up as we approach. But at least she hasn’t been sick, and doesn’t look as if she’s going to scream. When I get her to open her eyes, they’re much less drugged.
‘What did Paula take that you didn’t?’ I ask her.
Francie just shrugs, and drops her head back into her hands.
‘You won’t be doing her any favours by not telling us. We’re not the police. We just want to know so the doctors can figure out the best course of treatment for her.’
No response.
Her mum pokes her in the shoulder.
‘You speak to the man. It’s the least you can do.’
Slowly, Francie looks up at me, a wasted puppet with one string left uncut.
‘Four e’s,’ she whispers. ‘But I didn’t like the look of them.’

third time lucky

An elderly woman with a vigorously red face and a manner as sensible as her jacket greets us as we come out of the lift. ‘Thankyou both for coming so quickly,’ she says. ‘This way.’
She leads us into a flat so cluttered it is like we are walking into a gigantic box of junk. Piles of magazines, newspapers, cartons of medicine, books, bundles of paper, frameless pictures, empty frames, broken frames, equipment parts – all in stacks on either side of a hallway that was narrow to begin with. In fact, the only surface vaguely free in the flat is the ceiling; the walls are a patchwork of photos and crudely written lists with phrases underlined such as: don’t forget Wednesdays or check pocket for keys.
‘I’m Stephanie. I’m a visitor from the Salvation Army,’ says our guide, leading us through the maze of rubbish like a native with a machete. ‘I’ve started coming to see Emily every week, just to help out with shopping and whatnot. A bit of company. Poor Emily’s not herself today. I’ve not seen her this confused before. I don’t suppose she’ll want to go to hospital, but she’s not coping here on her own. Anyway – see what you think. She’s through here.’
We pass a curling photograph on the wall by the kitchen doorway: a thirty year old woman in a bird’s nest hairdo and tight sweater, posing with her arms around a young boy in front of a black clapperboard house. They both squint confidently out past the photographer, from a blazing forties sun into the foxed half-light of the present.

Emily is sitting in a partially collapsed chair, the enthroned Queen of Decay. Scoliosis has rounded her posture so that she can hardly look up as we say hello, but she tries, lifting her hand slightly.
‘Hello Emily,’ says Rae, picking out a route so she can kneel down in front of her. She touches her hand and smiles. ‘It’s the ambulance, Emily. What’s happened?’
‘Thankyou for coming, dear. I don’t mean to be a nuisance,’ she says. ‘I think the problem is I just need a poop. I haven’t had one in four days and I’m rather sore.’ She pats her abdomen, which does look swollen.

We give Emily a check-over, and then set to persuading her to come with us to hospital. She tuts, rubs her good eye, then suddenly leans forwards.

‘When I took this flat on – some thirty years ago – as soon as I walked through that front door I could sense it. Something was not right. I simply knew that the person who had lived here before had not died a natural death. So I said to the managing agent – a rather smarmy man with damp hands – I said “How did the former occupant die?” He said he didn’t know. So I said “Well, I’m almost positive it was not a natural death.” He muttered something along the lines of “That’s not the sort of thing we go around telling our clients”. But. When I came back to the flat I met a man on the stairs, a man who used to live on the top floor. I asked him about the woman who lived here, and he told me her name was Dabb. Mrs Dabb. And when I asked him did he know if Mrs Dabb died a natural death he said..”

At this point Emily assumes a stage-Cockney accent, widens her eyes, and leans so far forward that Rae has to put both hands against her shoulders to stop her falling out of the chair.

‘.. he said “Nah, she did not. She tried twice to kill herself. Then it was third time lucky.’

man on the verge

The man on verge of collapse is sitting on the steps leading up to the block entranceway, taking contemplative draws on a cigarette beneath the harsh utilitarian lighting. He is dressed in a little black leather jacket, white shirt undone half-way, smart black trousers and leather shoes. He looks about fifty, a squashy, sagging melon of a face, hair as black and slick as his jacket. He looks like Walter Matthau after some bad news.
‘Ambulance,’ I say as we approach, although presumably he can tell by the logos and writing on our jackets. Drag on the cigarette. ‘My name’s Spence, this is Frank. Can I ask your name?’
‘José.’
When I ask him what the problem is, he makes a vague, open-handed gesture around his middle and his chest, and grimaces.
‘When did this all come on?’
‘Three month. One month. I collapse this morning. At the centre. They took me to the hospital. I wait hours and hours. This, then that. I see fifteen doctors.’
‘Fifteen?’
‘Fifteen doctors. Paper and paper and paper. No good.’ He mimes tossing paper aside, then takes advantage of this unexpected momentum to reach for a bottle of Gaviscon, which he tries to drink, but finding it empty, lobs into the rhododendrons. ‘No good.’
Seeing the Gaviscon wakes us both up a bit. It’s been the silent witness at too many heart attacks to ignore. But speaking to José it seems clear that he is not symptomatic, and that his problems are more alcohol related.
‘How much have you had to drink tonight, José?’
He shrugs. ‘Two litre? Not so, anyway.’
‘And tell me what happened at the hospital? How come you ended up back here? Did you discharge yourself?’
He shrugs again. ‘Fifteen doctors.’
‘Do you want to go to hospital now?’ I ask him.
‘Yes. I don’t want collapse on my own.’
‘Well let’s go, then.’

On the vehicle we both give up trying to spell his name; he pulls out a wallet as big and squashy as its owner. Behind a laminate screen on the inside of the wallet is an old, full length photo of José, dressed exactly as he is now. He tugs out his EU driving licence from underneath it to show me his name.
‘Are you working at the moment, José?’ I say, sounding more like an immigration official than an ambulance man, but only making conversation whilst I write down all the patronyms.
Again the José shrug. ‘A little. Some week yes, some no.’
‘And you’re going to a centre for help. Is this a place to get help for your drinking?’
‘Yes,’ he says. He leans forward, and looks around the ambulance. ‘I see eh-spiders.’

At the hospital I’m describing my patient to the Charge Nurse when the ward clerk comes over. She says that José was in this morning, caused havoc, falling off trolleys, arguing with staff, wandering off. Eventually he disappeared altogether. But they didn’t think there was anything wrong with him much, apart from stomach ulcers, and a little … she taps her head.

We help him onto a trolley in good view of the nurses’ station. He thanks us for our trouble, and settles down.

Fifteen minutes later, when we’ve had a coffee and are getting ready to go again, Frank comes back out to the ambulance to say that José’s already fallen off the trolley.

***

Two and half hours later we get details of another emergency call. José’s address. We query it on the radio. Control says that it sounds like the same man but they can’t be sure as he’s difficult to understand. This time he’s presenting with a stroke. We’re duty bound to attend.

At least we don’t see him smoking a fag when we turn into the block courtyard. He buzzes us up to see him. There is no recognition when he answers the door. The only difference to his appearance is maybe one button more undone on his shirt, and his shoes are off.
‘José,’ says Frank. ‘Why are we here again?’
José makes the open-handed sign of sickness over the same area, vaguely his stomach and chest. ‘No good,’ he says.
‘They told us on the radio that you were having a stroke.’
‘Yes. Yes. Eh-stroke.’ He makes the same gesture over his stomach.
‘José – you are not having a stroke,’ says Frank, in the steely tone of a stage hypnotist. ‘I know what a stroke looks like. You are not it.’
‘No?’
‘No. In fact, I have to say José, you look really well.’
José brightens. ‘Really?’
‘Really. So please. Don’t call us out again tonight. It’s busy, we’re tired, and there are genuinely sick people out there who need us. Do us all a favour. Go to bed, get some rest. In the morning, go and see your Doctor.’
‘No stroke?’
‘No stroke. And José?’
‘Yes?’
‘If you call us out again it won’t be so funny. We’ll call the police.’
‘Oh. Okay.’
‘Goodnight, José.’
‘Goodnight.’
As he closes the door I notice the phone in his other hand, and wonder how long before he taps the golden numbers again.

virus

Midnight, and the night is heavy and black and tasting of rain. The elderly woman is sitting as described in the message: on a bench in the middle of the courtyard of the C-shaped block of flats. Beside the bench is a scrawny tree, and under the tree is a cat’s scratching post, some scattered cat toys, and a box of other pet junk. A black cat races from the bench across the courtyard and into some bushes. I give the woman a wave as I come in through the gate. With her bucket-shaped suede hat pulled down to the bridge of her nose, and with the collar of her quilted jacket zipped up under her chin, when she turns to look at me it’s like the turret of a tank swivelling round to meet the enemy.
‘Hello. My name’s Spence, and this is Rae. We’re with the ambulance.’
No reaction.
‘Can I ask your name?’
A firm whisper: ‘Mary.’
‘Mary - someone overlooking the courtyard has rung 999 because they were worried about you. They said you’d been sitting here for hours.’
Mary draws her arms in.
‘Do you mind if I sit down and have a chat? Just to make sure you’re okay?’
She shrugs, so I sit down. Rae hugs the clipboard to her and stands in front. The wind swings the empty bird-feeder in the tree from side to side. Tiers of windows rise up on the three sides of our curious little group. It feels as if we’ve arrived at the dark centre of a community of lights and curtains. Some people out on a balcony, watching us. Are they the ones who rang?
‘I’m not going back in my flat.’
‘Why not, Mary? What’s wrong?’
‘It’s infected. It’s got a virus. I’m not going in.’
‘Are you well in yourself, though?’
‘Apart from what the virus has done to my arm.’ She pulls up the sleeve of her quilted jacket and shows me what looks like a couple of flea bites. ‘The doctor gave me betnovate cream for those, but he doesn’t understand what’s really going on. It’s not safe.’
‘So what’s the story with the virus?’
She looks straight at me, and her eyes seem small and afraid.
‘I’ve been taking samples. I found traces. I took it all in a jam jar to the Town Hall, and now I’m waiting for them to get back to me.’
‘Traces of what?’
‘Stuff. A worm. All white and pointy. Stuff. It’s in everything. The walls, the carpets. The water.’ She turns back to face front again, gives herself a determined hug. ‘I’ve had enough. I saw the council this morning, but they didn’t seem to care all that much. I need a new flat. I’m not going back in there. I’m spending the night out here. My son will tell you.’
‘Where’s your son now?’
‘In the flat.’
‘Mary – it’s more than likely going to rain. You can’t stay out all night.’
‘I’m all right. I’ve got my thermals on. These boots.’ She kicks a leg forward to show us.
‘If we drove off now and left you sitting on this bench – well – we’d worry.’
‘I can’t help that.’
‘How about you come on to the ambulance, we can give you a little check up, then maybe go to the hospital? It’s nice and warm there. They can look into this virus thing, maybe do a blood test, make sure you’re okay. And in the morning things will be clearer, and someone can advise you the best way to proceed.’
‘No. Thank you. I’ll just stop here, if that’s okay.’
‘Do you mind if we go and have a quick word with your son?’
‘Be my guest.’
We walk across the courtyard to one of the entrance doors, and buzz her number. We are let in to a harshly-lit hallway, then over in one corner a door opens and a thin, middle-aged man with a scrubby beard steps out. His eyes seem edged with red, as if he hasn’t slept in a long while.
‘Come in,’ he says, attempting a smile.
The flat is dark and seems quite empty. It is papered with a heavy pattern of giant poppies on a dark blue background. Two toy lovebirds hang on a perch in front of the kitchen curtains. The son talks to us in the narrow hallway.
‘She’s bad tonight. She’s been going around putting these up.’
He hands us a cluster of handwritten signs, a shaky scrawl in thick red pen:
Quarantine. Keep out. Serious virus inside. Government informed.
Rae asks: ‘Is she having any psychiatric help?’
‘She has been to the doctor’s, when she started hearing voices, and he did offer to put her on some medication. But she didn’t want to take it as she said it would interfere with her osteo-arthritis. The trouble is, whenever she does go to see anybody, she seems absolutely fine and reasonable. It’s when she gets back here she flips. The other day she threw a load of stuff out - the microwave, the kettle, mugs and shit - because she said it was all infected. It’s mad. The thing is, I’m not here all that often. I work on the fair, and I’m away travelling a lot. I’ve only just got back from a few months off working a new ride up. And then I get all this.’
He gives us a tight-lipped smile. ‘It’s absolutely crazy and it is getting worse. My girl friend doesn’t want to stay here, that’s for sure.’
When we ask him if he thinks Mary is a danger to herself or to anyone else, he shakes his head. ‘I don’t think so. Maybe. She was throwing stuff around yesterday. I don’t know.’
We tell him that we’ll try to persuade Mary to come to hospital with us. He follows us back out to the bench.
Mary refuses to come on to the ambulance or to go to hospital. I try another tack.
‘Cal was telling us about the time you went to the doctor’s about the voices you were hearing, Mary.’
‘What about them?’
‘Well – I was just wondering – do you think this business with the virus might be something like that? Something that seems very real, but is maybe just happening more in your head?’

She stands up as if the bench is suddenly red hot, snatches up the blanket she was sitting on and kicks the basket of cat-things. A tin bowl and cat biscuits scatter around us.
‘I told you what I wanted but that’s not good enough for you, is it?’, she yells. ‘You simply won’t let me do what I need to do. You’re a bully and you won’t stop until you get your fucking little way and have me back inside that flat. Will you? God.’
‘Mary – I…’
‘Get out of my way!’ She turns to go, sees Cal, spits: ‘You! You traitor! You can fuck off, too! I’m not interested any more. Leave me alone!’
She strides through us all, slams open the front door, then we hear muted screams of frustration from the flat.

Cal follows her inside. We call the police. When they arrive five minutes later I tell them what happened and the concerns we have, but we realise now she has gone inside the flat there isn’t much they can do. Cal comes back outside to speak to us.

‘She’s gone into her room and it’s fairly quiet. I think she’ll be okay. Maybe tomorrow I’ll get her to come back to the doctor’s so we can see about getting her a psychiatrist or something.’

We leave him to have a chat to the two policemen, then go back to the ambulance. I get Control to phone me back on my mobile so I can tell them what happened in some detail. The Dispatcher is particularly taken with it all; she laughs quite a bit as she types pointy white worm into the notes.