hands

The house is easily identifiable. There are two police cars and a fire truck outside, the focus of all the neighbours in their front gardens and driveways. Although this focus is a shifting thing, turning inwards to chat, or shuffling about in the cold to keep warm, or looking up at the sky, or laughing and pointing at something, or simply watching, these are the eddies and swirls of a river flowing in one direction, an irresistible pull towards the open door we now walk briskly towards.

A bulky fireman burdened with equipment struggles out of the doorway before we reach it. He smiles and nods: ‘Hello, mate. All right to go in.’

A narrow hallway leads us through to the kitchen out back. I can feel a strong through-draught of cold air running along the floor, and by the afternoon light tipping in through an opened patio door ahead of us we see a policeman leaning over the figure of a man stretched out on his back on the floor. The policeman has the man’s left arm upright in both his hands. He looks our way and shouts: ‘Through here.’

My first thought is ‘What’s happened?’, but the second is even more specific: ‘Where can I stand?’ The man is lying with his legs up on a toolbox, surrounded by a large pool of blood which someone has tried to cover with kitchen cloths, towels – anything absorbent. I pick my way over to the policeman.
‘Let me take that,’ I say to him.
‘Thanks. I’m starting to cramp up.’
‘So what’s the story?’
‘He’s called Eddie. Forty-odd. His wife came home, found him like this. He’s cut his arm with a razor and by Christ there’s a lot of blood. Check the sink!’
Eddie is barely conscious, shivering beneath us, waxy, breathing hard.
There’s no room to get a trolley in; there’s barely room for us.
‘Chair please, Claire’, I say, then ask the policeman to help set some oxygen running.
‘Look on the side there,’ he says, fumbling with the strap around the back of Eddie’s head. There is a Leatherman on the kitchen counter, next to a green plastic safety razor. The blade has been torn out.
‘That’s what he used.’
‘And what’s the story about a gas leak?’
‘Yeah – he set that going, too.’
There is a boiler cover dumped on a plate rack, its white metal surface smeared with blood.

The mass of extemporary bandages around Eddie’s arm is stained through, but it’s not getting worse. When Claire comes in the with chair I get her to wrap a couple more bandages around the site just to be sure, then between us we haul Eddie up and on to the chair. He flops about, in this dreadfully emptied and unstrung state the purest measure of his weight. We hurry him out to the truck.

When he’s on the trolley, it’s a simple calculation: the time it would take for a paramedic to get here and set some fluids running, compared with a straight run to the hospital. I choose the latter.
The policeman comes to the door of the truck with his arm guiding a thin young woman who has a mobile pressed to her ear.
The policeman asks me: ‘Are you all right with Cheryl in there? Or do you want me to follow up with her in the car?’
I look at her. Her narrow face seems emptied of everything but a frown, a dark line low across the top of her eyes. She looks to the side, as if the phone is some independent, alien thing offering bizarre advice.
‘I don’t know about that,’ she says. ‘We’re going to the hospital. No, the other hospital. I can’t talk now.’ She lowers it to her side without seeming to hang up. The policeman helps her up the steps, then with a wave is gone. She sits down.
‘Is he going to be all right?’
‘He’s lost a lot of blood, but he’s still conscious, he looks strong, so I’d say he’s got every chance.’
I can hear Claire putting the ASHICE through in the cab.
‘I’ve got to ask you a few questions, Cheryl.’
‘Ready to go?’ shouts Claire through the hatch.
‘Yep.’
‘What do you want to know?’
The ambulance sways violently as we drop down off the curb, and we’re away. I check that everything’s okay with Eddie, then sit down and reach for the clipboard. Cheryl moves forward in her seat so she can take Eddie’s hand in hers. I think of the policeman, and how he had stood crouched over him, with his upper arm clamped in his hands.
I start in with the usual questions: date of birth; past medical history; allergies; GP. Cheryl is crying now, but despite her grief there is still a part of her that is able to tell me everything I need to know.
‘Sorry for asking you all this.’
‘That’s okay.’
‘Has he ever done anything like this before?’
‘No. No, I don’t think so. Maybe ten years ago. Before I knew him.’
‘How was he this morning?’
‘Fine.’
‘No suggestion he might do anything like this?’
‘No.’
‘So tell me exactly what happened?’
She makes a small, forward and backward rocking motion in her chair, urging the ambulance on.
‘I left for work, usual time. I was meant to be out till three but I came home early. There was a note on the door saying Keep out / gas. The chain was on the door and I couldn’t get in. I rang the police, and they broke in. We found him in the kitchen.’

She kisses his hand, touches it to her forehead, kisses it again, holds it in front of her, closes her eyes, starts in on a low, choked-up prayer, with the little red ball in the mask valve clicking up and dropping back, and the sats probe flashing, and the siren drawing and wailing and spinning away from us, flying out, falling across town like a furious, glassy blue web.

136

Even though it is late there is still some light left in the sky, a watery smear of slate gray at the vanishing point where the coastal road becomes the horizon. A ripple of blue marks a spot just down from there. It swells with definition as we get closer, and then separates. A police car, with its scene lights illuminating a group of four on the pavement: a woman and a policeman sitting on a low wall; a woman and a policeman standing. Frank parks the truck. I jump out and walk over to the seated couple.
‘Hello. My name’s Spence.’
The woman is sitting with one leg hooked over the other, bouncing the foot about, resting forward on the knee, using it as a smoking prop. Steve, the policeman beside her, seems professionally relaxed. He is studying his hands, turning a wedding band round and round whilst the woman blows out smoke and smiles at me despite her eyes. I feel like I’m interrupting a couple having a discussion about the state of their relationship at a party.
‘I’m fine,’ she says, tapping off the ash from her cigarette. ‘Honestly, there’s nothing wrong with me.’
‘Okay. Good! But you know, the message we were given was that a woman had tried to throw herself under a car.’
She laughs bitterly.
‘Oh for goodness sake. This is ridiculous. Look – I’ve had a bit to drink. Obviously. I’ve had a bad day. People do. Things were getting a little bit on top of me. I tripped on the pavement and I found myself in the road. And that – is – it. That’s all. What have I done wrong? Where’s the crime in that?’ She takes another pull on her cigarette and squints at me through the smoke.

Steve straightens up. Some policemen are burdened by their own equipment, but Steve seems lighter, more adaptable. He has the quiet self-possession of a craftsman who would only pick up a tool exactly when he needed it.

‘Hilary. We’ve been called, these ambulance guys too, because you threw yourself in front of a car. It was only your friend here that stopped you from succeeding, as well as that other guy who came over to help. They had to wrestle you to the ground. Do you remember, Hilary?’ He looks at me and says as an aside: ‘Amazing, the guy helping like that. Don’t know where he went to.’
‘But I’m fine.’
‘You’re not fine, are you, though? You’ve got to admit, none of this would look fine to a reasonable person. I mean, we all like a drink. But we don’t tell the person we’re with we want to die and then throw ourselves into the road.’
‘But really. Honestly. It’s a misunderstanding.’
‘No, listen to me, Hilary. What we’re all here to do now is figure out A, what happened and B, what we need to do next. Our main concern is you don’t do yourself any harm tonight. We need to get that sorted. So - as a first step - I suggest we get off this wall, go onto the ambulance and have a chat in private, out of the cold. Okay?’

Hilary flicks her cigarette out into the road and watches where it lands. Then she leans forward to tap the side of her boot.

‘I’m fine. Really. I twisted my ankle a little, that’s all.’

Steve gets to his feet. I take one step forward to help her up. At that moment she suddenly sprints off to the side, snapping away like a dog after a stick, her handbag slipping off her shoulder and flying up, her coat opening out like wings. Steve is ready for her, though. He intercepts her in one stride, and scoops her into his arms. As soon as he has hold of her she gives up, and when they’ve both found their balance, slowing down like a couple after a drunken waltz - she stands neutrally. Steve releases his hold. She repositions the strap of her bag onto her shoulder.
‘Let’s not be silly about this, now.’
‘I don’t want to go on an ambulance,’ she says, with the glittering tones of someone explaining a faux pas. ‘I want to go home.’
‘Come on, Hilary.’
He leads her to the truck. We sit her in a forward seat, and then take up positions around her. After the damp road the ambulance smells aseptic, anonymous. The light’s too bright and the trolley creaks when the two policemen sit on it. Hilary’s friend leans forward and touches her on the shoulder.
‘You so need help, Hillie,’ she whispers. ‘I’ve seen you bad, but not this bad.’
‘And what do you think they’ll do for me at the hospital? Hey? What would they do for me? You know exactly what they’d do for me. They’d say: let’s sober you up and see how you are. Let’s keep an eye on you and keep you waiting for fucking hours. Let’s give you some diaze-fucking-pam and send you home at five in the morning. There’s nothing they can do for me. I’ve been there and done that. God knows I’ve been there and done that. There’s nothing anyone can do for me. I lost my licence because of the last time. Six months. How did that fucking help? I just want it all to end.’

And more awful than the tears that run down her cheeks is the polite smile she dredges up from beneath it all.

‘I manage a large business,’ she says. ‘I’m fine. Really. I just need to go home, get some rest. I’m always like this when I drink. I’ll be fine in the morning.’ She pats her face with a wad of tissue. ‘I’ll go to work and no-one will know.’

Martin, the other policeman, is standing at the back of the ambulance. He takes a notebook out as if he’s going to write something down, but then stuffs it back inside his jerkin. Hilary’s friend sits absolutely still.

Steve says: ‘I’ll be perfectly honest with you, Hilary. Going home tonight is not an option.’

She makes a gasping noise as if he’s punched her in the stomach, but he says: ‘Just hear me out, Hilary. It’s not an option and I’ll tell you why. Our first responsibility is to see that you don’t hurt yourself. We all care about you here. There’s no way any of us would say “Okay Hilary, off you go” if there was a real chance you’d put yourself under a car or throw yourself off a cliff, or whatever.’
‘You just don’t want it on your conscience,’ she sniffs, rubbing her eyes with the heels of her hands so vigorously it’s like she wants to rub them clean away.
‘It’s nothing to do with consciences, Hilary. We’re doing our jobs, and that’s it. So. The options are: you go with Spence and – who is it? – Frank, here, to hospital, and get assessed by the medical team there, or I arrest you and take you to the cells. What’s it going to be?’
‘I’m fine. This is ridiculous. I just want to go home and go to bed.’
‘Hospital or the cells, Hilary?’
She drops her chin and whispers: hospital.

Steve tells Martin that he’ll be riding up in the ambulance, and that he should follow in the car. With a timid inclination of the head, Hilary’s friend agrees to come along, too. Whilst I put a seat belt on Hilary, Frank puts the step up, shuts the door and gets into the cab to drive.

We move off.

I ask Hilary her last name. She mutters a reply, seeming more interested in picking fluff off the front of her coat. When I ask her to speak up, she raises her chin slowly and looks at me, a wide and watery look that doesn’t see me at all, but rather seems to suddenly process the fact that the ambulance is moving.

And in one movement she unsnaps the seat belt, throws open the door and makes to leap out. But Steve is already behind her, both arms around her shoulders. I grab her round the waist, and between us she screams and kicks and pushes out the door whilst the ambulance lurches to a halt, but she’s slight and drunk and desperate, and we keep her on board. I can see the reflection of the blue lights of the following police car flicker up, guarding us from the traffic.

When Martin appears at the door, Steve simply says: ‘Cuff her.’ And then: ‘Let’s do this sensibly, Hilary. Arms in front, please. And then a nice, calm walk out to the car.’ He begins to explain what will happen to her – how she’ll be taken to the cells, stripped, searched, assessed by a doctor.

As Martin unclips the cuffs from his belt, Hilary looks round at her friend and shouts: ‘I hope you’re proud of yourself.’ But her friend says nothing in reply. Instead, she stares fixedly at her hands and wets her lips with her tongue.

Then Hilary seems to weaken. She shrinks back into her seat as the black and silver bracelets clack and snap round her wrists.

Martin produces a tiny key on an extendable line, and locks the cuffs into place. He gives them a little jangle for security and comfort.

Hilary looks straight at me. Her face is radiant with despair.

‘I was only going out for a drink,’ she says. Then she presents her hands out to me, gently wagging them backwards and forwards, as if to say: ‘Happy now?’

Martin stands to the side of the door, Steve moves up behind her, and I make room for them all to leave. The night gathers in around the doorway, thick and cool with the threat of more rain. She stares out into the darkness for a moment, sighs, then glances back at me.

‘Have you any idea,’ she says, pleasantly, ‘any idea at all - how difficult it is to kill yourself?’

check for fruit

We are running out in response to a personal alarm, one of those big red buttons worn around the neck or wrist to push if you need help. It’s come through as a silent activation; meaning that Button Control has not been able to talk to the client. If the person sets the button off accidentally – and they do, all the time – Button Control can reassure themselves that everything’s okay by speaking to them over an intercom system. A silent response is invariably a bad sign.

The instructions we have been sent to gain out of hours access to this flat are complex. There is a code for the front door, a code for a safe that contains a key to another safe that holds, amongst other things, the master key for all the rooms in the block. We are also to pull a chord to let the office know what we’re doing.

But it all works. The master key is hanging on its own peg inside the safe; I grab it, we re-shoulder our bags, and haul ourselves up to the third floor.

An elderly woman shuffles past us in the corridor.
‘Good evening to you both,’ she says, pleasantly. I’m struck by the thought that had we been dressed in gorilla suits, she would have been equally indifferent.
We reach the door and I knock twice.
‘Hello. Ambulance.’
Not waiting for a reply, I use the master key and we step inside.
The hallway is just big enough to accommodate the front door and access to the bathroom, kitchenette and sitting room. The door to the sitting room stands a little open, and I push it inwards.
‘Hello.’
There is an angle poise lamp up on a writing bureau over at the far side of the room, dumping a pool of bright light onto the high-backed chair beneath it. On the chair is the lumpish figure of an elderly woman, slumped forwards, motionless.
‘Hello.’
I stride over and touch her on the right shoulder.
She jumps backwards into the chair and lets out a yelp.
‘Hello – it’s the ambulance.’
‘The what?’
The woman is clutching a pear in one hand and a little curved knife in the other.
‘Are you all right?’
‘Am I what?’
‘Your button went off.’
‘I know that.’
‘People were worried about you.’
‘I heard them calling. I was on the loo. And they’d gone when I’d finished.’
‘So you’re okay?’
‘I’m having a pear.’
‘Good.’
‘Who called you?’
‘The Button people.’
‘But there’s nothing wrong with me.’
She shakes the pear at me, as if that proves it.
And, I suppose, in many ways, it does.

cans & birds

The son meets us at the garden gate with a wave and then a rub of his hands.
‘Before you go in, let me warn you – it’s cold. Very cold. But that’s just how we like it. It’s not ‘cos we haven’t paid the electric. It’s our choice.’
He nods and grins, looking in all his layers of clothing like the mystery package in Pass the Parcel. Without that belt straining around his middle, he would probably explode with the pressure of extra shirts and trousers he has on. His face has that shiningly radiant scarlet you see on long-term alcoholics and rough sleepers; his metal specs glimmer icily beneath the porch light.
‘What it is, Jack’s had a bit of a turn. We’d just got back from our daily jaunt, he sat in his chair, next thing I knew his eyes had turned up in his head and he’d gone all limp. I had a job to rouse him, but then when he did come round, he acted like nothing had happened.’
‘Let’s go inside and see how he’s doing.’
He leads us inside a dark hallway, clear of any of the usual hallway ephemera. No coats hanging up, pictures on the wall, boots lined up or kicked off, no bag dumps, brolly bins or boxes of junk to go; only a line of bare boards stretching off into the gloom. We follow the son deeper into the shadows, passing a couple of closed doors. He pushes open the furthest one, and takes us into a wide, square room sparsely lit by a standard lamp in one corner, and the gas flames of a portable gas fire waggling anaemically in the middle of the room.
‘Hello chaps,’ says the elderly man sitting in a threadbare armchair by the fire. ‘I’m sorry to be a nuisance.’
‘It’s no bother, Jack. Listen – Graham here says you had a bit of a turn earlier. Can you tell us what happened to you tonight?’
He looks up at us, a vision of his son accelerated forty years into the future: the same roly-poly agglomeration of clothes, the same red face, the same crooked turn of the mouth and set of the eyes that links them as securely as the photos of them on the mantelpiece, holding up a fish, waving spanners beside a motorbike, hanging off a carousel.
‘I’m all right,’ he says. ‘I’m eighty four, you know.’
Graham sits on the arm of the chair and straightens his Dad’s cap. When they talk, they fit their words around each other as precisely as the pieces of an intricate jigsaw puzzle.
‘Eighty four, walks fifteen miles a day.’
‘Up hill, down, back again.’
‘We collect aluminium cans from all around, you see. We take them down to Reynaud’s the scrap merchants.’
‘Everything we make we donate to the cancer charity that looked after mum.’
‘Well, we did most of the looking after. But they gave us a lot of help.’
‘At the beginning of it all they said she’d probably end up having to go into one of them special places, but we said “no, she’ll stay here, we’ll do it ourselves” – the washing and cleaning, the lot. It was difficult, but we managed it.’
‘Yep, we managed it.’
‘Lifting, washing. The whole bit.’
‘She died here, at home, and then after that, we started on the cans.’
‘And if we’re not picking up cans, we’re bird watching.’
‘You’d be amazed what you see.’
‘Blackcaps.’
‘What a song.’
‘An Arctic Tern.’
‘We think.’
‘Late heading off.’
‘On next door neighbour’s pond.’
‘We help him with his washing.’
‘The neighbour, not the bird.’
They both laugh.
And then there’s a silence, riding on the spluttering sounds of the fire. They look at us.
‘We need to find out what’s caused this little episode,’ I tell them. ‘How about we get you out on to the vehicle, do a few tests…’
‘I’m not going to hospital. I don’t need to.’
‘Well, we’re not going to kidnap you. But let’s take it one step at a time, see if everything’s okay, and take it from there.’
He insists on walking out to the vehicle, Graham one side and me the other. The sky is a glassy blue-black vault above our heads. An excoriating frost is working its way to the centre of everything tonight.
‘I don’t envy you that cold room,’ I say to Jack as we reach the vehicle and open the doors. ‘I bet it’s colder inside than out.’
He laughs. ‘All the better for it,’ he says. ‘All that central heating – it makes you ill.’
The inside of the ambulance is a sweat lodge in comparison. But the only concession the two of them make to the raised temperature is to take off their caps, which they both clutch in front of them. I wonder what experiences they’ve had in ambulances in the past.
‘Let’s have a look at you then, Jack.’

He settles himself down on the trolley.
It takes us five minutes to find our way to his chest.

atticus

‘So it’s pretty much always the same then? A fuck off through the letter box? That’s what happened the other day when we got a call out here, anyway.’
‘Yep. Same old same old. I’ve been out to Miranda maybe half a dozen times last year, and every time the same. But, we’ll see.’
George adjusts his heavy glasses and writes down the incident number and address as I pull away from the station. The ambulance doesn’t seem big enough for him. As he drops the clipboard back into the plastic well that separates us, out of the corner of my eye I half expect to see a great clawed paw rather than a hand. But even though he is too big for this cab, he’s otherwise perfect for the job. Strong enough for the lifts, empathetic enough for the patients, funny enough to do stand-by with. He has a slight under bite, his lower lip forward of his upper, which, with his scraggy beard and magnified dark eyes, gives him a lugubriously tolerant air. He reminds me of Spike, the bulldog in the Tom & Jerry cartoons, but crammed into greens and fresh out of anger management class.
‘What did you do before the ambulance?’ A lame thing to ask, as hackneyed as the so, do you actually drive the ambulance question that you inevitably field whenever someone finds out what you do for a living. But still always a surprising thing to ask, for all that. The ambulance service has something of the Foreign Legion about it: a place of mixed backgrounds, from teachers, plumbers and dental nurses to photographers, soldiers and horologists. Not a blue or white collar environment so much as a grey collar affair. We’re a mixed bag, a lucky dip of talent, and all the better for it.
‘I worked for a recycling company, doing the rounds on a big electric cart. I was one of the guys standing on the back, dumping cans in one stack and papers in the other, trying to hold on whilst the spliffed up driver ambled along the streets. I enjoyed it. It was a great craic. Hard in winter, but you had a laugh. There’s only so far you can go with that stuff, though, and your hearing takes a pounding. I studied music, originally. I’m a flautist.’

We pull up outside Miranda’s bungalow. We’re here so often I wouldn’t be surprised to see a space marked out for us. George hauls himself out of the cab and I follow him up the narrow concrete path to the front door. He knocks and we wait. He’s big enough to huff and puff and blow this house down, but he waits patiently, and then knocks again. There’s a dull stirring behind the net curtains. A shadowy figure leaves the living room and moves into the hallway. Any moment now I expect the usual expletives and half-hearted negotiations through the letterbox – but, incredibly, the door cracks open and she peers around the edge.
‘What do you want?’
‘It’s the ambulance,’ he says. ‘Are you all right?’
‘No of course I’m not all right.’
‘Well. Then. Can we come in and have a chat and see what the problem is?’
I half turn to go, but the door opens fully and Miranda says: ‘If you must.’
George looks at me, I look at him, and in that neutral little exchange there’s a great, psychic crashing of cymbals.
She leads us into her living room.
‘Sorry about the mess,’ she says, but the room has a measured tidiness, with magazines and papers and books forming regular margins of space that couldn’t happen by chance. Miranda takes up her position on a padded, high-backed chair, an orthopaedic throne within reach of a rack of remote controls, in front of a little plasma screen TV. There’s a DVD playing. Josh Groban in concert, singing with a curly haired sincerity that seems to be killing the audience. To the right of the TV is a sideboard of ceramic Arthur Rackham fairies, each one looking meticulously placed and dusted. Next to the sideboard is a stand of DVDs, each one concert footage, Bocelli, Bublé, Ball.
‘I want to die,’ she says.
George adjusts his glasses again and says, ‘Right.’
A scraggy black cat wanders into the room to investigate.
‘But I don’t want to waste your time.’
‘It’s no bother,’ he says, putting his clipboard to one side. ‘So what’s happened today? We were told you may have taken some pills.’
‘Temazepam. I just want to die.’
‘So how many temazepam did you take?’
She makes a vague gesture with her hand.
‘Not enough, obviously.’ Then she looks at him carefully. ‘You remind me of my son.’
‘Oh. That’s a good thing. Hopefully.’
‘He’s just like you. Big.’
‘And where’s your son now?’
‘Gone off and left me. Like all the others.’
‘Miranda? Would you mind if we checked you over? Did your blood pressure and that sort of thing?’
‘Do what you like. I don’t care.’
I get the kit out of the bag and start noting down the results. Alcohol fumes ripple off her like heat from a radiator. ‘How much have you had to drink today?’, I ask.
‘Not nearly enough.’
The cat noses around in the bag.
‘What’s your cat’s name?’
‘Atticus. Guess how old he is.’
‘Fourteen? Fifteen?’
‘He’s a hundred and twenty. Cat years.’
Atticus looks up at me as if to say I am, you know.

Miranda’s obs are fine.
George taps the board.
‘Look, Miranda,’ he says, ‘so far everything looks okay but obviously we’re very concerned. Not only that you’ve taken these pills – which may have a delayed effect – but also for the reason you took them.’
‘I’m not going to hospital. Last time I was there the security guard broke my jaw.’
‘Surely not.’
‘It’s true. He asked me to leave, punched me in the face and broke my jaw.’
‘Well I can guarantee that won’t happen this time.’
‘I’m not going.’
‘Whatever sort of person would I be if someone told me they wanted to die, and I just turned around and left them? Mm?’
‘No. You can’t make me.’
There’s a brief stand-off. I cut in from another angle.
‘But didn’t you call the ambulance, Miranda?’
She turns to look at me. For a moment it looks like my intervention may have nixed the whole peace process. But before she flicks off the safety catch, George speaks up again.
‘Miranda? Who’s going to look after Atticus if you kill yourself?’
She turns back to him.
‘Have you got a cat?’ she says.
‘Yes. I have a twelve year old tabby.’
‘What’s she called?’
‘Kasha.’
‘Kasha?’
‘Yep. And two dogs.’
‘We used to have dogs. I couldn’t have them, now.’
‘So what are we going to do then, Miranda? Are you coming with us to the hospital?’
‘No.’
‘Have you seen your doctor lately?’
‘He doesn’t want to see me.’
‘Don’t you have to see him at least to get your repeat prescription?’
‘He faxes it. He doesn’t want to see me anymore.’
‘Well – Miranda - if you won’t come to hospital, there’s nothing more we can do for you here. So if you’re absolutely sure you’re staying at home, I’ll just need you to sign my paperwork.’
‘I’m not signing anything.’
He shows her the board.
‘Will you sign?’
‘What – that you’re leaving me here to die?’

Josh Groban leans in to another ballad on the TV. She turns to look at him, folding her arms across her belly, the deep blue light of the screen reflecting in her glasses. Atticus rubs up against her leg but she doesn’t seem to notice it.

‘We’ll be going then.’
‘Suit yourself.’
We leave her sitting there, as fixed in her pose as any of the ceramic fairies on the sideboard.

Outside in the vehicle George finishes the paperwork, then gets on the phone to control to tell them everything that happened. Another crew pass us, waving and laughing and pointing. We all know it’ll probably be them sitting here tomorrow.

fore!

‘He’s walking funny. He’s got to be our man.’
‘I think he’s just drunk, Rae.’
‘Flash your lights.’
‘No. I honestly don’t think he’s the kiddie. If he is, why hasn’t he waved?’
‘Would you?’
‘Why not?’
‘Why not? Well – I don’t know – the golf ball stuck up his arse, for one.’
‘Who’s gonna know that?’
‘By the way he’s walking. D’uh.’

The front of the station is quiet, with a four in the morning, littery look to it. I slow down and give the man a meaningful stare, but he hobbles past without any sign, all his attention directed at staying upright, making progress.
‘Okay. So where’s our man, then?’
Rae gets back on the radio to tell them that we’ve made a couple of drive-bys of the area and not found any golfers in distress. Control says the man was a little vague and not terribly helpful, but they’ll ring him back to get a better location. I pull over and we wait.

‘So did they teach you much about fishing golf balls out of arses on the para course then, Rae?’
‘Yep. That was my most successful module. I got the golden plunger.’
‘Plunger? Too high spec for me. I like the old school, up to the elbow technique, like James Herriott.’

Control calls us back. Apparently our man is wandering up the road that runs along by the side of the station. He’ll flag us down.

I drive up that way, and half way along, opposite the great arched canopy of the station, we see a shadowy figure take a step into the road with one hand raised. I draw alongside. A curiously self-contained, drawn-out figure, with dark, razored stubble running unbroken from his head, round and down into a beard of the same length, he nods at us as we jump out of the cab, puts his mobile into his back pocket, then stands slightly stooped, perfectly still, studying the pavement.
‘So – what can we do for you?’
He looks up and to the side, and whispers something.
‘What? Sorry, I can’t quite hear.’
But instead of talking the man suddenly gives a little flap of his hand for us to follow him into the entrance of a block of flats. He pushes a button, and then smiles at us, raising his eyebrows with an awkward grimace, like we’re a group of strangers all waiting to use the same lift.
‘So – what’s been happening then?’ Rae asks him.
‘I – er – we were having sex tonight.’
‘Okay.’
‘And – er - we were using some golf balls, three – or…’ he looks up and to the right, moves his lips in a whispery little audit, then back down to the ground, then up again. ‘Yep, definitely three. Size 8s. And – er – only two came out.’
‘So it’s your partner who has a golf ball still inside?’
‘Yeah.’
The intercom crackles, and an angry sounding voice blasts out: Who the hell is this?
‘It’s me,’ says the man, quietly, his face pressed to the door. And then, as if he were checking for rot, he raps lightly a couple of times on the wood with a knuckle.

The door buzzes, he pushes it open and we follow him into a bare hallway with four doors and some concrete stairs leading up. The lock on the door straight ahead of us clunks, the door gets thrown open, and a man of about sixty years and two hundred and sixty pounds presents himself to us, rearing up like a walrus on some wild shore, a walrus dressed in a Tweety Pie t-shirt and no underpants, his pendulously fat penis swinging like a grotesque beast in a nest of silver wire. The man’s yardbrush moustache seems actually to vibrate, as he stands there shooting holes into us with his eyes and chuffing air through his nostrils.
‘What the fuck are you doing back here? And who are these people?’
‘We’re the ambulance,’ says Rae. ‘Can we come inside and have a quick chat?’
‘A quick chat? Who are these people? And what the fuck have you come back for?’

In the time it has taken the Walrus to take in the scene before him, the thin man has stepped up to the open door and insinuated himself half-way in, slope shouldered, like a dog that knows the risks.
‘Get out of my flat!’, the Walrus roars, grabbing him by the corner of his leather jacket. And then to us ‘Get him out of my flat! I don’t want him here!’
‘We’re not the police, we’re the ambulance…’
The thin man lifts his chin and says: ‘You have a golf ball inside you,’ then tries to move deeper into the flat.
‘A – what? A golf ball? Are you insane? What are you doing back here? And who are these people?’
Before we can say or do anything else, the walrus has grabbed the thin man round the neck and tried to tip him out of the flat. But the thin man spreads his legs and puts his arms out to be as awkward as possible. They stand there, wrestling ineffectually, whilst Rae says: ‘We’re just going to go outside and call the police, guys.’
We step outside, and the door closes behind us on sounds of crashing and swearing and shouting.

Ten minutes later the police arrive. We tell them what has happened so far.
‘A golf ball?’ says one of them, a policemen so young he must surely be a teenager on his way to a fancy dress party. ‘A golf ball?’
‘Well what kind of ball do you use?’
‘But a golf ball?’
His colleague steps up to the front door and presses the Walrus’ door button. It takes four or five goes before the intercom crackles alive.
‘Yes?’
‘It’s the police. Could you open up for us, please?’
There is a pause, and then the door is buzzed open.

We all troop into the hallway. The Walrus is standing at his front door as before, but this time he has a smart blue dressing gown tied securely around his waist.
‘What can I do for you, officer?’ he says.
‘The ambulance crew here tell us that a man reported you as having a – an injury. To your person. And that when you opened the door to him, you ended up having a fight. Is that correct?’
‘No.’
‘So that didn’t happen?’
‘Well – a man did come here. A friend of mine. And we had a disagreement, and some things got knocked over. But it’s all okay now, and everything’s calm, and as it should be, thank you.’
‘Can we just come in and reassure ourselves that everything is okay? We’ve been called, so we’ll need some details before we walk away.’
The Walrus pokes at us with his eyes as if he still can’t figure out who we are, then smiles at the policewoman again.
‘Of course. Come in – but just you two.’
‘Not the ambulance crew?’
‘No.’
‘So you don’t need any medical attention?’
‘Of course not. I have diabetes. But it’s under control.’
‘Something about a golf ball?’
‘A what? No. No – balls.’
He turns and leads the two police officers into his flat.
Before they disappear, the young policeman turns and gives us a wink. ‘We’ll take it from here, guys,’ he says. Then he taps the side of his nose, and treats us to a tiny little mime: Fore!

the lodger

The police car sits like a scandal outside number thirty seven, a tall, doll’s house residence as perfectly turned out as any of its neighbours. There are two policemen and two women on the chequerboard path leading up to the front door, standing as a square four at the end of a line of carefully clipped box. One of the women – a bearish figure in a dark fur jacket against which her face looks like a fresh batch of dough - steps forward.
‘Let me fill you in. Giles is really very unwell. He simply has to go to hospital. I’ve got to go to work tomorrow, I can’t afford not to. He’s an alcoholic. He’s been drinking non-stop for a week. He has ulcers on his legs and they’re infected. He’s desperately sick and not taking any of his medications. He saw the practice nurse three weeks ago and that’s it. The smell’s unbearable. He’s been aggressive to me and I can’t cope. I’ve done my best but I’ve run out of energy. I simply have to go to work tomorrow and there’s no way he can stay here on his own. You have to take him with you.’
‘Okay. Sorry – are you a relative?’
‘My name’s Ferdie. And no, I’m not a relative. Giles is staying here as my guest. He’s been here for three years.’
‘And can I ask – how aggressive has he been?’
One of the policemen tells me that they came in response to Ferdie’s call. The address isn’t tagged. As far as they can make out it was verbal aggression only; no violence, and the patient is calm at the moment.
‘Shall I go up and have a word with Giles then?’
‘Yes. Please. Top of the stairs, straight ahead. Just follow your nose, really.’

We step past them through a lead-lit doorway into what feels like a home improvements show: I can hear the anodyne jazz-funk soundtrack, and the modulated voiceover guiding us through the light and tastefully appointed hallway with its stripped pine floor and rich Persian runners leading the eye naturally into a reception area of comfortable conversational nooks. Here, stylish modern artworks rub up against a modest but intriguing selection of antique ceramics and pierced carvings, all of which lend a touch of opulence to this fantastic reception area, perfect for those vivacious meet-and-greets, as well as a private chill-zone for when the kitchen-diner becomes just too starry and loud.

A wide stairway takes us up onto a landing where there is a note lying on the floor outside a closed door. Scrawled on the back of an envelope: Please let’s not fight about this any more. Leave me to take care of myself. I’m going out later. We’ll talk when I get back. Giles x
I knock on the door.
‘Giles? It’s the ambulance. Can we come in?’
‘Yes of course. Please excuse the mess.’
I push open the door, but it only opens a little way. I look round it.

Giles is sitting on a two-seater sofa beneath the only window in a small, square room. A portable TV is off to his right on a plain wooden bookcase: on, with the volume right down and the colour up high. The door is stuck because the entire left side of the room is piled high with a great heap of discarded stuff – mostly books, DVD cases, clothes – as if the contents of all the drawers and bookcases and wardrobes in the house had been emptied into this room and then pushed up into an unsifted heap by a small bulldozer. Giles only has enough room on the sofa to lie down with his legs crooked up; every other available space is given over to trash. And lying over everything, as palpably as a mist over a swamp, the cloying odour of ulcerated flesh.
‘My name’s Spence,’ I say, as brightly as I can manage. ‘Do you mind if I come in and have a chat, take your blood pressure, that kind of thing? Ferdie’s a bit worried about you.’
‘No. Please do. Look. I know she’s worried about me, but honestly, it’s all in hand. I’m responsible for my own care. I know exactly what I’m doing – sorry if I appear rude, but probably much better than you or anyone. I’ll admit I’ve been a bit careless lately what with one thing and another. But I’m going to get myself cleaned up today and get myself down to the practice nurse tomorrow.’
He has exactly the voice that I imagined for the TV voiceover – blandly modulated, conscious of the appropriate intonations, entirely unconvincing.
‘Well let’s just see where we are now and take it from there,’ I tell him, looking for a reasonably flat surface to put the bag and board down. There’s no room for Rae to come in. She goes back down to talk to Ferdie and the police.

Giles sits neutrally on the sofa, his crazy, peppery black hair sticking out like a chimney sweep’s brush, and his teeth as grey as if he’d been snacking on ash. Both his legs are bandaged from knee to feet in thick swathes of dirty bandages. Rank fluid has seeped through both at the heel and instep, spreading out in flowerings of black and brown. I take his baseline obs, and they all come back fine.
‘That all seems okay, Giles, but it hardly needs me to say that your legs need attention,’ I tell him, folding away my stethoscope. ‘You’re absolutely right – I’m no expert. But these dressings haven’t been changed for awhile and there’s a bad smell in here. You must know you’re at risk of developing an infection – if you haven’t got one already. As soon as one takes hold, it can make you dangerously unwell very quickly. I really must insist that you come with us to hospital.’
‘Well, that’s awfully good of you, and I do very much appreciate you taking the trouble to come out here to see me like this. However, I reiterate. I am responsible for my own treatment. I’ve been a bit slack lately, I’ll admit, but that’s all going to change. I just need some time to myself to get things in hand, then I’ll be fine. I’m seeing the practice nurse tomorrow. So thank you, but I will not be travelling with you to hospital today.’
‘Okay, Giles. But if you won’t do it for me, will you come with us for Ferdie’s sake? She’s very upset about things at the moment. She’s worried about you and she wants to know you’re okay. Won’t you come with us to hospital just to set her mind at rest?’
‘Sorry but no. I’ll square things with Ferdie, don’t worry. That’s all I have to say.’

I leave the room and rejoin Rae and Ferdie downstairs.
‘There’s been a development,’ says Rae. Ferdie hooks some loose strands of hair behind her ear, closes her eyes as if she’s disclosing a grave confidence, tells me Giles has been stealing from her.
‘Somehow he got the pin number for my credit card and maxed it out. Cash from my purse, too. I know it’s his addiction to alcohol fuelling all this, but I just feel like I’ve reached the end of my tether.’
We try to persuade Ferdie to make a formal accusation of theft to the police so they can arrest Giles. ‘At least that way we can start to get him the help he needs. It’s more than just his legs, Ferdie, even though they need the most urgent care. He needs a thorough-going health assessment, for his drinking, his mental health. His living conditions up there aren’t good.’
‘I know,’ she sighs. ‘But I just couldn’t bear to do that to him. I couldn’t bear to have him arrested, to think of him lying in some cell somewhere.’
‘But as things stand, we can’t simply frogmarch him out of the house and into hospital, Ferdie. That would take a Section order, and I’m not sure he’s quite there yet.’
‘No.’
‘So do you want the police to arrest him for stealing from you?’
‘No. I couldn’t.’
‘Well then. He’s refused to come to hospital, so all we can do is report what we’ve found to our Control. But if anything changes, call us again.’
‘Thank you so much for coming.’ She shakes our hands, and the blue enamelled bracelets jangle round her wrist.

The second woman steps forward to shake our hands, too. Her sister? Neighbour? Whoever she is, she seems relaxed, radiantly content, beautifully framed as she is by the tapestry hanging behind her on the wall, a flock of doves on a pale winter oak.

incident at the mountain view

The Mountain View Hotel should be better than this.

The Mountain View Hotel should be made of pine and glass and quarried stone, be up on stilts, have a great sloping roof dressed in snow, have a balcony holding colonies of expensively casual people sipping glühwein and basking in the brilliant sight of each other behind wrap-around shades.

It should at least have a view of the mountains.

It needs renaming. The Poor Outlook, maybe. The Dim View. A tall, thin building, so shabby you might put its thinness down to malnutrition and neglect. Stuffed into the shadowy top right corner of a not-so-nice square, shielded from all but the highest and fiercest mid-summer sunlight, it’s a roost so bleak even the seagulls and starlings leave it alone.

We’re bluing our way through town to get to The Mountain View and a resident who has suffered a cardiac arrest. A crew is approaching from the other end of town; we meet at the entrance to the square, the others decide to drive the wrong way round it, so we meet nose to nose outside the hotel’s discrete front door.

A woman is standing there, waiting to let us in. She has her arms folded across her chest, and stamps her feet on the icy pavement. From the cab she looks dressed for a party, in a low-cut red silk dress and a sparkly cardigan; her long straight hair shining like yellow nylon. Up close, and the effect is slightly different. Her teeth are greyed with cigarette smoke. The makeup is thick. The hair’s a wig.

‘He’s right at the top,’ she says.
There’s one of those awkward little shuffles between Frank and the woman, when they both go forward together, then both hold back.
‘After you, love,’ he says, gesturing forward with a big hand, ‘You know where you’re going.’
‘Sorry there’s no lift,’ she says.
She leads our galumphing troupe up the narrow staircase.

Just as the building has not - never will have – a view of the mountains, it is not, and probably never will be, a hotel. It should more properly be called a hostel. Each landing has a bathroom and toilet, servicing three rooms. The woman leads us up five flights, arriving on a landing that has just two rooms and no bathroom.

‘We hadn’t seen Jed for a day or so, and we wondered if he was all right. I had a key to his room, so I came and had a look. Found him on the floor like you’ll see. I think he’s dead. I know he’s dead. But you’ll see.’

She reaches forward with her key.

‘Have you got a torch? Only there’s no power on in the flat. Jed had to top up his key at the post office, but I don’t think he’d done it for a while. It’s freezing in there. That’s what probably killed him.’

She opens the door. The light from the landing spills around and over us into the room, illuminating the facing wall and a spread of twenty or so baseball hats hung all over it, an unmade bed beneath them, a calor gas fire, and the body of a man curled around it. He is lying on his back, his legs drawn up, his mouth gaping open. His skin has a dull and waxy tinge, as devoid of human warmth as the air in this freezing black box of a room.
‘He is dead, isn’t he?’
‘Yes. I’m afraid so.’
‘I thought he was.’
‘When did you find him like this?’
‘About an hour ago.’
Frank raises his eyebrows.
‘An hour? If you don’t mind me asking – why the delay?’
‘Oh. Well. We didn’t know who to ring. Police? Ambulance? Relatives? We just didn’t know.’
She pauses and looks between us.
‘Did I do wrong?’
‘No, no. It’s just we need to be clear about the sequence of events. Who else was with you?’
‘Jack, another one of Jed’s friends.’
‘And where’s Jack now?’
‘He’s gone downstairs to get some fresh air. Look – did I do wrong or something?’
‘Don’t worry. We just need to be clear, that’s all.’

As the second crew, we’re no longer needed here. Frank asks us if we’ll take a couple of bags back down to the vehicle for them. The woman nods and gives us a terse smile as we pass.
‘I’m sorry for your loss,’ I say. She nods again.

As we reach the lobby the front door opens and a short, red-faced man puffs his way inside, alcohol fumes swirling around him like an invisible cloak. When he sees us he performs an oddly vaudevillian gesture of surprise, leaning back against the door, his arms crooked, his fists balled up to his mouth.
‘Aargh!’ he says. ‘You’ve seen him I take it!’
‘Do you mean Jed?’
‘Yes. Jed. Is he – ?’
‘Yes. I’m afraid he is. Dead.’
‘Aargh!’
‘I’m sorry. Are you okay? Are you going to be all right?’
He suddenly takes a staggering step towards us, straightening his arms down by his side but keeping his fists tight.
‘That bastard landlord!’ he shouts, jerking his fists down at the floor with each phrase. ‘The bastard! He did this! He froze him out! He killed Jed!’
‘Try to calm yourself…’
‘Take pictures! I want you to take pictures! I want the police here. This is terrible.’
Then, just as suddenly, he seems to run aground. He relaxes his fists, pulls out a filthy handkerchief and pats it across his forehead.
‘I don’t know. I’m terribly sorry. It’s been something of a shock. Jed was such a nice man. A nice, gentle man. He shouldn’t have gone like this. It’s so unfair. But of course it’s not you I blame.’
He stuffs the handkerchief back in his pocket, then stands in front of us, waiting for some kind of direction, blinking under the harsh fluorescent strip.

handy

I push past a ragged budleia that’s growing out across the steps, and press an old bakelite bell. A sonorous buzz sounds deep inside. I step back. The house is dark and quiet.
‘Get ready,’ says Rae. ‘Assume the position.’
We shouldn’t be here. Man attacking woman with walking stick. The police should go in and secure the scene first. But this is an over-run, and we can’t afford to hang around. The police are busy tonight, it’s so cold even the moon seems frosted over. We need to wrap this one up quickly. I need to be home, sliding into a snug bed and cuddling up to my wife. Such an absurdly rich vision of paradise. Am I that lucky? I stamp my feet and rub my hands to hurry things along.
A light goes on above the heavy black door.
Our breath hangs on the air.
A chain comes off the door and it opens.
‘Hello. Ambulance.’
An elderly woman stands there. From the dim overhead hall light she seems okay. No great gashes, no clumps of matted hair. She stands holding aside the heavy curtain that hangs just behind the door, smiling like an indulgent grandma, short and rounded out with layers of clothing, finished off by an apron whose string tie cuts into her middle and makes her upper half seem independent of the lower. When she turns around I expect her to swivel, those hefty legs to follow later.
‘I can’t go on like this,’ she says. ‘I don’t know what to do.’
She tells us that her husband, John, has Alzheimer’s but doesn’t know it. She tells us he hit her with his walking stick.
‘Not badly. Just on my lower leg. And I’m ashamed to say I slapped his face.’
‘Are either of you hurt?’
‘No. But I can’t go on like this. I packed my bag. I was going to leave tonight. But I couldn’t think where to go.’
‘Shall we come in and see what we can do?’
‘Yes. Please.’
She turns round and we step inside.
Another curtain hangs across the bottom of the stairs. We follow her up the treads which creak alarmingly. The house is utterly quiet, heavy with it. The thick brown paint on the stair panels and skirting boards, and the candy-striped, board-like wallpaper, yellowing and sliding off in places, gives the place a cloying, weighty feel. It’s like walking through an enormous old chocolate cake.
‘He’s in there,’ she says puffing slightly and pointing to another curtain that hangs across the entrance to the living room.
I pull it aside and go in.
Over the other side of the room an elderly man is standing in front of an armchair, his arms straight down by his sides. He has an intensely watchful expression, accentuated by great tufts of grey hair that sprout from his ears and a pair of wiry grey eyebrows that grow down over his eyes and make me think of the budleia outside.
‘Hello, John. I’m Spence and this is Rae.’
‘Yes,’ he says, glittering.
The woman wheezes past me and lowers herself into the armchair that faces his. She straightens her glasses, and then holds on to the armrests as if she thinks it’s going to take off any minute.
‘What do you want? Who are you people?’ he says.
‘We’re with the ambulance, John. Your wife…’
‘Vera?’
‘Your wife Vera is worried about you. She says you’ve been quite upset tonight. She says you’re not yourself and she’d like you to see a doctor at the hospital.’
‘Why would I need to see a doctor?’
‘Just for a check-up. To make sure everything’s okay. Will you come with us, John?’
‘No.’
My bed may as well be on the moon for how soon I’m likely to find myself in it. It feels as if we’ll be trapped in this room for hours, as motionless as those vast cream underpants drying by the fire, as fixed and foxed as that dog picture on the opposite wall. I look at John and he looks at me.
‘What doctor?’ he sneers.
Rae steps up to him.
‘Shall I get your coat, John? And you’d better wear a hat or something ‘cos it’s bitterly cold out tonight. In fact, I’d go as far as to say it's taters.’
‘Coat? Oh – yes – it’s over there on the chair.’
Vera struggles up again. ‘I’ve got his hat.’ She places it on his head. ‘There. I’ll come up and see you in the morning, darling.’ They both fuss around him. Vera gives him a kiss on the cheek; Rae helps him on with his coat. ‘You’ve got your good slippers on, they’ll be fine.’
‘There. What a picture!’
Rae offers him her arm. He takes it. She looks at me.
‘Oh. Right. Yep. Let’s go then.’
I get the door.

When John is safely stowed on the back of the ambulance, Rae gives me a wink, slams the door and we set off.
We haven’t far to go. John studies me as I race through the paperwork.
‘What do you do, then?’ he asks.
‘Good question. One I ask myself a lot.’
He frowns.
‘I had five brothers. Five. Count them. All went in the army. All through the war. All came out. Imagine that. Not easy places, neither. Egypt. Libya. Terrible.’
‘My uncle’s the same age as you. He was in Italy.’
‘Italy? Oh.’
He frowns at me again.
‘Where are we going?’
‘To the hospital?’
‘To the hospital? Why’s that, then?’
‘To get you checked up.’
‘Oh.’
He folds his arms. ‘We used to go to school through a hedge at the bottom of the garden. Out onto the lane, just a little way, and there it was.’
He smiles at me. ‘Handy, eh?’

seasonal lights

Behind the dark and padlocked toilet block in the frozen municipal gardens, a man lies on his side amongst the rhododendrons. Way over the other side of the park, through the tangled silhouettes of the railings, the trees and the park café, beyond the lines of ice white fairy lights strung from low branches and out on the bright artery of Christmas activity that runs along the far side, the man dimly senses a change there – undercutting the street lamps and the spilling, front of house glow of the theatre, now there is a clamorous rack of blue. And whilst all the other kinds of light meld and wash out only a little way into the park, these new lights leap out to him, glitterballing blue fragments careening off the trees, the frosted grass, the low night sky. And it seems to the man that these blue fragments spin and jump together, moving to a dance he is falling away from. And then the heroin draws his head back to the ground, and the fragments sweep across and over him.

And time slows with each further breath he takes.

And the man finds he can reach up and catch hold of these blue fragments as they turn past his face. He holds them against the sky, and finds that each one has a picture inside – images of other calls visited through the year – night scenes like his own, locked in the strange blue amber:

the hallway of a block where a young woman lies on her back amongst the junk mail, staring up at the ceiling rose, people running up the stairs, talking in phones;

a bedroom where a housewife sits on the corner of a bed with her hands clawed inwards, chest rising and falling, eyes unblinking, whilst her husband bustles about making tea down in the kitchen, discharged today after trying to hang himself from that dressing gown hook;

the car park of a hotel where a splinter-thin young guy struggles to find his pockets so he can put his hands in them and be sober;

a bench where a middle aged man is slumped over asleep, or dead, or as good as, t-shirt ridden up, inflated belly on display like a prize watermelon, the drool from his mouth as glittering as the interval drinkers who stamp and chatter out on the theatre steps opposite;

a spot-lit front room of a new-build, where a mother clutches one child, and where a father kneels by the side of another that lies on a blue yoga mat in the middle of the room, jaws clamped shut by a convulsion that rides her on and on and will not let her breathe;

a new-born baby wrapped in white towels, working its hands and feet in protest as its puckered face is gently cleared, launching a scrawling yowl onto the air;

a room of die-cast planes and cars and miniature whiskies and leather bound, back copies of the Radio Times, by the side of an elderly man on a red patterned rug, wrong side down with his catheter tube tangled around his ankles;

a shed at the bottom of a garden, where a camouflaged young guy emerges, swollen and pained, stumbling, his head laced with dried blood, his nose reduced to a flattened whistle, his sleeping bag rolled up;

a tasselled living room and a cherry-red Christmas of a man choking on an olive, his neighbour tapping him on the back with one hand, martini glass in the other;

a jetty, black water slopping up between the slats, where a young man’s black buckled boots poke out from a wrapping of foil and blankets, and a lifeboat crew stand around in orange survival suits;

But the blue fragments speed up again and the man lets them go. They snap away, and as they do the man turns his head and notices a different light approaching, two torch beams, rocking from side to side and sweeping the ground before them. And one of the beams catches him in the face and he raises his hand.

The ambulance men crunch across the frosted grass towards him.

He closes his eyes, opens them again at A&E.

Happy Christmas!

Thank you all so much for reading my blog through the year, and for all your comments and support.

I hope you have a great Christmas, and a wonderful New Year.

With lots of love, SK xx

losing it

Richard is flat on his back, on his flattened backpack. The weight of his fall has spilled the contents around him – little square sticks of pastel colours, a tin of fixing spray, a notepad and graphite pencils. Many of the pastel sticks have fractured, and their richly coloured dust stains the carpet where his feet and legs have moved over them.
‘Excuse me stepping over you, Richard.’
There’s no other way to get into the flat, he’s so close to the door. Frank stays the other side. We both crouch down to him. His girlfriend, Marie, steps over him, too, and goes to sit down on a computer chair near his head. Her black mascara has mixed with her tears, giving her face an expression of molten anxiety.
‘I thought he was dead. He came back from shopping, he stood there in the doorway, he said “Am I losing my mind?” and then just collapsed. I didn’t know what to do. He went all blue. He was shaking. His eyes were just all wrong. I was terrified. Rich – you terrified me.’
‘Sorry. I’m all right now.’
‘Richard. Did you hurt yourself when you went down?’ I check him over but he seems fine.
‘Really. I don’t need you here. I didn’t call you.’
‘You couldn’t call anyone, Rich. You were dead. I was shit scared. I thought I’d lost you.’
He lies quite still, his eyes open, idly surveying the ceiling. A slightly built man in his mid twenties, pale cheeks, wide brown eyes, dark curly hair and a sparse goatee coiling from the point of his chin - he seems strangely out of time, like a seventeenth century courtier crash landed into black jeans and t-shirt.
‘I’m fine. Really.’
He crosses his legs and arms, and wriggles a bit on the backpack to get comfortable. ‘I’m not going to hospital.’
Marie stands up and moves over to the window.
‘You fucking better not do this to me!’ she wails. ‘You fucking better not! If you die I’m going to kill myself. There’s no-one else I care about.’
Rich raises his eyebrows. ‘I’m not going. I don’t have to.’
‘Well let’s think about that in a little bit,’ I say, unpegging the sats probe from his finger and noting the results. ‘How are you feeling right now?’
‘Fine.’
‘Any pain?’
‘No.’
‘What can you remember?’
‘I ran up the stairs. I opened the door. I had this strange feeling in my head, like a zoning out. Everything felt stuffed up, yeah? Really close, but kind of hollow. I do remember saying “Am I losing my mind?” – because I felt like I was. Then the next thing I remember, you’re looking down at me. And that’s it. But I’m fine now.’
He pauses, licks his lips. Then without moving his head he turns his eyes up and raises his eyebrows again, as if he wasn’t talking to Marie so much as to a vision of her, he says: ‘Did I really go blue?’
‘Yes you fucking went blue. I never want to see that again. It was so, so scary.’
‘Well you did absolutely the right thing in calling for an ambulance,’ I tell her. ‘Marie, describe for us exactly what you saw when Rich collapsed.’
She describes what sounds like a tonic clonic fit.
‘Do you suffer from epilepsy, Rich?’
‘No.’
‘Ever had a fit before?’
‘Once. A month ago.’
‘And what happened with that?’
‘Nothing. I went to hospital. They let me go after an hour. Didn’t say anything.’
It doesn’t sound plausible, but I let it go.
‘What medications are you on? Any?’
‘I take a few things for depression. Well – I did. I stopped taking them last week. I didn’t see the point.’
‘Rich – what I’d like to do as a first stage is to get you out on to the ambulance so we can run a few tests. I promise we won’t do anything you don’t want to do. And we certainly won’t kidnap you. You don’t have to go to hospital if you don’t want to. But I have to say that I would strongly urge you to come with us today. It sounds like you may have had a fit, and I don’t know why. Imagine what would have happened if you’d had this fit alone. Imagine if you’d collapsed here today and Marie hadn’t been around to look after you. You could’ve died.’
‘I don’t care. I’m not going to hospital.’
Marie lets out an anguished moan. She pulls a crumpled leather sack towards her, dumps out the contents and paddles around in the debris for a pack of cigarettes and a lighter.
Rich laces his fingers, gently rubs his thumbs together.
‘I don’t have to.’
‘Well let’s just get down to the vehicle and do some tests. Okay?’
‘Fine.’
He rolls over and stands up in one clean movement, then – seeing the pastel crayons spread over the floor – begins to gather them up. He insists on sorting them right way up into the tray of a neat little portable wooden easel that he takes out of the rucksack. Marie watches him, alternately smoking the cigarette and biting the quick of her nail.
Job done, Rich wipes his hands on the back of his jeans, then turns to walk through the door. Suddenly, he stops to pick up three carrier bags.
‘I may as well take the recycling out,’ he says.
And just by the front door, without even seeming to look, he drops the plastic, the cardboard and the paper into their respective green bins.

uncle ted?

Michaela has arranged herself on the sofa, Swanson-style, her white silk chinoiserie gown crumpled around her with meticulous abandon, her dry hair sprouting out like thatch from beneath an alice band she looks to have stolen from a barrel maker. Her legs are Ice Age in their hairiness: she has one hoofing great foot placed flat on the carpet, the other up on a low leather pouffe, the big toe of that foot oozing blood from the nail.
‘Hi guys,’ she rasps, ‘thanks for coming. I don’t want to waste your time, but I didn’t know what else to do.’

We have run from the other side of town on one of the busiest nights of the year. Traumatic haemorrhage / lacerations. Downgraded from Category A to B. And then in the notes: Torn toe nail. Control were as embarrassed to send it as we were to receive it, but their best efforts to PSIAM the call had failed, and we were required to attend.

I put my bag down next to the pouffe and kneel at the altar of pointless calls.

‘How did this happen then, Michaela?’
‘Well. It’s all so stupid. I feel such a fool. I was cutting my nails, and I seem to have overdone it on this one. I’ve been having problems with my leg ever since I was beaten up at a fairground ten years ago and had my hip pinned. It’s been a long haul. I’ve got such a lot going on with me.’
‘Such as?’
‘You’ll have to look at my folder. I’ve no idea. But it’s all there.’
‘Where’s your folder?’
She waves vaguely over to the kitchenette. ‘Over there somewhere. By the drug safe, maybe. You’ll see it.’
Frank goes over to look. I put an inco pad underneath the foot to protect the pouffe, then investigate the wound with a syringe of sterile water and some gauze. The nail has split vertically from the root, leaving about half in situ.

‘What will happen to me? Will I need surgery?’

At this moment the flat door is flung aside and a large man hurries in, looking like a six foot toddler in multi-coloured dungarees, a banana yellow t-shirt and red leather boots. His hair is as curly as Michaela’s is straight. They look as if they have pulled costumes from the same dressing up bag.
‘What’s up, Mikey? Everything okay? I saw the ambulance!’
‘Everything’s fine, don’t panic,’ I tell him. Michaela slumps back on the sofa and puts the back of her hand to her forehead.
‘I didn’t want to bother anyone,’ she says. ‘I just felt so – helpless.’
‘Why didn’t you call me?’
‘I didn’t like to. You know me. Soldiering on.’
The large man looks at me earnestedly. ‘Please. If there’s anything I can do to help. Anything at all. We’re all really so grateful you came.’
‘Yes. They’ve been absolutely marvelous,’ says Michaela, brightening. ‘So – good looking, too.’
‘Well if there’s a silver lining, darling, you’ll find it,’ the large man says, pushing some sweaty bangs back from his face and blowing out his cheeks. ‘God, you keep it hot in here.’

I dress the wound.

‘Michaela – there’s not much to be done with this. I’ve cleaned it and put on a temporary dressing which should keep you going tonight. Then first thing I want you to go to your GP and see the practice nurse to get something more permanent sorted out. And maybe see your GP about your ongoing problems.’
I look over to the kitchenette. Frank is thumbing through a thick yellow care folder. He smiles at me as he turns another page and writes something else down on our form.
‘Don’t I need a new nail or something? Plastic surgery?’
‘It’ll grow back before you know it, so – no – I think you’ll be fine.’
‘I simply didn’t know what to do.’
‘Try to bear in mind that the ambulance is really busy, especially at this time of year. I don’t think this really needed us coming out to you.’
‘I’m so, so sorry for wasting your time.’
I tidy up. Frank comes over and hands Michaela the non-conveyance form which she signs with a grand, stage door flourish.
‘Once again – thank you both so much for racing to my rescue,’ she says, giving me back the pen. ‘It means such a lot to me.’
‘Okay. Just – take it easy with those clippers.’
‘I’d get somebody else to do it, but my feet are too ticklish.’
‘Bye then.’
She smiles with as much warmth and breadth as her layers of foundation and blusher will permit.
‘I promise I’ll hold back in future. But if I thought I might get you two again…’ She lets the idea hang in the air with the scent from the apple and cinammon candles on the mantelpiece; but when she drops her head coquetishly, by the candles’ flickering lights she suddenly reminds me of my dad’s eldest brother, Uncle Ted. With his toolbox head, spade hands and flat nose, that old army boxing champ and P&O steward would struggle to look alluring, too.

a difficult man

We are waved over to the corner bungalow of the close. It’s a tight squeeze past a builder’s lorry; a Desperate Dan lookalike in cement spattered tracksuit bottoms, check shirt and woolly hat, folds back the offside mirror so we can squeeze past. He nods sternly as we roll by, gives us a mug-at-arms salute.

The door to number 9 stands open. Outside are two elderly women. One of them is sitting on a low garden wall. She looks pale and distressed. The other is standing beside her with a hand on her shoulder. From this slightly tentative contact I would guess that they don’t know each other that well.
‘Are you okay?’ I ask the seated woman.
‘I’ll be all right. I just can’t stand the sight of it. The smell. Urgh.’
‘He’s in the bedroom on the floor,’ says the other woman, a thoroughly tweeded specimen with metallic white hair and a frank smile. ‘I think he’s been there some good while.’
‘Any relatives around?’
‘No. His sister lives up country somewhere. He’s a difficult character. Doesn’t want help. Unfortunately he’s put a good few people against him in the close.’
I walk inside.
George is lying on his front on the floor of a cluttered little box-sized bedroom, in the narrow space between the bed and the wardrobe. One of the ladies has draped him with a blanket from the bed. Carefully I pick out a place to stand near his head and squat down.
‘George? George? It’s the ambulance.’
He seems utterly inert. I pull back the blanket to check for breathing – and yes, there is some minimal stirring there. He is wearing a cardigan and shirt, but his bottom half is uncovered, with his trousers and pants down by his ankles. His skin has a dreadful, mottled white appearance, ice-cold to the touch. Then – inconceivably – he moves his right arm and lets out a noise, a thin, spidery scribble on the surface of the air, the kind of noise a spirit might make, reaching across the void to contact the living.
‘George. Have you hurt yourself?’
I’m worried that he’s fallen and injured his neck, but he can’t tell me, and a quick examination doesn’t seem to cause any pain. He needs oxygen, warming, lifting off the floor, getting off to hospital as quickly as possible. I ask Rae if she could bring the scoop stretcher and get the trolley as close as possible to the door.
I get some oxygen running, cut off his trousers and pants, put a thermal blanket sandwiched between a couple of ambulance blankets over him, then stand up to plan the route out. It’s a logistical challenge.
I clear a space at his head and feet as best I can, carrying a mahogany cabinet out into the hallway, lifting a rickety white wooden occasional table and all its contents up into a far corner of the bed. Rae comes in with the scoop and shuts the door behind her. She estimates George’s height, extends the scoop, unclips it along its length and hands me one half. I place it on the floor next to him, we roll him gently up onto his right side and over onto his back, raise him up again sufficiently to slip the other section in, then snap the two halves back together. We attach straps to keep him in place, lift him on to the bed, then I stay with him there as Rae opens the door again. The angles are such that we just have enough room to scrape through into the hallway and then on into the garden, the trolley waiting on the pathway, head towards us.

The elderly woman on the wall has gone. The other woman is still there. As we pass I ask her to get together as much information on the patient as she can; she hurries away to do that.

Once on the ambulance we take George off the scoop, snapping it apart, Rae taking it to stash away. I reposition George’s oxygen mask again. It keeps riding up because the left side of his face is flattened, rubbed red and raw by the pressure of his time on the carpet. It has left him with a tortured expression, like a man caught in the side of the face by a sulphurous blast. In fact, he has terrible pressure sores all over his body, just as if a devil, to illustrate the poor man's agony, had pressed a flaming brand to each point of contact, and then – as a ghastly flourish – destroyed his penis, blackening the foreskin to the root.
Rae steps back aboard and we work quickly around each other. I cut his arm free of his cardigan and shirt, wrap the blood pressure cuff on him, attach the sats probe. His temperature is unreadable, his blood pressure so low it’s a miracle he can make any noise or movement at all. Rae cannulates his right arm with a large bore cannula, I prep a warm bag of CSL and unwrap the giving set.
There is a knock on the ambulance door. The elderly woman has returned with a piece of card she has torn off a cereal packet. On it she has written the two things she has found out: his approximate age, and the phone number of the woman who helps him with shopping once a week. We thank her for her help.
‘Is he going to be all right?’ she says. ‘I’m sorry we weren’t able to do more, as neighbours. You know. But he was just – is just – such a difficult man.’
‘Don’t worry. We’ll do what we can. Thanks again for helping out.’

Rae passes the ASHICE through to control, and we head off. I reposition the oxygen mask again, and stroke the hair from his face. His one good eye opens, then closes again.

He dies in MASU a few hours later.

mixed

‘He’s a very sick man. Very sick. He’s been throwing up blood. He’s got an ileostomy, angina, rheumatism. He’s in and out of conscious. He was only discharged from hospital three days ago. He’s an alcoholic. Ten years ago he had a breakdown. Five years ago he had an operation on his foot. He takes a hundred different medications. It’s a miracle he’s here at all. Isn’t it, Bob?’
Bob raises his eyebrows. He is sitting under a bare duvet on a mushroom coloured sofa, looking so comfortable you would think the chair had grown up around him, like an old tree enveloping a metal post.
‘How are you feeling, Bob?’ I ask him.
‘Fine,’ he says. He certainly looks okay. ‘Absolutely fine,’ he says. ‘I didn’t want the ambulance.’
‘Have you been throwing up blood?’
‘No.’
‘So who called the ambulance?’
‘I did. I called the ambulance. Bob’s a very sick man and he just won’t admit it.’
The woman sits on a facing sofa with an obese Staffie behind her like an over-stuffed novelty cushion. The dog gives me the eye, and so does the woman.
‘Excuse me just a moment. Can I ask what your name is, and what your relation is to Bob?’
‘My name is Liz. I’m Bob’s carer.’ She scrapes her greasy hair back from her face as if she’s streamlining herself for a fight. ‘In fact I look after the two of them.’
The other person she refers to is sitting on yet another sofa, her hands folded in her lap, looking on the scene with a flat set to her lips. I remember being called out to her in the past – given as a Cat A unconscious, it had turned into a psych case, with the patient complaining that a neighbour had forced her to smoke crack, and she hadn’t been able to sleep.
‘So you’re not actually a relation?’
‘No. I live next floor up.’
‘But you’re an official carer for the two of them?’
‘Technically, no. But that’s what I do.
‘So Bob – you seem pretty compos mentis to me. Are you capable of making decisions for yourself?’
‘Yes.’
‘Has Liz been granted any kind of legal jurisdiction over you?’
‘No.’
I turn back to Liz. ‘Well, in that case, I need to be guided by Bob, Liz.’
‘Look. He’s desperately ill. He needs to go to hospital. He was unconscious. He takes all these pills. He recently came out of hospital. He was sicking up blood.’
‘For God’s sake! Let the man alone!’ snaps the other woman. She doesn’t move, though. She is as precariously immobile as the two garden spades incongruously propped up beside her chair. The room has the air of a well-to-do study commandeered during a time of civil unrest for use as a street-drinkers’ flop. High-end antiques and leather-bound classics struggle to maintain their identity amongst the scatterings of vodka bottles, pill packets, fast food containers and dog toys.
‘Bob. Are you in pain?’
‘No.’
‘Are you unwell in any way?’
‘No.’
‘Do you want to go to hospital tonight?’
‘No.’
‘Fine. We’ll take a few obs, and leave you in peace.’
‘This is ridiculous!’ says Liz. She stands up, strides over to a low table covered in spilling ashtrays and scrunched up tissues, and snatches up a grubby leather satchel filled with meds. ‘Just look at all these.’
‘For God’s sake! Let him alone!’ says the woman over by the spades. ‘Please!’
I take the satchel from Liz. ‘Thank you. Now - if you wouldn’t mind having a seat again and letting me get on with things, that’d be great.’
She dumps herself back on the sofa, nearly squashing the dog, who lets out a little whumping noise, and then gives me the eye again, as if him being flattened was part of my plan all along.
The meds are all mixed up: hers, Bob’s and Myrna, the other woman.
‘What were you in hospital for, Bob?’
‘The stoma got a bit infected, but it’s fine now.’
‘No discomfort?’
‘No.’
Frank quickly runs through the usual obs; they all come out fine.
‘Bob – if you don’t want the ambulance in future and someone rings on your behalf, you must try to stop them, or cancel it. It’s a waste of our time, otherwise. And someone who really needs us might suffer as a result.’
‘I know, but…’
‘So you’re not taking him in?’
‘Bob doesn’t want to go in. He doesn’t need to go in.’
Frank packs the equipment away, giving Liz a look he seems to have copied off the dog.
‘He should be in hospital.’
‘Bob – my advice is to get some rest tonight. Maybe see your doctor in the morning. Okay?’
‘Yep.’
I look across to Myrna. She sits as restrained and doll-like on her cushion as before, but it’s easy to imagine her suddenly snatching up one of the spades, swinging it above her greying head like a battleaxe and rushing at Liz. But instead she gives out a breathy little tsch, and brushes some crumbs from her lap.
Liz and the dog see us to the door.
‘Thank you for coming,’ she says. We feel the spike of their eyes in our backs as we push open the stairway door and head back down the communal stairs to the ambulance.

contagion

The sea is a sheet of liquid glass spreading in from the horizon, smooth around the worn wooden beams and concrete pillars of the old harbour wall, smooth around the pleasure boats and fishing boats riding at anchor, smooth around the jetty and the landing platforms, the steps down from the road, the ribs of ruined boats in the highest of the silt banks, black beneath the vast, shadowy bulk of the old swing bridge. The entire morning seems to leap up from this painfully bright surface; even the cormorant out near the harbour mouth has his wings outstretched, crucified by the surfeit of light.
Our patient, a middle-aged woman in a bulky blue winter coat, sits on a concrete block at the far end of the car park. She is hunched forwards like a fisherman asleep by the rod, her forearms supporting the weight of her upper body on her knees. Her left hand hangs down between her legs, fingers relaxed and open. In the other hand she has a Stanley knife.
‘Drop the knife! Now!’
The policeman who arrived on scene with us takes a step towards her, one arm out in front.
‘Drop it!’
She turns her head. Her neck is gaping open.
‘Drop it now!’
She stands up. Her coat is undone, reveals pyjamas stained with blood. She drops the knife and looks at us all with an expression as glassy as the water. Incredibly, she manages to talk.
‘Leave me here,’ she rasps. ‘I need more time.’
‘Put your arms out to the side,’ the policeman says. His hands are bare, so I give him a pair of blue gloves. He snaps them on. ‘Do you have any other weapons?’
‘No.’
He pats her down, then takes a step back to let us grab the woman before she falls. We walk her onto the ambulance and lie her on the stretcher.

She has a grievous wound to her neck, a frank, butcher’s slice that parts it neatly left to right, the adipose tissue and muscles exposed, her trachea laid open – but she has missed the major blood vessels, the other incredible aspect of this injury. As she breathes, the air rushes in and out with a gently wet flapping noise. I soak a dressing in sterile water and place it across the wound.
‘Please. Just one more minute.’
She sounds leaden with fatigue, a lumpish, domestic figure fixated on the last chore of the day.
‘I was supposed to fall backwards into the water,’ she says. ‘I have a bug in my stomach.’
‘Don’t talk. Try not to talk,’ I tell her, gently tying the dressing in place.
‘I have a bug in my stomach. My husband and daughter cleaned up a mess that came out of me, and now they have it, too. I’ve given them my bug.’
She tries to make little shakes of her head. We tell her to be still. Rae strokes her forehead like a child with a fever. ‘Ssh.’

Back outside the ambulance, the policeman asks me how she is.
‘It looked pretty bad,’ he says. ‘Was that her windpipe?’
‘Yeah. She had a pretty good go at it,’ I say, pulling off my gloves. ‘We need to get off.’
‘I’ll follow in the car.’

He tucks in behind us, a sparkling, early morning punch through the rush hour traffic back into town.

melissa

‘I’ve definitely been here before.’

Rae tries to remember for what as we walk up the concrete steps of the housing block. We had turned off the blue lights before we entered the estate, but the road had seemed to shiver like a tripwire; even before our bags were out, we were the multi-eyed focus of this stack of lighted windows.

On the second floor landing a door stands open. Just inside, a tall young kid of about seventeen, dressed in white trainers, a baggy white tracksuit, and a Nike baseball cap tilted up on his head, waits in the narrow hallway, cradling his right hand.
‘She’s in there, in the bedroom,’ he says. ‘And I’ve busted me hand.’
He turns, and leads us down the hallway. For a second I wonder if he’s injured his leg, too, but I realise that the stiff-hipped shuffle is a ghetto-style swagger. He shows us in to a room at the end.
‘Jayne. It’s the ambulance.’
A sickening wail rises up from a mattress on the floor. Jayne sits huddled up under the duvet, pressing herself against the wall. She holds the duvet up to her mouth, her hands either side like a tucked-up child, looking off into the shadows on the far side of the room. Her greasy hair shines dully in the light from the bedside lamp. Her face has the yellowy off-white colouring of old ivory, and her eyes are circumscribed by darkness. In front of her on the bed is a washing up bowl holding a slop of vomit, sopping tissues and a cider can. Beside the mattress is a cluster of vodka bottles. The rag rug is seeded with butts.

Rae says brightly: ‘The last time I was here you were just about to have a baby.’
The boyfriend leans in: ‘Yeah, mate, yeah. Taken into Care last month.’
‘Oh. Sorry.’
‘She’s necked all those,’ the boyfriend says, gesturing with his one good hand to a scattering of empty packets. I pick them up: fluoxetine, co-dydramol, paracetamol. ‘She also drank some bleach.’ He hands me a container of Harpic toilet cleaner. The swan-necked spout reminds me of the mouthpiece of a saxophone. I imagine putting it to my lips.

‘I’m not going to no fucking hospital. I’m not. Just leave me alone. I want to die.’ Jayne’s mouth gapes open with the grief of it all; threads of saliva quiver from tooth to tooth.
‘You’re fucking going,’ shouts the boyfriend, leaning over her, jabbing the air in front of her face with his bad hand. Then he winces emphatically.
‘God. Fuck. I won’t do that again.’
He laughs, then holds out his hand to me.
‘What have I done? Is it broken? I suppose I should’ve taken these rings off. My fingers feel like they’re going to explode.’
He has a ring that says DAD and another – a gold sovereign in a silver setting, distorted from the trauma, whatever it was. His fingers have swollen up around both of them.
‘Sorry – what’s your name?’
‘Johnnie’
He looks at me. The acne around his nose and mouth seems of a piece with the naïve clarity of his eyes. But there is something else about him, a twist of violence glinting below the surface, that makes me guarded and alert.
‘Johnnie – we’ll look at your hand in a moment. The first thing we’ve got to do is deal with Jayne.’
‘Of course. Yeah – go on, go on. You do what you’ve got to do. And you – you listen to them. They’re professionals. They know about this shit.’ His tone steps up to almost a shout. ‘Cos I’m not losing you. There’s no way you’re doing that to me.’
‘Mate – let’s be calm. You’re not going to help, otherwise. Just stand over here with me and let Rae see what’s what. Come on.’
He lets me steer him over to the other side of the room. Whilst Rae kneels down to talk to Jayne, I ask Johnnie to start gathering some things: shoes, a coat, a mobile phone, any prescriptions Jayne might have. The distraction works. He forgets his anger, and submits to the task with puppyish enthusiasm.
‘Don’t ask me where she put her trainers. Where did you put your trainers?’ he calls out. Then snorts: ‘Women.’ The word seems wrong from him, too adult, like the sovereign ring on his hand.
‘So tell me what happened to you?’
‘Shit. Some guy came to the door. An intruder. I don’t know. Never seen him before. A skinhead. I asked him what the fuck he wanted but he didn’t say nothing, he just tried to push past. So I battered him in the face. Like anyone would, fighting for their life, you know? I mashed him up proper. He fell backwards into the hall, and then he ran off. Look at this. It’s fucked, isn’t it? I’ve broken my hand, haven’t I? Christ – I can’t even turn it over.’
‘Did you call the police?’
He laughs. ‘The what? No mate, I don’t need no po-lice. They’re no good.’
‘Anyway. Those rings will need to come off, Johnnie. They’re cutting off the circulation.’
‘I can’t do it, mate. I promised my Dad I’d never take this off.’
‘Well I think your Dad would understand. And a good jeweller could repair it.’
‘Yeah? Hey – here they are. I’ve got your trainers, babe.’
He snatches them up and we both go back to the mattress.

Rae has persuaded Jayne to come to hospital. We help her to stand up, dress her in a parka coat and trainers, and walk her out to the vehicle between us. Johnnie follows behind, giving us an excited commentary on the skinhead in the hallway, what he did to him, what he will do when he finds out who he is.
‘No one does that to me. Especially not tonight, not with all this.’
We make Jayne comfortable on the stretcher. Her obs are good. Although she doesn’t tell me outright, I know that Rae doubts the number of tablets taken, the story about the bleach.
‘Here. Look at this,’ says Johnnie, carefully rolling up the sleeve on his injured arm. There is a tattoo of a girl’s name in elaborate, copperplate style - Melissa – with a date. ‘That’s when she was born,’ he says. ‘They let me cut the cord and everything. Fuck me, it was tough. That whole time - it was amazing. The way the head came out looking one way, then turned, like that…’ he does a comical, stiff necked turn to the left, ‘just like someone was inside, moving her. But of course they weren’t. I wouldn’t have missed that for the world.’ He cradles his damaged right hand in his left, then says in a different, quieter voice, half to himself and half to Jayne: ‘We’ll get her back. I promise you. We are definitely going to get her back.’

think of a name

‘Fuck off, Bizzies.’
‘It’s the ambulance, not the police, mate. We’ve been called to make sure you’re all right. These people here saw you slumped in the doorway and they were worried about you. As soon as we know you’re okay, we’ll be out of your hair.’
It really feels as if we are just like the leaf litter and twigs caught in his hair, an apocalyptic, sugar-watered, crow-black Gothic pile that makes his head seem roughly the height of his torso.
‘What’s your name, for starters?’
‘Fuck off, Bizzies.’
He lowers his eyelids and smirks; the effort of co-ordination involved in that has him sliding back down the shop doorway into a heap.
‘Come on, mate. Try to keep with it.’
The two people who called us are standing watching.
‘I didn’t know what to do. I thought he might be dead,’ says one, a fifty year old woman, hugging her shopping bags to her middle like they were children. ‘Do you think he’s on drugs?’
‘Well I don’t know about that. He smells as if he’s had a few drinks, though.’
The other one, an intense young woman in a beret and glasses, frowns. She still has her mobile phone in her hand, and I wonder if she’ll be tempted to take a few pictures.
‘Will you come on to the ambulance with us so we can reassure ourselves you’re fine?’
‘Fuck off, Bizzies.’
‘That’s not very nice, is it? We’ve stopped by to help, these people here have gone out of their way to make sure you’re okay, and all you can do is say “Fuck off, Bizzies”. How rude.’
‘Fuck off, Bizzies.’
‘Okay. Let’s try standing up, shall we?’
The middle aged woman takes an alarmed step backwards, but beret girl grips her phone with great resolution and leans in.
‘I think we’ll be fine now. Thanks very much for your help.’
The two women seem nonplussed.
‘Honestly. We can manage now. Thanks for calling.’
After a pause, they swap a confederate look of disappointment, then disperse East and West down the High Street.

Our patient is tall but lean. Standing him up is like helping some gigantic, alien fern to unfurl. He rises up between us, his dark-eyed pallor as much a part of his look as his pointy boots, drainpipe jeans, Fields of the Nephilim t-shirt and black jacket.
‘Fuck off, bizzies.’
‘Yeah. I think we’ve moved on from that one.’
He staggers between us to the ambulance and we load him on board, where he submits with haughty amusement to our checks.
‘Still not going to tell me your name?’
‘Ben. My name is - Ben.’
‘Right. Good. Okay, “Ben”. How are you feeling? Are you in pain? Have you hurt yourself? Tell me what’s been happening with you tonight.’
‘Fuck off, bizzies.’
‘All right. I don’t think we’re going anywhere with this, are we?’
I look at him. His pupils are wide and slow with drink. His obs are fine. When I ask if he wants to go to hospital he simply stares at me, his head moving as if his neck has been replaced by a large spring.
‘Can we do anything for you tonight? Or shall we simply release you back into the wild?’
He snorts. I make a quick grab for a bowl, but it really is nothing more than an attempt to show the level of disdain he has for this whole scene.
‘Come on then, Ben. Out you come.’
He steps off the ambulance, then – just as he seems ready to lurch away down the high street – he turns and comes back at me, holding out his hand for me to shake.
‘I love you,’ he says. ‘I really, really love you.’
‘Great. I love you too, Ben.’
Then he’s gone, riding the bucking pavement, using shops and rubbish bins to keep him on track.

I see a couple of young girls a way up ahead stand aside to let him pass. One of them turns to track his route back along the road; the power of her inquiry when it reaches us is like a wave crashing over the ambulance.

‘Fifty fifty we see him again sometime tonight. Those boots, sticking out of a paladin.’

But we don’t.

looking at monsters

The brave quartet turns to face the medieval gateway, waiting for the monster to appear. Close-up on their faces: half-open mouths, widening eyes, hands reaching for other hands. And then the monster does appear, a howling, black-cloaked figure coalescing out of vapours, roaring and clawing at the air, its face a mask, its teeth like stitches.

Chloe sits next to me on the sofa, legs tucked up into herself. She quickly presses a cushion to her face and tells me to turn the TV off.

‘But see – Chloe – see how Sarah Jane keeps looking straight at the monster. She’s scared, but she knows her best chance is to keep looking. That way she’ll be able to figure out exactly what the thing is. She knows it’s only by looking straight at it, it’s only by keeping her eyes open and figuring out what to do next, will she have any chance of winning. Chloe. Because although it’s scary, it’s still just a thing, in the same way a dog’s a thing, or a ladder, or a car. Say a big dog suddenly appeared in the gateway. You’d be better off looking at it, thinking about what it’s capable of, and then acting on that. So really, it’s good to look at these things – especially the things that scare you. Because then you’ll be able to see what needs doing.’

Chloe lowers the cushion. Together we watch the scene play out, watch Sarah Jane challenge the demon figure, and use her wits to send it back through the gateway. Cue music and titles.

**

A few days later I get the letter I’ve been waiting for, the results of the paramedic assessment day I sat last week, the first stage of the application process for the next university cohort.

It’s a thin letter.

I rip it open with a sick feeling. It’s all laid out coolly and plainly. I failed two of the four components. I won’t be called for interview.

I spend the next few hours trapped in caves of disappointment. Voices and echoes, sickeningly familiar, some I thought I’d heard the last of, some I knew were sleeping like viruses, ready to be activated when conditions were right. How could I have failed? Easy. I fail often. It’s the one thing I’m reliably good at. What must people think of me? What must they think of these crosses I’ve got to tote around with me now? These crushing dismissals? Even the trainees I helped find their feet have moved on. In a panic I see myself left behind. I thought I could simply strike into the next phase any time I wanted, but in reality I can’t. What else do I feel confident about that’s actually hollow, maybe even rotten, in the same way?

Eventually the crisis precipitated by the letter levels out, the sting of it eased by my family and friends. And it helps, too, to remember that night on the sofa, Chloe dropping the cushion from her face to look at the monster straight on. She’s seven. If she can find it in herself to confront whatever it is coming through the gateway, to see for herself what it really is, then - well – I’d better just get on and learn from her, and do the same, too.

the getaway

Clothilde sits slumped in her wheelchair, the despondent centre of a Glade-scented hurricane of concern.
‘We’re very worried about Clotty,’ says the Warden. ‘Sam! Shut the door before I say any more. Sam!’
Sam is an intense twenty year old with barely a millimetre of nose between his eyes. With his shaven head, black t-shirt and black jeans, he looks like an off-duty commando. At the first bark of his name he flashes the door shut - just in time. A care assistant had been shuffling by with a decrepit old man on her arm, and he had been ready to smile at us.
‘She’s really not herself,’ says the Warden, and then: ‘Sam. Sam! Go and get Clotty’s notes, would you? Now, please.’
Her rather hectoring manner with Sam seems bizarrely misplaced. He’s standing right by us, is quick to do whatever he’s asked, doesn’t have a problem with language or hearing – unlike Clotty. Her twin hearing aids squeal dreadfully. You have to put your lips to her ears to make yourself heard.
Sam dashes out through the smallest gap possible and is gone.

The room still feels tiny despite his absence. An overheated, floral box, it has space enough for a bed, a side table, a wardrobe, and two child-sized teddy bears. They stare at us with an overstuffed placidity. I wonder how long they have been resident here.

‘In what way is she not herself?’ asks Frank, readjusting his position on the edge of the bed and taking Clotty’s hand in his. ‘How is she different?’
‘Well normally when I come round with the pills I shout “Hello Clotty! Good morning, Clotty!” and she makes a face like this … and holds out her hand … like this.’
‘Okay. Anything else?’
‘The other thing is that usually she tramps about quite confidently with her Zimmer. Not a million miles an hour, but quite effective in her own way, you know. But this morning she just stood there, and when we asked her she said her legs were all gone to jelly.’
‘Did she fall?’
‘No. We got her into the wheelchair, lickety split.’
‘Has she fallen recently?’
‘No.’
‘Was she okay last night?’
‘Fine. The old Clotty we know and love.’

The door opens a crack and Sam the Shadow slips back in with a blue folder. He hands it to the Warden.
‘Let’s have a look,’ she says, opening it on her lap.

Frank and I take this opportunity to check Clotty over. She passes the stroke test, says she is not in pain, does not feel dizzy or sick. Her sats are normal, breathing easy and clear, her pulse is irregular but for a ninety five year old we would expect nothing less. The only thing that seems out of place is the Warden’s concern.

‘Obviously we don’t know Clotty,’ says Frank.
‘Oh – we do,’ smiles the Warden. ‘Lovely Clotty.’

Clotty looks sideways at her, then back to the front. Her hearing aids squeal, making that minimal movement of her neck seem like the attempt of a rusted iron statue to have a look around. Her whole expression during this interview has remained a welded shield of disdain.

‘You’re a paramedic,’ says the Warden. ‘You must have seen this before. What’s wrong with her? What should we do? Call a doctor? Send her to hospital? We don’t want her waiting up there hours and hours.’
Frank tells them that in this situation we have to be guided by them. To us, Clotty doesn’t seem too bad. It doesn’t look as if she’s had a stroke (what the call was given as), but it’s possible she’s had a TIA and not showing it much. She may be developing a UTI – there are a number of things that could be up. All we can do is accept that she’s noticeably ‘not herself’, and take her to hospital to see a doctor. On the other hand, she could stay where she is and have a doctor out to her in due course.
Frank looks at the Warden. ‘So what would you like us to do?’ he says.
The Warden hugs the folder to her chest. ‘What do you think, Sam?’ But before he has time to open his mouth, she says ‘Okay. Take her to hospital. She won’t be there long, I’m sure.’

I strike the resus bag, prep the vehicle and return with a chair.
Nothing has changed in the room. The two bears on the bed have shown more activity than Clotty, who sits slumped in her wheelchair as before.

There is a lift in the home, a dark brown, shabbily veneered affair, with concertina doors and dirty plastic buttons. I wheel Clotty inside. There’s just enough room for the two of us. Sam leans in and pushes button number one – which surprises me. We’re currently in the basement; I would’ve expected him to press the ground floor button. But maybe this home is built into a hillside or something (I try to think – is it?) and the floor plan is misleading. Maybe he hit the button for me because it was easier to do that than explain.
The doors clank shut, and we grind upwards slowly. I hear Frank, the Warden and Sam walking up the stairs, the Warden describing how lovely all the residents are.
We approach the ground floor, and I can see the blurred image of the three of them through the square of safety glass, standing waiting. Then we continue upwards.
‘Er – Spence. Where are you going?’ says Frank. But he’s below me now and we’re arriving at the first floor. The doors clank open. An elderly woman is standing there with a plastic jug. She tries to get into the lift, despite me telling her that there’s no room, that I’ll send it straight back up. She frowns, as if the air has thickened for some reason and won’t let her progress. Luckily, Sam bounds up the stairs and up to us.
‘Edna. Let the man go. Let him go.’
He eases her backwards, and looks at me.
‘You want the ground floor,’ he says.
There’s no point in me saying that he pushed the wrong button. I smile and nod – and then just as I go to push the ground floor, he leans in and pushes it for me.
‘There,’ he says. ‘Ground floor. That’s the one you want.’
The doors clank shut. I can hear him trying to explain the situation to the woman with the jug, as we sink down with a loose-cabled judder.
We approach the ground floor. I hear the Warden talking to Frank. The little windows match up – and then un-match, and we carry on sinking downwards.
‘What’s he doing?’ says the Warden.
‘Spence?’ says Frank.
I reach the basement. The doors clank open. The care assistant with the old man on her arm is standing there. He plants the gummy smile on me that he’s been saving all this time; she merely frowns. I make a joke about the strange lift they have here but she shakes her head as if she doesn’t agree. Before I have a chance to press the ground floor button, the doors clank shut again. We rise up.
‘Sorry about this, Clotty,’ I say to my patient. She makes no movement or sound.
We reach the ground floor. The windows match, un-match. We continue to rise. We reach the first floor. The doors clank open. The old woman with the jug tries to get in. Sam runs up the stairs again and pulls her out.
‘The ground floor button!’ he says.
‘There were – people in the basement,’ I begin to say. I sound crazy.
Sam reaches in to the lift and looks at the buttons.
‘Button number one,’ he says. ‘It’s wedged in. Someone’s pressed it too hard.’ He prods around to free it, then looks at me.
‘Don’t press any buttons,’ he says, then presses ground. The doors clank shut. We sink.
We arrive at the ground floor and the doors clank open. The Warden gives me a doughy smile.
‘There,’ she says. ‘Well done you.’