doors

Manning House has the glass and brick functionalism of a seventies telephone exchange, and it may once have been that. But now it serves as a hostel for rough sleepers, and if there are occasionally people to be seen sitting on the steps outside the door, smoking, their complexions are too blasted and their expressions too wasted for your average telephone engineer. Not that you see them outside for long, though. The staff controlling the entrance from their Plexiglas reception like to move them on pretty quick.

Lance has sliced the top of both his legs open. He is sitting with both legs raised and crudely bandaged, two members of staff standing right and left. He has a rolled cigarette between his bloody fingers, and waits patiently to be allowed to smoke it.

‘What did you use?’ I ask, shearing his blood-soaked jeans away.

‘The lid of a baked bean can. You know – the ring-pull kind. It’s pretty sharp, and you get a really nice grip.’

I’ve never thought about it before, but he’s right – it’s perfect. He’s neatly parted the flesh of his legs almost to the bone.

He stares down at his handiwork, the other side of some brutal, medieval practice that successfully opened a door and let the demons out.

As I’m re-dressing his wounds I ask about the other, older stripes on his calves and ankles.

‘I know,’ he says. ‘I’m sorry to waste your time.’

He fiddles with his cigarette, which adheres to his tacky fingers and almost tears.

‘Can I smoke this or what?’ he says.

‘Wait till you get outside,’ say the staff.

charlie

I’ve no doubt these were once fine houses. But the tide of urban prosperity has fallen right away in the last two centuries, leaving the buildings decrepit, semi-derelict, the fine clothes and gorgeous attitudes that once graced the street nothing more than the echo of a smart shoe on the rubbed stone flags leading up to the door.

The array of bells on the side is so chaotic it’s difficult to figure out which is number five. I press the middle one and hope for the best. After a long delay, the door release rattles, and we go inside.

It’s colder inside than out, and outside is freezing. There is a massy sense of damp in the hallway, colonising the far corners of the ceiling, feeding on what warmth there is in the bare, energy-saving light bulb.

None of these bedsit rooms have numbers on their doors. The only difference between them is the number of kickings each has taken, or the disposition of litter on the landing, a bike without wheels, a stained mattress, a carved plank of wood I could swear was a wormy old stocks. Three floors up I stop and call out Number Five? After a pause, there’s a shuffling and grunting, and the door in front of us opens.

Ambulance.

Mike is a fifty-year-old man who could comfortably stand in a casting line-up for a biopic of Charlie Peace. Consumptive, greyed, gripping the collar of his shirt, he nods once and shows us into his garret. It’s a mean affair, magazine pictures peeling on the walls, a coverless duvet on the sofa, a coffee table piled with cans, scattered letters, a composting pyramid of fag butts.

‘My chest hurts’ he says, dropping himself down on the sofa, jabbing a yellowing finger into the belly of the butts to find one with enough of a draw. Everything’s so damp I can’t imagine he’d be able to light it, though. Or even strike a match, because surely this atmosphere is incompatible with fire. With life.

Rae is attending and asks the questions. I stand back a little, ready to help, but ready to go, too. I know that Rae will want to get him down to the ambulance as soon as she can, for our sake as much as his. You wouldn’t want to stay in this place longer than absolutely necessary. You can hear the spores rustling with interest, orientating themselves to the heat from our necks.

The patient stands up and pulls his coat on.

I open the front door and pat the wall trying to locate the landing light, but it’s absolutely dark and the switch isn’t where I thought it was.

I take out my pocket torch and shine it about. And then, for some reason, I direct the beam up the stairs that carry on opposite.

Nothing there.

Which, given the feeling I’d had, is somehow worse. 

clear

‘Ready?’

‘Yep.’

Rae presses clear, and we wait to see what happens next, standby or job.

We’re one of four ambulances parked up outside A&E. Another one is just coming up the ramp. You can tell by the sound of the engine, the spread of the lights. One to our right sparks up and leaves. It’s like we’re drones servicing an enormous hive. Not cells, but cubicles. Not honey, but saline.

The car park in front of us is the usual muddle of taxis, police cars, private cars parked haphazardly, people hobbling in and out of the two entrances, smoking in groups, with drip stands or draped in blankets, squatting by the wall or sitting on the edge of the concrete planter. Any time of day or night it’s the same. Some we recognise, from earlier in the shift, earlier in the year.

The moon is just rising above the resus training block, waning now, but resonantly bright.

The screen remains inactive.

‘It’s amazing how quick the moon moves, when you think about it.’

Rae looks up from her phone.

‘It’s lighter ‘cos it’s missing a chunk,’ she says. ‘I can’t believe I’ve eaten all my lunch all ready.’

The sky is clear. It makes me wish I had an app that tells you what the stars are when you hold the phone up. I look at Orion’s Belt. I know one of the stars is Betelgeuse and one Rigel, but I can’t remember which is which, or what any of that means. A long way away, whatever the name.

A plane tracks across. It’s funny to think of those lights and what they represent. People, doing people stuff. Looking down at the city lights, wondering about them.

Still the screen remains quiet.

The last shift I worked we had a newbie, third-manning. He was so enthusiastic, he spent the entire shift with his head poking out of the little hatch that links the back with the cab, excited by the blue-light drives, and by the details of each job as it came through. I remember being that enthusiastic, terrified almost. The seriousness of each incident seemed overwhelming. You still get a flavour of those early anxieties when you’ve taken some time off, a couple of weeks or so, and it’s the night before your first shift, and you catch yourself thinking dreadful things, those Final Destination scenarios that are going to catch you out and expose you for what you are, an incompetent, a fraud, a chancer. But it only takes the first job to shoe you in to the usual run of things. Letting the jobs unfold in their individual way. Doing what you need to do. Coping, with the help of your colleagues, and the public, and a little luck.

Whaa-whaa-whaa. Whaa-whaa-whaa.

‘Why do they have to use such an angry noise?’ she says, jabbing buttons. ‘Why can’t they have something soothing?’ She puts on a bland, computer voice: ‘Rae? Sorry to bother you, Rae. But someone's in trouble.’

‘Maybe you could have a selection of voices. Darth Vader: Chawwwww. I feel a disturbance in the Force. Chawwww. Category A. Mobilise the fighters.’

Rae scrolls through the details.

‘Twenty-four year old female. Chest pain. Numb left arm. Familial cardiac.’

I put the ambulance in drive and we move off, passing another coming up the ramp.

We wave.

networks

There’s an electricity sub-station opposite Alice’s bungalow. A low, bare industrial spread, cones of ceramic insulators, fans revolving behind grids, pylons running cables. A low thrum, accentuated by the cold, clear blue of the sky. It feels like the whole morning is being powered by this place.

We find Alice lying in her hallway, the top of her body covered by a brown fleece she’s pulled over herself. It’s difficult to figure out exactly what’s happened. She doesn’t appear to have hurt herself. She doesn’t have any major health problems. She’s sixty, and in reasonable shape. Gradually it seems as if this is more a mental health issue than anything else. As gently as we can we help her up and into the sitting room, where she curls up on her side in a voluminous electric recliner, covers her face in her hands, and sobs.

Alice’s bungalow is scrupulously tidy, with the rubbed, almost scorched smell of cheap carpet vacuumed every day to the corner. I go into the kitchen for her care folder and find it on top of a free-standing cupboard, a retro, glass-fronted affair. Inside is a tin of salmon, three packets of Angel Delight and a month’s supply of instant porridge.

I take the folder back into the lounge, where Rae is finishing off the obs.

‘I can’t tell you,’ says Alice. ‘I just can’t. It’s too shameful. It’s a secret.’

‘It’d really help if you could tell us,’ says Rae. ‘Is it something you’ve done to yourself?’

‘No. I’m not saying. You’ll call the police and I’ll be carted off. My daughter has enough troubles of her own without that.’

I flick through the folder. Alice was assessed by the community mental health team a year ago, but refused all help and was signed off as low-risk.

‘What medications do you take?’ Rae asks.

‘Not much,’ says Alice, suddenly sitting upright, conversational. ‘Something for blood pressure. Pain pills for my back. They’re in the bedroom. Excuse the mess.’

I go to fetch them.

Alice’s medication is in a plastic toilet bag on the dresser. I half expect to see a scattering of empty packets, and glance at the rubbish bin to see if she’s tossed any there. But like the rest of the bungalow, everything is tidy and unremarkable. The only jarring detail is the number of handwritten notes Alice has placed about the room – all in shaky block caps, all describing various ailments, how she was feeling and when, what the doctor did or didn’t say, who did or didn’t come. It’s like a paper chase, except all the clues are on display, and don’t lead anywhere.

I go back to join Rae and Alice in the sitting room.

‘My gentleman friend has got a mobile phone but he never has it switched on,’ says Alice. ‘ He won’t be home because he likes to get out early, and I don’t know when he’ll be back. His sister might be home, though. I could give her a call.’

‘Would you like me to speak to her first?’

‘Could you?’

Rae makes the call. I can hear the woman answer on the other end – a warm, confident voice, immediately concerned. Rae explains what’s happened, then hands the phone to Alice.

‘Hello? Vera?’ says Alice, but then chokes up, and simply presses the phone to her ear whilst she cries, as if really that was the essence of the whole affair, the simple truth she needed to transmit down the wire.

a nice surprise

To look at Ellen you’d think she was dead. But it turns out she’s just deeply asleep, propped up on a stack of pillows on the sofa, her ancient face slack, her eyes not quite closed.

Her daughter, Sophie – an elderly woman herself – tells us about the doctor’s visit earlier in the evening.

‘Sorry to come barging in when it’s so late,’ I say to Sophie.  ‘It seems almost criminal to wake Ellen up now. But the doctor wants her in tonight, so we have to go with that.’

Sophie nods.

‘Last time she was in for weeks with her chest, so it’s best to get it sorted earlier on this time.’

‘Absolutely.’

Rae fetches in the chair.

* * *

The difference between Ellen asleep on the sofa and Ellen awake on the ambulance trolley is as marked as the difference between Off and On. She is sitting upright, swaddled in blankets, her hands resting lightly in her lap, the nails perfectly painted coral pink. There’s a sparkling focus to her attention, accentuated by the overhead spots. With a flush to her cheeks and her mouth rolled up in a smile, she looks like one of those ancient Chinese carvings, a wise old woman, laughing at the endless mischief of the world.

‘Comfortable?’ I say.

‘Oh yes. Very comfortable, thank you.’

‘How’s your chest feeling?’

‘Fine. Fine.’

It’s not, of course, but the fact we both know it only seems to add to her appreciation of the joke.

‘I would never have guessed you were ninety-eight’ I tell her.

She stares at me, glittering.

‘Nineteen-fifteen!’ I say, writing it down.

She laughs.

‘A nice surprise for my parents,’ she says. ‘Well – they needed one!’

‘I bet.’

‘It’s a long time ago, isn’t it?’ she says.

‘It is.’

‘My father had a motorcycle. GCF One Two Three. I used to ride pillion with him.’

‘What sort of bike was it?’

‘A Calthorpe.’

‘Calthorpe? I’ve not heard of them. Was that a British bike?’

She nods.

‘I’m impressed you can remember the bike’s plate.’

She nods again, then adds:

‘He was an excellent rider, my father. Mind you, I was absolutely fearless.’

Her hands flutter in the air.

‘Who does your nails?’ I say. ‘They look amazing.’

‘My daughter, Sophie. They’re pretty good, aren’t they?’

She holds out both hands for me to look, thumbs together, the fingers all in a row. Suddenly she starts a strange little mirror exercise, moving out each little finger together, then the little and third fingers in pairs together, then middle, third and little together, then splitting the fingers in pairs... it’s hypnotic, and extremely difficult to copy.

She laughs at my clumsy attempts.

‘I worked in a telephone exchange,’ she says, relaxing her hands back on to her lap.

I have to finish off the paperwork before we get to the hospital.

She watches me as I write, the ambulance gently rocking and hushing along.

Suddenly, she starts singing: ‘z y x, w v, u t s, r q p, o n m, l k j, i h g f, e d c b a’

‘Oh my good God,’ I say. ‘Is that the alphabet backwards?’

She nods.

‘That’s incredible! Now, Ellen. One last, quick question for the notes. Are you allergic to anything?’

She studies me a moment, like she’s finally found it, the most endearingly ridiculous creature ever to walk the earth.

‘Now how on earth would I know that?’ she says.

body language

Jenny has taken an overdose of pain meds. Nothing immediately life-threatening, but serious enough to warrant a trip to A&E. Her partner Geoff doesn’t need to get anything ready. Jenny was only discharged from the psychiatric hospital yesterday, and they haven’t unpacked yet.

He kisses her goodbye at the door, tells her he’ll be up later. It’s difficult for him, what with the pets and everything. But he’s used to it. Jenny’s been overdosing like this for years. The only surprise each time is the ease with which she’s still able to get hold of pills, her own prescription tightly regulated.

She takes my arm. I lead her to the ambulance.

‘Cold tonight,’ I say.

She doesn’t answer.

* * *

At the hospital the charge nurse greets us wearily. It’s been another busy night, but the crowds are thinning now and he’s got time to think.

He grabs the clipboard and wheels the portable obs machine in our direction.

‘Hello,’ he says. ‘My name’s Jack. What brings you to A&E tonight?’

He starts copying down some information from my sheet whilst I tell him the story – the overdose, the reason she took it, what it was and when.

‘Ah-ha,’ he says, putting the clipboard aside and wrapping a cuff round her arm. ‘Have you done this kind of thing before, Jenny?’

She nods.

‘Yeah – I thought I recognised you. Weren’t you in last week?’

She nods again.

‘Oh-kay. So tell me what happened tonight. Your man here tells me you took all these tablets. Why’d you do that, Jenny? Was it deliberate?’

She nods.

‘And would you go so far as to say you intended to kill yourself? Is that what you wanted from all this?’

She nods.

‘Okay. That’s fine.’

He writes down the blood pressure, SATS and pulse, takes a quick temperature then unwraps the cuff from her arm.

‘I just need to have a quick word to see where we’re going. Back in a minute.’

Jenny shifts restlessly on the chair.

‘I don’t like him,’ she says after a while. ‘He thinks I’m a burden.’

‘Oh no, Jenny. I don’t think he does. It’s been really busy here tonight. He’s probably just exhausted.’

‘He thinks I shouldn’t be here. I can tell by the way he looks at me. He thinks I’m a waste of time.’

‘I don’t think he does, Jenny.’

She’s not convinced.

She sits in the chair, holding on to the suitcase, jigging her leg up and down.

We both watch as Jack hands over to the main desk. The cubicle board is full, closely written in black and red, hectic as the tote board at a racetrack. Jack is there a little while. At one point he hangs on to the counter and stretches his back. The charge nurse takes a cloth, makes a change to the board. When Jack straightens up, the charge nurse is biting the end of the pen, studying the board. Then he tosses the pen back into the clutter on the desk and says something to Jack. They both laugh.

Jenny’s leg stops jigging and she straightens in the chair like she’s just been slapped.

She draws her suitcase closer in.

memories

‘I used to chase people for debt.’

Charles rearranges the blanket over his legs, and then adds: ‘But I was never mean to anyone. If they didn’t have it, I didn’t mind.’

Mean or not, Charles’ chasing days are over. Now, he finds it difficult making it to the bathroom without collapsing.

‘You’re not taking me to hospital again,’ he says.

‘Not if you don’t want to.’

‘No I don’t, thank you very much. I’ve seen quite enough of it – just as I have absolutely not a shred of doubt they have seen quite enough of me.’

Despite the ravages of his various illnesses and the depredations of age, Charles still has a certain poise about him, sitting straight-backed in his chair by the window, suspended by an invisible chord like a palsied but resolute puppet.

‘Have you been to America?’ he says, pointing to a postcard on the mantelpiece. A city at night. Welcome to Chicago busting over the skyline in block yellow.

‘Only New York,’ I say. ‘And some of the west coast. I’d love to see the Great Lakes, though.’

‘I’ve not been either,’ he sniffs. ‘But I understand my great nephew is having the most wonderful time there. Studying. For six months.’

‘What’s he studying?’

He looks at me for a moment, then blinks, the left slightly slower than the right.

‘Who?’

‘Your great nephew. In Chicago.’

Charles thinks about it, but the moment has crumbled away from him again. The little tremors in his neck and face intensify for a second, then pass. Finally he says:

‘I did my national service in India you know.’

‘Oh, really? My dad was there, too.’

‘Is that so? Where did he serve?’

‘I don’t know! He didn’t ever talk about it and I never thought to ask. I have a feeling he was a gunner, but that’s about it. Do you fancy a cup of tea?’

‘That would be marvellous. I’m quite parched after my ordeal.’

He watches me from his chair as I crash about in the galley kitchen, finding things. As I set the kettle to boil and sniff the milk just in case, I shout over my shoulder:

‘You and dad must have been in India around independence, and the partition and everything. That must have been difficult. But the only pictures I can remember seeing of him were when he’s got one foot up on a truck wheel with a fag in his mouth, or when he’s fishing in some river. It’s funny, really. I wish I’d asked him a bit more about it. Anything about it.’

I can sense Charles isn’t listening.

I find a box of sugar lumps behind the tea bags.

I turn round and rattle it in his direction.

‘One lump or two?’ I ask him.

‘What?’

through the rain

The Deer Valley estate is a synonym for trouble, even though outwardly it’s pleasant enough. A high escarpment rises around the edge of it like the rim of some gigantic broken bowl, whose absent fourth side leads down through a tangle of houses and flats to the older part of town, and the ocean. Five thousand years ago this was a valley and there were deer – giant antlered varieties, chewing the vegetation whilst keeping watch for wolves or hunters. If they were here now, the deer would have to watch out for that kid on the mini-moto, too, ducking their heads as he comes leaping over the crest of the landscaped communal garden.

You have to admire the kid’s toughness. It’s been horribly wet all day, and now the rain has settled into an endless flow of super-saturating fog. No-one else is out.

I’m working on the car, called out to a woman who lives on Deer Valley. Because of the tortuous road layout, I can’t drive up to her door. Instead, I have to walk across the park area, timing my crossing with mini-Knievel, who I have to admit, is pretty good on that thing. I’d wave if I didn’t have so many bags.

I find the house and put the bags down just inside a tiny overhang like the trim of a sports car nailed above the door to serve as a porch. I narrowly miss squashing a cat that’s sheltering there, too. When I apologise, move the bags, and crouch down to hold my hand out in the universal cat-language of friend, it slowly turns its head in my direction – not a look so much as a curse. The poor cat is soaked, its thick chocolate fur limp with water. I’m sure if I picked it up and gave it a squeeze I’d get about a gallon, but I can tell by the way it’s staring at me half of that would be my blood.

When the woman answers the door I say hello, pick up my bags – and then hesitate. I look down at the cat, expecting it to run inside ahead of me. It stays where it is, though, staring off into the foggy distance, as if it can still see the giant deer feeding, all those thousands of years ago.

‘Come on. Don’t worry about Claudie’ the woman says, waving me in. ‘Claudie loves the rain.’

K9 to the rescue

Charlie’s sister Christine lets us in.

‘You don’t mind Coco, do you?’

Coco is an old, soot-brown Cairn terrier who looks like she scurried down the chimney when she heard the doorbell.

‘All bark and no bite, thankfully. Charlie’s still in bed.’

Coco frowns and huffs then retreats back into the sitting room as Christine takes us upstairs.

‘He’s been having a rough time,’ she says. ‘Four hospital trips this year with vomiting. Sometimes they give him drugs, sometimes they put him on a drip. Nothing seems to stop it coming back though. I know he gets worked up with everything, but still, it’d be nice to have the whole thing sorted. I can’t have him stay with us much longer. He’s upsetting the kids.’

She pushes open the bedroom door, shouts: ‘It’s the ambulance, Charlie. Be nice.’ Then stands aside.

A cramped, child’s bedroom. Charlie is lying on the top bunk of a bed covered with stickers. Facing us as we go in, amongst the general clutter of toys that spill in an unstoppable mess from two open cupboards, standing proudly on its own on a low table, is a model of K9, the robot dog from Doctor Who.

‘Hello Charlie. Can you pull the cover back so we can talk to you?’

A muffled reply.

‘Charlie? It’s the ambulance. We just want to talk to you and see if we can help.’

‘I don’t want no fuckin’ help. I want this fuckin’ pain to go away. Make it stop! Please, please make it stop!’

‘We’ll do what we can, Charlie. But first things first. Can you pull the duvet down so we can talk to you?’

Suddenly the cover launches into the air as Charlie thrashes his arms and legs, whilst at the same time he screams out: I don’t fuckin’ want this! I can’t... I want my life back, man.... I want my life back.

‘Charlie? We’re here to help, but you’ve got to do your bit, too. You’ve got to stay nice and calm so we can figure out the best thing to do. All right?’

He slaps his head and kicks his legs, but at least he’s pointing in our direction now so we can get a look at him.

A man in his early thirties, his face has a scooped and waxy look, sharp cheekbones, and large, papery eyes. After a moment he starts thrashing his head from side to side, moaning and baring his teeth. The next moment, he’s sitting up, hunched over to the side, and started jabbing the fingers of his right hand down his throat. It’s not a gentle movement – more like someone furiously trying to unblock a drain. He makes such monstrous growls as he does it, I half expect K9 to swivel its head and shoot him.

‘Don’t make yourself sick like that, Charlie. You’ll just hurt your throat. You’ll make it infected and that’ll only add to your woes.’

‘I don’t fucking care. I just want it out of me.’

‘Want what out of you?’

But then suddenly he relaxes, and flops back down on the bed.

‘I’m sorry, sir,’ he says. ‘I’m really, really sorry.’

The change in him – and the oddly deferential tone – puts us even more on our guard.

After a pause, I ask him what his past medical history is.

It jump starts his fury again.

‘Aaargh! You know all this! Why do you keep asking me? Just take me to hospital and make me better. Fuck’sake!’

‘I’m sorry we have to ask you these questions, Charlie, but obviously we’ve never met you before and we don’t know the story. It’s like I said at the beginning, if you could do your best to stay calm, it’d really help us get you the treatment you need.’

‘I’m sorry, sir. Sorry. I didn’t mean to scare you,’ he says, instantly deflating. Then moans, rolls over, and buries himself in the quilt.

We go back outside to talk to Christine.

She’s in the bathroom, hanging out a trug of wet washing on a dryer.

‘So what’s the story with Charlie?’ I ask, handing over a sock she’d dropped on the landing.

She takes it from me with a tired kind of smile, drapes it over the dryer, then begins pulling the arms of a child’s pyjama top right side out.

‘He’s under a lot of stress,’ she says. ‘He fell out with his cousin and lost his job. Then he’s been looking after his own two kids in the holidays, and there were some issues there. He lives up north but came down to look for work, only he’s been having all this vomiting and stomach cramps, and it’s all getting out of hand. The doctors don’t know what’s going on. They’ve given him pain killers, stomach antacids and even some stuff to chill him out, but none of it’s helping. I can’t cope with him here, not with kids in the house.’

We tell her that we’ll take Charlie to hospital for another review, then go back to the bedroom to help get him ready.

‘I can fuckin’ dress myself!’ he screams. ‘Wait outside!’

And we hear him crashing around, swearing and cursing and crying, trying to find his boots.

‘Charlie – they’re here, where you left them!’ says Christine coming and putting them outside the door. Then she shakes her head, and goes back to the bathroom to hang out the rest of the washing.

the business of death

I know the entrance to the crematorium. I’ve been here before, a couple of years ago. Then, we’d turned into the top of the drive just as two men in black suits and sunglasses, smoking cigarettes, were walking out. It was a hot summer’s day and the ambulance window was down. As we slowed to make the turn, one of the men took the fag out of his mouth and shouted: You’re too late mate.

I got the joke. But even though it must have looked incongruous to see a big yellow truck pitching up to a crematorium, in fact it hardly needs saying that there are no places beyond our reach. In my short time as an EMT I’ve turned up at schools, hospitals, factories, homes, gardens, holes in the ground, holes in buildings, cars, boats, trains, railway tracks, woods, swimming pools and the sea. Anywhere that people go, an ambulance may follow.

This time, though, there are no smart jokes, just a gardener, waving frantically over by the Garden of Remembrance.

As I drive over I suddenly catch a glimpse through the arched gate just behind him: another gardener, kneeling beside a sprawled figure, pressing up and down on her chest.

I leave the engine running as we throw open the doors and drag out all the bags we’ll need. Over to the scene, and we find an elderly woman lying at the foot of some concrete steps. I take over chest compressions whilst Rae cuts through the woman’s top and slaps the pads on. There is vomit over the woman’s face, and blood from a grievous wound at the back of her head which fans out in thick, geometric lines along the joints in the pavement. Asystole. Rae tries to intubate, but the woman has aspirated so much it proves difficult to visualise the cords; the suction unit keeps getting clogged with chunks of food; we get little or no chest rise; her pupils are fixed and dilated, her skin the colour of pumice stone. The second crew turn up and between us we try every drug and procedure we can think of, but at the end of half an hour or more the woman is as flat and dead as before.

Police have turned up. They help liaise with the relatives, the crematorium management, gathering information and controlling access to the scene.

We call the resus, and drape a clean white blanket over the woman. We start to tidy up. The police call for the coroner to attend, so we stay to finish the paperwork and liaise with them. Also, it helps that our ambulance is parked in front of the garden entrance; there’s another funeral gathering out in the car park, and the truck is acting as a screen.

Rae and I go with the police to where the woman’s relatives are waiting by a car. Most of them have gone now, leaving just the immediate family. We tell them that she has died, and how sorry we are. We tell them what we found, what we tried to do, what we failed to do. They cry, and tell us some things of their own. Then we leave them with the police and go back to the scene.

That’s when I see two men, dressed in black, peering round the corner of the crematorium building. I’m not surprised; it’s unusual to see an ambulance and police car there, and they want to know what’s going on. When they catch my eye they nod and wave a little shamefacedly, as if they were embarrassed I’d caught them rubber-necking, and quickly duck back. But I don’t blame them. Out in the street it might be different, but this is a crematorium, a place dedicated to death, the business of it. And now with us, with me here in my uniform by this big yellow truck, the police car, the body on the ground, it’s like a piece of scenery has fallen down and revealed the staff who work the ropes.

I’d be curious.

All the same, I’m glad when the Coroner arrives, so we can finish tidying up.

the lair

The house hasn’t been decorated so much as riotously possessed by junk. The little front garden has been filled with every kind of cheap plastic nic-nac, from action figurines in bizarre poses to a line of perished toys strung out on a washing line like cruel reprisals from a raid on a toy village. The bricks of the wall are individually painted in white or red enamel, adding to the hectic feel of the place, whilst in the window of the front door, along with skeins of fairy lights and a scrawled sign saying: Welcome. Ring both bells is a collection of skull masks, spiders and joke snakes you’d think were there for Halloween were it not for the perished, sun-blasted look of the plastic. It’s all been here for some time.

‘Oh – my – God!

Rae knocks – then rings both bells. There’s no reply.

She shades her eyes with her hand and peers through the glass. I stand next to her and have a look, too.

Just visible in the gloom, Mr Robinson, sitting in his wheelchair right at the back of the house, staring back at us. He waves to say the door’s open. We go inside.

If this bungalow is a giant fruit, Mr Robinson is the bug who maintains a wheelchair’s tunnel from bed to kitchen to TV lounge. There’s so much stuff here, on all sides, even hanging from the ceiling, we have to stoop. Our senses are completely overwhelmed; even though we’re with him for half an hour, in retrospect it’s difficult to remember what was there. Only two things stick in my mind – a little framed drawing of a cock and balls signed and dated with kisses, and a model of King Louie from The Jungle Book, sitting at the wheel of a toy Cadillac, one fist in the air, one fist beating on the bonnet.

Mr Robinson is too drunk to tell us clearly what the problem is. Amongst a pile of ambulance sheets on the kitchen table I find one dated earlier the same day. The crew had established he was unhappy with his pain relief regime and had arranged a review with his doctor, but Mr Robinson had hung up when the doctor phoned, so it hadn’t been resolved. There’s nothing acute going on. We finish our visit, contact the out of hours service on his behalf, make our goodbyes and leave.

There’s an elderly woman in a pink tracksuit waiting for us outside on the pavement.

‘Can I ask you something?’ she says, her arms folded across her chest.

‘Yes. Of course.’

‘Not being funny or anything, but can you explain to me why there are ambulances here three, four times a day, or the early hours of the morning? Police cars. Fire engines. Yesterday there was an ambulance car and an ambulance.’

‘I know it must be a nuisance.’

‘A nuisance? Do you know how noisy these things are? Those big engines rattling on? Doors slamming? It’s terrible!’

‘You get it a lot, then?’

‘Yes, we get it a lot. And it’s driving us out of house and home.’

‘I’m really sorry.’

‘It’s not your fault, love. But it can’t go on. It really can’t. I know what he’s like. He gets pissed, rings the ambulance, then hangs up in the middle of the call so they’re bound to turn up. Then he refuses to go in. And when you’ve gone, he nips out in his wheelchair to the off licence round the corner, stocks up on beer, and when he’s pissed does it all over again. How would you feel?’

‘I’d feel murderous.’

‘But what can we do?’

‘I do sympathise. But the way things stand at the minute, if anyone rings for the ambulance, they’ll always send one, regardless of how many times they’ve rung before. Because they think: “Well – it might be for real this time”’

‘We’re going out of our minds with it. I know it’s not your fault. I’m not having a go at you, love. You’re just doing your job. But look what happened the other day. Nancy’s husband Reg took ill, and they were over an hour waiting for an ambulance. No doubt because someone like old Robinson here had got one instead. And then Reg goes and dies. Now how is that fair?’

‘It’s not fair. I think that’s absolutely terrible. Look.  I’ll flag this up with our control. Maybe if you talk with Citizen’s  Advice they’ll be able to tell you where you stand with the law on this. Or someone in the council. But it’s a tricky situation, and I don’t envy you. If it’s any consolation, we hate it, too.’

‘Sorry to go on. I just wanted to say something, you know.’

‘Good luck with it. I think if you and your neighbours all act together something might get done. Like I say, I’ll talk to Control.’

She watches as we drive off.

I get on the radio.

Control know all about it.

‘We’ll pass your concerns on,’ they say. ‘Maybe something’ll get done.’

hell

The only thing I can think of is the gardening I did earlier in the week. But it’s what I normally do; I didn’t fall over or lift any heavy bags. Pull any deep roots. Ooh – it hurts like hell and nothing seems to help. I’ve got to get it sorted or I’ll lose my mind.’

Mrs Allen shifts her position in the armchair, then stares at me with a baleful expression, her thick glasses magnifying her anxiety.

‘I tried to ride it out but these pills are just no good. I can’t go on like I am.’

‘Well, look. There are two things we can do, Mrs Allen.’

She leans forward.

‘One is to get the out of hours doctor involved again, the other is a trip up the hospital.’

‘The hospital please,’ she says. ‘Here – when I’ve locked up can you pop the keys round to number eight so she can feed the cats?’

* * *

Mrs Allen sits on the ambulance with a walking stick planted firmly in front of her, both hands resting on the curved handle.

‘I’m not the old lady you think I am,’ she says.

‘In what way?’

‘I’m normally so fit! Fitter than this! I do my yoga every day. I don’t eat wheat or animal products. Oh – it’s terrible what people do to animals in this world. I keep in touch with things on the internet and television but sometimes I wonder why I bother. It’s so depressing. So much cruelty. I think basically, people are horrible – present company excepted. Don’t you think? The things people do to animals? And now my hip’s gone, I’m in pain all the time, and I think Why go on? What’s it all for? Not that I’ve planned anything, you understand. It’s just a low mood. But it gets you down. ’

‘Well it’s not a nice thing, being in constant pain. We’ll do our best to get it sorted.’

‘Last night when it was bad I felt like praying to God, but I didn’t, because I thought He’d probably got better things to do with His time.’

She pushes her glasses back up her nose and stares at me.

‘Do you believe in God?’ she says.

‘No, I’m afraid I don’t.’

She leans away from me.

‘Don’t believe in God? Oh my love. Why not? You must!’

‘Sorry.’

‘But why go on? What’s to live for if you don’t believe in anything?’

‘It’s not that I don’t believe in anything. I just don’t believe in God.’

‘But if there wasn’t a God, there wouldn’t be any morals. There wouldn’t be a point to anything. The world would be full of cruelty and pain.’

‘It’s pretty bad as it is.’

‘Exactly.’

I don’t feel able to carry on the conversation. It’s interesting, but I don’t want to upset her. It comes down to personal choice, after all, and this isn’t the time to explore these things. But Mrs Allen won’t let it go. She’s genuinely appalled that I can think of carrying on without a belief in God.

She’s quiet for a moment, frowning at me. The she raps her stick on the floor, like Black Rod at the doors of Parliament.

‘But what about Hell?’ she says.

true story

I hadn’t seen Mac for a while. He worked at a small satellite station on the outskirts of town for one thing, so our paths only used to cross occasionally at the hospital. Plus he’d had some kind of health scare lately. So all in all it was a nice surprise when I saw him with a cup of coffee outside A&E one night.

I leaned back against the railings, and we caught up on all the gossip.

‘Not smoking?’ I said.

‘Given up. Bad for your health, apparently.’

It seemed as good a chance as any.

‘How’ve you been?’

‘Oh. You know. I had a heart attack.’

‘A heart attack? Really?’

‘Only a small one, but that stent seems to have done the trick. Yeah – I’m having to watch a few things now. Smoking, my weight...’

His nickname was Big Mac, so it was probably a good idea if he slimmed down a bit. Mac had been in the job almost forty years, and just lately he’d been struggling to get up once he sat down. By rights he should’ve retired, but there was some issue with his pension.

We talked about this and that, but I could tell there was something on his mind. Eventually, he got round to it.

‘I was on the car when it happened. First on scene at an old people’s home, one of those very new places that looked like it was flat pack. Soulless, you know. Migraine carpets. Anyway, the job itself wasn’t all that. An abdo, no rush. She needed to go in so I ordered up a truck. The staff said they wanted to put some clean clothes on her, so I said fine, I’d finish writing it up next door. They told me to use the games room across the corridor, because it was late at night and everyone had gone to bed. I said fine.

‘When I went in, it wasn’t empty at all. There were three old men sitting at the round table in the middle of the room playing cards. “Sorry” I said. “Whatsername said it was empty”. “Shows you what she knows” said one of the fellows, and they all laughed. That was when I clocked their gear. I thought it must have been some kind of fancy dress night, because they were all done up very strangely, one in a highwayman’s coat, one in a Victorian actor’s cloak and felt hat, and the other like an engineer on an old steam train, in a pair of overalls and a little red neckerchief. All of them covered in dust and cobwebs. They’ve really made an effort, I thought.

‘But then I had to sit down, because to be honest I wasn’t feeling all that great. I’d been having raging indigestion all week, and I felt kind of puffed. “I’d take the weight off if I were you, mate,’ said the highwayman. “Or we’ll have to call a paramedic – no, wait! You’re here already!” And they all laughed again. I thought they were a strange bunch but harmless enough, so I sat down and put the clipboard on the arm of the chair ready to start writing. But I just couldn’t take my eyes off the three old geezers. There was something – odd about them. Not just their clothes, but the way they were, in themselves. D’you know what I’m saying?’

‘I think I do.’

‘I put it down to me not feeling right, because sometimes your eyes can play tricks – late at night, when you’re tired and not the whole ticket. But it seemed to me that when they turned their heads to look at each other, or at me, their faces blurred a little, like in old photos, when the person moves when they shouldn’t, and leaves their features behind on the glass. It was very disconcerting, and made me feel a bit dizzy. “Watch out! I think he’s going!” said the Engineer. “Hold on!” cried the Actor. “We haven’t finished our game yet.”

“What game’s that, then?” I asked, struggling to my feet again. I did feel weird, but I wanted to take my mind off it, and anyway, I like cards. I wandered over to the table.

‘They were playing poker with a set of cards that had seen better days. What a bunch of characters, I thought. “A nice little set up here,” I said. “Your own little club.”

“Something like that,” said the Highwayman. “We do all right.”

‘It was then I noticed what they were betting with. Little plastic figures.  At first I thought they were toy soldiers, because they were in all these different poses, leaning over, throwing grenades, pointing rifles and whatnot. But when I leaned over to get a closer look, I saw they weren’t toy soldiers at all, but people, doing things like begging on their knees, pointing, running away, or lying on the ground.

“I’ve never seen chips like them before” I said to them.

“So you know the acronym?” said the Engineer. “CHIPS. The Chosen Host in Purgatory. That’s good, Mac. I’m impressed.”

‘And he looked right at me. And it was only then that the smell came on really strong. I’d smelt it as soon as I came in the room, but I put it down to a mixture of something caught in the kitchen earlier on, like burned sugar for toffee apples, and bleach to clean the floor.

“Who are you?” I said, taking a step back.

“I’m Pythius, that’s Astoroth, and he’s Belial. Pleased to meet you.”

“So what are you, then?” I said, brazening it out. “Demons?”

“He’s good” said Astoroth, snapping down another card. “He’s very good. Raise you a bent parson”

“Almost done here” said Pythius, smiling at me with all his fishy teeth.

‘Well I have to say I was more than a little scared. But you know what it’s like. You find yourself in a dodgy situation, and the best thing you can do is keep calm, act like there’s nothing wrong, and buy yourself some thinking time. So that’s what I did.

“Mind if I play?” I said to them, pulling over a chair.

“I told you you’d like Mac” said Pythius. “Of course. Belial – deal him some cards.”

‘Even though Belial’s hands were pretty much bones, he flicked me over five.

“What are we playing?” I said.

“First Circle” said Astoroth, yawning, then smacking his lips disgustingly.

“Don’t worry. It’s a bit like Lowball, only the Joker is the Horned One and you burst into flames!”

“Only kidding,” laughed Pythius. “Look at his face! Priceless. No – Mac. Seriously, it’s exactly the same as Lowball.”

“Then let’s play.”

‘I did all right. In fact, more than all right. Straight off I could tell these demons didn’t know much about poker, for all their smart talk. I got quite in to it. Pythius had stood me some chips. When I held one up to the light it looked like a tiny little dictator, complete with medals. He seemed to wriggle a bit in my hand, so I put him down again. Well, it wasn’t long before I had a whole load of others, and the demons were looking restless. I made conversation, to put them a bit more at their ease.

“So how come you play here?” I asked them. “A bit modern for you, isn’t it?”

“This new building is, yes. Ghastly. But you have to take a longer view.”

“What d’you mean?”

“Well the nursing home hasn’t always stood here, has it?”

“It was a laundry before that,” said Astoroth.

“A row of labourer’s cottages before that,” said Belial.

“Nothing but ice for a while. A long while. Dullsville. I remember there was a family of hunter gatherers before that, wasn’t there, Pythius? You remember that guy? Used to make those patterns in the ground and wave those lighted sticks in the air to keep us out? He was funny.”

‘Pythius chuckled. “Oh yes,” he said. “And then do you remember that business with the sabre-tooth?”

“Before my time,” said Belial. “Four of a kind.” And he lay his cards down.

“Straight flush,” said Pythius, spreading out his cards with a proud little nod of his head.

“I’ve got nothing,” said Astoroth, chucking in. And they all looked at me.

‘Well I’ve had some great moments in my time, but I have to say this next one was the very best. I looked from demon to demon, then laid out what I had. “Royal straight,” I said. “So put that in your cauldron and smoke it.”

‘It didn’t go down well. Astoroth and Belial both jumped up, knocking their chairs back with a crash. “You little fucker!” said Astoroth.

“Cheat!” said Belial. And they both waved their arms about, making growling and snapping noises that I have to admit were pretty scary.

‘Pythius just stared at me, and in a funny way that was worse.

“Mac,” he said after a moment, waving for the others to be quiet. “I think we’ve underestimated you. Many congratulations.” He smiled at me in that fishy way he had, but his eyes were glittering hard, goat’s eyes, you know? With the vertical slit? “Come, brethren. Let’s leave Big Mac here to enjoy his winnings. And who knows? Maybe we’ll have the pleasure again sometime soon.”

‘And with that, the lights dimmed, the windows slammed open, and suddenly I was alone in the games room. I don’t mind telling you my hands were shaking as I swept all the chips into a medication bag. I thought I’d figure out what to do with them later.

‘Just at that moment, the door opened and one of the nurses came in.

“Your crew mates have arrived,” she said. And then “Are you okay? You’re all sweaty and pale.” And before I knew it I was in the back of the ambulance that was meant for the old woman, being blue lighted into hospital with an MI.

‘It was some days later, when I was sitting up in CCU after the angio, when I thought I’d have a sneaky peak at my winnings from the card game. They’d put all my property in the little locker by the side of the bed, so when no-one was looking I had a root around for the medications bag. But it wasn’t there. So I called the nurse over and asked her about it.

“Oh that?” she said “What was that? It was just a black mess, like little slimy mushrooms when they’ve gone off. We threw them away. Why? You didn’t want them, did you?”

“No, not really” I said. “But someone else might be wondering where they are.” And I lay back down to sleep.

a cat-shaped onesie

I shine my torch up the path to the front door and two points of light reflect back – a  cat, crouching on the path. It’s a wild night for anybody to be out, let alone a cat. I bend down and make kissy noises; the cat trots over and wraps itself around my leg, but as soon as the door opens, the cat runs inside.

‘It’s all right’ says the woman standing in the doorway. ‘She live here.’

All the doors in the house are shut apart from one, up on the landing, a bedroom, where a young girl is sitting on her bed. The room is lavishly decorated, richly patterned wallpaper, an ornate bead and crystal chandelier, and a silvered chest of drawers. On the wall above the head-end of the bed is a black and white portrait of a young woman, the kind of three-quarter head shot you might see in a fashion portfolio, the frame surrounded by fairy lights.

‘Mariana took an overdose tonight,’ says the woman. ‘I’m her grandmother, Rosa.’

She kneels at Mariana’s feet and rests a hand on her foot.

‘I’m looking after her these days,’ she says. ‘That’s her mother in the photo. She died a couple of years ago and we’re still coming to terms with it. Mariana’s brother Felipe is a year older. I’m afraid Felipe’s gone off the rails, staying out, drinking, carrying on. He comes back and causes trouble. That’s why all the doors are locked.’

Mariana starts to cry.

As gently as we can, we establish what she took and when, and then encourage her to get ready to come to hospital.

The cat suddenly appears in the room. It jumps up on the bed and noses its way onto Mariana’s lap, demanding to be stroked. It flicks its head as a couple of tears land there, but purrs loudly, its little tongue poking out.

‘That was her cat,’ says Rosa.

We leave the room to give Mariana some privacy as she changes.

‘Just put your onesie on, querido,’ we hear Rosa say. ‘Don’t worry about that. It’s late. No-one will see.’

After a moment the door opens fully again and Mariana steps onto the landing.

She hasn’t put the hood of her onesie up, but I can tell from the pointy ears and from the tail dragging along behind what it’s supposed to be.

b&e

We can see Mr Collins through his lounge window. He’s sitting on the floor, resting up against the electric wheelchair he fell out of about an hour ago. He looks like Santa Claus – ten years after The Big Red One went off the rails, sold all his plush, thought bad thoughts, drank, smoked and stopped washing. He has a phone pressed to his ear, the mouthpiece lost in the mangy old hedge of his beard; when we knock on the window, he looks briefly in our direction, then irritably waves us away with a yellowing claw.

We walk back round the front.

At least the main entrance is open, letting us through into the c-shaped courtyard of this Victorian block. A black iron walkway circles overhead, shining wetly in the mist. In the middle of the courtyard, a raised flowerbed in brick, with a single, leafless tree. From one of the lower branches, someone has strung up a tatty straw object, the kind of thing a witch might hang as part of some dreadful territorial spell. It’s only when I get a bit closer I can see it’s actually a rustic bird-feeder.

Control get back to us.

He says he doesn’t know the keysafe number. We haven’t been able to get in touch with the carer, so it’s looking like you might have to force entry.

‘Have you asked him if he’s all right with that?

Stand by.

 I crouch down by Mr Collins’ letterbox and lift the flap to hear his side of the conversation:

‘Well if you don’t have the keysafe number you’ll have to break the door down... Yes I am hurt, thank you very much. My leg is excruciating.... No I can’t wait any longer.... I have to say you don’t sound in much of a hurry. I’m not impressed with your sense of urgency.... All I’m saying to you is I think it’s not like off the telly.... So when can I expect some help? Christmas? Because I’ve already been on the floor an hour and you don’t seem that bothered...’

I drop the flap and straighten up.

‘We’re going to have to kick the door in.’

Just as I say this, Control ring us back.

You’re going to have to kick the door in

I take a step back and then kick just below the lock as hard as I can. The noise reverberates around the courtyard. Three more attempts, and still the door remains intact.

‘It feels like a deadbolt or something,’ I say to Rae as I bend down to rub my knee. ‘We’re going to need the police.’

Whilst Rae is calling Control, a door opens off to my right and a guy in a wheelchair rolls out.

‘S’up?’ he says.

‘Sorry to wake you. Mr Collins has fallen out of his wheelchair and we can’t get in.’

‘You do know he’s got a keysafe, don’t you?’

‘Yes. We do. But unfortunately we don’t know the number.’

‘Ring his carer, then.’

‘Yes. Yes – we’ve tried that. But unfortunately the carer isn’t answering.’

‘Ask him.’

‘We’ve tried, but he doesn’t know it.’

‘Ask the guy across the yard. He’s got a keysafe.’

‘It won’t be the same number. Otherwise it wouldn’t be a safe safe.’

‘You’ll have to try kicking it in, then.’

‘Yes. I’ve tried that, but it’s not worked.’

‘No. It won’t. They’re tough these doors. What are you going to do then? Call the police?’

‘Just on it.’

‘Hm.’

He slowly rolls back inside.

After five minutes or so the police arrive – in impressive numbers. They stride into the courtyard carrying an  iron battering ram, a huge jemmy, thick gauntlets, lump hammers and a pair of safety goggles. After we’ve told them what we know, they examine the lock. One of them favours smashing the safety glass to reach round and flip the bolt, but another just wants to smash through with the ram. He puts on the gauntlets and goggles.

‘Stand back, ladies,’ he says. With three colossal, shuddering assaults on the door, it splinters at the jamb and flies back.

‘Don’t all rush at once,’ he says, putting down the ram.

The other one steps inside and examines the wreckage.

‘Yep. Should’ve gone in through the glass,’ he says.

‘Hello Mr Collins. Ambulance,’ I say as we all walk through into the lounge.

He bares his teeth.

‘Who’s paying for the door?’ he says.

light of the world

A dark, wet night.

A juicy scrunch as I step on a snail.

‘What a dreadful night!’ I say, reaching over to flip the latch of the garden gate, getting soaked as I brush up against the hedge.

‘Especially for the snail,’ says Rae.

Enid is waiting for us at the door, clutching the fluffy collar of her pink dressing gown around her neck, the light from the hallway spilling out around her onto the wet path.

‘He’s in the kitchen,’ she says, shuffling ahead. ‘Bert’s out looking for his other slipper.’

Enrico is slumped on a high-rise kitchen chair, resting his bloodied head against the door frame. He has on a khaki jacket and jumper, but below the waist just a pair of boxer shorts.

‘He’s ninety-six you know,’ says Enid, standing next to him and holding his hand. ‘I mean, I’m eight-three. But ninety-six.’ She gives his hand a squeeze. ‘Aren’t you, petal?’

‘Huh?’

Enrico lives over the road. He was going up to bed when he tripped and fell backwards, cracking his head on the way down. He managed to get himself up again, but instead of dialling 999 he decided to come over to Enid and Bert for help. It took a while for them to answer because they’d gone to bed, and anyway, they were nervous about opening the door so late at night. I mean, who could it possibly be? When they did they found poor Enrico, slumped amongst the pots and snails in the rain. They helped him into the kitchen, called us.

He has a nasty head wound, the scalp scraped open at the top, the dull cream of his skull below.

‘What? What’s this?’ he mumbles.

‘He hasn’t got his hearing aids in,’ says Enid.

I give him the quick once over. It’s going to be difficult to fit a collar on him because of his size and shape. We decide to get him out to the vehicle and immobilise him there on a vacuum mattress, as naturally and comfortably as we can.

I dress his head wound whilst Rae goes to fetch a carry chair.

‘What’s your past medical history?’ I shout in his ear.

‘Huh?’

‘Your past medical history. What do you suffer with?’

After a moment he raises his left arm.

‘What am I looking at?’ I shout.

‘It’s his arm,’ says Enid.

‘What’s wrong with your arm?’ I shout in his ear.

‘Strafed. By the Luftwaffe,’ he rumbles. When I push up his sleeve I can make out the scar tissue, visible as an odd ruck of pale skin, an incomplete tattoo.

Rae comes in with the chair.

As we’re helping Enrico onto it, there’s a stamping of feet in the hallway and Bert appears, a mac over his pyjamas, a torch in his hand.

‘I went up and down,’ he says, ‘but I couldn’t find it.’

He stands next to Enid as we help Enrico onto the chair. They watch with an appalled slack to them, witnesses to something they probably guessed must happen sometime soon but that came so unexpectedly tonight.

They snap out of it, though – Enid to move the hall table out of our way; Bert to light the path.

* * *

We’re rocking gently along to the hospital. I’ve dimmed the lights in the back. Enrico is held snug by the rigid sides of the vacuum mattress, the criss-crossing straps, the head blocks, the blankets. He opens his eyes when I ask him questions, but otherwise lies as still as an Egyptian mummy.

‘Who’s your next of kin?’ I ask him.

‘My mother and father,’ he says.

I stroke him on the shoulder and carry on writing.

He breathes gently and easily and seems to fall asleep for a minute or two, but then suddenly opens his eyes wide, his mouth open – not in fear, though. More in wonder.

‘What is it?’ I say, leaning forward in my seat again. ‘What’s wrong, Enrico?’

‘I can see a naked man,’ he says, looking up at the ceiling. ‘A naked man, shining.’

back in kansas

There was a plague of drunks that night. Everyone did their share. We had three – one of them, a guy of twenty or so, was sprawled face down on the pavement outside a fast food place, so covered in vomit it looked like he himself must have been eaten by a larger species of clubber and vomited whole a while later. There’s an art to moving patients like this. You swaddle them in blankets before you even think of getting them up, then after a few essential obs, postural adjustments, tactical placing of bowls and inco pads, you transport them to hospital and roll them onto a trolley in A&E. And there they lie, a collection of noxious pupae, waiting for the alcoholic tide in their blood to recede so they can be re-born. You’ll see them later in the morning, tentatively unfolding the stinking wings that will carry them home.

Our third drunk doesn’t even have the decency to be soiled.

A young guy in pipe jeans, denim shirt and punky, sugar paste hair as sad and folded as he is now.

Two friends stand over him.

‘What’s happened?’ I ask them.

‘Dave drank too much and says he can’t go on.’

‘I can’t,’ says Dave. ‘I’ve puked my guts up and it really hurts.’

‘Was it just alcohol tonight, Dave?’

‘Just’ says the other friend. ‘Look – how long’s this going to take?’

I ignore her.

‘Have you had any recreational drugs tonight, Dave?’

His friends laugh; I look up and repeat the worn old line that we’re not the police, we don’t care if you do or don’t take drugs, but as health care professionals we need to know so we can treat you appropriately.

‘I don’t do drugs,’ says Dave, spitting on the pavement, and the groaning some more.

‘What’s your medical history? Any problems – heart, breathing, that kind of thing?’

He shakes his head.

‘On any meds?’

No

‘Allergic to any?’

No.

‘What are you going to do with him?’ says the girl, checking the time on her phone. ‘We’re sorry to have called you but we didn’t know what else to do. The taxi said no.’

‘Take me home,’ says Dave. ‘Please take me home.’

Then groans as another bout of nausea rolls through him.

‘The only thing we can offer is a trip up the hospital. You can sober up there and get a cab home later.’

‘Why can’t you take me?’ he says, looking up. ‘Please? I just want to go home.’

‘Just run him home’ says the girl. ‘It won’t take long.’

I shake my head.

‘It’s not going to happen.’

Rae sighs.

‘How do you think that’ll play? When people hear the ambulance is giving free rides home when the taxis refuse?’

‘I know, but couldn’t you make an exception in this case? We promise we won’t tell.’

‘No,’ I tell them. ‘Absolutely not.’

Dave retches, then spits.

‘But he’s only had a bit too much to drink. He doesn’t need the hospital,’ says the girl.

‘I agree with you. And the hospital certainly doesn’t need him. Look. I’ll tell you what I’ll do. I’ll give you a blanket. You can wear that round your shoulders to keep warm, and here you are –have a vomit bowl, too, just in case. I think if you make a big effort and stand up straight, you’ll look well enough to go in a taxi. What do you think?’

He groans.

‘Just take me home,’ he says. ‘I want to go home.’

‘No.’

‘Please.’

‘No – Forget it. It’s just not going to happen, Dave. You’ve got to be realistic.’

‘Open your eyes, Dorothy,’ says Rae, pulling off her gloves. ‘You’re back in Kansas now.’

the stag

All the other spit n’sawdust pubs round here were long ago traded in for soft furnished, easy drinking bars with cute names, but The Stag bellows on. The sign outside is so decrepit, and the view through the windows so down-at-heel, you could easily misread it for The Stab. The view of the clientele any time of day or night remains unchanged – slumped forms, slumped tables, big screens.

Charlie has rung for an ambulance and he’s waiting for us in the street.

‘It’s my wife, Julie,’ he says. ‘She’s been having one of her manic episodes. She met this guy in the bookies and they’ve been in the pub all night. I don’t know what to do.’

‘Does she have a history of mental health problems?’

‘Yeah. She’s been in and out of hospital. But she’s not been taking any of her meds and things are getting out of hand. I called the out of hours mental health number, but they told me to call you.’

‘Have you told Julie you called us?’

‘No. I didn’t want to scare her.’

‘Okay. Well, look – do you think there’s a chance you could explain what’s happened and ask her to come outside for a chat? I don’t want to march in an embarrass her in front of everyone.’

‘I’ll try,’ he says, tucking his phone away like he’s re-holstering a pistol.

He goes back inside.

We wait.

After five minutes, he reappears.

‘She doesn’t want to,’ he says. ‘Can’t you come in and have a word?’

As I walk through the bar there’s the usual shouts of Oi Oi! and  Take him! or Buy this man a pint! or Slow night, is it? I go over to the table at the back where Julie is sitting next to an enormous, red-faced guy with ratty hair and a glass in his hand. As soon as Julie sees me she turns to the side and buries her face in the man’s anorak.

‘Go away!’ she says.

‘Julie? Hello. My name’s Spence. I’m with the ambulance. Charlie has called us because he’s a bit worried about your health tonight. Will you come outside and have a quick chat? We won’t do anything or take you anywhere you don’t want to go. All right?’

The big guy takes a gulp of beer and puts the glass down with a whump.

‘Come on love,’ he says, belching lager fumes. ‘Go see the paramedics, love. I’ll come with you.’

Julie turns on me.

‘You’re weirding me out,’ she says. ‘I’ve never seen you before in my life.’

‘I know this is all a bit strange,’ I say. ‘Five minutes then we’ll leave you in peace.’

She stands up suddenly, scraping her chair back. The Big Guy grabs her arm but she snatches it back.

‘Leave me alone!’ she shouts, then pushes her way out of the bar. The Big Guy and Charlie both chase after her. I follow. A muted cheer from the bar.

Outside in the street Julie reacts to the sight of the ambulance by ducking down, raising her arms up and screeching like a chimp.

‘They’ve come to take you away!’ shouts the big man with glee.

Charlie remonstrates with him in an ineffectual way. Julie falls back against the pub wall, then takes a few steps into the road. Cars hoot and make room. The Big Guy grabs her again and there’s a messy, three-way struggle. I tell the Big Guy to let her go.

‘No! Don’t hold her like that,’ I tell him.

‘She’s going to hospital,’ he says.

‘No. You let her go and you listen to me. Back off! And – listen. No-one is doing anything they don’t want to do.’

I turn my attention to Julie, who is standing there, breathing hard.

‘We’re only here to help you, Julie. But if you don’t want us, that’s fine, we can go.’

‘I don’t want you!’ she says, flush with alcohol and the drama of it all. ‘I don’t want your help. Why should I want your help?’

She puts an arm round the waist of the Big Guy, who leers horribly and drapes an arm protectively round her shoulder. ‘ I’m starved of human touch, okay?’ she says. ‘So thanks very much, yeah?’

She relaxes her hug to sufficiently to reach out with her right hand. When I take it, she starts to shake my hand, but it quickly deteriorates into an aggressive hand-pumping that I’m forced to control and then release. ‘Now you fuck off,’ she shouts in my face, then turns with the Big Guy and goes back into the pub.

We stand by the ambulance talking to Charlie, finding out some more facts and then offering what advice we can.

The landlady comes out, a blousy woman in weapons grade makeup. She studies us a while from the door of the pub, then comes over. ‘What’s the matter with that one?’ she says, jabbing her thumb backwards over her shoulder. ‘Do I want her back in my pub, or what?’