Siren Voices

junk abraham

2009-07-15T11:01:00.002Z

This playground has a post-Apocalyptic feel. Set up some years ago on a rise overlooking the great grey spread of the city, now the damaged seats of its swings rock gently backwards and forwards, worked by the ghosts of children long since grown up and gone. Mature weeds thick as trees rise up around the margins; the yellow slide stands water-stained and peeling; even the roundabout seems more like an abandoned instrument of torture than a plaything.

There is a cratered path that leads up alongside the playground, eventually widening into a patch of open ground and a signposted footpath to the downs. A woman with a child in a red buggy waves us along in that direction, then hurries off, the buggy wheels skittering on the grey granite chippings, the child leaning out to look backwards and see what the mother is so afraid of.

We come to a battered blue car with the driver’s door standing open.

A man is lying flat on his back on the ground, at right angles to the car, his arms spread out either side of him. There is another man kneeling beside him. He puts his mobile phone away as I jump out of the cab.
‘My brother,’ he says.
‘He’s got a pulse but he’s not breathing,’ I say to Rae. As she pulls out the resus and drugs bags I crouch down at the unconscious man’s head, lift his chin forwards to open his airway, and prise open his eyelids to check his pupils.
‘When did he take the heroin?’ I ask the man. He raises his eyebrows, smiles and shrugs, turning the palms of his hands towards me in the internationally accepted mime for: I’d like to help you, but…
‘We’re not the police. We just need to know so we can treat your brother. What’s his name?’
‘Rich.’
‘Did he smoke or inject?’
The man scratches his head roughly, then says:
‘Inject.’
‘When?’
‘Fifteen minutes ago.’
An ambulance car wallows along the pathway and scrunches to a stop next to us, kicking up a cloud of dust that’s snatched up by the wind and carried off towards town.
Rae hands me an airway which I put into Rich’s mouth, and then the BVM and oxygen so I can start bagging him. Frank is with us now. I ask him to draw up a syringe of Narcan. But just as he gets the kit together, Rich makes a sudden convulsive gagging motion, reaches in to pull out the airway, and sits up.
‘You see the effect I have?’ says Frank.
‘Hello, Rich. You were a little bit flat, mate,’ I say. He sits staring vacantly at the car, turns to look at me, then back to the car, like a man who has woken up inside a dream but doesn’t yet know how to influence what happens next.

A woman walks past with a black and white collie.
‘Morning!’ she says brightly, hauling on the dog’s lead, striding off towards the footpath. ‘Lovely morning!’ The dog regards us with fierce yellow eyes.
‘How are you feeling now, Rich?’
He grunts.
His brother gives him a push on the shoulder.
‘You were blue, mate. Honestly. You were so gone.’
Rich studies him with the expression we just saw on the collie dog.
‘What?’
‘Come and sit on the ambulance so we can check you over.’
We help him up.
As he leans forward and his t-shirt drops back, I notice he has a tattoo at the angle of his neck: a pair of angel wings either side of an Egyptian eye.

He sits up on the ambulance and submits to an examination. We leave the door open. The sky is overcast, but now and again the sun breaks through and touches a tiny row of houses way off on the far side of town with a gilding splash of light.
‘I’m supposed to be at work today,’ he says, rubbing his face. ‘I’m a Painter and Decorator.’
‘I can’t imagine getting smacked up can do much for your roller technique,’ says Frank, leaning against the door jamb, smoking a roll-up.
Rich looks at him. ‘I can’t help it.’
‘It must cost you a fair bit.’
‘Sixty pounds a day.’
‘Sixty? That’s a lot of paint.’
‘You could say.’
Rich’s brother has been back over at the car, but he comes back carrying a little white puppy.
‘Look what we bought yesterday,’ he says, holding it up in the air. Wrinkled and fat, its paws spread helplessly either side of the man’s encircling hands, the puppy could pass for the Lamb of God, hoisted up on a mountain top, hairless and helpless and utterly subject to the vagaries of a world it knows nothing about.

forty quid

2009-07-12T15:00:00.000Z

The window of the All Night store is heaped with a selection of goods you can expect to find inside. Jumbled and incoherent, it looks like the window dressing equivalent of a supermarket dash, a bored employee given sixty seconds to swipe as much as they can from the shelves and throw it in the window. And if this is a representative sample, what’s mostly on sale in this shop is beer and spirits. Dusty pyramid piles of bottles and cans rise up precariously against a background of dessicated celebrity magazines, boxes of sanitary products and a toy ambulance standing by in a yellowing plastic bubble. The whole scene is back-lit by the strip-lighting from within, and a purple neon sign that flashes on and off throughout the night and day: 24… Hour… Off… Licence.
Next to the store is a battered black doorway. It stands open to reveal a cavernous hallway with letters on the floor, as if the postman had thrown them there, too scared to go any further. A flight of stairs rises steeply upwards at the back of the hall. We step inside and walk up.
‘Hello? Ambulance?’
‘Up here.’
Short stubs of staircase switch back on themselves seemingly without logic, following the hidden architectural demands of the shop underneath. But eventually they lead us up to a large sitting room where two men hang back against the far window and a young blond girl lies motionless on her back on a wide, dark green tartan bed.
‘Help her, man. She gone. I think she dead.’
‘Yeah. Help her.’
The two of them have an enervated watchfulness about them, like husbands on a shopping trip outside a changing room. The difference between this girl being alive or dead is another tedious distraction.
‘She owe us forty quid.’

I can see from here that the girl is not dead. She’s not even unconscious. Her breath rises and falls evenly, her pulse beats in her neck and tummy, and her eyelids flutter as she resists the urge to sit up and look at us as we come closer around the bed.
‘What’s her name?’
‘I don’t know, man. We only met her tonight. At a club. Y’understand?’
‘So what can you tell me about her?’
‘Nothin’. She say she want coke. We come back here and get her some. She put it up her nose then gets well freaked and crashes out on us, man. What’s the matter with her? I swear no more. Last time.’
‘Anything other than coke?’
He tips his head back.
‘What’ya mean?’
‘It doesn’t make any difference to us. We’re not the police. We just need to know what she took so we can figure out what’s the matter.’
‘Ya listen ta’ me. Nothin’. A little bit a’ coke, vodka and the Bull. Thassit.’
‘The name on her credit card is Christina,’ says Frank, holding her shiny black purse.
I call her name, and when that doesn’t work, apply some painful stimuli. When she opens her eyes she starts to cry.
‘What’s happened to you, Christina?’
‘I don’t know,’ she sniffs. ‘I want my mum.’
‘I want my forty quid.’
‘I tell you what we’ll do. We’ll go down to the ambulance, check you out there and then decide what we’re going to do. Okay?’
She nods, her bottom lip clenching upwards as she cries, making her look like an eight year old caught in her older sister’s party clothes.
‘Come on. Take my arm.’
The second guy steps towards us.
‘What about our money?’
‘We just need a few minutes to ourselves on the ambulance, then we’ll let you know.’
‘Huh.’
The two men study us as we lead Christina down the stairs. She goes barefoot, hanging onto my arm, with Frank following behind carrying the response bag and a pair of black stiletto shoes.

‘Who are those men?’ I ask her as I wrap the blood pressure cuff around her arm.
‘I don’t know,’ she says. ‘I don’t like them. I was with some friends at a club. We got chatting to them. They said did I want some cocaine, so I said yes. We all started out together but somehow we got separated. I ended up in their flat. And when I took the cocaine, it made me feel bad. I felt all choked up and panicky. Then I must’ve collapsed. And when I came too they were standing over me, staring down, and I was scared.’
Frank gives her a roll of tissue to wipe her face. She looks at us.
‘Please don’t tell my mum.’
‘How old are you?’
‘Twenty one.’
‘Then it’s up to you whether you tell her or not. But I think you should come with us to the hospital and give yourself space to think about what to do next. I don’t think you’re safe here with these guys.’
‘No.’
She blows her nose.
‘Frank? I think we’re about ready to go. And if you see the guys outside…’
‘Yep. I know,’ he says. ‘Leave it to me.’

blood and flowers

2009-07-10T15:18:00.000Z

Any more calls to this hostel and they could usefully introduce valet parking for the ambulances. I swim through the late night traffic and we’re out of the cab even before the caller has hung up. He stands lookout at the end of the flagstone alley that leads to the side entrance, and waves his arms Help style when he sees us.
‘There’s a guy on the floor just up there,’ he says, breathlessly. ‘I think he’s cracked his head. My girlfriend’s with him.’
‘Lead on, Macduff,’ says Frank.

A young woman in a tiny club dress and white jacket has taken off her heels to crouch down by the side of a man squashed against the hostel wall. Her right arm is around the man’s back whilst her left hand strokes his face.
‘Come on!’ she says, leaning in closer, the party sparkles in her crimped blond hair twinkling in the beam of Frank’s flashlight. ‘Some amazing people are here to take care of you now, Jim. Jim? The help you need has come, darling. But don’t worry. I’ll be here. I’m not going to leave you.’
She looks up at us, but hangs on to Jim.
‘He’s hurt and alone. I don’t know what to do. Please do your best.’
The man who led us down the alley stands slightly back from his girlfriend. The hostel warden is leaning against the doorway, taking in the cool night air through a cigarette.
‘All right, gents?’ he says, considerately flicking the ash downwind. ‘I think Jim must’ve taken a tumble outside. He seems okay, but you’re the boss.’
Jim has a small cut and swelling above his right eye, and the blood has run down the side of his face.
The contrasts between the blinding sweep of Frank’s torch and the deep shadows and pools of darkness in the alleyway are marked, but even so you can figure by the shine of Jim’s coat and the dull glint of the bottle next to him that he’s a street sleeper with a drink problem.
‘He needs the best medical attention – and plenty of hugs,’ the woman says, giving Jim another squeeze. Frank looks at me. We’re quite prepared to touch Jim with our gloves on, but hugging? We’d need to be suited up like Dustin Hoffman in Outbreak.

‘Let’s have the trolley out, Spence,’ says Frank.
I know he wants to get Jim away as quickly as possible – for the woman’s sake as much as anyone.

When I come back with the trolley, she’s still giving Jim affectionate rubs on the arm and strokes of the face.
‘Be careful,’ I say to her. ‘He’s got blood on him.’
‘Oh I don’t mind about that,’ she says. ‘I just want what’s best for him.’
She gives him another squeeze, radiating love with as much chemical intensity as the product in her hair. Her partner is less committed. He hangs back from the scene, flipping his phone as if there were other calls he’d like to make.

We help Jim onto the trolley and rattle back up the alley to the ambulance.

‘You’re in the best, most expert hands the city can employ,’ she says. ‘They really are angels from heaven. I know you’re going to be fine, Jim. You’re going to be absolutely fine.’ She has a hold of his left hand, but he tries to pull it away and pillow his head. Like an irascible old terrier, Jim has had enough fuss and just wants to curl up for a while.

We load the trolley onto the vehicle. The woman wants to come on, too, but I stop her.
‘Thanks for your help,’ I say. ‘Do you want some alcohol gel for your hands?’
‘No. Thank you. I just want to know what I should do next?’
‘I think you’ve done as much as anyone could. We’ll take him to hospital and get him checked over. But he seems fine. Just a minor head injury. They often bleed quite a bit.’
I notice a long, diffuse smear down the right side of her jacket.
‘I’m afraid you’ve got blood on you.’
‘Have I?’
And for a moment something sudden and new seems to drop down around us in the night, like an unexpected scene change in a play. She stares at her hands. I give her some alcohol gel. Whilst she rubs the liquid between her fingers, her partner touches her on the shoulder.
‘Come on,’ he says.
She studies him silently for a moment, then turns back to me.
‘Can I send flowers?’ she says.

room 43

2009-07-09T10:58:00.002Z

Mrs Elizabeth ‘Betty’ Wilson, ninety-one not out, sits with her hands cupped in her lap, neatly perched on the edge of a plump and flowery sofa, her head wrapped in a bandage. She fell over in the bathroom and cut the back of her head; the bandage is there to hold a dressing in place whilst we wait for the paramedic practitioner to glue the wound here at home and keep Betty out of hospital. As the wound is right at the back of her head, the bandage has to take a couple of turns under her chin, too, otherwise the whole thing would gradually slide upwards.
‘You look like a proper Mummy,’ her son Jeremy says. ‘Or Marley’s ghost.’
Then he slaps his knees to spur himself into action, and goes off into the kitchen to make us all a cup of tea.
‘I saw a ghost once. Twice, actually,’ Betty says, leaning forwards and squeezing her eyes shut, smiling indulgently like a tipsy nun. ‘I used to work in an old hotel, a very, very old hotel. A coaching hotel, in fact. I looked after the linen. Well, I had a little office in the oldest part out the back, and I was out there one night doing the books, when I felt something strange in the air. Nothing frightening. Just different. Out of the ordinary, you might say. And when I looked up, I saw a man walk across the room and go up the stairs.’
She sits back up straight again and looks at us. After a pause, in which the only sounds are the heavy rain thrumming against the windows and Richard clinking cups in the kitchen, I ask:
‘So - how did he look?’
‘Just odd. Completely different.’
Frank wades in.
‘How do you know he was a ghost and not just some geezer staying at the hotel? Was he transparent? Head under his arm?’
‘Oh no. Nothing like that. He just looked - extraordinary. The outline of a person. All ripply. But I wasn’t afraid. Things like that don’t scare me. Why should they? It’s just the way things are. Like the clouds, or the rain. When my husband died he came back to me about a month later. He was just a smiling face, drifting across the room when I opened my eyes one night. He was saying: Don’t worry, Betty. Everything’s going to be fine.’
Jeremy comes in with a tray of tea, and takes up his seat again on a matching flowery pouffe at Betty’s side. We sit sipping our tea in a semi-circle, the rain booming down outside. Betty’s bird song clock suddenly cuckoo’s the half hour.
‘I heard a good one from some guys at another station,’ says Frank, replacing the delicate, rose-patterned cup on its matching saucer with the self-conscious precision of a navvy in a china shop.

‘They turn up to a resus in a hotel. They charge into the lobby and a guy on the desk says Room 43 – which was what they’d been told anyway. So they pile up the stairs to the first floor, find the door to Room 43 and knock on it. A guy comes to the door and says: “What do you want?” and they say: “We’ve been told there’s a sick person here.” And the man turns round and says: “I think you have the wrong room, mate. There’s no-one like that here.” So of course they say sorry and all that, the guy shuts the door, and one of them gets on the radio to ask if Control can check the address. Meanwhile, the manager appears at the end of the corridor and says: “Thanks for coming so quickly. I’ve got the key.” And they say to him: “Well it’s not Room 43. The guy there says he doesn’t know anything about it.” So the Manager gives them a funny look, leans past them, swipes his key card and pushes the door open. The same guy who answered the door to them just a minute ago is lying on the floor, and he’s been dead at least twelve hours.’

‘That’s a good one,’ laughs Jeremy, taking a swig of his tea. ‘I like that one.’
‘I know what you’re thinking, but they’re stand up guys, those two’ says Frank.
‘Stand up comedy, more like.’
‘All I’m saying is, there’s more to life than just what you see on the surface,’ he says, sitting back on the chair and looking round the room, as if the framed photos and needlepoint pictures could be covering something altogether more terrifying than a floral print wall.

There’s a sudden, urgent rapping on the door.

‘That’ll be the paramedic practitioner,’ I say, getting up to answer it.

‘You think?’

scusstin cat

2009-07-06T13:59:00.001Z

The side of this new ambulance is blazoned with stroke information but I think it should carry advertising for beer. At least that way we could generate some income and buy a few more of these trucks, which make the rest of the fleet look like hand carts.
And after all, beer is the motive force behind the majority of the jobs we’ve been hit with tonight. Drunken assaults, assaulted drunks, unconscious drunks, drunken falls, self-harming (with a bottle opener), spiked drinks, and a man – drunk - wanting his hip operation bringing forward at eleven o’clock on a Saturday night as he was tired waiting on the list.
I need a drink. But I have to settle for a Diet Coke down on the seafront as the sun drags itself above the horizon and survivors of the Saturday night apocalypse clatter home.

One last call – a psychiatric / suicide. Patient given as slightly violent, which I query with Control. Should we stand off a touch? It’s up to us. Police have been assigned, no ETA. There’s a grey wash of exhaustion in the air. Even the seagulls are gliding smack into buildings.
Frank takes the ambulance round the corner and into the street. There is a young girl standing outside a house with a mobile phone. She waves to us, it all seems calm, so we park up and introduce ourselves.
‘Mel’s upstairs,’ she says. ‘She’s taken about a dozen of these pills and says she wants to kill herself.’
She hands us an empty blister pack of Citalopram.
‘Is that everything she’s taken?’
‘I think so.’
We follow her up the stairs of a sparsely furnished student house towards a bedroom on the landing where a girl is being comforted on an unmade bed.
‘I just want to kill myself,’ she chokes. ‘I’m worthless and no good and everyone’d be better off if I was dead.’
All three girls are spilling out of ultra-short club dresses, the glossily sweet aromas of their make-up and perfume cut with smoke and sweat and alcohol. They are hyper-sexed figures from a Manga strip struggling in the grim dimensions and gravity of this room.
‘Kill me. Just kill me and walk away,’ Mel says.
At some point in the night someone has drawn a cat nose and whiskers on her face. ‘I’m scusstin. I’m a scusstin person and I want to die.’
Frank and I sit down on the other bed in the room. I put the clipboard on my lap. It’s an intolerable temptation to kick off my boots, lie down on this bed and go to sleep, and for a moment I wonder if that might actually help. Maybe it would be a calming influence. I remember reading an article about the psychiatrist R D Laing. If a patient was having a psychotic episode and was crouched on the floor with their hands over their heads, he would crouch down next to them and do the same. I bet R D Laing would’ve had no problem lying down. The shock factor. The distractingly idiosyncratic move. I could wake up after an hour or two, Mel would have straightened out, I could go home.
Instead I say: ‘What’s happened tonight to spark this off?’
Mel starts banging her head against the wall and her friend hugs her to stop it.
‘Nothing,’ the friend says, stroking away the strands of blond hair that are sticking to Mel’s face. ‘We had a nice time, came home, then this. She’s been like it before, but never as bad.’
Mel starts scratching at her legs, but her nails are all bitten back, so it doesn’t cause any damage.
‘Can’t you just give me an injection to kill me?’ she says.
There is a knock on the door downstairs and two policemen come thumping up the stairs.
I explain the situation to the first of them, a tall, buzz-cut guy whose blue eyes are no doubt capable of projecting his CV onto the wall.
Meanwhile, Frank says to Mel: ‘Do your family live nearby?’
‘They’re all miles away and I bet they’re glad about that.’
‘Brothers? Sisters?’
‘A little sister.’
‘What’s her name?’
‘Claire.’
‘Imagine if Claire came to you and told you she was really sad and wanted to kill herself. What would you say to her?’
‘I’d say don’t be stupid.’
‘Would you tell her she wasn’t thinking straight? She was being too hard on herself?
‘Maybe.’
There is a pause. The policeman has tucked his hat under his arm; his colleague stands behind him on the hallway discretely studying his watch.
Mel suddenly snatches up the empty packet of Citalopram and shakes it in the air.
‘These are meant to be happy pills but they don’t fucking work.’
She starts trying to bang her head on the wall again.
The policeman steps into the room. We make room for him on the bed.
‘Now Mel,’ he says. ‘Don’t do that or I’ll have to restrain you.’
He puts his hat on the windowsill, sits down between us then leans forwards to take her hands. For a moment they sit like that, Mel cradled in her friend’s lap, both her hands held by the policeman.
‘I’m scusstin,’ she whispers. ‘I’m a scusstin person and I have to kill myself.’
‘You’re not disgusting, Mel. I’ve only known you a few minutes but I would say you’re a well loved young woman who just feels a bit under the weather at the moment. Why don’t you come with these guys to the hospital and speak to someone about how you feel?’
‘A little ride in the ambulance, Mel,’ I say, sounding like a poor salesman. ‘The pills you’ve taken won’t cause you any harm, but the fact you took them is a worry. We need to make sure you’re safe. So why not come with us to the hospital and we can find someone for you to talk to? Otherwise, I’m afraid it’ll mean a trip to the cells.’
The policeman gives me a slantways look.
‘I don’t think that’ll be necessary,’ he says. ‘I know Mel’s going to be sensible about this.’
Ten minutes later, he leads her down the stairs and into the ambulance. The policeman explains to her why he believes she is a worthwhile person. I chat to her friend about her studies.
Mel moans and pulls her hair. ‘I’ve done bad things, scusstin things. I’ve had sex with boys to make them like me.’
‘When?’ says her friend.
‘All the time. I don’t tell you ‘cos I think you’ll hate me.’
She starts scratching and slapping at her legs.
‘Don’t make me have to restrain you,’ says the policeman, reaching out to take hold of both her hands again.
She stares at him, a smudged and bedraggled, scusstin cat, paw to paw with the long arm of the law in the early hours of the morning.

trouble sleeping

2009-07-03T12:15:00.004Z

As we climb out of the cab, the heat of the afternoon lays down heavy on our backs. In just the few seconds it takes to pull out our bags, open the little iron gate and walk up the path, our delicious, air-conditioned frosting is burned clean away.
I ring the bell.
Dogs furious. Commanding words, and a door firmly closed inside. A pause, and then a white shirted figure moves into focus behind the leaf patterned glass of the front door. An elderly man, trim and precise, waves us in.
‘She’s just through here,’ he says, turning and leading us through into the curtained bedroom where his daughter died last night.

She is lying on her back on a single bed, the counterpane neatly rolled and folded at the end, and even the single sheet she had been lying under drawn across and to the side in a wide triangular fold. She looks asleep, her arms out to the sides, palms up, a martyr to the night’s heat who found respite in the early hours.
I touch her forehead, but the dark staining along the lower edges of her arms and legs tells the story well enough.
‘I’m very sorry to say that your daughter has died, George.’
‘I thought so. They said to put her on the floor before you arrived but I knew it would do no good.’
‘It’s not much comfort I know, but at least there are no signs of distress. I don’t think she could have suffered at all.’
‘Right.’
He leads us out of the room and into the sitting room. Dogs barking and scratching even more frantically behind the kitchen door.
‘We don’t mind if you let them out, George. We’re okay with dogs.’
‘If you’re sure. They like to know who’s here and whatnot.’
The moment the door is opened two small black and white mongrel terriers bowl across the carpet in a frenzy of wagging and sniffing. The smaller of the two immediately launches into a campaign to jump up on the sofa. The other seems more wary, running in and out and around until she’s sure she knows how many there are of us and what we might do.
‘Nutmeg is an absolute pain,’ George says. ‘She knows she’s not allowed. Jenny will settle eventually.’
And she does, taking up position between his legs. Nutmeg inspects my boots.
‘I don’t know what’ll happen to them,’ he says. ‘They’re rescues. They were everything to Mary. But they’ll have to go back.’
I make a start on the paperwork. George strokes Jenny’s head and scrunches her ears as he answers my questions. He spoke to Mary last night before she went to bed. Everything seemed fine, nothing out of the ordinary. They were due to go shopping this morning. She didn’t show. She didn’t answer the phone. He drove round and used his spare keys to let himself in.
I tell George that I need to make a phone call to the police, the next stage of the procedure for a death at home. George says he knows.
‘I went through it all when my wife died a few years back. Don’t worry.’
His face is flushed and damp with sweat.
Rae bats Nutmeg away and leans forward to touch George gently on the shoulder.
‘Can I get you a cup of tea? Anything at all?’
‘No. I’m fine,’ he says, taking off his glasses and wiping his face with a handkerchief. ‘I’m fine. But I don’t know how the boys will take it.’

When the police arrive, Rae helps George put Jenny and Nutmeg back into the kitchen as I answer the door. I tell them what has happened, and take them into the room to see the body. They put on latex gloves and make a quick inspection for themselves, then I hand them the paperwork.
Back out in the hallway, George is standing with Rae.
‘We’ll be going now,’ I say to him. I shake his hand. ‘I’m very sorry for your loss.’
He thanks us for coming.
We pick up our bags, one of the policewomen holds the door open for us and smiles. We step back outside.
It’s so bright I can hardly open my eyes.

who had what

2009-06-30T12:49:00.002Z

The brickwork of these old dock workers’ cottages still manage to radiate something rooted and forbearing through the thick masonry gloss of their recent refurbishment. They seem to hang back from the margin of the main road and the commercial brutalities of the rest of the area, everything having been ripped out years ago, replaced with factory units, DIY outlets and scrap metal yards. But the cottages have lasted, still keeping a look-out over the busy quays and sheds below them on the other side, the dark rectangular strips of deep water, and the sea, constantly pressing in on the other side of the harbour wall.

The door to the last of these cottages is open, spilling a light of a friendlier, more domestic hue than the points of fierce magnesium that blaze over the cargo ship fifty feet below, loading timber.

A man is standing in the doorway. Silhouetted as he is, arms folded and feet planted either side, he could be a security guard guarding the entrance to a club. But up close, we see that the stab vest is actually a soft sleeveless jacket, the frown is apprehensive not aggressive, and the arms are folded out of a need for reassurance.
‘He’s just through here,’ he says, letting us in through the tiny hallway and into the main living area, so neatly furnished and colour co-ordinated it feels as if we are walking into a feature in Country Living. But a man is lying on his side on a patterned cream rug, dressed in a white cotton wrap, his head surrounded by a messy red halo of regurgitated mousakka.
He feebly raises his head.
‘Who’s this?’
‘The ambulance, John. You’ve had me so worried.’
‘I didn’t want you to call an ambulance.’
‘Just lie still and let them look at you.’
‘So what’s happened here?’
‘We were at a restaurant celebrating a friend’s birthday. Nothing big, nothing wild. We had less than half bottle of wine each, absolutely nothing out of the ordinary. Then we caught a cab home. We’d only been back a minute or two. John had gone into the bathroom, undressed, and was walking out tying his robe when he took a step or two into the living room and – bam! – he was spark out on the floor, pretty much where you see him now. He was just gray and awful and there was nothing I could do to bring him round.’
‘I was not.’
‘I’m sorry but you were, John. What would you know about it? You were unconscious. Then when he did come round he threw up, and I was so out of my mind with worry I called you.’
John moans from down on the rug.
‘I’m so embarrassed,’ he says. ‘I’ll be fine. It’s just one of those things.’
‘One of those things,’ says Peter. ‘Oh – right. One of those “drink half a bottle of wine and fall unconscious” things? I don’t think so.’
‘I’m so embarrassed.’
‘Let’s have a look at you.’
Rae checks him over, then we help him sit up and re-arrange his robe.
‘Urgh! I can’t believe I did this,’ he says, staring down at the mess on the rug. ‘It’ll never come out.’
‘Who cares about that? The most important thing is that we find out what happened to you?’ says Peter, putting both his hands on John’s shoulders as if he were reasoning with a child.
‘Well I don’t need hospital. What will they do for me there? Oh. I know. See a doctor. Have a CT scan. Find I’ve got a brain tumour. Game over. I know. We both work for the NHS, for God’s sake.’
Rae gives me a look.
‘Let’s not get too carried away, John. But I think Peter’s right. I think you do need to come to the hospital for a check over. It’s certainly not normal behaviour, passing out after half a bottle of wine with no warning.’
He wipes his mouth on the kitchen towel and stares at the result with disgust.
‘Well. I’m getting dressed first.’

Even though we tell him that he’s fine as he is, that he’ll only have to undress again and put on a hospital gown as soon as he gets there, John insists. He spends the next ten minutes struggling to put together an outfit, knocking things over in his search for flip-flops, staggering around trying to push his head up into the arm of his t-shirt.
‘John! Please!’ says Peter.
‘If I didn’t know any better, I’d say John was simply very drunk.’
‘But he’s had the same as me. Absolutely nothing at all. Trust me - this is completely uncharacteristic. When he fell backwards on the rug, I thought he’d died.’
We watch as John bends down to put on a flip flop and rolls backwards onto the sofa.
‘So what do you do in the NHS?’
‘I’m a nurse on an orthopaedic ward, he’s a radiographer.’

Finally, after some firm intervention, John has some clothes on, a mobile phone and a bunch of keys.
‘I don’t want to go,’ he says. But shuffles out anyway.

As I’m driving to the hospital, I catch sight of Rae in the mirror, raising the feet of the trolley up, leaning over and shouting ‘John? Come on, John.’ Then to me, through the hatch. ‘He’s gone off on me.’
‘Shall I pull over?’
‘No. I’m not sure about it. Just keep going and I’ll let you know.’
Further down the road, I can tell from the tone of her voice that John has come round.
‘It’s not funny, John,’ she says. ‘I don’t know why you’re doing this.’
I see Peter’s reflection in the mirror, leaning forwards, his face blurred with anxiety.

When we arrive at the hospital, Rae tells me that John seemed to have a curious kind of fit – not the usual phonus-bolonus, pseudo-fit we often see, but more like a partial seizure. His breathing had changed in character, becoming shallower and faster, and his heart had pounded out an irregular one forty plus.
‘I’m really not sure about this one,’ she says to me in secret, just before she goes to handover.
I wait by the trolley in the corridor. John seems genuinely embarrassed.
‘God. If anyone recognises me,’ he says. ‘I feel so bad about all this. I’m so sorry to waste your time.’
‘You’re not wasting anyone’s time,’ Peter says, pushing the fringe back from John’s forehead. ‘You mustn’t think like that.’ Then he looks at me and says: ‘What do you think it is?’
‘A brain tumour,’ says John.
‘Don’t say that,’ says Peter. He looks exhausted. ‘Don’t say such things.’
Rae comes back with a cubicle number. We wheel him into position.
Just as we do this, John seems to go off again, staring vacantly up into the ceiling, breathing rapidly, his pulse racing.
‘Has John taken any kind of recreational drugs tonight?’
‘No. Never. We don’t touch them.’
A doctor comes over and has a quick look.
‘Mm,’ he says. ‘Let’s do another ECG.’

Later that night we check in on John’s progress.
‘They’ve just gone up to the CT suite,’ says the nurse.

An hour later still, and we’re back in A&E again. I’m sipping coffee out by the ambulance when Rae comes through the double doors looking like she has something.
‘Well?’
‘I spoke to the nurse again. They’ve just got bloods back from our mate John,’ she says. ‘He’s absolutely loaded. Half a bottle of wine? Yeah, right – and Oliver Reed had a diet Coke.’

sea breeze

2009-06-24T10:31:00.002Z

The night has rolled on, thinning to a scrape of heels on concrete, a shriek in an alleyway, bass notes spilling from a passing car. The pier has closed finally, shutting down its multicoloured circuits for the night, leaving just a workshop window illuminated, tucked beneath the dark boardwalk. There’s a barely discernible silhouette moving about in there, like an ant caught in a light box. Meanwhile, the moon leans down low and bright, scrying our fortunes in the polished black surface of the water.

Karol is sitting in a wheelchair by a tall, open window that overlooks the sea. He grips the armrests, leaning forwards with his chin up, his face whiter than the net curtains, breathing like he’s just been running a race.
‘Please.’
His wife is holding on to one of the rear handgrips, either to keep herself upright or her husband in the chair, it’s hard to tell. She smiles at us as we haul our gear into the room – her smile, like her hair, thinning and untended.
‘Can’t you help him?’
Karol is a cancer patient of a year or so, the tumours slowly metastasising from where they first laid root in the right lung, creeping on through the rest of his body despite the drastic treatments called down on them. He manages his condition at home and at the local hospice, with a bottle of Oromorph to supplement the other pain relievers when things get too difficult.

The problem tonight, though, is that Karol is hyperventilating. He nods to say he understands what that means.
‘Don’t - leave me - until I’m better,’ he says.
‘We promise.’

I coach his breathing to bring it back down to a normal rhythm. He gradually relaxes his grip on the chair. His wife comes round to sit on a facing stool.
‘All day he’s been worrying that the cancer will stop him breathing,’ she says, rubbing his knee. ‘The doctors are happy with the way things are at the moment, and everything seems to be holding, but now and again Karol gets a bit – well - worked up.’
‘I think I tripped out on all the meds,’ he says, his breathing levelling out and his shoulders relaxing. ‘I grew up in the sixties. You’d think I could handle that.’ He laughs, but then his face seems to slacken again with a dreadful kind of existential sweat.
‘The walls just seemed to be bearing down on me,’ he says, wiping his forehead with the back of his hand. ‘I just couldn’t seem to get my breath.’
‘That’s why we came to the window,’ says his wife. ‘The ozone.’
‘It’s got to help.’

I make a phone call to request a home visit from the out of hours doctor. Karol could do with some lightweight sedation tonight, to see him through to a visit from a Macmillan nurse in the morning and a thorough-going review. A trip to A&E would only make things worse.

‘Karol is an artist. He did all these paintings,’ she says. ‘Look.’

We scarcely noticed them as we came into the room at first, but now things have calmed down we’re able to take in our surroundings. There are huge, square canvases hung around the room, vigorously painted, intensely coloured images of pelicans jostling on flaming yellow and blue beaches, a naked woman reclining on a leaping zebra, a cascading forest of orchids and tigers. And then, just by the door, an abstract canvas, the biggest of all of them, strung from ceiling to floor – a massing cloud swirl of ochre, burnt earth, carmine and terracotta.

‘I tried to get down how it felt to be told I had cancer,’ he says. ‘How it feels.’

We all look at the painting, as the net curtains gently bow and snap in the cool sea breeze.

vera the bog mummy

2009-06-18T09:59:00.004Z

‘She’s in a terrible state,’ says the caretaker of the flats, a man as square and brutally constructed as the building itself. ‘Absolutely terrible. No one had seen her for a couple of days, and I had a key, so…’
The lift springs to a halt and the doors slide back.
‘I expect you’re used to these things, but – er – it’s going to be one hell of a job for you.’
‘You’re not selling it, particularly’ says Frank.
We follow the caretaker over to a battered blue door that shows signs of having been kicked in a few times in the past. He knocks on it twice.
‘Vera? It’s Barry again, with the ambulance.’ Then to us: ‘Not that she’ll understand any of that, of course.’
He pushes open the door.
‘She’s under the table in the living room.’

As we stand in the doorway a dreadfully grey and foetid smell billows out around us and on into the pine fresh chamber of the hallway.
‘I told you it was bad,’ Barry says. ‘Poor thing. She’s been bad with the drink before now, but nothing like this.’
‘Hello? Ambulance!’ I say, and we step inside.

Three thousand years ago the early Northern Europeans, in an effort to buy off their gods and make the harvest work that year, would sometimes lead a person out onto the marshland and cut their throat. Then they would lay the body in a shallow grave, cover it with peat, walk away and evaporate into Time. But the body would be drenched in the aseptic waters of the sphagnum moss, would be drawn down into the deepening bog, that black and anaerobic world – until, shockingly, its tanned leather face is suddenly squinting back up into the sunlight again, another bog mummy for the museum, tucked up on its side, with a long dream of suffering playing across its flattened face for everyone to see.

But now - if instead of taking your bog mummy and carefully lying it in a presentation case, you dress it instead in a torn floral nightie, drop it down on some lino and slide it under a chipped white Formica table, and instead of respectfully placing its grave goods alongside it you scatter round the withered feet a half dozen empty bottles of cheap supermarket vodka, and instead of installing a clinical de-humidifier you take a bucket of cold urine and faeces and slop it generously all over your specimen – this is how you will come to see Vera as we see her now, groaning and wailing beneath the table on the other side of the room.

‘I told you,’ says Barry. ‘How on earth are you going to move her?’

miss claudine, in the hospital, with the hat

2009-06-17T11:59:00.001Z

If I was an alien visiting the earth, on a mission to sample the prevailing emotional flux of humankind, this would be my favourite time to touch down - the evening rush hour, when the bright weight of the day’s business eases up, and the sky deepens and pulls away, and people mass in the streets, following their routes and thoughts, but somewhat changed by the day that’s gone, roughened by all the compensations and accommodations they have had to make in order to keep these routes and thoughts running clear and in the right direction. And as the light changes, the bridges of stone they strode across so confidently that morning seem to have been replaced by something less certain, bridges of sticks, or black glass; in any case, they make their way home, back to the places they have strengthened to dream in safety, and close their doors against the night until the next day comes rolling around.

Claudine is led out of her house by her husband, Ed. A social worker stands on the pavement, clutching a manila envelope, flanked by two policewomen. Claudine looks as if she had been expecting to be led out onto the lawns of some lovely country estate. She is wearing an elegant lilac dress tied at the waist with a broad ribbon, plaited white shoes, Onassis sunglasses and a floppy cartwheel hat. She could be a Duchess, slightly cut on Madeira wine, paying a little too much attention to her feet as she is led out to greet her guests.
‘I don’t need an ambulance,’ she says, pushing her sunglasses back up her nose and smiling indulgently, first at Frank, then at me. ‘I’m not ill.’
‘Now, Claudine,’ says Ed, releasing her arm and putting both his hands on her shoulders. ‘We spoke about this. Remember? It’s just the way these things are done. You’ll be more comfortable in the ambulance, and there’s lots of room for everyone.’
‘Why? Who’s coming? Where are we going?’
‘To the hospital, Claudine. And I think a policewoman and – Spence – here, in the back with us.’
Ed looks around at us all to check that this is right. The policewoman nods.
‘I’ll follow in the police car,’ says the social worker. ‘I’ve got the papers.’
She clutches the envelope to her with such a self-conscious grip on the authority of what it contains, it reminds me of the ‘murder cards’ envelope in Cluedo, the one that sits in the middle of the board holding the weapon, the place – and the murderer, Miss Claudine, her smiling head stuck on a plastic counter. Except in this version of the game there has been no murder. In this sullied, real world version of the game, Claudine gets to be sectioned.
‘I was born thirty eight years ago next Wednesday,’ she says pleasantly, as I offer my hand to help her into the ambulance. ‘Thirty eight years since I was tucked up inside my Mother. I wish I could go back there now.’
She sits on the chair, and as I show the policewoman to her seat, Claudine slides right down and pulls her hat over her face.
‘You can’t see me,’ she says. She is charming, like a ten year old showing off to a bunch of stuffy relatives. ‘I’m invisible.’
Ed sits next to her and encourages her to put a seatbelt on.
‘No,’ she says, then: ‘Where are we off to?’
‘To Southview, to the hospital, Claudine.’
Frank slams the door shut.

As we ride along, the policewoman asks me questions about my shift patterns. Claudine listens in, frowning.
‘Who are these people?’ she asks Ed.
He straightens her hat.
A darkly thin man in his early forties, Ed is exhausted, someone inexplicably split from the normal run of things, like a man who fell asleep by a mirror and woke up to find himself trapped on the other side.
‘I haven’t slept in five days,’ he says to me. ‘Because she hasn’t.’
He says his mother has taken their children.

At Southview, Frank parks up and comes to the side to the open the door. The social worker and the other policewoman stand to his side. Ed gets out first, then turns to offer up his hand to Claudine. She steps out and looks around her.
‘My goodness,’ she says. ‘It’s amazing.’
We all walk along the pavement and into the foyer. A patient is standing over by the security desk. She has roughly cut ginger hair and a congested face like a plumped up cushion. When she sees us come in the door she pulls out her iPod earplugs and hurries over.
‘How are you? I’m fine. I’m always fine. Traffic all right? Made it here, anyways. Could’ve been killed, mate. Bang. Squashed. The roads. The roads are so dangerous these days. It’s a wonder there’s anyone left alive. Anyways. People know you’re coming? People know you’re here? Shall I ring? I’m Katy but I ‘spect you knew that already. I know what your name is. I can read it on your shirt! They don’t let you have pets in here. I had a dog. His name was Rufus….’

Claudine politely steps to one side and then carries on over to the Coke machine. She takes off her hat and glasses, kneels down on the floor, and peers up into the hole where the cans roll down.
‘Amazing,’ she says.
‘We’ll take her from here,’ the social worker says. We watch as Ed helps Claudine to her feet again, and then they all walk off down the corridor towards the secure ward, Katy talking incessantly at their backs, the leads of the earphones in her back pocket trailing down left and right behind her, like a spindly white tail.

dookey revisité

2009-06-15T13:24:00.003Z

The paramedic car has its hazards flashing, but we know exactly which house we need.
‘I haven’t been to Stanley’s for a little while,’ I say to Rae.
‘No. Perhaps he hasn’t been well.’
As I park the ambulance behind the car I wonder whether this might be the one time I visit the man and find he actually needs some help.

Although there is already a paramedic on scene, when we ring the bell there is the usual schtick about who we are and what we’ve come for.
‘Who do you say you are? The ambulance?’ As if an ambulance was the last thing anyone could have expected, despite Stanley having made the call not ten minutes ago, and despite the fluorescent bulk of one of our colleagues right there on his sofa, surrounded by kit. But finally – heroically - he buzzes us through into the hall, where we wait another couple of minutes by his flat door.
‘I’m just getting my keys,’ he says finally, pressing his mouth to the gap. ‘Now where are my trousers. The keys must be in the trousers.’
CJ the paramedic lets us in.
‘All right?’ he says, wearily. We follow him back into the sitting room.

Dookey, Stanley’s springer spaniel, flies over the back of the sofa to frisk us for affection, driven to heights of ecstasy never before seen in a dog.
‘Dookey!’ growls Stanley like some grumpy old stage manager somewhere off in the gloom. ‘Decorum!’
CJ gives us an exhausted look.
‘Just this shift and I’m nine days clear,’ he says. ‘Count them.’
Dookey licks him clean in the chops.
‘Yeuch! Anyway, guys, listen. I know this is one you’ve maybe come across before. But the story is, he rung up with DIB. He’s sounding a little bit crackly and his SATS are a touch low. So that and his previous means it’s inevitably a trip down the old choky. Sorry and all that. I have done some paperwork for you, though.’
‘He won’t go,’ says Rae, making a blue glove ball and tossing it for the dog, who almost demolishes a sideboard of antique glass in his eagerness to retrieve. ‘Oops.’
‘Well, he assures me that this time he means business.’
‘I definitely do,’ says Stanley, dragging himself into the room by the buckle of his belt. ‘I’ve never felt so rough.’
He looks slack and grey, but then his smoking and his reclusive lifestyle means he would never make too many demands on a palette of healthy colours. He regards Rae and me with disappointment.
‘Haven’t I seen you before?’ he says.
‘Come on, Stanley. We’re taking you to the hospital, apparently.’
‘Yes. I need to go. I’ve never been so ill. I just can’t get my breath.’
‘Have you had a cigarette recently?’
‘I may have had a consolatory puff or two. Look – this is not easy, you know. You really shouldn’t make fun of me like this.’
‘We’re not making fun of you, Stanley. We’re just trying to get the full picture.’
‘Yes. Well. The full picture as you say is that I’m not breathing at all well, and I’m quite possibly dying. You know how I feel about my darling Dookey, but even she cannot keep me from my appointment with the doctors at the hospital tonight, because I’m afraid that if I stayed here I would expire and that would be that.’
‘So let’s go, then.’
‘Look. Don’t rush me. I’ve simply got to find my keys.’
‘Keys are in the door,’ says Rae, turning Dookey onto her back and scrunching her fingers around on her tummy.
Incredibly, they are, right there in the lock.
‘Oh. Fine. Well then. I just need my shoes. Dookey! Un peu de l'étiquette s'il vous plaît.’ Then he turns to me and says:
‘Where is your chair?’
‘I don’t think you need a chair, Stanley. You’re moving about like an antelope. Let’s try a walk out to the vehicle, shall we?’
‘I don’t care for your tone,’ he says, ominously. Then after giving Dookey a series of instructions in English and in French, he shuffles out with us into the hallway.

Stanley lives on a road with a crow’s view of the city. It lies spread out before us, a thousand points of light below an ink blue sky.
‘What a night!’ I say, offering my arm.
‘For you, perhaps,’ he says with a sniff. ‘For me, a vision of hell. I’m not enjoying this, you know. And I most certainly will not manage those steps.’
‘Let’s just have a go and see. If you can’t, we’ll have a rethink.’
Stanley pulls his arm out from mine.
‘Really. This is ridiculous. So you’re refusing to take me to hospital.’
‘Not at all. If you need to go, we’ll go. But I’m not carrying you in a chair, Stanley. You don’t need it.’
‘Then I’m not going.’
He turns round and marches back inside, slamming the door behind him.

The paramedic joins us over by the ambulance.
‘That went well, then.’
‘He’s just an arse.’
‘Why wouldn’t he come?’
‘He insisted on a chair.’
‘Oh well. No doubt he’ll call back in a second or two. I’d wait here if I were you.’
I talk to Control and they stand us down from the job. Just a minute later, though, we get it back again. Control ask us to give him a severe talking to.
‘Tell him it’s you or nothing,’ they say.

When Stanley answers the door and sees me standing there, his mournful expression drops a clear foot.
‘You!’ he says. ‘You’re the one who refused to take me to hospital.’ Then he notices Rae and says: ‘But you, my dear. You have been the epitome of helpfulness and humanity throughout this entire ordeal. You I don’t mind.’
‘Stanley. This is your last chance. Either you walk out to the ambulance with us now and we take you to hospital, or you find some other way to cope with your illness tonight. We’re not a taxi service. We’re not here to answer to your every beck and call.’
‘Don’t be cruel,’ he says. ‘I’ve never been so ill.’
But he seems to lose a measure of haughtiness, takes my arm, and allows himself to be led out of the flat and down to the vehicle.
Dookey watches us go from her lookout behind the window.
I half expect her to wave.

underwater

2009-06-12T10:12:00.001Z

The bungalow looks as if it has been dropped from a height. It sits back from the road at the bottom of a steeply sloping bank of earth, clustered around with massy black shrubs and plants, the steps leading down through them illuminated by the sickly glow from half a dozen solar mushrooms. The front door stands open, spilling a brighter light.
‘Hello? Ambulance?’
In through the front door and we find Jenny, clutching at the edge of a card table and bending forwards to catch her breath.
‘Let’s sit you down,’ I say to her, taking her hand. She shakes her head and waves me off. ‘Come on. Have a seat and then we can see what needs to be done.’
There’s something about the way she holds herself, something posed and practised, that does not seem right. But for now I carry on trying to persuade her she should take a seat and talk to us.
Suddenly she straightens and says: ‘I’m not going to hospital. My dog, you see.’ Then she turns and leads us down a stubby wooden staircase into a sunken lounge filled with the oppressive fug of cigarette smoke and long closed windows. A dog as ungainly as the house hauls itself up from its nest by the fire to check our trouser legs.
‘Maisy,’ says Jenny, turning and flopping down into the chair. ‘Maisy, Maisy, Maisy. What would I do without you?’
The TV is playing quietly in the far corner: Paul Giamatti swimming underwater, examining strange objects, looking for something.
Maisy prods me with her nose to elicit some fuss.
‘Tell us what’s been happening, Jenny.’
‘I’m an old crone,’ she says. ‘But I used to be a lifeguard. I saved fifty three people from drowning. Fifty three. I got a certificate.’
She has a strange way of talking, starting confidently but the power quickly draining from her words until she trails off into a dry mouthing. She is like an asthmatic tragedian, worn through by repetition, the banal horror of everything.
‘I have a part-time husband. He’s away most of the time. A consultant in computing. I’m here on my own. But I’ve got you, babe. Maisy, Maisy, Maisy. Look at you now. You dear and lovely little thing.’
She may have been little once, but food and lack of exercise have done for her. She has ballooned into a piece of furniture with only a touch more animation than the sofa we currently sit on.
‘Have you been drinking, Jenny?’
‘Drinking? No.’
She has. There are no bottles or glasses around, but it wouldn’t take long to find them.
‘I know I shouldn’t smoke. It’s killing me. Killing me.’
‘And when was the last time you had an ambulance?’
‘A long while. Ages ago.’
Paul Giamatti has broken the surface of the water now: a hotel swimming pool by the look of it. What’s he doing?
Maisy has moved on to Rae, who musses her ears and rubs noses with her.
There is a heavy oak mantelpiece that runs along the far wall. Ornaments and trinkets have been placed along it, a measured distance between them. A drunken, ceramic pig in a sailor suit, one trotter draped over the edge; a brass lizard with an S-shaped tail; an abstract leaping antelope in ivory; a wedding photo in a fussy gilt frame; a pottery hedgehog.
‘I’m an old crone,’ says Jenny, leaning forward in her chair, staring at me with her jade green eyes, absently turning her wedding band around and around. ‘I know I’m nothing to look at now. But I used to be quite a catch.’

released back

2009-06-11T17:04:00.002Z

Two shadowy figures are standing on the cycle path that runs around the park. One of them waves, so Frank spins the ambulance round in a u-turn and we pull alongside the kerb. I lower the window.
‘Did you call the ambulance?’
‘You gotta do something about my ear, man.’
‘Okay. Let’s get you in the back.’
‘Come on.’
‘Just a second.’
He hardly waits for me to slide back the door and put on the light. He takes a big step into the ambulance and sits down on the trolley.
‘No. Don’t sit there. Sit on one of these chairs.’
‘Why? I just want you to sort my ear out.’
‘Do as the geezer says, Jay.’ And then to me. ‘He’s all right, really. It’s his birthday today.’
‘Really? Well, happy birthday Jay.’
‘Whatever. Just fix my ear.’
Now the lights are on I can see exactly who I’m dealing with. Jay and his friend are both still young, but their twenty years of life resonate around them like twenty strikes of a big black gong marked ‘Trouble’. The neatest thing about them is their insectivorous stubble. Neither of them look straight at me when I talk, but off to the side, as if they are used to covering all eventualities.
‘So what happened to you, Jay?’
‘My girlfriend smashed a glass on my head.’
‘Were you knocked out?’
‘What do you mean, was I knocked out?’
‘Well – just that. Did you lose consciousness?’
‘She’s a girl. Fix my ear.’
‘I need to know all the facts so I can treat you.’
Jay’s friend sits right on the edge of his chair like an excited child.
‘Don’t give him a hard time, Jay. He’s helping you, man. He’s here to help.’
‘Do you have any neck pain?’
‘No.’
‘Okay. Turn your head and I’ll see where all this blood is coming from.’
His only injury is a small cut just up from the root of the ear. It must have happened some time ago; the blood has congealed, lifting off his cheek like a papery, wine-coloured residue when I rub it.
‘It’s a minor cut,’ I tell him. ‘You don’t need to go to hospital. You just need to keep it clean so it doesn’t get infected.’
‘I haven’t got nowhere. How am I supposed to do that?’
‘I don’t know. How do you normally clean yourself up?’
He turns to his friend. ‘Listen to this.’ And then back to me. ‘I’m going to bounce you off the ceiling.’
‘Really?’ I toss the bloodied gauze pad into the bin.
Frank unfolds his arms. ‘Okay, mate. I think it’s high time you went on your way.’
The friend stands up.
‘Come on. Don’t listen to Jay. He’s just upset because his girl whacked him. He’s a good kid, not at all violent. He kept the bullies off me all through school.’
‘That’s nice. But I’ve done all I need to do here. Your part of the deal is to clean yourself up.’
‘How rude is that?’
‘It’s not rude, Jay. It’s just the way it is.’
‘Give me some more wipes.’
I want to say to him: What’s the magic word? But I give him some wipes in silence. He snatches them up, and then the two of them jump off the ambulance.

We watch them slouch away back into the shadows.

Once when I went fishing with Dad we unexpectedly hooked a pike. It thrashed furiously amongst the reeds until he cut the line and let it splash back into the water. It was only up for a second or two, but it seemed to hang there forever, snapping its body from side to side, fixing us dispassionately with the chill black button of its eye.

Dad shut and pocketed his knife, then sat back down on his fold-up chair.
‘I’m glad I’m not a fish in this particular stretch of water,’ he said. Then he drew his old canvas fishing bag to him, and slowly and methodically set about tying another hook to the line.

learning the language

2009-06-10T13:54:00.003Z

‘We think she had got up in the early hours to use the commode, and then just collapsed backwards. We haven’t moved her. We thought it best we didn’t.’

Hilda is lying on her back across the bed, neatly lain out with her mottled red feet set shoulder-width apart on the floor, her knees crooked at the edge of the mattress, her arms along by her sides. With her hands bunched into fists, her mouth sagging open, and with her fine white hair spread around behind her head like a makeshift halo, Hilda looks like a spirit singing a loud and apocalyptic note in the wilderness. But the power has gone and the music has faded, along with the last images she played out above her on the blank white screen of the ceiling. There’s nothing in the room now except a body on the bed, a collection of family photos on the sideboard and walls, and the four of us – the Warden, the policeman, Frank and me.

Frank goes over to Hilda and makes the official confirmation of death. There is a polite exchange of paperwork.

‘I should’ve finished an hour ago,’ the policeman says. ‘Do you mind if I have a seat?’
The home warden plumps a cushion for him on a white wicker chair.
His radio squawks, so he silences it.
The Warden tells us a little more about Hilda, then adds: ‘Who wants a cup of tea?’

When she comes back a few minutes later we’re all talking about Hong Kong.

‘My eldest sister went out there for a few months and now ten years later she’s only just thinking about where to go next. She loves it.’
‘I have a friend who’s just gone to China. He’s married a Chinese girl and he’s looking for work but I think he’s finding it tough. Where do you start with the language? And the writing – it’s just a sequence of lines.’
‘I’ve still got a little bit of school French. At least with that the words and sounds are recognisable. But Chinese? Where do you start with Chinese?’
The tea the warden made us is strong and reviving.

Through the window just above the bed I watch a man come out of his house across the road, stretch his back and then pick his way carefully down the wet stone steps of his garden to the road. He doesn’t pay any attention to the ambulance.
‘I think property is expensive in Hong Kong.’
‘Well, it’s so crowded. It’s going to be pricey. But there’s absolutely no crime over there. They don’t tolerate crime. You can go out without any kind of worry at all.’

The policeman takes another sip from his mug.

‘The relatives are on their way. I think they should be here in a little while.’
‘Would you like us to make Hilda a little more presentable on the bed?’
‘If you could.’
Hilda is small and frail. With the policeman controlling her legs, Frank around her middle and me with her arms and head, it’s a simple move to put her back into bed with her head on the soft white pillows and the quilt tucked up to her chin. I smooth down her hair and manage to close her eyes, but although we experiment with different pillow combinations we don’t succeed in closing her mouth.
‘Don’t worry. That’s better,’ says the Warden.
She looks out of the window, and then at the little silver watch on her wrist.
‘I do hope the Coroner’s men don’t get here before the relatives.’
‘No,’ says the policeman, putting his mug on the sideboard, then thinking better of it and picking it up again. ‘They don’t like to hang around.’

angles

2009-06-05T10:20:00.003Z

Tyra is lying on her back, half in and half out of the en-suite bathroom, a tastefully arranged study in suicide, her head turned to the left, her glossy hair spread around her on the black and white tiled floor, her left arm crooked up so the fingers of her left hand can brush against her cheek, her other hand curled delicately in the lap of her flower-patterned lycra trousers. Her knees are drawn up half way, balanced inwards, one against the other.
‘She took an overdose and cut her wrist. She wanted to kill herself.’
James, ‘not her partner, just a friend’, a pale and sharply anxious man, bristling with angles like a geometric theorem made human, adjusts his thick black glasses and paces about.
‘Help her. Please.’
I step into the bathroom and squat down beside her. Even this small disturbance makes her eyelids flutter.
‘Tyra? Open your eyes, Tyra. It’s the ambulance.’
She holds herself quite still.
‘Tyra. I know you’re not unconscious. Please open your eyes and tell me what’s happened this morning.’
Nothing.
There is a light swipe of blood on her trousers just visible beneath her hand. I lift it up and see that Tyra has scraped at her wrist with a safety razor, but the wound is ineffectual, nothing more than a graze.
‘Is this the only cut you made, Tyra? Please talk to me. It’s silly otherwise.’
Suddenly her eyes flip open and she looks at me.
‘I didn’t want anyone to find me,’ she says. ‘I didn’t want to wake up.’
‘Let’s sit you down on the bed and have a chat about what’s happened.’
James buzzes around behind us. As I offer my hand to Tyra to help her stand up, he squeezes his way in beside me and tries to take her under the shoulders.
‘Thank God I found you!’ he says.
His assistance actually makes it more difficult for Tyra to stand and leave the bathroom. Rae takes him aside.
‘What pills has Tyra taken?’ she says. ‘There are some empty packets here.’
‘No. Those are mine,’ James says. ‘She took some of these ibuprofen, and these – the amitriptyline.’
‘How many of each?’
Tyra is sitting on the bed, looking off into a corner of the room as if this is a socially awkward scene she would rather not have to endure.
‘As many as I could,’ she sighs. ‘I didn’t want to go on living.’
‘We need to know as accurately as possible how many you took of these pills, and when you took them.’
‘I don’t know. I wanted to kill myself. I wasn’t concerned about the time, was I?’
‘Roughly though.’
‘An hour and a half. Ten of the ibuprofen and one or two of the amitriptyline.’
‘Are the amitriptyline pills your own?’
‘No. My mum’s.’
The simple use of the mum word has a powerful effect on Tyra; her wide black pupils swivel four stops into focus.
‘Please don’t tell her. Oh my god! They won’t tell mum, will they, James?’
‘You’re twenty one,’ he says watchfully from the end of the bed. ‘You don’t have to tell anyone anything.’
Meanwhile Rae has fished another empty packet of pills out of the little wicker waste bin by the dresser.
‘What about these?’
And as unexpectedly as Tyra was energised by the thought of her mother, a simple mention of James’ wicker bin seems to sting him into a rage. He unfolds his arms and drops them down by his side.
‘I fucking hate ambulance people. How dare you go rooting around my personal stuff? Insinuating all kinds of shit. How dare you!’
He stomps around the room, leaves, comes back, leaves again. He reminds me of a furious house dog, conflicted by the need to protect and the need to run away.
‘James. Calm down for us, could you? It’s not helping. I don’t understand why you’re getting so worked up.’
‘No. You wouldn’t, would you? I can’t stand this fucking attitude. You come up here with your sniffy looks. You pry and you poke around. Who do you think you are? I won’t fucking stand for it. Sorry, Tyra, but it just makes me furious.’
‘Well you won’t be able to come with us to the hospital if you don’t moderate your language and behaviour, James.’
I sound like a school teacher. I feel like one.
‘Go and stand outside.’
He does. We hear him crashing about and swearing in another room. But after a moment he sidles back in to give Tyra her mobile, and help lead her down the stairs to the ambulance.
As we open the door to step outside, she puts her hand over her face.
‘I don’t want anyone to see me,’ she says.
But it’s half past four in the morning. There really isn’t anyone.

On the ambulance, Tyra sits in a seat, chewing a nail and staring through the slats of the window. James hugs himself in a seat just in front of her.
‘Who’s your doctor?’ I ask.
She smiles without looking at me. ‘I don’t go to doctors,’ she says. ‘I wouldn’t know.’
‘Is that your home address?’
James sighs.
‘Yes it’s her home address.’
‘Do you know the postcode?’
‘Yes, I know the postcode. I live there, don’t I?’
‘Could you tell me what it is then?’
He snips it out, then reaches over to stroke Tyra’s hand. ‘It’s okay,’ he says. And then to himself: ‘These fucking interrogations.’
‘James. Remember what I said about your language and attitude? These are simple questions I have to ask so Tyra gets the correct treatment. Okay? If you carry on like this you won’t be allowed in to the hospital.’
‘I’m sorry. I just don’t appreciate your tone.’
Tyra looks at me. She looks as if she is stifling a laugh.
‘But I want him there with me.’
‘Fine. But you must behave.’
The ambulance bumps along.

Once we have wheeled Tyra into a cubicle, we look for sanctuary and coffee in the reception office. As Zoe taps in the details, we cradle our drinks and mull over the job. Suddenly Rae clamps up, and I realise that James has come to the window.
‘How can I help?’ says Zoe.
James looks across at the two of us sitting on our swivel chairs. I nod at him, but he turns his attention back to Zoe without acknowledgement. After a pause, he adjusts his glasses, and says quietly:

‘The nurse says I need to book a blood test.’

venus

2009-06-04T19:18:00.001Z

The old man has rotten rabbit’s teeth, two opposing clumps of greasy yellow-black fragments that bow outwards at a poisonous angle. And from here it seems that - more than drink, fags, diet, or any of the other depravations a person of seventy endures - the thing that really seems to have blasted these teeth to the root is the bad language that passes across them.

‘Bring me that bastard Tony Blair,’ he screams. ‘I’ll bite his balls off.’

It is two in the morning. The man is lying on his side on the broken up tarmac of an estate car park, his knees drawn up to his stomach against the cold, his right arm pillowing his grizzled head.
‘Fuck you! And fuck your fascist state! Tell that Tony Blair I want him here, now. I’ll bite his cock off and spit it in his face.’
Rae drapes a blanket over him.
‘Thank you,’ he says. ‘You’re a kind person.’

The man and woman who made the call are standing at a safe distance over by a wall.
‘He lives up in one of those flats over there. Is he going to be all right?’
‘Hm. Not sure. But thanks for calling.’
‘Yeah – I bet,’ she laughs. They walk off, and the old man seems to react to the change in his audience.
‘I’ll tear his eyes out and stuff ‘em up my arse!’ he screams. ‘Murderer! Murderer!’
Then he whimpers, and rests his head back down on his arm.
‘Just kill me, fellas. Just put a pillow over my head and smother me. I don’t want to live any more.’
‘First things first,’ says Rae.
We both squat down at angles and distances he’d find difficult to strike or kick. ‘What’s your name?’
His head bobs up again.
‘Fuck you! Cunt! That’s none of your business. Leave me alone. Or kill me, and then leave me alone.’
‘Come on. We’re only here to help. You’re lying on the floor, cold and wet. Tell us your name and then we can talk like civilised human beings.’
‘My name? You want to know my name? Well, fuck you. My name is Tony Fucking Blair.’
A police car turns up the ramp into the car park.
‘Who the fuck is that, now?’, the old man says, raising his head and sniffing blindly.
‘It’s the police – erm – Tony.’
‘They’re going to beat me up and kill me.’
‘No they’re not. They’re here to make sure you’re okay, just like we are.’
‘Fuck off.’

We stand up and when the two PCs come over we tell them what we’ve found so far. The police man takes a few steps away to talk on his radio; the police woman squats down beside the old man. The lights from our torches reflect brightly off her neatly tied blond hair and pressed white shirt. She could be an angel come down to see what life is like on Earth, persuaded to wear a stab vest and cuffs.
‘Hello sir,’ she says. ‘My name’s Ella. What’s yours?’
‘Simon Larkinson,’ he says, meekly.
‘Hello Simon. What seems to have happened to you tonight?’
There is a pause. Simon pants quickly and quietly, like an exhausted animal.
‘I’m cold,’ he says.
‘Well no wonder. Lying on the ground like this. Let’s get you somewhere warm where we can talk properly.’
‘Okay then.’

I fetch the trolley from the ambulance.
We all work together, stand him up and settle him onto it.
As I’m strapping him in he looks up at me.
‘Did you see that fillum?’, he says, with a delicious shudder that runs from his scalp to his boots. ‘”Venus”, I think it was. Peter O’Toole. A great actor, there. And not much older than me.’
And then satisfied with that, he seals his lips around those dreadful teeth, tugs the blankets up to his chin, closes his eyes, and suffers to be manoeuvred onto the vehicle with the graven resolve of a newly beatified priest.

It doesn’t last.

trouble

2009-06-03T10:41:00.001Z

‘I’m well battered, me.’
Jaime is ticking with coke. Everything about him – his sudden, drawn smiles, the way he laughs and dabs at his swollen face with a beer towel, the way he ducks and changes direction as each new thought comes to him – every beat of him seems tapped out by a frantic chemical metronome.
‘I only came down here ‘cos I heard it was a chilled out place, and now look at me. I’d have stayed where I was if I’d known. Jesus.’
Jaime has the bony, drawn out face of a young deer. He comes out of the club foyer, blinking and scanning the early morning streets like he’s stepping out of a forest into a clearing.
‘My mother’ll just die,’ he says. Then: ‘Where’s Cal? I want Cal.’
‘Cal’s just talking to the security staff. Come on to the ambulance, Jaime. We need to check you over.’
We lead him up the back steps and sit him down. There is a fug of smoke and booze about him that rises up gently into the astringent glare of the ambulance.
‘I was doing a line or two in the toilets, like. Everything was fine, everything was lovely. A wee drink or two, you know? A night out, that’s what I’m saying. You know what I’m saying.’
‘So then what happened?’
‘Well, we’d gotten friendly with these guys. They bought us two a drink, we bought them a drink. Fine. Lovely. I went to do some coke in the toilet. They were there. I gave them a bit. Fine. Lovely. Then back upstairs one of them says to me did I want to come outside for a ciggie? So I says okay, right enough. So I follow him outside, he leads me round by the bins, then before you know it he has me by the throat up against the wall and he says “I kill people for a living”. So I says okay, fair enough. And he says “Give me all your drugs” and I says that was all I had, there, you saw it, I shared it with you, that was everything.’ He looks up at me as if I’m the guy in the alley, then looks down again as the moment passes.
‘So then some other guys turn up, and they throw me on the ground, start jumping up and down on me like I’m a kiddie trampoline, screaming they were going to kill me. Then they took my wallet and went. I had a hundred pound in there. All my cards. Oh my god. My mum’s going to kill me. And my little bro sick, too.’

Rae carries on cleaning his wounds. I step back outside.

Cal is waiting. A tall, lean black kid, he leans against the side of the ambulance smoking with self-possessed economy, blowing out a thin line of smoke, studying the police car as it turns down towards us from the top of the street.

‘Did you see what happened?’
‘Did I see what happened? No. Mate. Listen to me. If I’d seen what happened, it wouldn’t have happened. D’you understand me?’
‘Do you think Jaime was knocked unconscious?’
‘I have no idea about that. You’re the doctor. I think he must’ve been, yeah. He was well battered.’
‘He’s going to need treatment up at the hospital. Are you coming with him?’
Cal takes one more drag on his cigarette, then flicks it away up the alley. Before he goes up the steps onto the ambulance he turns and leans into me, angling his head past my shoulder as if he were about to give me a hug.
‘Things would’ve worked out very different if I’d have been there,’ he says in a low voice.
I give him a couple of encouraging slaps on the shoulder, and leave my hand there in case I need it.
‘It’s a shame he was on his own,’ I say, sounding to myself strangely flat and out of key, like an extra in a film suddenly given a line. ‘I’m sure Jaime wouldn’t have got into trouble if you’d have been there.’
‘No, mate.’ He looks me full in the eyes. ‘I would’ve stabbed the guy.’

cornered

2009-05-30T17:53:00.000Z

This hardware shop is a skewed triangle of a building, dropped into the space left at the end of a row of irregularly shaped terraced houses. It sits there like a darkly painted brick from a child’s toy, the right shape for the right hole, glass fronted, crudely lettered in white paint, with an old fashioned, white and black striped awning already wound out despite the early hour, thrumming and spattering beneath a sudden fall of rain.
There is a policeman sheltering under it.
‘All right, guys?’ he says.
We expect him to lead us straight into the shop, but instead he waggles his fingers confederately. We all huddle up under the awning.
‘Just so you know, your man Patrick inside is not unknown to the police. In fact he’s due in court in a couple of days on a fraud charge. So his story this morning – two heavies mugging him for the float and making him take drugs – well, I’ll leave it up to you to decide. But I would think it’s a classic case of Jackanory.’
‘We’ll bear it in mind.’
The policeman answers a call on his radio. ‘Yeah – LOB,’ he says, and waves us on. We make our way inside.

The shop is dark, despite a couple of yellowing strip lights precariously tacked to the ceiling and an angle-poise on the worn wooden counter. Even the shadows reek of oil. There is another policeman standing propped against some steel shelving with his arms folded. To his left, up against the counter and slumped on an upturned bucket, is a man in his sixties, dressed in a tight brown jersey and brown trousers. He is a study in dejection, the vee of his legs like an open drain for the energy pouring from his hands and his downturned face.
‘Patrick?’
His eyes and mouth remained zip-locked.
‘It’s the ambulance, Patrick. What’s happened to you this morning?’
‘Come on, Patrick. Tell these good people what you told us.’
Patrick raises his head but his eyes remain closed. He talks quietly, in a voice as dessicated and brittle as the fly husks on display with the cans and things in the window.
‘When I opened up this morning, two men pushed their way into the shop. They demanded money. When I said I didn’t have any, they hit me over the head with a piece of wood, then forced me to swallow some tablets. I don’t know what they were. They said they might do me some good.’
The policeman holds up a plain wooden stake.
‘This is what they’re supposed to have used.’
‘Is that right? Is that what they used, Patrick? Where did they hit you?’
‘Across my forehead, and across my arms.’
I look more closely at his face. The only marks I can see are a few speckled scabs of eczema. There is no evidence of any violence.
Patrick’s eyes remain closed.
‘Were you knocked out, Patrick?’
‘No. I don’t think so.’
‘Did you fall down?’
‘No. I kept my feet.’
He suddenly opens his eyes and looks at me, but it is a two dimensional expression, curiously fixed and unexpectant. I feel as if I’m being scrutinised by a mannequin.
‘It’s happened before. They’re always doing it. They demand money to leave me alone. They’re drug dealers. The police know about it but chose not to do anything, I don’t know why. I’ve been left to cope on my own.’
We give him a check over, which he suffers to happen with the same, flat expression of sufferance.
‘Everything seems fine, Patrick. How do you feel in yourself?’
‘Woozy.’
Rae goes into the back of the shop to see if she can find some examples of the pills Patrick says he was forced to swallow. The chain-link fly curtain swooshes behind her with a rattle.
The first policeman comes into the shop from outside.
‘How are we doing?’ he says, and when I tell him he folds his arms and says: ‘Okay. Look. In the spirit of openness, Patrick. What I suggest is that we say nothing more about this. You know and I know that this is nothing more than a diversionary tactic to get you out of appearing in court. But that’s not going to happen, is it? Let’s be realistic.’
‘You tell me. You seem to know everything.’
‘Well I don’t know everything, Patrick, but I know a fair bit about this. And this is a big waste of everybody’s time. Where’s the evidence of a struggle? Where are the witnesses?’
‘I don’t know. You tell me.’
‘I will tell you, Patrick. They don’t exist, Patrick. So what I suggest is that we drop the pretence and say no more about it. It’s a generous offer, Patrick. Let’s forget the whole thing so everyone can go about their business. But if you carry it on, I can tell you now it won’t do you the slightest bit of good. In fact, it can only make things worse. So what do you say?’
Patrick resumes the position he was in when we first came into the shop.
‘Patrick?’
I touch him on the shoulder.
‘From the ambulance point of view, there doesn’t seem to be anything wrong with you, Patrick. But our protocol is that if you want us to take you to hospital, we will. Is that what you want to happen?’
Without looking up he says: ‘I was attacked this morning by two men.’
‘Well then we’ll go to hospital. Come on. Let’s go out to the vehicle.’
At first he seems poised on the edge of a pseudo-fit, dropping his arms down by his side, tipping his head back, working up some tremors in his legs.
‘What are you doing, Patrick?’
He hesitates, gives up on that idea, stands up.
‘Let’s go,’ he says.

Outside, his shop assistant rolls up on his bike with a juddering squeal of brakes.
‘Patrick! Has it happened again?’, he says. ‘Two men pushing their way in, demanding money?’
We all look at him.

Is that a wig?

safe little dogs

2009-05-24T17:16:00.000Z

On the driveway of the block of flats there is an elderly woman standing half in and half out of a car, one hand on the open door and the other fiddling with a bunch of keys.
‘Is it for Richardson? Flat forty?’ she says. ‘Have you come for my daughter, Jane?’
‘Who are you?’
‘I’m her mum.’
‘Yep, we’ve come for your daughter.’
There is a little boy in the passenger seat. He studies me through the dirty windscreen.
‘I’ll just go straight up the hospital and see you there,’ the woman says, getting back into the car.
‘Okay.’
We hurry on inside.

The lift descends and opens. Two woman like hyper inflated character balloons bustle and jostle each other as they struggle out of the lift with a couple of bichon frises.
‘Morning,’ I say to them.
They all look horrified.

We let them pass, then carry on up to the fifteenth floor.
The lift door opens onto a man so consumptively thin he could hide behind a cane.
‘Hurry up, guys. She’s really done it this time.’
He leads us through a stark and dirty flat into a galley kitchen where his ex-wife Jane is lying on her back, blue lipped and unmoving.
‘I think she took some heroin,’ he says. ‘I just nipped out to the shops to get some things in. I was only gone a minute. Do you think she’ll make it?’
I set to work clearing and securing her airway, using a BVM to breathe for her, whilst Rae draws up some narcan to counteract the effect of the heroin.
‘I was here about four days ago, same thing,’ says Rae. ‘She’s pushing her luck.’
‘There’s some dodgy gear about,’ the partner says. ‘I told her not to take it on her own.’
‘Can you fetch us her list of medications please?’ Rae asks him. As soon as he’s gone she says: ‘Exactly the same last time. Only then the little boy was in the sitting room on the couch, watching the whole thing. I reported it to social services, but I haven’t heard back yet. Did you see him in the car just now?’
‘Was that him?’
‘Yeah – with the grandma. I’m not happy about this. I wouldn’t mind betting they called the grandma over to make it look as if she had the kid the whole time.’

The partner comes in again with a scrip.
‘How’s she doing?’
‘She’s making some effort to breathe for herself now. It shouldn’t be long before she’s up and talking to us.’
‘Thanks for coming, guys.’
‘No worries.’

Jane sits on the edge of the sofa, smoking a roll-up. Mike, her ex, paces about anxiously.
‘Please don’t tell the social,’ she says. ‘I’ll lose my boy for sure.’
‘We’re worried about the way things are at the moment, Jane. Not just for you, but for Josh, too. What happens if you take an OD like today and he gets left on his own? What would he do? How would that be for him?’
‘But he doesn’t stay with me. He stays with his Grandma.’
‘He was here when this happened to you just the other week, Jane. It was me who brought you back from the dead then, too.’
‘I am grateful, and I’m sorry. But please don’t tell the social. They’ll get the wrong end of the stick and I’ll lose little Joshie. I don’t know what I’d do if they took Joshie away.’
She starts crying, dragging fixedly on the cigarette between sobs.
‘The boy’s okay,’ says Mike. ‘His grandma takes good care of him.’
‘You can see our worries, though, can’t you? You can see how it looks to us?’
‘Yeah – of course. But please – don’t tell the social.’

Jane refuses to come to hospital, even though we explain that narcan has a short half-life, and the effects will wear off soon.
‘I’ll be with Mike,’ she says. ‘I’ll be fine.’
She signs our release papers, and we leave. As soon as we’re back in the cab, we request some off-road time to fill in a Vulnerable Child form back on base.

The two women we passed in the lobby are exercising their dogs on the slopes in front of the tower block. They play out spools of line to let the dogs wander on the grass, chatting watchfully as the white woolly heads bob up and down, like miniature sheep, grazing.
‘They must shampoo those dogs every day,’ Rae says.
‘And blow dry them.’
I imagine the dogs standing patiently in an aluminium sink, suffering jug after jug of warm, cleansing water to wash the suds and the dirt away.
Good, clean, safe little dogs.

I wonder which floor they live on.

coping strategies

2009-05-21T13:09:00.004Z

‘Let me begin by telling you a little bit about myself.’

The HR manager’s words drift out across the room of paramedics with the enervating creep of carbon monoxide. Everyone sprawls, a green slew of bodies scooped up from the big Trust pond in a bucket marked: Continuous Professional Development and tipped into this conference room. The programme today will cover Equality, Diversity, Coping with Stress and Listening Skills.

She smiles with political levels of resilience, and continues.

‘I’ve been a manager all my working life, after completing a degree course in Business and Economics. I worked five years as a senior HR manager with a large department store, enjoying the challenges of that position enormously. The retail world is fascinating, fast-moving, pretty demanding, and I loved it.’

She scans her audience. She reminds me of the robot Gort from The Day the Earth Stood Still. She has the same smooth metal styling, the same bulletproof purity of purpose.

‘But when the business was subject to a takeover, I was forced to evaluate my position with the in-coming regime, and actually found I didn’t much want to work for them. So I took voluntary redundancy and started a new business. In fact I ran away to Guernsey and opened a Bed & Breakfast. I enjoyed that challenge enormously, but anyone will tell you that running your own business is probably one of the most stressful things you can do. So after three years I’d decided that I’d explored everything that particular arena had to offer, and was ready to come back into a more formal place of work. So I joined the ambulance service, and have been here now as senior HR manager for about twelve months or so.’

She lifts her visor to gauge the level of interest.

‘But enough about me. Let’s go round the room and learn a little more about each other. I want you to tell us your name, where you’re from – and one thing you did this weekend that you really enjoyed.’

***

Jeannie is sitting on the bed with both hands resting palm upwards in her lap, the backs of her fingers and her red-painted fingernails lined up and resting against their opposite number, thumbs on top and relaxed, a neat arrangement of studied calm. The soft underside of her arms are turned upwards, and where Jeanie has striped across them with the kitchen knife, the skin stretches apart like a torn stocking.
‘Jeannie – it’s the ambulance. My name’s Spence and this is Rae. I can see you’ve hurt yourself, but what we need to do before we come any closer is to make sure you’re not going to do anything to hurt us.’
She looks across at us with a curiously tender expression.
‘I wouldn’t hurt you,’ she says, and smiles.
‘I just need to get that knife out of the way, though.’
I pick it up by the bloodied black handle and toss it across the room.
‘Any other weapons?’
She gives a shake of the head.
‘Where are the police?’ she says.
‘They couldn’t send anyone at the minute, so we thought we’d come in anyway and see how you were.’
‘That’s nice.’
Her bedsit is a compact world of light and dark, order and disorder. The rucked-up bed that Jeannie sits on is an island in a sea of magazines, food cartons and tangled clothes, but above the squalid brown horizon of all this, neatly tacked-up across the institutional magnolia walls, Jeannie has an array of baby photos, laid out in a grid.
‘My brother’s child,’ she says.
On a pile of books in one corner, there is a red plastic hamster cage.
‘And that’s Aiko. It’s a Japanese word. It means Little Love.’

**

We’ve been put into small groups and asked to think about all the things we do to cope with stress. We are to write them in a list, and then share what we have when we all come back together. The manager drifts between the groups. She comes and sits with us.
‘Show me what’s top of your list,’ she says.
We tell her that meeting back on base, sitting with our colleagues in the mess room, talking about the jobs we’ve done – this is one of the most helpful things. They’ll have come up against the same jobs, we say. They’ll have a view on it.
‘Unfortunately as you know the move is away from ambulance stations as such, so let’s just put that idea to one side and think about what other mechanisms you have to cope with stress. I see here you’ve written sport down. Good. Sport’s a good one. Doesn’t it create endorphins, or something? Is that right? You’re the experts.’

**

I clean Jeannie’s arms with a gauze pad soaked in sterile water. The new wounds overlay older wounds, where the skin has knitted back together in a tangle of puce coloured scar tissue.
‘I’ve had a few grafts,’ she says.
I bandage her arms up right and left.
‘One or two of these need attention at the hospital, Jeannie. Plus I’m not happy leaving you here alone. Will you come with us to the hospital? You’ll be able to talk to someone there.’
‘I think I’ve done enough talking,’ she says. ‘I’m all talked out.’
‘But you will come with us?’
‘If you want.’
She puts on a heavy brown woollen jacket, and roots about for her keys.
‘I’ll have a tidy up tomorrow,’ she says. ‘See you later, Aiko.’

**

The HR manager stands alongside a flip chart and explains how stress works.
‘I spent some time with the Samaritans,’ she says. ‘They deal with this stuff all the time, and they have a really interesting way of explaining the equation of stress, if you like – and it’s a diagram that I found really useful. I’ll draw it for you.’
With a fat black marker pen she squeaks out a more than wedge, then two parallel lines cutting down across the middle of it.
‘This end of the wedge you might call extreme happiness, or euphoria. The kind of feeling you have when you first fall in love, or look at a newborn baby. This end – the thin end – you might call despair, depression, suicidal thoughts, when you feel you can’t carry on. Of course, no-one could live either absurdly happy all the time, here at the euphoric end of the spectrum, but by the same token, nor could they live constantly in the pits of despair. So what happens is, people live mostly in the comfort zone, which is here, in the middle. Neither too happy or too sad. And what happens is that their emotional life is a series of little adjustments, sometimes this way, towards happiness, or sometimes this way, towards despair. It’s a constant battle to maintain the status quo here in the middle, the comfort zone.’

She taps the marker pen in her hand and gives us a sly look.

‘Now – here’s a story for you. A man rings up saying he wants to kill himself. Okay. Fine. The Samaritan is trained to deal with this. He says something like: ‘What’s happened?’ And then the man turns round and says he wants to kill himself because his toaster has broken. What do you make of that?’

Frank puts his hand up.

‘Has he got a grill?’

**

These pavements are the town’s arteries and these people its blood cells, pulsing through town, bustling and jostling beneath the high midday sun.
Jeannie sits with me in the back of the ambulance, staring out through the window as we rattle on towards the hospital.
A woman and her partner cross the street with a buggy.
‘You should see my brother’s baby,’ she says. ‘She’s such a cutie.’

**

Day Three of the course runs to a close. The HR manager thanks us for our participation and wishes us luck in our careers. She packs away her folder and pens as we make for the door. Outside in the hotel car park the spring air flaps around us, its heady blue flavours cut with pine bark chippings, softening tarmac and chip fat drifting out from the kitchen windows.
I say goodbye to the others and climb into my car.

Never has it felt so safe, so musical, so mine.

moving to fiji

2009-05-17T13:20:00.005Z

A police car is parked outside the all-night pizza place, a small group of people standing outside. We walk over. A middle-aged man with a bloodied face is talking to a couple of officers. I wait just to the side whilst he finishes what he has to say, then introduce myself.
The man gives me a slantways look.
‘I don’t need no ambulance,’ he says. ‘I just want to go home.’
‘Let’s have a chat on the truck, clean you up a bit and see what the damage is, then we’ll decide what to do next.’
‘Okay. Fine. Whatever.’
‘What’s your name?’
‘Is that a police question?’
‘No. It’s just a "what’s your name" type question.’
‘What’s your name?’
‘Spence.’
‘Spence? Whatever kind of name is that? What’s your first name? Pound-Shilling?’
He smirks, then hawks some blood out onto the pavement.
‘So are you going to tell me your name?’
‘Oh. Yeah. My ‘name’. It’s Murphy. Okay? Easy one to spell.’
The policewoman gives me an apologetic look, then says to Murphy: ‘Just behave and go with these people. We’ve got all we need and we’ll be in touch.’
‘Great. Be in touch. I know what you mean.’
I help him into the truck. Rae shows him to a seat.
‘Tell us what happened.’
‘Life, that’s what happened, Henny Pen. I was just swapping banter with some kids in the pizza place, they went mental, I got a battering. This one guy, he just kept punching and punching me. As hard as he could, working his fist right into my face. I haven’t had a beating like that since I were a kid. For what? For talking like a normal human being. For being human.’
He gives his swollen face some exploratory prods with his finger, and winces.
‘I don’t deserve that. No one does. I know I can be a bit mouthy sometimes, but I’m a decent bloke, at the bottom of it all.’
I start to clean his head up with a saline-soaked gauze swab.
‘Were you knocked out, Murphy?’
‘It’ll take more than those chimps to put me down.’
‘Well you’ve got a deep cut just here that’ll need glueing. And I think you might need an x-ray to rule out any facial fractures.’
‘No mate. I just want to go home and sleep it off.’
‘That’s not something we’d recommend, Murphy.’
He stares at a bloody tissue in his hands.
‘D’you know what, mate? I’ve had just about enough of this western world.’
I rip open some fresh swabs.
‘I don’t know there’s anywhere that’s free of this kind of stuff,’ I say. ‘I was brought up in the country, and we had our fair share of after-pub violence.’
‘Yeah? Well – there’s always Fiji.’
‘Fiji?’
‘Yeah. Fiji.’
‘Is that a good place, then?’
‘I have not the slightest idea.’

He grunts, smiles crookedly, then offers up his right palm, american style. I smack it.
‘Good one,’ I say.
He relaxes his hand back down onto his lap and then stares at it, like it just operated on its own accord. Then he sighs wetly through his nose and spits some more blood into a tissue.
I carry on cleaning him up.
Suddenly he says: ‘I can’t bear that my kids will have to see me like this tomorrow.’
And he starts to cry, shaking apart in the chair with sharp little jerks of his shoulders.
‘My kids love me,’ he chokes. ‘I am loved. I am loved. I don’t deserve this.’
We clean him up as best we can, and when we’re done, we take him to the hospital.

don't call me ruby

2009-05-14T16:00:00.001Z

Mrs Elswick is stretched out on the bedroom carpet between the second of the two single beds and the wall. She is neatly arranged; someone has put a pillow under her head and a duvet on top. She lies there looking up at us, her jaw springing up and down like a ventriloquist’s dummy on the back seat of a car.
‘I fell off the edge of the bed,’ she chatters.
Frank checks her over. There are two community responders in the hallway talking to Mr Elswick, a worn and rounded man with a habit of staring fixedly then blinking twice as an afterthought. He is standing in front of a long wall mirror; the effect is of someone split down the middle.
‘The very same thing happened yesterday,’ he says. ‘I just don’t know what to do.’
‘We’ll have a chair please, Spence,’ says Frank.

Out on the truck we run through our medical shtick.
‘We’ll be coming at you from all angles,’ says Frank, hauling out the ECG leads. ‘Like a pit stop at the Formula One.’
‘Ooh yes,’ says Mrs Elswick.
‘I’ll do your tyres,’ I say.
She doesn’t hear me.
Frank towers above the scene, his hands working with the easy autonomy that comes with repetition. If I looked into his eyes now I would catch him slouched back with his feet up on his brain’s console, flicking through a magazine.
‘Erm - one of the community responders told me not to call you Ruby,’ he says, peeling open the ECG dots, flipping the clear plastic circles into a vomit bowel and sticking her up. ‘Why’s that, then?’
‘Ruby’s my middle name,’ says Mrs Elswick, her jaw working up and down.
‘So what do you like being called?’
‘Ruby.’
Frank switches on the ECG monitor and feels her pulse.
‘I don’t get it. We’re not to call you Ruby, but it’s your middle name, and it’s what you like to be called.’
‘Yes.’
‘I’m missing something.’
Mrs Elswick rolls her eyes upwards in an exaggerated expression of teacherly despair, but any fine motor function is difficult whilst her jaw springs up and down as it does.
‘My middle name’s Ruby, but my Father said I shouldn’t ever use it. He said it was a tart’s name.’
‘What nonsense,’ says Frank, poking a thermometer in her ear and sniffing at the result. ‘Now - rhubarb. That’s a tart’s name.’

We are all laughing when I open the door to Mr Elswick.
He blinks up at us, twice, with great precision.

who will be there?

2009-05-11T11:30:00.004Z

‘Are you the man who stole my chairs, my carpets and my pictures?’
‘No. My name’s Spence and this is Rae. We’re from the ambulance.’
‘Are you sure?’
‘Yep. Your neighbour, Sheila, has called us because she’s worried about you.’
‘Every last stick of furniture gone, the carpets, everything. It’s an absolute scandal. Are you sure it wasn’t you?’
Margaret leans forward and scans me with eyes so ancient they carry only a memory of blue. She is sitting in her coat, buttoned up, ready for the off, her battered old brown handbag clasped on her lap. Sheila is standing next to her with one hand on her shoulder, as if she is posing for a plate photograph.
‘She’s not herself,’ she says.

Out on the ambulance, Margaret settles into the seat and brightens.
‘Are you taking me home?’
‘Where is your home, Margaret?’
She gives the address we have just led her out of.
‘Do you know why we’re here today, Margaret?’
‘I haven’t the faintest idea,’ she says, drawing her handbag closer to her. ‘All I know is that some man came and took my furniture and he had no right to it. I think it was you. I think this is all part of your stupid game.’
‘The reason Sheila called us out was that you don’t seem yourself. She says you’ve been very confused these past few days.’
‘Confused? My dear, I was fifty years in the government. I think you’ll find I know precisely what day of the week it is.’
Her eyes bore into me, two topaz stones set in a weathered mask.
‘And I want my furniture back.’

Later in the journey she asks me again where we are taking her.
‘To the hospital,’ I say. ‘You need to see a doctor.’
She pauses. A confusion settles on her, then lifts, then settles again.
‘Will my parents be there?’ she says. ‘My elder brother Jeremy?’
‘How old is Jeremy?’ I ask her, as gently as I can.
‘Forty,’ she says.
Then she looks at me, and smiles, as the ambulance floods with time.

scoot the merciful

2009-05-07T08:55:00.005Z

The notes tell us we will be met.
As we push through the revolving doors into the hotel lobby there is a fierce haircut of a man in white shirt and red waist coat standing in the centre spot of the circular parquet floor, his legs apart and his hands lightly clasped in front of him. He makes no gesture of recognition, or sign of any kind.
It hardly needs saying, but: ‘Ambulance.’
Without moving anything other than his lips, he says:
‘This way.’
Then with a lean limbed economy, pivots and strides off up the main staircase.
‘So what’s happened here tonight?’
‘They tell you.’
‘Okay. Good.’
He leads us onto the first landing where a young girl is lying in the recovery position. A select audience of hotel staff have lined themselves up in order of seniority along the opposite wall, from Chamber Maid to Manager. I could be a detective entering a murder scene. I should be saying: ‘Nobody leaves until I say so,’ but instead begin with the usual: ‘What’s happened?’
The Manager, a Praying Mantis in a stripy three piece and shiny shoes, steps forward.
‘My security staff were alerted to a disturbance in room 44, this lady’s room. People had heard loud voices, crashing noises, and so on and so forth. My staff had to force their way into the room, found this lady on the bed and her partner in the bathroom. When they helped the lady out of the room, she complained of feeling dizzy, so they assisted her to the floor, which is where you find her now.’
‘And did anyone call the police?’
‘I am assured they will be here soon.’
I kneel beside the patient. A heavy set girl in her early twenties, her age weighs more heavily in her face than it should. She seems embarrassed rather than distressed, reluctant rather than unable to talk. No apparent injuries. We sit her up.
She puts one hand to her face as if she is trying to remember something, then suddenly stands up decisively.
‘Let’s go to the ambulance,’ she says.
The manager and his staff almost applaud.

The ambulance sits outside the hotel, a cosy box of light amongst the feral noises of a Saturday night, flowing round us, moving on.
Leila says he’s attacked her before. Last time with a knife. Leila shows us a tiny scar just underneath her chin. Tonight they were arguing, she doesn’t remember what about. He grabbed her, threw her against the wardrobe, bruised her arms where he held her, scratched her breasts. She tells us this with a muted attention to detail that would seem casually conversational were it not for the context.
There is a knock on the door.
I let a policewoman on board.
‘Could one of you go back up and have a look at Ken, the other party? He’s had a bash to the head and an eye injury.’

En route to the hospital. Leila is back at the hotel being questioned by the police, Ken is on the ambulance, a head wound from an ashtray and an eye that’s been poked with a fingernail.
‘This is shit, man,’ he says.
The policeman riding with us says nothing. He looks exactly like the guy who met us in the lobby at the beginning. How could that be?
He smiles.

I hand in the paperwork at reception.
‘Is Scoot still there?’ I ask Zoe.
‘Yeah – come on.’ She opens the door and lets me in.
Scoot is exactly where he’s been all night, bundled up in blankets beneath the desk in the storeroom.
‘Hey Scoot. What d’ya say, what d’ya know?’
He looks up, gives my hand a sniff, then grants a dab or two of his head.
‘I dunno, Scoot. People, ay?’
Suddenly Scoot looks up, as if he is listening to a command from far away. But then he relaxes again as the impulse fades, gives a jaded smack of the lips, and settles himself back down amongst the blankets.

Scoot the Merciful at peace again, the fluorescent lights of the A&E department burning on through the night around him.

scoot

2009-05-06T09:47:00.002Z

A&E reception stands guard over the entrances to the Walk-In minors, GP out of hours and major zones. It is a foursquare, plexiglass temple to Admin Kali, the multi-tasking Mother of Process and Information, Creator of Record, Taker of Number, Keeper, Caller, Confessor. Zoe and Claire are two of her acolytes. I imagine they were free administrative spirits haunting a grove here on this hill a thousand years ago, and the hospital was built around them. Now they are caught within these walls, and the years have stacked up, and the ambulance crews come and go, endlessly bowling in through the magic doors with snow in their hair or rain on their shoulders or sunshine on their backs, a relentless train of pilgrims wheeling past the windows, surrendering their paper tributes, bothering them for pens.

Today as Rae and I hand in our patient report form Zoe stands up and smiles.
‘Come round and have a look at what we’ve got,’ she says. ‘You’re going to love it. Come on.’
She slides the hatch closed and then comes round to let us in through the security door.
‘Have a look in there,’ Zoe says, pointing in to their little storeroom.
Under a desk there is a dog curled nose to tail in a nest of blankets. It looks up.
‘His name’s Scoot.’
Scoot is a Springer Spaniel, a ragged brown and white scrap of a dog whose black eyes seem to make up four fifths of his body. His expression is so desperately mournful even Disney would have blushed. It fells us both, bringing us to our knees beside the nest.
Claire appears in the doorway behind Zoe.
‘What do you think of our new assistant?’ she says.
‘He’s so-o-o cute,’ says Rae, mussing the dog. ‘I want him.’
‘Well what he wants is another Cheddar biscuit,’ says Claire. She produces half a packet. It makes its way along the line to Rae, who taps one out and presents it to the dog. But Scoot’s either eaten his fill or he’s too overcome with depression – a condition which, judging by his expression, he has learned to live with. He gives the biscuit a disappointed sniff and then plumps himself back down again.
‘How did you get Scoot?’
‘He came in with a woman who’s taken an overdose. Nothing too serious, but they’re keeping her on CDU for a little longer. It’s not worth calling the RSPCA ‘cos she’ll probably be discharged tonight. So we offered to look after him. And he’s no bother at all – are you? Are you?’
Scoot raises his eyebrows in our direction, then carries on staring at his front paws.
‘Trouble is, we’ve just heard matron is coming on at seven, and she’ll have us all taken out and shot.’
‘She never comes in at that time!’ says Claire, kicking the door frame. ‘Why now? It’s so typical of her.’
‘I don’t think even Matron would mind about Scoot, though,’ says Rae. ‘I mean, look at him!’
We all look at him.
Scoot gives a professional sigh, and wriggles down further amongst the blankets.

Outside, a crew wheels past the serving hatch with a man strapped and groaning on a spinal board.

Rae places the cheddar biscuit next to the vomit bowl filled with drinking water, gives Scoot a last, loving fuss, then stands up. Her knees give an audible crack and she staggers slightly.
‘You’re worse than me,’ says Zoe, offering her one of the biscuits. ‘You’re falling to bits.’
‘I don’t think I’ll do anything else tonight,’ says Rae, snapping down the biscuit in two bites and smacking the crumbs from her hands. ‘I think I’ll just curl up under the desk with Scootie pie. And if Matron comes in and makes a fuss, well then I’ll just have to bite her bony butt. We don’t care, do we Scoots? We don’t care.’

But the dog is already asleep.