Thursday, October 23, 2014

the good

Malcolm, Chieftain of Drunks, a ruined, powerful man, a man whose barrel chest and protruding eyes make him look like a boiler about to blow, a man on first name terms with every agency you can think of, ex-para, ex-con, ex-IVDU, a brutal and brutalised man with a curiously feminine haircut, is sitting on the concrete steps outside the block of flats with his hands cuffed behind his back, surrounded by police. It’s like an extemporary street party, with Malcolm the Master of Ceremonies, presiding over the whole thing with a booming tirade that no-one minds at all:

‘Ah’m not taking another step without a smoke of my fag. But how’m ah s’posed to smoke it all troosed up like a Christmas turkeh, yah feckin’ wally, yous? Come on. You’ll just hev to hold it to mah mooth so ah’s can take a wee puff. Don’ look so scared, man. It’s not like ah’m askin’ you to tug mah willy, s’at? Come on, now. There you go. Now maybe I’ll think about answering yah feckin’ schoolboy questions. (...) I’ve told yez all wha’ happen. Ah wus only wadin’ in like to help mah fren. Anybody would! Scept maybe this one, yah lunkin’ great shite. I cannae think of you doin much more than tha’ washin’ up. Yah! You know it! Look at him, laughin’ away up there. Aye! Laugh it up, big man. You’re the one who’s sittin’ up all night wi’ the paperwork, yah buzzy big shite, yous. Yah dizzy wee Columbo. (...) Anyways. Ah’ve told yous. You’ve got the wrong man, son. I don’ understand why yah restin’ me fer, when I was only doin’ wha’ you should’ve been doin’. I was the one stoppin’ a man fram gettin’ killed tonight why yous was all tucked up in bed playin’ wi’ yerseln. (...) I told you. They come out of nowhere. Out of the air fer all I know. They were all over me, man. Like feckin’ foxes or something. With their shiting little razors. They don’ fight fair, y’ah nae. Not at all. But they don’ know me, I can tell you that. They don’t know I fight army style. I get in there – bam! – wi’ a chop to the adam’s apple and a thumb in the eye. Don’ look so scared, matey, yah big wee fairy. Although I could still take you with my hands behind mah back.  I could kill yous with a fart. Come on, now. Jes’ glue my cuts, you useless cunts, and I’ll be on mah way. I did a bit of gluin’ myseln’, as you can see. Wha’ d’you think of mah handiwork? (...) All I want is to go back home and finish mah film. (...) Wha? (...) The good, the bad, the ugly. Why? Have you seen it? You’ll know wha’ ahm talkin’ about, then. That’s me, all right. The good. The good. Why? What’re tryin’ to say? I don’ like what your incineratin’, pal.’

Monday, October 20, 2014

the paris tapes

 A woman walking her chihuahua; a woman flapping a dishcloth from an upper window; a man in a suit hurrying to work with a take-away coffee; a jogger doing her warm-down stretches on the railings opposite; a woman standing out on the porch next door smoking a cigarette; two medics, RAE & SPENCE, standing on the pavement with MR GREEN, an elderly man, just in front of them, waving his arms and shouting.

MR GREEN: And you! Everyone can see you for what you are. This one’s screwing you up the arse. This one’s going to prison for stealing. Call yourself paramedics? You’re glorified taxi drivers. You can’t even do that properly. I’m a professor. I’ve got a PhD. Do you even know what that is? Of course you don’t. You’re too idle and stupid. Look at you, with your silly little bag and clipboard. I know Princess Diana. I have houses in Monte Carlo and San Tropez. Do you think I don’t know you’re stealing from me?

RAE: Could you please just go back inside the house now. The police will be here soon. They can sort it out.

MR GREEN: Good! I’m glad! They’ll arrest you both for assault. You’ll be thrown in jail and everyone will see what a fucking bad show you’ve made of your life.

RAE: You’re obnoxious and abusive and I need you to step away from me, sir. Just go back inside and leave us alone.

MR GREEN: Oh? So now you’re telling me to go back into my own home! Is that what it is? This is a free country. I’ll do what I jolly well like.

RAE: Fine. As I say, the police are on their way.

MR GREEN: Let them come.

The man suddenly hurries back inside, only pausing on the steps to swear one last time at the paramedics before slamming the door shut behind him. A police car pulls up on blue lights. Two police officers get out, tazer guns in evidence on their hips.

1ST OFFICER: All right?

RAE: Thanks for coming guys. We’ll fill you in.

The woman with the chihuahua hurries over to the other side of the street.


RAE & SPENCE standing at the door of a house that’s been converted into flats. RAE presses a buzzer on the intercom. Almost immediately an irritable voice crackles through the speaker, not so much in answer to the call as being interrupted in the middle of an on-going conversation.

MR GREEN: I simply don’t understand what you want from me. Why are you harassing me in this manner? Am I not safe in my own home? Why are you coming to me with all these problems when all I require is the carer to come when they said they would come...

RAE: Leaning in. Hello? It’s the ambulance service.

MR GREEN: Yes, yes. I know very well who you are. Do you think I’m stupid? Look – what are you going to do about all this? I’m sick to death of all your repeated failures to address the central issues here...

RAE: Sorry to interrupt, Mr Green. Shall we come up and talk to you face to face? Rather than through the intercom?


INT. DAY. A warm, well-kept hallway, bikes, strollers and neatly stacked mail. Mr Green’s flat is at the top of the stairs. RAE & SPENCE go up. RAE knocks on the door. MR GREEN throws it open and stands there, breathing heavily. A simian quality to him, active, wiry and ill-contained.

MR GREEN: (shouting) I have ataxia! Do you even know what that is?

RAE: A neurological disorder that affects motor function. Shall we come in?

MR GREEN stares at her a moment, both his eyebrows bobbing up and down in unison.

He doesn’t!’ (stabbing a finger at SPENCE). He turns on the spot and holds the door open.
You’d better sort this out!

RAE: Okay. First things first. Can I ask your name?

FX: phone rings. MR GREEN picks it up, shouts into the receiver, then slams the phone down again.

MR GREEN:  Look. What have you done about it? When are you actually going to do something instead of all this useless standing around? Hmm? I have ataxia! I’m dying! I’ll be dead soon and it’ll be your fault.

RAE: How about we calm down, have a seat and talk about what’s going on today?

MR GREEN: You’re telling me to have a seat in my own home? What right have you to say these things? Who the hell do you think you are?

RAE: Mr Green...

MR GREEN: Don’t Mr Green me. Do your job, that’s what you’re paid for, isn’t it? Or have you just come to bully your way into my house and take what isn’t yours?

RAE: Please just try to keep your temper, Mr Green. Do you need our help or not? All we’ve been told is that you’d rung to say your carer was late and then hung up...

MR GREEN: Yes! I cut them off like they cut me off! Those bastards! And what do you think you can do? With your stupid bag and haircut? And him! Look at him! Skulking in the background. Have you come to rob me sir? Have you come to do me in? I’ll talk to you but not to him. I want him out of my house! Get out! Get out!

MR GREEN suddenly runs at SPENCE with his arms flailing in the air. He tries to push SPENCE against the wall, who struggles to restrain him by catching hold of his wrists. RAE ends up standing inside the room whilst SPENCE grapples with MR GREEN by the door. MR GREEN tries to kick the door shut with the back of his foot; SPENCE blocks it; RAE helps turn MR GREEN away from the doorway to make enough room to struggle back out with their bags. When SPENCE lets go of the old man’s hands MR GREEN tries to jump on him again. SPENCE pushes him back with the flat of his hand in the middle of his chest.

MR GREEN: Help! They’re attacking me! Get out of my house! Get out!’

RAE: We’re trying to! Stay back there whilst we leave.


He hurries past the medics, down the stairs to the front door. He stands there with his arms and legs outstretched. RAE calls for urgent police back-up.

RAE: Please! Mr Green! (clipping her radio back on) This is silly.

MR GREEN: (shouting up the stairs) You’re not leaving! I’m not letting you get away with this!

RAE:  Fine. You stay down there; we’ll stay up here, and we’ll all wait for the police.

Suddenly MR GREEN pushes himself forwards again and marches back up the stairs. The medics retreat up the next set of stairs. MR GREEN goes into his flat but doesn’t shut the door. The medics hurry down into the hallway and leave the building.


Mr Green storms outside to confront the medics on the pavement.
(Woman with chihuahua, man with suit etc.)



RAE: You’re not going to arrest us for assault, then?

POLICE OFFICER #1: (laughing) Nah! Funnily enough, Mr Green was as nice as pie with us. Just went on and on about his PhD and his fancy foreign houses. He’s got some on-going beef with – well, just about everyone. He says he doesn’t want any medical help. I don’t know what you think? Apparently community mental health are aware, and we’ll certainly be talking to them. I’m surprised you haven’t got this address tagged already. We’ve certainly got something to say he’s a handful and single responders shouldn’t attend. Anyway, so long as you’re both okay. We’ll put in a vulnerable adult form and chase things up our end. But that’s about it.

POLICE OFFICER #2: (leaning over to slap SPENCE on the shoulder) I don’t want to worry you mate, but apparently he says he’s going to tell Princess Di all about you.

POLICE OFFICER #1: Yeah! And we didn’t think it was a great time to tell him about Paris.

feeding chips to the dead

Helen is sitting comfortably in her favourite chair, wired up to the Lifepack, her arm in a BP cuff, her finger in a SATS probe, pinching a tissue in her other hand to the pin-prick where we took a sample of blood. She seems quite content though, like a melancholy queen surrounded by disappointing courtiers. There are four of us in attendance: Rae, me, and Helen’s two neighbours, Martin and Sheila, a bright, elderly couple, striding from the kitchen to the sitting room with tea, toast and information.
‘I think Helen’s son Richard’s the nearest, but it’s still a fair stretch for him to come.’
‘Diane’s had more to do with everything.’
‘Yes, but she’s in Spain. I hardly think she’s going to fly back today.’
‘If I know Richard, he’ll be straight down in the car.’
‘They’re both so good.’
‘It’s just getting very difficult for them. For everyone.’
‘Do you want me to call Richard?’ says Martin, picking up the phone. ‘I’ve got his number right here.’
‘Let’s just figure out what we’re going to do next, then we’ll give him a call,’ says Rae.
‘Right you are.’
‘Oh, don’t bother Richard,’ says Helen. ‘He’s got enough on his plate.’
All her observations are fine. Any chest pain she may have had early that morning has resolved. There’s nothing on the ECG, and nothing of concern anywhere else. I start taking everything off.
‘Good,’ says Helen. ‘Now I can have my breakfast in peace.’
‘It’s a bit of a worry,’ says Sheila, standing in the doorway, drying a cup. ‘Helen did have more care organised, but cancelled it because it was costing too much.’
‘I think not taking the medication has been a factor,’ says Rae. ‘Stepping the care back up would be good. The GP should co-ordinate all that, but we’ll certainly do our bit to flag it up.’
‘Could you? That’d be great’ says Sheila, ducking back into the kitchen.
‘I fed chips to the dead once,’ says Helen, calmly taking another bite of toast.
‘Oh? Hello!’ says Martin. ‘Hallucinations! Tick that box.’
‘So what happened?’ says Rae, sitting back a little, her pen poised over the clipboard. ‘Where was this?’
‘Oh, years and years ago. I was with my friend Rose. We’d bought a bag of chips each and we were eating them outside the shop when I said why don’t we go and sit somewhere comfortable? So we went over the road into the churchyard. We sat down on this old tomb by the side of the church, and started eating our chips. All of a sudden, this big, booming voice come up from the ground and it said: Those chips smell nice. Give us a couple. Well of course Rose dropped her bag and ran off screaming. I wanted to see what happened though. So I said to the voice: “How’m I supposed to do that, then?” and the voice said: Just pass them down. And the next thing you know, these two hands come up through a grille at the bottom. So I passed them the chips Rose dropped, and they seemed quite happy with that. Well, when I finished my bag, I thought I’d look into it all. So I went round the front and I knocked on the church door. After a while the vicar came out and I said “I’ve just been feeding chips to the dead people in your graveyard” “Oh?” he said. “That’s interesting. And very kind of you, I might add.” So then what he did was he said: “I think I can shed some light on this strange occurrence. But only if you’re feeling brave. Are you feeling brave?” I said I was, so he said “Good. Follow me.” So he led me through the church, through some big old gates at the back, down some steps and in to the crypt underneath the church. We went along there a ways to another set of gates at the far end, and there were two workmen, sitting on a pile of bricks eating Rose’s chips.’

Wednesday, October 15, 2014

the magician's hat

We take a call to a ‘generally unwell’ in-patient at a psychiatric hospital I haven’t been to before.
When we get there, Jake is lying flat on his bed with his legs crossed and both hands laced across his eyes. The psychiatric nurse standing next to him tells us the story: how Jake had been feeling unwell all day with a temperature and some dizziness; how he’d just started to complain of neck pain; how they’d tried to have him assessed in situ, but in the end had to arrange for an ambulance to take him to A&E.
‘So is this a query meningitis?’ I ask him.
He shrugs.
‘No!’ shouts Jake. ‘ I fell over. I was in the toilet and  I felt dizzy, yeah? Next thing I know I’m on the floor. So I crawl onto bed and I haven’t moved since.’
I feel his neck and he yelps when I apply a little pressure on the bone. When I pull my hand away there’s no trace of blood, no other sign of trauma. But still.
‘How was your neck before the fall?’ I ask him.
‘Do you have any funny feelings in your arms or legs? Any pins and needles?’
‘My left leg feels numb.’
I look at the nurse.
‘What’s your take on all this?’ I ask him.
He shrugs again. It’s difficult to tell whether he believes Jake’s story or not, but when I mention C-spine tenderness and immobilisation, he sighs a little. When I ask Jake to talk me through the course of events again his recollection is slightly different, all of which leads me to think he’s an unreliable witness, and this story of a fall lacks credibility. Nevertheless, he did flinch when I pressed in the middle of his neck.
‘It looks like we’ll have to treat you for traumatic neck pain’ I say, as much to the nurse as anyone else.
The nurse remains impassive.
‘So, Jake. That means full immobilisation. We’ll need to fit you with a cervical collar, get you onto our special vacuum mattress, and keep you nice and flat for the journey in. All precautionary. Okay?’
As I leave the room I ask the nurse if their lift will take a trolley.
He closes his eyes and nods, like an obliging maître d.
‘Of course’ he says.

I use the stairs to walk out to the truck, get the trolley, load it up with a scoop stretcher, vac mat, pump, blocks, tape and blankets, and head back in to the hospital.
The nurse on the front desk shows me to the lift and punches in the security code. We chat about this and that as we wait for it to come.
The moment the doors open I can see that the lift is only half the size of the trolley.
‘Is there another, or…?’
The nurse shakes her head sadly.
‘This is it. This is the one.’
‘But the nurse upstairs said it would take a trolley.’
‘It will.’
I look inside the lift again. I’m tired, after all. Maybe it’s like a magician’s hat. You can pull a ladder out of it.
‘I don’t think so,’ I tell her, after I’ve stepped inside and rapped the panels to make sure.
‘Yes, yes! Go on. You will see. They all do it.’
‘The ambulance. They all get their trolleys in there. This is how we bring bodies out.’
‘Go on. Try it.’
Despite the obvious problem, I go ahead and push the trolley inside.
A third of it sticks out.
‘No, no’ says the nurse. ‘Sitting up. You have to sit them up.’
I shrink it down top and bottom. Still, the doors will not shut.
‘More,’ says the nurse. ‘It will go.’
‘Maybe I’m going crazy’ I tell her, immediately conscious of the fact this is a psychiatric facility, ‘but seriously, this is never going to work. Anyway, we shouldn’t even be thinking of sitting our patient up. We’re querying a neck injury. He needs to stay flat.’
‘He can sit up for a bit.’
‘Not really.’
‘Yes. Just for a minute. One minute won’t matter.’
I smile at the nurse.
‘Well, it’s immaterial. The fact is the trolley won’t go in the lift.’
I wheel it back out again.
‘We’ll use a wheelchair,’ I say, putting the brakes on. ‘And the only reason I’m agreeing to that and not carrying him down the stairs is because I don’t seriously think he has hurt his neck.’
‘We don’t carry people,’ she says.
‘No. But we do, unfortunately. You need to get yourself a better lift, though. One that’ll take a trolley.’
‘We have one.’
‘You have one?’
‘Another lift?’
‘Yes. On the other side of the building. But you can’t get there from here.’

Tuesday, October 14, 2014

witness for the prosecco

Gill has drunk too much Prosecco. There was a stack of it at the family get-together, and whether it was nerves at the big gathering, or a tendency to drink too much when she goes out, the fact is she sank the best part of two bottles and suddenly fell ill.
‘She was okay – ish – when we left the restaurant. And the fresh air seemed to help. But we only got as far as this bench and suddenly she said she couldn’t go on anymore and just crashed out.’
Gill’s a pitiful sight, slumped forwards with her arms on her knees, her long hair falling in front of her face, the whole woman and the surrounding pavement as liberally splattered as if a stormy stomach cloud had stopped just above her head and unleashed a monsoon of vomit.
‘The taxis didn’t want to know, as you can appreciate,’ says Ed.
‘I’m surprised they even stopped.’
‘I just don’t want her choking to death,’ he says.
‘Well – she’s not completely spark out, so that’s good. You do have to bear it in mind when you put her down, though.’
‘What do we do, then?’
‘Take her to hospital, I suppose..’
‘I don’t want to waste your time.’
‘It’s okay. So long as she’s safe, that’s the main thing.’
He stands back whilst we set to work, wrapping Gill in a couple of blankets, getting the stretcher up close, angling everything so that what little support she has in her legs is enough to help us stand her up, turn her round and lie her down on the stretcher. It’s difficult not to get any vomit on us – I’m caught out by a strand of hair, and land a generous smear on my shirt front. On the ambulance I get the worst of it off with a cleansing wipe, making a mental note to change my shirt at the earliest opportunity.
Ed rides with us to the hospital.
‘Is it far?’ he says ‘We’re not from round here. We came up for the party.’
Gill moans, heaves, spits.
‘Please don’t spit,’ I tell her, repositioning the bowl.
‘Come on, Gill. Don’t be disgusting,’ says Ed. She makes no sign she recognises him.
I try to gauge Ed’s mood through all this. He seems friendly enough, but there’s something else, some inner tension that I guess is part embarrassment and part unease at seeing his sister like this. I try to show him I don’t really mind, that’s it’s a normal part of our job, but he remains slightly aloof, like he’s holding on to the most aerodynamic emotional shape possible to make it through the night.
‘We’re here!’ I say, unwrapping the blood pressure cuff and making things ready as Rae backs the truck in.
‘If you’d like to get off first’ I say to Ed. He touches Gill on the one clean patch of flesh she has on her shoulder, then makes his way to the back.


Erica the triage nurse listens sympathetically whilst she gets the story.
‘It’s bad enough getting pissed in front of your mum and dad – but actually I think it’s worse when you do it in front of your brother,’ she says, winking at Ed. ‘I don’t know why. Actually, strike that. I do know why. They never let you forget. Ever. It’ll be something else they have over you. Like my brother...’ she laughs. ‘God love him. But that time I disgraced myself big time, he was more than happy to add it to his collection.’
‘Yeah, well. This is serious,’ says Ed. He looks uncomfortable, restlessly changing position on his plastic chair whilst we tend to his sister. She groans, kicks the blankets and splays her legs over the side of the trolley. I cover her up again.
‘Has she had any drugs tonight that you know of?’
‘No. We don’t do drugs. Though, yes... I know ... alcohol is a drug.’
‘I don’t care either way,’ says Erica. ‘It’s just so we don’t have to worry about that and the alcohol.’
‘So what was she drinking?’ asks Erica, taking Gill’s temperature.
‘Mostly Prosecco,’ he says.
‘Prosecco? Ooh, good girl. Fantastic! I love Prosecco,’ says Erica. ‘Mind you, who doesn’t?’
‘Goes down very easily,’ I say, wiping Gill’s mouth and swapping the full bowl for a clean one. ‘Yep. Maybe with a drop of cassis at Christmas. Lovely.’
‘In fact, d’you know what? I think I prefer it to champagne.’
‘Do you? Yeah. Well. Champagne’s pretty amazing. It feels more substantial.’
‘More expensive, don’t you mean?’
‘By a stretch.’
‘Guys, guys...’ says Ed, shaking his head. ‘Come on. I really don’t think this is appropriate.’
‘Oh? How d’you mean?’ says Erica, cooling imperceptibly.
‘Well – you know. Going on about Prosecco like this. When it’s the Prosecco made her sick.’
‘I think you’ll find it wasn’t the Prosecco made her sick,’ says Erica, brightly again, clicking off the screen. ‘It was not having the common sense to know when she’s had enough. But there. That’s a whole other conversation! Cubicle three!’

Monday, October 13, 2014

gift ideas

In the normal run of things you only become aware of frequent fliers over time. They gather momentum slowly, until they’ve acquired enough critical mass for everyone to know the address, the details, every last thing about them.
Yvonne is different. She’s emerged fully formed, Godzilla rising up from the sea. Whatever it took to make her, the nuclear waste and the earthquakes, happened somewhere else, far away. And now suddenly here she is, reeeeooooarrrrghing in the harbour, an ambulance in her claws, shaking the paramedics out.
You can tell I’m tired.
Frequent fliers know when you’re most stretched, least able to cope. They feel it, in supernatural ways.
Yvonne has had an ambulance eight times in the ten days she’s been at the drink & drug dependency hostel. Her MO is always the same: drinks and smokes all day, wakes up in the early hours feeling tight in the chest, rings 999 saying she can’t breathe. The duty manager is never aware the call has been made. She will be sitting on her bed in the smoke-filled room, talking fluently without any wheeze or effort, complaining that she’s unable to breathe and needs a nebuliser.
The first time I went to her I was at the beginning of my run of nights. I gave her a full examination, (blasted in the ears when she carried on talking when my steth was on her chest); found nothing particular, tried hard to understand just why it is she won’t go to see her GP, won’t go to hospital, won’t follow direction about any medication that might have miraculously landed in her hands from somewhere, or any lifestyle change that might improve her situation. For every suggestion a reaction: she can’t get to the GP because her legs don’t work properly, she’s agoraphobic, the doctor isn’t any good anyway; she can’t go to the hospital because she doesn’t want to wait around with all those people, and can’t get back from the hospital because she had no money for a taxi and she had a bad experience on a bus; she has to smoke because she’s living in a hostel full of junkies and how would I feel?; she has sleep apnoea; she has panic attacks; she only wants a nebuliser. Where can she get one for herself?
And like many of the crews who’ve been out to her, I gave her a neb, to shut her up as much as anything else. But then taking it off her was a problem – ‘I want the whole bottle’ she said. I turned it off, unplugged her, to huge protest. We didn’t leave so much as retreat, bullets ricocheting off her hide.
Tonight, again, Yvonne.
Prepared this time.
No, we won’t give her a neb.
She needs to see her GP.
She can’t go on calling an ambulance like this.
We have Rick, the duty manager just outside the door; we call him in to review the situation and to witness the abuse.
‘I’m going to die and it’ll be your fault’ she says.
‘Yvonne, that’s enough’ says Rick. ‘They’ve come to help you. Listen to their advice.’
‘They just tell me what to do. They don’t want to help. Fuck off and leave me alone.’
‘We’ll be talking about this in the morning, Yvonne. We can’t go on like this.’
 ‘You’re not doing your job. I’m going to report you.’
‘These kind people have come to help and you’re refusing to take  their advice.’
‘They’re not nice. They’re wankers. Especially him.’
‘This is going in your file, Yvonne. We’ll talk later.’
‘Why won’t anyone help me? I can’t breathe.’
We retreat to the office.


The rain is really coming down now. The thick, dark leaves of the rhododendron outside the office window rattle and shatter beneath the force of it all. Rick, the duty manager takes his office chair and swings gently from side to side, looking out the window. He doesn’t have an office light on; there’s plenty of illumination from the security light outside, and the effect as it shines through the torrent of water is of the whole building melting and sinking into the ground.
The office couldn’t feel emptier, even though it’s muddled-up with administrative clutter, the trays of files and piles of correspondence, unwashed coffee cups, yesterday’s paper, over-pinned notice boards, dry-wipe boards of essential numbers. Only one computer on, a screen saver image skating round a blank screen.
I’m finishing off the paperwork. A couple of times Yvonne comes to the office counter, planting her arms wide left and right on the counter and fixing us with a stare.
‘I want a neb’
‘I’m not giving you a neb, Yvonne. You know what I think. You should come with us to the hospital or speak to your GP in the morning.’
‘I can’t. I’ve told you. I can’t use my legs.’
‘How did you get to the counter, then?’
She pushes herself back, says she’s going to kill herself, thumps off back down the corridor.
‘Are you going to check on her?’ I ask Rick.
‘Nah,’ he says. ‘She’s been threatening to kill herself the whole time. We’ll have a meeting about it tomorrow. We’re keeping a record in the log.’
I go back to my form.
Yvonne appears one last time. We have the same conversation. She makes the same threat, makes the same stomping noises retreating back to her room.
Rick shakes his head.
‘This can’t go on’ he says.
We talk about the whole 999 thing, how the policy is for an ambulance to be sent regardless of the pattern.
I tell him I’m surprised that Yvonne has surfaced like this here; we normally only associate the hostel with overdoses, respiratory arrests, serious jobs.
He laughs.
‘I know. We’re normally much better value.’
After a minute when we’re all quiet and the sound of the rain is filling the place, Rick shifts heavily in the chair and says: ‘I’ve taken loads of different drugs, you know, but I’ve always shied clear of heroin. I suppose because it’s always seemed such a one way street. But it does have plenty going for it.’
‘I know what you mean. Life’s difficult. It’d be great to take a little something to make it all better. Who wouldn’t want that?’
‘It’s just getting the quantities right.’
‘And not knowing what it’s cut with. I went to a user the other day who freaked when he had a reaction to his hit. He went all flushed and itchy and felt he was going to explode. And that was from his regular dealer.’
I make a few idle strokes on the patient record with my pen.
‘I mean, this was a nice, hard-working guy. He had three jobs, for god’s sake. He had a Burberry cap.’
‘No wonder he took heroin.’
‘He had to pay for it somehow.’
There’s the sound of a door slamming somewhere deep in the hostel, maybe Yvonne, looking to see if we’re coming down the corridor.
‘Yeah. Just enough to smooth things out. So long as you don’t get hooked,’ says Rick.
‘Or infected. I’ve seen some pretty horrendous needle sites. You run out of veins and start shooting up in your groin. Or your feet.’
‘Still. Just a little now and again.’
‘Yeah. It’d be great.’
I put the finishing sentence on the form, sign and date, hand him a copy.
‘Anyway, Rick. At least now I know what to get you for Christmas.’

Monday, October 06, 2014


It seems incredible to me that this is the 900th post on Siren Voices! A huge thank you to everyone for reading & commenting over the years. I know it’s quite a banal thing to say, but it’s absolutely true – I couldn’t possibly have done it without you!

To celebrate, I thought I’d do something a little different, but still in the voices theme: a list of 900 9 random ambulance cab conversations.

1.    ghosts
My Dad said he saw the ghost of an old woman on the stairs of the block he lived in as a kid.
– Did she look ghostly?
– A glowing skull – you know – all Scooby Doo?
– Did she disappear suddenly, walk through a wall?
– Did she hover in mid-air? Cackle a lot?
– So how’d he know she was a ghost then, and not just some random old woman?
Well he hadn’t seen her before.

2.    comets
That Rosetta probe’s landing on a comet sometime soon.
– What comet?
Not one anyone’s heard of. Apparently it looks like a duck.
– What are comets? What are they made of?
I think basically what they are is a loose bunch of gas, rock and ice
– How can you land on that?
It’s difficult. That’s why everyone’s so excited about it
– If the comet’s just a bunch of gas and ice, how come it’s stayed together all this time? How come it doesn’t fly apart?
– How does that work?
Gravity? No-one knows
– And how come something loose like a comet has got enough gravity to keep it together? Why not the whole universe? Why’s that still expanding?
– Is it? I don’t know
But the probe’s landing on this comet sometime soon you say?
– Apparently. Oh, and it’s shaped like a duck.

3.    dragons
I’m going to set up my own business and make a million.
– That’s a good idea
Go on Dragon’s Den
– Yep
All you’ve got to do is ask yourself: what’s the one thing everyone needs?
– Okay.
Go on then.
– All right. A sense of purpose.
– Health and well-being.
– Food and water. Security. I don’t know. A bike.
–  Go on then. I give up.
Personalised underwear.

4.    granddad
My granddad went all through the first world war without a scratch.
– That was lucky.
Once, he was in the trenches and he came to this junction, and he thought Do I go right or left? And he heard this voice in his head saying Go left! Go left! So he went left, and the very next thing, a shell lands in the trench to his right. Killed everyone in it.
– His guardian angel.
Yeah. And then a few months later he was fighting in the ruins of this chateau, and he suddenly realised it was his mum’s family home. She’d eloped with the gardener, and they disinherited her.
–  The gardener, your great-grandad?
Yeah. They cut her off and she never went back. And all those years later, there was granddad, fighting in the ruins.
– If he’d never been back, how’d he know it was his mum’s old house?
I don’t know. How’d he know to turn left and not right?
– A bit psychic, was he?
Yeah. And the weird thing was, he went all through the war, the Somme, you name it, not a scratch. Guess what killed him in the end?
– I don’t know. A whale?
No. Angina.

5.    klutz
Have you ever fallen over in front of a crowd of people?
– Yep. At school, having my photo taken.
What happened?
– The photographer was set-up on stage in the assembly hall. They had this system. Each class was called up in turn, you went on stage, sat down, had your picture taken, and then walked off down the stairs at the back, where everyone was hanging round in the corridor. I hate having my picture taken anyway. I was convinced I couldn’t smile properly, so I always ended up tilting my head on the side and smiling with my lips pressed tightly over my teeth. Like a serial killer, basically. And to make things worse, there was a girl I wanted to impress who’d just had her picture taken before me and I knew she’d be waiting at the bottom of the steps in the corridor with everyone else. So anyway – as soon as the camera flashed and the photographer shouted next, I got up, went to the head of the stairs, and I gave a little skip that was supposed to show everyone what a cool and crazy kid I was – except I didn’t take into account the fact that the stairs had a concrete lintel above them. I cracked my head on that, went all the way down the stairs on my arse and landed flat out in the corridor with everyone standing over me and laughing.
Did you ask her out?
– Eventually.
Did she say yes?
–  She said she was washing her hair.
What about later?
– Well, no. Apparently she was washing her hair all week.

6.    arañas
What are you like with spiders?
–  Me? Pretty good. I think. Depends on the spider.
I used to be terrible. Mind you, it’s not surprising, the childhood I had. Whenever Mum found a spider in the bath it was like that scene in Psycho.
–  It’s not so bad in this country, though, is it? At least you know there aren’t any really badass spiders. Not like Australia, where you get killed just putting the washing out. Although I did read somewhere those gangly leg ones you see in the garden here have got more venom pound for pound than a cobra. It’s just they’re so small you don’t notice.
Anyway, I’ve been trying to cure myself of the spider thing. I know they have their uses, and you shouldn’t just whack them with a slipper. So I’ve been gradually working up in size, picking them up in my hands, throwing them out the window. It’s not too bad. But we were over in Spain a few weeks ago...
–  How was that?
Great – except for this one thing that happened. We were back in the villa. I was cooking in the kitchen when all the girls started screaming. And I mean, screaming! It made my hairs stand up. Hannah came running down the hall shouting It’s the biggest spider in the world, Dad! Get rid of it! Spider? What spider? I said, trying to be brave, but I must admit all that screaming put the wind up me. I wasn’t sure about Spain. Do they have poisonous spiders? It’s warm enough. I thought I’d better play it safe, so I tipped the cheese out of a Tupperware box and went down the hall to sort it out. Well. I have to say, I almost screamed when I saw it. It wasn’t a spider, though. It was a cockroach, bold as you like, sitting right in the middle of the tiles like it owned the place. And it was huge. I mean, bigger than huge. It was so big, you could’ve thrown a saddle over it and ridden into town. It didn’t even seem that bothered it was causing all this fuss. One of its front legs was crooked up, like this, just like it was on the phone or something. So anyway, I moved a bit closer, got the Tupperware box in position – when it gave a little twitch and started forwards. Everyone screamed, including me. I panicked and dropped the box. Luckily it still landed on top of it, right way up. There was a pause whilst we all got our breath and wondered what to do next, maybe get a gun or something. We were all staring down at the box, when suddenly – it began to move! And it was the weirdest thing, watching a Tupperware box leave the room and slide off down the corridor.
–  So then what did you do?
I was tempted just to open the front door and let it go. But then I thought that wasn’t neighbourly, and anyway it was a shame to lose a good box. What would we put the cheese in? So I grabbed a laminate sheet of instructions from the kitchen, slid that underneath, then carried the whole thing out to the yard. When I took the sheet away the cockroach dropped out and immediately came running my way. I had to jump up in the air to get over it. And you know what? Not a word of a lie. It was like jumping over a Volkswagen.

7.    first names
I had a girlfriend whose first name was Princess.
– Princess! That’s pretty weird. You have to wonder about the parents.
Her dad was the worst. He’d served time for handling stolen property and had a lock-up in the back garden. He had these big, staring eyes, and long fingers. Like a bush baby.
– So what happened with Princess?
She never used her first name. Except on official papers and things. One time I went with her to the dole office. We were sitting in the waiting room when a voice came over the tannoy: Princess Michaels? Princess Michaels to cubicle one, please. Of course, everyone looks round. You could see they were all thinking the same thing. Blimey – times ARE hard.

8.    random noises
I had to drive my dad to the hospital the other day. Nothing too serious, thank god. Anyway, for one reason or another I haven’t had him in the front seat of the car with me in about five years. It was nice to spend some time with him. Anyway, we were driving along, chatted for a bit but then it went quiet. Which I didn’t mind, you know. Companionable silences and all that. I know he was anxious about his appointment. That’s when I became aware of this tick, tick, tick noise. And I thought, great! I’d only just got the car back from the garage. Cam belt and clutch. About a million pounds – and still not right! So I pulled over, got out, put the bonnet up, got Dad to rev the engine. Nothing. It all sounded nice and sweet. So I thought, maybe it was just a passing glitch and I won’t hear anything more. I get back in, we’re making up the time, and there it was again: TICK, TICK, TICK. Louder this time. So I pull over again. Get the bonnet up. And I’m scratching my head trying to figure out what’s wrong when Dad gets out to have a look himself. And it’s when he’s leaning over the engine next to me I find out where the noise is coming from.
– Where?
Him! It was Dad, sucking his top plate because he was anxious about missing the appointment! I didn’t mind though. At least it wasn’t the car. At least I didn’t have to go back to that garage. I mean, I don’t know about overalls; what they really need is hats, guns and horses.

9.    buzz
We had to have our eldest dog Buzz put down over the weekend.
–  I’m sorry to hear that.
Yeah, well. He was getting pretty old and knackered. He was fifteen and he’d been good up until last year. Then his back legs started to go, and on the Sunday he collapsed and started to be incontinent. The emergency vet said he reckoned it was a spinal lesion.
–  At least he didn’t suffer much.
No. It was all pretty quick. We buried him in the garden.
–  Wasn’t he a bit of an escape artist?
Buzz? He was amazing. I never knew a dog that had such a good head for heights, enclosed spaces, storms – you name it. Good swimmer, too. Terrible with other dogs for a while, but that’s another story. He had a real talent for disappearing. Hundreds of times. Once for a couple of days. We called the dog pound, the RSPCA, everyone we could think of, but nothing, no trace. He’ll turn up the warden said, but I wasn’t so sure. Next thing you know, though, there he was at the front door, covered in soil. He’d been stuck down some badger set somewhere. That was the thing with Buzz. He was a master of escapes, but then he was a master of getting back home, too. Often we wouldn’t know he’d gone until the neighbours brought him back. Or one time, there was a knock at the door and it was the bin men. Here’s Buzz they said. We knew where he lived, so after he helped us finish the round we gave him a ride back in the cab.

rosa alone

Three times now I’ve called Rosa to the intercom. She knows enough to answer, but not enough to buzz the door and let me in. Luckily another resident arrives back from the shops and lets me in.
‘Number fourteen?’ she says.
‘I can’t really say,’ I tell her.
‘It’s Rosa’ says the woman, holding the door open for me whilst I struggle in with all my bags. ‘It’s always Rosa. I’m in number six. Let me know if there’s anything you need.’
Up on the second floor Rosa’s door is standing open, propped with a chair. Rosa herself is standing in the doorway, half-dressed, wringing her hands.
‘What should I do? I know there are thousands of people dying all over the world but I just can’t bear feeling like this a minute longer.’
‘Come and sit down Rosa and let’s have a chat about what’s happening.’
She studies me with empty grey eyes for a moment, then straightens and turns back into the flat.
‘Just a minute’ she says, her tone of voice suddenly brisk and capable. ‘I’ll get my skirt on.’
It’s an extraordinary change, an abrupt flip from existential terror to domestic routine.
‘Are you all right?’ I say to her. She seems perfectly mobile though. The door to her bedroom is open and she’s putting on her skirt, standing on one leg to get the other through.
‘I’ll be in the sitting room,’ I tell her, and go through.
I look for a care folder and medication in all the usual places, but can’t find them. The flat is perfectly warm and tidy, nothing to indicate that anyone with any chronic health problems lives there.
Rosa walks in.
‘Would you like some tea?’ she says.
‘That’s very kind, Rosa. But first of all I’d like to find out why we’ve been called today.’
‘Who called you?’
‘I don’t know. I thought you did.’
‘Oh no!’ she says, putting one hand up to the pearls around her throat, as if they’d suddenly got tight and she was struggling to loosen them. ‘I haven’t done it again, have I?’
‘It’s okay, Rosa. Don’t worry. I just want to find out what’s been going on. So – do you think you might have called but don’t have any memory of it?’
‘I hope I’m not being a nuisance’
‘Don’t worry about that, Rosa. First things first. Do you have any pain at all?’
‘Do you feel sick? Dizzy? Short of breath?’
‘No – thank goodness!’
‘What’s your past medical history? What do you suffer with? Anything?’
‘I don’t know. You’d have to ask Stella, my daughter in law.’
‘Okay. Shall I give her a call?’
‘Be my guest!’
She gestures to the phone, where the names of four contacts are written in block capitals on a pad of paper.
Stella seems to know it’s the ambulance calling even as she answers.
‘What’s happened now?’ she says.
I start to tell her as much as I know, but Stella interrupts.
‘Look – I can’t understand what you’re doing there. They have specific instructions. You shouldn’t be going. Have you met Rosa before? I’d be amazed if you haven’t. I think everyone knows her – police, fire brigade, the army for all I know. Rosa has Alzheimer’s. We’re trying to get her a live-in carer, but for the moment she has someone in twice a day. Once between ten and three and once between five and nine. The problem we have is that outside of those hours she gets distressed and starts calling for help. Ultimately I think she can’t go on living at home any more. It’s not safe and it’s causing so much disruption. We get calls throughout the day almost and it’s beginning to tell on our health, too. Poor Rosa. She’s perfectly healthy other than this. But look – I really can’t understand why you’re there. We’ve had this discussion time and time again, with everyone you can think of, including the ambulance. You’re supposed to ring us if ever she calls 999. There’s a Samsonite suitcase with all her medication and information in, hidden behind an armchair. The padlock number is 9292 – but don’t let her see you work it. She’s perfectly able to write it down somewhere, and if she gets hold of it who knows what she’ll do....’
It’s difficult talking to Stella. I think she’s naturally pretty chatty anyway, but the stress of the situation has pushed her into overdrive. I have to talk over her and carry on talking before she stops to listen to what I have to say.
‘Stella? Stella? I think the problem from the ambulance point of view is that if anyone rings and says they have breathing problems or chest pain or something serious like that, they will always send an ambulance, regardless of any other notes on the system.’
‘Well. I don’t know then. I don’t know what else to do. As soon as you go she’ll be on the phone calling for help again...’
‘Let’s see what we can do. Shall I pass you over to speak to Rosa?’
I hand the phone across, and write up my notes as the two of them speak.


Rosa watches me as I finish writing, smiling as I look up. She takes a sip of her tea, carefully replaces the cup, then says: ‘What brought you here today? Not that I’m complaining – it’s nice to have a bit of company.‘
‘It looks as if you got a bit upset and rang 999 for help, Rosa.’
The smile fades and her eyes shine with tears.
‘Oh no, I didn’t! Please say it’s not true.’
‘Sorry, Rosa. Unfortunately I think memory loss is a symptom of your condition. But don’t worry. Everything’s in hand. Your son and daughter in law are both on the case. You’ve got a carer coming in any minute, so it’s not too bad.’
‘But I can’t carry on like this, can I? I don’t know my own mind. How can you carry on if you don’t know your own mind?
I take a sip of the tea she’s made me – perfectly presented in a china cup, a biscuit balanced on the saucer.
‘Thanks for the tea’ I tell her. ‘That’s very kind of you.’
‘Well – thank you for coming!’ she says. And smiling warmly again, she contentedly folds her hands in her lap.


‘Everything’s going wrong. The whole day. And to make matters worse we’re finishing late. We end up at this residential care home miles out of town. Turns out the patient isn’t at death’s door. In fact not only is he not at death’s door, he’s sitting up in bed drinking tea and watching Pointless. So we leave him with a GP referral and head back out to the truck. I’d been putting off going to the loo for the last couple of hours and there’s no way I’m making it all the way back to base with a bladder the size of a space hopper. I see there’s a visitor’s toilet in the lobby so I nip in quick, do the do, wash my hands, and then I’m looking round for a paper towel. But all they’ve got is one of those hand blowers on the wall. Great. I hate those things. Noise like a 747 and you still walk out rubbing your hands on your trousers. But anyway, I go through the motions. I put my hands underneath. Nothing. I look for a switch on the wall but can’t find one. I put my hands under again, a bit closer. Further away. I slap the side of it. Put my hands back really slowly. Nothing. Great. If there’s one thing I hate more than a blower it’s a blower that doesn’t work. Then the door opens and this guy comes in. He sees me standing there with my hands underneath the thing, about to rip it off the wall, throw it through the window and then drown myself in the toilet. And he says, really quietly, like he’s talking to a psycho: It’s actually a towel dispenser.

Thursday, October 02, 2014

a cold conductor

The cohort area is so crowded with people and trolleys and relatives and ambulance personnel, moving a patient anywhere is like moving squares in a cheap plastic puzzle – one space at a time, sideways, backwards, this piece then this – until you reach the other side, or make the picture, which in this case would be a simple, black & white word: Failing. But even though it’s difficult, everyone is keen to do what they can to let Arnold through. His sudden bursts of wild laughter, screams and incoherent singing have only heightened the End of Days atmosphere in the department. When conditions are as bad as they are, a little peace is worth almost as much as a chair, or a cup of water.
Poor Arnold has vascular dementia. Normally his carer says he’s pretty calm, but since a fall a few days ago his behaviour has become more erratic. The GP referred him in for a CT scan.
‘Mind your backs,’ I call as we negotiate the final hurdle and make the clear water of the corridor that leads to the CT suite. ‘Coming through!’
Arnold starts singing again, a gummy, open-throated bellowing, making panicked sweeps with his arms, like a conductor leading an orchestra in hell.
‘He’s a musician’ says the carer, soothing Arnold’s hands down as we negotiate another narrow gap. ‘Who knows what’s playing in his head?’

In contrast to the sweated atmosphere of the cohort area, the CT suite is cool and quiet.
‘I love this air con!’ I tell the radiographer.
‘You wouldn’t if you worked here all the time,’ she says, as we manoeuvre Arnold into position. ‘Five minutes and you’ll be snapping icicles off your nose.’
She smiles at Arnold as he starts waving his arms about and singing.
‘He’s a musician’ the carer says to her, easing his hands down again.
Is he? How interesting!’ says the radiographer, producing a couple of wide, Velcro straps. ‘Sorry Maestro. Just for the scan.’
She adjusts a grid of bright red lines over his head, and then with everything set, leads us into the control room. We stand behind her and watch as she operates the scanner, scrolling through section views of Arnold’s brain.
‘Ah-ha!’ she says, tapping the keys.
‘What have you found?’
‘It’ll need a consultant, of course. But just there – look.’
‘A bleed?’
‘No. Crotchets and quavers.’
She laughs, shakes her head, and stands up again.
‘Come on!’ she says. ‘Let’s get poor Arnold out of the fridge.’

the nice day

‘Well we had a nice day really. All this has come very much after the event as you might say. Yes, a nice day. We went up town and strolled around a bit. Agnes wanted a new pair of slippers, so we had a look at a few. Come lunch time we were a bit peckish so we went into that Prett Ah Mangger. And I tell you what – I had the nicest sandwich I ever had in my entire life. Guess what was in it?’
‘I don’t know. Gold?’
‘No. Crayfish and rocket. Crayfish and rocket. I tell you what. Once you had one of them you won’t want any of your old cheese and pickle no more.’
Agnes lies on the trolley between us, contentedly waggling her leopard print slippers from side to side. Every now and then she leans forward, squeezes her eyes shut, and gives a congested little gasp, like a cat stuck with a furball. But it passes as quickly as it comes, and she settles back happily enough. We haven’t been able to see anything. Her obs are normal. It’s all a bit of a mystery, so we’ve had to bring her in.
‘I hope they took the claws off’ I say to Agnes’ husband, Ron.
‘Oh, ye-es. It’s all proper stuff there. You ought to try it. Prett Ah Mangger. As I say, a very nice day, apart from all this business.’
He pats Agnes on the leg.
‘And we’d just settled down to watch our film, hadn’t we?’ he says.
‘Sorry, love,’ she says.
‘What film was that?’ I ask him.
‘I don’t know. Breakfast at Tiffany’s?’
Ratatouille?’ says Rae, taking the blood pressure cuff from Agnes’ arm.
Julie and Julia?
The Cook, the Thief, His Wife and her Lobster?
‘No. Full Metal Jacket.