Monday, April 21, 2014

hair scare

The hostel has a brisk, administrative feel to it, corridors and fire doors, numbered rooms, informative posters on pin-boards and a reception desk in the foyer. Natalie, the young key worker, meets us there and takes us up in the lift.
‘Bernadette’s lived here ten years or more. She lost her husband and went a bit crazy, ended up on the street, then here. She’s never been any trouble, no drinking or carrying on. She just keeps herself to herself, smoking away in her room, popping out every now and again. The mental health team have been keen to get involved for a while now but unfortunately Bernie’s a bit – how shall I put it? – independent minded?’
‘So what’s happened today?’
‘She pulled her alarm cord. Apparently she had a fall of some kind, don’t know why. She’d got herself up by the time we got there, and she doesn’t seem to have hurt herself. I wouldn’t have called you only she was behaving a little strangely so I thought we should. I hope we’re not wasting your time.’
‘It’s fine. Don’t worry. You should always call if you’re worried about anything.’
‘She’s just down here. Oh – and, one more thing. Don’t worry about her hair. She always looks like that.’
Natalie smiles reassuringly, then knocks on a door and opens it with her key.
It leads into a tiny hallway with a kitchenette and shower room straight ahead and two rooms, right and left. Natalie knocks on the door to our left, and lets us in to that, too.
‘Hello, Bernie. I’ve come back with the ambulance,’ she says.

Bernie is sitting on the edge of her bed. I’m glad Natalie warned us about her hair, because it’s the first thing anyone would notice. Whilst the rest of her long grey hair falls down around Bernie’s shoulders a little tangled a but otherwise quite normal, the top of her head is extraordinary. If I had to recreate it, I’d have to put a nest of baby yellow spiders on the crown of my head, spray them with a mist of sugared water and then get someone to pass a flamethrower over the whole affair.
‘Hello, Bernie,’ I say. ‘My name’s Spence, this is Rae. How are you feeling?’
‘Not good,’ she says. ‘Dreadful.’
‘I’m sorry to hear it. Natalie here tells us you had a bit of a fall earlier.’
‘Yes.’
‘Tell us about that. Did you hurt yourself?’
She rubs the small of her back.
‘Not much. Just where I landed on my bottom.’
‘Did you bang your head? Were you knocked unconscious or anything dramatic like that?’
‘No.’
‘Okay. So why did you fall? Was it a trip or something? Did you have a funny turn?’
Bernie looks at Natalie for a moment, then down at her hands.
‘I felt it coming through the day but I didn’t think much of it.’
‘Felt what coming?’
‘A darkness in the room. Coming over me. But I just ignored it. I went out shopping. Got some things. Had lunch. Chicken and chips. Came back. Felt tired, so I got into bed and fell asleep. I had some bad dreams, like the darkness had followed me there. Then when I woke up, it was right there, hanging over me. I couldn’t say nothing. Then it grabbed me out of bed and threw me on the floor. That’s when I rang for help.’
‘What do you think it was?’
‘A whatsisname. A poltergeist.’
‘A poltergeist?’
‘Yes.’
‘Okay. Wow! Have you seen it before?’
‘No. I don’t believe in ghosts.’
‘Well I have to say, neither do I. But something’s happened today, Bernie. Shall we run a few checks and see if anything’s amiss?’
‘If you like.’
There’s a curiously inert quality to her, the way she raises her arms and lowers them again, following instructions as neutrally as a mannequin. But everything seems normal, her blood pressure, blood sugar, temperature and so on. Up close like this it’s difficult not to look at her hair. There are two bold, brown streaks of matters from the temple back, like she dipped a finger in mud and swiped herself above each ear.
‘What have you done with your hair today?’ I ask her.
‘What do you mean?’
‘It’s just I haven’t seen that done before. What did you use?’
‘Lacquer.’
‘Is that what it is?’
‘I put it on every morning. For control.’
‘I see.’
I wrap up my cuff and steth.
‘Have you had any alcohol today, Bernie?’
‘I don’t drink.’
‘Anything else out of the ordinary?’
She shakes her head.
‘Well I must admit I’m a bit stumped. I’m glad you didn’t hurt yourself when you fell, but I’m a bit concerned about the reason for it all. The poltergeist, and so on.’
‘It picked me up and threw me down.’
‘Hmm. You see – I don’t think it was a poltergeist. I think it was something else, a hallucination of some kind. And it would be good to get a blood test done to see if there was a reason for it. Are you okay about coming with us to hospital for a check-up?’
‘I want to get dressed first.’
‘Of course. Shall we step outside and give you some privacy?’
Natalie helps Bernie get some clothes together whilst we wait in the little hallway. The place is having a refurbishment, because even though the walls in Bernie’s room are stained with ten years of tarry cigarettes, the kitchen and shower room are bright and white. In fact the kitchen has a notice taped to the sink: Wet Paint, and every surface is bare.
‘I suppose you’re just as likely to see a ghost here as anywhere else,’ says Rae, folding her arms and looking around. ‘They’re not obliged to hang around old houses and graveyards, are they?’
‘I suppose not.’
‘But I hardly think it can be a ghost.’
‘Why’s that?’
‘Her hair would scare it off.’

Sunday, April 20, 2014

a good night out

A guy in his early twenties is lying on the pavement, shivering, his knees drawn up, his hands bunched in fists beneath his chin. A streetlamp taints the sweat on his face a ghastly orange. Three men stand over him. They aren’t with him; they came across him when they left the pub. One of them laughs and gives the guy a gentle punt with his trainers. The wee lad’s taken something, right enough he says. Something he shouldn’t ay’

We thank them for their help and they move off noisily, slapping each other on the back, goofing around.

I squat down next to him and squeeze his shoulder.
‘How are you? What have you taken tonight?’

He can’t speak. All he can do is roll his pupils onto me, pupils so massively round and black, if I let go of this pen torch I could watch its pin-point of light trailing down about a mile inside him.

I can only just feel his radial pulse. The kind of hectic, protozoidal rhythm you should only see under a microscope, sculling through a drop of water.

We give him oxygen, scoop him up, call ahead.

I go through his pockets: phone, keys, driver’s licence, bank card.
Luke. I wonder who’ll make the call, and who’ll answer?

We get to hospital as quickly as possible. We pat-slide Luke onto the hospital trolley in A&E resus, shouting out the facts and figures, the little we know.
The team close round.
I book him in at reception.
By the time I’ve come back with the paperwork, he’s tubed and ready for ITU.
‘Well,’ says one of the doctors, wearily pulling off his gloves as the porters move in, ‘so that's what counts for a good night out these days.’

Saturday, April 19, 2014

son of the moon

There’s a low, blood-red moon tonight. It’s impossible to resist the feeling it’s having an effect.

On John, for example.

John is standing in the middle of a recreational ground just out of town. The hectic, drunken fuss of the centre is half a mile east, but you can feel the pull of it in your chest, like the presence of so much adrenaline has skewed the emotional isobars of the place. Only the sea is immune, running out flat and mirror-black the other side of the promenade. Standing like he is, perfectly still and upright, his white t-shirt ghosting in the strange half-light, John looks like some kind of sacrificial victim summoned to this place by forces he cannot resist, forces the alcohol have only helped liberate.
‘Is there someone we can call?’ I say, carefully hooking the phone from his pocket whilst Rae drapes a blanket over his shoulder.
‘Mum,’ he says.
‘Okay,’ I say, scrolling through his contacts. ‘What’s her name?’
He looks at me like I’m speaking from somewhere deep inside his head.
‘Mum,’ he says.

Thursday, April 17, 2014

like marilyn

The smell permeating the house gets stronger the nearer you get to Philip’s bedroom. There’s a shakily written note taped to the door:

No carers admitted. I will not be taking pills or speaking to ANYONE if this door is shut. It means I am sleeping and must not on any account be disturbed.

Several crossings out, different pens, one over the other.
We knock, get no answer, go in.

Philip has a poster of Marilyn Monroe on the wall facing him. She’s in bed, too, lying on her side, smiling at the camera, partially draped in a white cotton sheet, her head propped on one arm, her short blonde hair mussing down over her face, whilst behind her golden sunshine spills around her through the window, holding her in a warm and sensuous wash of light.

But even though fifty years, a camera lens, Life and Death, separate the two, it’s still surprising Marilyn doesn’t jump up and run.

The atmosphere is fetid and thick. One small window is roped open, the rest are sealed with mastic. There’s a liberal scattering of desiccated flies along the sill; a half-finished plate of food on a dirty chair; a jug of urine maturing underneath.

Philip is as sick as the room. A tall, powerfully-built man in his sixties, he’s been clothed and in bed so long that getting him out will be more exhumation than extrication. Rotten with neglect, even his wild, white goatee looks like the flaring of some exotic fungus.

‘Please don’t touch my legs,’ he whispers. ‘You’ll just have to use your equipment to lift me as I am. I know you have your equipment, and you like to use it. But please – I beg you – just go carefully.’

We pull down the sheet to see how he’s lying and how we might get him out. His shirt is unbuttoned to the navel, revealing a shockingly distended hernia, full and round and veined, just like the crowning of a baby’s head. And with his septic demeanor, and in the feverish atmosphere of his room, it’s easy to think he’s somehow fallen victim to some obscure, vegetative process. He’s been staring at the poster on the opposite wall so intently, and for so long, through so many days and nights, that the image has taken root in him, and grown, and come to fruition, pushing out from the ripening pod of his body, turning slowly towards the light, its features resolving, like a woman’s face, those eyes, that smile. Like Marilyn.

‘I’ll get a chair,’ says Rae. 

Sunday, April 13, 2014

guess what

‘You’ll need a back board,’ says Paul. Then he lets go of the door, turns round and heads back inside, where he resumes his position, spooning with Cariad on the bed in the sitting room. It’s a double-sized frame with two single mattresses, a high one for Cariad, and a lower one with a spread of all her necessaries – two laptops, a pile of inco pads, a box of tissues, an assortment of treats, a landline, mobile phone and walkie talkie, all charging in a nest of cables.
‘I’m not going to hospital,’ she says, pushing her wig back to get a better look.
‘The bloody doctor needs to get off her fat arse and get down here now,’ says Paul.
He’s as bulky as Cariad is fragile. The bed dips alarmingly in his direction, and she has to bunch up her knees and cheat her weight forward to avoid being drawn back and the two of them roll off onto the floor. But even if they did they wouldn’t hurt themselves. The bed is surrounded by a clutter of soft toys, coats, cushions and assorted bric-a-brac.
‘So what’s the problem?’ I say, adding a little pathetically ‘We haven’t been told much.’
‘What’s happening,’ says Paul, shifting his bulk into a sitting position, ‘What’s happening is that Cariad has been choking to death, turning blue and everything and the doctor won’t do a thing about it. She just told us to call you lot.’
The way he says lot. A candy-coating on something bitter.
‘Well if you were turning blue it’s no wonder he said dial 999.’ I put my bag down. ‘So how are you feeling now?’
‘Like I’m going to die, that’s how I’m feeling now,’ says Cariad. ‘I can’t breathe properly. My inhalers don’t work. I’m going to choke to death and no-one cares.’
Her voice is sharp and short as a paring knife.
‘The good news is that you’re able to talk to me now,’ I say. ‘So your breathing is okay for the moment.’
‘Oh? It’s okay, is it? Well I’m sorry if you think I’m wasting your time.’
‘No, no. That’s not what I meant. I can tell even without listening to your chest that you’ve probably got a bit of a chest infection.’
‘A bit of a chest infection? Is that what he said? A bit of a chest infection?’
Paul stands up and stomps out of the room, muttering.
I have a sudden, empty feeling, like a mountaineer who’s stepped confidently out onto a slope only to find it’s really a bridge of snow over a crevasse, doomed whether he goes back or carries on.
‘Anyway, it doesn’t matter,’ she says. ‘I’m not going to hospital. How will I get home?’
‘Why don’t we check your SATS, blood pressure and the rest and then take it from there?’ I say, opening my bag. ‘One step at a time.’
Paul comes back into the room, red in the face, like he’d only nipped out to shoot steroids in his neck.
‘What’re you doing now?’ he says. ‘I’m her carer. You should ask me first.’
‘Cariad’s the one who has to decide about her treatment,’ Rae says. ‘But obviously we won’t do anything that everyone’s not happy about.’
‘I’m not happy about it, ‘ he says. ‘Not happy at all. First the doctor, now this.’
Rae takes some observations, I write them down, asking questions that Cariad answers reluctantly.
‘Everything’s looking pretty good,’ I say at last. ‘It sounds as if you do have a chest infection, Cariad. Lying down like this makes it difficult to clear your lungs. Are you able to sit up? Only I saw your wheelchair in the hall and I thought maybe...’
‘No! I have to lie flat.‘
‘Okay. Well. Given that you went blue a little while ago, and it’s obviously been distressing for you...’
Paul snorts.
‘...the safest thing would be to take you to hospital. Even though it might be difficult to get you there.’
‘Like I said,’ snaps Paul, ‘You’re going to need a back board. Why does no-one ever listen?’
‘I can’t go to hospital. Not after last time.’
‘What happened last time?’
‘No-one would take me home, so I had to lie on the floor of a taxi, screaming in agony the whole way. I won’t do it, Paul! I can’t!’
‘If she goes to hospital, are you going to bring her back?’ he says.
‘It won’t be us, and I can’t even say it’ll be a frontline crew. But this should be the last of your worries given the problems you’ve had with your breathing. You’ll just have to cross that bridge when you come to it.’
‘I’m not coming home like that again,’ wails Cariad. ‘I’d rather die here.’
‘I’ll protect you,’ says Paul, plucking up a teddy bear by the face and looking at me.
‘If we do decide to go in,’ I say, trying to keep my voice as low and steady as I can, ‘it’ll be a little difficult getting out. We’ll have to clear all this stuff off the bed to get to you.’
‘No! Not my stuff!’
‘We’ll put it aside somewhere safe.’
‘Then what?’
‘Then we’ll have a think what’s the best way to get you out.’
‘A backboard. Christ, how many more times have I got to tell you.’
‘Try to keep your temper, Paul’ I say to him. ‘We’re doing our best.’
‘The last crew dropped her.’
‘I’m sorry to hear it.’
‘Yeah. Well. You’re sorry.’
He throws the bear off to the side, snatches up a box of tissues, tosses them after it.
‘We’re definitely going in then, are we?’ he says to Cariad.
‘I don’t know!’ she shouts. ‘Why can’t the doctor come out?’
‘We could certainly call the doctor and see what they say,’ I suggest.
‘Do it,’ says Paul.
‘I’m not speaking to her,’ says Cariad. ‘Useless piece of shit.’

Rae calls the doctor. After a while she hands to phone to Paul.
‘She wants a word.’
Paul grips the phone, holding it a little way off from his ear, like he’s wary of infection. After a short series of grunts and sighs he hands it back, then leaves the room again.
Rae finishes the call, and hangs up.
‘She wants you to go in for a chest X-ray, Cariad. Just to rule out the possibility of pneumonia or other complications.’
‘But how am I going to get back?’ says Cariad.
‘They can’t do an X-ray at home.’
Cariad buries her face in a pillow.

We call for another crew to help. Even though Cariad isn’t heavy, the fact that she has to be kept flat makes things tricky. The front room is cramped, we can’t get the trolley in the front door, and the only way out is through the kitchen and down a short flight of concrete steps into the garden. It’s no wonder the other crew struggled.

Ordinarily – perversely – I quite like these difficult extrications. Three-dimensional puzzles that demand a creative use of kit, teamwork and a flair for cheating angles. But Paul changes the dynamic. He masses darkly behind us all  like a thunderhead storm cloud, flashes of disapproval, spots of anger.

Just before the second crew arrives I offer to help clear the second mattress.
‘You’ve fucking asked me that already,’ he shouts. ‘I’m doing it, aren’t I?’
‘Please don’t swear at us, Paul. Okay?’
He keeps his back to me as he unplugs the laptops. I’m increasingly mindful of striking distances. 

The second crew gets here. Between us we discuss how best to get her out, at the same time struggling to contain Cariad’s rising levels of anxiety. She won’t even let us look at her meds. She clutches them to her chest like she’s terrified we’re going to steal them.
Despite everything we manage to get ourselves into position, ready to slide Cariad from the furthest mattress onto the backboard.
Ready, set – slide!
She screams, even though I’m certain we haven’t done anything to cause her any pain.
‘That’s it! Stop! That’s it!’ shouts Paul, storming forwards. ‘You can fuck off, the lot of you! I’m not having this. Put her back. You put her back how she was! Now!’
‘Please don’t swear at us,’ I tell him, wishing I could think of something else. ‘We’re doing our best.’
‘Well it’s not good enough. Put her back, now.’
‘Is that what you want, Cariad?’ asks Rae, in a steady voice. ‘We can carry on and take you to hospital if that’s what you’d like us to do.’
But Cariad is just crying and shaking her head, so we slide her back, pack up our things and leave.

We rendezvous back at base to put in an untoward incident form, and to alert any other crews who might have to attend in future. Whilst we’re there, Control ring. They want me to tell them what happened. ‘Because we’ve got Paul on the phone,’ says the dispatcher. ‘Guess what? He says you refused to take her to hospital.’

Saturday, April 12, 2014

visitors

Dan meets us outside his mum’s house. He looks like a depilated bear gone punk, hair in spikes, a Damned t-shirt stretched over his belly, paws stuffed into a pair of rotten Converse All Stars, studs in his ears and nose and lip. Every bare patch of his skin carries a tattoo – ghostly figures, flaming pumpkins, a headless horseman, glaring skulls, all amongst a general tangle of black roses, Celtic knotwork and ivy.
‘Thanks for coming,’ he says, carefully lighting the cigarette he’s been rolling. ‘I thought I’d better give you the heads up.’
His mum is an alcoholic, he says. She’s been in and out of rehab, not doing too badly but gone off the rails this past week.
‘She’s started seeing things again,’ he says, flicking the match away across the drive. ‘Hearing voices. I phoned the unit and they said to call you.’

He takes us inside.

The bungalow has been built villa-style, with arches leading off from the main room, terracotta tiles on the floor, rugs here and there, and in the centre, an alcove with a statue of a saint raising his hand in blessing. The whole place should be flooded with sunshine – it’s a particularly bright afternoon – but all the blinds are drawn, and whatever bands of light make it through the slats only serve to accentuate the soupy darkness.
‘Through here,’ says Dan. ‘It’s a bit of a maze.’
He leads us through a sequence of rooms, each as gloomy as the last. He knocks on a bedroom door and we follow him in.

Mary is still in bed. She gathers the duvet tightly around her as we say hello.
‘It’s okay, mum. It’s okay. It’s just the ambulance. You remember I said I was going to call them, like the people at the centre told me? They’ve just come to see how you are.’
She scuttles back in the bed, rising up on the pillows into a semi-sitting position, and stares at us.
‘Be a love and open the window,’ she says. ‘He’s hiding over there in the curtains.’
‘Who is, mum?’
‘The man. The one I was telling you about. The one who’s been going on and on at me to drown myself. If you open the window he might go out in the garden and we can talk.’
Dan looks at us, then goes over to open the window.
‘There’s no-one here, mum,’ he says as he lifts the latch and pushes it open.
‘Can’t you see him?’ she says. ‘Really?’
She looks at me.
‘What about you?’
I sit down on a stool just off to the side and try to look as non-threatening as possible.
‘I can’t see anyone there, Mary. I think it’s probably one of those hallucinations you’ve had in the past. Do you think that’s possible?’
She roughly presses the heels of her hands into her eyes to clear them, then peers at me more closely. After a moment she reaches out to her bedside table and produces an alcometer.
‘I’ve been good,’ she says. ‘I’ve only been drinking enough to keep me on the level. Look.’
She shows me the screen, but the device is switched off.
‘That’s great,’ I say. ‘But these hallucinations are a bit worrying. Dan called the team at the unit about it, and they said to take you to hospital. Would that be okay?’
‘I’m fine,’ she says. ‘I can’t see the point.’
‘You need to go in again, mum,’ says Dan. ‘You’re not well.’
‘Aren’t I?  I don’t know. I’d be fine if it weren’t for him.’
She looks over at the window, as we all do. And just at that moment a sudden breeze fills the curtains, gently rolling them in, and then back, and then in again.


Friday, April 11, 2014

joints

The ewe must have died in childbirth. Pete found her on his morning round, lying in the field with a bloody newborn nuzzled up. His son Craig helped him load the ewe into the back of the Landrover, and they all rode back to the barn with Pete cradling the lamb on his lap and Craig driving. They cleaned off the lamb and put it in a pen, then laid the dead ewe on her back. Pete took  up an empty bottle, then bent down to salvage as much colostrum as he could.
That’s when his hip dislocated.
He fell backwards onto a pile of straw, and lay there screaming whilst Craig called for an ambulance.

*

Once the morphine and Entonox have dulled the pain, we splint one leg against the other and then with Craig and some other farmhands, we slide Pete onto the vacuum mattress.

It’s a wonderful place to work. All around us in the muffled, straw-light and sun-warm peace of the shed, lambs suckle or chew intently with their snouts poking through the bars of their pens. Sparrows twitter and screech round the old oak beams, whilst out in the yard the chickens that were scared away by our arrival have returned to reclaim their territory, scratching around in the dirt. The lambs are all excited, trembling, watchful. Sometimes they spin around on the spot, or spring straight up and then bound away into the straw. They all have numbers sprayed in blue on their sides, the same colour as the vacuum mattress. Meanwhile, the corpse of the dead ewe lies off to the side just beyond the tail ramp of the ambulance, like an abandoned, upturned table, all four legs sticking straight in the air.

*

The ambulance bumps about on the road, but we’ve immobilised Peter pretty well and he seems content. We chat about this and that, farming, mostly, with Peter explaining about vaccination, vet’s bills, flooding, seeding problems and so on. He patiently hears me out each time I ask a question, holding the Entonox mouthpiece between his teeth and taking contemplative puffs, like he’s enjoying a pipe at The Bull.
‘Do you ever use any of the sheep’s milk for cheese?’ I ask him.
He takes another puff.
‘No’ he says. ‘There’s never any spare. It all goes down the lambs’ gullets, to fatten them up. You know – for chops.’
‘Lovely!’ I say. ‘I could do with a couple of chops.’ But for a moment and in spite of myself I feel a little dizzy. I think it’s the contrast between the beautiful lambs playing in the straw; the dead ewe lying on her back; the farmer harvesting milk to give the newborn a fighting chance; the warmth, the hour, the elaborate care of it all – and the fact that in a few short months, every one of those lambs will be killed, jointed, wrapped, labelled, table ready.
‘How’s the hip?’
‘Bloody thing,’ he says. ‘You may as well shoot me.’