Friday, November 28, 2014

the four bikemen

There are four kids hanging around the entrance to St George’s Rise, slouched over the handlebars of their bikes, hoods up, faces so deep in shadow when they turn to watch us walk to the door with all our bags, I could swear they didn’t have faces at all.
You’d know it was a tough block, even if it didn’t have a posse of dark knights guarding the entrance. The lift feels like a reinforced coffin, with anti-graffiti panels, an armoured security camera in the top corner, and the whole thing lit with an unearthly blue light to make shooting-up difficult.
Up in flat fifty-four, Jake is on the floor with Mick pumping up and down on his chest. We take over, whilst Mick gets his breath back on the sofa.
It turns out Jake smoked heroin half an hour before and eventually went into respiratory arrest. We protect his airway, support his breathing, give him narcan to reverse the effect of the opiates. Ten minutes later he’s sitting in our carry chair, pulling the plastic airway out of his mouth, and looking up at us with eyes as wide as if we were green angels from hell come to collect his soul.
We try to reassure him.
‘So I died?’ he says. ‘You mean like – dead died?’
‘You would’ve if Mick hadn’t stepped in to save you.’
Jake closes his eyes, and needs a shake to bring him back into focus. His hair is spiked with sweat. Now and again he grimaces, coughs and spits a glob of bright red blood into the bowl.
‘What’s this?’ he says, lifting up the bowl.
‘I was just doing what they said,’ says Mick.
When Mick came out of the bathroom and found Jake collapsed he called 999. They told him to put Jake on the floor and start CPR, because it must have sounded like cardiac arrest to them.
‘You saved my life then, yeah?’
‘I dunno. I just did what they said.’
Mick looks at me.
‘Did I do right?’ he says.
‘Absolutely, you did. Jake was definitely heading south.’
‘But all that blood. Have I hurt him?’
‘It’s possible you might have broken a rib and nicked his lung a bit.’
‘Oh god!’
‘But hey – full marks for getting down and dirty.’
‘I can’t believe you saved my life’ says Jake, then coughs again, clutching his chest and grimacing. He dredges up some more blood and spits it into the bowl.
‘Put the mask back on, Jake, and we’ll set off for hospital.’
‘Hospital, yeah? You think I need to go?’
‘All things considered, I do, yeah.’
‘I don’t like hospitals.’
‘No. No-one does.’
‘I can’t come,’ says Mick. ‘I’ve got things to do.’
‘What? Like saving more lives?’ says Jake.
‘Seriously, Jake. You’ve got to stop smoking that shit,’ says Mick. ‘I’m not going through that again.’

*

Back downstairs and the gang of kids on bikes have migrated to the ambulance. They watch in silence as I stow the bags, put the back down ready for the chair and prep the trolley.
‘Has someone died?’ says one, eventually moving in closer and looking round the cabin.
‘No. Not today.’
‘What did he say?’ says another.
‘He said no.’
‘I called an ambulance once,’ says one of the kids sitting further back.
‘Who for?’
‘My mum.’
'Yeah?’ laughs the other. ‘Mate - it’s always your mum.’


Wednesday, November 26, 2014

lucky slippers

Antoine had a fight with his girlfriend, left the house in his slippers, walked round to his friend Terry’s house. They smoked a bit, had a few cans, played Call of Duty, until he reckoned things had calmed down enough for him to go back. It was three a.m.
Almost outside the front door, Antoine trod on a broken bottle. A fragment of glass pushed up through the sole of his threadbare slipper into his left heel. He hopped inside and banged on the flat door. Siobhan opened it long enough to throw him a towel to staunch the bleeding, then slammed the door again.
He called 999.

*

Antoine sits on chair with his bandaged foot up on the trolley.
‘I can’t believe this,’ he says, wiggling his toes and watching them work from his great, smoked-up distance. ‘Thems supposed to be mah lucky slippers.’
With his dreads spilling out of his hat, a wide, warm smile, and an ee-zee way of talking as wispy as his beard, Antoine would make Bob Marley look like a City Trader.
‘Ah don’ think Siobhan’s gonna get over this one in a hurry’ he says, taking a sip from his Evian bottle. ‘The way she threw that towel at me, man. Ah’m surprised it weren’t a knife.’
There’s not much else to be done about his injury, so we chat about places he’s been, things he’s done, this and that.
He takes another sip of Evian.
‘See this?’ he says, tapping the label. ‘Do not store next to strongly flavoured food. Why would they even say that?’
‘I don’t know. Do not keep in the cheese cupboard. You wouldn’t want cheesy water.’
‘Nah mate. Cheesy water? You can keep it.’
He laughs and turns the bottle round in his hands.
‘I love it when they give you all that shit, man. It’s a bottle of water! Drink and enjoy! Thassit!’
Do not drink and drive.’
Yeah! This is not a toy.
Single use only.
Stop when bottle is empty.
Do not drink and swim.
Do not drink and walk in slippers.
He shakes his head, takes another sip, then screws the cap back on and relaxes back on the chair. He studies his foot again.
‘Siobhan, she’s really gonna kill me this time’ he says, wiggling his toes.

Sunday, November 23, 2014

dinosaurs

Tito’s chest is full of dinks and rumbles and squeaks and rasps. I might as well have put my steth against the engine cover of an old tractor, cranked into life after twenty years at the bottom of a ditch. He needs anti-biotics, steroids, pain killers. More than all of these, of course, he needs a place to live. Sleeping in a shop doorway night after night would be tough on anyone; for a man in his fifties with corrupted lungs, it’s tantamount to a death sentence. Still, he’s sanguine enough. He settles into the trolley, happy in the moment, with the warmth and the light, and the novelty of a sense of direction. The stench from his sodden trainers is truly appalling. You could track him blindfolded, across the wastes of Alaska, without dogs. For now, I’m just grateful he doesn’t have a foot injury I’m supposed to examine. Instead, I fix him up a neb, adjust the blanket, and he snuggles in for the ride.
I’m writing a few things down on the form when he taps me with his newspaper, the free one they give away outside the railway station.
He lifts the hissing neb mask.
‘Have you seen this?’ he says.
He points to a story just inside.
He puts the mask back on whilst I have a look.
A fossil of the world’s largest dinosaur has been discovered in Patagonia. A plant-eating Titanosaur, it was as big as seven T-Rexes. Sixty-five tonnes, thirty-seven foot neck, weaponized tail. Dreadnoughtus schrani.
‘Amazing!’ I tell him.
He pulls the mask aside again.
‘Can I turn this off, mate?’
‘Sure. You don’t have to wear it if you don’t want.’
‘Nah. It makes me nose all sweaty.’
I turn the oxygen off and sit back down.
‘You like dinosaurs then?’
‘Depends what you mean by like. I like looking at pictures and all that, thinking about how things used to be. I don’t know’s I’d want to keep one as a pet.’
‘It’d make one helluva mess of your garden.’
‘Aye, no doubt it would. And the whole street, come to that. I mean – look at the size of the thing. Why’d it get so big, d’you think? What’s the point in that?’
‘I don’t know. I remember seeing this programme about Apatosaurus once. It said they had long necks because they’d walk to a good position then stay there, grazing everything around them up and down without having to move. Apparently it was more efficient that way.’
‘Yeah? I’m a bit like that myself. I don’t like to move much when I’m feeding.’
‘Maybe in a few million years your relatives’ll all have very long necks.’
‘I wouldn’t mind. I think I’d look pretty good. Although it’d be a stretch putting my beanie on in the morning.’
He closes his eyes and seems to fall instantly asleep. Maybe it’s the unaccustomed heat in the back of the truck. I turn the dial down a bit and finish off the paperwork. After a few minutes he yawns and opens his eyes again.
‘What gets me is the names they come up with,’ he says, as if there’s been no pause in the conversation at all. ‘See this one they found? Dreadnoughtus here? After one of them big battleships from the first world war? Well, no surprises there I suppose. But you know what? If it was up to me I’d call it something else. A Humungasaurus. And whilst I was there I’d rename a few others. Your T-Rex? You know what I’d call him?’
‘What?’
‘A Meanmuthafuckasaurus. And if he were here now, chasing us down the street, no doubt you’d see my point.’

in the zone

Just a couple of years ago there were fields and trees here. Now, after an overnight shower, a small village has sprung up, so complete – with a central square, a village hall, a playground, a jogging track, and a variety of building styles from faux-thatch to balconied apartment to terraced house – you’d think the whole thing was designed on a computer and printed out brick by beam in a giant warehouse. Even the street names sound google-generated. Middle Way; Church Close; Woodvale Mead; Upton Hill.  The name of the village is spelled out on the access road in a line of fibreglass standing stones. Aligned with the city, no doubt.
I always get lost here. SatNav gives up, dumping its arrow in the middle of an approximate grey, marked Erewhon. When I stop to ask a postman, even he looks round, scratching his chin.
Pine Tree Close actually has three Rowans, still with their labels attached, planted in a raised central bed in the middle of a courtyard. There are six bunaglows arranged round them in a C-shape, the whole thing railed off, with access by a ramp left and right or a series of shallow steps up the centre.
I’ve been called to number three. A cause for concern. Apparently someone rang 999 asking for help, but hung up when the call-taker started asking questions. They hadn’t answered when the call-taker rang back, so could I go and check out the address?
I knock on the door. A young woman answers, smiling, but obviously a little alarmed to see me.
‘Sorry to bother you. We took a treble nine call from this address about ten minutes ago. I’ve no idea what the problem was or who called. They hung up before we got any more information and didn’t answer when we tried to ring them back.’
‘Really? Well there’s just me and my husband here, and we haven’t made any calls.’
Her husband appears behind her, cuddling a baby in a stripy baby-grow.
‘Everything all right?’ he says. The baby wobbles its head round to look.
‘He says someone called 999 from this address.’
‘I don’t think so,’ says the man. ‘Why? What did they say was wrong?’
I shrug.
‘I don’t know any more than that. It was a landline...’ I read out the number.
‘Nope. Never heard of it. We haven’t even got a landline. We just use our mobiles.’
‘Okay. Definitely not here, then.’
‘Maybe it’s a hoax.’
‘Could be. It’s strange that the number tracked here though. I’ll get back to Control and let them know.’
‘Do you think it could be Janet, the old woman who lives next door? She’s had the ambulance out a few weeks ago.’
‘Really? I’ll nip next door and give her a knock. Sorry to disturb you.’
‘No, that’s okay. It’s all a bit mysterious, isn’t it?’
They stand under the porch and watch me go next door.
I knock and wait. Ring the bell. Knock again.
‘No answer!’ I say to the young couple.
They smile and shrug.
The elderly woman from number five comes outside.
‘Whatever’s the matter?’ she says.
I tell her.
‘Well Janet’s not there. She’s been in hospital for the last six weeks with her hip. I don’t think it’s her. Unless she took her emergency button thingummy with her and pressed it by mistake.’
‘That wouldn’t account for the odd phone number, though.’
‘No. Well. I’m a bit stumped. And before you ask it definitely wasn’t me.’
‘Don’t worry. I think I’ve tried all the options.’
‘What about Mrs Duckworth? She’s not had the ambulance before, but I know she had a dose of the whatsits last week. Maybe she got into trouble. I’ll go and have a look.’
A man in one of the bungalows immediately opposite comes to his door.
‘What’s going on?’ he says. ‘Can I help?’
‘Someone’s had an emergency and we can’t find out who,’ says the elderly woman. She starts thumping on Mrs Duckworth’s door, then peering through the side window.
‘Is everything all right?’ says the man’s wife, appearing behind him with a vegetable peeler in one hand and a potato in the other.
I walk into the centre of the courtyard so I can talk to them all at once.
‘Someone rang 999 – don’t know why or what’s wrong – then hung up before we could find out anything else. The number apparently tracked to number three..’
‘It’s not us,’ says number three.
‘We’re fine,’ says the husband. ‘Aren’t we?’ (holding the baby up as proof).
‘I’ll give Roisin a call to see she’s okay’ says the man.
‘Oh, yes. You’d better. She had that thing not so long ago.’
He knocks on Roisin’s door.
‘She’s probably still at work’ says the man, knocking on the window. ‘Do you want me to go round the back and check there?’
‘If you like. I shouldn’t think it is her, though. I’m just waiting for Control to get back to me with more information. I expect it’s all just a technical glitch.
They all nod. It seems to be a popular explanation.
‘You don’t like to think of someone being in trouble like that,’ says the elderly woman at number five.
‘But they hung up. You wouldn’t hang up if you were really in trouble. Would you?’
‘Maybe the battery on their phone packed up?’ says the woman with the potato and peeler. ‘Our one’s pretty rubbish.’
My radio buzzes. I wave it in the air a little as if to say: Here we are. This’ll tell us.
I describe what I’ve found to Control, saying rather dramatically that I’ve knocked up everyone in the close but had no luck. The Dispatcher tells me that they’ll mark it as nothing found, and refer it to police to see if they’ve got anything to add. She stands me down. I clip the radio back on my belt.
‘Well! That’s it! Thanks for all your help!’
I pick up my bag and do a little turn in the middle of the courtyard, like I’m waving goodbye on a revolving stage.
‘Nice to meet you all.’
‘You too.’
‘Hope the rest of your shift is less eventful.’
‘I hope you find your next patient’
I walk down the central stairs, put my bag back in the ambulance car, and finish writing the paperwork.
Half-way through, the radio buzzes again.
‘The number definitely maps to that address’ says the Dispatcher. ‘Are you sure the patient wasn’t there?’
‘Positive. It’s a happy, healthy young family. They don’t even have a landline.’
‘Oh well. If you’re sure.’
‘Unless I’m in The Twilight Zone and everyone here’s an actor or something.’
‘Right’ says the Dispatcher. ‘Twilight Zone. I’ll make a note. Okay. Back to base.’
‘Wherever that is.’
And of course, even though I concentrate and try really hard to simply retrace my steps back out of the village, I end up getting lost.

Saturday, November 22, 2014

not long

Ted is ninety-three. Five years ago he had a serious stroke that left him bed-bound, unable to speak, incontinent, swallowing problems and so on. The best he can do is intimate pain – everything else is subject to the attention and good offices of the nursing home staff. He’s padded and catheterised, spoon-fed pureed food. He takes a dozen meds including prophylactic antibiotics for urine and chest infections. Every morning after breakfast Ted is hoisted out of bed to a wheelchair, bolstered with cushions, then pushed through to the lounge where he sits with his back to the window, facing the TV. There is no DNAR.
The last couple of days Ted has stopped eating and drinking. There’s a suggestion that he may have had another stroke but of course it’s difficult to say. The doctor was informed over the phone. After reviewing the situation he arranged for Ted to be collected by ambulance and brought to hospital with a view to fitting him with a PEG – a tube that passes through the abdominal wall to the stomach.
He’ll be admitted via A&E, pending an available bed further up the chain.
Ted’s daughter Fiona arrives. We tell her how things stand at the hospital, the delays, the queues in the triage area. She’s quite stoical about it. She says she faced a similar ordeal a few months back when he was admitted with his breathing.
She rests a hand on his shoulder and leans in to shout in his ear. Don’t worry Dad. I’m coming with you.
He stares ahead, his mouth hanging open.
The nursing staff hoist him onto our trolley. We collect his notes, his medication, his personal effects. We head out of the lounge to the lift.
‘Going on a trip?’ says one of the nursing staff, holding the lift door for us. ‘Have a good one!’
We ride down, the bright down spots of the lift casting all our eyes in shadow.
Fiona pats Ted on the hand, fusses with his blankets.
We wheel the trolley through the lobby, passed a potted fern, a couple of soft focus canvases, four leather armchairs round a glass table displaying a circle of leaflets.
Fiona takes a call on her mobile, makes arrangements.
An assitant in the lobby keys a sequence into a pad and the doors slide open. The wind out in the car park hits us cold, blowing in from the sea across a swathe of dark, freshly-tilled earth.
‘Won’t be long now,’ says Fiona.
There’s no reaction.

Wednesday, November 19, 2014

POV

Mark lies back on the trolley, staring up at the cabin spotlights. Every now and again he runs the tip of his tongue over his lips in a circular sweep.
‘They don’t half dry you out, them tablets,’ he says.
Mark had a sub-arachnoid haemorrhage five years ago. One of the side effects was short term memory loss. The majority of his meds are in a blister pack, but for one reason or another the Quetiapine was sent to him in a separate box. He overdosed last night. His CPN has sent him in for treatment.
All Mark’s obs are fine, but he’s told us about some hallucinations.
‘Are you having them now?’
‘Oh, all the time,’ he says. ‘It’s nothing to do with the meds. It’s just another side-effect of the bleed.’
‘How would you describe these hallucinations?’
He rubs his face with his hands, then turns to look at me.
‘Sometimes it’s just these big, shimmering spiderwebs. All colours – draped everywhere. And then other times, like now, it’s dead people.’
‘Dead people?’
‘Yeah. As real as you sitting there. A big crowd, hundreds, all huddled up. So close you can only see this much...’
He makes a frame with his hands, thumb and forefinger at right-angle, right over left, showing his eyes and nose. He stares at me like that for a moment, then relaxes his hands again.
‘That’s it. They don’t do much. You know what? I wish there was some machine I could plug into, like a PS4 or something. Then maybe we could touch hands and you could see what I see.’
‘I think I’d freak out.’
‘Yeah? Well. Maybe you would.’
He relaxes back on the trolley and licks his lips again.
‘I did, to begin with,’ he says. ‘You get used it.’

Sunday, November 16, 2014

ten minutes

Elizabeth is waiting for us in the conservatory. A tall, powerfully-built woman in her seventies, she has the worn, slightly bewildered demeanour of an athlete who threw a javelin so hard it never came back to earth.
‘David’s in the bathroom,’ she says, pushing the silvery strands of her hair back and showing us inside. ‘He didn’t fall with a terrible clatter or anything, but he’s rather unsteady on his feet and a little reluctant to bend in the middle. I tried to get him up myself, but I’m afraid I couldn’t quite manage it. He’s had problems with his back for years. The other thing is a touch of dementia, but we rub along, you know? So sorry to call you out like this.’
The house is tastefully decorated, landscape watercolours on the walls, silver photoframes on highly-polished furniture, the whole place as neat and perfect as an illustration in a country catalogue. A chair lift snakes round the balustrade up to a sunlit landing and the mosaic-tiled wet room where David is lying on his back, surrounded by cushions. He’s as olympian as his wife, except his health has taken more of a battering. His eyes are a pearlescent gray, and his hands shake when they reach out to us, flailing around without focus when we manipulate him into a better position.
We use our inflatable cushion to get David up from the floor. He can weight bear, but paddles his feet in a dangerously unstable way. We fetch a chair for him to sit on, and stand close in to keep him there whilst we consider our options.
‘Is this shaking new?’
‘No. They think it’s benign, though. Not Parkinson’s. Look – before you say anything – I just want you to know that hospital’s not an option. We’ve had a rotten time of it these last few months. David simply cannot go back there. I hope you understand. It may take some time to get him down the corridor and back to bed, but if you wouldn’t mind bearing with us I’d be terribly grateful.’
In the end we have to wheel him there on a commode. Even alongside the bed, David doesn’t seem able to make the transition. We help him to stand as positively and simply as we can, but at the last minute he loses confidence, relaxes his knees, and we have to sit him back down again. He’s easily distracted, and struggles to understand our instructions.
‘Come on darling,’ says Elizabeth, stroking his silver hair flat and kissing the top of his head. ‘There’s a good boy. We’ll get you to bed. You’ll be comfortable there. You can watch Countryfile. You know how much you enjoyed that last time.’
When she looks up at us she starts to cry.
‘He wasn’t always like this,’ she says. ‘He could do the Times crossword in ten minutes flat. Couldn’t you, darling? Ten minutes?’
She kisses his head again. He turns his head from side to side, like he’s struggling to pinpoint something he can hear in the distance.
‘Not the quick crossword. The cryptic one, you know? The difficult one.’ Then ‘Come on, David. You can do it. You’ve got to do it. One last try.’

Saturday, November 15, 2014

noise

We walk along a corridor bathed in an unearthly blue light through to the living room where Gillian is waiting, sitting on a leather sofa with a German short-haired Pointer by her side. On the wall opposite is a giant plasma screen sectioned into six, each segment the feed from a different security camera – views of the front of the house, the back, the garage, even the roof. There’s a server in one corner of the living room, a couple of laptops, only one open and on. Behind the sofa is an exercise bike, still in its wrapping. Apart from a large cage for the dog, the room is bare.
The Pointer looks up as we come in; Gillian does not.
I make the introductions; she quietly acknowledges.
‘I understand you’ve been feeling depressed tonight and cut yourself with a razor. Is that right, Gillian?’
She rolls up her sleeve and shows me the wound, a superficial scrape.
‘Have you done anything else to hurt yourself? Taken any pills?’
‘No. Just this.’
‘Your boyfriend called us…’
Ex-boyfriend…’
‘He said you sent him a text with a picture of you cutting yourself.’
She shrugs.
‘And words to the effect you were thinking of doing more.’
‘Yeah? Well – I didn’t.’
Rae dresses the wound. The dog jumps off the sofa to help. We have a laugh about that.
Gillian says she got angry when her boyfriend said he didn’t believe in her business. He should be more supportive. He doesn’t understand what she’s had to go through to get this far. He doesn’t know what she’s up against.
‘What are you up against?’
‘Oh. You know. Competitors.’
The dog has lost interest in the contents of Rae’s dressings bag. He walks over to his cage, turns round a couple of times, collapses in a compact heap.
‘I’m not going to hospital,’ Gillian says. ‘I didn’t even call you.’
We tell her it’s important she speaks to someone about what happened here tonight. Perhaps she could see her GP in the morning?
Gillian snorts.
‘I don’t think so,’ she says. ‘He just wants to get me medicated, but I’m like – no way. I don’t even smoke cannabis anymore.’
‘It doesn’t necessarily mean medication, Gillian. He could refer you on for some therapy. It might help to talk things through with someone.’
‘Yeah? Well – I tried all that and look how far it got me. I just want to be left alone to focus on the business. It’s a difficult time. Everything else, it’s just…’
She looks around, at the screens, the dog, the computers. Us.
‘…I don’t know… noise.’