The Shoes of the Ambulanceman

As he goes quietly and without fuss about the day to day business of his chosen profession, the ambulanceman will now and then find himself privy to an observation, perhaps offered by a disinterested bystander confronted by parts of the human anatomy not often seen in the course of his daily routine, or maybe voiced by a relative of a patient who has brought shame and dishonour upon the family name by discharging bodily waste products in prodigious quantity without the least consideration for the convenience of others.

“I couldn’t do your job,” they exclaim with a grimace of distaste, taking a step back and watching with stupefied fascination as we stuff eviscerated organs into gaping abdominal cavities or scoop diarrhoea from between the wobbling, dimpled buttocks of demented geriatrics; and while most of us could in all honesty address the very same remark with envious admiration to, for example, the brain surgeon or the astronaut, the spirit in which it is employed within the hearing of the ambulanceman is in reality more akin to the manner in which it might be directed not to the erudite restorer of neurological function, nor to the fearless explorer of the universe, but to the man who earns his living in the abattoir or the sewer.

What they mean, of course, is not that they are awed by the innate superiority of our physical and intellectual prowess, for in truth to undertake the work of the ambulanceman requires little more natural ability than a keen eye and a steady hand, but that they wouldn’t for a moment give serious consideraton to embarking upon a career of such unpleasant and menial servitude even if the wages were on a par with national average earnings.

The bald truth is that either you have the stomach for it or you do not and the time-honoured method for determining definitively if your digestive system is sufficiently robust to withstand the peculiar demands of our noble profession is to be taken without prior notice at the earliest opportunity to the very lip of the abyss and dangled over the edge by your ankles.

Max Callow, smooth of cheek and clean of limb, presented himself early one morning at the Clapham ambulance station fresh from the Royal Academy of Ambulance Studies in proud possession of a gleaming new stethoscope, unconscionably shiny boots and a pristine green knapsack bulging with bags of salt water and the latest word in plastic tubes. Like most paramedics he would never get to open his bag in anger, though not, as is customary, because the zips were jammed irrevocably by the rust and detritus of neglect but because he reached the eminently sensible conclusion early in his career that the rigours of the ambulance life quite simply were not for him and expressed his decision to quit not through the usual channel of submitting a formal letter of resignation to the Department of Human Commodities but by running screaming from Prince of Wales House and disappearing into the mist without pausing to offer so much as a word of explanation.

We’d been sent on our first call of the shift to a flat on the Balmoral Estate, the elderly occupant of which had not been seen for several weeks and from which there was reported to be emanating a nasty smell, and as that grim conglomeration of dirty grey towers hove into view, my hands started to tremble and my teeth chattered like castanets as the recollection of my own baptism of fire assailed my memory with a harrowing intensity and I had to force myself to clamp my lips tightly together to prevent a mixed kebab and several pints of Wandle’s Most Peculiar from disgorging themselves over the dashboard.

With a stark and terrible clarity, I remembered being propelled by the irrepressible enthusiasm of youthful curiosity, though assisted, I swear to this day, by a firm shove to the small of the back, through a doorway and into a stiflingly hot and gloomy bedroom, whereupon the stench of putrefaction struck me like a well-aimed jab to the oesophagus, bringing me up smartly and stopping me dead in my tracks with the sort of unexpected jolt usually associated with walking into a lamp post.

I gasped with shock and my lungs filled instantly with the noxious gases of corruption, causing me to gag and retch as though drowning beneath a tidal wave of nausea. Blinded by tears and bent double, my head spun with hypoxia and the cold sweat of panic prickled from every pore. Then everything went black as a cloud of bluebottles enveloped my head, crawling over my face, exploring every orifice, the volume and pitch of that fearful buzzing overwhelming my senses, banishing rational thought and driving me in a moment to the very brink of insanity.

Craving only light and air, I turned to find the door locked, and in a mounting frenzy of desperation grabbed the handle, pulling and tugging with what remained of my strength until it came off in my hand and I stumbled backwards, tripped over something bony and fell to the floor. Beside me, wearing striped flannel pyjamas, lay a writhing mass of maggoty flesh surmounted by a bare skull, its empty sockets staring sightlessly into infinity. Unable to breathe, I began fading in and out of consciousness, my limbs heavy and unresponsive as I surrendered finally, gratefully, to the warm and comforting embrace of oblivion.

And then, as I bobbed weakly to the surface of awareness for one last time, I heard the sound of mirthless laughter echoing across a void from far, far away and a gruff voice calling to me as though from somewhere high above.

“Welcome to ambulance work, son,” said Fred Ventricle, standing in the doorway, a roll-up dangling from his lower lip, smug amusement glinting cruelly in those cold, knowing eyes.

Many years and countless prescriptions later, I still have nightmares about my first day on the ambulances, and while I have been advised by my colleagues that chronic barbiturate dependency and those middle-of-the-night moments of waking, sweat-soaked terror are but a small price to pay for a comprehensive education at the hands of one of the great pedagogues of the golden age, in rare moments of introspection I sometimes have my doubts. But then again, I endeavour to console myself — for I am by nature, and despite everything, of an optimistic disposition — were it not for Professor Ventricle’s munificent tutelage, well, who knows where I might be today?

Being something of a stickler for old-fashioned good manners, I steeled myself, gritted my teeth and swallowed last night's dinner for the second time, shuddering with repulsion as I struggled to regain some semblance of composure. The dark edifice of Prince of Wales House loomed over us, silent and forbidding like a sinister monolith, the red crosses of St. George draped here and there providing the only respite from its unremittingly grey facade and lending it somehow the impression of a medieval fortress and serving to engender within me a curious mixture of dark foreboding and patriotic fortitude. I reached for my sword; and then remembered I was an ambulanceman.

A soft drizzle fell from a colourless sky as we hurried past the rubbish bins and up the concrete steps into the entrance, the heady aroma of stale urine and cheap disinfectant serving as an appropriate appetizer for the plat du jour which lay ahead.

On the seventh floor we found a trio of slippered pensioners huddled in squawking conference outside flat forty-eight, the door of which stood ominously ajar, revealing only darkness within. I stood on the threshold and a waft of warm air caressed my face. My nose twitched professionally in the manner of a scent hound and I detected more than a hint of putrescence upon the breeze. Shushing the fretting crones with a universal gesture of impatience, I strained my ears and heard a distinctive humming sound, whereupon a curious transformation occurred within me and things started to get a little odd.

Like an actor whose stage fright disappears the moment he steps from the wings into the spotlight, I felt suddenly calm and strangely detached from the peculiar circumstances of my own existence as I assumed the mantle of a character somehow more familiar to me even than my own, and I seemed at once to mutate physically into someone else. My stance altered, the feet spread, the legs slightly bowed, the shoulders subtly hunched. I felt I had become a little shorter, a little thinner, and though I couldn't have explained how it got there, I reached up without thinking and took a hand-rolled cigarette from behind my ear, muttering foul oaths as I lit it and resisting a very strong urge to spit on the ground.

“Come on, son, let’s take a look,” I said automatically, my voice having acquired a certain coarse quality, the words springing easily to my lips as though from the pages of a well-thumbed script, the line from the familiar scene where the innocent young man is lured unsuspectingly along a dark, malodorous passageway to face a harsh and unexpected scrutiny of his innermost resolution.

The air seemed to thicken as we walked along the corridor, the evil smell overpowering, that furious buzzing increasing in volume with every step and calling to us like the sweet, irresistible music of a siren song, drawing us inexorably onward to the closed door at the end of the hall.

We stopped and stood before it and I sensed a slight hesitation in Max as his knees quivered gently and a cloud of apprehension obscured his once unshakable enthusiasm and dulled the edge of his youthful perspicacity. He glanced at me for guidance, a distinct gleam of uncertainty in those keen eyes, a faintly green pallor beneath the surface of his clear complexion, and I was struck by his uncanny resemblance to someone from many years ago.

I reached across in front of him and turned the handle, my other hand hovering behind him, poised at the small of his back.

“Go on, son,” I said, smiling with the reassuring confidence of long experience, the roll-up dangling from my lower lip. “In you go. I’m right behind you.”