On the Main Road

Friday afternoon, the eve of the sabbath. Riding home from my shift in the Emergency Department at Alice Springs Hospital I would have missed her if I’d been abiding by the law. Luckily I was riding along the footpath when I came upon her. She looked about fifty but I reckon her true age at mid-thirties. Her large face seemed inflated, her eyelids puffy, her lips swollen, her natural flabbiness accentuated by deforming scars and oedema. The face was bronze in colour. Her gaze was inward – even when I was abreast of her, when I addressed her, I was absent to her. 

In all our minutes together we were never more than ten metres distant from people passing in cars and on foot. But in our leaden ballet we would dance alone.
She was shorter than I and a good deal heavier. The weight differential would matter when I’d struggle to lift her. I was a metre from her when I first registered her human presence. A slender tree at my right shoulder obscured her from sight. Abrupt movement caught my eye, a straining, forceful jerking of her thick neck and thorax as if she sought to escape. In fact the opposite was the case. 
The woman’s hands worked to adjust a cord that looped once around the tree then twice around her neck. I saw the cord and stopped. With all in place she suddenly slumped. Don’t! Don’t do that! – these were all the words I found. I flung my bike aside and threw myself towards the woman. She grunted but did not speak. My arms about her did not arrest her fall. The cord tightened. I remembered the knife in my lunchbox. As I groped frantically in my backpack she thudded suddenly to earth at my feet.  
A white cord floated down after her. The cord was a lengthy bootlace, the sort you pull on to tighten your running shoes. That slender tie would never support ninety kilograms of self nihilation.
Lying on the earth her silent body did not move. Was she breathing? A wave of alcoholic air reaching my nostrils answered that question. Was she conscious? I spoke. No response. I shouted. No answer. I placed my right thumb into the small bony notch above her eye and pressed hard. This truly painful stimulus evoked no movement, not a flinch. On the Glasgow Coma scale I reckoned her score at eight of a possible fifteen.
As I crouched in all my clinical perplexity an Aboriginal woman appeared at my side. Gesturing in the direction from which I’d been riding she said, The hospital is just back that way. Did I smile as I thanked her? I don’t know.
My lady was alive, breathing, intoxicated, apparently unconscious. In the long seconds since slumping she had not moved. What harm had her spinal cord suffered in that violent moment when the bracing cord arrested her fall? I could not know. My phone: where was it? Fast fingers delved and delivered from my pocket. I rang triple zero. The voice asked, Police, Fire or… Ambulance! I shouted. Ninety seconds after giving location and clinical details the siren sounded behind me. The vehicle pulled up alongside my waving, jumping body. A tall woman blonde woman alighted. She would have been in her thirties – like our patient, and unlike her. I answered her questions. A friendly smile lit her face as she said, Big shock for you, I’d imagine. This time I did smile. After a shift in Alice’s Emergency Department I’d become inured to shocks. The paramedic crouched over our patient and I heard her say: Hello girlfriend! as I mounted and headed home for the peace of Shabbat.
   

A Quiet Night in Casualty

A quiet night. Apart from the ten year old who coughs through every winter and the two year old with a cut leg, all our patients wash up on our shores on a tide of intoxicants. Subtract grog from these lives, says the Director, and we could close half our cubicles. Take away drugs and we’d need only a quarter.
We treat the thirty year old whose man – drunk – split open her scalp and broke three of her fingers; we check out the Frequent Flyer with (real) kidney failure disabled for the fourth night in a row by (spurious) chest pain; he seeks opiates and when denied a needle, suddenly invigorated, he walks out. Tall and elegant, the forty-something in the very high heels tripped over her long legs following a fusillade of shots (vodka). She tore her medial collateral ligament. The man snoring down the back treated his epilepsy with a slab in place of his Epilim. The ambos brought him in, fitting. He’ll need observation until morning…

The ward slows, starts to doze. Time to go to the loo. Above the urinal a laminated protocol provides advice on intoxication. The notice is headed:

TOILET PAPER – SEPTEMBER 2014.

Around two in the morning an irruption of large bodies in blue. One, two, three, four police officers, escorting one small man whose pale blue shirt is soaked. Handcuffed to the bedrails, he yet manages to give the cops the finger – two fingers actually – one on each hand. He blows kisses to the cops. The officers remain unprovoked.

The ambo, a non-combatant, provides the story: The pub called the coppers because he was behaving wildly. His friends say he had taken ecstasy, crack and alcohol. And another tablet – they don’t know what. He went crazy in the pub. Security tried to quieten him and he fought them; then he fought the cops. These four are only half the number it took to control him. They cuffed him. Somewhere along the line he vomited.

The man is surprisingly small. His short half shirt is soaked in lumpy vomitus. Between his gallery of tattoos patches of skin are missing from his knuckles. A large abrasion swells and shines dully on his forehead. A dull steel ring decorates his lower lip. Another improves an eyebrow. When a nurse tries to mask him (“You’ve been vomiting, we need you to wear a mask”) he speaks simple words in surprisingly mild tones: Please don’t touch me. Please don’t touch me. The nurse looks too slender, too young to handle this unpredictable person. Her speech is a further surprise. Turning from the patient to the gathering of uniforms congregating around the cubicle, she asks: Do we really need all these people? She draws the curtains, comes close to her patient and asks: Have you taken drugs?
No.
Any alcohol?
No.
Have you been in a fight?
No.
Has your head has been injured?
No.
Have you vomited?
No.
Do you take any regular medications?
No.
Do you have any medical history?
No.
This is a nineteen year old without symptoms, without any reason to be here. Mildly the nurse says, Well then, once we find there’s no reason to detain you will you have any objection if we return you to these officers?
No.
To his denials of all symptoms and concerns the man adds, I don’t believe I have any obligation to answer your questions.
A compact young doctor joins the conversation: Look, Simon, we’re here to help you. We aren’t the police, we’re not charging you, we’re not collecting evidence.
Like her nursing colleague the doctor speaks calmly. She focuses on assessing and helping the patient. Your heart is racing. You’re a bit dry. We’ll put a drip into this vein. Do you mind?
No answer. Eyes closed, resolutely mute, the young man affects a coma rather than concede anything to anyone.

The boy trembles as far as his manacles allow. Is he just scared? Are his drugs making him paranoid or is he frightened by the storm of chemicals that fight each other inside his brain? Or just terrified of the police?

His shirt is wet. The thermometer reads 35 degrees.
Are you cold?
No.
Would you like a blanket?
No.
Do you need to pee?
No.

Taking the nurse aside I confide: With this drip running he will need to urinate eventually. Handcuffed as he is, he’ll need help. How will you handle that?
We’ll give him a bottle.
He won’t be able to unzip. Someone will need to pull his dick out for him.
That will be your job.

An hour later, I find the nurse and ask for the bladder report.
He’s been. He’s voided.
How did you do it?
I took him to the toilet. He did the rest.
In handcuffs?
O no: the cuffs are off. He’s calm now. I walked him there and he managed himself. The cops are leaving.

I check in the cubicle. With no need of coma or bravado or petulance, the young man – or boy – lies on the bed and chats with his girlfriend – another surprise: impeccably presented, she’s a demure young lady.

Domestic violence, drug seeking, a lacerated child, another who coughs; grog, grog, grog, and multi-chemical intoxication…

A quiet night in Casualty.

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Toby’s Fingers Stuck in the Bath Hole

My wife Annette and I are having an early dinner when my phone rings. It is Rachel, our elder daughter: “No-one is hurt, everyone is OK, but I’ve called an ambulance: Toby’s fingers are stuck in the bath hole.”

I reckon I’m equal to this little challenge: ”Darling, just soap his fingers liberally then they’ll become slippery and he can just slip them out.”
“I’ve done that, Dad, and it didn’t work. I’m attending to Toby, but I need help with the other kids. Can you come over?”
“We’re on our way. We’ll be 15 minutes.”

In the car, Annette looks at her watch and calculates that Rachel’s brother, Raphael, will be driving home about now. He might get to Rachel’s before we do. She calls Raph and indeed he is only a minute away from Rachel’s house. He isn’t driving; he’s on his bike.

We drive into Rachel’s street which is blocked by two large fire trucks, a smaller fire car, two ambulances and a police car. There is no smoke and there are no signs of a motor accident.
We park at a distance and make our way on foot to Rachel’s house. Flung to one side on the grass is Raphael’s bicycle. Ahead of us the large torso and bum of a fire officer protrude from the bathroom window. The head and shoulders are out of view, presumably inside.
We make our way to the interior. A large man walks purposefully ahead of us, lugging a heavy timber box of plumber’s tools. From the narrow hallway an ambulance officer carries a plastic drink bottle into the bathroom. The bathroom itself is small. What with the toilet, the shower recess and the old-fashioned claw-foot bath, two is a crowd here. This evening the crowd is larger: the ambulance officer, a young lady, is leaning forward, passing the drink bottle to a male colleague who sits on the edge of the bath. The missing fireman’s face and shoulders are framed in the window, as he leans inward, observing and giving advice and instructions to another fire officer lying on the floor. This is another partial fireman, his face and arms invisible beneath the curve of the steel bathtub.
What he lacks in extremities and face he makes up for in length: this is a very tall fireman.
In the tub, drained of its bathwater, sits Rachel, her back to the door. On her lap is the skinny white body of Toby, aged five, a runt, a set of bones with a piping voice. One of his arms extends to the bath hole. His fingers are not seen.
The mother is reading a story to her child.

From the family room, children’s voices are calling: Toby’s twin, Miles, and their older brother, Jesse, have sighted us: “Saba! Savta! Toby is stuck. His fingers are stuck in the bath!
Look! Lollies! Raph is giving us a special treat.
The boys peel themselves from the arms of their uncle Raphael, who stands with his bare chest, wet with the sweat of his bike ride on this hot evening of 30 plus degrees.
Miles and Jesse pull at our clothing, dragging us to the bathroom, to see Toby and his missing fingers. They squeeze past the ambos, step onto the prostrate fireman and clamber into the bath. We follow them, secreting ourselves along the far wall and we greet Rachel. Raph stands behind us in the doorway.
Rachel smiles the smile that we’ve seen before, the smile that welcomes mere chaos that unseats tragedy.
Pasted over her fear, and threat and alarm, Rachel’s smile invites us to see and share the joke.
It is hot in the bathroom. Toby’s free hand wields a lollypop that disappears and reappears in and out of the recesses of his mouth. He cries out his greetings, his words emerging through a slop of saliva and lolly juice. He is having a pretty good time.

Rachel gives us a synopsis: “I called the ambulance and told them that Toby’s finger was stuck. These guys came and called the fire brigade. While I was on the phone, Toby’s free fingers were curled up and cramped, so he made them more comfortable by poking another couple into the plughole. Now there are three fingers that are stuck.
“The fire guys have all the right tools and equipment. They get fingers out of plug holes all the time. I didn’t know that bathplugs are a fireman’s specialty.”
The fire chief in the window frame elaborates: “Normally, a plughole is a ten-minute job. They’re all plastic nowadays. But this bath is a genuine antique, made of genuine steel. The plughole itself is probably made of toughened steel: it’s usually a disc about half an inch thick, with half a dozen circular holes, all of them just about the width of a toddler’s finger.
“The plan is to cut away the drain pipe. This will allow us to raise the bath from the floor, so that Steve can get right underneath and free Toby’s fingers from below. He’ll push up on Toby’s fingertips with his own finger.
If that fails, we’ll have to saw away the steel drain and free Toby from the tub, and then tackle the fingers.

“You and your family won’t be taking baths for a while, Rachel. This bath will be in pieces once we’ve finished here.”
I take a look at my watch. 7.45 pm. Toby has been in the bath for an hour and a half.
While we’ve been talking, the home phone has rung and rung out. My own mobile has rung unattended. Now Annette’s phone rings and it is Toby’s Aunty Naomi, calling from Sydney. She had called earlier, just when Rachel was racing between the stuck child and the other children and her urgent phone calls for help. Since that time, Naomi has learned sufficient to frighten, and nothing to comfort an aunt who has visions of fingers lost by strangulation or by nightmare surgery. Naomi has no children of her own yet and she loves her Melbourne nephews and niece with an intensity which increases with the distance.

Naomi asks to speak to Toby. “Toby, would you like me to sing Rainbow?”
Toby nods, his mouth occupied by his lollypop.
Rachel switches the phone to Speaker and says:
” Toby is busy with a lolly. He does want you to sing.”
Naomi’s voice floats into the bathroom.
“Somewhere, over the rainbow,
Way up high…”
The phrases float, spacious, into the bathroom, the words a familiar caress for the boys at their bedtime. Naomi’s singing voice is a sweet soprano, usually crystalline. Tonight the voice is thickened with an unfamiliar tremolo.
“ there’s a land that I heard of
Once, in a lullaby…”
Toby is transfixed. His brothers are still. Three lollypops are held, suspended, while Naomi sings.
All conversations stops. The lengthy plumber pulls his face out from under the steel belly of the tub. His face is wet with sweat. Bathroom lint clings to his chin and brow. He lifts his head and listens. The ambos and the fire chief stand, arrested. The voice rises, crests a high note and falls. The singing undoes us, soft family and hardy professionals alike.

A skinny woman appears. She is Laura, Rachel’s best friend. Alarmed by the emergency vehicles congregating outside, she races in: “What’s wrong? Is everyone alright? Can I bring food?”
She listens, looks, offers cuddles, kisses the air with her famous loud smacking sounds and leaves, disappointed not to be catering. Laura makes me laugh, always has.

The tall man pulls his head in again. The Chief hands us a hacksaw. We pass it to the tall man. We hear sounds of sawing, long metal screams.
Alarmed, Rachel wonders aloud about Toby’s fingers: are they safely out of the way of the singing blade? The Chief says: “Don’t worry. Steve knows just where to cut. He leaves a margin of pipe just shorter than his own index finger.”

At length the drainpipe is sawn through. Everyone gets out of the bath excepting for Toby and Rachel. Annette, Raphael and I make room so the bath can be lifted. Eight adult hands hoist the tub aloft. Toby squeals with delight as he levitates.
Steve’s voice comes from the floor: “Toby, can you wriggle your fingers?”
Rachel and the ambos relay the request. Toby says, explaining the obvious to the unintelligent, “I can’t. They are stuck.”
The voice from the floor warns Rachel that he is about to push Toby’s fingertips upwards from below. Steve pushes, Toby says “Ow! You are hurting me!”
Apologising, Steve has another try and Toby cries:”Stop it, you bumhead!”
Steve stops.
The Chief retires to the fire truck, returning with some new cutting equipment which he passes to Steve. Steve now sets about cutting free the metal disc with its six perforations and its three child fingers.
The Chief invites Jesse and Miles to come and inspect the fire truck. He shows them the hoses and the heavy brass fittings, then hoists them high into the cabin and places them onto the driver’s seat, beneath the steering wheel. In the massive truck they are very small.
The Chief points out the siren, the two-way radio, the switches that elevate the ladders and all the usual automotive controls. Two boys are in paradise. I remove them before they drive off in search of a fire.

Back in the bathroom, Toby is pacific once more. He sits in the tub in his mother’s arms watching a DVD. The ambos take turns holding the portable screen at the right distance for Toby’s comfort. The DVD is in a language foreign to the ambos and fire crew. It is “Bob Esponja”, Sponge Bob in Spanish.
Now his brothers clamour to watch too. Raphael and I take them outside and hoist them onto the window sill recently vacated by the fire chief.
All of this takes place well past the bedtime of such small boys as maintain a normal, detached relationship with their bathtubs.
The boys watch and translate for the ambulance man and lady, Ross and Joelle (‘call me Jodie’) respectively. It is a cultural treat for Ross and Joelle, who have only previously enjoyed Sponge Bob in English with respective nephews.

It is about 9.00PM when the plughole with its nubbin of pipe and its heavy perforate disc is freed from the tub. Sponge Bob has finished. Toby looks at his naked self and the empty tub. He says mildly: “I am ready to get out now.”
Rachel rises, her bum and thighs numb after three hours, cradling Toby and his massive steel bracelet as she does so.
Escorted by Joelle and Ross, they make their way to the kitchen. Here Annette has covered the kitchen table with towels and a pillow for Toby’s head.
Annette takes Miles and Jesse to their bedrooms. Their protests are audible from the kitchen.
Jesse appears in the kitchen. He says,”I can’t sleep. I’m too worried.”
Somehow Annette persuades him to come back to his room. She lies down alongside him and tries to help him relax.

Now the Chief produces a narrow strip of steel blade, about a foot long and an eighth of an inch wide. Its surface is roughened and irregular; it looks like steel with acne. The Chief explains: “Diamond saw. It’s the only thing that will cut through that steel.”

The Chief threads the stiff blade between Toby’s index finger and the inner edge of the steel annulus. The sharp edge of the blade is applied to the steel and moved up and down. It seeks a niche or crack to bite at hard, but the steel is obdurate and the blade bounces off it. The Chief tries again and again. He is relentless. Steel against steel, the Chief versus the disc.
An exquisite Argentine proverb of Toby’s father, Pablo, runs: con paciencia y con saliva, el elefante se cogio a la hormiga.*
Over the next long time, the Chief will need all the patience and saliva he can muster. He sneaks the blade between the hard steel and the soft boy. The blade makes glancing contact with the disc, leaving a fine scratch in the steel. Now the blade comes again, finds the line of scratching and attacks. The linear scratch deepens minutely. It is nothing like a fissure. Many more passes of blade, many minutes in which Rachel braces Toby’s hand against movement. Rachel searches the face of the Chief. Is he discouraged? He is not. He is the elephant seducing the ant. He presses on.
The room heats up, the disc heats up and Toby protests. Now Jodie produces a green gadget and shows Toby. It looks like a fat whistle. “You put this in your mouth, Toby, and you breathe in. Then your hand will feel good again.”
Toby takes the toy, breathes in and out, relaxes and smiles. He likes his inhaled narcotic.
More laborious sawing, more minutes pass, many single tedious minutes, dragging themselves into hours. The disc is hot, the Chief is resolute, the ambos take turns positioning Toby’s wrist and the Toby rescue industry hums on. Eventually – it is around 10.00pm – Toby becomes fractious. He addresses Jody, the wrist-bearer of the moment. “Put my hand down.”
Jody explains: ”We have to hold it up high to get your fingers out, Toby. It won’t take long.”
Toby is not placated: “Stop it, bumhead!”
Bumhead’s offsider, Ross, gives Toby another suck of narcotic and he subsides.

A further half an hour passes, half an hour of sawing, story reading, perspiring and concentrating. The cluster around Toby and his still buoyant mother falls eventually into speechless reverie. Each person in her own thoughts, each concentrating on three thin fingers that remain pink and on a small boy’s face, pale now with medication and fatigue.

There is a bloke at the front gate who wants to talk to any member of the family. I am greeted by a shortish man with a warm smile and a huge camera. He’s from one of the TV stations. He apologises for his intrusion, he hopes he is not causing distress, would any member of the family be prepared to describe what is happening? I answer, “No.” The man accepts this gracefully and walks away.
I retrieve a phone call. It is Pablo, Toby’s aphoristic father. “Howardo, what’s happening? Is Toby OK? Should I come home?”
Pablo is up country, the indispensable leader of his team’s annual residential seminar. He is out of town but painfully in touch. It tears him in two.
“No, Pablo, Toby is safe and cheerful, his mum is cheerful and the house is full of fire people, ambulance people, family, friends and kibitzers. There’s no physical space for a mere father. OK?”
Pablo is OK, just. I am to ring back later with more news.
Back inside, Toby stirs, complains: “My hand feels uncomterful.” Jody confers with Ross, then turns to Rachel: ”We can’t give Toby any more of the painkiller in case it depresses his breathing. Any further doses need to be given in the Children’s Hospital, with anaesthetic and operating facilities.”

Rachel flows into action. She kisses her other boys goodnight, tells them that Toby will go to the hospital to get his fingers out and he’ll come home soon. She grabs Toby’s teddy bear, a couple of books and another DVD.
Toby says a warm goodnight to all the emergency people, not excluding bumheads.
Rachel wraps Toby in a rug, marches from the house into the open ambulance, concealing her son from the TV camera, and in a moment they are away.

I follow in my car. I work odd night shifts in the Emergency Department of that hospital. I might be useful in some way; I know people there.
By the time I arrive in Triage, Rachel and Toby are nowhere to be seen. The nurse in Triage seems to expect me. “Go into the Minor Procedures Room, Howard. They’re all in there.”

Indeed they “all” are. There are Jodie and Ross and a new fire team. Steve and the Chief and our previous team only do outpatients, it seems. The new bunch comes from another fire station and they do the inpatient jobs. There is a firelady and a fireman, both selected, surely, for their tenderness towards children. The fireman is as tall as Toby is minute. He looks at me, I look at him, Rachel looks at him. He says, “Hello Doctor Goldenberg. We met at your clinic. I married your patient, Robyn. Do you remember?” Indeed I do remember. He is Nick. Rachel is looking at him hard and long because he is so good looking.

Nick has no hand for me to shake because his are occupied with an intriguing apparatus, whose principles he at length will explain. The principles are alarming.
Meanwhile I meet Lucy, who is operating a portable DVD player for Toby, who sits in his mother’s embrace on an operating table. Toby grips his pale blue teddy bear as he always does – with one of its arms in his mouth. Every night that bear develops a soggy upper limb. The bear keeps Toby company through his hospital stay and then disappears, forever lost. Bearnapped, we suppose.
There is a nurse who is helping a doctor administer intravenous pain killers to Toby. The doctor smiles and greets me. We know each other. A quarter of a century ago, when he was a boy, I used to be his family doctor. Then he became my medical student. Nowadays, when I work at the Royal Children’s, I operate under his direction. He is the paediatric consultant on duty tonight. His name is Dominic.

Nick explains his gadget. It is a miniature example of the famed ‘Jaws of Life’ that road emergency crews use to disimpact a crushed motor vehicle from its trapped occupant. Nick’s gadget is a menacing midget of frightening power. It looks like a pair of dark steel pincers emerging from a cylindrical contrivance connected by strong piping to a device that couches like sin on the floor of the O.R. That floor dweller is a pump that forces air under enormous pressure to the pincers, coercing them apart.
Nick introduces the fine pincers into one of the unoccupied annuluses of Toby’s steel ring. He allows the pressure to build and build. The steel of the annulus resists the steel of the jaws. All our jaws are clamped hard, as we watch in dread the application of irresistible force to an object not amenable to persuasion. I close my eyes briefly against a vision of a sudden sundering of the steel bracelet or else an explosion underfoot of the compressor. The latter would destroy the fourteen limbs standing nearby on the floor; the former could shatter my daughter and my grandson.
I adopt the business-as-usual expression that one always deploys when one’s gamble with a patient’s health hangs upon the coin that one has set spinning, spinning, as it falls to earth.
With a discrete metallic sigh the annulus cracks and gapes. Firelady Lucy hands Nick a diamond–blade saw, which he wields now with a free-swinging action well away from Toby’s flesh. As the saw makes its remorseless way through the steel disc, Dominic inserts a shield for Toby’s finger.
Millimetre by millimetre the blade divides the inviolate steel. Sixteen eyes follow the progress of the blade, a remorseless icebreaker freeing the trapped one. The saw falls still, a fraction short of the shield. Now Nick applies a wrench to the opposing shores of the bay where Toby’s finger is marooned. Another steel sigh and the disc surrenders. Toby’s finger is free. Watching Aladdin and his magic, he pays no heed to our drama.
Two more fingers to go. Pincers, saw, wrench – all are deployed in unhurried speed. Nick frees Toby’s digits, tears gather at the edges of my eyes as Rachel kisses those finger tips.

Dominic examines the fingers minutely. He is checking for tissue damage. There is the small skin indentation one sees when a ring has been a little tight. The skin is pink.
Dominic tells Toby to wriggle his fingers. Toby does so, his expression of scornful surprise registering wonder at the obtuseness of the adult world.
Dominic wants to be certain that there has been no damage to nerves and blood vessels. After x-rays he will keep Toby and Rachel here, in an annexe, until the morning, “just to be sure”.
The morning is not many hours away. I kiss my grandson and I hold my daughter’s face in my hands and squeeze her beloved flesh. Then I drive home.
On the way to the car, I phone Annette and share the news. And I forget all about phoning Pablo and Naomi.
***

In the bath a few weeks later 7 year old Jesse has an idea: “Why don’t you see if you can get your fingers into the bath hole, Toby?”.

 

* Pablo translates: With patience and with saliva, the elephant fucked the ant.

Melbourne Boy Rescued After Plug Hole Drama

Melbourne Boy Rescued After Plug Hole Drama

 

Broaden the Intervention?

I am working in my general practice in the CBD when the phone rings. The receptionist’s voice is urgent: Howard, there’s a man collapsed outside on the street. Can you go?

I can. Grabbing a few tools, I race out into the street where a small crowd is gathering around a man in a suit. He lies flat on his back on the footpath outside the bookshop. Behind his head is a cylindrical object in a brown paper bag. Liquor leaks through the brown paper.

The man lies hard against the foot of a large window displaying the cream of our written culture. The man would have leaned against the window for support, fallen and stayed where he fell.

The man lies, motionless. The authority of my stethoscope opens a space for me between spectators, ambulance callers, vociferous suggesters, silent gawkers, head cradlers. The stethoscope reassures, the suggesters fall silent.

The man we all regard, the man we all fear, does not respond to questions. Nor to deep pressure of my thumb against his forehead. He lies insensible in Martin Place, grunting his shallow breaths, creased face purpled and puffy, grey hair, grey suit awry. Beneath my finger a thin pulse beats, fast and feeble.

His breath is a brewery. The wrist in my hand is criss-crossed with ancient slash marks, white against ashen skin.

It is 10.00 a.m.

This is a human person of my age, nameless to us, nameless to himself, his being reduced by alcohol and secret griefs.

The ambulance arrives and I go back inside.

*** Continue reading