“How the hell did it get here so soon?” (Tom Waits, ‘i don’t wanna grow up’).

(To my regular readers: apologies to you both. No sexy talk again. More hospital shit today. Regular service will be resumed next week…just enjoy the build up, huh?)

Today I’m specialing Joanne. She’s thirty but could pass for forty or fifty. Wheelchair bound by some kind of ulcers, otherwise able bodied. But she’s on a DOLS (‘deprivation of liberty’. Dunno what the s stands for.) Basically they slap a dols on you as fast as possible if they decided you dont have capacity and you’re a threat to yourself or others and they want to have the power to stop you leaving the hospital. You just need a negative capacity assessment is all.

Ultimately she will need to be sectioned. She’s awaiting transfer to a mental health unit. Quite how she has come to be on a ward which specializes in old ladies feeling the strain of winter i don’t know. In case you hadn’t heard, the NHS in crisis. My Mum got up today on her sixty-seventh birthday to a phone call telling her her hip operation is going to be bumped by six weeks, minimum. This was only the first consultation so god know when she will get a date for theatre now. So in her case its the difference between stumbling about for a few weeks awaiting surgery; and now, probably ending up bedbound for months, in pain, unable to work…so all im saying is, yeah. It tough all over.

I am but a humble ‘special’ but its clear to me that when this ward is short staffed, everyone sends the nurses they value least. The one who hands over to me is woman with a full beard. No correlation between beard and not being very good at your job. But in this case….both qualities are present.

So its just me and Joanne. Joanne is another manifestation of a person i have met many times, in  many bodies. She could be the reincarnation of Tracy, she of the arms sliced up like garlic breads, the fake suicide woman of upper chorlton road, who tumbled down the strata of the system, failed and failing at every stage, from bad parents to useless care home to evil foster parents to terrible mental health care, and finally killed herself after years of trying. The girl who cried wolf turned out have a real wolf inside of her. They always do. Aesop didn’t know the half of it.

So. Joanne, like many severer alcoholics who find themselves in a ‘dry’ clinical setting, has a classic method of staying drunk: she drinks the alcoholic anti-septic hand gels, which are liberally dotted around the hospital: a dispenser on the end of every bed, by every sink, and ranged along the walls and corridors. They’ve all been removed from her bay, but shes already been caught with one under her mattress, mixing herself little cocktails with blackcurrant cordial. But shes not fussy: turn away for even an instant and she’s pressing the button on the nearest dispenser, oozing a little oyster of gel into her hand, then necking it, quick as an aspirin or a  salt lick for a tequila.

We get acquainted. she asks repeatedly why we are keeping her a prisoner when all she wants is her freedom to kill herself. Shes slurring her words like a motherfucker, and keeps needing the toilet. Now and then she threatens to punch her head through the window, and now and then we go outside for a smoke. “gotta laugh or i’ll cry” she keeps saying. She never laughs though. A nephew of hers is there, transparently a scrote. Says all the right things about the need for her to get well and back on her feet, but with the polished patter of a compulsive liar. A user of some kind himself, an addict. There’s no doubt. When he fucks off its just me, her, and Doreen in the bed opposite, who has dementia and talks the most surreal nonsense from the minute i arrive to the minute i leave. Bless her.

The punchline of the story is that baffled by Joannes apparently increasing drunkenness, I act on a hunch and go into the bathroom, where i go through the bin and find a secret bottle of gel. My pleasure at my street smarts is undermined by the fact i didnt think to do this until eight thirty, and hour before the end of my shift. She’s drunk a half pint of the stuff in the meantime. To catch a junkie, think like a junkie…when you get round to it.

So the glorious achievement of my eight hour shift is to leave my patient even drunker than i found her.But i have prevented any possible suicide attempts, so im not entirely useful. No head through the glass, and no zipping off out the ward in her wheelchair.

I take her for one last fag. The sky is starry and i can see Betelgeuse,  flashing purple and red. Somewhere out there, there is either another planet with life- in which case, there must be millions of them…or none at all.

The jury is still out. This may well be the only place in the universe, with any life. The only place with love and poetry. The only place with animals and plants. The only place with spoons and paperclips and arse fucking and anteaters. The only place with dysfunctional creatures, staggering around with sparks spitting out of their over complicated brains, drinking alco-gel to drown out the roar of the memories of the man who beat you and the father who fucked you and the pounding, screaming voice saying over and over:

kill yourself kill yourself kill yourself kill yourself kill yourself kill yourself……

My shifts over. I jump on my clanky little bicycle and away into the night i whizz, through the shifting city beneath the cold sky full of inscrutable stars.

Who knows, maybe we’re not alone. Maybe somewhere out there, there are planets crammed with intelligent beings, strange and different and just like us. The residents of Betelgeuse, as busy as us- waging their wars, fucking their kids. Drinking alco-gel and planning the apocalypse.

Saying corny-arsed hackneyed things like ‘gotta laugh, or i’ll cry’.









Christmas is coming and a man’s gotta work.

I call  this particular shift-pattern‘The Stinker’:  three fourteen hour days back to back. ‘Specialing’  David Arboghast, the  wild man of ward 69.

“Can i ask you a question? Where AM i?”

“You’re in hospital, Dave.”

Dave is amazed. Yet again.



“And where’s me Mum?”

“I’m sorry Dave. She’s passed away. But i do think you already knew that.”

Dave’s eyes widen, but he doesn’t break his flow “She’s passed away…? She’s in heaven. And can i ask you a question: where am i?”

“Hospital, Dave. You’re in hospital”

His eyes bulge with fresh astonishment: “ HOSPITAL? And when can i go home?”

“Well, we need to find you a new home, Dave. You don’t have one just now.”

More puzzlement. “I don’t have a HOME? And wheres me Mum?”

“She’s dead, Dave. YOU know this. It’s been five years.

Again, confusion wracks his face. “Dead? And where am i…?”

“Lets stop taking for a bit, Dave. Why don’t you drink your coffee?”

“Okay. But can I ask you a question? Where AM i?”

I leave the bay and step out into the ward. Wendy is in the sluice, having punched the girl specialing her and legged it down the corridor. No-one wants to go in after her. “why don’t you try? She’s good with you.”


Wendy is crouched behind the bedpan masher, her face contorted with the pain of constipation. “Come on Wendy. Let’s get you to the toilet.”

She lunges  with demon-speed, catches hold of my ID lanyard and starts to strangle me with it,surprising strength in her bony arm. Luckily its the quick-release model and comes loose in her hand. With a  scream of relief she unleashes a huge poo on the floor of the sluice room. Fatima pops her head in “you okay?”

“Sure. She’s pooed. I think she should be calmer, now.”

Mister Chang weaves past,  laughing, a snaking trail of urine in his wake…there doesn’t seem to be any other staff on the ward. I reach out to Mister Chang. “Mister Chang, wait…do you want the toilet?” The man in bed fifteen is screaming that his bed is on fire…a hand grabs my sleeve. It’s Bob, the boxer:

“What the bloody hell is going on? I need to get to work. Can you catch the bus, from here? I’ve never seen anything like it…”

Sounds emerge from Dave’s bay, cries of wrath and screams of fear.I rush in to find Dave, towering over Arthur in bed ten,  who is quaking like a child. Arthur is ancient, and has terminal cancer. He’s  compos mentis but suffering from acute anxiety.   Previously he regarded Dave as  an amusing  clown, having arrived at the ward after Dave recovered from his original state of disconsolate 24-7 rage. But now it’s back. Dave’s teeth are bared, cords stood out in his neck, a vein bulging on his forehead.

”Where the FUCK is that TWENTY QUID YOU OWE ME?”

This is another of Dave’s  little fixations, which he rotates. Earlier it was his Mother, yesterday  it was girls. Now the carousel has clicked back round to money. His fists are raised, face purple. I get between them.

“Dave! Get away from this man! He doesn’t owe you ANY money! Get BACK NOW!”

“NO!” Screams Dave, hysteria rising “He DOES! HE OWES ME TWENTY QUID AND I FUCKING WANT IT NOW!”

“Get out” I say. “Get out of the bay and into the day room!”




He pulls down his trousers and starts doing ‘the pelvic thrust,’ manically shoving his floppy dick at the terrified man, cowering in his bed, fists flapping menacingly. I give him the iron finger. “GET OUT!”

“RIGHT, THAT’S IT!”  He turns on his heel and goes storming out of the bay, his little fat bum wiggling angrily as he waddles into the corridor. I follow.

“Get your trousers on and get in that day room!”

“Okay.” He says, suddenly mild. Soon we’re sat watching ‘Come dine with me’, and hes meek as a lamb. “I’m so sorry. Its just, i get very confused. Me ‘ead’s in BITS.”


Is this confusion or a moment of clarity? Its hard to call. Dave, by the way, is not mentally ill. Nor is he an elderly patient like most of the others here, so it’s unlikely to be dementia. He is only thirty-nine years old.

Dave’s problem was supposedly a mystery. Me and Alicia  spent weeks telling everyone it’s Korsakoff’s but the Doctor’s wouldn’t have it. They’ were acting all ‘House’, scanning and testing for rare syndromes. The results eventually confirmed our amateur diagnosis. I can write the script, too.

Dave has never been that bright- I’d say a mild, undiagnosed learning disability, low IQ. He’s spent most of his life hanging around in shitty pubs where people of slightly higher capacity have found it hilarious to ply him with drinks, and eventually he’s attracted orbits of creeps who make a living exploiting vulnerable adults. There are skanky little cartels of them,  no-marks who inveigle themselves into their victim’s confidences then fleece them for anything they can. “I need to borrow your X-box mate, okay? And can you lend me fifty quid? How can I be ripping you off,  I’m your mate. Here, have a packet of fags.”

The worst of it is, Dave then forgets to eat. He drinks and drinks, plays the clown, while vitamin deficiency nibbles at his brain. By the time he’s found wandering the streets in an acute state of derangement, its irreversible. Now he’s beyond learning disability, he’s completely crazed.

I’ve been following reports of the plans for the first human head transplant, and one phrase stuck in my head. Denouncing surgeon Sergio Canavero as a madman, one doctor said that if the patient survives, he will ‘experience previously unknown levels of insanity”.

Looking at Dave, I have an idea what he might mean.

The divine spark of consciousness, instilled in the vulnerable porridge of a human brain. It’s a miracle it ever works at all. But when it goes wrong…hooboy. “The thousand shocks which flesh is heir to” said Hamlet.  Well, we’ve come a long way since your time, prince of Denmark. Now we have the medical encyclopedias breaking our bookshelves. Now we have thousands. Plural.

Nine-thirty. I’m out of here. More of the same tomorrow. I should sleep, but instead I’m on the net. Looking for flesh to drown in. Get some fun out of this meat suit before that unhappy inheritance turns up to take it all away.

Ooh look a party. For broad minded adults. Anything goes. Bring a bottle.There will be twister.Hollinwood ain’t so far away.




I sit in the little waiting room watching ‘homes under the hammer’ until i’m called through.

It’s a nice lady. It’s always a nice lady and they’re always gorgeous, why is that? Maybe they seem more lovely because of the situation. Their manner, the power of their job, their no nonsense attitude and warm, worldly wise understanding of everything they hear.

“I’m going to have to ask you some questions.”

“It’s okay.”

“How many sexual partners in the last six months?”


“Double figures?”


“Male or female?”

“Yes. I mean, both.”

Oral sex?”


“Penetrative vaginal sex?”


“Anal sex?”


“Giving or receiving?”

“Both” (blushes now. From me,)



“Protected with strangers?”


“Protected for anal?”


“And oral?”


“Even with males?”

“No protection for oral, no.”

“And the unprotected penetrative sex, is that with a regular partner?”


“Someone you know?”

“Does ex wife count as someone I know?”

a wry, indulgent smile.


“Multiple partners simultaneously?”

“Uh, yes”.
(I’m not sure she really asked that one, but it seemed like she did. Like she turned me inside out like a piece of fruit and saw everything there was to see.)

She smiles, folds away the paperwork.

“Well, you definitely meet the criteria. Your are entitled to a free Hepatitis vaccine.”

“thank god. The cost of all these vaccines is something else.”

“are you training as a nurse?’

“I wish. Well, maybe eventually. Right now, care support worker.”

She looks sympathetic. “do occy health not do them?”

“What occupational health?  Its an agency. They tell us its our own responsibility. It’s been a real slog to get them all. T.B, you can only get free if you live in cheetham hill, for some reason. Plus they told me I was too old and it wouldn’t work on me. Which isn’t true at all. I had to get it done at a travel clinic. And I had to threaten my G.P with P.A.L.S to get my MMR. Then again, he didn’t bother giving me the second dose.”

“Well, you’re alright here. You definitely meet the criteria for free hygiene.”


“Its OK. We hear all sorts. You’re normal.”

“Thanks. Actually, I’m special.”


“That’s the job title. Working one-to-one with a single patient, using skills gained from my experience in mental health. Confused or aggressive patients, in a general hospital setting. I’m a ‘special’.”

“Oh I see. Well, good luck with your specialing.”


We go through and she gives me my shots. She gives me a leaflet about PREP too- the new pre-exposure prophylaxis. She explains, in euphemistic terms, how you can now dose up on drugs and then go out and get filled with the spunk of the rugby team. No protection needed, 99.9% success rate, and no unpleasant side effects.
“But i’m sure you don’t need that. That’s for if you’re going to parties, with dozens of people, and…anyway, here’s the leaflet.”



Woo-hoo! Its off to my new job in the glorious NHS- complete with anti-social hours payments- time and a half for saturdays and night shifts, and double pay on sundays.

I’m allowed through the doors of that fabulous institution, the Manchester royal infirmary!  I work now for the mighty NHS, not some carpet bagging private firm mopping up the ongoing disaster of care in the community. I’m an NHS worker, and I can hold my head up  high!


They start me off gentle on an easy ward. I’m sat outside the door of a side-room, where a lad with terrible brain damage sits all day, rocking back and forth. Every now and then he gets up and ambles down the corridor, then out the door to smoke the dimps off the ground at the smoking shelter. He has a huge hole in his head, like someone took a bite out of it, big as your fist. His fingers are yellow with nicotine, he smells like an ashtray, and there’s always a sparkling silver string of drool hanging at his mouth. There’s no conversation, but I talk to him pleasantly, I feel, about the weather and the soaps and the price of fish and so forth. The ritual is repeated throughout the day.

He’s actually waiting for his mum to come and get him. Twitching with nervous expectation. She keeps not answering her phone, she’s getting later and later. We start to worry she’s playing him for a fool. The end of the day comes round and its clear she’s not coming. Who can blame her? He shuffles sadly back to his room, drooling the while. Then at the last moment, when my shift is just about to end, she comes crashing through the doors at the end of the corridor, arms wide. “Hey, son!” The traffic was terrible! C’mere, darlin’!”

He shuffles down the hall towards her at double speed, and my first day ends on a sunny note.

Day two, will be a whole ‘nother ball of wax. Two weeks in, you’re gonna need all that dirty time you told the nurse about in the clinic.  Just to keep your head exploding from all the things you’ve seen. And smelled. And touched.


I’d heard that you could get your vaccines for free if you told the clinic you were promiscuous. I told everyone at work that i made it all up, and they said i didn’t look the type to say such things. Well. ‘There’s no art to map the minds construction in the face’ said Shakespeare. And he should know.

They don’t ask everything at the clinic. No need to know if you take it up the arse from several big hairy, ugly men in a row, if you like two dicks in your mouth at once,e if you let me hit you and spit at you sa thank-you sir and beg for more. No need to enquire, whether the women you let lick your arse, do it in a room full of strangers, all high as kites on vodka and pills. It’s not relevant to your medical history, if you’ve fucked a twenty stone woman while he husband watches, smiling.

I’m 43 years old, divorced, father to a two year old,trapped in a human body, trapped in manchester, trapped in the year 2015. Trapped in a job a trained gibbon could do, because i’m too proud to get my head down and study for something better. Because I still think i’m a writer. Well, write about this, smart arse: you’ve traded in the mad and the dangerous for the ancient and the demented. Mopping up the shit at the last gasp saloon. Gently stroking the papery hands of  beings who are frightened and confused, because their mind is being stolen away, a little piece at a time.

Its all flesh.Various flavours.  This morning you’re wiping an old lady’s bum, tonight you’ll have a younger arsehole round your cock. At work, Death works right beside you, leaning over your shoulder, breaking off a few more crumbs with his fingertips. Dementia, brain damage and madness, all steal  life in instalments, like a higher purchase sofa. God instilled the divine spark of consciousness in the brain of an over developed ape. Some kind of joke i guess. I understand he moves in mysterious ways.

So dear Venus (40) and Penus (42) please may i come to your party? Its been a hell of a day and I’m looking to let my hair down. I promise you’ll be glad you asked me.

I got a lot of nervous energy, to work off.