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The Man in the Alley

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“You gonna eat this or do I have to take one for the team?” Katie says as she waves the last foil-wrapped chocolate at her colleague, a thank you from a grateful patient.

Rachel looks up from the notes she’s reading and grins. “It’s all yours.”


She closes the file and slips it back into the drawer while Katie unwraps the chocolate and bites into it happily.


“You see Britain’s Got Talent last night?” Katie asks, still chewing.


“Only the first ten minutes. Steve wanted the football on.”


“Huh. It’s good to know there are some benefits of being single.”


Rachel laughs. They’re four hours into a twelve-hour shift and things are reasonably quiet on their floor. Steve texted a couple of hours ago to say the kids were in bed and he’d finally sorted out the problem with their internet connection so all’s quiet on that front too. Although she prefers being busy, she’s experienced enough to take these lulls when they happen because in this hospital, they’re rare as rocking horse shit.


She’s about to go and check on her patients when the phone on the desk starts to ring. Before she picks up the handset she looks at Katie.


“I’ll get this, can you go and check on Mr. Parkinson? He needs a BP reading.”


“Will do,” her colleague replies, pushing away from the nurses’ station and heading off down to the wards.


“HDU,” she says by way of greeting.


“Hi hon,” the caller says, the soft Geordie accent identifying her instantly. “You busy?”


“Aw, don’t make me tempt providence, Kel. How’s things in the zoo?”


“So-so,” her colleague replies.


Rachel worked Accident and Emergency for eight years so she knows ‘so-so’ means that there’s the usual assortment of drunk and destitute cluttering up the waiting room alongside people who would be better waiting until the morning to see their own doctors. ‘So-so’ means very few actual accidents or emergencies, which, understandably, isn’t a cause for complaint.


“Did you get those results you were chasing earlier?”


“I did, thanks. Hey, did you get the green light for this Saturday?”


“I did,” Rachel replies, grinning. “Steve’s gonna take the kids up to his mum’s.”


At the other end of the phone there’s a crash and unintelligible raised voices. Kelly’s lack of reply indicates that she’s obviously been distracted by whatever’s going on there.


“Kel? Everything okay?”


“What the hell...” she hears her colleague mutter before she seems to remember that she’s on the phone. “Rach? I’ll call you back.”


The handset’s dead instantly. Rachel frowns and replaces it just as Katie returns from her ward round.


“Problem?” Katie asks, seeing her expression.


“Dunno. It was Kelly. Something’s kicking off down there.”


Katie rolls her eyes.


“God, I don’t miss working A&E.”


“You and me both.”


OoOoO


A short time later, Rachel finds herself taking the elevator down to the ground floor. One of her patients on High Dependency has regained consciousness and is raving about his personal effects, so she’s promised she’ll go down to A&E to see if they’re there from when he was admitted earlier.


As soon as she’s on the shop floor she realises that something feels different. It’s busy - not Friday or Saturday night busy, but all attention seems to be focussed on one particular bay. She can hear Kelly’s voice in there, but it’s tense-sounding and she’s clearly in the thick of whatever’s happening. Hospital security is out in force alongside some uniformed police officers, one of whom she recognises.


“Pete?” she says when she’s close enough to attract his attention. On closer inspection, his uniform is dirty with... mud? “What’s going on?”


“Wish I knew,” he says, running a hand across his shaven head. “We got a call, right? There’s a guy in an alley behind Mumbai Spice in St. Pancras; it was called in as an assault.”


“And?”


“And, it’s not like any assault I’ve ever attended.”

He stops as there’s a shout from the end bay, an animalistic noise born of pain, fear or both. They both look, but there’s nothing to see with the curtain firmly drawn. The two security guards edge closer. Pete turns to look at her again.


“We get there and at first we can’t see anything. The guy’s like, hidden himself between some bins. Anyway, when we find him, we tell him it’s safe to come out, but he doesn’t move. So, Tony goes in to help him thinking maybe he’s injured and the guy friggin’ leaps at him like a wild animal. Took three of us to restrain him and he still didn't stop fighting us. The paramedics had to sedate him in the end, which is the only reason he's not still there.”


“Is he old, young, what?” she asks.


“No goddamned clue, but he's bloody strong. You wanna see him, Rach,” he says shaking his head. “If he wasn’t in the middle of St. Pancras, I’d have sworn that they’d found him in a swamp or something.”


There’s more shouting, then the curtain snaps back and Kelly emerges from the bay. She’s got dirt smeared on her face and uniform. When she sees Rachel, she hurries over, looking relieved.


“Tell me you’re here to help.” She’s not kidding either.


“I can,” Rachel replies, still perplexed. “What do you need me to do?”


“Come help me get some Midazolam in this guy.”


Things must be bad if they’re trying to sedate him again. Kelly’s got that winning combination of firm manner and good looks, so if she’s failed at reasoning with the guy then drugs are obviously the only option. Instantly in business mode, she snaps on some latex gloves while Kelly goes to sort out the medication.


She draws back the curtain and goes in. The bay is actually three bays together and yet it still looks crowded with other medical and security staff cluttering up the place, their collective attention on the furthest corner.


On the floor a man is sitting hunched, back pressed against the wall, one arm wrapped tightly around his body as his eyes dart around the assembled group warily. He’s caked head to toe in mud and his clothes are tattered and torn. There’s blood, too, in the mess that should be his hair, but it’s impossible to tell where it originated. He looks wild.


She steps forward without a second thought.


“Hey,” she says gently, crouching down, although she’s still a safe enough distance away in case he tries to attack her. “What’s your name?”


Silence. His gaze flicks upwards, eyes narrowed, as if he’s in pain.


“Can we turn off these lights?” she says over her shoulder, mindful of keeping her voice even.


Someone does as she asks. She doesn’t think she’s imagining it, but the look of pain eases a fraction.


“We just want to help you,” she says, studying him closely. “My name’s Rachel. I’m a nurse. I won’t let anyone hurt you, I promise.”


He looks straight at her now, and she waits while he appraises her. She moves forward a fraction, still poised to turn and run if need be, but keen to see if he will allow her closer. Now she looks, she can see his right arm is hugged tight to his chest and, whereas his left hand is balled into a fist as it rests against his legs, his right is splayed open. It doesn’t take an x-ray to see that most, if not all, of the fingers have been broken.


His gaze suddenly flicks away from her face to somewhere over her shoulder. Kelly, she realises, has come up behind her, presumably with a syringe full of sedative to bring this standoff to a swift conclusion.


“Give it to me,” Rachel says calmly, holding out her hand without turning.


“Rach...” Kelly says and her tone is awash with concern.


Please.”


The syringe and a swab is placed on her outstretched palm, the action watched by their mystery man. Her colleague backs away, and even though there is a phalanx of strong men poised to ride to her rescue, it feels like she and the man on the floor are the only two people in the world.


“I want to help you,” she repeats evenly. “Will you let me? You look like you need a friend right now.”


She’s closer than ever now – mere feet from him. He remains stock still, which she’s stubbornly telling herself is a good thing. Although he’s already seen it, she shows him the syringe.


“I want to give you this. It’s something that will help you relax because we just want to help you.”


Her heart’s in her mouth as she reaches out and touches his left arm. He flinches slightly, but doesn’t pull away or go to strike her. His eyes are flicking between the sedative and her face.


“I know you’re scared, but I want you to trust me.”


There’s a couple of inches of wrist clear of the ragged cuff of his jacket, which she decides to aim for; it’s far from ideal because his skin is so dirty and the small alcohol swab won't be enough, but needs must. She knows the staff behind her will be expecting her to strike quickly, but instinct is telling her not to – she’s asking him to trust her so tricking him seems unfair when he’s plainly terrified.


“Can I?” she asks quietly, meeting his eyes, communicating that she won’t do this without his permission.


He studies her for what feels like an eternity, then glances down to the purchase she has on his arm. His eyes flick briefly back to her face before they close. Permission given.


“Okay,” she says, finally allowing herself to breathe as she sets to work. “Thank you. You’re doing great.”


She can feel the collective release of tension in the room with the sedative administered; it’s fast-acting so within a few minutes it should take effect, allowing them to finally examine him. If this were a movie, she thinks, the people behind her would probably burst into applause, but it’s not and they don’t. They’re sensible enough to hang back because they can see that she’s going to stay with him until the drugs have kicked in.


With the imminent danger resolved, she studies him more closely, all the while still muttering gentle words of encouragement. Pete was right – the guy’s dirty, dishevelled appearance makes it impossible to age him, but she thinks he’s younger than they’re all imagining. He’s got facial hair, but nothing she’d describe as a beard because it’s patchy and it seems that there have been rudimentary attempts to keep it from getting too long.

 

All in all, whatever’s happened to him has reduced him to this level of trauma. She’s moved and also profoundly touched that he allowed her to help him. Much later when she's reflecting on the evening's events, she’ll blame this unexpected cavalcade of emotions for what she does next.


Within five minutes the guy’s basically asleep and the world behind her has come back to life. She tunes into a conversation – Kelly and one of the other nurses – about what the hell they’re going to do with him, because the sedation won’t last forever.


“Bring him upstairs,” she finds herself saying suddenly. “The isolation ward is empty. We can put him in there.”


Kelly approaches her as she stands up, her knees creaking in protest. “But-”


“It’s okay,” she replies. “I’ll clear it with management.”


She glances back to the figure slumped in the corner. The decision will undoubtedly come with headaches, but it’s still the right one.


OoOoO


Unsurprisingly, there’s little resistance from her colleagues in A&E about her plan to take him upstairs to the isolation ward. Security are, at first, insistent that they accompany the gurney up there and stay, until she convinces them that she’ll be fine – she’ll call them if she needs them.


The sedative they used is one supposed to cause conscious sedation, but it’s knocked him for six. While he’s out for the count she does some preliminary checks and sets about getting him out of his clothes and cleaned up so they can check him over properly.


Katie’s agreed to keep everything else ticking over so she can get as much done as possible while he’s still unconscious. She’s grateful, although she’d seen Katie’s bemused expression when she’d returned from a run downstairs to look for some guy’s wallet with a whole new patient in tow.


“Okay,” she says, more to herself than the sleeping man on the trolley. He’s lying on his side, in no better state than he had been when he’d first been admitted. Time to remedy that. She gets to work with her scissors, cutting a path through his upper clothing first. He’s wearing a leather jacket so, at first, she makes frustratingly slow progress. After that, things are much easier.


As she cuts away an overshirt and then a t-shirt, she realises that her original assessment about his build is way off. He’s definitely tall – over six foot for certain – but the body beneath the dirty clothes is thin in a way that says it hasn’t seen food for a significant amount of time, and her concern for his pitiful condition increases tenfold.


She cuts everything away, and tosses it all into a clinical waste bag. While he’s still so out of it, she fills a bowl with warm water and begins to gently soap away the dirt on his skin. It takes more time and pressure than she’d anticipated, telling her that the grime has been there a while. She can’t apply too much pressure though because who knows what injuries lie beneath it all?


“What the hell has happened to you, fella?” she says quietly.


It takes a solid hour, but eventually she stands back to admire her handiwork.


It’s worse than she thought.


He looks, for want of a better word, like he’s been mauled. His bare flesh is riddled with injuries – some look old, others much more recent. There are puncture wounds, slashes – hell, there’s even some that she’d swear are claw marks. She’s mulling this over when the door opens and Katie steps into the room.


“Holy...shit,” Katie says under her breath as she approaches, which Rachel considers a pretty accurate summation of her own feelings on the matter.


“Do you know if Pete’s left yet?” Rachel asks.

The police will need photos because even though they don’t know what’s happened to him yet, a crime has undoubtedly occurred. People definitely don't get into this state by choice.


“Yeah, they’ve gone. They’ve asked you to call when they think he might be ready to be interviewed.”


“They not had any luck IDing him yet?”


Katie shakes her head, her eyes still fixed on the broken body on the bed. “No. I’ve given them the phone you found in his pocket. If it doesn’t work then they’ve got nothing...”


They stand for a moment, studying his sleeping form.


“Poor guy,” Katie says, shaking her head. “Poor, poor guy.”


OoOoO


It’s another hour before he comes around. Rachel is in the room when he starts to stir and she takes a preparatory breath, hoping she’s ready for whatever will happen next. The lights are dimmed and she’s managed to get him into underwear and a gown and under blankets on the bed in the hope that when he wakes, he’ll feel safe and not threatened. She’s managed to take blood and carry out other basic tests whilst he was asleep so, for now, she can focus on gaining his trust.


“Hi,” she says gently when his eyes open and land on her. She’s keeping a safe distance again, for both their sakes.


She hears his sharp intake of breath as his eyes dart around, frantically trying to work out where he is.


“You can relax, you’re safe.”


She’s willing him to believe her because if she has to call security, then there’s a possibility they may decide he’d be better in police custody and she really doesn’t want that to happen, for his sake. She remains completely still and after several tense moments, his breathing slows.


“I’m Rachel,” she says, not sure if he’ll remember her introduction from downstairs. “I'm a nurse here. Can you tell me your name?”


Her question’s met with silence. She’s considered that he might not speak English, but she has to at least try.


"You're at University College Hospital in London."


Her query that he might not speak English is answered soon enough as his eyes widen in apparent shock. Since he's been taking in his surroundings, she can only assume that it's the 'London' part of what she's just said that's causing his surprise. She then wonders if he's got some kind of memory loss.


"I want to try and help you. I'll explain everything I want to do and I won't do any of it without your permission, okay?"


He doesn't give her an answer, but his eyes flick to meet hers. Good enough, she thinks.


"Okay, good. First, I need to know if you're in pain anywhere. Can you show me if anything hurts you right now?"


Her eyes go automatically to his right hand and the twisted, gnarled fingers and then back to his face, but his expression never changes. It's possible that they aren't painful - they may just be old like a lot of the wounds on his body and have healed, albeit badly. They'll probably need X-Raying at some point, even if it's not critical that it's done now.


"Okay. Are you hungry?"


This time she catches a flicker in his eyes - she almost misses it - even though his expression remains like it's been cast in marble. You are, she thinks, but it's clear he isn't going to give any indication that he is. She makes a decision then.


"I'll be right back," she tells him with a warm smile.


There's a kitchenette on this floor, for relatives whose loved ones are here for the long haul. A quick search of the cupboards yields some chocolate chip cookies and a couple of apples. She grabs them along with some water and heads back. If she's right about him being hungry she can phone catering to see if she can get him a meal, but for now she'll try this.

She re-enters the isolation room and is relieved to find that he hasn't moved. His eyes follow her like lasers and it's hard to not feel intimidated by the scrutiny, even though it's clear that he's more afraid of her than she is of him.


"Here you go. Sorry it's not much, but I can try and get you a meal."


His eyes study her for a moment before they move to the food and drink in her hands. She holds it out to him, but if anything he seems to retreat further into himself.


"Okay," she says gently. "I'll just put these here."


She moves away, but a quick glance back tells her that he's frozen in place. His expression, still fixed on the food, is almost painful in longing.


"I've just got to go and check on something," she announces even though he's not even looking at her.

Without waiting for a reaction, she heads out, ensuring that the door closes fully behind her. She waits a beat and then carefully moves so that she can see in through the small window in the door. Breath held, she watches as he looks around furtively before easing himself off the bed and using his one good hand to grab all the food and the bottled water. He looks utterly desperate as his eyes flick around the room and she starts to wonder if this was such a good idea after all.


Suddenly he darts out of view and she has to lean further to be able to see where he's gone. He's now on the floor, hunched over in the corner of the room. The bottle sits in front of him, untouched, while he uses his left hand to feed himself the cookies. He devours them with stomach-churning haste before reaching for the first apple. Barely a minute has passed before the piece of fruit is gone, core included. She turns away before he starts on the second, having seen enough.


Concern for him growing by the minute, she heads for the nurses' station. If she can't get him a meal she'll go down to the kitchens and make him one herself. She doesn't know what's happened to this man, but she's going to do everything within her power to help him.

TBC...