Trip and they will catch you

When the going gets heavy at this summer's rock festivals, a team of doctors and nurses is on hand. Hangover or heroin, it's all the same to them.

"You've got to remember, this is not reality. This is not real life." A doctor is kneeling next to a tearful girl with a pale and anxious face, her multi-coloured Bjork bunches looking forlorn. She has lost her friends, had a long night on a bad E and is desperate to go home. "You need to find somewhere quiet, to calm down. I promise you'll feel better soon," he tells her.

Over the weekend the 300 doctors, nurses and paramedics working at Glastonbury's Medical Centre repeat this mantra again and again. More than 3,000 tired, wounded and distraught people are treated by the Festival Medical Services team every year, a voluntary group which does the round of summer festivals - Glastonbury, Phoenix at Stratford-upon-Avon in two weeks' time and Reading in August.

Like everyone else, the doctors at the Medical Centre, a heated marquee at the top of Worthy Farm, are up to their ankles in mud. The rain-sodden tent is more MASH than ER - the organised chaos of the trenches. Smiling receptionists in moon boots and green vests emblazoned with DOCTOR and NURSE take names and notes in the waiting room. Ravaged revellers sit and wait for treatment, while at the other end of the tent emergency cases are rushed into a makeshift "crash" room by paramedics. One terrified girl is brought in on a trolley with suspected neck injuries. She was dancing on a tractor and fell headfirst. In the observation room spaced- out patients lie silently on mattresses.

Most of the people making the long slippery trek up to the Centre come with minor problems: cuts, diarrhoea and cystitis. Some need replacements for prescribed drugs stolen from their tents. Others want the morning- after pill, although the pharmacists say that bad weather reduced demand this year. Most common are sprained, fractured and broken ankles. Almost everyone seems to be limping, their feet askew in dustbin liners.

Midwives are permanently on call - and needed. A pregnant woman, coated in mud and two days overdue, comes in for a check-up. One couple arrive with a tiny two-day-old baby, needing vitamins. An ambulanceman once delivered a baby here, to a girl who didn't know she was pregnant. She called her baby daughter Avalon, a good Glastonbury name.

Midday on Saturday, the Centre starts getting busy. The fields are still quiet, with most of the 90,000 festival-goers still asleep. But the ones who've been up all night start feeling the worse for wear. A man in his early thirties is brought in by two rambler types who have found him lost and child-like. He sits with his head in his hands but occasionally looks up, his face contorted in terror until he can't stand it any more and starts to cry. "Just get me out of here," he begs.

With severe paranoia, the last thing he needs is the advice of Jimmy, a Trainspotting lookalike from Edinburgh. But Jimmy insists on offering words of wisdom: "It's just drugs and alcohol, mate. Looks like you've overdone it." Jimmy is not what you would call a sight for sore eyes - bare-chested, shaved head, scarred face, scary enough straight, terrifying to the tripping. It's too much for the paranoid man and a nurse whisks him off to a quiet corner.

Jimmy has trench foot, "the" ailment of this year's Glastonbury. It was common in the First World War, caused here by dirty feet sweating into bin liners, and gives feet that shrivelled prune look of being in the bath too long. "I've lost my Filas, but I'm not bothered 'cos I've got them on my head," he says pointing to the Fila symbol shaved into his skull.

The doctors are GPs and specialists: trauma nurses, psychiatrists, anaesthetists and physiotherapists. Junior doctors like the chance to do some social work. They work six-hour shifts, and go to see bands in their time off, many of them Glastonbury veterans since the Seventies, with pierced ears, crystal pendants and hippy skirts. A patient in his late twenties sitting in the reception area can't believe they are real doctors: "Jesus, look at them. These people are connected."

Dr Chris Lawson heads the psychiatric team, which is mostly treating people with paranoid psychosis caused by drugs: "When people are really distressed we give them valium." Most of the drug casualties are the younger, less experienced festival-goers. There are a lot of meek, weepy young girls. But the doctors' and nurses' approach is uncritical. These are people experimenting with drugs, not hard-core drug-takers. Many come to the festival to celebrate the end of exams, but pills and the rain push them over the edge. All-day drinking and hash-cakes cause as many problems.

"People we see in that state in our normal workplaces disappear," Dr Lawson says. "Here we get to see them recover 24 hours later, back on track, the psychosis gone. There are so many people enjoying themselves at the festival, only a tiny number end up here. When people say the younger generation is degenerating, I just think you should look at how most have survived this weekend, how they've coped in these conditions.

"My real worry about drug use is not knowing the long-term effects. We still don't know how ecstasy affects the brain, if there'll be a whole generation of depressives."

News comes in of two deaths, one is later confirmed as a heroin overdose - a man in his forties who was here with his children. The team are saddened. Until this year there has only ever been one death at Glastonbury. But the tragedies probably say more about the wave of heroin said to be sweeping through the country than anything about the festival.

A few addicts wander in to ask for needles, but the Centre does not run a needle exchange, for fear of encouraging new intravenous habits. A scrawny but efficient-looking girl arrives to ask for naloxone, a drug that immediately reverses the effect of heroin, because she thinks she has overdone it. The paramedics who drive through the crowds carry naloxone to treat any heroin users they find turning dangerously blue. "They tend to leap up and clobber you when they come round because they've been having a good time," says Gavin De Vine, the head nurse, who usually works in a Bristol A&E ward. Later, a shaken middle-aged paramedic arrives. He has just been jumped on and his face is cut up.

The security guards who watch over the Medical Centre staff have never seen anything like it. Three coachloads of them came over from Dublin, but a third of them had fled home, unpaid. "I tell you," says one of them, "we didn't get all this when we did Sting in Cork." Over the weekend they had been bitten, attacked and held at gunpoint.

But the doctors and nurses love being here. "This is fun," says Gavin De Vine. "It's good to work with young people we can patch up and send off again." The rainy weather has been this year's biggest factor, there has even been pneumonia. Usually it is dehydration and sunburn. With drugs, trends come and go. The doctors have seen it all before. "We only see the tip of the iceberg, but we're pretty tolerant here," says Dr Lawson. "Most people recover and go back into the fold"n