small world

Petra, Ema’s great-grand niece (I think – the fax is so scrappy it’s almost illegible) opens the door. She seems exhausted, her heavy make-up and long, coal black hair emphasising the pallor of her complexion.
‘Come in,’ she says, pushing the door wider and then immediately retreating. ‘Thank you for coming.’ There’s only room for me to step inside and then shut the door behind me. I’m thrown for a minute. Even though from the outside it seems like a normal end of terrace house, for some reason the party wall on my left narrows to the width of the door, widening out further into the house. Different coloured paint on the other walls makes it feel like I’ve walked into an optical illusion. When I follow Petra down the corridor, I fully expect to decrease in size.
I glance into a room we pass a room on our right. There’s an ancient woman sitting in an armchair.
‘Hello!’ I say.
Petra sighs.
‘No,’ she says. ‘Is not that one.’
We pass further through, to a bed in a backroom, and Ema, lying like a corpse with her eyes closed, her jaw slack, her hands gently folded on her tummy.
‘Here is Ema,’ says Petra.
‘Is there a yellow folder?’
‘A yellow folder?’
‘Yeah. You know. The nursing notes.’
‘No. No yellow folder. Is nothing.’
‘Oh. Okay. Not to worry.’
I put my bag down and go over to Ema to rouse her as gently as I can.
There’s a scream from the sitting room. ‘Ana!’ says Petra, and goes to see. I remember making out the word dementia on the referral, but it suppose they meant the sister rather than the patient. Maybe Ema is Ana’s carer, and Petra has come in to help from somewhere now that Ema has fallen ill.
‘Hello!’ I say, as Ema opens her eyes. ‘Sorry to give you such a rude awakening. My name’s Jim, from the hospital. I’ve come to see how you are today.’
‘Terrible,’ she says after a moment or two. ‘Thank you.’
‘I’m sorry to hear that. In what way do you not feel well?’
She blinks and smiles, unlacing her fingers just long enough to make a gesture of  saintly forbearance.
‘Are you in pain?’
‘No. No pain.’
‘Do you feel sick? Or have you been sick?’
‘Perhaps. A little.’
‘Short of breath? Dizzy?’
She shakes her head.
‘Any change today? Or much the same, would you say?’
‘Same thing. Always too much.’
‘Well. I’m sorry to hear that.’
I look at the faxed referral again. It’s almost impossible to make out much beyond the sketchy 5/7 unwell, poor E&D, hx hyponatremia, something something obs & bloods pls. We would have requested clearer information, but the Bank Holiday means that getting back to the referrer will be nigh on impossible. And anyway, the request itself was straightforward: obs, bloods – a little lacking in context, perhaps, but sometimes you just have to go with what there is.
I start a new obs chart and run the basics.
I can hear Ana protesting next door.
But I’m her sister! I should know what he’s doing in there!
And Petra, speaking in her flat tone:
– You cannot disturb him. He has come to do the blood.
I’m her sister!
– Here. Have more grape.
I don’t want a grape. I want to see my sister.
I unplug my ears from the stethoscope and call through: ‘It’s okay, Petra. I don’t mind if Ana comes through.’
But there’s no answer. Everything goes quiet.
‘Honestly. I don’t mind at all.’
I carry on examining Ema.
Everything seems fine – blood pressure, temperature, SATS and the rest. Nothing obviously neurological, no acute injuries. It’ll all hang on the blood test, I think, as I get the kit out.
‘Where are you from originally?’
‘Croatia,’ she says.
‘No! Really? We were just there! On holiday! Whereabouts in Croatia?’
‘Well it’s a small world, as they say. That’s where we were! It’s beautiful there. The castle, the mountains. The lovely blue sea. We loved it.’
‘Thank you.’
I tighten the tourniquet and decide which vein to go for.
‘How old were you when you came to this country?’ I say, unsheathing the needle.
‘Four, five. I don’t remember.’
‘Have you been back at all? Sharp scratch…’
‘Thank you!’ she says, tensing a moment, then relaxing as the immediate pain of it changes into something else. ‘Yes. A little, but lately – not so much.’
Ana starts shouting next door again.
But it’s my sister! I want to know what he’s doing to my sister.
– He taking the blood, auntie. Don’t worry.
I want to be in there.
– No. He need peace and quiet.
We’re sisters!
– Yes. I know that.
‘I really don’t mind if she comes through’ I call over my shoulder, but there’s no reply, and it all goes quiet again.
With the last vacuette done, I release the tourniquet, withdraw the needle and tape a square of gauze to the wound. ‘I’ll check it in a few minutes and see if you need a plaster,’ I tell her. ‘But that’s it – the worst part’s over. All done!’
‘Thank you!’ she says.
Petra appears in the doorway again.
‘Ready to go?’ she says.
‘Yep. Just a sec whilst I write up the yellow sheet…’
I half expect to see Ana pop-up behind Petra, but for whatever reason, she stays in the sitting room.
When I’m packed up and I’ve said goodbye to Ema, I follow Petra back along the corridor. I glance in at the door of the sitting room as I pass. Ana is still in the armchair. She turns to look at me, her face bunched over her gums in anger.
‘Ema says she and Ana were born in Trogir,’ I say to Petra as I
reach to open the front door. ‘We were in Trogir just this week! On holiday!’
Petra doesn’t reply.
‘Small world!’ I say as I step outside.
‘Yes,’ she says. ‘Thank you for coming.’And she closes the door, slowly and firmly, without any discernible click of the latch.


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