We’re short on carers this morning, so I’ve been given a half dozen patients to see before my clinical calls. First on the list is Helen, an end of life case who has deteriorated markedly in the last twenty-four hours. The private agency the family uses has struggled to cope with the change, so I’m to double-up with their carer, assess the situation and come up with a plan.
Helen lives up in the suburban hills on the outskirts of town, where the original Thirties bungalows are gradually being replaced by expensively discrete designer houses. A chill mist lies across the valley below, isolating every sound so effectively I can hear the jangle of the man’s keys as he walks down the steps ahead of me to Helen’s front door. I guess he must be the carer I’ve come to liaise with, so I grab my bag, lock the car and follow him down.
‘Hello!’ I say, from the top of the steps. ‘I’m Jim, from the Rapid Response Team.’
‘Who?’ he says. ‘Well. I suppose you’d better go in.’
He opens the door and stands aside.
It’s obvious he’s not the carer. Something’s not right about this, but the momentum of my progress down the steep garden steps overrides the instinct to stop and find out more.
‘Thanks,’ I say, and go through.
I had been expecting a hospital bed in a front room; instead, there are a half a dozen people still in their hats and coats, sitting, standing, holding coffee cups, fiddling with phones. They all turn to look at me.
‘Hello,’ I say. ‘I’m Jim. From the hospital. Come to see Helen.’
An elderly man staggers over to stand in front of me.
‘She died,’ he says, frowning, with the crumpled, rather dazed look of someone saying something terrible out loud for the first time. ‘I’m afraid you’re too late.’
‘Oh. I’m so sorry.’
‘Easy call,’ says someone.
‘I’ll let the hospital know,’ I say, and then adding, rather hopelessly, ‘I’m sorry for your loss.’
No-one says anything as I turn to go.
The man who showed me in is still standing by the front door. As I pass he says: ‘I suppose I could’ve told you that before you went in.’
Just before I step outside, someone calls to me from back inside the house. I wait as the elderly man from the front room walks towards me, painfully favouring his left hip, working his way along by using the walls, the book case, the stair rail. When he’s close enough he pauses to catch his breath, then holds out his hand. I shake it.
‘Thank you so much for coming,’ he says, ‘I really do appreciate it,’ and then drapes his left hand over his right, for emphasis, support, or both, it’s hard to tell.