out out

When I was little we used to play a game called Jack Straws. You had a box of plastic tools – ladders, shovels, brooms, rakes and so on – you dumped them in a pile in the middle of the table, and then you took it in turns to try to hook as many away as you could. If the rest of the pile moved, you were out, and you passed the hook on.

Talking to Paula is a lot like playing Jack Straws, but instead of tools it’s walking sticks, letters, appointment cards, blister packs, items of food and then – the biggest category by far – people, dozens of them, in all shapes and sizes, some of them old, some of them young, some of them in uniform. And it’s difficult to resist the idea that the box got emptied on the table about the time her partner Eric died.

I’d been given the background story by someone else. Twenty years ago Paula and Eric had left their respective partners and children to start a new life together in a different part of the country. Paula had always been an anxious person, something that deteriorated in later years to the point where Eric had been acting as her carer. His recent, unexpected death cut Paula adrift, and everyone around her was struggling to cope. She’d been calling the ambulance a great deal. The police, too. Carers had been arranged but quickly dismissed, accused of laziness, rudeness, or the latest, making faces and going through her things. Everyone was trying to help. No-one was getting anywhere.

I’ve been sitting on the sofa struggling to think of a new angle to come at all this. It doesn’t help my situation that Paula’s friend Nigel is so aggressive. No doubt he’s stressed, too, but I don’t get the impression he’s normally easy. He has that way some men have of walking slightly back on his heels, arms out to the side, like it’s an effort to accommodate so much masculinity in such a short frame.
Right at the beginning of the meeting I’d checked Paula was okay with him being there.
‘Nige? He’s taking me shopping,’ she said. ‘Of course I want him here.’
‘That’s fine. I just needed to make sure.’
‘What’s up?’ said Nige, wobbling back into the room.
‘He says he wants you to go.’
‘Does he?’ he said, poking his glasses back into position with a finger as hard as a nail gun. ‘Why’s that, then?’
‘Don’t worry, Nigel,’ I said to him. ‘It’s fine. It’s just standard procedure when I’m talking to a patient about private stuff.’
‘Private stuff, yeah?’ he said, then thrust a doctor’s letter out for me to read. ‘Well go on, then. What are you going to do about this private stuff?’


It’s the end of the meeting. Physically Paula seems fine. The only positive contribution I can think of to make is a referral to social services, although I’m pretty sure they’ll already be well aware of the situation.
‘I just want to go back up north,’ she says. ‘Can’t you find me nowhere?’
‘How d’you mean?’
‘A house or a flat. Back up near my daughter.’
‘Well – that’s a little beyond what we normally do. But there’s nothing to stop you or your daughter looking for properties yourself.’
‘I don’t know. Online. There are loads of good websites.’
‘I haven’t got a computer.’
‘Your daughter, then.’
‘She doesn’t want me near her.’
‘She doesn’t?’
‘I’m sorry to hear that.’
‘So what are you saying, then? You’re not going to help me?’
‘I’ll see what I can do.’
‘But I can’t go on living here, can I? I can’t cook. I can’t look after myself. I can’t go out.’
‘I thought you said you were going shopping with Nigel?’
‘No,’ she says, taking out a cigarette, her hands trembling. ‘I mean out out.’

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