a head for depths

Craig has the key so we agree to meet outside Sally’s flat at midday, when he’s due to make her lunch.
‘Have you been here before?’ he says, bending down to stretch some blue plastic covers over his trainers.
‘I hear it’s bad,’ I say, taking some out of my bag.
‘It’s not the worst, but you’ll definitely need these.’
Craig seems tired, a reflection of my own state of mind. It’s not so much the number of patients on the list and the number of miles we cover, hurrying from place to place. It’s more the endless parachuting in to situations that are failing in one way or another, trying to set them straight – or, at least, straight enough so you can feel some kind of progress is being made, and that things might change for the better.
An adult safeguarding report has already been put in on Sally, but it’s complicated. In the meantime, we’re going in to do what we can to ameliorate the situation.
‘Okay then.’
He knocks on the door and then opens it with the key.
‘Sallly? It’s Craig – and Jim. From the hospital. How are you doing?’

He’s right. Whilst it’s not as bad as many places I’ve been in, it’s definitely the kind of place you have to start with shallow mouth-breathing for a minute or two, till you’ve adjusted sufficiently to breathe normally through your nose. Walking down the hallway, our covered shoes make the ticky-tacky noise so characteristic of encrusted and unsanitary surfaces, and the air has a familiar and gloomy sag to it.

Sally’s waiting for us in the lounge, in an armchair so low and squashy and discoloured it looks less like a piece of furniture than some giant, malignant bloom. She’s wearing an electric blue silk nightie with a green cardigan over the top. Her bare legs are mottled, swollen, pressed together at the knee. She smiles easily, reaches up to shake our hands, but her conversation is muddled and difficult to follow. One of my tasks is to take some blood, to determine whether infection is making her more confused, but I can see I’m going to have to sidle up to it.

Whilst Craig busies himself preparing a microwave meal in the kitchen, I chat to Sally about this and that, and take her observations as carelessly as I can, almost as if I’m as surprised as her to be doing it.

When Sally talks it’s the equivalent of pretend writing. The patterns of her words, the fact that they follow a line, and start and stop in the usual way, with the usual loops and flourishes, everything looks superficially like conversation. But the truth is, I have to make assumptions about what she might mean, and reflect it back to her, and she’ll either laugh or frown, or wave her hand in the air, and we’ll move on, as if something’s been said, though neither of us really knows. But there’s the reassurance of the tone of what we’re saying, if nothing else, and it does seem to be working. She’s distracted sufficiently to let me take some blood, and whilst she obviously doesn’t have mental capacity to refuse, I take the fact that she doesn’t pull her arm away as consent.
Just before I actually puncture the vein, I ask her some more about her family, particularly her father, who (I think) she said was a miner.
‘Have you ever been down a mine?’ I say, preparing the needle.
She answers with a laugh and a string of garbled words that, if they were in a foreign language and I was forced to guess the meaning, I would say: That was a long time ago now / He was a lovely man / He worked so hard.
‘He sounds great!’ I tell her. ‘You know – I’ve always quite fancied the idea of going down a mine.’
She laughs again.
The blood flows into the tube.
‘God knows, it must be a difficult job.  But I quite fancy seeing what it’s like. I mean, when you think where it all came from, what it was, all that coal. Millions of years ago, all these giant trees and plants in some wacking great swamp somewhere, and then it all gets buried and changed into black rocks you can burn. I know I probably wouldn’t pay much attention to any of that if I had to go down in a cage every morning and swing away with a pick. If that’s what they do. I’ve really no idea.’
She listens to me with a tolerant smile on her face, tutting at some things, frowning at others, but keeping her arm still so I can get what I need.
‘There! All done!’ I say, taping a piece of gauze to the crook of her arm. ‘You’re a model patient!’
Meanwhile, Craig has come through with lunch. He’s standing just behind me with a tray of Lancashire hotpot.
‘You thinking of a career change, Jim?’ he says, helping Sally get set up in the chair, ready.
‘Me? Maybe,’ I say, stashing the phials of blood and peeling off the gloves. ‘I don’t know though. I’m not sure I’ve got a head for depths.’

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