There’s a builder’s truck blocking the mews. It’s up on hydraulic stabilisers as the driver operates the winch, dropping off enormous bags of sand and gravel, the engine labouring as the next load gets taken up, the back of the truck lurching with the sudden change of weight. I can’t imagine what building project would require such a massive delivery – maybe one of those basement excavations you read about, an underground pool and cinema and gym, perhaps. A lift shaft to a cocktail bar and viewing platform at the earth’s core. Whatever the reason, the contrast with the ancient backstreet couldn’t be more extreme. Two hundred years ago these would have been a row of stables with offices, lofts and basic accommodation above; now they’re a mixture of chi-chi businesses, full-scale conversions, and the cobbled street curves down right and left not to straw and manure-heaped gutters but expensive planters, artisanal signs and cutely painted old bikes with geraniums in the basket.

We’ve had to park at the far end by the equipment van that’s here to deliver a hospital bed. They could only have beaten us by fifteen minutes and yet they’re already half-way through. Once again I’m in awe of their efficiency and sheer work ethic, like scaled-up ants in yellow jackets. A hospital bed is no light thing. It comes in sections, of course, but the main frame is pretty heavy. A feature of the flats in these mews is a steep and narrow staircase running straight up from the front door – no doubt originally to a hay loft. To make things even more awkward, the house we’re visiting has a stair lift, so really there’s hardly any room at all to get the bed in. When we stroll up, though, they’ve already got the frame delivered, and all that’s left are the mattress, a cantilever table and a few other bits and pieces.
‘What did you do – commandeer the truck?’ I say to one of them, who is so red-faced I want to lean in and loosen his collar.
He laughs, slicks his antennae back.
‘Maybe you could take the table?’ he says.

The whole thing is something of a rush job. The GP had visited George late last night. George is a ninety-five year old man with a recent palliative diagnosis who has declined rapidly and unexpectedly straight into an End of Life scenario. He was refusing hospital, so the GP had prescribed anticipatory meds, made referrals to the District Nurse and Palliative teams, and to us for urgent review first thing in the morning. Katrina had gone straight there from home and was busy by eight. By nine she’d phoned in to make her report: it was bed care only, so George needed a hospital bed with pressure mattress and slide sheet to be delivered the same day, with someone to be there to help with a pat slide; George needed care support four times a day, double-up; he needed pads, pressure cream, foam lollipops for mouth care – the works. I said I could meet Katrina there at lunchtime to get the whole thing done.

George’s wife Valerie greets us at the top of the stairs.
‘Forgive my hair,’ she says, patting it. ‘I must look a fright. But as you can imagine I’ve had quite a night.’
Both Valerie and the flat have the shocked look of something hit by lightning. Everything is essentially as it was – the pictures, the chairs, the collections of antique pill boxes and books, the Moroccan rugs and tables and lamps, the family pictures on the walls – everything so perfectly placed and orderly the housekeeper must have a tape measure in their pocket. But the furthest end of the flat – the main bedroom end – has a sprawled, disrupted appearance, with a wreckage of discarded packaging, plastic strapping and so on spilling across the hallway, whilst through the open door the sound of construction and the movement of heavy furniture adds to the feeling of emergency. The noise from the builder’s truck outside sounds like a fire engine.
‘What a business!’ says Valerie. ‘But you know, everyone’s been so kind. We really are most grateful.’

There’s a large tabby cat staring at me from the middle of the living room rug. It’s as perfectly groomed as Valerie, and I half-expect it to reach up with a paw and pat itself delicately on the head, as she did.
‘Grammaticus is very put out,’ says Valerie, walking over to him. ‘He’s nineteen, you know? Like us – old and worn out. He can’t tolerate the fuss.’
She bends down stiffly and painfully, scooping him up to cradle him in her arms, just exactly as you would a baby, pressing her nose to the top of his head, rocking him up and down, swinging her hips a little from side to side. He maintains his stare, making little adjustments to accommodate the motion.
‘He looks good for his age,’ I say.
‘Do you think?’ she says. Then – still rocking the cat – she looks off towards the window. Down in the street, the noise from the builder’s lorry has eased. It sounds as if all the deliveries might have finished, and instead there are shouts and raucous laughter, the plaintive whining of hydraulic legs being lifted, the off-kilter clattering of a concrete mixer.
‘Good God,’ says Valerie. ‘When will it all end?’