Highdale Lodge sounds like a golfing hotel. Truth is, the nearest it will ever get to a fairway is the smear of grass in the middle of the road running by it, and the only shots the residents make are into-the-vein.

You’d never know it was there if you didn’t know it was there. When the weather’s better you might wonder about the people hanging around, leaning against the wall, but you’d probably think they were something to do with the Magistrate courts in session a few doors down. Because otherwise, Highdale Lodge is ruthlessly, determinedly anonymous, no nameplate or number, utterly forgettable. The building itself seems to sit up from the general run of the street, the first row of windows higher than usual, like the road was subject to flooding or riots. The main door is set back at the end of a narrow recess four or five feet deep, an odd architectural feature, somewhere between an alcove and an alleyway. The door – if you paused long enough to look into the recess – is severe, thickly-painted, double-hinged, more like the fortified entrance to a private citadel than the front door to a hostel. There’s a single, metalled button to the left of it to talk to the staff, linked to a security camera so sturdy it could take a swing from a lump hammer and still be looking down at you.

Everyone who enters the Lodge has to go up a half dozen steps and pass the office counter on the left. It would be a cliche to describe the Lodge as a hive – even though the layout is exactly like a hive, with endlessly bifurcating, shoulder-width corridors leading to a bewildering number of tiny rooms, and everyone who takes you to each particular room seems to do a little wiggle to let you know how to get back – but if I DID feel tempted, and DID describe it as a hive, I’d have to say it would be a particularly busy hive, administratively confusing and always at the point of failure, the kind of hive where every bee has to sign in and out, and many are tagged, and have their stings monitored, and the farmer is at his wits end, desperate for more hives, but you’d have to think there’s no money in honey.

My patient, Keith, seems happy enough, though. To begin with, at least. He stubs out his cigarette and turns on his nebuliser.
‘Sorry about the mess,’ he gasps.
There’s a great smear of damp in the corner, spreading upward like a malignant wave. It’s a poor situation for someone with COPD.
‘I’m hoping to get ah’t of ‘ere soon,’ he wheezes through the mask. ‘It’s a shit’ole. I ave’da go upstairs to the kitchen. Me like I am it may as well be the moon. So it’s not like I even get a decent meal.’

I check him over. Unsurprisingly, his SATS are lower than you’d expect.
‘I don’t need to tell you the smoking’s not helping,’ I say, writing in the folder.
‘Oh – here we go!’ he says. ‘It’s all my fault! Yeah – I know! But listen, mate – it weren’t so long ago they give you a fag with yer bottle a’milk at school. Everyone smoked everywhere, all the time – on the buses, the tube, the pictures. Saturday night, you couldn’t see the cowboys for the smoke! So don’t come round ‘ere blaming me for everything…’
‘I know it’s difficult, Keith. I just meant it’d be better if you could cut down, given how bad your lungs are. Even a little bit. That’s all. There are things around to help, patches and whatnot.’
‘Patches!’ he says. ‘Don’t talk to me about patches! What about them patches over there, eh?’

And he turns away to nod at the damp, and then turns back again, and glares at me over the rim of his mask.