Avondale.

Sounds beautiful. Magical. I bet the architect was a fan of Lord of the Rings. You expect to see an ancient castle draped in moss and mist, with strange, long-legged birds circling and crying overhead, a plangent waterfall and so on, elfcetera, elfcetera. Instead what you get is an anonymous, pre-fab block just off the high street, tucked away behind a phony Italian restaurant. It’s only been up a year or so but already it has a tired, beaten-down kind of look, strips of tape over the intercom where the buttons have fallen off. If the same architect had worked on Helm’s Deep, I don’t think Saruman would’ve needed much more than a couple of orcs and a wheelbarrow to tear the place down.

The one magical thing about Avondale, though, is its uncanny ability to screw up the SatNav. The app doesn’t recognise the postcode at all, and ends up recommending you ‘make a u-turn’ and then ‘make another u-turn’ so that if you were truly dependent on it, you’d end up simply driving in a circle at the bottom of the high street until you ran out of fuel or the police threw stingers down.

I know all about Avondale, though.
I’ve been here before.

Cherry lives on the first floor with her little Jack Russell, Dave. Cherry has a long list of health problems, from mental health and self-harming to morbid obesity, diabetes, breathing problems and recurrent infections, and she’s been referred to us many times in the past. She’s got a reputation for being difficult, but I think because I make a fuss of Dave whenever I go there she takes it easy on me.

‘Cherry was pretty sick this time,’ says Michela, the co-ordinator. ‘She went in with an exacerbation of COPD, but then self-discharged against advice. She was so bad they gave her home oxygen. So can you pop-in, see how she’s doing? Get her to sign a non-concordance form if necessary.’

*

Cherry is propped up in bed watching CSI. The first thing I notice – after Dave has finished leaping madly around my legs – is that Cherry’s wearing a nasal cannula connected by a long, plastic tube that snakes across the bed to an oxygen cylinder by the window. The second thing I notice is the fag in her mouth.
‘Erm … Cherry? You really can’t be smoking when you’re using oxygen.’
‘What? Wha’dy’a mean?’
‘You’ll blow yourself up. And everyone else. You’ll send Dave into orbit. Honestly, mate – you’ve got to put the fag out.’
She shrugs, pinches the end out, and rests it carefully on the ashtray by the bed.
‘Thank you,’ I say. ‘I’m sorry to be so blunt about it, but you absolutely cannot smoke with oxygen around. This whole place’ll go up.’
‘I only have one now and again. It’s not a problem.’
The heaped ashtray and the smoky fug in the room tell a different story. I know I’ll have to report this to her GP and the Community Respiratory Team as soon as I’m back in the car, but for now I move on.

Dave is on the bed now. He rolls onto his back so I can rub his tummy, his tongue lolling out with the ecstasy of it all.

‘So how’ve you been?’ I say to Cherry. ‘Sorry to hear about your recent hospital trip.’
‘Yeah – well. What can you do? They said I had to go. I didn’t want to. I mean – what are they going to do about anything?’
‘I don’t know, Cherry. But to be fair, they do seem to have done quite a bit. Put you on IV antibiotics, sent you for chest x-rays, got you back on your feet.’
‘Yeah, but they didn’t, did they? Look at me!’
‘It says in your notes you self discharged against advice. Is that right?’
She shrugs.
‘They made it impossible. It was noisy. I couldn’t sleep. They wake you up every five minutes to fiddle about. The nurses were rude. The food was unbelievable. I mean – you’ve got to be really sick to want to go to that place.’
‘That’s true. And from the sounds of it – I think you were pretty sick. And still are.’
I unclip the SATS probe from her finger.
‘Your oxygen levels are terrible, Cherry – even for you. And that’s five minutes after you came off the oxygen.’
‘Yeah – and I’d still be on it if you hadn’t said.’
‘It’s a choice, though, isn’t it. No oxygen and low SATS, or oxygen and burst into flames. Isn’t it, Dave? Isn’t it…?’
Something suddenly occurs to him, because he flips himself upright again, hurls himself off the bed, and skitters off across the laminate flooring into the kitchen.
‘Oh my God! Wait for it,’ says Cherry.
There’s a single, loud squeak from the kitchenette, and then Dave hurries back with a red, rubber bone in his mouth. It’s so big he can’t make it up on the bed again without a boost from me. As soon as he’s there, though, he chows up and down on it, making it squeak as regularly as a monitor in a hospital for clowns.
‘God – it’s noisier than the ward,’ says Cherry. ‘And before you say anything, I don’t care, I’m not going back.’
I look down at Dave.
‘What do you think?’ I ask him. ‘What do you think mummy should do?’
He stares up at me, panting excitedly, flicking his eyes without moving his head…. down to the bone…. up to me…… down to the bone…up to me.
‘Dave says it’s tricky.’