John is sitting cross-legged on the floor playing an Xbox game. On the giant plasma screen in front of him are two weird aliens, standing on a barren planet that’s being bombarded with rocks and space junk. Both aliens are about the same except one’s fluorescent blue and the other green. They look like huge, organic, see-through machines, waving delicate antennae, flexing toothy mouths. Spooky electronic music plays on a loop.

‘Alright?’ says John, glancing up as I come in, then moving his spaceman avatar a little closer to the aliens.

John’s an amiable drunk. His alcohol consumption has moved into that cirrhotic purgatory where he needs a certain quantity just to maintain basic function. Quite how he got to that point – and, crucially, how he’ll get out of it – are questions John will have to work through himself along with the support workers from the substance abuse team. For now, we’ve been referred in to help him with any equipment and therapy that might help.

‘This is my spaceship,’ he says, putting the controller to one side and leaning back against the vast futon behind him. ‘Whaddya think? Double king size. And the good news is – I can just crawl in.’

Crawling is how John gets about, mostly, or a strange, insectivorous variation. His legs are terribly deconditioned, fixed in a lotus position from long years on the floor. He reminds me of a magazine article I read once about an Indian sadhu in Delhi who lived forty years or more with his right arm held straight up in the air to distract him from the luxuries of normal life or something. An act of devotion, anyway.

‘They didn’t know what to do with me in the hospital,’ says John, smiling. ‘They wanted me to stay in bed, but I weren’t having none of it. So I tried to escape. ‘Course – they was all waiting for me in the corridor, the nurses, the security people, all standing there with their arms folded. I said to them Oi Oi! What’ve we got here, then? The Gestapo? But they didn’t wanna know. They just dragged me back to bed. And here we are. I suppose you want to do my blood pressure and all that. I think you’ll find it’s in order.’

I run through the obs, one eye on the sphyg gauge, the other on the weird, winnowy aliens on the screen. It feels like they’re hanging back, waiting for me to finish before they attack again.

I unwrap the cuff and take the steth buds out of my ears.
‘How’m I doin’ then, doc?’ he says.
‘Fine. Your blood pressure’s better than mine.’
He laughs.
‘I like that! Better’n yours!’
Then he nods and narrows his eyes.
‘How old are you?’ he says.
‘Guess,’ I tell him. ‘And be kind.’
‘Hmm,’ he says. ‘It’s difficult behind that mask….’
He looks me up and down, scrunches up his face in a series of exaggerated thinking expressions, then snaps his fingers and points at me.
‘Fifty seven!’ he says.
‘Wow! Dead right. Although … I’m a bit disappointed. People usually say I look younger than my age.’
‘Yeah, well,’ he says. ‘You can’t trust people.’
Then he picks up the Xbox controller, and edges his avatar towards the aliens.