Mr Blatchford is a double-up for two reasons. The first is manual-handling: he’s a bed-bound, double-amputee, so he needs two people to log-roll in situ for personal care and wound dressing, and for repositioning in the bed. The other reason is he’s aggressive.
‘It sounds like a suit of armour job,’ says Rosa, the coordinator today. ‘Long sleeved gown, mask and visor, gloves of course. Shoe covers, probably.’
‘Because he’s aggressive?’
‘No. Because he spits.’
‘Yes. Spits. Intentionally. Not just when he’s talking.’
‘Has he got dementia or something?’
‘No. He’s just spitty. And sweary. Sorry.’
‘You’re not selling him.’
‘I’m not, am I? Still – he shouldn’t be with us long.’
‘Let’s hope not.’
‘You’ll have to double-up with his usual carer, Mandy this morning. When she’s not there we’ll have to find another pair of hands.’
I know the block well – a warden-controlled place on the outskirts of town. The kind of prefabricated, glass and red-brick building you could throw up in an afternoon if you knew your way round a box of Lego. Mandy meets me at the front door. She seems thoroughly pleasant, which is encouraging.
‘Dickie’s so happy to be home,’ she says, showing me up the main stairs. ‘He’s got all the equipment he needs, so we’re pretty well set-up.’
She gives me a hesitant, backwards glance over her shoulder.
‘What have they … said about him?’
‘They said he was a bit of a handful,’ I tell her. ‘They said he spits.’
She stops on the landing with one hand on the fire door.
‘They’ve said a lot of things about Dickie,’ she says. ‘To be honest with you, I don’t know where it’s come from. I mean – it’s true – he can be plain-spoken. He’s always been a bit fruity with his language. And I think it’s true his mental state has taken a bit of a dip. But this spitting business? I’ve not seen it. Treat him as you find him, of course, but don’t worry about the spitting too much. I think it might’ve got a bit blown out of proportion.’
‘I’ll still gown-up in the corridor, though, if that’s okay.’
‘You do what you have to,’ she says. ‘I’ll go on in and tell him you’re here.’
Dickie is an elderly guy in the last weeks of his life. He’s lying on his back in a hospital bed, the covers tucked neatly up to his chin. The flesh has fallen away from his nose and cheeks and his grey hair is combed back in gelled lines. A pair of enormous steel-rimmed glasses are balanced on the ridge of his nose which magnify his eyes and – with his mouth half-open – give him the appearance of an ancient fish, unexpectedly landed, salted away in a box.
‘It’s the nurse, Dickie,’ says Mandy, gently laying a hand on the covers. ‘Come to see how you are.’
He moves his lips up and down in an approximate way. Mandy smiles up at me.
‘Dickie has trouble speaking,’ she says. ‘But he does make sense if you concentrate.’
I move closer to the bed and lean over, my apron rustling, my visor fogging up.
‘Hello, Dickie,’ I say, speaking loudly to be heard through everything. ‘My name’s Jim. I’m a nursing assistant. Welcome home!’
He turns his head to look at me, and his mouth waggles.
‘What’s that?’ I say. ‘I can’t quite get it.’
‘He says Can you lip read?’ says Mandy. ‘It’s okay. I’ve known him a long time. I’m quite good at it.’
‘I’ll have a go!’ I say, leaning in a bit closer.
He waggles his mouth again.
‘Nope. Sorry. Can you say it again?’
‘Oh, Dickie…’ says Mandy.
‘Once more…?’ I say, leaning in even more closely, frowning, staring at his mouth. The bottom teeth biting the upper lip and then releasing in a tired flick; the lips dropping into something of an O; the bottom teeth touching the upper lip again, releasing more softly.
‘Oh. Okay. Yep. Got it that time.’
‘He doesn’t mean it,’ says Mandy. ‘Do you, Dickie?’
Dickie slowly turns his head to look at her, and his gnarly old eyebrows quiver – as best they can – into the up position.