If you stepped out of the general press of the pavement traffic for a moment, stopped and really looked at the street – maybe somewhere out of the way, in the shade of this plane tree – you might see how things have gone along here, how the street was developed over the years. Some old fisherman’s cottages further down, tucked away from view now; two rows of Georgian townhouses, mirror opposites on either side; three Gothic red-bricked houses with dragon finials and black and white floor tiles, and then a lumping sequence of tall, rectangular blocks – art deco, modernist, brutalist. Accompanied by a jerky, stop-start animation of men in straw hats, flat caps, baseball caps; women in bonnets, beehives, sunglasses; horses and buggies, bread vans on bicycle wheels, cars with fins, electric cars…

John and Velma live in the basement of one of the red-bricked houses. It’s strange to think that when the houses were built in the mid-nineteenth century, all the bricks would have been delivered by horse and cart. Now it’s just me walking up the driveway, dragging a pull-along suitcase of equipment, a bag over my shoulder, an ID badge swinging from my belt.

Waiting at the back door for an answer, I can see the house has fallen on hard times. The Victorian bell-pull has been painted over so often it looks like it’s been moulded out of fondant icing, and a handful of other vintage buzzers exist only as empty bakelite brackets or waterlogged plastic shells hanging by the wire. The only buzzer that looks remotely patent doesn’t light up when I press it, so I face that familiar dilemma: Do I ring again, more positively, in case it hadn’t worked before? Do I wait longer, knowing that John has mobility problems (and guessing Velma has gone out)? Do I phone again – knowing full-well that if John is halfway to the door, he’ll only turn around and slowly go back to answer it? Because it’s been a little while now. I’ve looked around some – seen the buddleia and hart’s tongue ferns sprouting out of the brickwork; seen the sun-bleached Father Christmas grinning helplessly amongst the denuded forks of the dead Christmas tree in the pot; wondered about the sequence of events of breakages and repairs to the stained-glass panes of the door.
I ring the bell again.
Five minutes later I give in and phone.
‘Yes?’ says John, immediately, as if he’s been waiting there all along.
‘Hi John. It’s Jim – from the hospital. I’ve rung the bell but I wasn’t sure if it’s working or not.’
‘Yes, I’m coming,’ he says. ‘Sorry. I’m a little slow.’
An age later there’s a glimmer of movement through the miss-match of panes, a shuffling sound, the ghostly image of a hand reaching forwards, the door gives a shudder and swings open.
‘Hello John!’ I say, gently pushing it wider. ‘It’s Jim, from the hospital.’
‘Yes, you said,’ he says, a broad smile behind an enormous beard every bit as Christmassy as the figure in the plant pot. ‘Please come in. Sorry I was slow, but…’ He shrugs. I’ve read the notes. John has cerebellar ataxia. Any kind of getting around is a struggle.

* * *

Velma is busy in the kitchen as I finish off the visit. She’s as thin and active as John is heavy and slow. It’s like the balance of their relationship has tipped physically as well as emotionally, Velma radiating energy, John turning inwards.
‘I like my consultant, though,’ says John, widening his arms and hands, as if the consultant were a hologram he was conjuring in his lap. ‘When I asked him what causes this, he said in my case he just doesn’t know.’
‘I suppose it’s better to be as clear as you can about these things.’
‘Absolutely. I want the truth. What else is there?’
We chat about the things our service can do to help, the physio and occupational therapy.
Velma hurries through with a trug of washing on her hip to hang outside in the garden.
There’s a knock on the door – which I think Velma must have left open when she got back – because there’s a Hello? Delivery? and seconds later a hesitant guy in a yellow vest pops his head round the door and waves a clipboard. He looks at me for a response, but before I can say anything Velma rushes back in.
‘Let me show you,’ she says. They both go down the corridor, into the kitchen.

* * *

On my way out, I look in on Velma to say goodbye. She’s standing surrounded by swathes of clear plastic wrap, cardboard panels, polystyrene blocks. Towering over her is a new fridge-freezer. I can’t imagine how she’s going to cope with finding space, let alone moving it.
‘Do you want a hand…?’ I say – with some hesitation, I have to admit. I’ve got other patients to see; this’ll take some time.
‘No, thank you,’ says Velma, wiping her forehead with the back of her hand. ‘I’m getting  good at this.’