and I’ll tell you something else

I’m a liar liar / truth denier
I’m a deep fact fryer
a self-made / weapons grade / dumb for hire
I’ve had a kiddin-me transplant / a government grievance grant
I’ve got a heavyweight, click-bait, racist agenda
a shockproof, through the roof, bias defender
I’ve had a truth tuck / a conscience bypass
I’m invasive as pampas grass
swinging or otherwise
I’m so counter I’m clockwise
I’m a meal deal bants with fries
a vanilla alt shake
all talk and no take
I’m number one
a bit of fun
I’m fast & furious III
built for speed
morally free
one hundred and ten percent me
mate
and if you don’t like it, great

I’ve got rants and I’m not afraid to use ‘em
I’ve got flag pants and I’m not afraid to wave ‘em
so stop misbehavin’
toe the line
wherever that is
see that boneyard? that’s where my flat is
I’ve even got a lanyard / picture of a hokey, low key / old time backyard
‘Accost All Areas’

I’m the lairiest / scariest / hairiest
I’m the 4G golem
I follow people just to troll ‘em
I’m the baddest mother spider on the web
I’ll kiss you goodnight and put you to bed
and transfuse your brains with soup instead
then hurry home to chicken and cheap white bread
I’ve got a whole bag of sticks and stones / mobile phones
and if that don’t work I’ll try hammers
memes and flames from internet scammers
I’m anti-woke / spookily spoke / blankety bloke
I put the onion in opinion and the crack in croak /
I’m all spach like zarathustra / (now I’ve confus’d ya)
god is dead
yeah?
so stand by your beds
I’ve come to speak for Him instead

IMG_1706

st peter, the nhs & the list

St Peter / the last, great meeter & greeter / zips up his perfect windcheater
to the dimpled point of his silver-haired chin / getting ready to let the next one in

He yawns / (he’s been up since about a million dawns) / watching them trail across the lawns
he waves his clipboard / an angel strums a heavenly chord / God I’m bored
he thinks / drinks / from a goblet / takes a bite from a bar of everlasting chocolate
this way! he says / ready with his quiz

A tired middle-aged woman steps up / stands there watching him drink from his cup /
waits politely / trembling ever so slightly

St Peter glares down / frowns / flicks through the list / Jane the podiatrist?

Yes! she nods / What are the odds? / Me hobnobbing with the gods!

God – singular – I think you’ll find / unless you’ve got some other place in mind?

Me? No! This’ll be great / judging by the fancy gate

Hmm says St Peter / stepping back a good half metre
Podiatrist? isn’t that feet? / sounds a little bit too downbeat

Lower limbs too / says Jane / happy to explain
There’s a lot more to it than corns and bunions / a top chef has to know more than onions

Is that right? is that right? / says SP, scrupulously polite / fine….okay / so what brings you all the way here today?

Nothing, shrugs Jane / well – a sudden pain / endless night / a blinding light / a pretty wild kinda flight / why – is that alright?

St Peter slowly lowers his board / he’s been here so many times before / things have moved on since the days of yore (whatever yore is) / the thing is, he’s a bouncer who knows where the door is / and he’s pretty damn hot / about who gets to come in or not

You don’t earn enough / and whilst I know that sounds tough / we’ve got to be strict about this stuff

Jane / looks pained

But I spent my life caring for people / and what was that shit about camels and needles?

Yes, yes, says the elderly saint / how quaint / but that was just a fairy story / it was never based on sound economic theory / look at this place! these clouds aren’t cheap / I’ve got overheads that’d make you weep

Suddenly a suit sidles up / gives St Peter a monogrammed cup

Wow! says Pete / that’s pretty neat! / thanks!
Compliments of the bank! / says the man / shaking his hand / now – if you’d kindly show me the line / where you’d like me to sign…

A cherub floats down, gives his curls a flick / opens the gate with a cute little back kick / The banker chuckles / cracks his knuckles / tips his hat / dissolves into a cloud just like that

So what happens to me, then? says Jane

St Peter looks down at her again / Jesus Christ! Jane! Do I need to explain? / Podiatrists go to hell / with all the other HCPs as well / the nurses and scientists / gardeners and  pharmacists / ODPs and dieticians / drama therapists and audio technicians / the porters and the hospital sparks / the paramedics and record clerks / I’m sorry Jane, but that’s all there is to it / you had your chance to make some money and you blew it / anyway, I’m sure you’re used to that shit / the NHS was ever a fiery pit

But heaven… says Jane… who gets to go?
Trust me, yawns Pete / you don’t wanna know

IMG_1696

a (very slow) uprising

One day all the old people will wise up
tear off their medicalerts and rise up
they’ll finally decide they’ve had enough
of the endless emollient creams and stuff
the scratchy stockings and handy grabbers
the phlebotomists and care home managers
and they’ll move as one to the coded signal
of a renegade grandma in Newport Pagnell
who entered retirement unconvinced
by Murder She Wrote and the purple rinse
by adverts for scooters and fancy lifts
ballpoint pens and benefits
who stole a ship and escaped to sea
to rally the cause electronically
hacking the loops and hearing aids
of the millions who’ll build the barricades
from static commodes and stools and hoists
and taunt the police in one croaky voice
and when the army arrives in tanks and trucks
meet them with vollies of tommee tippee cups
and the soldiers will not deploy their weapons
because they couldn’t shoot Joan or Uncle Kevin
and the rebels will mass at the top of the street
and bang their zimmers and stamp their slippered feet
and their fighting colours will snap overhead
(an overweight pug and a flaming bed)
and so shall it begin, the grey terror of the world
dressing gowns gaping and hair uncurled
(because they may be weak, and they may be confused
but they’re old and they’re fierce and they’ve got nothing to lose)

IMG_1690

the magician’s app

Upon the morning of the first day
enter the nearest bookshop upon thy way
go direct to the outermost shelf
of the section on popular psychology & self-help
close thine eyes
I beseech you
pluck out a book
within easy reach of you
cast it over your left shoulder
take the first and third letter
of the second thing
anyone says
– Quitteth the bookshop

Upon the evening of the second day
enter a green and public space
having first furnished thine head with a hat
and dressed the rim with peanuts and rubbed fat
walk confidently backwardly
widdershins
taking care
to enumerate the seagulls
that flock to you there
– Quitteth the space

Withdraw to holy quarters
Enter the letters and the number
into the app you hath saved
i’the i’Phone

and if thy signal be strong
and thine thumb be true
and thy patience be long
and thy phone doth actually belong to you
the gift of a magic gif
will be thine in a 3G jiff
and thy fatal fortune revealed all at once
for the fee of just one ninety-nine a month

IMG_1684

feeling the heat

Anna, the coordinator for the early shift, waves me over.

‘Jim? I’ve got a P2 for you, darlink. Nothing massively urgent but I think if you could go there this morning that would be wonderful. I’ve sent it through to you. See what you make of it. Let me know if you need anything else. Okay, darlink? Perfect. Okay? See you later.’

I’m about to ask her something but the phone starts ringing again. She pulls a face, holds up a finger, answers the phone – and immediately gets drawn into something complex. It’s early in the shift and she’s already quite red in the face. Some of that’s the office. The boilers here seem to have two settings: OFF for the summer, ON for the winter – ON being approximately The Surface Temperature of the Sun. It’s ironic that there are disposable cardboard thermometers pinned up around the place, the kind that we give out to our elderly and at risk patients. All of them are so far in the RED zone the caption advises calling 999. Nothing ever changes. We stew when we come back to the office to catch up on admin and stay out as long as we can.

I touch Anna on the shoulder, nod and smile as if to say don’t worry, I’ve got everything I need, and loosening my collar, head for the door.

*

A P2 faller is a patient who needs to be seen reasonably urgently but a little delay is probably fine. The ambulance  made the referral. They had attended Mrs Davenport that morning for a non-injury fall, and identified a few things they thought we could help with.

She doesn’t answer the phone when I call, which is a little concerning, given the history. There’s a keysafe number on the referral. I decide to go over there on spec, just in case she’s on the floor again.

*

‘Hello? Mrs Davenport? It’s Jim, from the Rapid Response Team.’
Nothing.
I’m standing in a long, bare-boarded hallway that stretches ahead to a steep staircase, and past that, into a kitchen with the faintest spill of light.
‘Helloooo? Mrs Davenport? It’s Jim. From the hospital.’
Nothing.
I decide to go into the kitchen first.

The light is coming from a table lamp, set by a rubbed but comfy-looking armchair. There’s a bottle on the floor by one of the claw-foot legs, and a dirty tumbler on a table to the side. I’d guess from the look of the kitchen it’s the place Mrs Davenport spends most time. There’s a Roberts radio next to the tumbler, its aerial so bent she either fell on it or took a bite when the news was bad. Either way, it’s resolutely off.
‘Mrs Davenport? Hellooooo?’
The place has a hunkered-down feel. Stuff piled in the sink. Curtains drawn.
There’s a door at the back. I knock and open it. A toilet and washbasin, both the worse for wear.
‘Hellooo?’
I retrace my steps and begin opening the doors along the hallway. The first is the old sitting room, completely dark, nothing to suggest that anyone’s been in more recently than 1962. Opening the next door makes me jump, because there are coats hanging from a hook and they swing out a little. The next door is Mrs Davenport’s bedroom.
‘Hello?’
She’s lying in bed, completely covered by a quilt. All I can see – apart from the lump in the quilt – is a spread of lank grey hair on the pillow.
‘Mrs Davenport? Hello. Sorry to bother you. It’s Jim, from the Rapid Response Team.’
‘What?’
A clawed hand pushes the quilt from her face and she glares at me.
‘What do you want?’ she says. It’s like I’ve disturbed a wild creature, an owl or something.
‘I’m so sorry to wake you like this,’ I say. ‘I was asked to come and see you by the ambulance.’
‘The who?’
‘The paramedics. They said they picked you up when you fell this morning.’
She blinks a few times.
‘I did not fall,’ she says. ‘I slipped.’
‘But you didn’t hurt yourself, so that’s a blessing.’
She blinks again. It’s like being photographed.
‘Why would I have hurt myself? I went to sit on the bed. I slipped gently to the floor. That’s it.’
‘But then you couldn’t get up.’
‘So I pushed my button. As I’ve been told to do. The paramedics came. They helped me up.’
She stares at me, a little more awake now.
‘Who did you say you were?’
I tell her, explaining as simply as I can what the Rapid Response Team is, and how we can help.
‘But I don’t want any help.’
‘That’s fine. We’ve only come round because the paramedics said so.’
‘We?’
‘Well – me. But there are other people on the team, as I say.’
‘I was asleep!’
‘And I’m so sorry to have disturbed you.’
‘I don’t understand why you’re here.’
I take a different tack.
‘Are you feeling unwell?’
‘No! Why would I?’
‘Are you in pain? Is there anything troubling you at the moment?’
She stares at me for a very long time, then hooks the quilt back even further so she can get a better look.
‘Yes,’ she says, eventually.

Janet the dog walker

Millie’s poodle Rosie bounds off the sofa when I come in. She lies with her paws either side of a well-chewed rubber Bugs Bunny, glancing down at it, then up to me, then down to the rabbit again, daring me to take it. I can’t decide who has the maddest expression: the rabbit or the dog.
‘I think… she thought… you were Janet,’ says Millie. ‘Janet… the dog walker.’

Millie furniture-walks to a seat at the dining room table. COPD has blasted her body, robbing her of any spare flesh. It’s left her tentative and frail, spindle-thin as a giant crane fly, fumbling for purchase, somewhere to land and catch her breath and think about the day.
‘I don’t want much,’ she wheezes. ‘I’ve got… the medication I need… plus a little something… for anxiety. What I really need… is someone… to come in now and again… to help me… with a bath. That’s all. Do my back… y’know?… the awkward bits.’
The doorbell rings and a breezy woman swathed in waterproofs stamps into the kitchen. I’m guessing it’s Janet.
‘Hiya Millie!’ she says. ‘Phew! It’s bad out there. Oh! You’ve got company!’
I introduce myself, get up to shake her hand which is ice cold.
‘You need gloves’ I say.
‘I need a lot of things,’ she says, pulling out a hankie and blowing her nose so loudly I take an involuntary step backwards. ‘I need to win the lottery,’ she says.
Meanwhile, Rosie has ditched the rabbit and dashed through to greet her. Janet kneels on the kitchen floor with her arms wide. Rosie puts her paws on the woman’s knees so she can reach up and lick her face.
‘You silly girl!’ she says. ‘I’ve had a wash today. I don’t need another one. Do I? Hey?’
‘Will… she be… alright?’ says Millie. ‘It looks… pretty bad out there.’
‘Of course!’ says the woman, grasping the kitchen counter, struggling to get up again. ‘Oof!’
She looks at me.
‘Got any spare knees in your bag?’
‘I’ll have a look.’
‘Good boy.’
She reaches into her pocket for a treat, and for a moment I think she’s going to throw it to me. But Rosie sits excitedly at her feet, and Janet hands it down to her instead.
‘She’ll be fine,’ the woman says. ‘It’s so windy out, I’m thinking of tying some string round her legs and flying her like a kite.’
Millie gives her a panicked look.
‘Seriously, though, we’ll just go for a short one round the park,’ says Janet, giving me such an exaggerated, lop-sided wink I’m guessing her face is still numb from the cold.

smile and act normal

‘You wouldn’t think it, but I’m seventy myself.’
Sam’s right, of course. With her metallic white hair cut jaggedly short and swept back in spikes, her sharp shirt, skinny jeans and fluorescent trainers, I’d have put her at fifty, tops.
‘My knees are worn out. Every few weeks I have to have a needle in my eye because of the macular degeneration. Which means I can’t drive. So I have to take the bus over here every day. And you know what buses are like. It takes me the best part of an hour there and back, twice a day. On top of that I’ve been living in the hospital most nights ‘cos my son in law had an accident and my daughter’s not coping. Plus my own life to sort out. Which needs a LOT of sorting out, these days.’
She takes a breath, staring off into the bright fall of afternoon sun through the window. ‘And I’ll tell you something else,’ she says, trailing off. ‘I’ll tell you something…’
Her chin begins to tremble and she has to turn away.
‘Sorry,’ she says, pulling a tissue from her pocket. ‘Sorry about this.’
‘That’s okay. I can see it’s hard.’
‘Hard!’ she says, with a bitter laugh. ‘Childbirth was hard. Divorce was hard. This is bloody impossible!’
She blows her nose and bins the tissue. Gives her head a little shake.
‘There!’ she says. ‘Now. Good. Where were we?’

We talk through the situation. How her mum Avril is ninety-eight, increasingly frail and forgetful, not eating or drinking, falling more often but refusing to accept any of the practical changes that might improve her situation. She went into hospital for a few days after the last fall. Being discharged today and expected home by ambulance any minute. Although there’ve been a lot of false starts and mix-ups as far as THAT goes. Anyway – Sam is the main carer for her mother, with a little private top-up help from a family friend. Sam has Power of Attorney, thank goodness, which is something, a small victory. But so far it hasn’t helped all that much in practice. Avril refuses to talk about residential care, even for respite, whether for her benefit or – more significantly – for Sam. Things have been staggering on like this for a while. It’s not getting any easier.
‘She was always bloody minded,’ says Sam. ‘I suppose it’s how she’s lived to such a ripe old age. It’s probably what’s kept her going all these years. I mean – It’s not like she’s any different now she’s old. In some ways I think she’s actually more of herself than she was. Which sounds odd, but you know what I mean. Do you?’
I nod and say I think I do.
‘Some things have changed, of course. She repeats herself a lot. Over and over. If I hear that story one more time of her in the air raid shelter with the GI and the rabbits I’ll scream. But essentially she’s still Mum. Which is what makes it so hard. Don’t get me wrong. I love my mum and I’d do anything for her.’
Sam laughs again.
‘Like get the bus twice a day! Anyway – enough of my moaning. Let me show you how I’ve organised her laundry…’
‘Okay.’

I follow her into the hallway. She opens an airing cupboard where a water heater is surrounded by shelves of slacks and vests, everything ironed, neatly stacked and lined up, orderly piles of pants and socks, a clutch of enormous bras hanging down from the top shelf like outlandish nests.
‘What d’you think?’ she says.
‘Wow!’ I say. ‘Pretty organised. You do an amazing job.’
‘You know what? I think I do,’ she says, giving the clothes a long, proprietary look, then slowly closing the door.
The buzzer goes. She stiffens.
‘That’ll be mum,’ she says. ‘Smile and act normal.’

time traveller

I took the path down
by the cemetery
where heavy rains
had scoured the ground
clear down to
the greensand rock

millions of years ago
(I suppose – I don’t really know)
this was a river delta
where iguanodon waded
buzzed and serenaded
by pterrible pterosaurs
wailing and wheeling
in a sulphurous sky

just over the hedge
two churchwardens
prod a smoky bonfire
‘Alright?’ one says

IMG_1648

anna, landed

If this happened in a dream – and with the amount of opiate medication Anna is taking, I’m guessing most things must seem fuzzy and dream-like – it would no doubt happen like this: Anna drifts down from the sky in a semi-recumbent position, her eyes closed, her hands folded on her tummy. The roof of the house shivers, becomes transparent and loose, moves apart. Anna drifts down through the Anna-shaped gap, down through through the attic, the upper bedroom, the floor, the fixtures, the criss-crossing joists, the cobwebbed bricks, the insulating wool. Down through the cloying air of the living room, to settle finally on the soft brown sofa. And the ceiling heals up, the roof and everything else. And the cushions roll over like squashy boulders and mould themselves around her. And she’s there, back from the hospital, thoroughly landed. And she opens her eyes as her daughter Christine wanders in to see her, a jug of iced water and a glass tinkling gently on the tray.
‘Did you put in a pinch of vitamins?’ says Anna, grunting as she pushes herself into a more upright position.
‘Yes.’
‘A pinch? Not a spoonful?’
‘A pinch. Yes.’
‘Last time it tasted like a spoonful.’
‘I don’t think so.’
‘Well it did to me.’
Christine shrugs and goes back out to the kitchen where she carries on talking to her friend in an urgent kind of tone.
‘She’s a good girl,’ says Anna. ‘I don’t know what I’d do without her.’

I finish writing up my notes and then put the folder to one side.
‘The thing about back pain – the advice they give these days – is to keep moving.’
She snorts.
‘That’s easy for you to say. You’re not the one in agony.’
‘I know it’s difficult, Anna, but the longer you stay on the sofa the harder it’ll get. You’ll become deconditioned. You’ll be at risk of getting pressure sores.’
‘I know my own body.’
‘Absolutely. But I think there are some practical things you could do to make things easier for yourself. To give yourself the best chance of recovery.’
‘Such as?’
‘Sleeping in bed, for a start. You’d be flatter at night, which is better for you. It’s higher off the ground for getting in and out. And with a bit of re-organisation, you’d have more chance of getting mobile again.’
‘Where do you suggest I put everything?’
I look around. The house is packed full with ornaments and hangings, boxes on top of tables on top of bigger boxes, every bookshelf crammed with books, even the windowsills piled up with stuff. The only free space is the giant plasma TV screen on the wall facing the sofa. Anna turned it off when I came in, and now it hangs there, a window onto a darker, clearer world.
‘It’s difficult, I know, but not impossible. All you need is a decent amount of space for you to get about. As things stand, you’re much too restricted. How do you even swing your legs over to go to the loo?’
She closes her eyes.
‘I manage,’ she says.
‘I’ll ask the physio to come and see you, but I know that’s the first thing they’ll say.’
‘I’ll think about it,’ she says, then reaches to the side for a glass of vitamised water. ‘In the meantime – please speak to the doctor about my pills. Because nothing’s working and I’m in absolute agony.’
‘Of course,’ I say, picking up my bag to go. ‘I’ll pass on the message.’

the cat knows everything

Gary’s shown hostility to health care professionals in the past, and the record says we’re only to visit in pairs. I’m a little early meeting up with Lisa, so I park up outside and take the opportunity to finish off some notes on the laptop. I’ve just settled in to start writing when Gary’s door opens and a woman steps out. She’s tall and pale and pinched looking, wearing a green and black nylon tracksuit, her long hair dragged back in a ponytail. She takes out a fag packet and is just about to have a smoke when she sees me, sitting there. I wind down the window to tell her I’ve come to see Gary and I’m just waiting on my colleague, but before I can say anything she shoves the fags back in her pocket, walks backwards into the doorway, and maintaining eye contact for as long as she can, slowly shuts the door.

It doesn’t augur well.

Lisa turns up ten minutes later. I’d trust any of the team to go on a difficult visit, but if I had to choose, Lisa would be it. The Italians have a word for how she is: sprezzatura – a kind of nonchalance or ease, wearing her skill lightly, with great warmth and humanity, as if it’s really nothing and no trouble at all, and what was it that needed doing, now, and suddenly it’s done, and everyone feels better.

‘How’s it going there, Jim?’ she says, padding along the street. ‘Have you been waitin’ long?’

We go together through the terrible little garden, knock and wait. There are sounds from inside. An exchange of light and shadow in the frosted panes above the door. A clattering of the lock, and suddenly the door opens.
A bare chested man, his eyes squeezed shut, his smile as wide and flat as the Man in the Moon.
‘I expect you’re wondering why I’m half naked?’ he says. ‘Only I was just having a carton of cherry and raspberry squash, and I didn’t want to get any on my t-shirt.’
‘No. That would stain, right enough,’ says Lisa.
‘Yes,’ he says. ‘You’d never get it out.’

There’s a steep, bare board staircase just behind the man. The woman I saw earlier is crouched at the top, peering down at us on all fours.
‘Don’t listen to him!’ she shouts. ‘He sees ghosts!’
‘Okay, now! That’s interesting!’ says Lisa. ‘So… is yer man through in this room, or … ‘
‘Ye-es,’ says the man, stepping to one side and knocking on the door. ‘I say Gary? There are two lovely nurses to see you.’
Show them in but keep Jackie out.
‘Righto.’

The man pushes the door open and nods for us to go through. Meanwhile, Jackie has started coming down the stairs, slowly feeling with her feet for each tread whilst her face stays as fixed on us as a steadicam.
‘Now, now, Jacqueline!’ says the man. ‘Gary doesn’t want you there.’
Jackie gives a petulant scream, sits down on the step and folds her arms.
‘After you,’ says the man.
We step into the room.

It’s hot as a sauna – the foetid, barrelling kind, where you fling urine on the coals instead of water. I wonder how long Gary’s been lying on his bed like this, his teeth grey and claggy as if he’s been snacking on ash. It’s like we’ve stumbled into a mausoleum, where the occupant took up early residency for want of anything better to do, and his stuff got chucked in after him. There are two posters on the wall: Jimi Hendricks leaning back from a guitar solo; The Beatles all in a line.
‘Wha’d’ya want?’ says Gary.
‘Hello there!’ says Lisa, offering him her hand. ‘Nice to meet you, Gary. This is my colleague Jim. We’ve been asked to come see how you’re doing.’
‘How’m I doing?’ he says. ‘I’m NOT doing.’
‘What’s troubling you today, then, Gary?’
‘I can’t keep nothin’ down. I feel sick all the time. I’ve got no energy. I’m wracked with pain. Is that enough for you?’
‘That’s enough for anyone,’ she says. ‘You poor thing. Let’s see what’s what, then. I’ll just do your blood pressure and whatnot and see how that is, and Jim here’ll take a wee bit o’blood, if that’s okay?’
‘I don’t care,’ he says. ‘You may as well. I’ve got to go to the toilet first, though.’
He nods in the direction of a commode whose pot has been removed so it can fit over a bucket.
‘Do you need a hand getting out of bed, there, Gary?’ says Lisa.
‘I’ll be alright, thanks,’ he says. ‘If you wouldn’t mind stepping outside for a bit.’
‘No worries.’
We leave him to it.

Out in the hall the bare chested man has gone and Jackie is nowhere to be seen. Instead, an ancient black and white cat yowls as it approaches us from the living room. I’m guessing it’s blind because both its eyes are white. It feels its way along the wall, one paw at a time. I crouch down and hold my hand out. The cat stops, sniffs the air, then moves in my direction. When it gets closer I see that its tongue pokes out to the side, too.
‘Poor wee fella!’ says Lisa.
I stroke the cat. It starts purring – a deep, rumbly sound – his tail pointing straight up, as if he’s absorbing the affection and transmitting it somewhere.
‘The cat! The cat knows everything!’ says a voice at the top of the stairs.
Jackie is there, staring down at us again.
‘Oh – they do, though, don’t they?’ says Lisa, smiling up at her. ‘Cats. You’re right there, Jackie. They certainly do.’