When Vera finally answers the phone I tell her how relieved I am.
‘Sorry,’ she says. ‘I was chatting to Dolly. She’s my darling little sis’ and I love her to bits but she doesn’t half go on.’
‘I’m just glad everything’s all right, Vera.’
‘What d’you mean? Why wouldn’t it be?’
‘I was worried when I couldn’t get through. I thought you might have knocked the phone off the hook or something. I thought you might be lying on the floor.’
‘Well I did have a fall,’ she says. ‘But that was last year.’
‘I thought for a minute I might have to kick the door down.’
‘Kick the door down? Why would you do a thing like that?’
‘How else would I get in?’
‘I’d come and let you in.’
‘You wouldn’t be able to, not if you were on the floor.’
‘But I’m not on the floor.’
‘Anyway – you couldn’t come and let me in, could you? It’s absolutely freezing out here.’
‘Out where?’
‘Out here. Outside your front door. I’ve been ringing and knocking for the last twenty minutes.’
‘I haven’t heard anything.’
‘Never mind. Could you come and let me in?’
‘Well I’m looking out the window and I can’t see you.’
‘I’m at the front door.’
‘What do you mean, the front door?’
‘The door. At the front.’
And suddenly I realise what’s happened.
‘What number are you, Vera?’
‘Ninety. Why? What number are you?’
‘Eighty. Don’t worry. I’ll be with you shortly.’
‘Righto.’

A minute later I walk through a gap in a large privet hedge and see Vera waiting on the step with her ancient bull terrier Riley. The only difference between them – apart from height and number of legs – is that Vera is wearing a wig (apparently made of straw, and tilted at an angle, like a bonnet put on in a hurry), and Riley is completely bald.
‘There he is!’ says Vera, leaning down to tap Riley on the head.
Riley stiffens, leans forward to focus, then after giving me a wheezy kind of bark, pushes himself up, and turns to lead us all inside.
‘I bet you’re glad you didn’t go kicking down any doors,’ says Vera.
‘Oh – I would’ve tried a few other things first.’
She laughs, and when Riley turns to look at me, I could swear he raises an eyebrow.

I’ve been coming to this sheltered housing block for years, but if Sheila wasn’t here to lead me to the guest room – down a long corridor, to a sharp, unexpected left through a fire door set back in a recess, out onto a tiny, overgrown patio surrounded by fences, with two doors facing each other, one to an electrical plant room, one to the guest room – I’d never have thought it was there.
‘It’s a good job we’ve got this room,’ says Sheila, talking quietly to me as we walk. ‘Alan wasn’t at all safe where he was. I don’t know if you know the story…?’
‘They didn’t tell me much.’
‘No? Well – short version – Alan was living in our sister place over the other side of town. He’s a lovely old guy, bit vulnerable, likes a drink, never been any trouble. Then a month or two back he got himself involved with this fella Chris, a nasty piece of work, a real polecat, d’you know what I mean? About twenty years younger, a really aggressive sort, who knocked him about, stole his things, used his cards and I don’t know what else. And then the police got involved but they said they couldn’t do nothing in the end because Alan wouldn’t press charges. Psychological, you see, a lot of it. And he’s such a sweet and scrappy little thing. Skin and bone – that’s it – I’ve seen more meat on a daddy long-legs. We’ve been trying to feed him up, and what have you, and he gets proper grumpy about it, but we can’t just let him starve. All this is short term till we can sort something better. But he can’t go home, not with that Chris hanging around. He knows not to show his face round here whilst I’m on duty. And if he comes when I’m out, I’ve warned the others what to say, and to call the police. And hopefully, even if he does manage to get in, no-one’ll know where to send him.’
Just before she knocks on the door she says to me: ‘And that’s why they call it the guest room, you see? Because if you didn’t know it was there, you’d never have guessed!’
She waits for me to laugh.
‘No? Oh, please yourself…’
I follow her in.

With the rail at the bottom of the stair lift extended, there’s no room to open the front door. So I stand outside watching through a window as Mrs Michaels rides down, her son Lionel behind her with one hand resting on her shoulder to keep her in place. Once the chair reaches the bottom – after such an inching, infinitesimal glide it feels less like the chair moving and more like me growing – there’s a great deal of chivvying and coaxing and psychological game-play to get her onto her feet and far enough forwards so Lionel can put the chair into reverse and re-activate the folding mechanism.
He hits the button.
The rail judders and flexes back into position.
He opens the door.
‘Sorry about that!’ he says, breathing hard. ‘Bad timing!’

I follow them into the front room.

You’d never put them as mother and son. Mrs Michaels is a tiny silver mouse of a woman, with pinched features and uncertain blue eyes; Lionel is enormous, his t-shirt riding up over his belly, his palms pointing backwards as he walks, and a friendly if rather dazed expression, like he turned to say hello and unexpectedly walked into a wall.
‘It’s been that kind of day,’ he says. ‘Everything happening at once. Not as bad as yesterday, though.’
‘Why? What happened yesterday?’
‘Well – we’d been waiting for this new fridge to be delivered. I had to pop out for an hour, but I made sure I was back for the time slot they said. When they didn’t show I rang them up. We delivered it they said. Er – no you didn’t I said. Er –yes we did. The driver got a signature and everything. So I said to them, I said Well how come I’m looking around and I can’t see no fridge? They said they couldn’t do nothing about that. They had a signature. The driver dropped it off. They’d fulfilled their side of the bargain. You’ll have to take us to court they said. Well for a start that doesn’t scare me, ‘cos of the job I used to do.’
‘What job was that?’
‘Bailiff. So anyway, I said Fine, then. See you in court. I think they were a bit taken aback by that. It’ll just be your word against ours they said. But I told them I had a secret weapon…’
He nods at the wall behind me. At first I think it’s just a normal flat-screen TV, but then I realise it’s divided into segments, each one a different view of the house, timed and dated.’
‘Smile! You’re on candid camera!’ he says, and then exhaling heavily through his nose, and tugging his t-shirt down,  and folding his massive arms across his belly, turns to look at his mum.
‘In’t that right?’ he says. ‘Candid Camera?’
But in a spooky way, although her eyes are open, and there’s a suggestion of a smile on her face, I think Mrs Michaels is actually asleep.

Mrs Hornchurch had an episode of fast AF last week, was rushed to hospital by ambulance, cardioverted in resus, kept in a couple of days and discharged home yesterday. She has a blown, slightly startled look to her, and holds a handkerchief in her hands, turning it over and over.
She’s taken me through to her front room. It’s as hot as an orchid house in there, with the sun blazing through the patio windows, the radiators on.
‘This is a nice spot,’ I say, immediately sweating.
‘I like it toasty,’ she says.
Just the other side of the glass is a timber walkway leading down to the garden, and a small, black café-style table with a single chair.
‘My great grand nephew Josh built that,’ she says. ‘He’s a carpenter.’
‘Looks like he did a good job.’
‘He did a very good job. He’s a very good boy. He did it when he came back from Thailand. He came straight over from the airport and hardly stopped for tea.’
‘It must make it easier getting down to the garden.’
‘It wasn’t for me. He built it for Ralph, when his hips started going off.’
‘Ralph?’
‘My lovely dog.’ She nods over to a framed portrait on the wall, a Border Collie. ‘He died last month.’
‘I’m sorry to hear that.’
I clip the SATS probe on her finger and count her pulse at the wrist.
‘Collies – I think they’re the most intelligent breed,’ I say. ‘I mean, we’ve got a lurcher, Lola, and she’s pretty fast, although she’s slowing down a bit now. And you know, the only thing that’s ever been able to catch her is a Collie.’
‘Really?’
‘Yep. What he’d do, this Collie, he’d sit down and watch her go racing off in the distance. And he’d take his time, figuring out all the angles. Then he’d stroll over to cut her off at the nearest point. And she’d pull up short, you know. She’d dig her paws in, like one of those cartoon stops. And she’d look up at me in disgust. What am I supposed to do with this?’
‘They are smart,’ says Mrs Hornchurch. ‘Poor old Ralphie.’
I unclip the probe, write the figures down, and wrap the blood pressure cuff round her arm.
‘The only thing that uses the ramp these days are next door’s cats,’ she says.
‘How many cats?’
‘Four or five. I think it’s four. I think one of them just goes round again. It’s like they take it in turns, up and down, up and down, tails in the air, like models on er…on a catwalk.’
‘And what do you think about that?’
‘I don’t mind. I’ve never been one of those I’m a dog person or I’m a cat person. I’m just an animal person. They’re all different, aren’t they? They’ve all got their thing. I even like watching birds on the bird table.’
‘I bet the cats, do, too.’
‘Oh – they’re interested all right, but they never seem to do much about it. There’s this one bird, a wood pigeon. A big old item. I’m surprised the table’s still upright. He comes down and he just sits there, and he eats and eats and eats. Clears the whole table. I call him Henry.’
‘The Eighth?’
‘No. The Hoover.’

Wernicke’s Aphasia it says in the notes. Minor right-sided deficit.

Of course, Mr Girondello still has capacity to make decisions for himself, even if some of those decisions – to be discharged home to this run-down caretaker’s lodge in the middle of a run-down park, for example – seem less than ideal. He has carers three times a day, and they do a good job, making sure he’s clean and fed, and that nothing untoward happened between calls. He has an emergency button, too, and if it’s true he probably wouldn’t think to push it if he got into trouble, it’s some reassurance.
He took a fall recently, and the GP sent us in to review the situation.
‘How are you today, Mr Girondello?’
‘…dello right! It happened, it just happened like that, and the place it was there, and so on…’
‘Well it’s good to see you, Mr Girondello. I’m from the hospital and I’ve just popped in to see how you are, to take your blood pressure and so on. Is that okay?’
‘…s okay. Good. Ahm…Wednesday around and oh boy!….they took it there and it was something else….’
‘Would you like me to make you a cup of tea before we start?’
‘…up tea… start. Yes, that was another trial right in there, that and they thought… and so the box was open… and so…. sugar.’
‘You’d like some sugar?’
‘Ahm…I think horse.’
‘There you go.’

It’s a sunny morning outside, not that you’d know it. Mr Girondello’s kitchen looks out onto what used to be the depot yard, a narrow, high-sided quadrangle, with broken down sheds opposite, and poplars rising high over the slates. If that wasn’t bad enough, someone has hung some heavy green material across the window as a makeshift curtain, nailing it in position so you can’t draw it back. Even with the kitchen striplight on, and a little light coming in through the frosted transom window over the door, the overall effect is of a cold and soupy aquarium. I can hear voices far away across the park, and for some reason it makes the whole place gloomier.

Mr Girondello seems happy, though.
‘There you go!’ I say, carefully passing him the mug. ‘That’ll put hairs on your chest!’
He takes it in both hands, and after taking a sip, looks up at me and says: ‘Ah! That’s how it is..and…and soon… and…and I just hope the water comes down for you, too.’

Mr Epstein is taking a shower. His skin has so many growths and curious moles, so many fascinating patches and bumps and lumpy swellings, that, along with the furrows of his ribs and the wide, satisfied downturn of his mouth – he reminds me a little of a humpback whale. In fact, he’s loving being in the shower so much, I’d go so far as to say that the only real difference between Mr Epstein and a humpback whale is that Mr Epstein used to work in the rag trade.
‘It was a fabulous business. Fabulous,’ he says, vigorously working the loofah. ‘I had my own fleet of vans, running up to the city and back. We used to supply all the big fashion houses. Uh-huh – it was really something to see, I tell you. Now – just a minute…’
All in all, the shower takes an hour. Mr Epstein is perfectly sanguine about the whole thing. I can’t see that he really needs much help. He has a set routine, he follows it meticulously. His recent fall knocked his confidence, no doubt. But on the basis of this morning’s performance, I’d say he was coping perfectly well.
‘See that towel? No, not that one – the big blue one? Harrods. They don’t sell them anymore. Put it over the stool, would you? And then put the smaller one on the floor. That’s it. Now, I’ll just move over here…’

If Mr Epstein is a humpback whale, his wife is a clown fish.
‘I just don’t know what to do,’ she says, trembling down in the kitchen, after I’ve helped Mr Epstein safely in to the front room and deposited him into his favourite armchair in a cloud of talcum powder. ‘He thinks he can do these things but he can’t.’
‘I don’t know. He seemed to be managing quite well…’
‘Quite well? What about the other night? He got up to go to the toilet, fell over and cracked his head. Quite well? There was blood everywhere. I thought he was dead.’
‘So … erm … what happened?’
‘The paramedics came and patched him up, that’s what happened. I wanted him taken to hospital but he’s stubborn and said he didn’t want to go. He can’t stay here, though. What am I supposed to do if it happens again?’
‘You’d just have to call the ambulance again.’
‘I can’t keep calling the ambulance.’
‘No. But this is the first time in a while. And he seems pretty stable. It may well have been a one-off…’
‘A one-off?’
‘Let’s hope so.’
‘He should go in a nursing home.’
‘Myself? I think you’ve a long way to go before that’s necessary. You’re really well set-up here. But anyway – that’s something the two of you can discuss.’
‘No. I don’t think you understand. I’m saying he has to go in a nursing home.’
‘Well – so long as someone has mental capacity to make decisions for themselves, you can’t just put them in a home.’
‘What about me? How am I supposed to cope?’
‘If it’s a question of getting some help – you know, getting him up in the morning, showering and dressing, and getting to bed at night – we can always look at the care aspect.’
‘And what about if he gets up in the middle of the night to go to the loo and falls over and cracks his head again? What am I supposed to do then?’
‘That’s when you’d call for an ambulance. But there are lots of practical things you can do. Maybe we could look at putting a commode in the bedroom, so he hasn’t got so far to walk.’
‘A commode?’
‘Maybe. It’s worth considering.’
‘I just don’t know how you think this is going to work.’
‘And then of course it might be worth looking at giving you some time away, Mrs Epstein. Some respite. There are two of you in the relationship. It wouldn’t help if you got sick as well.’
‘No. It wouldn’t.’
In the pause that follows we can hear a noise coming from the sitting room.
‘What’s he doing now?’ she says.
‘I don’t know. It sounds like singing.’

Eric is propped up in bed, smoking a cheroot and watching The Good, The Bad and The Ugly at top volume.
‘All right?’ he says, raising a skeletal hand.
‘Fine, thanks, Eric. How’s it going?’
‘All right, son.’
‘The usual?’
‘If you would.’
I take his empty bowl, cup and tray and go through to the kitchen; he stubs out his cheroot and gets himself into position.

Eric’s easy to cater for. Breakfast, lunch, supper – it’s always the same: two banana Weetabix with three spoonfuls of sugar and a splash of hot water, and a mug of raspberry and rosehip herbal tea (also with three sugars).

‘Lovely!’ he says when I come back through and put the tray on his lap.
It happens to coincide with that scene in the film where Lee Van Cleef walks in to a Mexican casa to eat supper with an old guy in beard and braces. It’s pretty tense, everyone bent over their bowls, slurping away, including Eric.
‘Looks like I’m the only one not eating,’ I say.
‘Get yourself a bowl,’ says Eric.
Suddenly, Lee Van Cleef draws his gun and shoots the old guy.
‘Not enough sugar, I expect,’ I say.
‘No, no,’ says Eric, licking his spoon clean then waggling it at the TV. ‘They’re eating beans.’

They’d warned me about Gloria’s house, but really, when I get there, it isn’t too bad.
The Extreme Cleaning team has been working most of the morning and they’ve made good progress. There’s a pile of debris in the front garden, the kind of festering mess you might see after a terrible flood, or a swamp exhumation. The teams are obviously hard-working and well-prepared. They have two hi-tech vans, both with side-opening door like tiny fire trucks, one with an aluminium ramp to off-load heavy equipment, the other with a length of industrial hose leading in to a jet wash. The team itself is dressed CSI-style – white polyester overalls, latex gloves, clear plastic face guards and blue hair nets. Before I go in I stop to put on some overshoes and a plastic apron, but I must admit I feel a little under-dressed, like I’m wandering into a slaughterhouse with a cook’s apron and a wooden spoon.
‘Hello? It’s Jim, from the hospital.’
One of the cleaners is hard at work in the front room, operating a stainless-steel cylinder vacuum cleaner so powerful I’m in danger of being sucked up myself when I tap her on the shoulder. She flicks the switch and turns round.
‘I’ve come to see Gloria’ I shout as the noise subsides, as impressively as a hovercraft coming in to port.
The cleaner nods to the far end of the room, then turns the machine on again.

Gloria is sitting on the wreckage of her sofa, a blanket draped over her shoulders. The windows are open either end of the room and there’s a significant through-draft, but despite all this, twenty or so fat and frowsy-looking flies are still dotted round the walls, too stunned by the assault on their home to move.
‘Hello, Gloria. My name’s Jim. I’m from the hospital – come to see how you are.’
‘Wha-at?’
I hold out my hand for her to shake. Hers is crabbed-over, the nails rimed with filth.
I make a gesture for her to wait, then go back over to the cleaner, tapping her on the shoulder.
She switches off the machine again.
‘Can you give us a minute?’ I shout.
‘Sure,’ she says, pulling down her face-mask and wiping her forehead on her arm. She’s ludicrously attractive, dark eyeliner, clear blue eyes. ‘Of course!’ she says, smiling. Then nodding at Gloria, she steps outside for some fresh air and a cigarette.
‘That’s better! So – Gloria – how are you?’
‘Fine!’ she says.
‘Good!’ I say, ‘That’s good!’ although I hardly need take any readings to know that Gloria’s only about as fine as you’d expect from someone who’d been living in squalor for years, and hadn’t moved from the sofa since Christmas.
‘Could you get me another blanket for my legs?’ she says. ‘It’s a bit chilly with these windows open.’
‘Of course.’
Suddenly, the noise in the kitchen subsides, the door opens in a cloud of steam, and the other cleaner comes in, holding the dripping jet-wash nozzle in front of her.  When she sees me there she pulls her face mask down, and for a moment I wonder if this Extreme Cleaning outfit isn’t really just a bunch of super-models making a little extra money on the side.
‘Can I help?’ she says, and when I don’t immediately reply – as a threat or a prompt, I’m not entirely sure – she gives the nozzle a little shake.

The terraced houses running either side of the street are all of Regency vintage – narrow, three-storey town houses, many with the original bow windows and filigree iron balconies, heavy oak doors, leaded fanlights and pointed black railings. But whilst it looks as if they’ve all managed, more or less, to hold on to these features, time and the vagaries of the housing market have both had an effect. There’s scaffolding up at three of the houses; the rest are either restored or falling to pieces, so that the overall feel is of a street going through a significant change, a street that doesn’t quite know what it is yet.

For example, the house opposite Zelda, the patient I’ve come to visit, is now a boutique hotel. Zelda’s house has yellowing net curtains sagging in the window; the hotel has a series of fine, egg-blue painted shutters. To the side of Zelda’s door is a mish-mash of doorbells, sellotaped names, no names at all, and clear signs of forced entry on more than one occasion; the hotel – a five-star plaque.

I knock, then let myself in with the key safe.

Zelda is in the drawing room – smoking room, these days.
‘Don’t worry. I’ll put it out,’ she says, dabbing her fag into the side of a pyramid of butts in the ashtray beside her.
‘Thanks’ I say, but it doesn’t make any difference, as there’s probably more smoke in the room at the minute than a test facility at Philip Morris.
‘How much do you smoke a day, d’you think?’ I ask her. It’s a moot point, especially given her breathing problems.
She screws her face up.
‘I dunno. Fifty, sixty maybe?’
‘Wow! It’d be cheaper doing heroin.’
‘Don’t get me started,’ she says, and laughs, such a loud and sludge-wracked thing, it’s almost enough to drown out the noise of all the renovation work next door.

George is ill, that much is clear. For years he’s been caught between the Scylla and Charybdis of his failing heart and kidneys, struggling to navigate a way through on meds that push him disastrously first one way and then the other. George has suffered frequent spells in hospital with low blood pressure, low SATS, deranged bloods and so on, the last time ending up with a week on ITU. I’m not surprised he greets my suggestion of an ambulance with complete horror.
‘I really don’t – want to go – to that damned – hospital again,’ he says. ‘I couldn’t bear it.’
‘I completely understand,’ I tell him. ‘I mean, you wouldn’t want to book a holiday there. But the thing is, George, with your blood pressure this low, I can’t see how we can safely treat you at home. Look – best case scenario – you go in, they stabilise you, and then they turn you back home again in short order. They won’t keep you in unless they absolutely have to. What d’you say?’
‘I would really – rather not.’
‘The other thing to bear in mind is that right now is the perfect time to go in. The doctors haven’t started sending patients in yet; it’s too early for the pubs and clubs. The day’s just beginning. This is the quiet time.’
‘Quiet?’
‘Quiet-er.’
‘Hmm.’
‘Okay, then. How about I ring your GP and we all discuss it over the phone?’
‘Fine. If the doctor says so – I’ll go.’
‘Great.’
He hands me the phone. I ring the surgery, leave a message with the receptionist for the doctor to call me back urgently, then spend a moment writing out my notes.

On the opposite wall there’s a cute, A4 sized photo of a cat, a long-haired tabby, in extreme close-up, its head angled to one side, frowning with such exaggerated concern you’d think it was an election poster for a cat MP.
‘Who’s that in the picture?’
‘Nelson.’
And right on cue, Nelson wanders in.
He’s very much older than his photo now, moving as stiffly as a puppet cat made of sticks.
‘Nelson!’ he says. ‘Good boy! C’mon Nelson!’
Nelson gives a strangulated meow – like someone forcing the door on a rusty tin shed – then teeters towards George’s legs, his ragged tail in the air.
‘I knew I wasn’t right – when I got out of – puff this morning – giving him – his brush,’ he says, struggling to reach down.
‘Would you like me to call anyone to come and look after Nelson?’
Nelson looks across at me; so does George.
‘Let me speak – to the doctor first,’ says George, straightening. Nelson takes that as his cue to jump up on George’s lap, and would have fallen straight off if George hadn’t stopped him.
‘There we go!’ he says. ‘Good boy.’
He works his right hand down Nelson’s back, the cat slowly raising its hips to meet the end of each stroke.
‘I bet – I know – what the doctor – will say,’ says George, after a minute or two. ‘And I bet Nelson – does, too. Don’t you?’