sleep

Arthur is about as cold and severe as it’s possible to be without actually being struck from a block of granite. Tall and broad, a little stooped at the hip, he slowly wheels his wife Pat into the kitchen, parks her at the table, fusses some things on the tray in front of her – a box of tissues, a beaker of cold tea – then sits heavily in the chair opposite.
‘What do you propose to do now?’ he says.
I explain why I’ve come. He listens, frowning, hardly able to meet my eye he’s so cross.
‘How long will it take?’ he says, cutting me off. ‘I’ve got things to do, you know.’
‘I’ll be as quick as I can. I should think about twenty minutes.’
‘Twenty minutes? Couldn’t you make it fifteen? She’s got her feet at one.’
‘I’ll do my best.’
My best is obviously not good enough. Impervious to my attempts to soften him up and win him over, Arthur folds his arms and watches me prepare my things. Every now and again he releases a quantity of air through his nose, like it’s a safety valve easing the pressure in his head.
‘You should come like you arranged,’ he says.
‘Yes. I’m sorry I was delayed. But it’s not that far off. Is it?’
‘You shouldn’t make appointments if you don’t intend to keep them.’
‘I know, I know. It’s just really difficult to judge. Things happen.’
He grimaces.
‘An appointment’s an appointment,’ he says.
‘Absolutely. You’re right. I could always come back later…’
I hope he won’t take me up on that, because then I’ll really fall behind. But, luckily for me, all he does is check his watch and wave me on.
‘So long as you’re quick,’ he says.

Pat, on the other hand, is almost completely inert. Her dementia has made her childlike – or, if not that, exactly, then animated by a disquieted kind of wonder at her own condition, looking at me and Arthur and the room we’re in without any apparent differentiation.
‘I don’t know what good you think any of this will do,’ says Arthur, as I take her obs. ‘The doctor did it all last week.’
‘Things change,’ I say, pulling the stethoscope from my ears and unwrapping the blood pressure cuff. ‘You have to take a few readings over a period of time, so you get a good picture of what’s going on. But in this case, everything seems fine.’
He grunts, sighs, rubs his face, checks his watch again.
‘So that’s that,’ I say, filling in the last of the figures. ‘Now. What about you?’
‘Me?’
‘How are you coping?’
He shrugs.
‘Are you getting the help you need?’
‘What kind of help?’
‘Carers. You know. That kind of thing.’
‘I’m her carer. What would a carer do?’
‘I don’t know. Help get Pat washed and dressed in the morning. Take care of her meds.’
‘I do that.’
‘Okay. Great!’
‘I do everything. I get her up in the morning, I put her to bed at night, and everything in between. Not that she sleeps. Last night I was up at half past twelve, half past two, half past four, half past six…. I’ve not had a decent night’s sleep in years. She calls out in the night, you know. All the time. And I have to take her to the toilet. And then bring her back. And wash her down when she doesn’t make it. I don’t know how I’ve been getting through the day, I’m so tired…. I don’t know how I’m going to ….I don’t know…’
And suddenly he leans forward, puts his face in his hands, and cries.

Pat watches him from her wheelchair, then slowly picks up the beaker from the tray and takes a sip. A dribble of tea falls down the front of her dress.
‘Here, love. Sorry. Let me get that for you,’ he says, and wiping his nose on his sleeve, he hauls himself up, pulls a handful of tissues from the box, and starts dabbing her dry again.

the very model of gentleness

Midday, and the sun is the blinding centre of everything, scorching every surface, every car bonnet, brick wall, bare arm; blazing over the city; bubbling in the gooey tack of the road; dry-frying the leaves on the trees; flaming across the intersection of every street, irradiating everything with its vast and pitiless eye. It feels as if the sun has moved in close, into some newer, more punishing orbit – on a grudge, on a whim – and it absolutely will not quit until the last squeak of moisture has been drawn from the cell of every living thing.

Which is to say, I’m hot and thirsty.
Even winding up the car windows when I park feels like an act of madness.
In the seconds it takes to step out, I’m sweating.

Agnes’ daughter Janice meets me at the door.
‘Gosh, it’s hot, isn’t it?’ she says.
Inside the house is dark and cool.
‘The doctor’s still here,’ she says.
‘Great!’
I follow her upstairs.

Doctor Middleton is sitting on a blanket chest quietly fanning himself with a magazine supplement.
‘Hello Doctor,’ I say, putting my bag down and reaching out to shake his hand. ‘I’ve been sent to take some blood.’
‘Excellent!’ he says. ‘I suppose you know the circumstances?’
‘Just the basics.’
‘Well let me fill you in. Agnes has taken to her bed the last couple of weeks. Nothing specific. A little abdo pain perhaps but you could probably ascribe that to diverticula disease. No diarrhoea, no nausea or vomiting. No distressing symptoms particularly, other than this loss of energy and appetite and general decline. The weather’s not helping, of course – it certainly is warm – but let’s just say it’ll be interesting to see what the bloods show. If you’d be so kind as to throw the net wide – kidney, liver function, infection, anemia, that sort of thing. And put it in as urgent, if you wouldn’t mind. And we’ll take it from there. Okay? Great.’
He looks from me to Janice then back again, smiling broadly, shining in the close heat of the bedroom. Then he puts the magazine down, picks up his things, and with a large, friendly wave, heads for the stairs.

I turn my attention to Agnes. She’s lying on her side on furthest edge of the large bed, her left hand crooked under her head, her right hand resting on the point of her elbow. She’s staring at a small, white fan that’s been set on the floor, angled up so that a current of air plays gently across her face.
Janice sits down on a wicker chair just opposite – a position I’m guessing she’s held these past few days – as I kneel at the side of the bed and gently stroke the back of Agnes’ hand. When she opens her eyes and looks at me I explain who I am and what I’ve come to do. She listens passively, allowing me to straighten her right arm, put on the tourniquet, and tap up a vein. She barely reacts as the needle goes in and I draw off two phials of blood.
‘There! All done!’ I say, taping a little wad of gauze over the wound.
‘What do you think’s wrong?’ says Janice.
‘I don’t really know,’ I tell her. ‘The observations the doctor took don’t seem to point to anything. Has it been a marked decline, would you say? Or was it more gradual?’
‘A bit of both,’ she says, and by way of illustration raises her hand in the air and swoops it back down again, like she’s describing a rather lacklustre ride she took at the fair.
‘I wish I knew what was wrong.’
‘Well the bloods will certainly give a good indication. You’re doing the right things. though. Keep Agnes cool, give lots of fluids – doesn’t matter so much about food at this point. And we’ll take it from there.’
The phone rings, so I mime a Goodbye. She waves and smiles, and I see myelf out.

The first thing I do when I get back to the car is open all the windows. The seat is uncomfortably hot when I sit down, but at least there’s a scrap of breeze now, so I don’t need to drive off immediately and find somewhere shadier.

My habit is to make sure I have all the details I need for these phlebotomy jobs, take the sample and then fill in the form and the labels on the phials when I’m back in the car. It’s a long and fiddly bit of admin, and I don’t want to bother the patient any more than I have to. So it’s only when I settle in to do the paperwork that I notice Agnes’ date of birth.

She’s well over a hundred years old.

It makes me think of my friend Jo and his old sheepdog, Lewis. When Lewis reached the very end of his life, he took to lying by their garden pond. The last time I saw him, in fact, the day before he died, he was in his usual spot, his head between his paws, staring with his eyes half closed at the ripples in the water his fading breath made. And I think of Agnes, upstairs on the bed, quietly staring at the little white fan spinning round and round.

I drop the bloods off at the hospital.

It’s only at the very end of my shift, when I’ve arrived back at base to handover my caseload, that I hear Agnes died – an hour or two after I left. Apparently an ambulance was called, and because there was no DNACPR, the crew had to go through the resus protocol.
‘Unsuccessfully, surprise, surprise,’ says the co-ordinator, clicking her pen and pulling a fresh report sheet towards her. ‘I’m amazed there wasn’t one in place, but who knows? Maybe the family refused. You never know with these things. Shame though.’
‘I certainly wouldn’t want anyone jumping up and down on my chest when I was in my hundreds,’ I say, taking a seat next to her. ‘Or sticking me with needles, come to that.’
‘No. Me neither,’ she says. ‘Maybe it was you taking blood that pushed her over the edge.’
But she immediately smiles, and pats me on the arm.
‘Only kidding,’ she says. ‘I’m sure you were the very model of gentleness.’

to rinse or not to rinse

Ken is sitting in his pants, sprawling out of the armchair, his long arms and legs pointing east, west, south east, south west, as startling to look at as a giant species of starfish unexpectedly brought up in the nets.
‘Hot, in’t it?’ he says, just managing to lift a hand to acknowledge me as I come in. ‘I think I might actually be melting…’
At least he has a fan, though. It rattles away on a nearby table, surprisingly little air moving despite the racket, just enough to tease a few strands of hair from the top of his balding head.
‘Take a seat,’ he says. ‘Yellow folder’s just there.’
‘Thanks.’

I’ve come to give his daily Tinzaparin injection.
‘They showed me how to do it,’ he says, struggling to sit up, ‘…but when it came to it, y’know, to actually putting the needle in, I just couldn’t. My nerve completely went. So I’m sorry you’ve been dragged out to take care of business.’
‘Don’t worry about it, Ken. It was good of you to try.’

I chat to him as I get things ready.
‘I know what you’re doing,’ he says, tapping a finger on the side of his nose. ‘You’re taking my mind off what’s coming next. I know all the tricks.’
‘Yeah – but the other thing is I’m actually quite nosy.’
‘You’re in the right line of work, then.’
‘I suppose so.’
He tells me he’s originally from Warwickshire.
‘That’s a beautiful county,’ I say. ‘Sharp scratch.’
‘It is,’ he says. ‘Ouch.’
‘Sorry, Ken.’
‘No need to apologise. You’re doing a grand job.’
‘There! All done!’
‘Not too bad,’ he says, a little subdued, rubbing the spot on his abdomen. ‘These days I feel like a bloody pin cushion.’
‘I went to Statford-upon-Avon for the first time a couple of years ago,’ I tell him, popping the used needle into the sharps bin. ‘I thought it was an amazing place.’
‘It is an amazing place,’ he says. ‘It’s where Shakespeare was born.’
‘Yep. We did the usual things. Went round the house. Saw a play at the theatre.’
‘He was definitely what you might call a genius,’ says Ken. ‘I don’t think that’s too strong a word. Some people are clever, like, but he was in a whole other league. Have you seen pictures of him, with his forehead bulging out like that, like a bloody balloon? That must’ve been the pressure of all them brains. And the thing was, it all come from nowhere. His dad was some kind of businessman. I don’t know what his mum did. And suddenly they have this kid who’s writing all these poems and plays all over the place. Amazing, when you think of it.’
‘It is.’
Ken laces his fingers across his belly and watches me write in silence for a while.
‘What would-a happened to me, in the past, like?,’ he says eventually. ‘Before all these injections?’
I shrug.
‘I don’t know, Ken. Maybe nothing. But I suppose people didn’t tend to live so long in the past, did they? I mean – look at Shakespeare. He was dead by the time he was fifty-two.’
‘I ‘spose. I’m not sure how much good it does any of us, all this jabbing and poking, all these whatnots, these pills. It’s just dragging it out. I mean, take my old mate, Bill. Not the Bill you’re thinking of, another one. He weren’t that old when his kidneys packed up. So every other day he had to go to the hospital to be plugged in to a big machine that rinsed ‘em out and kept him going a while longer. I said to him, I said Bill! Is it worth it, mate? Wouldn’t it be better to let nature take its course? So he came off the machine and he was dead by the weekend. I said to the doctor, I said Did you give him a kick, to make sure? And the doctor give me a look like this…’
He widens his eyes, straightens his mouth and leans towards me out of the chair. Then after a funny kind of pause, relaxes back again.
‘Didn’t bother me,’ he says. ‘Everyone’s entitled to their own opinion. But by Christ! It ain’t half ‘ot today…’

horrific honorific

I can’t remember the last time someone called me ‘sir’.
It makes me feel officious, remote, about a hundred years old.
I check Stan for intention (sarcastic? hostile? guarded?), but I don’t get a sense of anything other than an eagerness to show how much he appreciates the visit. Still – it’s oddly deferential, and I can’t help squirming.
‘The good lady wife’s just through here, sir,’ he says, showing me along the hallway to the lounge, and then standing aside, nodding and closing his eyes. All he needs is a pair of white gloves and a silver tray under his arm. ‘She can’t go far, I’m afraid. You’ll see why.’
Vera has been discharged from the hospital with home oxygen. She sits on the sofa, working her shoulders like a landed carp, her eyes just as large and round and glassy.
‘Oh – hello, dear,’ she gasps. ‘And what – have you – come for?’
I introduce myself. She pats the sofa cushion next to her for me to sit down.
‘Can I fetch you a drink, sir?’ says Stan. ‘A tea, perhaps? Or something cool?’
‘That’s very kind, Stan, but I’ve just put one out.’
‘Oh!’ he says, raising his eyebrows and tipping back on his heels. ‘Like a cigarette, you mean! Yes. Very good. Well – let me know if you need anything. Is it all right if I…?’
He gestures to an armchair the other side of the room.
‘Of course! If Vera doesn’t mind.’
‘We’ve been – married – forty-five years,’ says Vera. ‘It’s a bit – late in the day – if I do.’

the old shed

I tore down the shed today
I can’t say it was difficult
the whole thing was rotten
I could’ve huffed and puffed and blown the shed down
dispossessing not three little pigs but
innumerable spiders
horrible as currants,
abandoning their nurseries
screaming from the light;
slugs, ribbed jelly thumbs
gummed to the strandline
of an upturned pot;
a brace of frogs, both alike in dignity,
stopping just long enough to give me the eye
before lolloping off any-old where

(and so on
I had a shed to scrap
you can over-think these things)

but now it’s all gone
ripped, pulled, smashed, stacked,
carted off to a designated recycling facility

it is no more
no roof, no floor
no window, no door,
that slouchy, shed defined space
released to wilder territories of air

I wonder if any of it comes back, though?
do spiders and frogs and slugs have a memory for these things?
for those bounded spaces where life once held them close?

do sheds?

the tree’s revenge

Lionel has the same birthday as me, minus forty years.
‘So you’re the twenty-ninth of December, too?’ he says. ‘How interesting! I don’t know about you, Jim, but one thing I noticed was the tendency to get rather a lot of suspect Christmas and birthday present combinations.’
‘Me too. I was always tempted to ask for the receipt so I could work it out.’
‘Yes!’
‘But there were consolations. I never used to mind it when I’d finished opening my Christmas presents because I knew I’d be getting some more in a few days’ time.’
‘There was always that consolation. And then it’s New Year’s Eve…’

It’s interesting, meeting patients with the same birthday. Sometimes it’s best not to say anything, though, tempting as it is, especially if the patient shares the same year, too, and hasn’t fared so well. The last patient I met who was my exact astrological twin was an alcoholic whose career had ended, wife run off with his best friend, been made homeless, and fallen down a flight of stairs. I’m pretty safe with Lionel, though. There’s the great age difference, to give us a tactful margin. And then there’s the fact that Lionel is one of the most inspirational ninety-five year olds I’ve ever met.

‘I would never have guessed you were ninety-five,’ I say to him, reflecting on his dates. ‘If you’d have said eighty I’d have said no way.’
‘You’re too kind!’ he says. ‘But carry on…’

Lionel’s been referred to us because he fractured his arm gardening.
‘I’ll tell you what happened,’ he says, shifting awkwardly in the armchair. ‘I was out there pruning back the fuchsia when I took a step back to see what needed to come off next. But the trouble was, you see, I’d forgotten about the laburnum stump. I’d taken the thing down about five or six years ago, something like that, pretty much to ground level, but I’d put off grubbing up the roots. It’s quite a tough job as you know, and I was working up to it. So what happened was I caught my foot and over I went, flailing around like Charlie Chaplin on a bad day, landing on my arm and causing the injury you see before you. An absolute bloody nuisance, but there you are. You make the best of these things.’
He settles back in the chair.
‘I suppose you’d have to say it was revenge,’ he says. ‘That poor tree! I expect it’s been waiting to get me all this time…’

going native

Quite how the conversion was done or how it all hangs together it’s impossible to grasp. All you can say with any certainty is that at some point in the last twenty years a substantial Georgian house was designated as hostel accommodation, completely gutted and then divided up into numerous studio flatlets. The effect is of a grand old bee-hive. If I was a giant, I could take the roof off and lean in to inspect the interior, layer on layer of compact cells, each divided by nothing more than paper (and all the bees looking up at me, shaking their fists).
The cards describing the flat numbers give you a flavour. Random, hysterical groupings, arrows pointing left and right and round the corner – which is where the door to the staircase leading up to Terry’s flat is located, in an alleyway that funnels the wind so furiously it makes my ID lanyard flap backwards over my shoulder and snatches the sunglasses from the top of my head.
Hello?
Hello. It’s Jim, from the hospital. Come to see Terry.
Hello?
I put my mouth to the intercom.
Hello! It’s Jim, from the…
The door buzzes and I step inside.
A steep staircase, something of a cubist spiral, steeply rising up and up past flat doors whose numbers seem completely random.
By the sixth floor I’m slowing up and breathing hard. Terry is waiting for me by the door.
‘Why didn’t you say anything when I answered?’ he says, clutching his bathrobe around him.
‘I did… but the… wind was so strong…phew! That’s a long haul!’
‘I suppose you’d better come in,’ he says, and retreats into the flat.

I’m astonished to see how much IT equipment Terry has in his living room. There are laptops, desktops, a 3D printer the size of a small family car, plus shelf after shelf of spare parts, manuals, odds and ends, and then miles of cables of every colour and size, looped chaotically over hooks and hangars and any other appendage that might take them. It’s like climbing to the top of a great pine tree to find a crow’s nest with a fully-stocked workshop, fridge and snooker table.
‘Wow!’ I say. ‘I’m exhausted just carrying my bag’ dropping it down and then sitting in a chair. ‘This is amazing!’
‘I didn’t do it all at once,’ he says.
I want to say that doing any of it at any time would be inconceivable, but I let it pass.
‘I’ve come to see how you are,’ I say. ‘To do your blood pressure and that sort of thing.’
‘What – again?’ he says.
‘I know it’s a pain, but it’s good to get a picture over a period of time.’
‘I suppose,’ he says. ‘I just don’t think it means anything.’

Terry is an extraordinary figure. He’d be a shoe-in for Ben Gunn, if his robe had been woven from grass and not cotton towelling. Terry hasn’t cut his hair in years; it stands out in long, grey strands that, back-lit in the harsh light from the window, looking like the splayed ends of a fibre-optic cable. His thick glasses enlarge and dilute his eyes, holding their rather lost expression regardless of the wild changes of emotion Terry expresses.
‘It would help if it bloody worked’ he says, suddenly enraged, picking up a tablet and then crashing it down on the table again. ‘Windows 7,’ he says, his whole body trembling. ‘All I wanted was to download the driver for my printer so I could bloody well use the thing, but will it do it? Yes, it will.’
‘Oh! Good!’
‘No – but just wait a minute. Yes, it will download the driver, but it won’t let me load it!’
‘That must be frustrating…’
‘Frustrating? It makes me want to… I want to….’
He tails off, overwhelmed by the injustice of it, his whole head wobbling, as if the sudden change in pressure in his brain had loosened something critical in his neck.
‘What about getting advice on a forum…’
‘Forum? Don’t make me laugh! I haven’t got time for forums. They don’t want to… I can’t…’
It’s simply too much; he runs out of breath.
‘Unfortunately I’m not the one to advise you on this sort of thing,’ I tell him. ‘I struggle to find my way around my phone. I’m a bit hopeless, to be honest. If my daughters were here, though…’
‘Ah. Well,’ he says, blinking hard. ‘Digital natives.’
Terry seems so tortured by his environment it’s strange to think he’s responsible for it. I couldn’t be more confused than if I saw a mouse deliberately lower itself into a vivarium and then sit on a rock, quivering.
‘Try these on,’ he says, in a tone of voice suddenly balanced and conversational. He reaches behind him and hands me a pair of hi-spec glasses, connected to a handheld device that turns out to be some fantastically ergonomic controller. Through the glasses I’m presented with a virtual desktop, so vibrant and unexpected I’m momentarily lost for words.
‘Wow!’ I say, moving my head around and gently experimenting with the controls. ‘That’s – amazing!’
‘Yes,’ he says. ‘It is – or it would be if my hands didn’t shake so much I can’t work the damn thing!’

 

suede head

‘Are there any special precautions for suede?’
The salesman hesitates.
‘What like?’ he says. ‘What d’you mean, special precautions?’
‘Well – you know – for rain’
‘Don’t, is my advice. Check the forecast.’
‘Okay.
‘But if you want to go out…. if you have to go out,
just don’t go splashing around.
‘Okay.’
‘And get some special coating. They sell it next door.’
‘Spray-on?’
‘Yes.’ He looks at me. ‘From a can.’
After a moment, he boxes the shoes and starts ringing them up.
‘These too,’ I say, handing him a clip of black socks.
‘Do you want a bag?’ he says. ‘Five pence?’
‘No,’ I say. ‘That’s okay. Put the socks in the box.’
‘The socks in the box?’
‘Yes. The socks in the box.’
He opens the box, puts in the socks.
Shuts it, leaving his hand on top for a moment
like he’s scared the socks’ll try to bust straight out of there.Image result for black suede shoes
I hand him my card.
‘Don’t forget about the rain,’ he says
Jabbing the buttons on the till
‘I won’t. If it’s raining too hard, I’ll just
Stay in. Or if I absolutely have to go out
I’ll tie a couple of bags round my feet.’
‘Yeah,’ he says, handing me my receipt
‘You could totally do that.’

birth story

five years ago the university held an open day here,
the site of a Neolithic causewayed enclosure
a series of gigantic, concentric circles picked out in chalk
‘so you could see the structure from a long way away’ he said.
now, close-up, it’s hard to see anything much
beyond the black bags, fly-tipped fridges, and brambles
although from a distance, once you know it’s here,
you can start to pick out the ghosts of a more ancient design
rippling through the landscape.

mast_sm

the site has been used many times
in the ten thousand years since it was built, he said
during the war, locals dug for victory
they built a radar emplacement, a racecourse
and latterly, a mobile phone mast
(barbed wire round the gantry feet,
sign saying Danger of Death)

they found a few graves, he said
a young woman,
the bones of a baby lodged in her pelvis
(he didn’t say whether they were
finally separated, c-section by trowel,
ten thousand years too late)
he did say that her grave had been skilfully cut, though,
the body placed just-so,
a halo of loom weights,
a clay pot at her feet
high status he said
and then, nearby, another grave,
an older woman, this,
pitched head first, any old how
backfilled with disdain
‘the midwife, I expect’