Sandra, one of the District Nurses phones to see if we have capacity.
‘Don’t worry! It’s not a full-on referral,’ she says. ‘More of a favour, really. I’ve just been round to see Harry, one of our palliative patients. A lovely gentleman, stubbornly independent, you know the sort. Coping remarkably well up to now. No carers, just friends helping out now and again. Anyway, he’d had an episode of incontinence, probably food related more than anything. I cleaned him up, changed his bed things and put them in the wash. Medically he’s stable. It’s just he cried when I was there and it was a bit of a shock to be honest. We’re all a bit worried about him. It’s too late to sort out a proper care package tonight, if that’s what he needs. I just wondered if you could send someone round last thing to see he’s okay for tonight.’

Harry is eighty something, fifty years at sea, twenty of those a captain, the beard and the bearing to prove it.
‘Can I see some identification, please?’ he says at the door. I show him my badge.
‘Thank you,’ he says, hands it back and shows me in.
He walks uncertainly, like a man in a dream, running his hands over the walls and the furniture not for balance but to reassure himself they’re real. I follow him into the sitting room. He eases himself down into a sculpted leather armchair, a TV showing Twenty20 cricket, the sound off.
‘Sandra asked if I’d drop by to see how you are,’ I tell him.
‘Sandra. Yes.’
‘How are you feeling?’
He stares at me. There’s a delay before he replies each time, no doubt a symptom of his cancer.
‘I’m fine,’ he says. ‘I had a little setback, but everyone’s been so kind.’
I take my coat off and drape it over my bag.
‘What can I do to help?’ I ask him. ‘What about a cup of tea?’
He considers that.
Eventually he says: ‘Thank you. Tea. Yes.’
‘How do you have it?’
Another long pause. He wets his lips a couple of times.
It’s a physical thing. You can almost see the images passing in front of him: the kettle, the cup, the milk.
‘No sugar,’ he says. ‘Thank you.’

Often, when you go into people’s houses, there’s a slight confusion. Where do they keep their tea things? Which is the cutlery drawer? Where’s the bin? You spend a minute or two opening and closing cupboards, expecting one thing, finding another. Harry’s kitchen is different. Everything is just where you might expect it, neatly stowed. I get the impression if the house unexpectedly put to sea, you could still make breakfast quickly, and nothing would fall on the floor. The draining board is a work of art, all the cutlery standing handles down, forks and knives on one side, spoons and teaspoons opposite, plates in size order. There’s a tray over by the kettle with caddies for tea and coffee. Tea-towels hanging from hooks. I’m the untidiest thing there.
‘Here we are!’ I say, bringing him a cup of tea. ‘How about something to eat?’
‘I couldn’t,’ he says after a while. ‘I’m afraid I’ve lost my appetite. But thank you.’
‘You’re welcome. Sandra asked me if I’d empty the washing machine and hang it all out to dry. Is that okay?’
‘Please,’ he says. ‘I don’t feel quite up to it.’

There’s a clothes rack in the utility room, full of pyjamas, shirts, pants, socks, handkerchiefs and jumpers. I fold them all up as neatly as I can, put them in a pile on the sideboard, then take out the washing. I shake out the sheets, duvet cover, pillow slips and towels, space them out as much as possible, then go back into the lounge.

‘Shall I put the dry things away for you?’
He looks over at me, then nods.

I take the pile of laundry and go into his bedroom. Again, it couldn’t be easier. There are specific drawers for each item, and I square everything away, everything except the towels. I check the bathroom and the hallway, but I can’t find an airing or linen cupboard, or any place else that might double for that. So I go back into the lounge.
‘What about these?’ I say, holding up the little pile of towels.
He stares at me, at them. After a while he says:
‘Lay them on the chest, could you? In the bedroom.’
I want to say Aye Aye, but I just smile and turn about.

The chest is a vast sailor’s trunk, made of dark African woods, intricate marquetry ships with masts and sails, riveted, braced with copper bands. I place the towels on top of it, then go back into the lounge.
‘Is there anything else I can help you with tonight?’
‘No. I’ll be fine,’ he says. ‘I’ve got friends popping round later.’
‘Sandra’s back in the morning. Maybe you can have a think about what kind of help you might want from now on.’
‘I’m a cussed old thing,’ he says. ‘I like to be as independent as I can.’
I stand to go.
‘If there’s nothing else…’
‘There is one thing,’ he says, and points to the table in front of him. To a tea spoon resting on a woven Jute coaster, the handle aligned with the edge of it, both of them parallel with the remote control.
‘That’s the culprit,’ he says. ‘The bad spoon. I’m sure of it. You couldn’t wash it up for me, could  you?’
‘Of course.’
I take it into the kitchen, give it a good scrubbing, then place it, handle first, with the others.

Mr  Smith’s diagnosis came six years ago – inoperable brain tumour, prognosis of anything up to ten years – but it wasn’t until the CVA  a few years later that he became so incapacitated.
The Smith family are coping with his illness as well as any family could. They have all the equipment their small terraced house can take: a hospital bed with a dynamic mattress, pressure relieving equipment, a commode on wheels, bath boards, perching stools and anything else the OTs can think of. Mrs Smith has steadfastly refused any care support. She has three sons, all of whom take turns helping  their father in and out of bed. Mr Smith was referred by his GP to the Rapid Response as an NCH – Not Coping at Home – but no doubt if there was an acronym for In Need of Respite from the Physical and Emotional Strain of Caring for the Terminally Ill, the GP would have used that instead.
‘He just needs to see something other than these four walls,’ says Mrs Smith, catching the loose strands of her hair and tying them back in place. ‘Me too, probably.’

I finish the health screen and tell them I’ll be in touch with the palliative team to see what can be done.

I shake hands and leave.

*

I’ve been working in community health for almost a year now, but I still struggle to understand how all the different agencies interact. No doubt it’s simply a matter of funding. Who lives where, under what medical centre jurisdiction, which Commissioning Care Group and so on. What makes it even harder to figure out is that so much of what we do overlaps. There are specialties, of course – Palliative care being one – but people are sick for the same reasons, and often need the same treatment, regardless of the provider.
Still, Mr Smith is a palliative patient. It seems fair to assume that all aspects of his treatment would now fall to the Palliative team. So I make the call.
Eventually I get to speak to Wendy, one of the senior nurses. She’s a little abrupt to begin with – Who am I? Where am I calling from? – a friable quality to her voice that suggests things are as stressful there as they are here.
‘Yes, we’re aware of Mr Smith,’ she says. ‘Why have you become involved?’
I explain the situation, the fact that the GP referred them to us because they weren’t coping at home. I tell her that Mr Smith seems stable. His obs are okay. The family don’t want more care, as such. They just want a break.
‘A break? What exactly do you mean? Respite care? An In-Patient bed? I don’t think he’s there yet. Do you?’
‘I just think they’re all pretty exhausted and need a break.’
She sighs.
‘I don’t think you understand the situation,’ she says. ‘We’re bursting at the seams here. If his symptoms haven’t deteriorated there’s nothing we can do. I’ll talk to the District Nurses to see if they have any capacity to go round, but really, I’m sorry. We can barely cope with the patients who are actively dying, let alone those that are tired and need a break.’
‘I know you must be busy…’
‘Busy? About as busy as you, I should think! No-one’s got capacity for anything. I wish I could tell you differently.’
There’s a sense of her moving away from the phone to gather herself.
‘Hello?’ I say, after a pause.
‘Look,’ she says, coming back. ‘Leave it with me. I’ll speak to the DNs and figure something out. I’m not promising anything. Certainly not a bed. But we’ll talk to the family and find out what’s going on.’
‘Thanks for that.’
‘What did you say your name was?’
‘Jim.’
‘Thank you, Jim. I’m sorry I can’t be more positive.’
‘That’s okay. I know how it is.’

I think about the Smith family, how brilliantly they’re doing together, taking on so much of the burden of Mr Smith’s care. How much they’re saving the NHS in doing that. How they could just use a break.

Still.

I write out the bones of the conversation, and file the notes away.

Rose is sitting in her chair surrounded by dozens of teddy bears, all neatly queued up along the edge of her bed, on another chair, on a bookshelf and either side of the TV. She’s watching a violent police drama, with much the same expression as the bears.
‘Hello Rose! How’re you feeling today?’
‘How am I feeling? Terrible.’
‘Oh. Sorry to hear that.’
‘Waaal,’ she says, swatting her troubles away with her hand, and then settling back again to focus on the TV. The detective has caught up with the bad guy and they’re slugging it out amongst the casino slots, people screaming, quarters everywhere.
‘Are you in pain?’
‘Am I what?’
‘Pain? Do you have any pain?’
She hitches her skirt and swings both legs up. They don’t look too bad from here; there’s no mention of any leg problems.
‘What’s wrong with them?’ I ask her.
‘I got blowed up?’
‘Blown up?’
She nods.
‘Knocked right off my feet.’
‘When did you get blown up? During the war, I suppose?’
I check her date of birth.
‘You must have been quite small…’
‘Knocked right off my feet and throwed across the road. Into a bush!’
‘Blimey.’
‘Yaaaas. They couldn’t find me. I copped it all down the backs of me legs.’
She rubs them tenderly.
‘Were you on your own?’
‘Me? No. I was with me father.’
‘Was he hurt?’
‘He died.’
‘I’m so sorry.’
‘Must be thirty year, now.’
‘So he wasn’t killed by the bomb, then?’
‘Who?’
‘Your father?’
She rubs her chin.
‘No. He drank himself to death.’
She watches the TV again. The detective has thrown the bad guy up onto a roulette table, screaming who sent you? who sent you?
‘Matter o’fact, I got blowed up twice’ says Rose.
‘Twice?’
She nods.
‘Second time it took out all the houses down our road. Whoosh! Gone! Like a pack of cards. They was all out looking for me. Rose? Rose? I could hear them, pokin’ about, but it weren’t no good.’
‘Blimey. Blown up twice! Who were you with that time?’
‘No-one.’
‘So how old were you?’
She shrugs and turns her attention to the TV again.
The detective is trying to get the bad guy to talk by repeatedly dunking his head in a fish tank.
‘Blowed up!’ she says. ‘Twice!’

‘How am I looking?’
‘Great. Perfect for your size.’
I help Marion off the scales and she sits back down again.
‘I hate weighing myself. Always have.’
‘I know what you mean. I try to avoid it.’
I use the chart to figure out Marion’s BMI, and write that down.
‘I took our dog Lola to the vet’s the other day,’ I tell her. ‘To my shame, the vet said she was over-weight and had to go on a diet.’
‘Really? Poor thing.’
‘I know. She gets loads of exercise, but I think we’ve been a bit slack with portion control and the odd treat and it soon builds up. She doesn’t look overweight, but I suppose they’re right. For a lurcher she’s started to lose that pinched-up waist, and apparently when you run your fingers down her sides you’re supposed to feel the ribs with just a little pressure. With Lola you have to press a bit.’
‘Dogs have always got a good appetite. Jasmine was like that. She’d give me such a tragic look, like she hadn’t eaten for a week, even though I’d only put the bowl down five minutes ago. I miss her terribly. The house feels too big with just me.’
‘What sort of dog was Jasmine?’
‘An afghan. And smart? She could have finished the crossword if she could have figured out a way to hold a pen. Every morning we’d go out for a lovely long walk and we’d come back past Graham’s the corner shop. Jasmine sit! I’d tell her, and straight away she’d plonk herself down, tidy as you like. And when I came out again, that’s exactly where she’d be, never mind anything else. That’s her up there.’
She points to the mantelpiece, and a row of three silver-framed photos.
I’m not wearing my glasses, but I can make them out well enough: an early, formal, three quarter profile, black and white shot of Marion as a young woman, short bobbed hair, long, serious face, hands in lap; another one of Marion, a few years later, at a music festival in the sixties, maybe, certainly more relaxed, with frizzed-out hair, kohl-rimmed eyes, and then a more recent one of Marion, Reactolite lenses, white polo shirt, red-faced smile, playing deck quoits on a cruise ship.
‘Where?’ I ask her.
‘There. Second one in.’
I get off the sofa and take a closer look.
‘Oh.’

Ellie’s off sick, Glenda doesn’t come in till twelve, so I’ve been taken off my morning visits to cover admin.

There’s a scene in Peter Jackson’s King Kong when the sailors are trapped in a canyon with thousands of giant insects, hornets the size of dogs jumping on their backs, cockroaches and spiders and horrible leggy things scampering towards them over the rocks as the light from the last flare peters out. Monstrous worms with circular teeth and pulsating mouths chomping down on the cook’s head whilst he flails about with his machete…

Fact is, I don’t like working in the office.

It wouldn’t be so bad if the phone would stop ringing. Referrals, queries about referrals, queries about queries, requests for clarification about inappropriate referrals, amongst a hundred other calls, from carers on bad mobile phones needing information, from doctors and social workers and Guy the house clearance guy, from the parking permit people, the discharge people, the something or other team, the clusters and the hubs and the BandB people, equipment provision, a mental health nurse (I particularly want to keep him on the line because he sounds so heartbreakingly poised, but he’s busy, apparently, so I have to move on) – everyone with a complicated situation that needs sorting out now, please, something which might actually be possible if you could just have one clear damned minute to figure anything out. Meanwhile, it appears no-one on the team knows how to file anything alphabetically, or knows where the faxes are kept, or has the faintest idea how to find even the simplest number. I’m in the middle of a call with a tearful relative when Jake puts a urine specimen in front of me.
‘How do I fill out the form?’ he says.

None of this is particular to this morning, of course. It’s obvious they need more staff, but there isn’t the budget. Jake’s working zero hours, to all intents and purposes. He starts early, goes home for four hours in the middle of the day, comes back to finish late. It’s as clear a sign as any. The squeeze is on.

‘See if you can make a start on the filing backlog, okay?’ says Susan, the Co-ordinator, slapping me on the back and smiling as brightly as a freshly stropped razor. The carpet is covered with hundreds of tiny white paper circles where someone knocked the bottom off a hole-punch yesterday. ‘And if you could have a little tidy up, that’d be great, too!’ she says. ‘I’m joking, of course.’

The morning passes incredibly quickly. I glance at my watch and for a moment I think it must have stopped last night – but no, it is actually half past ten. I’ve been at work two and a half hours already. The phone is ringing again. I finish writing out the last referral and in-putting the information on the computer whilst I crook the receiver between my ear and shoulder.
‘Good morning. Rapid Response Service. Jim speaking.’
Oh, hello. Jean here. Sorry to disturb you. Is that the Response people at the hospital? Only I wanted to say how grateful I am what you did for Bill.
‘That’s very sweet of you, Jean.’
No, I mean it. You’re a wonderful bunch of people and I wanted you to know how much it meant to me and the family all what you did for us this last month. It really was a difficult time, what with one thing and another. So anyway, I wanted to give you a present. There’s a friend of mine who does this engraving, with cut-glass. He’s ever so good. I’ve used him before, the last time Bill was up the hospital. Not your hospital, the other one…
‘Oh yes?’ (handing a form to Susan who is circling overhead; pulling out another document; writing a note to myself to call Guy the house clearance guy; opening another database on the computer…)
Bill was in the other one for a while and they were ever so nice to him there. So I got this friend to engrave a cut-glass bowl for them, too. I thought it would be nice to have something that lasted, you know. Something you could put on a shelf and look at and always remember.
‘That’s lovely, Jean’ (checking the referral email line; finally filling out that MSU form; trying to mime to Jake where it needs to go next)
So could you tell me a list of who works there? So I can them all engraved around the edge of the bowl?
‘Well – it’s very much a team effort, as you know, Jean.’
Oh, yes. You’ve all been very kind. I don’t think there’s been one person we’ve met who hasn’t been really nice. What’s your name?
‘Jim.
Tim?
‘Jim.’
Jim? That’s nice and short. Jim. All right then. Jim. Who else?
‘How about putting “To everyone in the Rapid Response Team”?’
The whosname?
‘The Rapid Response Team.’
Wait a minute. I’ll just get a pencil.

An old man gets out of his car when I leave by the main entrance. I can tell something is wrong by the way he stands by the open car door looking uncertainly in my direction. It’s only then that I realise the parking spaces are numbered. I’m in his slot.
I put my bag down and go over.
‘I’m really sorry,’ I say to him. ‘I didn’t think.’
‘It’s okay,’ he says. ‘I know you’re doing your job.’
‘Where else can I park, though? There’s nothing out on the street…’
He turns and points with his car keys.
‘See that pub there? The one on the corner? Take that turning and follow the road down.’
‘To the cemetery?’
‘There is a cemetery, but the road keeps going. It brings you out behind the block. There are plenty of spaces there.’
‘I didn’t know. I’ll definitely use that next time.’
‘If you would.’
‘I’ll be out of your way in a second.’
I turn to go back to the car. A middle-aged man has opened in is window on the first floor, and he’s leaning out.
‘You bloody people! You get on my nerves!’ he shouts.
‘I’m sorry?’
‘Yeah! You’re sorry! You know perfectly well you’re not supposed to park there. These are private spaces, mate.’
‘I didn’t know that.’
‘Yes you did. You liar. I’ve seen you here before.’
He changes his position, tucking the net curtain more securely behind him. He’s a gnarly looking guy, bare-chested in a leather waistcoat, handlebar moustache, squint. In another life he could have been a comedy drunk in a short by Mack Sennett; for now, he’s a vigilante parking guy, shouting abuse.
‘That poor guy’s been out at work all day and now he’s had to wait an hour for you to move.’
I look at the old man. He smiles and shrugs his shoulders. He looks terribly sad, like this is just another unaccountable obstacle between him and home.
I turn back to the vigilante.
‘I’m a nurse!’ I say, a little pathetically. ‘I came here to look after someone who’s sick.’
The Vigilante sniffs and smoothes his tache.
‘Well, yes…’ he says. ‘You do a good job…’
But he obviously means that very generally, or only loosely, in principle, because the next moment he leans further out of the window and says: ‘Move your car, you arsehole. Don’t make me come down there.’
‘You can come down here if you like!’ I say, half-heartedly. Not because I don’t think I could handle him, but because I know how ridiculous the whole thing would look.
‘I’ve apologised to the man’ I say, trying to get control again. ‘I’ve found out where I should park in future. I think that’s fair enough. And I think you’re being incredibly unpleasant.’
The vigilante withdraws, slamming the window shut. For a moment I expect him to come rushing out, but nothing else happens. I go back over to the old man, who’s still standing there, holding his car key.
‘Sorry about that,’ I tell him.
‘That’s all right,’ he says. Then adds ‘I haven’t been at work.’
‘No?’
‘No. I’ve been visiting my ex-wife. She’s got dementia and she’s really struggling with it now.’
‘I’m sorry to hear that.’
‘We kept in touch after the divorce. Just recently I’ve been going over there a bit more, doing what I can, but I don’t really know what to do.’
‘Are you getting much support?’
‘Everyone’s been really good. But I suppose there’s only so much you can do.’
I’m tempted to talk to him some more, to find out what help they’re getting. But he seems tired and I’m conscious of the other visits I have to make before I finish.
‘Well – all the best,’ I say. ‘It’s a good thing you’re doing.’
He shrugs.
‘I don’t know,’ he says.
‘And sorry about our friend there,’ I tell him, pulling a face and nodding up to the window on the first floor.
‘He’s not my friend,’ he says, then turns and gets back into his car, gently closing the door, ready to park up when I’ve gone.

‘I’m Jim from the Rapid Response service, come to see Mary.’
Lenny’s response wrong-foots me. He doesn’t say hello, but continues to stare at me with an expression that’s one part wryly amused and three parts hostile. It doesn’t bode well for the consultation. I certainly don’t feel able to ask him not to smoke.
‘How is she?’ I ask, putting my bag down, trying my best to put him at ease. ‘How’s she doing?’
Lenny shakes his head.
‘How’s she doing? You do know the past medical history, do you? You haven’t just turned up?’
‘They did tell me, yep. Some. But I took the details on the hoof, so…’
‘I’ll fill you in then, shall I?’
‘If you would.’
‘Mary is very unwell indeed. Mary has Wernicke-Korsakoff syndrome.’
‘Ah yes! They did say.’
‘She’s lost a lot of weight because she’s not looking after herself. She went to the hospital the other day and they said there was nothing new going on so they sent her home again. To this!’
This being a frigid two-roomed flat, spots of mould in the high-corners, and bizarrely, a copper-wire pagoda of sherbet yellow canaries in the window.
‘What have you come to do, then?’ says Lenny. He takes a drag on his fag; when he exhales, the smoke rolls out and over his lips like a fire set back in a cave. He coughs, and I could swear some ash falls from his hair.
‘I can’t shake this bloody cold,’ he says, taking a filthy handkerchief out of his pocket and trumpeting his nose. ‘Tell me again why they’ve sent you?’
‘When anyone gets referred to us we always do a set of obs to start with, you know – blood pressure, temperature, that sort of thing. Like a health screen.’
‘Health screen? What on earth d’you mean? he gasps, his eyes watering. ‘I told you. She’s not well.’
‘No. I know. It’s just a way of finding out for ourselves how unwell. And then acting accordingly.’
‘I see,’ he says, inspecting the handkerchief with a disappointed look, and then stuffing it back in his pocket. ‘Well, she’s in bed. Just through there.’
Mary is lying on her back, duvet up to her chin.
‘We don’t live together anymore,’ says Lenny, standing behind me in the doorway whilst I take her pulse. ‘But I still come round on the weekend, to see how she’s doing. We go down the pub and have a couple.’
‘So she’s still actively drinking?’
‘Oh no. Not like she used to. Not bottles and bottles. Just a couple to keep her ticking over. And some fish and chips to balance it out. But that’s the problem, see? Her memory’s affected. She’s lost a lot of weight these past few weeks. No-one can get her to eat.’
‘And she went to the hospital, you say?’
‘She had a collapse so we called the ambulance. They did all the tests. The hospital put her head through a doughnut, but they said nothing had changed so they sent her home. To what?  I’m telling you. This isn’t good. This isn’t good at all. I mean – look at it!’
He gestures around him.
The birds in the cage behind him leap from bar to bar, chirruping alarmingly.
‘She needs re-housing!’ says Lenny. ‘She needs putting somewhere so they can feed her up!’
He takes one last drag of his fag, then drowns it in a mug of old tea.
‘Mind you,’ he says, putting the mug down on the bedside table and hitching his trousers up. ‘If they did, she’d never remember where it was.’

Imelda is worried about taking anti-depressants.
‘It’s frustrating, not being able to do the things I used to do,’ she says. ‘But I don’t want to take happy pills every time I feel blue.’
‘I know what you mean. But you’ve got a lot on your plate. It’s perfectly natural to feel depressed. The pills are just a means to an end. If they make your situation a little easier to bear, that mightn’t be a bad thing. At the very least they’ll give you a bit of space to think about things calmly. Make some adaptations. But you’re the boss. You don’t have to take anti-depressants if you don’t want to.’
‘I don’t want to get addicted, you see.’
‘You won’t. They’re not like that. Although – if you decide to come off them, you should do it in a controlled way and not just stop. Your doctor will explain.’
She watches me write for a while, then rearranges things on the table. Newspaper, glasses, calendar, diary, squared-away, size-order.
‘I’m just so used to being the person everyone came to,’ she says.
‘I can imagine.’
‘It was always Melly this, Melly that. What time are we supposed to be there? Where’s my shirt? How am I supposed to do this? As long as I can remember. And now I can’t remember, you see. And my balance has gone to blazes. And then I fell over and hurt my shoulder. Honestly! I’m a shadow of the woman I used to be!’
‘Well – with a little physiotherapy we can get your shoulder working again. And as far as the memory lapses go – there are techniques you can adopt to make things a little easier for yourself.’
‘Notes, you mean?’
‘Notes, yep. Notes are good. There’s nothing wrong in making notes to yourself. I do it all the time.’
‘I’m going to be one of those dotty old women who have signs everywhere. This is the front door. Don’t go out. This is a ladder. Don’t go up.’
‘Whatever works!’
Imelda sighs and stares out of the window.
‘You know, the funny thing is, I used to work for a psychiatrist. As his personal secretary. After the children had grown up I was at a loose end, so I learned shorthand and typing and got the job. It was a small hospital, family-sized. Just a few streets away. Closed now, of course, but I used to love walking there every morning. It was always so fascinating. You got used to being around people with the most extraordinary view of the world.’
She turns to look at me again, her gaze level and clear.
‘I remember one particular morning. So bright, just like today. The outside of the hospital was being painted and the workmen were setting out their things. Well, just as I came across the road one of them shouted Melly! Melly! There’s an effing arm hanging out the window! And they were all looking up and pointing. And sure enough, there was an arm, draped out of the open window with blood dropping from the fingers. Making quite a splash on the lovely new paintwork below!’
‘Who was it?’
‘We had a young girl with us at that time who used to cut herself quite a bit. I hurried up and everything was fine in the end. Mr Flack, the psychiatrist I worked for, he was a lovely man. So kind and funny. The day I went in for my interview, he was sitting on the edge of his desk, his great long legs sticking straight out. And when I came in he jumped up and offered me a toffee from his pocket. And for a moment I didn’t know whether he was a patient or not. But I took it! And d’you know? I was jolly glad I did!’

The Co-ordinator asks if I’ll help Graham, one of the nurses, with a blocked catheter. ‘The patient needs hoisting, so there’s that,’ she says. ‘But anyway I’ve got a note to say he’s extremely bad tempered, so you’ll definitely need to double-up.’

I recognise the address from a few years back when I was working in the ambulance. Mr Batchelor was a large man even then. He’d fallen out of his chair and needed help getting up. I remember him being quite a laugh, in a bracing kind of way. He’d sworn inventively when we’d struggled to use the inflatable cushion. I wonder how he’s doing.

The change in that time is marked. He’s completely lost the use of his legs, now, confined to a hospital bed in his living room, doubly incontinent, persistent pressure sores and only moveable by means of a gantry hoist. There are three over-bed trays positioned around him, one with a laptop, one with a variety of cups, and one with a phone, remote controls, wet-wipes and a few magazines.
‘Rapid Response’ he says when we let ourselves in. ‘That’s what you call rapid, is it?’
‘Sorry it took us a while. We’ve been busy this morning.’
‘Yes, and I’ve been in considerable pain. But you wouldn’t be interested in that, would you?’
‘We’ll sort you out as quickly as we can.’
‘Don’t touch that!’ he snaps when I go to move one of the tables. ‘Just stand there and listen to me for a moment. I’ve had this done a hundred times and I know exactly what needs to happen. First of all, I want you to go into the room behind you on your left. Your left! You’ll find all the equipment you need in there. Bring it through and put it on the sofa, and then we’ll start thinking about repositioning me.’
Graham goes to fetch some things through.
To break the silence I tell Mr Batchelor I’ve met him before.
‘I don’t think so,’ he says.
‘I used to work in the ambulance. We came and picked you up after you’d had a fall.’
‘Oh. One of that crowd.’
He obviously doesn’t want to revisit that time, so I change the subject. ‘Shall I start moving the tables?’
‘All right. I suppose you may as well. This one first – slowly! Put it over there. And move the laptop more fully on. The last carer dropped it. That was six hundred pounds up the swanee’
I move everything with meticulous care, coaching myself not to respond to his verbal bullying. His catheter is blocked and needs changing; someone has to do it or he’ll end up in hospital.
‘How small are you?’ he says, watching me work.
‘Average height.’
‘Average height,’ he sneers. ‘I’m six foot two. Or was, before all this.’
‘Yeah? Well, that might be handy for getting things off a top shelf. Me? I’m perfectly adapted for working in the mines.’
‘Or living in the Channel Islands,’ he says. ‘They must be relatives of yours.’
‘It’s the Neanderthal bloodline. Anyway, endomorphs conserve the heat.’
‘Endomorphs, ay?’ he says, adjusting his glasses. ‘That’s a big word for a little man. So we’re a professor of something now, are we?’
His tone smarts, but Graham comes in with a handful of stuff ready to begin, so I distract myself by making things ready.
Graham is an excellent nurse. Even though Mr Batchelor is a difficult patient both physiologically and emotionally, he re-catheterises him without any problems. The urine flows into the new bag. The relief is palpable.
‘Thank you so much,’ says Mr Batchelor. ‘I really am grateful. There’s a tub of sweets on the kitchen counter. Grab yourselves a handful. But don’t touch anything else.’
Needless to say, we don’t take any sweets. Graham finishes the paperwork whilst I tidy up and start putting the tables back. Mr Batchelor is hyper-fussy about the angle of everything, telling me right and left and towards me like I’m some kind of voice-activated robot.
‘I need my laptop just-so,’ he says. ‘It’s my Houston Control. I do lots of reading on there, research, that kind of thing.’
He taps the laptop into life.
‘I’ve been reading quite a bit about Groucho Marx. I don’t suppose you know who that is.’
‘Groucho Marx? Didn’t he used to wear a stick on moustache, but lost it before one performance and painted one on, and that’s how he kept it.’
‘Yes! That’s him. There’s a quote of his that’s quite apt on this occasion. I never forget a face…’
I jump in to finish it off.‘…but in your case I’m happy to make an exception.’
Mr Batchelor frowns at me.
‘Don’t slam the door on the way out,’ he says.

‘D’you wanna see a picture of my new car?’
‘You’ve got a new car?’
Lena nods, closing her eyes and smiling at the same time. All she needs is a feather sticking out of her mouth to look like a giant and very well satisfied cat.
‘I have,’ she says.
‘Wow!’
‘It is wow. It’s wow times ten. Have a look.’
She sits next to me and gets out her phone – more like a mini-tablet than a normal mobile. She taps it into life and brings up an endless succession of photos of a sleek and silvery cabriolet.
‘That’ll be just the thing in the summer,’ I say, thinking maybe I should be asking her stuff about the engine and the alloy whatever.
‘It’s got a hard-top,’ she says, taking the phone again. ‘It folds away. They’ve got the technology, you know.’
‘I’m not very good with cars.’
‘Don’t like cars! Don’t like rugby! Call yourself a boy?’
‘That’s why I grow a beard. Otherwise you’d never know.’
She holds the phone at arm’s length.
‘How much d’you reckon?’ she says.
‘Loads. I don’t know. I’m crap at this sort of thing.’
‘Go on. How much?’
I don’t want to undervalue it, because that might suggest I think she’s been ripped off. Then again, I don’t want to go too crazily over the odds. I remember a very similar car someone else showed me once, very flashy, retractable hard-top just like this. His was extremely expensive, and although Lena’s is an older plate, it could well be up there.
‘Twenty thousand,’ I say.
‘How much?’
‘Twenty thousand.’
‘Twenty thousand?’
‘Yep. Or thereabouts.’
‘Twenty thousand?’
‘Why? How much was it?’
‘D’you think I’m the kind of person who’s got twenty thousand pounds to spend on a car?’
‘I don’t know. Maybe it’s some kind of lease?’
‘Seriously? You think I’ve got twenty grand spare?’
I shrug and make a I’m just a simpleton when it comes to money kind of face.
Lena stares at me, then says: ‘Fifteen hundred.’
‘Really?’
‘Yes. Really.’
‘Oh. Well. That was a bargain then.’
She sighs and puts the phone back in her pocket.
‘What happened to the last car?’
‘That was more of an instant cabriolet.’
‘What d’you mean?’
She gets out her phone and opens the gallery again.
‘I crashed it,’ she says. ‘The fire brigade had to cut me out.’