Douglas has been suffering from chronic fatigue, but no-one’s found anything wrong. His blood pressure tends to the low, which makes him slightly more susceptible to giddy spells when he gets up; his appetite is a little off, and he has to be reminded to eat, but the last blood test was unremarkable, and he has no other concerning symptoms. Physically and mentally he’s in remarkably good shape for someone of ninety-five.
He’s sitting by the window of his fourth floor flat, staring out across the lawns and roads to the sea, his gnarly old hands draped over the handle of his stick. The wind’s been picking up all day. Dark clouds are streaming in from the horizon, and even from this distance, you can feel the waves lumping onto the beach.
A sudden rattle of spray hits the window and makes me jump.
‘It’s coming in now,’ says Douglas. ‘Thirty years I was in the Navy. The war and what have you. I’ve seen some filthy weather.’
‘There’s no way I could have gone to sea,’ I tell him. ‘I get sea-sick. Last time I was in a boat I was this close to jumping overboard and swimming back.’
‘Shooting’s quicker.’
‘Anything rather than stay on a boat.’
‘Yes, well. One gets used to anything in time.’
He turns his attention back to the window. I finish writing my report.
‘So… everything seems fine, Douglas. We’re just left with this unexplained tiredness. What do you think is causing it?’
‘I don’t know,’ he says, raising his eyebrows. ‘I’ve thought about it a good deal, of course. There’s really only one conclusion I can reach.’
‘What’s that?’
He lowers his chin onto his hands.
‘I’m ninety-five,’ he says.

A sign in the window.
No Bible Bashers.
I’m suddenly conscious of the fact I’m holding my appointment diary up to my chest, very like a bible. I just have time to lower it when the bolts go back and the door opens.
A rugged old man with a plaster on the side of his face. Wild white hair clumping out either side of a knitted hat. T-shirt, jogging bottoms, slippers held together with duct tape.
‘Hello, Mr Holdsworth. My name’s Jim. From the Rapid Response Team. How are you feeling?’
‘Hey?’
‘I said how are you feeling?’
‘Bloody awful, thanks for asking,’ he says, leaning back. ‘But I suppose you’ve come for John.’
‘Oh.’
‘He’s still in bed. He’s been so tired lately, you see.’
‘Yes. Oh. I’m sorry.’
‘You’d better come in.’
‘Thanks. And you are…?’
‘Sorry?’
‘Are you a relative?’
‘It’s no good. You’ll have to speak up.’
‘I didn’t catch your name…’
‘Eloise,’ she says. ‘He’s through here.’
And as his wife leads me through to the bedroom, I can only pray she didn’t hear me call her mister.

‘I was in the meat trade,’ says Charles, struggling to get his breath back after the exertion of pushing himself further up the bed. ‘Now look.’
‘We just need to get you over this hump.’
‘Hump? Cliff, more like.’
He’s a Casting Director’s dream of a butcher: fulsome belly, large, fleshy hands, and the kind of professionally detached expression you might expect on the face of someone who knows how to swing a cleaver. I can imagine him with his great forearms folded across his belly, standing in a shop doorway, hooks and metal trays, plastic grass, award-winning sausages, a cut of blood in the air. A straw boater, maybe. An apron.
‘Sorry to be a nuisance,’ he says.
‘Not at all. I’m sorry you’re not well.’
‘Waaall – what can you expect? I am eighty-four.’
He closes his eyes and takes a breath. His belly expands dangerously, like he’s hyper-inflating a space hopper.
‘Jerry over the road is older than me,’ he says, opening his eyes again. ‘But you see – Jerry was an accountant. I spent my life throwing hundred pound carcasses around. The biggest thing he ever picked up was a paper clip. It’s no wonder there’s no oil left in my knees.’
I check his pressure areas. It’s hard to shake the butcher thing. I feel like I’m assessing his cuts – brisket, shoulder, hock. Commode.
‘Do you think you’ve got all the equipment you need?’
‘Everything except a bolt gun,’ he says.

It’s dark, squalling with rain, dazzling headlights at rush hour. It’s impossible to read these house numbers as I drive along the road, so I pull over to get an idea how much further I might have to go. By some miracle, I find I’m exactly where I need to be. So I put my parking sign on the dash, grab my bag and book, and run up a flight of concrete stairs to the Collins’ front door. Even though there’s a small porch at the top, it doesn’t provide much shelter from the storm.
By the time Mr Collins comes to the door, I’m soaked through.
‘What do you want?’ he says, the door chain still on, peering through the crack.
‘I’m Jim. Rapid Response. I’ve come to see Mrs Collins.’
‘They’ve been already.’
‘Yes. Yes, I know. But she wasn’t able to get any blood, so they’ve sent me to have a go.’
‘I don’t want all these people traipsing through the house.’
I think he’s closing the door, but actually he’s just slackening off the chain so he can slide it off.
I wipe my feet on the mat as best I can as he shuffles back into the gloomy interior.
‘Who is it?’ says Mrs Collins from the front room.
‘Somebody else,’ says Mr Collins. ‘I don’t know. This is absolutely unacceptable.’
‘I’m sorry to bother you,’ I say, closing the door and following him through. I take my jacket off. Mr Collins stares at me. ‘Where shall I put this?’
He frowns.
‘I’m afraid it’s very wet,’ I say.
‘On the floor. Down there,’ he says. I lay it down as gently as I can, then turn to talk to his wife.
She’s semi-recumbent in the hospital bed that’s been provided for her, looking warm and comfortable, surrounded by magazines, remote controls, watching Pointless on the TV.
‘How are you feeling?’ I ask her.
‘Not bad,’ she says. ‘I feel all right.’
‘We don’t want you lot keep coming in and messing about,’ says Mr Collins. He comes over and sits on the end of the bed, like an old toymaker tormented by mischievous elves.
‘I know it must be very annoying, having people endlessly turn up,’ I say. ‘But we all just want to make sure you’re okay and have everything you need.’
‘First it was the bed, then the commode and rails. Then the nurse. Then the physio. And now you. Prodded and poked about. She’s exhausted.’
‘I’ll be guided by you,’ I say to Mrs Collins. ‘You don’t have to do anything you don’t want to do.’
She seems quite happy, though – only a little put out she can’t see the TV through her husband.
‘I don’t mind,’ she says.
‘Celia the nurse couldn’t get any blood earlier and the doctor wants some,’ I say. ‘You know what they’re like. Vampires.’
It doesn’t get a response.
‘Prodded and poked about,’ says Mr Collins.
‘I know you’ve got a job to do,’ says Mrs Collins.
‘I’ll be as quick as I can.’
I get my kit ready.
My hair is so wet I’d like to grab some kitchen towel and give it a quick rub, but I don’t think the suggestion would go down well.
‘I’ll just try the once,’ I say, putting my gloves on. ‘If Celia couldn’t do it, you must be tricky. We  might have to call in the big guns. With the tiny needles.’
‘Just once!’ says Mr Collins. ‘And then out you go.’
I put the tourniquet on and start tapping up a vein. I can feel a drip of water forming on the end of my nose so I bring my arm across to wipe it dry on the sleeve of my shirt.
Suddenly there’s a click by my ear, a bright light, and for a second I think Mr Collins is illuminating my face, like I’ve committed some dreadful sin of infection control. But he plays the beam of the torch down onto his wife’s arm.
‘Wow! Thanks!’ I say. ‘That’s really helpful!’
‘Once,’ he says. ‘That’s all you’ve got.’
His breath is heavy in my ear as I unsheathe the needle and lean in.

There’s an algebraic simplicity to Derek’s predicament. A chest infection meant he preferred sleeping downstairs in the recliner chair where he could be nice and upright. Because he was further away from the toilet he stopped taking his diuretics, so he wouldn’t have to face the stairs every five minutes. The less he used his legs, the more swollen and painful they became. He mobilised even less. He took to wearing inco pads his wife Maureen bought. Eventually he was off his legs completely. When he needed to open his bowels, it was all Maureen could do to help him stand for one precarious minute whilst she cleaned him up. He developed a pressure area. A urine infection. When eventually the doctor was called (they didn’t like to bother anyone), he prescribed a broad-spectrum antibiotic, and referred Derek to the Rapid Response Team to co-ordinate care, equipment and physiotherapy at home.

Derek’s fourteen year old granddaughter Leah is in the house when I visit with Connie, the occupational therapist. Leah is sprawled on the vast leather sofa that dominates the room, her attention split between the phone she holds in one hand and the giant TV screen in front of her, playing Strictly Come Dancing at top volume. She stares at the dancers on the screen with expressionless disdain.
‘Can you turn that down a bit, Leah?’ says Maureen.
‘Uh?’
‘Can you turn the TV down?’
‘Uh!’
She points the phone at the screen, blinks a couple of times, and when nothing happens, sighs, picks up the remote from her lap and uses that instead. The noise diminishes a fraction.
‘Thank you poppet.’
The whole thing inspires her to start texting; she brings the phone right up to her face and starts furiously jabbing away with her thumb.

We assess Derek, seeing what he can do, how he can stand, the state of his bottom and so on. I half expect Leah to make herself scarce, but as neither Derek or Maureen ask her to go, we carry on regardless.
‘Oh! Oh! I’m widdling myself…’ says Derek, staggering as we try to manoeuvre him on to the commode we’ve set up alongside the chair. Unfortunately, when we took the old pad away, we hadn’t thought to have a fresh one ready and now our hands are full.
‘Leah! Leah! Can you fetch me over a clean pad from the bag on the sofa next to you?’ says Maureen.
‘Uh?’ says Leah, not looking up from the phone.
‘Quickly darling! Can you fetch me a clean pad? Grandpa needs one right away.’
‘Uh!’
Leah leans to the side and starts blindly patting the space next to her, falling short of the pad bag by a foot.
‘Quickly darling… oh, never mind. Don’t worry. It’s only an old carpet. I can soon clean that up.’
‘Thanks for all you’ve done,’ wheezes Derek as we land him safely on the commode. ‘I can’t thank you enough.’
‘You’re welcome!’ I say to him.
I turn round to change my gloves. Leah has resumed her sprawled position on the sofa. I can’t imagine how Maureen puts up with her, but I’m guessing there are reasons why things are as they are. I can’t help feeling slightly queasy, though. She’s like some giant, featherless cuckoo, landed in an alien nest, staring at all the spangly birds on Strictly Come Dancing, wondering if she wouldn’t have been better off hatching there.
‘Shall I make everyone some tea?’ says Maureen. ‘Leah? Would you like a cup of tea? And some of those fancy biscuits?’
‘Uh,’ says Leah.

It’s inconceivable that a ninety-six year old man should live four flights up, without a lift.
‘That’s why I’ve cut down on the gin,’ says Lionel. ‘Otherwise I get a bit giddy on the top step.’
It’s a lovely Georgian flat, though. No doubt the nursery or servants quarters or something when the house was first built. It has a shonky, out-of-line feel, as if centuries of high winds and direct sunlight have warped the beams and brickwork.
‘None of the windows shuts properly,’ he sniffs. ‘All very beautiful from the outside, but just try spending a winter here. The Georgians had a great flair for composition, but I wouldn’t give tuppence for their craftsmanship. Would you like a seat?’
He gestures to a worn leather armchair that looks dangerously comfortable. ‘Can I get you anything?’ he says. ‘A coffee or tea perhaps?’
‘No, I’m good thanks, Lionel.’
He laughs.
‘They all say that! I’m good. Now – what does that mean, exactly? I asked you if you wanted a coffee. I wasn’t questioning your morals.’
Lionel is so charming it’s hard to focus on the purpose of the visit – the basic health screen to see how he’s doing after a recent exacerbation of gout.
‘Damned feet!’ he says, stretching both his bandaged legs out straight. ‘But I had to laugh when the doctor said gout. I told him I didn’t touch port. Far too sweet. Or cheese. Or nuts. I’m quite circumspect when it comes to food. Which is probably just as well, given the altitude.’
As I work through his obs he entertains me with a benign commentary on the world.
‘Do you have children?’ he says.
‘Two girls.’
‘Two! Ah! A happy number! Now – you know – the odd thing is, I never used to have time for children. They were just a sort of incidental nuisance. Something one saw in the background, like pets. Most of my friends seemed to be sufficiently motivated to have a couple, but I never did. I have to confess to you, though, that just recently I find them quite amusing. Watching them jump about the place. They seem so unencumbered by life, so fresh. Just like dogs, actually. Now, dogs are also quite amusing to watch. Except dogs keep their charm. Children grow up into such hulking great brutes. I remember chatting to Harry, a good friend of mine, and I couldn’t help noticing this young woman of quite alarming proportions smoking a cigarette on the corner. And when I asked Harry who it was he told me it was Milly, Arnold’s eldest. Is it? I said. Little Millicent? Good gracious me! What on earth went wrong?’
He rubs his arm as I take the blood pressure cuff off.
‘Dogs are different in that respect,’ he says. ‘They keep their charm as they get older.’
‘Well, gout withstanding, everything seems fine, Lionel. You’re in amazing shape. What’s your secret?’
‘Oh, I don’t know,’ he says, re-buttoning his shirt. ‘Just luck and sheer bloody-mindedness, I suppose. If you can call it luck. I seem to have outlasted everyone. I had the most wonderful parents you could imagine. The house was filled with light and music. Do you like music? And then my younger brother, Merv. So funny and charming. All gone now. All gone. And now it’s just me, stuck up here, sitting around like a chump.’
He stretches his legs out again.
‘Me and the feet.’

‘You want to know what it feels like? I’ll tell you what it feels like. It feels like I’ve been cut in half, my legs filled with concrete, and then the top half shoved back on top again.’
Francis drills me with a look, intensified by the tufts of wispy white hair that rise left and right of his head, like plumes of steam from the vents of his ears.
‘Oh? Is that right, legs?’ he says, addressing his legs.  ‘That’s how you want to play it?  Maybe I’ll smash you and see how much you like it.’
He begins the painful business of mobilising, turning round on the spot with his zimmer frame, maintaining a commentary that’s so aggressive it makes me want to laugh.
‘How do you spell your name?’ I say, covering myself with his yellow folder. ‘Is it Francis with an I or Frances with an E?’
He stops, turns, and looks at me again.
‘With an I! It’s Francis. With an I. Not an E. Francis with an E is a girl’s name. Why are people always saying that? I had someone here the other day. The doctor. She said is it Francis with an I or an E? I said you what? She said is it Francis with an I or an E? I said I’ll give you Francis with an E. I said the last person who asked me that I smashed them with my fists. She said you seem a little bit angry. I said wouldn’t you be? People spelling your name wrong all the time. Mixing up their E’s and I’s. Well, she said, I only want to get it right. Yes. You do want to get it right, I said. And you want to fix my legs n’all. There’s no need to be like that, she said. Like what I said. All angry and furious. Well wouldn’t you be all angry and furious, your legs full of concrete, and everyone spelling your name wrong?’

‘I’m seven years younger, you know. Her toy boy.’
Jack takes the photo from me and studies it closely himself, like he’s just noticing something new about it after sixty years. Then he puts it back in its place on the bookshelf and makes his shaky way back to the dining room table.
Ruby is still asleep in the chair, curled in on herself like a giant dormouse, pale and empty.
‘I’ve just got to get over this blasted thing,’ says Jack, stretching out his bandaged leg. ‘Touch it! Go on!’
I touch it. It’s wet.
‘I’ve been taking the antibiotics,’ he says. ‘But they don’t do no good.’
I write a few notes on my little yellow sheet.
‘Can I get you anything?’ he says.
‘I should be the one getting you something,’ I tell him. ‘What do you want? Cup of tea?’
‘Don’t be so daft. I’m not that far gone I can’t make a cup of tea. How do you take it? Medium?’
‘Sounds good.’
He staggers off to the kitchen, his left leg dragging.
I finish writing my notes.
After a while Jack comes back.
‘Ruby used to take a load of sugar,’ he says, pushing a kitchen trolley precariously laden with stuff.  ‘But then they rationed it in the war and she got used to going without. There you are! Help yourself.’
He puts a plate in front of me piled high with pink wafer biscuits.
‘I thought you could do with a little something special,’ he says. ‘I thought we all could.’

Alexandra is furious.
‘But who are you?’
‘The Rapid Response Team.’
‘Rapid Response Team? Do you know Kasha?’
‘Kasha? No. Who’s she?’
‘Kasha was here this morning. She took me out, in the wheelchair.’
Alexandra scowls at me.
‘And what did you say you want?’
‘I’ve come to do a health screen. Your blood pressure and whatnot.’
‘Whatnot? Yes – I don’t doubt whatnot. That’s what they all want. And who sent you?’
‘The doctor.’
‘The doctor? But she was only here a minute ago.’
‘That’s probably when she decided to send for us.’
‘Well why didn’t she tell me about it? She could at least have rung.’
‘I’m sorry it’s all so unexpected. Would you like me to come back another time?’
‘No, no. You do what you have to do. And be quick about it.’
She lets go of the door, grabs hold of the kitchen trolley and pushes it ahead of her, rolling heavily at the hips, like a farmer ploughing a muddy field by hand.
‘Do you have any pain today, Alexandra?’
‘You, maybe. Don’t you ring before you visit people?’
‘Sometimes. When I can. It’s been pretty busy.’
‘Busy! That’s no excuse.’
‘I know. I’m sorry. I’ll make sure everyone knows to call first.’
‘I might have been out. Kasha was here. She took me for a walk. In the wheelchair.’
‘Well I must say it was a lovely day for it.’
‘Lovely day.’
She acknowledges the comment with a snort and carries on moving forward.
The room is wonderfully bright, crammed with interesting paintings, books, ceramics. Propped up on one of the bookshelves we pass are two black & white photographs, one of a young woman climbing monkey-style up a palm tree, the other of a young man, at the foot of the same palm, with a ladder.
‘That’s nothing,’ says Alexandra. ‘I was climbing when I was three. I’d be up the top in no time, throwing down coconuts.’

‘Now listen. Are you listening? Oy – what is wrong with this thing?’
There’s the sound of banging, like Ben’s put his mobile phone on the table and started banging it with the heel of his shoe – and suddenly the line goes dead.
I hold the receiver away from my ear, gently hang up and then dial his number again.
It rings and rings and rings.
Is it broken?
Or has he put it down and gone off somewhere?
Just before I decide to hang up and try again later, he comes back on the line.
‘What?’ he bellows.
‘You rang me, Ben. And then we got cut off.’
‘Oh yes? Well. Now. Yes. Tell me. What do you propose doing about the situation?’
The situation is his sister, Beth. At eighty-one she is five years younger than Eric, but her health hasn’t been good lately. A few weeks ago she fell and broke her arm, which made the basics of day-to-day living pretty complicated. We’d already been in to see her a number of times, and then discharged her from our services once we were reassured she had all the equipment, follow-up appointments, day centre visits and other referrals she needed. Yesterday we heard she wasn’t coping again.
Eric, her only living relative, lives miles away. He was there in the flat with Beth when I went in for the first time all those weeks ago. Despite his wild manner – something he obviously got as a job lot with the wild eyebrows and beard – we got on well.
‘I recognise your voice, young man,’ he says. ‘You’re the one who lives in that godforsaken village. You have some kind of dog, don’t you? And you like to write.’
‘Yes! And you have an old black cat called Jaime, and you still run your own print shop.’
‘Enough of that!’ he says, as if I’ve radically overstepped the mark. ‘Now, Jim – listen to me. It’s vital we sort things out here. Beth is not coping so well. She’s panicking, Jim, she’s panicking. And when she panics, she goes all over the place.’
‘All over the place?’
‘Yes! Last time she had to be brought home by the police. Now last night my son was able to go down and stay with her, but he has his own life and can’t be expected to do this every time. So now I’m wondering what you can do to help? Eh? Because we can’t go on like this. Something will happen and it will not be a good something.’
Each time he takes a breath, I try to jump in with a question, but each time he comes straight back and talks over me.
‘I know what you’re going to say. You cannot do this or that because you haven’t the money, or it’s not the kind of thing you do, or you’ll have to refer her to some other place. But I’m begging you, Jim – I’m begging you. Please. Take some action. Sort this problem out. Because if you don’t, I think the consequences will be most serious.’
‘Ben, I …’
‘We have a care home ready to take her. A nice Jewish place. They tell me they are happy for Beth to stay for a week or two, to help her find her feet and make her confidence to grow again. But of course this is all funding permitting. D’you see? So how do you propose we do that? What is your suggestion?’
I seize my chance.
‘Let’s take this one step at a time,’ I say.
‘One step at a time! Now – Jim. Are you reading from a script?’
‘Me? No!’
‘It sounds to me as if you’re reading from a script. First this, then this. One step at a time. And so on. Look. Jim. I’ve met you before and I trust you will do the things you say you are going to do.’
‘Good.’
‘So please. Put down the script and talk to me. Make your own words.’
‘Ben – honestly. I’m not reading from a script.’
‘No script! Okay? So tell me. What are you going to do about Beth?’
As steadily as I can I review the situation. Beth is safe this evening. Beth has an appointment at the day centre first thing in the morning. This buys us a little time for the social workers to investigate respite care and funding options.
As I’m working my way through these things I can hear Ben breathing heavily into the mobile.
‘Okay. Okay,’ he says at last. ‘Fine.’ Then he sighs, so violently it’s like the mobile phone has exploded in his hand.
Silence for a moment.
‘Ben? Are you still there?’
‘Aye’ he says. ‘Well. Gam Zeh Y’a’vor, I suppose.’
‘What does that mean?’
‘This too, shall pass.’