You can tell Selina used to be a Sister. The way she operates the bed, rearranges the pillows, sets out the hot water, flannels and towels – everything calm and deliberate, capable, reassuring, accentuating the obvious love she has for Jack. She’s been his main carer for a few years now, seeing him through strokes, heart attacks, cancer scares, each time pulling him through by sheer strength of will.
We chat whilst we work.
‘I love that holly tree you have outside, with all the feeders. I’ve never seen so many birds.’
‘Yes. They’re doing quite well.’
‘Quite well? It’s like Grand Central for sparrows.’
‘They need a bit of help these days.’
We finish washing Jack and put him into clean pyjamas.
‘My son’s coming over this afternoon,’ she says, tucking in the duvet.
‘Oh? That’ll be nice.’
‘Yes. We haven’t seen him in a little while. He’s been away on business.’
‘How many children do you have?’
‘Only one now. Our other son died.’
‘I’m sorry.’
‘It’s a long time ago now. Forty years or more.’
‘What happened?’
‘A girl. Nothing but trouble from the start, but what can you do? You have to let them live their lives. She was taking drugs, selling them, you name it. It was such a surprise, because Andrew was always such a quiet child, you know. Anyway, she fell pregnant and said it was his. They got married in secret, moved in together. And to earn a bit of money Andrew started working for the girl’s father, a right so-and-so, who ran a dodgy warehouse business. Then one day there was a fire…’
‘That’s dreadful.’
‘Like I say, it was a long time ago. Of course the girl and her father disappeared. Changed their names and everything. And that was the last we heard.’
She collects the washing things together.
‘I would’ve liked to have seen the child. But there you are.’
We help Jack back to bed and settle him in.
‘There! Amazing what a lick and a spit can do!’ she says, carrying the dirty water into the bathroom.
I open the care folder and start writing out a sheet.
‘Wasn’t it dreadful about Paris?’ says Selina, coming back into the room. ‘Those poor people.’
‘I know. Awful. My youngest daughter is on a school trip to London later this week and it’s hard not to worry.’
‘Yes. Well. It’s understandable.’
She gently combs Jack’s hair.
‘There’s no shortage of things to worry about,’ she says. ‘I remember in fifty-two there was a smallpox epidemic. No-one wanted to go anywhere then.’
‘I suppose. You can drive yourself crazy.’
‘Absolutely.’
She steps back and admires her hairdressing skills.
‘Do you remember that time on the bus, Jack? When we were going home to tell Mum we were getting engaged? And it was terribly foggy, a real pea-souper? And the driver was cursing and swearing and carrying on, until the conductor said he’d had enough of it, jumped off and walked the rest of the way in front, swinging a lamp?’
He smiles up at her, a creased, drawn-out kind of smile, rests his hand on hers a while, then turns to look at me.
‘She’s a wonderful woman,’ he says, with a wink. ‘But don’t let on I said so.’

I’ve had a day of it, racing round town, one end to the other, a mixture of clinical and care work. I’ve tried everything I can think of to rationalise the calls and group them sensibly, but there’s only so much you can do with these things. As the day segues into evening, I’m down to the last three – two in the east, one in the west. I’ve figured that if I leave the west job until the end, at least I’ll be the right side of town to head home. But to make it all work, I’ll have to get through the two eastern jobs as quickly as I can, and then use every scrap of local knowledge I have, every rat run, sewer sprint and wormhole, to beat the traffic and make it west at a reasonable hour.
The eastern part of the plan has gone well, and I’ve finished up at the second of the calls with ten minutes in hand. This should be quick, too. Gerald has dementia. His wife needs help caring for him, and we’re standing in until a full-time agency can find the capacity.
He’s in the lounge, watching TV. I escort him to the bathroom, change his stoma bag, clean him up, treat his sore areas, re-dress him and have him back in the lounge just as Homer leaps to the side as Marge parks the car at the beginning of The Simpsons.
I sigh, and pull out a fresh yellow sheet to write up what I’ve done. His wife Laura chats to me. I’m efficiently relaxed and pleasant, but I know in myself it’s all a bit of an act. I’m horribly conscious of the time, and I want to be away as quickly as I can.
I have to be heading west in the next five minutes.
‘Thank you so much for helping us tonight,’ she says. ‘I don’t know what we’d do without you.’
‘It’s a pleasure,’ I say, clicking my pen, closing the folder, standing up, shouldering my bag. ‘Any time.’
I move towards the door. She holds it open.
The porch light shines on the bushes in the garden as they whip from side to side in the wind.
‘My daughter should be here soon.’
‘Lovely.’
‘The eldest.’
‘Yes?’
‘The other one died. Last year.’
‘Oh. I’m so sorry.’
I resist the urge to check my watch.
‘What happened?’ I say.
‘Alcohol.’
‘That’s dreadful.’
‘She was a brilliant girl. A research fellow at the university.’
‘Wow.’
‘But the project she was working on got cancelled, for some reason. She had money troubles. Came to live with us for a while. Fell and broke her leg badly. Suffered a stroke because of it. And I think she just found the whole rehabilitation process just too frustrating. It was all too much, her job, her health, money worries, you know? Drinking more and more. But we all thought she’d turned a corner. She bought a flat and moved out. She said she needed a few days to get herself together, and I shouldn’t worry if I didn’t hear anything. When it went on for a week I knew something was wrong. I called the police and they found her. I wanted to go and say goodbye to her at the mortuary but they said not to, what with one thing and another.’
Laura is holding on to the door. Outside the wind is getting stronger and the sky is swept and black. What light there is, from the houses across the road, from the streetlamps, and from the slow trail of commuter traffic passing along the main route just below us, make it all seem harder and more resonantly cold.
‘I’m so sorry,’ I tell her. ‘How are you bearing up? Have you got someone to speak to about all this?’
The objective part of me sneers: Someone other than you, you mean?
‘Family and friends,’ she says. ‘We’re getting through. But look – I know you’re busy. I mustn’t keep you.’
And I want to sit down and talk to her some more. I want to shrug off that single-minded, watch-tapping part of me that has a plan, that always knows where he is in terms of place and time, and drives me on. I want to make time, but it’s the end of the day, I’m late, and I find I don’t have any.
‘I’m so sorry for your loss,’ I say, and go.

If there’s one cat in the world least likely to sprint past you when you open the front door it’s Binksy. I’ve seen more risk of flight from a grand piano. Still, it’s Alice’s main worry. She even taped a notice to the front door. Don’t let the cat out!
Binksy is pretty chilled, though. I’ve only ever seen him in one place, draped over the arm of the sofa, paws pendant, more throw than pet. You’d think he was stuffed were it not for the stupefied way he blinks when Alice crinkles another sachet of food.
‘Salmon’s his favourite,’ she says. ‘Salmon and Tuna.’
Alice is ninety-four. Binksy, about ten. Of the two of them, Alice is by far the more active.
‘I have to go to the bank,’ she announces, pulling on a crocheted hat and fiddling with her handbag. ‘And then to Sainsbury’s to get some Warburton’s. Is that how you spell it, Warburton’s?’
She shows me her shopping list: Warburton’s.
‘Yep. That’s fine.’
‘Good,’ she says, putting the list in her bag along with her purse. ‘Come on, then.’
‘Do you really need to go to the bank?’ I ask. I know how slow she walks, and I’ve got half a dozen other calls to make this morning. I can’t really afford the outing, but I feel guilty for trying to put her off. ‘You’ve got plenty in already. There’s half a loaf in the fridge. And Binky’s got enough food to last him all winter.’
‘It’s stale,’ she says, even though I take out a slice and hold it out in a pathetic attempt to convince her otherwise. ‘The seagulls can have it. Come on.’
I follow her down the hall.
She collects her walking stick, shakes it at Binksy, who hasn’t moved.
‘Now you stay put,’ she says. ‘I shan’t be long.’
Outside on the pavement she takes my arm.
Even though I’m pushed for time it’s a pleasure to walk with Alice. She’s been in that house since way back, when she was skating in the big ice shows, living at home with her parents. There’s a colourised photo of her on the mantelpiece, roses in her hair. Time has wasted her figure and looks, but despite her great age now she still has the same curl to her lip, a mordant expression, equal parts cynicism and charm.
‘Sandra used to live there,’ she says, jabbing the door of the next house with her stick, so hard I wonder if someone will come out. ‘Frank was a roofer. I got him to lay my carpet. He says to me: “I lay roofs, not carpets”. But I got him to do it just the same. He did a good job.’
She tells me a little something about each house and business we pass on the street.
‘This one here,’ she says, pointing to a ruined shop front, boarded up, buddleia growing out of the gutters and broken windows, ‘ this one used to have a little dog called Jonesie. Do you know why they called it Jonesie?’
‘No, why?’
‘Because that was the name of the shop. Jones.’
She talks in a loud voice because her hearing aid isn’t quite working and anyway, she doesn’t much care who hears her or not. She’s so charming, everyone we pass smiles and makes way. I feel like I’m escorting the neighbourhood’s grand old ghost. Even the techie guy working in the window of a premises Alice grumpily says used to be a haberdashery looks up and waves. She shakes her head sadly and we pass on.

Thankfully the bank is empty. There are two women at the cashier desk. The younger one is so bored she’s sniffing her own hair; the other smiles at us as we shuffle slowly towards the window.
‘Hello, Alice,’ she says. ‘What can I do for you today?’
I show the woman my ID.
‘It looks a bit dodgy, showing an old woman to the bank to draw money,’ I say, but the woman doesn’t respond and I feel a bit awkward for bringing it up.
‘Here,’ says Alice, pushing a cheque made out to Cash through the grille. ‘I need some Warburton’s.’
‘And how would you like it?’ says the woman, stamping it efficiently and putting it aside. ‘The money, not the Warburton’s.’
Her colleague is smiling at us both, grateful for the distraction.
‘Pounds,’ says Alice.
‘In pounds? You want fifty pounds in pound coins?’
‘Really?’ I say to Alice. ‘That’s a lot of coins. You won’t be able to stand up. How about a mixture?’
Alice grumbles but doesn’t say no. The cashier counts out the money.
‘There you are,’ she says, sliding the cover across so Alice can reach in. ‘Anything else I can help you with today?’
‘Where’s the woman with dark hair?’ says Alice.
‘Leanne? She doesn’t work Wednesdays.’
‘Oh,’ says Alice, putting the money in her purse and then grabbing my arm again. ‘Shame. Come on, then. You can help me get this Warburton’s.’

Margaret is sitting in her sunny seat by the window, a napkin spread on her lap, peeling an orange. Her face is scrunched up as her fingers tear through the flesh, and the room is filled with the zest of it. But then she gathers it all up and sets it on the table next to her, as if peeling the orange were the main thing, and now it’s done, she’s lost interest. She wipes her hands on another piece of tissue, then turns it in her hands as she talks.
‘I’ve always been active,’ she says. ‘When I was young I walked everywhere and I suppose that kept me fit. When I was still living at home I used to go for a walk every day in the Pennines. There was a man who lived in a cave up there, him and his two dogs. Horrible, ferocious things they were…’ She holds her hands up like claws and bares her teeth. ‘Grrr!’
‘Blimey!’ I say.
She relaxes her hands again.
‘Oh – they never gave me a bit of trouble,’ she says. ‘Any road, I used to walk that way every day and I s’pose they must’ve just got used to my face. I felt sorry for the man. He was a soldier who got shell-shocked in the war. Ran away from everything. Took to living in a cave, with sacks round his legs. Well one day he wasn’t there, and the next day, and the next,  and I knew summat was wrong. So I went and told the police, and they came up with guns. The dogs wouldn’t let anyone near his body, so they shot them. Didn’t have a choice. I cried for three days after that. The war didn’t do nobody any good. My dad got gassed so he couldn’t work, and the pension he got wasn’t worth nothing. Me, I had to go and earn my keep. At the wood mill, making pit props. But that’s all in the past and there’s nothing to be done about it.’
She puts the used napkin along with the discarded orange on the table.
‘I eat a lot of fruit,’ she says.

‘Eloise has died,’ says the Co-ordinator, putting the phone down. ‘The morning carer found her.’
‘Poor Eloise!’
‘Get me her file, would you?’
I know what she’s thinking. We’ve had plenty of involvement with Eloise over the past few weeks. It’d be as well to have a look through the notes to make sure everything was in order, just in case it went to Coroner’s. There’s not much chance of that, though. It’s not exactly unexpected. Eloise had a multitude of health problems, decrepit old age being the least of it. Bed bound, doubly incontinent – mentally intact, though, when she wasn’t in the throes of another UTI.
‘What happened?’
‘Eloise passed.’
‘Poor Eloise!’
The news travels round the office.

The last time I saw Eloise was just three days ago. I’d gone round in the evening to do a set of obs, check she was settled and had everything she needed to hand. She was propped up in the living room of the house she’d lived in since the forties, the room now re-arranged to accommodate a hospital bed, padded around with cushions and pillows, a remote control on the duvet, drinks and snacks on the over-bed table, staring at the television screen at the bottom of the bed. It was playing some property programme at top volume so she could hear it.
A woman in a pink coat talking to two guys in a dilapidated house.
‘So what do you think, Chris? Phil? Are you up for this?’
‘We’re always up for it.’
They all laugh.
The woman in the pink coat rubs her hands.
‘Well let’s get cracking!’
Cut to montage of Chris and Phil in t-shirts and masks throwing old plaster into a skip. Drilling and hammering. Background music: Hi Ho Hi Ho it’s off to work we go…
Closing shot: Chiris and Phil standing in the garden with the masks up on the tops of their heads. Chris slaps Phil on the back. Cloud of dust. Laughter.
Cut to: slinky mood music. Shimmery dissolve to how the house looks now. Laminate flooring, modern radiators, fancy mirrors &c.
The woman in pink describing the new look house: ‘Chris and Phil have gone for a sleek, modern feel, economical, but still with those all important homey touches. The kitchen opens out through double doors onto a patio area just perfect for barbecues….’
Eloise jabs the TV off.
‘What do you want?’ she says.
‘Sorry to bother you, Eloise, but I’ve just come round to see you’re okay and you have everything you need.’
‘What?’
‘How are you feeling?’
‘How am I feeling?’
‘Yes.’
She stares at the blank screen and strokes the remote control. I half expect it to come on again. For Chris and Phil and the woman in pink to be standing there in a line, looking out at us. But the screen stays blank.
‘Who are you?’ she says.

‘Nightmare, start to finish,’ says Craig, sitting on the side of the bed. ‘Just call me the Lizard Man.’
He tells me he’d been out of the country for a few years, teaching in the Congo. When the civil war started to bite he was forced to come home, even though he’d fallen in love with the country and the people. It just so happened that his decision to leave coincided with an outbreak of total body psoriasis. Starting with a pervasive itch, his skin started to flake and come away, to the extent that he left a trail of scurf whenever he moved. His legs dried up and cracked into scales. The condition spread until there was not a centimetre of flesh that wasn’t affected – not his ears, his eyelids, foreskin, the palms of his hands. The paraffin based ointment he was using had turned his skin a hectic red; he looked like the victim of a nuclear accident.
After a brief spell in hospital when he was repatriated, he was discharged into temporary accommodation. And it was whilst he was moving from that place to new, longer-term digs that he found he’d lost all his documents, including his passport.
‘The surgery needs it to register me on the system,’ he says. ‘So I’m a bit stuffed. I could get a new one, fast track. But then there’s the issue of the photo.’
He smiles at me. ‘I think I might break the camera.’
I’m amazed he can be so upbeat about his situation. To say that nothing was going right for him was like saying Job was having a bad day. Truly, his misfortunes had taken on a biblical aspect. Even his new accommodation was dreadful – a housing block so racked with social problems it may as well have a pedal at the bottom to open the roof and throw the tenants in at the top.
‘And now the DWP are on my case,’ he says. ‘I’ve got to explain why I can’t work at the moment.’
‘You’ll be all right,’ I tell him, but trail away, uncertainly.
He holds his arms out, right and left.
‘I can’t think many places would have me, even if I felt well enough,’ he says, then falls back to scratching. Chunks come away.
‘But I dunno. They’re the experts. Maybe they’ll find work for me.’
He peels off a scab, and drops it into the bin beside the bed. We both watch as it floats down.
‘At the zoo or something.’

Judy would be a perfectly glamorous granny if it wasn’t for her teeth. She has a chic silver-blonde haircut, a white silk dressing gown, pink nails and a flowery walking stick, and holds herself nicely upright in the red-velour, scallop-backed armchair. It only needs a spot of fixative to keep those teeth in place, but they’re not the only thing on the slide. Her flat is clean but cluttered, pills and magazines, plates and old coffee cups jumbled together on the kitchen trolley and any other horizontal surface.
‘I’m in a damned state,’ she says, smiling sadly, her teeth wandering south until she closes her mouth again to put them back in place. She has to talk in short bursts to keep the teeth in her mouth.
‘Don’t get old,’ she snaps, and jabs her walking stick into the carpet.
I sort out her meds, especially the morphine patches she’s supposed to be wearing. She has chronic pain; without analgesia, it’s no surprise she’s feeling so low and distracted.
‘Have you heard of Peggy Ashcroft?’ she says as I tidy up a little.
‘Funnily enough I was thinking about her the other day.’
‘Were you?’
‘I was reading Catcher in the Rye. And there’s a bit where Holden’s talking about how much his sister likes that Hitchcock film “The 39 Steps”, and how she knows the script off by heart. Especially that scene where Robert Donat and Madeleine Carroll are hiding out in a Scottish crofter’s cottage, and Peggy Ashcroft is playing the crofter’s wife. She has a line, something about eating the herring. Anyway, it made me think about her.’
Judy smiles at me again (those teeth…)
‘And what about Flora Robson?’ she says. ‘Heard of her.’
‘Yep. Not seen her in anything, but she’s pretty famous.’
‘Dora Bryan?’
‘Yep.’
‘I used to be in the theatre.’
‘Did you?’
‘I did. And my good friend Pamela knew them all.’
She holds her smile longer than is strictly safe. Just before I hold out my hands to catch the teeth, she clamps her mouth shut again, and winces as she puts her legs up on a stool.
‘Ye-es. I had a life in the theatre. So at least I have my memories.’
‘Lovely!’
‘Just as well,’ she says. ‘Because do you know what my life is like these days?’
‘No?’
‘One hundred per cent of nothing.’

When I knock on her flat door, Mrs Millard screams at me from behind the glass.
 Push it! Push it! It’s open!
From the tone of her voice I’m expecting the Medusa; what I get is a seventy year old woman in terrier-print PJs holding on to a kitchen trolley.
‘Oh hello!’ she says, smoothly. ‘Thanks for coming.’
She turns round with some difficulty – her flat is like a burrow in a landfill – and leads me into the lounge.
‘What’ve you come for?’ she says.
‘To see you’re okay, really. To do your blood pressure and that kind of thing. And to take some blood…’
I’d already been warned Mrs Millard was difficult.
She frowns at me when I finish speaking. To pre-empt the rage I can feel brewing, I ask her about the signed photos on the wall behind her, just beyond the tideline of all the junk: Helen Mirren, from youthful stage shots to glamorous Hollywood stills.
‘I thought she was great in Prime Suspect’ I say, putting my bag down and setting out my gear. ‘Loads of things, actually. The Cook, the Thief, his wife and her lover. Loads of things.’
‘I’m glad you think so,’ she says. ‘I’m a big fan. Have been. For Years.’
‘I can see that. She’s amazing. What’s your favourite role?’
‘Now. There’s a question.’
She thinks about it whilst I do some basic obs.
‘The Queen,’ she says. ‘You’ve got to be good to play the Queen.’
‘Shall I have a go at taking some blood, then?’
She holds out her arm.
‘If you hurt me I’ll punch your lights out,’ she says.
‘No pressure then.’
She smiles, quite serenely.
‘Helen wouldn’t hurt me,’ she says, as I offer up the needle.

Totterdown Court is the urban equivalent of an ox-bow lake. The cars along the main road have cut themselves a newer, more direct channel. A wide pavement has been lain down. Houses have disappeared, replaced with industrial units, a car hire business. Totterdown is the only domestic building left – and must surely be doomed. Even the name on the outside has gone, leaving only a trace of letters in the grime. It’s a leap of faith parking up and walking to the front door. With my bag on my shoulder, I feel like a fisherman on an expedition to a secret spot.
Up to a thirties glass case with painterly numbers, and slots for cards indicating IN or OUT. A buzzer intercom with dirty white Bakelite knobs.
No reply.
Even though it’s half past ten in the morning I try the TRADESMAN button. The mechanism clicks and lets me through in to a high and echoing hallway, blue marmoleum on the floor, remnants of stained glass fruit in some of the landing windows as I walk up to the third floor.
To Patrick’s door.
I knock and wait.
After a second and third – some grumbling and shuffling. An indistinct figure through the safety glass, and the door opens.
‘I havn’ee got any pants on,’ he says.
He’s about sixty, six feet tall, with the kind of thick, blooming peppery grey beard that looks less like hair and more like chiselled granite. He’s wearing a thin blue nylon tracksuit top without anything underneath. His lower half is naked.
‘Hi, Patrick. I’m Jim from the Hospital Avoidance Team. I’ve just come round to see you’re okay.’
‘I’m okay. Okay? I’m okay.’
‘Do you mind if I come in and have a chat.’
‘By all means,’ he says, letting go of the door and almost falling over. Amazingly, like a gyroscope running down but still just about maintaining to the vertical, he keeps his balance and staggers back into the front room.
‘Please excuse me,’ he says. ‘But ah’m goin’ back to bed.’
His bed has been dragged into the front room. Judging by the mess, the scattered food and clothes and letters and stuff, it’s the one place in the flat he occupies. The kitchen is crapped-up. I can’t bring myself to look in the toilet.
‘Tim did you say?’
‘Jim.’
‘Jim?’
‘Yes.’
‘That’s a good Gaelic name,’ he says.
‘Is it?’
‘Seumus.’
‘Or Jacob in Hebrew.’
‘Aye. If you say so.’
‘So. How are you doing?’
‘How am I doing? I’m drunk, man, as you can probably tell.’
There’s a cluster of vodka bottles on the table by the bed.
‘I fell over and busted my ankle,’ he says, pulling the filthy duvet back again and looking mournfully at his foot.
‘I think it’s a bad sprain,’ I say. ‘They’d have cast it if it was broken. Or put a boot on or something.’
‘Would they?’
‘I think so.’
‘It hurts like fuck, whatever you want to call it.’
‘I bet.’
He covers the foot up again and lies back on the pillow.
‘Jim you say?’
‘Yep.’
‘What d’you think when you see a character like me, Jim?’
I shrug.
‘I see someone who’s got a problem with alcohol.’
‘A problem with alcohol, y’say?’
‘I think so. I mean – you fell over and totalled your ankle, for a start. I bet you fell over because of the drink.’
‘You think so?’
‘Probably. Are you getting any help with your drinking problem, Patrick?’
He rests an arm over his eyes, and takes a long, sighing in-breath that seems to inflate his whole body and leave him thinner than he was.
‘I used to be a bricklayer,’ he says. ‘More than that, Jim. I used to work in stone.’
‘Like a stonemason?’
‘Nah! I don’t mean carving fancy names and gargoyles and all that rubbish. I used to build walls. Beautiful walls, man. I built this one wall, I was so proud of it. The way it jes’ grew up out of the ground, y’know? Like a fuckin’ wave. It was so natural. And the people of the village, y’know what they did? They wrote my name on it! They wrote it out on a slab at the gateway: Patrick’s wall. Patrick built this.’
He opens his eyes and starts to cry.
‘Patrick’s wall, they wrote. They liked it so much they wrote my fuckin’ name.’
He wipes his face on the duvet.
‘You could get back to all that,’ I say. ‘If you got some help with the drink I’m sure you could get back to the stone work.’
He looks at me.
‘Have you got kids?’ he says.
‘Two. Two girls. Fourteen and ten.’
‘I used to have a fifteen year old. A beautiful wee boy. And he died.’
‘I’m so sorry.’
‘He feckin’ died, man. Do y’know what that’s like?’
‘I can’t imagine.’
‘And d’you know how he died?’
‘No.’
‘On a boating lake. A fuckin’ boating lake, for chrissake! For boats!’
He collapses back on the pillow and cries some more. I tell him how sorry I am.
After a minute or two the grief leaves him as suddenly as it came. He opens his eyes and looks round.
‘Bit of a shit hole, this. D’you not think?’
‘It could do with a tidy.’
‘Are you offering?’
‘No!’
‘Quite right, Jim. Quite right. Is that your name? Jim?’
‘Yep.’
He holds out his hand and I shake it. A heavy, calloused hand, sensitive, capable. Then he relaxes back on the bed and shuts his eyes again.
‘Don’t mind me, Jim,’ he says, gathering the duvet around him. ‘Don’t you worry. I’ll be all right once I’ve had a kip. And you cut this bastard foot off.’

I’d been out to Sean just the other day.
‘He’s got a formal mental health assessment coming up soon,’ the co-ordinator said, ‘but meantime they’ve asked us to go in and make sure he’s safe. Apart from his medical issues there’s already a history there of withdrawal, maybe some paranoid behaviour. No recorded episodes of violence, though, so you should be all right. It’s really just to do some obs, see if he’s taking his meds. And check his blood sugar. He’s not been all that compliant lately.’
When I got there the flat was dark. I knocked and waited until eventually I heard some shuffling behind the door, felt I was inspected through the peephole, then a rattling of a chain being put on, and the door cracked open.
A pair of eyes, the head turned to fit them both vertically in the gap.
‘Hi! Hello! Sean, is it?’ I said, making myself as friendly as possible. ‘My name’s Jim. I’m from the Hospital Avoidance Team. I’ve just come round to see how you’re doing.’
Who sent you?
‘The hospital. They were worried you might not be taking your meds.’
Who did you say you were?
‘Jim. From the Hospital Avoidance Team. Here’s my card.’
I pulled it from my pocket to show him. I carry my card in my pocket, on one of those secure clips that plays the card out on a length of nylon. He recoiled at the sudden shushing noise.
‘It’s okay Sean! It’s okay! It’s just my ID card.’
After a moment he peered back through the crack.
Have you come to kill me?
‘No! God, no! The opposite, in fact! I’ve come to see you’re all right. But if you don’t want me to come in, that’s fine. You don’t have to see me if you don’t want to.’
He shut the door. At first I thought that was it and I turned to go, but then I heard the chain being taken off, and the door slowly opened, wider this time. Sean stood just behind it, waiting. He was draped in a duvet cover; in the poor light, and with his thin hands poking out holding onto the door and the hem of the duvet, it was unnerving, like I was being shown into the home of a giant woodlouse.
‘Why don’t you go first?’ I said. He didn’t respond, and stared at the carpet, breathing through his mouth, waiting for me to go through.

Up till that point I’d been feeling pretty tired. A long day, with one last patient before I could go home. Suddenly I was energised again – especially when he closed the door and put the chain back on.
‘Do you mind if I sit on the sofa?’ I asked, already thinking that when he took his seat I’d sprint back to the door, throw the chain off and run down the hall.
He didn’t answer, but came and stood on the other side of the room, by the window.
Are you sure you haven’t come to kill me?
‘Sean – I haven’t come to kill you. I’m here to ask you a few questions, and test your blood sugar if that’s okay. Do you test yourself sometimes?’
He nods.
‘So you know how important it is to keep up to date with all that?’
He nods again.
I open my bag as gently as I can.
‘All I’d like to do is scratch your finger and that’s it. I can see you’re really tired and I don’t want to disturb you anymore than I already have. So why don’t I just do the blood test and go? How does that sound? But if you don’t want to do it, I’ll completely understand.’
He didn’t answer, but shuffled off into the kitchen.
I was really worried, then. I thought he might have gone to fetch a knife or something, and I scanned the room looking for something I could use to defend myself.
He came back in with a sheet of kitchen towel.
‘Right!’ I said, trying to mask the relief in my voice. ‘I’ll be as gentle as I can.’

That was yesterday.

Today, they doubled up for safety and sent two nurses in to do the health screen.
I heard what happened when they got back.
‘He wasn’t answering the door at all and we were worried,’ said Rachel. ‘Sean’s neighbour came out and said that was his car outside so we called the police. They tried everything, but it looked bad, so in the end there was nothing else for it and they smashed the door in. And what do you think? Empty. Nada. Nobody home. And we’re all standing around scratching our butts feeling stupid when the neighbour comes out again. ‘Oh,’ she says. ‘No. I never said that. I only said I thought that car was quite like Sean’s.’
‘Great way to improve someone’s paranoia,’ said the co-ordinator, typing in the details. ‘Come home to find the police have put your door in. Anyway. Never mind. Least said, soonest mended. Good work, people.’