camel tales

The nurses are busy catching up on admin, chatting about this and that, their day, their troubles, their plans. The conversation turns to holidays and the general mess of it all. Cancelled bookings, weddings abroad postponed, so-and-so who’s gone to visit family in Cyprus, somebody else who got caught in Spain and now won’t get paid for the two weeks quarantine they’ve suddenly got to do when they get back.
‘We were supposed to go to Turkey again this year. Turkey’s lovely. Have you been?’
‘Yeah. Hot and cheap and that’s how I like it.’
‘Cornwall’s nice but you end up spending just as much, you can’t fly there and – let’s be honest – it doesn’t matter how much you dress it up, the North Atlantic’s not the Aegean.’
‘Yeah. You go snorkelling and all you’ll see are jellyfish and tampons.’

They swap info on some patients, visits and so on, then get back to the important stuff.

‘Have you ever been to Egypt?’
‘Once.’
‘What did you think?’
‘It was great. Well I enjoyed it. We stayed on a resort. Sharm El Sheikh. Before the trouble, of course. Everything was controlled on the resort, so you were pretty well looked after. It can get a bit much, getting swamped with demands for money or crappy souvenirs when you go out of the resort into some of the markets. But once you get used to just smiling and saying No Thanks they get the message. I told Steve, I said Steve, don’t keep waving your hands and saying Maybe later like that. They remember this stuff and bother you worse next time. But he wouldn’t have it. It was like he couldn’t help himself. And I tell you another weird thing. Steve has a phobia about camels.’
‘Camels? Why? Did he get bitten by one or something?’
‘No. He’d never seen one before. Just didn’t take to them, really. He said it’s the way they look at you.’
‘Well maybe in retrospect Egypt wasn’t a great choice, then. I mean – that’s pretty much where all the camels live. Isn’t it? I’m right, aren’t I?’
‘I suppose. Anyway – what happened was, we decided to leave the resort and go to a shop on the outskirts. We wanted to get a lilo and some flip flops, and we thought it’d be a bit cheaper. On the road out to it there’s this guy sitting on a camp stool with a big old camel next to him. And of course the man gets up and starts gesturing to the camel, trying to sell us a ride. Steve goes all funny. Keep that thing away from me he says. And he starts walking really quickly to the shop, and I have to make apology faces to the man, and then catch up. So we’re in the shop, and I’m having a nose around. I find some flip flops and I turn round to Steve to see what he thinks. And he’s not there. So I think – what the hell? And I look out the shop window, and there he is, sitting on top of the camel, with the man standing next to him holding the reins about to set off. So I run out there and I shout Steve! Steve! What the hell are you doing? And it was then I notice the man is wearing Steve’s sunglasses. So I ask the man if he’d mind letting Steve down, which he does, eventually. And I get the sunglasses off him, and we walk back to the shop. And I say to Steve, What was that all about? And do you know what he says?’
‘I cannot imagine.’
‘He says The camel made me do it.’
‘The camel?’
‘Yep. He said he could see it looking at him through the shop window, and there wasn’t a thing he could do about it.’

rick’s drey

There’s nowhere to park on Moreton Street, not even space to pop the car up on the narrow pavements. So I leave it on the wider road at the top along by the railway line and walk back down. I don’t mind, though. The sun has swept out from behind the clouds and the day has come alive. This street is a private and pretty exclusive tributary these days. The old buildings down here, the workshops, the chapel, the railway cottages, they’ve all been meticulously renovated, their brickwork blasted, their roofs made good with slate or thatch, every window and sign and gate made new again. It’s all so ruthlessly authentic, though, it makes me feel a little self-conscious, like I’m walking through a film set. There’s a postie delivering mail the other side of the street, and even he looks like he just stepped out of make-up.
‘Good morning!’ he says, touching the brim of his baseball cap.
‘Good morning!’
‘Lovely day!’
‘Isn’t it?’
(We may have to re-shoot that; I could do better with that last line.)

Rick lives in a flat at the very top of The George pub at the bottom of the street. The George is a relic, an old Helmstone boozer, one of the last old corner pubs still pulling pints. There’s astro turf in the yard at the back so you can sit at the tables under the outside heaters and pretend you’re in the country. They’ve painted the exterior walls a chi-chi, slate blue. They’ve even put dried grass in vases and lines of old books in the window. But if The George was struggling before the pandemic, it’s looking pretty hollow-eyed now. The whole place has an abandoned feel. It’s hard not to think that when the virus has retreated, time will be called for the last time, the scaffolding will go up, and the repurposing will begin in earnest.

It’s been hard getting in touch with Rick. The mobile number I was given turned out not to work, and I had to do some detective work to find an alternative. He definitely needs our help, though. He had some major surgery recently, he’s struggling to get about, and there’s no-one around to help him with the basics.
‘I’ll meet you at the street door,’ he says. ‘It’ll take me awhile to get down, so give me five minutes at least.’
When he does appear, he’s on two elbow crutches.
‘Could you do us a favour?’ he says. ‘Could you go to the newsagents and get me a bottle of Coke, a packet of crisps and The Daily Star? Thanks, mate.’

*

Rick is as lean and gnarly as an old whippet – if a whippet could live for sixty years working as a hod carrier, tattooing its legs and arms with blurry women and daggers and swallows, smoking spitty little rollups. Apart from his orthopaedic surgery, though, Rick is remarkably fit. His grey hair is so short and square cut I can only think it was done with a chainsaw, and his tan is so deep the bones must be scorched. He talks quickly, and his eyes sparkle like flinty chips.

‘Thanks Jim, thanks,’ he says, throwing himself down on his bed with his bad leg kicked out straight. I put the paper, the drink and the crisps down next to him. ‘Thanks a lot, mate,’ he says. ‘Cheers! I was gasping. Now then. Let me tell you what’s been going on with me. No! Sorry! Where are me manners? You first! You go! Go on! I’ll shut up. Who are you, then? Apart from Jim? Or Jimmy, is it? Nah – Jim. James when you’re in trouble. Just Jim, then. Aah – Jim Lad. Yeah. Sorry.’

Ordinarily he’s thoroughly independent. His flat is tucked away just under the tall chimney pots on the roof, as remote and contained as a squirrel’s nest at the top of a pine tree. For a man who’s lived all his life going up and down ladders it seems pretty appropriate. For a man on crutches  the next couple of months, it’s a practical difficulty.
‘I can’t keep asking Billy to get my shopping,’ he says. ‘It’s embarrassing. He’s got his own shit going on. I just can’t keep doing it. Know what I mean?’
‘Have you got any family?’
‘Nah. Not any more. It’s just me. Which is okay most of the time.’
‘So – what happened with the accident?’
‘Well. Funny story. I was running out to go down the bookies when I tripped and fell arse over tit down the first flight of stairs.’
‘Ouch!’
‘Tell me about it. It hurt like a bastard but I thought I’d just bruised myself or pulled something. So I crawled back up to the flat, which took all morning. Lay on the bed, and that was it. I was there all day and night. Couldn’t move or nothing. Eventually I thought I had to do something or I’d starve. So I made it over to the door but the pain was unbelievable. Couldn’t go no further. It was just too much. The door was shut and the key was up on its hook by the side – see? Where it is now? Luckily, I had a crutch propped up in the corner from when I dropped a brick on my foot a few years ago. I used that to knock the key off its hook and then drag it towards me. Another bit of luck – there was a pen and a paper on the table just above me head. I play the horses. You follow?’
‘That was lucky.’
‘It was, Jim. It was. So I knocked that down with the crutch, wrote a note what said I need help. Rest the key on it, then shoved it under the door. When I heard Billy across the landing come back, I banged on the door with the crutch. He come over, saw the note, let himself in, found me in a state, called the paramedics. And that was me sorted.’
‘Amazing.’
‘Sometimes I think – what if I hadn’t had that brick drop on my foot that time, so I had to have a crutch? And then – what if I’d given the crutch back when I should? It was only ‘cos the crutch was in the corner I could do them things what I did and get help. Otherwise I’d have croaked and they’d have been seeing flies coming out under the door and not a scrap of paper.’
‘Maybe.’
‘So somebody up there loves me. Hey, Jim? Somebody loves me.’
He adjusts his position on the bed and winces with the pain. ‘Although – having said that – not so much they wouldn’t trip me up and throw me head first down the stairs in the first place.’

dave says it’s tricky

Avondale.

Sounds beautiful. Magical. I bet the architect was a fan of Lord of the Rings. You expect to see an ancient castle draped in moss and mist, with strange, long-legged birds circling and crying overhead, a plangent waterfall and so on, elfcetera, elfcetera. Instead what you get is an anonymous, pre-fab block just off the high street, tucked away behind a phony Italian restaurant. It’s only been up a year or so but already it has a tired, beaten-down kind of look, strips of tape over the intercom where the buttons have fallen off. If the same architect had worked on Helm’s Deep, I don’t think Saruman would’ve needed much more than a couple of orcs and a wheelbarrow to tear the place down.

The one magical thing about Avondale, though, is its uncanny ability to screw up the SatNav. The app doesn’t recognise the postcode at all, and ends up recommending you ‘make a u-turn’ and then ‘make another u-turn’ so that if you were truly dependent on it, you’d end up simply driving in a circle at the bottom of the high street until you ran out of fuel or the police threw stingers down.

I know all about Avondale, though.
I’ve been here before.

Cherry lives on the first floor with her little Jack Russell, Dave. Cherry has a long list of health problems, from mental health and self-harming to morbid obesity, diabetes, breathing problems and recurrent infections, and she’s been referred to us many times in the past. She’s got a reputation for being difficult, but I think because I make a fuss of Dave whenever I go there she takes it easy on me.

‘Cherry was pretty sick this time,’ says Michela, the co-ordinator. ‘She went in with an exacerbation of COPD, but then self-discharged against advice. She was so bad they gave her home oxygen. So can you pop-in, see how she’s doing? Get her to sign a non-concordance form if necessary.’

*

Cherry is propped up in bed watching CSI. The first thing I notice – after Dave has finished leaping madly around my legs – is that Cherry’s wearing a nasal cannula connected by a long, plastic tube that snakes across the bed to an oxygen cylinder by the window. The second thing I notice is the fag in her mouth.
‘Erm … Cherry? You really can’t be smoking when you’re using oxygen.’
‘What? Wha’dy’a mean?’
‘You’ll blow yourself up. And everyone else. You’ll send Dave into orbit. Honestly, mate – you’ve got to put the fag out.’
She shrugs, pinches the end out, and rests it carefully on the ashtray by the bed.
‘Thank you,’ I say. ‘I’m sorry to be so blunt about it, but you absolutely cannot smoke with oxygen around. This whole place’ll go up.’
‘I only have one now and again. It’s not a problem.’
The heaped ashtray and the smoky fug in the room tell a different story. I know I’ll have to report this to her GP and the Community Respiratory Team as soon as I’m back in the car, but for now I move on.

Dave is on the bed now. He rolls onto his back so I can rub his tummy, his tongue lolling out with the ecstasy of it all.

‘So how’ve you been?’ I say to Cherry. ‘Sorry to hear about your recent hospital trip.’
‘Yeah – well. What can you do? They said I had to go. I didn’t want to. I mean – what are they going to do about anything?’
‘I don’t know, Cherry. But to be fair, they do seem to have done quite a bit. Put you on IV antibiotics, sent you for chest x-rays, got you back on your feet.’
‘Yeah, but they didn’t, did they? Look at me!’
‘It says in your notes you self discharged against advice. Is that right?’
She shrugs.
‘They made it impossible. It was noisy. I couldn’t sleep. They wake you up every five minutes to fiddle about. The nurses were rude. The food was unbelievable. I mean – you’ve got to be really sick to want to go to that place.’
‘That’s true. And from the sounds of it – I think you were pretty sick. And still are.’
I unclip the SATS probe from her finger.
‘Your oxygen levels are terrible, Cherry – even for you. And that’s five minutes after you came off the oxygen.’
‘Yeah – and I’d still be on it if you hadn’t said.’
‘It’s a choice, though, isn’t it. No oxygen and low SATS, or oxygen and burst into flames. Isn’t it, Dave? Isn’t it…?’
Something suddenly occurs to him, because he flips himself upright again, hurls himself off the bed, and skitters off across the laminate flooring into the kitchen.
‘Oh my God! Wait for it,’ says Cherry.
There’s a single, loud squeak from the kitchenette, and then Dave hurries back with a red, rubber bone in his mouth. It’s so big he can’t make it up on the bed again without a boost from me. As soon as he’s there, though, he chows up and down on it, making it squeak as regularly as a monitor in a hospital for clowns.
‘God – it’s noisier than the ward,’ says Cherry. ‘And before you say anything, I don’t care, I’m not going back.’
I look down at Dave.
‘What do you think?’ I ask him. ‘What do you think mummy should do?’
He stares up at me, panting excitedly, flicking his eyes without moving his head…. down to the bone…. up to me…… down to the bone…up to me.
‘Dave says it’s tricky.’

if I go I go

Malcolm doesn’t have a phone. Not one that works, anyway. So all you can do is pitch up and hope for the best.

It’s a fair bet he’ll be in, though. For one reason or another he’s had a series of falls – getting dizzy and going over at the bus stop, the queue at the post office, the supermarket. They’ve put him through the usual tests, given him a pacemaker, a range of medication, a walking stick. He’s been to countless follow-up appointments (falling over on at least two of them). He’s had a new hip. If you x-rayed his arm you’d see two plates and a line of screws. All in all, he’s a walking (and falling) phenomenon. All they can really do now is adjust his meds from time to time, and maybe dress him like an American football player when he wants to go out.

‘Come on in, why dont’cha!’ he says when I knock on his open door.

He’s bent over a boiled egg and crumpet, working away at it, his good elbow pointed straight up.
‘Lovely!’ he says, leaning back and wiping his chin. ‘Now,’ he says, waggling the eggy spoon in my direction, ‘you can’t do no better than an egg in the morning!’

These days Malcolm’s flat is pretty down-at-heel. Casting your eye about the place is like sending a deep water drone through the wreck of the Titanic – a settled and claggy sediment over every surface. Despite his straitened circumstance he declines all offers of help, though.
‘I keep myself to myself,’ he says. ‘I don’t do too bad.’

There are two black and white pictures on the wall behind him: Malcolm as a young man in the army. The first picture is of his unit, posing in full uniform in four rows; the second is a blow-up of the same picture, zooming in on Malcolm and the guys on either side. It’s hard to see any likeness, though. Both pictures are so faded, it’s disconcertingly like someone’s dressed a row of mannequins in uniform, the peaked caps emphasising the blankness of their faces.

‘I’ve jes’ got to nip down to the laundry room,’ he suddenly announces. ‘You don’t mind, d’you? Only the other fellas’ll be gurnin’ on about it.’
Before I can even offer to go for him – it’s down two flights of stairs after all – he’s pushed himself up from the armchair and set off.
‘I’ll come with you’ I say, hurrying after.
At least he lets me go down the stairs first.

When I take his bed clothes out of the dryer they’re so hot I have to juggle them around.
‘Done!’ he says, slamming the dryer door in a blast of superheated, fabric conditioned air. ‘C’mon, fella!’
And we’re off again.
He nods at the manager’s door.
‘Furloughed,’ he says. ‘Alright for some.’

‘You can pause on the landing,’ I say, chasing after him back up the stairs, almost tripping on the bottom sheet. ‘There’s no rush.’
He waves his hand in the air – which I’d rather he’d use to hold on to the rail.
‘Feck it. If I go, I go,’ he says. ‘You can catch me in the sheets.’

Back in the flat, he tells me to dump the stuff on a chair by the bed. It’s only then I notice his bed is heaped up with what looks like skeins of shredded cotton. It reminds me of the bedding my hamster Horace used to have, how he’d scuffle it all up and then bury himself in the middle.
‘Are you sure you wouldn’t want someone to look in on you, Malcolm?’ I say. ‘We could get you some new bedding, if you’d like?’
‘That’s kind, but I’m okay,’ he says, throwing himself down into the armchair again. ‘Phew! That little jaunt took it out of me. You’re spinning like a regular Father Christmas!’
‘Father Christmas? Why? Does he spin?’
Malcolm rests his head back and closes his eyes.
‘I don’t know, fella,’ he says. ‘I don’t know. It certainly looks that way to me now.’

mr brandt’s glasses

Mr Brandt is sitting up in his bariatric hospital bed, the head-end elevated so he can watch TV. Given the display cabinets of train models, a railway scene puzzle half completed on a cantilever table, framed photographs of trains, train manuals, timetable collections and almanacs, shelf tidies with colour-tagged railway magazines, rack upon rack of train DVDs, and a lower shelf crammed full of hardback, glossy coffee-table books about the trains of the world and so on – it’s not a surprise to see that Mr Brandt is watching a programme about trains. A team of hard-hats are standing around trying to figure out how to get an old steam locomotive onto a low-loader.
‘Look at that lot!’ says Mr Brandt. ‘Bunch of jokers! The Pere Marquette’s about two hundred tonnes. The forty-one model, anyway. And they’re gonna move it with that Tonka toy hoist? I don’t think so. D’you?’
‘You seem to know a lot about trains.’
He shrugs.
‘There’s a lot to know.’
‘Did you work on the railways?’
‘Nah. I was a bus driver. But I dunno. I just liked trains.’
‘Fair enough.’
‘There’s something about them.’
‘I know what you mean.’
He raises a hand and makes something like a fey karate chop.
‘Pee-owww!’ he says. ‘Straight there.’
‘Great!’
‘Not if there’s something on the line, though,’ he says, frowning. ‘There’ve been some terrible accidents.’
‘You’re right.’
‘Of course – you know what the worst ever rail accident was?’
‘Clapham?’
‘Quintinshill.’
‘Never heard of it.’
‘Near Gretna Green.’
‘Scotland?’
‘Full marks, that man!’

I’m running late, so I’m reluctant to ask what he obviously wants me to ask. But he’s looking at me in the same way my pet lurcher Stanley looks at me when he wants a duck stick. Impelled by the same, sudden lack of will-power, I’m driven to say:
‘So – what happened at Quintinshill?’

‘May, Nineteen fifteen,’ says Mr Brandt, letting out a huge and luxurious sigh, like a publican pushing back his plate after a particularly big dinner. ‘A troop carrier packed with Scottish soldiers heading south en route to Gallipoli. But the railway company’s short on rolling stock, so they’re in old, wooden bodied carriages lit by gas from tanks slung underneath.’
‘That sounds dodgy.’
‘It was worse than dodgy. It was positively lethal. So what happened was – there’s a complicated bit of track at Quintinshill. I could explain it to you but I can see you’re pressed and anyway you wouldn’t understand.’
‘You’re right there.’
‘All you need to know is there’s a track going north, a track going south, and two loopy side bits of track either side. The signalman temporarily reversed a northbound local train onto the southbound track, then forgot about it. So it was hit head on by the troop train heading south. And then the wreckage was hit by a northbound express. And the whole lot went up in flames when the gas tanks exploded.’
‘That sounds horrendous.’
‘An absolute inferno!’ he says. ‘Two hundred people died, more or less. I think it was hard to tell in the end. Worst ever railway accident in the United Kingdom.’
‘Awful.’
‘Both the signalmen went to prison for a year or so. But you have to think they were scapegoated. I mean – come on! it was shocking how badly trains were being run up there. And those old gas-lit carriages? A disaster waiting to happen. The men made a mistake, of course they did. But the company was equally at fault. And you can tell they knew it, ‘cos when the two guys come out of prison they give ‘em jobs straight back on the railway.’
‘Really?’
‘Yeah. Just not as signalmen.’

On the TV, the low-loader crew are making good progress dragging the old locomotive onto the flat-bed of the low-loader.

‘It must’ve been terrible,’ he says. ‘Them two signalmen, standing at the window of the signal box, knowing what they’d done, watching the whole thing go up in front of them.’
I take a breath and shake my head.
‘I can’t imagine.’

But something else must be happening on the TV at the foot of the bed – some fast jump-cuts or adverts or something – because suddenly the light from the screen changes rapidly, and just for a second I’m conscious of the flickering reflections on the lenses of Mr Brandt’s large, steel-rimmed glasses.

‘Or – I don’t know,’ I tell him. ‘Maybe I can.’

living space

Marianne is standing waiting for me at the front door. When I wave from the car she doesn’t react, but watches me with a pinched intensity.

‘Would you like me to take my shoes off?’ I say, glancing at the cream carpeted steps rising up behind her.
‘Yes,’ she says.
I follow her up into the maisonette flat. It’s as quiet as a photo in a lifestyle magazine, smelling of floral air freshener and toast.
‘Through here,’ she says.
‘I’m sorry to ask, but I need to be clear. What’s your relationship to Jeremy?’
‘He’s my ex,’ she says, ‘but we live together. He’s dying of cancer. You know that, don’t you?’
‘Yes,’ I say.

* * *

It’s an unwritten rule that the jobs you think will be the easiest and most straightforward will turn out to be the most difficult.

Looking over my workload for the day, I saw that I was down for a support visit with Jenna, the OT. A palliative patient needed a hospital bed, which meant transferring him out of the existing one, dismantling it, letting the equipment company set up the new one, then putting him back in. The notes said he could just about weight-bear, so there wasn’t the usual problem of having to set the new bed up next to the old one and pat-sliding him across. True – the family normally take care of dismantling the old bed, but in this case the partner didn’t have anyone to help with that, so we’d take care of business. Another OT had been ahead of us to case the joint, so it should be a breeze.

I didn’t read too far into the notes. Just the basics. The patient had prostate cancer. His disease had suddenly progressed, and his care would increasingly be limited to bed. The GP had visited in the first instance and identified what needed to be done. Our job was limited to setting up the new care environment, prior to the palliative team going in.

Straightforward.

* * *

Jeremy is lying on his side in bed, one hand crooked behind his head, his legs drawn up. He’s so exhausted we withdraw to the hallway again and talk to Marianne instead.

Jeremy’s room is small and cluttered, a substantial bedside table with a phone, drinks and things to the side, and a glass display cabinet at the foot end, filled with model planes. As things are at the minute, the hospital bed won’t fit, but the first OT hasn’t left any instructions about where he wants the bed to go. I can’t think he means the front room. The maisonette is a narrow, two bedroom set-up. The lounge is the brightest, most spacious living space in the flat. If the hospital bed goes in there, it’ll mean Marianne will be limited to her bedroom and the tiny galley kitchen. If Jeremy stays in his bedroom, though, it’ll mean the busy and sometimes distressing business of End of Life care can be contained more effectively. Marianne seems so anxious and friable, I can’t imagine her spending the next few months confined in that way.

‘I think the bed will actually go pretty well in Jeremy’s room,’ Jenna tells her. ‘Especially if we move the display cabinet next door and put the bedside table over by the window. When the hospital bed’s in, you’ll have more time to have a think about things. You could ask some friends or family to help with taking some stuff away, maybe putting it in storage. What do you think?’
‘I don’t understand,’ she says. ‘What’s going to happen with the bed he’s on now?‘I don’t want to get rid of it.’
‘I suppose we could dismantle it and store it behind the sofa in the sitting room.’
‘Why can’t we put him in the lounge?’
‘I just think with all the comings and goings – carers four times a day, district nurses and so on – it won’t work so well. You need space for yourself, Marianne. This room’s more than adequate. It’s nice and sunny. It’s got a view outside. A TV. It’s perfect, really. It just takes a little bit of reorganisation.’
‘If you think so,’ she says.
‘I do.’
‘Okay.’
She doesn’t sound too convinced, though. The problem is, the delivery driver is almost here. If we send them away to give Marianne time to think, there’ll be a delay before it can be reordered. Jeremy needs to be on a hospital bed as quickly as possible. The care agency will refuse to authorise care on the bed he’s currently on. It’s a manual handling nightmare.
‘It’ll work out,’ I tell her. ‘You’ll see.’

We set to work, moving stuff. It’s a delicate job, shifting the model lancaster and spitfire planes on their display stands, then crystal glasses, trophies and cups. We bus them next door, followed by as many drawers as we can manage from the bureau to make it light enough to slide over to the window.
‘Look at all that dust,’ says Marianne. ‘I’ll get the hoover.’
She comes back with an ancient thing, certainly older than the flat, big enough to ride on, with a huge square light at the front and a cloth bag hanging off the handle. She starts rolling it around, the vibrations of it as brutal as a rotovator.
‘I think that’ll do,’ I say, tapping her on the shoulder and shouting over the noise. ‘The van’s outside with the new bed, so we’d better get on and transfer Jeremy into the wheelchair. Then we can dismantle his bed and make room for the new one.’
‘Just a bit more,’ she says.

Jeremy remains as passive as the furniture, but at least he manages to stand sufficiently well to make the transfer into the wheelchair. We take him through to Marianne’s bedroom, and gently lay him on the bed. Marianne watches the whole business with horror. I’m guessing that the original OT who’d organised the job had explained what it involved, but Marianne was too stressed to take it all in. There should have been a note in the folder, though. I make a mental note to talk to him back in the office.

The bed is mercifully quick to dismantle. We take it through and stack it behind the big cream sofa in the lounge. It’s all pretty neat. We’re sweating in our PPE, but it feels like a job well done.

‘Like I say – it’s only temporary,’ I tell her. ‘When we’ve gone you can ask someone to help you find a better place to store it.’

The delivery driver is fast and efficient, installing the hospital bed in twenty minutes or so. We spend the time talking to Marianne, trying to reassure her, finding out what support she has or might be expecting. It’s difficult, though. She uses all the phrases that suggest she knows Jeremy is dying, but there’s a palpable gap behind them. It’s like someone standing on a beach watching an enormous wave curling up into the sky and thundering towards them – and pointing, and saying ‘Look! A dangerous wave! I must get to safety!’ but standing completely still, watching it come down.

‘The palliative care team will be in touch,’ I tell her. ‘They’re incredibly supportive. They’ll give you numbers you can call to help out.’
Marianne stares at the dismantled bed behind the sofa.
‘It can’t stay there,’ she says.

Once the hospital bed is set-up and the dynamic pressure mattress inflated, Marianne walks in with an electric sheepskin underwarmer, as old as the hoover.
‘He hates the cold,’ she says.
‘I’m afraid that can’t go on this mattress,’ says Jenna. ‘Those straps will restrict the flow of air. His pressure areas will start to breakdown, so it’s important nothing gets in the way of preventing that. And I’m afraid it’s too much of a fire risk.’
‘But he’ll get cold.’
‘This is really well insulated, Marianne. He’ll be fine. And he’s got a nice, warm duvet. Honestly, this will be so much more comfortable for him than his old bed. Plus the carers need a hospital bed to care for him. They need to get either side to roll him, and it has to be at the right height otherwise they’ll hurt their backs.’
She stands holding the sheepskin blanket.
‘He feels the cold,’ she says, then walks out.

* * *

The next day, Jenna calls me over in the office.
‘I’ve got to go back to Jeremy, that patient we saw together.’
‘Why? What happened?’
‘Marianne put his old bed back together in the lounge, then somehow dragged him through.’

the mysterious S

Deanna, the most senior woman in the admin team, who would almost certainly beat me to death with a stapler if she heard her described in that way, turns sixty in a few weeks. There’s been a collection organised by Sara, the youngest in the team. And I have to say, Sara is pretty ingenious. In an effort to generate as much money as possible – no doubt keen to avoid the usual excuse of ‘I haven’t got any cash on me at the minute’, accompanied by the universal ‘patting of the empty pockets’ mime – has set up a Paypal account. All we have to do is arrange a transfer via email, and then all she has to do is go out and buy the bunch of flowers, horse and revolver or whatever else it is she’s got planned. And it’s because of this that Rachel, the second most senior admin person, has come to see me now.
‘Can you do me a favour?’ she says, leaning in and whispering. ‘But you’re going to have to be a bit creative.’
‘What’s it about?’
‘Sara’s had a big amount of money donated by someone called S Avery, and no-one knows who they are. We’ve tried everyone. All the old hands. But we’ve drawn a blank. If I ask Deanna she’ll just grill me and I’ll end up breaking and giving the game away. You know what I’m like.’
‘So what do you want me to do about it?’
‘Think of a way to find out who S Avery is.’
‘How?’
She shrugs.’
‘I don’t know, Jim. Be creative.’

I think about it, but nothing comes to mind.

‘I could tell her I had a dream. I’m standing in an aviary, wearing a T-shirt with the letter S on it. And then Deanna turns up and says Who’s S? And I say That’s what I was going to ask YOU!’
‘No,’ says Rachel. ‘That’s not going to work. She doesn’t dream.’
‘O-kay…’

I think some more.

‘I know! We’re going to sign a card, aren’t we?’
‘Yes.’
‘So why don’t we draw a picture of a shadowy figure at the bottom? Someone wearing a trilby and raincoat, but everything shaded in. With claws. And then we sign it With love from S Avery. And she’ll either say Who the hell is this S Avery? Or she’ll say S Avery! I thought she was dead…’
‘Or he.’
I shake my head.
‘That’s it. That’s all I’ve got.’
‘Well you’re a fat lot of good.’
‘Does it matter, though? You’ve got their money.’
‘Maybe it’s – you know – one of those things.’
‘What things?’
‘One of those fishing expeditions.’
‘Really? I don’t think so. S Avery hasn’t been asking for anyone’s bank details. Have they?’
‘They don’t need to. Sara’s pretty much handing them out on a flyer. She was in the canteen the other day going table to table. You can’t fault her. She’s very dynamic. It’d be nice to know who they are though. S Avery… I wonder what the S stands for?’
‘Stanley? Sheila? Or maybe that’s just what people knew them as. Maybe their first name was completely impossible but they shortened it to S. That’d be cool.’
‘Like you, then. Everyone knows you as F.’
‘What’s that short for?’
‘Fucking useless.’

sharp scratch

It’s been so hot and humid, all the windows of the office are thrown wide. Despite this, there’s not a breath of air. The only things moving are the fingers of the nurse on the late shift typing out her report, and the swifts outside, shrieking and swooping through the tall brick canyons of the place.

I think if our team had a flag, the swift would be the perfect animal to have on it. They travel thousands of miles each year, living entirely on the wing. They’ve even evolved so that half their brain shuts down and sleeps without them falling out of the air – a talent we can all applaud. And despite the swifts’ roving ways, they always come back to the same spot to lay their eggs each year, the gaps and cracks in the craggy bricks and eaves of the old Victorian hospital. So having a swift for the flag seems about right. A heraldic flag made of yellow line bandage, with a sharps bucket in one corner, a bunch of swifts in the other.

A late job comes through. Urgent bloods requested on a patient in a nursing home. The only people who can do it other than me and the lead coordinator is the nurse at the other desk, but she’s already up against it. When she hears about the job she looks up with such a panicked look on her face I really can’t do anything other than offer to take it myself. The phones are quiet, so we should be okay. And anyway, it’s nice to have an excuse to get out. An easy win all round.

I fly off, shrieking and swooping.

* * *

Maple Court is tucked away at the top of a drive so winding and confusing you feel like the architect must’ve had an ammonite on her table when she drew the plans. The whorls of the drive are deeply screened by trees and shrubs, too, and the building itself deceptively shallow, built into the hill so that if from the front it looks like a single storey place, it’s actually two or three. If you had to find a headquarters in a zombie apocalypse, you couldn’t do better than Maple Court. Low, defensible, anonymous. With a surprisingly good view over the city out the back.

The main doorway is shut, secured by a code. There are two people sitting in lobby armchairs just the other side of the door – an elderly man with his back to me, and an elderly woman facing him. He’s wearing a surgical mask, she isn’t. They don’t seem to be talking or doing much, but then the glass is thick and I might be wrong about that. The man seems to sense from the reaction of the woman that I’ve approached the door, because he turns round with a sudden, melodramatic start. After tugging his mask down to get a better look at me, he reaches over to punch the code into the panel, and the doors slide open.
‘Hello!’ I say. ‘I’m Jim from the Rapid Response team. I’ve come to take some blood.’
‘You don’t want me,’ he says. ‘You want Kim, the manager. I don’t work here.’
‘Oh!’
‘She’s gone off somewhere. I don’t know when she’s coming back.’
The old woman frowns and leans forward.
‘What does he want?’
‘He says he’s come to take some blood.’
‘Goodness!’ she says. ‘Whatever for?’
I’m just about to suggest that I come in and ring a bell or something when the woman I guess is Kim comes striding round the corner.
‘Is it for Ken?’ she says. ‘About time! Follow me…’
I put on my PPE as we go, through fire doors, up stairs, through more security doors, onto a scrubbed and ruthlessly bright level.
‘He’s in the garden,’ says Kim. ‘Wait in there and I’ll bring him through.’

The waiting room is boxy and bright, a square table with four square chairs in the middle, padded chairs around the walls, a tea making place with some magazines, a television and a water cooler. The water cooler looks like a happy face, with taps for eyes and a drip tray for a mouth. I take a photo with my phone, because I like things that look like faces – and then hurriedly put my phone away when I hear Kim and Ken coming down the corridor.

I can immediately see why the doctor wanted the urgent bloods. Ken looks terrible. He’s sitting in an electric wheelchair, slightly slumped forwards, his right hand draped over the controls, Kim shouting ‘left a bit, right a bit’ from behind. She stares over his head at me and winces, like a scientist who’s presenting a reanimated mummy to the Royal Society but suddenly having second thoughts.

‘Made it!’ says Ken with a grimace, running up against the table and then turning the power off. ‘Which arm d’you want?’
‘Ken is getting good at this,’ says Kim, pulling up a chair with a terrible scraping noise. ‘You’re used to the old vampires, aren’t you?’
‘Hey,’ I say. ‘Less of the old.’
Ken shrugs.
‘Get on with it,’ he says. ‘I want a smoke.’

I lay my kit out on the table, put a cushion under his arm, tighten the tourniquet, tap up a vein.
‘Have you tried those vapes?’ I say. ‘They’re supposed to be good. And they’re better for you.’
‘Nah,’ he says. ‘You may as well smoke Glade. Besides – I’ve got cancer, mate. I think the time for worrying about fags is over. Don’t you?’
‘Well,’ I say. ‘Yep. You’ve got a point.’
‘Are you going to say sharp scratch?’ says Kim. ‘That’s what they all say, isn’t it? Sharp scratch? Why don’t you say just a little prick?’
‘Because I’m not Dr Evil. Anyway, I don’t usually say anything.’
‘What? You just jab them?’
She strokes Ken’s other arm.
‘I don’t think he’s going to jab you,’ she says.
He shrugs.
‘I don’t give a monkey’s.’
‘So what do you say, then?’ she goes on. ‘I hope you don’t mind me asking. I’m just interested.’
‘I don’t mind. No – I think what I do is I say: okay, here we go, then… or something like that. Sometimes I might say: take a breath in … and out…. and that’s when I put it in. I got that from the tattoo woman who pierced my ear. It seemed to work.’
‘Less talk and more work,’ says Ken.
‘Sorry, mate,’ I say. ‘Here we go. Sharp scratch…’

accounting for ghosts

It’s been a hot day, busy and chaotic, but it’s late now, almost finishing time, and the fierce light of the afternoon is settling around the old hospital into something easier and more golden. There’s only me and Jane in the office, the long, empty room settling and ticking in tiny sounds of absence, like a car finally parked up and cooling. I’m sitting opposite Jane at the coordinator’s desk. Jane’s been pretty quiet the last hour, focused on working through a printed sheet of stats, the summation of the week’s activity. It’s a painstaking task and she sighs a lot. I’ve been fielding all the calls from patients and staff to give her the space, but they’ve eased off now and there’s nothing much else to be done.

Suddenly one of the connecting doors on the far side slams shut. At the same time, an overhead light flickers and goes off.
Jane looks up.
‘Ghosts,’ I say. ‘This used to be a surgical ward. It’s probably infested.’
She leans back in her chair and stretches. When she sits forward again she fixes me with a long look.
‘You’ll probably think I’m mad if I tell you this,’ she says. ‘But the place I live is haunted.’
‘Is it?’
‘It used to be an asylum. Then it was just a big, fancy house. Then it was flats. So it’s no wonder there’s stuff going on.’
‘What sort of ghosts?’
‘It depends,’ she says. ‘Mostly it’s odd bangings and things, whispering. Stuff gets thrown around. The other night when Steve came over, I went to bed and I saw his shadow on the door. So I told him to stop mucking about. Nothing happened, the shadow just stayed there. Suit yourself, I said. Then the shadow went away, and I heard Steve coming up the stairs. Who were you talking to? he said. So I realised it wasn’t him.’
‘Were you scared?’
‘Not really. I’ve got used to them now. I think they like the company. They get a bit restless when there’s been some change in things, like the lockdown. But otherwise they keep themselves to themselves. They’re basically just lonely, I suppose.’
‘It’s weird about ghosts,’ I say. ‘I mean – logically I don’t believe in them. But that doesn’t mean I don’t spook myself out a lot.’
She nods, but in a non-committal way, acknowledging the words but not the feeling.
‘When you think of all the places people die,’ I say. ‘Not just hospital, but everywhere. All over the place. Like where we live. It’s pretty old, used to be owned by a farmer. When we moved in, the old woman next door took great delight in telling us he choked to death on a chicken bone, in the front room. She rushed in to save him, but it was too late. So I thought – Oh, great! We’ve moved into a haunted house. But nothing. Not a cough. And none of the dogs or cats we’ve had have hissed or done anything strange. And they’re supposed to be sensitive, aren’t they?’
‘Depends on the dogs.’
‘And then you’ve got to think – if everyone who dies makes a ghost, wouldn’t we be completely snowed?’
‘Maybe we are. Maybe only some of them can make themselves known. And only some of us can see them.’
She smooths out the spreadsheet in front of her and stares at it.
‘Who knows?’ she says, planting her elbows on the desk, cradling her chin in the palms of her hands and pressing her fingers into her eyes so vigorously her glasses ride up onto her forehead. ‘I’ve never been good with numbers.’

how they met

Stepping through the front door into Mary’s house is like stepping into a crazy echo chamber. There’s a radio playing full blast in the kitchen, a TV in the front room with loud music and studio applause, and a TV in the back room with explosions and machine gun fire. The whole effect is made worse by the fact that the house has laminate flooring, and there’s not much in the way of soft furnishings. When I call Mary’s name to announce myself I have to shout. Her four wheel walker is at a strange angle in the middle of the hall, like she dumped it there in a hurry. I’m worried something’s happened, but as soon as I go forward to put it straight, she emerges from a tiny bathroom under the stairs.
‘I said go through,’ she says. ‘Didn’t you hear me?’
‘Well it’s quite noisy, Mary. D’you mind if I turn things down a bit?’
‘Suit yourself,’ she says, then takes the walker from me and walks with it through into the back room, her shoulders hunched, rolling heavily in the hip, like an old farmer ploughing a muddy field.
I do a quick tour of the house, switching off the TV and the radio. It only leaves the TV in the back room, a giant plasma affair. It’s playing a forties war film. There’s a close-up of John Mills looking tense, which feels about right as I ask Mary if she’d mind turning it off for a bit.
‘You do it,’ she says.
I can’t see the remote, so I just touch what looks like the off button on the bottom of the screen. The whole thing immediately dumps to a white fuzz accompanied by a hideous noise.
‘Oh what’ve you done now?’ she says, producing the remote from her cardigan pocket and zapping it off. ‘Good God almighty!’
‘There! That’s better!’ I say. ‘I couldn’t hear myself think.’
She raises her eyebrows, like she could say a few things about that if she wanted to.
‘How are you feeling?’ I ask her.
‘Much the same,’ she says. ‘Terrible.’
‘I’m sorry to hear that. In what way terrible?’
‘What?’
‘I say in what way terrible?’
‘What d’you mean?’
‘Are you in pain?’
‘No. Thank God.’
‘Do you feel sick? Dizzy? Short of breath?’
‘No.’
‘Lacking in energy?’
‘I do my best.’
‘I’m sure you do. So when you say you feel terrible, what… erm….’
She’s ignoring me now, fussing with a heap of stuff next to her on the sofa, so I decide not to push the “feeling terrible” thing any further and see if her obs offer any clues instead.
‘Would you mind if I did your blood pressure and temperature and so on?’ I ask her, unzipping my bag.
‘Be my guest,’ she says, and immediately rolls up the sleeve of her cardigan.

Just behind her on the wall is a large, three part picture frame, a photo of the Queen on the left looking a little dazed, a royal letter on the right, and the two panels separated by a golden tassel like a light pull or a curtain closer. I wonder what would happen if the glass wasn’t there and you could reach in and pull it. Maybe the national anthem would play and then the whole thing burst into flames.
‘What’s that for?’ I ask her.
‘We were married sixty years,’ she says.
‘Wow! That’s lovely.’
‘He’s gone now.’
‘I’m sorry.’
‘What can you expect?’
‘I suppose.’
‘He built this place.’
‘Did he? That’s amazing.’
‘He was a builder.’
‘Yes. I bet he must’ve worked hard.’
‘He never stopped.’
‘Sixty years! That’s very impressive, Mary. You’ll have to tell me your secret.’
‘What secret?’
‘How you managed to stay married for sixty years.’
‘I couldn’t think what else to do. Besides, you get used to someone.’
‘I suppose that’s true. So how did you two meet?’
‘He tripped me up in Woolworth’s.’
‘Where? By the pick n’mix?’
‘All I know is, his friend was going with my friend.’
She sighs and looks pained, as if the effort of remembering these things is exhausting her.
‘’That didn’t last,’ she says. ‘Are you done now or what?’