acing it

Brenda has had a busy day – ironic, given she’s supposed to be in semi-retirement. It’s as if keeping busy is just something she naturally does, hard-wired into her DNA. No doubt if you took a sample you’d see it. If you picked a strand of hair from the floor, a strand that had floated clear from her as she rushed past, her arms clutching bags and a note clamped between her teeth. And you respectfully sealed the strand in a ziploc bag, and took it to a laboratory, and slid it under a microscope, or whatever it is you have to do to visualise DNA (I really have no idea). No doubt it would all come into focus, the delicate, molecular twist of it, the multi-coloured ladder curving in on itself, rungs of the base elements: blue for capability, yellow for experience, green for humanity, red for love.

Brenda’s long service was rewarded recently. She got a certificate, a 40 year service pin for her uniform, a voucher for fifty pounds.
‘So that’s 80p for every year,’ I said.
‘It’s not about the money, Jim,’ she said. ‘Which is just as well…’

To be fair, everyone’s had a busy time of it today. The hospital has been discharging patients like wrecked sailors bailing out a lifeboat. Not only that, our existing caseload has plenty of complication to keep us distracted. There are blocked catheters to deal with, deteriorating patients, reports of increased confusion here, cause for concern there, anxious relatives, access issues, cars breaking down. I’ve spent the morning seeing patients and then struggling to make contact with their doctors, who I know are buckling under the strain themselves. Now I’m back at the office, helping coordinate for the rest of the day, which feels like a Battle of Britain pilot being dragged off their plane the moment it lands, put in an operations room, and asked to move figures around on a table with a mop.

By the time Brenda comes back into the office late into the evening, I am fully and fatally in that ‘Answer Any Question’ mode, that marginally insane, input / output, ruthlessly reactive, beep, beep beep state of mind that doesn’t stop at the end of the shift so much as power down and slump.

‘Oh my God! What a day!’ says Brenda, hurrying down the aisle and throwing herself into a chair, tipping her head back, her legs straight out, her arms straight down, like she didn’t just walk into the office so much as drop through the ceiling. Then looking up at the clock, making a cartoon Aargh! noise, plugging in her laptop, snapping up the screen, and furiously typing up her notes.

You could write a book on the different IT approaches you see around the office. The equivalent of a bird spotter’s guide, The Wild Office maybe, a detailed drawing of each individual, their markings and bandings, a note on the variety of calls they tend to make, and then a description of their typing style. Brenda reminds me of Rowlf , the dog who played piano on The Muppets, the way he leant over the keys, enthusiastically pounding away, staring closely at his paws, but periodically looking up to check he was following the notes.
‘Oh…!’ says Brenda, leaning back in the chair and smacking her head.
‘What’s up, Brenda?’
‘I can’t think what it is…’
‘Can’t think what what is…?’
‘That thing! You know! When golfers play golf. They put the ball on a little bit of plastic. What’s it called…?’
I’m blindsided. Has Brenda seen some kind of golfing injury?
‘Tee?’
‘I thought you’d never ask!’ she says, with a huge smile. ‘No sugar…’

signs of life

Maria is sitting in the sunshine at the kitchen table, a newspaper spread out in front of her, a cup of coffee to the right, a pink wafer biscuit on a square of black slate to the left. She’s staring at an article all about the latest Mars landing. There are detailed drawings of the descent, how the boosters deployed, cutaways to explain all the instrumentation carried on the probe. It’s quite a thing.
‘What an amazing achievement, sending something all that way,’ I say, taking a seat opposite.
‘What is?’ says Maria.
‘The Mars probe. The mission to discover traces of life.’
‘Oh,’ she says. ‘Is that what it is?’

Maria could be some kind of alien visitation herself, landed on her chair, her white blouse glowing brilliantly in the sunshine, her lipstick a shock of red, the coloured beads in her headband sparkling red, blue and green.
‘How are you feeling?’ I ask her.
‘Lost,’ she says.
‘It’s understandable. You’ve been through the wars.’
‘Have I? You see – that’s the worst of it. I don’t really remember. I used to be in control. Now I’m not.’
Her husband Klaus strides back from the kitchen with a cup of coffee and a biscuit for himself. He’s as striking as his wife, his long white hair swept back, his blue eyes preternaturally sharp against the liver-spotted leatheriness of his face.
‘Are you sure you wouldn’t like a cup?’ he says to me. ‘It’s very good.’
‘Absolutely. It’s kind of you to offer, though.’
‘Not at all!’ he says, sighing and settling next to Maria. She barely acknowledges him.
‘Don’t forget your biscuit, darling,’ he says, giving the slate a little turn, as if that’s all it need to capture her interest.
‘Thank you darling,’ she says, but carries on sitting as inertly as before.

The house is filled with Maria’s paintings and sculptures. I’m guessing the bronze on the little plinth by the window is Klaus as a young man. The face may be longer and thinner, the hair more tightly curled, but the birdlike intensity of his expression is the same. It’s an unsettling experience, sitting with her amongst these things. It’s as if the artist is gradually fading from the room after decades of creation, leaving only the light and the colour and the breath, a twist of steam from a coffee cup, a glimmer of moisture in the corner of an eye.

‘Could you speak up?’ says Klaus, when I start to ask them about the sequence of events, the tests that were run at the hospital, the things the doctors said. ‘You see – that’s the devil with those damned masks! We’re both rather deaf unfortunately and we rely on seeing the whole face.’
I apologise, and speak up.
He answers my questions, then when I pause to write a few things down, takes a sip of his coffee, putting the cup back on the saucer so carefully it barely makes a sound.
‘Mind you,’ he says, dabbing at his mouth with the corner of his linen napkin, then spreading it out on his lap again, ‘…of course – one gets so much more than that from a face. Take you, for instance…’
He stares at me, leaning slightly forwards.
‘Yes,’ he says, relaxing again. ‘Yes. Your eyes are nice enough. But who knows under that mask? You might have evil lips.’

stronger than honey

It’s something of a miracle the square has survived at all. Driving up to it, especially on a night as dark and damp as this, along a service road ruthlessly lit by yellow street lamps, past a multi-storey car park, a concrete and steel hotel, a loading bay to the back of a shopping centre, everything deserted, everything thrumming with a thrill of brutalist development – it’s an act of blind faith, a hope against hope that things will turn out alright, that when you take a left at the mini roundabout you will actually come to an address, somewhere warm and domestic and settled, somewhere someone could live, maybe, or at least, come back to from hospital, to get better.

No doubt the Regency architects who built Coleridge Square were looking for a romantic endorsement of their wrought-iron canopies and filigree balconies. Two hundred years later and times have changed; there’s more wrought-irony to be had from the fact that Coleridge was a smackhead. The smart townhouses are all on the slide, backstreet hotels, hostels, bedsits, the red neon NO flickering on the sign that says VACANCIES, like it wants us to get closer before it commits.

We’ve come to see Roo, an IV drug user who has been discharged from hospital to one of the hostels in the square.
‘Why d’you think he’s called Roo?’ I say to Brenda, the nurse I’m doubling-up with. ‘What’s that short for?’
‘I don’t know. Rupert? Rooney? Maybe it’s like in Winnie the Pooh. Roo with the pouch, where he keeps his stash.’
‘That’s a whole other version. Might explain Tigger, though.’

We ring the bell.
Nothing happens.
We try ringing Roo’s mobile again; it goes straight to voicemail.
The door’s on the latch, so we go inside.
‘Hello? It’s the nurses!’ says Brenda.

A heavy but loose-limbed guy walks down the stairs, methodically and carefully, one at time, like a marionette with lead boots. If he is a puppet, it looks like they made the head from a potato, two eyes shot into it with a BB gun.
‘Yes?’ he says, stopping before he reaches the bottom, stabilising himself on the gappy bannisters.
‘Oh hi!’ says Brenda.

She’s amazing. I’m sure if she knocked on the gates of Hell and a daemon slid back the latch, she’d be just as delighted.

‘We’ve come to see Roo!’ she says. ‘We don’t have a room number and he’s not answering his phone.’
‘He’s out.’
‘Oh! When did he get back?’
The man shrugs.
‘A couple of hours ago. He didn’t like the room he’d been given.’
‘Oh! Why was that?’
‘It was filthy,’ says the guy. ‘Which – to be fair – it was. So I put him in room two.’
‘Room Two? Is that a nice room?’
‘Nicer.’
‘But he’s not there now?’
‘No. He dropped his things and then went round to a friend’s.’
‘We’ll have to come back another time then.’
‘I’ll tell him you called.’
‘Would you? Thanks again!’
And we turn and leave. The man watches us from the stairs. It’s only when we’re back out in the street does he come all the way down and then slowly close the door.

‘What a waste of time!’ says Brenda. ‘Of course he’s out! He’s been in hospital a week! What else is he going to do?’

We stand in the square, Brenda by her car, me by mine, looking forlornly right and left, at the mist blowing softly across the square like someone quietly erasing a painting in the dark.
‘I don’t blame him though,’ says Brenda, hugging her laptop bag and folder whilst she unlocks her car. ‘You need something stronger than honey on a night like this.’

anything close up looks strange

Wanda is happily sawing away at a breaded cod fillet, arms tucked in, elbows up, her woolly hat pushed at an angle by the pillow back of her neck.
‘Sorry to interrupt your lunch,’ I say, coming into the room. ‘Bad timing!’
‘Sit on the bed,’ she says, pointing in that direction with a ketchuppy knife. ‘This won’t take me long.’
‘There’s a bit of paperwork to do, so I’ll get on with that whilst you finish up.’
She jabs up a nest of chips and only manages to get them in her mouth by moving her head from side to side.
‘Don’t give yourself indigestion,’ I say.
‘No,’ she says, ‘Mind you, I’m a martyr for that,’ half-choking as she struggles to get the words past the chips.
I pass her some water.
‘Thanks,’ she says, gulping it down – then sets back to finishing off the plate.

The ambulance service has referred Wanda to us. She’d had a couple of falls recently, minor injuries, observations fine but needed following up with nursing, therapy and so on. Wanda has some medical conditions that put her at more risk of falls, but at first glance I can’t see any more adaptations that could be made, and she lives pretty independently, so I’m not sure there’s much to be done. So long as everything checks out this visit, it might well be just a referral back to the care of her GP.

‘Done!’ she says, tossing the knife onto the empty plate with a clatter and a broad grin, like some kind of niche circus act.
‘Let me take that for you,’ I say. ‘Would you like to see the dessert menu?’
‘I’ll save that as my treat when you’re gone,’ she says. ‘So what’s this all about?’
I explain who I am, the team I work for and why the ambulance suggested we get in touch.
She sighs and brushes bread crumbs from her lap.
‘I don’t know why I’ve been falling so much lately. I suppose if you have one you’re more likely to have another.’
‘That’s true.’
‘I feel alright, though.’
‘Is there anything troubling you at all?’
‘The beetles,’ she says.
‘What beetles?’
She leans to one side and hauls out a mobile phone.
‘Just a minute…’ she says.
She curses and sighs as she tries to remember her pass code, and then navigate to the photos app. At one point she gets so frustrated she bangs the phone on the arm of the chair.
‘Do you want me to….?’
‘Just give me a minute!’ she says.
And then finally: ‘There!’
She hands me the phone.
It seems to be a close-up picture of tiny balls of carpet fluff.
‘I don’t get it.’
‘Zoom in!’ she says. ‘Slide your fingers!’ She makes a pinchy gesture in the air.
‘I know how to zoom in, Wanda,’ I say.
I zoom in.
‘I still don’t get it.’
‘Beetles!’ she says. ‘Look at the eggs! The legs!’
‘I can’t see it. Honestly – it just looks like fluff to me.’
‘The carpet’s infested. I see them all the time.’
She takes the phone back and shrugs.
‘They’re quite beautiful when they’re grown up, though,’ she says. ‘Blue-green backs, like little brooches. There’s one!’
She pushes herself up out of the chair and bends down to pluck something up from the carpet. I have to plant a hand on her shoulder to stop her from pitching head first into the dresser.
‘There!’ she says, brandishing another piece of fluff. She drops it into my palm, then sits back down again.
I look at it.
‘I’m really sorry, Wanda, but I think it’s just fluff.’
‘Look closer!’ she says.
I do, but it makes no difference.
‘The thing is, Wanda,’ I say, carefully giving it back to her – ‘if you look at anything close up it starts to look strange.’
‘Well maybe you can’t see it but I can.’
‘I’m not an expert on pest control,’ I say. ‘But honestly – it looks fine. Let’s do your observations and make sure everything’s okay in that department…’

It takes five minutes. There’s nothing out of the ordinary.
‘Any medication changes recently?’ I ask as I write down the figures.
She says that the doctor has adjusted a few things.
‘Why was that?’ I say.
‘Because they were worried I was having a psychosis or something.’
‘Oh yeah? In what way? What’s been happening?’
She pulls a face.
‘I’ve been seeing things. Especially at night. I’ll look out the window and there’ll be half a dozen people standing in the garden looking up at the window.’
She pauses to illustrate, tilting her head up but letting her jaw hang slack.
‘Like that!’ she says. ‘And I have to have the mirror on the floor before I go to bed because otherwise they keep peeking over the top of it and annoying me. Last night there was a woman standing out on the landing. And then when I’m sitting reading my Kindle, I’ll have a boy standing looking over this shoulder and an old man looking over the other.’
‘Does that worry you?’
‘Oh no! I’ve gotten used to it. I talk to them. I say What d’you think about that, then?’
She illustrates again, jabbing at her knee and glancing back over her right shoulder.
‘And what do they say?’
‘Nothing! They never talk!’ she says, looking at me again. ‘But I don’t mind. I like the company.’
She balls her fist and taps herself a couple of times on the centre of her chest.
‘Oof!’ she says, puffing out her cheeks. ‘I shouldn’t have had all them chips. I’ll pay for that later.’

the full set

I turn off Elm Road into Birch Grove and park outside Mulberry Court. It’s a shame Edie isn’t called Mrs Hawthorn or Mrs Rowan, or at least be wearing a hat made of leaves. She does come to the door in a rose patterned housecoat, though, so that’s something, and she’s so elderly she looks like a tree, a gnarly old olive you might see growing out of rocks in Greece, magically galvanised into answering the door, and then rooting it awkwardly back to her perch.

We chat whilst I work through the various tests, and then set out my things to take some blood.
‘I get a bit lonely,’ she says. ‘Especially after Eric passed.’
Edie nods at a portrait on the mantelpiece: a smiling old chestnut with a row of medals on his trunk. Edie starts to cry, so I fetch her a tissue.
‘Sorry,’ she says. ‘But when you’ve been together fifty years, it’s a bit of a wrench.’
‘I bet it is,’ I say.
‘He went in June,’ she says, dabbing her nose. ‘I wish I’d gone with him.’
‘I’m so sorry, Edie. How did you meet?’
‘He was the brother of my eldest sister’s husband. They set us up when he came home on leave.’
‘That’s lovely.’
‘Yes,’ she says. ‘He was a dancer. A lovely little mover.’
‘It looks like he was in the navy?’
‘A submariner.’
‘Oof. I don’t think I could’ve been on the submarines. Imagine that – being stuck underwater for days on end.’
‘Me neither. But he seemed to get on alright. He had the head for it.’
‘He was good in tight places?’
‘He was short.’
‘That must help.’
‘I made a bit of a habit marrying service men.’
‘Did you?’
‘My first husband was in the army. We got married very young. Near the end of the war. Only he got wounded and sent home.’
‘How was he wounded?’
‘He got kicked by a horse.’
‘A horse?’
‘Yes. God knows what that was all about. But he never really got over it. Drank to forget I suppose. Then we got divorced and I ended up with Eric.’
She blows her nose. I fetch her a glass of water and she has a sip.
‘Thank you,’ she says, setting it to one side. ‘Sorry to carry on.’
‘You’ve had a hard time lately.’
‘Yes. Well. There’s nothing to be done about it, I suppose.’
She stuffs the tissue up the sleeve of her housecoat and then takes one of those brave, exaggerated breaths that segues from a shrug to a smile.
‘All I’ve got to do now is find myself an airman and I’ll have the full set!’ she says.

Henry who?

No reply on Henry’s landline or mobile, so I call Nancy, his daughter.
‘He should be in,’ she says. ‘Unless he’s gone out.’
‘Shall I just take pot luck and pitch up? Will he mind?’
‘No. He won’t mind. Are you alright with dogs?’
‘Yeah. I like dogs.’
‘Eric’s yappy.’
‘Don’t worry, Nancy. Look – I’ll call you when I’m there and let you know your dad’s alright.’

*

Half an hour later, I’m standing outside the front door, sheltering as best I can from the kind of supersaturating rain that drags along the street in sudden waves like the pleats of a monstrous ball gown dragging through town. There’s no answer at the door. What’s even more worrying is that when I call Henry’s landline again I can’t hear the phone ringing inside the house. Have I got the right number? There’s a keysafe by the door that I don’t have the code to – so the easiest thing is to ring Nancy again. She confirms the address. When I ask about the keysafe she says there’s no key in it. 
‘Not that I know the code anyway. He keeps changing it. I’m worried he hasn’t answered the door, though.’
‘Maybe he took the dog for a walk,’ I say, glancing behind me at the rain, imagining the two of them paddling off in a canoe.
‘Maybe, she says. ‘He’s crazy enough. I’ll come over.’
‘Do you live nearby?’
‘About twenty minutes at a trot. I’ll come through the park so I’ll catch him if he’s there. See you soon.’
She hangs up. 
I peer through the letterbox and ring the doorbell at the same time. Nothing, not a hint of movement, not the sound of a dog or any other living thing. 
I check the back door. That’s locked, too. I peer through the windows but can’t make anything out. The only thing to do is wait for Nancy, so I hurry back to my car. At least I’ll be warm and dry. I can’t see the front door from there, though, so I decide to wait ten minutes and try again. Maybe Henry will have come back. If not, Nancy will pretty much have made it. 

*

This time when I ring the doorbell, there’s a furious barking from deep inside the house, followed by what sounds like a basketball bouncing down the stairs and colliding with the front door. A light goes on. Just discernible beneath all the barking, the sound of creaking stairs. After a minute or two, the door chain gets thrown back. A white haired Westie – presumably Eric – head butts my ankles as Henry stands there narrowing his eyes. He’s still in his vest and pyjama bottoms. 
‘I was in bed,’ he says, with an edge. 
‘Sorry to disturb you!’ I say. ‘The doctor has asked me to come and take some blood.’
‘Has he?’ says Henry. 
Eric is pretty much frisking me for evidence so I crouch down to make it easier. 
‘Nancy’s on her way over?’ I say.
‘Oh?’ says Henry. ‘What does she want?’
‘She wants to know you’re alright. We were worried because you weren’t answering your phones.’
‘They’re downstairs and I’m upstairs,’ he says, as if that settles it. ‘I suppose you’d best come in.’
Eric gruffs and puffs and snuffs and follows close behind me as I go through into a wood panelled room set up just-so, a high backed chair in front of a television, a fleecy basket between the two, a small breakfast table, a tiny sofa. Henry gestures for me to sit on the sofa. 
‘Won’t be a tick,’ he says, then leaves the room.

I sit on the sofa. Eric jumps up and sits at right angles, staring at me.
‘Alright, Eric?’ I say, tickling his chest, which he accepts a little grumpily, like a guard who’ll take a bribe but won’t commit.
The house falls silent again.
Eric continues to stare at me. 

For a second I have a dizzy, prickly kind of feeling, like I’ve dreamed all this, that actually I’m Henry, and Eric is my dog, and Eric is just concerned because I’m having another one of my turns. 

There’s the sound of a key in the lock. I snap-to and realise with a guilty lurch I should probably have called Nancy to say her dad was home and okay and let me in. But it’s too late. She’s standing in the hallway now, soaked to the bone, frowning at me as she swipes off her hat. And once again I have the disquieting, telescopic feeling that I’m Henry, this is my house, Nancy is my daughter, and I’m going to have to explain to her – once again – why I didn’t answer the phone, and also why I’m sitting on the sofa dressed as a nurse.

It doesn’t help that Eric is still staring at me, unblinking.

‘Hello Nancy,’ I say. 

Smile.

Swallow.

the swans

We’re standing round waiting for the enema to work.
‘Anything yet?’
William moves his head tentatively from side to side without lifting it from the pillow, the tube of his nasal specs shifting only slightly, the air compressor in the corner of the room clunking and whirring. Ralph the dog gives a harrumph from under the bed, rests his chin on his paws. Tina the nurse, William’s daughter Bella and I do much the same.

It’s a peaceful scene, all in all – quite a contrast from the cries of pain William made when we rolled him onto his side to administer the enema.
‘Shouldn’t be long now,’ says Tina.
‘That’s what you said when you give me the suppository,’ says William. ‘What’s the next thing on the list? A stick of dynamite?’

Only Fools and Horses is playing quietly on the TV behind me. I glance back at it. Del boy, Rodney, Grandad and Trigger are all sitting on the sofa, looking depressed. It’s a strangely bleak scene for a sitcom. More like a downbeat suburban drama.

William reminds me of one of the other characters, Boysie, the dodgy guy who ran the car showroom, the one who put on airs and graces and wore a mohair coat over his shoulders like a count but was really as rough as the others. His living room is the kind of living room Boysie might have had – plush velvet drapes pleated like cinema curtains, fancy plates wired to the wall, carved gilt chairs, comedy scatter cushions. It’s an expensive house though, overlooking a quiet stretch of the river.
‘Are the swans back?’ he asks Bella.
‘The what?’
‘The swans. Are the swans back?’
‘The white one is. Not the black one.’
‘I like the black one.’
‘Well he’s not back yet.’
‘Where is he?’
‘I don’t know, Dad. Maybe he’s on his holidays.’
‘At least someone’s having a nice time. This? This is suicide.’

It’s a pretty tough situation for William. He went into hospital with a broken arm and came out with a diagnosis of terminal cancer, prognosis four weeks. We’re filling in for the palliative team, but at least he’s got a hospital bed and so on.

‘How about now? Anything?’ says Tina.
‘You’ll know about it when it happens,’ says William.
‘Dad – the whole neighbourhood’s gonna know about it when it happens,’ says Bella.
‘Yeah,’ says William, then appears to fall asleep.

Tina takes her gloves off, checks her fob watch, then sits outside in the hallway to write up the notes so far. The front door bell rings; Bella hurries downstairs to answer it. I stay standing next to William. He opens his eyes and looks directly at me, as if he’d secretly been watching me from behind his eyelids.
‘I mean – landmines,’ he says, as if we’d just been talking about that.
‘I know,’ I say. ‘It’s a terrible thing.’
‘Why would you make something like that? Killing and maiming innocent people. What’s that all about, then?’
‘I’m pretty sure this country still makes them, though. And other stuff. The arms trade is pretty big.’
‘Why can’t we all just get along? If you want to go to a church, or a mosque, or wherever – fine. It’s none of my business. But the next thing you know, we’re at each other’s throats.’
‘That’s a good point,’ I say. ‘Too many wars over nothing at all.’
‘Then of course what happens is – you say one thing – I say another – fine – your lot have a go at my lot – I say what’s going on here – they move over there – I say hang on a minute – and the next thing you know millions are being slaughtered.’
‘It’s complicated.’
‘Is it really so hard for us to share this planet?’
‘That’s true.’
‘But I tell you one thing.’
‘What’s that?’
‘There ‘ain’t half been some evil bastards in this world.’
‘It’s definitely had more than its fair share.’
‘Take that Clinton woman.’
‘Hillary Clinton?’
‘I read a book about her. Now that’s evil on a whole other level.’
Hillary Clinton?
‘If I wasn’t laid up in bed – if I could get outta this bed – you know what I’d do? I’d take a machine gun and machine gun the lot of ‘em.’
Bella comes back in the room.
‘Amazon delivery,’ she says. ‘Any developments?’
‘The lot of ‘em!’ says William.
Bella looks at me and raises her eyebrows.
Tina walks in, snapping on fresh gloves.
‘Alright?’ she says.
Behind me, the Only Fools and Horses theme tune starts to play.

the three bears

There aren’t many things I remember from Geography class, but one of them is the oxbow lake. It’s that thing that happens when a river meander gets loopier and crazier until the river nips it off at the top and leaves it to one side as a curved body of water. (Note to reader: I did NOT score highly in my Geography exam).

This close reminds me of an oxbow lake. The main drag thunders across the top, leaving a U-bend of terraced houses with a thin strip of wasted grass and brambles in the middle. Driving round it, I can’t figure out the numbers at all. It’s as if they built the houses first, then took a bag of numbers, shook it up, and ran round throwing them randomly at the doors. I can’t see any sequence to it at all – and worse than that, I can’t find any sign of a number eleven. (Note to reader: I did NOT score highly in my Maths exam).

There is an unnumbered door round the corner from number nine, though. So although strictly speaking it should count as an address on the main road, I take my chances and my bags and go down the cluttered path to knock on the door.

There’s a long wait, then the sound of someone clumping downstairs.
The door gets thrown wide.
An elderly woman with thick round glasses and a startled expression.
‘Hello!’ I say. ‘I’m Jim, the nursing assistant from the hospital. I rang your carer Stevie and she said it was okay to visit. Are you Agnes? I’ve come to take some blood!’
I extend my ID badge on its elasticated string but she doesn’t look at it.
‘Come on, then!’ she says, batting the air. ‘Follow me!’
She turns and stomps back up the stairs.

I’m encouraged by how full of life she seems. The Doctor had asked us to visit today as a one-off for bloods and a set of obs. The community phlebs were full so it was a bit of a favour.
‘I didn’t like the sound of it,’ the doctor said. ‘The carer was talking about jaundice and abdo pain. If you could take a look for us that would be great.’

I put the rest of my PPE on in the hallway and follow Agnes up the stairs into her sitting room.
She’s already back in her chair – a throne of white cane, padded with red and yellow cushions and set in the middle of the room, with a card table next to it for her biscuits and orange squash, telephone and remote control. She’s watching Flog It! A punter and a dealer are sitting either side of a table looking down on a tiny vase; the dealer starts laying out lines of twenty pound notes. Uh-huh! says the punter. The dealer lays out some more. ‘Try harder’ says the punter.

‘You’ve come for my blood!’ says Agnes. ‘You’d better be gentle!’
‘How are you feeling?’ I say. ‘Stevie said you haven’t been yourself lately.’
‘Who’ve I been then?’
‘Well. She didn’t go that far.’
‘No. I bet she didn’t.’

Lined up on a small sofa behind Agnes are three bears: one giant polar bear, one medium-sized grizzly bear and one small teddy bear. The teddy bear is perched on the lap of the polar bear.
‘They’re giving me a funny look,’ I say, nodding at them.
‘They do that with everyone,’ says Agnes. ‘Just ignore ‘em.’

We chat about how she’s been feeling. I take a history, give her the once over, take her observations.
‘All good!’ I say. ‘So tell me again how this all started.’
‘It was that burger,’ she says. ‘It was all mushy. And mayonnaise? That wasn’t mayonnaise! It was lumpy and grey.’
‘Eurgh! Doesn’t sound good.’
‘No. It wasn’t good. And that was the start of all my troubles.’
‘Have you felt sick? Or been sick?’
‘No.’
‘Have you had any diarrhoea?’
‘No. I went this morning.’
‘And was that all normal.’
‘Depends what you call normal.’
‘Well – firm. Fully formed.’
She pulls a face.

Behind me in Flog It! things are getting serious. The dealer has spread out a whole wallet of notes now, but the punter folds her arms and leans back in the chair. I can’t believe a tiny vase could be worth so much.

‘Any pain?’ I ask Agnes.
‘A little. Round my middle.’
She makes a sawing motion with the flat of her hand.
‘Sorry to hear it. Is it there now?’
‘No.’
‘Have you taken anything for the pain?’
‘What like?’
I shrug.
‘Paracetamol? That’s quite effective but shouldn’t upset your tummy any more.’
‘I haven’t got any.’
‘Maybe Stevie could get you some.’
‘Maybe.’
‘I’ll talk to her. So – Agnes? Have you had this pain before?’
‘Oh yes.’
‘Tell me about that. When was the last time?’
‘A couple of months ago.’
‘And what happened there?’
‘I had a chilli.’

The punter has taken the vase and put it back in her bag. The dealer is shaking his head and clearing the cash away.

‘Do you mind if I put the light on?’ I ask Agnes. ‘Only Stevie said you were jaundiced and I need to get a better look.’
‘Help yourself. The switch is over there.’
The moment I put it on the room is flooded with light. It’s made more pronounced by the lack of a lampshade, but even so it’s astonishing how powerful that bulb is – like I didn’t throw a sitting room light so much as shoot a flare overhead.
‘Wow!’ I say. ‘That thing’s bright! I need welding goggles.’
‘I like to see what’s happening in the world,’ says Agnes. She thumbs at the bears behind her. ‘And so do they.’

sugar coating

The night has been long and cloudless, so cold that everything is locked in a thick hoar frost. A crystalline web sags heavily on Mr Rawlinson’s front gate. I imagine the spider that spun it must be something of a jewel itself now, glittering like a leggy diamond somewhere, deep-frozen in its lair.

Mr Rawlinson is luckier than the spider, though. His bungalow is filled with a fulsome warmth that seems to ripple as I move into it.
‘Come in! Come in!’ he says. ‘And be quick about it.’

We’re short on carers this morning, so I’ve been asked to drop by. Looking at Mr Rawlinson, I wouldn’t think there’s much to be done, though. Not only has he managed to wash and dress himself, but he’s done it so well he looks almost too perfect, standing straight-backed, holding on to his kitchen trolley, a pensioner on parade. It’s like a team of make-up artists has been challenged to put together the most perfect pensioner they can, and really, they’ve excelled themselves. Mr Rawlinson’s silvery hair is brushed to the left and the right of a geometrically precise parting, his moustache perfectly trimmed, his shirt buttoned to the neck with a blue tie in a Windsor knot symmetrically in place; cuffs sharply in line; cardigan just-so; canvas trousers with pleats like origami folds, and slippers so buff I imagine a valet must have been fussing over them with a monogrammed brush moments before.
‘Are you here to fetch me breakfast?’ he says.
‘Absolutely. Whatever you need.’
‘Smashing. I’ve left it all ready to go. The bowl, the muesli, the sugar and so on. I’d like a portion of muesli, some milk in a jug, a slice of toast with thick-cut Oxford marmalade and a cup of Earl Grey tea, medium strength. Are you okay with all that?’
‘No problem.’
‘Splendid.’

I’ve been given the job on the fly, so I haven’t had a chance to read his notes. It strikes me that Mr Rawlinson is functioning extremely well, and I wonder why the care has been requested. After all, it’s not too much of a stretch to put muesli in a bowl, especially once you’ve gone to the trouble of setting the packet and the bowl out in the first place. But maybe I’m missing something. It could be that without a carer coming in to supervise these things, he’d hit the skids and wouldn’t bother. I’m happy to oblige, of course, but I make a mental note to follow-up the job when I get back to base.

‘Why don’t you sit down at the table and I’ll bring everything over?’ I say to him.
‘Righto!’
‘I thought this muesli already had sugar in it?’
‘Yes, you’re right, it does, but I like it sweet. Three sugars in my tea, as well, if you wouldn’t mind. When you get to my advanced old age, a few extra spoons can’t hurt.’
‘That’s true.’
I fold a square of kitchen towel into a triangle and put it with the point towards him on the table, followed by a knife, dessert spoon and teaspoon. He adjusts the angle of them, to line up more precisely with the napkin.
‘When I was in the RAF,’ he says, folding his arms, ‘there was a chap there, forget his name, Canadian, I think. The most athletic man I have ever met. Played any sport you could think of, and probably a few others. Mostly one of those track types. You know? A runner. Faster than a blessed hare. Well! He used to do it all, sugar, tobacco, alcohol – you name it.’
He finesses the cutlery a little more.
‘Maybe it would have had some effect eventually,’ he says, after a moment. ‘But we were never afforded the privilege of finding out, of course. The poor chap was shot down somewhere over the Atlantic.’

pugs!

If you work on the coordination desk long enough you’ll feel yourself change.

Nothing dramatic or immediate, but imperceptibly, stealthily. It’s a hazard of the job, the frantic business of it, tapping away at the computer keys, answering two phones at once, taking questions from colleagues who wait in a restive line like shoppers at the Deli counter. A function of the distracted firing of your brain cells, the agitated beating of your heart, the immobility of your body in the chair. All these things will take hold, come together and warp you at a genetic level, cannoning your atoms into novel patterns like a drunken God with a billiard cue until – too late – you realise you ARE the phone, you have BECOME the computer, you have ABSORBED the notepad. You’ll only notice at the end of the day, when you go to stretch and your arm snaps in half because it’s changed into a pencil. Or you roll your neck to ease the cramp and your head logs off. Or you go to stand up but you can’t because your vasculature is now the furniture and your spinal cord has extended through the floor tiles and uploaded you to the network.

That’s the down side.

The upside is that eventually you’ll find yourself in synch with the office. You’ll be tuned-in to everything happening around you without even trying. You’ll be working the desk like a dreaming, caffeine-crazed spider, a little bored maybe, a little restless, your compound eyes flickering with the light of the database, whilst you unconsciously monitor the action around you by the vibrations you feel through your feet.

Which is a complicated way of saying I was aware Karen was on the phone before I really knew it.

Sophie was talking to her. Sophie is one of the administrators. She’s on the frontline of the operation, taking calls, giving information, directions, advice, or deciding where to redirect – which more often than not means patching them through to the coordinators. Sophie is great at her job. She’s warm and friendly, however long the day or trying the circumstances. I love the way she answers each call with the same intonation – saying the company name with a flourish like she was throwing a fancy tablecloth over a workbench. But then her tone changes immediately, coming down a notch, and within seconds she’s speaking to the caller as if she was gossiping with a favourite aunt.

Only this time, she wasn’t.

Sometimes even Sophie struggles to connect with the caller – especially if the caller is Karen.

Karen has been referred to us many times before. She’s difficult, in the way that Medusa was difficult, except in Karen’s case it’s not snakes but pugs. She lives in a state of constant war with everyone and everything, storming through the world with a half dozen pugs clutched to her chest, their bug eyes an expression of the stress she’s under, or the strength of her grip, or both.

I zone into the conversation half way through.

‘…Karen? Karen? I’m afraid you’ll have to put the dogs in another room or something because I can’t hear a word you’re saying…. Karen? Karen? Honestly – it’s impossible. Put the pugs in another room, Karen. Yes. That’s right. Another room. And shut the door… I’m sure they’ll be fine… it’s just for a minute, Karen, so I can understand what the problem is. Lovely. Thank you. Could you start again, please? …. Okay… Okay…. So you need help of some kind, is that right? A nurse. Okay. Well – I see from the notes here that a nurse came round to see you about an hour ago and you didn’t let them in… Is that right, Karen? …. Okay…. Okay…. Well, as I’m sure you’ll appreciate, it’s difficult for us to specify male or female… No, Karen. They’re all nurses. They’ve taken the same qualification…. It’s very difficult to do that, Karen. We can try, but it may mean a delay in getting you the help… Yes. I understand that, Karen…. I’m sorry you feel that, Karen…. but they probably only knocked like the police because they didn’t know whether you’d heard them or not… Well, because of the dogs barking….Yes, well, I’m sorry your dogs were upset by that… I’m sure they do… Karen? If you want to put in a complaint you’re more than welcome to do so. But if I could just… if I could just… No, that’s not what I’m saying, Karen…. if I could just…Have you let the dogs back in, Karen?..Karen…?’

Sophie holds the phone away from her ear, catches my eye, shakes her head, plunges back in.

‘Let me put you through to Jim,’ she says. ‘Maybe he can help…’

She punches in my extension.

‘Karen for you,’ she says when I pick up. ‘Good luck.’

And when my phone connects, it’s like a bone being tossed in the middle of a dog fight.

‘Karen? Karen…?’