what more can I say

I’m sitting with my daughter in a large and crowded waiting room at the health centre. No-one’s talking much, just the occasional appointment confirmation and instruction at the reception desk, the rustle of magazine pages, some self-conscious throat clearing, whispered conversations. What dominates the room is an elderly woman in a wheelchair. I’m guessing she has some form of dementia, because she keeps saying the same two sentences, over and over again.
There’s a carer with her, one hand on hers. She’s doing her best, but the elderly woman is relentless.
‘I’m not well’ she says. ‘I’m not well. What more can I say?’
Now and again she clears her throat with a vigorous, dredging cough, making as much of it as she can, like a cartoon voice-over artist vocalising the scene where a rabbit vomits up a grizzly bear, gives itself a shake, then blithely hops off as the bear stares after them.
‘I’m not well. I’m not well. What more can I say?’
In the context of the waiting room it’s strangely hypnotic, especially with the carer making periodic shushing and soothing noises, the whole thing coming together like the libretto of a spare modern piece: The Waiting Room, maybe. The Poor Patient.
‘I’m not well. I’m not well. What more can I say?’
Actually, I like the way she says what more can I say. She falls into it, high to low, in a helpless, rush, landing flat on the say.
‘It’s okay, Fenella’ says the carer. ‘Don’t worry. Everything’s fine. We’ll see the doctor soon.’
‘I’m not well. I’m not well. What more can I say?’
When I chat to my daughter, Fenella takes it as a cue to speak more loudly. The receptionist peers round the stack of folders on her counter, and frowns.
The carer is doing her best, but it’s difficult for her and I wonder about their situation. I’m guessing Fenella is an inpatient in a nursing home. Normally they have a GP who visits regularly through the week, to spare the patients – and the staff – the stress and risk of an outpatient appointment. I can only think that they’ve come to see a specialist holding a clinic, someone who won’t make individual trips. I’d like to ask the carer about it, but I’m not at work, it’s nothing to do with me, and anyway, she’s got her hands full.
‘I’m not well. I’m not well. What more can I say?’
I look over my shoulder and smile at the carer, who gives me a polite but slightly wary acknowledgement. I can see she’s stressed.
‘Don’t worry, Fenella,’ she says. ‘Here – let me rub your shoulders.’
She turns in the chair, reaches round and starts gently massaging the back of Fenella’s neck.
‘Oh – that’s lovely!’ says Fenella.
The whole waiting room relaxes.

Enid vs. the CIA

Enid stares at me from the hospital bed with a wide and fixed expression, like an old Morris Minor up on the ramp. There are two other cars come to visit her in the rehabilitation unit: me, a battered old Toyota, well-maintained but worried about the next MOT, and the unit GP, an old Volvo people wagon, boxy, unkempt, a little clumsy, perhaps, but still good for a few thousand miles.
‘Tell me more about the man you saw this morning,’ says the doctor, leaning forward in his chair. ‘The man from the CIA’

Enid isn’t the most obvious recruitment target for the Central Intelligence Agency, but then you’d have to think they’re probably a little underrepresented in the eighty year old, retired bookkeeper demographic. Still, Enid’s taking it well. She waggles her mirrors and begins.
‘It was early in the morning,’ she says, folding her hands in her lap and giving her shoulders a settling shrug, ‘… about half past five, I should think. I heard someone cough, and I thought That’s odd. And when I sat up, there he was, standing at the foot of the bed, staring down at me.’
‘What did he look like?’
‘Oh – about forty, I should think. Pleasant chap. Short blond hair. Wearing a sports jacket but no tie. Smart casual, I suppose you’d say. And he stared at me a good long while, and then he said: Enid? You’re not who you think you are.’
‘How extraordinary! And he was from the CIA?’
‘Yes. He said they wanted to recruit me for a mission. I said I’m sorry, but I don’t think I’ll be much good to you like this. I’m really not up to any mission. And he said You’re on our list. And I said Well, I can’t help that. I’ve just had a pacemaker fitted.’
The doctor smiles, nods, writes something down.
‘It’s happened a few times before,’ she says.
‘The CIA?’
‘No. Last time I woke up in a Burka. There was an enormous man with a big black beard, and he pointed at me and said I had to go to the mosque. And I told him I didn’t want to go, because – well – I wouldn’t know what to do. And he said I’d soon pick it up.’
‘So it’s all about identity?’ says the doctor. ‘Fascinating!’
‘I don’t know about that,’ says Enid. ‘I’d sooner just wake up and have a cup of tea like normal people.’
‘And this has only been happening since the operation?’
She nods.
‘Do you think that’s what’s caused it?’ she says.
‘Possibly,’ says the doctor. ‘I think we need to take some blood and check for a few things. So – do you get any kind of warning before you see these people? Any strange smells, funny sensations? Sounds? Odd visual effects?’
She shakes her head.
‘Do your limbs feel heavy or frozen?’
‘No. I’m sitting up talking to them just like I’m talking to you now. I get a little frightened.’
‘But you don’t feel unwell in any way?’
‘Hmm’ says the doctor.
‘It’s not always people who talk, though. The time before that it was an alien.’
‘Like ET?’
‘I don’t know about that. He wasn’t very friendly. Pacing up and down. When I asked him what he wanted he picked me up and threw me in the cheeseplant.’
‘Well! That’s aliens for you! Look – Enid – I’ll leave you with my colleague here who’s very kindly agreed to take some blood, and we’ll have a look at that and see if there’s anything causing these hallucinations. They may just be lucid dreams, of course. You’ve been through a lot recently and you’ve had a disrupted routine and everything else. But we ought to rule out organic causes first. Okay? Lovely to see you.’
And he leaves.
‘Do you think I’ve lost my marbles?’ says Enid as I get my kit out.
‘No! Not at all. I think like the doctor says, you’ve got a lot on your plate.’
She stares at the toast cooling on the table beside her.
‘I don’t fancy much,’ she says, then turns her attention back to me.
‘I don’t bleed,’ she says, brightening. ‘Everyone struggles. There’s only one person who can get it – a girl who works at the surgery. Ever so nice, she is. Lovely teeth. She chats away a mile a minute, and the next thing you know she’s waving a tube in your face. I said to her, I said you’re a vampire, you are. And she said yes, and that’s why I like my job so much.’

We chat about the whole lucid dream thing whilst I tap around for anything vaguely resembling a vein. She’s right. It’s Slim Pickens and that’s a fact.

‘I’ve had a couple in the past,’ I tell her. ‘Dreams where I’ve woken up in the middle of it all and thought: This is a dream. And I knew if I concentrated hard enough I could make things happen. There was this one time, I’d gone to America and I was due to fly home that morning. Well I woke up in the dream, and I was standing on a wide prairie plain. So I thought I’d see what I could make come over the horizon. I concentrated as hard as I could, and I tried to summon one of those old western coach and horses – you know – like you see in the films. And then I could get in and see where it took me.’
‘Oh yes. That would be nice.’
‘But it never came. Instead there was this tiny figure running towards me with its arms outstretched. A woman, in ceremonial robes, Japanese robes, all flapping out behind her. And when she got a bit closer I could see it was my mum, and she had this expression on her face, like she was shouting out and trying to warn me. And I got so scared I turned around and woke myself up. And I was so freaked I rang the airline to change my ticket, because I thought maybe she was trying to tell me the plane was going to crash. Sorry – that vein disappeared when I went in.’
‘They do that. They can hear you coming.’
‘So later on I thought I’d better ring the airline again to check the new arrangements, and they told me they had no record of my previous call.’
‘Did you catch your plane?’
‘Yeah.. It was fine.’
‘I see.’
She reaches out and takes a desultory bite of her toast and chews it without much relish. I have to admit, I’m a little disappointed with my story, too. It sounded like a straightforward dream. The mystery of it had rubbed off over time; now it just seemed like the kind of thing you might get with jet lag.
‘I wonder what your mum was trying to tell you?’ she says, looking for the positive.
‘Who knows? I asked her about it later and she said she hadn’t had any premonitions. There we go! You have got blood after all…’
She sighs.
‘Yes. Well. Everyone struggles,’ she says.

the battle of don’s deep

Donald sits low in the armchair, his left leg bouncing up and down like a jackhammer, his left arm in a sling, his right hand restlessly picking at the chair fabric. However neutrally or sympathetically I try to phrase my questions to gauge what he needs since his discharge home, it’s impossible to get a straight or reasonable answer. I’m not making  progress.

I have to say I’ve never met anyone quite so burned-up with fury – or anyone whose eyebrows angled up in the middle so perfectly. It’s like his nose is the prow of a bony ship, and the eyebrows are the arms of a cantilever bridge raising to let it through. His eyes are in sync, too; closing as the eyebrows go up, as if he’s reading his diatribes back of the eyelids, like an autocue.

At least Don’s environment is fine. Potted plants. Laminate flooring. An enormous flat screen TV. Donald muted it when we came in, but the show he was watching continues to play. I think it’s one of those how things are made programmes, this episode all about buttons. Pastel buttons, tartan buttons, spotty buttons, two-holes, four-holes…. The manufacturing process is complex and fascinating. About a million buttons pouring into some kind of steaming bath, then rolling out on a conveyor belt. What for? Do we need this many buttons in the world…?

‘…all you bureaucrats, trying to reduce everything to a simple yes or no, clicking your little keys, ticking your little boxes. Life doesn’t work like that. Pain certainly doesn’t. Pain doesn’t conform to your pissy rules. If I say yes I can do that, you’ll put down yes, and you’ll say he can totally do that – he’s fine, we can leave him alone. But the fact is sometimes I can and sometimes I can’t. It costs me enormous levels of pain and suffering just to get out of the chair. You don’t know what it’s like. I used to be a bodybuilder. I used to be fifteen stone, built like a brick shithouse. I’ve got a toleration for pain your brain could never conceive of, never conceive. I’ve got an IQ that’s in the top one percent. I know what you’re talking about, so don’t try to fool me. I know what’s behind your words. I can’t be bought off like the rest of them. And just because I refuse to be bullied into accepting things that aren’t right, I get stigmatised and put down as difficult…’

I’m so glad I’m doing this assessment with Agnes. She’s so experienced and battle-hardened, I couldn’t feel better about it if I was an elf on the ramparts of Helm’s Deep watching the orcs approach with ladders, and Gandalf was holding my hand.

‘I’m sorry to have to ask you these things,’ I say to Don. ‘I know it’s a bit one size fits all. But we need to get a rough idea what we can do to help. Like physiotherapy, for example. Do you think you might benefit from some?’
The eyebrows flick up; the eyes close.
‘Oh? Yeah? Physiotherapy? You try living with the pain I’ve got. You try doing their little exercises. Me just scratching my head is like you running a marathon. Physiotherapy! And what will they do? They’ll come and they’ll sit where you are and they’ll say Oh, Donald, if you don’t do anything you’ll get this and that. You’ll get muscle wastage, deconditioning, ligament contracture…. Bullshit! They don’t know what it’s like to suffer like this. They wouldn’t last five seconds.’
‘And where was your fracture again? It’s on the system somewhere, but if you could just tell me…’
Eyebrows up.
‘What’s the point? You wouldn’t understand. I’ve got a better understanding of anatomy and physiology than the surgeons. That’s why they didn’t like me. They couldn’t get rid of me quick enough. I knew their language. I knew what they were up to.’
‘Try me. Just – you know – the basics.’
He sighs, then winces, fiercely and dramatically, as if that simple exhalation of breath was the most exquisite form of torture. And then when he’s recovered from that, and re-found the energy and the deep spiritual reserves required to continue talking, the eyebrows go up again, and the eyelids come down.
‘I have a type two coracoid process fracture distal to the coracoclavicular ligament. Yeah? Know what that is? Thought not. Just put busted shoulder. What’s the point of talking about physiotherapy if you don’t even know what it is I’ve got?’
‘The thing is, Don – I know this is difficult for you…’
‘Oh! You know, do you? How do you know? Been through it yourself, have you?’
‘What I mean is – I can see how distressed you are and from that I can guess how difficult you’re finding it…’
‘This is the problem,’ he says, eyebrows up, lids down. ‘This is the problem, right there. Everyone thinks they know but everyone in fact doesn’t know. Everyone knows precisely jack shit….’

I’m struggling to make any headway at all with this assessment. And because Don’s speech is so overwhelming and so full of invective, and because his eyes are closed and I can get away with it, I can’t help glancing at the screen again. Another batch of buttons are going through some kind of electroplating bath, in plain, out golden. They look great. A bit showy, maybe. Still. Nice to have gold buttons….

Agnes takes over. The fact that she’s Scottish seems to help. There’s a broad warmth to her voice that deflects Don’s sniping more successfully, for a while at least. But after ten minutes or so of her best attempts, even she begins to waver. In fact, I’d go as far as to say she starts to sound a little snappy – but then her phone rings.
‘Sorry!’ she says. ‘Do you mind if I take this…?’
And she ups and leaves the room.
I couldn’t feel more abandoned than if Gandalf suddenly waved a bony finger in the air, produced a phone from his cloak, and stepped back from the ramparts just as the orcs came over the top.

I turn to face Don again.

His eyebrows go up.

the wrong end of the brush

When I walk into his room, Ted is leaning forwards in his wheelchair, dabbing energetically at a canvas on an A-frame easel. He’s wearing gold lame running shorts, a lime green sports vest and a leopard print bandanna to keep his wild white hair out of his eyes and – presumably – out of the paint.
‘Whaddya think?’ he says, leaning back.
He hasn’t got much done so it’s hard to tell what it is. In fact, to be honest, it’d be clearer if he’d just splodged the paint on directly from the tube. It also doesn’t help that he’s working from the top down, like someone drawing a primary coloured cover over a blank space. If I had to guess, I’d say it was a picture of ivy growing down a wall – maybe at a cafe, because I can just about see the pencil outlines of a round, cafe-style table and two chairs immediately beneath all the green. I’m not sure though.
‘Van Gogh’ he says, chewing the end of the brush and tipping his head to the right.
‘Oh! I see it now!’ I tell him, throwing my bags down on his bed. ‘Yeah – that’s great! All you need to do now is practice the signature and you could totally pass it off.’
‘What d’you mean?’
‘I mean – it looks like the real thing.’
‘Well I should know, shouldn’t I? I’ve been there. I took photographs.’
I think he means the Van Gogh Museum in Amsterdam.
‘I’d love to go!’ I say, trying to steer things back into safer waters.
‘Why doncha then?’ he says, dabbing on some more green. ‘It’s just a shame the flight takes so long.’
‘Does it?’
‘Yeah. Expensive, too. But cheap when you’ve landed. And so hot! And lush!’
‘Is it?’
‘What – Amsterdam?’
‘No. Bangkok.’

the strange case of the book and the banana

I’m sitting in a cute, bright kitchen on a plain wooden stool next to a washing machine on the dry cycle. For a small machine it’s making a lot of fuss: grinding revolutions, sudden hesitations, short beeps, longer beeps, slow backward rattles, more beeps, a noise like rizh-or-rizh-or-rizh-or-rizh – then back to the grinding revolutions again.

It feels like my mind. I’ve had such a day of it, racing from one thing to the next, and I’ve ended up on a job that – potentially, at least – had stress and delay stamped all over it.

We’ve had a call come through, darlink and I wonder if you’d go and take a look for us, sweetie. It’s an eighty year old woman, decrease mobility, stuck in chair. We haven’t got anyone to go with you, but there’s a live-in carer – named like flower or somethink? – Daisy? Petal? I don’t know. Somethink like that. Anyway, she’s on scene so you should be okay. We can’t make out from the lady exactly what might be going on here, but can you just go and see what you think? Okay, darlink? It might need an ambulance, it might not. Ring me and let me know. Thank you so much, sweetie. Bye, bye. Bye. Bye. Bye.

In the end, it was more straightforward than it sounded. Maureen has rheumatic joint pain, particularly in her knees. She’d been sitting in her new riser-recliner too long, and felt a bit shaky. All her obs were normal, so it didn’t look as though there was anything more sinister going on. Rose, the live-in carer, needed an extra pair of hands to help Maureen transfer safely to a commode, which we could use to wheel her over to the hospital bed that occupies one half of the room. Once that was done, Rose asked if I wouldn’t mind sitting in the kitchen whilst she changed Maureen into her nightie. So I took off my gloves, walked through, sat down on the stool next to the washing machine, and waited.

These days, in slack moments like this, I’ll take out my phone and check social media, or swipe through The Guardian, or maybe Google something I’d been thinking about. This time I thought I’d make a more conscious effort just to sit and do nothing – or, at least, a more mindful kind of nothing. Maybe by reviewing exactly what was happening at that time, what the kitchen was like, how things essentially were in that moment, I’d root myself in Time, and just breathe, and in that way release the stress of a long and busy day.

I survey my surroundings, my attention passing round the neat little kitchen as smoothly and neutrally as the second hand on the clock on the opposite wall.

At one o’clock: a tall, grey-silver fridge-freezer, magnet clips of shopping vouchers, a dog in a sailor hat, little magnet photo frames of people; between the fridge and the outside wall, a lap tray shoved in vertically; patio windows letting out onto a Mediterranean-style patio, red and white geraniums in pots, a climbing hydrangea hanging down over a flint wall, a metal bistro table with a half glass of orange squash in the middle and a metal chair at an angle next to it …. (I can’t help jumping when an Intercity express train suddenly hurtles past the end of the garden – but in a funny kind of way it actually helps, because it feels like my stress levels are definitively snatched away, and I’m even more settled as I continue to look round). At three o’clock, to my immediate right, a plastic, yellow, three-tiered vegetable rack, potatoes and sweet potatoes mixed together in the top, a nest of carrier bags in the middle, and gardening gloves and secateurs in the bottom. There’s a small, round, highly-varnished table with two matching chairs immediately in front of me in the centre of the kitchen. On the table is a stack of three paperback books: The Divided Self by R D Laing, The Interpretations of Dreams by Freud, and Lost at Sea by Jon Ronson. Next to the books is a wire fruit basket. The basket is designed a bit like a scorpion, with a long, arching tail rising up at the back with a hook on the end, presumably for bananas. In the basket are three apples. By the side of the basket is a single banana.

My focus settles on the fruit basket and the banana.

Does it mean that there was a hand of bananas hanging down, and this banana is the last one? Obviously you can’t hang a single banana. Although maybe there’s a special attachment for that. If you’re worried enough to have a basket with a separate banana hook, you might well like a single banana attachment, because having a single banana left over from a hand of bananas is something that’s going to happen quite a lot. Maybe the attachment got lost. If that’s the case, why not rest the banana with the apples? I vaguely remember something about people not mixing bananas and other fruit because it makes everything rot more quickly. Is that right? Maybe the banana was lain with the apples, and Rose took it out to eat – and read one of the books, probably Lost at Sea, because although they’ve all got bookmarks poking out, the Ronson is lying on the top of the pile. Maybe Rose took the book and the banana – which was lying in the basket – and sat down for a break. The other two books are quite obscure, probably part of some psychology coursework or something. Maybe Rose felt a bit guilty reading Lost at Sea, because she’s falling behind with her schedule, but this was her break, goddamn it, and if she hadn’t earned a quick banana and a bit of Ronson, who had? But if this was a break, where was her drink? You’d have a drink before a banana, wouldn’t you? Where was the mug of tea going cold? Then I remembered the orange squash out on the patio. So that was the sequence! Rose had poured herself a drink of orange squash, grabbed the last banana that – because of a lack or loss of a single banana attachment was lying any-old-how among the apples – picked up the Ronson (after a twinge of guilt looking at the other two books), gone outside to enjoy herself, and at that moment heard Maureen call out for help. So she hurried back inside with the banana and the book but not the squash. Because carrying three things is precarious, and although she managed it slowly when she had the time to take things easy, as soon as she was in a rush she took the two most portable things, the book and the banana. Or maybe they just happened to be in her hand when she heard Maureen shout – and she dropped them off on the kitchen table on her way through – because there’s no way you’d have a book and a banana in your hand if you were answering a cry for help. That would be ridiculous.

So why wasn’t the banana on top of the book on the table…?

‘Ready for you now!’ says Rose. ‘Sorry to keep you.’
‘No worries,’ I say, stretching. ‘It’s nice just to sit and do nothing.’

virgil the bullet

Glad lives with her husband John in the basement of a grand, Georgian terrace house on the coast road out of town. Originally I imagine the flat would have been the servants’ quarters for the entire house. The stone steps leading down to it are worn in the middle; you can almost hear the footsteps pattering up and down them, to meet a carriage, or to fetch wine from the cellar, or any of those other relentless, below stairs tasks. Still – the conversions in these buildings are all expensive, wherever they feature in the house, so as I descend I’m expecting a beautiful flat with varnished floorboards, ornate mirrors, fine works of art – the usual, high-end sensibilities of the residents around here.
It’s a shock when Glad answers the door.
‘Don’t let Virgil out,’ she says. ‘He’ll be up the steps like a bullet.’
She shushes me in quickly. There’s a fat tabby licking his paws over by some flyblown cat bowls. He reminds me of those cartoon cats, the fine diners around the dustbins, wearing napkins, sucking joke fish bones with a claw in the air.
‘I let him out the back, not the front,’ says Glad, shuffling through the gloom of the kitchen. ‘He can’t get out the back.’
Virgil stops licking his paws long enough to give me a stare, as if to say: What do you know about the front?
‘He’s a sweet cat,’ I say.
‘When he’s been fed,’ she says. ‘Don’t believe his propaganda.’
She leads me into the living room, a hellish space decked out all in red: red drapes and throws and velvet curtains, red wallpaper, deep red carpet, and worst of all, a gas fire on, four bars. It feels like I’ve been swallowed by a dragon.
‘Pete likes it warm,’ she says, lowering herself into a brown armchair (which I can only imagine was red when they bought it).
Other than the belly-of-the-beast theme, the other thing that catches my attention is a large, antique drinks cabinet in the shape of a globe. Arranged around the circular foot of it – in a pattern like a solar stream, or maybe space junk – are dozens of spirit bottles, everything represented, from gin, rum and whisky to the more exotic flavoured stuff. I don’t know why they wouldn’t throw the bottles out. Maybe they just like to see exactly how far they’ve got in their journey around the world in eighty spirits. Either way, it’s a terrible trip hazard.
‘Here any good?’ says Glad, propping her leg up on the cat’s beanbag.
‘What’s happened to the telly?’ says John, suddenly and inexplicably conscious again. I smile and wave. I can’t believe he’s actually lying on the sofa under a rug.
‘I turned it off so as not to disturb the nurse,’ says Glad.
‘I’m not actually a nurse. I’m a nursing assistant,’ I say, looking for something to sit on so I won’t have to kneel on the carpet. ‘It’s a simple leg dressing, though, so it should be fine. If not, I’ll call in the cavalry.’
‘What – more cowboys?’ says Glad. ‘Only joking. I’m sure you know what you’re doing.’

fix or nix

‘Here’s a list of my bowel movements!’ says Thomas, handing me a closely-written sheet of paper with all the dates and times, accurate to the minute, GMT. ‘I used to work in telecoms’ he says, settling back into his armchair. ‘I know how to keep track of output.’

Thomas is so old, I imagine telecoms at that time would have been horses, valves and copper wire. He must have been a useful figure, though, because they sent him all over the world – Sierra Leone, the Bahamas, Patagonia.
‘Four children, four continents!’ he says, with a practised flourish. He smiles broadly, like someone unzipped a work bag and a couple of old hacksaws fell out.

He may have travelled the world many times over, but these days Thomas’ advanced age and precarious mobility means he’s pretty much confined to his room. He seems happy enough, though. It’s all been set up very sensibly – as you’d expect – everything to hand, everything in its place according to need and frequency of use, as neatly and logically planned as a circuit diagram. From his dilapidated armchair he can look out of the window, watch television, or simply survey the multitude of family photographs spread across the walls. It gives his chair a strange kind of height, I suppose, that prominent point you might reach if you were to climb a tall telegraph pole, lean back in your straps, thumb your helmet back, catch your breath and wonder at the diminishing curve of the world.

‘What do you think?’ he says. ‘Fix or Nix?’