peas in a pod

The moment I press the front bell a furious howling and barking starts up deep within the house; a half second later, a malevolently dark shape starts leaping up and down the other side of the door, battering itself against the frosted butterfly glass, crazy as a baby wolf on a trampoline, doing everything it can to get to me bar setting up an oxy acetylene cylinder and cutting a hole through the panel. A minute or so passes but the dog doesn’t tire. It even seems to be trying out some fancy moves – a half-tuck, a forward roll. Eventually, a light goes on. A shadow coalesces through the butterflies, three pane zones into one.
‘Shashi! Shashi! For goodness sake – shush now!’ A chain rattles back, a lock turns, the door opens. Despite myself, I can’t help drawing back, expecting the dog to launch itself at my throat; instead, it trots out quite happily to sniff my shoes, as if it was only contracted to bark so long as the door stayed shut.
‘Lovely to see you!’ says June. ‘Sorry about Shashi. She sounds terrible but she’s perfectly harmless.’
‘Her bark’s worse than her bite.’
‘Well her bite’s pretty bad, to be honest, but since she had her teeth out she’s calmed down in that respect.’
I’m relieved.’
June leads me through to her living room. It’s a tidy space, dominated right and left by two enormous Georgian-style doll’s houses. Each house has a little patch of garden in front, surrounded by a white picket fence. In the garden of one, two elderly dolls lounge in deck chairs, reading the paper; in the other, a doll mows the lawn with a dog exactly like Sashi following behind.
‘Have a seat,’ says June. She gets into position to sit down herself, unaware that Shashi has already jumped up onto the armchair and – apparently – fallen asleep.
‘Watch out!’ I say.
‘What? Oh – d’you mean the dog? She’ll move.’
I can hardly watch. June drops down into the chair immediately above the dog, which only moves at the very last second, reaching out with a paw to whip its tail out of the way as June lands with a weighty sigh.
‘There!’ she says. Then looks around.
‘I don’t know where the other is. They’re thick as thieves, normally. Brother and sister. Peas in a pod.’
I’d spoken to June’s son before coming here today. He’d talked to me about June’s increasing problems with dementia, her loss of short term memory, her habit of leaving the cooker on, door open, bath running. The whole thing is moving towards residential care, but for now the family were looking at increasing the number of carers during the day.
‘It’s been a difficult few days,’ he says. ‘Yesterday we had to have one of the dogs put down. The vet came out and it was pretty awful, but I’m not sure Mum remembers too much about it.’
I look over at Shashi. She’s left June’s armchair to curl up on one of two plush, tasselled red cushions on the opposite sofa. As if she can read my mind, she raises her head and stares at me.
‘Don’t!’ she seems to say.

glenda calls time

Glenda watches as I unpack my kit.
‘Why is everyone so obsessed with my blood?’ she says.
‘The doctors want another sample. I think they’re mostly interested in how your liver’s doing.’
‘I think you’ll find it’s not doing all that well, Jim. It’s ninety-five, like the rest of me.’
Glenda has a steady, sad demeanour, like an ancient donkey peering through a gate.
‘You know – it’s perfectly alright to say no to any of this stuff,’ I tell her. ‘So long as you understand what it is you’re refusing.’
‘I don’t mind if you take some more blood,’ she says. ‘I don’t want to be difficult. Anyway, it passes the time.’
‘I don’t think you’re difficult,’ I tell her, setting out my things. ‘In fact I think you’re a model patient.’
‘Now – you’re either very kind or a good liar. Which is it?’
‘Honest answer?’
‘Only a liar would say that.’
‘Well there you are, then.’
‘Yes. Here I am, then. More’s the pity.’
I fetch over a pillow for her arm.
‘Why are they so exercised about the state of my liver?’ she says.
‘It mentions a paracetamol overdose on the blood form.’
‘Ah,’ says Glenda. ‘That.’
‘So – was it accidental, or….’
‘Absolutely not! Accidental! I knew perfectly well I wanted to kill myself.’
‘Oh! I’m sorry.’
‘What? That I failed?’
‘No! That you felt so bad you wanted to kill yourself.’
She shakes her head and gestures to the room.
‘It’s not exactly the Ritz, is it?’
‘It’s not bad. You’ve got a view of the garden. Those trees are lovely.’
‘It’ll take more than a couple of Japanese maples to convince me life is worth living. I mean – come on! I’m ninety-five! Look at me! I’m worn out! I’ve had my time and very nice it was too. But longevity is no fun, let me tell you.’
‘I can see that.’
‘Stuck in the chair for hours on end until someone decides to put you back to bed.’
‘Have you spoken to anyone about how you feel?’
‘You mean a psychiatrist?’
‘We’ve got some mental health nurses on the team. They’re really nice.’
‘I would hope they are. But I’d be wasting their time. You see – this isn’t a mental health problem. I belong to something called Dignity in Dying. Have you heard of it?’
‘Vaguely. I think so.’
‘You wouldn’t be so vague if you were ninety-five, I can assure you.’
‘Maybe not.’
‘Definitely not.’
‘The thing is, Glenda. There’s so much going on in the world. Brexit. Climate Change. The rise of populism. Nationalism. Trump, for God’s sake! These are scary times. Interesting times. And we need you to stick around and tell us what you think. You’ve lived through a war. People forget. They start to feel invulnerable – you know? – like they can go on as they like forever, and nothing really matters.’
Glenda laughs.
‘Just get on and bleed me,’ she says, pushing up her sleeve. ‘You’re absolutely priceless! You want me to carry on living so I can see how Brexit turns out? My God – if the nurses hadn’t locked my tablets away I’d be throwing them back by the handful.’


There’s no sign of a keysafe at the front of the building. Some of them have a ruling about these things. Even though the majority of the residents are elderly and vulnerable, they think the little black boxes on the walls are unsightly. In which case I figure it’ll be round the back. It’s the kind of detail that would be really helpful to have on the notes, but who knows? Maybe I missed it or something? I pick up all my bags and walk back out to the road, along the front of the block, down a service road, and up to the rear access doors. I can immediately see the keysafe, clamped to the wall above the recycling bins, like some kind of robotic mussel at low tide. Worryingly, alongside it I can also see a keypad. As if to illustrate what it’s for, a guy walks up, taps in a code, and then smiles at me as the automatic door swings open.
‘Wanna come up?’ he says, reassured I’m genuine by my uniform and bags.
‘That’s okay. I’d better use the keysafe to get the keys for the flat,’ I tell him. ‘Thanks anyway.’
The door closes after him.

Of course – the number doesn’t work on the keysafe and neither does it work on the keypad.
I take out my phone and ring the patient.
‘Hello? Mrs Craig? It’s Jim, from the hospital.’
‘Well – I don’t know – I’m outside the back door, and the keysafe number doesn’t seem to work. I wonder if I’m at the right door…?’
‘Is it the first one you came to from the road?’
‘Then it should work.’
‘There’s a keypad here, too.’
‘I don’t have the code.’
‘Why not?’
‘I don’t know.’
‘Okay. Great. Thanks.’
‘Come up to the third floor. I’ll open the door to you.’

I ring off. Punch the numbers into the keypad. The automatic door swings open. I go inside. Take the lift to the third floor, then stand in the lobby, looking round. Mrs Craig lives at fifty-two; the highest number here is twenty something. There must be another rear entrance to this place. So I take my bags, head back down in the lift, exit the block and walk further along.

There’s a guy in pristine white overalls slowly painting the first of a series of pristine white garage doors. I wonder if at the end of the line he stands up straight and paints himself. I nod as I pass; he stops to stare at me, then carries on when I’m far enough ahead not to worry about.

I was right. There is a second entrance, deeper set than the first and camouflaged by some planter shrubs. I try the number on the keypad. The door swings open. I take the lift to the third floor. Mrs Craig is standing waiting at the open door, clinging on to a kitchen trolley and trembling.
‘What took you so long?’ she says.
‘I’m really sorry. I went to the wrong door.’
‘Patently!’ she says, then tuts, turns, walks unsteadily back into her flat, her coffee cup rattling on its saucer, more with rage than infirmity it seems to me. I follow on behind.
The flat is immaculate. It’s like walking into a computer reconstruction.
‘I’d better take my shoes off,’ I say to her.
‘Yes,’ she says.
The living room is forensically clean, every item of furniture, book and photo, every picture, piece of wax fruit and ceramic chicken meticulously measured and set each to another like random items on a grid. I’m the dirtiest thing this place has ever seen, and it gives Mrs Craig obvious pain to watch me drop my bags and sit down on the Ercol sofa.
‘I didn’t get all the access details,’ I tell her.
‘Why not? Wasn’t it in the notes?’
‘Not that I saw.’
‘Vihaan came straight here.’
‘Did he?’
‘Yes. And Barbara did. And Anna.’
‘Do they have access to the same notes?’
‘They do.’
‘Maybe it was in some obscure place.’
‘Not so obscure that three other clinicians came straight here without any bother.’
‘Perhaps you’d better read the notes more carefully next time.’
‘Probably a good idea.’
I unpack the first of my bags.
‘I saw the numbers weren’t running in the right direction,’ I tell her, trying to strike a breezy conversational air, ‘…but I thought there might be a corridor connecting the floors.’
‘Well there isn’t.’
‘We don’t associate with the low numbers.’
‘The riff raff.’
‘I’m joking, you understand?’
‘Yes. Me, too, Mrs Craig.’
She smiles in a thin and approximate way.
‘Anyway,’ she says. ‘That’s all in the past now. The thing is – are you here for my fingers?’ She waggles a bandaged hand in my direction.
‘Yes,’ I say. ‘Fingers.’
‘Good,’ she says. ‘Because they’re sending me absolutely doolally.’

a big ol’ splash

Vince has been having trouble with his catheter. It’s all been pretty traumatic for him these past few days, from the discomfort of going into urinary retention in the first place and the trauma of the catheterisation process, to the horror of finding out he’ll have to keep the catheter in for a number of weeks, at least, if not longer. Vince suffers from BPH – Benign Prostatic Hyperplasia. He’s had drug therapies, surgical interventions, and they’ve all more or less helped, but a cure is beyond their remit and he knows he’s looking at ongoing work.
‘The latest thing was stapling’ he says, flapping his dressing gown, as if the mere thought of what the urologist did to him on that table needed releasing. ‘Can you imagine? Passing a probe up the urethra and stapling the prostate right and left. It’s pretty brutal. I mean – good grief!’
What makes it worse is that Vince is a fit, thoroughly independent man in his late sixties. A civil engineer, his whole life devoted to assessing, planning, coming up with solutions. The fact that he has to handover his care – his entire sense of self – to experts in a field he knows little about is obviously difficult for him. And now the catheter’s playing up again. Blood in the bag, pain in the penis. In and out of A and E. It should all be settling down by now. He’s doing all the right things. Nothing seems to work.

When I’ve finished checking him over and making my recommendations, we chat about other things, how he’s coping, his plans for the future.
‘It hasn’t helped with my wife being away,’ he says. ‘She’s tidying up her family’s affairs in Alaska’ he says. ‘I don’t know. We might move there. We’re both retired. It might work out.’
‘I’ve never been to Alaska. I’d love to go.’
‘Well – yeah – it IS amazing,’ he says, a little half-heartedly, as if he’s being forced to admit to something he didn’t particularly want to. ‘I like to see the whales.’
‘Do they get them there?’
‘Humpback. Beluga. Orca.’ He draws a breath. ‘It’s great to see ‘em. The humpbacks especially. They do this thing – breaching – where they rise out of the water in a spiral and then thump back down.’
‘What is that – a mating ritual?’
He shrugs.
‘There are theories. Could be play. Could be they’re communicating about food, or a warning. Who knows? Maybe they just like making a big ol’ splash.’
He manages a grim smile, gives his catheter a tug. ‘This’d slow ‘em down though,’ he says.

calamity june

I ring Albert to ask if it’s okay to come round and see him. When he picks up I wait for him to say hello or something; when he doesn’t, I say hello instead – but then he talks over me, pretending to be an answer machine:
I’m sorry we’re not here to take your call, but quite frankly, we couldn’t be arsed. So if you’d like to leave your name and number and what you had for breakfast, then – please – do that, but don’t hold your breath for a reply, because quite honestly you’re not going to get one. Thank you very much, and goodbye…
I hear his wife June in the background saying Who is it, Albert? – a scuffling sound as the phone gets handed over – then: Hello? Who IS this?
‘Hi June. It’s Jim, from the hospital. I came round to see Albert the other day.’
‘Yes. Hello. Sorry about that. Albert does like to muck about.’
‘He probably thought it was a nuisance call. The number comes up as private.’
‘We get a lot of that.’
‘Me too.’
‘So what do you want?’
‘Is it alright if I come over and do Albert’s blood pressure again? The GP wanted a few days’ worth…’
‘That’s fine. Come over. It’s not as if we’re going anywhere.’


‘Sorry about earlier,’ says Albert, answering the door and shaking my hand. ‘I get a bit carried away sometimes.’
June is standing behind him, leaning against the doorway to the kitchen, wiping her hands on a tea towel.
‘I wish you would get carried away,’ she says.
‘Hark at that’ says Albert.
‘Well I thought it was great!’ I tell them both. ‘I always swear I’ll say something clever or weird next time we get a nuisance call, but of course I never do. I always end up saying Please don’t ring here again. Which is so pathetic it practically guarantees they will.’
‘I’ve had a lot of practice,’ says Albert. ‘I’ve always been a bit of a clown.’
‘Is that what you call it?’ says June.
Albert shakes his head, then turns and walks unsteadily to his favourite chair, lowering himself into it with exaggerated care. June follows behind, perching herself on the arm of the settee opposite, whipping the tea towel over her shoulder, then folding her arms. It’s difficult to figure June out. She doesn’t smile easily, and when she speaks it’s clipped and to the point. It’s understandable, though. The strain must be awful.
Albert and June are a retired couple in their late seventies. June is as fit as you could hope to be – as rootin’ tootin’ as Doris Day in Calamity Jane – but Albert looks twenty years older. He has a palliative cancer diagnosis, and he’s becoming frailer day by day. Symptomatically Albert’s steady, functioning at a reasonable level, the pain controlled pretty well, but the prognosis is bleak. It’s impossible to say when he’ll enter the End of Life phase. One month, six months, a year, two…. I’m not surprised June has her pistols drawn.

I run through the observations. At every point, Albert makes a joke. When I put the tympanic thermometer in his ear (The light’ll come straight out the other side); when I count his pulse (So I’m not dead yet?); when I pump up the cuff to do his blood pressure (Jesus Christ! You’ll have my arm off at this rate); when I scratch his finger for his blood sugar (That’s very nearly an armful).
June sighs heavily each time.
‘Just let him do his job,’ she says.
‘There! All done!’ I say, packing my stuff away.
‘A-one back to the front!’ says Albert.
June fold the tea towel into a square and smooths it flat on her knee.

When I’m ready to go, Albert insists on seeing me to the door. When he gets there, he turns and leans against it.
‘Can you give me some advice?’ he says.
‘Of course. What about?’
‘I don’t want my family coming round any more.’
His chin starts to tremble. He takes a breath to steady himself, then raps his stick on the carpet a couple of times, summoning the will to speak.
‘I don’t want them seeing me go like this,’ he says. ‘I want them to remember me as I was. So what would you suggest I do about that, hmm?’
‘It’s hard,’ I say. ‘I know what you mean. But I think anyone who loves you would want to see as much of you as they could. I know I would. I think they’d find it hard staying away.’
‘Well. There we are,’ he says. ‘Thank you.’
I give his shoulder a squeeze.
‘Come and sit back down, Albert. I worry about you.’
‘I’ll be alright. I’ll keep on my feet if you don’t mind.’
‘Okay then. You take care. I’ll let the GP know what your facts and figures are.’
‘Thirty-eight, twenty-four, thirty-six,’ he says, then takes out a hankie and blows his nose.
June comes over and leads him back to his chair.
‘Close the door on your way out,’ she says.

home visit

Charles Court sounds like a tabloid headline but it’s actually one of the smartest addresses in town. Even the approach is elegant: a shallow arrangement of steps and brass handrails, a decorative filigree canopy, wide, brass-handled glass doors, and swirling blue and white paisley tiling right and left – so that the whole thing looks more like the entrance to an expensive hotel than an apartment block.
I’ve actually come here to see two patients – a retired doctor with back pain on the sixth floor, and a newly catheterised patient on the fourth. I buzz the guy on the fourth, figuring I’ll work my way up, just as a snappily dressed elderly man carrying a deli bag walks up the steps towards me.
‘Excuse me, sir,’ he says. ‘Are you here to see Doctor Richards? I’m his friend and colleague, Doctor Samuels.’
‘Nice to meet you,’ I say, holding out my hand. He gives me the deli bag, which confuses me. We shake hands. I give him the bag back. Which confuses him. ‘Thank you,’ he says, immediately turning to walk back down the steps.
‘Aren’t you going to see your friend?’ I say.
‘What? Oh – yes! Yes, of course!’
He walks back up the steps, just as my patient answers the intercom.
‘Dr Samuels here,’ says Doctor Samuels, leaning pass me to answer in a gruff, doctorly kind of way.
Who? says my patient.
‘It’s okay’ I tell him. ‘It’s Jim, from the Rapid Response.’
With a doctor?
‘No. He’s visiting a friend. Another doctor.’
Oh says my patient. He mutters something. The door buzzes. We both go into the lobby.
‘Yes, yes,’ says Doctor Samuels. ‘Of course, we trained together, Doctor Richards and I. Saint Bartholemew’s, London. Nineteen fifty nine! Sixty years ago!’
He shakes his head sadly.
‘I’m seeing a patient on the fourth,’ I tell him. ‘But it won’t take long and I’ll be up to see Doctor Richards in about half an hour. Will you still be there, d’you think?’
‘Yes, yes!’ he says. ‘Now look. I want to thank you for all the marvelous work you do. It’s simply wonderful. We’re very lucky to have you.’
‘You’re welcome.’
‘I’m a doctor, too, you know. Well – retired! I’ve had my share of home visits, I can tell you!’
‘I bet you have!’
‘Oh my goodness, yes! I’ve been everywhere, seen everything and all stops in between. So I know what you’re up against and I thank you most sincerely for the trouble you go to. It’s much appreciated!’
We walk together across the thickly-carpeted lobby to the lift. I push the button. The doors slide open.
The lift is tiny – a sign of how old the place is, I would think. Dr Samuels is a portly guy in a huge mohair coat. He’s even wearing some kind of panama hat with a brim. In fact, if he hadn’t said he was a doctor I’d probably guess he was a Mafia Don. With all the bags I’m carrying, it’s going to be quite a struggle for us both to fit in. For a second I’ll think I’ll take the stairs, but then Dr Samuels says: ‘After you.’
‘Well I’m getting out on the fourth and you want the sixth so maybe you should go first.’
‘Please’ he says, pressing his eyes shut and gesturing to the lift. ‘I insist.’
It’s easier just to go along with it, so I say thank you and get in, putting my bags on the floor. Dr Samuels follows on, and we end up almost nose to nose. The doors slide shut, and for a moment we stand there, Dr Samuels with his eyes shut, breathing so heavily I’m worried he’s fallen asleep.
‘Excuse me…’ I say, struggling to reach around him to press the buttons.
‘Not at all! Not at all!’ he says, still with his eyes shut.
The lift judders up.
‘Ninety fifty-nine!’ I say, to make conversation. ‘That’s a long time ago.’
‘Yes,’ he says. ‘That’s when I went to medical school to start my medical training, you know.’
‘Is it?’ I say. ‘Amazing!’
‘That’s where we met, of course. Dr Richards and I.’
‘At Barts.’
He opens his eyes.
‘Yes!’ he says. Why? Were you there, too?’
‘Just a lucky guess.’
The door slides open.
‘Well. This is me,’ I say.
‘Thank you,’ he says, but even though I pick my bags up, he makes no effort to move. The doors slide shut again and we carry on up to the sixth.

‘Here we are!’ I say as positively as I can when the lift doors open again.

This time Dr Samuels does reverse out. I walk with him across the hallway to Dr Richard’s flat, just to make sure he gets there safely. I don’t want to be there when the door opens, though, because it’ll be embarrassing to have to explain why I’m not coming in just yet. My other patient is expecting me. I’ve confused things enough as it is.
‘I’ll be back up in a minute’ I say, heading for the stairs.
‘Why? Where are you off to?’
‘Down to the fourth,’ I say.
‘Marvelous!’ he says. ‘Well. Lovely to see you!’
He makes no move to ring or knock, but I hope for the best and leave him to it.
When I turn to look for the last time, he’s still standing there, idly rocking backwards and forwards. I wave, and he waves back with the hand holding the deli bag. Seems surprised to see it. Looks inside. Rummages around. Pulls out a sandwich. Starts eating it.

making up for lost time

Leslie opens the door, mid-chuckle, like he was waiting there all this time to do just that.
‘Well come in! Come in!’ he laughs. ‘We don’t stand on ceremony here you know!’
I hold the door so he can let go, grabbing him when he almost plunges backwards into an umbrella stand, then holding onto him till he finds his balance again. ‘Thanking you,’ he says. ‘Must take more water with it. Er-hem. This way!’ He walks ahead, rocking from side to side, lifting his legs stiffly from the hip and working his arms, like a robot in an old sci-fi movie.
‘Through here!’ he says, as if there was anywhere else to go in the tiny flat, leading me into a sitting room with two armchairs conspicuously together in front of the television, one of them now being used as a place to put magazines and letters. ‘Sit where you like!’ he says. ‘’scuse the mess.’
Leslie’s doing well for ninety-eight. The only time his bright mood slips is when he mentions his wife, who died a couple of years ago. ‘We were a good team,’ he says. ‘I miss her a lot. It doesn’t seem fair. Still – that’s the way of the world! I’ll see her again soon.’
The doctor referred Leslie in to us for physio and nursing care, nothing too drastic. He’s pretty independent. Goes out most days – or did, before his fall. He has a son who lives a couple of miles away. Visits all the time.
‘My confidence got dented along with my pride’ Leslie says, squeezing his eyes together as he wipes his round glasses on his untucked shirt. ‘Still – I’ll find it again, don’t you worry! You can’t keep old chaps like me down for long!’ He puts his glasses back on and blinks at me happily. There you are! I can see who I’m dealing with now!’


When I’m done and writing up my notes, Leslie hands me a paperback he’s been reading – a history of the spitfire.
‘Any good?’ I say, flipping it over to read the blurb.
‘It’s alright,’ he says. ‘My son got it for me. I was a bit disappointed, to be honest with you. It doesn’t mention my lot at all.’
‘Oh yeah? Who was that?’
‘The One Five Two. Black Panthers. So called ‘cos we had a panther on the side, jumping over the roundel. I was one of the technicians, loading ‘em up, fixing ‘em when they went wrong – well, trying to, at least. Out in Burma.’
‘That must’ve been tough.’
‘We got through it. I remember one of the new pilots, South African he was. Tall, handsome chap. Big dimple in his chin, like Superman. He says to me one day, he says Sorry to trouble you old chap, but would you be able to do anything with this blasted watch? And he handed it over, and it was this big ol’ German thing, big as my head. Beautiful it was, a real precision piece. Lord only knows how he got it. Or how he lifted his arm when it was on. Anyway, he says to me he says The blasted thing’s losing time but it’s my lucky watch and I don’t want to fly without it. So I looked it over, but honestly I didn’t have the foggiest. I mean – half the time with dodgy instruments you just chucked ‘em out and replaced ‘em. Why they ever made me a technician in the first place is a mystery. So anyway, I give it back to him and I said Sorry squire! I think you’ll have to get it fixed in Berlin next time you’re over. So he took it back, and they flew out on a mission that night, and he never came back. And I think about that watch sometimes. I think if I’d have took it from him to fix, I’d probably still have it now. Not so lucky after all, was it?’
‘That’s quite a story.’
‘Don’t get me started,’ he laughs. ‘Change the record, that’s what Vera used to say.’
He seems to dip a little.
I tell him about Mr Burton, the guy who ran the corner sweet shop we used to go to on our way back from school.
‘He was this huge guy, big shining face, hardly any teeth, in a shopcoat with all the buttons straining and scuff marks down the front where he wiped the sugar off his hands. And used to stand at the counter with all these sweet jars behind him, rows and rows of them, breathing hard whilst we made our choice. Sherbet lemons, gobstoppers, aniseed balls, flying saucers – you name it. And whenever he weighed the sweets out from the jars, he’d pop one in his mouth. It was like: A quarter for you and one for me. A quarter for you and one for me. It was only years later I found out he was on the Burma railway. Just skin and bone when he got liberated.’
‘He was lucky to get out of that one,’ says Leslie. ‘Poor chap. It was a hard business, that’s for sure. He was probably just making up for lost time. Anyway – how’m I looking? A-one? Or a ticket home?’
And he gives his knees a vigorous rub, like he’s priming an engine or something, winding himself up, ready for action.