glove up

The good news? I’ve got the number to the key safe. The bad news? There are about a thousand of them, row upon row of squat black boxes trailing up the wall like mussels  on a quayside at low tide. Sometimes you get some detail, initials smeared on in nail varnish, a sun-bleached sticker or a smiley face painted on in Tippex, but in this case, they all look the same. The only thing to do is work through them methodically. I put my bags down and start at the bottom. Flip the rubber cover, punch the buttons, press the release catch. Nope. Replace the rubber cover. Move on to the next. Flip the cover, punch the buttons, press the catch. Nope. And the next. And the next. All the way up to the top. That doesn’t open, either.
Maybe I put the wrong number in. Maybe the number was written down in the first place.
I’ve just pulled my phone out to call the office and check when I become aware of an elderly man standing watching me in the lobby. I smile and wave the phone in the air – a mime that’s supposed to tell him that although I’m more than happy to stand there and phone someone to gain entrance, I’d also be happy to speak to him directly. He stares at me for so long that I guess I’d better go ahead and make the call, but just as the office answers he comes to the door and opens it. I ring off, put the phone back in my pocket and hold my ID badge out to him on its extendable line. He grimaces and draws back. It makes me feel a bit like Max von Sydow in The Exorcist. ‘The power of Christ compels you…’
‘Hello. My name’s Jim. I’m a nursing assistant, and I’ve come to visit one of the residents here,’ I tell him.
He pulls the door aside.
‘What am I supposed to do with all this?’ he says, gesturing to a great pile of plastic containers and cardboard trays, donated food of one sort or another, heaped up in the lobby.
‘Where’d it come from?’
He shrugs.
‘Well – is the manager here?’
He shakes his head.
‘I don’t know,’ he says. ‘She’s probably buried under this lot.’
‘It looks like nice stuff.’
‘Would you eat it?’
‘I’m okay, thanks. But maybe you should dig in. You might find something you like.’
He’s not convinced. I leave him standing there, staring at the pile of food as I walk up the stairs.

The corridor that eventually leads to Janet’s flat is guarded by two old women, standing chatting outside their doors. They retreat a little when they see me approaching.
‘You come to see Janet?’ says the first one.
‘I have, actually.’
‘Well she’s not in.’
‘She’s in hospital,’ says the second. ‘The amb’lance took ‘er.’
‘Did it? Oh! I heard she’d been discharged this morning.’
‘What – Janet?’
‘Yes.’
‘No.’
‘Oh. Well – seeing as I’m here, I may as well check.’
‘Suit yourself,’ says the first one.
‘You be careful,’ says the other.
I’m aware of them watching me as I reach the far end of the corridor and turn the corner.

* *

When I knock the door opens automatically. Janet is sitting on the far side of the room in her riser-recliner. She gives me a tired, queenly wave. I wave back, then put on my PPE in the corridor.

* *

Afterwards, I undress in the kitchen, bag and dispose of the waste, say goodbye, and leave the flat.
The two old women are still standing guard in the corridor.
‘Was she in, then?’ says the nearest.
‘Janet,’ says the other, helpfully.
‘Yes, she was.’
‘Oh. How is she, then?’
‘Bearing up…’ I tell her, and I tap my chest to illustrate.
‘Ye-es,’ the furthest one says, ominously. ‘It’s that corner virus, in’it?’
‘Actually – she was tested and was negative. So that’s a relief.’
‘Can I ask you a question?’ says the nearest.
‘Of course.’
‘I don’t mean to keep you ‘cos I know you’re busy.’
‘It’s okay.’
‘Why aren’t you wearing gloves?’
‘Well – I did when I went in. I put all the protective gear on, because she’s very vulnerable. But I took it off before I came out.’
‘I don’t mean with Janet. I mean when you’re just walking about the place.’
‘I don’t need to. So long as I’m careful to wash my hands and not touch my face I should be alright.’
‘Oh. That’s a shame,’ she says. ‘Only I like a man in latex.’

the hospice cat

Mac is sitting on the balcony, smoking a cigar. It’s so bright when I step out to join him I can barely open my eyes. We don’t shake hands because of the virus, and I’m careful to keep my distance, but even as we make the usual jokes we both know the strange quirk of this situation. It would matter to me if I caught C19, but not really to Mac. He’s been sent home to die, with a prognosis of ‘weeks’.

‘What a view!’ I say, sitting down on one of the wicker seats opposite, shielding my eyes.
‘I’ve missed it so much,’ he says. ‘I was going a little crazy back in that hospital.’

I’m not kidding about the view. The balcony overlooks a busy port area, stacks of lumber, pyramids of gravel, warehouses, through-ways, the deep waters of the quayside in contrast to the silvery-grey ocean on the other side. It’s eerily quiet, though. All the cranes and forklifts are parked up. No people, no ships. The pandemic has cleared the place. Even the seagulls look uneasy, gliding past, wondering where the change is, what it means.

I’ve been asked to find out what Martin needs immediately, with the longer-term palliative teams to follow. I was a little nervous coming to see him. It’s never clear from the documentation just exactly what the patient knows or has accepted about their diagnosis. You have to tread carefully, feeling-out the right approach. Martin makes it easy, though. From the outset he’s able to talk freely about the treatment options that gradually closed off to him, the hard decisions, the plan as it currently stands.

‘I don’t need anything for the minute,’ he says, blowing out another, luxurious cloud of smoke. ‘I’m getting by, taking it as it comes. I know it’s going to get harder but for the minute I’m alright.’
I tell him how the service works, how quickly we can get back in touch if anything changes.
‘We’re just on the end of the phone,’ I say. ‘A couple of hours and we’re back.’
‘That’s good to know,’ he says.

His family join us. We sit in a semicircle, squinting out over the silent dockyard.
‘They asked me whether I wanted to go to the hospice,’ he says. ‘But – n’ah! I’m not there yet. Maybe it’ll come, maybe it won’t. I’m not sure.’
‘You could stay at home, if you wanted,’ I tell him. ‘We’d have to change things round a little, nearer the time. Put in a hospital bed. Other stuff. It’s up to you. It’s so lovely here. And you’d have the nursing teams coming in to support you.’
‘Everyone’s been so good,’ he says.
‘But the hospice is always an option, too.’
‘I mean – it’s a nice place and everything,’ he says, leaning forwards and carefully knocking the ash from his cigar against the edge of the ashtray. ‘I went there for a bit a little while ago.’
‘What did you think?’
‘They even had a cat wandering about the place. The way they treated him, you’d think he was one of the consultants.’
‘Yeah! I’ve seen that cat! He’s hilarious!’
‘If you like cats. Which I do. No – I’ve got nothing against the place. But it’s just – I don’t know. You get chatting to the geezer in the next bed, and you think you’re dying. And the guy opposite. And the guy next to you. Stuff like that. It can really freak you out.’

He takes another toke on the cigar. A lone seagull wheels and turns overhead. And in the near distance, and further away, the waters around the dock, the sea running out to the horizon, every last plane and detail of it – everything – it all just crackles and jumps with light.

stand by your beds

Jack is sitting slumped on the edge of his bed, a huge brown dressing gown draped over his shoulders.

‘I’ll make more sense when I put my teeth in,’ he says. ‘Get ‘em for me, would you? Go through to the kitchen. Hard left. Over to the sink. On the window ledge, by the soap dish. You’ll find ‘em there. Give ‘em a rinse and I’ll bung ‘em in.’
It’s the fourth or fifth trip I’ve made to the kitchen. First it was a cup of tea. Then it was his slippers. He wanted a knife to open the letters I’d pulled out of the letterbox – but not the knife I brought through. He wanted his frame….

I find the teeth, soaking in an old yogurt pot. They look a little scummy, so I run them under the tap.

‘That’s the ones!’ he says, reaching out for them. ‘Jes’ a minute.’
He puts them in – an extraordinary process, his wrinkled mouth gabbling round the plates. It’s like watching an octopus trying to crack an oyster. Finally he gets the teeth into position,  then hands me the yogurt pot again.
‘Done,’ he says. ‘Put that back.’

I don’t mind his bossiness. There’s something about the way he gives all these orders, directly and without an edge, that makes it entertaining. Anyway, he’s had a hard time lately. Not only has he fallen over twice – once in the surgery, once at home – but now his boiler’s broken and there’s no heating or hot water.

‘Never mind that,’ he says. ‘Set that sofa back over there, would you? Not there. There!’

He used to be a motor mechanic and I can quite imagine him up to his knotty elbows in grease, a fag in the corner of his mouth, shouting something across a garage in the nineteen fifties. Something about a wrench.

He’s got so many wounds on his arms and hands it takes me a while to check them all and renew the dressings.
‘There!’ I say at last, tossing the last of the wrappers in the rubbish bag and peeling off my gloves. ‘That’ll get you through the MOT.’
‘You think?’ he says. ‘We’ll see!’

I take the trash out and bring him another cup of tea.
‘Put it there,’ he says. ‘Now – move the table closer. That’s it! Y’know – them girls’ll miss me down the surgery. I was supposed to go there today with my feet. Not that they’d have been open. Not with this virus flying about. You wait till till they hear what happened, though,’ he says, wrapping his horrible brown dressing gown more tightly around himself. ‘They’ll piss ‘emselves laughing.’

His old friend Sally has been keeping an eye on things, but she’s in her eighties, self-isolating, hasn’t been round in a while.
‘I don’t suppose I’ll see her for a few weeks,’ he says. ‘If ever. Did I tell you how we met?’
I’m writing the notes up, so I’m only half-listening when he tells me the story, a long and complicated affair that mostly seems to focus on a guy called Barry. I lose the thread and ask him who Barry is.
‘Oh never mind,’ he says. ‘It was a long time ago.’

The last thing I do before I go is make Jack’s bed up. These days he’s sleeping downstairs on a rickety put-you-up, something he’s adamant he doesn’t want changing.
‘I’m used to it,’ he says. ‘I know its ways.’
I make the bed as well as I can, shaking out the duvet, plumping the pillows, smoothing the bottom sheet, lining up the duvet and tucking it in the wall-side, putting his favourite tartan blanket neatly over the bottom half of the bed, then turning back the near corner so it’s ready. When I’m done, I stand at the head end and salute.
‘Military man?’ he says.
‘No,’ I tell him. ‘I thought about it once, but I’m no good at taking orders.’

next door’s dog

I’ve never seen such an old stair lift. It sits at the bottom of the stairs like a traction engine whose wheels have fallen off. It even has a hatch under the seat, which must be where the coal goes.
‘It was my husband’s’ says Maria. ‘Shame it’s broken. It means I can’t go upstairs.’
‘What about getting it fixed?’
She shakes her head.
‘The company went bust years ago.’
‘But surely someone somewhere would know what to do with it?’
‘I know exactly what to do with it. Throw it in a skip and start again. But I’m alright downstairs. I’ve got everything I need.’

I follow her into the living room, almost tripping over a metal milk holder with three pints in it that Maria has brought inside and put in the doorway.
‘Shall I put these in the fridge?’
‘Yes. Sorry, dear. That’s as far as I got.’

Maria is self-isolating, like the rest of our patients these days. She was discharged from the hospital after treatment for a chest infection, referred to us for ongoing care.

‘I do alright,’ she says, when I bring her through some tea. ‘I’m not as badly off as others. I’ve got two gay gentlemen living next door. They’re so lovely and kind. They do my shopping and what have you. Most mornings they knock on the door when they take the dog out. They’ve got this little dog, you see. Don’t ask me what sort it is. I’m not good with dogs. I pretend to be interested but between you and me it’s not that impressive. It’s fur sticks out all over the place and it has this odd, cross-eyed look, like someone clonked it with a frying pan. I wouldn’t trust it as far as I could throw it, but they seem to like it, which is the main thing.’

We chat as I check her over. She tells me about her husband, Jack. A small businessman with a big laugh, apparently.

‘Yes,’ she says. ‘It’s true. I married the boss. That’s him, there…’
She points to a photo in a frame: An elderly man sitting in a chair, Maria standing behind him with her arms around his shoulders, the point of her chin on the top of his head. The picture has stood in direct sunlight for so long the colour has faded. All the flesh tones have merged, leaving a blurry but strangely transcendent quality to their faces. Only the stronger patterns remain: the curve of Jack’s glasses, Maria’s auburn curls, the laces on Jack’s shoes.

‘I still miss him, all these years later,’ she says, carefully taking a sip of tea. ‘Maybe I should get a cat. What d’you think?’

a big change of scene

There’s something wrong with the lift. It only says Please…Doors when it arrives, and then Doors when they close. I press the button for the fifth, and wait. After what seems a longer delay than normal, the lift says Going – and we go. I stare at my fragmented reflection in the textured steel door, wondering if I should have taken the stairs.

Doors says the lift when we arrive. It doesn’t say anything when they close behind me.
I wonder if there’ll be a sign on it when I finish the consultation and come back. Existential Breakdown, or something.

When I ring Mr Turner’s bell the door slowly swings open on its automatic arm. The hallway is dark apart from a flickering grey light at the end of it.
‘Hello Mr Turner! It’s Jim – from the hospital!’ I say, and go through.

He’s sitting in a riser-recliner watching TV – an old, black and white war movie, Stanley Holloway in a soldier’s uniform, cockneying around a crowded kitchen making jokes about tea.
‘I like the old movies,’ says Mr Turner. ‘They’re always about something.’

Apart from a bookcase filled with DVDs, the chair he’s sitting in, an adjustable table and the TV, there’s nothing much else in the room. The only decoration on the walls is a framed, three-panel picture set of Donald Campbell and Bluebird – Donald smiling and posing with a team of mechanics around the boat; Donald waving from the cockpit; Donald sprinting across the lake.

After the examination I offer to make him some tea. The kitchen is as bare and functional as the living room. Whilst I’m waiting for the kettle to boil I notice a tea tray on top of the little fridge. It has two tiny plastic figurines in the middle of it: a workman in overalls, a commuter in a suit and hat. The detail is really good. The workman has a tiny wrench in his hand, the commuter an overnight bag. I’m guessing they’re from a model railway scene or something, although there’s nothing else in the flat to suggest it. They’re standing nose to nose, which makes it look as if the workman is about to hit the commuter with his wrench. If he did, maybe the commuter could use his bag to defend himself, buying enough time for him to leap off the fridge onto the kitchen counter (although he’d have to be careful not to land in the toaster). I’m guessing one of the carers found the figures somewhere and put them on the tray for want of anything better to do. Whatever the reason, to freak the carers out, I reposition the figures so they’re now standing shoulder to shoulder at the edge of the tray, looking out. For a moment I wonder what it says about us: the carers putting the figures nose-to-nose, me putting them shoulder-to-shoulder. Although, in my defence, all I really wanted to do was have a big change of scene, so the carers might notice. Which they probably won’t. You can worry too much about these things.

The kettle rumbles wildly, then clicks off. I make the tea.

‘How’s that for starters!’ I say as I go back into the room. ‘A lovely cup o’ Rosie Lee!’
But the mood in the film has changed. The camera is moving from one character to the next, everyone serious – even Stanley – their faces blurry in the old black and white lighting. They’re all leaning-in to an enormous fan-grilled radio, listening to something about Germans marching into Paris.

‘What?’ says Mr Turner.

the pigeons

Maria’s scream is more of a shock than the pigeons – although, admittedly, there are a lot of pigeons.
‘You see? Do you see them?’ she wails. ‘Argh! Look! It’s disgusting!’

Both houses have a small patio immediately outside the back window, then a few steps down into a sloping garden. Whilst Maria’s lawn is trim and well-kept, the one next door is wild and neglected. Maria’s patio has a neat, white coffee table and two chairs; her neighbour has a rough wooden bird table. The neighbour has covered the bird table in seed, then scattered handfuls more around the base of it. It must have happened just before I arrived, because suddenly the pigeons descend in a great, grey storm, a soft thundering of feathers and excited popping noises. They mass on the table and round the base, climbing over each other, pressing down, using their wings to balance and shoulder advantage, frantically trying to get to the seed. Flapping up. Settling again.
‘Do you see them?’ says Maria, pointing at the window. ‘Do you see them?’
‘I see them. There are quite a few. It must be annoying.’
‘It’s a health hazard! All the poo. The noise. Would you like it?’
‘No. I wouldn’t. Have you spoken to your neighbour?’
‘It doesn’t do any good. She’s not right – up here,’ says Maria, tapping her temple. ‘She wanders. She came to my door in her nightdress. I called the police. All they did was put her back to bed. Her family don’t want to know. Why don’t they take her away and put her in a home? I don’t see why I should have to move.’
‘Have you spoken to environmental health?’
‘Every day. What’s the point? Nothing ever happens. What’s wrong with this country? I work all my life. Build a home with my husband. And now look! He’s passed away and left me with the pigeons.’

I want to ask why she doesn’t draw the curtains on that side of the window, or move the chair so it’s not pointing so directly at the patio. But something about Maria’s expression, the gaunt intensity of it, one eye bigger than the other, the way she grips the arms of her chair so tightly her knuckles whiten, the way she flicks her head between sentences for emphasis, looking for all the world like some giant, hyper-vigilant bird – well, it makes me hesitate.

‘So of course, I fell over,’ she says, as if it was the pigeons’ fault. ‘So the ambulance came and took me down the hospital. Hours and hours on a trolley. Me with my back! And then this person – I don’t even know if she was a doctor or not – I couldn’t understand ‘em – she said she didn’t like the look of my eye, so she packs me off over the road to the Eye Hospital. And I was there for even longer. All these people – walking in, going in ahead of me. I was there first! For what? Five minutes and someone to tell me it looks alright to them. They didn’t even give me an x ray! So they put me in a taxi at four in the morning and sent me home. It’s a disgrace. You wouldn’t treat a dog like that.’
‘I’m sorry you had such a bad experience.’
She stares at the writhing heap of pigeons on the table.
‘You see them, though? Don’t you?’ she says, leaning forward and pointing. ‘You see the pigeons?’
‘I do. I do see them, Maria.’
‘Urgh!’ she says.

malcolm the robot vs. tina dreadful

Tina’s surname is Redmond but everyone calls her Tina Dreadful.

Nothing prepares you for her. Nothing. Not meditation. Not medication. Not prayer.

You’d have to say Tina is following her vocation. She’s raised nastiness to the level of art. Made rudeness a competitive sport. Transformed vileness and good ol’ fashioned meanness into a spiritual quest. She’s racist, sexist, casually abusive. She’s uncooperative, obstructive, distracting. Now and again she’s content, in the way that torturers turn off the loud television sometimes, to soften you up for the next onslaught. Mostly, though, she’s just a bully.

I defy anyone to visit Tina and keep their cool.

The Dalai Lama would stomp across the road and kick a trash can.
Mother Theresa would storm out of the front door, tear off her headdress, fling her sandals up at the window. (And then swear at you for tutting).
The Pope would hurry outside, kiss his cross, light a fag, jump in his Pope Mobile, and do a doughnut in the street in his hurry to get away.

Tina is on a slowly repeating cycle, a sine wave of sickness and degradation. On the downward phase she self-neglects to the point of ill health, gets admitted to hospital (when she’s so far gone she can’t protest); the deep-clean team goes in to steam-blast the floor, replace the bed, buy in new sheets and towels and so on; Tina gets discharged back with a package of care, and the whole cycle starts again. Over the years, Tina has left many tearful health care professionals in her wake. She’s had umpteen multi-disciplinary meetings between the council, social services, neighbourhood representatives, psychiatrists and police, but no amount of special delivery letters, no amount of signed contracts or verbal consents, have done anything to change her situation or her character. She does have mental capacity. None of this has been found to be an expression of mental illness. It’s just plain cussedness, and no-one seems able to do anything about it.

I met her daughters once. They were the loveliest, most caring women you could imagine. But they’ve lived so long in the foothills of this dark and forbidding personality they can only protect themselves as best they can, apologise, try to make amends, and wait for the next rockfall.

However, I have to say, now and for the record: Malcolm can handle Tina.
And I’ve finally figured out how he does it.

Malcolm is a robot.

Here’s what I think happened.

I think a scientist – mad or otherwise – sat in on one of the multi-disciplinary meetings. I think this scientist patiently listened to everyone moaning on about the latest awfulness, and then when things fell quiet, calmly got up, went to the door, opened it, and invited Malcolm in.

Malcolm is perfect. He’s average height, medium build. He has a hairless, wipe-clean head. He has cool, evaluating eyes and realistic hands. He speaks with great modulation, in phrases designed to advance understanding and minimise flare. He moves with economy – but there’s power there, too, on a graduated scale from 1: puncturing the film on a microwave meal or 2: kicking through a wall. His demeanour is gyroscopically monitored, one hundred and eighty degrees of equanimity and poise. And his battery is good for eight hours.

You might think it’s a bit extravagant to use a robot such as Malcolm in this banal social situation. But maybe this is a field trial. Maybe this is part of the stress-testing you’d want to put such a unit through before you send them off to recolonise Mars or something.

The fact is, he’s amazing.

And the reason I think he’s a robot? Two things.

1: When the other carers see that they’re down to visit Tina they wail and plead and do everything they can short of throwing themselves out of the window to escape having to go. Malcolm just smiles.

2: Reading his notes afterwards. He writes coolly, neutrally, with great measure. You get a sense behind his words of the vile language Tina is using, the awful tenor of the situation, but nowhere does Malcolm rise to it. He describes himself moving through the scene, relaying the facts with a detachment that borders on nervelessness.

But the biggest giveaway?
He talks about himself in the third person.

For example: The Carer suggested that Tina roll to the left a little so he might change the inco sheet. Tina declined to do this, saying that she did not want to. The carer pointed out the negative effect lying on urine soaked sheets would have on the integrity of Tina’s skin. Still, Tina declined to cooperate. The carer asked Tina whether she would like something prepared for lunch. Tina declined, saying there was nothing in the fridge. The carer suggested he look in the fridge. Tina said that he could if he liked, it was a free country. The carer looked in the fridge and discovered a microwave meal – sausage hot pot and dumplings. The carer presented this to Tina. Tina said she was sick of sausage hot pot and dumplings and she would rather starve. She then went on to describe issues she was having with her mobile phone, a Sim card problem the Carer was not able to resolve at this time. Tina made comment about this in a generally abusive manner. Tina then requested the sausage hot pot and dumplings be heated anyway, which the Carer proceeded to do. The carer made tea, which Tina declined in favour of pineapple juice. Then Tina said the tea was not sweet enough, and she required apple juice not pineapple juice, and not in that beaker. Then she spilled the tea and had to be cleaned up. The Carer then presented the sausage hot pot and dumplings in a bowl. Tina used many swear words when the Carer placed the bowl beside the bed, saying that ‘it was no good there, was it’ even though she could easily reach the bowl. The Carer took action to remedy the situation, and with nothing further to be accomplished, left the scene, all being well at that time.

We need more Malcolms.