angela’s secret

Using the key from the key safe I let myself into the hallway. A steep flight of stairs rises up in front of me; Angela is waiting at the top. I wave, introduce myself.
‘I’ll put my mask and things on in the hall,’ I tell her.
‘That’s right,’ she says. ‘The other nurse did that.’
Angela watches me carefully as I tie on the apron and mask. She’s propped up on an elbow crutch, the light from the maisonette kitchen a bright halo of white around her. Her glasses are enormous – great pale circles – accentuated by her bouffant hair and red lips. It’s like being scrutinised by a species of giant domestic fowl.
‘All done? Good! Into the living room…’
Despite the crutch and her advanced age she vaults the second set of stairs and is well-ahead of me by the time I reach the top.
‘Let’s sit at the table in the window,’ she says. ‘You there, me here.’

I’m already sweating. The room has a close, two-dimensional feel, like the set of a sitcom. Every time I say something I expect to hear canned laughter – except, I don’t get much opportunity, as Angela has all the lines, limiting me to a few nods and uh-hums. In fact, she’s so chatty I have to talk over her to ask a question, apologising for my interruption each time.

I’ve been sent round on a mission to get some clarity. Angela had been referred to us recently for care support and a little physio, but the therapist who did the initial assessment found that actually there was nothing for us to do, and with Angela’s agreement, ended the referral. But then Angela had rung the office to ask where all the help was. It had proved too difficult to figure things out on the phone – for reasons that are now becoming clear – so I was asked to attend.

‘Apologies for being déshabillé. You wouldn’t normally find me waltzing around in a dressing gown at half past ten in the morning,’ she says. ‘But everything’s been so muddled lately. I have this condition you see. Not exactly narcolepsy, but near as damn. Chronic Fatigue syndrome? There are lots of names for it, but it’s really neither here nor there. Take last night, for example. I read through the paper and decided what I wanted to watch. A documentary. On whales. And I settled down in my chair – which isn’t nearly as comfortable as you might think – and I turned on the television set to enjoy it. Well – you see – the next thing I know I’m opening my eyes and it’s half past four in the morning! And I wasn’t just awake, but absolutely and completely awake! So I got up, made myself something to eat, and then sat here at this table, and decided to do the crossword. I had just opened the dictionary to look up a word – I can’t remember which one – but that doesn’t matter – the point is, the next thing I knew, I was opening my eyes again and it was nine o’clock! I’d simply put my head on the dictionary and pfft! The lights had gone out! Well of course this isn’t at all unusual for me. This has happened quite a bit. The doctors are flummoxed. They’ve run all kinds of tests and things but nothing seems to stick….’

I can feel my eyes becoming heavy, too. In fact, I can’t think of anything better than putting my head down on the dictionary and snatching a few hours myself.

‘…I was always a bit of a live wire,’ she says, then stares at me. I’m worried for a second I might have had a microsleep and started snoring, but the moment passes.
‘What did you do before you retired?’ I manage to say, pathetically.
‘Private secretary,’ she says, with a proud snap of her jaws. ‘To an extremely high-profile businessman.’ She taps her nose and winks at me.
‘Goodness,’ I say.
‘Yes. It was a different time altogether. I was on the go from dawn to dusk. Angela! my friends would say to me. Angela! What’s your secret?
‘And what was the secret?’
‘Oh – the usual! A steady nerve, a cool hand and sturdy boots.’

the switch

A high-pitched, whistling kind of voice picks up. I’m guessing it’s George’s wife – although I don’t remember reading in the notes he was married. She repeats the number like it’s nineteen fifty or something.
‘Two four two nine one six’
‘Hello. My name’s Jim. I’m a nursing assistant with the Rapid Response service at the hospital. I’ve been asked to come and visit George this morning. Is he there?’
‘Oh! I’m sorry, George! This phone line’s terrible. I can barely hear you. Let me move position…’
I hold the phone away from my face for a second, then bring it back again.
‘There! That’s better! How are you feeling today, George?’
‘Not bad, thank you. Excepting for this damned leg.’
‘Ah! Well it’s the leg they want me to look at.’
‘Do they?’
‘Absolutely. And to see how else we can help.’
‘That’s very kind of you.’
‘It’s a pleasure. I could be round in half an hour or so…’
‘Lovely. See you then.’


I park up on the estate and haul all my bags out of the boot. An elderly woman staggers past, walking a small dog at the furthest extent of the lead. The dog must have recently been showered or something because its fur sticks straight out all over. It drags the woman in my direction, produces a nose from somewhere, and begins sniffing my trousers.
‘He’s cute,’ I say. ‘Or she.’
‘She,’ says the woman. ‘Come on, Marilyn! Leave the nurse alone.’
‘She’s alright! She can probably smell my dogs.’
‘Oh!’ says the woman. ‘What sort?’
‘Lurchers,’ I say, patting Marilyn where I’m guessing the top of her head would be.
‘I love lurchers!’ says the woman. ‘I used to be a volunteer walker at the shelter. Before my hip.’
‘That’s a nice thing to do.’
‘We got up to all kinds of mischief. Mind you – life’s not boring with Marilyn, either. Is it? Hey? Is it?’
She hauls on the lead, and then rolls onwards, rocking from side to side like her legs were on retractable springs.


George opens his flat door and stands there watching as I put on my PPE.
‘I’ll be glad when all this is over,’ I say, hooking the mask round my ears.
‘I hope you won’t get too hot in all that,’ he says. ‘Only I put the radiators on to dry my pants.’

It certainly is hot in the flat. George is in his nineties and doesn’t seem to feel it. He is tiny and frail, perfect, in a bloodless kind of way, immaculately dressed in black slippers, sharp-creased slacks held up by braces and a shirt buttoned to the neck. George’s front room is equally squared-away, spectacle cases in a line on the table, neat piles of letters and things, pencils and biros in size order, and a stack of socks so well-ironed they look fresh out of the box. There’s not much in the way of decoration. A simple cabinet with a few photos and things, a couple of old model locomotives, two campaign medals in a display case, a television, a copy of the Radio Times, and then draped over the radiator under the window, a line of baggy white pants.

‘Excuse the mess,’ he says, then carefully lowers himself into his chair.

We chat as I work. He tells me what Hamburg was like in the months just after the war.
‘Everyone scratching around. Using whatever they could. It’s terrible, what people can do to each other.’

After the war he worked on the railways, first on the track, then as a driver, then as one of the station staff. After he retired he made model railways, the scenery and buildings and things. I imagine him hunched over a bench, working on the tiny scenes with a pot of enamel paint, staring through a bendy magnifying glass, his eyes huge and intent.
‘I used to sell them,’ he says. ‘Kept a few for myself, of course. But then when I moved here I had to get rid of them.’
‘That’s a shame.’
‘Well,’ he says. ‘One learns to adapt.’


Back out in the car I think about George and his model railways. It makes me think of a short story I read a long time ago. It was called ‘The Chicken Switch’ or something. It was about a journalist who interviews a guy who’s just about to go inside an underground box for a month. As a stunt. And later the journalist suffers terrible claustrophobic panics – almost loses his mind. Until the underground guy gets exhumed, steps out, looking perfectly fresh and relaxed. The journalist asks him how he did it, and the underground guy says he has this trick. Just before he goes into a situation like that, he mentally switches places with the last person he talked to. At least – I think that’s what happens. He transfers his stress and anxiety onto that person.

I can imagine George doing something similar, switching places with one of his station figurines. I wouldn’t mind betting there’s a model railway somewhere, a perfect thing, with trees and barns and cows and people waiting with their bags on the platform. And the station office, with a tiny little George staring contentedly out of the window, every detail perfect, the shiny black cap, the mug of tea, the chain of his fob watch, the medal on his jacket, standing securely on his plastic base that only rocks a little as the giants come thundering up the stairs again, and the lights come on, and the transformers crackle and hum, and the trains start rolling  again, round and round the track.

Frank’s nest

Sixty years ago, when Frank was a young man, he worked in the shipyards, on the cranes. At least, I think he did. He’s got such a strong Geordie accent, and speaks in such a slurred and rumbling kind of way, it’s impossible to be sure. There’s a half empty bottle of whiskey tucked discreetly on the floor behind his legs, too, and I’m sure that’s not helping things.
The kitchen is oppressively hot. I’m wearing full PPE. My apron feels so tight I feel like a big, blue sausage beginning to squeal under the grill.
‘Ah’ was fitter in them days,’ he sighs, staring out of the kitchen window. His little flat is on the uppermost floor of a converted house, with plane trees so close to the front it’s as if we’re sitting in the cab of a crane high over the street. ‘I didn’t gi’a shit about nuttin’!’ he says, swatting the air with his good hand. ‘Ah was scamperin’ about like one of them squirrels there. Ah used ta stand wi’ ma legs on the girders, swingin’ ma’ hammer, snakin’ out the wire…it was like ah’ was buildin’ a big nest for meseln’ in the sky.’
‘Wow,’ I say, wiping the sweat from my forehead with my arm. ‘That sounds amazing!’
He stares at me for a second, like he’s trying to get me in focus.
‘D’you mind if ah’ smoke a tab?’ he says, reaching for his tin.
‘Could you wait a bit, Frank? I’m almost done.’
‘Oh. Okay.’
He pushes the tin back, and sighs again.
‘I can open the window if you want?’
‘If yer don’ mind.’
It feels good to let the air in. Frank closes his swollen eyes and turns his face in the direction of the breeze. He had a fall in the kitchen a couple of days ago. Got taken to hospital and kept in for observation. To look at him you’d think he’d pitched head first out of the window. Livid purple bruises distort his eyes and face, there’s a steri-stripped laceration to his forehead, a bandage on his hand.
‘Ah’m sick of it,’ he says, opening his eyes and turning to look at me again. ‘Sick of it! Ah jes’ don’t want to go on, to tell ya the truth.’
‘I’m sorry to hear that, Frank. It’s understandable, though. You’ve got a lot on your plate. Do you want to speak to one of our mental health nurses about how you feel?’
‘Nah – what’s the point?’ he says. ‘Ah’ll jes’ carry on as I am, thanks very much. Tess’ll be in later wi’ ma things.’
I imagine her labouring and cursing up the six steep flights to Frank’s flat, shopping bags filled with microwave meals, fags and whiskey.
On the wall behind him is a calendar with a picture of a Matchless motorbike, one of the small, single cylinder machines, drop handlebars, bucket seat, cafe racer style.
‘Nice bike’ I say, nodding at the calendar, then wiping my forehead on my arm.
‘Ay’ he says, turning stiffly in the chair.
‘Did you ride?’
‘Whey aye! Ah tell ya, man – I was that fast – I’d be there a’fore I left.’

about george

I’d met George a few times in the past, so I had my doubts.

‘You have to take him,’ said Lyra, the manager of the rehab unit. ‘He’s been here six weeks and it was only supposed to be a couple of days.’
‘But you say he’s hoist only now?’
‘In that house?’
‘And it’s been cleared? It was so tiny and cluttered. You’ve actually managed to fit a hoist and a commode in there?’
There’s an ominous pause.
‘Yes,’ she says. ‘I wouldn’t be sending him home, otherwise. Would I?’

The conversation hadn’t started well.

George had been referred to us for an initial assessment. I’d phoned the unit to clear a couple of things up. When the first person answered I went through the usual spiel: Hello. My name’s Jim. I’m a nursing assistant from the Rapid Response team. I’m just calling to find out about George’s discharge today.
‘Oh. Hold on. You need to talk to another nurse.’
She put the phone down on the desk without muting it, so I could hear her calling out (although the other person was too far away to hear): I don’t know. Some guy asking about George…. I don’t know what he wants…. Why don’t you speak to him?…. Well where IS she?…..
Then some general clattering, muttering, background noise. Laughter. Eventually someone else picked the phone up from the desk.
‘Hell-oo?’ she said, in that drawn-out, slightly hesitant voice you might use for a sales call or worse.
‘Oh – yes – hello! My name’s Jim. I’m a nursing assistant from the Rapid Response team. Sorry to bother you. I’m just calling to find out about George’s discharge today.’
‘George Masters.’
‘No. Who are you?’
‘Me? I’m Jim. Nursing assistant. Rapid Response Team.’
‘Just a minute…’
She puts the phone back down on the desk, again – without pushing the mute button.
I don’t know. He says he’s a nursing assistant called Jim. Asking about George.
There’s some toing and froing between the two, then she picks the phone up again.
‘What is it you want exactly?’
‘Well – two things. One is that on the discharge summary they give an address that’s different to the one we’ve got. So we need to clear that up. And the other thing is to find out what time he’ll be home.’
‘Just a minute…’
She does the same thing. This time, I’m waiting for five minutes, hanging on the phone, listening to all the traffic and fuss of the unit. Just as I’m about to hang up and call again later, the phone gets picked up by someone else.
‘Hello. Erm. Yep. My name’s Jim. I’m a nursing assistant from the Rapid Response Team. Erm.. can I ask who I’m talking to?’
‘My name’s Sheila. How can I help?’
‘Are you a nurse, or …’
‘Yes – I’m a nurse.’
‘Great! Do you know about George Masters?’
‘What about him?’
I take a breath, then go into the two things I need to know about George so we can be there to do the initial assessment.
‘You need to speak to Lyra,’ she says.
‘Who’s Lyra?’
‘The unit manager… LYRA…!’ she shouts, so loudly I have to lean away from the receiver. She slams the unmuted phone back down on the desk.
Another five minutes.
Eventually the phone gets picked up again.
‘Hello? Lyra speaking?’
‘Hi Lyra. Can I just say, before I go on – I’m not all that happy with the way this phone call has gone. I’ve spoken to three different people. They’ve all put the phone down without even muting it, so I can hear them shouting across the unit…’
‘Don’t get clippy with me,’ says Lyra.
‘I’m not clippy, I’m just saying…’
‘I don’t appreciate your tone…’
‘All I’m saying is that it’s been really frustrating ringing your unit today….’
‘We’re busy. What d’you expect?’
‘Everyone’s busy.’
‘I think you need to look at the way you speak to people. Who did you say you were?’

We struggled on with the conversation, but by the time I hung up I was sweating more than a pilot who’d spent half an hour fighting to stop a plane crash.

‘So – when’s he home?’ said Anna, who was due to handle the initial assessment with me.
‘She’ll call me,’ I said. ‘Maybe.’

To be fair, from that point on Lyra was more amenable. I think it was because she was desperate to discharge George, who’d been a disruptive presence on the unit, constantly ringing his button, throwing tissues everywhere, generally playing up. I’d met George before, of course, and I knew he could be difficult. But when I’d known him he was still at home – a tiny, cluttered house with a kitchen whose ceiling was halfway down and whose downstairs toilet was so unspeakable you wanted to clean it up with a flamethrower. He had a cute dog, though – a perky little brown and white Jack Russell called Lily, so it would be nice to see her again.
‘I’m sorry about the way the phone call went,’ said Lyra. ‘We’re completely rammed here, as you can imagine. And I’m having to get by with agency nurses, and they don’t know the routine.’
‘That’s okay. I’m sorry if you thought I was clippy.’
We laugh about it.
End the call.

Later that day I’m sitting in George’s front room. We’ve just hoisted George from the wheelchair onto the hospital bed, but already he’s talking about putting himself on the floor because ‘it’s too early for bed,’ even though he couldn’t sit in a chair without three feet of rope and a crash mat. The neighbour who we were told would be coming round with shopping and generally keeping an eye on things is actually self-isolating and not leaving his house. To add to the woeful picture, we’ve just found out the boiler doesn’t work. Our team have been asked to provide bridging care four times a day, but even so you couldn’t say with any confidence that George would be safe between calls. He really needs some kind of residential facility. Still – at least Lily the dog has been rehomed.

There’s nothing else for it.
I ring Lyra.
She answers.
I tell her the situation.
There’s an ominous pause…

The nightlife of Berlin

‘How are you getting on, Jorge?’
‘Fine. I’m just finding somewhere to park. I won’t be a minute.’
‘See you in a bit, then.’
I put the phone back in my pocket.
Take a breath.
Lean against the railings.
Look around.
I can’t see Jorge’s car, though, which is odd. There’s a clear view up and down the road, and of the D-shaped green just opposite.
I wonder if I’ve got the right address.
I have a sudden feeling of dislocation. Everything seems unnaturally still, like I’ve wandered into an old plate photograph in the short walk from my car to these railings. But instead of a frozen horse and cart, a geezer in a bowler hat, a woman in a hooped skirt and bonnet, there’s a guy in a T-shirt sitting in his van staring at the front door where he dropped his tray of groceries, and across the road, a man in white surgical gloves staring at a rack of rentable bikes.
I wait.
Re-shoulder my bag.
Look around some more.
I can’t see Jorge’s car anywhere. Maybe I have got the wrong address.
I ring him again.
‘Yes, yes. I’m just coming. Look! I can see you…’
But I can’t see him!
It’s peculiar – then, suddenly, bursting through the paper of the photograph, there he is, waving his phone in the air from the centre of the grassy D, and everything comes back to life. The delivery driver slams his door and moves off. The guy begins wiping down the saddles of the bikes.
‘Have you been here long?’ says Jorge.
‘Hardly any time.’
‘Come on. Let’s see if he’s in this time.’

We’ve teamed up for the assessment because there’s a safety caution both for Gary and the address. Gary had suffered an injury to his leg and gone to A and E, but it was obvious from all the collateral noise around the referral – emails between the hospital, surgery and social services – that no-one knew what to do with him or felt able to take responsibility. Gary had such a long history of non-attendance, non-compliance, non-cooperation, non-everything, you’d think it would be easy just to type NON in big red caps on his notes and leave it at that. Except Gary wasn’t quite so definitively NON that he wouldn’t stop presenting at the hospital complaining he couldn’t cope. As a last resort he’d been referred to us. We’d tried over the last few days to get in touch with him, but he didn’t answer the phone, didn’t reply to messages. Then his phone was switched off. None of his other contact numbers worked, or the people who did answer either knew where he was and didn’t want to say, or didn’t know, or didn’t care, or all of the above. A couple of days ago a therapist had let themselves into his flat with the keysafe, but there was no-one in. The next day there was no key in the keysafe.
Today’s visit from Jorge and me is the last throw of the dice.
I ring the intercom.
And again.
And we’re just about to turn round and leave when it crackles into life.
Come up he says. Make sure you put your masks on.

Gary looks a bit like Eddie Vedder from Pearl Jam – or would do, if Eddie Vedder had spent the last thirty years shooting up, smoking crack and eating chips. He stands unsteadily at the flat door, an unlit joint clamped in the corner of his mouth, his puffy eyes squeezed shut like a sick and denuded mole coming up for air. He’s naked, except for a threadbare dressing gown and a velcro support boot.
He waves his hand in the air.
‘Come on in,’ he says.
We rustle after him, stand hopelessly in the middle of the room as Gary waddles to the sofa and eases himself down into it.

These days we have to gown and mask up for every patient – to protect them as much as us. And normally I hate it. Not only is it uncomfortably hot, but it also acts as a barrier to that open, human interaction you depend on so much to get things done, move things on. Now I’m glad of it. The room is as fetid and unkempt as Gary, ropes of old spider web hanging down so thickly you could jump up and swing from one side of the room to the other. There’s a case of beer on the kitchen counter, scatterings of pill packets, smoking gear, not much else. The TV looks like it’s been punched off.
‘Hello Gary,’ says Jorge. ‘You know – everybody’s been trying to get hold of you.’
‘Before you start,’ says Gary, shakily hooking his lank hair to one side. ‘Before you have a go, I’ve just got to do this. Alright? I’m breathless. I need to do my puffer. Okay? Is that okay?’
‘That’s fine,’ says Jorge. ‘You need to take your medication. We can wait a minute.’
‘Thank you,’ he says.

There’s a glass coffee table in front of him. On it is a spacer device with an aerosol of beclomethasone in one end, a glass of water, a mug of tea and a DVD of a guide to the nightlife of Berlin. Gary picks up the spacer device, gives it a shake, squirts the aerosol, puts the business end of the device in his mouth, and starts breathing through it, slowly and deeply, for five goes. Then he lowers the device. Gives it another shake. Another squirt. Puts it to his lips, repeats. When that’s all done, he gently and reverently puts the device back on the table.
‘Good. Well done,’ says Jorge.
Gary holds a finger up.
‘Just a minute,’ he croaks.
He picks up the water, takes a mouthful, puts the glass back down, leans back on the sofa, tips his head, and begins to gargle – a long, deep sound, like a lumpy old British motorbike. It seems to go on forever. Me and Jorge exchange looks over the line of our surgical masks. Gary takes another sip of water. Repeats the gargle. Swallows loudly.
‘Better?’ says Jorge.
‘Just a minute. Please. Just a minute,’ says Gary.
He takes the tea – very slowly – and takes a sip of that. Then he takes the DVD of Berlin and places it on top, to keep the tea warm.

A man appears from a room just behind us. He’s as grey and ruined-looking as Gary, except longer in the body, more stooped.
‘I’ll keep outta your way,’ he says, and ducks back inside.

‘So – Gary!’ says Jorge, clapping his blue gloved hands together. ‘You’re a difficult man to get hold of. Why didn’t you answer your phone when we’ve been calling?’
‘I was in too much pain.’
‘Yes – but – you see, if you don’t answer your phone, we start to get worried. One day you weren’t even in the flat.’
‘I’d gone out.’
‘Of course. But then the next day there was no key in the safe.’
‘I told you. I was in too much pain.’
‘But when we can’t see you we start to worry. And then we think about calling the police.’
Gary opens his eyes and looks straight at us – but then lets it pass with a shrug.

Jorge starts trying to explain to Gary who we are and what we do as a service, but Gary already has firm ideas. He doesn’t want physio or nursing – he knows his own body. All he wants is a carer to come in every day to wash his good foot, and maybe give his foreskin a freshen-up with a personal wipe.
‘Excuse me? Your what?’
‘My foreskin!’ says Gary. ‘You know… down there.’
‘Well! I think you can do that for yourself, can’t you?’ says Jorge. ‘I mean – for goodness sake! You need to be as independent as possible.’
‘Where’m I gonna get the wipes?’
‘From the shops. Any of the supermarkets round here will sell them.’
‘They haven’t got any.’
‘How do you know?’
‘Because Stu does my shopping.’
‘Is that Stu in there?’
‘Yes. But he’s not there all the time.’
‘But he is there some of the time.’
‘So maybe Stu could buy enough for the week when he goes.’
‘I just told you. They haven’t got any.’
‘It’s not the sort of thing we do, I’m afraid, Gary. We’re an emergency service. We have to look after very sick and vulnerable people. People who don’t have other people around them to help. You’ve got Stu. So that’s good.’
‘What you’re saying is, basically, you can’t do nothing for me?’
‘On the physio side, maybe. Do you have a support worker?’
Gary shakes his head.
‘That’s gone, now,’ he says. ‘That’s all finished.’
‘I’m sorry to hear that.’
Gary bristles.
‘If you’re not going to help me with the things I need, then what use are you? Just get out.’
‘Okay. That’s fine, Gary. We will go. And we’ll refer you back to your GP.’

Back outside, the air is wonderfully cool and fresh.
‘What a complete waste of time,’ says Jorge. ‘I think he was playing some kind of stupid game with us. What do you think?’
‘He was using that spacer device like a crack pipe.’
‘Yes! And my God – when he started gargling like that! I didn’t know where to look!’

A young couple pass by on the pavement, both of them hugging cardboard boxes of supplies. There’s such a tangible air of competence and vitality and neighbourliness about them I can’t help smiling.
‘Where did you park?’ I ask Jorge.
‘Over there! Under that tree!’
‘Let’s walk together!’
So we do.


Staff always joke about the Q word. It’s the community health team equivalent of saying Macbeth in the theatre – a witchy guarantee things will go wrong. But you don’t need to say it’s Q. It’s so Q you can see it. Q has settled over the office like a snow drift, a fog, a magic spell. It’s so Q I can hear the birds outside – although that’s not saying much; the seagulls are lined up on the roof opposite, a raucous, white-throated Chorus of the Apocalypse.

I’m helping the coordinator again, but it’s so Q I’ve even got time to catch up on my e-learning. Unfortunately there’s quite a backlog. I yawn, scrolling through the ones remaining: Adult Safeguarding Level 2; Fire Safety Level 1; Record Keeping; Information Governance… not attempted; not attempted; not attempted… a Sisyphean task, except Sisyphus has been taken off boulders and sat in front of a laptop instead. Immediately nostalgic for boulders.

Grace is suddenly standing next to me, in a diffident, two-metreish kind of way.

Grace is well-named. She’s one of the senior OTs, a therapist whose skill and experience is only exceeded by her great poise and humanity. I’ve never seen her cross or grumpy or out of sorts. She has such an unassuming strength about her it’s positively saintly. I can imagine her standing in the path of a tornado, holding her hair out of her face, smiling so sweetly and directly at the funnel it would immediately pipe down and wander off to kick through some leaves.

‘Sorry to interrupt,’ she says. ‘I just need to book a follow-up visit for that patient I went to see.’
‘Who’s that?’
‘Well – he’s down on the system as John Smith, but he likes to be called Frank Brandenburg.’
‘I know! It’s quite strange, but there you are.’
‘Frank Brandenburg? Sounds like a seventies detective. Brandenburg? You’re off the case. I want your badge and your gun.’
‘I think I’d rather be a Frank Brandenburg than a John Smith. Although John Smith is quite anonymous, I suppose.’
She waits with her papers.
‘What’s the story with the name, then, Grace?’ I ask her as I finish off the booking.
‘I’m not sure. His friend was there and they were both – how can I put this? – a bit unusual. I get the impression there’s some kind of street history there that might be interesting to go into if you had the time. He’s got a lovely dog, though.’
‘Oh yeah? What sort?’
‘A lab-collie cross. Although – who knows? It’s probably really a chihuahua.’


It’s the end of the day. The window by the coordinator’s desk is all the way open, and a sultry breeze drifts in off the corrugated metal roofing of the document storage shed next door. I’ve been helping the coordinator through most of the afternoon, answering the phone, processing referrals, sorting out problems. It’s had its manic moments, as it always does, but mostly it’s been eerily quiet. I’ve heard the phrase ‘the calm before the storm’ a few times now. It almost makes me want the storm to come, just to get it over with. I don’t think I’m alone in that.

Ethan, one of the senior nurses, has come back to the office after sending his last patient back into hospital.
‘They’re shoving everyone out, regardless,’ he says. ‘I know they’re supposed to clear the decks for the C19s, but seriously? I wouldn’t be surprised to see a whole herd of them wandering along the prom pushing drip stands.’

Ethan has a fantastic way of saying these things, raising his eyebrows, staring at you for a second with wide eyes, then dropping his jaw, rocking back in the chair and laughing energetically. He’s an experienced nurse, with a background in so many areas of acute medicine – sexual health clinics, A and E, ITU and so on – he’s definitely earned his stripes. He’s a great person to talk to about the pandemic, because as well as all his knowledge and experience and great love of nursing, he has an impish sense of fun that leavens the seriousness of the whole affair and makes it less overwhelming.

So, of course, after a little while talking about the strange businesses of viruses, whether they’re living things or not, the alien way they’ve evolved alongside mammals, we soon move on to some of the other weird organisms he’s come across.

‘The Sexual Health Clinic was good for that,’ he says, one leg crooked over the other, idly tracing the arched line of his eyebrow with a fingernail. ‘I saw some weird things there, I can tell you. There’s one called Trichomonas vaginalis. It’s this ‘orrible little protozoan parasite that lives in the vaginal tract or the urethra. Men can get it but it’s mostly women. Anyway, it’s a disgusting little thing. Shaped like a pear with these flagella whipping about. Lives on scraps of dead cells, causing infection. I saw one under the microscope. It looked happy enough, swimming around on the slide. I think it actually saw me.’ And holding on to the back of the chair with one hand, he suddenly tips back, sticks his legs out and kicks them like he’s doing the backstroke at the pool, waving up at himself looking down through the lens of the microscope. ‘Coo ee!’ he says. Then he straightens again. ‘We had one woman come in. She said she knew she had a dose and had been trying to cure herself.’
‘I hate to ask – but – how?’
‘She’d been rubbing her fanny with raw hamburger. You know – to tempt them out. To tempt them out!
He stares at me for a second, then laughs.
‘It’s true, though!’ he screams. ‘Honest to God! I’m laughing, but it’s true!’

buckeye bev

‘Here I am, mate. In ‘ere. The Top Shed.’

I have to say, Eric looks quite content despite his condition, laid out on the bed long and straight as a railway sleeper, his head elevated on a bank of pillows, his gnarled hands coupled across his belly.

I’m wearing full PPE, so I rustle as I come into the room, waving like a friendly alien.
‘Oh – watch out!’ he says.

If I didn’t know Eric used to drive steam trains, I could’ve made a reasonable guess. It’s not just the memorabilia all around the room, the plaques and models, the faded black and white photos of men in overalls or civic chains, leaning in to shake hands against a background of gigantic engines and so on. It’s that taking him all in – his nineteen fifties black frame spectacles, the gap in his front teeth for holding his pipe, the deeply grooved lines in his face, sculpted by miles of cinder track, years of squinting out of side windows at a hundred miles an hour – well – he absolutely looks like one. All he needs is a neckerchief and a cap. And if it’s true the chassis has been somewhat reduced by age and illness, still it looks like there’s plenty of coke left in the firebox.

‘How are you bearing up?’ I ask him, setting my back down and smiling over the top of my mask.
‘Oh I’m alright!’ he says, cheerfully. ‘It’s you lot I worry about. What a time, eh?’
‘Tell me about it.’

We chat whilst I carry out the examination. He tells me about his long years on the railway, the different places he worked. London. Abroad.

‘’Course – it’s changed a lot now. There’s a lot more women drivers, for a start. Which is a good thing! We always used to have ‘em, of course, but not so many. I remember one ol’ gel. We called her Buckeye Bev. She was funny, she was. And strong? She was stronger ‘n me! She could put her shoulder under a coupling chain, lift it up, and lift the hook with her hands. You should try it sometime. It’s not easy!’

As if to demonstrate, I bend down to fetch something out of my bag. The masks we’ve been issued with are so flimsy and hopeless, it actually unhooks from around my ear and swings free of my face.
‘Oops!’ I say, straightening up again and putting it back in place. ‘Sorry! I’m like some kind of nursing clown.’
‘You’re alright,’ he says. ‘Don’t worry. I don’t reckon I’ve got this thing.’
‘Trouble is, without testing we’ve got no idea.’
‘Why in’t they testing, then?’
‘Who knows, Eric? I don’t think they’ve got the stuff. They test people in the hospital. But so far, out in the community, there’s not much happening. They’re trying to ramp it up. There’s just a shortage of kits.’
‘Poor planning,’ he says. ‘As per usual.’
After I’ve taken his blood pressure he straightens the sleeve of his dressing gown and laughs, a deep and wheezy chuckle.
‘Buckeye Bev!’ he says. ‘Blimey! I hadn’t thought about Buckeye Bev in forty years, and there she is, plain as I see you, uncoupling an engine with her bare hands. I tell you what – she was something else!’

My mask rides up when I smile.

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?’
‘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.