I spy

There are four of us, strewn over our chairs like so much debris hung up on tree roots after the flood. It’s been a busy day, but unusually, we’re back in the office at the same time, all the admin and follow-ups completed, nothing else to do but sit and chat and think about going home. We’re exhausted; after a while the conversation dries.
‘I spy with my little eye…’ says Keisha.
‘Or drone,’ says Mel. ‘Gives it more scope.’
‘Okay then. I spy with my little drone… something beginning with…. S.’

‘A soaking,’ says Laurence. ‘I was standing outside the patient’s house, no shelter, no porch, not even a bush. And it started to rain. The patient was ages getting to the door, and then when they got there, they rattled the handle a few times, and they said I’ve just got to go and get the key. And went away again. By the time they let me in I was half drowned. You’d better take your shoes off she said. So I said I’d better take EVERYTHING off – but I heard myself as I said it, and she looked shocked, so I just said Joke and carried on. And then …. and then!… it turned out I wasn’t even needed. She’d seen someone the day before! I’d been double-booked!’
‘No,’ says Keisha.
‘Oh,’ says Laurence. ‘Suit yourself.’

‘Sandwich’ says Kerry. ‘Does anyone want my sandwich?’
‘Why? What’s wrong with it?’
‘It’s got avocado. I don’t like avocado, especially when it’s been sitting around.’
‘Who made your sandwich?’
‘I did.’
‘O-kay.’
‘I’ll have it’ says Laurence. ‘Thanks.’
‘Laurence, the human dustbin,’ says Vihaan.
‘It’s called survival,’ says Laurence, tucking in.

‘Saluki,’ says Barbara. ‘I met this gorgeous dog today. It was stunning. Absolutely beautiful. Like someone stuck a wig on a greyhound. It just followed me around with this sad expression, you know? Like it could see exactly what the problem was and how I was doing my best but really we all knew it wasn’t going to turn out well. It’s funny – I remember more about the dog than the patient. I could’ve sworn it showed me to the door when I was finished, shook my hand and said goodbye. So – Saluki.’
‘No,’ says Keisha. ‘Next.’

‘Syringe driver,’ says Anna. ‘I mean – how can you have a syringe driver, anticipatory meds, nurses coming in and out all the time, a hospital bed, everything, all the equipment, all the fuss and this and that – and still not know you’re dying? There’s a note on the system – very clear – do not talk about end of life issues with Mr Smith. And then what does he do? He goes and asks me, very directly. Why am I having all this stuff? So I just say to him, I say We-ell, Mr Smith… you’re really not very well. So they’ve given you this for the pain, this to make you feel more relaxed, this for your chest…. I think if you speak with your GP they might be able to tell you a little more. Okay darlink? I feel so bad doing it, but the note is very clear. Later on I speak with the district nurses and they say he does know he’s dying but he doesn’t like it to be acknowledged, you know? He doesn’t like it all out in the open, which make it more real for him. He freak out and can’t handle it. Which I can understand. It’s a freaky-scary situation, God knows. But I hate dodging the question like that. It’s not me at all. I prefer to be open about things. Especially scary things. But he’s not my patient, so…’ Anna shrugs, finishes her coffee in one gulp.
‘No,’ says Keisha.
‘Oh. Okay,’ says Anna. ‘Fuck you and your stupid drone.’

Keisha looks at Vihaan and raises her eyebrows.
‘I don’t know,’ he says, yawning, stretching, glancing across the desk. ‘Stapler?’
‘Yes!’ she says.
We all groan.
‘Shut up,’ she says. ‘It saw it during take-off, okay?’

at the very top of the street

You wouldn’t think people actually lived on this street. It’s one of the main thoroughfares, an artery of urban bustle, crowds spilling over the pavements day and night, drinking in the pubs and cafes, streaming in or out of the concert venue, staring in the windows of the chi-chi boutiques, taking selfies outside the old theatre, or crowding round the buskers who work the passing trade on the pedestrian cut-throughs. The street heads up at a shallow incline, diverging endlessly left and right, then gradually thins, and quietens, until it runs out of energy at the top, where a main road cuts across it at right angles, running from the station to the sea. Here the shops are more down-at-heel. There’s a second hand camera shop, an antique clothes shop, a tailoring and alteration shop, a shop for rent, all of them weathered and worn, their wooden facades peeling. The person who did the display in the window of the antique clothes shop – how long ago? – has opted for a nightmarishly whimsical look: a stuffed fox head tied into a hacking jacket; some tackle lying around, a few vacant toys, as if they’d given up trying and taken to lure customers in with appalled terror instead. I wonder if there’s anyone in the shop at all. Maybe they’re just behind the netting, holding their breath, staring at me as I cup my hand on the glass to see better.

Mr Lake lives in the flat above the tailoring shop next door. There’s a young woman sitting in the shop window, dreamily needling some trousers draped on her lap. She pauses with the needle in mid-air as I fetch the key from the keysafe and turn to open the side door. I smile and nod but she doesn’t acknowledge me; in fact, I don’t even see her lower the needle as I push the side door open.

The hallway is dark and cramped, the only light coming from a yellowing square of glass at the far end, and a single, winking point of red from the console of the electric scooter on charge. I can’t see a switch for any hall light, and there’s no room for me to put my bag down and find my torch, so instead I wait a minute until my eyes have adjusted, then slowly creep forwards past the scooter and piles of junk, onto the sagging carpet of the stairs, and head up
‘Hello? Mr Lake? It’s Jim – from the hospital.’
There’s a TV playing in one of the rooms overhead, a rowdy studio debate, raucous shouting and applause – which somehow makes the place feel quieter.
‘Hello?’
A toilet with no door on the first little landing, a twist to the left, a galley kitchen on the right with a glimpse of stacked plates and bulging plastic bags, and then up onto the top landing, where a heavy curtain has been nailed across a doorway.
‘Mr Lake?’
I hook the curtain aside.

Mr Lake is sitting on a high-backed chair, surrounded by boxes and cabinets, piles of old Picture Post and Hobbycraft magazines, crates of clocks and teasmades and novelty telephones. It’s difficult enough for me to find a way through all the mess, so I can’t imagine how Mr Lake manages it. But then, no doubt, he’s used to it all and it fits him pretty well, like a hermit crab making its shell from a tin can or a discarded doll’s head.

I’m here to dress a wound on his leg. It’s not easy, setting up a sterile field, though. I have to move a few things.
‘Temporarily!’ I tell him. ‘If I’d had a pound for every time I’d said temporarily….’
‘You’d have five pounds fifty!’ he says.
‘No doubt.’
We chat whilst I set up. He tells me about his life. How he used to be an engineer.
‘I was always good with my hands,’ he says. ‘Taking things apart, putting them back together, that kind of thing.’
‘That’s a great skill to have.’
‘It kept me fed and watered.’

I glove up.
‘Any family in the area…?’ I ask as I lean in to remove the old dressing. The smell is gacky – the cloyingly sweet smell of decay.
‘No. No family,’ he says, watching me drop the filthy dressing into the waste bag. ‘I was married for a while. But she left. Ran off with the best man. And one day he dropped dead at work. So she killed herself.’
‘Oh – I’m sorry,’ I say, changing my gloves. ‘That’s terrible.’
‘Ah. Well,’ he says. ‘She was always a bit up and down.’

When I’ve finished the dressing and I’m ready to go, I notice some framed pictures on the wall behind the TV.
‘Is that you?’ I say, pointing at the picture of a smiling young man in a smart suit and waistcoat, holding a scowling baby up to the camera.
‘No! That’s my mother!’ he says.
‘Your mother? What? This one?’
‘Where are my glasses…?’ says Mr Lake. He grumbles and fumbles around his chair, the glasses magically appear in his hand, he hooks them over his ears, then screws up his face and leans forward.
‘Oh. Yes. You’re right. That’s me,’ he says.
‘Who’s the baby?’
‘That one? No idea.’
Amongst all the other portraits is one of a young woman in a floppy white hat and wide-collared raincoat. It’s a posed, three-quarter shot, the woman staring sleepily off to the right, her eyes heavy, her mouth slightly open. The odd thing is, she has her right hand raised in mid-air, palm down, off to the side at shoulder height, as if she’s pushing through invisible undergrowth, or maybe working a marionette whose strings she’d dropped but didn’t think anyone would notice.
‘That’s her,’ says Mr Lake. ‘That’s my wife. She made that coat. The day I took the photo we’d gone out for something to eat. We were sitting in the cafe, and the owner of a fancy boutique came over, and he said Where did you get that coat? And she said I made it. So he said Why don’t you come and work for me! We need people like you.
‘And did she?’
‘No,’ says Mr Lake. ‘She didn’t.’

poirot wraps it up

Every now and again Geoff screws up his mouth at the side and ticks air through his teeth. It’s the kind of thing a builder or a mechanic might do before they quote for a difficult job.
Funnily enough, Geoff used to be a builder. He was active into his seventies, but then suffered a series of health problems, including a stroke that affected his right side, recurrent chest infections, and now his latest and most challenging problem, dementia. His wife Lena is normally home to look after him, but Lena’s been admitted to hospital with an MI – which is why Geoff’s GP has referred him to Rapid Response. Geoff’s dementia is low key at the moment, but he does get confused in the early hours, and has a tendency to wander and do dangerous things. We’ve been tasked to provide bridging care and night sitters to keep him safe until a regular agency can pick-up. I’ve come by to take some obs, see how he is.
‘I’m fine’, says Geoff. ‘I’m okay. C’mon! Feel that grip. No, no, not the right hand. The right hand’s the shite hand…’
His right is hooked over in a kind of claw, but his left is certainly strong.
‘Wow!’ I say. ‘That’s impressive!’
‘I was known for it,’ he says. ‘Now…’ He shrugs, makes the ticking noise again, then turns his attention back to the TV.
Poirot is wrapping things up, surveying a room of characters, building up to the big reveal. I don’t know who looks more bored – Poirot, or Geoff.
Behind the wide-screen TV is a wider-screen window, looking without interruption over the sea. It’s calm today, a clean, silvery slice of light. Dotting the horizon are several dark vertical lines – an offshore wind farm. I read somewhere they’ll provide the power for half the houses in the county. That’s a lot of houses. A lot of Poirot.
‘My son’ll be here later to take me to the hospital, says Geoff, cradling his bad hand. ‘I try to get over to see Lena most days. I know she worries about me.’
‘Have they said when she might be coming home?’
‘Nah! They keep changing their minds!’ he says. ‘Nobody knows anything!’ He turns his attention back to Poirot, so I do, too. The camera’s right on the detective, so tightly that his lugubrious face fills the entire screen. I half-expect him to look straight at us and say Ah! Monsieurs! But it is perfectly plain to me when Mrs Lena is to be discharged from the hospital. It will be next Monday. At approximately half-past eight. And YOU will be there to greet her!
Then wink, and curl his moustache.

Geoff screws up his mouth.
Tick.

a tumbleweed of barbed wire

If I was a comic I’d be dying on my arse. In a tiny, Thirties-themed, immaculately hoovered comedy club. Three people in the audience, two of them arms folded, stony faced, one of them smiling (the one with dementia).
It’s bracing, to say the least.

‘I’m not wearing a bra’ says the elderly woman.
‘That’s alright. Neither am I’
Tumbleweed.
‘Who are you again?’ says the son.

I’d been expecting an easier gig. I’d rung the first listed next of kin, a daughter called Louise. She’d been so chatty and friendly on the phone – sorry she wouldn’t be able to make it down today, she was caught up at the stables… not in a bad way… horses? who’d have them…. that kind of thing… but it was okay… her brother and sister in law would be over to meet me… thanks for ringing… thanks for everything, and so on.

Walking into the house was like walking into a wall. Made of ice.
‘So – what are you?’ says the son.
‘A nursing assistant.’
Assistant?’
‘Yes. Well – my official title is Assistant Practitioner. But everyone just thinks that means I’m a doctor. So I never call myself that – unless I’m ringing a surgery, in which case it helps get past the receptionist.’
Another tumbleweed. Probably the same one.
I can feel myself starting to sweat, even though the room is actually pretty cold.
‘Are you registered?’ he says.
‘No. But I’ve got a lot of experience, and the rest of the team are just a phone call away.’
‘I see.’
(I wish I was a phone call away. At the very least.)
‘What team?’ he says.
I describe the make-up of the response team. It sounds inauthentic, like I’m reading off an autocue.

I’m not sure which of them is tougher, the son or the daughter-in-law. It’s not good cop / bad cop. It’s bad cop / awful cop. I have a giddy, out of body experience, where my temporal body carries on talking, but my ghost unplugs, drifts over, raps on their foreheads, and finds – to no great surprise – they’re actually made of tin.

‘…so, we get referrals from the GP, the hospital or the ambulance, and we go in and annoy the hell out of people in the cause of making sure the patient is safe to be left at home.’
A tumbleweed the size of a small planet. I wish I could jump inside and roll away, like one of those big, plastic balls. Zorbing, is it? Geo Balls?

They’re staring at me.

I try to shake myself out of my funk and focus on the patient instead. That’s who I’m here for, after all. I have no idea why they’re being so hostile. It could be any number of reasons – they’re stressed to the gunnels about something, they’re annoyed they had to come out here instead of Louise, they’re angry with each other and taking it out on me, they’re terribly shy and it just reads as defensive – but frankly, I’m here for the patient, and anyway, she’s much warmer and more fun than they are.
I go through the usual routine of taking blood pressure and so on. I use all my best lines. The patient likes it, but Mr and Mrs Medusa just glare at me from the sofa.
‘I just need to take your hearing aid out so I can do your temperature,’ I tell the patient.
The son stands up.
‘Let me do it,’ he says. ‘They cost two thousand pounds.’
‘Thanks,’ I say. ‘I’m scared of those things.’
His wife snorts.
‘Don’t let him any where near them,’ she says, meaning her husband, thank god. ‘He left his in when he went for a swim in the sea.’
‘Oof!’ I say. ‘Apart from that – how was the holiday?’

A tumbleweed of barbed wire.

get it right

Mrs Heywood is ninety-seven but looks older. She’s lying in bed tucked up to her chin, hands gripping the quilt either side of her face, blinking anxiously and rapidly, like an ancient dormouse in a converted matchbox in an illustration by Beatrix Potter.
‘Please help me,’ she squeaks. ‘Phillip hasn’t been in. I can’t remember the last time Phillip was in. Not the carers, not anyone. Please help me.’

I might be worried – if I hadn’t passed the carers on the front door, just leaving, and if the carers hadn’t told me that Phillip had been in that morning and was due back at lunchtime. And even without those things, I would still have guessed Mrs Heywood was mistaken about things, by the warm mug of tea, cup of fresh water and plate of bourbon biscuits on the trolley by the bed, the newly-ordered and spotless shine of the commode, the neatly folded clothes on the armchair, the general air of everything having been done.
‘Don’t worry, Mrs Heywood. I’ll do your blood pressure and what have you, make sure you’re alright, then I’ll call Phillip and we can have a chat about things. How does that sound?’
‘I’m terribly ill,’ she says. ‘No-one’s been in.’
She’s so thin, I have to change the cuff for an infant size. Despite her frailty, though, all her observations are good.
‘Let me write it down before I forget,’ I say.
Mrs Heywood pulls the quilt more tightly about her, frowning and pouting, like a child who’d been put to bed for no reason, and I was writing a letter to the teacher or something.

Flipping through the folder I notice that her surname has been spelled in two ways – Heywood and Hayward. I ask her which is right. She levers herself up on both elbows, lowers her chin and fixes me with a severe expression: ‘It’s Heywood!’ she says. ‘H-E-Y-W-double O-D!’ Then, after a pause to satisfy herself I’ve received the information, she carefully lowers herself flat again, and draws the quilt back up to her chin.

Just then the front door opens and a man’s voice says: ‘Hello? Mum?’
‘Phillip!’ says Mrs Heywood, sitting up again.

A second later and Phillip clumps into the room. He’s a heavy, hearty-looking man in his mid-sixties, with a chin so square and scrubby he could kneel down and sand the floor with it. As he stands there looming over us in his vast fluorescent yellow tabard, dusty combat trousers and beaten Caterpillar boots – it’s impossible to think of Mrs Heywood ever giving birth to such a figure. We shake hands, mine getting lost in his hefty builder’s paws, calloused and capable, a grip that could dent a pipe.
‘I tried ringing you before I came but it just went to voicemail,’ I tell him, in case he’s cross I’m here without him.
‘Yeah – sorry about that,’ he says, swiping off his beanie and scratching his head. ‘I got the message, but reception’s terrible. Anyway – I was only working round the corner so I thought I’d pop in and catch you.’

After we’ve settled his mum we go into the kitchen to chat. His demeanour rumples a little when he talks about their situation. His dad died a couple of years ago, it hit his mum hard, her dementia’s getting worse. She’s got carers four times a day and Phillip comes in as often as he can, but he doesn’t think it’s enough. She’s up and down, often unhappy, doesn’t remember things. It’s becoming dangerous.
‘She’s had a few falls,’ he says. ‘The only reason she hasn’t hurt herself is ‘cos she’s so light it’s like dropping a feather. Thing is, all this time she’s always been dead against going in a home. Don’t you go putting me into one of them places she says. I’m not going into no old people’s home. But I can’t think what else to do. I know you can get live-in carers, but she wouldn’t want someone strange in the house. It was hard enough getting her used to the carers. It’s a worry, that’s for sure.’
‘Maybe you could try getting her in for a spot of respite. Just for a couple of weeks. See how she goes. My bet is she’ll settle right in. There are people there all the time, keeping her company and making sure she’s safe. There’s a lot of resistance to the idea of residential care, but it’s not what they think. She’d have her own room, nice n’ cosy, familiar things around her. I think she might like it.’
‘How do we go about doing that, then?’
‘There’s nothing to stop you looking around for yourself. Asking people for recommendations. But if you’re worried about the financial side of things I could always get a social worker to talk to you. This is more their domain.’
‘Could you? That’d be great. I just need to get a clear idea of where we are and what’s to be done.’
‘I’ll do it today.’
I start coughing. Phillip pulls out a packet of Fisherman’s Friends cough lozenges.
‘Try one of these!’ he says. ‘I swear by ‘em. When you’re outside all the time you need something with a bit of a kick.’
It certainly has that – and it stops me coughing.
‘I’ll tell you the best cold remedy,’ says Phillip, putting the packet back in his pocket. ‘Drop one in a glass of vodka. Sloosh it round. Down in one.’
‘A bit like sloe gin for builders.’
‘Something like that,’ he says.

After I’ve said goodbye and let myself out, I notice a huge lorry parked outside the house. On the side of it, in great, big, block white capitals: HEYWOOD & sons.
H-E-Y-W-double O-D

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.’