sketches

a ceramic pelican

~ jim clayton ~ Leave a comment

The muddled wave of sycamore trees growing up along the embankment at the back, the viaduct rising high above the houses in a straight line to the heart of town, the shuttered pub on the other side of the road, the makeshift garage with the stack of tyres and the rusting car up on blocks – everything conspires to give this street a neglected, backwater feel.
I’m meeting up with Magda for a joint visit. There’s been a safeguarding raised against Bob’s wife Geena. We’re here to support each other, to see how he is, how things are today.
‘Jimmy boy!’ says Magda, tossing her hair back and holding it in place with her blingy sunglasses. ‘S’up?’
We talk a little about the situation before we knock.
‘I doubt she’ll even answer the door,’ I tell her. ‘Did you read the notes? She’s been turning everyone away. Going mad. And even when she lets them in, she abuses them and throws them out pretty quick.’
‘Sounds like my kinda girl.’
‘The social workers are on the case.’
‘Well!’
‘She even swore at Pete the physio and threw him out.’
‘Peter? Man! That’s like being cruel to puppy.’
‘I know! So – I’m not sure how far we’ll get.’
‘You want me to go first, Jimmy? It might be dangerous.’
‘Okay.’
‘Okay.’
She goes up the steps to the front door and knocks, heavily, like a debt collector or something. We wait a while. She knocks again.
I’m just about to lean over the railings and peer through the front window when the door unexpectedly opens.
A sixty year old woman dressed in a hornet stripe jumper, purple slacks and velcro shoes, frowning at us with a pinched expression. It’s like a spiteful child picked a doll up by the face, stood her at the front door of the doll’s house, and got ready to shoot her with a BB gun.
‘What?’ she says.
‘Gemma! Hi there! My name is Magda and this is my colleague Jimmy. I’m so sorry to disturb you. We’re from the rapid response team and we’ve been asked to come see your husband, Bob. It’s lovely to meet you.’
‘I told them. I don’t want you people coming round no more.’
‘I know, I know. It’s problem. But we won’t be long, Gemma, I promise you. Just a hi and a bye kind of deal. Trust me. You’ll hardly know we were here.’
There’s a tense pause that the rumbling of a passing train does nothing to ease. I fully expect Gemma to slam the door, but Magda generously interprets the hesitation as an invitation, and starts moving forward. And really, when Magda starts walking forwards it’s very difficult to say no. So instead Gemma flattens herself to the wall, closes her eyes and lets us pass.
‘That’s very kind of you, Gemma. I appreciate that. Thank you very much, darling. Through here…?’
I follow Magda into the house. It’s tall and dark and watchful. A narrow hallway leads off to the kitchen out back, the sitting room to our left.
‘Bob!’ says Magda. ‘There you are! Hello mate!’

Bob is sitting behind the door in a high-backed chair, a zimmer frame to the right. He’s dressed in stripes, too, although his are blue like his eyes and easier to look at. Everything about him is the opposite to Gemma. They could be the figures in an emotional weather clock: Bob summer, Gemma winter.
‘Hello!’ he says, holding his arms left and right like he’s known her all his life. ‘What’s all this about, then?’
Magda explains who we are whilst I get my obs kit out. Bob is wearing shorts, so it’s immediately apparent to both of us that he has a wound on his leg.
‘What have you been up to, Bobby? How you hurt your leg like this?’
She bends down to look. Gemma, who up to this point has been sitting on the arm of a sofa like a storm on the horizon, suddenly springs up, hurries over, and clutches the zimmer frame with white knuckles.
‘You are not to look at that!’ she says. ‘I’m his wife! I take care of him!’
‘Well – yes – I understand this, Gemma, but you know we are here to see Bob. And to be honest with you, unless you have Power of Attorney…’
‘I DO have Power of Attorney!’
‘Great! That’s great! So now, of course, we need to see paperwork. You have paperwork, Gemma?’
Gemma gives a huff, releases the zimmer frame and stomps back to the sofa.
‘I’m his wife!’ she thunders. ‘I say what happens.’
Magda shrugs this off and chats to Bob whilst I clean and dress the wound. I want to take a photograph, but I’m conscious of Gemma staring at me and I think if I do the flash of it will tip her over the edge. She’ll probably snatch up that large, ceramic pelican and smash it over my head, Magda or no Magda. So I finish off with a set of obs – all of which are fine. I can feel the rumbling of her teeth grinding through the floorboards, although it might just be another train.
‘So tell me, Bobby? Tell me what happen with leg,’ says Magda.
‘I fell out of bed,’ he says, and then slowly, and irresistibly, he turns to look at his wife.

the guru comes back

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It’s so hot it feels as if the sun has dropped in closer and burned away every last scrap of moisture. I’m okay though – waiting for the social worker in the shade of the tall privet hedge that marks out the perimeter of this estate. I don’t mind the wait. I stand with my bags at my feet, waving to the people coming and going along the driveway. The postman in his foraging cap with a strip of blue canvas hanging over his neck; the young couple striding out with a pram covered in netting; an elderly woman with her shades flipped up, her permed hair glinting metallically in the sun. It starts to feel strange, like I’ve been standing like this for years. When the postman comes out again I half expect him to come over and hand me a letter: To the Man by the Hedge. ‘Dear Standing Man…’

Liam the social worker hurries across the road, hugging a battered leather briefcase to his chest, looking right and left over his shoulder like he’s escaping with secrets and expects to be shot.

‘Phew! Sorry I’m late!’ he says, striding towards me over the lawn. ‘Have you made contact?’
‘No. I thought I’d better wait.’
‘Good. Good,’ he says, pushing back his long hair, the sweat standing out on his forehead. ‘Well, then. Shall we…?’

Nanette’s daughter Roo answers the door.
‘Thank you for coming,’ she says. ‘Although quite what you’ll be able to do I don’t know.’

It’s a difficult scenario. Nanette was discharged home after some disagreement amongst the clinicians about her mental capacity. Nanette has chronic health problems, made worse by a recent infection. Her history of taking medication is patchy to say the least; she prefers to take herbal remedies, to meditate and follow a strict dietary regime – all of which is fine, of course, except it’s reached the stage where it’s difficult to say whether the progress of the illness is affecting her ability to make rational decisions about her health. She was so unhappy and disruptive on the ward, the hospital took the view that on balance she’d be better off at home with the support of community health teams.

None of this would matter so much if Nanette wasn’t suffering, and putting herself at considerable risk.

‘She was outside last night in the early hours, knocking on random doors asking for ice cream,’ says Roo, taking a steadying breath. ‘I live miles away. I just can’t be here all the time.’

What makes it even harder is that Nanette won’t accept any care support. She’s been turning people away, shouting at them through the window, telling them to piss off, and worse. The self-neglect is starting to show now. I’ve been sent in with Liam to do as much of a review as she’ll tolerate, to see how she is and what more can be done short of sectioning.

We put on our masks and gloves and follow Roo up the stairs.

Nanette is sprawled on the sofa. Emaciated, a dump of stringy limbs loosely wrapped in a threadbare dressing gown. The tiny flat is super hot; the little fan turning its head ineffectually right and left and back again, like a sad little robot saying no, no, no.

‘Hello Nanette!’ says Liam, giving a little nod. ‘I’m Liam, a social worker, and this is Jim, a nursing assistant. We’ve come to see how you are.’

‘Well now you’ve seen me so you can piss off,’ she says.

‘We’ll go if you want us to, but first we’d like to see how things are and how we can help.’
‘You can see how they are,’ she says. ‘They’re hot.’
‘I know. It really is hot today,’ says Liam. ‘Would you mind if we sat down over here and had a quick chat. We won’t keep you long. Promise.’
She shrugs.
‘If you must,’ she says.

Roo fetches in two small, brightly coloured stools, the kinds of things you might find in an infant school. We sit with our knees up to our necks, and try to smile with our eyes over the rim of our masks.

‘Would you mind if I did your blood pressure and so on?’ I ask her.
She sighs.
‘I’m fine!’ she says. ‘Why is everyone so obsessed with blood pressure? This is what’s wrong with the world. Haven’t you got anything better to do?’
‘Not at the minute. We’re here for you.’
‘Well that’s nice,’ she says, not meaning it. ‘Go on then. But don’t pinch.’
I run through her obs, which are surprisingly good, considering.
‘Thank you!’ I say, sitting back down on the stool. ‘That’s all fine.’
‘I told you! You won’t listen. There’s nothing wrong with me. And if there is, I cope with it my own way…’
‘Who’s that in the photo?’ says Liam, nodding over to a large, gold-framed, hyper-colourised photo of an Indian man in yellow robes, a string of flowers round his neck. He’s holding his hands out, palms-up, smiling so widely his eyes are creased shut.
‘That’s my guru,’ says Nanette. ‘I followed him for years. He died a little while ago.’
‘I’m sorry to hear that,’ says Liam.
‘Dont’ be,’ says Nanette, painfully pushing herself up on her elbows. ‘See that other picture, there? The one to the right?’
In a silver frame. A shaky, grainy, long-distance shot of a young Indian guy in white robes, striding onto a stage in front of a huge audience.
‘He came back,’ she says.

two dwaynes

~ jim clayton ~ Leave a comment

I’ve come to do Elaine’s assessment with Lisa, one of the physio assistants. Elaine is eighty, her cancer advancing rapidly towards end of life, to the point where she needs a great deal more equipment and care. The District Nurses want her to go into a hospice, because she has no family or friends to help out, she’s isolated and vulnerable where she is, and there’s a limit to what the various community health teams can do. Elaine doesn’t want to go, though, despite numerous falls and incidents. The DNs have referred her to us to see what else we can provide, including night sitters.

We’re told that Elaine is able to buzz us into the building with a remote device, but when we ring her number there’s no reply and nothing happens. The building manager isn’t in his office, so we push the emergency buzzer on the console. Because we don’t know the password, and the door’s not camera monitored, they won’t let us in. We ask if they’ll phone the hospital and check that way. It’s not part of their protocol, they say. They can’t do it.
‘She might be on the floor,’ says Lisa.
‘Sorry.’
They ring off.
Lisa curses, buzzes random flats. Eventually someone takes pity on us and lets us in.

Luckily, Elaine’s door is unlocked. She’s sitting on the floor leaning back against the bed. The only injury she has is a skin flap on her arm, so together we gently help her up again and settle her back in bed. I check her over and dress her wound.
The phone rings. Lisa answers on Elaine’s behalf.
‘It’s Dwayne,’ she says. ‘From the Salvation Army. He says he’ll call back later.’
Elaine nods, gently raising and then lowering her uninjured arm like a marionette sadly acknowledging some change in her surroundings, then she gently closes her eyes and rests her head back. She’s so frail and emaciated she hardly makes any impression on the pillow.
‘Dwayne is so sweet,’ she says. ‘There are two of them, you know.’
‘Two Dwaynes?’
‘Identical twins.’
‘Buy one get one free,’ says Lisa.

Gently holding the primary dressings in place, I wrap Elaine’s arm in a bandage.

‘I used to play tennis with this guy,’ I tell her. ‘It was only a year later I found out he had an identical twin. For some reason it just never came up. I went round to pick him up one day and when he came to the door I thought Whoa! What’s different? He just stood there looking at me whilst I tried to figure it out. Was he wearing new glasses? Has he cut his hair? What was it? After a while he said So I’m guessing Simon never told you he had an identical twin? It was so weird! They were the same but different. Very unsettling.’
‘I’ve not met Dwayne’s brother,’ says Elaine. ‘I’ve only ever seen pictures.’
‘What’s his name?’
‘Dwayne.’
‘What – they’re both called Dwayne?’
‘No. Dwayne’s called Dwayne. I don’t know what the other one’s called. Something or other, I expect.’
‘I was gonna say. If you had identical twins you wouldn’t call them both Dwayne. It’s confusing enough.’
‘I dunno,’ says Lisa. ‘Might make it easier.’

I tape the bandage.

‘There! Good as new!’
I gather all the rubbish together.
‘You know – it’s only recently I found out you can’t have identical twins of different genders,’ I say, peeling off my gloves, adding it to the waste bag, then putting it in the kitchen bin.
‘You can, actually,’ says Lisa. ‘It’s pretty rare, but it can happen. It’s all about the fertilisation. If you get two eggs developing in the uterus you get fraternal twins; if you get one egg that splits in two you get identical twins, boy boy or girl girl. But then sometimes one of the halves drops the Y chromosome and you get boy girl identical twins. Very rarely though. See what I mean?’
‘‘How do you know all this stuff?’
She winks and points.
‘Stick to the bandaging, Florence. Leave the science to me.’
Elaine tentatively flexes her bandaged arm.
‘Oh dear,’ she says. ‘I look like Boris Karloff.’
She sighs and closes her eyes again.
‘Maybe I had better think about that hospice,’ she says.

a bit of adjustment

~ jim clayton ~ Leave a comment

Mr Curtis’ maisonette flat is so high up, on an unadopted dirt road close to the cliff edge, he could rent it out to the coast guard as a lookout. When he tells me he used to be a submariner, it’s hard not to think he had so many years being underwater he wanted to live the rest of his life as high above the surface as he could get.
‘So what did you do on the submarines?’ I ask him, unwrapping the blood pressure cuff with a rasp of velcro.
‘I was a spy,’ he says, rubbing his arm.’
‘A spy? I didn’t know they had spies on submarines.’

I imagine a guy in breathing apparatus, shadowing his goggles as he peers through a porthole.

‘Radio operators, you know. Specialists. We used to sit on the sea bed for weeks on end, monitoring the Russians coming and going. We had to wear slippers and creep about. We had no idea where we were. Could’ve been under the Arctic. Could’ve been the Bahamas. You had to guess by the sailing time and how stiff your socks were.’
‘Sounds horrendous.’
‘It was alright. A great gang of fellers.Although I was taller than the others so my feet stuck out the cot.’
He winds his shirt sleeve back down, neatly buttons it at the wrist.
‘You was properly on your own, though,’ he says. ‘Which sounds funny, given how crowded we were. It all took a bit of adjustment.’
‘I’m not sure I’d have lasted.’
‘You got weeded out beforehand. Put through your paces. Although sometimes it got too much and someone flipped. I remember one guy, we had to pull him off the hatch he was swinging off it, shouting and screaming. We had to knock him out with happy pills and drop him off a week later to a passing ship. Never did see him again. No one blamed him. It could get to you, that’s for sure. It weren’t like topside. It weren’t like the skimmers.’
‘How d’you mean?’
‘Well – y’see? – it was all so top secret. They used to adapt the submarine before we went out. In case we got caught. They used to paint out all the numbers, on the tower and whatnot. And they used to take off anything that weren’t strictly necessary, to save weight. They even stripped out the rescue buoys – y’know? – the things you’d launch to mark your position if you got stuck down there. If you did – God help you – no other fucker would. There wouldn’t be anyone launching no rescue missions. That was it. The powers that be would shrug and deny all knowledge. Like it never happened. Like you never existed.’
He stares at me.
‘And now look! I fall over in the bathroom and five minutes later the bloody cavalry are riding through the door.’

camel tales

~ jim clayton ~ 2 Comments

The nurses are busy catching up on admin, chatting about this and that, their day, their troubles, their plans. The conversation turns to holidays and the general mess of it all. Cancelled bookings, weddings abroad postponed, so-and-so who’s gone to visit family in Cyprus, somebody else who got caught in Spain and now won’t get paid for the two weeks quarantine they’ve suddenly got to do when they get back.
‘We were supposed to go to Turkey again this year. Turkey’s lovely. Have you been?’
‘Yeah. Hot and cheap and that’s how I like it.’
‘Cornwall’s nice but you end up spending just as much, you can’t fly there and – let’s be honest – it doesn’t matter how much you dress it up, the North Atlantic’s not the Aegean.’
‘Yeah. You go snorkelling and all you’ll see are jellyfish and tampons.’

They swap info on some patients, visits and so on, then get back to the important stuff.

‘Have you ever been to Egypt?’
‘Once.’
‘What did you think?’
‘It was great. Well I enjoyed it. We stayed on a resort. Sharm El Sheikh. Before the trouble, of course. Everything was controlled on the resort, so you were pretty well looked after. It can get a bit much, getting swamped with demands for money or crappy souvenirs when you go out of the resort into some of the markets. But once you get used to just smiling and saying No Thanks they get the message. I told Steve, I said Steve, don’t keep waving your hands and saying Maybe later like that. They remember this stuff and bother you worse next time. But he wouldn’t have it. It was like he couldn’t help himself. And I tell you another weird thing. Steve has a phobia about camels.’
‘Camels? Why? Did he get bitten by one or something?’
‘No. He’d never seen one before. Just didn’t take to them, really. He said it’s the way they look at you.’
‘Well maybe in retrospect Egypt wasn’t a great choice, then. I mean – that’s pretty much where all the camels live. Isn’t it? I’m right, aren’t I?’
‘I suppose. Anyway – what happened was, we decided to leave the resort and go to a shop on the outskirts. We wanted to get a lilo and some flip flops, and we thought it’d be a bit cheaper. On the road out to it there’s this guy sitting on a camp stool with a big old camel next to him. And of course the man gets up and starts gesturing to the camel, trying to sell us a ride. Steve goes all funny. Keep that thing away from me he says. And he starts walking really quickly to the shop, and I have to make apology faces to the man, and then catch up. So we’re in the shop, and I’m having a nose around. I find some flip flops and I turn round to Steve to see what he thinks. And he’s not there. So I think – what the hell? And I look out the shop window, and there he is, sitting on top of the camel, with the man standing next to him holding the reins about to set off. So I run out there and I shout Steve! Steve! What the hell are you doing? And it was then I notice the man is wearing Steve’s sunglasses. So I ask the man if he’d mind letting Steve down, which he does, eventually. And I get the sunglasses off him, and we walk back to the shop. And I say to Steve, What was that all about? And do you know what he says?’
‘I cannot imagine.’
‘He says The camel made me do it.’
‘The camel?’
‘Yep. He said he could see it looking at him through the shop window, and there wasn’t a thing he could do about it.’

rick’s drey

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There’s nowhere to park on Moreton Street, not even space to pop the car up on the narrow pavements. So I leave it on the wider road at the top along by the railway line and walk back down. I don’t mind, though. The sun has swept out from behind the clouds and the day has come alive. This street is a private and pretty exclusive tributary these days. The old buildings down here, the workshops, the chapel, the railway cottages, they’ve all been meticulously renovated, their brickwork blasted, their roofs made good with slate or thatch, every window and sign and gate made new again. It’s all so ruthlessly authentic, though, it makes me feel a little self-conscious, like I’m walking through a film set. There’s a postie delivering mail the other side of the street, and even he looks like he just stepped out of make-up.
‘Good morning!’ he says, touching the brim of his baseball cap.
‘Good morning!’
‘Lovely day!’
‘Isn’t it?’
(We may have to re-shoot that; I could do better with that last line.)

Rick lives in a flat at the very top of The George pub at the bottom of the street. The George is a relic, an old Helmstone boozer, one of the last old corner pubs still pulling pints. There’s astro turf in the yard at the back so you can sit at the tables under the outside heaters and pretend you’re in the country. They’ve painted the exterior walls a chi-chi, slate blue. They’ve even put dried grass in vases and lines of old books in the window. But if The George was struggling before the pandemic, it’s looking pretty hollow-eyed now. The whole place has an abandoned feel. It’s hard not to think that when the virus has retreated, time will be called for the last time, the scaffolding will go up, and the repurposing will begin in earnest.

It’s been hard getting in touch with Rick. The mobile number I was given turned out not to work, and I had to do some detective work to find an alternative. He definitely needs our help, though. He had some major surgery recently, he’s struggling to get about, and there’s no-one around to help him with the basics.
‘I’ll meet you at the street door,’ he says. ‘It’ll take me awhile to get down, so give me five minutes at least.’
When he does appear, he’s on two elbow crutches.
‘Could you do us a favour?’ he says. ‘Could you go to the newsagents and get me a bottle of Coke, a packet of crisps and The Daily Star? Thanks, mate.’

*

Rick is as lean and gnarly as an old whippet – if a whippet could live for sixty years working as a hod carrier, tattooing its legs and arms with blurry women and daggers and swallows, smoking spitty little rollups. Apart from his orthopaedic surgery, though, Rick is remarkably fit. His grey hair is so short and square cut I can only think it was done with a chainsaw, and his tan is so deep the bones must be scorched. He talks quickly, and his eyes sparkle like flinty chips.

‘Thanks Jim, thanks,’ he says, throwing himself down on his bed with his bad leg kicked out straight. I put the paper, the drink and the crisps down next to him. ‘Thanks a lot, mate,’ he says. ‘Cheers! I was gasping. Now then. Let me tell you what’s been going on with me. No! Sorry! Where are me manners? You first! You go! Go on! I’ll shut up. Who are you, then? Apart from Jim? Or Jimmy, is it? Nah – Jim. James when you’re in trouble. Just Jim, then. Aah – Jim Lad. Yeah. Sorry.’

Ordinarily he’s thoroughly independent. His flat is tucked away just under the tall chimney pots on the roof, as remote and contained as a squirrel’s nest at the top of a pine tree. For a man who’s lived all his life going up and down ladders it seems pretty appropriate. For a man on crutches  the next couple of months, it’s a practical difficulty.
‘I can’t keep asking Billy to get my shopping,’ he says. ‘It’s embarrassing. He’s got his own shit going on. I just can’t keep doing it. Know what I mean?’
‘Have you got any family?’
‘Nah. Not any more. It’s just me. Which is okay most of the time.’
‘So – what happened with the accident?’
‘Well. Funny story. I was running out to go down the bookies when I tripped and fell arse over tit down the first flight of stairs.’
‘Ouch!’
‘Tell me about it. It hurt like a bastard but I thought I’d just bruised myself or pulled something. So I crawled back up to the flat, which took all morning. Lay on the bed, and that was it. I was there all day and night. Couldn’t move or nothing. Eventually I thought I had to do something or I’d starve. So I made it over to the door but the pain was unbelievable. Couldn’t go no further. It was just too much. The door was shut and the key was up on its hook by the side – see? Where it is now? Luckily, I had a crutch propped up in the corner from when I dropped a brick on my foot a few years ago. I used that to knock the key off its hook and then drag it towards me. Another bit of luck – there was a pen and a paper on the table just above me head. I play the horses. You follow?’
‘That was lucky.’
‘It was, Jim. It was. So I knocked that down with the crutch, wrote a note what said I need help. Rest the key on it, then shoved it under the door. When I heard Billy across the landing come back, I banged on the door with the crutch. He come over, saw the note, let himself in, found me in a state, called the paramedics. And that was me sorted.’
‘Amazing.’
‘Sometimes I think – what if I hadn’t had that brick drop on my foot that time, so I had to have a crutch? And then – what if I’d given the crutch back when I should? It was only ‘cos the crutch was in the corner I could do them things what I did and get help. Otherwise I’d have croaked and they’d have been seeing flies coming out under the door and not a scrap of paper.’
‘Maybe.’
‘So somebody up there loves me. Hey, Jim? Somebody loves me.’
He adjusts his position on the bed and winces with the pain. ‘Although – having said that – not so much they wouldn’t trip me up and throw me head first down the stairs in the first place.’

dave says it’s tricky

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Avondale.

Sounds beautiful. Magical. I bet the architect was a fan of Lord of the Rings. You expect to see an ancient castle draped in moss and mist, with strange, long-legged birds circling and crying overhead, a plangent waterfall and so on, elfcetera, elfcetera. Instead what you get is an anonymous, pre-fab block just off the high street, tucked away behind a phony Italian restaurant. It’s only been up a year or so but already it has a tired, beaten-down kind of look, strips of tape over the intercom where the buttons have fallen off. If the same architect had worked on Helm’s Deep, I don’t think Saruman would’ve needed much more than a couple of orcs and a wheelbarrow to tear the place down.

The one magical thing about Avondale, though, is its uncanny ability to screw up the SatNav. The app doesn’t recognise the postcode at all, and ends up recommending you ‘make a u-turn’ and then ‘make another u-turn’ so that if you were truly dependent on it, you’d end up simply driving in a circle at the bottom of the high street until you ran out of fuel or the police threw stingers down.

I know all about Avondale, though.
I’ve been here before.

Cherry lives on the first floor with her little Jack Russell, Dave. Cherry has a long list of health problems, from mental health and self-harming to morbid obesity, diabetes, breathing problems and recurrent infections, and she’s been referred to us many times in the past. She’s got a reputation for being difficult, but I think because I make a fuss of Dave whenever I go there she takes it easy on me.

‘Cherry was pretty sick this time,’ says Michela, the co-ordinator. ‘She went in with an exacerbation of COPD, but then self-discharged against advice. She was so bad they gave her home oxygen. So can you pop-in, see how she’s doing? Get her to sign a non-concordance form if necessary.’

*

Cherry is propped up in bed watching CSI. The first thing I notice – after Dave has finished leaping madly around my legs – is that Cherry’s wearing a nasal cannula connected by a long, plastic tube that snakes across the bed to an oxygen cylinder by the window. The second thing I notice is the fag in her mouth.
‘Erm … Cherry? You really can’t be smoking when you’re using oxygen.’
‘What? Wha’dy’a mean?’
‘You’ll blow yourself up. And everyone else. You’ll send Dave into orbit. Honestly, mate – you’ve got to put the fag out.’
She shrugs, pinches the end out, and rests it carefully on the ashtray by the bed.
‘Thank you,’ I say. ‘I’m sorry to be so blunt about it, but you absolutely cannot smoke with oxygen around. This whole place’ll go up.’
‘I only have one now and again. It’s not a problem.’
The heaped ashtray and the smoky fug in the room tell a different story. I know I’ll have to report this to her GP and the Community Respiratory Team as soon as I’m back in the car, but for now I move on.

Dave is on the bed now. He rolls onto his back so I can rub his tummy, his tongue lolling out with the ecstasy of it all.

‘So how’ve you been?’ I say to Cherry. ‘Sorry to hear about your recent hospital trip.’
‘Yeah – well. What can you do? They said I had to go. I didn’t want to. I mean – what are they going to do about anything?’
‘I don’t know, Cherry. But to be fair, they do seem to have done quite a bit. Put you on IV antibiotics, sent you for chest x-rays, got you back on your feet.’
‘Yeah, but they didn’t, did they? Look at me!’
‘It says in your notes you self discharged against advice. Is that right?’
She shrugs.
‘They made it impossible. It was noisy. I couldn’t sleep. They wake you up every five minutes to fiddle about. The nurses were rude. The food was unbelievable. I mean – you’ve got to be really sick to want to go to that place.’
‘That’s true. And from the sounds of it – I think you were pretty sick. And still are.’
I unclip the SATS probe from her finger.
‘Your oxygen levels are terrible, Cherry – even for you. And that’s five minutes after you came off the oxygen.’
‘Yeah – and I’d still be on it if you hadn’t said.’
‘It’s a choice, though, isn’t it. No oxygen and low SATS, or oxygen and burst into flames. Isn’t it, Dave? Isn’t it…?’
Something suddenly occurs to him, because he flips himself upright again, hurls himself off the bed, and skitters off across the laminate flooring into the kitchen.
‘Oh my God! Wait for it,’ says Cherry.
There’s a single, loud squeak from the kitchenette, and then Dave hurries back with a red, rubber bone in his mouth. It’s so big he can’t make it up on the bed again without a boost from me. As soon as he’s there, though, he chows up and down on it, making it squeak as regularly as a monitor in a hospital for clowns.
‘God – it’s noisier than the ward,’ says Cherry. ‘And before you say anything, I don’t care, I’m not going back.’
I look down at Dave.
‘What do you think?’ I ask him. ‘What do you think mummy should do?’
He stares up at me, panting excitedly, flicking his eyes without moving his head…. down to the bone…. up to me…… down to the bone…up to me.
‘Dave says it’s tricky.’

if I go I go

~ jim clayton ~ Leave a comment

Malcolm doesn’t have a phone. Not one that works, anyway. So all you can do is pitch up and hope for the best.

It’s a fair bet he’ll be in, though. For one reason or another he’s had a series of falls – getting dizzy and going over at the bus stop, the queue at the post office, the supermarket. They’ve put him through the usual tests, given him a pacemaker, a range of medication, a walking stick. He’s been to countless follow-up appointments (falling over on at least two of them). He’s had a new hip. If you x-rayed his arm you’d see two plates and a line of screws. All in all, he’s a walking (and falling) phenomenon. All they can really do now is adjust his meds from time to time, and maybe dress him like an American football player when he wants to go out.

‘Come on in, why dont’cha!’ he says when I knock on his open door.

He’s bent over a boiled egg and crumpet, working away at it, his good elbow pointed straight up.
‘Lovely!’ he says, leaning back and wiping his chin. ‘Now,’ he says, waggling the eggy spoon in my direction, ‘you can’t do no better than an egg in the morning!’

These days Malcolm’s flat is pretty down-at-heel. Casting your eye about the place is like sending a deep water drone through the wreck of the Titanic – a settled and claggy sediment over every surface. Despite his straitened circumstance he declines all offers of help, though.
‘I keep myself to myself,’ he says. ‘I don’t do too bad.’

There are two black and white pictures on the wall behind him: Malcolm as a young man in the army. The first picture is of his unit, posing in full uniform in four rows; the second is a blow-up of the same picture, zooming in on Malcolm and the guys on either side. It’s hard to see any likeness, though. Both pictures are so faded, it’s disconcertingly like someone’s dressed a row of mannequins in uniform, the peaked caps emphasising the blankness of their faces.

‘I’ve jes’ got to nip down to the laundry room,’ he suddenly announces. ‘You don’t mind, d’you? Only the other fellas’ll be gurnin’ on about it.’
Before I can even offer to go for him – it’s down two flights of stairs after all – he’s pushed himself up from the armchair and set off.
‘I’ll come with you’ I say, hurrying after.
At least he lets me go down the stairs first.

When I take his bed clothes out of the dryer they’re so hot I have to juggle them around.
‘Done!’ he says, slamming the dryer door in a blast of superheated, fabric conditioned air. ‘C’mon, fella!’
And we’re off again.
He nods at the manager’s door.
‘Furloughed,’ he says. ‘Alright for some.’

‘You can pause on the landing,’ I say, chasing after him back up the stairs, almost tripping on the bottom sheet. ‘There’s no rush.’
He waves his hand in the air – which I’d rather he’d use to hold on to the rail.
‘Feck it. If I go, I go,’ he says. ‘You can catch me in the sheets.’

Back in the flat, he tells me to dump the stuff on a chair by the bed. It’s only then I notice his bed is heaped up with what looks like skeins of shredded cotton. It reminds me of the bedding my hamster Horace used to have, how he’d scuffle it all up and then bury himself in the middle.
‘Are you sure you wouldn’t want someone to look in on you, Malcolm?’ I say. ‘We could get you some new bedding, if you’d like?’
‘That’s kind, but I’m okay,’ he says, throwing himself down into the armchair again. ‘Phew! That little jaunt took it out of me. You’re spinning like a regular Father Christmas!’
‘Father Christmas? Why? Does he spin?’
Malcolm rests his head back and closes his eyes.
‘I don’t know, fella,’ he says. ‘I don’t know. It certainly looks that way to me now.’

mr brandt’s glasses

~ jim clayton ~ Leave a comment

Mr Brandt is sitting up in his bariatric hospital bed, the head-end elevated so he can watch TV. Given the display cabinets of train models, a railway scene puzzle half completed on a cantilever table, framed photographs of trains, train manuals, timetable collections and almanacs, shelf tidies with colour-tagged railway magazines, rack upon rack of train DVDs, and a lower shelf crammed full of hardback, glossy coffee-table books about the trains of the world and so on – it’s not a surprise to see that Mr Brandt is watching a programme about trains. A team of hard-hats are standing around trying to figure out how to get an old steam locomotive onto a low-loader.
‘Look at that lot!’ says Mr Brandt. ‘Bunch of jokers! The Pere Marquette’s about two hundred tonnes. The forty-one model, anyway. And they’re gonna move it with that Tonka toy hoist? I don’t think so. D’you?’
‘You seem to know a lot about trains.’
He shrugs.
‘There’s a lot to know.’
‘Did you work on the railways?’
‘Nah. I was a bus driver. But I dunno. I just liked trains.’
‘Fair enough.’
‘There’s something about them.’
‘I know what you mean.’
He raises a hand and makes something like a fey karate chop.
‘Pee-owww!’ he says. ‘Straight there.’
‘Great!’
‘Not if there’s something on the line, though,’ he says, frowning. ‘There’ve been some terrible accidents.’
‘You’re right.’
‘Of course – you know what the worst ever rail accident was?’
‘Clapham?’
‘Quintinshill.’
‘Never heard of it.’
‘Near Gretna Green.’
‘Scotland?’
‘Full marks, that man!’

I’m running late, so I’m reluctant to ask what he obviously wants me to ask. But he’s looking at me in the same way my pet lurcher Stanley looks at me when he wants a duck stick. Impelled by the same, sudden lack of will-power, I’m driven to say:
‘So – what happened at Quintinshill?’

‘May, Nineteen fifteen,’ says Mr Brandt, letting out a huge and luxurious sigh, like a publican pushing back his plate after a particularly big dinner. ‘A troop carrier packed with Scottish soldiers heading south en route to Gallipoli. But the railway company’s short on rolling stock, so they’re in old, wooden bodied carriages lit by gas from tanks slung underneath.’
‘That sounds dodgy.’
‘It was worse than dodgy. It was positively lethal. So what happened was – there’s a complicated bit of track at Quintinshill. I could explain it to you but I can see you’re pressed and anyway you wouldn’t understand.’
‘You’re right there.’
‘All you need to know is there’s a track going north, a track going south, and two loopy side bits of track either side. The signalman temporarily reversed a northbound local train onto the southbound track, then forgot about it. So it was hit head on by the troop train heading south. And then the wreckage was hit by a northbound express. And the whole lot went up in flames when the gas tanks exploded.’
‘That sounds horrendous.’
‘An absolute inferno!’ he says. ‘Two hundred people died, more or less. I think it was hard to tell in the end. Worst ever railway accident in the United Kingdom.’
‘Awful.’
‘Both the signalmen went to prison for a year or so. But you have to think they were scapegoated. I mean – come on! it was shocking how badly trains were being run up there. And those old gas-lit carriages? A disaster waiting to happen. The men made a mistake, of course they did. But the company was equally at fault. And you can tell they knew it, ‘cos when the two guys come out of prison they give ‘em jobs straight back on the railway.’
‘Really?’
‘Yeah. Just not as signalmen.’

On the TV, the low-loader crew are making good progress dragging the old locomotive onto the flat-bed of the low-loader.

‘It must’ve been terrible,’ he says. ‘Them two signalmen, standing at the window of the signal box, knowing what they’d done, watching the whole thing go up in front of them.’
I take a breath and shake my head.
‘I can’t imagine.’

But something else must be happening on the TV at the foot of the bed – some fast jump-cuts or adverts or something – because suddenly the light from the screen changes rapidly, and just for a second I’m conscious of the flickering reflections on the lenses of Mr Brandt’s large, steel-rimmed glasses.

‘Or – I don’t know,’ I tell him. ‘Maybe I can.’

living space

~ jim clayton ~ Leave a comment

Marianne is standing waiting for me at the front door. When I wave from the car she doesn’t react, but watches me with a pinched intensity.

‘Would you like me to take my shoes off?’ I say, glancing at the cream carpeted steps rising up behind her.
‘Yes,’ she says.
I follow her up into the maisonette flat. It’s as quiet as a photo in a lifestyle magazine, smelling of floral air freshener and toast.
‘Through here,’ she says.
‘I’m sorry to ask, but I need to be clear. What’s your relationship to Jeremy?’
‘He’s my ex,’ she says, ‘but we live together. He’s dying of cancer. You know that, don’t you?’
‘Yes,’ I say.

* * *

It’s an unwritten rule that the jobs you think will be the easiest and most straightforward will turn out to be the most difficult.

Looking over my workload for the day, I saw that I was down for a support visit with Jenna, the OT. A palliative patient needed a hospital bed, which meant transferring him out of the existing one, dismantling it, letting the equipment company set up the new one, then putting him back in. The notes said he could just about weight-bear, so there wasn’t the usual problem of having to set the new bed up next to the old one and pat-sliding him across. True – the family normally take care of dismantling the old bed, but in this case the partner didn’t have anyone to help with that, so we’d take care of business. Another OT had been ahead of us to case the joint, so it should be a breeze.

I didn’t read too far into the notes. Just the basics. The patient had prostate cancer. His disease had suddenly progressed, and his care would increasingly be limited to bed. The GP had visited in the first instance and identified what needed to be done. Our job was limited to setting up the new care environment, prior to the palliative team going in.

Straightforward.

* * *

Jeremy is lying on his side in bed, one hand crooked behind his head, his legs drawn up. He’s so exhausted we withdraw to the hallway again and talk to Marianne instead.

Jeremy’s room is small and cluttered, a substantial bedside table with a phone, drinks and things to the side, and a glass display cabinet at the foot end, filled with model planes. As things are at the minute, the hospital bed won’t fit, but the first OT hasn’t left any instructions about where he wants the bed to go. I can’t think he means the front room. The maisonette is a narrow, two bedroom set-up. The lounge is the brightest, most spacious living space in the flat. If the hospital bed goes in there, it’ll mean Marianne will be limited to her bedroom and the tiny galley kitchen. If Jeremy stays in his bedroom, though, it’ll mean the busy and sometimes distressing business of End of Life care can be contained more effectively. Marianne seems so anxious and friable, I can’t imagine her spending the next few months confined in that way.

‘I think the bed will actually go pretty well in Jeremy’s room,’ Jenna tells her. ‘Especially if we move the display cabinet next door and put the bedside table over by the window. When the hospital bed’s in, you’ll have more time to have a think about things. You could ask some friends or family to help with taking some stuff away, maybe putting it in storage. What do you think?’
‘I don’t understand,’ she says. ‘What’s going to happen with the bed he’s on now?‘I don’t want to get rid of it.’
‘I suppose we could dismantle it and store it behind the sofa in the sitting room.’
‘Why can’t we put him in the lounge?’
‘I just think with all the comings and goings – carers four times a day, district nurses and so on – it won’t work so well. You need space for yourself, Marianne. This room’s more than adequate. It’s nice and sunny. It’s got a view outside. A TV. It’s perfect, really. It just takes a little bit of reorganisation.’
‘If you think so,’ she says.
‘I do.’
‘Okay.’
She doesn’t sound too convinced, though. The problem is, the delivery driver is almost here. If we send them away to give Marianne time to think, there’ll be a delay before it can be reordered. Jeremy needs to be on a hospital bed as quickly as possible. The care agency will refuse to authorise care on the bed he’s currently on. It’s a manual handling nightmare.
‘It’ll work out,’ I tell her. ‘You’ll see.’

We set to work, moving stuff. It’s a delicate job, shifting the model lancaster and spitfire planes on their display stands, then crystal glasses, trophies and cups. We bus them next door, followed by as many drawers as we can manage from the bureau to make it light enough to slide over to the window.
‘Look at all that dust,’ says Marianne. ‘I’ll get the hoover.’
She comes back with an ancient thing, certainly older than the flat, big enough to ride on, with a huge square light at the front and a cloth bag hanging off the handle. She starts rolling it around, the vibrations of it as brutal as a rotovator.
‘I think that’ll do,’ I say, tapping her on the shoulder and shouting over the noise. ‘The van’s outside with the new bed, so we’d better get on and transfer Jeremy into the wheelchair. Then we can dismantle his bed and make room for the new one.’
‘Just a bit more,’ she says.

Jeremy remains as passive as the furniture, but at least he manages to stand sufficiently well to make the transfer into the wheelchair. We take him through to Marianne’s bedroom, and gently lay him on the bed. Marianne watches the whole business with horror. I’m guessing that the original OT who’d organised the job had explained what it involved, but Marianne was too stressed to take it all in. There should have been a note in the folder, though. I make a mental note to talk to him back in the office.

The bed is mercifully quick to dismantle. We take it through and stack it behind the big cream sofa in the lounge. It’s all pretty neat. We’re sweating in our PPE, but it feels like a job well done.

‘Like I say – it’s only temporary,’ I tell her. ‘When we’ve gone you can ask someone to help you find a better place to store it.’

The delivery driver is fast and efficient, installing the hospital bed in twenty minutes or so. We spend the time talking to Marianne, trying to reassure her, finding out what support she has or might be expecting. It’s difficult, though. She uses all the phrases that suggest she knows Jeremy is dying, but there’s a palpable gap behind them. It’s like someone standing on a beach watching an enormous wave curling up into the sky and thundering towards them – and pointing, and saying ‘Look! A dangerous wave! I must get to safety!’ but standing completely still, watching it come down.

‘The palliative care team will be in touch,’ I tell her. ‘They’re incredibly supportive. They’ll give you numbers you can call to help out.’
Marianne stares at the dismantled bed behind the sofa.
‘It can’t stay there,’ she says.

Once the hospital bed is set-up and the dynamic pressure mattress inflated, Marianne walks in with an electric sheepskin underwarmer, as old as the hoover.
‘He hates the cold,’ she says.
‘I’m afraid that can’t go on this mattress,’ says Jenna. ‘Those straps will restrict the flow of air. His pressure areas will start to breakdown, so it’s important nothing gets in the way of preventing that. And I’m afraid it’s too much of a fire risk.’
‘But he’ll get cold.’
‘This is really well insulated, Marianne. He’ll be fine. And he’s got a nice, warm duvet. Honestly, this will be so much more comfortable for him than his old bed. Plus the carers need a hospital bed to care for him. They need to get either side to roll him, and it has to be at the right height otherwise they’ll hurt their backs.’
She stands holding the sheepskin blanket.
‘He feels the cold,’ she says, then walks out.

* * *

The next day, Jenna calls me over in the office.
‘I’ve got to go back to Jeremy, that patient we saw together.’
‘Why? What happened?’
‘Marianne put his old bed back together in the lounge, then somehow dragged him through.’