sketches

Janet the dog walker

~ jim clayton ~ Leave a comment

Millie’s poodle Rosie bounds off the sofa when I come in. She lies with her paws either side of a well-chewed rubber Bugs Bunny, glancing down at it, then up to me, then down to the rabbit again, daring me to take it. I can’t decide who has the maddest expression: the rabbit or the dog.
‘I think… she thought… you were Janet,’ says Millie. ‘Janet… the dog walker.’

Millie furniture-walks to a seat at the dining room table. COPD has blasted her body, robbing her of any spare flesh. It’s left her tentative and frail, spindle-thin as a giant crane fly, fumbling for purchase, somewhere to land and catch her breath and think about the day.
‘I don’t want much,’ she wheezes. ‘I’ve got… the medication I need… plus a little something… for anxiety. What I really need… is someone… to come in now and again… to help me… with a bath. That’s all. Do my back… y’know?… the awkward bits.’
The doorbell rings and a breezy woman swathed in waterproofs stamps into the kitchen. I’m guessing it’s Janet.
‘Hiya Millie!’ she says. ‘Phew! It’s bad out there. Oh! You’ve got company!’
I introduce myself, get up to shake her hand which is ice cold.
‘You need gloves’ I say.
‘I need a lot of things,’ she says, pulling out a hankie and blowing her nose so loudly I take an involuntary step backwards. ‘I need to win the lottery,’ she says.
Meanwhile, Rosie has ditched the rabbit and dashed through to greet her. Janet kneels on the kitchen floor with her arms wide. Rosie puts her paws on the woman’s knees so she can reach up and lick her face.
‘You silly girl!’ she says. ‘I’ve had a wash today. I don’t need another one. Do I? Hey?’
‘Will… she be… alright?’ says Millie. ‘It looks… pretty bad out there.’
‘Of course!’ says the woman, grasping the kitchen counter, struggling to get up again. ‘Oof!’
She looks at me.
‘Got any spare knees in your bag?’
‘I’ll have a look.’
‘Good boy.’
She reaches into her pocket for a treat, and for a moment I think she’s going to throw it to me. But Rosie sits excitedly at her feet, and Janet hands it down to her instead.
‘She’ll be fine,’ the woman says. ‘It’s so windy out, I’m thinking of tying some string round her legs and flying her like a kite.’
Millie gives her a panicked look.
‘Seriously, though, we’ll just go for a short one round the park,’ says Janet, giving me such an exaggerated, lop-sided wink I’m guessing her face is still numb from the cold.

smile and act normal

~ jim clayton ~ Leave a comment

‘You wouldn’t think it, but I’m seventy myself.’
Sam’s right, of course. With her metallic white hair cut jaggedly short and swept back in spikes, her sharp shirt, skinny jeans and fluorescent trainers, I’d have put her at fifty, tops.
‘My knees are worn out. Every few weeks I have to have a needle in my eye because of the macular degeneration. Which means I can’t drive. So I have to take the bus over here every day. And you know what buses are like. It takes me the best part of an hour there and back, twice a day. On top of that I’ve been living in the hospital most nights ‘cos my son in law had an accident and my daughter’s not coping. Plus my own life to sort out. Which needs a LOT of sorting out, these days.’
She takes a breath, staring off into the bright fall of afternoon sun through the window. ‘And I’ll tell you something else,’ she says, trailing off. ‘I’ll tell you something…’
Her chin begins to tremble and she has to turn away.
‘Sorry,’ she says, pulling a tissue from her pocket. ‘Sorry about this.’
‘That’s okay. I can see it’s hard.’
‘Hard!’ she says, with a bitter laugh. ‘Childbirth was hard. Divorce was hard. This is bloody impossible!’
She blows her nose and bins the tissue. Gives her head a little shake.
‘There!’ she says. ‘Now. Good. Where were we?’

We talk through the situation. How her mum Avril is ninety-eight, increasingly frail and forgetful, not eating or drinking, falling more often but refusing to accept any of the practical changes that might improve her situation. She went into hospital for a few days after the last fall. Being discharged today and expected home by ambulance any minute. Although there’ve been a lot of false starts and mix-ups as far as THAT goes. Anyway – Sam is the main carer for her mother, with a little private top-up help from a family friend. Sam has Power of Attorney, thank goodness, which is something, a small victory. But so far it hasn’t helped all that much in practice. Avril refuses to talk about residential care, even for respite, whether for her benefit or – more significantly – for Sam. Things have been staggering on like this for a while. It’s not getting any easier.
‘She was always bloody minded,’ says Sam. ‘I suppose it’s how she’s lived to such a ripe old age. It’s probably what’s kept her going all these years. I mean – It’s not like she’s any different now she’s old. In some ways I think she’s actually more of herself than she was. Which sounds odd, but you know what I mean. Do you?’
I nod and say I think I do.
‘Some things have changed, of course. She repeats herself a lot. Over and over. If I hear that story one more time of her in the air raid shelter with the GI and the rabbits I’ll scream. But essentially she’s still Mum. Which is what makes it so hard. Don’t get me wrong. I love my mum and I’d do anything for her.’
Sam laughs again.
‘Like get the bus twice a day! Anyway – enough of my moaning. Let me show you how I’ve organised her laundry…’
‘Okay.’

I follow her into the hallway. She opens an airing cupboard where a water heater is surrounded by shelves of slacks and vests, everything ironed, neatly stacked and lined up, orderly piles of pants and socks, a clutch of enormous bras hanging down from the top shelf like outlandish nests.
‘What d’you think?’ she says.
‘Wow!’ I say. ‘Pretty organised. You do an amazing job.’
‘You know what? I think I do,’ she says, giving the clothes a long, proprietary look, then slowly closing the door.
The buzzer goes. She stiffens.
‘That’ll be mum,’ she says. ‘Smile and act normal.’

anna, landed

~ jim clayton ~ Leave a comment

If this happened in a dream – and with the amount of opiate medication Anna is taking, I’m guessing most things must seem fuzzy and dream-like – it would no doubt happen like this: Anna drifts down from the sky in a semi-recumbent position, her eyes closed, her hands folded on her tummy. The roof of the house shivers, becomes transparent and loose, moves apart. Anna drifts down through the Anna-shaped gap, down through through the attic, the upper bedroom, the floor, the fixtures, the criss-crossing joists, the cobwebbed bricks, the insulating wool. Down through the cloying air of the living room, to settle finally on the soft brown sofa. And the ceiling heals up, the roof and everything else. And the cushions roll over like squashy boulders and mould themselves around her. And she’s there, back from the hospital, thoroughly landed. And she opens her eyes as her daughter Christine wanders in to see her, a jug of iced water and a glass tinkling gently on the tray.
‘Did you put in a pinch of vitamins?’ says Anna, grunting as she pushes herself into a more upright position.
‘Yes.’
‘A pinch? Not a spoonful?’
‘A pinch. Yes.’
‘Last time it tasted like a spoonful.’
‘I don’t think so.’
‘Well it did to me.’
Christine shrugs and goes back out to the kitchen where she carries on talking to her friend in an urgent kind of tone.
‘She’s a good girl,’ says Anna. ‘I don’t know what I’d do without her.’

I finish writing up my notes and then put the folder to one side.
‘The thing about back pain – the advice they give these days – is to keep moving.’
She snorts.
‘That’s easy for you to say. You’re not the one in agony.’
‘I know it’s difficult, Anna, but the longer you stay on the sofa the harder it’ll get. You’ll become deconditioned. You’ll be at risk of getting pressure sores.’
‘I know my own body.’
‘Absolutely. But I think there are some practical things you could do to make things easier for yourself. To give yourself the best chance of recovery.’
‘Such as?’
‘Sleeping in bed, for a start. You’d be flatter at night, which is better for you. It’s higher off the ground for getting in and out. And with a bit of re-organisation, you’d have more chance of getting mobile again.’
‘Where do you suggest I put everything?’
I look around. The house is packed full with ornaments and hangings, boxes on top of tables on top of bigger boxes, every bookshelf crammed with books, even the windowsills piled up with stuff. The only free space is the giant plasma TV screen on the wall facing the sofa. Anna turned it off when I came in, and now it hangs there, a window onto a darker, clearer world.
‘It’s difficult, I know, but not impossible. All you need is a decent amount of space for you to get about. As things stand, you’re much too restricted. How do you even swing your legs over to go to the loo?’
She closes her eyes.
‘I manage,’ she says.
‘I’ll ask the physio to come and see you, but I know that’s the first thing they’ll say.’
‘I’ll think about it,’ she says, then reaches to the side for a glass of vitamised water. ‘In the meantime – please speak to the doctor about my pills. Because nothing’s working and I’m in absolute agony.’
‘Of course,’ I say, picking up my bag to go. ‘I’ll pass on the message.’

the cat knows everything

~ jim clayton ~ Leave a comment

Gary’s shown hostility to health care professionals in the past, and the record says we’re only to visit in pairs. I’m a little early meeting up with Lisa, so I park up outside and take the opportunity to finish off some notes on the laptop. I’ve just settled in to start writing when Gary’s door opens and a woman steps out. She’s tall and pale and pinched looking, wearing a green and black nylon tracksuit, her long hair dragged back in a ponytail. She takes out a fag packet and is just about to have a smoke when she sees me, sitting there. I wind down the window to tell her I’ve come to see Gary and I’m just waiting on my colleague, but before I can say anything she shoves the fags back in her pocket, walks backwards into the doorway, and maintaining eye contact for as long as she can, slowly shuts the door.

It doesn’t augur well.

Lisa turns up ten minutes later. I’d trust any of the team to go on a difficult visit, but if I had to choose, Lisa would be it. The Italians have a word for how she is: sprezzatura – a kind of nonchalance or ease, wearing her skill lightly, with great warmth and humanity, as if it’s really nothing and no trouble at all, and what was it that needed doing, now, and suddenly it’s done, and everyone feels better.

‘How’s it going there, Jim?’ she says, padding along the street. ‘Have you been waitin’ long?’

We go together through the terrible little garden, knock and wait. There are sounds from inside. An exchange of light and shadow in the frosted panes above the door. A clattering of the lock, and suddenly the door opens.
A bare chested man, his eyes squeezed shut, his smile as wide and flat as the Man in the Moon.
‘I expect you’re wondering why I’m half naked?’ he says. ‘Only I was just having a carton of cherry and raspberry squash, and I didn’t want to get any on my t-shirt.’
‘No. That would stain, right enough,’ says Lisa.
‘Yes,’ he says. ‘You’d never get it out.’

There’s a steep, bare board staircase just behind the man. The woman I saw earlier is crouched at the top, peering down at us on all fours.
‘Don’t listen to him!’ she shouts. ‘He sees ghosts!’
‘Okay, now! That’s interesting!’ says Lisa. ‘So… is yer man through in this room, or … ‘
‘Ye-es,’ says the man, stepping to one side and knocking on the door. ‘I say Gary? There are two lovely nurses to see you.’
Show them in but keep Jackie out.
‘Righto.’

The man pushes the door open and nods for us to go through. Meanwhile, Jackie has started coming down the stairs, slowly feeling with her feet for each tread whilst her face stays as fixed on us as a steadicam.
‘Now, now, Jacqueline!’ says the man. ‘Gary doesn’t want you there.’
Jackie gives a petulant scream, sits down on the step and folds her arms.
‘After you,’ says the man.
We step into the room.

It’s hot as a sauna – the foetid, barrelling kind, where you fling urine on the coals instead of water. I wonder how long Gary’s been lying on his bed like this, his teeth grey and claggy as if he’s been snacking on ash. It’s like we’ve stumbled into a mausoleum, where the occupant took up early residency for want of anything better to do, and his stuff got chucked in after him. There are two posters on the wall: Jimi Hendricks leaning back from a guitar solo; The Beatles all in a line.
‘Wha’d’ya want?’ says Gary.
‘Hello there!’ says Lisa, offering him her hand. ‘Nice to meet you, Gary. This is my colleague Jim. We’ve been asked to come see how you’re doing.’
‘How’m I doing?’ he says. ‘I’m NOT doing.’
‘What’s troubling you today, then, Gary?’
‘I can’t keep nothin’ down. I feel sick all the time. I’ve got no energy. I’m wracked with pain. Is that enough for you?’
‘That’s enough for anyone,’ she says. ‘You poor thing. Let’s see what’s what, then. I’ll just do your blood pressure and whatnot and see how that is, and Jim here’ll take a wee bit o’blood, if that’s okay?’
‘I don’t care,’ he says. ‘You may as well. I’ve got to go to the toilet first, though.’
He nods in the direction of a commode whose pot has been removed so it can fit over a bucket.
‘Do you need a hand getting out of bed, there, Gary?’ says Lisa.
‘I’ll be alright, thanks,’ he says. ‘If you wouldn’t mind stepping outside for a bit.’
‘No worries.’
We leave him to it.

Out in the hall the bare chested man has gone and Jackie is nowhere to be seen. Instead, an ancient black and white cat yowls as it approaches us from the living room. I’m guessing it’s blind because both its eyes are white. It feels its way along the wall, one paw at a time. I crouch down and hold my hand out. The cat stops, sniffs the air, then moves in my direction. When it gets closer I see that its tongue pokes out to the side, too.
‘Poor wee fella!’ says Lisa.
I stroke the cat. It starts purring – a deep, rumbly sound – his tail pointing straight up, as if he’s absorbing the affection and transmitting it somewhere.
‘The cat! The cat knows everything!’ says a voice at the top of the stairs.
Jackie is there, staring down at us again.
‘Oh – they do, though, don’t they?’ says Lisa, smiling up at her. ‘Cats. You’re right there, Jackie. They certainly do.’

two from the queue

~ jim clayton ~ Leave a comment

Maybe in the future they’ll have an AI coordinator. Something with a wipe-clean face and a decent range of expressions. Something that can reply to an email, accept a referral, schedule a visit, settle an argument, make a clinical decision, take a note, make an amendment, triage a patient, liaise with a pharmacist, sort out an IT problem and laugh sympathetically at the struggles of a new member of staff – whilst at the same time keeping tabs on the thirty or so patient visits that are happening at any given moment. Until they do, though, they’re stuck with us.

Coordinating makes you crazy. Uncoordinated. Or, if not that, exactly, more hyper-coordinated, so that everything you do, even the little things, are done so intensely and with such purpose, you feel a little shaky by lunchtime – something which all the coffee you drink does nothing to ease.

You’re besieged by nurses and therapists, managers and carers, cleaners and admin staff, a constant coming and going, everyone wanting something, from a shift swap to an update to a pencil sharpener. I’m so conscious of the noise levels I’ve toyed with the idea of wearing a Daft Punk-style helmet – maybe with a light on the top that’ll flash when I’m available. I feel sorry for whoever it is I happen to be speaking to on the phone. They must think I’m calling from a bus station or a call centre. It can’t sound good.

There are some perks, though. Limitless coffee is one. The buzz of getting things in order is another. But one of the best are the random conversations you overhear when people are waiting to handover.

For example:

A: I went on that dating app you told me about.
B: Yeah? How d’you get on?
A: Alright. I struggled a bit with my profile. I thought I sounded a bit boring, so when it said hobbies I put chess.
B: Chess?
A: Yeah. Why?
B: Can you even play chess?
A: No.
B: Aren’t you worried you’ll get found out?
A: We’re hardly likely to be playing chess on our first date, are we? Unless they’re a complete perv.
B: But what if they ask you about it?
A: I’ll just say I like to play it now and again and that’s it.
B: But what if they ask you stuff?
A: Like what?
B: I don’t know. Who your favourite player is.
A: (laughs) They won’t.
(pause)
B: Don’t you think it might put them off?
A: I’ve already had two dates.
B: Two?
A: Two.
(pause)
B: They must be desperate.
A: Thanks a lot.

And another:

A: I was at the doctor’s the other day and there’s this kid with his hoodie up standing in front of me in the queue, shuffling about. And I think to myself – hang on a minute, that’s Tiffany’s youngest, Brandon. So I tap him on the shoulder, and he turns round, and fuck me, it was! So I says to him “What are you doing here, Brandon?” – but then I think – No! Noooo no no! That’s naughty. I can’t be asking him that. I mean, he might go and tell me, and that’d be awkward. For both of us. I mean – I’m best mates with Tiffany and I might struggle not to spill the beans. But do you know what he says? He says “I’m too embarrassed”. So I say “Well you gotta tell me now.” And he goes: “No. You’ll just think I’m a dullard.”
B: A dullard?
A: A dullard. That’s what he says. A dullard. I didn’t even know what it meant. I thought it was a kind of duck.
B: What teenage boy uses a word like dullard?
A: A Brandon-type boy, obviously Shell. Anyway, I say to him: “Whatever it is I won’t think any the worse of you. Promise.” So he says: ‘I’ve got a fingernail stuck in my throat”.
B: A fingernail?
A: He bites his nails and swallows it. And a bit got stuck in his throat.
B: Urgh! Who bites their nails and swallows it? Gack!
A: Yeah? Well – sorry to ruin your world, Shell, but a lot of people do. And not everyone who picks their nose flicks it, neither.

a ghost called alf

~ jim clayton ~ Leave a comment

I’m looking through Judy’s notes, the last time someone listened to her chest. I can’t help laughing.
‘What’s so funny?’ she says.
‘Well – I think the nurse who wrote this must’ve been hungry. She’s written bilateral crepes.’
I show her the little drawing in the notes. The rough sketch of her lungs, a line of little crosses at the bottom of both, an arrow pointing to them.
Judy’s expression doesn’t change.
‘What does that mean?’ she says.
‘It should say creps.’
‘Craps?’
‘Creps. Short for crepitations. I think that’s what it stands for. Anyway, it’s that crackly sound you get sometimes when there’s gunk in the lungs.’
Judy shrugs.
‘I know all about that,’ she says. ‘I’ve had enough of that.’
‘You’re sounding better today, though.’
‘I’m not dead yet, then?’
‘No! Alive and kicking.’
‘I’ll kick you in a minute.’
‘I wouldn’t mind.’
She stares at me.
‘Where are you from?’ she says. ‘Or-stralia?’
‘Australia? No! I was born in London but brought up in the Fens.’
‘Oh,’ she says. ‘That explains it.’
I shut the folder and carry on with the examination.

Judy is ninety-eight but looks older. In fact, with her quilted housecoat, netted, silvery hair, enormous slippers, stiffly jointed movements – the way she wobbles along clinging to a kitchen trolley loaded with toast, Tommy Tippee beaker and emergency button – it feels like I’m in a marionette update of the Red Riding Hood story, where the Big Bad Wolf works for a Community Health Team, and lets himself in with the keysafe.

‘Are you going to be much longer?’ she says.
‘No. Almost done.’
She takes a toot of tea from the beaker.
‘Would you like me to freshen that up for you?’
‘No – thank you,’ she says. ‘I shall need the lavatory.’
There’s a pause whilst I add my notes to the folder.
‘What did you do – before you retired?’ I say.
‘Shorthand typist,’ she says.
‘How lovely!’ I say. ‘I like typing. It’s one of the most useful skills I ever learned. That and driving.’
‘I worked in a brewery,’ she says, moving on. ‘That’s where I met Alf.’
‘Did he work in the office, too?’
‘Nah. He was in and out. But we’d throw things at each other and we sort of went on from there.’
‘Sounds brilliant.’
‘It was hard during the war, though. Terrible hard. There were these Ack Ack guns on the roof. You should’ve heard ‘em when they went off. Boom! Boom! Boom! The whole place shook like it was gonna fall in. They were having a pop at all them German bombers comin’ over. It was a terrible business. Terrible.’
‘How long were you married, Judy?’
‘A long time. So long I couldn’t tell ya. But Alf’s been gone for years now and – well – that’s that.’
‘I’m sorry.’
‘What for? It’s not your fault. Is it?’
‘No. I suppose not.’
‘Well then.’

I put the finishing touches to the notes.

‘Why don’t you go upstairs and have a lie-down if you’re tired?’ she says.
I look up from the folder.
‘Sorry, Judy – what?’
‘Not you,’ she says. ‘Him.’
She narrows her eyes and nods at the empty chair behind me. I turn to look.
‘My old man,’ she says, sighing and leaning back again. ‘If I don’t keep talking to him he might go orf’ with someone else.’

fuzz

~ jim clayton ~ Leave a comment

It doesn’t help that Moira takes out her hearing aid the moment I put it in.
And when I kneel down next to her chair to shout in her ear and explain why we’ve come to see her, I kneel on a tack strip.
‘Are you alright dear?’ she says as I swear and leap up again.
‘Fine. I’m fine,’ I say, rubbing my knee, tentatively exploring the small hole in my trousers.
Moira stares at me, her jaw bobbing up and down, like a ventriloquist’s doll on satellite delay.

It’s not a great hospital discharge, that’s for sure. It’s going to take a while to figure out what’s what, and even whether it’s safe for Moira to be here. For a start, her landline’s out of action, which means the Carelink alarm box is also redundant. Not only that, the phone is in the middle of the carpet, the power line one side of her chair, the phone line snaking across the carpet and off into the socket in the hall. Not so much a trip hazard as a trip trap. Someone’s obviously taken the view that Moira should stay downstairs. There’s a bed in the corner, a commode and a zimmer frame, but the bed’s unmade, the bedrail on its end against the wall, and the commode in the middle of the room. She’s wearing pads but no sign of any fresh ones. The fridge has the barest minimum – a loaf of bread, a tub of spread, a pack of cheese slices, a pint of milk. The freezer has a pizza and a few oven meals whose date I haven’t checked but from the packaging look fairly antique. All in all, it doesn’t seem as if much has happened since Moira was taken into hospital two months ago. And although we’ve arranged for carers to come in four times a day, it’s debatable whether that’s sufficient. In fact, looking at Moira sitting in her chair, surrounded by not much, I’m wondering if they’ve started outsourcing the discharging of patients to an online delivery company. Although, I’m sure if they DID, at least you’d need a signature, and in this case, she’d have gone back to the depot.

‘What’re you going to do now?’ she says.
‘I need to sort your phone out.’
‘My what?’
‘Your phone. It’s not working, Moira. It’s too dangerous left on the floor like this.’
‘Don’t you go breaking it.’
‘I won’t.’

The first thing I do is call the Carelink people. They say they’ll send a technician round within the hour to install a box that works off the mobile signal until the landline is up again. Luckily there’s a power socket in the hall, so I plug the phone in there and put it safely on a table, ready to be fixed.

‘What’s your son’s number?’ I shout.
‘My what?’
‘John. What’s his number?’
‘Who’s it you say?’
‘John…’
I make the international sign of the phone.
She immediately races through the number.
‘Oh – hang on a minute,’ I say, getting out my mobile. ‘Okay. What’s it again?’
‘The what?’
‘John. His number.’
She stares at me.
I go to kneel down by her but stop myself at the last minute.
I lean in and shout in her ear.
‘WHAT’S JOHN’S NUMBER?’
She races through it again. I repeat it to myself as I put in the area code.
‘What about the telly?’ says Moira, pointing a crooked finger Grim Reaper style at the screen. But John’s picking up, so I hold up my hand as if to say ‘shan’t be a second’ and walk into the kitchen to speak to him.

The man that answers sounds utterly spent.
‘I was round there for hours and she never showed,’ he says. (I want to ask him what he did for all those hours, but I let it ride). ‘I’m in my seventies myself,’ he says. ‘I’ve got my own problems.’
‘It’s difficult,’ I say.
‘I give her some of the stuff outta my fridge, but she wouldn’t have it. Mum’s not easy – I don’t know if you’ve found that out yet? She was always difficult. Old age hasn’t done nuffin’ to improve on things.’
‘She won’t put her hearing aids in.’
He laughs.
‘Yep. And that’s the least of it. I could go on, but you don’t want to hear it, and I don’t particularly want to say it.’
‘We’ve got to get her landline fixed,’ I tell him. ‘Without it, the personal alarm won’t work.’
‘My son’s sorting that out,’ he says. ‘Or should be. I’ll give him a nudge. ‘Course – he’s busy with his own life.’
‘There’s the TV as well. It doesn’t seem to be working.’
‘Yep. He’s looking at that n’all.’
‘Great. We’ll be putting carers in four times a day, and we’ll have various clinicians and therapists coming in and out. Can I give them your number?’
‘Why not?’ he says. ‘Although I’m not sure what I can really do.’
I ask if he’ll do a shop to stock up on the things she might like, microwave meals and so on, plus a supply of pull-up pads.
‘Righto,’ he says. ‘I’ll drop them round tomorrow morning.’
He rings off.

Back in the sitting room Moira is staring at the blank TV. I turn it on, but it just goes to a fuzz and nothing I try makes it any better.
‘John’s sorting it out,’ I tell her.
She holds out her hand and makes a flapping motion with her fingers.
‘Where is it?’ she says. ‘What’ve you done with it?’
I hand her the remote.
She points it at the screen, flips it on and off. On, off. On, and then off.
Fuzz.

who wakes the lion?

~ jim clayton ~ Leave a comment

Mrs Kerridge isn’t at all how I imagined her from the phone call a couple of days ago. Instead of a velociraptor in wig and slippers, shreds of flesh trembling from her teeth, I shake hands with a trim, short-haired woman in her sixties. Her smile does seem a little flat, though, like those masquerade half-faces on a stick – but to be fair, mine probably looks just as forced. We’re both doing our best.
‘Good to meet you!’ I say, holding out my hand.
‘You too!’ she says, shaking it.
‘Sorry for the confusion.’
‘Can’t be helped.’
‘No.’
We stand in the hallway, smiling, swaying slightly.
‘Lovely house!’ I say, shoving my hands deep into my pockets.
‘Thank you! We do try.’
‘Amazing.’
‘Yes.’

Greg, the equipment technician saves us, wiping his boots hard on the mat.
‘Mind if I check the lie of the land?’
‘Not all!’ beams Mrs Kerridge. ‘It’s going to be quite a house full!’

We go through to the living room where Mrs Kerridge’s father has been installed on a hospital bed. His mobility has deteriorated to the point where he needs a dynamic, pressure-relieving mattress, but because he’s non-weight bearing – and a hoist had been ruled out due to the distress it causes him – the only solution is to assemble the replacement bed and mattress next to him, slide him across, strike the old bed and then move him back into position. I’d tasked two of my colleagues to help with the transfer. They arrived in good time, and we stand around making chit-chat whilst Greg puts the new bed together.

Mr Kerridge snr is oblivious to the whole procedure. Opposite, half-way up the wall, is a large, flat screen TV. It’s currently playing a Zoo Vet programme. There’s a ventilated lion on the operating table, vets in scrubs standing around with their gloved hands in the air, like no-one wants to be first to start.
‘A lion!’ says Mrs Kerridge.
‘Imagine!’

For some reason, what it makes me think of is the last time I’d spoken to Mrs Kerridge. She’d rung the office to complain, and even though I didn’t know anything about the case and had had no contact, I was the only one available to take the call. She’d been furious, incandescent. There were a number of things that had gone wrong since her father had been with our service. Promises made and broken. Conflicting advice. Disruptive appointments. It was a list that spooled out furiously as I held the phone slightly away from my ear. And even though I had the patient record open in front of me, and tried as hard as I could to make sense of what she was saying, there was nothing I could come up with that would placate her. In fact, it was less of a complaint and more of an audio onslaught, a release of verbal steam, and the best I could do was lob-in the occasional I’m sorry to hear that or let me look into that for you. The advice in these situations is never to take it personally. The complainant feels aggrieved, so just hear them out, make notes, and resist the urge to promise to fix things that might only end up making the situation worse. It was difficult to bite my tongue, though. I could see from some of the narrative entries on screen that she’d been hostile in the past, refused help and then complained when it didn’t arrive, turned equipment away, and generally made life difficult for the therapists and clinicians.
‘I think there’s some sort of family rift,’ said Anna to me afterwards. ‘Best not go there. Once the bed’s in he’s open to the district nurses, so…’

Of course, it just so happened that the bed was late. There was a misunderstanding between the therapist who ordered it and the senior therapist who signed it off (it’s an expensive piece of kit). So the delivery date got bumped, and I was tasked to call Mrs Kerridge to tell her we couldn’t make the appointment but would be there the following day at the same time. I was fully expecting her to reach through the phone and throttle me, but it went to voicemail. I left a message. I heard nothing back. Everything was eerily quiet. The kind of quiet that falls on a lush rain forest in the lee of a volcano before it blows.

I was dreading the appointment. I’d volunteered to be one of the three, not just because I felt mean off-loading it onto someone else, but because I was curious to meet the woman who’d been so vile on the phone. What would she look like? How would she be? How well would I be able to withstand that kind of assault in person? It was something of a morbid fascination, like feeling drawn to the edge of a cliff to look down on the wild sea raging below.

But no. Here we are, perfectly calm, half watching Greg assemble the bed, half-watching a lion having its gall-bladder removed.
‘Amazing!’ I say to Mrs Kerridge.
‘I wouldn’t want to be the one who wakes it up, though. Would you?’
And she nods at me, and smiles.

ozymandias

~ jim clayton ~ Leave a comment

Each patient record has a reminder area on the home page. It’s supposed to draw your attention to essential details or dangers, such as the need for double-up visits, the contact numbers of the relatives you must liaise with first, the keysafe code, any environmental dangers you should be aware of. So the first thing I write is:

Two small dogs – friendly, but bark when you knock

It’s only when I read it out loud I see the problem with the sentence. So I delete and write instead:

Two small dogs. Loud to begin with, but soon settle down.

*

Mrs Albright is ninety-seven. She lives alone in a ramshackle bungalow, top of a narrow lane of cottages and heavily-buttressed flint walls leaning out at extraordinary angles, an ancient church under scaffolding, and a strange, round building with worn stones and arrow slits standing alone in a paddock, that looks like maybe it’s the last thing standing of a castle, currently serving as a chicken house.

Like most of everything else down the lane, Mrs Albright is old and falling down. But although physically she’s reaching the end of her ability to cope, intellectually she’s as formidable as ever.
‘Apart from the carers coming in twice a day, and your family popping in when they can, do you manage to see anyone else?’
‘Anyone else? Do you mean socially?’
‘Well – yes, I suppose I do.’
‘I run an ancient history group once a week, if that counts. Does that count?’
‘I think that counts.’
‘Excellent. Then – yes. Every Wednesday I have a dozen or so people round and we discuss a broad range of topics. Last Wednesday Sally did the Assyrians. This Wednesday it’s Margaret on Alexander the Great.’
Whilst we’re talking, Mrs Albright’s dogs – two bug-eyed pugs – have plopped themselves down to sleep around her feet.
‘Yes – I’m afraid they do that a lot,’ she says, peering down. ‘They like to be near me in case I drop anything overboard, a bit of crumpet or what have you, which I’m afraid to say does happen from time to time. The problem is I forget the damned things are there and when I get up to spend a penny, I go flying. It’s a miracle I’ve lasted this long without breaking anything. Not so much as a cup.’
Mrs Albright’s son Richard is sitting with us at the table. He’s already mentioned that the family are looking at residential care, something Mrs Albright seems happy to think about.
‘I’ll miss the old place,’ she says, planting both hands firmly on the table and looking around. ‘But – you know, one thing that became very apparent to me very early on in my career, is that nothing lasts forever.’

into the hive

~ jim clayton ~ Leave a comment

Highdale Lodge sounds like a golfing hotel. Truth is, the nearest it will ever get to a fairway is the smear of grass in the middle of the road running by it, and the only shots the residents make are into-the-vein.

You’d never know it was there if you didn’t know it was there. When the weather’s better you might wonder about the people hanging around, leaning against the wall, but you’d probably think they were something to do with the Magistrate courts in session a few doors down. Because otherwise, Highdale Lodge is ruthlessly, determinedly anonymous, no nameplate or number, utterly forgettable. The building itself seems to sit up from the general run of the street, the first row of windows higher than usual, like the road was subject to flooding or riots. The main door is set back at the end of a narrow recess four or five feet deep, an odd architectural feature, somewhere between an alcove and an alleyway. The door – if you paused long enough to look into the recess – is severe, thickly-painted, double-hinged, more like the fortified entrance to a private citadel than the front door to a hostel. There’s a single, metalled button to the left of it to talk to the staff, linked to a security camera so sturdy it could take a swing from a lump hammer and still be looking down at you.

Everyone who enters the Lodge has to go up a half dozen steps and pass the office counter on the left. It would be a cliche to describe the Lodge as a hive – even though the layout is exactly like a hive, with endlessly bifurcating, shoulder-width corridors leading to a bewildering number of tiny rooms, and everyone who takes you to each particular room seems to do a little wiggle to let you know how to get back – but if I DID feel tempted, and DID describe it as a hive, I’d have to say it would be a particularly busy hive, administratively confusing and always at the point of failure, the kind of hive where every bee has to sign in and out, and many are tagged, and have their stings monitored, and the farmer is at his wits end, desperate for more hives, but you’d have to think there’s no money in honey.

My patient, Keith, seems happy enough, though. To begin with, at least. He stubs out his cigarette and turns on his nebuliser.
‘Sorry about the mess,’ he gasps.
There’s a great smear of damp in the corner, spreading upward like a malignant wave. It’s a poor situation for someone with COPD.
‘I’m hoping to get ah’t of ‘ere soon,’ he wheezes through the mask. ‘It’s a shit’ole. I ave’da go upstairs to the kitchen. Me like I am it may as well be the moon. So it’s not like I even get a decent meal.’

I check him over. Unsurprisingly, his SATS are lower than you’d expect.
‘I don’t need to tell you the smoking’s not helping,’ I say, writing in the folder.
‘Oh – here we go!’ he says. ‘It’s all my fault! Yeah – I know! But listen, mate – it weren’t so long ago they give you a fag with yer bottle a’milk at school. Everyone smoked everywhere, all the time – on the buses, the tube, the pictures. Saturday night, you couldn’t see the cowboys for the smoke! So don’t come round ‘ere blaming me for everything…’
‘I know it’s difficult, Keith. I just meant it’d be better if you could cut down, given how bad your lungs are. Even a little bit. That’s all. There are things around to help, patches and whatnot.’
‘Patches!’ he says. ‘Don’t talk to me about patches! What about them patches over there, eh?’

And he turns away to nod at the damp, and then turns back again, and glares at me over the rim of his mask.