sketches

in the cage

~ jim clayton ~ Leave a comment

Imelda’s flat is so small and cluttered it’s like trying to install a commode in a hamster’s sleeping compartment.
‘By the bed’s fine, love,’ she says. ‘I can shuffle m’self straight onto it.’

Shuffling seems to be Imelda’s primary means of getting about these days. Her legs are terribly raw and swollen, and with decreased mobility has come significant weight gain. You might call it the snowball effect – if the snowball had given up rolling, was covered in a rash, and its internal organs were squealing under the strain.
I ask her if she’s got family nearby.
‘Five kids,’ she says. ‘They’ve all done well. Went to college and everything. America. You name it, they’ve done it. And I brought them up all on my own.’
‘That must’ve been hard.’
‘It was hard. My husband died young and there I was, five kids, looking around and wondering what the hell I was going to do about it.’
‘What happened to your husband?’
‘He was killed at work. A big door fell on him.’
‘How awful. So what did you do?’
‘I didn’t have a clue. It wasn’t like I was good for anything much. I wasn’t trained like he was. I didn’t have certificates. Shelling out kids was mostly what I’d done. But once he’d died I had to find a way to put food on the table and shoes on their feet. So I went dancing. And it turns out there was good money in it.’

When I ask her what kind of dancing, I think she says ballroom.

‘You must’ve been really good.’
‘I was good. You wouldn’t think to look at me now, but loads of people came to watch.’
‘That’s amazing!’
‘Yeah. I had a wonderful time. And I made so much money through tips the kids did alright. And now look at them. America and everything.’
‘Tips?’
‘They’d stuff the notes in your costume.’
‘I had no idea there was so much money to be made ballroom dancing.’
‘Ballroom dancing? No! Pole dancing.’
‘Oh!’
‘Can you imagine me swanning around in a chintzy skirt? Don’t answer that.’
‘So you were a pole dancer?’
‘And I was good. I took the kids with me up to London and I did very well. There was a guy there, one of the big club managers, and he said to me Imelda? I’m going to make you a lot of money – but don’t worry! Not like you think! You’ll be quite safe.’
‘And were you?’
‘I was. He put me in a cage.’

back to baseline

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‘Do you know who we are? Has anyone told you what we do?’

I say it a lot. Almost as many times as I say ‘Do you have a yellow folder?’

Sometimes I feel like an actor in a long-running play, overly conscious of his hands in the middle of a monologue on a wet Wednesday matinee in February.

But that’s the trick, I suppose. Finding truth in the same old lines, even though you’ve said them so many times they’ve picked up a dodgy shine.

‘We’re an NHS community health team. We’ve got lots of people working for us – nurses, nursing assistants (that’s me), physiotherapists, occupational therapists… you name it!…We’ve got a small bank of emergency carers… we’ve even got a pharmacist!’

I like putting that one in. It makes us sound like a friendly high street, all the usual shops.

‘We work on a pretty tight schedule. Just three days. We get referrals from the GP, who might be worried someone needs a little extra support. We get referrals from the ambulance, who might have gone round to someone who fell, for example, and they want us to follow up to make sure everything’s okay. Or a referral from the hospital, because someone’s being discharged and needs help. That kind of thing. So we pitch in, see what’s what, and either refer the patient on to a more specialist health team like the Respiratory nurses, the Heart failure team, the District Nurses and so on. Basically we’re here to keep people safe at home and help them stay out of hospital if possible.’

Invariably the patient will interrupt on the second sentence of the spiel, though.
‘Three days! Is that all?’
And if they do, I’ll say something like: ‘Well – yes – we are what they call an acute service. We’re very short term and we do try to move people on as soon as we can. But the bottom line is, we won’t leave anyone in the lurch. We’ll keep patients on for as long as it takes for the other team to pick-up.’

Mostly that works. Sometimes they fixate on the three-day thing, and it takes a bit more reassurance. More often than not, though, they’re just relieved to have someone – anyone – coming through the door. Because a great many of the patients we see are struggling. They may have suffered a recent exacerbation of their health problems, an accident or an illness. Maybe they’ve suffered a change in their social circumstance, the death of the partner who was their main carer, or some other family breakdown. But although the specifics of their situation change, the basics stay the same: they can’t cope, and they need help to get back to coping, whatever that might look like.

There’s a phrase you see used a lot in the team – Back to baseline – a simple expression of the outcome we’re looking for. Back to baseline means getting the patient back to where they were before they needed all these interventions.

A simple plan. And like all simple plans it hides a world of negotiation, and difficult decisions, and compromise.

Back to Baseline.

‘Any questions?’

what a ride

~ jim clayton ~ 2 Comments

The best way to see Helmstone is by seagull – if you’re a pixie, don’t have a drone, have no interest in drones, or actually, you DO know someone with a drone but you wouldn’t feel happy throwing your leg over anything with rotors – although the seagull doesn’t seem much better, having a huge beak and a pretty terrifying kind of appetite. But then, I’ve no idea about seaside pixies. They may well have a good relationship with seagulls. Unlike town pixies, who have a thing for pigeons but a terrible allergy to crows. But I digress. The point is, you’re an incredibly cute little authorial device, you’re able and sufficiently motivated to ride a seagull, and you’re all set to give us a tour of this wonderful seaside town that, from the point of anonymity, but entirely unconvincingly, I’ll be calling Helmstone.

Okay?

Good.

So.

Also – I should say – because I want to start the tour from out at sea, for artistic reasons, I’ll be assuming you’re friends with a fisherman, who maybe rescued you from the crappy canoe you made out of coke cans, and you owe him big time for that, and he’s pretty kind anyway, even though economically he’s not doing so great, and there are official letters waiting at home he’s VERY reluctant to open. But whatever – he hooks you from the water a couple of miles off Helmstone, and after some fantastically witty dialogue that I haven’t got time to go into now, he agrees to let you ride the tame seagull who often hangs around his boat,  and who’s looking a little jealously at you, so you can take a tour of the town that will benefit the readers and give them some local colour. And no doubt the fisherman’s hoping that maybe when you’re done you’ll come back and do some interviews and talk shows with him, and make him enough money to carry on doing the thing he loves best, which seems to be sinking empty lobster pots into the English Channel, and hauling them up still empty twelve hours later.

The fisherman – let’s call him Steve, although personally I’m not at all convinced by that, but I don’t want to waste any more time thinking up a better name, because ‘Steve’ doesn’t feature at all in the book except for this dreadful prologue, which I hope you’ve skipped, but there we are – Steve helps you onto the bird’s back, which is waiting at the front of Steve’s crappy little smack, flicking its wings nervously, wondering what the old guy’s planning now, and maybe it’s time to find another boat to hang around. Steve fits the seagull with a hilariously inept canvas saddle and reins made out of dental floss – something the seagull REALLY doesn’t want in its beak, but Steve insists, because it’ll give you some measure of control. And he gives you a cute little flying hat, and a snug little fur jacket he made out of the pelt of a rat, for God’s sake, which you hate putting on, but you don’t want to upset the guy, because he’s doing his best, and anyway, this book will never get started if you don’t agree to wear the horrible fucking rat jacket.
And he says farewell my brave little aeronaut, quite patronisingly, and throws you into the air. And for a second you’re terrified the seagull is planning to flip you over its head and swallow you whole, either because it’s hungry, or because it’s a seagull, and in the rat jacket you look exactly like a rat, which seagulls have long-standing issues with. But let’s just say the seagull comes to terms with it, finds its wings, and actually starts to enjoy having a flying buddy. And the two of you soar away into the sky, circling once overhead to wave at Steve down below, who’s inadvisably standing up his smack, waving his cap, which he loses overboard, and then follows with a splash. And you can’t help laughing, despite everything the poor guy’s done for you, because you’re a cheap little pixie who really doesn’t deserve anything good.

But there you go.

So.

Fly low over the waves, lightly, through the gobs and spits of foam, and watch as the city of Helmstone slides up into view, acquiring definition as you skim towards it, a strip of beach, red brick arches, iron walkways, hotels, conference centres, traffic on the coast road. Rise up over the pier. Rise up along the mackerel lines of the old fuckers at the end, up over the theatre and the hurling seats on the end of crane arms fairground rides, squabbling with the other gulls that scavenge the boarded length of it, high over the heads of the winter crowds there, and follow the boards to the pebble margined land. Snick over the pointy top of the old iron clock; over the beach and the giant blue Slush puppy dog and the crazy golf, the chip stands, the EFL kids throwing pebbles into the sea; bank down and round, faster now, with more purpose, to skim the traffic stalled by the aquarium, up towards the Victorian one way system; go graciously by the hand of a green and bilious Queen, her celebratory gardens, the council workers prodding in bulbs for the spring; come in low along the cycle paths, the bus lanes, the pot-holed roads; flash along past the tourist tick lists, the anonymous business frontages, past the fake Tudor pub, the computer-designed flats, the Georgian terraces and wrought-iron balconies, leave in your wake the traffic stalled by the skate park, the converted municipal buildings, mews apartments and student halls; pull up over the bendy-buses queuing at the lights, blocking the junction; blast away up the hill towards the edge of the great half cup that forms this seaside town, easing off on the seagull’s reins as you reach the top, banking into the  entrance of the old workhouse they made into a hospital; fly up the drive; glide to a stop on the window ledge of the first floor; catch your breath – and when you’re ready, let the seagull tap once on the window with its beak.

And wait.

work it, baby

~ jim clayton ~ Leave a comment

With his thick black hair shaved at the sides and gelled back in a riotous, rockabilly quiff, white framed sunglasses and perfect designer stubble on perfect designer cheekbones, Ethan the nurse makes every visit a fashion shoot. I can see him waiting for me further up the street. He’s lounging back against a lamppost, one white trainer kicked back, the furry grey hood of his parka arrayed like a luxurious ruff around his neck. He’s snapping gum, staring at the cars going by. He looks fabulous.
‘Oh there you are !’ he says, pushing himself upright, flashing me a look over the rim of his sunglasses. ‘I wondered where you were. I was clean-shaven when I got ‘ere.’

We’ve come to see Martin, a difficult patient with a history of drug and alcohol abuse, a few incidents of aggression. I’ve met Martin before – admittedly a while ago. He’s young, but only on paper. When I met him he’d just been discharged from hospital following a fall down a dozen steps and a long lie at the bottom. The fact he survived at all was a miracle. But miracles are fleeting, and there’s always something waiting the other side of them. In Martin’s case it’s a list of medical acronyms that reads like a roll-call for the damned. What’s worse is his recent history of non-compliance, missed appointments, saying one thing and doing the opposite. He was referred to us by the hospital again, this time to dress an abscess in his thigh, the latest wound from his attempts to find anything resembling a patent vein. We’ve been formally tasked to get him to sign an official waiver if he declines help again, so long as we feel he has capacity.
‘Feeling lucky?’ I say to Ethan.
‘Darling – I was born lucky,’ he says. ‘The rest is just exercise and a great skincare routine.’

Martin is staying in supported housing – in this case, a pleasant-looking semi in a tree-lined street, a tall privet hedge screening it off from passers-by. A mosaic path runs from a gap in the hedge through a functional, stone chipped garden to the front door. There’s a brushed steel intercom by the door with a line of illegible, rain-smeared names by the buttons.
‘Shall we ring it?’ says Ethan.
‘Let’s ring it.’
‘You ring it.’
‘No you ring it.’
‘Okay I’ll ring it.’
Ethan rings it.
Rings again.
Eventually a woman answers in a drawly voice.
‘Who is it?’ she says.
‘Oh hi there!’ says Ethan, leaning closer to the intercom and giving me a cartoon-panicky look at the same time. ‘It’s Ethan and Jim, nurses from the rapid response team? We’ve come to see Martin?’
‘He can’t see you. He’s ill,’ she says.
‘Ah. Well. That’s probably a good reason for us to come in, then. I mean – you know – being nurses and everything…’
‘I told you. He’s ill. Come back tomorrow.’
‘Erm… we kind of need to see him face to face so he can tell us himself,’ says Ethan. ‘Otherwise we’ll get in trouble. Would that be alright?’
‘No,’ she says. ‘Come back tomorrow.’
The intercom goes dead.

Whilst we’re standing there wondering what to do next, a man and a dog appear through the hedge. They both look extraordinary – the man because he has a heavily tattooed face and more piercings than the cenobites in Hellraiser; the dog because it has three legs and a lop-sided, piratical expression.
‘Who’ya’fter?’ he says.
‘Oh, hi there!’ says Ethan, shrugging and tipping his head coquettishly on one side. ‘We were just wondering if we could come in and see Martin?’
‘Martin?’ says the man, frowning. ‘No. You can’t. He’s ill.’
‘Yeah. I know. We’re nurses.’
The man fishes a key out of his pocket (although I wouldn’t have been surprised if he pulled it out of his ear).
‘No,’ he says. ‘Come back tomorrow.’
And he lets himself in.
Only the dog looks back.
The door slams shut.
‘Fine! Suit yourself!’ says Ethan, shouldering his bag. ‘Waste my time why don’t you!’
He puts his sunglasses back on, and we leave. The sun comes out. Ethan walks down the path with an exaggerated throw of his hips.
‘Work it, baby!’ he says.

me, maud & peter o’toole

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Maud is watching ‘Lawrence of Arabia’ on a plasma TV screen so enormous you’d need a camel to get from one side to the other. She’s sitting in a padded wheelchair, her bad right leg straight out on a leg support. It’s a nice contrast, seeing Maud in her wheelchair like that, Peter O’Toole on his camel. I picture her tying her leg to the hump.
‘Have you ever ridden one of those?’ I ask her.
‘No. But I went on the dodgems once.’

Maud’s daughter Isabel is supposed to be meeting me here. She’s already rung to apologise and say she’ll be late, though. Apparently the taxi driver sat outside her house and didn’t bother letting her know he was there.
Maud shakes her head.
‘That’s Isabel for you,’ she says.
We’ve done all the medical stuff so there’s nothing to do but wait. Isabel has some questions and concerns, so I need to hang on for a while.
‘I hope she won’t be long,’ I say.
‘She’ll be twenty minutes,’ says Maud. ‘You can set your watch by it.’
We watch as Peter O’Toole and his guide draw water from a well in the middle of a vast expanse of desert. Suddenly they see a shimmering black shape in the distance. A mirage? What is it? The shape gets bigger. A figure on a camel, riding straight at them. The Arab guide fetches out a rifle and takes aim. Peter O’Toole tries to stop him but it’s too late. The approaching figure fires first; the guide drops to the sand, dead. Finally the figure arrives. It’s Omar Sharif.
‘Now there’s a good looking man,’ says Maud, pushing herself more upright in the wheelchair. ‘He can shoot me any day.’
‘I’ve got a story about Omar Sharif,’ I say.
‘Oh yes?’
‘My brother in law is Lebanese. Or was. He’s dead now, unfortunately.’
It suddenly strikes me it’s an odd thing to say. Do you stop being Lebanese just because you died? Maybe you do. Maybe that’s death. You stop being anything.
‘What did he die of?’
‘Cancer.’
‘Yes,’ says Maud, flatly, as if she expected it all along.
‘Anyway, he used to work in Maroush, a famous Lebanese restaurant on the Edgware Road.’
‘I’ve heard of it. I think.’
‘It’s pretty swanky. Saad was the Head Waiter. One day Omar Sharif came in, surrounded by all these glamorous people. Saad went to take their order and settle them in, and Omar looked up at him and said: Would you like my autograph? And Saad said: No. Would you like mine?’
‘I liked him in Doctor Zhivago,’ says Maud. ‘He was lovely in that.’
‘I haven’t seen that one.’
‘No? You should.’
Me, Maud and Peter O’Toole watch Omar Sharif ride away on his camel.
The door bursts open. It’s Isabel.
‘So sorry about that!’ she says. ‘Stupid driver.’

feeling the heat

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Anna, the coordinator for the early shift, waves me over.

‘Jim? I’ve got a P2 for you, darlink. Nothing massively urgent but I think if you could go there this morning that would be wonderful. I’ve sent it through to you. See what you make of it. Let me know if you need anything else. Okay, darlink? Perfect. Okay? See you later.’

I’m about to ask her something but the phone starts ringing again. She pulls a face, holds up a finger, answers the phone – and immediately gets drawn into something complex. It’s early in the shift and she’s already quite red in the face. Some of that’s the office. The boilers here seem to have two settings: OFF for the summer, ON for the winter – ON being approximately The Surface Temperature of the Sun. It’s ironic that there are disposable cardboard thermometers pinned up around the place, the kind that we give out to our elderly and at risk patients. All of them are so far in the RED zone the caption advises calling 999. Nothing ever changes. We stew when we come back to the office to catch up on admin and stay out as long as we can.

I touch Anna on the shoulder, nod and smile as if to say don’t worry, I’ve got everything I need, and loosening my collar, head for the door.

*

A P2 faller is a patient who needs to be seen reasonably urgently but a little delay is probably fine. The ambulance  made the referral. They had attended Mrs Davenport that morning for a non-injury fall, and identified a few things they thought we could help with.

She doesn’t answer the phone when I call, which is a little concerning, given the history. There’s a keysafe number on the referral. I decide to go over there on spec, just in case she’s on the floor again.

*

‘Hello? Mrs Davenport? It’s Jim, from the Rapid Response Team.’
Nothing.
I’m standing in a long, bare-boarded hallway that stretches ahead to a steep staircase, and past that, into a kitchen with the faintest spill of light.
‘Helloooo? Mrs Davenport? It’s Jim. From the hospital.’
Nothing.
I decide to go into the kitchen first.

The light is coming from a table lamp, set by a rubbed but comfy-looking armchair. There’s a bottle on the floor by one of the claw-foot legs, and a dirty tumbler on a table to the side. I’d guess from the look of the kitchen it’s the place Mrs Davenport spends most time. There’s a Roberts radio next to the tumbler, its aerial so bent she either fell on it or took a bite when the news was bad. Either way, it’s resolutely off.
‘Mrs Davenport? Hellooooo?’
The place has a hunkered-down feel. Stuff piled in the sink. Curtains drawn.
There’s a door at the back. I knock and open it. A toilet and washbasin, both the worse for wear.
‘Hellooo?’
I retrace my steps and begin opening the doors along the hallway. The first is the old sitting room, completely dark, nothing to suggest that anyone’s been in more recently than 1962. Opening the next door makes me jump, because there are coats hanging from a hook and they swing out a little. The next door is Mrs Davenport’s bedroom.
‘Hello?’
She’s lying in bed, completely covered by a quilt. All I can see – apart from the lump in the quilt – is a spread of lank grey hair on the pillow.
‘Mrs Davenport? Hello. Sorry to bother you. It’s Jim, from the Rapid Response Team.’
‘What?’
A clawed hand pushes the quilt from her face and she glares at me.
‘What do you want?’ she says. It’s like I’ve disturbed a wild creature, an owl or something.
‘I’m so sorry to wake you like this,’ I say. ‘I was asked to come and see you by the ambulance.’
‘The who?’
‘The paramedics. They said they picked you up when you fell this morning.’
She blinks a few times.
‘I did not fall,’ she says. ‘I slipped.’
‘But you didn’t hurt yourself, so that’s a blessing.’
She blinks again. It’s like being photographed.
‘Why would I have hurt myself? I went to sit on the bed. I slipped gently to the floor. That’s it.’
‘But then you couldn’t get up.’
‘So I pushed my button. As I’ve been told to do. The paramedics came. They helped me up.’
She stares at me, a little more awake now.
‘Who did you say you were?’
I tell her, explaining as simply as I can what the Rapid Response Team is, and how we can help.
‘But I don’t want any help.’
‘That’s fine. We’ve only come round because the paramedics said so.’
‘We?’
‘Well – me. But there are other people on the team, as I say.’
‘I was asleep!’
‘And I’m so sorry to have disturbed you.’
‘I don’t understand why you’re here.’
I take a different tack.
‘Are you feeling unwell?’
‘No! Why would I?’
‘Are you in pain? Is there anything troubling you at the moment?’
She stares at me for a very long time, then hooks the quilt back even further so she can get a better look.
‘Yes,’ she says, eventually.

Janet the dog walker

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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

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‘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

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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.’