sketches

sixty years on

~ jim clayton ~ Leave a comment

‘How long have you lived here?’
‘Ooh – I don’t know. I should think about sixty years or more’ says Thomas. ‘We moved when we had Lily, and I’d got that new job. D’you remember, Lucy?’
‘Of course I remember!’ says Lucy, rearranging a napkin on her lap. ‘I was here, wasn’t I?’
‘Sixty years,’ says Thomas, absorbing Lucy’s tetchiness with a wistful shake of his head and then a sudden, gaping smile, the kind you might see on a ventriloquist’s dummy. ‘Long enough!’ he says.

It’s a beautiful old cottage – or used to be. Could be again, with a little work. Emptying out all the clutter, ripping out what remains of the fixtures and fittings, stripping back the plaster to the bricks, taking up the floor, rewiring, new doors and windows. New roof, come to that. Redecorating throughout. Cutting back the garden, and so on. An album of Before and After photographs. These things take a little imagination, but totally worth it if you can see beyond the mess. Clink, clink. Cheers!

Thomas and Lucy wouldn’t feature in any of the quotes, of course, even if the builders were game, and had a few geriatricians, cosmetic surgeons and orthopaedic consultants on the team. Because it goes without saying that the same passage of years that wreaked such damage on the house hasn’t spared the occupants, and whilst ancient buildings can be straightened out with hard work and a certain amount of cash, the same can’t be said of the people who live in them.

‘Push that button – no! That one!’ says Thomas, leaning out to interfere with Lucy’s attempts to operate the riser-function of her chair.
‘Let me do it! Let me do it…!’ says Lucy, wresting it away from him and getting in a muddle. The back of the seat goes down and the footrests shoot out. ‘Blast!’ she says, and promptly turns the whole thing off.

They have carers three times a day – once to get them up and dressed, once to give them lunch and prepare some cling-filmed sandwiches for tea, and once to put them to bed. Although I have to say it’s looking pretty much as if the ‘bed’ aspect has gone by the board. They’re sleeping in their chairs full-time now, and only getting up to stagger precariously through the jumble of everything to a commode.

At first it seems like a pretty sad kind of existence, and I can’t help feeling sorry for them. Wouldn’t it be better if they sold up and moved into a nursing home? Somewhere with staff on hand to keep an eye on them? To wash, dress and feed them, and keep them warm (not that this place is cold – they have a free-standing oil-filled radiator in the middle of the room, on full). I’m sure they could sit next to each other somewhere, either in their own room or in the lounge? Because no-one could say they were remotely safe in this place. A small stack of ambulance sheets is a testament to the increasing number of falls they’re having.

But they don’t strike me as unhappy. The bickering isn’t unpleasant or aggressive; more the sniping of two caged creatures, fussing over the minutiae of their shrunken existence. I wonder how well they’d fare if they were removed from this place, even taking into account the trip hazards and the damp and the dodgy electrics. I wouldn’t be surprised if they faded away the moment they were helped to a couple of comfortable chairs, in a wide and well-lit room, with a television, and a trolley doing the rounds at half-past ten, and three.

‘Give it here… look! You’ve turned the damned thing off!’
Thomas tries to snatch the remote, but it’s like watching a tortoise make a swipe for another tortoise’s lettuce leaf.
‘Ha!’ says Lucy. Then after glaring at him triumphantly, she slowly presses it up to her nose to figure it out.

a bit of a drama

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The living room is as brilliantly lit and formally arranged as the opening scene in a play. A man and a woman sitting side by side on the two-seater sofa in the bay window, stage left; me with my folder on my lap on a matching armchair just downstage from them, and then an elderly woman stage right, the focus of attention, sitting on a dining chair turned sideways to the table, her hands neatly folded in her lap. A bright and pleasant room, crowded bookshelves, pictures on the walls, a giant fern in a green pot, and a plain-framed mirror over the mantelpiece casting back that light pours in through the windows.

And if it was a scene from a play, the director might well decide to hold it there, curtain up, and not have anyone speak their lines for a beat or two, giving the audience time to settle, take it all in, and wonder about the four characters. What assumptions might they make?

They’d know I was official, and not just from the obvious stuff, the uniform and lanyard, bag and folders. They’d probably think there was something a little self-conscious about the way I was sitting, a conciliatory duck of the head, maybe, a professional sharing of attention between the other three. They’d think the other man was a relative, the son, no doubt. He’s the right age, of course, but he looks like someone who’s spent a lot of time in this room, one way or another. And the way he massages his hands and jogs his knee up and down. He looks like someone who’s been brought here over some distance, at some inconvenience, still wearing the suit he was in when he took the call. A nice, professional son, then, worn down by circumstances he finds more difficult because they’re out of the normal run of things, and hard to quantify in the usual way. The woman sharing the sofa is sitting so close to him they must be in a relationship. There’s something resolutely straight-backed about her posture, and the encouraging smiles she shares around the room. There’s something about the way they are together that suggests long conversations and negotiations. They’ve arrived at a decision – he, more reluctantly – resolved to face it together, shoulder to shoulder. The elderly woman has a bewildered look. There’s a vagueness about her in strange contrast to the sharp delineation of everything else, as if the bright sunlight flooding the stage is causing her to lose definition rather than gain it.

‘Tell me about the whole bath thing’ I say. ‘I didn’t get the whole story.’
‘Well it does sound a bit crazy, even to me,’ says Helen, the elderly woman. ‘You see – I took a bath as I usually do in the evening, but then I blacked out, and it was some time before I was found.’
‘How long?’
‘Three days.’
‘That’s a long time.’
‘Yes. It is.’
‘Was the bath filled with water? You were lucky not to drown.’
‘No. The water had gone.’
‘Who drained it?’
‘It must have been me, although I don’t remember.’
‘Three days in a bath! I’m surprised you didn’t freeze.’
‘It’s a warm flat.’
‘When did you regain consciousness?’
‘The whole thing’s quite blurry. I’m not really sure.’
‘It’s perhaps a strange question to ask, and I’m sorry for asking it – but had you been incontinent?’
‘No, I hadn’t.’
‘So you passed out in the bath. Came round at some point. And then couldn’t get out of the bath. Is that right?’
‘I suppose so. Although it sounds pathetic when you put it like that.’
‘Who found you?’
‘Maria, the cleaner. She comes every Wednesday morning.’
‘And did she call the ambulance?’
‘Yes.’
‘And they took you to hospital?’
‘They did. And I had a whole series of tests. The works. And all they found wrong with me was a silly little cut on my toe. Would you like to see it?’
‘Maybe in a minute or two.’
‘I don’t know how I did it. Probably on the tap, I should think.’

She looks at her son, Matthew, who sits on the sofa with his knee jogging up and down. Matthew’s German wife, Helga smiles brightly back at Helen.
‘We will get things sorted,’ Helga says. ‘Don’t worry.’
‘Absolutely!’ I say, flicking through the discharge summary, at the normal blood results and scans and so on, the recommended follow-ups. ‘We’ll figure something out.’
‘I do hope so,’ says Helen. ‘It’s all a bit of a drama, I’m afraid.’

learning how to land

~ jim clayton ~ 2 Comments

Vera is as formidable as the tartan wrap she has over her shoulders.
‘But who sent you?’ she says.
‘The GP. I think she was a bit worried after that fall you had.’
Vera stands holding the door, hesitating on the threshold of a determination to be alone and an anxiety not to appear rude.
‘Well I suppose you’d better come in,’ she says, releasing the door and turning on the spot as ably as her ninety year old hips will allow. ‘But I’m not happy about this. Not happy at all.’

I follow her through to the sitting room, a ruthlessly bare place with just a television, an armchair, a pouffe and a side table. There are half a dozen framed photographs on the walls, arranged in a regular pattern. The photos are mostly black and white, one of a wedding but I can’t be sure from here. She sits in her armchair and gestures for me to take the pouffe. I sink into it, my knees pressed into my chin, and I squat there looking up at her like an acolyte at the feet of a master.
‘The important thing to remember is that you’re the boss of you,’ I say.
‘What on earth do you mean? Of course I’m the boss of me.’
‘That’s great! It’s just – sometimes I think it’s easy to lose sight of that with all these different people and agencies piling in all the time. You tell them what you want and don’t want, and so long as you understand the consequences, no-one will mind.’
‘Of course I understand the consequences. I do the Times crossword every morning. Do you?’
‘I don’t understand cryptic clues. I can only manage the quick crossword.’
‘It’s not the same thing at all,’ she says. ‘But you’re right. You have to tune your ear to the language.’
She adjusts her shawl, loosening it a little. I hug my knees and try to rock into a more comfortable position.
‘I just don’t want all this fuss,’ says Vera, warming to her theme. ‘People barging in all hours of the day and night, left right and centre. I haven’t asked for any of it. They want to give me frames and trolleys and contraptions for the toilet and goodness knows what. But I simply don’t want them. They clutter the place up. I want to be able to move, freely, in my own time. Can you understand that?’
‘Yes. Completely. But you know – they’re only making these suggestions because you had that fall. They want you to be safe.’
‘You see – I fundamentally don’t understand why these people can’t leave me to live my life as I want to live it. I have my cleaner who comes in once a week. My granddaughter does the shopping. I’m perfectly happy with the way things are. I pay them to help me, and there we are.’
‘Do you pay your granddaughter?’
‘Well of course I pay her? She wouldn’t do it for free, would she?’
‘Family… I don’t know.’
‘That’s not the arrangement I want. It has to be clear. Everyone has to know where they stand. I’ve had people say to me why don’t you live with your son or your daughter? In a granny flat? A granny flat! I can’t think of anything more ghastly – for them or for me. Being walled-up somewhere, like a nun, perhaps… Why in heaven’s name would I want that? They have their lives and I have mine.’
‘That’s perfectly fine. It’s a free country.’
‘So far as I was aware, yes, it is. So if you don’t mind, I’d like not to be bothered in future.’
‘I’ll say goodbye then. And of course, if anything changes, your GP can always make another referral. What I would say though, is it’s probably a good idea to wear your alarm pendant.’
‘I won’t do it. I’m not having that plastic monstrosity anywhere near me.’
‘The thing is, if you fell again and – worse case scenario – broke your hip, you might be lying on the floor for a long time…’
‘No I wouldn’t.’
‘I’ve seen it happen.’
‘Not to me, it hasn’t.’
‘I’m just saying – it’s worth thinking about.’
‘When I fell last week I crawled to the phone.’
‘Next time you might not be able to crawl’
She fixes me with her sternest look, making little circular grinding motions with her mouth.
‘Listen,’ she says at last. ‘I used to race horses. Have you any idea what it’s like to fall off one of those things?’
‘Pretty hard, I expect. I fell off a motorbike once and that was bad enough.’
‘Well I don’t know about motorbikes, but falling from a galloping horse is a significant prospect. I should know – I’ve done it more times than I care to remember.’
‘Did you break anything?’
‘Only my pride. The crucial things is, one must learn how to land, and then get back in the saddle. There’s nothing else for it.’
I’m tempted to carry on the discussion by pointing out the number of years that have passed between that young woman cartwheeling through the air, and the older, osteoporotic version going over in the bathroom, but I can see that nothing’s going to persuade her. I struggle to my feet from the pouffe, collect my things together and shake her hand.
‘Goodbye then, Vera. It’s been lovely to meet you, and I’m sorry for disturbing your morning.’
‘That’s quite alright,’ she says, hobbling after me to the door. ‘It’s been a pleasure to meet you, too. But please – and I mean this in the nicest possible way – don’t come back.’

maud’s mother

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It’s been three weeks since I last saw Maud. She’s the one hundred year old woman who spooked me a little by saying she was worried she couldn’t look after her parents who were asleep upstairs. I’m here this time with Stacy, a physiotherapist, to conduct a mobility assessment. The carers have reported a sudden and significant drop in Maud’s ability to stand. We need to figure out if this is a confidence issue or something more permanent.

Stacy is exactly the kind of person you’d want to have with you in a haunted house. She may be small, but she has big feet, a disproportionately loud voice, and a vigorous, open-faced, square-shouldered approach to things. I can imagine her standing in the middle of a dark room, the hectic shreds of wailing ghosts swirling round her, planting her bag on the floor and saying: Right! Firstly, no-one’s impressed. Secondly, what do you hope to achieve by this? Thirdly – just because you’ve been dead two hundred years, doesn’t mean you can fly around with the posture of a cashew nut. So straighten yourselves out, settle down, stop messing about and we’ll see what we can do to help. The ghosts would immediately clam up and hover in line. And Stacy would sort them out.

She could be a whole new kind of health visitor. A physioexortherapist.

Who ya gonna call?

Stacy listens carefully when I tell her about what happened last time, the whole ‘ghostly parents asleep upstairs waiting for their daughter’ deal, and also about what her next of kin, Alan, said about it, which was that in many religions it’d would be seen as quite normal to be ‘met’ as you neared the end of life.
‘Okay,’ she says. ‘Fine. But you do know that Maud spent many years looking after her parents? So I don’t think it’s all that surprising she’s a bit muddled with the timings. I hardly know what day of the week it is myself, and I’m supposed to be young and fit.’
‘No. I suppose when you put it like that.’
She re-shoulders her rucksack, reaches up, and knocks so firmly with the rapper on the door it makes me think of Jack from Jack and the Beanstalk, knocking on the door of the giant’s castle. But instead of a giant housekeeper coming to the door, it’s Alan, still wearing the same Nordic sweater,shirt and tie, his goatee beard as perfectly groomed as a chin dipped in silver paint.

‘Good to see you!’ he whispers, shaking our hands. ‘Thanks so much for coming.’ And he shows us in.

Maud is in the hospital bed in the living room, as before. If anything she seems in better form, alert and smiling, with that copy of Anna Karenina on her lap.
‘Ah!’ she says. ‘Here comes the cavalry!’ putting the book aside.

The last week or so, Maud has stopped being able to stand with assistance and transfer to the commode. There doesn’t seem to be any infection or other organic reasons why she shouldn’t be able to do this. And she certainly has the strength. When we’ve lowered the bed and raised the backrest, she swings her legs over the edge ready for the off. It’s just – that’s as far as she gets. Stacy is great at clearly and firmly describing what Maud needs to do to stand up, even sitting next to her at one point and demonstrating – but Maud just can’t translate it into action. She keeps putting her feet too far out in front, and then waggling them up and down on the carpet, like a child splashing her feet in a puddle.
‘It’s no good!’ she says. ‘I’m falling!’

We persevere for as long as we can, but it’s a game of diminishing returns. The more we try, the more anxious Maud becomes, until her efforts to stand are such an approximate and off-kilter thing, leaning back against our hands, the zimmer frame lifting off the carpet, that we have to accept defeat, and help her back to bed. It’s strange to see how well she lifts her legs back onto the mattress and snuggle down again. Strength is certainly not the issue.
‘It’s definitely a confidence thing,’ says Stacy, snapping off her gloves. ‘Which isn’t any less incapacitating, of course.’
‘No, of course,’ says Alan. ‘So what’s to be done?’
Stacy shrugs.
‘Seems a shame to be thinking about hoisting. But other than that I suppose it’s bed care and some gentle encouragement to overcome the block.’

‘You see that woman over there,’ says Maud, pulling the bedclothes up to her neck, and then pointing straight in front of her. For a second I wonder if it’s another ghost – until I realise she means the sideboard facing her, and an ornate, silver frame in the centre of it. ‘This one?’ I say, going over to take a closer look. It’s a sepia photograph of a young girl standing on a dark, southern English beach. She’s dressed in a billowing white dress and enormous circular brimmed hat, which she holds on her head with one hand as she squints off into the distance. ‘That’s my mother,’ says Maud. ‘Now she’d have known what to do.’

stairway to helen

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I’ve never seen so many stairs. The whole place is a monument to them, an Escher wet dream of pointless meandering, a riotous architectural celebration of ascent and descent. It’s a shrine to steps, a mounting Mecca, a pilgrimage to Our Lady of the Handrails and Bannisters.

It’s certainly a lot of stairs.

It’s not simply wilful overuse, though. There’s a simple geographical explanation. Helen and Graham’s house is built into the side of a hill. For a start, the road leads down to it at quite a pitch. Then you have two flights of concrete steps down to the front door, a couple of steps over the threshold onto a landing, and then stairs leading down into the lounge straight in front, or up steeply to the right in two flights to the bedrooms and bathroom. The view from the lounge is an impressive, eagle-eye view of the city; I imagine that’s one reason they bought the place sometime back in the sixties.

I’ve come here with Sye, the physiotherapist, specifically to do a stair assessment (Initial assessment? Too many stairs). Helen has just been discharged from hospital after a total knee replacement. If they haven’t given her the robotically-enhanced version, she’s going to struggle.

‘I’ll be alright,’ she says, shifting uncomfortably on the sofa. ‘It’ll just take a bit of getting used to, that’s all.’

Graham is even more dismissive about the practicalities of the thing. There are two enormous, plush leather sofas in the lounge, meeting at the doorway and making a narrow corridor. It’s awkward for us to get through, let alone Helen, but Graham won’t countenance moving things around to make it easier.
‘You’ll just have to pass the frame over and come through sideways,’ he says.
‘Are you sure we couldn’t just move the sofa over?’ says Sye.
‘Where to?’ says Graham.
We make some suggestions. But it would mean losing a coffee table and one easy chair, something that Graham regards with horror.
‘No,’ he says ‘Absolutely not. We’ll manage.’

And to be fair, Helen seems to be the past master at managing. Once she’s negotiated the Clashing Rocks of the sofas, she hobbles on to the bottom of the first set of stairs.

‘Just remember,’ says Sye. ‘It’s good leg up to heaven, bad leg down to hell.’
‘Heaven. Hell. Got it,’ says Helen.
She makes heavy going of the stairs going up.
‘I think we should make camp here’ I say on the second landing. ‘Strike out for the summit in the morning.’
‘No. Come on, now. Keep up,’ says Helen.
And after a great deal of puffing and swearing, swinging her bad leg off to the side like Long John Silver at musket point, we finally make it to the very top landing.
‘Phew!’ she says, catching her breath. ‘You’d think I’d be used to it by now.’
‘You’ve just had a major operation,’ says Sye. ‘Cut yourself some slack.’

On the return, Helen insists on coming down backwards. That’s the way she got used to doing it in the months leading up to the operation.
‘Unorthodox,’ she says. ‘But it’s the only way I know.’
‘Good grief!’ says Sye, as she turns round at the very edge of the top stair, takes hold of the handrails either side, and begins the slow descent.

Back down in the lounge, there’s the same problem as before, negotiating the narrow gap between sofas before Helen can sit back down in her favourite spot. Graham is sitting the other side of the room, watching a natural history programme, something about bats.

‘All finished?’ he says, as a great flock of them swarm out of a giant cave at sunset.

‘I can’t speak for these two gentlemen,’ says Helen. ‘But I sure as hell know I am.’

the old bird

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‘Really – I’m fine. I don’t know what you’re making such a fuss about.’
Mrs Roberts has a determined, no-nonsense demeanour, fussing with the arms of her jumper to even them out, then sitting straight-backed in the armchair, distributing a brave smile about the room, bright as a lighthouse, to anyone who needed or cared to see. It would be easy to think that here was a ninety year old woman perfectly and admirably in control of her life, if it wasn’t for the livid, green and black bruises extending from her eyes down both swollen cheeks, the stitches on the bridge of her nose, and the bandage on her left hand.
‘You’re not fine, though. Are you, Mum? You’re very far from fine,’ says Steven, her son, sitting in a chair opposite.
‘Rubbish!’ she says. Then turns to me. ‘You see what I have to put up with?’
Steve buries his face in his hands.
‘Are you okay?’ I ask him.
After a moment he emerges again, his eyes shining, his face red. He straightens in the chair, takes a deep breath, and nods.
‘It’s difficult,’ I say. ‘It’s difficult for everyone.’

The situation has many practical angles and complications, of course, but the crux of it is simply the frailties of old age. Mrs Roberts has managed the early years of her ninth decade with impressive self-determination, only needing carers these past six months, when a dip in her mobility meant she struggled to get ready in the morning. It was a carer who found her on the floor just last week – a heavy fall with superficial injuries, thank goodness, but there’s no getting away from the fact that she’s more vulnerable than before. Steve lives in Germany, has done for many years. His brother is in the UK somewhere, but a family rift means Steve is the one left to sort things out.
‘I’ve just got to go back tomorrow,’ he says. ‘Work…life…y’know?’
His mother smiles at him as she gently dabs at her nose with a handkerchief.
‘Don’t you worry about me,’ she sniffs. ‘I’m perfectly capable of looking after myself.’
There’s talk of getting her into a respite bed for a period of recuperation. She doesn’t want to go, but she’s willing to do it if it means Steve can get back to Germany and not worry himself to death.
‘I wouldn’t go for good, though,’ she says. ‘I’m not ready for the funny farm yet.’

There’s nothing in her observations to suggest a reason for the increased falls. She says she feels well in herself.
‘It’ll be interesting to see what the bloods show,’ I say, preparing my kit to take a sample.
Steve asks me how long it might take to get a respite bed.
‘There’s a bit of a wait,’ I tell him. ‘There just aren’t that many available, what with all the cuts. The few they have they triage pretty thoroughly.’
‘It’s just – what’ll happen when I go back? She’s really not safe. Even with the carers upped to four times a day.’
‘If you funded a place independently you could get one more quickly, but of course that’s only if you have the money. Like a lot of things, I suppose. Without getting too political…’
He thinks about that, both hands flat over his mouth, so that I can hear his breath moving over his fingers.
To distract Mrs Roberts I nod at the mirror just behind her. There’s an old, velvet parrot on a perch hanging down in the middle. One of its eyes has gone, and the whole thing leans precariously to one side. It has a tuft of faded yellow fur in the middle of its head, like a comedy wig. I get the feeling if I unhooked it from the mirror and gave it a gentle shake, much of the colour would come back.
‘I like your parrot,’ I say. ‘And that’s not something I thought I’d be saying today.’
‘Percy? He’s a love, isn’t he? Steven gave that to me when he was a little boy. He saved up his pocket money and he bought it at the school fair. Didn’t you darling?’
Steve nods, reaches over and strokes her knee.
‘Looking a bit tatty now, though’ he says.
‘Oh I don’t know,’ she says. ‘There’s life in the old bird yet.’

met

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Maud’s designated next of kin, Alan, lets me in. A tidy man in his early sixties, his grey beard is as scrupulously clipped and pressed as his Nordic woolly jumper.
‘Just through there, in the living room,’ he whispers, giving a little bow of the head, his eyes closing momentarily behind a glint of steel-rimmed glasses, like a kindly psychoanalyst welcoming a new client. ‘The social worker’s with her at the moment. I don’t suppose Maud will mind the two of you.’

Maud is sitting out of bed in an armchair, still wearing her cat-print pyjamas, looking around with a detached, slightly befuddled air. Beside her, on a hospital table, is a selection of the things she needs: tissues, beaker of tea, remote control, reading glasses, and a copy of Anna Karenina.

I introduce myself. When I shake hands with Maud she holds her hand out limply, looking up at me like someone who thinks they might still be asleep.
‘I can’t believe you’re a hundred years old,’ I say to her, sitting down opposite.
‘Am I?’ she says. ‘Well, then. Neither can I.’
The social worker fills me in on the situation. Maud has Alzheimer’s, but has been coping pretty well with care support and so on. Just recently there’s been a bit of a decline, and people were worried.
‘It doesn’t look like an infection, so that’s good,’ says the social worker. ‘Maud would like to stay in her home, but we’ve just been talking about that, and what we might be able to do to help.’
‘I’m in your hands,’ says Maud, then nods at Alan. ‘You’ll know what to do, won’t you, dear?’
‘It’s whatever you want, Maud,’ says Alan, smiling. ‘But don’t worry. Nothing’s decided til it’s decided.’

I carry out a quick set of observations whilst the social worker reads through the notes. Everything seems fine. Maud seems to be in rude health, considering her extreme old age.
‘The thing that bothers me most,’ says Maud, ‘is I can’t get up the stairs to look after Mum and Dad. And if I can’t do it, who will?’
‘By upstairs do you mean – upstairs? In the bedroom?’
‘Where else would they sleep?’
‘It’s understandable that you’re worried about them,’ says the social worker, pausing a moment to choose her words. ‘But I think they’re safe now. I think they’re pretty much at rest.’
‘I know that!’ says Maud. ‘I’m a hundred years old! I’m not daft!’
‘No,’ says the social worker. ‘You’re certainly not.’
‘It’s just they’re upstairs waiting for me, and I’m stuck down here, and I can’t do anything about it.’

When it’s time for me to go, Alan shows me to the kitchen door. I take this opportunity to ask him what he thinks about Maud. He stops to listen, adopting a thoughtful attitude, supporting the elbow of his right arm with the hand of his left, gently pinching his upper lip.
‘I haven’t met her before,’ I tell him. ‘So I don’t know how much of this is new.’
‘You mean this thing about her parents?’
‘Has she talked about them before?’
‘Off and on,’ he says. ‘I know how it sounds, but I suppose there are two ways of looking at it. One is that it’s all just a symptom of her cognitive decline, some organic disease and so on. The other is to say that perhaps, yes, she can actually see her parents. You might think it odd to hear me say that; other people, in other cultures, with certain religious beliefs, would probably understand it quite well. You see, it’s been my experience in circumstances like this that people nearing the end of life are – how shall I put this? – met?’
‘That’s certainly a different way of looking at it.’
‘It is, isn’t it!’ he says, brightly, patting me on the shoulder. ‘Now then. Good to see you, and thank you so much for coming!’

I walk over the road to my car and throw my bags in the boot. When I turn round to look, Alan’s still there, watching me from the kitchen door.
I wave.
He waves back, then turns and goes inside.

For the life of me, I can’t help glancing up at the bedroom window.

the ghost of bert

~ jim clayton ~ 2 Comments

Godfrey’s son, Ian lets me in.
‘He’s in the front room watching athletics,’ he says. ‘Go on through. I’m just making some tea. D’you want some?’
‘No – I’m good, thanks.’
‘Okay, then.’

An easy start to things – which is why it catches me off guard to find Godfrey in an armchair, his head thrown back, his eyes closed, his mouth slack, his arms by his side and his legs straight out, twitching and jerking.

If there was one thing I learned from all my years as an EMT in the ambulance service, it’s not to panic. There’s always time – even if it’s just a few seconds – to take a moment and see as clearly as possible what’s happening in front of you.

I’ve seen a great many seizures, and of course they vary enormously in presentation, from absences and automatisms to full-body convulsions. Godfrey’s was different to any of those, though. It struck me as the kind of performance you’d give if you’d only seen these things on the telly. He seemed to think it was mostly about waggling his hands at the wrist.
‘Godfrey? Hello! It’s Jim, from the hospital,’ I say, putting my hand on his shoulder.
He immediately stops, straightens up in the chair, wipes his mouth with the back of his hand and shakes his head.
‘Dear oh dear,’ he says. ‘Some kind of nurse you are.’
‘Nursing assistant.’
‘I thought I’d give you a bit of a scare when you come in. But you’re obviously a hard-hearted bastard.’
‘Well at least that’s some kind of heart, anyway.’
‘I can see we’re going to get along.’
‘I hope so. I can always get the big needle out…’
‘Now, now.’
Ian comes in with the tea.
‘You’re not making a nuisance of yourself, are you, Dad?’ he says, handing him a cup. ‘I can only apologise on behalf of my father. I’d say he means well, but I’d be lying.’
‘I’m not getting involved,’ I say, setting out my stuff.
‘Too late. You’re involved,’ says Godfrey, taking a sip of his tea. ‘Ahh! Now then. I suppose you’ve come about this leg?’

Godfrey strikes me as depressed, which isn’t surprising, given the trouble he’s had with his leg. Although he’s elderly now, he’s been pretty independent, living alone, taking care of himself and so on. Now his mobility is seriously compromised, he’s found himself thrown onto the care of his family, which mostly means Ian, being the closest geographically, and carers coming in to help with this and that. It’s obviously as much a torture to him as the pain itself, and it looks like he’s supplementing his Gabapentin and Co-codamol with a little clowning.

‘You wouldn’t think to look at this wreck of a body, but I used to be a diver,’ he says. ‘That’s a hard job. You’ve got to be mentally tough. Not many can hack it, you know, down there in the dark and the cold.’
‘I bet.’
‘I’ve done some things in my time. I remember once we were sent in to find a body. It’d been there so long, the arm came off in my hand.’
He demonstrates, widening his eyes and pulling away from a phantom corpse.
‘I enjoyed the work, though,’ he says, relaxing back again. ‘Kept me busy.’
Ian nods at me from across the room. I can tell he’s heard these stories a million times before.

Godfrey’s quite a handful but I’m warming to him. He reminds me of my Uncle Bert, who had the same mischievous sparkle in his eyes, deliberately saying something provocative and then waiting to see what you’d do. I invoke the ghost of Bert to help me whilst I’m talking to Godfrey, joining in the banter, until it really feels we’re building a good rapport.
‘You’re all right, son,’ he says. ‘I’ve forgiven you for leaving me to die earlier.’
‘I could tell you were all right because you still had your hand on your wallet…’

The phone rings. Ian goes to answer it in the next room. I start filling in the obs sheet. Godfrey turns his attention to the race on the TV.
‘Look at him, running with his arm in a sling,’ he says. ‘That’s good, innit?’
‘It must make it so much harder.’
‘And look at that one,’ he says. ‘Horribly burned.’
It’s a moment before I realise he means the black athlete.
Godfrey grins when he sees the comment has landed. He folds his arms, and watches me.

It throws me far more than the fake seizure at the beginning of the session, and for a moment I can’t think what to say. It’s disturbing and disappointing enough, but what makes it worse is the intention behind it. This is obviously a test, to see if I’m really on his side, part of the crew, one of the gang.
I return his gaze a moment whilst I think.
He’s a depressed, embittered old man in a great deal of pain. I’m not going to pretend that I think it’s okay, but I don’t think it’s going to achieve much if I confront him. In the end I settle for a miserable compromise.
‘You can’t say that,’ I tell him.
‘Oh! Here we go! The thought police. In my own home, too. What’s the world coming to?’
‘It’s just – not a nice thing to say, Godfrey. People are people. You should know that by now.’
‘You and me are gonna fall out, mate.’
‘I don’t care, if you say things like that.’
Ian comes back in the room.
‘What’s happened?’ he says.
‘I said a bad thing,’ says Godfrey. ‘Apparently.’
Ian winces and shakes his head.
‘Once again – I can only apologise for my father.’
‘That’s okay,’ I say, automatically. ‘Don’t worry about it.’
But the way Ian takes his seat again, quietly, with an exhausted hang of the shoulders, I can tell he does.

not exactly Lear

~ jim clayton ~ Leave a comment

Zikri and I have been asked to do an environmental assessment on a patient.

‘What is this environmental assessment? What do they mean environmental assessment?’ says Zikri, saying it so emphatically again and again it sounds like a sneezing fit. He rapidly flips the page backwards and forwards like he’s trying to shake the sense out of it by main force. ‘They’ve already said it’s unhygienic and dreadful. Faeces on the floor etcetera, a terrible mess. What more do they think I can add to that? Hmm? A colour chart?’
I love working with Zikri. He’s a zesty combination of warmly humane and emphatically pragmatic. With his slightly greying goatee and his steel framed glasses, and his habit of staring at you with his mouth slightly open, like he’s savouring everything you have to say, and preparing himself to jump in with warm words of praise or a stinging rebuke. He’s the best teacher you never had. He’d have made a great theatre director, or maybe an oncologist. You could take any amount of criticism from Zikri and still think he’d given you a compliment.
‘He asked Anna to leave. So she did. She wasn’t able to complete the assessment, but she was there long enough to get this much done. Nowhere does it say she thinks he lacks capacity. And now we’ve been asked to go in and do an environmental assessment. I think all we’ll be doing is making him angrier and less inclined to co-operate than he already is.’
Zikri takes his glasses off and pinches the top of his nose.
‘Well, okay, alright,’ he says at last. ‘What time do you want to meet there…?’

*

I’ve been to a great many scenes of self-neglect, both in the ambulance and latterly as a community health worker. But I have to say Mr Frederickson’s basement flat is by far and away not anything like any of those places. In fact, I’d go as far as saying it’s actually very nice. It has a warm, stripped pine floor; walls populated with framed playbills, woodcuts of seabirds, watercolour landscapes, family photographs; quirky, vintage furniture; palms in jardinieres, and a view through a bright sash window of a rich and well-tended courtyard garden. I can’t help thinking we’ve come to the wrong house. In fact I’m so certain that must be the case, I quickly check the paperwork as Zikri makes the introductions.

‘It’s lovely to see you both,’ says Mr Frederickson, shaking our hands and then tying his dressing gown more tightly around his waist. ‘You catch me rather déshabillé, but then I suppose it is the weekend, so perhaps you’ll let me off.’

He’s utterly charming.

Zikri looks at me.

I know exactly what he’s thinking.

Environmental assessment.

‘If you’d be so kind to pass my apologies to your colleague,’ says Mr Frederickson, ‘… the girl who came here the other day. I’m afraid she caught me at rather a bad time. I stood there with my hair all over the place. I must have looked like Lear on the heath. I think I scared the poor girl out of her wits.’
‘No worries,’ says Zikri. ‘We will be sure to convey your apologies’
‘That’s kind of you,’ says Mr Frederickson. ‘Now – how can I help you this morning?’
‘Well…’ says Zikri.

stars in battledress

~ jim clayton ~ Leave a comment

‘I’ve never been what you might call quiet,’ says Elsa, tugging the bedclothes up around her neck. ‘That’s one thing you could never accuse me of. I suppose you’re either a talker or you’re not. You never have to worry about awkward silences with me. It’s just the way I’m built. Like being left-handed. Or having a head for heights…’

I’m waiting with Elsa for the ambulance to come. I’d been sent round for an initial assessment, ECG and bloods. But it was clear as soon as I walked in the bedroom that Elsa was acutely unwell. A closer examination led me to suspect she was suffering a serious internal bleed, so I called 999.

‘They’ll be here soon,’ I told her, putting the phone down. ‘Try not to worry. Meanwhile, I’ll get a few things together…’

*

It’s been a while, now. Three-quarters of an hour.

When I go next door to phone ambulance control for an update, I’m told that they’re doing their best, an ambulance will be dispatched just as soon as one is available – only, people are having heart attacks, strokes…. surely I can understand? I know it’s difficult, I tell him, but the fact remains, we need to get Elsa to hospital as soon as possible. She’s compensating reasonably well at the moment, but I don’t think that’ll last much longer. We’re doing our best, they say. Of course, I say. I appreciate your help.

When I hang up I carefully document the delay.

‘Not long now,’ I tell Elsa, going back into the bedroom.

Before what, I wonder. She looks so fragile, lying on the bed like this, the sockets of her eyes ghosting through the pallid stretch of her face.

‘I’m glad you’re here,’ she says. ‘I wouldn’t want to do this on my own.’

‘I’m glad I’m here, too,’ I tell her, sitting beside her to do another set of obs. ‘So – go on. You were telling me about Stars in Battledress…’

She’d always been mad on the stage, she says. Singing, dancing, doing sketches. And that was what they wanted. A friend of hers put her up to it. She said I was just the kind of girl they were looking for. It was such a shame what happened to her.

‘Why? What happened?’

‘It was a famous murder case. She was on a cruise ship coming back from a show in South Africa and she was murdered by one of the ship stewards. He tried to make out she’d agreed to have sex with him, but then died of a fit or something, and he panicked and shoved her body out of the porthole. They never did find her body. He was convicted, of course. I think he only escaped hanging because of some loophole or other. Died in prison, years later. Funny how these things work out. Poor Gay. She was such a kind girl, a lovely girl. But these things happen, I suppose. On a ship or anywhere else. You’ve just got to be careful and lucky and hope for the best.’

Elsa tells me about the shows she was in. About one in particular.

‘As well as performing, everyone had a job to do. Mine was to put together these wooden steps for the big dance number in the second half. I was just tightening up the screws when someone dropped a curtain pole straight on my head. Knocked me clean out! When I came to there was only a minute to go before I was on. I had no idea who I was or where I was, but the lights came up, they pointed me in the right direction, and I walked out into the light. Anyway, the words seemed to come from somewhere, so it worked out in the end.’

‘When that show was over I moved into the intelligence corps. I remember – we were all lined up in the corridor, six girls in front, about thirty men behind. You can imagine what that was like. I was the last girl to be called forward. When I heard my name I thought – right! I’ll show these men a thing or two! – so I marched as smartly as I could up to the desk, swinging my arms and hips. But you see, what I didn’t realise was there was this rug just in front of the desk, and the floor was highly polished. As soon as my feet touched the rug it flew out from under me and I slid the rest of the way on my aris, disappearing up to my shoulders in the footwell. The Major he stood up and peered over the edge of the desk.

‘Are you alright down there?’ he said.

‘Yes Sir!’ I said, and saluted, flat on my back, and everyone laughed. But it didn’t do me any harm, apart from a few bruises. They took me on.’

The flat door buzzes. I’m relieved to hear it’s the ambulance.

Two paramedics walk in.

‘Alright?’ says one I vaguely recognise. ‘Wait a minute… didn’t you use to work for us?’