sketches

the very model of gentleness

~ jim clayton ~ Leave a comment

Midday, and the sun is the blinding centre of everything, scorching every surface, every car bonnet, brick wall, bare arm; blazing over the city; bubbling in the gooey tack of the road; dry-frying the leaves on the trees; flaming across the intersection of every street, irradiating everything with its vast and pitiless eye. It feels as if the sun has moved in close, into some newer, more punishing orbit – on a grudge, on a whim – and it absolutely will not quit until the last squeak of moisture has been drawn from the cell of every living thing.

Which is to say, I’m hot and thirsty.
Even winding up the car windows when I park feels like an act of madness.
In the seconds it takes to step out, I’m sweating.

Agnes’ daughter Janice meets me at the door.
‘Gosh, it’s hot, isn’t it?’ she says.
Inside the house is dark and cool.
‘The doctor’s still here,’ she says.
‘Great!’
I follow her upstairs.

Doctor Middleton is sitting on a blanket chest quietly fanning himself with a magazine supplement.
‘Hello Doctor,’ I say, putting my bag down and reaching out to shake his hand. ‘I’ve been sent to take some blood.’
‘Excellent!’ he says. ‘I suppose you know the circumstances?’
‘Just the basics.’
‘Well let me fill you in. Agnes has taken to her bed the last couple of weeks. Nothing specific. A little abdo pain perhaps but you could probably ascribe that to diverticula disease. No diarrhoea, no nausea or vomiting. No distressing symptoms particularly, other than this loss of energy and appetite and general decline. The weather’s not helping, of course – it certainly is warm – but let’s just say it’ll be interesting to see what the bloods show. If you’d be so kind as to throw the net wide – kidney, liver function, infection, anemia, that sort of thing. And put it in as urgent, if you wouldn’t mind. And we’ll take it from there. Okay? Great.’
He looks from me to Janice then back again, smiling broadly, shining in the close heat of the bedroom. Then he puts the magazine down, picks up his things, and with a large, friendly wave, heads for the stairs.

I turn my attention to Agnes. She’s lying on her side on furthest edge of the large bed, her left hand crooked under her head, her right hand resting on the point of her elbow. She’s staring at a small, white fan that’s been set on the floor, angled up so that a current of air plays gently across her face.
Janice sits down on a wicker chair just opposite – a position I’m guessing she’s held these past few days – as I kneel at the side of the bed and gently stroke the back of Agnes’ hand. When she opens her eyes and looks at me I explain who I am and what I’ve come to do. She listens passively, allowing me to straighten her right arm, put on the tourniquet, and tap up a vein. She barely reacts as the needle goes in and I draw off two phials of blood.
‘There! All done!’ I say, taping a little wad of gauze over the wound.
‘What do you think’s wrong?’ says Janice.
‘I don’t really know,’ I tell her. ‘The observations the doctor took don’t seem to point to anything. Has it been a marked decline, would you say? Or was it more gradual?’
‘A bit of both,’ she says, and by way of illustration raises her hand in the air and swoops it back down again, like she’s describing a rather lacklustre ride she took at the fair.
‘I wish I knew what was wrong.’
‘Well the bloods will certainly give a good indication. You’re doing the right things. though. Keep Agnes cool, give lots of fluids – doesn’t matter so much about food at this point. And we’ll take it from there.’
The phone rings, so I mime a Goodbye. She waves and smiles, and I see myelf out.

The first thing I do when I get back to the car is open all the windows. The seat is uncomfortably hot when I sit down, but at least there’s a scrap of breeze now, so I don’t need to drive off immediately and find somewhere shadier.

My habit is to make sure I have all the details I need for these phlebotomy jobs, take the sample and then fill in the form and the labels on the phials when I’m back in the car. It’s a long and fiddly bit of admin, and I don’t want to bother the patient any more than I have to. So it’s only when I settle in to do the paperwork that I notice Agnes’ date of birth.

She’s well over a hundred years old.

It makes me think of my friend Jo and his old sheepdog, Lewis. When Lewis reached the very end of his life, he took to lying by their garden pond. The last time I saw him, in fact, the day before he died, he was in his usual spot, his head between his paws, staring with his eyes half closed at the ripples in the water his fading breath made. And I think of Agnes, upstairs on the bed, quietly staring at the little white fan spinning round and round.

I drop the bloods off at the hospital.

It’s only at the very end of my shift, when I’ve arrived back at base to handover my caseload, that I hear Agnes died – an hour or two after I left. Apparently an ambulance was called, and because there was no DNACPR, the crew had to go through the resus protocol.
‘Unsuccessfully, surprise, surprise,’ says the co-ordinator, clicking her pen and pulling a fresh report sheet towards her. ‘I’m amazed there wasn’t one in place, but who knows? Maybe the family refused. You never know with these things. Shame though.’
‘I certainly wouldn’t want anyone jumping up and down on my chest when I was in my hundreds,’ I say, taking a seat next to her. ‘Or sticking me with needles, come to that.’
‘No. Me neither,’ she says. ‘Maybe it was you taking blood that pushed her over the edge.’
But she immediately smiles, and pats me on the arm.
‘Only kidding,’ she says. ‘I’m sure you were the very model of gentleness.’

to rinse or not to rinse

~ jim clayton ~ Leave a comment

Ken is sitting in his pants, sprawling out of the armchair, his long arms and legs pointing east, west, south east, south west, as startling to look at as a giant species of starfish unexpectedly brought up in the nets.
‘Hot, in’t it?’ he says, just managing to lift a hand to acknowledge me as I come in. ‘I think I might actually be melting…’
At least he has a fan, though. It rattles away on a nearby table, surprisingly little air moving despite the racket, just enough to tease a few strands of hair from the top of his balding head.
‘Take a seat,’ he says. ‘Yellow folder’s just there.’
‘Thanks.’

I’ve come to give his daily Tinzaparin injection.
‘They showed me how to do it,’ he says, struggling to sit up, ‘…but when it came to it, y’know, to actually putting the needle in, I just couldn’t. My nerve completely went. So I’m sorry you’ve been dragged out to take care of business.’
‘Don’t worry about it, Ken. It was good of you to try.’

I chat to him as I get things ready.
‘I know what you’re doing,’ he says, tapping a finger on the side of his nose. ‘You’re taking my mind off what’s coming next. I know all the tricks.’
‘Yeah – but the other thing is I’m actually quite nosy.’
‘You’re in the right line of work, then.’
‘I suppose so.’
He tells me he’s originally from Warwickshire.
‘That’s a beautiful county,’ I say. ‘Sharp scratch.’
‘It is,’ he says. ‘Ouch.’
‘Sorry, Ken.’
‘No need to apologise. You’re doing a grand job.’
‘There! All done!’
‘Not too bad,’ he says, a little subdued, rubbing the spot on his abdomen. ‘These days I feel like a bloody pin cushion.’
‘I went to Statford-upon-Avon for the first time a couple of years ago,’ I tell him, popping the used needle into the sharps bin. ‘I thought it was an amazing place.’
‘It is an amazing place,’ he says. ‘It’s where Shakespeare was born.’
‘Yep. We did the usual things. Went round the house. Saw a play at the theatre.’
‘He was definitely what you might call a genius,’ says Ken. ‘I don’t think that’s too strong a word. Some people are clever, like, but he was in a whole other league. Have you seen pictures of him, with his forehead bulging out like that, like a bloody balloon? That must’ve been the pressure of all them brains. And the thing was, it all come from nowhere. His dad was some kind of businessman. I don’t know what his mum did. And suddenly they have this kid who’s writing all these poems and plays all over the place. Amazing, when you think of it.’
‘It is.’
Ken laces his fingers across his belly and watches me write in silence for a while.
‘What would-a happened to me, in the past, like?,’ he says eventually. ‘Before all these injections?’
I shrug.
‘I don’t know, Ken. Maybe nothing. But I suppose people didn’t tend to live so long in the past, did they? I mean – look at Shakespeare. He was dead by the time he was fifty-two.’
‘I ‘spose. I’m not sure how much good it does any of us, all this jabbing and poking, all these whatnots, these pills. It’s just dragging it out. I mean, take my old mate, Bill. Not the Bill you’re thinking of, another one. He weren’t that old when his kidneys packed up. So every other day he had to go to the hospital to be plugged in to a big machine that rinsed ‘em out and kept him going a while longer. I said to him, I said Bill! Is it worth it, mate? Wouldn’t it be better to let nature take its course? So he came off the machine and he was dead by the weekend. I said to the doctor, I said Did you give him a kick, to make sure? And the doctor give me a look like this…’
He widens his eyes, straightens his mouth and leans towards me out of the chair. Then after a funny kind of pause, relaxes back again.
‘Didn’t bother me,’ he says. ‘Everyone’s entitled to their own opinion. But by Christ! It ain’t half ‘ot today…’

horrific honorific

~ jim clayton ~ Leave a comment

I can’t remember the last time someone called me ‘sir’.
It makes me feel officious, remote, about a hundred years old.
I check Stan for intention (sarcastic? hostile? guarded?), but I don’t get a sense of anything other than an eagerness to show how much he appreciates the visit. Still – it’s oddly deferential, and I can’t help squirming.
‘The good lady wife’s just through here, sir,’ he says, showing me along the hallway to the lounge, and then standing aside, nodding and closing his eyes. All he needs is a pair of white gloves and a silver tray under his arm. ‘She can’t go far, I’m afraid. You’ll see why.’
Vera has been discharged from the hospital with home oxygen. She sits on the sofa, working her shoulders like a landed carp, her eyes just as large and round and glassy.
‘Oh – hello, dear,’ she gasps. ‘And what – have you – come for?’
I introduce myself. She pats the sofa cushion next to her for me to sit down.
‘Can I fetch you a drink, sir?’ says Stan. ‘A tea, perhaps? Or something cool?’
‘That’s very kind, Stan, but I’ve just put one out.’
‘Oh!’ he says, raising his eyebrows and tipping back on his heels. ‘Like a cigarette, you mean! Yes. Very good. Well – let me know if you need anything. Is it all right if I…?’
He gestures to an armchair the other side of the room.
‘Of course! If Vera doesn’t mind.’
‘We’ve been – married – forty-five years,’ says Vera. ‘It’s a bit – late in the day – if I do.’

the tree’s revenge

~ jim clayton ~ 2 Comments

Lionel has the same birthday as me, minus forty years.
‘So you’re the twenty-ninth of December, too?’ he says. ‘How interesting! I don’t know about you, Jim, but one thing I noticed was the tendency to get rather a lot of suspect Christmas and birthday present combinations.’
‘Me too. I was always tempted to ask for the receipt so I could work it out.’
‘Yes!’
‘But there were consolations. I never used to mind it when I’d finished opening my Christmas presents because I knew I’d be getting some more in a few days’ time.’
‘There was always that consolation. And then it’s New Year’s Eve…’

It’s interesting, meeting patients with the same birthday. Sometimes it’s best not to say anything, though, tempting as it is, especially if the patient shares the same year, too, and hasn’t fared so well. The last patient I met who was my exact astrological twin was an alcoholic whose career had ended, wife run off with his best friend, been made homeless, and fallen down a flight of stairs. I’m pretty safe with Lionel, though. There’s the great age difference, to give us a tactful margin. And then there’s the fact that Lionel is one of the most inspirational ninety-five year olds I’ve ever met.

‘I would never have guessed you were ninety-five,’ I say to him, reflecting on his dates. ‘If you’d have said eighty I’d have said no way.’
‘You’re too kind!’ he says. ‘But carry on…’

Lionel’s been referred to us because he fractured his arm gardening.
‘I’ll tell you what happened,’ he says, shifting awkwardly in the armchair. ‘I was out there pruning back the fuchsia when I took a step back to see what needed to come off next. But the trouble was, you see, I’d forgotten about the laburnum stump. I’d taken the thing down about five or six years ago, something like that, pretty much to ground level, but I’d put off grubbing up the roots. It’s quite a tough job as you know, and I was working up to it. So what happened was I caught my foot and over I went, flailing around like Charlie Chaplin on a bad day, landing on my arm and causing the injury you see before you. An absolute bloody nuisance, but there you are. You make the best of these things.’
He settles back in the chair.
‘I suppose you’d have to say it was revenge,’ he says. ‘That poor tree! I expect it’s been waiting to get me all this time…’

going native

~ jim clayton ~ Leave a comment

Quite how the conversion was done or how it all hangs together it’s impossible to grasp. All you can say with any certainty is that at some point in the last twenty years a substantial Georgian house was designated as hostel accommodation, completely gutted and then divided up into numerous studio flatlets. The effect is of a grand old bee-hive. If I was a giant, I could take the roof off and lean in to inspect the interior, layer on layer of compact cells, each divided by nothing more than paper (and all the bees looking up at me, shaking their fists).
The cards describing the flat numbers give you a flavour. Random, hysterical groupings, arrows pointing left and right and round the corner – which is where the door to the staircase leading up to Terry’s flat is located, in an alleyway that funnels the wind so furiously it makes my ID lanyard flap backwards over my shoulder and snatches the sunglasses from the top of my head.
Hello?
Hello. It’s Jim, from the hospital. Come to see Terry.
Hello?
I put my mouth to the intercom.
Hello! It’s Jim, from the…
The door buzzes and I step inside.
A steep staircase, something of a cubist spiral, steeply rising up and up past flat doors whose numbers seem completely random.
By the sixth floor I’m slowing up and breathing hard. Terry is waiting for me by the door.
‘Why didn’t you say anything when I answered?’ he says, clutching his bathrobe around him.
‘I did… but the… wind was so strong…phew! That’s a long haul!’
‘I suppose you’d better come in,’ he says, and retreats into the flat.

I’m astonished to see how much IT equipment Terry has in his living room. There are laptops, desktops, a 3D printer the size of a small family car, plus shelf after shelf of spare parts, manuals, odds and ends, and then miles of cables of every colour and size, looped chaotically over hooks and hangars and any other appendage that might take them. It’s like climbing to the top of a great pine tree to find a crow’s nest with a fully-stocked workshop, fridge and snooker table.
‘Wow!’ I say. ‘I’m exhausted just carrying my bag’ dropping it down and then sitting in a chair. ‘This is amazing!’
‘I didn’t do it all at once,’ he says.
I want to say that doing any of it at any time would be inconceivable, but I let it pass.
‘I’ve come to see how you are,’ I say. ‘To do your blood pressure and that sort of thing.’
‘What – again?’ he says.
‘I know it’s a pain, but it’s good to get a picture over a period of time.’
‘I suppose,’ he says. ‘I just don’t think it means anything.’

Terry is an extraordinary figure. He’d be a shoe-in for Ben Gunn, if his robe had been woven from grass and not cotton towelling. Terry hasn’t cut his hair in years; it stands out in long, grey strands that, back-lit in the harsh light from the window, looking like the splayed ends of a fibre-optic cable. His thick glasses enlarge and dilute his eyes, holding their rather lost expression regardless of the wild changes of emotion Terry expresses.
‘It would help if it bloody worked’ he says, suddenly enraged, picking up a tablet and then crashing it down on the table again. ‘Windows 7,’ he says, his whole body trembling. ‘All I wanted was to download the driver for my printer so I could bloody well use the thing, but will it do it? Yes, it will.’
‘Oh! Good!’
‘No – but just wait a minute. Yes, it will download the driver, but it won’t let me load it!’
‘That must be frustrating…’
‘Frustrating? It makes me want to… I want to….’
He tails off, overwhelmed by the injustice of it, his whole head wobbling, as if the sudden change in pressure in his brain had loosened something critical in his neck.
‘What about getting advice on a forum…’
‘Forum? Don’t make me laugh! I haven’t got time for forums. They don’t want to… I can’t…’
It’s simply too much; he runs out of breath.
‘Unfortunately I’m not the one to advise you on this sort of thing,’ I tell him. ‘I struggle to find my way around my phone. I’m a bit hopeless, to be honest. If my daughters were here, though…’
‘Ah. Well,’ he says, blinking hard. ‘Digital natives.’
Terry seems so tortured by his environment it’s strange to think he’s responsible for it. I couldn’t be more confused than if I saw a mouse deliberately lower itself into a vivarium and then sit on a rock, quivering.
‘Try these on,’ he says, in a tone of voice suddenly balanced and conversational. He reaches behind him and hands me a pair of hi-spec glasses, connected to a handheld device that turns out to be some fantastically ergonomic controller. Through the glasses I’m presented with a virtual desktop, so vibrant and unexpected I’m momentarily lost for words.
‘Wow!’ I say, moving my head around and gently experimenting with the controls. ‘That’s – amazing!’
‘Yes,’ he says. ‘It is – or it would be if my hands didn’t shake so much I can’t work the damn thing!’

 

making the collar

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You wouldn’t need the commemorative display on the sideboard (whistle & chain, stripes, badge, photograph, certificate) to know that Ray is a retired copper. Despite his great age and his various ailments, he still has that Dixon of Dock Green posture, that certain way of looking at you with his hooded eyes that’s both warm and sad at the same time. And when he sniffs – which he does, frequently, bunching-up his lips and twisting them off to the right along with the tip of his aquiline nose – you wouldn’t be surprised to see him pull a notebook from his pyjama pocket, lick the end of a pencil and say Right, then.
‘Shame you didn’t have your whistle when you got stuck behind the bed,’ I say, nodding at the sideboard.
‘Yes!’ he says. ‘They’d have come running, all right.’
He waits patiently as I unpack all my stuff, then adds:
‘But you know – everyone’s been so good. I can’t fault them. The ambulance girl who showed up. On that rapid response car. She was wonderful. Just a little scrap of a thing. But fiery! A real pocket rocket. She couldn’t get me out on her own but she made me comfortable, and then called for back-up. Yes – I’ve had such good attention. Honestly, I couldn’t ask for more.’
‘So what happened when you fell?’
‘We-ell. It was just one of them things. I’d been feeling a little – shall we say – under the weather? Completely lacking in oomph. I don’t know why. My daughter Jenny had just gone off to work. I went to go to the bathroom, toppled over backwards and ended up wedged between the bed and the wall. I was like that for ages. I called out for help but o’course, no one could hear me. I cried with the pain, at one point. In my shoulder. Thank God Jenny rang midday to ask what I wanted for lunch, and when I didn’t answer, she came over. That’s when she called the ambulance. And they got me up and carted me off to hospital. So what with one thing and another, you could say I’ve been in the wars, poor old sod.’
We carry on chatting as I run through the tests.
‘I don’t want her to worry,’ he says, offering out his arm. ‘I tell her, I say Jenny – I’ve had my life. You can’t hang around here. You’ve got to go out and live yours. But I suppose it can’t be helped.’
‘How long were you a policeman?’
‘Forty years. I did pretty much all of it. Beat bobby, CID, crime scene, fingerprints and all that. Ye-es, I had a wonderful life. Mind you, you get to see the other side of things. I’d go to the most appalling crime scenes, murders, every conceivable abomination. People can be wonderful, but they can be dreadful, too. It makes you think. Post mortems. I lost count of the post mortems I went to. And it’s hard to put that lot behind you. You can’t help carrying it round. It gets to be a bit them and us. One minute it was Good evening, constable – how are you? would you like a cup of tea? The next minute they’re jumping on your back trying to cut your throat. But I wouldn’t have changed a thing. I enjoyed my work. And I always had my family to come back to.’

After I’ve finished taking his blood pressure and packed my gear away, I write up the notes and then pause to talk some more.
‘Here’s something you might be interested in,’ I say.
‘Oh, yes?’
‘My mum doesn’t have any fingerprints!’
‘No? Why’s that then?’
‘Well – my youngest sister was convicted of fraud and did some time in prison, unfortunately. Eighteen months – although she didn’t serve all of that.’
‘Oh dear.’
‘Anyway, when mum went to visit her in prison, they went to take her fingerprints, as part of their protocol.’
‘Yes’
‘They couldn’t get them! It caused a hell of a fuss.’
‘I bet it did.’
‘No-one had ever heard of it. Apparently it’s quite a rare genetic disorder.’
‘Is that so?’ he says. ‘Well – she missed her calling, then. She could’ve been a world famous cat burglar.’
He smiles, then sniffs, with that brilliant, sideways twist of the lower half of his face. And then vigorously rubbing his index finger under his nose like a violinist energetically working his bow, he settles himself again, and adds: ‘Although – I’d have still made the collar.’

cat & man

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It’s so hot, even Reg’s cat Lionel barely has the energy to look up as I come into the little back yard. Don’t mind me he seems to say, just go ahead and ring the bell and he’ll be with you presently. Then blinking once, to seal the deal, and yawning broadly with a funny little snap of his jaws, he collapses back into the shady patch beneath the cotoneaster, and immediately falls asleep again. He’s a magnificent animal – just like Orlando, the marmalade cat, rich stripes of apricot and orange flowing down his sides.

If Lionel is an object lesson in glamorous health and vitality, his owner Reg is the complete opposite. In fact, Reg is so banged up, with so many wounds and dressings, he looks like an extra in a horror movie unexpectedly called to the door of the make-up wagon. The worst is a palm-sized gash to the right of his forehead, stitched up as vigorously as a rugby boot, the hair shaved around it in a punky and free-ranging kind of tonsure. He has two black eyes, swollen cheeks, a thick wodge of plaster over the blackened steri-strips holding his nose together, a split lip, and bruises in every hue and colour between black and yellow roiling up and down his arm.

‘Yes?’ he says, pulling his dressing gown together and swaying in the doorway. ‘Can I help you?’

faller

~ jim clayton ~ Leave a comment

We’ve all had a turn at going in to see Jasper. He’s one of the regulars, an intractable alcoholic, a serial self-neglecter whose M.O. is to get drunk, take too many pills (by mistake or design it’s impossible to say), fall over, be admitted to hospital and then discharged with a referral to the community health team. He’s had numerous multi-disciplinary team meetings, everyone from the psychiatrist to the CPN, physio and occupational therapists, pharmacists and social workers, everyone doing their best to come up with a workable plan. But inevitably Jasper ends up back in hospital, and the whole thing starts again.

This time was different, though. I heard about it from Carla, one of the carers, the next day.
‘It was the same old thing,’ she said, settling in to the story. ‘Door locked, curtains closed, no answer when I buzzed or called his phone. I mean – that’s always the way it is with him. He’s hardly ever there.’
‘It’s so frustrating.’
‘Anyway, I thought – right – I’ll just try one more thing and then call it quits. The curtain was a little caught up in the corner, so I shielded my hand over the glass like this, and had a good, long look. That’s when I saw the boot. You know those dreadful things he wears? There was just the suggestion of it, poking round the end of his bed. And it was difficult to tell, but I got the impression that there was a foot in there, too, the angle it was keeping. So I banged on the window a bit, and when nothing happened, called the police. They came pretty quick. Put the door in, and there he was, wedged down the side of the bed. We had to see if he was alive or not – and I know it doesn’t sound very caring – but what we did, we dragged him out by the leg. And you didn’t need a doctor to tell you he was dead, because he kept the same position he was in when we got him clear, all crumpled up on his side, poor thing, and a look on his face – I don’t know – like he was falling down a great big hole, which in a way, I suppose, he was.’
‘Sounds horrible.’
‘It wasn’t nice. Still…’ she says, taking another generous bite of her sandwich, and dabbing at the corner of her mouth with a napkin. ‘you’d have to say, it was a long time coming.’

game over

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Graham pulls his top up to show me his scar – a flap fully half the size of his abdomen, the edges as puckered as the crimped edges of a pasty.
‘Wow! That’s impressive!’ I say.
‘Yeah. The surgeon wanted plenty of elbow room’ he says. ‘I think he pretty much climbed inside’
He lowers his top again and sits on his bed, suddenly forlorn. Jake, his friend, is standing next to him, fidgeting from side to side. He takes a step forward.
‘Look at this, then,’ he says, joining in the display of medical horrors. An angry-looking rash extends up both his arms, bubbling up through his tattoos.
‘Horrible, innit?’
‘It looks pretty sore. Is it itchy?’
‘Yeah, it’s itchy. Itchy as fuck. So what d’you think?’
‘I don’t know. They look like bites.’
‘I think you’re right,’ he says. ‘This place is crawling with bed bugs.’
I can’t help glancing down at the bed Graham’s sitting on, but if he heard or already knows about the bugs, he makes no sign.
Over Graham’s bed is a poster of Bruce Lee, in the famous fighting pose from Enter the Dragon.
‘He was amazing,’ I say. ‘It’s such a shame he died so young.’
‘Thirty-two,’ says Graham, looking up. ‘Same age as me.’
‘What about all those rumours? You know – Triads and death touches?’
‘Nah. That’s just conspiracy theory bullshit. He’d gone round Betty Tingpei’s house to talk about his next film, Game of Death, and she give him a pain killer for a headache. Only it turned out Bruce was sensitive to the Meprobromate in it, his brain swelled up, and that was that. Game Over.’
‘Ask Graham anything you like about Bruce Lee,’ says Jake, still swaying from side to side. ‘Anything at all.’
‘Yeah. Or drugs,’ says Graham.

making it down there

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There’s a note on Mrs Layland’s file to say that her daughter, Ellie, has to be contacted before any visit. Mrs Layland gets extremely anxious the notes says. Make sure you ring first before going in. It gives Ellie’s mobile number, underlined, twice.

‘How about one?’ I say.
‘Perfect.’
‘See you then.’

I have three patients to see that end of town. As it turns out, one of them has been admitted to hospital, and the other is surprisingly quick. My remaining visits are some distance away, so I won’t be able to go to them and make it back for one o’clock – so I call Ellie to see if she can make it any sooner, perhaps eleven?
‘That… should be okay,’ she says, after a pause which sounds like she’s flipping through a diary. ‘That should just give me time to make it down there. Okay – fine. Let’s make it eleven.’
‘Thanks. I’ll give you a call when I arrive.’
‘Lovely.’

Just before eleven I pull up outside the apartment block, and after writing down my arrival time, take out the mobile and call Ellie. It rings six times and goes to voicemail. I leave a message to say I’ve arrived and asking her to call me back so we can go in together. Then I spend the next ten minutes going over what visits I’ve got left, and figuring out the routes.

When there’s still no call-back from Ellie, I ring her again. Straight to voicemail.
‘I wasn’t sure whether I left my number or not,’ I say, ‘…so just in case…’
I read out the number, then end with something like  ‘looking forward to meeting you soon’ and hang up.

Time starts to drag. I keep checking the phone, to see if it’s registered any calls that for some reason I may not have heard. I hold the phone in different places in the car, just in case. I start watching the road ahead, and the road behind in the rear view mirror, wondering if each car that passes is going to be Ellie. Maybe she’s cycling? Is that Ellie, walking along the pavement, checking her phone? Is this a signal blackspot? Anyway, it’s almost half past now, so I’m guessing if it was Ellie she’d be walking a little more quickly – unless she’s very relaxed about appointments. But then again, maybe she’s forgotten about the second call? Maybe she thinks we’re still meeting at one? The woman talks animatedly on the phone as she walks past. I check mine again, then drop it on the passenger seat and wonder what to do.

I think about going to the intercom and buzzing Mrs Layland’s flat. The instructions were pretty clear, though. In fact I’d go as far as saying they were emphatic, written in block caps, in haste, as if something bad had happened last time and there was no room for error. If I rang the buzzer, and Mrs Layland let me in, what would I do? Wait in the flat for Ellie to arrive, whilst Mrs Layland got more and more anxious, and I struggled to reassure her? And then what would I say to Ellie? That I left two messages, and thought I’d go in anyway? But then she might say: ‘What messages? I didn’t get any messages!’ and ‘You should have waited. I thought I made it clear…’

So I wait some more.

Eventually, at twenty to twelve, I ring again, and Ellie picks up.
‘Where the hell are you?’ she says.
‘I’m outside, in the car.’
‘I thought you said you wanted me here at eleven?’
‘I did. I was waiting for you to get here.’
‘What do you mean, waiting for me to get here? I live on the next floor.’