I’ve never seen so much food. Walking into the kitchen I stop and shake my head in wonder. I’m like Howard Carter stumbling into the tomb of Tutankhamun, suddenly confronted by shelves piled high with fabulous riches: sweet chilli noodles; party packs of M&Ms; currant pastries; catering packs of crisps and cheetos (not for resale); a Colin the Caterpillar, happily gutted from the middle out; cream cheese n’chive pretzels; a plate of fruit (untouched); chocolate biscuits; chocolate rolls; chocolate truffles, chocolate for injection (I think) – and as if that wasn’t enough sugar, a shrink-wrapped twelve-pack of energy drinks.

It’s a perfect storm of junk food, and the reason for it is that there’s been a perfect storm of people leaving.

There are always good reasons to go. It might be the exorbitant cost of accommodation in the south. It might be better job offers elsewhere, better opportunities to train, or upgrade, or move into management. It might be the need to do something different, to shake things up, to rediscover what it was that drew you to nursing in the first place, or confirm what it was that made you want to quit. It might be burn out, ill-health, retirement, whatever. The fact is, though, if you take a step back, and breathe, and cast your eyes over the broader picture, you have to think this team’s retainment record is shot. It’s the kind of graphic you’d hastily click through in a presentation, or – ideally – omit from the slideshow altogether.

Honestly? I don’t know why things are so bad (national pandemic aside). Nursing in the community isn’t for everyone, that’s a given. You don’t have the immediate support you have in a hospital. You’re not surrounded by doctors and nurses and administrators and cleaners in a well-lit building with every kind of machine and every kind of clinician to work them. In a community health team, every day you’re stepping out into the medical wildlands, with only a kit bag, a nose for danger and a phone. It’s a level of responsibility that has some practitioners quickly developing a twitch, but for some it’s the perfect place to practice their skill. You’re forced to improvise, to adapt to the crazily different scenarios you walk into: environmental, social, medical. And until they develop a drone that will hover at your shoulder and offer reassurance and advice, YOU are the drone, and you’re flying by yourself.

*

It’s late in the evening. I’ve swapped hats, from nursing support to office administrator, helping on the phones, taking referrals, troubleshooting. I’ve just come back from the sugar nirvana of the kitchen with a handful of M&Ms, and I’m busy tossing them down my beak with one hand whilst I work through the patient list with the other. And suddenly – whether it’s something in the blue M&Ms, or that lucent kind of tiredness you get when you’ve been concentrating for hours – but I have a sudden moment of insight, and I’m not just scrolling through names on a screen anymore but through a landscape of scenes, drifting through them like a tiny, shiny, sugar-coated ghost. The woman who was discharged home to die, and promptly did die, that very afternoon, before any of us had a chance to see her. The man who self-discharged from hospital after an overdose, and went back to his boat to drink whisky and consider his options. The woman struggling to look after her husband whose dementia means he punches the cot sides all night and day. The man who took out his phone to film the occupational therapist when she called on him to see what he needed. The woman who nursed her husband through his last years, and now faces her own decline completely alone. The woman who cannot cope at home, but doesn’t want to leave her home, and the exhausted daughters who want us to simply put her in a home. The woman starving herself, staying in bed so long she has pressure sores. The woman with the new stoma, who died on the table, and saw God, and came back, and how angry she is about that, and the business of wearing a bag. Each scene merging into the other, blurring on the screen, until it’s not one or two patients anymore, but a never-ending roll call of problems, because for every one we solve and discharge from service, another two referrals come in.
‘GP on the line’ says April, the call taker in the hub. ‘Wants to know if we’ve got capacity for a faller…’
I toss down the last of the M&Ms, smack my hands clean, pick up a pen.
‘Put ‘em through.’

Because – I don’t know – what else is there?

I only realised I’d met Thaddeus before when I squeezed through the gap in the hedge and walked up the path. The entrance to his house is ridiculously narrow, with two wooden panels left and right – the left one bolted shut – a step down into a porch just big enough for one person, then a step up to a front door that can only open so far because of all the clutter. It’s such a struggle forcing my way inside, it makes me feel like a calf being born, breech, only in reverse.

The last time I’d seen Thaddeus was a couple of years ago. He’d waved to me from his armchair in the front bay window, a cheery academic in some kind of bibliographic lighthouse, surrounded by hefty works on history, art, art history, philosophy and so on. He’d been having trouble with his mobility back then – a feature of his increasing age and frailty, and the number of books lying around. As I go through into the lounge, I see that his armchair and the books are still there, the eclectic range of pictures on the walls, Frieda Kahlo, Napoleon’s retreat from Moscow, a yellowing certificate from the Sorbonne, and so on – but the man himself was gone, wheeled through to the backroom and the hospital bed newly installed there.

‘Ah!’ he says. ‘Welcome! Do come in! Lovely to see you! How are you?’
He seems lighter than before. Even his beard seems thinner, the flesh of his face pale and drawn down.
‘Do take a seat,’ he says. ‘I’m afraid you find me in rather straitened circumstances.’

I’ve come with Dipna the OT to review the use of a stand aid that’s been delivered, but it quickly becomes apparent that Thaddeus needs cleaning up, the bed changing and so on. A quick set of obs also makes the idea of anything other than bed care inadvisable. I set up a cleaning station with a trash bag, a bowl of warm soapy water, wipes, towel and barrier cream, and set to work, Dipna assisting with log-rolling as the clean advances and we figure out how to change the sheets. It’s a complex, ruthlessly practical business, but Thaddeus takes it all in good heart, maintaining a commentary of such a wide-ranging and erudite character it’s difficult to keep up. At one point, though, amongst all the French and Latin and what have you, I make out the name Dreyfus.

Sometimes, when you’re watching a quiz like ‘University Challenge’ or ‘Mastermind’, you instinctively respond to the toughest question because it hooks something out of you that you didn’t know you knew. And because you say it so confidently and naturally – like it was nothing at all, something anyone would know – it suddenly makes you look incredibly smart, even though for most of the time you’ve been watching the quiz with your mouth slack, because you’re too lazy to get up and look for the remote. And the truth is, maybe you saw the answer years ago, in an advert, maybe, or overheard it on the train, and it lodged for some reason, like those people who get shot in the war and it’s only years later when they go for an x-ray to investigate migraines and the radiographer points to the pale outline of a bullet. And maybe you have a whole mess of other scraps in there, too, a mess it would take a lifetime of quizzes, or maybe some kind of truth drug, to clean out.

The point is, Thaaddeus says Dreyfus.

‘Ah!’ I say, tossing a wipe. ‘The Dreyfus Affair!’

Thaddeus grabs my gloved hand.

‘I thought I recognised those eyes above the mask! Esterhazy! So it was you!’ he says. ‘Mon Dieu! Now I see it! You’ve been using your time travelling skills and your schmutzig Deutschmarks to foment bitterness about the world! Will you never be satisfied?’
‘C’est vrai!’ I tell him. ‘C’est moi!’

And I just hope he doesn’t expect any more French than that.

As soon as Frank tells me he used to be a butcher I can totally see it. It’s not just his dressing gown, the long blue and white stripes, exactly like a butcher’s apron. There’s something in the way he sits, his large hands draped over the armrests of his chair, the heavy, slightly disappointed sag of his face, the stainless steel glint of his specs, like someone who stood fifty years behind a chopping block waiting for a customer to choose between the knuckle and the brisket.
‘My sausages were famous,’ he says. ‘They went into space.’
‘How d’you mean?’
‘To Cape Canaveral, anyway.’
‘They took your sausages to Cape Canaveral and shot them into space?’
‘Nearly. One of the astronauts came by and took a coupla pound of my pork and apple specials. Said he was taking them back to Florida.’
I imagine an astronaut in a space suit, plodding in slow motion through customs, a string of sausages swinging from their respirator.
‘Risky,’ I say.
‘Yeah. Well. Astronauts get special treatment.’
Frank wrinkles his nose and vigorously rubs his forefinger back and forwards under it, a gesture accompanied by such a range of facial distortions it’s like the finger belongs to someone else and he’s only just learned to tolerate it.
‘He said he was an astronaut. I had no reason to doubt him. I had all sorts in my shop.’
He nods to a watercolour picture on the wall, a view of the old place. It’s a nostalgic, mournful kind of picture, like you’re looking at the shop through a shower of rain, or tears.
‘There was another butcher at the end of the street. Not nearly as good.’
‘A bit of competition.’
‘Only on price. You get what you pay for. One thing they absolutely could not do was make dripping. He used to make me laugh. He’d get his mum to come round and ask for a few pounds of dripping. I like it in me sandwiches she used to say. Is that right? I’d say. There’s quite a lot there. And she’d say Yes. I know. I like it a lot. And then the next thing you knew there it was, priced up in the window.’

I’d rung to say I’d be there in twenty minutes. I’m standing outside the front door exactly twenty minutes later. So I don’t understand why Graham isn’t answering the door.

I reach out to rap the knocker again, the loudest rap so far. The door knocker is one of those weighty, old Victorian affairs, a hand grasping a heart or a brain or something, the whole thing cast in bronze with a green patina. The shock of my knocking reverberates through the house. I fully expect to hear angry footsteps coming down the stairs, Graham shouting Will you just hold on a minute! Even though I’ve been here at least ten.

I step back onto the pavement and look up at the bedroom window.
The curtains are drawn. Nothing disturbs them.

I check the address again, which is pointless, as I was only here a couple of days ago.
I look up at the window again.
Still nothing.

Maybe after I phoned Graham he decided to go to the bathroom and fell over. Maybe he’d been having a nap and fell asleep again the moment he hung up. It makes me think of that line from When Harry Met Sally : you either don’t want to talk to me, or you do want to talk to me but you’re trapped under something heavy…

I look up at the window again.
No movement. Nothing. Nada.

I take out my phone and wonder whether to call again. It’s a landline number, a cordless phone, one handset by the bed and one on the hall table. I know that Graham is slow getting about, but also that he’s determined to be as independent as possible. He absolutely refused to consider having a keysafe fitted outside the front door, even though it would mean he wouldn’t have to go through the pain and rigmarole of coming downstairs to answer the door. When I called him to say I was on my way, I hoped that meant he’d have started his slow and laborious descent to the front door, so that he was there to let me in. But even if he hadn’t – even if he’d waited till he heard that gloomy rapping of the knocker before hauling himself up off the bed – he’d have made it by now.

I put the phone back in my pocket and in lieu of knowing what else to do, wait some more.

I notice some ants wandering about on the flagstones. They don’t seem to be in much of a hurry either. One of them disappears into a gully. Comes out again almost immediately. Pauses to look around. Zig-zags across the stones to a clump of grass. Another ant comes to join it. They’re doing okay. Maybe when they find something they’ll be more energised. As it is, they’re behaving like I do when I’ve finished all my urgent stuff and drag things out a bit to look busy.

This is ridiculous.
I take out my phone again.
Hit redial.
After a few rings Graham picks up.
The moment I say my name he fumbles the phone. I hear a yelp, some swearing, and the line goes dead.

Yikes.

Just as I’m wondering what to do next, the bedroom curtains get hooked aside and a fist bangs repeatedly on the window. I’m not sure what to make of it. Graham’s obviously trying to tell me something but I don’t know what it is. The angry part is pretty clear, though – and at least that means he’s conscious and breathing and able to make it to the window.
I decide to do nothing and see what happens next.

Eventually I hear movement. Cursing, thumping. Something big and angry humping down the stairs. A pause, then the unmistakable sound of Graham in motion, foot and stick: shuffle tap shuffle tap shuffle tap. The chains on the door rattle off. The door flies open.
Graham points at me with his stick.
‘You made me drop the phone on my foot.’