Arthur is about as cold and severe as it’s possible to be without actually being struck from a block of granite. Tall and broad, a little stooped at the hip, he slowly wheels his wife Pat into the kitchen, parks her at the table, fusses some things on the tray in front of her – a box of tissues, a beaker of cold tea – then sits heavily in the chair opposite.
‘What do you propose to do now?’ he says.
I explain why I’ve come. He listens, frowning, hardly able to meet my eye he’s so cross.
‘How long will it take?’ he says, cutting me off. ‘I’ve got things to do, you know.’
‘I’ll be as quick as I can. I should think about twenty minutes.’
‘Twenty minutes? Couldn’t you make it fifteen? She’s got her feet at one.’
‘I’ll do my best.’
My best is obviously not good enough. Impervious to my attempts to soften him up and win him over, Arthur folds his arms and watches me prepare my things. Every now and again he releases a quantity of air through his nose, like it’s a safety valve easing the pressure in his head.
‘You should come like you arranged,’ he says.
‘Yes. I’m sorry I was delayed. But it’s not that far off. Is it?’
‘You shouldn’t make appointments if you don’t intend to keep them.’
‘I know, I know. It’s just really difficult to judge. Things happen.’
He grimaces.
‘An appointment’s an appointment,’ he says.
‘Absolutely. You’re right. I could always come back later…’
I hope he won’t take me up on that, because then I’ll really fall behind. But, luckily for me, all he does is check his watch and wave me on.
‘So long as you’re quick,’ he says.

Pat, on the other hand, is almost completely inert. Her dementia has made her childlike – or, if not that, exactly, then animated by a disquieted kind of wonder at her own condition, looking at me and Arthur and the room we’re in without any apparent differentiation.
‘I don’t know what good you think any of this will do,’ says Arthur, as I take her obs. ‘The doctor did it all last week.’
‘Things change,’ I say, pulling the stethoscope from my ears and unwrapping the blood pressure cuff. ‘You have to take a few readings over a period of time, so you get a good picture of what’s going on. But in this case, everything seems fine.’
He grunts, sighs, rubs his face, checks his watch again.
‘So that’s that,’ I say, filling in the last of the figures. ‘Now. What about you?’
‘How are you coping?’
He shrugs.
‘Are you getting the help you need?’
‘What kind of help?’
‘Carers. You know. That kind of thing.’
‘I’m her carer. What would a carer do?’
‘I don’t know. Help get Pat washed and dressed in the morning. Take care of her meds.’
‘I do that.’
‘Okay. Great!’
‘I do everything. I get her up in the morning, I put her to bed at night, and everything in between. Not that she sleeps. Last night I was up at half past twelve, half past two, half past four, half past six…. I’ve not had a decent night’s sleep in years. She calls out in the night, you know. All the time. And I have to take her to the toilet. And then bring her back. And wash her down when she doesn’t make it. I don’t know how I’ve been getting through the day, I’m so tired…. I don’t know how I’m going to ….I don’t know…’
And suddenly he leans forward, puts his face in his hands, and cries.

Pat watches him from her wheelchair, then slowly picks up the beaker from the tray and takes a sip. A dribble of tea falls down the front of her dress.
‘Here, love. Sorry. Let me get that for you,’ he says, and wiping his nose on his sleeve, he hauls himself up, pulls a handful of tissues from the box, and starts dabbing her dry again.