‘That’s got to be one of the worst discharges I’ve ever had the displeasure of seeing. I mean – for heaven’s sake! It was tantamount to fly-tipping!’
Rosie is smiling like she always does – an easy, enfolding, wise-woman kind of smile that’s been tested for years in the community and is all the warmer for it – but I can tell even Rosie is shocked.
‘I mean – poor thing’s end stage COPD. Thin as a rake. Can’t stand on her own – certainly not safely. I wouldn’t send her home with a live-in carer, but she’s still only got people going in twice a day. When I went in she wasn’t wearing her nasal specs, so her SATS were non-existent. She was in a right state.’
‘So what did you do?’
‘I sent her straight back in! I know they’re short of beds, but that was ridiculous.’
It’s early evening. The rapid response office is cooler and calmer. The change from the morning is astonishing. Then, every desk space was occupied, the kitchen crowded with people making drinks, people walking backwards and forwards, stopping for urgent briefings, catching-up, gossiping, serious conversations, hilarious conversations, secretive conversations, the whole thing layering and building and rising with the press of the day’s business until it reaches a peak and all you hear is a great massy buzz, the murmuration of a large community health team getting ready to fly out over the city. Now, at the end of the day, the last of us are coming back, handing over, doing admin. It’s quiet. There’s plenty of space. I love it.
‘And that’s not all,’ says Rosie, sitting on the edge of the desk and reaching into her pocket. ‘I brought back a friend…’
She pulls out a clear plastic specimen tube, about as big as your thumb, with a screw-top lid. She holds it in front of her and gives it a little shake. Inside is a bed bug. It’s on its back wiggling its legs in the air, but she taps the tube helpfully, it rights itself, and begins pacing up and down the tube, exploring the confines of its prison.
‘The place was riddled,’ she says. ‘They were supposed to have fumigated it but it obviously didn’t work. You’d think they’d have checked. These things are indestructible.’
She waggles the tube again; the bed bug tenses.
‘I heard they’re a really ancient life form. They were being a pain when the dinosaurs were around. Although they probably weren’t called bed bugs then.’
‘No? Probably Tyrannosaurus Rex bugs.’
‘Jurassic pain in the arse bugs.’
One of the admin workers at the far end of the office has the radio on quietly, which is always a nice touch this time of day. It starts to play the famous intro to that Frank Sinatra song, New York, New York.
Rosie gives the tube another shake and holds it up to her face to have a close look.
‘They’re quite cute, in a horrible kind of way,’ she says. ‘I suppose we’ve all got our roles in life. You have to respect that.’
‘What are you going to do with it?’
‘Oh – I thought I’d probably put him down the toilet. Burial at sea. Poor thing. I’ve got enough pets, though.’
She smiles, and starts singing along with Frank.
‘I’ll make a brand new start of it, New Yoooork, New Yoooork…’
She slips the tube back in her pocket and jumps off the desk.
‘But that’s the way of the world, I guess. Somebody singing New York, New York; somebody getting flushed.’
‘Just press the button at the top and let yourself in the main door,’ says Giles. ‘I’ll leave my flat door open.’
‘Great. See you in about ten minutes.’
‘Right you are. Goodbye.’
I’m not entirely convinced, though. Giles sounds drunk, speaking with that slow and over-elaborate articulation, tying each word off individually, like balloons.
I know Giles’ block very well. It’s a neat, self-contained complex, a sequence of four, ten storey buildings connected by a corridor and terminating in a bigger, more recent block for residents with higher dependency needs. It’s often the case that patients we see start in the flats at one end and finish in the flats at the other, like they’re being fed through some kind of slow-moving machine.
As I park up outside the entrance to Giles block, I see a gloomy, cadaverous man with long, frayed hair, wearing a string vest and yellow shorts, his left arm in a sling, like he put his shoulder out rolling the stone away from the tomb. He’s struggling to uncoil a garden hose from a drum, and even though it reminds me of a scene from Silence of the Lambs, I go over to help him.
‘Thank you,’ he says. ‘Could you unkink it for me, please?’
I put my book and bag down, and then carefully release the hose as the guy staggers backwards with the nozzle.
‘Are you alright there?’ I ask him.
‘Fine’ he says. ‘Now – could you turn it on when I shout?’
‘Okay. Just don’t be looking in the end when I do.’
‘Don’t look in the end when I turn the water on.’
I jerk backwards in a comedy mime.
‘No,’ he says, then wobbles off round the corner of the block, the hose slithering behind him.
After a while it goes slack.
I start to wonder what’s happened, but just as I’ve decided to put my head round the corner and see what’s happened, he shouts: ‘Okay! Turn her on!’
The hose gives a shudder, and I hear a spraying noise.
I figure he’s watering the grass – which seems pretty futile. The scrubby little patch out front is so brown now it’ll take a monsoon and a bag of seeds to make it better.
I pick up my book and bag and then go round to talk to him. He’s standing there, spraying the grass with a tragic look, shifting his arm in the sling occasionally, staring through the water vapour and the little rainbow it makes.
‘I’m afraid I’ve got to go inside’ I tell him. ‘I’ve got an appointment with someone.’
‘Couldn’t you wait just a few more minutes?’
‘No. Sorry. He’ll be waiting.’
The man gives a desultory little sniff, and then turns his sad gaze back to the grass.
‘Bye then!’ I say, and turn back to the entrance.
Up on the fifth floor Giles’ flat door stands open, just as he said. I knock loudly, shout Hello Giles! It’s Jim, from the hospital!
When he still doesn’t answer I go inside to check he isn’t on the floor. It’s quickly apparent the flat’s empty, though. I’m guessing he just stepped out for a moment, because there’s a cone of incense smouldering on a saucer in front of his chair, filling the room with so much smoke he may as well have set a bunch of tires alight.
I go back down to the car to make some calls.
The old guy watering the grass has gone, as has the hose. It’s so hot outside, what water there was on the drive has almost entirely evaporated.
I ring the office to check I’ve got the right address (I’m guessing I have, as Giles’ directions had been accurate). The only other explanation I can think of is that he popped round a friend’s flat and will be back shortly. I make a plan. If he still doesn’t answer the phone, I’ll go back up and knock on the flats either side to see if they know anything. Other than that, I can’t think what else to do. It’s frustrating, as I’ve got several more visits to make. I had thought this would be straightforward. But then again, it’s always the straightforward jobs that end up taking the longest.
I make one last call to his flat.
‘Yes? Giles speaking.’
‘Oh! Hi Giles. It’s Jim again, from the hospital. I called up to see you but you weren’t in.’
‘I don’t understand. I’ve been here all along.’
‘Well – yes!’
‘Okay. I’ll be up in a second.’
Of course, Giles is the hose guy. He’s sitting in the chair wreathed in smoke from the incense cone, the same lugubrious expression, shifting the weight of his arm in the sling. He makes absolutely no sign that he recognises me from outside, or even that he’s moved from the chair at all. And for some reason, neither do I.
Just as I’m getting ready to do the examination, there’s a vigorous knock on the door and two huge guys in tight blue t-shirts and white powder gloves thump into the sitting room.
‘Bed bugs!’ the older of the two says. ‘We’ve come to check your mattress, mate!’
‘Be my guest!’ says Giles, waggling the yellowing fingers of his right hand.
The bug guys go into the bedroom.
Giles tells me about his poor health lately. He drinks a lot of whisky, he says. He was assaulted by a blind man at a bus stop. He’s in dispute with the police, the hospital – really, it’s such a long and complicated list, I lose track.
The bug guys come back in.
‘All done!’ they say, and turn to go.
Later on, when I’ve finished the examination and left Giles to kipper quietly in front of his cone, I see the bug guys again, stomping down the stairs in front of me. And maybe it’s an effect of the incense, or the sudden blast of fresh air, or both, it’s hard to say, but suddenly I feel quite exhilarated.
‘Beeeeed Buuuuuuug Maaaaaan!’ I sing.
The older of the two looks round at me and frowns.
‘Don’t,’ he says.