jarring

Muriel had a fall recently. She hurt her neck, so they put her in a support, a fat, white fabric affair that pushes her chin up and makes a presentation of her face, a modern riff on the Elizabethan ruff. Muriel doesn’t look too happy about it. In fact, her expression is intensely mournful. You could draw her face pretty quickly as a series of downward curves: two for the eyes, two smaller ones for the nostrils, one big one for the mouth.

‘I’ve popped in to see how you are, Muriel. And the physio asked me to give you this zimmer frame.’
‘Oh yes?’ she says, leaning forwards but not actually opening her eyes. ‘Why would I want that, then? I’ve got my stick.’
‘Your stick’s great, but this is safer,’ I say, slapping it twice, like some kind of dodgy market trader. ‘They say you’ve had a few falls lately, Muriel, so hopefully this’ll help.’
‘Everyone’s been so kind,’ she says, turning away and heading back to the sofa. ‘I don’t know. I just don’t know.’

The referral had come from the ambulance, but we’ve had plenty of follow-up calls, especially from the neighbours. They’ve seen her wandering outside the house at all hours, distressed, confused. At least now there are several people on the case – the GP, social services, mental health and other nurses. A night sitter has been booked to keep an eye on things tonight, but a decision will have to be made soon as Muriel isn’t safe to be home alone.

I help her settle back on the sofa. I offer to make her a cup of coffee and find some biscuits.
‘You don’t mind if I watch my quiz?’ she says.
‘Of course not.’
‘I like my quizzes.’
‘I bet.’

The TV is playing one of those afternoon shows where the set is so emphatically neon it makes you feel hysterical. I wouldn’t be able to answer with my own name, let alone who played James Bond in Dr No. The quizzes always have to have a gimmick. This one seems to be about lists. The contestants answer questions on a subject, and either go through and win some money, or not. Warwick Davis presides over the whole thing with a smile as bright as his shirt.
‘Let’s play Lists!’ says Warwick.
I escape into the kitchen.

It’s so orderly in there I wonder whether this confusion is more an acute thing, or whether Muriel already has help of some kind. Everything’s exactly where you’d expect it to be. Utensils hanging in height order from a rack. Chopping boards neatly aligned. There’s even coffee in a jar marked ‘Coffee’. When I fetch the milk out of the fridge, the souvenir magnets are all lined up in alphabetical order. There’s a big ceramic bear on the counter. When I twist its head off I find it’s filled with mini cookies. I grab out a handful, arrange them in a circle on a saucer, and take it all through on a tray decorated with kittens.

On the telly lights are flashing and klaxons sounding, so I’m guessing someone is going home empty-handed.
‘There you go, Muriel!’ I say, putting the coffee and biscuits on the table beside her. ‘I’ll just write up my notes in the folder then I’ll leave you in peace.’
‘Righto,’ she says, tossing down the cookies one after the other, crumbs already sticking to the powdered hairs on her chin.

The yellow nursing folder is in the middle of a circular dining table on the far side of the room. There are no chairs round the table, except for a green plastic garden chair with a wooden box on it. The box has a brass plate – commemorating the ashes of her husband Frank who died just a couple of years ago. It’s strange to see the box there. It’s such a formal, substantial thing, like a miniature coffin. I wonder whether Muriel’s taken it down from somewhere to clean it, or whether she moves it about and talks to it. I try to imagine how I’d feel, having it around the place, like I’d been interrupted on the way to the cemetery. Something like the cookie jar would be friendlier and less – well – jarring.

‘Let’s play Lists!’ says Warwick.

home visit

Charles Court sounds like a tabloid headline but it’s actually one of the smartest addresses in town. Even the approach is elegant: a shallow arrangement of steps and brass handrails, a decorative filigree canopy, wide, brass-handled glass doors, and swirling blue and white paisley tiling right and left – so that the whole thing looks more like the entrance to an expensive hotel than an apartment block.
I’ve actually come here to see two patients – a retired doctor with back pain on the sixth floor, and a newly catheterised patient on the fourth. I buzz the guy on the fourth, figuring I’ll work my way up, just as a snappily dressed elderly man carrying a deli bag walks up the steps towards me.
‘Excuse me, sir,’ he says. ‘Are you here to see Doctor Richards? I’m his friend and colleague, Doctor Samuels.’
‘Nice to meet you,’ I say, holding out my hand. He gives me the deli bag, which confuses me. We shake hands. I give him the bag back. Which confuses him. ‘Thank you,’ he says, immediately turning to walk back down the steps.
‘Aren’t you going to see your friend?’ I say.
‘What? Oh – yes! Yes, of course!’
He walks back up the steps, just as my patient answers the intercom.
‘Dr Samuels here,’ says Doctor Samuels, leaning pass me to answer in a gruff, doctorly kind of way.
Who? says my patient.
‘It’s okay’ I tell him. ‘It’s Jim, from the Rapid Response.’
With a doctor?
‘No. He’s visiting a friend. Another doctor.’
Oh says my patient. He mutters something. The door buzzes. We both go into the lobby.
‘Yes, yes,’ says Doctor Samuels. ‘Of course, we trained together, Doctor Richards and I. Saint Bartholemew’s, London. Nineteen fifty nine! Sixty years ago!’
He shakes his head sadly.
‘I’m seeing a patient on the fourth,’ I tell him. ‘But it won’t take long and I’ll be up to see Doctor Richards in about half an hour. Will you still be there, d’you think?’
‘Yes, yes!’ he says. ‘Now look. I want to thank you for all the marvelous work you do. It’s simply wonderful. We’re very lucky to have you.’
‘You’re welcome.’
‘I’m a doctor, too, you know. Well – retired! I’ve had my share of home visits, I can tell you!’
‘I bet you have!’
‘Oh my goodness, yes! I’ve been everywhere, seen everything and all stops in between. So I know what you’re up against and I thank you most sincerely for the trouble you go to. It’s much appreciated!’
‘Pleasure!’
We walk together across the thickly-carpeted lobby to the lift. I push the button. The doors slide open.
The lift is tiny – a sign of how old the place is, I would think. Dr Samuels is a portly guy in a huge mohair coat. He’s even wearing some kind of panama hat with a brim. In fact, if he hadn’t said he was a doctor I’d probably guess he was a Mafia Don. With all the bags I’m carrying, it’s going to be quite a struggle for us both to fit in. For a second I’ll think I’ll take the stairs, but then Dr Samuels says: ‘After you.’
‘Well I’m getting out on the fourth and you want the sixth so maybe you should go first.’
‘Please’ he says, pressing his eyes shut and gesturing to the lift. ‘I insist.’
It’s easier just to go along with it, so I say thank you and get in, putting my bags on the floor. Dr Samuels follows on, and we end up almost nose to nose. The doors slide shut, and for a moment we stand there, Dr Samuels with his eyes shut, breathing so heavily I’m worried he’s fallen asleep.
‘Excuse me…’ I say, struggling to reach around him to press the buttons.
‘Not at all! Not at all!’ he says, still with his eyes shut.
The lift judders up.
‘Ninety fifty-nine!’ I say, to make conversation. ‘That’s a long time ago.’
‘Yes,’ he says. ‘That’s when I went to medical school to start my medical training, you know.’
‘Is it?’ I say. ‘Amazing!’
‘That’s where we met, of course. Dr Richards and I.’
‘At Barts.’
He opens his eyes.
‘Yes!’ he says. Why? Were you there, too?’
‘Just a lucky guess.’
The door slides open.
‘Well. This is me,’ I say.
‘Thank you,’ he says, but even though I pick my bags up, he makes no effort to move. The doors slide shut again and we carry on up to the sixth.

‘Here we are!’ I say as positively as I can when the lift doors open again.

This time Dr Samuels does reverse out. I walk with him across the hallway to Dr Richard’s flat, just to make sure he gets there safely. I don’t want to be there when the door opens, though, because it’ll be embarrassing to have to explain why I’m not coming in just yet. My other patient is expecting me. I’ve confused things enough as it is.
‘I’ll be back up in a minute’ I say, heading for the stairs.
‘Why? Where are you off to?’
‘Down to the fourth,’ I say.
‘Marvelous!’ he says. ‘Well. Lovely to see you!’
He makes no move to ring or knock, but I hope for the best and leave him to it.
When I turn to look for the last time, he’s still standing there, idly rocking backwards and forwards. I wave, and he waves back with the hand holding the deli bag. Seems surprised to see it. Looks inside. Rummages around. Pulls out a sandwich. Starts eating it.

party line

When Agnes finally reaches the front door, she looks so beautifully turned-out in her vintage, poppy-print housecoat it’s like she set off from the back kitchen sometime in the nineteen fifties.
‘Hello!’ she says, through a crackle of thick, coral pink lipstick. ‘Thank you so much for coming.’
She leads me slowly through into the lounge, and after gesturing to the sofa, perches herself on the edge of an armchair and fixes me with a bright smile.
‘Now. What’s this all about?’ she says.
I explain that her doctor has made the referral, but as I carry on talking I can’t help wondering if I’ve got the right address. Struggling with ADLs the referral said. Recent UTI. Needs TDS care & help with meds. Really? The room’s as perfect as Agnes. No sign of dust or disorder; nothing out of place; a clock and two porcelain clowns equally spaced on the mantelpiece; a TV remote symmetrically aligned with paper, pen and reading lens on a discreetly placed, Moroccan side table.
‘How are you feeling today?’ I ask her, opening the yellow folder.
‘Oh. You know,’ she says, smiling even brighter. ‘Annoyed with myself. I took the Christmas decorations down yesterday and now I can’t find them.’
‘I’m sure they’ll turn up.’
‘I hope so. Some of them were very old. Falling to pieces, but – well – you get used to these things.’
I know what you mean. My favourite decoration is a snowman playing the violin. He’s looking pretty shabby these days, but it’s nice to see him every year.’
‘I bet!’
‘I’m sure your decorations will turn up.’
‘I hope so,’ says Agnes. ‘I feel so cross with myself.’

-oOo-

After the examination I review the facts. All Agnes’ observations are normal. Her medication is nicely ordered in a dosette box that her son, Barry, organises at the beginning of each week. She is perfectly able to wash and dress herself; before her recent illness she was driving once a week to bridge club.
‘Shall I ring Barry and see what he has to say?’
‘That’s a good idea!’
‘Do you mind if I use the landline? Only – if I ring using the work mobile, the number won’t show and he might think it’s a sales call.’
‘Of course! Please – help yourself…’
Barry is on the address function. I press call – and it’s immediately apparent that the phone is on loudspeaker.
‘How do I take it off?’
‘Oh – it’s always like that’ says Agnes. ‘Don’t worry. Barry won’t mind.’
The phone keeps ringing – extremely loudly – and I’m still trying to figure out how to mute the thing when he picks up.
BARRY MOSS says Barry, in a voice so thunderous and sharp I want to hold the phone away from my ear.
‘Hello Barry. My name’s Jim. I’m a nursing assistant from the hospital…’
YES. UR-HUM.
‘Barry? The doctor’s asked that we come round to see your mum’s alright – to do her blood pressure and so on….’
YES
‘…but before I go on, can I just say… you’re on speakerphone at the minute and I don’t know how to take it off’
I smile and nod at Agnes; she smiles back.
YOU CAN’T. IT’S LIKE IT ALL THE TIME.
‘Would you like me to call you back on my work mobile?’
NO. IT’S ALRIGHT.
‘Okay. Agnes is sitting right here with me…’
I can’t make it any clearer that he’s being overheard, but if Barry’s understood, he makes no sign.
HOW IS SHE?
‘She’s fine. Aren’t you, Agnes?’
‘Absolutely!’ says Agnes, shaking her head and smiling. ‘Never felt better!’
YOU CAN’T TRUST A WORD SHE SAYS, YOU KNOW.
‘Oh, now – I don’t know about that…’
Agnes straightens in the chair. Although her smile doesn’t falter, I can see her fingers whiten round her knee.
Because I can’t immediately think of a way of stopping him saying anything else, I look to buy myself some time.
‘Let me hand you over so you can have a quick word with your mum,’ I tell him. ‘Then we can all have a chat about what to do next.’
HAND HER OVER, THEN
‘Hello darling!’ says Agnes.
HELLO MUM shouts Barry. WHAT’S ALL THIS? A PARTY LINE?