this ol’ hound

this ol’ hound is proper glitchy
incredibly itchy, unfeasibly twitchy
he harrumphs and garrumphs when he rolls on his back
his big wiry paws paddling then slack
like he’s having a canine heart attack
then he sneezes
freezes
carries on as he pleases

this ol’ hound is proper chaotic
sometimes floppy, sometimes robotic
he runs up the stairs like a rugby team in boots
but he’s sneaky when it suits
creeping round the kitchen to sniff with his snoots
so beware
in there
or you’ll trip and break a hip I swear

this ol’ hound is proper crazy
fifty percent hyperactive, fifty percent lazy
he sleeps so deep you can watch him dream
gamboling through landscapes of rabbits and streams
giant foil trays of doggy supremes
till he wakes with a start
a sad little bark
back to reality with a broken heart

this ol’ hound is proper distracting
it’s impossible to work with the way he’s acting
staring at you long and hard
then marching around the room with a placard
‘Wark!’ (which – you’ll admit – for a dog isn’t bad)
till you crack
fill your pockets with snacks
take him round the park and back

willard the exception

Lolly and Richard slot around each other like two old spoons. Or two pieces of an antique jigsaw (maybe ‘Seaside View’ or ‘A Day at the Races’). Everything they do is coordinated. The way they move, for example. Even though it’s a big house they seem to continually be in each other’s way. When Lolly starts up the stairs, Richard wants to come down. When Lolly heads for the sitting room, Richard comes out. When Lolly goes into the kitchen to fetch something, Richard goes with her, so that when she turns round, she has to put her hands on his shoulders and manoeuvre past him in something that – from a safe distance – looks suspiciously like a dance. Their conversation is slotted, too. Their sentences run into each other. They finish what the other was saying. They snipe, but in such a practised and good-natured way, they’re like two elderly vaudevillians whose routine is domestic war and loving irritation. They’ve been touring this show for so long now and they know their parts back to front. It’s a job to see where one performer ends and the other begins.

They’ve got a dog, too. Willard – a Golden Retriever.

To begin with, I think it’s Willard who answers the door when I ring. It’s the way he paws it to one side, with such an open and happy expression I half-expect him to say Good Morning and How may I help? Instead, the door opens even wider and I see Lolly standing there.
‘You’re the nurse are you?’ she says. ‘Good. Maybe you can take him away. He’s driving me mad. ‘
‘Who is it Lolly? Who’s there?’
‘It’s the nurse. Come to give you a brain transplant.’
‘A brain transplant? Excellent. Ask him if he’ll give you a heart at the same time.’
‘Where do you want him?’ says Lolly, sighing and looking back at me. ‘I could give you a couple of suggestions.’
In the meantime, Richard has come halfway down the stairs.
‘I’m easy,’ I say. ‘Wherever he’s most comfortable.’
‘He wants you in the bedroom,’ says Lolly, putting a hand on the balustrade, as if she’s going to stop him coming any further by main force.
‘I’m glad somebody does.’
‘Oh dear God,’ says Lolly. She sighs. ‘He’s been a bit – you know – since the op.’

It’s one of the reasons I’ve been asked to visit, to check the wound and make sure he hasn’t got an infection. The GP has already given him some antibiotics, delivered remotely, as they often are these days. I wouldn’t be surprised if next year they started using drones. Although – to be fair – looking at myself reflected in the hallway mirror – it looks like they already are.

Lolly starts up the stairs. There’s a battle royale, Richard wanting to come down, Lolly telling him to reverse. I say I don’t mind where. Richard says he wants the sitting room. Okay I say. No says Lolly. Reverse. Lie on the bed. Willard is right behind me, smiling broadly. The four of us continue up the stairs in one well-coordinated bundle.
‘He’s been hallucinating,’ says Lolly, as Richard lies back on the bed.
‘I have not,’ he says.
‘Yes you have, darling.’
‘When?’
‘This morning.’
‘Why? What happened?’
‘There!’ says Lolly, nodding at me. ‘Even his memory’s going.’
‘No, no!’ says Richard, quite happily, adjusting the pillows behind his head and then folding his hands on his tummy. ‘I’m simply disputing your version of events.’
‘You said there was a big orange fish behind the telly.’
‘Not was, darling. Is. There IS a big orange fish behind the telly.’
‘You see,’ says Lolly. ‘D’you think it’s serious?’
‘Have a look for yourself!’ says Richard.
‘Oh for goodness sake.’
I go over to the telly.
‘I hate to say this, Lolly – but there is actually a big orange fish down there.’
‘Not you too… oh!’
We’re both looking down at the gap behind the telly. There’s a cuddly toy lying on the cables – a Finding Nemo clown fish.
‘Well who put that there?’ says Lolly.
Willard looks up at me with a broadly innocent look on his face. I’m immediately suspicious.
‘Search me’ says Richard. ‘Look – are we going to do this thing or not? Because quite frankly, I’m hungry and I want my kippers.’
‘That’s a good sign,’ I say, turning back to the bed.
‘Is it?’ sighs Lolly. ‘Is it?’

*

‘All our dogs have started with a W,’ says Lolly, as I tidy up my things. ‘First there was Winston. Then it was Willow.’
‘No, darling. No. It was Wilma after Winston. Then it was Willow.’
‘You’re quite right. Winston. Wilma. Willow. Willard.’
‘I like that!’ I say. ‘How did it all start?’
‘It was Lolly’s idea,’ says Richard.
‘They’ve all been rescues,’ says Lolly. ‘We didn’t like their names so we had to change them. Winston was easy, because his original was Branston.’
‘Like the pickle,’ says Richard.
‘Like the pickle,’ says Lolly. ‘We didn’t like the idea of calling out Branston and immediately thinking of pickle. Neither of us likes pickle. So we wanted a name that sounded like Branston, so the dog wouldn’t get confused. And Winston seemed to fit.’
‘So that was the first W?’
‘Yes. And after that it just became a bit of a thing.’
‘Wilma was originally Alma,’ says Richard. ‘But I didn’t fancy that. Shouting Alma! Alma! was like barking yourself.’
‘So we called her Wilma,’ says Lolly. ‘It was a bit tricky to begin with, because we had to bend the name into shape gradually, so the dog wouldn’t get confused.’
‘You should’ve seen her,’ says Richard. ‘Standing there going AAHHAUUUUWAUUHMMMAAA! Everyone must’ve thought she was mad.’
‘No darling. They thought I was a singer doing vocal exercises.’
I look down at Willard. He returns the gaze.
‘So – what about Willard?’
‘Ah!’ says Lolly. ‘Willard was the exception. Willard has always been Willard. Haven’t you, darling?’
And I have to admit, I’ve never seen a dog agree more.

Ollie’s Collie

When I walk into the front garden, a young collie rushes up from the back garden to the rusting, curlicue iron gate that pens it in, pushes its muzzle through the gaps, and barks crazily. I say hello, which only makes it worse, of course. It’s a funny-looking dog. The eyes are different colours – one brown, one blue – which, along with the patchwork black and white fur, mismatched paws, one ear up, one ear down, reminds me of an oil painting my auntie Ollie did of a collie dog, staring up from a hectic, pea-green background.
‘Whose dog is that?’ I said.
‘No-one’s,’ she said. ‘I did it off the calendar.’

All that remains of the keysafe at the front door is the base, though, and I realise that I’m expected to go to the side door, beyond the gate guarded by the mad dog. It gets so excited when it sees me coming back to the gate, it does an insane war dance on its back legs, spinning round on the spot, stopping itself by slamming its paws against the gate, then spinning round in the other direction. It looks pretty crazy, but I think what the hell, and reach in to flip the latch. The dog runs off into the garden, then sprints back with an empty plastic Coke bottle.
‘Thanks!’ I say.
It drops it at my feet. I toss it away into the garden again, then seize my chance to go through the kitchen door standing open on my right. ‘Hell-oooo…’

Maisie is lying on her bed in the gloom. There’s a substantial electric mobility scooter in the bedroom doorway – more like one of those big, sit-on mowers – with a seamy jacket slung over the seat and a basket filled with crap strapped to the bumper.
‘Over here,’ says Maisie.
The dog rushes in behind me and prostrates itself on the floor with the Coke bottle in its mouth, biting it with loud crackles.
‘Flash! Leave him alone!’ says Maisie. Flash drops the bottle and smile-pants up at me. I stroke Flash’s head, then straighten up, breathe in, and squeeze past the scooter into the bedroom.
‘The diet starts tomorrow,’ I say.

I’m guessing there’s been a partial deep clean at some point. There are lots of yellow bags zip-locked, piled up around the place. Maisie’s bed seems enormous, Maisie spread-eagled on it, like a depressed housewife cast adrift in a yellow ocean on a giant orange sponge.
‘’Scuse the mess,’ she says.

The phone rings. She grunts and rolls towards the side table. Before I have a chance to pass the phone to her, she knocks it off its base and the two things fall down the back of the bed. To be fair, it would be difficult NOT to knock anything off Maisie’s side table. It’s a cheap, warped affair, made worse by the fact it’s littered with stuff – bottles of spray, a glass of water, a mobile phone, an alarm clock. When I retrieve the phone and the base, hand Maisie the phone, and put the base back on the stand, I knock the alarm clock off. When I retrieve the alarm clock and set it down again, I knock the phone base back onto the floor.
‘Jesus Christ!’ I say.
‘Whoopsie!’ says Maisie. She holds the phone to her nose and prods the buttons myopically. ‘Dunno who that was,’ she says after a while. She hands me the phone. ‘Don’t drop it,’ she says.
I rearrange the side table as best I can, then start in on the examination.

*

Turns out, the phone call was from the pharmacist. She rings again and this time Maisie manages to answer it without anything else happening. There’s a long conversation, Maisie saying yes or no or yes or no or sometimes, all in a bored, non-committal way – then hands the phone to me.
‘She wants to talk to you,’ she says.
The pharmacist is someone I know well. She has the kind of incisive questioning that’s light and pleasant but still makes you sit up a little straighter.
‘Maisie says she hasn’t got her medication. It should be in a green bag somewhere. Could you check for me?’
I don’t have to check very hard; the bag is right there in front of me, beside the table. Not only that, the drug chart in the folder at the foot of the bed shows that the carers gave the morning dose as prescribed.
‘Good!’ says the pharmacist. ‘That’s a relief! Although why she told me she didn’t have it….is she confused this morning?’
‘No, she seems pretty orientated and okay. All her obs are fine…’
Flash has climbed on the bed by this point. He’s lying on his back with his legs in the air as Maisie tickles his tummy.
Who’s a silly boy? Who’s a silly boy?
Flash stares at me with his tongue hanging out, his mismatched eyes spinning with ecstasy.
‘No. She seems fine,’ I say.

*

The pharmacist has arranged to visit later to check up on things. I say goodbye to Maisie, and with the dog leaping around me like a species of giant flea, I see myself out, closing the gate as quietly as I can behind me.

I open my laptop and write my notes in the car. There are a few things to sort out, so I’m there fifteen minutes or so. I’m just about to finish up and move on when I hear a clatter from the gate. Maisie is coming out on the electric scooter, Flash trotting by her side. Maisie pauses at the front of the garden. She pulls out a packet of fags, nips one out with her lips, lights the fag with a flip of her Zippo, puts the packet back in her pocket, all in one smooth, practised motion. Then she sits there smoking a minute or two, looking right and left along the street, blowing smoke from her nose in a business-like way. Then she twists the key on the scooter again and heads right, at speed, to the park, I’d guess, with Flash high-stepping alongside her, trying to avoid the wheels. On the top of the basket, I can see an empty plastic Coke bottle rattling from side to side.

I wonder who put it there.

dave says it’s tricky

Avondale.

Sounds beautiful. Magical. I bet the architect was a fan of Lord of the Rings. You expect to see an ancient castle draped in moss and mist, with strange, long-legged birds circling and crying overhead, a plangent waterfall and so on, elfcetera, elfcetera. Instead what you get is an anonymous, pre-fab block just off the high street, tucked away behind a phony Italian restaurant. It’s only been up a year or so but already it has a tired, beaten-down kind of look, strips of tape over the intercom where the buttons have fallen off. If the same architect had worked on Helm’s Deep, I don’t think Saruman would’ve needed much more than a couple of orcs and a wheelbarrow to tear the place down.

The one magical thing about Avondale, though, is its uncanny ability to screw up the SatNav. The app doesn’t recognise the postcode at all, and ends up recommending you ‘make a u-turn’ and then ‘make another u-turn’ so that if you were truly dependent on it, you’d end up simply driving in a circle at the bottom of the high street until you ran out of fuel or the police threw stingers down.

I know all about Avondale, though.
I’ve been here before.

Cherry lives on the first floor with her little Jack Russell, Dave. Cherry has a long list of health problems, from mental health and self-harming to morbid obesity, diabetes, breathing problems and recurrent infections, and she’s been referred to us many times in the past. She’s got a reputation for being difficult, but I think because I make a fuss of Dave whenever I go there she takes it easy on me.

‘Cherry was pretty sick this time,’ says Michela, the co-ordinator. ‘She went in with an exacerbation of COPD, but then self-discharged against advice. She was so bad they gave her home oxygen. So can you pop-in, see how she’s doing? Get her to sign a non-concordance form if necessary.’

*

Cherry is propped up in bed watching CSI. The first thing I notice – after Dave has finished leaping madly around my legs – is that Cherry’s wearing a nasal cannula connected by a long, plastic tube that snakes across the bed to an oxygen cylinder by the window. The second thing I notice is the fag in her mouth.
‘Erm … Cherry? You really can’t be smoking when you’re using oxygen.’
‘What? Wha’dy’a mean?’
‘You’ll blow yourself up. And everyone else. You’ll send Dave into orbit. Honestly, mate – you’ve got to put the fag out.’
She shrugs, pinches the end out, and rests it carefully on the ashtray by the bed.
‘Thank you,’ I say. ‘I’m sorry to be so blunt about it, but you absolutely cannot smoke with oxygen around. This whole place’ll go up.’
‘I only have one now and again. It’s not a problem.’
The heaped ashtray and the smoky fug in the room tell a different story. I know I’ll have to report this to her GP and the Community Respiratory Team as soon as I’m back in the car, but for now I move on.

Dave is on the bed now. He rolls onto his back so I can rub his tummy, his tongue lolling out with the ecstasy of it all.

‘So how’ve you been?’ I say to Cherry. ‘Sorry to hear about your recent hospital trip.’
‘Yeah – well. What can you do? They said I had to go. I didn’t want to. I mean – what are they going to do about anything?’
‘I don’t know, Cherry. But to be fair, they do seem to have done quite a bit. Put you on IV antibiotics, sent you for chest x-rays, got you back on your feet.’
‘Yeah, but they didn’t, did they? Look at me!’
‘It says in your notes you self discharged against advice. Is that right?’
She shrugs.
‘They made it impossible. It was noisy. I couldn’t sleep. They wake you up every five minutes to fiddle about. The nurses were rude. The food was unbelievable. I mean – you’ve got to be really sick to want to go to that place.’
‘That’s true. And from the sounds of it – I think you were pretty sick. And still are.’
I unclip the SATS probe from her finger.
‘Your oxygen levels are terrible, Cherry – even for you. And that’s five minutes after you came off the oxygen.’
‘Yeah – and I’d still be on it if you hadn’t said.’
‘It’s a choice, though, isn’t it. No oxygen and low SATS, or oxygen and burst into flames. Isn’t it, Dave? Isn’t it…?’
Something suddenly occurs to him, because he flips himself upright again, hurls himself off the bed, and skitters off across the laminate flooring into the kitchen.
‘Oh my God! Wait for it,’ says Cherry.
There’s a single, loud squeak from the kitchenette, and then Dave hurries back with a red, rubber bone in his mouth. It’s so big he can’t make it up on the bed again without a boost from me. As soon as he’s there, though, he chows up and down on it, making it squeak as regularly as a monitor in a hospital for clowns.
‘God – it’s noisier than the ward,’ says Cherry. ‘And before you say anything, I don’t care, I’m not going back.’
I look down at Dave.
‘What do you think?’ I ask him. ‘What do you think mummy should do?’
He stares up at me, panting excitedly, flicking his eyes without moving his head…. down to the bone…. up to me…… down to the bone…up to me.
‘Dave says it’s tricky.’

peanut

I press the bell and wait. The porch door is shut but the inner one is open and I can see through into the house. A dark hallway with a baby gate halfway. It’s all pretty quiet.
I press the bell again. The button is held together with weathered tape and doesn’t look too healthy. It’s only then I see there’s a piece of paper tacked to the window. The writing has faded almost to nothing but I can just make it out: Bell not working. Please knock.

As soon as I do, there’s a wild yapping and snarling from the front room, and a caramel coloured Jack Russell hurtles out into the hallway and throws itself at the gate. Although ‘hurtles’ isn’t quite right – more a cross between hurtling and a skitterish kind of wobble. At any rate, the expression on its tiny face is one of the purest and most pitiless hatred.
‘Peanut! Be quiet! Go in the garden, darling! Go on! In the garden!’
Peanut pays no attention, but spreads its paws, daring me to come any further.
‘I’m in here!’ says the man.
I put my hand on the handle.
Peanut narrows her eyes and gives a hectic sneeze.
I open the door.

Peanut goes completely nuts. She swells to twice her size, her eyes bulging out, like I’ve inadvertently cracked the outer door on a space station, and the catastrophic change in pressure is making her pop.

I’m good with dogs but I’m not stupid. I wait for the man to appear, to give me some credibility. Instead I hear him cry out in pain from the front room. There’s nothing for it but to go forward and brave the beast.
‘No, Peanut!’ I say in an Alpha wolf voice. ‘No.’
Peanut obviously doesn’t care for wolves. As soon as I open the baby gate it goes for me. The only thing that saves me is the fact that Peanut is old and fat and her range of movement is seriously compromised. It also helps that she doesn’t have any teeth. All she can manage is a furious gumming of my shoes, which sounds horrendous but is actually quite pleasant, how I imagine it would feel like if I stuck my foot up through the sunroof when I put the car through the car wash. The only real danger is that when I carry on walking she’ll trip me up. Maybe that’s the plan. Maybe the moment I’m down she’ll roll up onto my face and suffocate me. Luckily I manage to stay upright, though, lifting my legs like some kind of fastidious wading bird, high-stepping through a lake of hostile fish into the front room.
‘Good girl!’ says the man, approvingly.
Whatever made the man cry out has passed. He’s perfectly calm.
‘On the sofa, Peanut. On the sofa. Hup!’
The dog is too exhausted from the shoe wars. Anyway, if there was ever a dog in the history of dogs less likely to jump onto a sofa at the word Hup it’s Peanut. She completely ignores the man, choosing instead to wobble exhaustedly over to the far side of the man’s chair, collapsing on the carpet with an audible whump like someone delivering coal.
‘Oh Peanuuuuut!’ says the man, drawing out the last syllable into a tortured wail. Of all the things to despair about, this is the least worst thing. Peanut’s obviously used to it. She gives another of her disdainful sneezes, then settles her face onto her paws. With her huge eyes and curled lip, she’s a spit for Peter Lorre.
‘What are we going to do with you, Peanut?’ says the man.
‘Does she have a harness?’ I ask him.
‘There. Behind you,’ he says, gesturing to the sofa with his scrubby chin.
I pick it up. It’s a complicated affair, heavily-padded corduroy, confusing straps and velcro and snappy fixings. It looks more like a Victorian straitjacket.
I hold it up.
‘Peanut! Who’s a good girl…?’

death of a game dog

I saw Marian over the woods
her young golden-eyed GSP
rapt, en pointe
– Where’s the other one?
Oh – didn’t I tell you?
I had to say goodbye to Helga on Monday
– I’m so sorry
Long story short
She’d gone a little lame
I put her on Metacam and bed rest
It seemed to clear up okay
then I felt a lump on her neck
took her to the vet
lipoma they said
we’ll keep an eye on it
a few days later she stopped eating
I took her back
they did a scan
cancer everywhere
EVERYWHERE
liver, kidneys, lungs
– where DIDN’T they find cancer? –
they talked about chemo
but I didn’t want to put her through that
I’ve always thought
you have to know when to act
better a few days early
than a week too late
– I’m so sorry
that’s okay
she was such a game dog
– I know
80 pheasants last year
did you know
there are badgers over there
their setts last 200 years
I remember once
coming back from a shoot
me and Helga saw
some badger cubs
playing with some fox cubs
right about where you’re standing
Helga looked up at me
as if to say
what do you want me to do about this?
so I said to her
I said Helga – RELAX
let’s just stand a while and watch

IMG_2705

about george

I’d met George a few times in the past, so I had my doubts.

‘You have to take him,’ said Lyra, the manager of the rehab unit. ‘He’s been here six weeks and it was only supposed to be a couple of days.’
‘But you say he’s hoist only now?’
‘Yes.’
‘In that house?’
‘Yes.’
‘And it’s been cleared? It was so tiny and cluttered. You’ve actually managed to fit a hoist and a commode in there?’
There’s an ominous pause.
‘Yes,’ she says. ‘I wouldn’t be sending him home, otherwise. Would I?’

The conversation hadn’t started well.

George had been referred to us for an initial assessment. I’d phoned the unit to clear a couple of things up. When the first person answered I went through the usual spiel: Hello. My name’s Jim. I’m a nursing assistant from the Rapid Response team. I’m just calling to find out about George’s discharge today.
‘Oh. Hold on. You need to talk to another nurse.’
She put the phone down on the desk without muting it, so I could hear her calling out (although the other person was too far away to hear): I don’t know. Some guy asking about George…. I don’t know what he wants…. Why don’t you speak to him?…. Well where IS she?…..
Then some general clattering, muttering, background noise. Laughter. Eventually someone else picked the phone up from the desk.
‘Hell-oo?’ she said, in that drawn-out, slightly hesitant voice you might use for a sales call or worse.
‘Oh – yes – hello! My name’s Jim. I’m a nursing assistant from the Rapid Response team. Sorry to bother you. I’m just calling to find out about George’s discharge today.’
‘Who?’
‘George Masters.’
‘No. Who are you?’
‘Me? I’m Jim. Nursing assistant. Rapid Response Team.’
‘Just a minute…’
She puts the phone back down on the desk, again – without pushing the mute button.
I don’t know. He says he’s a nursing assistant called Jim. Asking about George.
There’s some toing and froing between the two, then she picks the phone up again.
‘What is it you want exactly?’
‘Well – two things. One is that on the discharge summary they give an address that’s different to the one we’ve got. So we need to clear that up. And the other thing is to find out what time he’ll be home.’
‘Just a minute…’
She does the same thing. This time, I’m waiting for five minutes, hanging on the phone, listening to all the traffic and fuss of the unit. Just as I’m about to hang up and call again later, the phone gets picked up by someone else.
‘Hello?’
‘Hello. Erm. Yep. My name’s Jim. I’m a nursing assistant from the Rapid Response Team. Erm.. can I ask who I’m talking to?’
‘My name’s Sheila. How can I help?’
‘Are you a nurse, or …’
‘Yes – I’m a nurse.’
‘Great! Do you know about George Masters?’
‘What about him?’
I take a breath, then go into the two things I need to know about George so we can be there to do the initial assessment.
‘You need to speak to Lyra,’ she says.
‘Who’s Lyra?’
‘The unit manager… LYRA…!’ she shouts, so loudly I have to lean away from the receiver. She slams the unmuted phone back down on the desk.
Another five minutes.
Eventually the phone gets picked up again.
‘Hello? Lyra speaking?’
‘Hi Lyra. Can I just say, before I go on – I’m not all that happy with the way this phone call has gone. I’ve spoken to three different people. They’ve all put the phone down without even muting it, so I can hear them shouting across the unit…’
‘Don’t get clippy with me,’ says Lyra.
‘I’m not clippy, I’m just saying…’
‘I don’t appreciate your tone…’
‘All I’m saying is that it’s been really frustrating ringing your unit today….’
‘We’re busy. What d’you expect?’
‘Everyone’s busy.’
‘I think you need to look at the way you speak to people. Who did you say you were?’

We struggled on with the conversation, but by the time I hung up I was sweating more than a pilot who’d spent half an hour fighting to stop a plane crash.

‘So – when’s he home?’ said Anna, who was due to handle the initial assessment with me.
‘She’ll call me,’ I said. ‘Maybe.’

To be fair, from that point on Lyra was more amenable. I think it was because she was desperate to discharge George, who’d been a disruptive presence on the unit, constantly ringing his button, throwing tissues everywhere, generally playing up. I’d met George before, of course, and I knew he could be difficult. But when I’d known him he was still at home – a tiny, cluttered house with a kitchen whose ceiling was halfway down and whose downstairs toilet was so unspeakable you wanted to clean it up with a flamethrower. He had a cute dog, though – a perky little brown and white Jack Russell called Lily, so it would be nice to see her again.
‘I’m sorry about the way the phone call went,’ said Lyra. ‘We’re completely rammed here, as you can imagine. And I’m having to get by with agency nurses, and they don’t know the routine.’
‘That’s okay. I’m sorry if you thought I was clippy.’
We laugh about it.
End the call.

Later that day I’m sitting in George’s front room. We’ve just hoisted George from the wheelchair onto the hospital bed, but already he’s talking about putting himself on the floor because ‘it’s too early for bed,’ even though he couldn’t sit in a chair without three feet of rope and a crash mat. The neighbour who we were told would be coming round with shopping and generally keeping an eye on things is actually self-isolating and not leaving his house. To add to the woeful picture, we’ve just found out the boiler doesn’t work. Our team have been asked to provide bridging care four times a day, but even so you couldn’t say with any confidence that George would be safe between calls. He really needs some kind of residential facility. Still – at least Lily the dog has been rehomed.

There’s nothing else for it.
I ring Lyra.
She answers.
I tell her the situation.
There’s an ominous pause…

next door’s dog

I’ve never seen such an old stair lift. It sits at the bottom of the stairs like a traction engine whose wheels have fallen off. It even has a hatch under the seat, which must be where the coal goes.
‘It was my husband’s’ says Maria. ‘Shame it’s broken. It means I can’t go upstairs.’
‘What about getting it fixed?’
She shakes her head.
‘The company went bust years ago.’
‘But surely someone somewhere would know what to do with it?’
‘I know exactly what to do with it. Throw it in a skip and start again. But I’m alright downstairs. I’ve got everything I need.’

I follow her into the living room, almost tripping over a metal milk holder with three pints in it that Maria has brought inside and put in the doorway.
‘Shall I put these in the fridge?’
‘Yes. Sorry, dear. That’s as far as I got.’

Maria is self-isolating, like the rest of our patients these days. She was discharged from the hospital after treatment for a chest infection, referred to us for ongoing care.

‘I do alright,’ she says, when I bring her through some tea. ‘I’m not as badly off as others. I’ve got two gay gentlemen living next door. They’re so lovely and kind. They do my shopping and what have you. Most mornings they knock on the door when they take the dog out. They’ve got this little dog, you see. Don’t ask me what sort it is. I’m not good with dogs. I pretend to be interested but between you and me it’s not that impressive. It’s fur sticks out all over the place and it has this odd, cross-eyed look, like someone clonked it with a frying pan. I wouldn’t trust it as far as I could throw it, but they seem to like it, which is the main thing.’

We chat as I check her over. She tells me about her husband, Jack. A small businessman with a big laugh, apparently.

‘Yes,’ she says. ‘It’s true. I married the boss. That’s him, there…’
She points to a photo in a frame: An elderly man sitting in a chair, Maria standing behind him with her arms around his shoulders, the point of her chin on the top of his head. The picture has stood in direct sunlight for so long the colour has faded. All the flesh tones have merged, leaving a blurry but strangely transcendent quality to their faces. Only the stronger patterns remain: the curve of Jack’s glasses, Maria’s auburn curls, the laces on Jack’s shoes.

‘I still miss him, all these years later,’ she says, carefully taking a sip of tea. ‘Maybe I should get a cat. What d’you think?’

Janet the dog walker

Millie’s poodle Rosie bounds off the sofa when I come in. She lies with her paws either side of a well-chewed rubber Bugs Bunny, glancing down at it, then up to me, then down to the rabbit again, daring me to take it. I can’t decide who has the maddest expression: the rabbit or the dog.
‘I think… she thought… you were Janet,’ says Millie. ‘Janet… the dog walker.’

Millie furniture-walks to a seat at the dining room table. COPD has blasted her body, robbing her of any spare flesh. It’s left her tentative and frail, spindle-thin as a giant crane fly, fumbling for purchase, somewhere to land and catch her breath and think about the day.
‘I don’t want much,’ she wheezes. ‘I’ve got… the medication I need… plus a little something… for anxiety. What I really need… is someone… to come in now and again… to help me… with a bath. That’s all. Do my back… y’know?… the awkward bits.’
The doorbell rings and a breezy woman swathed in waterproofs stamps into the kitchen. I’m guessing it’s Janet.
‘Hiya Millie!’ she says. ‘Phew! It’s bad out there. Oh! You’ve got company!’
I introduce myself, get up to shake her hand which is ice cold.
‘You need gloves’ I say.
‘I need a lot of things,’ she says, pulling out a hankie and blowing her nose so loudly I take an involuntary step backwards. ‘I need to win the lottery,’ she says.
Meanwhile, Rosie has ditched the rabbit and dashed through to greet her. Janet kneels on the kitchen floor with her arms wide. Rosie puts her paws on the woman’s knees so she can reach up and lick her face.
‘You silly girl!’ she says. ‘I’ve had a wash today. I don’t need another one. Do I? Hey?’
‘Will… she be… alright?’ says Millie. ‘It looks… pretty bad out there.’
‘Of course!’ says the woman, grasping the kitchen counter, struggling to get up again. ‘Oof!’
She looks at me.
‘Got any spare knees in your bag?’
‘I’ll have a look.’
‘Good boy.’
She reaches into her pocket for a treat, and for a moment I think she’s going to throw it to me. But Rosie sits excitedly at her feet, and Janet hands it down to her instead.
‘She’ll be fine,’ the woman says. ‘It’s so windy out, I’m thinking of tying some string round her legs and flying her like a kite.’
Millie gives her a panicked look.
‘Seriously, though, we’ll just go for a short one round the park,’ says Janet, giving me such an exaggerated, lop-sided wink I’m guessing her face is still numb from the cold.

ozymandias

Each patient record has a reminder area on the home page. It’s supposed to draw your attention to essential details or dangers, such as the need for double-up visits, the contact numbers of the relatives you must liaise with first, the keysafe code, any environmental dangers you should be aware of. So the first thing I write is:

Two small dogs – friendly, but bark when you knock

It’s only when I read it out loud I see the problem with the sentence. So I delete and write instead:

Two small dogs. Loud to begin with, but soon settle down.

*

Mrs Albright is ninety-seven. She lives alone in a ramshackle bungalow, top of a narrow lane of cottages and heavily-buttressed flint walls leaning out at extraordinary angles, an ancient church under scaffolding, and a strange, round building with worn stones and arrow slits standing alone in a paddock, that looks like maybe it’s the last thing standing of a castle, currently serving as a chicken house.

Like most of everything else down the lane, Mrs Albright is old and falling down. But although physically she’s reaching the end of her ability to cope, intellectually she’s as formidable as ever.
‘Apart from the carers coming in twice a day, and your family popping in when they can, do you manage to see anyone else?’
‘Anyone else? Do you mean socially?’
‘Well – yes, I suppose I do.’
‘I run an ancient history group once a week, if that counts. Does that count?’
‘I think that counts.’
‘Excellent. Then – yes. Every Wednesday I have a dozen or so people round and we discuss a broad range of topics. Last Wednesday Sally did the Assyrians. This Wednesday it’s Margaret on Alexander the Great.’
Whilst we’re talking, Mrs Albright’s dogs – two bug-eyed pugs – have plopped themselves down to sleep around her feet.
‘Yes – I’m afraid they do that a lot,’ she says, peering down. ‘They like to be near me in case I drop anything overboard, a bit of crumpet or what have you, which I’m afraid to say does happen from time to time. The problem is I forget the damned things are there and when I get up to spend a penny, I go flying. It’s a miracle I’ve lasted this long without breaking anything. Not so much as a cup.’
Mrs Albright’s son Richard is sitting with us at the table. He’s already mentioned that the family are looking at residential care, something Mrs Albright seems happy to think about.
‘I’ll miss the old place,’ she says, planting both hands firmly on the table and looking around. ‘But – you know, one thing that became very apparent to me very early on in my career, is that nothing lasts forever.’