moth orchids

For the life of me, I cannot figure out this gate. It’s held with a strange drop-down mechanism I’ve never seen before, something you have to raise up then angle straight out so the hoop of the gate can pass over it. Something like that.
Brenda watches me from the back door.
‘There!’ I say. ‘Made it!’
‘Well done!’ she says, clapping in that speeded-up way people do with their wrists together. ‘It is fiddly!’
She stares at me so intently, her makeup and hair so perfect, her pink slacks and knitted white cardigan so – I don’t know – central casting, I get the strange feeling I’m in a sitcom. And I’ve forgotten my lines.
‘Come on in!’ says Brenda, improvising to cover. ‘We’re so grateful you stopped by.’
I follow her into the front room. It’s as immaculate as Brenda, of course, with the same, stagey aura of perfection.
‘Shall I fill you in on some background?’ she says, gesturing to a sofa.
I put my bags down, and when I sit on the big cream sofa, it’s hard to resist sitting exactly like Brenda, knees together, legs angled off to the left, like a debuttante or something.
‘I’m worried about James,’ she says, massaging the rings on her gnarly fingers.
‘I’m sorry to hear that, Brenda. Why? What’s been going on?’
‘He’s not himself. Six weeks ago we were on the bus together, going off along the coast, having a lovely day out. Having adventures. I mean – he’s never been the chatty sort, but if you ask him a direct question – nose to nose! – he’ll answer you alright!’
When she says ‘nose to nose’ she puts the flat of her hand to the end of her nose, then peeks round it, and smiles.
‘So – six weeks ago, James was his normal self. And now… what’s happened?’
‘Well he’s just become sleepier and sleepier, until this last week he can’t even get out of bed.’
‘It’s really not like him. He’s normally so active. I’m so glad you’re here because otherwise I don’t know what I’d do. I’ve got Steven of course, our son, and he’s wonderful. But he’s not a doctor, is he? He’s as worried as me.’
‘Well I’m sorry to hear you’ve had a difficult time of it, Brenda. Shall we go upstairs and say hello to the man himself?’
‘Yes!’ she says, brightening and standing up. ‘We’re both so grateful for the NHS. You’re lifesavers, really you are.’
‘That’s kind of you to say so.’
‘Oh I mean it. I have nothing but admiration for the work you do.’

I follow her up the stairs, past a pot of green and white moth orchids, reaching down towards us from their alcove.

James is lying on his side in bed, his flushed and veiny face quite a contrast with the crisp, white duvet. Brenda walks round to the other side and gives him a tentative shake.
‘Jimmy? Darling? It’s a nurse from the hospital. He wants to see how you are…’
James slowly opens his eyes and stares blankly at me. Then he smiles and mouths the word hello.
He does seem very sleepy, nodding off when I talk to him. And whilst it’s true the room is warm and close, still I’m concerned. I take a set of obs, which surprisingly come back as normal.
‘And six weeks ago you were off together on the bus for a day out?’ I say, feeling his pulse, wondering what on earth is going on with his guy.
‘Yes! He’s always been so fit. I can’t understand it.’
‘Has the doctor actually visited James?’
‘No,’ she says. ‘They rang me up and we had a chat. I don’t know what to make of it at all.’

I phone the lead nurse and we talk through the situation. She agrees that it’s a good idea to take some bloods and see if that sheds some light. Meanwhile, we book in a follow-up nurse visit for later in the day.
‘We’ll be in touch!’ I say, waving to Brenda as I walk back through the front garden, expertly flipping the gate latch. with one hand.
‘Thank you so much!’ she says, then steps back inside, and quietly closes the door.


Later that day I talk it over with the nurse who took the follow-up visit.
‘It’s strange,’ she says. ‘He looks really unwell, but I can’t put my finger on it. Brenda says six weeks ago they used to go on the bus along the coast. I couldn’t decide whether his speech was affected or not. Brenda says he’s never been chatty, but if you ask him a direct question nose to nose…’
She makes the same hand gesture that Brenda did when she told me the story, too.
‘Brenda’s known to the memory clinic,’ I say to her.
‘Er-hum,’ says the nurse. ‘But she seems pretty fine for all that.’


The bloods are all fine. Nothing at all to indicate any acute illness, nothing to explain his sudden six week decline, increased lethargy and inability to get out of bed.

I try ringing Steven, the son, for some more information, but his phone keeps going to voicemail. In the end I decide to book in some further nursing visits, and to email the GP with a breakdown of what we’ve found, and what we think might need to happen next, including CT head to exclude any acute changes there.

Luckily, I try one last time to call Steven before I send the email.

‘You know mum’s got dementia, right?’ he says.
‘Well … I read she was known to the memory clinic.’
‘Right!’ he says. ‘She’s pretty confused. I know she presents well, but honestly, she’s clueless. The thing is, up till now she’s been the one getting dad out of bed in the morning. Ever since his stroke he’s been much less active. If you left him to it he’d just stay there all day. Once he’s up he’s not too bad, but he needs a lot of encouragement. Mum’s been good up till now, but for some reason these last few weeks she’s not so able. She’s got this idea he’s going to fall and it’ll be her fault, or something. I don’t know. Anyway – I do what I can to help out, but I can’t be there every morning. I’ve got a job and my own family to take care of. So that’s why the GP got you lot involved.’
‘So this story about how six weeks ago they were off on the bus together along the coast…?’
‘Six years, maybe.’
‘And you’re not worried that your dad’s more unwell?’
‘Dad? No! He’s the same. I mean, look – he’s never been what you might call chatty…’

the december deadbeat club

Walking up the steep stone steps to the Gaynors’ front door is like ascending to heaven – a drowsy, sweet-scented, brightly-coloured heaven, with bees thrumming drunkenly flower to flower, and the afternoon sun laying so thickly over everything I just want to lie down in the shade of that azalea and sleep.

The oldest thing about the house seems to be the door – a worn, iron-riveted oak construction that would look more at home on the front of a medieval abbey. As it is, I can only think the door was here before the house, standing on its own on top of a small hill, before the garden and the other houses and the road and the lines of parked cars. And it was such a perfect door, they thought they’d build a house around it.

Mrs Gaynor is as old as the house. She hobbles to the door and then steps back whilst I put on my mask and gown. She tells me about her accident – or non-accident, actually, as she can’t remember anything about it. Only she caught her leg on something and now it’s swollen up. Mr Gaynor is there, too, a gaunt figure in the background. He hasn’t got much to add, other than that the thing happened, and Mrs Gaynor is on Warfarin, and it’s a bad business all round. The ambulance came and dressed it, she says. They just need something a little more permanent, and some advice.

They show me through to the front room. Oak panelled, a carved settle in the bay window, a Windsor chair, and a spread of framed family photos around the room, daguerreotype to digital, a hundred and fifty years of the same beaky nose and quizzical look, give or take a bonnet or a ludicrous moustache.

‘Let’s have a look,’ I say, after setting up my wound care station on the settle. ‘Does it hurt?’
‘No, no,’ says Mrs Gaynor. ‘I’d hardly know it was there.’
‘Until you fell over,’ chips in Mr Gaynor.
‘That had nothing to do with the leg’ she says.
‘Ah!’ he says. ‘There we are.’

The whole thing is pretty straightforward. We chat about things whilst I work, how long they’ve lived here (they can’t remember exactly), how they’re coping with the lockdown (business as usual, really). I’m overwhelmed with sleepiness again, probably because it’s so hot in the front room, especially in the apron, mask and gloves. I have to wear glasses to see properly, but then they steam up.

‘I’ll be glad when all this is over,’ I say, straightening up and trying to clear my glasses by wiggling my eyebrows and then pushing the glasses back up with the back of my wrist.
‘It’s certainly dragging on,’ says Mr Gaynor.
‘And then my leg happens,’ says Mrs Gaynor.
To force myself to stay awake I jump on another subject – the fact that I share a birthday with Mrs Gaynor.
‘The fag end of the year,’ I tell her. ‘My dad was the same.’
‘He wasn’t!’
‘Well – not exactly. His birthday was the day before. The joke was that I delayed coming out till I could have a birthday of my own.’
I hold my arms out left and right to illustrate how I did it.
She laughs.
‘Your poor mother.’
‘I’m a December baby, too, you know,’ says Mr Gaynor, in case Mrs Gaynor decides not to tell me.
‘So we’re all Capricorns!’ says Mrs Gaynor. ‘How extraordinary!’
‘The December Deadbeat Club,’ says Mr Gaynor. ‘Present company excepted, of course.’

walking home

There are two single beds side by side in the middle of the room, the nearest one occupied, the furthest one empty with the bedclothes rucked up. Ted’s wife Rita is in the nearest, lying on her back with her arms by her sides on the top of the covers, perfectly aligned with the legs beneath, as graven and still as the alabaster figure of a woman in a tomb – albeit one that was irritated her partner had got up after a thousand years and gone to sit in the Windsor chair by the window.

‘She’s on that many pills,’ whispers Joan, their daughter, standing in the bedroom doorway and looking in on the tomb with her arms folded. ‘If I took what she took you could tie a string round my leg, take me outside and fly me.’

Ted is staring out at the communal gardens below. There’s an empty perspex bird-feeder suckered to the window just the other side of him.
‘Do you want me to put some seed in the feeder?’ says Joan. ‘It’ll give you something to look at.’
‘I’m alright’ he says, batting his hand. ‘They’re alright, too, I ‘spect. They’re birds.’
‘Suit yourself.’

It’s hard to know what to do about Rita. Degenerative illness means she suffers from chronic pain. Even if there was a total body replacement available, at ninety one she’d never survive the op. Joan had given me the heads-up downstairs in the kitchen. ‘‘She’s become her illness,’ she said. ‘She doesn’t talk about anything else – except when she’s being snippy about my cooking. I thought coming to live with us would help, but it’s been a nightmare.’
‘Do you want to speak to a social worker about it?’
‘A social worker?’ she’d said, frowning and leaning back. ‘Why? What could they do?’
‘Well – if things are too stressful here, they could talk about alternatives.’
‘What d’you mean, alternatives?’ she says over her shoulder as she filled the kettle at the sink. ‘D’you mean put her in a home?’
‘Some kind of residential care, yes. Somewhere set up for someone with complex needs. You never know – she might like it.’
‘And what about Dad? What would he do?’
‘Maybe he could go, too.’
‘Put Dad in a home?’ says Joan, slamming the full kettle onto its stand and jabbing the switch. ‘You might as well shoot him.’

Whilst I’m with Rita, taking her blood pressure and temperature and so on, Ted divides his attention between us and two dogs that have run into the garden to play tug-of-war.
‘I met her when I was back on leave,’ he says, as if the dogs brought it all to mind. ‘I went to the picturehouse, and there she was, having her hair pulled by these kids sitting behind her.’
‘My friend hadn’t showed up so I went in alone,’ says Rita, her eyes still shut, her eyelids flickering like the film she saw has started playing the other side. ‘I didn’t know what else to do.’
If Ted hears, he makes no sign.
‘So what I did was,’ he says, shifting forwards in the chair, ‘I snuck up behind them, like this… and I reached out… and I banged all their heads together, like this! Then when she ran outside I followed her. And I said to her, I said I’ll walk you home…’
‘I didn’t want him to,’ says Rita. ‘I said I was perfectly capable of walking home by myself, thank you very much.’
‘When we got there, I didn’t try to kiss her or nothing. I just shook her hand, all gentlemanly like, and I said I hoped she had a nice time and everything, and maybe could I see her again. Two years later the war was over. I come back from Italy. We got married. And that was seventy-four years ago.’
He chuckles, settles back in the chair, and stares out of the window again.
The dogs have gone inside.
‘I didn’t want him to walk me home,’ says Rita. ‘I said to him. I said, I’m perfectly capable of walking home by myself, thank you very much.’

the birdbath

‘Funny – you being called Jim. My mother christened me Stanley but everyone calls me Jim, too. I don’t know why. I must look more like a Jim than a Stanley.’
‘Well I was christened James’, I tell him. ‘But no-one ever calls me that. Unless I’m in trouble.’
‘Two Jims!’ says Jim. ‘That should make it easier.’
‘Oh God!’ says Erica. ‘One’s enough!’
The phone rings, and Erica hurries into the hall to answer it.
‘One of her girlfriends, I ‘spect,’ says Jim with a sniff. ‘There’s half a dozen of ‘em at least. Or there was…’ he says, drifting off slightly and scratching his head.
Erica’s delighted laugh trills through from the hallway. I get the impression she laughs easily and often. She’d laughed when she opened the door to me, when I introduced myself and said what I’d come to do – even when I’d slipped my shoes off.
‘A housetrained man!’ she’d trilled. ‘Well I never!’
They’re both in their nineties. Of the two, Jim is fairing the worst. He’s frail and stooped, tentatively feeling his way from sideboard to sofa like a ghost unexpectedly granted one last corporeal turn about the place. Erica, on the other hand, seems to be intensifying with age, her girlish spirit ringing through the dusty air.
‘Hark at that!’ says Jim, collapsing back into his armchair. ‘She’ll be on the phone for hours now.’
But he closes his eyes as if it’s the sweetest sound imaginable.
Whilst Erica is occupied on the phone I run through the examination and take some blood. By the time she hops back into the room I’m pretty much done, just asking some questions about eating and drinking, how he’s managing with personal care and so on.
‘Are you able to use the shower?’ I ask him.
‘The shower?’ says Erica, leaning over the chair and combing his thinning grey hair with her fingers. ‘Goodness, no! He has a birdbath.’
‘A birdbath?’
‘Yes! You know! He grips the sink with his claws, flaps his wings, and splashes his face with water!’

sixty years on

‘How long have you lived here?’
‘Ooh – I don’t know. I should think about sixty years or more’ says Thomas. ‘We moved when we had Lily, and I’d got that new job. D’you remember, Lucy?’
‘Of course I remember!’ says Lucy, rearranging a napkin on her lap. ‘I was here, wasn’t I?’
‘Sixty years,’ says Thomas, absorbing Lucy’s tetchiness with a wistful shake of his head and then a sudden, gaping smile, the kind you might see on a ventriloquist’s dummy. ‘Long enough!’ he says.

It’s a beautiful old cottage – or used to be. Could be again, with a little work. Emptying out all the clutter, ripping out what remains of the fixtures and fittings, stripping back the plaster to the bricks, taking up the floor, rewiring, new doors and windows. New roof, come to that. Redecorating throughout. Cutting back the garden, and so on. An album of Before and After photographs. These things take a little imagination, but totally worth it if you can see beyond the mess. Clink, clink. Cheers!

Thomas and Lucy wouldn’t feature in any of the quotes, of course, even if the builders were game, and had a few geriatricians, cosmetic surgeons and orthopaedic consultants on the team. Because it goes without saying that the same passage of years that wreaked such damage on the house hasn’t spared the occupants, and whilst ancient buildings can be straightened out with hard work and a certain amount of cash, the same can’t be said of the people who live in them.

‘Push that button – no! That one!’ says Thomas, leaning out to interfere with Lucy’s attempts to operate the riser-function of her chair.
‘Let me do it! Let me do it…!’ says Lucy, wresting it away from him and getting in a muddle. The back of the seat goes down and the footrests shoot out. ‘Blast!’ she says, and promptly turns the whole thing off.

They have carers three times a day – once to get them up and dressed, once to give them lunch and prepare some cling-filmed sandwiches for tea, and once to put them to bed. Although I have to say it’s looking pretty much as if the ‘bed’ aspect has gone by the board. They’re sleeping in their chairs full-time now, and only getting up to stagger precariously through the jumble of everything to a commode.

At first it seems like a pretty sad kind of existence, and I can’t help feeling sorry for them. Wouldn’t it be better if they sold up and moved into a nursing home? Somewhere with staff on hand to keep an eye on them? To wash, dress and feed them, and keep them warm (not that this place is cold – they have a free-standing oil-filled radiator in the middle of the room, on full). I’m sure they could sit next to each other somewhere, either in their own room or in the lounge? Because no-one could say they were remotely safe in this place. A small stack of ambulance sheets is a testament to the increasing number of falls they’re having.

But they don’t strike me as unhappy. The bickering isn’t unpleasant or aggressive; more the sniping of two caged creatures, fussing over the minutiae of their shrunken existence. I wonder how well they’d fare if they were removed from this place, even taking into account the trip hazards and the damp and the dodgy electrics. I wouldn’t be surprised if they faded away the moment they were helped to a couple of comfortable chairs, in a wide and well-lit room, with a television, and a trolley doing the rounds at half-past ten, and three.

‘Give it here… look! You’ve turned the damned thing off!’
Thomas tries to snatch the remote, but it’s like watching a tortoise make a swipe for another tortoise’s lettuce leaf.
‘Ha!’ says Lucy. Then after glaring at him triumphantly, she slowly presses it up to her nose to figure it out.

a job lot

It’s already late when I get there, the sun low on the hills, shreds of pink cloud against a deepening sky.
Roy answers the door with a tea cloth in his hands.
‘Come on in!’ he says, flipping the cloth over his shoulder, shaking my hand warmly and ushering me in. ‘Jean’s just through here. She will be pleased to see you.’
He follows me into the living room, dragging his left foot a little, like his hips are starting to go.
‘What a pair we are!’ he says. ‘A job lot. Aren’t we Jean? A job lot?’
Jean is sitting by the patio window in a high-backed armchair, smiling at us both with as much of a delighted expression as her stroke will allow. She tries to speak, too, and though it’s incomprehensible, Roy seems to know what she means, and fills in the gaps.
I’ve come to change the dressing on her arm. For some reason she can’t help picking and scratching at it, and the wounds have become infected.
‘I did clip the nails on her hand,’ says Roy, ‘but she was still finding a way through it all. Weren’t you, Jean?’
He strokes her hair. ‘Thanks again for coming out. We do appreciate it.’
‘It’s no trouble.’
He stands over me whilst I prepare the dressings.
‘I have to apologise if I smell a little – you know.’
‘I can’t smell anything,’ I tell him. ‘Why – what have you had? Garlic sausage?’
‘Me? No! A little glass of whisky.’
‘I think you’re more than entitled to a glass of whisky. What sort is it?’
‘Famous Grouse.’
‘That’s a good one,’ I say, sounding as if I know about these things. To back it up, I tell him about a job I used to have a few years ago, working for an company that maintained intranets. ‘One of the clients ran a gin distillery,’ I tell him. ‘They showed us round once. It was amazing! These gigantic stills, filling the place, right up to the roof, like giant copper onions.’
Roy laughs.
‘I wouldn’t mind seeing that,’ he says. ‘Mind you – I’m not really a gin man.’
I start cutting off the old bandage. Jean watches me with her eyes wide and her mouth hanging open.
‘Alright?’ I say. ‘I’m just going to use a little bit of sterile water…’

Roy helps out where he can, passing me things, comforting Jean, keeping her distracted. It’s all pretty straightforward and I’m done in a few minutes.

‘Good as new!’ I say, peeling off my gloves and starting to clear up.
‘Here! You might be interested to see this..’ says Roy. He unhooks a framed, black and white picture from the wall. A man in overalls, neckerchief and peaked cap standing on the tracks beside an enormous steam engine.
‘I used to work the locomotives. A fireman to begin with, until I made driver. It’s funny to think of it now, y’know, but on an early turn I used to stop off on the way into the yard for a pint of Guinness. Not for the alcohol, y’understand. For the oomph. I tell you what – it was hard work, shovelling coal, keeping it going. But it was the best job in the world. You got into a sort of flow after a while, and there was nothing you couldn’t do. I’d be all the way to Newcastle and back, and I’d suddenly think hang on a minute! I haven’t had a wee since breakfast! But that’s how it was.’
We both look at the picture for a moment. Roy has one hand on the rail of the cab, one foot on the plate, and he’s standing looking at the camera with such a strong and confident gaze you’d think for tuppence he could pick the whole thing up and wave it over his head.
‘These days the only exercise I get is wheeling Jean along the front,’ he says, wiping the glass with his elbow and then carefully hanging it back on the wall. ‘But we do alright, don’t we Jean? Hey?’
He bends down to give her a kiss on the cheek, and she gives him a big, adoring smile in return, before turning her attention to the new bandage, looking for any weak spots with her other hand.

the name of the fox

Ray answers the door. I know from the referral he’s eighty something, but if you snatched a look on a foggy night after falling out of the pub you could be persuaded he was twenty-four. His skin has a deep leathery tan, hair dyed black, swept up in what would have been a substantial quiff in the late fifties; his teeth suspiciously even, cardboard white, his flowery shirt unbuttoned to the navel, revealing a slew of chains of differing lengths and thickness, pendants of silver and gold, crosses, St Christophers, a US dog tag, an Egyptian ankh.
‘Hi!’ he says. ‘Come in!’
‘Just a flying visit, Mr Clarke. The nurse asked me to drop by with a couple of things for Daphne.’
Daphne?’ he calls over his shoulder. ‘Another lovely person to see you.’
Oh fantastic! Wowee!’ says a thin voice from the room straight ahead.
‘Go through’ says Ray.

The lounge is a shrine to Elvis. Images of The King on everything, from mirrors and paintings and gold records and film posters, to ceramic statues, a throw over the back of the sofa, even the clock over the mantelpiece – Elvis in his Las Vegas incarnation, legs apart, arms windmilling the minutes and hours.
‘Hello, Daphne! Lovely to meet you. I’m Jim, from the hospital.’
‘Lovely to meet you, too!’ she says, holding on to my hand, squeezing it, gradually pulling me in. ‘Aren’t you handsome?’
‘You’re making me blush,’ I say.
‘Now, now,’ says Ray.
She laughs and releases my hand..
‘I’ve just dropped round to bring you this special cushion to sit on. To protect your bottom. And some cream for the carers to put on in the morning.’
‘Now – you hear a lot about the NHS,’ says Ray, taking the things off me. ‘But I have to say, we’ve had nothing but the very best treatment.’
‘That’s good to hear,’ I say.

Daphne is beaming up at me from the armchair. I’m guessing Ray does her make up, because there’s something doll-like in the way the lipstick and rouge has been applied. She’s immaculate, though, as perfect as the figurine of Elvis, circa sixty-eight special, in a glass bell jar on the coffee table. She’s cuddling two soft toys, a fox in a waistcoat under her left arm, a scruffy looking teddy bear under her right.
‘And who are these two gentlemen?’ I say, patting the bear on the head. ‘They look amazing.’
‘Guess their names!’ she says.
‘Well – this one here, I’m going to start low and say … Ted!’
‘Yes!’ she says. ‘Now – what about this one?’
‘Mr Fox? Hmm. That’s a bit more tricky. But I’m going to take a wild guess, and I’m going to say… Elvis!’
‘No. It’s Montgomery. How do you do?’ and she offers up his paw for me to shake.