Andre the Nurse

The flat we want is actually round the corner, on the front. Parking there is impossible, so I arrange to meet Andre the nurse outside the Chinese restaurant in an adjacent side street. There’s no time for much conversation; a squall of rain is sweeping in off the sea – so fierce it almost tears the boot from Andre’s car and empties the contents – all the dressings and folders and so on – out into the street. People squeal as they pitter past us, holding bags over their heads, wrestling with umbrellas turned inside out.

‘Let’s go!’ snarls Andre, and we run.

Andre the nurse reminds me of Andre the Giant from The Princess Bride. Not so much in height, although he is pretty tall. It’s more in demeanour, the same lunkishly, lowering kind of look. An ogre in a nurse’s tunic. Andre is basically harmless, though. I’m sure he could spend many happy minutes stroking a dove’s head – if a dove was ever dumb enough to land on his outstretched paw. And if it survived the stroking, and flew off in a dazed and crooked line, I’m sure the dove would feel affectionately towards him, too.

We’ve come to visit Rick, a patient referred to us by the GP, more as a welfare check than anything else, and to see if our team could help out in any way, with care or therapy or nursing and so on. ‘At risk of unconsciousness or death’ the referral had said, bleakly.

‘We’re ALL at risk of that, my friend!’ snorts Andre, buzzing the intercom half a dozen times, and then banging on the main door with the edge of his fist, with such brutal energy you’d think it was a SWAT team calling rather than a nurse from the hospital.

There’s no reply, just as there was no reply from the patient’s phone. Andre seems ready to pick up the block and shake Rick out, but luckily a delivery guy turns up with a code to get in, so we tailgate the rather anxious looking guy and then trudge up the plush steps to the third floor, grumbling about the weather all the way up.

Once we find Rick’s flat, Andre bangs on the door with such force the whole thing jumps in its frame.
‘Nurse!’ he shouts, which would have any sane person leaping from the bathroom window.
I look through the letterbox. The flat is silent, everything under sheets, buckets and paint trays and rollers on the floor.
‘I think it’s being refurbished,’ I say, straightening up. ‘He must be somewhere else.’
Andre sighs, goes to the flat next door and bangs on that, too.

Amazingly, an elderly woman opens it.

‘Oh – so sorry to disturb you,’ says Andre, using a whispery tone of voice so sinister the woman visibly recoils. ‘Me and my esteemed colleague are nurses from the hospital,’ he says. ‘I wonder if you would be so kind as to tell us where Rick is, please?’
The woman shudders, shuffles back in alarm, slams the door. There’s the sound of several bolts being thrown, a chain rattling on. Maybe a small wardrobe dragged into position.
‘Thank you so much!’ says Andre, giving a little salute to the door, then glares at me like I’m somehow responsible.
‘I’ll ring the office,’ I say.
‘You do that, Jimmy,’ says Andre. ‘Meanwhile I will stand here and think about why God is punishing me like this.’

The coordinator sounds sleepy.
‘Yes,’ she yawns. ‘The address is wrong. He’s in a flat on the other side of town.’
She texts us both the new address. Andre stares down at his phone as if he can’t decide whether to put it in his pocket or on the floor so he can stamp on it.
‘Come on, Jimmy!’ he says, choosing the former. ‘We can’t stay here the rest of our lives.’

The squall has settled into something more terrible, a hybrid inundation somewhere between a hurricane and the Great Flood. Even with the wipers on full it’s difficult to see where I’m going. It gets so bad I could be persuaded I’d left the road completely and was driving along the sea bed, following a whale that fails to indicate when it turns left. More by luck than skill I end up outside the alternative address; Andre parks in front of me and we both run with our coats over our heads to the entrance to the flats, a battered black door with a font of water rushing out of a broken downpipe across the pavement and over our shoes.
Andre beats on the door.
‘Come on! Come on!’ he says.
Just before we have to stop knocking and start treading water, the door opens and Rick stands there, his long hair matted, his beard worse.
‘Yes?’ he says, holding on to the door, then resting his face against the edge of it. ‘Can I help you?’
‘We are nurses from the hospital. Can we come in please?’
It sounds like Andre’s asking for sanctuary, which in a way, of course, he is. Luckily it seems to work. Rick releases his grip on the door and drifts back into the flat.
‘Your doctor asked us to visit,’ says Andre, shaking his coat and slapping the rain from his bald head. ‘Your doctor is worried about you.’
‘Oh?’ says Rick. He trails further back into the flat, sits on something that must have been a sofa once, and starts rolling a cigarette. He’s surrounded by empty cans of lager, and I’m impressed he managed to sit down without disturbing any of them.

Andre drags a stool over and tries to explain the reason for the visit, growling through the basics with the patience of a WWF wrestler called ‘The Nurse’. Rick is oblivious, though, fastidiously licking the strip of gum on the cigarette paper, rolling it, admiring it, then lighting it with the snick of a match.
‘Yes?’ he says, blowing smoke. ‘Er-hmmm.’
‘So this being the case, would you be accepting of such help from us, please?’ says Andre.
‘No,’ says Rick, picking strands of tobacco from his lips. ‘No, I would not.’
‘Do you understand what I am telling you?’ says Andre, almost tearing the folder in half.
Rick sighs, hooks the hair from his eyes, and – strangely – closes them when he looks at Andre
‘Like I said, officer,’ he says, ‘I’m perfectly fine.’
‘Okay. Good. You are perfectly within your rights to refuse, my friend,’ says Andre, trembling from the effort of control. Would you be so kind as to sign here, then?’
‘What’s this?’
‘This? This is a form to say that you do not want any help from us, and that you understand the risks involved in not accepting help,’ says Andre, handing him the paper and tapping with his pen where he wants Rick to sign.
‘What risks?’
‘Unconsciousness and death’ says Andre.
And the way he smiles at Rick, it’s like he doesn’t mind which.

looking for geppetto

The front door is open. When I go in and close it, I see a sign thumb-tacked just above the letter box: Keep The Door Closed. 

I can hear Raymond talking animatedly on the phone in the front room. When I stick my head round the corner and wave, he waggles his free hand in the air and continues:

This is absolutely fucking ridiculous…. of course I can’t tell you the card number… well, for the simple reason I’ve lost the card. That’s the entire purpose of my call. If I had the card to read the number I wouldn’t be ringing you, would I? No I won’t calm down. I demand that you reinstate the two hundred pounds that was stolen from my account…. I don’t KNOW how they got the pin number. They’re CRIMINALS. That’s their JOB. All I want is for you to do YOUR job and give me back my money….

Something happens with the phone. He curses, holds it away from his face, bangs it twice on the arm of the chair and then tosses it out into the chaos of the room. 

‘Battery’s dead!’ he says. ‘You couldn’t do me a favour, could you?’

‘Of course.’

‘Locate the base that’s somewhere over there and charge it up again?’

The little front room is in a mess, as devastating as if flood water had unexpectedly rushed through the house and then back out again, leaving a tangled tideline of random stuff – trainers, trousers, duvet covers, exercise bike, milk cartons, who knows what. The only clarity in the place are the bookshelves, safely screwed to the walls out of harm’s way, the books neatly aligned in height order. They mostly seem to be about film, especially animation. Which makes sense, given the display on the hallway wall of some early Disney drawings – character studies of Jiminy Cricket, Figaro the cat, Pinocchio. 

I’d had some warning of the state of play this morning. The therapist who’d been in to see Raymond the day before had written an illuminating note: Patient reports that a stranger visited last night with a bottle of brandy – stayed for sex – stole money on his card. Police informed. 

Notes further back show that this isn’t an unusual event. Raymond has a long history of alcohol abuse and all the associated complications, medical and social. I’ve come round to dress the wound on his head, and generally see how he’s doing. 

He has no recollection of the fall.

‘Is that unusual for you?’ I say, gently cleaning the wound with saline, holding a swab to his eyeline to catch the drips.

‘No, sadly,’ he says. ‘It’s the booze, of course.’

‘I read that you tried a detox programme last year – which is good.’

‘Is it? Well – you get shunted into these things. My heart wasn’t in it. I’m afraid I didn’t just fall off the wagon I rolled it over and took everyone down with me.’

‘Worth trying again…?’

‘I don’t think so,’ he says, with a deflationary sigh. ‘It’s not worth it.’

I photograph the wound, dress it, check him over more thoroughly. He’s got lots of injuries, old bruises, new bruises. It’s like he drinks a bottle of brandy then throws himself into a giant tumbling machine. It’s a miracle he ever emerges. 

‘I love the Disney drawings you have on the wall,’ I say. 

‘Thank you.’

‘I remember the first time I saw Pinocchio. That scene where Lampy turns into a donkey. Good grief! And that bit where Pinocchio’s walking on the sea bed with a rock tied to his tail. Calling out Faaaa…ttttthhhherrr! And all the seahorses and clams and things come out to look. But when he asks them if they’ve seen Monstro the whale, they look terrified and disappear! I mean – what an absolute freakin’ nightmare!’

‘Yes,’ says Raymond. ‘I know. Story of my life.’


It’s quite a contrast to see the two of them together – Alex, wraith-like, matted hair, scooped eyes, shivering, hugging his legs in bed with a filthy duvet piled up around him; and Graham, the support worker from the alcohol and substance abuse team, shaven-headed, gym-fit, in a smart grey reefer jacket and leather man bag, perched on the arm of the sofa with his hands in his pockets. It could be a fashion shoot for an edgy magazine.
‘You’ve got this far, yeah?’ says Graham. ‘Hats off to you, mate. It’s no easy thing you’ve done there. Don’t go and spoil it now. After all we’ve been through. You got to realise – this is a disease we’re talking about, yeah? There are all kindsa toxins and shit floatin’ around your body right now. You can’t just expect to jump up and be cured. It’s a long, hard process. And you’re doin’ great, man! Isn’t he? This guy’ll tell ya…’
‘You are. Graham’s right. Alcohol addiction’s the hardest thing.’
‘See what I mean?’
Alex doesn’t seem convinced. He draws his legs closer to him, gives his head a peremptory shake.
‘I don’ know, man. I jus’ feel like I’m wastin’ everyone’s time. I mean – I brought it on myself.’
‘You can’t afford to think like that,’ says Graham. ‘Everyone’s different. You’re totally worth it, man.’
‘Is there a social worker involved?’ I ask Graham, flipping through his folder.
‘No,’ he says. ‘When they see they’re still drinking they pull out.’
He shrugs, scuffs his shoes in the trash.
‘It’s hard, but it’s just the way it is.’
‘It’s not like I’m not trying,’ says Alex.
‘Yeah – but there’s trying, and there’s doing, Alex. You’ve got to be in a position to accept the help. It’s just how it works. You know that.’
‘We’re here for you, though.’

There are several bottles within easy reach of Alex’s bed – a two litre bottle of cider, a couple of quarter bottles of vodka, some other, less obvious stuff in bottles with the labels torn off. A dull yellow light filters through the filthy windows. The flat is an apocalyptic mess; it looks like an extemporary shelter somebody hollowed out with their hands in a landfill site. Here and there you can just make out traces of the orderly life Alex once used to live. There’s a mountain bike in the hallway, quietly fossilising under a press of junk; over by the window-ledge, a tool box, some work boots.
‘We’ve got to find a way to keep you out of trouble long enough to detox properly,’ says Graham. ‘Yeah?’
‘Yeah,’ says Alex. He doesn’t sound convinced.
Graham shrugs, pushes his hands deeper into his jacket.
‘How long’ve we known each now?’ he says. ‘Gotta be nine, ten years.’
‘Is it?’ says Alex, rubbing his face. ‘Fuck, man! Nine years? No! That’s like…’ He screws up his face to figure out what percentage of his life that represents: ‘…that’s like… a fuck of a long time, man!’
‘I think so,’ says Graham. ‘First time I met you you’d just been beaten up and taken to hospital. You were in a bad way, my friend.’
‘Was I?’ says Alex. ‘I don’t remember.’
‘Yeah – well – you don’t remember much, to be fair. You didn’t remember I was here yesterday, so maybe that’s not headline news.’
‘No. You’re right. Probably not.’
‘I’ve seen you in and out of hospital a hundred times. Lost sight of you for months on end when you took yourself off somewhere. You’d always turn up again, half dead, some new injury. And now look.’
He’s right. I’m reading through the latest discharge summary. For someone so young, Alex has a terrible list of things wrong. In fact, it’s a miracle he’s still here at all. Looking at him on the bed, though, it would be easy to think that maybe he wasn’t – that maybe he’d died that last time in hospital, but his spirit was so cussed it dragged itself back across town to find rest in this cold, cold bed.
‘It’s like training, yeah? You can’t just jump on a treadmill and bang out ten K. You might feel great at the end of it, but the truth is, if you don’t get the intervals right you can be setting yourself up for a lot of trouble. It’s all about the interaction between the sympathetic and the parasympathetic nervous systems, the way your body metabolises the shit and tries to get straight again. Jim’ll tell you. Hey?’
They both look at me – Graham as if he’s about to pick me up and bench press me, Alex with a haunted, shivery look.
‘That’s right,’ I say, ‘Uh-huh.’