smile and act normal

‘You wouldn’t think it, but I’m seventy myself.’
Sam’s right, of course. With her metallic white hair cut jaggedly short and swept back in spikes, her sharp shirt, skinny jeans and fluorescent trainers, I’d have put her at fifty, tops.
‘My knees are worn out. Every few weeks I have to have a needle in my eye because of the macular degeneration. Which means I can’t drive. So I have to take the bus over here every day. And you know what buses are like. It takes me the best part of an hour there and back, twice a day. On top of that I’ve been living in the hospital most nights ‘cos my son in law had an accident and my daughter’s not coping. Plus my own life to sort out. Which needs a LOT of sorting out, these days.’
She takes a breath, staring off into the bright fall of afternoon sun through the window. ‘And I’ll tell you something else,’ she says, trailing off. ‘I’ll tell you something…’
Her chin begins to tremble and she has to turn away.
‘Sorry,’ she says, pulling a tissue from her pocket. ‘Sorry about this.’
‘That’s okay. I can see it’s hard.’
‘Hard!’ she says, with a bitter laugh. ‘Childbirth was hard. Divorce was hard. This is bloody impossible!’
She blows her nose and bins the tissue. Gives her head a little shake.
‘There!’ she says. ‘Now. Good. Where were we?’

We talk through the situation. How her mum Avril is ninety-eight, increasingly frail and forgetful, not eating or drinking, falling more often but refusing to accept any of the practical changes that might improve her situation. She went into hospital for a few days after the last fall. Being discharged today and expected home by ambulance any minute. Although there’ve been a lot of false starts and mix-ups as far as THAT goes. Anyway – Sam is the main carer for her mother, with a little private top-up help from a family friend. Sam has Power of Attorney, thank goodness, which is something, a small victory. But so far it hasn’t helped all that much in practice. Avril refuses to talk about residential care, even for respite, whether for her benefit or – more significantly – for Sam. Things have been staggering on like this for a while. It’s not getting any easier.
‘She was always bloody minded,’ says Sam. ‘I suppose it’s how she’s lived to such a ripe old age. It’s probably what’s kept her going all these years. I mean – It’s not like she’s any different now she’s old. In some ways I think she’s actually more of herself than she was. Which sounds odd, but you know what I mean. Do you?’
I nod and say I think I do.
‘Some things have changed, of course. She repeats herself a lot. Over and over. If I hear that story one more time of her in the air raid shelter with the GI and the rabbits I’ll scream. But essentially she’s still Mum. Which is what makes it so hard. Don’t get me wrong. I love my mum and I’d do anything for her.’
Sam laughs again.
‘Like get the bus twice a day! Anyway – enough of my moaning. Let me show you how I’ve organised her laundry…’
‘Okay.’

I follow her into the hallway. She opens an airing cupboard where a water heater is surrounded by shelves of slacks and vests, everything ironed, neatly stacked and lined up, orderly piles of pants and socks, a clutch of enormous bras hanging down from the top shelf like outlandish nests.
‘What d’you think?’ she says.
‘Wow!’ I say. ‘Pretty organised. You do an amazing job.’
‘You know what? I think I do,’ she says, giving the clothes a long, proprietary look, then slowly closing the door.
The buzzer goes. She stiffens.
‘That’ll be mum,’ she says. ‘Smile and act normal.’

a ghost called alf

I’m looking through Judy’s notes, the last time someone listened to her chest. I can’t help laughing.
‘What’s so funny?’ she says.
‘Well – I think the nurse who wrote this must’ve been hungry. She’s written bilateral crepes.’
I show her the little drawing in the notes. The rough sketch of her lungs, a line of little crosses at the bottom of both, an arrow pointing to them.
Judy’s expression doesn’t change.
‘What does that mean?’ she says.
‘It should say creps.’
‘Craps?’
‘Creps. Short for crepitations. I think that’s what it stands for. Anyway, it’s that crackly sound you get sometimes when there’s gunk in the lungs.’
Judy shrugs.
‘I know all about that,’ she says. ‘I’ve had enough of that.’
‘You’re sounding better today, though.’
‘I’m not dead yet, then?’
‘No! Alive and kicking.’
‘I’ll kick you in a minute.’
‘I wouldn’t mind.’
She stares at me.
‘Where are you from?’ she says. ‘Or-stralia?’
‘Australia? No! I was born in London but brought up in the Fens.’
‘Oh,’ she says. ‘That explains it.’
I shut the folder and carry on with the examination.

Judy is ninety-eight but looks older. In fact, with her quilted housecoat, netted, silvery hair, enormous slippers, stiffly jointed movements – the way she wobbles along clinging to a kitchen trolley loaded with toast, Tommy Tippee beaker and emergency button – it feels like I’m in a marionette update of the Red Riding Hood story, where the Big Bad Wolf works for a Community Health Team, and lets himself in with the keysafe.

‘Are you going to be much longer?’ she says.
‘No. Almost done.’
She takes a toot of tea from the beaker.
‘Would you like me to freshen that up for you?’
‘No – thank you,’ she says. ‘I shall need the lavatory.’
There’s a pause whilst I add my notes to the folder.
‘What did you do – before you retired?’ I say.
‘Shorthand typist,’ she says.
‘How lovely!’ I say. ‘I like typing. It’s one of the most useful skills I ever learned. That and driving.’
‘I worked in a brewery,’ she says, moving on. ‘That’s where I met Alf.’
‘Did he work in the office, too?’
‘Nah. He was in and out. But we’d throw things at each other and we sort of went on from there.’
‘Sounds brilliant.’
‘It was hard during the war, though. Terrible hard. There were these Ack Ack guns on the roof. You should’ve heard ‘em when they went off. Boom! Boom! Boom! The whole place shook like it was gonna fall in. They were having a pop at all them German bombers comin’ over. It was a terrible business. Terrible.’
‘How long were you married, Judy?’
‘A long time. So long I couldn’t tell ya. But Alf’s been gone for years now and – well – that’s that.’
‘I’m sorry.’
‘What for? It’s not your fault. Is it?’
‘No. I suppose not.’
‘Well then.’

I put the finishing touches to the notes.

‘Why don’t you go upstairs and have a lie-down if you’re tired?’ she says.
I look up from the folder.
‘Sorry, Judy – what?’
‘Not you,’ she says. ‘Him.’
She narrows her eyes and nods at the empty chair behind me. I turn to look.
‘My old man,’ she says, sighing and leaning back again. ‘If I don’t keep talking to him he might go orf’ with someone else.’

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.’

making up for lost time

Leslie opens the door, mid-chuckle, like he was waiting there all this time to do just that.
‘Well come in! Come in!’ he laughs. ‘We don’t stand on ceremony here you know!’
I hold the door so he can let go, grabbing him when he almost plunges backwards into an umbrella stand, then holding onto him till he finds his balance again. ‘Thanking you,’ he says. ‘Must take more water with it. Er-hem. This way!’ He walks ahead, rocking from side to side, lifting his legs stiffly from the hip and working his arms, like a robot in an old sci-fi movie.
‘Through here!’ he says, as if there was anywhere else to go in the tiny flat, leading me into a sitting room with two armchairs conspicuously together in front of the television, one of them now being used as a place to put magazines and letters. ‘Sit where you like!’ he says. ‘’scuse the mess.’
Leslie’s doing well for ninety-eight. The only time his bright mood slips is when he mentions his wife, who died a couple of years ago. ‘We were a good team,’ he says. ‘I miss her a lot. It doesn’t seem fair. Still – that’s the way of the world! I’ll see her again soon.’
The doctor referred Leslie in to us for physio and nursing care, nothing too drastic. He’s pretty independent. Goes out most days – or did, before his fall. He has a son who lives a couple of miles away. Visits all the time.
‘My confidence got dented along with my pride’ Leslie says, squeezing his eyes together as he wipes his round glasses on his untucked shirt. ‘Still – I’ll find it again, don’t you worry! You can’t keep old chaps like me down for long!’ He puts his glasses back on and blinks at me happily. There you are! I can see who I’m dealing with now!’

*

When I’m done and writing up my notes, Leslie hands me a paperback he’s been reading – a history of the spitfire.
‘Any good?’ I say, flipping it over to read the blurb.
‘It’s alright,’ he says. ‘My son got it for me. I was a bit disappointed, to be honest with you. It doesn’t mention my lot at all.’
‘Oh yeah? Who was that?’
‘The One Five Two. Black Panthers. So called ‘cos we had a panther on the side, jumping over the roundel. I was one of the technicians, loading ‘em up, fixing ‘em when they went wrong – well, trying to, at least. Out in Burma.’
‘That must’ve been tough.’
‘We got through it. I remember one of the new pilots, South African he was. Tall, handsome chap. Big dimple in his chin, like Superman. He says to me one day, he says Sorry to trouble you old chap, but would you be able to do anything with this blasted watch? And he handed it over, and it was this big ol’ German thing, big as my head. Beautiful it was, a real precision piece. Lord only knows how he got it. Or how he lifted his arm when it was on. Anyway, he says to me he says The blasted thing’s losing time but it’s my lucky watch and I don’t want to fly without it. So I looked it over, but honestly I didn’t have the foggiest. I mean – half the time with dodgy instruments you just chucked ‘em out and replaced ‘em. Why they ever made me a technician in the first place is a mystery. So anyway, I give it back to him and I said Sorry squire! I think you’ll have to get it fixed in Berlin next time you’re over. So he took it back, and they flew out on a mission that night, and he never came back. And I think about that watch sometimes. I think if I’d have took it from him to fix, I’d probably still have it now. Not so lucky after all, was it?’
‘That’s quite a story.’
‘Don’t get me started,’ he laughs. ‘Change the record, that’s what Vera used to say.’
He seems to dip a little.
I tell him about Mr Burton, the guy who ran the corner sweet shop we used to go to on our way back from school.
‘He was this huge guy, big shining face, hardly any teeth, in a shopcoat with all the buttons straining and scuff marks down the front where he wiped the sugar off his hands. And used to stand at the counter with all these sweet jars behind him, rows and rows of them, breathing hard whilst we made our choice. Sherbet lemons, gobstoppers, aniseed balls, flying saucers – you name it. And whenever he weighed the sweets out from the jars, he’d pop one in his mouth. It was like: A quarter for you and one for me. A quarter for you and one for me. It was only years later I found out he was on the Burma railway. Just skin and bone when he got liberated.’
‘He was lucky to get out of that one,’ says Leslie. ‘Poor chap. It was a hard business, that’s for sure. He was probably just making up for lost time. Anyway – how’m I looking? A-one? Or a ticket home?’
And he gives his knees a vigorous rub, like he’s priming an engine or something, winding himself up, ready for action.

fix or nix

‘Here’s a list of my bowel movements!’ says Thomas, handing me a closely-written sheet of paper with all the dates and times, accurate to the minute, GMT. ‘I used to work in telecoms’ he says, settling back into his armchair. ‘I know how to keep track of output.’

Thomas is so old, I imagine telecoms at that time would have been horses, valves and copper wire. He must have been a useful figure, though, because they sent him all over the world – Sierra Leone, the Bahamas, Patagonia.
‘Four children, four continents!’ he says, with a practised flourish. He smiles broadly, like someone unzipped a work bag and a couple of old hacksaws fell out.

He may have travelled the world many times over, but these days Thomas’ advanced age and precarious mobility means he’s pretty much confined to his room. He seems happy enough, though. It’s all been set up very sensibly – as you’d expect – everything to hand, everything in its place according to need and frequency of use, as neatly and logically planned as a circuit diagram. From his dilapidated armchair he can look out of the window, watch television, or simply survey the multitude of family photographs spread across the walls. It gives his chair a strange kind of height, I suppose, that prominent point you might reach if you were to climb a tall telegraph pole, lean back in your straps, thumb your helmet back, catch your breath and wonder at the diminishing curve of the world.

‘What do you think?’ he says. ‘Fix or Nix?’

going home

The old, shadowy, three storey Victorian townhouse is the last one left in the line to be re-developed. Whereas the neighbours either side are smartly painted and appointed, have patios, architectural plants, chimeneas, vine-hung arbors, off-road parking, the old house staggers on with the archaeological scars of the last 150 years: a dilapidated gate you go round and not through; a rusting iron bench, a chunk of obsidian beside an unmade path, a horseshoe nailed to a yew tree. The whole thing has a blasted, portentous feel, like someone built a family home on the hill at Golgotha – and then realised what they’d done, and walked away.

‘Margaret’s coming home to die,’ says Philip. ‘She’ll be here in a minute.’

Philip is an old family friend. He’s known Margaret all his life – when she was a retired music teacher and he was a child student, come to learn the piano, reluctantly climbing the dusty slope to the front door, little knowing he’d still be doing it fifty years later.
‘She’s amazing for her age,’ he says, putting the finishing touches to the room. ‘The only pills she takes are Senna. And you have to crush those up in secret.’

Philip shows me into the room she lives in now – the only occupied room in the entire house. It’s been set up as a micro-environment: bed, zimmer frame, commode, armchair for sitting out in, health permitting, to stare out of the window at the busy road below and beyond, the vast bright spread of the city.

It’s a poignant experience, standing in this room. The piano she last played a dozen years ago when she was ninety is now an extempore stand for photos and wet wipes and sanitary products. Around it, quietly disappearing into the muted walls, a selection of photographs of ancient vintage, sepia family groups, Edwardians in suits and bowler hats lounging awkwardly on the grass; fading figures in boats or on horses; matriarchs in severe black dresses promenading along a sea wall, fishing boats with sails in the bay; men in huge moustaches and braided uniforms; a woman in a tweed suit and upswept, tortoiseshell glasses, smiling up at the camera, a pen in her hand.

We hear the ambulance crew struggling up the path, so we go out to help them.
They carry her into the house on their portable chair, a decrepit royal on a bier.
‘Where d’you want her?’ says one of them, sweating.

* * *

Later, when Margaret’s settled and we’ve brought in all her things, the same ambulance man kneels down in front of her and holds her hand.
‘We’re going to go now,’ he says, loudly and slowly, ‘but we’ll leave you in the care of these good people.’
‘Let me tell you something,’ says Margaret, pulling him towards her. ‘You have a very rare gift – the ability to give people complete confidence, and to put them at their ease.’
‘Well – that’s very kind of you,’ he says, blushing. ‘Thank you very much. No-one’s ever said anything like that to me before.’
‘That’s a shame!’ says Margaret, patting his hand and releasing it. ‘Everyone needs a little encouragement, don’t you think?’ She looks around the room, sees me, and leans back.
‘Now. What in the devil’s name is THIS?’ she says.

a scarcity of goats

‘Can I see some identification?’
‘Of course’
I pull my ID card as far out on its elasticated string as it’ll go; Maud grabs it and pulls it closer, and I’m forced to step forwards, caught off-balance, like a fisherman surprised by a particularly feisty trout. She presses the card to the end of her nose and scrutinises it with her eyes shut, squeezed so tightly in fact that a little tear appears in each corner. ‘Well. That all seems to be in order,’ she says, letting it go with a snap. ‘So sorry about all that,’ she says, flapping her hands and lifting her chin in the air. ‘But one cannot be too careful. Especially these days.’
‘Absolutely.’
‘Please. Go through to the living room. And do excuse the mess. I’m not normally such a slattern.’
‘I wouldn’t call it a mess. Or maybe only a creative mess.’
‘You’re kind. But no – let’s face it. Let’s call a mess a mess. And if any creativity comes of  it, I’ll be the proverbial monkey’s uncle. Or aunt, in this case.’
Maud feels her way to the armchair and plants herself squarely into it.
‘There!’ she says. ‘Good. Lovely. Now then. What can I do for you?’

Maud is as sharp as you could want in a ninety-five year old. When I ask her to demonstrate how she’ll put the eye drops in after her cataract operation, she shows me a faultless technique, tipping her head back and using the bridge of her nose to brace her hand against.
‘There!’ she says, blinking hard and rolling her eyes. ‘Happy?’
I tell her how impressed I am.
‘I’ve never seen anyone use their nose like that. Just out of interest – what line of work were you in?’
‘Originally? Well – I started off as a goatherd!’ she says, carefully placing the tube of eye drops on the table next to her, then lacing her wrinkled hands together in her lap. ‘Not London, of course. Yorkshire. There was a scarcity of goats in London after the war.’