spit spot

I’m in awe of the equipment company. They have an uncanny ability to put a hospital bed into the most inhospitable place. I’m sure one day we’ll be called to a lighthouse with a bed seesawing on the roof just above the lamp. Looking around Eileen’s small and cluttered bedroom, it seems to me they would only have had two options: lift the roof off and drop it in with a crane, or beam it into position from the transporter deck of the Starship Enterprise.

Nobody needed a hospital bed more than Eileen, though, so it’s great they persevered.
Eileen is rapidly approaching the end of her life, her flesh falling away, the most vital thing about her the glassy shine to her preternaturally large eyes.

‘I want to sit out,’ she says, gripping the sides of the bed. ‘I’m sick of this.’

It’s no small ambition. Aside from Eileen’s general frailty, we’ll need to consider the two lines from the morphine drivers feeding in to her right and left, her catheter, the nasal specs for her oxygen. And if that wasn’t complicated enough, there’s the practical difficulty of the bedroom itself. We had trouble getting in the door, let alone negotiate a complicated transfer. Still, Eileen won’t be dissuaded, and (incredibly) her observations are strong enough.

‘Hmm,’ says Vihaan, looking around.

I’m standing on Eileen’s right, squeezed in between a stack of pads, bedclothes, boxes of stuff, a cantilever table, a floor-standing aircon unit, a wicker bath chair piled with towels and things, a life-sized porcelain dog – really, it’s more like a storage cupboard than a bedroom for the terminally ill. Vihaan is to her left by the window. A little clearer his side, but not much.

‘Actually, Eileen, you know, I think it’s not going to be all that easy,’ says Vihaan. ‘Okay? I think it would be safer for all concerned if you stayed in bed and rested there.’

Eileen stares at him, a little hypnotised. It happens a lot. Vihaan is so striking, with a Bollywood intensity and perfect, crow-black quiff, standing with his hands on his hips, glancing around the place, speaking so rapidly and so musically it’s easy to get distracted, like standing by a stream fascinated by the play of light, utterly forgetting you’re supposed to be catching fish.

‘What?’ says Eileen.
‘Are you sure you wouldn’t want to stay in bed a while longer?’ he says. ‘Okay? You’re absolutely sure about this?’
Eileen turns her head slowly to stare at me, then turns back to Vihaan.
‘Of course I’m sure,’ she says.
‘Okay, then, Eileen. Whatever you say. You’re the boss, actually. We’ll give it a go and we’ll do our best,’ he says. ‘But we’ll take things slowly, one thing at a time – okay? – and then if anything changes, actually, we’ll stop and think it over again. Okay? Okay.’

The hospital bed is in the only possible place it can be, in the centre of the room, the feet towards the door. The best we can do is to cheat it more to the right, making enough space to the left for the wicker chair and a zimmer frame to help with the transfer. It’s a spatial puzzle, where you have to move everything in strict order, this then this, or that over there first, to move these, and that there temporarily, whilst you hand over these – careful – back up a bit, then that can go there…

Eileen watches it all pass backwards and forwards over her bed. She’s on so much morphine I wouldn’t be surprised if she thought the room was reordering itself, flying through the air in a magical, Mary Poppins kind of way. Spit spot. A clap of the hands. Vihaan would make a great Mary Poppins. Not so much the outfit – although he’d be a sensation in that – more his brisk but warm practicality.

‘Okay,’ he says, when at last the thing is done. He leans on the zimmer, one foot up on the strut. ‘So now the room is better arranged for you to sit out from your bed actually,’ he says. ‘The wicker chair is a good height for you and we’ve made it comfortable with cushions and what have you. So let us begin to raise you up on the bed, okay? And we’ll take it very slowly, Eileen. Step by step. And we’ll help you to sit out in the chair for a while.’
She turns her big eyes up to him, and although she doesn’t smile or say anything, you can see her gratitude holding there, at some depth, but poised, and delicate, and perfectly true.

technical glitch

The rush hour has a hectic, drawn-down feel, people hurrying home through the damp streets, clutching their collars against the rain, struggling with umbrellas, the headlights and brake lights of the traffic around them fitfully illuminating the wintry October night.

Arthur is our last assessment for the day. If we’re to be off on time we’ll need to be quick, but so far at least, the omens aren’t good.

To begin with, we just cannot find the damned house.

I’d spoken to his wife June just half an hour ago to let her know we were coming. But now when I try to call her to ask where on earth thirty-eight South Road is, the phone is permanently engaged. We park up outside the block which, on the Satnav at least, bears the flag. There’s a man sheltering in the doorway, smoking a fag. When I ask him for directions he shrugs and taps some ash off to the side, carefully holding the fag cupped in his hand to shield it from the rain.
‘Is that a flat somewhere, maybe?’  he says, shuffling from side to side, glancing beyond me down the street. ‘Dunno, mate,’ he says. ‘Can’t think.’
We go round him, into the offices of what turns out to be a parcel delivery company. The receptionist behind the desk is bright and helpful, determined to find out where number thirty-eight South Road might be.
‘Sorry to bother you..’ I tell her.
‘Not at all,’ she says. ‘Happy to help. One…. moment….’
She taps around on the computer.
‘Oh! Apparently this is thirty-eight!’ she says, setting back and blushing. ‘Sorry – I only started here yesterday.’
‘So – do they live upstairs, then?’
‘No. Maybe. I’m not sure. I thought that was just a storage area.’
The manager comes through – slowly, as if he’d been hiding round the side of a screen and was reluctant to reveal he’d heard the whole thing. He stares at us neutrally as the receptionist explains who we are and what we’ve come for. No, he says. This is sixty-eight. And no, there isn’t an elderly couple living upstairs amongst the boxes, not as far as he’s aware.
‘I’m sure I would’ve seen something,’ he says. ‘Some nibbled cardboard, maybe a hat. But anyway – let’s have another look on the computer.
We huddle round another laptop as he opens Google maps. It seems a bit weird, going into street view for what is effectively the area just beyond the window, but it’s nice of him to try, and so long as June isn’t answering, I can’t think what else to do.
‘Here we are…’ he says.
He zooms in, but unfortunately, a huge truck had been passing the day the Google mapping car drove down South Road, so we’re unable to get any further with that.
‘Not to worry,’ I tell him. ‘Thanks for your help.’
I’m aware of them standing side-by-side at the counter, following us with their gaze as we hurry out into the rain.

Back in the car I try calling June again. This time she answers.
‘Oh,’ she says. ‘Everyone has this problem. I bet you followed your satnav, didn’t you? What the machines don’t seem to realise is that South Road actually starts beyond the traffic lights.’
‘Does it?’
‘Yes! We’re tucked away up here, but that’s how we like it.’
We leave the car parked where it is, because to move it would mean driving all the way round the one way system, which at this time of day would take forever. By the time we reach the front door, we’re both soaked through.
‘Oh dear!’ says June. ‘Is it raining?’
She shows us in to the narrow hallway, where we take off our coats and shoes and go through to a modest sitting room. The house has electric lighting, the sockets and switches so old the electricians who screwed them into place were probably tutting about the Suez crisis.
June is content, though. She sits by the fireplace, as immaculately pearled, coiffed and cardiganed as a minor royal.
‘He’s upstairs in bed,’ she says. ‘Although I don’t suppose he’ll be terribly pleased to see you. What exactly is it that you want to do with him?’
‘We’ve been asked to come in by the care agency to do a bed assessment,’ says Beatrice, the OT leading the assessment. ‘The carers say that the one Arthur’s in is too low, especially with his reduced mobility.’
‘He can hardly stand,’ sniffs June. ‘He’s pretty frail, you know.’
‘Exactly. We want what’s best for Arthur, but at the same time we have to be mindful of the health of the people looking after him.’
‘I know that,’ says June. ‘I know that very well. I’ve got arthritis as it is. It’s not doing me any good, bending down all the time.’
‘It’s just he’s such a stubborn old so-and-so. I can’t see him agreeing to a hospital bed.’
‘I think we have to try, though, June. Otherwise we’ll just run into more problems further down the line.’
‘Well. If we do, we do.’
‘Shall we go up and introduce ourselves?’
‘I’ll show you the way,’ says June, getting up with some difficulty. ‘Just don’t expect me to run there.’
The staircase rises steeply, past the first floor landing, winding on and up into the gloom of the upper storeys. I’m glad Arthur’s bedroom is on the first floor though, as getting this far has taken a fair while, June struggling to make the climb, putting her good left foot up first, then hobbling up with the right, sliding her hand along the rail, pausing for breath, and then repeating the process again. The nearer we get to the landing, the more distinct is the noise of Arthur’s oxygen machine, whirring and clicking beneath a large, foxed print of Napoleon’s retreat from Moscow.
‘He’s through there,’ puffs June. ‘You go on.’
The notes had described Arthur as a palliative COPD patient, not quite end of life. The ‘not quite’ is a surprisingly optimistic qualifier, certainly from where I’m standing. The ravages of his respiratory illness combined with his extreme old age have left him cruelly stripped of anything resembling flesh. His hands lie outside the covers, and it’s astonishing to see their complex mechanism laid as bare as an anatomical model: the tendons, the ligaments, the veins.
It’s a shock to see him open his eyes.
‘Oh,’ he says. ‘And what do you want at this ungodly hour?’
‘It’s half past six, Arthur’ says June, finally making it into the bedroom and sitting down on a rattan chair that creaks dangerously.
‘Yes. I know. Half past six in the morning.’
‘In the evening’
‘The evening? Have I really been sleeping all day?’
‘Yes, Arthur. You have’
‘Well, I humbly beg your forgiveness, one and all,’ he says. ‘I find my rather straightened
circumstances are not conducive to keeping a proper track of the time.’
‘No worries!’ says Beatrice.
‘I have this marvellous electronic watch, d’you see?,’ says Arthur, slowly lifting up his left arm.  An old Casio digital watch slips down almost to the elbow.
‘Unfortunately it seems to have stopped working,’ he says, gathering it back up to his wrist, and then relaxing his hands back on to the covers. ‘Once upon a time it used to beep’
The business with the watch seems to have exhausted him. His breath comes in and out through his slack mouth, making a dull whistling noise.
The carers were right to be concerned. Arthur is more or less bed-bound, on a low single divan in the corner of the room. I can’t imagine how you would go about washing and cleaning him, creaming his pressure areas, changing his pyjamas. Even sitting him up to drink would be a struggle. When we’ve roused him again, Beatrice explains the situation with great courtesy and clarity, gently steering him in the direction of a hospital bed.
‘They’re very comfortable,’ she says. ‘You can change the position at the touch of a button, sit up to eat or watch telly, raise the mattress at the knee to ease the pressure on your legs, go up and down – whatever! They’re brilliant, really. And then your carers won’t have to worry about hurting their backs. Because if they do, Arthur, they won’t be able to come in and help you, or any of the other patients on their books. And I know you wouldn’t want that, would you, Arthur? Hmm?’
He slowly shakes his head from side to side, the oxygen tube riding up over his ears and back down again. Someone’s put a little scrap of tape on top of his left ear, to stop it rubbing.
‘No,’ he says. ‘I completely understand what you’re saying, and I thank you for coming here and saying it. But I’d really rather not be moved. I’d rather just be left here in peace for now, and everything else can wait. Thank you.’
We try a little while longer to persuade him to change his mind. In the end, though, the best we can manage is to arrange to come back the following day.‘It’s been lovely meeting you,’ says Beatrice, taking his hand in hers and giving it a squeeze.
‘Likewise,’ he says. ‘Only – when you come back – please, don’t make it quite so early in the morning.’