don’t mention the tattoo

Even without the diagnosis from the discharge summary, you’d know Charles was at the end of his life. He’s lying on his side, propped up on pillows, one leg hanging out of the bed, his face mottled and ghastly, his lips puce, his limbs puffy with fluid, a horrible rasping sound shifting deep in his chest. I hardly need put a hand on him to know how bad he is, but I do – not because I’ll be calling an ambulance, but because I might need to get one of the palliative team out, and it’s good to have the leverage.

His wife Maureen watches from behind me, leaning with her arms folded on the bedroom door.
‘Listen to the nurse,’ she says, her arms folded. ‘If you won’t listen to me.’
‘Ah! Woman!’ says Charles.

The District Nurses are case managing. They’ve only referred to us for some bridging care, and to see if we can persuade him to agree to some changes in the set-up at home. There’s a perfectly good hospital bed in the front room, but Charles refuses to use it. He wants to die in his own bed, even though it makes caring for him extremely difficult. There’s no room to move about, the bed’s too low, and Maureen has been struggling. They’ve had the ambulance out twice to get him up when he’s fallen. A patient his size? In this condition? In this tiny room? I can’t imagine how they did it.

‘How about we help you to the bed next door?’ I say. ‘It’ll be much better for you. It’s got a special mattress so you’ll be less likely to get pressure sores, it goes up and down to make it easier on the carers, and you’ll be in with the TV so you can watch the football.’
He snorts.
‘Football!’ he says . ‘There’s not much football where I’m going.’
‘No. The ball’d catch fire,’ says Maureen.
‘Yeah?’ he gasps, struggling to sit up. ‘Well at least I can pass your respects on to your mam.’
‘There now,’ says Maureen. ‘Isn’t that charming?’
‘Ah!’ says Charles.
‘So will you come with us into the front room?’
‘No I will not.’
‘Why not?’
‘I don’t want to.’
‘Take him. I’m done,’ says Maureen, and hurries away.

I lean back against the wall and sigh.
He opens one eye and glares at me.
‘Don’t let me keep you,’ he says.
‘The thing is, Charles…’
‘What’s the thing, now?’
‘The thing is – I respect your decision to stay in your own bed.’
‘Do you? Well that’s big o’you.’
‘But what about Maureen? You’ve got to think about her, too. And the carers. As your condition worsens you’ll need looking after in bed, and this one’s just not up to the job. They’ll hurt themselves trying to change your pads and whatnot. It’s too low, and there’s hardly room to swing a cat.’
‘Don’t be taking to me about no cats.’
‘And anyway, Charles – next door’s so much nicer. You’ve got that lovely big window you can look out. You’ve got the TV.’
‘No,’ he says. ‘I’m staying put.’
‘The other thing is – that hospital bed is so flexible. You can sleep more upright, and that’ll help your breathing. ‘
‘I’m staying where I am, thank you.’

My colleague has been on the phone to the DNs. He comes back in and says they’ll be visiting to review things later in the afternoon.
‘Good!’ I say to Charles. ‘That’s brilliant! How about we get you next door onto the hospital bed, so you’re ready for them.’
‘You don’t give up, do you?’
‘I know. I’m really annoying.’
‘I wouldn’t say annoying. I’d say something far worse.’
‘What d’you think, though, Charles? Shall we give it a shot?’
‘Give what a shot?’
‘Going next door onto the bed.’
‘How’m I going to get there, then?’
‘We’ll use this bottom sheet to slide you over to the other side of the bed. Then we’ll help you sit up, and when you’re strong enough we’ll help you stand and scooch over onto the wheeled commode. Then we’ll wheel you through to the living room, and do it all in reverse.’
‘Just like that.’
‘Just like that.’
‘And if I do it you’ll shut up about it.’
‘Promise.’
He sighs and shakes his head.
‘Give me five minutes,’ he says.
‘No worries.’
Maureen reappears in the doorway.
‘Is he going then?’ she says.
‘He is, yes.’
‘Oh my God,’ she says. ‘It must be the uniform.’

Charles has softened back onto the pillows.
There’s a faint outline of an old tattoo on his forearm. It looks like the number ten.
‘What’s that?’ I say, tapping it. ‘The number ten. Why’d you get that on your arm?’
He raises his arm, blearily stares at it, then plops it back down again.
‘That’s not a number ten,’ he says. ‘That’s a heart with a scroll underneath.’
‘Oh! Yes! I see it now! And what does it say on the scroll?’
Phyllis,’ says Maureen. ‘And no – it’s not his mother.’

signs of life

Maria is sitting in the sunshine at the kitchen table, a newspaper spread out in front of her, a cup of coffee to the right, a pink wafer biscuit on a square of black slate to the left. She’s staring at an article all about the latest Mars landing. There are detailed drawings of the descent, how the boosters deployed, cutaways to explain all the instrumentation carried on the probe. It’s quite a thing.
‘What an amazing achievement, sending something all that way,’ I say, taking a seat opposite.
‘What is?’ says Maria.
‘The Mars probe. The mission to discover traces of life.’
‘Oh,’ she says. ‘Is that what it is?’

Maria could be some kind of alien visitation herself, landed on her chair, her white blouse glowing brilliantly in the sunshine, her lipstick a shock of red, the coloured beads in her headband sparkling red, blue and green.
‘How are you feeling?’ I ask her.
‘Lost,’ she says.
‘It’s understandable. You’ve been through the wars.’
‘Have I? You see – that’s the worst of it. I don’t really remember. I used to be in control. Now I’m not.’
Her husband Klaus strides back from the kitchen with a cup of coffee and a biscuit for himself. He’s as striking as his wife, his long white hair swept back, his blue eyes preternaturally sharp against the liver-spotted leatheriness of his face.
‘Are you sure you wouldn’t like a cup?’ he says to me. ‘It’s very good.’
‘Absolutely. It’s kind of you to offer, though.’
‘Not at all!’ he says, sighing and settling next to Maria. She barely acknowledges him.
‘Don’t forget your biscuit, darling,’ he says, giving the slate a little turn, as if that’s all it need to capture her interest.
‘Thank you darling,’ she says, but carries on sitting as inertly as before.

The house is filled with Maria’s paintings and sculptures. I’m guessing the bronze on the little plinth by the window is Klaus as a young man. The face may be longer and thinner, the hair more tightly curled, but the birdlike intensity of his expression is the same. It’s an unsettling experience, sitting with her amongst these things. It’s as if the artist is gradually fading from the room after decades of creation, leaving only the light and the colour and the breath, a twist of steam from a coffee cup, a glimmer of moisture in the corner of an eye.

‘Could you speak up?’ says Klaus, when I start to ask them about the sequence of events, the tests that were run at the hospital, the things the doctors said. ‘You see – that’s the devil with those damned masks! We’re both rather deaf unfortunately and we rely on seeing the whole face.’
I apologise, and speak up.
He answers my questions, then when I pause to write a few things down, takes a sip of his coffee, putting the cup back on the saucer so carefully it barely makes a sound.
‘Mind you,’ he says, dabbing at his mouth with the corner of his linen napkin, then spreading it out on his lap again, ‘…of course – one gets so much more than that from a face. Take you, for instance…’
He stares at me, leaning slightly forwards.
‘Yes,’ he says, relaxing again. ‘Yes. Your eyes are nice enough. But who knows under that mask? You might have evil lips.’

the full set

I turn off Elm Road into Birch Grove and park outside Mulberry Court. It’s a shame Edie isn’t called Mrs Hawthorn or Mrs Rowan, or at least be wearing a hat made of leaves. She does come to the door in a rose patterned housecoat, though, so that’s something, and she’s so elderly she looks like a tree, a gnarly old olive you might see growing out of rocks in Greece, magically galvanised into answering the door, and then rooting it awkwardly back to her perch.

We chat whilst I work through the various tests, and then set out my things to take some blood.
‘I get a bit lonely,’ she says. ‘Especially after Eric passed.’
Edie nods at a portrait on the mantelpiece: a smiling old chestnut with a row of medals on his trunk. Edie starts to cry, so I fetch her a tissue.
‘Sorry,’ she says. ‘But when you’ve been together fifty years, it’s a bit of a wrench.’
‘I bet it is,’ I say.
‘He went in June,’ she says, dabbing her nose. ‘I wish I’d gone with him.’
‘I’m so sorry, Edie. How did you meet?’
‘He was the brother of my eldest sister’s husband. They set us up when he came home on leave.’
‘That’s lovely.’
‘Yes,’ she says. ‘He was a dancer. A lovely little mover.’
‘It looks like he was in the navy?’
‘A submariner.’
‘Oof. I don’t think I could’ve been on the submarines. Imagine that – being stuck underwater for days on end.’
‘Me neither. But he seemed to get on alright. He had the head for it.’
‘He was good in tight places?’
‘He was short.’
‘That must help.’
‘I made a bit of a habit marrying service men.’
‘Did you?’
‘My first husband was in the army. We got married very young. Near the end of the war. Only he got wounded and sent home.’
‘How was he wounded?’
‘He got kicked by a horse.’
‘A horse?’
‘Yes. God knows what that was all about. But he never really got over it. Drank to forget I suppose. Then we got divorced and I ended up with Eric.’
She blows her nose. I fetch her a glass of water and she has a sip.
‘Thank you,’ she says, setting it to one side. ‘Sorry to carry on.’
‘You’ve had a hard time lately.’
‘Yes. Well. There’s nothing to be done about it, I suppose.’
She stuffs the tissue up the sleeve of her housecoat and then takes one of those brave, exaggerated breaths that segues from a shrug to a smile.
‘All I’ve got to do now is find myself an airman and I’ll have the full set!’ she says.

a second set of clothes

‘They said there’s nothing more they can do for Jean. They said it’s terminal. Do you think that’s right? Do you think there’s anything more to be done?’
Stan’s eyes bore into me. There’s a slack and waxy look to his face, like he hasn’t slept for a week.
‘I don’t know, Stan,’ I tell him, and look down again at the discharge summary in my hands. The journey Jean has taken from ambulance admission to A and E and then back again is described in lean, jargonistic language, but no less damning for all that.
‘What did they say at the hospital?’
‘Not much. But then a doctor came round here the day after Jean came home and said that was it, basically.’
‘It’s so hard,’ I say. ‘How are you bearing up?’
He massages one fleshy hand with the other, working the thumb into the palm, like he only needed to get a little strength back there and he’d be able to do something, to make some change.
‘I’m used to sorting things out, getting things done,’ he says. ‘I’m the one they all came to. I even organised the skiing trips. But this? I just don’t know. I just don’t know.’
‘Do you have family around, Stan? Friends, neighbours?’
‘We didn’t have children,’ he says. ‘Not that it bothered us, after a while. We had Jean’s family, our friends, of course. They’re all elderly, now. Half of them are dead. I think I’m the only man left amongst the old lot. So – what do you think? What should I do?’
I lay the discharge summary gently on the table, beside the DNACPR and the scrip for the anticipatory meds.
‘You know – just reading what the medics have written here, it does look like Jean’s cancer is untreatable. So the thing is to take care of her at home now, if that’s what you both want. It’ll be about symptom control, making Jean comfortable. Have the palliative team been round yet?’
He nods.
‘There’s been a lot of people in and out.’
‘It gets confusing. Whoever comes in should write in the folder here – who they are and what they’ve done – so there’s that. And there’s a list of the main numbers to ring if anything changes or you’ve got any questions. I’ll give the palliative team a call in a minute and ask where we are with visits and things. What to expect next.’
‘They left all these medicines. What am I supposed to do with them?’
‘Those are what they call the Just in Case meds. It’s things for pain relief, to help Jean’s breathing, anti-nausea meds, that sort of thing. You don’t have to worry about them, Stan. The District Nurses will be in to take care of all that. Is that okay?’
‘I suppose it’ll have to be.’
‘They’ve referred Jean to us for some urgent equipment and care support.’
‘Right. Got you.’
I wait a minute, then stand up.
‘What d’you think? Shall we go up and say hello to Jean?’
‘Yes. Sorry,’ he says. ‘It’s funny. She’s normally up with the lark, but she’s feeling pretty worn out so she’s staying in bed.’
‘I don’t blame her.’

He leads me up a narrow, carpeted staircase, worn to the thread in the middle, the boards sagging and creaking. The landing window is open and an unseasonably warm afternoon breeze nudges through the curtain.
‘Jean?’ says Stan, as we go into the bedroom where Jean is propped up on four pillows. She’s breathing quickly, her cheeks flushed and her lips pursed, with the rapt expression you sometimes see on patients who are riding their discomfort and don’t have room for anything else.
‘Hello, Jean!’ I say, waving. ‘Shall we sit you up a bit? It’ll help with your breathing.’
Once she’s more upright her breathing does ease a little, and her oxygen levels are surprisingly good. Despite her wasted condition, she still manages to tease me. Stan sits in the wicker chair beside the bed, and starts kneading his hands again.

‘I’ll need to make a quick call to the palliative team,’ I say to them. ‘Is that okay?’
Jean squeezes my hand.
‘You do what you have to do,’ says Stan.
I step away from the bed to make room for him, then make the call standing at the bottom of the bed, using the duvet as a desk for the open folder, which Jean moves with a cheeky nudge of her foot.

Luckily, Sandy answers the phone. Sandy’s a palliative nurse I’ve never met in real life but who always exudes great competence and compassion.
‘We’ll send a nurse out in an hour,’ she says. ‘Meanwhile, have a scootch around and see what you can do in the way of equipment. And start the care as soon as you can.’

‘I think you’ll really feel the benefit of a hospital bed,’ I tell Jean, putting the phone back in my pocket. ‘They’re fantastic, these beds. You can adjust the height, sit the back up – all sorts. All at the touch of a button. The pressure mattress is nice and comfortable, and means you’ll be less likely to get a pressure sore. We can get it installed pretty quick. All we need to decide is where it goes. We’ll need to clear space for it.’
‘I’ll show you the second bedroom,’ says Stan. He gives Jean a kiss then takes me next door.

The second bedroom is half the size of the first, with a single bed in the centre, a wardrobe in the corner and not much else. I’d guess it was the room Stan’s been sleeping in, although you’d hardly know it. There’s a shirt, a pair of trousers, a pair of pants and a pair of socks neatly laid out on the bed, side by side. They look exactly like the clothes he’s got on already.
‘This is great!’ I say, looking around, but not moving. ‘Plenty of room for the hospital bed once this one’s gone. A nice view of the garden. Lovely! What do you think you’ll do with this bed?’
‘I’ll just stand it on its end in the corner by the wardrobe. Maybe throw a sheet over it.’
‘Do you want a hand to do it?’
‘Me? No,’ he says. ‘That’s one thing I’m still good for.’
And we both stand there, side by side, staring at the clothes on the bed, like we fully expect them to magically jump up, throw themselves together and start flying round the room.
‘I’ll make the order,’ I say.
‘Stanley?’ cries Jean.
‘Yes, love…’ he says, and hurries 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.

the right one

Ray has the kind of face Disney would draw if he were animating an oak tree. A knotted, gnarly, weathered kind of face, smiling the width of his trunk, a songbird nesting in his hair.
‘Thanks for coming,’ says Ray, then turning stiffly on his roots, leads me into the sitting room.

And if Ray is a tree, Daisy is a deer – an ancient, other-worldly kind of deer, with sad pale eyes, uncertain footsteps and a wistful manner.

‘So!’ I say to her, dropping my bags and sitting at the other end of the sofa. ‘How are you feeling today, Daisy?’
She laughs – an unexpectedly girlish trill – as if I’ve asked the most ridiculous and scandalous thing possible.
‘How am I feeling? What a question! How do you think I’m feeling?’
‘Me? I don’t know. You look well, I have to say.’
‘Tell the gentleman about the fall, Daisy.’
‘The fall? Where?’
‘Not so much a fall as a slip out of bed. Onto your bum.’
Daisy looks at him blankly. But in the time it takes for her to turn and look at me, the moment has completely gone. She frowns a little, then fiddles with the cuff of her cardigan, muttering something I don’t quite catch.
‘You know about the dementia?’ says Ray, mouthing the words more than speaking them.
I nod.
‘Is it any worse?’
He shakes his head.
‘This was a little setback. I think we’re okay, though. Aren’t we Daisy? Eh? We’re okay?’
‘What are you talking about!’ she says, then turns to stare at me again.
‘Seventy-five years we’ve been married,’ says Ray. ‘Imagine that.’
‘Congratulations! That’s quite an achievement.’
‘That’s one word for it.’
‘How did you meet?’
Ray leans forwards in the armchair.
‘I was eighteen, just about to join the navy. There was a fair on the common, so I went there with my mate Harry to see what’s what. Daisy was there with her identical twin Maisy, so we hung out with them for a bit. Which one do you want? Harry said. I said does it matter? I can’t tell ‘em apart! So we took up with each other, and there you are. Harry got chucked after two days, and here I am, seventy-five years later, still wondering if I married the right one.’
‘How come she chucked Harry?’
‘He was too cocky. Me? I was just the right amount.’
He laughs and leans back in the chair. He has a twitch in his right eye, which he tries to ease by kneading it vigorously with a knuckle.
‘Nah!’ he says, dropping his hand after a while. ‘I definitely married the right one. Didn’t I Daisy? Eh? I say I married the right one!’
‘My husband should be back soon,’ she says, blanking him, folding her hands neatly in her lap. ‘Shall I fetch you some tea?’

fridge magnets

Mr Yelnats talks with an unending cadence, running one sentence into the next. It wrong-foots me, because when it sounds like he’s coming to a full stop and I’ll be able to answer some of his anxieties, he picks up steam again and carries on. The result is that I spend the next five minutes occasionally drawing a breath ready to speak, then letting it out slowly again, nodding sympathetically, trying to keep a hold on the points I’ll need to cover to calm him down. In the end, though, I’m driven to talk over him a little, and ease him to a stop, like intercepting a bolting horse by standing in its path, holding my hands out and stroking its nose.

‘Well first of all – has anyone told you who we are?’ I say.
He changes his position on the sofa again, throwing his right arm over his head to scratch the opposite ear, then changes back again.

‘No,’ he says. ‘No they haven’t. What they did say is that all this would be done. I mean – I wasn’t expecting brass bands and flags in the street. I mean – I’ve been away a long time but I’m not stupid. I know how these things go. But why did they say it’d all be done? I’d have the things that go over the toilet. I’d have the stair rails. I’d have the thing that goes over the bath. A perching stool, whatever that is. I mean – I wasn’t expecting a team of workmen drilling holes in the wall as I walked in the door. This isn’t the movies. But still – a promise is a promise. Why did they say they’d do these things if they weren’t going to happen? I mean …’

‘I’m sorry you were given the wrong impression about how it all works, Mr Yelnats,’ I say. ‘But let me just explain…’

‘I’m not as bad as some. I’m pretty bad, as you can see. But I do my best. I can get about – of sorts. I’ve been away three months and things are a bit difficult at the moment. Don’t get me wrong. I’m an independent sort of chap. Still. My wife died six years ago and I’m still getting over that. Not that you ever do.’

‘I’m sorry to hear that.’

‘It’s as well to know your limits. I want to get better. I think I can get better. In fact I’d go as far as to say I expect to get better. But I’ll need a little help. As things stand I’m not sure what I can do and what I can’t do. Let me tell you something. When I was on that ward…’

He holds out his hand, spreads his fingers and taps them one after the other with the other hand, listing all the things he was told on the ward. And – actually – it comes down to five things. He’d have a toilet aid, a walking frame for upstairs, a bath board, a perching stool, and care support all waiting for him when he got home.

‘Okay,’ I say, as evenly as I can. ‘Okay. First things first. Let me quickly tell you who we are. We’re an NHS community health team. We’ve got lots of people on the team – physios, OTs, nurses, pharmacists – you name it. It’s a pretty big team. We’ve also got a small bank of carers who give emergency support to patients. Our job is to either support people being discharged from hospital – like you – or to stop them being admitted in the first place. So the hospital has referred you to us, and I’ve come round on a kind of fact-finding mission to see exactly what it is you need.’

‘Let me stop you there…’ he says.

‘Just one more thing,’ I say. ‘And this is pretty key. We’re a short-term service, so we work very very quickly. We like to move things on as fast as we can. If someone needs longer term help, we refer them on to the District Nurses or any of the other specialist teams. And if they need longer term care, we refer them on to full-time care agencies.’

‘Yes, yes, I get all that,’ he says, as I nod and gesture for him to continue. ‘But why did they say it’d all be in place when it wasn’t?’

‘I don’t know. There are two types of arrangement. One is an access visit, where an OT from the hospital comes to the house to put in essential equipment ahead of the discharge, and then there’s a referral to us.’

‘What – coming to my house when I’m not here? I wouldn’t want that.’

‘Okay – so that’s probably why they referred you to us. But as I say, we work pretty quickly.’

‘How quickly?’

‘I could call the office now and see if they’ve got availability for an OT to come out with the stuff. They’re horribly busy, but it’s worth a shot.’

He frowns at me.

‘What are you like with toilets?’ he says.

‘Toilets?’

‘My toilet won’t flush.’

‘Oh. Well. I’m not a plumber. But I could have a look…’

He struggles up out of the sofa, waving me away when I go to help. It’s like watching a daddy long-legs trying to free itself from a glob of treacle.

‘That’s quite low for you,’ I say.

‘It’s comfortable,’ he says, puffing and straining. ‘I’m used to it.’

Eventually he manages it, and after taking a breath, straightening his cardigan and swiping his hair to the right, he staggers out of the room with me following behind. We pass along through a narrow kitchen, Mr Yelnats using the counters and cupboards for support, me with my hands out like an anxious parent ready to catch.
‘I need some rails here,’ he says, slapping the wall.
‘I can see that.’
‘It’s in there,’ he says, chinning me in the direction of the loo.

A creamy green toilet with one of those cisterns with a push-button flush. I’ve really no idea, but I take off the heavy lid and look inside. The water is up to the top. There’s a strange looking plastic box on a push-fit over the handle spindle. I pull it off, flip the lid open and try to figure out how it works. When you push the button on the outside of the cistern, a rod pushes a sprung thing that tugs on a wire that feeds down a tube into some other thing that operates the flush. The sprung thing is sticky, so I wiggle it. Eventually – miraculously – it seems to work again. The water empties with a gratifying rush.

‘Don’t it?’ says Mr Yelnats, waiting outside the door.
‘All done! Seems to be fine now.’
But … when the flush is finished and the water starts to come back into the cistern again, the water level doesn’t go beyond a couple of inches, and all the excess runs off into the toilet bowl. No amount of wiggling makes any difference.
‘Oh,’ I say.
‘What?’ says Mr Yelnats.
‘I can’t stop it filling.’
‘Let me see…’ he says, and comes into the toilet. There’s no room for both of us at the loo, so I squeeze past him. Eventually he supports himself on both hands, staring down into the noisy cistern.
‘What have you done?’ he says.
‘Like I say – I’m not a plumber…’
‘It’s going to run like that without stopping now.’
He tries some wiggling, too, but nothing makes any difference.
‘Let me have one more look,’ I say. We go through the same elaborate manoeuvre as before, and swap places.
In the end, for want of anything else, I get a Toilet Duck and wedge it under the ballcock, stopping the water about half-way up the cistern.
‘It’s only temporary,’ I tell him. ‘I’m afraid you’re going to have to get a plumber in.’
‘Where am I going to get a plumber?’
I shrug.
‘Do you have any family nearby? Any friends, or…?’
‘No.’
‘The internet?’
‘Hmm,’ he says. ‘There’s a plastic bucket back in the kitchen. Fetch that in here, would you? I can use it to flush things through.’
‘Okay.’

I find the bucket on a stool beside the fridge. The fridge is covered with a grid of fridge magnets – a Picasso portrait, an abstract pattern, hokey one liners with cartoon illustrations: My wife might not always be right but she’s always the boss or There’s nothing wrong with me that a little chocolate won’t fix. A Fender Stratocaster. A Triumph.
‘Where’s that bucket?’ shouts Mr Yelnats.
‘Coming!’

annie’s yuccas

Outside John’s window are two enormous flowering yucca plants, bees bimbling drunkenly up and down the spikes.
‘Look at that lot,’ he says. ‘What d’you reckon?’
‘Pretty impressive.’
‘And they’re socially distanced, n’all. I was going to put a mask on ‘em, but I thought the bees would get annoyed.’
‘That’s a good one! I like that!’
‘Yeah!’ he says, ‘This bungalow, it’s the best plot in the street. It’s got the garden. It’s got somewhere to park the car. ‘Course, the garden was really Annie’s area of expertise. But she’s gone now and I’m not so good as I was on my pins. Still – can’t complain. Honestly, if I was a millionaire I couldn’t be any better set up. I’ve got everything to hand, look. The kitchen, the bathroom, the bed. I’ve got a TV. I’ve got my iPad for doing the email and putting a few quid on the horses. I’ve got friends next door who do my shopping and run the hoover over. I’ve got family who pop in when they can. So you tell me. What better life could a millionaire have than what I’ve got?’
‘I can’t think, John. It seems pretty great.’

And it’s true. It is.

John is ninety-two, but he’s been lucky with his health – that, and the fact he played a lot of sport and stayed active all his life. He never smoked, he says, and only drinks on special occasions, which is ‘any day with a D in it.’

He sits upright on the armchair, his gnarled hands restlessly moving, from a stroking kind of action on the ends of the arm rests, to a vigorous rubbing of his bulbous nose, to a dog-like scratching of his ear, then back to the arm rests. It’s like watching an old but well-maintained tractor, idling in the yard before rattling off down the lane.

But his demeanour suddenly changes when he tells me what happened with Annie.

‘Wa’aall,’ he says, batting the air. ‘They messed up the appointments and whatnot. There was a lot of toing and froing. Me ringing the surgery asking whether the blood results was back yet; the surgery saying ‘what blood results?’ and this and that. You get the picture. Till finally when they found out what she had it was too late. She got took by the cancer. It wasn’t easy. And then there was this in-quiry, see? But I tell you what – I was prepared. I had all the dates written down, all the lost appointments, all the tests they missed. And I sat up in that room in the hospital, with the consultant and all the rest of them sitting opposite me. And the consultant he said she would’ve died anyway. So I got a bit hot, I can tell you. And the woman from the wherever-she-was-from, she said I had to show a little respect. So I said where was the respect you showed my Annie? Where was the respect there? ‘Course, they went quiet at that.’

He shrugs, strokes the arms of the chair.

‘It’s all in the past now,’ he says. ‘I got a letter saying sorry, so there’s that.’

He looks out of the window, at the bright sunshine pouring down into the garden, the hedges looking a little ragged now, the shed leaning to the right.

‘What about them yuccas, though?’ he says. ‘Socially distanced! Hey?’

pellets

There’s an approximate number one with a crooked arrow beneath it, crudely painted in black, nailed to a board beneath the crappy intercom at the front of the house. I guess the Cartwells have a flat round the back, so I head in that direction.

Beside the front door to Flat One is a large electric button, so new it stands out from everything else. In fact, it’s such a contrast – the bright plastic box, the imposing but ramshackle old house – I’m surprised the whole thing didn’t cave in when they screwed it in. But then again, I’m guessing they took the safe option and used glue.

There’s a thick carpet of blue slug pellets scattered in front of the door. Two or three cartons worth. They must have a terrible slug problem. Or maybe they think it’s good for health visitors, too? Pellets crunching underfoot, I reach out, press the button and wait.

Nothing.

I’m not sure it rang anywhere, but sometimes it’s difficult to tell.
I look around. Waggle my feet experimentally on the pellets.
Press the button again.

Nothing.

Is that even a button? Maybe it’s a fancy design feature and the button’s somewhere else. Maybe it’s actually a camera. I lean in to look, and then lean out again, not wanting to scare them. Feel around the box. No – it must be the button. Why would you have a feature on a doorbell that looked like a button but wasn’t? That’d be crazy.
Maybe I just didn’t press hard enough.
I prod a little harder. A couple of times.

Whaaaat? cries a voice from deep inside the house. Why’d’ya keep pressing the fackin’ button? Who ARE you?
‘Oh! Sorry! It’s Jim – from the hospital. Come to see Mr Cartwell…’
I rap on the door with my knuckle and gently push it open.
‘Alright if I come in…?’

There’s a steep flight of stairs leading straight up to a landing. An elderly woman leaning over railings at the top, looking down. She looks insanely hostile – flaring white hair, wide eyes, and a great toothless mouth. She looks down at me with such a rapt expression, I’m worried she’s suddenly going to extend her neck down the stairs and snap me up – head, bags, lanyard and all – in one convulsive gulp. Luckily she stays where she is, gripping the bannisters.
‘Who sent you?’ she says.
‘I’m so sorry to disturb you. It was the hospital. When Mr Cartwell was discharged they asked us to come and see how we could help.’
‘Urgh,’ she says (or sounds like). ‘I suppose you’d better come up then.’
She lets go of the bannister and shouts ‘Eric! It’s someone from the hospital to see you.’
A voice from a room somewhere.
‘But I’ve only just got ‘ere.’
‘C’mon. Get up. He’s come to see you he says.’
‘What for?’
‘I don’t know. He’ll tell you.’
‘I was having a kip.’
‘Have it later.’
Inaudible curses.
‘C’mon, then if you’re coming.’

I walk up the stairs, scattering blue pellets behind me like a cat leaving a litter tray.

‘Sorry to be a nuisance,’ I say.
‘Go in the sitting room,’ says Mrs Cartwell. ‘He’ll see you in there.’
‘Okay. Lovely. Thanks.’

The flat is tiny, the narrow layout made worse by all the clutter. There’s just enough room to move from one place to another, and when Mrs Cartwell comes in we have to choreograph each move in advance to make it work.
‘So they obviously didn’t tell you who we were,’ I say, looking for somewhere to dump my bags but giving up.
‘No,’ she says. ‘Who are you?’

We’re interrupted by Mr Cartwell, wheezing and puffing and cursing as he comes down the corridor towards us. His belly is so distended, it reminds me of the spacehopper I used to have, bouncing round the garden, tugging on its ears. It’s such a squeeze for him, moving through the flat, and he fits the width of the corridor so perfectly, it’s hard to resist the idea that he made these walkways himself, just by moving around, and if he’d stayed in hospital a few months longer, the whole place would’ve closed back up again, and that would be that.

Mrs Cartwell waves me to the right, then she moves to the left; I move to where Mrs Cartwell was; Mr Cartwell rolls into the room, eventually easing himself into a decrepit computer chair that creaks and sags alarmingly.
‘What’s all this about?’ he wheezes, flapping the sides of his open dressing gown like wings. And when he turns to look in my direction, he doesn’t open his eyes.

a ceramic pelican

The muddled wave of sycamore trees growing up along the embankment at the back, the viaduct rising high above the houses in a straight line to the heart of town, the shuttered pub on the other side of the road, the makeshift garage with the stack of tyres and the rusting car up on blocks – everything conspires to give this street a neglected, backwater feel.
I’m meeting up with Magda for a joint visit. There’s been a safeguarding raised against Bob’s wife Geena. We’re here to support each other, to see how he is, how things are today.
‘Jimmy boy!’ says Magda, tossing her hair back and holding it in place with her blingy sunglasses. ‘S’up?’
We talk a little about the situation before we knock.
‘I doubt she’ll even answer the door,’ I tell her. ‘Did you read the notes? She’s been turning everyone away. Going mad. And even when she lets them in, she abuses them and throws them out pretty quick.’
‘Sounds like my kinda girl.’
‘The social workers are on the case.’
‘Well!’
‘She even swore at Pete the physio and threw him out.’
‘Peter? Man! That’s like being cruel to puppy.’
‘I know! So – I’m not sure how far we’ll get.’
‘You want me to go first, Jimmy? It might be dangerous.’
‘Okay.’
‘Okay.’
She goes up the steps to the front door and knocks, heavily, like a debt collector or something. We wait a while. She knocks again.
I’m just about to lean over the railings and peer through the front window when the door unexpectedly opens.
A sixty year old woman dressed in a hornet stripe jumper, purple slacks and velcro shoes, frowning at us with a pinched expression. It’s like a spiteful child picked a doll up by the face, stood her at the front door of the doll’s house, and got ready to shoot her with a BB gun.
‘What?’ she says.
‘Gemma! Hi there! My name is Magda and this is my colleague Jimmy. I’m so sorry to disturb you. We’re from the rapid response team and we’ve been asked to come see your husband, Bob. It’s lovely to meet you.’
‘I told them. I don’t want you people coming round no more.’
‘I know, I know. It’s problem. But we won’t be long, Gemma, I promise you. Just a hi and a bye kind of deal. Trust me. You’ll hardly know we were here.’
There’s a tense pause that the rumbling of a passing train does nothing to ease. I fully expect Gemma to slam the door, but Magda generously interprets the hesitation as an invitation, and starts moving forward. And really, when Magda starts walking forwards it’s very difficult to say no. So instead Gemma flattens herself to the wall, closes her eyes and lets us pass.
‘That’s very kind of you, Gemma. I appreciate that. Thank you very much, darling. Through here…?’
I follow Magda into the house. It’s tall and dark and watchful. A narrow hallway leads off to the kitchen out back, the sitting room to our left.
‘Bob!’ says Magda. ‘There you are! Hello mate!’

Bob is sitting behind the door in a high-backed chair, a zimmer frame to the right. He’s dressed in stripes, too, although his are blue like his eyes and easier to look at. Everything about him is the opposite to Gemma. They could be the figures in an emotional weather clock: Bob summer, Gemma winter.
‘Hello!’ he says, holding his arms left and right like he’s known her all his life. ‘What’s all this about, then?’
Magda explains who we are whilst I get my obs kit out. Bob is wearing shorts, so it’s immediately apparent to both of us that he has a wound on his leg.
‘What have you been up to, Bobby? How you hurt your leg like this?’
She bends down to look. Gemma, who up to this point has been sitting on the arm of a sofa like a storm on the horizon, suddenly springs up, hurries over, and clutches the zimmer frame with white knuckles.
‘You are not to look at that!’ she says. ‘I’m his wife! I take care of him!’
‘Well – yes – I understand this, Gemma, but you know we are here to see Bob. And to be honest with you, unless you have Power of Attorney…’
‘I DO have Power of Attorney!’
‘Great! That’s great! So now, of course, we need to see paperwork. You have paperwork, Gemma?’
Gemma gives a huff, releases the zimmer frame and stomps back to the sofa.
‘I’m his wife!’ she thunders. ‘I say what happens.’
Magda shrugs this off and chats to Bob whilst I clean and dress the wound. I want to take a photograph, but I’m conscious of Gemma staring at me and I think if I do the flash of it will tip her over the edge. She’ll probably snatch up that large, ceramic pelican and smash it over my head, Magda or no Magda. So I finish off with a set of obs – all of which are fine. I can feel the rumbling of her teeth grinding through the floorboards, although it might just be another train.
‘So tell me, Bobby? Tell me what happen with leg,’ says Magda.
‘I fell out of bed,’ he says, and then slowly, and irresistibly, he turns to look at his wife.