the guru comes back

It’s so hot it feels as if the sun has dropped in closer and burned away every last scrap of moisture. I’m okay though – waiting for the social worker in the shade of the tall privet hedge that marks out the perimeter of this estate. I don’t mind the wait. I stand with my bags at my feet, waving to the people coming and going along the driveway. The postman in his foraging cap with a strip of blue canvas hanging over his neck; the young couple striding out with a pram covered in netting; an elderly woman with her shades flipped up, her permed hair glinting metallically in the sun. It starts to feel strange, like I’ve been standing like this for years. When the postman comes out again I half expect him to come over and hand me a letter: To the Man by the Hedge. ‘Dear Standing Man…’

Liam the social worker hurries across the road, hugging a battered leather briefcase to his chest, looking right and left over his shoulder like he’s escaping with secrets and expects to be shot.

‘Phew! Sorry I’m late!’ he says, striding towards me over the lawn. ‘Have you made contact?’
‘No. I thought I’d better wait.’
‘Good. Good,’ he says, pushing back his long hair, the sweat standing out on his forehead. ‘Well, then. Shall we…?’

Nanette’s daughter Roo answers the door.
‘Thank you for coming,’ she says. ‘Although quite what you’ll be able to do I don’t know.’

It’s a difficult scenario. Nanette was discharged home after some disagreement amongst the clinicians about her mental capacity. Nanette has chronic health problems, made worse by a recent infection. Her history of taking medication is patchy to say the least; she prefers to take herbal remedies, to meditate and follow a strict dietary regime – all of which is fine, of course, except it’s reached the stage where it’s difficult to say whether the progress of the illness is affecting her ability to make rational decisions about her health. She was so unhappy and disruptive on the ward, the hospital took the view that on balance she’d be better off at home with the support of community health teams.

None of this would matter so much if Nanette wasn’t suffering, and putting herself at considerable risk.

‘She was outside last night in the early hours, knocking on random doors asking for ice cream,’ says Roo, taking a steadying breath. ‘I live miles away. I just can’t be here all the time.’

What makes it even harder is that Nanette won’t accept any care support. She’s been turning people away, shouting at them through the window, telling them to piss off, and worse. The self-neglect is starting to show now. I’ve been sent in with Liam to do as much of a review as she’ll tolerate, to see how she is and what more can be done short of sectioning.

We put on our masks and gloves and follow Roo up the stairs.

Nanette is sprawled on the sofa. Emaciated, a dump of stringy limbs loosely wrapped in a threadbare dressing gown. The tiny flat is super hot; the little fan turning its head ineffectually right and left and back again, like a sad little robot saying no, no, no.

‘Hello Nanette!’ says Liam, giving a little nod. ‘I’m Liam, a social worker, and this is Jim, a nursing assistant. We’ve come to see how you are.’

‘Well now you’ve seen me so you can piss off,’ she says.

‘We’ll go if you want us to, but first we’d like to see how things are and how we can help.’
‘You can see how they are,’ she says. ‘They’re hot.’
‘I know. It really is hot today,’ says Liam. ‘Would you mind if we sat down over here and had a quick chat. We won’t keep you long. Promise.’
She shrugs.
‘If you must,’ she says.

Roo fetches in two small, brightly coloured stools, the kinds of things you might find in an infant school. We sit with our knees up to our necks, and try to smile with our eyes over the rim of our masks.

‘Would you mind if I did your blood pressure and so on?’ I ask her.
She sighs.
‘I’m fine!’ she says. ‘Why is everyone so obsessed with blood pressure? This is what’s wrong with the world. Haven’t you got anything better to do?’
‘Not at the minute. We’re here for you.’
‘Well that’s nice,’ she says, not meaning it. ‘Go on then. But don’t pinch.’
I run through her obs, which are surprisingly good, considering.
‘Thank you!’ I say, sitting back down on the stool. ‘That’s all fine.’
‘I told you! You won’t listen. There’s nothing wrong with me. And if there is, I cope with it my own way…’
‘Who’s that in the photo?’ says Liam, nodding over to a large, gold-framed, hyper-colourised photo of an Indian man in yellow robes, a string of flowers round his neck. He’s holding his hands out, palms-up, smiling so widely his eyes are creased shut.
‘That’s my guru,’ says Nanette. ‘I followed him for years. He died a little while ago.’
‘I’m sorry to hear that,’ says Liam.
‘Dont’ be,’ says Nanette, painfully pushing herself up on her elbows. ‘See that other picture, there? The one to the right?’
In a silver frame. A shaky, grainy, long-distance shot of a young Indian guy in white robes, striding onto a stage in front of a huge audience.
‘He came back,’ she says.

work it, baby

With his thick black hair shaved at the sides and gelled back in a riotous, rockabilly quiff, white framed sunglasses and perfect designer stubble on perfect designer cheekbones, Ethan the nurse makes every visit a fashion shoot. I can see him waiting for me further up the street. He’s lounging back against a lamppost, one white trainer kicked back, the furry grey hood of his parka arrayed like a luxurious ruff around his neck. He’s snapping gum, staring at the cars going by. He looks fabulous.
‘Oh there you are !’ he says, pushing himself upright, flashing me a look over the rim of his sunglasses. ‘I wondered where you were. I was clean-shaven when I got ‘ere.’

We’ve come to see Martin, a difficult patient with a history of drug and alcohol abuse, a few incidents of aggression. I’ve met Martin before – admittedly a while ago. He’s young, but only on paper. When I met him he’d just been discharged from hospital following a fall down a dozen steps and a long lie at the bottom. The fact he survived at all was a miracle. But miracles are fleeting, and there’s always something waiting the other side of them. In Martin’s case it’s a list of medical acronyms that reads like a roll-call for the damned. What’s worse is his recent history of non-compliance, missed appointments, saying one thing and doing the opposite. He was referred to us by the hospital again, this time to dress an abscess in his thigh, the latest wound from his attempts to find anything resembling a patent vein. We’ve been formally tasked to get him to sign an official waiver if he declines help again, so long as we feel he has capacity.
‘Feeling lucky?’ I say to Ethan.
‘Darling – I was born lucky,’ he says. ‘The rest is just exercise and a great skincare routine.’

Martin is staying in supported housing – in this case, a pleasant-looking semi in a tree-lined street, a tall privet hedge screening it off from passers-by. A mosaic path runs from a gap in the hedge through a functional, stone chipped garden to the front door. There’s a brushed steel intercom by the door with a line of illegible, rain-smeared names by the buttons.
‘Shall we ring it?’ says Ethan.
‘Let’s ring it.’
‘You ring it.’
‘No you ring it.’
‘Okay I’ll ring it.’
Ethan rings it.
Rings again.
Eventually a woman answers in a drawly voice.
‘Who is it?’ she says.
‘Oh hi there!’ says Ethan, leaning closer to the intercom and giving me a cartoon-panicky look at the same time. ‘It’s Ethan and Jim, nurses from the rapid response team? We’ve come to see Martin?’
‘He can’t see you. He’s ill,’ she says.
‘Ah. Well. That’s probably a good reason for us to come in, then. I mean – you know – being nurses and everything…’
‘I told you. He’s ill. Come back tomorrow.’
‘Erm… we kind of need to see him face to face so he can tell us himself,’ says Ethan. ‘Otherwise we’ll get in trouble. Would that be alright?’
‘No,’ she says. ‘Come back tomorrow.’
The intercom goes dead.

Whilst we’re standing there wondering what to do next, a man and a dog appear through the hedge. They both look extraordinary – the man because he has a heavily tattooed face and more piercings than the cenobites in Hellraiser; the dog because it has three legs and a lop-sided, piratical expression.
‘Who’ya’fter?’ he says.
‘Oh, hi there!’ says Ethan, shrugging and tipping his head coquettishly on one side. ‘We were just wondering if we could come in and see Martin?’
‘Martin?’ says the man, frowning. ‘No. You can’t. He’s ill.’
‘Yeah. I know. We’re nurses.’
The man fishes a key out of his pocket (although I wouldn’t have been surprised if he pulled it out of his ear).
‘No,’ he says. ‘Come back tomorrow.’
And he lets himself in.
Only the dog looks back.
The door slams shut.
‘Fine! Suit yourself!’ says Ethan, shouldering his bag. ‘Waste my time why don’t you!’
He puts his sunglasses back on, and we leave. The sun comes out. Ethan walks down the path with an exaggerated throw of his hips.
‘Work it, baby!’ he says.

the mysterious mr manager

There’s an elderly guy I see quite often over the woods. An intriguing character, neatly dressed in a shirt and tie, windcheater and slacks, carrying a shabby leather briefcase. It’s only when you look closer you can see the grimy shine to his clothes, and the kind of tan you get from being outside in all weathers, all year round. He has an odd, politely deranged look,  like a manager who had a breakdown at the bank and ran off to live in the forest.

Earlier in the year I’d gone off the usual paths, looking for new things to photograph, and I’d come across an extemporary shelter, a tumble-down roundhouse made of scavenged rubbish bags, fallen timbers, tied together with garden string and Christmas tree lights. There was a shelf inside with a blue tin cup, a half-opened tin of pilchards, and a sleeping bag, rolled up and stashed out of the rain in a corner. It wouldn’t take much to image Mr Manager making all this, fussing with the string, tutting over the lights, then resting his head on his briefcase at night, lying awake in the dark, listening to the rustling in the undergrowth, or the pattering of the rain.

I don’t see Mr Manager all the time. When I do, he’s either sitting somewhere sunny or marching through the trees, talking to himself in that low and level way people do sometimes when their thoughts are breaking surface without them knowing. I always make a point of saying hello and waving, and although it’s taken a while, we’ve got to the point where he trusts me enough to smile and wave back.

Today when I saw him I was very tempted to go up and find out more. He was sitting on a fallen tree in one of his usual spots – a raised bank of grass overlooking the woods – and I was ambling along the bottom looking for mushrooms. I waved, and after a moment, he did, too. For a minute I thought I might walk up there and introduce myself, chat to him – about what, I wasn’t sure. Probably the weather, the time of year, the usual introductory stuff. I could ask him if he’d seen any fly agarics yet (that was one thing I was looking for today, although I have a feeling it might be too early in the season). And then in the way these things go, one thing would lead to another, and I could find out his story. Normally I wouldn’t hesitate, but something held me back. So I settled for a cheery ‘Good morning!’ and carried on.

I worried about it for a while. He could be a vulnerable adult, ‘fallen through the net’, at risk of self-neglect, dependent not just on the kindness of strangers, but on their professional conscience, their willingness to step in and make the necessary calls.

But then I pictured him sitting contentedly up on the grassy bank, sipping water from a bottle, looking around – about as happy as I was, (as far as I could tell), mooching around the young oaks at the fringe of the wood, looking for mushrooms.

And who was I kidding? It suited me better, not knowing the facts about Mr Manager. I was happier making up stories about his circumstances, happy one minute, sad the next. Which I suppose you could see as either a worrying dereliction of duty, a vote for individual self-determination, or a romantic vision of how a life could be lived, wholly outside the normal run of things, out in the woods, lying in the dark, listening to the rain.

New post in ‘Voices’

Job No: 2013
the name of the fox






Thanks for reading!