mental health

Rick the duck

~ jim clayton ~ Leave a comment

Gavin lives in a new development near the station.
‘It’s tucked away,’ he’d said to the call taker. ‘Ours is the one with the triangular balconies.’

Except – they’re actually rectangular.

‘Maybe he got his shapes mixed up,’ says Alexi, pressing the buzzer. ‘Maybe it’s more of a geometrical crisis.’

It’s a smart, designery place, with a wide, plate-glass main door and giant chrome handle, the name etched into the glass in bold lettering – the kind of details you might expect to see on a hotel. There are lots of nice touches, in fact. A rack of multicoloured letterboxes, a series of inset lights. And then out front, a garden area that incorporates some old industrial features, with a slatted wooden walkway snaking gently up to road level alongside a wall with climbing hand grips. A kid on his way to school is demonstrating their use, doing some last-minute bouldering on his way to school, his mum creeping up the slope beside him, his superheroes backpack in one hand whilst she checks her phone in the other.

We’ve come out early because Gavin has rung the service to say he was going to kill himself. The person who took the call tried to give him the crisis number for Mental Health, but he rang off, so our only options are to call the ambulance service or go ourselves. We know the ambulance is appallingly stretched, and we’ve got space this morning, so we’ve come along to triage the call in person.

Gavin comes down to meet us at the front door, although he could just as easily have buzzed us in and let us come up. If you didn’t know he’d made such a distressing call you would never have guessed. He’s a trim, easy-looking guy in his early fifties, stubbly white hair, tanned complexion, dressed in a white cotton shirt and trousers, and comfy sports sandals. He could have stepped out of a catalogue for the stylish retiree.
‘Have you been here before?’ he says, pleasantly. ‘Follow me.’
He shows us up to his flat, a smart, bijou studio overlooking the communal gardens. There are art prints and photos around the place, a bookshelf crammed with art books – Van Gogh, Goya and the like – an expensive SLR camera on the coffee table, and then a smaller bookcase with Penguin classics and a few self-help titles, and on the wall a collection of DVDs that reads like a list of the Fifty Films You Must See Before You Kill Yourself.

‘Take a seat,’ says Gavin, smiling pleasantly, and then running his hand backwards and forwards across the silvery stubble on the top of his head.
‘How can we help?’ I say, as Alexi and I sit on the sofa.
‘You can’t,’ says Gavin. ‘No-one can.’
I nod as neutrally but encouragingly as I can. Alexi’s leg begins to jiggle up and down. He has his obs kit on his lap. I know he’s keen to get stuck in medically.
‘So – you rang the office saying you wanted to kill yourself?’
Gavin takes a long breath and closes his eyes.
‘I’m sorry things are so difficult for you at the moment,’ I say. ‘But just to be clear – have you done anything to hurt yourself this morning, Gavin? Or made specific plans to do that?’
‘I’ve been planning to kill myself since I was nine,’ he sighs, carefully pulling out a chair and sitting down. It’s an odd and not entirely comfortable configuration – me and Alexi side-by-side on a low sofa, looking up to Gavin on our right.
‘I have monsters in my head,’ he goes on, rubbing his stubble again, as if that’s all he can do these days to contain them.
‘Do you have a support worker? Or a number to call when things get difficult?’
He shakes his head.
‘No-one can do anything,’ he says. ‘I’m dangerously ill. I have severe heart problems. Lung problems. I almost died when I was rushed into hospital. They didn’t know what was wrong. I collapsed several times. It’s been going on for years. I’m on every medication you can think of.’

We’d looked over his past medical history before setting out. There’d been nothing about heart problems or any other medical issues other than some minor orthopaedic work in the past. He’s not on any medication for anything other than Mental Health.

‘I’m constantly dizzy,’ he goes on. ‘I have pins and needles. I can’t breathe. My legs aren’t working properly. This morning I went outside and collapsed….’
‘I’m sorry to hear that, Gavin. What happened?’
‘My legs buckled.’
‘Did an ambulance turn up?’
‘No,’ he says. ‘I managed to get up again and crawl back inside.’
He looks at me and sighs.
‘I’m fighting for breath,’ he says. ‘I can’t speak. I’m dangerously ill, but no-one can do anything. I know more about my condition than the most senior doctors in the country. I have to tell them what’s wrong with me, and that can’t be right, can it?’
‘It does sound difficult for you.’
‘I’ve tried every approach under the sun. You name it, I’ve done it. Deep meditation, CBT, group therapy. I’ve been exorcised. I’ve done cleansing rituals. I’ve swallowed every antidepressant and antipsychotic that was ever made. I’ve even written a book about my experiences…’
He reaches over to the table behind him and produces a red plastic document pouch bulging with paper.
‘It’s not quite ready to be published but when it is it’ll change the way they do medicine in this country.’
‘What’s it called?’
‘Don’t Think I Won’t Because I Will’ he says.
‘Amazing.’
He puts it back on the table.
‘The thing is, Gavin – we’re a little limited how we can help you this morning. As you know, we’re a community health team. We either support people coming out of hospital or try to stop them going in to begin with.’
‘I see,’ he says.
‘So – I think this morning we’ve got two options. One is to help you contact the Mental Health crisis line, or the other is to call an ambulance to take you to hospital. I really don’t think hospital is the right thing to do, though. It’s horribly busy there at the moment – definitely not the place to go if you’re feeling anxious or – you know – delicate. So why don’t we ring the crisis line? See what they have to say? They’re the experts. How does that sound?’
He nods, then crossing one leg over the other and hooking his hands around the knee, waits for me to make the call.

The line is answered almost immediately by Rick, a mental health liaison nurse I know well. Rick is the most affable guy you could wish for, addressing the most extreme behaviours with such a soft Irish accent it immediately makes you feel better.
‘Jim!’ he says. ‘How funny! What’re ya doing there today? How can I help…?’
I explain the situation as evenly as I can, then pass the phone over to Gavin. It’s strange to hear Gavin describe his situation: struggling to breathe… collapse…. monsters…. all in the most conversational tones. I can hear Rick responding, gently but firmly getting to the nub of it all. After five minutes, Gavin hands me the phone back.
‘That’s fine, Jim. Leave it with me. I’ve got his notes here. There’s a few bits and pieces we can do. I’m going to ring him back in five minutes and talk some more, but it’s fine if you want to toddle off. Thanks for coming out – and it’s so lovely to talk to you again…!’
‘You, too! See you soon.’
I put the phone back in my pocket.
‘So – is that okay, Gavin? Rick’s going to ring you back in five minutes, and we’re going to head off. But in the meantime, if anything happens, you’ve got some numbers you can call, including 999 in a desperate emergency.’
‘My whole life is a desperate emergency,’ says Gavin, rising and smiling pleasantly. ‘I’ve had fifty years of it.’
‘Good luck with the book,’ says Alexi.

Back outside, we tear off our plastic aprons, our masks and gloves, and breathe in the sharp morning air.
‘I couldn’t work in mental health,’ says Alexi.
‘Me neither,’ I say. ‘I thought about retraining as a counsellor at one time, but I’m not sure I’ve got the patience.’
‘Rick is amazing, though,’ says Alexi. ‘Did you see the way he coped with it? It was like water off a duck’s back. Is that the expression? Water off a duck’s back?’
‘It is!’ I say.
And I think of Rick as one of those lush Mandarin ducks, button eyes and punky hair, splashing about in a big old pond somewhere, bobbing under the water, up again. Under. Up. Shaking off the water. Basically loving it.

the wrecking ball

~ jim clayton ~ Leave a comment

I knew the street – or thought I did. A utilitarian cut-through in an older part of town, with the sort of uniform civic redevelopment it makes you wonder whether the original buildings fell victim to town planning or the Luftwaffe. The street is dominated on the leading corner by a long, low, smoked glass office building, leading on to other, smaller offices, a single, more original building in a rotten-looking antiques warehouse – mobile phone number painted on the peeling double-doors where the cart used to go in and out – and half way up, a pristine meditation centre, operating out of the old telephone exchange, finding new ways to make connections.

Giles’ block is narrowly squeezed-in, set-back, anonymous, thrown together from the same Lego tin as its neighbours. The only thing that gives it away as a private address is the scrappy intercom console, the names of the people who live there scrawled in marker pen, stuck over with tape or missing completely. Two office workers vape and sip coffee, leaning up against the black pointed railings to the right. They’ve both got such perfect, Edwardian-style beards and moustaches, it’s a shame they can’t get vapes designed like long clay pipes. Before I can suggest it, Giles buzzes me through.

If the exterior of the apartment building looks flimsy and plastic, the conversion inside is even more extemporary. It looks so thin, if I tripped and put out my hand to save myself, no doubt all the walls would tumble down one against the other like a pack of cards, until I was left standing in the shell (with the two bearded vapers peering in at the window).

Giles’ door shows signs of a forced entry. I know he was admitted to hospital after an overdose, so I’m guessing that’s what it was. It wouldn’t have taken much putting-in, that’s for sure. A butterfly could’ve done it. With an ant as a battering ram.

No need for that today, though. Giles is waiting for me in the doorway. He’s gigantic – much too big for this place – a vast, fleshy monolith of a man, wearing an old Motorhead t-shirt and cut-off trackie bottoms. When he turns and leads me into his flat, his left shoulder slightly higher than the right, his palms swipe backwards to help him along, like a polar bear paddling for purchase in the floes. The whole building bounces.

His living room is a mess. There’s one armchair in the middle of it all, blackened and sagging in the middle. When Giles sits himself into it with a thundering sigh, he’s almost completely subsumed, like he’s dropped himself down into the maw of a particularly giant and noxious kind of fungus. He spreads his fingers on the arms – to stop himself disappearing straight through the floor, probably – and regards me with a baleful look.
‘What’s all this about?’ he says.
I explain what the team is and the things we do.
‘I’ve come for the initial assessment,’ I tell him. ‘It’s a formality, really. I think you’ve been referred to us by the hospital for very specific things. For physiotherapy – because I think you injured your shoulder? Is that right? And for some bridging care, to help you get back on your feet. Unless you think there’s any equipment you might need?’
He raises his eyebrows.
‘What do you mean? Equipment?’
‘Well – in the loo, for instance. To help you get on and off. Given your shoulder problems. To make sure you don’t have any more falls.’
‘I fell because of the overdose’ he says.
‘Yeah. But still…’
He gestures behind me.
‘Be my guest. See what you think.’
‘Okay.’

What I think is that the toilet is as terrible as the rest of the flat. I imagine the gateway to Hell might look similar – although I’m sure even Satan would be a bit shamefaced and throw something down there. The only equipment this place needs is a wrecking ball.

‘Hmm,’ I say, going back in to the living room. ‘Maybe I’ll get the OT in to see you after all.’
Giles nods and smiles.
‘I’m sorry,’ he says, making an effort to get up again, but defeated almost immediately. ‘I haven’t offered you tea.’
‘That’s kind,’ I say. ‘But it’s fine. I just had one.’
‘As you wish,’ he says.
We smile at each other.

display purposes only

~ jim clayton ~ Leave a comment

Henry doesn’t come to the door so much as slowly coalesce from the shadows beyond the glass.

Henry is frail but not physically unwell. I know his story pretty well by now. He’d been living in Portugal for many years until things started to go wrong, his marriage ended, he was hit by severe financial problems, lived a while in his car, was sectioned following a suicide attempt. After a great deal of toing and froing, his daughter Diane managed to repatriate him, temporarily setting him up in a basement flat whilst she sorted out something more suitable and long-term. I’d spoken to Diane many times on the phone. She was bright and busy and supremely well-organised, but I knew she was struggling to cope with work and family as well as the traumatic fall-out of her parents’ separation. Diane knew as well as anyone that the basement flat wasn’t great. It had a set-aside feel, silent and secluded – not at all the kind of place you’d choose for someone suffering depression and anxiety. But even though it suffered from having the generic, impersonal feel of showroom flats the world over – blown-up photos of Times Square and a colourised London bus driving over Westminster Bridge in the rain; enormous, squashy leather sofas impossible to get out of once you’d sat in them; glass vases with white pebbles and a single, artificial lily; a flat screen TV; venetian blinds – at least it was warm and safe, and near enough to where she lived to make keeping a regular eye on her father vaguely feasible.

The good news is that Diane had managed to find a better, brighter place. Henry is due to move the following morning; my visit here this evening is to be the last in this place, a welfare check, to see he’s okay.

‘Hello,’ says Henry.
We’ve met a few times before, but he makes no sign he recognises me. He’s as still as a photograph, completely neutral, like it really makes no difference to him whether he shakes my hand here in the doorway or stands inside staring up through the casement window at the feet of the people walking by.

He lets me in. We relocate to the living room. Henry drifts over to the kitchen counter, next to a tall suitcase on wheels, all zippered up and ready to go. I have the eerie feeling that If I was an alien probe sent into the room to scan for life, I’d struggle to differentiate between them.

‘Have you eaten anything this evening?’ I ask, glancing around for clues.
He shakes his head.
‘Aren’t you hungry?’
‘No.’
‘Do you mind if I have a look and see if there’s something I can get you?’
He shrugs.
I go into the galley kitchen area, so pristine you can smell the caulking gun.
The fridge has nothing in it. I open the overhead cupboards, and I can’t help thinking of the old nursery rhyme: …but when she got there, the cupboard was bare, and so the poor dog had none.
The only food I can see anywhere are five Kilner jars of pasta lined up on a shelf, each one holding different shapes and colours.
‘I could do you some pasta…’ I say, wondering what on earth I’d use for a sauce.
He shakes his head again.
‘Display purposes only,’ he says.

something good is just about to happen

~ jim clayton ~ Leave a comment

Harold doesn’t just suffer with anxiety – he’s anxiety incarnate. He is fret and worry and apprehension and dread, bound together with chains of despair. He is one hundred percent uneasiness, with a side order of foreboding. Anxiety has invaded his body, worn him thin as a pier post submerged by the tide, the black water rusting out the bolts, leaving just a pair of drilled holes for eyes.

‘But how do I know you’ll come?’
‘I will come, Harold. I promise. I’ll be there in about twenty minutes.’
‘But what if you don’t? Who would I call?’
‘You could call the office. The number’s in the folder. But I should be there in twenty minutes, traffic permitting.’
‘What do you mean, traffic permitting? You mean you might not get here at all?’
‘Well – sometimes the traffic’s a bit sticky, Harold. But twenty minutes should do it.’
‘But it might not do it. It might not. And then where would I be?’
‘I think you just have to trust that things will work out.’
‘But you can’t guarantee it.’
‘No. I suppose when it comes down to it, I can’t.’
‘So you can’t promise me you’ll come?’
‘I can promise I’ll try.’
‘And you you’re not lying to me.’
‘No. I would never lie to you. I’ll always be honest. Even though it might not help sometimes.’
‘Because I don’t want to be told one thing and then something else happens.’
‘No. That’s not nice at all.’
‘So you’ll be here in twenty minutes?’
‘Twenty minutes. Try not to worry.’
‘But it could be longer?’
‘I’ll see you in a bit, Harold. Take care.’

I ring off. Take a breath.

Take care? Why did I say take care? It sounds too final – the kind of thing you say when you don’t think you’ll see someone for a while. Certainly longer than twenty minutes.

Even over the phone I can feel the glittering mycelia of anxiety reaching out to me. I shake them off. Take a breath. Drive more positively than normal. Get there in ten.

*  *  *

When Harold comes to the door it’s like someone throwing a curtain aside on a  monologue.
‘I was worried I’d caused a stain on the road.’
‘A stain Harold? What do you mean?’
‘A stain. I could see a black patch on the road outside, and I was worried my milk had leaked from the bottle. There was a workman outside and I asked him about it.’
‘What did he say?’
‘He said it wasn’t the milk, it was the repairs they’d made to a hole. He said if it was milk it would’ve dried by now. But it could’ve been the milk, couldn’t it? The milk could’ve leaked and caused damage to the road? And then what would I have done?’
‘It definitely wasn’t the milk.’
‘You’re sure?’
‘Positive. There are many things I’m not sure about, Harold, but I can absolutely guarantee your milk hasn’t leaked and damaged the road surface.’
‘But it was all black and shiny.’
‘That’ll be the bitumen.’
‘Bitumen?’
‘Yep. I would think.’
‘What’s bitumen?’
‘It’s a tarry substance they use to resurface roads.’
He frowns.
I take the opportunity to redirect his attention.
‘Would you mind if I came inside, Harold? The doctor wants me to take a little sample of blood…’
His round eyes deepen.
‘Blood? What on earth for?’
‘Let’s go inside and I’ll tell you all about it.’
‘But why does the doctor want you to take my blood? Am I ill?’
‘It’s nothing to worry about, Harold…’

It carries on like this all the way in to the living room. I put my right hand lightly on his shoulder, hoping the human weight of it might reassure him a little. When we reach the living room he hitches up his trousers, lowers himself with enormous care into a ruined armchair, then sits with his hands gripping the armrests, his spindly legs close together, his slippered feet flat on the floor. Only when all this is safely done does he turn his drilled gaze onto me.

I try the usual tactics. I ask him about his family, what job he used to do. I ask casual but specific questions about his daily routines. What he eats. How he sleeps. I ask about his bowel habits. How he’s managing. I make banal comments about the weather. I make him tea, and so on. But despite adopting the conversational profile of a pebble, every last thing gets turned into evidence of imminent ruin and disaster.

I settle back.

The walls are covered with pictures: kitsch, mini motivational posters, one of a kitten in a boot saying I hate Mondays; some with blocks of text saying stuff like Only I can change my life… or something good is just about to happen – but the one that really catches my eye is a copy of the Mona Lisa with a photoshopped spliff in her hand.

I look back to Harold and smile.

‘Am I ever going to be well?’ he says. ‘And don’t lie to me.’

a bit of a drama

~ jim clayton ~ Leave a comment

The living room is as brilliantly lit and formally arranged as the opening scene in a play. A man and a woman sitting side by side on the two-seater sofa in the bay window, stage left; me with my folder on my lap on a matching armchair just downstage from them, and then an elderly woman stage right, the focus of attention, sitting on a dining chair turned sideways to the table, her hands neatly folded in her lap. A bright and pleasant room, crowded bookshelves, pictures on the walls, a giant fern in a green pot, and a plain-framed mirror over the mantelpiece casting back that light pours in through the windows.

And if it was a scene from a play, the director might well decide to hold it there, curtain up, and not have anyone speak their lines for a beat or two, giving the audience time to settle, take it all in, and wonder about the four characters. What assumptions might they make?

They’d know I was official, and not just from the obvious stuff, the uniform and lanyard, bag and folders. They’d probably think there was something a little self-conscious about the way I was sitting, a conciliatory duck of the head, maybe, a professional sharing of attention between the other three. They’d think the other man was a relative, the son, no doubt. He’s the right age, of course, but he looks like someone who’s spent a lot of time in this room, one way or another. And the way he massages his hands and jogs his knee up and down. He looks like someone who’s been brought here over some distance, at some inconvenience, still wearing the suit he was in when he took the call. A nice, professional son, then, worn down by circumstances he finds more difficult because they’re out of the normal run of things, and hard to quantify in the usual way. The woman sharing the sofa is sitting so close to him they must be in a relationship. There’s something resolutely straight-backed about her posture, and the encouraging smiles she shares around the room. There’s something about the way they are together that suggests long conversations and negotiations. They’ve arrived at a decision – he, more reluctantly – resolved to face it together, shoulder to shoulder. The elderly woman has a bewildered look. There’s a vagueness about her in strange contrast to the sharp delineation of everything else, as if the bright sunlight flooding the stage is causing her to lose definition rather than gain it.

‘Tell me about the whole bath thing’ I say. ‘I didn’t get the whole story.’
‘Well it does sound a bit crazy, even to me,’ says Helen, the elderly woman. ‘You see – I took a bath as I usually do in the evening, but then I blacked out, and it was some time before I was found.’
‘How long?’
‘Three days.’
‘That’s a long time.’
‘Yes. It is.’
‘Was the bath filled with water? You were lucky not to drown.’
‘No. The water had gone.’
‘Who drained it?’
‘It must have been me, although I don’t remember.’
‘Three days in a bath! I’m surprised you didn’t freeze.’
‘It’s a warm flat.’
‘When did you regain consciousness?’
‘The whole thing’s quite blurry. I’m not really sure.’
‘It’s perhaps a strange question to ask, and I’m sorry for asking it – but had you been incontinent?’
‘No, I hadn’t.’
‘So you passed out in the bath. Came round at some point. And then couldn’t get out of the bath. Is that right?’
‘I suppose so. Although it sounds pathetic when you put it like that.’
‘Who found you?’
‘Maria, the cleaner. She comes every Wednesday morning.’
‘And did she call the ambulance?’
‘Yes.’
‘And they took you to hospital?’
‘They did. And I had a whole series of tests. The works. And all they found wrong with me was a silly little cut on my toe. Would you like to see it?’
‘Maybe in a minute or two.’
‘I don’t know how I did it. Probably on the tap, I should think.’

She looks at her son, Matthew, who sits on the sofa with his knee jogging up and down. Matthew’s German wife, Helga smiles brightly back at Helen.
‘We will get things sorted,’ Helga says. ‘Don’t worry.’
‘Absolutely!’ I say, flicking through the discharge summary, at the normal blood results and scans and so on, the recommended follow-ups. ‘We’ll figure something out.’
‘I do hope so,’ says Helen. ‘It’s all a bit of a drama, I’m afraid.’

a head for depths

~ jim clayton ~ Leave a comment

Craig has the key so we agree to meet outside Sally’s flat at midday, when he’s due to make her lunch.
‘Have you been here before?’ he says, bending down to stretch some blue plastic covers over his trainers.
‘I hear it’s bad,’ I say, taking some out of my bag.
‘It’s not the worst, but you’ll definitely need these.’
Craig seems tired, a reflection of my own state of mind. It’s not so much the number of patients on the list and the number of miles we cover, hurrying from place to place. It’s more the endless parachuting in to situations that are failing in one way or another, trying to set them straight – or, at least, straight enough so you can feel some kind of progress is being made, and that things might change for the better.
An adult safeguarding report has already been put in on Sally, but it’s complicated. In the meantime, we’re going in to do what we can to ameliorate the situation.
‘Ready?’
‘Ready.’
‘Okay then.’
He knocks on the door and then opens it with the key.
‘Sallly? It’s Craig – and Jim. From the hospital. How are you doing?’

He’s right. Whilst it’s not as bad as many places I’ve been in, it’s definitely the kind of place you have to start with shallow mouth-breathing for a minute or two, till you’ve adjusted sufficiently to breathe normally through your nose. Walking down the hallway, our covered shoes make the ticky-tacky noise so characteristic of encrusted and unsanitary surfaces, and the air has a familiar and gloomy sag to it.
‘Hello?’

Sally’s waiting for us in the lounge, in an armchair so low and squashy and discoloured it looks less like a piece of furniture than some giant, malignant bloom. She’s wearing an electric blue silk nightie with a green cardigan over the top. Her bare legs are mottled, swollen, pressed together at the knee. She smiles easily, reaches up to shake our hands, but her conversation is muddled and difficult to follow. One of my tasks is to take some blood, to determine whether infection is making her more confused, but I can see I’m going to have to sidle up to it.

Whilst Craig busies himself preparing a microwave meal in the kitchen, I chat to Sally about this and that, and take her observations as carelessly as I can, almost as if I’m as surprised as her to be doing it.

When Sally talks it’s the equivalent of pretend writing. The patterns of her words, the fact that they follow a line, and start and stop in the usual way, with the usual loops and flourishes, everything looks superficially like conversation. But the truth is, I have to make assumptions about what she might mean, and reflect it back to her, and she’ll either laugh or frown, or wave her hand in the air, and we’ll move on, as if something’s been said, though neither of us really knows. But there’s the reassurance of the tone of what we’re saying, if nothing else, and it does seem to be working. She’s distracted sufficiently to let me take some blood, and whilst she obviously doesn’t have mental capacity to refuse, I take the fact that she doesn’t pull her arm away as consent.
Just before I actually puncture the vein, I ask her some more about her family, particularly her father, who (I think) she said was a miner.
‘Have you ever been down a mine?’ I say, preparing the needle.
She answers with a laugh and a string of garbled words that, if they were in a foreign language and I was forced to guess the meaning, I would say: That was a long time ago now / He was a lovely man / He worked so hard.
‘He sounds great!’ I tell her. ‘You know – I’ve always quite fancied the idea of going down a mine.’
She laughs again.
The blood flows into the tube.
‘God knows, it must be a difficult job.  But I quite fancy seeing what it’s like. I mean, when you think where it all came from, what it was, all that coal. Millions of years ago, all these giant trees and plants in some wacking great swamp somewhere, and then it all gets buried and changed into black rocks you can burn. I know I probably wouldn’t pay much attention to any of that if I had to go down in a cage every morning and swing away with a pick. If that’s what they do. I’ve really no idea.’
She listens to me with a tolerant smile on her face, tutting at some things, frowning at others, but keeping her arm still so I can get what I need.
‘There! All done!’ I say, taping a piece of gauze to the crook of her arm. ‘You’re a model patient!’
Meanwhile, Craig has come through with lunch. He’s standing just behind me with a tray of Lancashire hotpot.
‘You thinking of a career change, Jim?’ he says, helping Sally get set up in the chair, ready.
‘Me? Maybe,’ I say, stashing the phials of blood and peeling off the gloves. ‘I don’t know though. I’m not sure I’ve got a head for depths.’

the story of Old No.7

~ jim clayton ~ Leave a comment

Before I go up to the first floor I stop by the warden’s office.
‘Pete? He’s what you might call a colourful individual,’ says the warden. ‘He’s certainly done a lot in his life, what with his boxing and his business interests and his running around. I’m not so sure about the Krays, though. You have to take a lot of what he says with a shovel of salt. But y’know – we’re all worried about him. Pete’s always had a short fuse, but he’s gotten a whole lot crankier. The carers are having to double-up.  For safety – y’understand? God knows he’s got a lot on his plate, poor bastard, what with his eyes and his back. We take his meals up and try to rouse a bit more of a spark in him, but.he’s retreated to his room these last few weeks, and short of dragging him out by the feet, there’s not a lot else to be done. It’s like he’s given up.’
‘They’ve sent me round to take some blood this morning.’
‘Yeah? Well good luck with that!’ says the warden, shaking his head and leaning back in his office chair. ‘My advice? Keep it simple. Don’t fuss. And wear a tin hat.’

Pete is standing waiting for me in the doorway to his flat. A tall, pale, withered figure, dressed in boxer shorts and a string vest, he peers out at me as I approach along the corridor.
‘What took you so long?’ he says.
‘Sorry, Pete. I stopped by to have a word with Gerry.’
‘What for?’
‘Just a quick hello. He’s a nice guy, isn’t he?’
‘If you say so. Anyway. What’ve you come for? I’m sick of all these people barging in all hours of the day and night.’
‘It must be annoying,’ I say. ‘But I suppose it’s just because people are worried about you. They want to make sure you’re okay.’
‘What people?’
‘Carers, nurses. The usual.’
‘Well, I’m fed up with it.’
‘So how are you today, Peter?’
He shrugs, but lets go of the door handle and turns to walk back to his armchair.
‘Just be quick,’ he says.
‘I promise I won’t keep you long.’
He settles back into his chair as I get my things ready.
‘What are you? Some kinda nurse?’ he says.
‘Nursing assistant.’
‘Ah!’ he says. Then after a pause: ‘In Spain you’d be called a practicado.’
‘I like that. Practicado. That feels about right. So – how come you know Spanish?’
‘Well I should do. I lived there ten years. I had a bar on the Costa del Sol.’
‘Wow! That sounds great. Hard work though, I expect.’
‘See that bottle up there,’ he says, pointing to an ornate glass bottle on the top of a shelf of sculptures and photographs. ‘That’s a traditional Spanish whisky, about a million per cent. So spicy it’ll blow your tits off.’
‘I bet.’
‘I haven’t touched it in over twenty years. Don’t suppose I ever will now.’
‘You know – the worst drunk I ever got was on an American whiskey. Something called Wild Turkey. I was knocking it back because it was so smooth and easy. And I was thinking This is all right! This is great! And the next thing I knew, I was lying flat on the floor with my eyes going round and round, like the red spot on one of those old electricity meters.’
‘American whiskeys are the best,’ he says. ‘Have you ever had Jack Daniels?’
‘Yep. Love it.’
‘D’you know the story behind it?’
‘Was it something to do with the Civil War? Or was that Colonel Sanders?’
‘No! He was the chicken man, you numpty. What I mean is – why’d they call it Number Seven?’
‘Don’t know’
‘It’s because his first batch was just seven barrels, and they all come loose in a storm and rolled down the mountain, and the only one they never found was this number seven. And it’s still out there now. So if you went and found it, you’d be a millionaire.’
‘I’ll just take this blood and then I’ll be off.’
‘Ye-es, mate. I’ve lived all over the world. Spain, Italy. America. I’m no good now, though. I mean – look at me! And then have a look at me on the beach.’
He nods over at a bookcase as I tape a wad of gauze to his arm. Shaking the vials of blood, I go over to the picture. A young man in his twenties, doing that greased-up, muscle-man thing of leaning forwards whilst flexing his arms and shoulders, smile-grimacing into the lens.
‘You look quite a prospect.’
‘Wha’d’ya mean, prospect?’
‘I mean you look handy.’
‘I could take care of myself, don’t you worry.’
I sit down to write the vials up when he says, in a surprisingly shaky and vulnerable change of tone: ‘What d’you suggest I do about all this, then?’
‘About what, Pete?’
‘About all this what I feel. I’m no good any more. I’ve got pain the whole time. I can’t hardly see nothing. The doctors have run out of ideas.’
He licks his lips and then adds: ‘Do you know what irony is, Jim?’
‘What – d’you mean it’s ironic you were so fit and now you’ve got all these health problems?’
‘No. The irony is – a few years back everyone wanted to kill me, and now that I’m properly fucked and want to die, they all want to keep me alive.’
‘I’m sorry you’re feeling so low. It’s not surprising, though, given all the things you’ve got to put up with.’
‘Yeah, well,’ he says.
‘I can refer you on to our Mental Health nurse. She’s really good – and she can start figuring out ways to help you feeling better again.’
‘If you think,’ he says.
‘Good. I’ll speak to her when I get back to the office.’
I’m just putting my stuff away when he leans forwards and says:
‘Have you heard the one about the two psychiatrists in Chicago?’
‘No. Go on.’
‘So there are these two psychiatrists in Chicago, both working in the same building, nodding to each other when they pass in the lobby. The first one’s always bright and cheerful, dressed nice, expensive hat, big cigar, whilst the second one, he drags himself around looking shabby and down at heel, with a face like a smacked arse. So anyway, eventually, this second, sad psychiatrist, he can’t take it no more, and he stops the first one in the lobby, and he says: I don’t get it, mate. We spend all our time listening to the same old dreary problems, none of which we can’t do nothing about, and yet there you are with this big smile on your face. And the first one, he turns round, and he says: ‘Who listens?’

out out

~ jim clayton ~ Leave a comment

When I was little we used to play a game called Jack Straws. You had a box of plastic tools – ladders, shovels, brooms, rakes and so on – you dumped them in a pile in the middle of the table, and then you took it in turns to try to hook as many away as you could. If the rest of the pile moved, you were out, and you passed the hook on.

Talking to Paula is a lot like playing Jack Straws, but instead of tools it’s walking sticks, letters, appointment cards, blister packs, items of food and then – the biggest category by far – people, dozens of them, in all shapes and sizes, some of them old, some of them young, some of them in uniform. And it’s difficult to resist the idea that the box got emptied on the table about the time her partner Eric died.

I’d been given the background story by someone else. Twenty years ago Paula and Eric had left their respective partners and children to start a new life together in a different part of the country. Paula had always been an anxious person, something that deteriorated in later years to the point where Eric had been acting as her carer. His recent, unexpected death cut Paula adrift, and everyone around her was struggling to cope. She’d been calling the ambulance a great deal. The police, too. Carers had been arranged but quickly dismissed, accused of laziness, rudeness, or the latest, making faces and going through her things. Everyone was trying to help. No-one was getting anywhere.

I’ve been sitting on the sofa struggling to think of a new angle to come at all this. It doesn’t help my situation that Paula’s friend Nigel is so aggressive. No doubt he’s stressed, too, but I don’t get the impression he’s normally easy. He has that way some men have of walking slightly back on his heels, arms out to the side, like it’s an effort to accommodate so much masculinity in such a short frame.
Right at the beginning of the meeting I’d checked Paula was okay with him being there.
‘Nige? He’s taking me shopping,’ she said. ‘Of course I want him here.’
‘That’s fine. I just needed to make sure.’
‘What’s up?’ said Nige, wobbling back into the room.
‘He says he wants you to go.’
‘Does he?’ he said, poking his glasses back into position with a finger as hard as a nail gun. ‘Why’s that, then?’
‘Don’t worry, Nigel,’ I said to him. ‘It’s fine. It’s just standard procedure when I’m talking to a patient about private stuff.’
‘Private stuff, yeah?’ he said, then thrust a doctor’s letter out for me to read. ‘Well go on, then. What are you going to do about this private stuff?’

*

It’s the end of the meeting. Physically Paula seems fine. The only positive contribution I can think of to make is a referral to social services, although I’m pretty sure they’ll already be well aware of the situation.
‘I just want to go back up north,’ she says. ‘Can’t you find me nowhere?’
‘How d’you mean?’
‘A house or a flat. Back up near my daughter.’
‘Well – that’s a little beyond what we normally do. But there’s nothing to stop you or your daughter looking for properties yourself.’
‘How?’
‘I don’t know. Online. There are loads of good websites.’
‘I haven’t got a computer.’
‘Your daughter, then.’
‘She doesn’t want me near her.’
‘She doesn’t?’
‘No!’
‘I’m sorry to hear that.’
‘So what are you saying, then? You’re not going to help me?’
‘I’ll see what I can do.’
‘But I can’t go on living here, can I? I can’t cook. I can’t look after myself. I can’t go out.’
‘I thought you said you were going shopping with Nigel?’
‘No,’ she says, taking out a cigarette, her hands trembling. ‘I mean out out.’