in the house of alma

‘How much do you know about – the situation?’
Charlotte is standing with me and my colleague Olufemi where we agreed to rendezvous outside the house. She seems anxious, her long blond hair tied back in a purposeful ponytail, her eyes drawn and tired.
‘Not much, only that Alma has been going downhill a bit lately, at risk of self-neglect.’
‘If it wasn’t for me she would’ve died already – sorry to be so blunt.’
‘No. That’s okay. It’s good to be clear.’
Charlotte unconsciously moves Alma’s keys from hand to hand, as if they’re too hot to hold for long.
‘The fact is we’re moving,’ she says. ‘And I’ve no idea what’ll happen when we’re gone.’
‘Does she have family?’
‘No. A niece somewhere. I’ve never seen her.’
‘That is a pity,’ says Olufemi. ‘That is sad for the lady.’
‘What about carers?’
‘You’re looking at her. Not that I meant to do it, or even wanted to, really. But what can you do? I used to be a nurse, too. About a thousand years ago.’
‘So you’ve been providing a measure of care for Alma? Doing what, exactly?’
‘It started off just buying her food. Bit and pieces here and there. Clearing up. Domestic stuff. She never paid for any of it, but what could I do? I couldn’t just let her starve. But then lately she’s been unwell and I’ve had to start cleaning her up. She’s started falling, staying in bed. Been incontinent – that sort of thing. I’ve changed the sheets and quilt any number of times. Thrown them out, bought new. It’s been quite stressful. On top of all the hassle of moving. That’s why I had to get social services involved.’
‘Sounds like you’ve done everything you could and more.’
‘You are a good friend and neighbour,’ says Olufemi. ‘The best.’
‘The other thing I need to tell you is – she says hurtful things.’
‘To you?’
‘And I know it probably comes from a place of fear. I don’t doubt she’s scared people are going to take her independence away. It just makes it all even more difficult to handle.’
‘What hurtful things?’
‘Well. No doubt you’ll see when we go in. Don’t get me wrong. Deep down Alma’s okay. A little eccentric, in her own way. But erm…you really have to brace yourself.’
‘Okay. Thanks for the heads up.’
‘Let’s see what she’s like today, then, shall we?’
Charlotte gives us both a brave smile, then pushes open the gate and we all walk in a line down the overgrown path to Alma’s front door.

I’m guessing the house was built sometime in the thirties. A little down-at-heel now, it still has that air of moneyed class-consciousness you see in some suburban homes. When Alma dies I imagine it’ll be sold off and re-developed into separate flats. There’s certainly space for it. Inside it’s hard to imagine one person living on their own here, let alone a ninety-five year old confined to one room upstairs.
‘It’s cold,’ says Olufemi.
‘I put the heating on but she turns it off again,’ says Charlotte. ‘Doesn’t want to spend the money.’
‘But a person needs heating,’ he says. ‘This is not good. Not good at all.’
We’re all of us standing in the gloomy hallway looking round. Archways leading off into dark, unoccupied rooms. It’s early morning, and a thin light sparsely illuminates the kitchen.
‘It’s a mess,’ says Charlotte. ‘I’ve done my best, but…’
She stands at the bottom of the staircase with one hand on the balustrade.
‘It’s no good calling because she won’t hear you,’ she says. ‘We may as well just go up.’
So we do.

The landing is as cold and resonantly empty as the rest of the place. All the doors stand open and dark apart from the door to Alma’s bedroom, which is closed, with a little light spilling out from under it. A radio is playing loudly – a gardening programme, something about azaleas.
Charlotte knocks, then turns the handle.

Alma is lying on the floor.
‘Oh Alma!’ says Charlotte, hurrying over.
‘Get away from me!’ says Alma. ‘And whilst you’re at it, lose some weight.’
‘Don’t be like that, Alma. Look. I’ve brought some people to see you. Some nurses from the hospital.’
‘Nurses from the hospital? Whatever for?’
Olufemi and I go over to her to introduce ourselves and see if she’s alright.
‘How did you end up on the floor?’ I ask her.
‘I slipped! D’you think this is some sort of game? Concentrate, boy! Why not try using your mind for once? You might like it.’
‘Let’s help you up…’
She’s obviously uncomfortable, though, because once we’ve ascertained she hasn’t hurt herself, she lets us gently help her up and back onto the bed.
She’s wearing a t-shirt and nothing else, her withered legs scarcely able to support her.
Alma catches her breath, and when she’s ready, divides her attention between me and Olufemi. It’s like being scrutinised by a giant, partially denuded chicken, her eyes preternaturally bright and sharp.
‘You!’ she says to me, suddenly clawing at the air between us so unexpectedly that I have to lean back. ‘Pah!’ she says. ‘You’re no use.’
‘Please, Mrs Alma. We’ve only come here to help you,’ says Olufemi, kneeling beside the bed.
‘And as for you,’ she says, turning slowly to smile down at him in a horribly leering way. ‘YOU – my little pickaninny friend. You can go and kneel somewhere else.’

the ghost of bert

Godfrey’s son, Ian lets me in.
‘He’s in the front room watching athletics,’ he says. ‘Go on through. I’m just making some tea. D’you want some?’
‘No – I’m good, thanks.’
‘Okay, then.’

An easy start to things – which is why it catches me off guard to find Godfrey in an armchair, his head thrown back, his eyes closed, his mouth slack, his arms by his side and his legs straight out, twitching and jerking.

If there was one thing I learned from all my years as an EMT in the ambulance service, it’s not to panic. There’s always time – even if it’s just a few seconds – to take a moment and see as clearly as possible what’s happening in front of you.

I’ve seen a great many seizures, and of course they vary enormously in presentation, from absences and automatisms to full-body convulsions. Godfrey’s was different to any of those, though. It struck me as the kind of performance you’d give if you’d only seen these things on the telly. He seemed to think it was mostly about waggling his hands at the wrist.
‘Godfrey? Hello! It’s Jim, from the hospital,’ I say, putting my hand on his shoulder.
He immediately stops, straightens up in the chair, wipes his mouth with the back of his hand and shakes his head.
‘Dear oh dear,’ he says. ‘Some kind of nurse you are.’
‘Nursing assistant.’
‘I thought I’d give you a bit of a scare when you come in. But you’re obviously a hard-hearted bastard.’
‘Well at least that’s some kind of heart, anyway.’
‘I can see we’re going to get along.’
‘I hope so. I can always get the big needle out…’
‘Now, now.’
Ian comes in with the tea.
‘You’re not making a nuisance of yourself, are you, Dad?’ he says, handing him a cup. ‘I can only apologise on behalf of my father. I’d say he means well, but I’d be lying.’
‘I’m not getting involved,’ I say, setting out my stuff.
‘Too late. You’re involved,’ says Godfrey, taking a sip of his tea. ‘Ahh! Now then. I suppose you’ve come about this leg?’

Godfrey strikes me as depressed, which isn’t surprising, given the trouble he’s had with his leg. Although he’s elderly now, he’s been pretty independent, living alone, taking care of himself and so on. Now his mobility is seriously compromised, he’s found himself thrown onto the care of his family, which mostly means Ian, being the closest geographically, and carers coming in to help with this and that. It’s obviously as much a torture to him as the pain itself, and it looks like he’s supplementing his Gabapentin and Co-codamol with a little clowning.

‘You wouldn’t think to look at this wreck of a body, but I used to be a diver,’ he says. ‘That’s a hard job. You’ve got to be mentally tough. Not many can hack it, you know, down there in the dark and the cold.’
‘I bet.’
‘I’ve done some things in my time. I remember once we were sent in to find a body. It’d been there so long, the arm came off in my hand.’
He demonstrates, widening his eyes and pulling away from a phantom corpse.
‘I enjoyed the work, though,’ he says, relaxing back again. ‘Kept me busy.’
Ian nods at me from across the room. I can tell he’s heard these stories a million times before.

Godfrey’s quite a handful but I’m warming to him. He reminds me of my Uncle Bert, who had the same mischievous sparkle in his eyes, deliberately saying something provocative and then waiting to see what you’d do. I invoke the ghost of Bert to help me whilst I’m talking to Godfrey, joining in the banter, until it really feels we’re building a good rapport.
‘You’re all right, son,’ he says. ‘I’ve forgiven you for leaving me to die earlier.’
‘I could tell you were all right because you still had your hand on your wallet…’

The phone rings. Ian goes to answer it in the next room. I start filling in the obs sheet. Godfrey turns his attention to the race on the TV.
‘Look at him, running with his arm in a sling,’ he says. ‘That’s good, innit?’
‘It must make it so much harder.’
‘And look at that one,’ he says. ‘Horribly burned.’
It’s a moment before I realise he means the black athlete.
Godfrey grins when he sees the comment has landed. He folds his arms, and watches me.

It throws me far more than the fake seizure at the beginning of the session, and for a moment I can’t think what to say. It’s disturbing and disappointing enough, but what makes it worse is the intention behind it. This is obviously a test, to see if I’m really on his side, part of the crew, one of the gang.
I return his gaze a moment whilst I think.
He’s a depressed, embittered old man in a great deal of pain. I’m not going to pretend that I think it’s okay, but I don’t think it’s going to achieve much if I confront him. In the end I settle for a miserable compromise.
‘You can’t say that,’ I tell him.
‘Oh! Here we go! The thought police. In my own home, too. What’s the world coming to?’
‘It’s just – not a nice thing to say, Godfrey. People are people. You should know that by now.’
‘You and me are gonna fall out, mate.’
‘I don’t care, if you say things like that.’
Ian comes back in the room.
‘What’s happened?’ he says.
‘I said a bad thing,’ says Godfrey. ‘Apparently.’
Ian winces and shakes his head.
‘Once again – I can only apologise for my father.’
‘That’s okay,’ I say, automatically. ‘Don’t worry about it.’
But the way Ian takes his seat again, quietly, with an exhausted hang of the shoulders, I can tell he does.