normal on critical

The house has no number, just a name in big white letters above the electric gates that’s either a composite of the people who live there or a tribute to a Klingon commander. I want to ask Ella where it comes from, but she’s so stressed there’s no opportunity. She’s waiting for me outside, still in her slippers, arms folded, glancing up and down the street whilst I lock up the car.
‘Hi Ella. I’m Jim, from the hospital,’ I say walking over.
‘I gathered that.’
‘Are you okay?’
‘No. Not really. Mum’s going downhill and no-one seems to care. Not the doctor, the hospital, no-one. She came to stay with us a couple of weeks ago for respite, and ever since then she’s been wasting away. She’s not eating, she’s not drinking. Crying out with pain all hours of the day and night. Honestly, Jim, I’m at the end of my tether. I just don’t know what to do anymore. I just can’t cope.’
‘I’m sorry to hear that.’
‘She had an appointment at the Elderly Patient Clinic tomorrow but she’s just too unwell. I mean – how was I supposed to get her there?’
‘Well – there’s patient transport. They have a tail-lift on the back of the vehicle. They can take her in a wheelchair.’
‘Can they? No-one told me that. I’d better go and see if they’ll reinstate the appointment…’
She turns and hurries inside, and I follow.
‘Mum’s through there,’ she says. ‘Go and introduce yourself whilst I call the hospital.’

It’s a large, comfortable family house, racks of shoes in the hallway, richly patterned rugs on the floor. Ella’s mum Deidre has her own room, off to the left at the end of the hall. She’s lying in an electric bed with the back raised, propped up on half a dozen pillows and cushions, a warm zebra-striped fleece thrown over the rumpled sheets. When I shake her hand she squeezes it warmly and then resumes her original position, something like wistful forbearance, staring out of the french windows into the garden.
I start by explaining who I am, what my job is and why I’ve been asked to come. She nods, and twiddles her fingers, as if yes, this was exactly as she’d been expecting. I work through my usual questions to see how she is, and to clarify the problem; she answers as if there’s nothing the matter at all, or at least, nothing beyond what you’d expect of a woman of her age. She’s even a little bewildered to hear that people are worried about her.
I check her observations. Everything’s normal, unremarkable. I ask her about her eating and drinking, her bowel habits and so on. Again, she seems fine. She looks fine, too, a healthy colour to her cheeks, decent weight and so on. It’s difficult to see the dangerously ill patient that Ella described, even allowing for the possibility that Deidre is confused about everything. And she certainly doesn’t seem confused.
Ella comes back into the room.
‘They never answer the phone,’ she says. ‘So I left a few messages.’
‘A few?’
‘I kept thinking of other things I wanted to say. How is she?’
‘Well – she seems fine, actually. Sorry to talk about you like this, Deidre.’
‘That’s okay,’ she says, staring out of the window.
‘I’m not surprised,’ says Ella. ‘No-one can ever find anything wrong. They always say the same thing. They always say she’s fitter than they are. But they don’t have to live with her. Sorry mum, but it’s true. They don’t see you when you’re crying out in the middle of the night. The doctor’s bloody useless, excuse my French. The last time he saw her – which is a joke for a start, because he may as well have stood outside with a megaphone – the last time, he just upped her citalopram. But it’s not working and we can’t go on like this.’
‘You said Deidre wasn’t eating or drinking.’
‘Hardly anything. She just picks at her food. And I make all her favourites. I have to nag and nag to get her to eat.’
‘What about drinking? Because that’s more important.’
‘Again, nag, nag, nag. And I hate to do it, because she’s my mum, and I don’t want to go on at her like that. But someone’s got to. The carers don’t.’
‘She has carers?’
‘Three times a day. And all they do is put things in front of her, and clear them away again. That’s no good, is it?’
‘So how much would you say she is managing to drink?’
‘Cups of tea, beakers of juice, fortifying drinks. Everything with a straw, though.’
‘So that sounds – quite good, then.’
‘It may sound good to you but it’s not enough, is it? I mean – look at her…’
And I do, and from her throne of pillows and cushions, she looks comfortably back at me, too.

Deidre hasn’t had any bloods for the past two weeks so I run a set, just to be sure. I put them in as urgent. They come back normal. I ring Ella to let her know, and she tells me that – miracle of miracles – the Elderly Patient clinic has managed to reinstate the appointment.
‘Maybe they’ll find something wrong,’ she says. ‘I mean – something has to happen. Otherwise she’ll die and it’ll be too late.’