Betty was sitting so upright and still in the chair it looked as if she was a shop display, immaculately dressed and pressed in a white blouse and tartan skirt, her hands neatly folded on her lap. Only the eyes gave away that she was real, dilute and watchful behind the great round lenses of her spectacles.
I knelt down next to her. 'So what's happened, Betty? What's wrong?' Barely moving her head she said: 'Well, you'd best ask my daughter that. I'm not sure myself. All I know is I had more trouble than usual with my legs when I woke up this morning.' Those enormous eyes turned down to look at me. 'I'm ninety four you know. Worked all my life.' The essentials.
Her daughter, an old woman herself, rubbing her hands with the worry of it all, told me the rest. Normally quite mobile - can manage by herself but I call in every day and the carers come in morning and night - takes water tablets for her legs - badly swollen today - couldn't get out of bed on her own - due a health check next Monday but GP said to call for an ambulance today. Hope that was okay.
The care centre manager, who had been standing in the hallway, swinging a bunch of keys, chipped in.
'Betty wears an emergency call button round her neck but she'd lay on the floor all week and never use it. She's an amazing woman - aren't you Betty? - so independent. Strong-willed. Only does what she wants to do - isn't that right, B?'
'That's right, dear.' She looked down at me, sadly. 'They're all such good people.'
My crewmate Helen and I reassured them that it was fine and that we'd certainly take Betty to A&E if that's what she wanted. It was probably the best thing to do. The doctors could run lots of tests and find out what was happening. Betty squeezed my hand. 'It is what I want, dear. I'm not myself. I'm normally pretty good. I don't like to make a fuss.'
We took a few basic observations, all of which seemed normal for her age, and reassured ourselves that she hadn't suffered a stroke. The daughter loomed over us. 'Okay, Betty,' I said brightly, let's get you down the hospital and sort things out.'
The daughter took me by the elbow. 'We - erm - didn't make it to the commode just now. I don't want to let her go down the hospital all wet like this. Could we change her before we go? Have we time?'
So as not to embarrass Betty, Helen helped the daughter get her ready whilst I filled in the paperwork with the care centre manager, who had all her details. Finally, we lifted Betty onto our carry chair and wheeled her out to the vehicle. 'Mind you don't hurt yourself,' she said, a number of times, as we negotiated lift doors and stairways. She waved like the Queen Mother to the other residents who'd come out to watch.
'You're no weight at all', I said, 'You must eat more.'
'You don't eat,' she said, feebly, 'not when you're ninety-four.'
'Definitely not herself,' the daughter said, then gave her a kiss before we loaded her up into the vehicle and made her comfortable on the trolley. 'I'll see you down there a bit later,' she said, then gave us all one last anxious smile as we closed the doors.
During the journey I tried to chat to Betty, but she seemed locked into position again, her enormous watery eyes fixed straight ahead. I let her rest.
At A&E I described the case to the sister in charge, who came over to introduce herself to Betty. I stood at the foot end of the trolley, with Helen up at the top.
'What's happened today?' she said. A thrill of attention seemed to energise Betty. She pushed her glasses firmly back on to her nose and looked around.
'Well. I don't know why I'm here, that's for sure.'
The sister glanced at my name badge. 'Spence says you had trouble with your legs this morning.'
'No. No more than usual.'
The Sister, Helen and Betty all looked at me. Alarmed, I touched Betty's foot and gave her toe an encouraging wiggle. 'Don't you remember, Betty? You couldn't get out of bed? Your daughter said you were quite bad this morning?'
Betty frowned at me disapprovingly. 'Did she? Well I wasn't. I feel fine. What's all the fuss about? There's nothing wrong with me.'
The Sister pulled back the blanket and looked at Betty's puffy legs. She did some strength tests, asking Betty to raise each leg in turn, to flex the ankle, to push against her hand - all of which Betty did perfectly well.
'Okay Betty,' said the Sister. 'Let's have you in cubicle three.'
'I don't like to make a fuss,' Betty said, and then, giving Helen's hand a squeeze and nodding in my direction added: 'Is he always like this?'