Tuesday, September 04, 2007


It is a lovely long blast out along the coast road. The sea is out, flat, crab-boated and crystalline, and the mysterious foreshore of pools and boulders lie baking in the bright sunshine. K. is driving; I’m lounging back in the attendant’s seat as our sirens peg out our progress above these scuttling patterns of traffic and our blue lights sparkle in a hundred rear view mirrors. It’s a beautiful morning, and this is a great job.
We pull up outside the flats. The call is to a fall at home, so I jump out and grab my magic red bag out of the back.
At the main door I ring the flat number, as there is reportedly a carer on scene. She crackles onto the intercom and buzzes the entrance, but for some reason the door will not open. Just as I’m about to push the button again, a woman in a white uniform trudges up the steps behind me toting a face of disapproval.
‘You pushed it too soon,’ she says.
‘Oh. Okay. Have you got a key?’
‘No. Why would I have a key?’
‘If you push it before they buzz, it ruins the mechanism.’
‘Shall I buzz again, then?’
‘You can try,’ she says, then looks behind at her and shrugs to some imaginary, incredulous audience.
I push the button again, the door clicks and I open it.
‘You were lucky,’ she sighs, and pushes ahead of us.
‘It’s flat 19 we want,’ I say to her back.
‘Third floor. And the lift’s out.’
‘Thankyou’, I say, and then exchange a look with K. We make our way up to the third floor and find number 19. The door is open. The carer is standing waiting for us, a spherical woman clutching a sheaf of papers and swinging a big bunch of keys.
‘Had trouble getting in?’ she says brightly.
‘It wasn’t too bad. Now – where’s the patient.’
The woman nods around the corner, then retreats into the kitchen for some reason. I walk around the corner and see a white-haired old lady in a nightdress lying on her back on the floor beside her bed. There are ornaments and cosmetics jars all around her, looking as if she cleared the dressing table when she tried to stop herself falling. At first I think she has covered herself in some kind of mud pack, and then realise that this is actually faeces. She has been on the floor for some time, and in her confused state has smeared it over her face, in her hair – everywhere you might touch with your hands over the course of a few incoherent hours. The smell is overpowering, and I realise that I have been standing doing nothing for a minute whilst I took in the scene and wondered how we were going to proceed.
‘Hello, it’s the ambulance,’ I begin, bravely. ‘My name’s Spence, and this is Rae. What’s your name?’
‘Hello, Spence,' she says. ‘I’m Helen. I wonder if you could help me. I seemed to have got a bit stuck.’
I clear a space around her, and check her over to make sure she hasn’t hurt herself in the fall. Then with Rae we help her up and sit her down on the bed, grabbing pillows and her duvet to prop her up and make her comfortable. Rae goes into the kitchen to fetch a basin of warm, soapy water, a flannel and a dishwashing brush, and then we set to a brisk cleaning of her hands and face, at least. The carer hovers uncertainly in the background.
It seems that Helen has been perfectly mobile and self-contained until today. At ninety-three, she still looks after herself in this flat, and only has a carer in a couple of times a week to help with hoovering and the occasional shopping trip.
As I rub away the unspeakable mess from her face, she tells me that she has a flannel wash every morning. In fact, she repeats this several times, further evidence of a confusion that seems with her high temperature to point to a urinary tract infection.
When I tell Helen that I think a trip to the hospital is needed, she is indignant.
‘I have never been to hospital in my life. Not once. Not for either of my children, nor anything else. And I certainly do not intend to start now.’
She looks up at a portrait of a formidable woman in a big straw hat.
‘What would mummy say?’
I finish wiping her face and sit back on my heels like an artist.
‘I think mummy would want you to get help when you needed it.’
It’s a measure of the depth of her confusion that she cannot recognise the extremity of her situation, and twenty minutes of patient repetition to persuade her that a hospital trip would be a good idea fail utterly. Even a phone call with her son does nothing to change her mind. Eventually, Rae says:
‘If you can stand up and take a few steps we’ll leave you in peace. But if you can’t stand up, how on earth are you going to cope?’
Incredibly, Helen seems to recognise the logic in this, and tries to stand up from the bed. Each time she slumps giddily backwards, but each time she says: ‘No! No! I can do this! I will do this! I am not going to hospital!'
She gives up after the sixth attempt, and sits looking utterely dejected.
‘Come on, Helen,’ I say, handing the bowl of filthy water to the carer. ‘Let’s get you to hospital. You’re son can meet you up there. It’s not so bad.’
She looks up at the portrait on the wall, smooths her filthy nightdress across her knees and straightens slightly.
‘I suppose we’d better go, then,’ she says with a sniff.
We put her into our chair and carry her out to the lift which turns out to be working after all.

The day seems fresher than ever.

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