Tuesday, October 13, 2009

abdication

The screen suddenly changes and starts yelping with a series of triplet barks, like a crazed robotic poodle chasing its tail. The new system works well, but there must surely have been better sounds to choose from. I wish – for the eighth consecutive time this shift – we could change it for some bongos, maybe a fog horn.
Rae taps the screen to acknowledge the job.
‘What is it?’
‘Cat C fall.’
‘Where?’
‘Don’t know. Sounds familiar, but they all do. I’m sure we’ve been here though. Recently. Oh! OK. It’s Dolly.’
The Queen of the Wallop is down again. This is getting beyond a joke. We were only out to her last week.
‘Something has definitely got to change,’ I say, nodding to thank a car for letting us out, hauling away with all the enthusiasm of a donkey back in harness at the water wheel.

Outside Dolly’s bungalow, the carer is standing guard with her arms folded.
‘She’s stuck in the chair. The neighbour’s here with me but we can’t get her up just the two of us.’ She seems defensive, but no-one could take issue with the call. The BFG couldn’t get Dolly up without some help.
She turns to lead us into the bungalow.
‘Is she pretty much her normal self?’
‘I don’t think so. I think her mobility’s worse, if that’s possible.’
‘Will she need to go in, do you think?’
‘Probably.’
She stands aside to let us go first, shouting ahead:
‘It’s the ambulance, Dolly!’
There is a disgruntled kind of mumbling from the sitting room.
‘Well, hello Dolly,’ I say, pushing open the sitting room door, and only catching the connection with the big musical number after I’ve said it. I blush with embarrassment.
‘Very funny,’ she says. ‘Very droll, mate.’

Dolly studies me from where she sits packed into an old upright chair in the middle of the sitting room. She is a strangely abstracted figure, simmering like a volcano dressed in a filthy housecoat. The next door neighbour – a spindly young woman with lank hair and the kind of anaemically confidential manner you might find leaning upwards in the dark – unfolds her arms sufficiently to give us a little wave, then tucks back in to her vigil.

Dolly is slowly becoming that chair. She has been sitting in it for so long the essence of its shiny fabric has crossed the barrier of her skin, the outlines of its flowers visible beneath the bruises, dimples and folds of her arms and legs; the cushion stuffing has insinuated its plastic mycelia out through the ticking and in through her pores. She is now more cushion than person. I imagine her eyes will be the last to go – two small grey sofa buttons, permanently fixed on the TV.
‘How are you, Dolly?’
‘Fantabulosa, darling. What do you think?’
‘How can we help today?’
Dolly looks at the carer.
‘This hay bag says I can’t go to the toilet.’
‘I did not say that, Dolly! I gave you your frame and I tried to get you up but you said you couldn’t do it.’
‘Get me up? I can’t see you getting anything up, love.’
‘Charming.’
‘Look – Dolly – we’re all here to help,’ I say, putting my bag down and going across to her. ‘Everyone’s got your best interests at heart. So try not to say hurtful things.’
‘Who’s saying hurtful things? I just said she couldn’t get me up, that’s all. Where’re my fags?’
‘You can’t smoke with us all here, Dolly.’
‘Why not? It’s my house.’
‘Yeah, but it’s our lungs. And we’ll stink of fags the rest of the day if you spark up. Just wait til we’ve decided what’s going to happen.’
‘What do you mean? All I need’s a hand up so I can go to the carsey. Unless you want me to cack my strides.’

The neighbour speaks up: ‘She’s not herself.’
‘In what way?’
‘Well I’ve never seen her this bad before.’
Dolly frowns and leans forwards about half an inch. ‘What’s she saying?’
‘I’m saying you should go with these nice people to the hospital,’ the neighbour shouts, her voice taking on an unexpected metallic stridency. Everyone winces.
‘I’m not mutton, you know.’
‘Yes you are,’ she shouts, then resumes her position.
‘Dolly. First of all we’ll give you a hand up…’
‘Bingo!’
‘And after that we’ll have a think what to do next.’
‘Oh we will, will we?’
‘Yes.’
‘Well you can think all you like mate. I’m not going to no hospital. I’ve had three friends carted off there and not one of them ever came back.’
‘Come on. Give me your hand.’
‘Not one of them! You’ll not get me there.’
‘We’ll talk about it in a minute.’

We set to the business of getting Dolly out of the chair, levering bits of chair out of the way, manoeuvring her feet into position, negotiating angles for her massive arms, our extemporary gang working together beneath the insults and curses of a tyrannical boss who would definitely use a whip if she had one, and the wherewithal to snap it.

Raising the Mary Rose would have been easier. Admittedly they had tides to contend with, but at least the Solent was fresh, and they could use a barge with a crane.

Eventually we have Dolly on her feet. With the carer and the neighbour either side, she stomps off to the toilet. I’m left with Rae in the sitting room, surrounded by the detritus of Dolly’s chair-bound vigil – great tumbleweeds of garbage, crumpled Pringles tubes, crisp bags and fag packets, balled up tissues and other, less readily identifiable matter.
‘This can’t go on. We need to get her in and assessed.’
‘It’s going to take a bariatric truck.’
‘I wonder how long that’ll take?’

But suddenly we’re hurrying back along the hall. Dolly is shouting in the bathroom, carrying on with all the puff and spit of a mad Berwick Street trader. I expect to see rotten oranges come flying out, knocking pictures off the walls. The neighbour seems to be trying to blend in with the shower curtains whilst the carer backs slowly out, feeling behind her, keeping her eye on the tiger the whole time.
‘What's the matter now?’
Dolly is sitting on the toilet, frowning under a dangerous head of pressure.
I will not be going to no crapping bone yard’ she yells.
‘Fine. But in that case we’ll arrange for the doctor to come out today, and I can tell you exactly what they’ll say. You’re only postponing the inevitable.’
‘I’ll do more than that, sunshine,’ she says, huffing like a boiler, making as if to get up, but then, finding she has no way of moving without our help, subsiding again. ‘I’ll do more than that.’ She breathes heavily, flicking a look from one to the other of us.
‘Get me back to the chair,’ she says. But her words suddenly seem as thin and hopeless as trailed smoke. The neighbour steps forward, sensing the change. Dolly sinks inwards a little. The carer comes back in and folds her arms. Dolly relaxes her grip on the white steel rails that corral the toilet.

‘Can I take my wheelchair?’ she says.

Rae calls for the truck.

8 comments:

lulu's missives said...

Hi Spence,
It's so sad watching someone else have that painful reality moment, when they no there is no other choice.
Poor Dolly.
x jo

Wren said...

Poor Dolly. Poor carer. Poor neighbor. Poor Rae and poor you. I have to wonder how Dolly ended up the way she is, morbidly obese, mean and combative on top of it. I've a morbidly obese friend, now bedbound, unable to walk, and with a myriad of serious illnesses related directly to her weight. She's endured unspeakable rudeness and stunning meanness from strangers, in public, regarding her weight over the years, yet she remains good natured. She was raped twice as a young woman. I don't know if that's the reason that she ate until she lost herself (perhaps she doesn't know either), but I do wonder. At any rate, what a horrible situation Dolly's is. She must be mortified.

Spence Kennedy said...

Jo - It was difficult for her, but she couldn't have carried on with things as they were.

It's an ambivalent situation for us: on the one hand feeling okay about the need to do the right thing, but on the other, feeling bad about precipitating such a stressful change of circumstance.

It'll be interesting to see just how Dolly's living situation does change in the future. Sometimes things don't always go as you think they will!

Wren - Eating until you lose yourself - that's such an apt description. I bet Dolly was a force of nature when she was younger (and lighter).

She's only in her mid-seventies now, and should really be enjoying an active life. As it is, she's completely house and chair bound, with a poor quality of life.

We're in a difficult position with patients like Dolly. Whilst we'd want them to live the kind of life they choose, it's frustrating to be called on to pick up the tab, often at some risk to our own health. In Dolly's case, the bungalow is so cluttered there's precious little room for our inflatable mattress, let alone the hoists and specialist beds and chairs that would make handling a large patient like her ergonomically viable. So in many ways these tough interventions are as much about looking after the carers as the patient.

A significant problem is that Dolly will not recognise the dangers she is exposing us all to, the people she relies on every day to support her lifestyle .

A tough problem for anyone, to balance personal freedom with a wider social responsibility.

I hope your friend is getting all the help she needs.

Thanks for the comments! :) xx

lulu's missives said...

Hey S,
I bet there will be a social worker involved in resettling Dolly.
x

Spence Kennedy said...

Let's hope so! I expect they'll be a long queue outside her bungalow, everyone from the local GP through social services, the falls team, district nurses and CPNs ending up with Virgil from Thunderbird 2.

BTW - any luck with the first aid course at work? x

uphilldowndale said...

'Eating until you lose yourself'
My friend starved herself until she became invisible, flip sides of the same coin. Tragically,that need won over the will to live.

Camilla Winlo said...

Have you read The Third Policeman by Flann O'Brien? It also has the idea that if you spend enough time in proximity to something, you will exchange atoms and become each other (in that case, the policeman and his bicycle).

I think you should feel really proud of yourselves for being the catalyst. The idea of change seems to become increasingly stressful with age and infirmity and people do seem to be prepared to put up with living conditions that younger, more mobile people couldn't contemplate. As you say, that puts pressure on their support networks.

Dolly might not like the idea now but hopefully she'll find herself somewhere much more congenial and thank you in time. Who knows - it might even improve her mood!

Spence Kennedy said...

Hi UHDD - Eating is such a primal activity, it'll always be a profound marker of someone's state of mind and health.

I'm so sorry to hear about your friend. I just wish that the support of family, friends and health care agencies would always be enough to prevent deaths through eating disorders, but I suppose individual circumstances will sometimes overcome everyone's best efforts. x

Hi Camillo - Funnily enough I was thinking about Flann O'Brien just the other day. Apparently they're doing a film version of At Swim Two Birds with Colin Farrell and Cilian Murphy. (BTW - In Bruges is worth a look. CF is great in that).

I do love that idea of a blurring at the margins, a process of change thru' osmosis or something. At an atomic level, everything starts losing its definition, anything seems possible. I bet there's an office at CERN - swipe cards and security guards - and sitting in a swivel chair examining the screens and pushing buttons ... Merlin!

I do hope Dolly gets help to establish a much better living situation. A clearer flat, a specialised chair & bed, some rails along the wall ... there's lots to be done. I think she had frozen into an idea of going into hospital and not coming out!

:) x