Geoff is sitting on the edge of the sofa, his legs pressed together and a pillow clutched to his middle. What light there is spilling in through the sitting room window is absorbed by the pallor of his face, flat as cream.
Alan, his partner, stands over by the mantelpiece and folds his arms.
I go over to Geoff and squat down beside him.
‘What’s happened, then?’
‘I was sick,’ he whispers. ‘I threw up blood.’
‘He threw up loads of blood. Three times. I’m so worried,’ says Alan, unfolding his arms, then straightaway folding them again.
‘Have you been feeling unwell through the day?’ I ask Geoff, feeling his pulse. Regular, sufficient.
‘No. I was fine.’
‘Did you get any warning you were going to be sick?’
‘Some. We’d eaten, I felt a bit dizzy, and when I came in here to lie down on the sofa I had to rush into the bathroom.’
‘Have you flushed the toilet since?’
‘I left it in case you wanted to look.’
I leave Geoff sitting there and follow Alan into the bathroom.
It’s a startling effect: the bathroom brightly lit, scrubbed and neat, a linear pattern of clean grouting, bleached white shower curtains, chrome towel rails, cute trinkets and mirrors – and then a splattered brown and red mess around the rim of the toilet. Inside, the bowl is full and dark.
‘And Geoff has thrown up like this three times?’
‘Yes. God – what do you think it is?’
We go back into the sitting room.
‘Do you have any pain at the moment?’ I ask him, putting on a SATS probe.
‘Any other strange feelings anywhere?’
‘No. A bit dizzy still, that’s it.’
‘What medical problems do you have?’
‘Any family history of anything? Stomach ulcers, digestive problems? Anything like that?’
‘Any recent operations?’
‘No. Except for some root canal treatment. But that was two years ago.’
‘And your health has been okay recently?’
‘Let’s have a feel of your tummy.’
He lies back and pulls up his t-shirt. Everything looks okay.
‘Tell me if anything hurts.’
The only time he winces is when I press to the right of his abdomen, about where his liver is.
‘Eating and drinking okay?’
‘What about alcohol? How much would you say you got through a week?’
‘Nothing much. Hardly anything.’
‘Bowel movements all right?’
‘And nothing out of the ordinary in any other respect?’
‘No. What’s wrong? What’s the matter with me?’
‘I don’t know, Geoff. It looks like you’ve had a significant bleed either from your stomach or high up in your digestive system, but I don’t know why. It’s a trip to hospital, I’m afraid.’
He starts to cry.
‘Why didn’t I listen? Why?’
‘What do you mean?’
‘You have to tell them everything, Geoff. They have to know.’
‘It’s so embarrassing,’ he sobs. ‘I can’t bear it.’
‘What? What’s been happening?’
Alan sits down with him on the sofa and takes his hand.
‘He’s been using pain killers. Nurofen Plus.’
‘Okay. How many?’
Alan hands him a tissue. Geoff blows his nose, collects himself, then stares down at his hands as they gently tear the tissue into pieces.
‘Thirty, thirty two,’ he whispers.
‘I knew it was bad but I just couldn’t help myself.’
‘For how long?’
‘Since the tooth operation.’
‘About that.’ He looks up. ‘I’ve done some damage, haven’t I? I knew I would but I couldn’t stop myself. What’s going to happen to me?’
‘First things first,’ I say. ‘Let’s get some shoes on, keys, phone, wallet. Let’s get you up the hospital where we can start to get you better.’
Alan gets the stuff together whilst Geoff sits quietly.
‘It’s so embarrassing,’ he says.
‘It’s an addiction, that’s all. It’s been a problem for a while, but today’s the day you start to do something about it.’
‘I’ve taken so many, though.’
‘You have. But it’s surprising how many people are in the same boat. One step at a time, though. Let’s get you to a doctor and see what they have to say. There’s lots to be done.’
He rolls the shredded tissue into a ball and tosses it into a bin.
Alan comes over with his slippers.