Wednesday, June 15, 2011


A wash of aquamarine draws up across the dark margin of houses and trees. There is a stunned clarity to the air - birds are beginning to sing themselves back into the world, and the sound is profoundly refreshing after the long night shift.

I ride in Frank’s wake to the front door and watch as he buzzes the intercom. After a moment the catch releases and we step into the lobby of a retirement block so perfectly squared away we could be stepping into an architect’s three dimensional plan. The lift runs us up smoothly to the third floor, the door hushes aside and we find ourselves in a hallway the exact copy of the one downstairs. If it wasn’t for the fact that an aspidistra had been switched for an umbrella plant, there’d be no proof we’d moved at all – that, and the higher numbers on the doors. As we follow them to the right, we meet a middle aged woman standing in the middle of the carpet. I feel like a sleepy mouse who turned a corner and met a Kite. She makes a smile, then tears through the facts.

‘Before we go in let me tell you about my father,’ she says. ‘It’s tricky.’
‘I got a call to come down yesterday around supper time. The cleaner found my father on the floor, confused and complaining of some vague pains here and there. My sister’s away so I came over – miles, actually – and whilst I was on my way the cleaner called you people, the first crew. They did a marvellous job because I have to warn you, he’s not the easiest of customers. They checked him over, couldn’t find any injuries from the fall, but his legs are very swollen and he’s not in terribly good shape. They got him back on his feet and sat him in the lounge – which took an hour. I got here soon after. Normally Daddy’s as sharp as anything but there’s something not right. I’ve been abroad and I haven’t seen him these past few months and I have to say he doesn’t look good. The thing is, he can’t get up on his own, can’t do the basics, but he’s refusing to go to hospital. The other crew were here for a couple of hours trying to persuade him. We tried everything. Reason, bullying, begging – everything, but nothing worked. He’s stubborn and he flatly refused to go. So your colleagues arranged for the out of hours doctor to visit, and they left. The doctor’s in there now, and it looks like he’s finally persuaded Daddy to go with you. And that’s the story so far. Except to say you’ll have to forgive him if he seems a little – abrupt. He’s got it into his head that the first crew manhandled him. So I’m sorry if he causes offence. Just please try not to rise to it. It’s taken such a huge effort to get him this far.’
‘Of course. Shall we go in and say hello?’
She shows us into the flat.

Mr Williams is sitting in the middle of a neat yellow sofa with a stick planted firmly between his legs, both hands draped magnificently over the bone handle. He is a wild and withered version of his daughter, the same raptor profile, his oiled grey hair quivering from the tension of keeping his body erect. He smacks his lips together and raps the cane on the floor like a tetchy magician trying to turn us all into birds.
‘Who are you?’
The out of hours doctor, a plump and friendly man we’ve met many times before, makes the introduction.
‘This is your transport, sir. Your transport has arrived.’
‘Transport? Transport where?’
‘To the hospital. Do you remember? We talked about it.’
‘I’m not going to the hospital. It’s far too late. I’ll make my way there on my own next week, when it’s more convenient.’
‘We discussed all this, Mr Williams. Do you remember? I’m not at all happy with your condition.’
‘My condition?’
‘Your blood pressure is very low. Your legs are swollen. You’re so weak you can’t get yourself up off the sofa to get to the bathroom or take care of yourself. You need someone to look after you.’
‘I am perfectly able to take care of myself. I just need a little time. So will you please stop all this nonsense, leave me alone and let me get to bed. Who are all these people?’
‘The ambulance, Mr Williams. They’ve kindly come over to take you to hospital. Look. They’ve even brought a special chair.’
Mr Williams shakes his head.
‘No. It’s completely unacceptable. The last lot picked me up and threw me across the table. I couldn’t believe it. Threw me – across the table. I shall be making a formal complaint.’
His daughter folds her arms.
‘But Daddy they didn’t.’
‘They did. You weren’t here.’
‘I was right here. You’re seeing things.’
But she sits down on the corner of a table in the hallway, and seems less certain.
‘I’m not crazy,’ he says. ‘I’m in full control of my faculties.’
He glances at me.
‘You. Give me the alphabet – backwards.’
‘It’s way too early in the morning, Mr Williams.’
‘Would you like me to recite it for you?’
And he does, closing his eyes and racing through the letters.
...E,D,C,B,A. There. As I explained. I am in complete control of my mind, and as such insist that you leave me be.’
His daughter unfolds her arms and makes a desperate gesture with her arms: Scoop him up! Put him in the chair! But the doctor picks up his briefcase instead.
‘Mr Williams. I’ve made my position clear. You need urgent treatment at the hospital and it’s not a rational decision to refuse it. My next step is to get a mental health team out to assess your capability with a view to taking you, regardless. I’m very sorry it’s come to this, but we’ve tried everything else.’
‘What are you saying?’
‘We’re going to leave you now, but the team will be in touch within the next couple of hours.’
The daughter stands behind the sofa and puts her hands onto the backrest for support.
‘You mean you’re not taking Daddy now?’ She seems brittle, ready to fly into pieces. ‘You’re leaving him here?
Who is?’ says Mr Williams.


jacksofbuxton said...

It must get awkward for you and Frank being stuck in the middle of these sorts of conversation.

Don't know if I like the idea of just scooping him up and putting him in the chair.Isn't that kidnapping?

Spence said...

It does get awkward - particularly in the early hours when it's difficult just to stay vertical, let alone have a rational conversation.

And yes - that would be kidnapping! I think the daughter didn't really understand that you can't bundle someone off to hospital if they don't want to go - that it takes a certain amount of legal process. Still, I don't think she'd had an easy night of it...

Cheers for the comment, JoB. (BTW - you'd laugh - we're having the village summer show in a few weeks and I've been roped in to sing in a barbershop quartet :/ )

Lynda Halliger-Otvos said...

My parents are aging and the man in this story sounds eerily like them arguing for staying put. Makes it tough on caregivers.

Conundrum said...

I worked on the ambulances for a couple of years so I've seen this kind of thing for myself. On the para course they went into great detail on the subject of 'consent' and the dire consequences of kidnapping patients.

Also, my sister is an approved social worker so she also has experience of carting off unwilling patients. As always its the relatives who get the most stressed out when we couldn't persuade people to come to the hospital, on one memorable occasion I got threatened with a golf club when I failed to take an obviously ill patient. But short of dragging him off by the hair or administering a chemical mallet there was no way he was coming.

I think I'm better off as an IT Geek, saving people on the mean streets is much harder on the stress levels.

Keep up the posts on your blog, always a good read.

Spence said...

Lynda - Tough on everybody, but particularly the carers. You want to do what's best - and sensible, given the facts - but you don't want to force someone into anything that will cause them distress. Awful dilemma - repeated endlessly!

Hope everything's good with you & yours, L.

Conundrum - Consent is a difficult area, no question. It's absolutely dreadful when you have to cart someone off against their will. You try every trick in the book to avoid that awful moment (and luckily, it rarely comes down to the men with the big net). I think it's true that often the relatives don't understand the subtleties of the consent issue. Often they do expect you to put them in the chair and go - and get spiky when you don't.

Love the chemical mallet image. Maybe I could make my own - find a highly coloured toad in our pond and make a blowpipe. I'm sure no-one would mind.

IT Geek sounds good. BTW - I'm having this problem... laptop a bit slow/virus/crashing/blah.... (I wonder how many times you hear that!)

Thanks for the comments!

jacksofbuxton said...

Stripy jackets and jolly smiling faces,with huge handlebar 'tache by any chance.

Luckily I've not been roped in to do any ambulance driving of late....

Spence said...

I'll have to see if the fancy dress place has a h'bar moustache. If not I'll just have to improvise with a draught excluder or something.