‘If it’s gross, I’m not going anywhere near it.’
‘How bad can it be?’
‘I’m just saying. I had a tough night last night and I’m still feeling a bit delicate. I know what you’re like. You’ll want to throw whatever it is wide open and dive in up to your elbows. But I’m just giving you fair warning, Spence. I’m not in the mood for any Sweeny Todd.’
To be fair, Frank does look pale. If I showed him a mirror, he’d probably hurl. But at least he’s driving and gets to sit in the front. If it does turn out to be noisome, he’ll be fine in the cab with the radio on and the window open.
And the weather must surely help. It’s been freezing for the past week; when we turn on to the estate, everything is fixed beneath drapes of snow and ice.
A man dressed like a superannuated lumberjack waving stiffly from the far corner.
‘Just through here,’ he says. He shows us in to a low and boxy flat, the light of the snow caught in the metal frames of its windows. There is a penetrating, crystalline tang to the air, so cold I would expect anyone living here to be swaddled in furs.
Our patient is in the bedroom, up to her neck in a duvet.
‘What do you want?’ she says. ‘I’m not going anywhere.’
‘I understand the doctor’s been out?’ I say, nodding and smiling, rubbing my hands like a vicar at a jumble sale. ‘Has he left anything? A letter, or...?’
Her husband snorts and shuffles round to the other side of the bed. ‘Here,’ he says, handing me a print-out of information with some scrawled notes on the back. ‘I couldn’t make head nor tail. But he wants her in, and she doesn’t want to go.’
‘Thanks. We haven’t been told much, but there was something about a fall...?’
The husband folds his hands in front of him.
‘She went over a couple of days ago going from the bed to the commode and scraped her leg on the frame. I wanted to call the ambulance but she wouldn’t hear of it. She’s scared of hospitals, you see.’
‘Me too,’ I say. No-one reacts. I glance back at Frank. He is frowning at me, willing me not to pull back the duvet.
‘Hospitals,’ she says. ‘I won’t go.’
‘So it happened two days ago. But you’ve only just got the doctor in?’
‘I knew what he’d say. And I don’t want to go to hospital. You can treat me here or not at all.’
‘We won’t ask you to do anything you don’t want to do,’ I say, glancing down. ‘But let’s take it one step at a time. Tell me again what happened.’
‘I don’t know. I got up to go to the loo, lost my balance, caught my leg. It’s nothing. I don’t know why they’re all wasting your time like this. I’m not going to hospital. They’ve got those killer germs and bugs. I’ll never make it home again.’
She has the most incredible mouth. It swings open and shut like one of those curve-topped kitchen bins, two blackened tooth stumps at either corner.
‘Is it giving you much pain now?’
‘And how’s your health normally? Suffer with anything?’
‘I’m not getting up, if that’s what you mean.’
Her husband leans in.
‘Joyce has – social problems. She doesn’t get out of the flat all that much.’
‘Anything else? Osteoporosis? Heart problems? What kind of pills do you take, Joyce?’
‘He’ll tell you.’
‘It’s all on the sheet.
‘I’m not going anywhere.’
I take hold of the duvet.
‘There’s nothing for it,’ I say. ‘Would you mind if I had a look at your leg?’
‘Let’s see what’s been going on. Are you decent under there?’
Frank moves back a foot.
I gently pull back the cover.
Her leg is crudely wrapped in inco pads, taped with brown parcel tape.
‘Who put this on?’
The husband nods. ‘She wouldn’t let me do anything else. I wanted to, but she wouldn’t have it.’
‘There’s nothing wrong with me,’ she says. ‘I wish you’d all just clear off.’
‘Has it been changed since?’
‘No. I didn’t want to disturb it,’ he says, shifting uncomfortably.
‘Let’s have a look. See what we’re dealing with. You don’t mind, do you? At least we can get something a bit cleaner on it.’
I flip open my bag and pull out a pair of shears.
‘Here we go.’
I snip through the layers, and then open a sachet of saline to soak the last layer free. I peel it back and reveal the wound, a devastating injury to the skin and muscle of the lower leg, a laying open to the bone, with pale globules of adipose tissue nestling amongst the darker meat, the whole thing as horrific as if a shark had swum up on her beneath the duvet and taken a bite.
‘That’s quite a - significant wound,’ I say, underplaying the shock of it, exploring the extent of it, irrigating as I go. Frank has overcome his queasiness and moves in with some fresh dressings. ‘No wonder the doctor wants you in.’
‘I’m not going anywhere,’ she says, then grimaces and bares her stumpy teeth again.
I straighten up despite myself.
The husband taps me on the shoulder.
‘Good luck,’ he says.