Thursday, February 07, 2013

us londoners

There’s a flat-pack, showroom feel about this place. A bland painting of Chinese junks in Hong Kong harbour; a blue glass bowl on a table, with blue glass fruit; spot lights, up-lights and a brushed steel standard lamp; a brown leather three-piece arranged around a brown wool rug – the whole thing catalogue-fresh, untouched, unreal.
Eric doesn’t seem real, either. Lying like he is, half on and half off that armchair, his wasted legs supported on a Moorish-leather pouf,  he looks like some wizened old derelict magically transported from a Dickensian poor house. His sallow face is partially hidden by long, greasy grey hair and a wild grey beard; his filthy parka and jeans barely touch the sticks of his emaciated body. Whilst we talk, he absently picks and rubs at his nose with grimy nails.
His son Edgar is kneeling next to him; in the middle of the room stands Eric’s ex-wife, Wendy, a woman whose expression seems as fragile as that bowl of fruit.
I smile and raise a hand up in greeting, and walk over.
‘Hello! Hello! I’m Spence. This is Rae. Can I ask your name?’
The son looks up at me.
‘What do you mean? Don’t you even know who’ve you’ve come to see?’
I imagine a pilot would feel the same sudden lurch of alarm, unexpectedly flying into a pocket of dead air. I straighten up and try not to grab at the controls.
‘Well – yes. They give us the basics, of course, but it’s always nice to start from scratch on scene, so to speak.’
‘So then, Spence. The basics are that my father is extremely unwell. The doctor has been out to visit and arranged for my father to be taken into hospital where a bed is waiting for him on the Medical Assessment Unit. So if you could go and get your trolley that would be great. As you can see he’s in a very delicate state and he needs careful handling.’
The son’s face trembles with the stress of all this.
Eric turns his head so he can see me.
‘Oh – hello!’ he says. ‘Just give me a minute.’
‘There’s no rush,’ I say. ‘Let’s take our time and get this right. Now then – did the doctor leave a letter at all?’
Edgar sighs.
‘No, the doctor did not leave a letter. As I’ve explained to you, the doctor has made arrangements for my father to be admitted to the Medical ... Look. I think it would be best if you just went outside and talked about this with my mother. Okay? You’re upsetting Dad.’
‘Fine. No problem.’
I smile at Wendy; she turns and leads us back outside.

‘What do you want to know? I thought that was all perfectly clear. Doctor Blackthorn spoke with a consultant at the hospital and arranged for my ex-husband to be admitted to the Medical Assessment Unit. Is there a problem?’
‘Well – no. And fingers-crossed that’s exactly what will happen.’
‘What do you mean, fingers-crossed?’
‘It’s just that the hospital has been particularly busy lately, and it may be that because of bed availability and one thing and another, Eric may have to go via A&E.’
‘No. Absolutely not. Doctor Blackthorn assured me Eric would go straight to the unit. He spoke to a consultant, for God’s sake. Was he lying? Why would he say it if it wasn’t true? This is ridiculous.’
‘I know, I know. It’s far from ideal.’
Far from ideal?
‘But I just want to be honest with you so you’re not disappointed when you get there. These days, it’s almost inevitable that you get triaged at A&E first, then moved up when a bed becomes available. I can only give you the facts as they are.’
‘We may as well have taken Eric up by ourselves. At least that way we’d have got the bed.’
‘It wouldn’t have made any difference, I’m afraid.’
‘You know how difficult this has been for us? Do you? Do you have any idea? Eric’s been drinking himself to death for years now. Years. Living in filth. Finally we rent this flat and persuade him to move into it so he can be near to us. He’s utterly phobic about hospitals. He absolutely cannot lie on a trolley in A&E. He won’t do it. He’ll walk out, go off home and die. Is that what you want?’
She looks tearful.
‘Doctor Blackthorn promised us,’ she says. ‘Why don’t I ring him and see what he has to say about all this?’
‘You’re more than welcome to ring him. And maybe I could have a word, too. Rae is ringing the hospital now to get the final word. Who knows? Maybe this time we’ll be going straight to the assessment unit. I certainly hope so. But I’m just being honest with you, Wendy.’
‘You can tell Edgar,’ she says. ‘I don’t know how he’ll take it.’
Rae puts her phone away and comes over to deliver the news.
‘A&E,’ she says. ‘No beds in the unit.’
‘Pathetic!’ says Wendy.
She walks quickly inside.
We hear some furious whispering.
Edgar marches out and stands close up in front of me.
‘What’s happening?’ he says, the muscles in his face twitching. ‘Why aren’t you doing what the doctor ordered?’
‘I know this is stressful for you, Edgar.’
‘Do you?’
‘I can imagine. But like I said to Wendy, I’m only trying to give you the facts. There are no beds available on the assessment unit, so it means Eric will have to spend a bit of time in A&E until one becomes free. It’s disappointing, I know, but it’s just the way it is.’
He takes a step closer, just a head butt from me.
This whole system is a complete joke!’ he shouts. Then he steps away and says quietly: ‘I’m not blaming you, of course.’ And then in a strangely even-handed and vaguely sergeant-majorish kind of way, he repeats the whole thing to Rae.
 ‘This whole system is a complete joke! I’m not blaming you.’
Then he goes back inside.

We can’t fit the trolley into the flat – a fact that doesn’t improve the atmosphere at all – so we bring our carry chair instead. I set it up with a couple of blankets next to Eric’s chair.
‘Okay Edgar...’ I say to him, getting the names wrong.
Edgar is back in my face again.
‘No! I’m Edgar, Remember? The son? He is Eric, the patient. That is Wendy, my mother, you are Spence, she is Rae. You see? It is possible to get it right. Or do you want us to wear name-tags like you?’
I hesitate.
My instinct is to confront him with his behaviour. But with that adrenalized insight these situations sometimes give you, I see the whole scenario played out in an instant: the stress of withdrawal; the explanations on the radio; the replacement crew dispatched; the wait for police back-up; the paperwork... and in the middle of all this warring, Eric, suffering on the armchair, refusing to go in, this last chance for treatment closing off.
I take a breath.
‘Sorry for mixing up your names. It’s been a long day.’
‘Don’t drop him off your chair,’ says Edgar. ‘Look. I’d better do it.’
‘No. What I need you to do is stand over there and let us do our job,’ I say as evenly as I can.
He moves away.
We load Eric onto the chair, get him out to the ambulance.


The whole journey in, Edgar sits on a jockey seat behind the trolley, his arms folded, staring at me. Somehow I manage to ignore him. After all my observations are done and the paperwork completed, I sit forward and chat to Eric instead. It turns out he’s from the same part of London I was born in, just south of the river, off the Vauxhall Bridge Road. It cheers him up to talk about the place, what he did there, what he knows. I don’t tell him that the family moved out of London when I was only two, so all these impressions I have are from much later. I don’t want anything to get in the way of the warm, confederate feel as we go over the old names: John Islip Street, Millbank Gardens, Bessborough Place.
After a while he reaches out a dreadful, nicotined claw, and we shake hands.
‘Lovely,’ he says, placing his other hand over the top to seal the bond. ‘Us Londoners – us Londoners have got to stick together.’


jacksofbuxton said...

I appreciate the stress the family are going through,but you did well not to have words there Spence.

Spence Kennedy said...

I can't for the life of me think how I didn't, Jacks! Normally I would. I must have been having a good day... :/

Sabine said...

That was a not so nice person, eh? But he is right, the whole system is a complete....

In my neck of the woods (Germany) we had the case of a cardiac patient made to spend the night in the hallway on a bed as his place in the room (here, patients are in 2-3 bed rooms) was needed for an emergency and the shit hit the fan in the local and national media.
At the same time, my elderly aunt in Dublin spent 4 days and nights on a stretcher with a fractured thigh before she was allocated a bed on some crowded ward.

Tell me, was it ever any better?

Spence Kennedy said...

Hi Sabine

There's no question about it, the system is under an awful lot of pressure. A&E is a particular pinch-point, and there's often long queues because of bed-blocking / lack of beds further up the chain. So many factors play into it, one of them being an increase in demand. It's a huge subject with no quick-fixes, but I think what's required - from all sides, users as well as providers - is a healthy dose of honesty.

Sorry to hear about your aunt. Dreadful story. Hope she made a full recovery.

Thanks for the comment, Sabine :)

Daniel Rutter said...

"He'll walk out, go off home and die. Is that what you want?"

"Actually, since you ask, yes! We're from the Alcoholic-Father-Murdering Unit, Totenkopf Division Nine. We only need to finish off your dad to make our quota for this week. Then it's bonuses all round, and free novelty leather lampshades!"

(There are so many, many reasons why I would not last long doing your job.)

Spence Kennedy said...

I know! It's one of those rhetorical questions that's actually weirder the more you think of it. But I suppose it's just a sign of the level of stress they're under.

That's me rationalising it after the event. At the time I was struggling to keep my cool, of course. But I have to say, at no time was the patient a problem. He struck me as a very reasonable (but very vulnerable) guy who genuinely needed help - help we were happy to give. It just wasn't exactly the kind of help the relatives were expecting. C'est la Guerre...


Lynda Otvos said...

@Daniel Rutter--that's rich humor and I thank you for it.

Spence--another well-told tale. Sending a link to your blog becomes a joyful moment for me when recipient truly appreciates you. Happened again this morning; thank you for your writing.

Spence Kennedy said...

Thanks Lynda! I owe you! :)