Monday, June 17, 2013

the red house

Betty is holding the phone a little way away from her ear, frowning.
‘Shall I have a quick word?’ I say to her.
‘Please! She’s asking all these questions and I just want some help.’
The ambulance call taker on the other end is relieved to speak to me.
‘Thank god you’re there,’ she says. ‘Is this a cardiac arrest? I can’t seem to get anywhere with the lady.’
I glance over at Betty’s husband Lou, slumped over in his armchair. Rae has pulled the blanket off him and his breathing is plain to see, even from here.
‘No. We’re good. We don’t need anyone else at the moment.’
‘Excellent. Thanks. And er... Good luck!’
‘No worries.’
I hang up.
The click galvanises Betty, pitching into a jowly, endlessly complaining monologue that’s more like a function of the weather than a coherent description of her woes.
I’ve had a stroke... he can’t cope... the lift doesn’t work... look at my legs... his daughters don’t care... my son’s in Denmark... the nurses say they’re coming round but they don’t... he drinks... I haven’t had any breakfast...’ and on and on, apparently without breath.
I try to get Betty just to hold off for a second whilst we assess Lou. After all, he’s the reason we’ve come this morning. But she’s incapable of being quiet, only pausing to answer the questions Rae asks Lou, mixing in all kinds of irrelevant detail.
Meanwhile, Lou has ended his stagey collapse in the chair and sits with his face in his hands, sobbing.
‘I can’t cope! I just can’t. It’s all too much.’
Rae tries to figure out exactly what’s happened whilst I sit down with a care folder and start getting some details.
‘I’m sorry,’ sobs Lou. ‘The place is a shit hole.’
We reassure him that it’s not. And it isn’t. Even the TV magazines on the coffee table are aligned, corner to corner, the pen that marks out the evening’s viewing neatly capped and set parallel with the edge. On the opposite wall are a spread of family photos, surrounded by a brace of lurid royal plates, Princess Diana at the top. On the floor by the gas fire is a large ceramic biscuit barrel in the shape of a bear.

Betty continues her monologue from her armchair across the room, even though I try to get her to stop. At one point, Rae holds the flat of her hand out in her direction, like she’s been forced to use a magic spell. 
The magic doesn’t work.
We can’t go on like this... the doctor’s no good... I haven’t been out in five years... the dog downstairs barking all hours... my daughter would be the first to be round for money if we dropped dead... I can’t sleep... the lift doesn’t work...’
‘Yes it does. We came up in it.’
In fact, it was the most bizarrely over-engineered lift I’ve ever been in. It had a neon button console like something out of the space programme, and an enthusiastic voice commenting on every last action: ‘lift door opening! lift doors about to close! lift doors closing! proceeding to floor number four in five, four, three, two, one... proceeding to floor number four...’
Betty narrows her eyes at me.
It didn’t work for a long time.

Lou has stopped crying. He dabs at his eyes, examines the handkerchief, then turns to look at me.
‘Married?’ he says.
‘Two girls.’
Suddenly he laughs, his face squashing up livid and red, the funniest thing he’s heard in years. When he quietens down, he leans forward in the chair and talks to me again. Even Betty is quiet now.
‘Heard of the Red House?’ he says.
‘The Red House? No.’
‘Used to be a coffee place. ‘Course, I’m going back a few years. A girl I saw used to hang around with the guy who lived in the flat above it. D’you follow? Anyway, he was a bit of a local chancer, if you get my drift. Into this and that. Well – it turns out, so was she! So what did he do? He got himself a shotgun and boom! That was that.’
He raises his eyebrows and smiles at me.
‘He got eight years for that.’
‘Eight? That’s not much.’
‘I know, I know’ says Lou, resting back in the armchair, looking tearful again. ‘Things were different then.’


jacksofbuxton said...

I suspect I may be able to understand Lou having a bit of a wobble there Spence.

I wonder if he's considering 8 years as well.......

Anonymous said...

Hi, I'm a long time reader of your wonderful blog, but haven't commented until now. I work as a doctor in a health centre. The cases like the one you described here are such time-consumers and so difficult to solve, specially in the evening hours with nobody in care services answering the phone...

Do you sometimes feel like you're trying to open a round lock with a square key, or some other appropriate idiom? The only help or attention available is medical, but the problems and thus their solutions aren't medical, and the situations quickly get very tangled.

What did you do to this couple in the end?

Spence Kennedy said...

Jacks - Poor guy. It was all getting a bit much. He'd taken early retirement after a spot of ill-health, and things had gone downhill since. I don't think he was drinking all that much, but certainly 'self-medicating' to a certain extent.

8 years really didn't seem like much; I'm sure Lou had spent a few evenings in his armchair doing the maths... :/

Anon - Thanks very much!

Yep, these 'acopic' cases do soak up a lot of time & resource. With Lou and Betty, neither of them were that elderly or that incapacitated, so not prime candidates for the usual regime of carers & such. They did need some kind of intervention, though, and in fact we found out that the community team had already been round to assess them. Lou didn't score too badly on the PHQ9 questionnaire he answered about a fortnight before, but based on what we found that would probably have to be re-done. On the whole though, 'Acopia' pretty much sums it up.

Sometimes in the ambulance it feels like we're the 'grunts' of the NHS, parachuted in to these situations with only a few blunt resources to sort them out. The weekend just complicates it further. In this case, we ended up referring back to the GP to make a call back.

Thanks for the comments!

Sabine said...

Stories like this one make me fear my old age. One in three - dementia or some other statistic.
I have in my extended family two elderly girls in residential care (aged 100 and 96) and they have a lift like that which they call an "auld tosser trying to chat me up".

Spence Kennedy said...

Hi Sabine

Mind you, there's a woman who lives near here - 98, completely independent / no carers. Inspirational, really. But it is a worry when you think about the statistical likelihood of these things.

Love the way your 2 girls described the lift! Maybe the manufacturers should extend the vocab a bit, let them be a little more chatty. It wouldn't be that difficult.

MrTomVee said...

Chatty lifts, eh? Be careful what you wish for...

All I can say is Sirius Cybernetics Corporation.

Spence Kennedy said...

Well, I had to google that - and now I think I must read 'Hitchhiker's Guide...' :)

Lydia said...

Oh Spence, you HAVE to read hitchhikers!

So long, and thanks for all the fish..

there's a frood who knows where his towel is..

at least for the quotes alone! :)

Unknown said...

You must Spence. You must.

Spence Kennedy said...

It's on my To Do List!
:) x