Mrs Simms is framed in the lighted window, sitting in a straight-backed chair.
She gets up to open the front door.
‘Hello! Where are we, then?’ I say to her, looking past her shoulder into the house.
‘Where are we? Here!’
‘I mean – where’s the patient? Straight through?’
‘It’s me! I’m the patient. I do hope I’m not wasting your time.’
‘Oh! Okay. Well I’m glad you’re not as bad as they said. We got the job as a Category A difficulty in breathing.’
‘I do suffer with breathing problems. I have bronchiectasis. Do you know what that is?’
‘I have a rough idea.’
‘Do you know how to spell it?’
‘I think so.’
‘Because I’ve got it written down on an envelope in the kitchen. If you’d like to see it. The drawer beneath the microwave on the right, just behind the..oh, on second thoughts, I’d better go and get it for you.’
She hurries off into the kitchen and returns with an envelope with the word bronchiectasis written in a shaky hand on the back.
‘I think you’ll find I’m pretty organised,’ she says, sitting back in her chair. ‘My husband always made a point of it so I’m following in his footsteps. It makes life so much easier.’
‘Absolutely. Now, Mrs Simms. How are you feeling?’
She puts her hand to her throat and gathers the edges of her collar together.
‘Not good,’ she says. ‘Not good at all.’
‘In what way, not good.’
‘Shall I tell you the story from the beginning?’
Rae puts down the response bag, sits down on the sofa opposite and folds her arms.
‘Okay. What’s happened today?’
Mrs Simms smiles, an unnerving thing, as sudden and sharp as a paper cut.
‘Well. The family opposite were getting ready for their holiday this morning, very early, packing the car. I gave them a wave, but they had obviously a lot on their plate, so I wasn’t all that upset they didn’t wave back. We’re on good terms. Not friends, you understand. But we acknowledge each other’s existence once in a while.’
‘When I went to look again a little later they’d gone. Just a dry spot outside where the car was standing. Which made me feel sad. You see, I didn’t know exactly where they’d gone or when they’d be back. They hadn’t said anything. Not that I expected them to. As I say, they had a lot on their plate, what with the children and everything. So anyway. That was that. And then we come to the bins.’
‘Yes. The bins are collected once every two weeks, as is usual in this area. I live on my own, and hardly produce any rubbish at all. In fact, I produce so little, I keep it in supermarket carrier bags and place them in the bin when they’re full. I have a special dispensation with the council to do this. Three little carrier bags, every two weeks. The bin men don’t even need the bin placing out in the street. They lean over the wall and pick out the bags, and that’s that. Well today, there was a large black bin in there. And I know whose it was.’
‘The family over the road. It’s true, we did have an agreement. They produce a lot of rubbish; I produce very little. They asked me some time ago if they could use my bin as an overflow when their bin was full, and I said yes. So this bag appearing isn’t completely out of the blue. It’s just – I don’t know – they could’ve said something. As it was the bin men had to drag the bin over the wall, and I could see they were unhappy about that. And I had to wheel it back round at the end of the day, which I didn’t like to do. So all in all, the whole thing just set me off, and I’ve been feeling anxious and upset ever since.’
‘I’m sorry to hear it.’
‘You probably think it’s all nonsense.’
‘No. It’s obviously acted as a kind of trigger.’
‘Plus I haven’t been sleeping. Plus my breathing’s been bad again. The doctor said he couldn’t hear all that much and he simply gave me some more antibiotics, with some pill or other to help me sleep. But I was a so miserable and I didn’t know what to do so I called you. I hope I did the right thing.’
‘You should always call if something seems amiss. But I’m just wondering what we can do for you today, Mrs Simms. We’re an emergency ambulance, of course. We generally deal with heart attacks, falls down stairs, that kind of thing.’
‘Oh – you are cross with me! I don’t blame you one bit. I’m a stupid old woman who should know better.’
‘No, no. You’re a bit anxious about things, that’s all. I don’t think your breathing’s a problem today, though. Thank goodness.’
‘No, I don’t think it is.’
‘What does your doctor think about your anxiety?’
‘Oh – he’s pretty useless. He prescribed something or other. What’s that thing everyone gets for depression these days?’
‘No. It’s something for depression.’
‘Citalopram’s an anti-depressant.’
‘No. It begins with an M.’
‘No. It begins with an M and it stops you being depressed.’
‘Oh – I don’t know then.’
‘My prescription is in the kitchen. You know where the envelope was? In the drawer under the microwave on the left? Well it’s just past there, on the little side table with the papers and the … oh, you know what? It’s probably safer if I go.’
She gets up again and hurries out of the room.
I catch Rae’s eye. We both sigh.
‘At least we’re not picking some drunk up.’
‘It’s warm. It’s comfortable. I’m not in pain.’
‘What was that?’ says Mrs Simms, coming back in with a blister pack.
‘We were just saying how lovely and warm your house is.’
‘It is, isn’t it? I like to think it has a welcoming atmosphere. My daughters want me to move. They want me to go into a warden controlled place. But why would I do that? I’m settled here. I know where everything is. And so I should – I’ve been here since nineteen sixty-three!’
I look through her meds.
‘When are you due to take your Mirtazapine?’ I ask her, waving the pack in the air.
‘Not yet. Not till I go to bed.’
‘What time do you normally go down?’
‘I expect you’ll think it’s ridiculously early, but I’m normally tucked up by nine. So in about half an hour.’
‘Well, here’s my suggestion. I don’t think you need to go to hospital, Mrs Simms. I think that would only make things worse. So what I suggest is you have your Mirtazapine a little early, treat yourself to a cup of warm milk, and get a good night’s rest…’
‘Warm milk? What on earth for?’
‘To help you sleep.’
‘Goodness me, no!’
‘Oh. Why’s that?’
‘Are you lactose intolerant?’ says Rae.
‘No! It’s just not the right thing to do at all. I’m going to bed, for goodness sake. Why would I have a hot drink?’
‘Okay. Well. Just follow your normal routine, then.’
‘Warm milk! Whatever next!’
‘Some people like it.’
‘Yes, but – just before bed?’
‘I just thought…’
‘Oh no, no.’
Rae sighs and shakes her head slowly.
‘Anyway, whatever you like, Mrs Simms,’ I say, batting on. ‘The point is, you could treat yourself to an early night. Take your Mirtazapine. And then speak to your doctor in the morning. I’m sure there’s lots to be done about how you’re feeling.’
‘Other medication. Talking therapies. They could even refer you to a day centre or something. There’s lots out there.’
‘I don’t know…’
‘Why don’t you phone one of your daughters and speak to her about it? It’d be good to see what they think about all this.’
‘Oh I know what they think,’ says Mrs Simms, picking some fluff from her skirt. ‘I know perfectly well what they think. That’s the trouble. They won’t shut up about it.’