Thursday, April 09, 2009

a bag of nuts

The satnav has failed but I recognise the street from a siege last year. A burglar with a knife had been disturbed, chased by police and gone to ground in one of the terraced houses there. After a time, a police dog handler had arrived. The crowds taped off at the end of the street had been parted to let this new and terrifying apparatus through. The dog handler had parked in front of the house, stepped to the back of the van, and opened the door with the gravitas of an executioner. At a snap from his fingers out leaped a dog that, from where we stood, looked one part Alsatian, three parts grizzly bear. It sat in front of him, he gave it some instructions – which the dog seemed to understand and enjoy – then they padded off through the front door, and as far as I understand it, the burglar ran out the back into a big net. Anyway, it was a sunny, do-nothing standby, with people leaning out of car windows, looking on with folded arms, comparing mobile phones, cleaning their sun glasses on their shirts, or passing time with the easy, expansive chat that breaks out when anything cuts across the norm; a mixed crowd of sudden sociability, from the stab-vested police and evacuated neighbours to the local press, TV crews and any one of the hundreds of commuters drifting past on homeward currents, stopping to have a look.

The street is different now. The lamps have all failed, and the only illumination is the yellowy overspill from the railway station and a full moon hangs above us like a hub cap. The house numbers are difficult to read. But just as I go to pull a torch out of the rack to have a closer look, the truck headlights pick out a policewoman emerging from the gloom at the top of the street. Rae drives up and I climb out.
‘We weren’t told you’d be here,’ I say. ‘The job came through as a sick elderly woman.’
The policewoman smiles and comes up close.
‘Her name is June – we think. She was found wandering in someone’s garden, very confused. They took her in and called us. She says she lives in one of the cottages backing onto the alley, but doesn’t have a key, the people looking after her have never seen her around before, and well – it’s difficult to figure out quite what the story is. Come and see what you think.’
She leads us back up to the top left corner of the road and turns confidently into what would seem to be a high wall. But the thicker darkness there is actually the entrance to an alleyway I would never have guessed existed, a twitten tucked away as neatly as a secret compartment in a Georgian writing desk. A few yards along it we come across another policewoman standing by an arched trellis. She shows us through into a pocket-sized courtyard and the front door of a narrow cottage in front of which stands a figure who appears in the shadows to be a speaking facet of the rough flint wall.
‘Oh no. What now? Who’s this?’ she says.
I resist the urge to switch my torch on. The beam would blind us all, and the woman is so insubstantial it feels as if she would simply disappear.
‘Hello, June. My name’s Spence and this is Rae. We’re with the ambulance service.’
‘The ambulance service? Well for goodness sake! No-one’s sick, are they?’
‘That’s what we’re here to find out. How are you feeling?’
‘How am I feeling? Why do you want to know that?’
‘Because people are a little concerned about you, June.’
‘Are they? Who? Why are they concerned about me?’
‘June – it’s pretty cold and dark out here. Would you like to come and sit on the ambulance and chat to us there? It’s so much warmer and more private. We can sit down in comfort, have a chat and get to the bottom of this mystery.’
‘What mystery?’
‘Exactly. Will you do that, June? Come on, just for a minute or two. We won’t drive off anywhere, or do anything you don’t want to do.’
‘All right, if you think it’s absolutely necessary. One must always trust those in public positions of responsibility. But I have to say it all seems rather a nonsense. Who are you, do you say?’
‘The ambulance service.’
‘And why are you here?’
I take her by the hand. Even that small movement is enough to disturb an unsettling odour from her. It spreads out around us, a seamy musk of neglect.
‘Follow me.’
I lead her back along the alleyway to the ambulance. We sit her in a forward seat, close the door and settle in as pleasantly as we can.
‘And this is an ambulance, you say?’
June looks around like some visiting dignitary making conversation. Her silver hair is scraped neatly back into a black scrunchy, and her jacket and trousers have a smart line to them. But it looks as if she has been wearing the same clothes for some time now. They have a hazy, forgotten look about them.
June has a wide face, with an asymmetric twist to her mouth that would have been terrifying in middle age. Now it seems somewhat disconnected from her eyes, which flicker dully around her surroundings.
‘Would you mind if we did a few very basic tests, June, just to make sure everything’s okay?’
‘Of course everything’s okay. Why the fucking hell would they not be okay?’
‘Try not to get upset, June. Let me explain what the problem is.’
‘I wish you would. And don’t bamboozle me with jargon. Speak plainly and simply. I am not a fool and I will not be treated as a fool.’
‘Absolutely. Okay. Here’s the thing. Some people who live near here found you wandering in a confused state in their garden. They were worried about you, so they called the police. The police called us because they thought there might be something wrong with you.’
‘Something wrong with me? Like what?’
‘A urinary tract infection, for example. That can make you confused.’
‘Who’s confused?’
‘You seem confused.’
‘About what?’
Rae joins in. Whilst we give her a quick health screen, we try different approaches to find out the facts of her situation – where she lives, who she lives with, where she has been today and what she thinks of this whole situation. Her vital signs are fine, but although she is articulate and forceful, she seems to lack any reasonable insight into her predicament. And by the simple expedient of repeating isolated phrases back to us, she starts to make it seem as if we are the ones in need of focus.
‘Please. This is not amusing in the slightest – although I don’t doubt this fellow thinks it’s a hoot. I worked fifty years for the foreign office in Africa, and believe you me I know my way around the garden. I’ve put up with worse antics than you. I know what you’re about.’
‘June, let me try to explain again what the problem is.’
‘Please do. All ears.’
‘We’ve never met you before. We have no way of knowing what is normal behaviour for you and what is not. We can only go by what we see, the facts of the case.’
‘And they are?’
‘An elderly woman found wandering in the cold and dark, unable to give an account of where she has been or what she intends to do next. No key to get in, and no plan of action.’
‘What key? What are you talking about?’
‘June – do you live in the house you were standing in front of?’
She screws up the handle of her black bag.
‘Oh this is fucking ridiculous. Here you are talking about keys and confusion. You and your fancy equipment. Your mumbo jumbo.’
‘Okay. June. Do you have a key to that house? Would you mind looking in your bag?’
‘For what?’
‘For a key.’
She opens up the bag and rummages around. It flops about emptily, until suddenly she pulls out an unopened bag of salted peanuts.
‘Would you like a peanut? They’re very good for you, apparently.’
‘No thanks, June.’
‘How about your lovely colleague? Can I pass you a nut, dear?’
‘No thanks, June.’
There’s nothing else in the bag other than a two pence piece and a dirty handkerchief.
‘I don’t suppose you have the key on a string round your neck?’
June stares at me.
‘And why on earth would I have a key round my neck? Do you take me for an imbecile?’
‘June. Our duty first and foremost is to make sure that you’re okay.’
‘Good. Yes. You must do your job.’
‘Yes. It’s our job to make sure that no harm comes to you.’
‘I see.’
‘As things stand, we have no way of knowing if you actually live there, and no way of knowing what you will do next. What would you do if we dropped you off in the street now?’
‘I’d go home.’
‘And where is home?’
‘You know where my home is. I’m tired of these stupid questions.’
‘It’s cold and dark, and we couldn’t possibly just let you wander off. So here’s my plan. Come to hospital with us. It’s warm and safe there. You can see a doctor, just to make absolutely sure there’s nothing physically wrong with you. And there are people there who can help figure out what to do next. How does that sound?’
‘You must do what you must do. But I think the whole thing is a colossal waste of time.’
Rae climbs out to tell the policewomen what is happening. Then she calls back the leaving scene time through the hatch, and we set off for the hospital.
‘This is a rickety old charabanc,’ June says, sniffing and twisting her lips, hugging her bag to her on her lap. And then: ‘What an absolutely fucking ridiculous end to the day.’


loveinvienna said...

Definitely sounds like a UTI (of course, I'm an expert :S lol). Did you find out what the problem was? Any underlying psych issues? I don't know much about short-term memory loss/dementia other than what I saw at the Care Home and the majority of residents who had it didn't seem as crisp and 'eloquent'. But that's an uninformed opinion. Love the word charabanc :D evokes memories of reading 'Little Woman'.

Liv xxx

Spence Kennedy said...

It could've been a UTI, but my guess is that she had a form of dementia, maybe Alzheimer's. She was emotionally pretty volatile - the unexpected swearing one minute, and then quite happily handing round the peanuts. And she really had no short term memory. It made no difference how many times we went over the story - it was as if she was hearing it for the first time.

All we learned at the hospital later on was that she was actually registered at that address, but had had no contact with the hospital and nothing on her medical records. Our shift finished before we found out any more. I get the feeling she was a geriatric case who had fallen below the radar. But by taking her in at least she was on the way to getting some help. A sweet old woman, but difficult to deal with!
:) x

Gerry said...

I confess complete ignorance of your ambulance work, but I do know a thing or two about writing, and you are doing some good work here. The telling details, the apt similes, the straight-up descriptions . . . the respect and tenderness for the people who bump up against your crew in the river of who-knows-what.

Really good work, Spence.

mumof4 said...

Love your writing as per norm Spence. Your prose always captures the scene brilliantly - even for the non medical like myself.
Passing on a fabulous blogger award (it's a woman with a dog - which ain't how I picture you at all)....but just to know that your blog is much appreciated.

Spence Kennedy said...

Hey Gerry! Hey Mo4!
Thank you so much for your encouragement, and for coming back to read the blog regularly. I owe you!
Spence :)

Michael Morse said...

It appears we share the same ability to talk sense with the senseless. Some people, while well intentioned could have made this call a complete disaster. I've seen it too many times. All it takes is a little patience, and maybe having been senseless a number of times doesn't hurt.

Spence Kennedy said...

It is difficult to align yourself with someone who's very confused. Logic will only take you so far, then - if you think they need to go to hospital - you have to resort to diplomacy and outright cunning! She was a sweet old lady who needed help, so it's no bother to take a bit of time getting a result. I know you feel the same!
Cheers Mike
S :)

.. said...

I think I might have had difficulty not enjoying this scenario. It challenges you to think in a manner that they *might* understand.

Kudos to you and your partner.

I do have to say I giggled once or twice. Sounds like my Grams.

Spence Kennedy said...

I think I've learned so much about talking to old people that I could go deep cover - a little bit of makeup (not that much required these days), a little wardrobe adjustment - no-one would notice. Except maybe when some Michael Jackson came on the radio and I started moonwalking, but otherwise a perfect disguise...

I bet your Grams would notice though. I bet she'd use a few choice words.

;) x

.. said...

Sure... if she could remember them.