helpless

Martin has fallen in the kitchen. The carer lets us in.

‘Do you need me for anything? Only...’

I’ve barely finished saying ‘I don’t think so...’ when she’s grabbed her coat off the back of a chair, the lift door closes and she’s heading down.

‘Get me up!’

Martin hasn’t hurt himself, but he’s a fair size and we’ll have to use the inflatable cushion.

Rae goes back down to the truck to fetch it; I start taking his obs.

Martin is only in his early sixties, but his illness is in an advanced stage. He’s PEG fed and catheterised.

‘How did you get into the kitchen, Martin?’

‘Walked.’

‘With your zimmer?’

‘Walked.’

‘Without a stick or anything?’

‘Walked! Get me up!’

 He talks in a harsh monotone, his heavy-lidded eyes staring at a point six inches beyond the tip of his nose. The paperwork doesn’t refer to any learning difficulties, but I wouldn’t be surprised.

‘Get me up!’

‘Won’t be a moment, Martin. I’m sorry there’s a delay, only we need some special equipment.’

‘Get me up!’

‘Not long now.’

Despite the eight carers he has each day, the flat is still only marginally habitable. Excepting a few islands of order – a space at the end of a kitchen work surface where some medical apparatus has been laid out to dry; some information sheets in plastic folders tacked to the cabinets; the hospital bed in the lounge and the cabinet next to it – everything else is tacky and malodorous. At the foot of the bed is a high chair with a padded blue cushion facing the television, a pile of porn magazines to one side.

‘Get me up!’

He has a prominent underbite, exposing a line of greasy grey teeth that glisten under the kitchen striplight.

‘I can hear the lift, Martin. She’ll be back in a minute.’

‘Get me up!’

*

The cushion works well, but even so, Martin is difficult to handle. As each of the four interlinked cushions inflate, the patient needs to move their feet back to give them some kind of purchase and stop them slipping forwards. Martin doesn’t seem able to do this.

‘Falling!’ he says.

‘How did you get in the kitchen?’

‘Walked!’

‘I’m just a bit surprised, the way your legs are at the moment. Are they worse than normal, would you say?’

‘Yes.’

‘I think we’ll have to take you to hospital then, Martin.’

‘Don’t want hospital.’

‘Let’s get you in our chair and then have a chat about it.’

He doesn’t seem able to weight bear at all well, and it’s a struggle to stand him up, take the cushion away and put the chair behind him. Even when he’s in the chair, he starts to slip forwards again.

‘Maybe you’re a bit weaker today, Martin.’

‘No. Don’t want hospital.’

‘We can’t very well leave you here like this, though, can we? How would you get to the loo?’

‘Catheter.’

‘I mean the other loo.’

‘I want my chair.’

But there’s no way we can leave him like this. Although it feels perilously like kidnap, we bundle him up and start heading out. It takes a while to leave, though, as we can’t find the key, and have to phone the care agency to clarify the situation.

Down in the ambulance Martin is as uncooperative as before. And in the cold light of the ambulance, it does seem more attitude than illness. All his observations are normal, so there’s not even much of a suggestion of a UTI or any other organic reason why he might fall and not be able to get up again.

‘So how are you feeling now to how you normally feel?’ I ask him, struggling to find a way to phrase it. ‘Do you feel your normal self is what I mean.’

‘Yes.’

‘Nothing out of the ordinary?’

‘No.’

‘So why did you fall?’

‘Don’t know.’

‘Have you fallen in the past?’

‘Yes.’

‘And gone into hospital?’

‘Yes.’

‘And what did they say, the last time it happened?’

‘Don’t know.’

I shuffle through the papers again.

‘But you didn’t seem able to take your own weight when we helped you up, Martin.’

‘No.’

‘And that’s normal for you?’

‘Yes.’

‘And you walked to the kitchen?’

‘Yes.’

‘Unaided.’

‘Yes.’

I turn to Rae.

‘I still think he’ll have to go in. Off legs.’

‘Fine,’ she says, and gets into the driver’s seat.

But after five minutes or so of grinding clicks and clunks, she turns and looks back at me through the hatch.

‘Won’t start,’ she says.