Saturday, February 28, 2015

case solved

The jogger is obviously relieved when I tell her we’re fine, thanks for your help, we’re good from here.
‘Stay safe, Nige, yeah?’
She jogs on.

‘Let’s get you up, then.’
We help him up.
His trousers fall down.
We haul them back up.
‘Sorry about that. Sorry. But look - the awful thing is – I appear to have lost my keyssss...’
‘We’ll have a scout about in a minute, Nige. Let’s get you on the ambulance and see what’s what.’

What’s what turns out to be concussion, a piece of plastic from his shattered glasses frame poking out of his cheek, and a potential discrepancy in the size of his pupils.
‘You need to come to hospital,’ I tell him.
‘Really? The thing is, I think I may have lost my keyssss...’
The way he says it, his teeth clamping together on the last syllable, squeezing the sibilant ‘S’ through the sides of his mouth.

Rae jumps out to have one last look around with her torch whilst I take a bit more history.
On ‘gardening leave’ for an unspecified misdemeanour. Spent the evening in the pub. Made it off the bus. Fell over and cracked his head. Vomited twice. Coronation chicken.

‘The thing is, I think I may have lost my keyssss...’

Rae climbs back on board.
‘Come and have a look at this,’ she says.
‘Hold that thought,’ I say to Nige.

Rae points her flashlight at something, a pile of faeces on the driveway where he fell.
‘That explains the trousers,’ she says.

When I rejoin him on the back of the ambulance he has his arms folded, looking about the cabin.
‘Hello!’ he says. ‘Well! This is all very strange. The thing is, I think I may have lost my keyssss...’

blue water

The house is a new-build – so new it feels more like a show home, the paintwork immaculate, grey slate unmarked on the kitchen floor, Lavender Sunrise drifting up from the plug-ins.
‘I didn’t want to call you,’ says Marion, closing the door behind us. ‘Bill only has a couple of weeks left. We’re really waiting on a bed at the hospice. But when I spoke to the doctor he said to get in touch to rule out a stroke.’
She leads us upstairs to the spare room. Bill is perched on the side of the bed, hands planted either side, breathing quickly, staring down at his bare feet like he’s watching them move further away.
‘Hello Bill’
He doesn’t look up.


‘Chest’s clear,’ says Rae, taking off her steth and looping it round her neck. ‘I don’t think it’s a stroke, Bill. All things considered I’d say you’ve probably got a UTI, but a urine dip will clarify. I think we can keep you out of hospital.’
‘Thanks,’ says Marion. ‘He called me a few choice names when he heard I’d called you.’
‘Let’s get you comfy on the sofa downstairs, then we’ll arrange for the GP to come out later.’
I walk backwards down the stairs in front of him, holding on to the banisters in case he pitches on to me. I offer him my hand at the bottom but he shakes his head and makes his own way, steadying himself against the walls. He lies down on the sofa in the lounge, and closes his eyes.
‘He gave me such a dirty look,’ says Marion, joining us in the kitchen. She takes a tissue from the tissue box on the counter and blows her nose. ‘It’s not easy.’
To the left of the tissue box is a bottle of Classic Coke; to the right, a cluster of medicine bottles and packets. Marion makes a small adjustment to the size order of the medicines, then tosses the used tissue into a shining bin.
‘Are you all right?’ says Rae.
‘I’ve got to be,’ she says. ‘It’s just – I don’t know. We both retired last year, bought this place. We had so many plans. Then my sister in law dies of cancer. My nephew was killed in a car crash. Bill gets sick. It’s just – everything’s happening at once.’
‘I’m so sorry,’ says Rae, putting down her pen and looking as if she’s about to give Marion a hug.
‘Don’t,’ says Marion. ‘Sorry. It’s just...’
She wets her lips, smiles, then lifts the kettle to check it’s got water in it, puts it back on its base and presses the switch.
‘I used to manage a nursing home,’ she says, putting out the cups, dropping a tea bag into each of them. ‘You’d think I’d be used to all this.’ Then she stops and stands quite still, staring at the blue lit water through the viewing port as it starts to bubble and boil.
‘Don’t think twice about calling us,’ says Rae. ‘We really don’t mind.’
‘You’re very kind,’ says Marion. ‘Everyone’s been so helpful.’
The kettle clicks off. She lifts it up and starts to pour water into the cups.
‘Oh, well. At least I know what to expect,’ she says, carefully putting the kettle back on its base. ‘Milk and sugar?’

Friday, February 27, 2015

500 calories of revelation

Mr Williams is one hundred and two. He slid off the bed onto the floor and couldn’t get up, so he pressed the red button on the cord around his neck and lay there waiting for help.


The first extraordinary thing about Mr Williams’ house are the shrubs outside, pruned in immaculate waves like a blocky, three-dimensional portrait of a wild sea. The second is how perfectly neat it is inside, the magazines and newspapers, letters and bills, sheet music, books and portraits – everything lined up and in its place. The kitchen especially, everything just so. Even the kettle has been thoughtfully placed, velcroed into a metal sling that’s engineered to tip at exactly the right angle to fill the teapot without spilling a drop.
‘Just help me up, would you?’ he says. ‘I’m not hurt or anything. I’m just a bit stuck.’
The hearing aids in his ears are turned up so high you can hear a faint echo of yourself as you speak.
‘Here we go!’
We stand either side to steady him whilst he finds his balance, then help him into the living room where he takes a seat in the sunshine.
Rae gets busy writing out the sheet; I run through the basic obs. Once I’ve finished, I offer to make him some tea.
‘I’ll have a sweetener in it if I may,’ he says. ‘One click is quite sufficient!’
I bring him in a cup, and sit opposite him, waiting for Rae to finish.
The sitting room is a homage to the steam train, with model engines, prints and photos, and a small library of old train timetables and other books.
‘I was thinking about trains the other day,’ I say to him.
Were you?’ he says.
‘First you had steam. Then it was electric. And now they’re working on maglev engines.’
‘Giant magnets, floating over the tracks. So they don’t have much friction, and they travel really fast.’
‘I suppose leaves on the line will be a thing of the past, then,’ says Rae.
‘Yeah. I don’t know.’
Magnets, you say?’  Mr Williams, frowns and leans forwards to pick up his tea. ‘Hm. How wonderful.’
‘I think they’re pretty expensive though. You’d have to lay a whole new set of tracks. It’d be like starting from the beginning.’
‘Yes. Well. There is that,’ he says.
‘What’s your secret?’ says Rae, signing her paperwork and tearing off his copy. ‘A hundred and two, no carers, no pills...’
‘Ah!’ says Mr Williams. ‘I have faith!’


Outside in the truck we try to put a referral through to the falls team. Mr Williams is pretty well set-up, but his mobility is deteriorating and there are a few improvements that could be made. There’s a delay in getting through. Rae had them on her mobile but the signal was interrupted and they’re slow to ring back. She sets the phone between us, pulls a bag of crisps out of her lunch bag and starts working her way through them.
‘It’s ironic,’ I say, sliding down the chair and bracing my knees against the dash. ‘On the one hand you’ve got Mr Williams saying his faith has kept him alive all this time, and on the other you’ve got all those thousands of people killed in the name of faith. Millions, probably.’
‘Religion’s worse than politics,’ she says. ‘I stay clear of both.’
‘But then again, I suppose it’s not religion that causes trouble but the way people interpret it. I’m not religious, but I understand why people are. You know, that desire to get close to the divine, to find spiritual meaning in all this. It’s as old as the oldest human.’
Rae laughs.
‘As old as Mr Williams.’
‘I saw this documentary. The Cave of Forgotten Dreams. About a prehistoric cave in France somewhere that got sealed off by a rock fall and left completely undisturbed for thirty thousand years. And they found loads of beautiful paintings inside. Horses, deer, bears – all signed with handprints. And there was even the skull of a giant bear on a kind of rock plinth in the middle, like an altar in a cathedral, beautiful. So even then, people were trying to make sense of things. Which isn’t news, I suppose. Humans have always been looking for ways of expressing the divine, finding stories to explain it all, from Stonehenge to the Christian Scientists.’
‘And back again.’
‘I think the difficulty comes when people take the stories too literally. They end up contradicting each other, and the fighting starts. But in the end everyone’s probably just trying to say the same thing. I don’t know. Maybe it’s all just an evolutionary anomaly. In the long run it’ll either work or it won’t. Anyway. I don’t suppose that cat over there wastes too much time worrying about the divine.’
‘I can’t say I do, either.’
I yawn.
The phone rings.
Rae smacks her hands clean before she touches it.

‘Anyway. Ignore me,’ I say, straightening up again. ‘ I’m feeling a bit – you know – drawn out. I’m on this 5:2 diet and today’s a fast day.’

jack & iris

Jack has so many things wrong with him it’s difficult to know where to start. This morning he’s almost certainly had another TIA.
‘I didn’t want to call you,’ says Iris, his wife. ‘But the doctor was pretty clear.’
‘She’s right,’ I tell her. ‘These things can be the precursor to a stroke.’
‘I know. He’s had one of those already.’
We talk over the options. In the end they decide to go in.
‘Is it busy?’ she says.
‘I’m afraid so.’
She looks crestfallen.
‘We waited so long last time. It’s like we were invisible.’
‘I’m sorry to hear that, Iris. It gets mad there sometimes.’
‘Not to worry. Well. Come on then.’


Jack is comfortable on the way in. With his thick and warty nose, his eyes made tiny by the folds of a wide smile, and his massive hands folded contentedly across his belly, it’s like we’re transporting an ancient humpback whale, inexplicably dressed in a cardigan and cashmere scarf.
‘Sixty-five years,’ he says. ‘Marvellous.’
That was a wedding,’ says Iris, leaning in to shout in his ear. ‘Do you remember, darling?’
‘What’s that?’
‘The wedding? We drove down to Somerset in your Dad’s Morris Minor.’
‘That old thing?’
‘It was pouring with rain. Do you remember? You hit that hole in the road and crashed into a tree? I ended up in the cottage hospital with broken ribs, they put you up in the pub.’
‘Oh ye-es.’
Iris settles herself back in the chair.
‘There was this policeman who came along on his bike,’ she tells me. ‘He said he knew exactly what hole it was, because he’d fallen down it the week before.’
‘I had lobster for dinner!’ says Jack. ‘Two and four. I even remember the pub. It had the same name, you see.’
‘What? The Lobster?’
‘The Dorset.’
‘You didn’t take it as an omen then?’ I say to Iris. ‘Crashing on your honeymoon?’
‘I don’t believe in omens. Things happen. That’s life. You learn to cope.’
‘It’s a good philosophy.’
She’s quiet for a while.
The ambulance rocks gently from side to side, and the noises of the road and the evening traffic hush around us.
Jack seems to drift off to sleep.
‘I used to be a matron,’ says Iris. ‘You’d think I’d be used to all this, but the last few years have been very hard. Very hard. Jack’s been so unwell. He has a DNAR, by the way.’
‘I have it here if you want to see it?’
‘He had a cardiac arrest last time he was in, but they managed to bring him back. I’m glad they did, of course, but really, he’s got such a lot on his plate, it wouldn’t be fair.’
‘No. I can see that.’
She’s quiet for a moment or two. At one point she leans forward to brush him gently on his arm. He turns to look at her, then settles back and closes his eyes again.
‘No one should have to die twice,’ she says.

Thursday, February 26, 2015

tip of the tongue

Milly sits patiently on the blue chair I’ve set for her in the cohort area of the ED, watching everyone come and go.
‘Busy, isn’t it?’ I say.
‘So many people dying,’ she says, smiling sadly, like a middle-aged nun finding love in her heart for all the evil in the world. ‘How many people are dying, d’you think?’
‘I don’t know. Maybe some, but then I suppose you have to think there are lots being born, so life goes on and we’re all right.’
‘What do they do? Burn them?’
‘Sometimes. It depends what the person wants. Some people opt for natural burials. You know – with a tree. So the graveyard ends up a wood.’
She’s still smiling at me.
‘Which is nice,’ I add.
I look around to see if the psych nurse has arrived yet, but I can’ t make her out in the chaos of the department.
It’s difficult having a conversation with Milly. She whispers, and I have to lean in. When I do understand what it is she’s saying, I struggle to come up with anything more than blandishments, vague reassurances. My own sense of reality feels increasingly tenuous.
‘What’s that word?’ she says.
‘What word?’
‘Helly something. Is it? Hell?’
‘Hell? Do you mean as opposed to heaven?’
‘Where you go up. You spin up.’
She illustrates by turning her hand vaguely in the air, and then placing it neatly in her lap again.
‘That’s a nice way of thinking about it,’ I say. ‘Like the seed of a tree, spinning upwards.’
Trees again.
She smiles at me, unchanged
‘What is that word? I’m sure… hell…is it? Hell?’
‘I don’t know. Is it a person? Helen, maybe?’
She shakes her head.
A team comes out of resus pushing a bed with a patient wired-up to monitors and drips,  heading for ITU.
She sighs, watches them pass, and then looks straight at me.
‘Helicopters,’ she says.

Sunday, February 22, 2015


The station was divided.

Some liked having a station cat. It was comforting, homey, good luck. Some were quietly annoyed that he took up two seats and walked on the kitchen surfaces. Some were allergic. Whatever their feelings, though, it was hard to deny the kitchen had started to smell bad. Worse, at least. Keeping it clean had always been a challenge, with so many people in and out all times of the day and night. The fridge was particularly bad. No-one in their right mind would open it without gowning-up. But lately even the toughest nose had to admit Cat A’s meat bowl was making the place smell like a condemned abattoir. Something should probably be done.
Cat A was taken to the vets to be scanned. He wasn’t chipped, so returning him to an owner was ruled out. Discouraging him from hanging around by not feeding him or even using cat repellents was simply impractical. More direct action was needed.
The email that followed was straight-forward enough. A list of reasons why Cat A had to go: Hygiene, Allergies, Station security, company policy etc. Could anyone take him? Otherwise it was the RSPCA.
The majority of responses fell into either camp, Shame or About time, although one was surprisingly emphatic: Is there no end to the things you’ll do to make this job unbearable? it said.
There were reassurances, updates, claims and counter-claims, everyone copied in. The only one not stirred by any of it was Cat A, of course, who carried on snoozing on his blanket spread across two chairs, nosing amongst the dirty dishes in the sink, or wandering through the station looking for someone to fill his bowl.
And then a more definitive email: Cat A has left the building.
To the RSPCA after all, (with certain re-assurances about its euthanasia policy). Any contributions to the cost of vaccinations and other treatments gratefully received &c.
A few more emails, tailing off until the final one, a couple of days later:
Ahhh! Cat A! it read. And then a single emoticon:
: /

Monday, February 16, 2015

the cat

‘The old credit card trick,’ says the police officer. ‘Worked a treat. Don’t ask me where I learned it.’
‘I thought that was just in films.’
He shrugs.
‘Depends on the lock.’
Leila is sitting on the sofa, the focus of our attention. Outwardly calm, her ancient hands folded neatly in her lap, still there’s something worryingly vague about her, like she’s not really on the sofa at all, but asleep in bed, witnessing a strangely lifelike dream.
‘She was standing outside in her nightie,’ says the other officer. ‘Someone passing saw her, thank God, and called us. She was quite cold and confused, but once we got her inside with a cup of tea she warmed up nicely. We don’t have any notes on this address, so we’re still in the dark.’
‘What were you doing outside, Leila?’ asks Rae. ‘It’s a wonder you didn’t freeze to death.’
‘Is it? I ... we were ... erm ... the cat ... I was expecting, you know ... it’s not as if ...’
She drifts on in this way until her words peter out into a passive smile that she distributes amongst us. Then she sighs, looks down at her hands, and begins idly turning her wedding ring round and round.

We check her over.

She can’t have been outside for long, because her temperature has normalised. In fact, none of her physical observations are out of the ordinary.
I look around the flat for clues.
Beautifully decorated, warm and well-furnished, shelves of books and ceramics, an annotated manuscript open on a table beneath a large reading glass, it looks like the home of an elderly academic. I can’t find any of the usual signs of someone suffering from dementia, the simple notes taped to things, the care folder, the locked container of medication, the keysafe.
‘We’ve not had any other calls to this address,’ says the first officer. ‘It’s all a bit of a mystery.’

The other officer presses the speed dial button on the phone with JOHN written next to it.

‘He wasn’t surprised,’ says the officer, hanging up after a short conversation. ‘He says she’s being assessed, but things are moving quicker. She’s had a couple of episodes like this; last time it was the neighbours who brought her back. So far the family have managed to keep things ticking over, but he doesn’t know for how long. Anyway, he says he’s coming over. He only lives local.’
‘Who?’ says Leila, looking up.
‘John. He says he’ll be here in a minute.’

Saturday, February 14, 2015

rita the fuss

Rita is eighty-two. She has end-stage COPD, but she’s well set-up at home with oxygen, a hospital bed, TV, wet room, stair lift, riser chair. Everything is well-ordered, plenty of room to manoeuvre. She lives with Sonia, her daughter, who seems a little frayed at the edges, but otherwise in good humour, coping with it all. The house has just been decorated, with feature walls, woven hearts, bundles of cracked willow in tall glass jars, and a stencil on the landing that says: Dance like no-one’s watching / Sing like no-one’s listening / Love like you’ve never been hurt before.
Rita has a DNAR. It’s at the front of her folder.
‘I don’t want no-one jumping up and down on me when I go,’ she says. ‘Not my chest, anyways.’
‘Mum!’ says Sonia, watching from the doorway. And then to us: ‘I’d say she’s not normally like this, but that’d be a lie.’
 ‘I suppose you want my top off?’ says Rita, pushing the duvet down and hauling up her nightie.
‘Hang on, Rita. Let’s do the rest of it first.’
‘You’re right. Best take it slow.’
‘Mum has just had one chest infection after another. This one seems to have gone on forever. And then she started to have pain up here when she breathed in.’
‘It’s not too bad,’ says Rita. ‘I don’t know what the fuss is about.’
‘You,’ says Sonia. ‘You’re the fuss.’
‘Am I? A nice fuss, I hope?’
‘Yeah. You’ll do.’
‘What about now?’ says Rita, hauling up her top again. ‘Ready for me now?’

Friday, February 13, 2015

best in show

Geoffrey sits quietly in his armchair, hands left and right on the armrests, feet placed equidistant in large, knitted slippers. Even though the house is well heated, he’s wearing a ton of clothes – long-johns, patterned pyjamas, and a sweatshirt with the hood pulled up over a big furry cap, like he couldn’t decide whether to go up to bed or outside to hunt ducks. He stares straight ahead, at the empty armchair on the other side of the room.
His carer stands in the doorway. A tough-looking guy as solid as Geoffrey is frail, the carer has an unexpectedly soft voice. It’s a surprise when he talks, like having a convict press himself up against the bars, open his mouth and recite poetry.

He waves for me to come into the kitchen for a private word.

‘Ahm – Geoffrey said he felt dizzy his evening so I had to call you,’ he whispers. ‘Policy. I’m so sorry. What do you think? Is he going in?’
‘I don’t really know. Nothing’s showing up. It says in the notes he’s got a history of anxiety...’
‘Ye-es,’ says the carer, smiling sadly.  ‘I’m afraid so. He’s had these episodes on and off for decades. His wife Agnes used to look after him, but then she passed a couple of months ago….’ He folds his enormous arms, tattooed with tribal patterns. Cancer he mouths. ‘Ever since then Geoffrey’s been at sixes and sevens. I don’t know what we’re going to do. His family are miles away. There’s only so much we can do.’

The carer goes to make Geoffrey a cup of tea and a jam sandwich whilst I complete the paperwork.
I go into the bedroom to fetch his blister pack of medication.

There are two single beds side by side, one with the covers thrown back and a stack of pillows, the other neatly made-up. Blu-tacked to the wall above the dresser is an ancient newspaper article – a middle-aged couple with a rosette at a flower show. I recognise Geoffrey. Even though he’s holding the rosette, he has the same set expression he’s wearing under his cap. Agnes is smiling though, her arm linked through his, her free hand resting proudly on top. And even though the picture has leached in the sunlight, and it’s difficult to make out much detail, you can still see quite clearly the flowers in the pot on the table in front of them. Exuberant red pom-poms. Dahlias, I think.

I go back into the sitting room to discuss the options.

Tuesday, February 10, 2015


Marian is lying on the floor beside her bed with a duvet thrown over her.
‘I don’t know what happened, but she had that collapsible table on top of her, too.’
‘How long do you think she’s been like this?’
The carer shrugs.
‘Could be five minutes. Could be five hours. All I know is she was fine when I left her first thing.’
We check her over. She seems intact, happy enough. We stand her up, and the carer fetches a chair.
‘Marian has dementia, so she can’t really tell you much. She’s been okay recently. She does tend to get UTIs, though.’
It looks as if that might be behind the fall, so we arrange for a paramedic practitioner to come and dip her urine.
‘I’ll get you a sample before I go,’ says the carer. ‘She wears pads, so it’s difficult otherwise.’
We help set the room to rights, then have a quick look round the house to see if the Falls Team need to visit.
Marian lives in the little back room, with a bed, a fire, a sofa, a commode and a television. The rest of the house has an abandoned feel, like the family ran outside in the early seventies and never came back. The new fridge in the kitchen stands out against the yellowing units, the geometrically-patterned lino still crazing it out between the worn spots, sticks of dead plants in clay pots on the windowsill. Upstairs is no better. A threadbare carpet leading up past a row of lighter, square patches where pictures used to hang, to a landing of rooms, all junked up, beds beneath boxes, dressing tables beneath covers – everywhere a sense of the life that was lived here, a life now buried beneath a sediment of neglect, confusion, and loss.
‘She doesn’t go upstairs,’ says the carer, when we go back down. ‘But we had a new rail fitted, just in case.’
Marian is hugging a stuffed squirrel, whose bulging eyes and protruding tongue make it look like it’s being squeezed too hard.
‘Jeffrey!’ she says.
‘Hello Jeffrey. How are you today?’
She wiggles him about.
There’s a wedding photo on the mantelpiece just above the fire. A woman who looks like a younger version of Marian, arm-in-arm with a thin man whose slick black hair matches the intensity of his gaze.
‘Who’s this handsome chap?’ I ask her.
‘My brother!’
I look at the photo again, then at the carer.
The carer smiles and shakes her head.
‘Lovely!’ I say, and put it back.

Monday, February 09, 2015

the little red hen

Six o’clock in the evening, half an hour before the end of a long and complicated car shift. Things haven’t worked out well. I’ve ended up the wrong side of town, there are calls going out on the radio for jobs with no vehicles to assign, and the shadow of a late-finish is lying across me, scythe & cloak.
I’ve been to this particular address once before – Rachel, a woman in her seventies, equivocal diagnosis somewhere on the scale between dementia and mental health, the result being the same – carers four times a day, keeps to her bed, poor levels of self-care despite all the help.
I can hear her TV from outside. She likes it loud.
I retrieve the keys from the keysafe and let myself in.
‘Rachel? Hello? It’s the ambulance.’
She’s in bed.
‘Do you mind if I turn the TV off? I can’t hear myself think.’
The carers do their best to arrange things so she stays reasonably neat between calls, but Rachel always manages to get in a state. The remains of her sandwiches are scattered around, the lid has come off her beaker and spilled tea on the bedclothes, the little table with her things on – remote control, box of tissues, magazine and so on – is lying on its side.
‘Help me,’ she says.
She holds her hands out. They’re caked in faeces. I pull the duvet aside. Her incontinence pads are half-way down her legs, spilling over.
Rachel’s outstretched hands speak eloquently to me of the predicament I’m in. The fourth carer won’t be in till eight. There’s no prospect of any crews to help me on this one, at least until the half-sixers book on, and anyway, the likelihood is they’ll be sent out on any of the high priority calls currently stacking. I either wait it out and finish horribly late, or I take care of things myself.
‘Let’s get you cleaned up,’ I say.
I take my jacket off and hang it safely out of reach in the lobby.
I put on some gloves.
I fill a basin with soapy water, take a roll of toilet paper, a flannel and a towel and carry it all through.
I put it out of the way whilst I strip the duvet, carefully cut off Rachel’s pants, scoop the worst of it up with wads of tissue, bundle everything up with the inco pad and stuff it all in the bin by the TV.
I put another inco pad underneath Rachel (who doesn’t seem able to help at all by pushing down with her feet and lifting her bottom), and soap her as clean as best I can.
I change the water and do it again, along with her hands, although the intricate tucks of her rings need a brush to clean properly. I leave that for someone else.
Once she’s as clean as I can make her I dry her off, put on some clean pants, strip the damp bottom sheet and remake the bed. I help her to stand up whilst I secure the main inco sheet, then settle her back.
I dispose of the filthy water, dump the dirty sheets in the bath. I can’t find a new duvet cover so I leave that for the eight o’clock carer.
I right the table and restore her things to their position.
I turn the TV back on for her whilst I go into the front room and write down everything I’ve done.
I ring the son to let him know we’ve been out.
‘Thanks,’ he says. ‘I don’t know what we’re going to do about this. It’s all getting out of hand.’
I make sympathetic noises, but actually I’m still writing stuff down so I’m not paying too much attention. All I want to do is finish and get home.
I leave the paperwork somewhere obvious, then go back in to the bedroom.
‘The carer will be in soon,’ I tell Rachel. She’s staring at a game show on TV and doesn’t respond. The audience laughter is as grotesque and highly-coloured as the studio.  I keep my back to it as I tell her that I’ll be putting the key back in the keysafe.
I shut the door and hurry down the steps.
The interior of the car feels beautifully snug and quiet.
I take my radio off and throw it on the seat next to me. I’m not going to speak to anyone on that thing again tonight. I’m not even going to look at it.
Incredibly, I’m not that late. Just quarter of an hour. I can’t believe I’ve done so much in such a short time.
I tap the screen clear.
My feet and hands drive me back.

Thursday, February 05, 2015

old neighbours

From where I stand on the other side of the street, the old terrace seems less like a row of houses than a long, defensible wall, striped in different coloured paint, chequered with windows, crenellated eaves running along the top like battlements and regular breaches in the wall at the bottom for the steps that lead up from the pavement to each double porch.
At least the gaps are numbered. I go up the steps to Mary’s house. It takes a little searching around with my flashlight to find Mary’s keysafe. In the end I pick out the hunched black shape of it, clinging to the wall behind the drainpipe like a species of giant mussel.
The door opens so easily I hardly need the key.
Hello? Ambulance.
A cry from upstairs.
I hit whatever switches I can find and head up.

Mary is sitting on the floor of the bedroom where she fell, her plastic over-knickers round her ankles, an upturned commode behind her. When I come into the room and turn on the light, she moves her whole face in my direction. On or off, it makes no difference. Mary’s lost her sight years ago.
 ‘Have you hurt yourself, Mary?’
‘No. No. Well, a bit, but I don’t want to go to hospital. Have I made a terrible mess? Has it gone everywhere?’
I pick the commode up and set it back on its legs. Incredibly, a great wad of tissue in the bowl has combined with the generous rim to keep the contents inside.
‘No – you’re fine,’ I tell her, putting the lid back on. ‘But it was a close run thing.’
‘I can’t believe that,’ she says. ‘It tipped right over.’
‘There’s nothing on the carpet.’
I ask her more questions about the fall. It seems she got a bit tangled when she went to stand up, and went down hard on her bottom. I give her a few exploratory prods and get her to move her legs. She says she’s not in any pain.
‘How do you feel about standing up?’
‘I just don’t know how I’m going to do that.’
‘I’ll help.’
She’s not at all heavy, so it’s not too bad. I crouch down, take a firm grip and we stand up together. Once we’re vertical Mary winces, staggers a little, grips tightly on to my arms.
‘Oh – oh!’
‘I won’t let you go,’ I tell her. ‘I promise. Let’s get you sat on the bed. It’s just a couple of feet to your left.’
She can only take tiny steps, dragging her right leg awkwardly.
‘That’s uncomfortable for you, isn’t it?’
‘Yes, a little, but – I’ll be fine.’
I help her onto the bed, drape some blankets around her, prop her up with a stack of cushions.
The pain appears to be deep in the crease of her groin.
‘You’ll need an X-Ray,’ I tell her.
‘Such a stupid thing to do,’ she says. ‘I’ve only been home a month. It was my breathing, last time.’
She tells me she lives in the house alone, with carers coming in four times a day.
‘What’s your mobility like normally?’
‘A bit iffy. Well, I am ninety, so I suppose it’s to be expected. I have a stick of course, but it takes me a good while.’
I radio for a truck. Luckily there’s one nearby, so it won’t be long. Meanwhile, I fill in some details and take a few obs.
‘Can you tell John next door I’m going in? And Wanda on the left? I know it’s early but they’ll both be up. They’ll worry otherwise. And could you let the care agency know I won’t need them? It’s a lot to ask and I’m so sorry to be a nuisance.’
‘When the crew gets here we’ll sort everything out.’
She looks at me with her filmy eyes, and moves her head very slightly from side to side.
‘Thank you so much for all you’ve done,’ she says.
And she holds out her hand. 

Tuesday, February 03, 2015

what barbra wants

Jane is coming out of the window. We all stand down in the garden watching her climb out. It’s not a long fall – probably ten feet, down onto one of those scrubby, corner plot gardens that’s accumulated the casual trash of five years or so – but there’s a water butt and a small pile of broken paving slabs that might cause some damage.
She’s turned to go out backwards, her right boot emerging first, cautiously tapping for the end of the sill.
‘Don’t jump!’ says  the police sergeant, her hands shoved right and left into the webbing of her stab vest.
There’s a pause whilst she thinks of a reason.
Finally she says: ‘We don’t want you to.’
‘I’m doing it,’ says Jane.  ‘I’m jumping!’

It’s a cold, black night. Deep space holds dominion – that, and the moon. A strange, portentous moon I haven’t seen before, a faint but perfect halo around it like the flare through a lens.
What does it mean?

Meanwhile the other police officers have been ringing the front door bell. Another resident shuffles into focus through the glass, opens the door and stands there scratching himself, peering out. The officers hurry through.
Half a minute more and Jane is pulled back into the room, the window slid shut.
We all go in.

There’s no room in Jane’s room for everyone, so the rest of us wait on the landing whilst Rae and the sergeant talk it through. It’s odd, just hearing the voices, wondering how they’re standing, what they’re doing. I want to peer round the door but I think it might freak them out.

The sergeant touches on the window issue. Jane is still emphatic. She’s going out, she’s had enough, that’s it.
‘I can’t let you do that,’ says the sergeant. ‘Duty of care and all that.’
‘I’m doing it.’
‘No, Jane. You’ll have to go through me first.’
‘You can’t stop me.’
‘I’m hardly going to stand here and watch you jump out of a window, now, am I?’
‘I don’t know.’
‘Well I’m not. You’re not going out the window and that’s that.’
The sound of a struck match.
‘Sorry love,’ says Jane. ‘I need a smoke. It helps calm me down.’
‘That’s okay. But we have to figure out what we’re going to do with you tonight?’
‘What d’you mean, what we going to do with me tonight? I’ve told you what I’m doing. I’m going out the window.’
‘No, you’re not, Jane. Think about it. How do you think that would make us feel, seeing you jump? Not nice, is it? And what about outside? What if there was a young mum with a child going past? What if they saw you drop down right in front of them? How do you think that would make them feel?’
‘I dunno. I’d let them go past first.’
‘Seriously. It’s not going to happen.’

One of the officers on the landing has been busy on the radio finding out the state of play with the 136 room at the psychiatric hospital. Apparently it’s been a night for it and nothing’s free. The only alternatives are the custody suite or A&E.

Sudden, boozy laughter from the room next door to Jane’s. The floor creaks behind the closed door. Someone listening?
More laughter.

Meanwhile, Rae has tried to move the conversation onto other, more mundane subjects.
‘So you like Barbra Streisand, then?’
‘Yeah. I love her.’
‘Ever see her in concert?’
‘Twice. Once in New York, once in Las Vegas.’
‘Yeah. She was amazing. Straight on. Starts singing. Two and a half hours later, she’s still going. I’ve seen Cher, too.’
‘Yeah. Forty minutes late and gone in half an hour. Not a patch on Barbra. Barbra’s my favourite. Don’t get me started. I’ll be Barbra this, Barbra that.’
‘I don’t mind.’
‘Come on, then,’ says the sergeant. ‘Let’s get you down to the ambulance and carry on talking there.’
‘The paramedics want to check you over and make sure you’re all right. You know – all those health things. Then we can think how we can help you tonight.’
‘I don’t want help.’
‘Come on.’

The door opens and Jane appears first. A small, round, middle-aged woman with watery eyes and patchy hair, she walks slowly out onto the landing like a neglected pet being coaxed out of a box.
‘I’m going out the window,’ she says, straightening, looking round for it.
‘No,’ says the sergeant. ‘That’s not what Barbra wants.’