Go Not Gently

by Cath Staincliffe

  This was a corner room with two bay windows. In the recess of the one at the front there was a table with high-backed chairs. A woman sat writing. In the other bay two women, deep in conversation, sat on a chintz-covered sofa. Each held a cat on her lap.

  Around the rest of the large room were three clusters of high-backed easy chairs and side tables. People were sitting in some of these, reading papers and books, sewing and playing chess. The atmosphere was relaxed, quietly busy.

  ‘She must be in the other room,’ said Agnes.

  We crossed the hall and opened the door. The room had the same decor but a semicircle of chairs faced us, arranged to focus on the television set, which was blaring out. There were six people there. A couple looked up as we went in. Agnes moved over to the woman sitting nearest to us, on the outside of the group.

  ‘Lily, hello. How are you?’

  The woman turned to face her. She stared blankly, unwavering, at Agnes for two or three seconds then turned back to the television set. I heard Agnes sigh. I put my hand on her arm. The poor woman. Her closest friend had no idea who she was.

  CHAPTER FOUR

  ‘Lily,’ Agnes bent over close to her friend, ‘it’s me, Agnes. I’ve come to see you. Lily?’

  ‘She had a bad night,’ a man sitting in the centre of the semicircle spoke up, ‘wandering about. They’ll have given her something to calm her down.’

  There was no response from Lily, who continued to stare at the television.

  ‘I think there’s too much of it myself,’ the man continued, ‘pills. Take a pill for anything these days. People go to see the doctor and they’re not happy unless they come away with a bottle of tablets. Look at her, you couldn’t say she was well, could you? Just keeping her quiet. Doped up.’

  ‘Shush.’ The woman on his left glared at him.

  ‘I’m just saying they’re too quick with their tablets. There’s some folk in here would rattle if you shook ‘em…’

  ‘Be quiet, will you? I can’t hear the television,’ his neighbour admonished him.

  A young woman wearing a maroon overall came into the room carrying a tray of drinks. Agnes asked her about Lily.

  ‘You’re best talking to Mrs Knight,’ she suggested. ‘I think she’s in the office at the back. Do you know the way?’

  Agnes nodded She squeezed Lily’s hand, told her she wouldn’t be long and straightened up.

  Mrs Knight, the matron, exuded competence and efficiency. She provided us with chairs, sent for cups of tea and made notes as we talked. She wore a dark blue nursing uniform and a hat. Her hair was thick and black and cut in a pageboy bob that seemed to emphasise her long face and drooping eyes.

  Agnes introduced me as a family friend and asked about Lily.

  ‘Mrs Palmer was rather disturbed in the night. I’m afraid she suffered some incontinence, which obviously distressed her, and she was quite hard to settle. She was given a sedative. That may have left her a little groggy.’

  ‘She doesn’t even recognise me,’ said Agnes.

  ‘I’m sorry,’ said Mrs Knight. ‘I realise how upsetting it must be for you. It is a common symptom but it won’t necessarily persist. You may find a great improvement on your next visit.’ The words were sympathetic but there was no warmth in her manner. ‘Mrs Valley-Brown probably explained to you that we’re dealing with a slow degenerative illness. It proceeds unevenly. Although we can’t halt the disease we can make life as comfortable as possible for Mrs Palmer until such time as she needs additional care.’

  ‘What would happen then?’ I asked. Out of the corner of my eye I saw Agnes freeze, the teacup halfway to her mouth.

  ‘Excellent care is provided at the psycho-geriatric unit at Kingsfield.’

  Agnes’ hand was shaking so badly that the cup clattered as she put it down. Everyone had heard of Kingsfield – one of the vast, old-style asylums.

  ‘I thought it was shut,’ I said. ‘I thought they were closing all those places down.’

  ‘Many wards did close and much of it has been put to other use but there’s a very successful psycho-geriatric unit.’ Mrs Knight seemed oblivious to Agnes’ distress. ‘The staff have a great deal of skill in dealing with confused and frail elderly

  people. We do recognise that community facilities aren’t appropriate for some patients, or they simply aren’t available. Kingsfield still has a role.’

  Agnes cleared her throat. ‘I was wondering whether Lily’s problems might be due to a physical upset. There’s something I’ve read about called acute confusional disorder.’

  Mrs Knight nodded. ‘The doctor ruled that out. The state you’re referring to is quite easy to identify because we can connect the confusion to a particular physical illness. In Mrs Palmer’s case there was no such link. She was given a complete medical on her arrival here. It’s something we offer all our residents – we even arrange X-rays at the hospital so we can be absolutely sure that people have no physical problems that have gone undetected.’

  ‘But it happened so swiftly,’ Agnes went on, ‘it wasn’t gradual.’

  ‘I know all the books talk about Alzheimer’s progressing very slowly,’ Mrs Knight clasped her hands on the table and leant forward as she spoke, ‘but quite often early symptoms go unnoticed. Mrs Palmer may well have been forgetful for some time without it causing anyone undue concern. In a new environment some of these symptoms stand out more clearly.’

  ‘She’s always had an excellent memory,’ insisted Agnes.

  ‘That was just an example,’ remarked Mrs Knight, unsmiling, ‘but I’ve been in nursing for twenty-five years, I’ve specialised in geriatric care and I’ve no reason to think Mrs Palmer has acute confusional disorder rather than progressive dementia.’ Subject closed.

  ‘Who’s her doctor?’ I asked.

  ‘Dr Goulden. He holds a regular surgery here every week. Mrs Palmer transferred when she moved in.’

  ‘So we could ask him about this?’ I ventured.

  ‘By all means. But Dr Goulden is only going to repeat what I’ve already told you.’ Her voice was icy.

  ‘Do you have his number?’

  ‘Certainly.’ She gave me it then rose from her chair. The interview was over. Then she made an effort to redeem the atmosphere. ‘I hope he’ll be able to set your minds at ease. We do feel it’s important that friends and relatives have all the information they can about each individual care plan here.’ Still no smile, though. It was unnerving. A missing bit of body language that made it feel that the whole conversation was askew. Well, the exchange had hardly been harmonious. Medical types sure don’t like their judgement questioning.

  Agnes wanted to sit with Lily for a while so we returned to the TV lounge. Lily didn’t resist when Agnes sat beside her and took her hand. They were like that for ten minutes or more. Lily staring at the box, Agnes, her eyes cast down, looking up at her friend every now and then.

  Lily was small, her feet barely reached the floor. Her neck craned forward and the top of her spine was curved with age. She had steel-grey hair, tightly permed. Her face was round, crosshatched with fine lines. A pair of modern glasses with pink and cream frames rested on her small nose. A trickle of saliva edged its way down from the side of her mouth. Agnes wiped it away with her hanky. Lily didn’t notice.

  I pretended to watch a feature on how to cook borsch.

  Agnes stood up and said goodbye, told Lily she’d come again tomorrow, bent forward and kissed her cheek. No reaction.

  We were halfway back to Agnes’ house before she broke the silence. There were tears in her voice, and determination. ‘I want you to see that doctor, talk to him about the diagnosis. I wasn’t at all satisfied with that woman’s explanation. She hardly gave much consideration to concerns.’

  ‘Made up her mind already,’ I said. ‘People like that don’t believe in uncertainties. She’d never admit they were wrong, I bet. Too much at stake. She was frosty, though, wasn’t she? Did you notice she never smiled, not once?’
>
  ‘It’s all happened so quickly,’ said Agnes, ‘that’s what I was trying to tell her. Lily got ill suddenly, not progressively, and today she’s much worse.’

  ‘You’ve never seen her like that before?’ I asked.

  ‘No. She’s always known me, known…’ she shook her head, grappling for words to explain, ‘known herself, even if she’s been quiet or distressed. I’m so worried.’ She broke off.

  I pulled up outside her house and turned the engine off. It ticked as the metal cooled.

  ‘I want to see that doctor and I’d like you to be there. Sometimes people are a little dismissive because of my age. I realise you’ll want a fee and I’ll be happy to pay for your time. And I’ll ring Charles, Lily’s son. He should know. I’m sure he’d want to.’

  ‘Is he close to his mother?’

  ‘Not really. I think he functions on guilt. He sends money. He’s a very busy man.’ There was a bitter edge to her voice. ‘I must sound harsh. It just seems so unfair. Still, I shall talk to him.’

  ‘It might be worth contacting Lily’s former GP as well,’ I suggested. ‘The doctor I talked to said to get the whole physical history, find out the order in which things happened.’

  ‘Well, that’s Dr Chattaway. He’s my doctor, too. I’m sure he’ll help if he can.’

  ‘I’ll try and make an appointment with Dr Goulden first,’ I said. ‘Are there any days that are bad for you, any regular appointments?’

  ‘Nothing I can’t break.’ She smiled. ‘So you don’t think I’m being silly, wanting to know more?’

  ‘No, not in the least. In the end we might find that Goulden’s diagnosis is right but there’s enough doubt in my mind to ask a few more questions.’

  Agnes nodded. ‘Thank you. I’d never forgive myself if there was anything…’ She sucked in a breath and let it go, unbuckled her seat belt. I got out and opened the door for her.

  ‘I’ll ring as soon as I’ve fixed a time.’ I waited until she’d opened the front door before turning the ignition. She waved and I drove off. It was twelve thirty, I was ravenous and a Greek feast awaited.

  CHAPTER FIVE

  Rachel, my social worker contact, was one of life’s great prattlers. She burbled on over stuffed vine leaves and tzatziki, vegetarian moussaka and kebabs. I’d never worked out whether she did this to her clients as well or whether behind closed doors a listener emerged – mouth shut and all ears.

  We were sipping strong coffee from dinky cups before she asked me about the case. I sketched it in for her without giving away anything that would break confidentiality.

  ‘Check it out with the doctor,’ she agreed. ‘But there could well be a lot of denial going on, you know, from the friend. Alzheimer’s is the new scare, worse than cancer. People are very frightened. It’s understandable – you have to watch someone lose their identity, their personality. How do you keep loving someone who’s not there any more?’

  ‘She’s no fool, the friend,’ I defended Agnes.

  ‘I’m not saying she is. You could always get a second opinion – ask her old GP to come and see her or get a referral to a consultant.’ Rachel fished a sugar cube out of the bowl on her spoon.

  I nodded. ‘What about her social worker?’

  ‘How do you mean?’

  ‘I think there was a social worker involved with the move. Would they have made reports on the woman at the time, her state of mind and so on?’

  ‘Oh, yes.’ She lowered the spoon into the tiny cup, the sugar cube turned brown. ‘There’d be case notes. Probably just the standard things, a general outline of the case, assessment of needs. But from what you’ve said the social worker might only have seen her once. She’s not at risk. I wouldn’t rely too much on finding anything very illuminating there.’ She tipped the coffee-soaked cube into her mouth and sucked.

  ‘Wouldn’t they do any follow-up?’

  ‘No need. The home’s registered, they take responsibility for her care. Which one is it?’

  I hesitated.

  ‘It’s all right,’ Rachel laughed at my caution, ‘I can keep a secret. It’s just that there’s a couple of places have got a bad name for themselves.’

  ‘Homelea, on Wilbraham Road.’

  She shook her head. ‘Nope. Did it look OK?’

  ‘Yeah.’

  ‘Smell all right?’

  ‘What?’

  ‘It’s a good indicator. If it stinks of piss or even boiled cabbage you know they’re not doing all that they can.’

  ‘No, it was fine, nice. People looked busy, you know. Well, apart from the TV lounge.’

  Rachel laughed. ‘There’s always a TV lounge. Mind you, we’ve all got them, haven’t we? Just looks different if you’ve a dozen people sat in high-backed chairs watching it.’

  I asked Rachel a few more questions about the role of Social Services in the care of older people. She told me that in the situation I’d described it would be peripheral. My research complete I sat back and listened while Rachel chuntered on and sucked sugar cubes.

  I paid the bill wondering whether it hadn’t been a rather pricey way of finding out virtually nothing. On the other hand I had enjoyed my time with Rachel. She was lively company, and when you work alone it’s fun to have lunch out. Later, though I didn’t know it then, her help was going to be invaluable. In a totally unexpected way.

  There was a van parked outside the Dobsons’, a white Transit with the words ‘Swift Deliveries – Swinton’ emblazoned in vivid red along the side and an arrow in flight underlining the message. A man sat in the front seat, reading a tabloid and smoking. He flicked his eyes from the paper to me as I turned to walk up the drive. A black guy with a serious haircut. A precisely honed wedge.

  He wound down the window and called to me, ‘Kilkenny’s?’

  ‘What is it?’ I asked. I hadn’t ordered anything, no deliveries due. Swift or otherwise.

  ‘I rang you.’ He cocked his head towards the house. ‘The answerphone.’

  Aahh! Of course, the young man with no name. ‘Yes. Come on in.’

  He locked up the van and followed me up the path. In the office he agreed to coffee and introduced himself as Jimmy Achebe.

  It was hard to judge his age, though he had a very young face, unlined coppery skin, black hair. Closer to I saw the sides and the back were shaved and the wedge section glistened with oil or gel. He wore gold rings in his ears and a gold wedding ring. He was drenched in eau de nicotine. I wondered whether he’d light up without asking. I don’t keep an ashtray in the office. It’s a deliberate policy to prevent people smoking there. You’d be amazed how many chronic smokers still try, offering desperately to ‘use the bin/cup/saucer if you haven’t an ashtray’. Jimmy Achebe wore a pale blue nylon zip-up boiler suit with the legend ‘Swift Deliveries’ embroidered on the back in red.

  ‘So, how can I help? I gather you were interrupted yesterday.’ I brought the mugs over to the desk.

  ‘Yeah. Sorry ‘bout that. My wife.’ He took the coffee from me.

  I sat down opposite him. Fished out a pad and pen.

  He looked away, shrugged, fidgeted and sighed.

  ‘Is it about your wife?’

  He nodded, rubbed his nose with a broad palm. ‘Yeah, I think there’s something going on. She’s out when she should be in. I’m not saying it’s anything wrong, you know, but there’s something going down.’

  ‘Have you asked her about it?’

  He sighed again. ‘She gets all defensive, tells me I’m paranoid, that I’m going to ruin things between us. Says I have to trust her. She’s been that moody, flies off the handle and that.’ He frowned, at a loss how to deal with the situation.

  ‘Tell me about her,’ I suggested.

  ‘What?’ He glared as though the idea were somehow improper.

  ‘What’s she like? How did you meet her? When did you get married? What’s her job?’

  He groaned. ‘She’s called Tina. She’s a fashion designer. She makes her o
wn gear – jackets and that – tries to sell it on to the buyers. It’s hard though. She’s tried for a few jobs in the trade but…’ He shrugged. ‘It gets her down sometimes. We’ve been married eighteen months. She’s epileptic – that makes it harder to get the work. People think she’s gonna have a fit every five minutes. I tell her not to say anything but she wants to be upfront about it. She’s proud, you know, doesn’t want to hide it but people just freak out.’

  ‘Does she work from home?’

  ‘Yeah. She tried renting some space in the craft village but that didn’t last long. She says she needs some capital to get ahead. So now she uses the spare room.’ He spread his hands.

  ‘And you’re a driver?’

  ‘Yeah, money’s crap but it’s regular.’ He glanced to see if his language had given offence. I smiled.

  ‘OK. So tell me about recently. She’s been going out a lot at night?’

  ‘No, no. It’s in the day. When I’m at work. A couple of times I’ve called home if I’m doing a delivery that way – grab a cuppa or some food – and she’s not there. I asked her about it later, “What you done today?” and she said she’d just been in and when I said I’d been home she says, “Oh yeah, I went up the shops.” I could tell she was lying. And the next time I asked her straight out, that’s when she got all upset and that.’

  ‘So this has happened twice?’

  ‘More than that. Other times I’ve rung up. I hate checking up on her but I don’t know what’s going on. She won’t talk to me about it. Your mind starts thinking all sorts, I mean all sorts. I know her regular things like aqua-fit and Fridays she likes to go down the market but this is different. She’s keeping something from me.’

  ‘Do you know how long she’s out?’

  He shrugged. ‘A couple of hours.’

  ‘Any particular days?’

  ‘Middle of the week, I think.’

  I thought about the way he’d described her moods. ‘She ever use drugs?’