She looks at me, processes the question.
‘Yes, it’s okay.’
‘You sure? You don’t mind?’
‘It’s okay,’ she repeats, in a tone suggesting she can’t think why it wouldn’t be.
After Esther leaves my room I send Mum a message, vindicated:
Asked Esther re underpants. She said it’s FINE to put them in wash. YOU’RE the weirdo.
My victory is short-lived. Mum writes back:
You can’t do that! They are too polite – they’ll say yes to anything u ask.
Me: But I told her I could do them myself and she said it was fine!
Mum: No!!!!!! HAND. WASH. YOURSELF. BRAT.
Alice says I’m being insane, but that night I see Millicent smuggling what I’m sure are her own wet knickers back to her room after showering. Maybe it is an outdated colonial habit, but I reluctantly carry on with my secret underwear routine for the entirety of my stay.
Walt’s personal care isn’t the only thing that keeps him going. Every day, we pump a cocktail of life-preserving chemicals into him.
Walt is on beta-blockers and alpha-blockers, steroids and aspirin. He has pills for his cholesterol, for reflux, for angina. One tablet lowers his heart rate but increases his blood pressure, so that’s got to be offset by another tablet that lowers his blood pressure but is contraindicated in people with renal impairment, so that has to be offset by yet another tablet that helps prevent fluid retention. We give him pills to prevent heart attacks, pills to widen his blood vessels, and pills to inhibit the beta-oxidation of fatty acids by blocking acetyl-coenzymes to enhance glucose oxidation in his ischaemic cells, whatever that means.
Red pills and blue pills, white pills and yellow pills, pills that can’t be taken together and others that ideally should, pills for the morning and pills for just before bed, pills that are crucial and pills that can be skipped: a carefully titrated extension of life expectancy, rattling around in plastic.
The night before Marguerite arrives, while Alice puts Walt down to bed, Fiona sits me down on the floor of our bedroom to take me through the process of managing Walt’s pills. Alice is already across what he needs to take, it had been part of her job in England. But now that we’re in Kenya, Fiona wants to establish a new routine. ‘Doing Walt’s Pills’ is to always take place in this room – his medication is kept inside a padlocked suitcase in the top of the cupboard.
‘Marguerite can’t be trusted, so we need a good place to hide the key,’ she says, then – without asking – opens my underwear drawer, rifles past my jocks, and pulls out a box of tampons. ‘How about in here?’
Sure. Fine. Why not, I think, giving up any last hope of personal space or privacy.
Fiona takes a plastic binder full of documents out of the suitcase. She spreads the documents out on the carpet around us – years’ worth of Walt’s medical records, doctors’ letters, prescriptions and test results.
She says she wants me to understand the backstory to what’s been going on – why it’s so important we keep such a close eye on him here.
‘I went to see Dad at their house after he started becoming unwell, and I swear he was drugged. He was a zombie – a vegetable!’ she says. ‘He wasn’t at all himself. Even his eyes – you could see. They were so dull and grey. It was horrible.’
Then, Fiona discovered he’d been taking an antidepressant.
‘This one.’ She hands me a printout of the Wikipedia article on ‘Citalopram’. Sections of the text are highlighted in yellow. She lists the possible side effects as I look over the pages.
‘Drowsiness … insomnia … fatigue … cardiac arrhythmia… I mean, with his heart condition! Can you believe it? Blood pressure changes … anxiety … mood swings … dizziness … he shouldn’t be on anything like this.’
Fiona draws my attention to a section double underlined in red pen: increased apathy and emotional flattening.
‘That is exactly what Dad was like. Flat. Absolutely flat.’
Well, he had just had a heart attack, I think. You wouldn’t expect him to be bouncing off the walls.
‘So why was he put on this in the first place?’ I ask.
‘Because he’d finally mustered the courage to tell Marguerite he’d had a gutful of her! He tried to kick her out of the house – he’s wanted to for years – so she took him off to see her doctor about getting him sedated. Just doped him up on this stuff so that he was easier to control.’
Fiona pulls out a letter from Marguerite’s doctor to the Smyth family trust which gives a slightly different version of events. This doctor reports that Walt’s behaviour was becoming increasingly erratic and aggressive – that his declining mental state was causing him great distress and serious difficulties at home. It says that on a number of occasions he had lashed out at Marguerite – sometimes physically – and was a potential danger to her and to others.
‘Rubbish!’ Fiona says. ‘Dad wouldn’t hurt a fly!’
The letter says it is common practice to prescribe dementia patients a mild antidepressant to help manage these sorts of symptoms at this phase of the disease, and that the ‘extremely low dose’ of ten milligrams would simply ‘take the edge off’ his anxiety, lowering the risk of violent outbursts.
It’s all bullshit, according to Fiona.
‘Marguerite’s got that doctor in her back pocket,’ she says. ‘He’ll say whatever she tells him to.’
I quietly note the part in the Wikipedia article that says:
There are studies suggesting that citalopram can be useful in reducing aggressive and impulsive behaviour. It appears to be superior to placebo for behavioural disturbances associated with dementia.
‘I got a second opinion,’ Fiona says, handing me another doctor’s letter. ‘This doctor says the Citalopram is “completely unnecessary”. It says that the focus should be on “creating a safe and supportive living environment” and that he should cease taking the Citalopram immediately, especially given its interaction with all the other medication he’s on.
‘So I tipped the whole lot down the loo. But I wouldn’t put it past her to have a stash hidden away somewhere. We’ll have to have a snoop when she gets here.’
It starts to rain outside. Fat gusts of damp and dusty air billow out from behind the linen curtains, blowing the papers across the floor. While Fiona gathers them up and shuts the windows, I pull out my laptop to read more about Citalopram.
I flick through drug information sheets and patient reviews and health forums, trying to get a handle on how the drug – an SSRI antidepressant – works, and what effect ten milligrams is likely to have.
I mention to Fiona that the therapeutic dose range is ten milligrams to forty milligrams, so he was on the lower end of the scale. Was it really possible for that to turn him into a ‘zombie’?
Fiona sets me straight.
‘She was giving him much more than ten milligrams.’
Fiona grits her teeth, angry tears pool in the corner of her eyes as she looks through the papers for her next piece of evidence.
She hands me a photocopy of a scrap of lined paper. It’s a handwritten list of Walt’s medications. She points to a figure scrawled beside the word ‘Citalopram’.
It says ‘75mg’.
‘No bloody wonder he was so unwell! It’s a miracle he was even conscious. I will never, ever forgive her.’
The bed alarm starts beeping. Fiona unclips the baby monitor from her waistband, sees that Walt is up, pacing in his room. ‘Bugger,’ she says, wiping her eyes. ‘I’ll go and take over from Alice. She can fill you in on the rest.’
But as she leaves the room, I notice something else about the photocopied handwritten list Fiona thinks is a smoking gun.
‘Citalopram’ falls between ‘Aspirin’ and ‘Clopidogrel’, both of which have ‘75mg’ listed – correctly – as the dosage beside them. I check every other list of medication in the folder – the prescriptions, the pharmaceutical receipts, the hospital discha
rge summaries. Nowhere else is the Citalopram listed as ‘75mg’. It’s always down as ‘10mg’.
I do some sums: if Marguerite had been giving Walt seventy-five milligrams of Citalopram per day, she’d have been going through an entire box of pills every four days. It’s impossible that she’d have been able to get away with that without raising suspicions somewhere along the line.
It seems vastly more likely that a seventy-something-year-old woman was jotting down a list of her husband’s medications and absentmindedly wrote ‘75mg’ between the two drugs that were meant to be ‘75mg’.
It seems to me Marguerite is guilty of nothing more than a mistake. I point it out to Alice, who concedes my point then returns us to the task at hand, apparently not as keen to play Nancy Drew as I am. She pulls out a pair of plastic pill dispensers. ‘Here – these need to be restocked every fortnight,’ she says. The Monday-to-Sunday tubs of colourful beads rattle like an advent calendar of death-defying Skittles. ‘And we’ve got to make sure we’ve got reserves of everything for at least another three months. Fiona says it’s good to have a buffer, in case anything “goes down” in Kenya and it’s hard to get things in from England.’
Alice and I pull everything out of the suitcase. In addition to the medicines there’s an old rolled-up sock, an asthma inhaler and some tubs of Vaseline that we put aside. We remove the rubber bands holding boxes of capsules and tablets together, and lay them out across the floor, arranged in alphabetical order. We work our way through the list on the spreadsheet, pull out the foiled blister packs and pop out the required number of pills. Some don’t come in the exact dosage Walt requires – we have to halve or quarter them using a pill splitter.
The pill splitter sucks. Alice goes to get a sharp knife and cutting board – that’s not much better. Tiny bits of tablets are pinging across the room and we’re on all fours sweeping our hands over the carpet trying to find them, grasping for crumbling half-moons hiding under the bed or behind the dresser, or caught in the piles of crumpled pharmaceutical blurbs. And all the while, I’m trying to cross-reference what’s gone into the dispenser and how much is left and update the spreadsheet as we go.
Alice had warned me that it took ‘a while’ to do Walt’s pills. Turns out she underplayed that too. It takes hours, literally hours to get the job done. I knew coming to Africa to look after a rich old man would involve some dullness, but I didn’t expect to be doing stocktakes until midnight.
5
THE WIFE
‘Yoo-hoo! Yoooooo-hooooooo!’ An alarming, high-pitched cry torpedoes down the passageway from the front door. It takes me a moment to recognise it as a human voice – it sounds like the cry of a demented bird.
‘She’s here,’ Fiona says, poking her head into my room as I’m doing up my bra. Alice has taken Walt out for the morning – Fiona said Marguerite’s arrival would be too disruptive for him, but thought it would be good if I were here. ‘Come, let’s wait for her in the living room.’
I’m expecting a cool, coiffed, sharp-tongued socialite: someone buttoned-up and bossy, the sort of person who takes tea without milk or sugar, says ‘no’ to cake and shoos friendly animals away. A wicked, money-grubbing bitch. I’m certainly not expecting Marguerite to be quite so … bubbly.
‘Yoo-hooooooooo! It’s meeeeeeee!’
Six suitcases roll into the house behind her, as she yodels about how ‘terribly suffocating’ Virgin Atlantic’s first-class seating arrangements are.
‘Fancy having a divider all the way up between you and the chap beside you!? I mean, really. How jolly awful if you’d like to talk to each other. And you know, I do like to talk to people and find out their business. Well. It didn’t matter in the end, did it? I took one of those wonnnnnnnnderful Temaze tablets and blipped through the whole thing. Oof! It did fly by. I was almost sorry it was over when we landed – I didn’t even get to wear my aeroplane pyjamas! Such a shame. Now where’s Esther? Esther! Esther! Yooo-hoooo! Oh, Esther, do come here, won’t you? Quickly. Quickly now. I have a lo-ver-ly pressie for you!’
I find myself smiling – I can’t help it. Marguerite’s the most British person I’ve ever met. She somehow combines the plummy voice of Hyacinth Bucket from Keeping Up Appearances with the scatty demeanour of Eddie from Absolutely Fabulous. It’s like seeing Big Ben for the first time and finding it’s held together with licorice allsorts.
I feel Fiona watching me, trying to work out whether I can resist Marguerite’s spell. I reset my face, stand up straight, try not to appear quite so … entertained.
Marguerite can’t stand still. She paces figure eights around the living room, directing David and James to leave her various bags in various corners, where they spring open with the pressure of her colourful wardrobe, jack-in-the-boxes full of embroidered handkerchiefs and resort-wear flying around the room, catching on floor lamps and armchairs and picture frames. Fiona and I stand silently with our backs against the wall on the far side of the room, trying to follow Marguerite’s frenzied index finger as it assigns the order in which her bags are to be unpacked.
When Esther appears at the door, Marguerite presses into her hands the complementary set of pyjamas she was given on the flight. ‘Ohhhh, Esther, there you are. Now. I’ve brought these in just for you – they’re super! Don’t you think?’
Esther, I suspect, does not think the set of stretch cotton tights and top is all that super. Nonetheless, she dutifully expresses gratitude – ‘Ohhhhhh, asante sana, memsahib, asante!’ – before retreating to the kitchen, leaving Marguerite elated by her own generosity.
‘Oh, they do like it when I bring things back for them,’ she gushes, bouncing on the spot with joy, fairy clapping herself. I’m transfixed.
It’s like watching someone offer a homeless person a doggy bag full of leftover lobster.
Then – for apparently the first time since entering the room – Marguerite spots me. ‘And now, who might you be?’ She makes a beeline for me, pulling up mere inches from my face, retrieving a crumpled tissue from under her bra strap and holding it up to the corner of her mouth. I glance over at Fiona for guidance but before I have a chance to answer, Marguerite squeals, ‘Ooooh! I know – don’t tell me – you must be Kirsten, the other Or-stray-lyan girl! Did I guess right?’ She taps my shoulder with the lipstick-stained tissue, her eyes wide and sparkly, a guileless pink grin spanning her face.
‘Yes … that’s right,’ I reply, thankful that someone has, after all, told her I’m here.
Marguerite’s mouth falls open in faux shock. ‘Oh! Is it really?’ She spins to Fiona for confirmation. Fiona nods wearily. Marguerite spins back to me. ‘Oh my, I am clever sometimes, aren’t I!?’ She hoots with laughter so hard I jump. ‘And where’s my darling Walt? And young Alice! Tell me – is she liking Keen-ya?’
‘They’ve gone down to the Club for morning tea, but they’ll be back any minute,’ Fiona says, speaking to her stepmother as though she’s addressing a hyperactive five-year-old. ‘Now, Marguerite, can we please put all these bags away so they don’t confuse Dad? He’ll think he’s about to go on a holiday if he sees them.’
‘Ohhhh, the Club!’ Marguerite shrieks again – startling Esther, who’s come through with a tray of tea for us; the teaspoons jitter against the saucers as she makes her way to the patio. ‘Shall we meet there for lunch?’ Marguerite asks. ‘Is it curry day!?’
‘No, Marguerite. Khamisi is making us lunch. We’re having roast beef. It’ll be ready at half-twelve.’
‘Who’s “Kasimi” then?’ asks Marguerite, sitting on the edge of the settee to peel her flight socks off.
‘Khamisi. He’s your new cook,’ says Fiona. The Smyths’ old cook had retired several months ago, and Marguerite had no intention of hiring a replacement.
‘Do we really need a cook? Surely with all these young helpers around there are enough of us to take care of the kitchen.’
‘You’ll need a cook to make it easier to cater for Dad,’ says Fiona. ‘Khamisi is
very good. I’m sure you’ll be happy with him.’
‘Oh, how lovely! Alright then. We’ll do the Club tomorrow. I say, the weather really is much nicer here than in England. Do you know they’ve closed Heathrow for the snow? I must have only just escaped it. Oh, I do have such wonderful luck sometimes …’
On and on it goes, this soprano flurry of noise and movement, whirling around the house. Marguerite asks me to help set up her new laptop, and her shoe rack, and to sort out the SIM card for her Kenyan mobile phone. I can see where this is going. I won’t just be Walt’s ‘carer’ here – I’ll also be her personal assistant.
Discrete piles of belongings start forming in various corners of the living room: soaps and shortbreads, scarves and shirts and socks. Marguerite hands them out as though they’re gift bags. ‘Alright now, David, you take this stack of goodies through to the bathroom for me, won’t you? And James, you take this lot through to the pantry, there we are. And you, Esther, can take this lot through to my bedroom.’
Marguerite has brought a whole pile of things for Walt with her from the UK. But as Fiona points out, they’re all wrong. The Harrods socks are too thick: they’ll make Walt’s feet sweat – no good. The lavender-scented hand soap will be too harsh for his skin. He can only use soap-free products from the chemist; Marguerite should have known that. The polo shirt is too bright; he’ll never wear that colour. And in any case, short sleeves are no good.
‘Dad bleeds very easily, Marguerite. His skin is very fragile.’
‘Yes, Fiona. Mine is too. That’s what happens when you get old.’
‘Yes, Marguerite. But the thing is, Dad’s skin is thinner than most.’
‘What a pity. I’ll have to give the soap and socks to the staff, I suppose. Perhaps you could exchange the shirt when you go back to England?’
‘Actually, I can imagine Jonathan pulling this off. He’d quite like it!’
Jonathan is Fiona’s husband. He’s ‘minding the fort’ for her back in England. I suspect he does and wears whatever she tells him to.
I Built No Schools in Kenya Page 6