You Lot

Balancing on the icy pavement, Alfie flags me down and watches the car practically skate down the road towards him. The snow has finally stopped, and what's left on the roads is now compacted into thick sheets of ice. The nights seem brighter, moonlight and streetlamps reflecting off the shimmering surfaces. Abandoning the car in the middle of the road, I step out onto the frozen pavement making doubly sure of each step. Non-slip boots might work on oil, or water, or blood, but they're useless when competing with ice, so I put a bag on each shoulder, hoping for some extra balance.

"She's in here, mate," Alfie yells, already standing back in the front porch. I follow him in, and as I catch up he starts telling me a little about her.

"Mum's got dementia, so you have to take some of what she says with a pinch of salt. Other than that, she's pretty good. Only takes an aspirin every day." He shows me into the bathroom, a favourite haunt for elderly fallers.

"What's her name?"

"Loretta Dent. But just call her Loretta. She's not really one for formalities."

"Hi Loretta," I turn towards the patient, kneeling down beside her, "what are you doing down there?"

"Well, I'm not really sure! I was just on my way back from the loo, about to go to bed I think, and the next thing I know, Alfie's in here with me, a phone plugged to his ear, and he's telling me not to move!" She looks around her, making sure that she really is on the floor, and that she's not going to fall any further.

"Alfie!" She calls. "Alfie dear, be a good boy and pick your school bag off the floor. Your father will be home any minute, and you know how much he hates things in the middle of the lounge!"

Alfie takes me to one side, and explains that his parents divorced when he was twelve years old. He hasn't heard from his dad since, some forty years or more.

"It's alright Mum, everything's clear. Let's get you sorted. This nice gentleman has to come to help you up off the floor." A mock look over my shoulder to locate said nice gentleman fails to do so, and I tell Loretta that I presume he means me.

"Are you a doctor?"

"No. A paramedic. An ambulance man."

"Oh, well you're better than doctors anyway, you lot."

"Must be the dementia!" I say to Alfie, outwardly humble, and inwardly proud. Even a little smug.

"Oh no," he replies, "this time she knows what she's talking about. You lot always have the time for us. When I have to get the doc out for her, they're in and out in five minutes. Hardly bother checking her blood pressure. Sometimes they just guess over the phone, and prescribe something. Think that absolves them of responsibility!"

I don't really know what to answer. I try to defend the doctors, saying that they're on a much tighter schedule than we are and joking that maybe they get paid by the patient, and we get paid by the hour. Alfie just shrugs his shoulders.

The crew turn up a few minutes later, and together we help Loretta off the floor, recheck all the numbers, and prepare to leave her at home so she can get back to sleep. We place her gently back in bed, and Alfie makes sure she's tucked up, the thick duvet covering her up all the way to her chin. I think of how many times I do that for my kids, checking on them several times a night to make sure they're warm enough and all wrapped up, and how many times over the years Loretta must have done the same for him. Years of motherly kindness partially repaid with each gentle gesture. 

"Goodnight, Loretta!"

"Goodnight you lot! Thank you ever so much!"

As we leave, Alfie turns off the light in her room, and walks us to the door.

"Call us again if you need us." I tell him. "If it's before seven in the morning, you might be very unlucky and it'll be us lot again!"

"Careful what you wish for!" Alfie answers. "You never know what she'll get up to in the night. You lot might be back sooner than you think."

Two hours later, we were.

"Oh, am I glad to see you lot again..."

Wanderings

My head takes me to a different time and a different place. It's somewhere around eleven o'clock in the morning there, a city I hadn't seen for almost twenty years. The famous bridge looking over a beautiful harbour, ferries sailing across from Circular Quay to oddly named suburbs like Manly, the shell-shaped opera house that its creator never lived to see completed.

I have fond memories of Sydney. It presented me with my first experiences of rugby and cricket, and even my first ever international football match. The beach was never more than twenty minutes away and so much of life was based on being outdoors. As we were chilling in the big freeze in London, the person I was calling was enjoying their summer. Well, all except for the cricket scores.

It's not a habit of mine, making long-distance calls from other people's phones, but this time, I have no other choice. Leon lived on his own, his nearest living relative the son we were now trying to reach. Friendly neighbours were plentiful, but how friendly they would be if woken at midnight was another question. The police had found him wandering the streets in the middle of the night, dressed in nothing but a dressing gown and slippers. He had no money and no keys with him, and was completely lost. The police had discovered his address, and luckily he had a key-safe by the front door to which he somehow remembered the number so they could get back in. The police then called on us just to "check him out" and put his mind at ease.

Physically, Leon was fine. His numbers all added up, he felt generally well, but from what we could ascertain he had never before gone strolling in the middle of the night. He also couldn't remember where he lived, and didn't recognise the fact that when the police found him they were only a block away from home.

Dementia was listed as his only medical condition, and having finally got through to his son, we discovered that it was still fairly mild. His short term memory was affected intermittently, but he would normally function day-to-day quite happily and capably on his own. He had a cleaner come in once a week who would also take him shopping since he'd had to give up driving. Otherwise, he did everything on his own.

Nocturnal travels, however, were a new, potentially hazardous occurrence, and left us all with a problem.

I was loathed to take Leon to hospital, but had no other way to guarantee his safety. There was no-one we could ask to come and stay the night, just to make sure he stayed home. Leon was reluctant, and his son even more so, but both saw the logic to the argument that we couldn't just leave him alone. Hopefully the hospital would be able to care for him until his son arrived from the other side of the world.

"We've been thinking about a residential home for Dad." He tells me that they'd had honest discussions, and that the plans were in the pipelines. Now they'd have to be brought forwards. "I can be there in thirty-six hours."

"Don't forget it's winter here," I told him.

"Oh, I know. I'll say goodbye to summer as soon as I take off from the airport."

As we all stroll out to the ambulance, my mind takes its own little walk and wanders back again to Sydney's Kingsford-Smith, my last sight of it, and its runway that ends in the beautiful blue sea.

Real World

In her late 30s, she's barely older than either of us, but her body's betrayed her already. Lying in her bed at home, her face is gaunt and gray, her limbs little more than skin-covered bones. Her breaths shallow, laboured attempts at feeding the cells with the oxygen they crave, whilst sunken eyes share their fear and sadness with all those present.

We're there on a mission of mercy. The call is neither an accident or an emergency, but a penultimate journey that no-one wants to be a part of, one where everyone understands its necessity. A hospice bed awaits at the end of this transfer, a gentle room, surrounded by large windows, the other side of which is a beautiful garden, lovingly tended to by a gardener who clearly realises and appreciates the significance of the nature he maintains.

Kara's cancer had almost beaten her. She'd been given weeks to live, and she, her family and their doctor had agreed that she should spend that time with round-the-clock palliative care on hand. There was nothing left to do, other than make those final hours and days more comfortable, as pain-free as possible. Tony, her partner of three years smiled through his tears, making no attempt to hide them as we moved her as gently as we could onto the trolley. Her parents stood either side of the door, a guard of honour testament to her bravery, and whilst her mother's tears flowed, her father's tear-soaked eyes were held back by a stoic dam, ready to burst at any moment.

We wheeled Kara as slowly as we could, feeling every bump almost as much as she did, whilst she'd reassure us.

"It's fine, I know it's not you. I'll get Tony to sue the council". I'm sure the reassurance should have headed in the opposite direction.

Tony travelled with us in the ambulance and brought with him a large pink, flowery case with a few of Kara's things. Pyjamas, some make-up, her favourite books.

"Not really my colour, is it?", he says, as he drags it up the back steps. Kara smiles, and everyone else forces one too, especially Tony.

A few minutes travel down the road, and we arrive at our destination. A suburban setting, hidden in its very own forest, away from prying eyes and the noise of the real world. It's a truly beautiful place, serene but never sombre. The staff have an amazing talent of making everything seem just right, nothing is ever too much effort, from simply spending as much time as needed to make a pillow just right, to attending to all the medical needs.

We wheel Kara into her room, number 3, and help her settle before handing over to the tender and experienced hands of the hospice nurses.

We turn and leave, saying goodbye to Kara, Tony, and her parents, and they in turn thank us for our kindness. Why is it that it's always the people who don't need to say "thank you" who are the first to do so?

We load the trolley back into the ambulance and sit for a while in silence. The radio blares out a song that seems completely at odds with what we've just done and where we are, and we both reach for the off button at the same time. The comedy of hands slapping each other breaks the tension, and we leave the grounds, back out onto the main road and into the real world.

Two weeks later we were back there, taking another patient to be cared for, just for a while. In her late 80s this time, Lira was going into respite to give her equally elderly husband some time alone, time to care for himself a little.

"It's just a week, Lira", he tells her, "just some time for me to tidy the house properly for you". He looks exhausted, and explains that he'll be living with their son for the week, just as a break, so he can go back to looking after her as soon as she's home.

Elaine, one of the nurses, directs us. "Second room on the left".

"Isn't that room number 3?" I ask.

"That's the one. Beautiful view of the gardens", she adds, turning to Lira as she does so.

"We know it". We look at each other and think back to the previous fortnight.

And back to the reality of the real world.

Fiancé

On the steps of the town hall she sits, staring out at the world, looking for something she knows, someone she recognises. The stairs look familiar, but in an unfamiliar world. The pigeons crowd around her, hoping for food, but she harbours nothing but good intentions and lost thoughts.

"Hello! What's your name?"

"Marjorie."

"What are you doing here? You waiting for someone?"

"I'm just having a rest. My legs seem to be tired today. My fiancé should be here somewhere."

The word 'fiancé' catches us off guard. Marjorie must be at least eighty years old.

"Where do you live?"

"Only up the road. Not far at all. I just couldn't seem to make it today."

As we stand there, he turns up, his lungs out of breath and face full of panic.

"Marje! What are you doing here?"

The sound of her own name startles her, and she shies away a little.

"Just having a rest for a few minutes, waiting for my fiancé." The words hit him hard.

"Your fiancé? But we've been married for nearly 50 years!"

We watch through his eyes how his heart breaks, and he explains. He tells of Marjorie's dementia, how she sometimes forgets where she is, where she's going, what she's doing.

But she's never forgotten who he is.

We check to make sure she's not had a fall, we talk to witnesses, to the person who called for the ambulance. Physically she's fine, but lost in a haze of time and memories that she can't quite fit together. She's comforted, reassured, and slowly accepts a muddled reality.

And then she walks off, hand-in-hand, with her fiancé of fifty years.