Last Orders

 

I remember seeing her on the first cold evening of October, with her head hunched over both knees, as if she was desperately trying to hide some valuable item or personal possession from us. She was ninety three years old, but passed for at least a hundred on a good day. Her age was no excuse for her appearance. The ambulance man carried her up the front steps with all the care and gentleness of a farmer with a new steaming calf. He elbowed the doors apart with consummate ease, while his assistant followed behind, holding two black bin bags.

I was not instantly aware what this frail thing was, male or female, animal, or otherwise. The dark and gloomy reception area made immediate recognition almost impossible; it was not until the visitors were virtually on top of me that my squint changed into a forced smile

"Can I help you ", I enquired nervously, failing to disguise my disbelief.

"Elsie Hughes, the relatives will be here shortly," replied the large man as he scanned the room for a vacant wheelchair.

"I'll just fetch one, won't be a minute". I returned pushing a rather floor-weary model, complete with flat tyres and sticking brake.

"Look Ron, you'd think we were back in the hospital" said the big man, half laughing. Ron answered with a sarcastic ''yeah'' as he placed the bags down near the door.

By this time, a few of my colleagues had appeared, passing through on their way to the dining room, as it was nearly tea-time. One of the care assistants gestured to the ambulance man carrying the lady to follow her, while I inwardly notched up another breakdown in communication, an all too common occurrence amongst the trained staff. I followed on behind the entourage, annoyed at the fact that I had not been informed of this woman's imminent arrival. I hoped and prayed a room had been allocated and prepared

"Number 18, here we are", announced Mary the Senior Care Assistant as she peered at the miniature name card on the door. On entering the room, I was relieved to see the bed had been made, and a clean towel and face cloth draped neatly over the washbasin.

"Where do you want these mate?" said Ron breathlessly, as he struggled in carrying the bulging bags, like a burly refugee fleeing from some disaster zone. Mary pointed at the wardrobe with one hand while her other quickly folded the bedcovers back. The other man lowered Elsie onto the bed, removing the blankets she was wrapped in and pulled up the bed clothes in well-practised synchronicity, to cover her bony frame.

"Thanks very much. Would you like a cup of tea"? I said, secretly hoping they would refuse on the grounds they were far too busy, as were we.

"It’s OK mate, we’ve another three old dears to drop off before we finish. Thanks anyway."

Why were ambulance staff so bloody cheerful all the time? Perhaps it was because they never had to get involved, and somehow managed to distance themselves from their cargo. A correct mixture of platitudes and detachment was all that was required before they ejected their hapless passengers. Their script was short and sweet, ours was improvised and ad-libbed.

Whilst all the kerfuffle had been taking place, Elsie had remained silent, probably unaware of her new surroundings, or too busy channelling her thoughts and actions into staying alive. Disorientation manifests itself in many different guises. Some people chatter away like discontented simians, while others choose to clam up, most likely as a result of sensory overload, or a defective hearing aid battery. As she lay there, foetal-like I was reminded of the time I found a wounded animal at the side of the road. It had obviously suffered multiple injuries under the wheels of some car or lorry and was evidently not long for this world. Even though its injuries were terrible and its appearance disfigured, the one thing that remained defiant and unaltered was the innocence locked into those deep brown eyes.

A rare quality of innocence shouted at me from inside this shell of a woman, a childlike quality reborn out of necessity or maybe finality. To say that she was thin was an understatement. When I drew back the sheets to examine her I couldn’t believe the extent of her emaciation. She looked more x-ray than human. The bones in her spine were like the teeth of an immense cog, turning under a translucent drum of skin. There was the odd stain of muscle here and there, strung together by cords of veins and arteries.

I picked up the sheaf of papers that passed for her medical file, flicking through all the ancient history until I found the most recent entry. "Profound muscle wasting and weight loss continues. I suggest this lady who has suffered from Pagets Disease for a number of years is transferred to a nursing home for intensive dietary supplements coupled with T.L.C. (tender loving care)."Then, with such a startling intensity that caused me to drop the file, there came a loud rasping cry from beneath the bedcovers.

"Get me a black treacle sandwich, Nora!" It was a totally unexpected outburst delivered with an all too apparent note of urgency, and would not be ignored. Who Nora was I don't know - it didn’t matter. I hastily glanced over the file to make sure that she was not a diabetic, and discovered she wasn't, so I closed the pages and left the room. On my return, complete with a very speedily fashioned sandwich, I noticed that Elsie's breathing was laboured and noisier than before. I attempted to sit her up, but her body resisted. It was curled up like a tensioned watch spring and every time I straightened her legs the torso wound ever tighter forcing the head into her chest. When I attempted the same manoeuvre with her upper body the legs doubled up in retaliation. The only way I could get near her mouth was to crouch on my knees and feed her from the side, which caused me excruciating neck pain, but it worked. She gnawed noisily at the glutinous offering pointed in the direction of her mouth, only stopping to suckle the air or swallow with her eyes screwed tight. Finishing the sandwich, she let out a deep sigh of contentment. By now, her whole body was tinged pale blue and her skin was cooling quickly. Her breathing, now reduced to tiny puffs of air was hardly noticeable in the stillness of the room

"Thank you Nora", she whispered as I craned my neck to hear. Wiping a few crumbs from her mouth, she turned up the brightness in those lambent eyes, before sighing deeply, and then died. I gathered the scattered papers together and my eyes were drawn to something written in red felt-tip under the heading "Dietary Preferences.'' In block capitals it read -

"ELSIE LOVES BLACK TREACLE SANDWICHES"...


(c) Simon Daniels