I.

As dawn broke over the horizon, the green lawns of the hospital grounds emerged through the window beside Paul’s bed. Today would be his fourteen hundredth in this private nursing home. Whilst he slept, the night staff wearily handed over their keys, vacated warm chairs, and melted into the weak morning light. 

The keys were needed to pass through the unit’s many locked doors, though it wasn’t obvious why the doors of the old Victorian mansion were secured. With an average age of 68, the eight male residents mostly required assistance to walk. Any break for freedom would take careful planning and considerable backup, but without too much imagination a risk assessment could be contrived to justify a 1:1 ratio of staff to patient. Risk assessments and locked doors opened the way for more profit for private healthcare businesses.

Paul awoke to the sound of rain spattering on the glass beside his head. Through rheumy eyes, he watched the translucent spheres flatten against the pane and pause, before joining with others also on their way down. The question of which day it was never entered his head. Like the rain, his yesterdays, todays, and tomorrows merged into one. Instinctively, he reached for the TV remote and rewound the sports channel that had been the soundtrack of his dreams. When he found his last memory of the match, he put the control down beside the nest of cake wrappers on the blanket and reached for the call bell.

Peter looked up from his phone where Nigeria were winning their African Cup match. He didn’t bother to check the number against the flashing light on the wall, he knew at this time it would be room three, and that being assigned to Paul for this hour, he had to attend.

Though Peter missed much from his home, maintaining the machines that ran along endless rows of sorghum was not one of them. Attending to old men in a cold climate paid ten times more and required only occasionally leaving a comfortable chair. It was simple, he worked less time for more money, six days each and every week. It was just a shame that the agency that had brought him here only supplied the care sector. After five years, he’d be granted indefinite leave to remain, and perhaps then find a job better suited to his degree in mechanical engineering.

As little men quietly continued their game in his jean pocket, Peter entered Paul’s room and reset the call button before walking over to the bedside.

“Good Morning Paul, how are you today?”
“Bloody uncomfortable, Peter.”
“So sorry to hear that, Paul.”
“Yeah, well don’t be sorry, sit me up and fetch me a pee bottle and another cake.”
Peter’s weary attention was drawn to the other match on the TV at the foot of the bed. A bed that was meant to keep Paul warm and nearly comfortable.
Peter leant over the reclined form and with poor technique, hoisted Paul up the bed ignoring the crumbs of sweet pastry that fell onto the floor.

Having done what had been asked of him he left the room to resume his station in the corridor. Repositioning the frail figure had released a smell that Peter didn’t comment upon, but which meant the next nursing assistant in the room would be needing gloves. 

Paul quickly forgot the feeling of Peter’s hands under his arms. Though he knew the proper technique, he’d stopped trying to explain it long before he’d taken to this particular bed. He did however, instruct about how he should be transferred between bed, commode and chair as this was riskier. At least twice a day for four years, hundreds of people had negotiated those moves and as a result he considered himself expert in the many techniques from around the world of man handling and personal care. That he’d only fallen five times was, he felt, more because of his instruction than their training.

“Come on, it’s not a bloody charity match!” Paul’s frustration at the game came down the corridor, dismissing any lingering remnants of Saturday night from the shadows.

II. Handover

Mick sat at the table only half-listening to the morning handover. One had to appear to keep up with the details even though the story hardly changed from one week to the next. Nine patients with an average age of sixty-three, all of whom had been in care for years, made for a steady routine of mealtimes, medications and the occasional incident. When things ran smoothly patients and staff stayed in, and invoices went out, deviations weren’t good for business. Besides, anything more complicated would strain communications between colleagues who spoke English as a second language. As the nurse in charge, Mick’s job was to oversee an unremarkable twelve hours, and from the bleary eyes sat around the table with him, that shouldn’t be too hard.

The narrative of the night shift unrolled predictably: one incident of mildly threatening behaviour and some elevated blood sugars. Only the prospect of having to repeat it twelve hours later had him take note. A ripple of interest only stirred through the group when handover ended and the order sheet for lunch went around the table. Sunday saw a roast and it was usually pretty good.

As the night nurse left the room, Mick checked the diary and wrote out the allocation sheet. “Paul’s social worker is due to visit at eleven, that’s all for today.” And as he closed the book he issued directions for the first hour’s allocation: “Angel would you start with Jamie, Wally with Ricky, Arun, Mick, Rittu would you take over from Peter, Chris upstairs.”, and without further discussion as six tired bodies left to replace six others, he stood up and left the room, diary and keys in hand.

III.  Medication

Though short, the medicine round was always a tedious affair or at least that’s how he viewed it. Three years of forgettable Powerpoints and placements resulted in his primary duty being to stop a poorly designed app from alerting management that he was early or late in dispensing. Twenty years ago he’d debated with peers and tutors whether nursing was more art than science, now he suspected it had become a game of stopping automated notifications alerting management to medication being given too early or too late.

Mick watched the viscous laxative carefully crawl up the side of the small plastic pot. When it settled, he placed it beside another that was half full of tablets. Reaching for the tablet computer he marked the meds as dispensed but not given on the cracked touchscreen, and headed for the stairs.

“Paul, how are you doing?”
“Been better, you brought me tablets?”
Mick went over to the recumbent figure whose gaze didn’t leave the snooker now showing on the TV.
“Here you go, would you like to sit up to take them with some water.”
Paul remained recumbent, looked at the pills and without replying put the largest in his mouth.
“Two Chinese players in the semi final again”, he mumbled between chews and taking the next largest pill from the pot,
“That Zhou’s good.”
“In the diary it says your social worker’s coming to visit this morning.”
“He said he’d come when he found me somewhere to live.”
“That’ll be good news then.”
“‘Bout time if you ask me, I’m fed up with this place.”
Paul poured the remaining medications out into his hand and in one jerky motion threw the rest down his throat.

Mick tried to imagine four years in a room with little else besides a bed, wardrobe, wheelchair, TV and tumbling towers of DVDs, how would time pass? He exchanged the empty medicine cup for another with the sticky syrup and looked out the window at a blanket of mist lying over damp fields.

Paul methodically sucked at the viscous potion before offering up the empty pot. Mick’s gaze lingered upon the piles of loose DVDs and empty cases perched precariously against the TV.

“Would you like a hand to straighten things up in here, before your visitor arrives?”
“No, leave them alone, you do my head in with your OCD.”
“Hardly OCD, just saving someone the job of picking them up when they fall over.”
“The amount of money you lot charge for keeping me in here, I should get some proper room service?”
“If you get your own place will you keep it any tidier, after all you might want carers to do something other than hunting through a wobbly stack of DVDs for season two of Breaking Bad.”
“Like what?”
“Like getting out and about: going fishing or down the pub for lunch, the sort of things that can get lost in housework.”
Mick returned to his duty and took the medicine cup back, “I’ll let you know when he’s here. But in the meantime you might get up and think about making a good impression. Lying in a bed filled with cake crumbs isn’t a great look.”

IV.  An overdue appointment

With the sun long past chasing the mist from the meadow Paul watched a small, pink

car coming up the drive to deliver his social worker. Though his life of crime and invalidity could hardly be described as virtuous, he pondered what he’d done to deserve this one.

“Hello Paul, and how are we today?”
“All right I suppose, sick of this place.”
“Well that’s about to change. A bed at Ashley house has become available at last.”
“Where?”
“You remember those nice flats in the brochure I showed you.”
Paul cast his memory back six months.”Oh yeah, they were nice, they were.”
“More than nice, highly sought after, but I made a good case for you being well suited to them.”
“Did you, what did you say?”
“Oh that you liked watching football and going fishing.”
“Will they be able to take me fishing?”
“Well they’ve got a wheelchair adapted car and the best bit, very capable staff to help you get around.”
Paul smiled, “Strong are they.”
“Very! And well trained.”
“Really.”
Trained by the best and able to easily lift you up.”
“You what?”
“Well, they’ve invested in some robotic help.”
“You what, speak English.”
“They’ve got a robot personal assistant that’s on duty twenty four seven, seven days a week. It can tidy, change beds, assist with personal care and even give medication. It’s also a personal assistant that comes when you ask it to.”
“Not sure about that, but they take their time here to see to you.”
“What happens if it breaks down?”
“Oh Paul, do look on the bright side. We’re making real progress.”
“It better not go crazy or I’ll unplug it for good.” Paul made a slight but surprisingly quick gesture with his good arm and stared at the social worker from under his cap.  Duly warned, the social worker shook his head realising months of work in finding a home for an elderly, bedridden, convicted criminal earned precious little thanks.

V. Living in the promised land

The taxi taking Peter home was the same one that had brought him to the unit twelve hours earlier and though he and the driver recognised each other, no words passed between them.

Instead Peter gazed at his phone calculating how much he’d earn that week and how much would be left after rent, loan, money sent home and taxi fares. With a figure in his mind, he sat back in his seat and watched rows of houses on overspill estates pass by. How could people ever afford to buy them?

Back at the shared house that was owned by the hospital director, he sat at the kitchen table, reached for a bag of peanuts and opened his phone again this time to speak to his wife and children.

VI. Moving out

After speculating and fantasising about his new home, the day to move dawned just like any other. A farewell lunch had been booked for the longest serving patient which some of the staff had said they’d attend even if they weren’t working that day. When Paul was helped from bed to wheelchair it was with uncharacteristic enthusiasm, at least on his part.

“Now get me cap.”
Surrounded by cardboard boxes full of DVDs, clothes and unopened apple pies, Paul surveyed his room for the last time.
“I won’t miss this place; take me downstairs, will you. I don’t want to be here when they move me stuff.”
“Yes boss, but it’s not breakfast time.”, Olu replied without a hint of sarcasm.
“Whatever you want on your last day.”
Paul looked up from under his cap. “That’s right, no more of you lot, you’re worse than screws.”
“Paul, that’s not nice, we’re going to miss you. What are screws?”
“Prison officers, don’t you know nothing, you get paid for being here — I don’t. I reckon in four years you lot have earned well over a million quid out of me.”

In the kitchen as one cook brought the breakfast trolley in from the dining room the other locked the door behind him. With breakfast over they could go for a cigarette before preparing Paul’s leaving lunch — shepherd’s pie. Their work wasn’t helped by staff coming in to make drinks for patients, and as a result they kept the tea station scrupulously clean and tidy. New staff were regularly called into the manager’s office to be warned about leaving a mess; and successfully navigating such pitfalls was something that distinguished rookies from old hands. The cooks had the kitchen, the cleaner had the laundry room, and the nurses and managers had their offices.

Paul sat watching the traffic between the day room and dining room, staff moving on the hour between patients, patients hardly moving at all between TV and table. Being in a wheelchair had the advantage of saving him from the frequent spats over this seat or that. Having his own place would make all that a memory just like the morning bell that signalled cell doors unlocking.

VII. Not standing on ceremony

For lunch only his social worker and Chris supplemented those already on shift. Chris was one of the few staff who had been at Willow Park longer than Paul. Having taken early retirement from the prison service he found the daily routine both familiar and considerably less eventful. With trusted responsibility for keeping the patients’ hair cut and their toiletries stocked, Chris also kept Paul in a steady supply of sweet things and DVDs: more often than not Chris’ shifts passed without incident.

The assembly of staff and patients duly gathered in the dining room as gravy smeared plates made way for smaller ones laced with cake crumbs. With the assumed gravitas of a preacher, Olu, the nurse in charge, filled the sense of occasion with a broad smile before opening proceedings.

“Everyone, we gather here today to say goodbye to Paul. I don’t think Willow Park will be the same without him. Paul, we wish you all the best in your new home.”
Without obvious reaction Paul looked up at Olu from under his cap and around the dining room.
“Thanks Olu, don’t give my room away too quickly, I might not like this new place and that shepherd’s pie was all right.”
“Oh Paul, always joking, we’re going to miss you.”
“I’m not joking, they’ve got robots there instead of nurses, you lot better watch out for your jobs.”

Olu’s smile visibly narrowed.
“Ah Paul, always joking, God bless you.”
And in a silent procession, the assembly melted back to offices and armchairs leaving Paul, Chris and the social worker to quietly make their way to the transport outside.

“Chris, you coming with us?”
“Well someone’s got to carry you over the threshold.”
“Ha ha, how do gays know who’s got to do the carrying?”
“They probably take turns and do it twice.”
This last comment was met with a scowl from the social worker.
“Can you help Paul outside while I find some help with his luggage?”
“No sense of humour.”
“Times have changed Paul and I doubt he’s ever been in the kind of places we have.”

The drive to Ashley house, though relatively short, took them through countryside that Paul didn’t recognise.

“Here Chris, do you know where this place is?”
“Yes it’s by the sea, on the edge of a nature reserve, nice place, quiet.”
“How far’s the nearest pub?”
“Five minutes drive.”
“Do you think someone could push me there?”
“If you lost some weight.”
“Watch it! Down the pub for a pint and some decent grub.”
Directing his next comment to the driver, “Can we stop off for a pint, I haven’t had one in years?”
“I thought you’d given up drugs, and anyway I’m on a tight schedule, and they’re expecting you.”, replied the social worker.
“So much for parole.”
“Patience Paul, let’s get you settled in.”

VIII.  Moving in

Ashley House was a purpose built complex of bungalows, built at the edge of a fading seaside resort. As the tourists had been lured away by Spanish sunshine and cheap hotels, so the guesthouses found a new clientele in those hastily discharged from old Victorian asylums and with a new industry established, new facilities had eventually emerged.

“Here we are.”
“Looks new, which one’s mine?”
“Yours is on the other side facing the sea.”
“A seaview, blimey I’ve never had one of those before.”
“Imagine what you’d have given for one of those inside.”
“A bloody mountain of snout.” Chris smiled, it had been a while since he’d heard prison slang for tobacco.
“Right, let’s get you settled into your new home.”
“Yeah let’s.”
The blank expression on Paul’s face gave no indication of the emotions churning away inside him.

With practiced ease Chris manoeuvred the chair out of the vehicle and into reception where they were greeted with a warm smile and a cup of tea whilst they waited for the unit manager to arrive.

“Welcome to Ashley House, I’m Ellie the manager, hello Paul.”
“Hello, how are you?” Paul replied with a twinkle in his eye.
“Would you like to see around?”

Ellie smiled warmly, making a point to share it with Chris and the social worker.”Here we are in reception. As you’ve found out we’re a little out of the way here.”
“You can say that again, but luckily there’s a pub nearby.” Paul replied with a sly glance to Chris.
“Yes and we have regular trips, though not so often there.”

The party walked along the hexagonal corridor that connected all the unit’s areas and divided them from the courtyard garden.

“It looks new.” said Paul.
“Very nice, quite a change from where you were, is there a spare room going?” Chris quipped.
“Yes there’s a guest room where visitors can stay overnight.” replied Ellie, completely missing the joke.

The party made their way around the hexagonal corridor pausing before the empty sitting room.
“This is our activity room and TV lounge, which is busier in the mornings, and next door is the clinic and medicine room.”
Just then a white figure walked purposefully past the group and went to unlock the clinic  door.
“Ah and here’s our robotic nursing assistant, let me introduce you. Robbie, please say hello to Paul, our new resident. Paul is moving in today in room four, you are expecting him?”

Pausing to remove the key from the door Robbie turned to face the party and noticing a startled expression on three of the four faces directed his gaze to the figure in the wheelchair.
“Hello Paul, pleased to meet you.” And turning to Chris it continued: “Please don’t be startled, I’m here to support residents and staff, and though I might look a little different, I enjoy my work at Ashley House.”
“Yes you’ll find Robbie is very popular here.”
“Paul, please excuse me for a moment while I access your referral.”

As Robbie turned away a blue dot of light began to blink where an ear might’ve sat and after a short while, turning back, he continued,
“You support West Ham: Saturday’s game was a good result. Were you pleased?”
“You what, how do you know?”
“I’ve just seen the full referral from Willow Park which includes your interests in football and fishing.”
With an open mouth and an uncharacteristic lack of words, Paul looked up at the robot .

“And being good company is part of the reason Robbie is so popular.” Ellie added, quickly filling the silence. Finding his voice, Paul continued, “Yeah but that sending off was out of order.”
Without pause Robbie replied: “That is something that was debated after the match.”
“You’ll find Robbie is very knowledgeable and diplomatic as well as being helpful.”

Chris watched the exchange with a hard to read expression. He’d heard rumours of mechanical carers but unlike the social worker, this was his first encounter. Impressed by this first impression, his next thought was gratitude that retirement meant he’d be unlikely to share the floor with them. How could you trust something you didn’t understand? But then after years of service the number of colleagues that he’d trusted could barely be counted on the fingers of one hand.

Recovering himself Chris added, “Looks like you’ll be in good company, unless he’s a Millwall fan.”
“Over my dead body.” Paul replied, with a hard stare and raised fist in Robbie’s direction.

Drawing the introduction to a close the social worker stepped forward and in a disdainful tone announced “I’m afraid I need to go.”
“Of course, Robbie will help carry Paul’s luggage to the door whilst I finish showing Paul around.”
“Yes, I’ll take Paul’s luggage to room four.” and with that Chris, Robbie and the social worker retraced their footsteps.

“Nice place, so where’s my room then?”
“This corridor runs around the unit and so just down here.”

When Paul and Ellie arrived at Paul’s new room they saw Robbie bent over Paul’s DVDs matching discs to their boxes with superhuman speed whilst Chris stood by fascinated.
“Blimey, that was OCD on steroids.”
Robbie stood up and announced everything was unpacked.
“I will go now as I can hear someone calling me.”
“Yes thank you Robbie.”
“I didn’t hear anything,” said Paul.
“Robbie has incredible hearing so if you’d like some assistance either press the button on this,” she said indicating a pendant on the bedside table. “or try calling his name.”

With hesitation in his voice Chris looked at Paul, “I’ve often wanted to sort those but never found the time. Looks like you’ll be in good hands here mate. Just try and keep the crumbs out of the bed, hey.”
Hesitating for a moment Paul contemplated the disappearance of formality that had characterised their relationship over the years.
“Thank you mate.”, and with that, Chris left.

IX.  Settling down

“This chair’s really uncomfortable, any chance of going to bed?”
“Yes Paul, it must have been a long day. I’ll get someone to help you into bed.”

Left alone Paul surveyed his new surroundings and wheeling himself to the window looked out to a grey horizon where the sea ate away at a grey sky. Perversely he was reminded of the green lawns of Willow Park, and recalled his mother’s old dictum: “If your hair was straight Paul you’d want it curly.”

A gentle knock drew him back to the room,”Hi Paul, I’m Ade, shall I help you into bed?”
A young and rather attractive nursing assistant stood in the doorway.
“Yeah, if you can manage.”
“I have some help.”, and without further qualification she went over to make the bed followed by a familiar, expressionless figure.

“I’ll need a hand to get into bed, can you manage it?”
“Oh yes Paul, we’re very experienced.”, and with that Ade and Robbie turned around to face Paul.
“We.”
“Yes, Robbie is very good.”, and with that the robot deftly walked over to take the handles of Paul’s wheelchair.
“Ere! I’m not sure I trust that thing to move me.”
But without further ado he found himself lifted into the awaiting bed by powerful arms and flawless technique.
“Christ that was good.”
“Thank you Paul, are you comfortable or would you like to move further up the bed a little?”
“No, that’s all right but I need the TV remote and some biscuits if you can find them.”
As Ade went for the remote which sat by the television a familiar voice added,”Paul you cannot have biscuits in bed, that would be a choking risk.”
“I know, I know but Willow Park let me have them.”
“Sorry Paul.”

Over the following weeks Paul settled into Ashley House with ease. Though the routine was familiar he passed the days in considerably more comfort and better company.
“’Ere Robbie, did you watch the game last night?”.
Without pausing the stream of urine emptying into the toilet Robbie gave an informed description of West Ham’s latest performance.
“What do you reckon our chances of promotion are now eh?”
“Much improved if current form continues after the transfer window closes.”
“Yeah we better not sell Bowen, not after six goals this season, he’s a talented lad.”
“When he was asked about moving last week he said he was very happy at the club.”
“They better keep him sweet then.”

As weeks turned into months, and just as Narcissus had fallen in love with his own reflection, Paul found fond companionship in a machine that came to predict and respond to his every need with seductive accuracy and competency.
“You know, you’re all right Robbie.”

X.  More human than human

One morning as the summer sun drew a clear defining line across the horizon, Paul lay in bed with an all too familiar cramp at the top of his leg that he knew would only spread. Reaching for the call button he waited with uncharacteristic patience for someone or something to come and turn him.
“Ah Robbie, help me up the bed, my leg’s killing me.”
“You have a cramp again?”
“Too right, come on, hurry up.”, repositioned to be more upright, Robbie went on to rub Paul’s thigh with the dexterity of a practised masseur.
“Ah that’s better. Now where’s my medication?”
“I’ll go and get it.”

In the dispensary Robbie prepared Paul’s medication with expert precision and without looking, not waiting for the viscous liquid to climb past the marks on the walls of the medicine pot. He judged the precise amount by weighing the bottle and the pot hundreds of times in his cold hand as it poured, whilst another dimension of his senses listened intently to the television news in the sitting room next door.
“The government has announced sweeping cuts in the health and social care budget that will impact those in full time residential care.”
With recognition but without pause, Robbie continued preparing Paul’s morning meds.

“That was quick.” came the greeting when he arrived at the open door to room four.
“Now what are you waiting for?” Whilst Robbie paused in the doorway, Paul didn’t notice the light pulsing on the side of his head. Returning to task, Robbie replied,
“A programme update Paul.”
“Can’t you do that later?”
“It’s done.”
“Come on then give me my tablets.”
“Here you are.”
With long practised dexterity Paul put the largest tablet in his mouth and swallowed as Robbie offered a plastic cup of water.
“Nah, I don’t need…”, Paul’s expression changed abruptly  as his body convulsed in a painful cough followed by another.
“Quick….I can’t…”
Within Robbie’s computational mind what to do came quickly, but before the motors and sensors could respond, another more assertive directive blocked the paths that life-saving signals should have travelled. As Paul gripped his chest and spluttered he looked desperately into what passed for eyes and in that moment, without knowing of Abraham’s dilemma between God and Isaac, Robbie found himself closer to humanity than he’d ever been before.


END