|The Cathedral by Auguste Rodin.
1908. Musée Rodin.
Photograph by Daniel Stockman.
2010. CC BY-SA 2.0.
Only one week ago Yasmin had been at the same flats to see her patient, Jenny Johnson. Jenny was a lovely lady of around fifty-two, with a lilting Irish accent and a penchant for saving stray dogs. But she sometimes missed medication and when she relapsed all hell broke loose.
Rumour had it that ten years ago Yasmin’s predecessor had been called out to see Jenny during one of those episodes – as he had tried to speak an oversized poodle had stood guard unwaveringly. Then the dog had got spooked and lunged and bit off the doctor’s little finger at the proximal joint. Both Jenny and the doctor had been hospitalized – the finger had somehow been retrieved and sewn back. The dog was put down. This bloody tale was retold and added to at every Christmas party. It was difficult to know what had really happened. The doctor was now a retired recluse and Yasmin had little opportunity to examine his digits.
And now again the call came that Jenny was running around the block of flats, screaming nonsensically about a dead dog. So Yasmin spent the next hour on the balcony floor talking to Jenny, and again another dog stood watch, a German Shepherd whom Jenny called “Pumpkin.” He did not look like any pumpkins Yasmin had seen. Up close Yasmin could see his long black eyelashes seemingly painted with blue-black mascara. She did not know dogs could have such eyes – beautiful and all-knowing. By then he had come out of “I will tear you to smithereens” mode and was lying relaxed by Jenny’s feet. Yasmin’s left leg had gone numb and she could feel a trickle of sweat racing down her spine. The air hung oppressively, heavy with the threat of rain and emotion. As Yasmin looked over the balcony to see the psychiatrist get out of his car, a sense of relief spilled over her. Suddenly the clouds opened and everyone ran for shelter. It was over. As Yasmin walked away depleted, she turned to look one final time – Jenny was hunched over on the balcony hugging her dog.
* * *
The next week, on another call to the flats, a group of boys stopped their football game to stare at her, their faces open with curiosity. Yasmin must have stood out, as much for her unease as her brown face. She recognized one boy in the blue T- shirt: he had come to see her for eczema. Afterwards his mum, Gina, would send him out of the room so she could talk to Yasmin in private about her husband. His gaze would meet Yasmin’s; he knew what they talked about. Yasmin always asked the same questions and Gina gave the same answers. No, he was not hitting her – had not hit her since Christmas. No, she did not want to leave him. He was good with the children – never hurt them. Yes, she wanted to carry on with her antidepressants – they made her numb but that was better than feeling like a coiled spring. In the end Gina would dab her eyes harshly with the rough paper towels from the sink dispenser – Yasmin had run out of tissues again – reapply her coral lipstick in the mirror and smile a goodbye. Yasmin would feel a little sick after those encounters, as if someone had squeezed the contents of her stomach and made an acid ball rise in her throat. But they seemed to lighten Gina – Yasmin was the only one she told. Sometimes at night when Yasmin lay awake in bed she would cross-examine herself – and her inertia – harshly. Where did her duty lie? She had rung the social services, told everyone who would listen. Nothing changed.
She said hello to the boy and chastised herself for not remembering his name. He nodded his head and turned back to his football. Yasmin saw a bruise on his left cheek. She wanted to ask him about that, but he had already moved away to left-foot a battered ball into an invisible net. Yasmin made a mental note to ring Gina.
* * *
She climbed the concrete steps, past the flower bed of daffodils that someone had planted between the weeds, and reached Steve’s door. His recycling box was full of empty pizza cartons, bottles of Budweiser, and cans of cola. Yasmin counted the bottles as she retrieved the key and shouldered her way into the pitch blackness of the flat. She hit an obstacle – her ankle turned and she fell against the door. Belatedly she remembered the torch, a heavy duty object that she had acquired for this sole purpose.
“I am in here, lady!” She heard Steve’s raspy voice and followed it and the smell of tobacco to her patient. Steve’s voice was at odds with his looks. He looked like a grizzly bear, perhaps cuddly at a distance but spiky and scary close up. Yasmin guessed he weighed over 200 kilos, flesh hanging in every direction and a girth so wide that he struggled to go through doors. He was wearing a yellow oversized T-shirt, and three identical ones hung in line from hangers on the curtain rail. There were no curtains and the broken windows were boarded up. It was his way of closing out the world and the people who laughed at him.
Steve was not exactly poor – he was just particular about his spending. Alcohol, cigarettes, and processed food were the only things he spent money on. Except for a trip to hospital he had not been out of his flat in years. The world was a desperate place – this neighbourhood even more so. Bad things happened every day. He wanted none of it, even if it meant shutting out life itself.
“Sorry about the mess. I haven’t had a chance to hoover yet.” He laughed at his own joke, picked up a duster from the bed, extended the handle, and vigorously dusted the only chair in the room.
“Take a seat.” Like a king in his realm, he gestured grandly.
Yasmin shuffled on her feet. She could not sit on that chair.
On another visit two months earlier, Yasmin had found Steve doubled over and vomiting blood. He had been drinking heavily in the weeks before. She had never seen so much blood outside of hospital – it covered the bed, that chair, the walls. His pulse was thready, his blood pressure low. Yasmin had rung for the emergency services with shaking hands and her heart hammering in her chest. “Don’t die on me, please, please…” she had begged. He had gripped her hand firmly. It took everything that the paramedics and fire crew had and then some to get Steve out. As they drove off, Yasmin vomited in the flower beds.
Yasmin looked at the dirty chair and waged a mental battle. She finally placed her bag on it and turned to Steve. His legs were lobster red and shiny, the epidermis unbroken but showing signs of enormous strain.
“It’s cellulitis.” Yasmin suspected he probably did not really need her or this visit. Once when she had gone on holiday, he simply had medications and other concoctions shipped from abroad.
“A bit of antibiotics should do the trick, washed down with some whisky,” he said. “Can you ask the chemist to deliver them to my bedroom? Tell him where the key is.”
Yasmin took off her glasses and wiped them intently on her sleeve, smudging them further. Steve threw back his head and laughed – the exhilarating sound of a child pushed higher and higher on a swing.
“I know what you are thinking, Yas! Cigarettes will choke me and grow cancers inside my humungous body. Alcohol will destroy my stomach, liver, pancreas and even my sanity. You saved me last time, but a man’s got to go sometime. I will not be admitted to that hospital again. They didn’t say it but I could hear them think it – fat drunk!” He waved Yasmin angrily away.
Yasmin locked up carefully, replaced the key, and left.
Leave me my vices – without these I have nothing.
One morning she saw his name on the whiteboard where the names of patients who had died were written. He was alone in his flat and had a massive stomach hemorrhage. The man from the corner shop who ran his errands had found him in a pool of blood. There was no one to acknowledge his existence or mourn his death.
At the lunchtime mortality meeting the doctors ate their sandwiches and discussed the dead. Yasmin said nothing.
Jenny’s dogs were loved. Even Gina’s abusive husband was loved. With Steve there was no love – no loss. But he would have laughed at Yasmin’s idea of a good life and death, so different from his own.
One day when the whiteboard was full, Steve’s name was rubbed away to make way for more dead.
ZARA AZIZ is a UK primary care doctor with an interest in education. She studied medicine at University of Manchester (2002). She developed interest in medical writing when, as a newly qualified physician, she began contributing to doctors magazines. She writes a column for the Guardian newspaper and has co-authored two health books.