We get another one of our bog standard 'nan down' calls. An elderly person, not too spry on their feet has fallen over and needs us to come and pick them up again.
The door is opened by her son, two eyes stare at us suspiciously from over a foot long beard. A half smoked cigarette is dangling between his fingers.
'Come in then', he says gruffly then, indicating his mother's bedroom, he disappears into the living room to continue smoking.
His mother is on the floor in an awkward position. She's wearing a filthy dressing gown, she obviously hasn't washed in some time and her toenails have grown so long that they have curled under her feet. I'm later told that she also smells.
She is in quite some state of neglect.
We check her over while she remains on the floor, she's not confused, just a bit frail – she tells us that she has no pain anywhere so we set about standing her up.
I put my hand on the wall to steady myself, it comes away yellow with nicotine.
She stands up, almost unsupported, but can't seem to straighten herself up. She tells us that there is now a tiny bit of pain in her hip area, but that it's probably from where she fell.
She can't walk, she can't stand up straight. I'm ready to take her to hospital if only to get a swarm of support workers to come to her house and make things better for her.
'A little bit sore, not too bad', is how she describes the pain in her hip. We pop her in our carry chair and take her out to the ambulance. Putting her on the trolleybed we notice the shortened and rotated leg – an indicator of a broken hip.
Because of the cluttered bedroom and the way she was laying we couldn't have noticed it before, because of her not complaining of any pain we didn't suspect it. I'm still not sure – it looks like a broken hip, but from what the patient says it doesn't sound like a broken hip.
We'll treat her for a broken hip – it's a benign treatment (mostly splinting), so even if we are wrong it won't have any side effects.
Before we go off to hospital I return to the house to tell the son what we are doing – he's smoking a new cigarette.
'Yeah, whatever, bye, I'll call later'.
I leave him to return to the living room.
Now, I know I'm not a psychiatrist, but I do have a fair amount of experience with people who have mental illness. In this case the smoking, the personal neglect, the 'attitude' – it makes the word schizophrenic float to the front of my mind. It would explain the living conditions, both are ill – one of the body, one of the mind.
We drop our patient off at the hospital – it's one of the excellent nurses in charge so I know I can trust her to rally the army of social workers, home carers, occupational therapists and whoever else to get this woman the help she needs.
The next day I ask the nurse what happened to our woman – she did have a fractured hip, a bad one at that, yet pulled herself off the trolley onto a commode without a sign of pain. The nurse also suspected that our patient had jaundice until she realised that it was an all over body stain of nicotine.
The son did phone later and on being told that his mother had broken her hip, seemed untroubled.
I hope that she's not in the 20%-35% mortality rate. But I know that should she survive she'll get the help she needs.
And if the son has slipped through the net, maybe he'll get some help as well.
I'm not dead – just a combination of spotty internet connection and a deceased laptop has meant that I've been buggered by circumstance.
Now I'm deciding if I should wait until the end of January for the rumoured Apple event before getting a new Macbook Pro. That and, of course, how the hell I'm going to afford it…