Page 23 of The Night Shift
‘How depressing,’ said Violet, her attention having at least partially returned to the unsettling picture her colleague was describing, although she remained aware of Gus in the periphery of her vision. The atmosphere in the room seemed more charged as a result of his presence.
Anjali sighed. ‘To be fair,’ she said, ‘perhaps some of it is just that people can’t cope with the increased pressure on the family home during the festive period, it’s likely not all about inconvenience. My parents, for example, they’ve had Nana and Dadi living with them for years, but during big events like Diwali when me and my siblings and all our partners come to stay, it can get a bit hectic. And Nana will often develop a multitude of aches and pains on those occasions, probably in response to the stress. She can be quite demanding.’
‘But your parents wouldn’t call an ambulance for that?’ Violet said. ‘Not unless they thought she was actually ill. They wouldn’t do it just to get rid of her.’
Anjali shook her head. ‘No,’ she said. ‘We go through the usual routine, take her to the GP, have a nice chat, agree it’s another bout ofall-over body painthat doesn’t really have a pathological cause, she feels better for having seen a medical professional, we go back home, all good. But then this isn’t an Indian phenomenon. My parents would kick the rest of us out of the house before they even questioned the elders.Granny-dumpingis just not something we do.’ She shifted and looked a bit uncomfortable. ‘I don’t want to sound racist or anything,’ she said, ‘but this is very much a White British issue. The difference in how we treat our elderly across the cultures is staggering. You just look at the demographic in residential care. Overwhelmingly White British.’
‘To be fair, isn’t that just because there’s more White British old people living in the UK?’ asked Gus.
‘Yes, probably,’ conceded Anjali. ‘But look at the proportion of elderly people from ethnic minorities living with their families compared to the number in residential care in this country. And then look at the ratio amongst Caucasians, or strictly speaking, Anglo-Saxons, because Mediterranean cultures often have a similar attitude to their elderly as Asians, Africans, everyone else really– just not the Brits. They ship their grannies off in the same way they ship their kids off to boarding school.’
Violet was quiet for a moment, thinking about her grandmother’s care home where she’d been only a few hours earlier. What Anjali said about the lack of diversity amongst the residents was true. There wasn’t a single ethnic minority group represented in the entire building, unless you counted the staff looking after them. But she still felt slighted by the implication that moving your relative to a care home was the same as dumping them into an acute hospital bed on Christmas Day. She considered the prospect of having her grandmother to stay for the holidays, whether it would be practical on any level. Now with her dementia so advanced, she guessed not. Two or three hours was usually Gran’s limit before she became restless and agitated, before she started wandering and throwing things at people and knocking stuff over. Maybe she did that at the care home too, but there were staff on hand twenty-four-seven, people looking after her, keeping her calm and safe. Her parents couldn’t provide that level of sustained attention. She knew that they had thought long and hard about ‘what to do with Gran’, the conversations lasting late into the night and often accompanied by guilty tearful recriminations. The words burst out of her before she could stop them.
‘People don’t just chuck family members into care homes because they can’t be bothered with them,’ she said hotly. ‘You’re making it sound as though it’s an easy decision. And it’s not. Often residential care is the best place, the safest place.’ She was embarrassed to feel tears pricking at the back of her eyes and blinked them away furiously.
There was a moment’s silence and Violet was acutely aware of Gus standing nearby having witnessed her reaction. She kept her gaze focussed on her knees.
‘I know that.’ Anjali said. ‘Sorry, I didn’t mean to upset you…’
‘I’m not upset.’ Violet looked back up and met Anjali’s gaze. ‘I’m fine,’ she said and tried to smile.
‘O-kay.’ Anjali continued to look at her strangely. ‘Well, either way, I’m sorry if I sounded judgemental. I think I’m just becoming a bit jaded.’ She sighed. ‘You stay in medicine for long enough and you start to see pretty shoddy behaviour from some people– and their families. I’ve almost come to expect it. Sometimes makes me question what this job is doing to my view of humanity though.’
Violet mulled this over. She’d never heard Anjali admit to anything other than being completely happy in her work but maybe she wasn’t the only one who had occasional doubts about her career choices. Perhaps she should ask her about it, check that Anjali was okay. Trouble was, that was easier said than done. Violet usually preferred to avoid that type of conversation. She had a feeling she might make things worse.
Anjali returned to the task at hand and looked down at her list. ‘So, John, how about the others?’ she said, the smile back on her face looking a little fixed.
The rest of the handover passed without incident but Violet felt awkward about snapping at Anjali and decided that she deserved some sort of explanation.
‘I’m sorry about earlier,’ she said afterwards as they walked away from the admissions unit and towards the stairs. ‘I– my grandmother is in a care home. She’s got dementia and it’s– well– sometimes it’s a bit difficult.’
Anjali nodded. ‘Okay,’ she said. ‘I’m sorry to hear that. Makes sense. I’d be sensitive about it too. If you need to talk, you know, about?—’
‘No.’ Violet was quick to shut her down. ‘No, thanks. I don’t need to talk about it. I just wanted to explain, why I was so prickly earlier. Well– why I was even pricklier than usual.’ She gave one of her abrupt laughs.
Anjali slowed her pace and looked Violet directly in the eye. ‘Thank you for telling me,’ she said. ‘I know you’re not a fan of emotional conversations. And I know you’re a very private person. But it does help sometimes to share these things. It means people around you can understand your reactions a bit better and sometimes, believe it or not, it can help make you feel better too. Less alone?’
Violet nodded. ‘Thanks,’ she said quietly. ‘I’ve been to visit her this evening. In her home. They’re really lovely there and she’s happy, I think. She’d certainly tell them if she wasn’t. I guess I just resented the implication that my family had dumped her in the same way as the families you’re describing. It hurts– to feel judged for something like that.’
Anjali nodded. ‘I get that,’ she said. ‘And I’m sorry. Sorry about your grandmother too. Were you close?’
‘We are close,’ said Violet. ‘Still. Even closer if anything. She’s the only other member of the family who is as capable of causing immediate and lasting offence as me. My parents are tact and diplomacy personified, but Gran’s a hoot– makes me look like a UN peacekeeper in comparison.’
‘She sounds brilliant.’ Anjali paused. ‘Violet,’ she said. ‘Please don’t worry about offending me. Honestly, I get it. My brother’s on the autistic spectrum. Well, it was called Asperger’s when he was diagnosed but I suppose you’d now call it high-functioning autism. He’s a professor of astrophysics at Imperial so it’s not like the diagnosis held him back at all, but he comes out with some pretty blunt statements from time to time, so I’m used to just…’ She reached out suddenly to touch Violet’s arm. ‘Sorry. I’m not suggesting that you’re– I, uhm– what I meant was…’ She trailed off and brought her fingertips to her forehead.
‘No– right.’ Violet laughed self-consciously. ‘That’s okay. I– right…’ The conversation had taken an unexpected turn– it must be bad if evensherealised that Anjali had said something awkward. Keen to get back on familiar turf she pulled her list out of her pocket and scanned the patient names while Anjali rearranged her face. ‘So, who do you want me to see first,’ she said eventually. ‘The shortness of breath, the chest pain or the swollen leg?’
They parted ways and Violet allowed herself a small smile. It wasn’t often that she was the innocent bystander while someone else put their foot in it. But as she strode down the corridor to ward five she began to process Anjali’s words and consider them a little more deeply. The fact that Anjali had mentioned autism chimed with a conversation she’d overheard her parents having many years ago. She’d been unable to sleep one night, she wasn’t sure why, something had happened, one of those occasions where she’d misjudged a situation, and she’d tiptoed downstairs to get a glass of water. Her parents’ raised voices had surprised her, she remembered that, because it was so unusual to hear them disagreeing. Her father had said something about ‘traits’ and ‘the spectrum’ and Violet’s mum has said something like, ‘doesn’t seem to be a problem’ and ‘no different to your brother Dave,’ and her dad had said, ‘What? Dave with his collection ofLord of the Ringsfigurines and his spreadsheet of Chelsea’s goal average spanning the past twenty years?’ And her mum had gone quiet for a bit.
During her time at medical school Violet had paid attention to their one lecture on neurodiversity a little more attentively than her classmates, but one of the key points was that autism occurred much more commonly in boys, and besides, she wasn’t prone to anxiety, she wasn’t hypersensitive to noise, and she didn’t think she’d ever had a meltdown or a shutdown episode. The criteria didn’t really seem to apply to her any more than the ones for polycystic ovaries or irritable bowel syndrome did, and she knew there was always a danger of medical students convincing themselves they had every condition under the sun. Now, as on those two previous occasions, she stored Anjali’s comment away for later analysis. After all, there was a hell of a lot going on in her head already without having to consider a self-imposed diagnostic category to add to the ‘geek’, ‘frigid’ and ‘odd’ labels of her youth. Those were words she had worked hard to distance herself from– she didn’t want to deliberately unearth another one.
* * *
Later, after she’d clerked in two new patients and reviewed the blood results of several others, she bumped into Gus on ward seven. He was writing up his notes at the nurses’ station and looked up as she approached.
‘Hey! I forgot to ask earlier. How was your swim?’ He smiled one of his easy grins and her heart gave a little lift of relief. He didn’t seem to have made any negative judgement following her earlier outburst in the MAU office.
‘Yeah, it was good thanks.’ She smiled back shyly as she took a seat next to him. ‘I slept much better today. Could you just pass me one of those continuation sheets?’
