Go Not Gently - [8]

people. We do recognise that community facilities aren’t appropriate for some patients, or they simply aren’t available. Kingsfield still has a role.’

Agnes cleared her throat. ‘I was wondering whether Lily’s problems might be due to a physical upset. There’s something I’ve read about called acute confusional disorder.’

Mrs Knight nodded. ‘The doctor ruled that out. The state you’re referring to is quite easy to identify because we can connect the confusion to a particular physical illness. In Mrs Palmer’s case there was no such link. She was given a complete medical on her arrival here. It’s something we offer all our residents – we even arrange X-rays at the hospital so we can be absolutely sure that people have no physical problems that have gone undetected.’

‘But it happened so swiftly,’ Agnes went on, ‘it wasn’t gradual.’

‘I know all the books talk about Alzheimer’s progressing very slowly,’ Mrs Knight clasped her hands on the table and leant forward as she spoke, ‘but quite often early symptoms go unnoticed. Mrs Palmer may well have been forgetful for some time without it causing anyone undue concern. In a new environment some of these symptoms stand out more clearly.’

‘She’s always had an excellent memory,’ insisted Agnes.

‘That was just an example,’ remarked Mrs Knight, unsmiling, ‘but I’ve been in nursing for twenty-five years, I’ve specialised in geriatric care and I’ve no reason to think Mrs Palmer has acute confusional disorder rather than progressive dementia.’ Subject closed.

‘Who’s her doctor?’ I asked.

‘Dr Goulden. He holds a regular surgery here every week. Mrs Palmer transferred when she moved in.’

‘So we could ask him about this?’ I ventured.

‘By all means. But Dr Goulden is only going to repeat what I’ve already told you.’ Her voice was icy.

‘Do you have his number?’

‘Certainly.’ She gave me it then rose from her chair. The interview was over. Then she made an effort to redeem the atmosphere. ‘I hope he’ll be able to set your minds at ease. We do feel it’s important that friends and relatives have all the information they can about each individual care plan here.’ Still no smile, though. It was unnerving. A missing bit of body language that made it feel that the whole conversation was askew. Well, the exchange had hardly been harmonious. Medical types sure don’t like their judgement questioning.

Agnes wanted to sit with Lily for a while so we returned to the TV lounge. Lily didn’t resist when Agnes sat beside her and took her hand. They were like that for ten minutes or more. Lily staring at the box, Agnes, her eyes cast down, looking up at her friend every now and then.

Lily was small, her feet barely reached the floor. Her neck craned forward and the top of her spine was curved with age. She had steel-grey hair, tightly permed. Her face was round, crosshatched with fine lines. A pair of modern glasses with pink and cream frames rested on her small nose. A trickle of saliva edged its way down from the side of her mouth. Agnes wiped it away with her hanky. Lily didn’t notice.

I pretended to watch a feature on how to cook borsch.

Agnes stood up and said goodbye, told Lily she’d come again tomorrow, bent forward and kissed her cheek. No reaction.

We were halfway back to Agnes’ house before she broke the silence. There were tears in her voice, and determination. ‘I want you to see that doctor, talk to him about the diagnosis. I wasn’t at all satisfied with that woman’s explanation. She hardly gave much consideration to concerns.’

‘Made up her mind already,’ I said. ‘People like that don’t believe in uncertainties. She’d never admit they were wrong, I bet. Too much at stake. She was frosty, though, wasn’t she? Did you notice she never smiled, not once?’

‘It’s all happened so quickly,’ said Agnes, ‘that’s what I was trying to tell her. Lily got ill suddenly, not progressively, and today she’s much worse.’

‘You’ve never seen her like that before?’ I asked.

‘No. She’s always known me, known…’ she shook her head, grappling for words to explain, ‘known herself, even if she’s been quiet or distressed. I’m so worried.’ She broke off.

I pulled up outside her house and turned the engine off. It ticked as the metal cooled.

‘I want to see that doctor and I’d like you to be there. Sometimes people are a little dismissive because of my age. I realise you’ll want a fee and I’ll be happy to pay for your time. And I’ll ring Charles, Lily’s son. He should know. I’m sure he’d want to.’

‘Is he close to his mother?’

‘Not really. I think he functions on guilt. He sends money. He’s a very busy man.’ There was a bitter edge to her voice. ‘I must sound harsh. It just seems so unfair. Still, I shall talk to him.’

‘It might be worth contacting Lily’s former GP as well,’ I suggested. ‘The doctor I talked to said to get the whole physical history, find out the order in which things happened.’

‘Well, that’s Dr Chattaway. He’s my doctor, too. I’m sure he’ll help if he can.’

‘I’ll try and make an appointment with Dr Goulden first,’ I said. ‘Are there any days that are bad for you, any regular appointments?’