Now, though, she was a shrunken, hunched-up figure. Her hair was dishevelled and her immaculate everyday uniform of slim-cut, ankle-length chinos, white blouse, pearls and pastel cashmere cardigans had been replaced by an old purple polo shirt, tucked into baggy grey elasticated slacks over a pair of cheap sneakers. She was holding her purse on her lap and she kept opening it, taking out a tightly folded piece of paper, unfolding it, staring blankly at the handwritten words scrawled across it, folding it up again and putting it back in the bag.
Dr Wilkinson watched her go through one complete cycle of the ritual before very gently enquiring, ‘Do you know why you’re here, Betty?’
She looked up at him suspiciously. ‘No, no I don’t,’ she said. ‘I haven’t done anything wrong.’
‘No, you haven’t done anything wrong, Betty.’
She looked at him with a desperate expression of anguish and bafflement in her eyes. ‘I just … I … I … I can’t sort it all out … all these things. I don’t know …’ Her voice tailed away as she opened her purse and pulled out the paper again.
‘You are merely suffering from a period of confusion.’ Dr Wilkinson said kindly, trying to cloak the awful truth with the gentlest possible tone of voice. ‘Do you remember we talked about your diagnosis?’
‘We did no such thing! I don’t remember that at all. And I’m a grown woman in her fifties.’ Betty was in fact three weeks shy of her seventy-third birthday. She continued forcefully, ‘I know what’s what and I remember all the things I need to know, I can assure you of that!’
‘And I believe you,’ Dr Wilkinson said, knowing that it was pointless arguing with an Alzheimer’s patient, or attempting to drag them from their personal reality back into the real world. He looked at her husband: ‘Now, perhaps you can tell me what happened, Ronnie.’
‘Yes, well, Betty’s been having a lot of trouble sleeping,’ Bunter started. He looked at his wife, whose full attention had now reverted to the piece of paper, and went on, his voice tentative and his words very obviously skirting around the full truth: ‘She became a little confused last night, you know, and she was … overwrought, I guess you might say.’
‘Oh, for God’s sake, Dad!’ Brad Bunter exclaimed with an anger born of frustration. ‘Why don’t you tell Dr Wilkinson what really happened?’
His father said nothing.
‘So what do you think happened, Brad?’ Dr Wilkinson asked.
‘OK.’ Brad gave a heavy sigh, collected his thoughts and then began, ‘Seven o’clock yesterday evening, I’m still at the office and I get a call from Dad. He’s at home – these days he likes to be home by five, to look after Mom – and he needs help because Mom’s packed a case and she’s trying to get out of the house. See, she doesn’t believe it actually is her house any more. And Dad’s on the ragged edge because she’s been shouting at him, and kicking and punching him …’
Ronald Bunter winced as if the words had hurt him more than his wife’s fists or feet ever could. Betty still seemed oblivious to what was being said.
Brad kept going. ‘And she’s having crying jags. I mean, I can hear her sobbing in the background as I’m talking to him. So I go over and I try to get her calm enough to at least eat something, right? Because she doesn’t eat any more, doctor, not unless you make her. Then I get home about quarter of nine, to see my own wife and kids, except Brianne’s already put the kids to bed, so we watch some TV, go to bed.’
‘Uh-huh,’ Wilkinson murmured. He wrote a couple of words on his notes. ‘Was that the final disturbance last night?’
‘Hell no. Two o’clock in the morning the phone goes again. It’s Dad. Same thing. Can I come over? Mom’s out of control. I’ll be honest, I felt like saying, you want help in the middle of the night, call an ambulance. But, you know, she is my mom, so I go over again, same story, except this time – and I’m sorry, Dad, but Dr Wilkinson needs to know this, she’s walking around stark naked, babbling God knows what nonsense … and she’s got no modesty or embarrassment at all about it.’
‘There’s nothing embarrassing about the human body, Brad,’ Wilkinson said.
‘Well, just you remember that the next time one of your parents turns your home into a nudist colony.’
‘Excuse Brad please, Dr Wilkinson. You know that he can be a little abrupt sometimes,’ said Ronald with exaggerated politeness that failed to hide his anger.
‘No, Dad, I just tell it like it is. This can’t go on, doctor. My parents need help. Even if they say they don’t want it, they need it.’
‘Hmm …’ Wilkinson nodded thoughtfully. ‘From what you say, it certainly sounds like we’re reaching a crisis point. But I don’t want to rush to any conclusions. Sometimes there’s a physiological cause for a series of episodes like the one you describe. I have to say, I doubt that in this case, but it pays to make sure, just in case there’s a little infection or something going on. So, Betty, if you don’t mind I’m going to do a few tests.’
Now she perked up again. ‘I’m certainly not sick. I know I’m not sick. Never felt better in my life.’
‘Well, that’s great to hear, Betty. And don’t you worry, I won’t be doing anything too serious at all, just checking your blood pressure, listening to your chest, simple stuff like that. Are you happy for me to do that, Betty?’
‘I suppose so.’
Ronald patted her arm. ‘You’ll be fine, Betsy-Boo. I’ll be right here watching over you.’
From nowhere, like a sudden ray of sunshine on a cloudy day, Betty Bunter produced a dazzling smile that just for a moment brought all the life and beauty back to her face. ‘Thank you, sweetheart,’ she said.
It took Wilkinson less than five minutes to go through his tests. When he’d finished he sat back in his chair and said, ‘OK, well, as I suspected, there are no physiological problems to report. So what I’m going to do is prescribe something for Betty to help calm her at moments of particularly acute anxiety. Ron, if you or Brad can make sure Betty takes half of one of these pills whenever you feel things are taking a turn for the worse that should help a lot, but no more than two of those halves in any one day.’
He looked around to make sure that the two Bunter men had taken in what he’d just said, then he continued, ‘We have an established crisis-management procedure for cases like this, to make sure we can get our patients effective care. I’m going to make a few calls this morning and try to work out something for you guys by the end of the day. Brad, I wonder if you could take Betty out to the waiting room for a moment. I just want a quick word with your dad … because he’s my patient too, after all.’
‘That sounds alarming. Should I be worried?’ Ronnie asked.
Wilkinson gave the kind of chuckle that’s intended to reassure, though seldom does. ‘No, I simply want a chance to talk, on a doctor–patient basis.’
No more words were exchanged until Brad had led his mother out of the room; then Ronnie Bunter asked, ‘So, what’s this all about, Frank?’
‘It’s about the fact that Betty isn’t the only one I’m worried about,’ Wilkinson replied. ‘You’re exhausted, Ron. You’ve got to get more help. At this stage, Betty really needs round-the-clock care.’
‘And I’m doing my damnedest to give it to her. I swore an oath, Frank: “in sickness and in health”. And in my business, oaths matter. You don’t break ’em.’
‘Nor in my business, either, but you’re not being a smart husband to Betty if you make yourself sick trying to look after her. Caring for