Going to Hell

In a grimy Northern Town many years ago......The referral was anonymous. It could have been from any of the neighbouring flats in the grim complex. I approach the door, passing graffiti and rotting rubbish and swear I see a curtain twitch as I hesitate before knocking on the cracked glass. She glowers at me as I explain who I am but leads me through to the bedroom willingly enough. It seems she doesn't see what I see, she seems to feel she is the unsung heroine of the story, selflessly devoting herself to caring for her husband.

I have never seen anything like it. His wife says she has been caring for him for years but it is hard to see what it is she has been doing that qualifies as "caring". Bert is a skeletal figure with a Catweazle beard lying in a bed that is beyond filthy. This squalid room in a rancid council flat has been his sole residence for God knows how long. His wife is called Mary, she is a squat creature whose fingers are stained with tobacco and who looks as if she hasn't washed or changed her clothes in weeks. She squints at me through the haze of stale smoke that hangs like a bad dream in the room as I try to talk to Bert. "Ent no point talkin' to 'im - e's a miserable bugger" she says round the cigarette that seems a permanent fixture in the side of her mouth.

I have to try and assess the situation but every time I try to speak to Bert she interrupts, talking over him with a litany of complaint about the doctor, the council and most of all Bert who is allegedly the most useless, miserable excuse for a husband a good woman could ever have been cursed with. Bert closes his eyes, passive in the face of her onslaught. He has given up. I ask Bert if he can stand and he says he can get to the commode. I ask him to demonstrate and she whips the sheet from him. I almost retch at the sight of his feet. They are completely black with grime and his nails are long and yellow, so long they are curled round almost to the sole of his foot. The professional mask slips and I insist she leaves the room so that I can talk to Bert alone. I have no authority to do so but maybe she sees something in the set of my jaw because she retreats muttering dark curses at me as she goes. I don't scare easily but somehow she exudes an air of malevolence that raises the hairs on the back of my neck.

I know I don't have much time so I get right to the point. I ask Bert if he wants to stay in this hell hole or if he wants me to take moves to get him away. To my despair Bert isn't playing. He says he wants to stay where he is. It is patently obvious to me that he is too beaten and weak to fight. He is as institutionalised as any maximum security prisoner.

Adult abuse is a complex matter. If it is suspected that a child is being abused then there are legal powers that can be invoked to remove that child to a place of safety. An adult of sound mind has the right to remain in an abusive situation if they so wish and there is nothing to be done about it except wait it out. The Psycho geriatrician reluctantly concludes that Bert is capable of making the decision to remain at home and the best I can do is persuade Mary that she deserves some help and get some home care in there to monitor the situation. This situation must break down soon and maybe if we win Bert's, or even Mary's confidence I can get the situation resolved.

I don't have long to wait. It is only a couple of weeks later when I get a phone call from the Home Care Department to say that the carers have found Mary dead when they went in for the morning call. I am shocked, she had appeared in good health, certainly in comparison to her husband, nobody could have predicted this. I race round to the house and find Bert more animated than I have ever seen him. He sits up in bed and grasps my arm as he tells me the most spine chilling tale I have heard in the whole of my career. "She was going on at me, you know, like she does" he said "And then she started clawing at her face and screaming and running around and then she just dropped dead" I must say he doesn't seem remotely upset, if anything, he appears excited. I ask him if she said anything and he actually smiles and nods "She was saying "They're coming for me, get them off me, get them off me!"

Bert is moved to a residential home for assessment. He is bathed and given new clothes and when I go to see him a couple of days later he is almost unrecognisable. He is still thin of course but he is clean and tidy and is sitting in the lounge talking with another chap and looking just like anyone else in the room as he tucks into his lunch. The staff are a bit baffled. They know his wife died suddenly but they don't know any details. Bert won't talk about it beyond to say that he doesn't want to see her body. They are trying not to judge but his cheerful demeanor and his total refusal to go to the funeral shocks them. It even shocks me a bit, despite everything I know. I take Bert into a side room and he is talkative and engaged, discussing the possibility of a permanent flat in a warden controlled complex but when I tell him the post mortem has shown that Mary had a massive brain bleed and ask about what funeral arrangements he wants to make his face goes blank and he will say nothing beyond the bald statement that he "wants nowt to do with it" This is unique in my experience and I am at a loss but I can't help feeling that he will regret not going to the funeral of the woman he has been married to for thirty odd years. She may have been a horror but she was his wife. Surely he is in shock, I try to broach the subject again and he looks at me with a matter of fact determination "I reckon the devil came for her and the devil can have her" he says.