The Care Home

HONESTY, SEX, GUILT, DRUGS, LOVE, PAIN. – Lee Carrick, The Care Home

First-time novelists face two problems. The first is what to write about. The second is how to write about it. I’m not sure which is worst. What usually happens is they try to write about their lives but because they’re usually young they’ve not lived and nothing much has happened to them but they milk what they have and present it in the dulcet tones of their favourite writers as best they can manage to imitate them. Most first novels simply need to be got through and stuck in a drawer as a constant reminder of just how inadvisable it is to try to write a book. Everyone has a book in them and that’s exactly where most should stay.

Lee Carrick’s The Care Home is a first novel, well, first novella—it’s only ninety-two pages long—and it shows. It also shows potential. It’s clearly semi-autobiographical although I suspect the ratio is nowhere near a clean 50:50; there’s a lot here that’s clearly autobiographical. An awful lot. It reads more like a memoir than a novel. But that’s okay, a lot of novels are presented as memoirs although the patina of fiction is often, as I suspect here, palpably thin.

Occasionally, however, a first novel comes along that kicks your feet from right under you: Irvine Welsh’s Trainspotting or Iain Banks’s The Wasp Factory. And, of course, sometimes a first novel is just the first one the author’s managed to get accepted; Iain Banks wrote his first novel when he was eleven. If the character of Nicky Daniels in The Care Home is really a barely-disguised Lee Carrick (which I believe he is) then he’s been trying to write a book for a while but has been wise enough to stop once he realised he was writing the wrong book. And it takes guts to go back to the bottom of the hill and begin again. So all credit to him for even finishing one even if it is only a novella. Now was it worth the effort?

Lee hails from South Shields which is a coastal town in Tyne and Wear in the north of England, located at the mouth of the River Tyne and about five downstream from Newcastle upon Tyne. It has been for many years a centre of the shipbuilding industry; the Scottish equivalent would be Clydebank which is just down the hill from me. I’ve been to South Shields—my sister married a bloke from there—but to be honest the action in this book could be set anywhere which I consider a plus. This, however, is what Lee says about his hometown on his blog:

South Shields is the social equivalent of a life support machine; it will keep you alive, you can breathe the air, eat the food and drink the water but it will provide few positive emotional experiences. You can breathe in and out, in and out, in and out and your blood will flow but you will never truly know what life can give you.

And my birth town is not unique; this country is littered with similar areas that infuse their residents with nothing; no reason to stay and no reason to leave. They have been forgotten by time, culture and the interesting people. They are a flat-line on a monitor when life should zigzag like a healthy heartbeat; sharp highs and desperate lows, wins and defeats, elation and misery. Then one can thoroughly explore the vast scope of the human condition.

This is the world Nicky Daniels has grown up in. He’s eighteen, none too bright, suffers from depression, has a criminal record, a bit of a drug problem and not much going for him apart from the scabby, uncared for flat he’s somehow ended up with. Oh, and he thinks he might be a writer. We don’t learn much about his family or his past but we can imagine:

A year previously I had been kicked out of my grandparents’ house. My grandmother accused me of stealing a box of Pro-Plus. I denied it. She told me to leave. I left. Since then I had been living in a council flat on a street in South Shields affectionately known as Heroin Row.

I had managed to stay on at college for a year, surviving on state benefits, cash hand-outs and food parcels from friends and family. But after a year it became too much…

For all you might forgive him if he wallowed in what life has doled out to him the one thing he has going for him is that he doesn’t seem to want to. He wants to work. He wants to improve himself. And if the first step on that road to… well, out of South Shields for starters … happens to be the shittiest of jobs in a care home then so be it.

I chose that adjective with care. It’s one of those words that’s moved away from its origins and we probably don’t think about what we’re really saying when we say a TV programme’s shit or we feel like shit because we don’t like to think about shit. It happens behind us—or underneath (you know what I mean)—and it’s not the kind of subject one brings up in polite conversation. Well, those of a delicate sensibility need not apply because in a care home shit is unavoidable. As Nicky is informed:

One hundred per cent of the residents were incontinent to some degree or another and thus they would all wear a sanitary pad that resembled a baby’s nappy. The management were so worried that a family member would hear the pad being referred to as a nappy that you could be sacked for the most innocent of Freudian slips. At no time were the inhabitants of the home to be likened to children. The sanitary pad was held in place with a pair of net underpants that were so sharp they would leave nasty criss-cross marks all over the rubbery backsides and upper legs of the person wearing them.

His first day does not go well but he survives. At home that night he reflects on his “crazy day”:

On my first day I had wiped faeces from an old man’s testes, watched a seventy-two year old woman finger herself, vomited on one of my new colleagues, bed bathed a lady who was so ill she didn’t even know I was there scrubbing her breasts with a moist flannel, and all for £3.60 an hour.

Surprisingly—and this says something about the character of the boy—he turns up the next day (on time even) ready for more.

Ricky Gervais got a bit of stick recently for his comedy Derek, most of it, it has to be said, before the pilot even aired. For those who haven’t seen it it’s set in a care home and Gervais plays the lead, Derek, who seems mentally limited although we’re never told exactly what’s wrong with him; it doesn’t matter. In an interview he said:

In any sitcom, there have to be two ingredients. The first is that the characters have to be trapped, either literally or psychologically. Look at Porridge or Bilko or Steptoe and Son. The other ingredient is that the characters have to be a family, either literally like The Royle Family or Only Fools and Horses, or metaphorically, as in Dad's Army. They have to be fighting outside forces together. In Bilko, for instance, they have the attitude that, "We're all in this together. It's us against the world." While in Only Fools, they are joining forces to fight the economy.

[…]

[In Derek] they're fighting the outside world. They often say, "No one cares". So I have a lot of uncaring intruders coming into the care home. A council man comes in and he clearly doesn't care. And sons and daughters drop off their parents, and immediately start looking at their watches. They are all outsiders who don't care. They are a stark contrast to the people who work in the care home.

Derek is a hero, an innocent. Nicky is not. Well, actually he is a bit. He hasn’t lived. He’s barely had a girlfriend. This is only his second job—he lasted sixteen days with Kentucky Fried Chicken—and he doesn’t seem to have much of a life. He’s not a drug addict, not like Renton in Trainspotting, but he has a bit of a habit—crack cocaine is his drug of choice—although I don’t know how he affords the stuff on £3.60 an hour I have because he also comes across as surprisingly responsible, a man who pays his bills with the one exception—on principle—of his television licence:

They would send me letters twice a month which I would put in the bin without opening; TV’s are more dangerous than guns, but you shouldn’t need a licence.

The Care Home is not a sitcom but is often funny, although you’ll need to have “a certain sense of humour” to appreciate it. I do think most of the rules that Gervais is applying to a good sitcom can apply to a good novel.

Surprisingly Nicky settles into his job. He’s assigned to the elderly mentally infirm ward—or EMI for short:

EMI was the polite, politically correct way of announcing that the residents of this ward are nuts, insane, mental, dementia ridden pensioners, pre-dead humans dressed in pastel cardigans; clothes they would have long ceased to wear if they were compos mentis enough to remember that the evil that is vanity and narcissism could be used for good when deciding to throw away beige, moth bitten attire. These poor souls had forever lost the ability to function normally as productive members of society; in fact, they were now considered a burden.

The residents fall into three types: the bedridden—those incapable of movement, the sitters—who can get around but would be in danger of falling and breaking a hip if they tried, and the walkers:

[T]hese particular residents still have the strength to walk, and walk they do. All day, every day, round and around, constantly searching for a door that will lead them out of the hell that their family has placed them in. Their mumblings were incoherent, but the look on their faces was obvious; they were desperate. Desperate to leave anyway they could. Desperation looks different as we age, for a child it appears and disappears in a moment, but in the elderly it’s tattooed on their faces and screaming to be heard.

The home is required by law to do a background check on all its employees. Remember I mentioned Nicky had a criminal record? In his case it’s assault but this doesn’t stop the home from hiring him. To his mind this says everything about the place.

The book settles down after this into a routine. Nicky talks about his work and he talks about his attempts to write. Eventually he gets a girlfriend—one of the women who works there—and so he talks about his love life and his sex life too. As a writer myself I found the sections when he’s talking about why he feels he needs to write interesting and I suspect these are the most autobiographical bits in the book but that’s fine. Anything to get away from the shit:

I never wanted to be a poet, I never dreamed of having an anthology on the national curriculum, it was just simple to write, somewhere to start and fun.

I wrote then as I do now to reveal myself to the world without having to converse with anyone. I find conversation too combative and useless when trying to reveal the depth of a real emotion. I discovered, through reading, that in the world of fiction nothing was impossible or prohibited, not anymore anyway, and so a writer no longer had to contemplate the what ifs?, the can you imagines? or the wouldn’t it be wonderfuls? There is nothing more liberating than a blank page on the table and a pen in the hand and no preconceived ideas of what one might write. With a stroke of the pen you become the God of the pages.

As a lifelong depressive I also found myself relating to the sections where the Black Dog says his bit:

And now the Black Dog was on my shoulder, whispering in my ear and sinking his rabid teeth into my neck.

– What have you done, Nicky, what have you done? You should have known she was a coke slut, she didn’t insist on protection and she let you cum inside her; you silly little prick. What were you fucking thinking, and now you’ve certainly caught herpes, that shit’s for life man, no getting rid of it, what are you going to tell your girlfriend? And you spent one hundred quid on toot, on toot, Nicky! You’re borrowing money from your family for food and then you go and spend a hundred notes on white powder. It’s your first fucking day at work, man. Sort yourself out.

Nicky doesn’t have an angel on one shoulder and a devil on the other. Like Churchill—and Samuel Johnson before him—he has a black dog on his back. (There is an excellent article by Paul Foley on the subject: ‘Black dog’ as a metaphor for depression: a brief history.) Giving the dog a voice and a personality was a touch of genius.

For the most part the patients are nameless and faceless or as good as nameless and faceless. Nicky has no qualms about accepting a blow job in Eddie Davis’s room but then Eddie’s reached the seventh and final stage in his dementia:

Very severe cognitive decline. This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement. Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered. Individuals need help with eating and toileting and there is general incontinence of urine. Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.

Eddie wouldn’t have had a clue what was happening. This sounds very callous but I used to have a sister-in-law who had been a geriatric nurse for many years and a more emotionally-detached woman I have yet to meet; her ability to compartmentalise and switch off was absolutely frightening and she told me straight that it would have been impossible (for her at least) to survive doing the job she did without being able to switch off. It’s sad how quickly Nicky manages this. But everything changes—later that day in fact—with the arrival of Janey Taylor who’s being wheeled in just as Nicky is about to leave for the night:

I got my coat and waited for Louise in the corridor, we had decided to go for a few drinks after work. Karen appeared from around the corner pushing the new inmate in a wheelchair. As she approached me she began to shout and scream.

– John, John, John. Howay man, John.

They went past me and Janey Taylor looked at me directly in the eyes. She was still screaming when I walked through the locked double doors with Louise and off the ward.

Janey thinks that Nicky is her husband.

Janey’s husband had died five years previously, his name was John Taylor and he was a welder from Newcastle. She had three children, two girls and one boy, all of whom were alive. Her son, Ronald, had emigrated to New Zealand in the 1980’s. Her two daughters, Sylvia and Elizabeth, still lived in the North East. There were no records of them ever having visited her.

When Nicky is around Janey is manageable—when she’s not trying to kiss him—and so she becomes his special case and gradually we start to see a change in Nicky. He was never a bad lad but he had a lot of growing up to do. Now he starts to see his patients as people and not simply lumps of flesh to be cleaned, fed, rotated or medicated. For me, though, the most moving story is of the first death Nicky has to cope with. Over three pages we watch Jimmy Pepper die and it’s terribly moving:

I fetched some clean sheets from the linen room and met Sheila there. Jimmy looked terrible, his eyes were sunk into his head and he was struggling to breath.

We had to take his vest, underpants and sanitary pad off first and replace them all. I had to lift Jimmy’s bony, dying body off the mattress and hold him in position while Sheila fought with his vest to get it off. I then took down his underpants, removed his pad and replaced them both. All the while, Jimmy was dying.

We then removed his blankets, leaving him uncovered. I pulled his lifeless body over to me while Sheila pulled his bed sheet from under him before replacing it. Jimmy continued to die.

I then covered him with some new blankets. Sheila instructed me to clean his room, including vacuuming the carpet. I got the vacuum from the utility closet, took it back to his room and turned it on. The vacuum was loud and annoying, as all vacuums are. Jimmy lay there dying.

Sheila returned and told me that she had called the family and told them to come right away. I was told to wait with Jimmy until they arrived and ensure he was clean and presentable. She went back to her office; she probably had paperwork to do.

So I pulled up a chair beside his bed and sat with him, watching the life drain away from his eyes was very sad.

Jimmy was a “miserable old bastard” but he ends up dying alone apart from Nicky. Later on we learn why his two sons had failed to appear. And it’s probably the most upsetting thing in the book.

When I first started reading this book I expected to find examples of horrendous abuse—there’s been a bit on the news recently about Southern Cross Healthcare (Sean Abbott from South Shields, admitted four charges of assault on the patients in their eighties)—but there wasn’t any. Really what this is is a coming of age novel, a fairly classic Bildungsroman:

A Bildungsroman tells about the growing up or coming of age of a sensitive person who is looking for answers and experience. The genre evolved from folklore tales of a dunce or youngest son going out in the world to seek his fortune. Usually in the beginning of the story there is an emotional loss which makes the protagonist leave on his journey. In a Bildungsroman, the goal is maturity, and the protagonist achieves it gradually and with difficulty. The genre often features a main conflict between the main character and society. Typically, the values of society are gradually accepted by the protagonist and he is ultimately accepted into society—the protagonist's mistakes and disappointments are over. In some works, the protagonist is able to reach out and help others after having achieved maturity. – Wikipedia

That paragraph is a decent enough summary of this novella but part of the problem here is that Lee chose to write a novella rather than a novel. 25,000 words is all find and good—and I’m a huge fan of the novella when it’s done right—but you have to be choosy about what you write about and some of this felt rushed. At the end of the book after surviving an overdose—which happens somewhere between chapters nineteen and twenty (a wasted opportunity)—something happens that will change his life forever:

I received an email from a magazine that I had never heard of. They got my details from a literary website, of which I was an inactive member. The email gave details of a writing competition based in London. The challenge was to write a novel or a novella over a weekend in their offices in Camden. The plan was to write from eight in the morning until eleven at night; fifteen hours per day for two days. The prize for best novel was a published ebook through a reputable company that I had heard of.

We’re then told that what we’ve been reading has been the results of those two days. We don’t find out if he won. If he had I wouldn’t have believed it because this is not a prize-winning novella. But it does excuse some of its weaknesses, its lack of refinement. Perversely the book also lacks the rough-and-readiness that made Trainspotting such a startling debut. Trainspotting was about drugs, end of story. One of Nicky’s early efforts is a book called Sniff:

It made sense to me that if I couldn’t take cocaine I might as well write about it; I hoped to trick my mind into thinking we were still doing coke by explaining what it was like in the form of a novel entitled Sniff.

I had been reading a lot of Irvine Welsh books at the time and I decided to try and write in a style that was similar to his; it was the style that I liked to read, so I decided that it should be the style that I write in.

[…]

I wanted to write Trainspotting for the cocaine generation. I wanted a low budget movie to be become an international success, but most of all I wanted the recognition.

I rewrote the first 30,000 words of Sniff, ironing out the flaws and adding to the plot; when I’d finished, I realised something. I hated it. I stopped writing it and never added to it again.

What I had realised was that I couldn’t write like Welsh, not because I was a bad writer, but because I wasn’t Irvine Welsh. I knew that I had to find my own style, my own content and be satisfied with what I could produce.

It’s a good thing he did. One Irvine Welsh is quite enough. In subsequent goes he also resists trying to imitate Bukowski and Burroughs although maybe the ghost of Hemingway is still hanging around here. I don’t think Lee has found his voice yet. This is a bit too polite in places. Yes, Nicky swears but he also uses words like “converse” and each of the three times the word crops up it rankled me. Geordies are like Glaswegians: if we use a word like “converse” we’re taking the piss.

As a story this works fine. As a novel maybe not so much and I suspect the problem there is that it’s sticking too close to the truth—novels are fictions; fictions are lies so if you’re going to lie make it a good one—but it has something. Most of it is perfectly readable—a good, solid three-star read (if I gave stars which I don’t)—but every now and then there’s a glimmer of a fourth star and even a suggestion of a fifth. I wouldn’t have spent the last three days working on this article if I didn’t think there was something here worth encouraging.

You can buy the ebook for a mere 77p—I bought my own copy, no one asked me to review this—or if you prefer a paperback it’s available as one of them too. The book was published by McStorytellers and McStoryteller-in-residence Brendan Gisby’s like me; he wants his authors to be read which is why he keeps the price down.