‘I am very old, I don’t think I can manage any more.’

That was how it began, as I listened.

He is old. Next birthday will be 97. So far, living alone, supported by occasional carers.

He is thin despite a healthy appetite; ruddy cheeks and soft hands; fingernails thick.

The hair on his head is sparse, eyes watery.

This is what happens when the steam is running-out of you.

In medical terminology he is frail – a word I dislike less every time I hear it. Why do we so love to straight-jacket people into categories and classes? Is it so difficult to get our head around alternative person-centred descriptors?

Massive stroke.

Major haemorrhage

Acute bleed

Chronic anaemia

You get the idea.

Frail and robust.

Young or old.

The more we trip into organisational nomenclature, the further we drift from people.

I won’t say his name; I’ll make one up. It could be anything.

Arnold, Albert, George.

Names aren’t that distinctive any more.

Back when I began medicine, when Victorians were my patients I remember Wilhelmina and Thomasina. Funny corruptions of boy names.

Albert is worrying.

Not at all sure about his immediate future.

Interesting; you get to be nearly one hundred years old and you’re worried about tomorrow.

As we age, time passes more quickly.

Something to do with heart-rate; A gerbil’s timescales are indefinite.

Fleeting concerns about tomorrow; and, before you know it another day has passed.

We rehabilitate, enable, convalesce, manipulate you into managing just a little more.

Our health and social care systems long ago ran out of coppers to pay for your time in care.

Wilhelmina would have had her grandchildren and extended family, Albert is left alone.

You don’t want to tell him, ‘Hard luck. Home you go.’ To be locked behind fob-accessible door in 21st Century isolation. The TV will keep you company. Your Apple Watch will remind you that you have friends. Kiss, kiss. As if.

Is it a relief for something definite to happen? Fall, pneumonia, cancer. A juicy condition for the services to focus their intentions. ‘Here, take this antibiotic, you’ll be right in no time at all,’ aka, delaying tactic, panacea, falsehood.

And still, he sits alone. By his bed. Silky Paisley-Pattern dressing gown adhering to skinny legs. Untouched sippy-cup. Drug rounds, pharmacists, technicians, porters, cleaners, nurses, a whirling hierarchy, a dizzying display of health and care.

And, he’ll wait.

His family will argue the case.

He will move through the system.

Wheeled in a plastic chair to place A or B or C.

Manoeuvred, positioned strategically in location 1 or 2 or 3.

He hopes for the best when his thoughts aren’t crowded by memories.

Born in 1922.

Interwar period.

Coming of age in 40’s.

All of living history rolled into his experience.

The analysis, assessment of the moment. Now, today, tomorrow, I am never really clear.

Where will our humanity lead us?