Patient

The rain rattled on to the single-glazed skylight that stretched part-way across the barge's roof. Above the glass, greyness pervaded the grim lower atmosphere of North London, and if we moved down through it, we'd have been able to see two men engaged in deep conversation. One of them was irate, the other appeared incredibly relaxed, but note his contribution to the thick fug of smoke collecting above him. The fumes moved across to the opposite side of a lacquered kitchen table attached to the side of the barge, which, surrounded as it was by two upholstery-clad benches, could be classified as a "dining area". The smoke just hung there. The other man was none too happy about it.

Vinny felt anxious. He bounced one leg, told himself this trip was a waste. Different parts of his brain disagreed over the most basic of facts.

"OK, so let me get this straight," he said, gnashing his teeth and tightening the elastic holding his sleekly-conditioned pony tail. "You think I enjoy patronising people."

Unlike Vinny, who was dressed in a light grey Thom Browne suit, pink socks, fake leopard-skin brogues, and clear-lensed Oliver Peoples glasses, Vinny viewed the man opposite him as a non-sophisticate. Squinting in the gloom, Vinny considered with some disdain his friend Jimmy's pile of red dreadlocks tied above his head, his tortoiseshell knock-off Wayfarers and silk kaftan open to reveal tufts of russet chest hair.

"I'm not saying it's not a good idea," said Jimmy, taking tea from a king-sized Chelsea Football Club mug, then smiling to reveal a gold incisor. He finished rolling a large joint, using paraphernalia spread across a year-old copy of the Reader's Digest. "Just question your motives."

"How about being less selfish for a change," said Vinny, ruffling his brow with what he hoped was appropriate sincerity. "I mean, you know. I could be sitting on my arse all day."

Jimmy laughed. Vinny scowled and grabbed the now-ignited joint, placed it carefully in his mouth and inhaled, slamming the gas into his lungs. He sat there for a moment and took in the view outside. He could just make out the light grey dragon's claw of St Pancras pasted against the whitened sky, high above the waterway's scarring surface. But it was too cold to take comfort from the shelter.

What was aggravating, thought Vinny, was that he knew Jimmy had a point. Vinny ran a successful chain of bars and nightclubs. Apart from his parents' split when he was five, he'd never needed anyone, really, left school at 16 to make his own way, then it was all business. Flyering, plugging, promoting, junior office boy at White Records, a matesy relationship with its owner Dominic White had morphed into a profitable partnership organising parties for 11-year-olds that made him widely hated and staggeringly rich. He'd bought Dominic out a few months after that to develop his own brand. At one end of the spectrum he owned gritty bars that were barely furnished with pub garden tables, dart boards and delightfully offensive ex-punks as staff. At the other, he had spas, boutique hotels, an events management wing. He was regularly featured in the society pages of glossy magazines, described as the perfect mix between a self-made man and a connoisseur of luxury. All of which had been great until two months ago when his mother died.

He'd got the call in a business meeting. The mobile's screen flashed "home" and he'd buried it. Several hours later, upon returning his father's call he'd been greeted gruffly with one-word answers. He'd immediately caught a cab, thrust three twenties into the cabby's mitt and met his sister outside the hospice. She was tearful. He didn't feel anything.

Vinny had been ushered down a long hall, the sharp smell of disinfectant playing in his mouth. Mum's room had unfolded before him like the closing scenes of a Greek tragedy. His father stood upright in the corner like a snooker cue, his mother equally silent and upright in bed, the light cutting depressingly real stripes into a peach-coloured hospital blanket across her legs. Dad made a point of not eye-balling his son and marched out. His mother was silent for a moment then turned her eyes towards Vinny. Even then she looked like royalty.

"You know when you were a little boy you had a pathological fear of trains?"

"Mmm?"

"Your father and I used to have to lie to you every time we took one, otherwise you'd foam at the mouth," she said, looking up at the gap in the room left by his Dad. "We should have bought a car."

It was story he'd heard a thousand times. He had begun fidgeting, and his mother must have clocked his eyes glazing because she stopped talking and peered at him, curiously, the same look she would have given him when he was a kid and she was inspecting his fingernails.

"Just go."

"Thanks Mum."

Vinny kissed her on the forehead, and a look of anger flickered across her face before evaporating. She smiled. "Go out and enjoy yourself." He'd equivocated for a while, then left. Outside his father, always the silent type, just patted Vinny's back. It was funny, really. Vinny hoped he'd remember more.

Upon returning to work, he'd recounted the incident, pretty much exactly as he'd seen it, to Lex, one of his bar girls. She was in possession of a seemingly bottomless heart that he often relied upon to make him feel good about himself when he was suffering from low mood. She'd been supportive, indulgent of his guilt, as had many of his friends. But as the days wore on he'd noticed subtle changes in people's behaviour that were consistent enough not to be explainable by latent paranoia. Sly looks and an emotional cooling had infected his entourage.

Like normal he made the mistake of trying to escape his alienation by looking inwardly. Finishing a a typically restless sleep in the apartment he owned above one of his more successful nightclubs he'd heard the post arrive an hour earlier than normal. Pulling on a silk dressing gown and moving from the apartment into the nightclub, the heavily-varnished pine applying a series of cold compresses to his bare feet, he'd discovered a wad of 10 identical leaflets scattered around the letter-box. They were from "Happy to Help", a locally-funded BanglaTown charity shuttling home-help volunteers to the needy. An unintelligent font spelt out "300 per cent increase in demand due to Tory spending cuts".

"I just think it might help," he muttered to Jimmy, clawing the smoke away from his face. "I could do with a patient. Someone to work on." Before long Vinny was halfway out of the door and bracing himself against a grimy squall. Within the hour, he was back home and tucked up in bed.

***

Ten days later Vinny stood on the doorstep of a ground floor new-build brick council flat in Rotherhithe. A group of children were playing a raucous game of football behind him. He was wearing a tight-fitting Paul Smith black suit, Paul Smith shoes, and a flourescent nylon yellow bib with a logo on its left breast depicting a stick man helping another stick man leaning on a stick. Vinny slowly rapped on the door, moving his eyebrows into what he hoped was a sympathetic "V". To his surprise, nothing happened. He waited for several moments then knocked again. Straining against the sound of the soccer match, he thought he heard the sound of several saucepans falling to the ground followed by some barely audible cursing. Just as he was about to turn to leave a second time, the door crept open two inches.

Through the crack he could just make out what appeared to be a huge, bloodshot eye with a large, thin oval pupil running from top to bottom. Whoever it was wore what Vinny thought looked like a surgical mask. His eye-level was barely two feet from the floor.

"What you want," said the crack.

"Here and happy to help," Vinny chanted, nervously, gesturing to his bib. The man hesitated for several seconds and Vinny could just make out some further grumbling. It was followed by the sound of several locks being unclasped and the door flew open. Vinny stepped into the gloom.

As his eyes adjusted, Vinny made out what appeared to be a studio apartment. The disarray of its contents was at odds with the apartment's newness. A small, black and white TV with a dial-tuner sat on a wooden crate in the corner of the room with the words "This way up" stenciled across it in thick black letters. On the far side of the room was a small kitchen area, its sink piled high with washing up and playing host to a family of flies. A dirty mattress was heaped with black bin bags in the opposite corner and seemed to be the only other feature, and Vinny suspected that this was where the room's inhabitant slept.

In front of him sat what appeared at first glance to be a furry dwarf in a wheelchair. As the man pulled down the surgical mask, however, Vinny noted that it was concealing not fur, but two symmetrical serpent tattoos that began on the man's forehead and wound their way down to his chin. Perfunctorily, the man turned his wheelchair around and made off towards the kitchen area. Vinny felt like he wanted to faint, possibly due to the quantity of drink he'd had that morning to calm his nerves. He couldn't quite remember what it was he he was supposed to be doing.

The patient seemed to be making tea. Vinny didn't want to sit down, not least because he thought it would make him dizzy. The TV appeared to have incredibly poor reception. To appear useful, Vinny moved towards it and began adjusting the dial-tuner. He happened across the flickering outline of a suited man. There was a loud clattering of dishes. Vinny quickly turned, reluctant to survey any scene of carnage that he couldn't deal with while inebriated. He saw the patient, his back to him, banging his fists into the side of his wheelchair. He had apparently been attempting to remove a saucepan from the bottom of the washing up, which by way of reward, had mercilessly buried him. His heart racing, and feeling helplessly inequipped, Vinny ran to his charge's aid.

"Fuckin' no," screamed the man, grabbing a ceramic bowl from the floor and hitting it against the edge of the sink with a dull clunk.

"It's OK," said Vinny, unconvincingly, making "calm down" gestures with his arms though taking care not to make contact with the patient's mangy-looking dressing gown. "Is there anything I can do?"

The man started sobbing, and started to smash the crockery on the ground. He picked up a colander and began swirling it around his head like a butterfly net. Vinny noticed what he desperately hoped wasn't a puddle collecting beneath the wheelchair. The patient restarted his languorous assault against his knees. Vinny looked at his watch.

"You shouldn't be here," gasped the patient.

"I'm just here to help," Vinny repeated. The patient was right. He shoudn't be there.

The man looked even further into his lap. "Move me, please," he said, barely audible.

Vinny pushed him in front of the TV. He tried to compose himself. He could only perceive reality from a distance, like a tourist viewing a neighboring town from the top of a church. For several seconds, Vinny's brain shut his body down. But bit by bit he forced himself back, and set about clearing the mess.

***

"I'm not sure I can do it, Sal," said Vinny. He was relaxing in one of his Clerkenwell bars after closing time. Helmut Newton prints adorned bare brickwork from top to toe and white chairs snaked like inverted 'S's' across a white laquered floor. There were bookshelves. Nan Goldin, Proust, Dave Eggers. Projections showed black and white slides of Cossacks. A few regulars chatted on a battered leather sofa in the corner as the bar-staff cashed up.

"Well, as long as you're doing it for the right reasons," said Sal. Sal was Vinny's girlfriend. She was long-suffering, hideously attractive and intelligent. Vinny wondered how long he could hang on to her for.

"I don't know what the right reasons are," said the bar-owner, rubbing his temples. "It's good to do good, right, I mean, but will I get better at it?"

Sal remained tight-lipped. She looked like she wanted to leave, like she didn't want to talk to her boyfriend about moral dilemmas. Vinny's guilt managed to attain an extra dimension he'd hitherto assumed was impossible.

He lit up a cigarette. "I'm selfish, I know that."

She laughed. "That's why people like you, Vinny."

"What if he has a heart attack and I don't know what to do?"

"Call a doctor. Look, you're doing your best. Maybe worry less about what you could be using the time to achieve and spend more time worrying about how you're going to look after this guy, OK?"

She planted a sympathetic hand on his knee. "Listen Vinny, I've got to go. I'll call you tomorrow."

****

Vinny found the following days went slowly. Sal was taking a long time to reply to his messages. He found work to be an unfriendly place; his employees continued to sneer at him and he occasionally burst in on them completing a hatchet job on his personality. He retreated further into himself, and discovered on more than one occasion that he sought solace with the patient.

The entrepreneur discovered he had a certain affinity with the guy. His incontinence and nauseating personal hygiene aside, Vinny saw him as a fellow traveller from the slums to somewhere else. The patient didn't say much, but Vinny felt like he could see inside his head; it was almost like a social second sight. He'd learned what he could from "Happy to Help". The patient had had a tough upbringing, out of town. He'd been clean-living for much of that, but had spent a spell in prison. Vinny felt he could sympathise with the persecution.

The following years the man had sold heroin, before using it himself. He currently claimed he was clean and suffering from a degenerative condition, which thankfully meant he wasn't forced by the state to seek work. A suite of doctors had trouble diagnosing what exactly was wrong with him. Vinny listened to this with rapture. For the first time he thought he could make a difference. By burying himself in the patient's problems, he could forget a little about the past few months and potentially win back the respect of his peers.

One evening the pair of them were watching TV. It was a wildlife programme, the kind of thing that's warrants breathless presentation. The alien shapes of monstrous ants lurched across the screen. Their legs flickered, as did the colour and clarity of the image. A swarm of insects appeared to be clustered over the shiny, brown thorax of some kind of larger insect. They appeared to be feeding on it. The patient stared, impassive. His greasy hair was swept back with the single sweep a comb. His right hand clung to a cigarette that was rapidly burning out.

Vinny noticed that when the patient's face did not assume its resting expression of barely-suppressed rage, his jaw would slacken but his eyes would continue to stare intensely at the screen. He would nervously look at Vinny every so often as though Vinny's presence was disturbing the formulation of a beautifully intricate plan. Vinny wondered what he was up to, then scalded himself for his prejudice. But he couldn't help but wonder what was going through the patient's mind. He knew him well, after all. Maybe he was going to kill himself. "Maybe he wants to kill me." Vinny suddenly found himself panicking. He glanced at the screen, the tinny sound of scrabbling ants both hypnotic and revolting. For a split-second Vinny imagined a blanket of insect swaddling his legs. The patient alongside him suddenly became a huge ant, its antennae twitching, its head bulbous and severe. Vinny jolted. The patient must have noticed and turned towards him.

Vinny tried to compose himself. The dwarf looked looked him up and down with authoritative disdain. He blinked several times, managing to make even this simple act derisive, and began to speak. "Let me tell you a story," he said. Vinny played with his hair and leaned forward, a display of enthusiasm that he hoped would make the patient like him. Instead, the patient sneered at Vinny, his chapped lips curling back off a patio of yellow and brown teeth. Vinny could smell cheese and vegetables on his breath.

"I went to a bank, not long ago. Wheeled myself in. They told me to wait, gave me a ticket," said the patient, producing a scrap of paper, and pointing at it. "And I wait. For ages. After a while I go up to the woman who gave me the ticket," he added, beginning to rock animatedly. "I say, don't you have any respect for the disabled? I tell her I need to see somebody."

Vinny nodded. "Mmmm." He tried to focus on the story, but found it very boring. He made an effort not to look back at the television. The patient leant in towards him. Vinny felt uncomfortable. Despite the patient's weak legs, he still boasted a not-unimpressively-muscular upper body.

"I mean, how would you like it if that happened to you?" The patient jabbed his fist into Vinny's upper arm several times. Vinny crumpled, noticeably. He stole himself for successive punches. He didn't want the patient to know he was weak. Though somehow, he felt, the dwarf must have figured this out by now.

"An hour later," the patient said, his voice now raised. "I get to the see the manager. Some spotty kid. I tell him I'm in a bad way, need a little help, not much, just a loan. I'm practically on my knees, fella. I know this little schmuck isn't going to help me out, oh no."

"Um, so what's the story."

The patient snorted. He started twitching his wheelchair slowly from side to side, as though trying to burn off his anger. "This guy looks at his computer. I can tell he's just reading off a load of computerised shit or something." The patient moved his wheelchair between Vinny and the television. Vinny's heat sank. He wondered how much more of this he was going to have to take. "He gives this standard spiel about not being able to help. Ridiculous." The patient gestured to illustrate his surprise, and his left arm swung involuntarily out to one side. By accident the arm hit the television, which rocked for a second or two, threatening to topple over. Vinny winced. The patient looked back at it, and then over to Vinny, challenging him. His eyes were wide. He looked crazed. Vinny hoped he wasn't going to wet himself again.

"And shall I tell you the worst thing," said the patient, now shouting. He lurched forward in his wheelchair and pushed Vinny's shoulder, goading him. "When he saw my legs, he wanted to change his mind." The patient's voice had raised into an irritating squeak now, his face foreshortened, his shouts punctuated with nervous giggles. Vinny craning his head to one side to escape his breath and try to avoid making contact with the wildly gesticulations.

Vinny knew he should be walking. He should tell the patient to stop. He should address the patient in a calm, collected fashion, tell him such behaviour was excessive, that Vinny couldn't tolerate it, that he would be unable to visit the patient again if he continued to get physical. But for some reason, he didn't want to. He didn't feel much panicked. As far as Vinny was concerned the patient could do with him what he pleased. He'd come here of his own accord, he'd put his time in, he'd shown willing, now it was the patient's turn to give a little back. It wasn't just take, take, take, in this world, didn't he know that? Vinny discovered that this abdication of any responsibility was something of a relief. "So what are you going to do about it," Vinny said confrontationally.

The patient's eyes narrowed, his voice lowered. Vinny tried to catch sight of the television above the patient's right shoulder. The patient leaned in again, his nose centimetres from Vinny's ear. Vinny exhaled slowly, pressing himself into his seat. He locked eyes with the dwarf for the first time.

"How do you think that made me feel?"

Vinny was thrown back off his chair. He caught sight of the flat's stucco ceiling flying past his eyes, before he hit the back of his head on the concrete floor. Smacked by the impact, Vinny thought it felt like someone was firing a nail gun into strategic positions along the length of his spine. He winced, he squirmed, his eyes began to fill with water. He glanced up to see the patient, apparently standing. Vinny murmured, incomprehensibly, expressing surprise at the patient's sudden apparent mobility. He'd never seen one before, but judging by its shape, lustre and the way the patient was smirkingly pointing it at him, he now guessed he was looking up the barrel of a sawn-off shotgun.

"Give me something I want."

****

Helping huh? It can be fun. It can be real fun. The man smiled at himself in the mirror, then frowned, then tied back his pony tail. He turned off the Womack and Womack playing on the stereo in an opulent private apartment. There was a picture of the man's family next to the bathroom which he kissed before opening the door and descending into the club. He whistled. It was Beethoven's Fifth.

In a marked departure from the decor of the apartment - framed stills of the cast of West End musicals, John Hughes film posters, brocaded drapes - the nightclub was an exercise in sleek minimalism. Helmut Newton prints adorned bare brickwork from top to toe, white chairs snake like inverted 'S's' across a white laquered floor. There were bookshelves. Nan Goldin, Proust, Dave Eggers. Projections showed black and white slides of Cossacks.

The patient strutted through, nodding to the bar maid, who had a shaved head and large hoop earrings. Underneath the man's bib he was wearing Thom Browne; Oliver Peoples spectacles with clear lenses perched on the end of his nose. He had a single, silver, hooped earring in his left earlobe. His mobile phone rang.

"Hey Vinny, how ya doing? Ah...yep. Yep. You need to slam the side of it. Adjust the aerial. If that doesn't work, turn if off and then on again." The patient smirked to himself. He hung up. He slammed the door behind him, the sound cacophonous in the hollow interior of the empty bar, and started straightening his cuffs.