With You in Mind

by Jane Fraser

A little earlier, Eva Thomas gives her height in feet and inches, and her weight in stones and pounds. The nurse has asked her how tall and heavy we think we are. She needs to record the results as part of what the marketing leaflet has promised will be her personal health profile. Eva feels the need to apologise in advance for the fact that she’s not sure what five foot and half an inch is in centimetres, or eight stone in kilos.

“I’m not a dinosaur – just haven’t gone metric in some areas of my life. Tend to stick to imperial as I was taught in school,” she says.

She is already sensing that this private, top-to-toe health check does not bode well, and doesn’t seem to be living up to its with you in mind pitch that she’s bought into and shelled out £300 for the comprehensive package: an MOT consisting of thirty-six blood tests; an ECG with six leads, no less; blood pressure monitoring; urine analysis; and online GP consultation and 24/7 helpline. She’s even signed up for a Vitamin D and specialist Lipoprotein test – the full works – disillusioned as she’s been for longer than she cares to remember with her treatment by the local GP who puts everything down to ageing, or too much time researching ailments online.

The nurse doesn’t look up from her desk, sighing as she tells Eva that it’s one hundred and fifty-four centimetres and fifty-one kilos.

“We’d better check. Can we take our shoes off and hop on the scales, there?” she says.

Here we go again, thinks Eva, looking around the room for someone else who is going to make up the ‘we’ for a joint hop onto the scales. No-one. What is it with the medical profession that uses the patronising first person plural when communicating with people of a certain age? And hopping? Not with her right hip the way it is. The debilitating pain is part of the reason she’s here in this sterile, hired, hotel room on an industrial estate in Swansea, at the time of her choice, on a wet Monday afternoon. And the need to be listened to and taken seriously for a change. To be seen, as they say these days.

Eva unties her trainers, padding in her socks to stand on the base of the portable stadiometer, positioned against the wall. She breathes in, hoping to expand her being, and lengthen her spine, vertebra by vertebra, as far as she is able. The nurse brings down to the slider hard on the top of her head, flattening her blow dry.

“Can we keep nice and still, now. I need this to be accurate,” says the nurse, who’s obviously not been blessed with great inter-personal skills.

“I’ll try my best,” says Eva.

“Seems like we’ve shrunk, Mrs Thomas. Unless we’ve been telling porkies,” says the nurse.

Eva senses the nurse’s new-found glee, dishing out a brand of humiliation she’s perhaps not even aware of. Or her off-handedness might simply be to break the monotony of a Monday afternoon, patients dribbling in every forty-minutes, each in search of something other than perhaps reassuring medical results.

“It happens to us all as we age, but women more than men. About two inches between thirty and seventy, so you’re about average. We’ve got four foot eleven inches, here,” continues the nurse.

“How much is that in centimetres, then?” asks Eva, with a wry smile.

“It’s about one hundred and eighty centimetres, Mrs Thomas. Thereabouts. We’ve lost height because of disc flattening and bone density reduction.”

As Eva steps on the scales, getting a glowing report from the nurse that she’s ‘spot on’ with her weight, she is overwhelmed by a sense of loss, feeling herself physically shrink. She’s not at all surprised that women start disappearing at a faster rate than men and not solely down to the physical changes in the spine, either. Though Eva wonders whether the nurse’s time frame is slightly skewed, as in her own particular case, she believes the feeling of diminishing became apparent when she was about forty, menopausal, and en-route to later irrelevance. And it will only get worse, Nursey, decade by decade, crumbling more and more, you becoming invisible as this youth-obsessed society deems you irrelevant now that you wear a different skin.

“We can keep our shoes off, Mrs Thomas,” says the nurse, breaking Eva’s internal ramblings. “Just climb onto the couch, when we are good and ready. Are we alright with lying flat? Any dizziness?”

Eva wonders if this young, obviously pre-menopausal nurse judging the lustrous shine and volume of her dark hair, has a script that she enacts every time a woman of a certain demographic, bleaching out in front of her, comes into her so-called care. It’ll come to you one day, my girl, Eva wants to shout. You need to imagine how it might feel to get older as I must remember what it feels like to be young. Have a bit of ruddy empathy, go off piste, ask me a few questions about my life. My hopes. My dreams. Because I still have them, you know, I don’t get by on memories. But she doesn’t. And as Eva’s years seem to get gulped down at an ever-increasing rate, it’s not only her physical presence that is dwindling, but her voice, muting. And even if she opened her mouth and dared shout, no-one would listen.

On the couch, Eva lies motionless, her eyes staring blankly at the ceiling with the white polystyrene tiles, as the nurse takes her blood pressure, which she informs her is very good for her age. Attaching the leads for the ECG to her ankles, her wrists, her upper chest, the nurse begins to witter on about the struggle she has as a working woman with a teenage son, sapping the life out of her, how she is teaching him to drive, how he expects everything and gives nothing back. Eva tries as best then to say that it won’t be forever, her time will come, and she’ll get her life back, though she knows it’s a lie and that the way it is for the nurse now is as good as it gets.

Eva reckons the nurse has yakked without drawing breath for a full ten minutes of her £300 forty-minute appointment. If her maths is right, it’s already cost her £75 to be the nurse’s counsellor as she herself lies, hostage and horizontal on the couch, prisoner to her woes, when it is she, Eva Thomas, who has forked out her heard-earned money (yes, Nursey, you’ll be working for a lot longer than you think!) for the privilege. She sees the irony in what the nurse has told her about her son giving nothing back.

Now, as many a time in the last few years, she takes bets with herself to assess how long it might be until she gets asked a question. She glances at the clock on the wall. Not much chance of that as she is soon onto the next profile, the final test: to assess the capacity of her lungs.

With trepidation, she inhales as though she needs to take a breath so deep that it will propel her though the rest of her life, preparing to place her lips around the mouthpiece of the spirometer. She’s not a one hundred metre Olympic sprinter for goodness sake, but she doesn’t want to be found failing in front of this nurse who makes her feel she is losing more inches, or bloody centimetres, call them what you will, by the second. There’s a competitive woman with a pulse and oxygen behind this costume of wrinkled skin and half-white hair, you know, she wants to shout. But of course she doesn’t, but saves her breath, expelling it in one long, forced exhalation into the machine.

“Hold for six seconds if we can, Mrs Thomas,” says the nurse.

Eva does as she’s told and does well, so well that the nurse has to repeat the test as the result is much better than predicted for a person of her age, height, and sex.

“Your lung age is very good, Mrs Thomas. Well done,” says the nurse. “Your FEV1 and FEV6 is a good 70% higher than your predicted values.”

There is no rostrum, or gold medal, or raising of a flag, but Eva feels a momentary victory. Though when the flag descends, and the imaginary applause ceases, she feels deflated again, as if all the air is being sucked out of a balloon, the latex remaining crinkled, torn, and useless.

“Well, we’re all done for this afternoon, Mrs Thomas. I trust we’ve found our personal health check satisfactory and if there are no further questions, we can get our shoes on and we’re good to go. Your health check summary will be with you soon digitally. We’re okay with digital, are we, Mrs Thomas?”

“Yes, digital will be perfect,” says Eva. “I’ve already downloaded the app.”

“I think you’ll be surprised when the health profile comes to you that your metabolic age is way younger than your chronological age,” says the nurse.

Eva doesn’t answer. What is this fixation with age and numbers? She’s seventy-one. Fact. She’s had her three score years and ten and is into her bonus years. Even if her health-check isn’t telling her that, then society is, every single day, so she doesn’t really care about her metabolic age, for all the good it will do her.

“Here. Let me get the door for you,” says the nurse, closing Eva’s file and scraping her chair across the floor as she gets to her feet.

“It’s fine,” says Eva. “Stay where you are. We can manage, thank you.”

And then she turns, making her way to the exit. She stoops low on her forty-five-year-old (metabolically speaking) legs, bending backwards, from the waist, taking all the weight on her thighs. Inhaling deeply, she calls on the power of her record-breaking lung age, and limbos down, easing her way out through the inch gap between the bottom of the consulting room door and the tiled floor.

Jane Fraser lives, works and writes fiction in a house facing the sea in Llangennith, in the Gower peninsula, south Wales. She is the author of two collections of short fiction, The South Westerlies (2019) and Connective Tissue (2022) both published by Salt. Her debut novel, Advent (2021) was awarded the SoA’s Paul Torday Memorial Prize in 2022. Her short stories have been broadcast on BBC Radio 4’s Short Works series and placed highly in many international short story competitions: Manchester Fiction Prize finalist, 2017; Rhys Davies Short Story Prize, Fish Short Story Prize and the prestigious ABR Elizabeth Jolley Prize. In 2024, she took second place in the Bath Short Story Competition, with ‘The Glitter Path’.