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“Sure.” It’s probably about the operation. The break must be pretty serious. He doesn’t want to worry his grandad, but he has an uneasy feeling about it.

He peers at his nan. She’s always been such a tough woman, never taking bullshit from anyone. There’d even been one time she’d marched up to the school, demanded to see the headmaster and screamed at him because some kid kept stealing Rory’s lunch. She was also the person who’d taught him to throw a punch. She said everyone needed to know how to do it.

“I don’t want you to ever do this,” she’d said, “and don’t tell your grandad, but just in case.”

She doesn’t look so tough these days.

The doctor arrives fifteen minutes later. A woman roughly his own age who beckons them into the corridor and stands there waiting for them with the ward sister. He doesn’t like the look of it or the smell, and he fiddles with the cuff of his shirt, shuffling on his feet.

“This is my grandson, Rory,” his grandad tells the doctor, resting his hand on Rory’s shoulder.

“I’m Dr Sharpai.” she holds out her hand and Rory shakes it, noting how hot her hand is and the deep serious lines between her brows.

“We are going to operate on Mrs West tomorrow. Most probably after lunch. It’s a relatively straightforward operation, but given her age and diabetes there is always a risk, and such a procedure can impact the cognitive function in someone so elderly. We will, of course, do our best for Mrs West but i do have to make you aware of these risks.”

His grandad nods.

“Do you have to operate?” Rory asks. “Can’t she just have a cast? I mean, if it’s so risky.”

“No, a femoral neck fracture won’t mend unless we pin it which requires us to operate. I’m afraid this is often the case when elderly women break bones because of the high rates of osteoporosis. The fractures are, unfortunately, rather nasty and do take longer to heal, especially in the elderly. I expect we will need to keep Mrs West immobile for some weeks.” The doctor pauses and her eyes flick to the sister’s. “We think you might need to start considering Mrs West’s care once she’s ready to leave the hospital. I expect we will keep her in for a few days, but then she will need to be moved to a nursing home. Sister Maggie can help to arrange a place. She is going to need that support while she recovers.”

“She can recover at home," his grandad tells them.

The sister smiles kindly at them. “Your wife’s going to require specialist care, she’ll be immovable for some time and there’s a risk, because of her age, that she may never fully recover her mobility. We understand she already had limited mobility, so I’m afraid I’d probably be thinking about this as a full-time arrangement.”

“No,” his grandad says, shaking his head and folding his arms. “No, I’m not putting Mary in a care home. That’s not going to happen.”

“Mr West, I understand it’s a difficult decision to make, but caring for your wife at home, alone, would put an awful lot of strain on you and could possibly be unsafe for her. She’s already had one nasty fall. You don’t want her to have another.”

“I can help more, be there more,” Rory says. There’s no way his nan’s going into a home. There’s no way he’ll let them separate his grandparents. She would hate it and his grandad would be heartbroken.

The doctor frowns. “Even if you moved in full time, you’re not professionals and your grandmother, going forward, is going to require more expert care.”

“Well, can’t we arrange for professional carers to come to her then?”

“Social services are extremely stretched. You wouldn’t be a priority. Not when a home would be a more appropriate option.”

“It isn’t an appropriate option for my nan.” He squeezes his grandad’s shoulder. “We’ll find another way.”

His grandad glances up at him with harrowed eyes.

“We'll leave you to think about it,” the sister says softly, leading the doctor away.

They watch them walk down the corridor and turn into the medical staff office, their feet squeaking on the floor.

“I can’t do it to her, Rory. I just can’t. We always promised each other, always promised, that we’d take care of each other. I can’t break that promise.” His shoulders slump in defeat and Rory thinks his heart cracks in two.

“It’s fine, Grandad. I’ll sort it.”

“You heard them though.” His grandad stares down at the floor, his shoulders falling further.

“We can arrange for a carer, two carers — whatever Nan needs. It doesn’t have to be through the council.”

“That costs a fortune though, lad. Anne at the church paid someone to help look after her husband. The cost crippled her.”

“I’ll pay for it," he says quickly without giving it a second thought.

“I can’t ask you to do that.”