In the old days (by which I mean a few months ago when I lived in Australia) I used to work as a district nurse. This involved driving from patient’s home to patient’s home and providing nursing care in the person’s own environment. The work day would finish by heading back to the office and sitting around a table with my peers and having a serious discussion about our patient’s needs. It also involved having a not-so-serious discussion about the absurd things we’d come across that day, each of us trying to best each other’s latest edition of the bizarre things humans are capable of.

Working in the community opens you up to a plethora of (what’s the politically correct way of phrasing this?) “interesting” people. These are the people who treat social norms as more of loose guidelines than hard-and-fast rules. Normally, this is a good thing. Life would be boring if we all behaved the same, dressed the same, and said the same things. Unfortunately, some of these patients take it too far, and dismiss certain social norms that are norms for very good reasons. Let me give you an example to help clarify what I mean.

One day a friend of mine told me casually over the work table that she’d been met at the door by her patient, a middle-aged man, “windmilling” his penis at her. I think he was wearing an open robe, but it’s equally likely he was stark naked. This is one of those times where the social norm is beneficial for everybody — let’s stick to shaking hands instead of shaking alternative appendages.

For anyone wondering, I think the term “windmilling” was invented by my friend, and I find it brilliant because right now everyone reading this has an image in their head of exactly what took place. You lucky things.

This is the first example that came to mind, but rest assured there are many more. From a smoker with a chest wound that puffed out cigarette smoke every time he coughed, to a woman dressing in a garbage bag while having her catheter changed to preserve her dignity (mind you, a hole had to be created to get to her catheter, so I’m not really sure what this achieved).

A colleague who has worked as a nurse for over thirty years once said to me that she wished she’d written some of these stories down, that for all the ridiculous tales she could remember there were twice as many she’d forgotten.

Now that I’m in London and doing essentially the same sort of work, I thought I’d learn from my friend’s hindsight and pencil some of the stranger incidences down.

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From the outside, the block of apartments looked dignified. Ancient trees drooped limp branches over the grass ringing the building, and the flats were constructed of old brick begging to be strewn with a lace-work of ivy. I read the name from my sheet — Patricia — and pictured the sweet old lady that belonged to this sweet old building, already looking forward to her proper accent and polite ways.

I walked around the apartment block and found the line of buzzers by the exterior door, checking her number on my list of patients and pushing the button. A few seconds later, there was a mechanical whirr and a click, and I pushed on the door and stepped into the stairway. It was dank, but it’s London, so that wasn’t particularly unusual. I climbed the creaking wooden stairs, scanning door numbers until a green door bearing the appropriate digits stood before me, and I rapped on the wood.

Footsteps sounded from inside the apartment and I straighten my coat, wanting to make a good first impression. Appearances can say a lot, after all. The door opened and I blinked, my introduction falling from my lips on instinct.

‘Good morning, I’m Jonathan, the community phlebotomist.’

An adult diaper covered her crotch and buttocks, but everything else from her flabby breasts to her varicose-veined legs were on show. She was younger than I’d anticipated, around sixty-five, although from what I could see, time had not been kind to her. She smiled at me, a toothless smile revealing gums as naked as the rest of her, and she asked, ‘Are you here for the blood?’

‘That’s me,’ I replied. She seemed completely comfortable with her attire, entirely unperturbed at being barely clad in front of a young male stranger. I felt the weird sensation that it would have been rude of me to make an issue of it.

She waddled down her dark hallway and into her cluttered living room, saying over her shoulder, ‘You’ve caught me in my nappy.’

‘I can see that,’ I said, moving into the room and inhaling the scent of years of cigarette smoke soaked into walls and floorboards. Her house was stifling from the warmth of her heater, and I pulled off my jacket before I began to sweat. A method of cutting down on her heating bill occurred to me, but I decided not to mention it. I reasoned that I had obviously interrupted her preparing for the shower, and wanted to give her an out. ‘I not bothered by it if you aren’t.’

‘No, I’m not bothered.’

‘I’m happy to wait,’ I said, sliding my backpack to the ground, letting the implication hang in the air that the time spent to put clothes on was no burden to me.

She plonked down onto the couch, plucking an already lit cigarette from an ashtray on a coffee table and took a drag. ‘Wait for what?’

That was when I realised she obviously wasn’t putting clothes on, and just as obviously hadn’t been preparing for any shower.

‘Never-mind,’ I said, smiling at her, and wondering exactly when it was this woman had last showered.

With an internal shrug, I went to work going through the routine of preparing my blood-letting equipment while keeping up a stream of small talk. For those of you who have never attempted to take blood from an elderly woman wearing nothing but a diaper, I can tell you, it’s a distracting process. It’s hard thing to carefully thread a needle into the twisted and constricted veins of an actively smoking patient while her breasts are bobbing in your periphery. I had to bite down the urge to ask “Are you sure you wouldn’t be more comfortable with clothes on?”, the subtext of the query being that I sure as hell would have been more comfortable if she’d put some clothes on.

Luckily for me, Patricia was as unbothered by the situation as she had stated, and merrily nattered away, as comfortable as a babe in her crib. Which is ironic, because that’s exactly what she looked like. Well, an ancient over-sized baby in a nicotine-stained couch, but it equates to the same thing.

Once I had pierced her vein and drained the required blood, I taped a cotton ball to the site and pressed the fingers from her opposite arm to the cotton ball, instructing her to apply pressure for at least a minute. She kept up her flow of conversation while I squatted on a stool and wrote her details in the microscopic space provided on the tubes. It wasn’t until I was done that I looked up and found that she was bleeding.

The minute I had asked for her to apply pressure had lasted for as long as it’d taken me to glance away, and blood had seeped out from the small hole I’d created in her vein.

‘Patricia, you’re bleeding.’

‘What?’

She lifted her arm and revealed a red puddle running down her arm and pooling on her thighs. I instructed her, again, to apply pressure to the cotton ball while pulling on another pair of gloves and got to work cleaning her up.

A bleed always looks worse than it is and it didn’t take long to mop up the spilled fluid from her arm and thighs and have her back in her not-so-clean state. She smiled at me, that naked-gum smile to match her outfit, and thanked me.

‘No problem, Patricia. It turns out it was a good thing you weren’t wearing any pants,’ I said, raising my brows and nodding at her recently blood-smeared thighs.

‘Yeah,’ she answered cheerfully, ‘it really was.’ She seemed proud of this, as if the decision to wear nothing but a nappy had been a genius stroke of forethought on her behalf, rather than the neglect of a very basic human desire to put on clothes. I let her have it — I figured an adult who spends their day walking around their home in an adult diaper didn’t get many wins.

‘Nicely played,’ I said, shrugging on my jacket and giving her a wink, and immediately reflecting that winking at an almost naked elderly patient probably wasn’t the smoothest thing I could do.

I said my farewells and waved goodbye to my new nudist friend, stepping back into the stairway and making my way out into the fresh air and away from the tropical heat and cigarette-perfumed environment I had just left with relief.

As I found the address of my next patient and begun trudging away, I looked back over my shoulder at the beautiful English building I had just left. It really did look quite dignified.

But looks can be deceiving, I suppose.