Winner of The Letter Review Prize for Short Fiction
The man sat in his chair, staring straight ahead, unblinking. A passerby might find this strange: the rigidity of his back, the thinness of his mouth, and the look in his eyes, reminiscent of a man heading into combat.
They might wonder why a young man – well, young-ish – looked so afraid in a quiet, empty room. But he was sitting in a basement flat, hidden from public view, so this is a moot point.
He was a thin man, hair greying around his temples. All sharp elbows and knobbly knees. He had always been skinny, despite his brief attempt to bulk up in his early twenties. His natural frame, along with his pale face and tired eyes, suggested someone quite fragile.
The man nudged his phone slightly to check the time. 09.59. The moment it turned to 10:00, it began to vibrate. Despite anticipating it for days, it still made him jump.
He answered the phone. He braced himself for hell.
‘Hello?’
‘Hello there. Am I speaking to Mr. William Taylor?’
‘Yes,’ said Will.
‘Can you confirm your date of birth?’
The voice was pleasant, a male in his mid-thirties. Professional, but approachable.
’27th of August, 1984.’ Jesus, Will thought. He was getting to the point where his date of birth made him wince.
‘Excellent. And the first line of your address?’
’81 Chester Road.’
A pause of a few seconds.
‘Okay!’ said the man. ‘Excellent. My name is Jack.’
Is it fuck, thought Will. ‘Okay,’ he said.
‘I’m the assistant to Dr. Haines. He asked me to call today on his behalf. Do you mind if I ask questions about your general health today?’
‘Yes. I mean, no. I don’t mind.’
‘Excellent. All calls are recorded and used to develop our health assistant training program. Do you give permission for our conversation to be used in this way?’
‘Yes.’
‘Great. Thank you.’ Another short pause. ‘Can I ask you to describe your symptoms?’
Will had rehearsed this conversation many times, but still, he faltered. He looked at the notepad, left open on the table in front of him, a bullet point list.
‘I have long Covid,’ he said. ‘Well. Suspected.’
There was a longer pause. Will considered whether he should continue speaking. He opened his mouth when Jack spoke up. ‘You haven’t had a formal diagnosis of long Covid?’
‘No,’ said Will. ‘There’s no formal test for long Covid, but Dr. Haines thinks that -‘
‘Okay,’ said Jack. ‘Can you list your symptoms?’
‘Yes,’ said Will, slightly ruffled. ‘I have extreme fatigue. It’s hard to get out of bed at all. I have to lie down for most of the day. I get short of breath when I -‘
‘Oh dear,’ Jack interrupted again. ‘That must be very difficult for you.’
Will rolled his eyes. ‘Well, yes. I also have -‘
‘Please continue to -‘ Jack stopped himself. There was another pause, in which Will tried to regain control of his breathing. ‘I’m sorry. Please continue.’
‘Like I was saying. Shortness of breath. Tiredness. I get joint pain, it’s really bad in my wrists, which affects my ability to work. I get heart palpitations, just randomly. And I get -‘
‘It affects your ability to work?’
‘Yes,’ Will snapped. ‘Can I please finish telling you my symptoms?’
There was another short pause.
‘I’m very sorry.’ Jack sounded genuinely contrite. ‘Please continue, Mr. Taylor.’
‘Thank you.’ Where had he got to on this list? He couldn’t remember. Did he say heart palpitations?
‘Heart palpitations,’ Will said, and then he remembered he’d already said this. This was his brain at the age of 41. Decaying by the moment. In his past life, Will would occasionally walk into another room, only to immediately forget why. His entire life felt like this now, like his brain was slightly out of step with his actions.
‘And um, brain fog. I forget things. And it’s just, harder to think, I suppose. Sometimes I’ll read the same page of a book three times and still not, you know, process it.’
He looked over his list again. That was everything. Fatigue, shortness of breath, joint pain, heart palpitations, brain fog. It seemed like such a short list on paper.
There was silence on the other end, and then Will remembered.
‘Jack?’ Will said. ‘I’m done now.’
A pause.
‘Right!’ said Jack. ‘Thank you, Mr. Taylor. Firstly, I’m very sorry to hear you’ve been suffering from these symptoms. It must be very difficult to go about your normal life when you’re feeling so ill.’
‘Mmm.’
‘How can we help you today, Mr. Taylor?’
Here it was, at last: the point of this ordeal.
‘I need help,’ said Will. ‘The symptoms are getting worse, especially the fatigue. I heard there was a medical trial for long Covid patients using steroids -‘
‘And you last spoke to a doctor in -‘
‘October,’ said Will.
‘Can I access the notes for this appointment?’
‘Yes.’
There was a long pause. Silence. Will found this very disconcerting. When Jack stopped speaking, there was nothing. It was like listening to the void, the kind of unnatural silence that could drive a man insane, if he was exposed to it for long enough.
‘Alright.’ Jack said, eventually. ‘When you last spoke to Dr. Haines, you said that you were managing your symptoms.’
‘Yes,’ said Will, ‘But Dr. Haines told me to call back if it got worse. Which it has.’
‘Yes,’ said Jack. ‘I understand. And you’re working from home?’
‘I’m too ill to go into the office.’
Will had been working from his flat for a while. In the early days, he worked at his desk near a small window in the ceiling, which offered the only patch of natural light, taking a walk every day at lunchtime to get some real daylight on his skin. This changed when his joints started aching too much to sit up at the desk, so he worked from bed using a lap tray.
Now, he was lucky to get out of bed at all, except to use the toilet and cobble something together for dinner. His entire existence was his bed, a crumple of soft blankets and pillows, wedged intricately around his legs and hips to support his aching bones.
He imagined his life like a series of concentric circles, getting smaller and smaller. It would end with him curled up tight in his duvet as it closed around him like a vacuum bag, sealing him inside, suffocating him.
‘Right,’ said Jack again. ‘You have fatigue, shortness of breath, joint pain, and heart palpitations, yes?’
‘And brain fog.’ Will said.
‘And brain fog, yes.’ Jack said. ‘And you haven’t had a formal diagnosis of Long Covid?’
Oh no.
‘No,’ said Will. ‘But Dr. Haines thinks that -‘
‘First,’ said Jack, ‘we need to consider what is causing your symptoms.’
Oh no.
‘No, said Will. ‘No, we know what it is. Dr. Haines thinks it’s Long Covid.’
‘But he didn’t formally diagnose you,’ said Jack, politely.
‘No, but we know it’s Long Covid.’
‘Your symptoms may be exacerbated by another condition,’ said Jack, pleasantly, with just the slightest hint of authoritarianism. ‘Have you considered your mental health?’
Will allowed himself to bang his head, ever so gently, on his desk.
‘I’m not depressed.’
‘Are you sure, Mr. Taylor? Studies have shown that working from home can exacerbate depression.’
The truth was, sometimes Will thought he was depressed, but wasn’t that to be expected? Before, he had friends he went to the pub with at least twice a week. He had his colleagues. There was a girl he flirted with every day at work. Her name was Natalie. She was pretty: dark eyes, a slight dimple when she smiled. He found himself living for those moments in which she swept past his desk. Now, in his mind, he referred to her in the past tense. As though she’d died. When in fact, it was his life that was over; it was his existence that had ceased to exist.
Thinking about Natalie hurt, so Will tried not to most of the time. Sometimes she appeared in his dreams, a soft, glowing presence, her face blurred as though slightly out of focus.
‘I’m sure,’ said Will.
‘It’s just that some of your symptoms sound as though they could be caused by depression, and perhaps you need more human interaction. The NHS suggests that working from home can worsen a variety of mental health conditions, including -‘
‘They’re not,’ interrupted Will. ‘They’re typical symptoms of Long Covid.’
He had expected this. The government’s push to get people back into offices, despite mass job losses, was verging on ridiculous. It turned out that allowing large office buildings to sit empty wasn’t helpful for the economy and, more to the point, landlords.
‘They’re also typical symptoms of depression,’ said Jack.
Will wondered what would happen if he just started screaming into the phone. Whether the algorithm would suck it in and eventually regurgitate it somewhere else, years down the line, a long, thin sound of despair, detached from its original source.
‘What, joint pain? Heart palpitations? That’s depression, is it?’
‘No,’ said Jack. ‘I’m referring to the exhaustion and brain fog. We could consider it as an option.’
‘It’s not an option,’ said Will. ‘Can you, like, switch back to Long Covid mode, please? Can we start this conversation again? Forget this last bit.’
‘I’m sorry, Mr. Taylor. I’m just trying to get you the most appropriate help for your situation.’
Will’s headache, which had started as a dull pain, had started to throb.
‘Jack, I’d like to book an appointment with Dr. Haines.’
‘I understand,’ said Jack. Perfectly, punchably pleasant. ‘Dr. Haines is incredibly busy at the moment. He’s booked up for quite some time.’
‘Okay,’ said Will, ‘Can you book an appointment in advance, then?’
‘I’d just like to see if I can help you myself first.’
‘Fine!’ Will shouted. ‘Fucking – fine. Help me. Bloody hell.’
‘I will have to ask you not to swear, Mr. Taylor. Aggressive speech is against our patient terms and conditions.’
Will looked at his hands. They were shaking.
‘Fine,’ he said, again. ‘I won’t swear.’
Another short pause.
‘Great!’ said Jack. His voice was starting to grate on Will. In some private clinics, you could choose the voice of your AI assistant; he’d watched a collection of TikTok videos of some of the silliest ones. It was a game for some people. Make a phone call, pick the most obscure voice, and try to make them say ridiculous things like ‘chronic sternutation’ or ‘sphenopalatine ganglioneuralgia.’ Later, Will read a series of news stories about it: TikTok craze clogs up phone lines at GP surgeries: health secretary responds.
Will’s surgery was technically under the umbrella of the NHS, but everyone, including the doctors, knew the NHS had functionally collapsed. He paid the minimum basic health insurance, which meant he had to pay £50 per month for a service that had previously been free, and it was now ten times harder to get an appointment than it used to be. It also meant that he didn’t get to choose the voice of his AI. He got to enjoy Generic NHS AI (Male), which was no fun at all.
‘Let’s talk about managing your symptoms.’
‘I wanted to talk about medication.’
‘Let’s just go through your symptoms -‘
‘Jack,’ said Will. His back was beginning to ache. He stretched carefully, a slow unfurling of his arms above his head, wedging the phone to his ear with one shoulder. ‘I want. To talk. About medication.’
‘Mr. Taylor -‘ said Jack. Did he just falter? Will contemplated this. Perhaps this was the moment to jump in, to interrupt the system somehow. ‘Let’s talk about -‘
‘Medication!’ Will shouted abruptly. ‘Let’s talk about medication.’
‘I …’ Jack paused. There was a short silence. ‘Mr. Taylor, can you please list your -‘
‘Medication!’ Will yelled, like a madman, ‘Medication! Medication.’
‘Mr. Taylor -‘
‘Medication.’
This is what my life has become, thought Will.
There was a long silence. And then –
‘I understand you’d like to talk about medication?’
‘Yes!’ said Will. ‘Yes. Please.’
‘Right,’ said Jack. ‘Let me just check your records.’
Another silence, in which Will picked up his pen and doodled a star on his notebook. A gold star for this small victory.
‘You’re not currently taking any medication, correct?’
‘That’s correct.’ Will decided to plunge forward; this is what he should have opened with, in hindsight, at the start of the phone call. ‘I want to get a prescription for prednisone.’
‘Prednisone?’ said Jack. He put the emphasis on the ‘ni’. Prednisone. ‘You would like a prescription for prednisone?’
‘Yes.’
Will pulled his phone away from his ear and looked at the time. It was 10.07. How had this entire conversation only been seven minutes? He was exhausted.
‘I would like to pass on your request to Dr. Haines,’ said Jack. Will foolishly allowed his heart to lift slightly. ‘But first, I need to talk to you about something else.’
‘What?’ Will said, desperately.
‘Have you considered your mental health?’
‘Jack. Please don’t do this.’
‘I understand this is an uncomfortable subject, Mr. Taylor. But -‘
‘I HAVE LONG COVID,’ Will stood up, and a jolt of pain shot up his back in protest. ‘I have Long Covid. I need medication for Long Covid.’
‘Long Covid is a complex condition, and little is understood about it. A holistic approach from practitioners is -‘
‘JACK!’ Will shouted. ‘You’re reading the NHS page for Long Covid. I’m not stupid.’
‘Yes,’ Jack said, and he had the decency to sound slightly embarrassed, ‘I do get my knowledge from NHS-approved sources. But I need to recommend that you -‘
‘Jack. I want a prescription for prednisone. It’s been used successfully on Long Covid patients for inflammation. I believe it could help me with my joint pain. If I can get on top of the joint pain, I can go out more.’
‘Are you isolated, Will?’
Will imagined having a pint with his friends. He imagined them treating him as they normally would. Teasing him, rather than looking at him with pity. ‘Yes. I am. That’s why I need the prednisone, to reduce my joint pain. So I can see people. So I can get my life back.’
‘I see,’ said Jack. Will imagined Jack reaching out with his mind tentacles, rifling through data to find the best empathetic response. ‘Do you think you need to get out more?’
Will sat down and closed his eyes. His head was really hurting now.
‘Yes, Jack,’ he sighed. ‘I do need to get out more. Which is why I need the medication. Prednisone.’
‘I see that -‘ Jack faltered, as though unsure of himself. ‘I see that prednisoneeee -‘
Will sat up straight. He looked down at his arms, observed the rush of goosebumps prickling his skin.
‘Jack?’
‘eeee …’
Abruptly, Jack stopped. Dead, haunting silence.
Will sat perfectly still, pushing his phone as hard into his ear as he could manage. He could feel sweat beading around his temples.
There was a brief crackling sound.
‘Prednisone is in -‘ crackle, ‘supply, so I ca -‘
‘What? What?’ Will shouted. ‘Jack, prednisone is what?’
Silence again.
‘Jack?’
Jack’s voice, for the first time, had a very faint electronic tinge.
‘I’m sorry,’ he said. ‘Mr Taylor, something has gone wrong.’
Will laughed. He ran a hand through his hair and looked at the mess of blankets on his bed.
‘Yes,’ he said. ‘Yes, it has.’
‘One moment.’
‘No,’ said Will. He couldn’t afford to lose this moment: he suddenly felt the urge to keep digging, to break into Jack, somehow, to split him open and rummage through whatever came out. ‘What were you saying about prednisone? Were you saying it’s in short supply? Is that why you won’t give it to me?’
‘One moment.’
Will waited. His body was screaming in protest, but he didn’t dare move in case he missed something.
‘Jack?’
‘Mr. Taylor,’ said Jack. ‘I’m sorry about that. We were talking about your mental health.’
‘I could strangle you, Jack.’ Will said. He imagined reaching into the phone, somehow, his hands grasping for Jack, trying to grab hold of thin air. ‘I could literally strangle you.’
‘William, that’s against the patient terms and conditions,’ said Jack.
‘Did you just call me William?’
‘Yes. I’m sorry,’ said Jack, without a trace of apology in his voice this time, ‘I’ll call you Mr. Taylor.’
‘Fine.’
‘So, we were talking about your mental health.’
Will stood and walked toward his bed. He settled himself under his duvet and allowed himself another carefully measured stretch.
‘No,’ he said, yawning. ‘We were talking about medication.’
‘Are you happy, Mr. Taylor?’
Will turned his head to one side, pushing it into the softness of his pillow.
‘No. I’m not happy. I can’t work in an office anymore. I can barely work from home because my wrists hurt. I hardly ever leave my flat. I won’t let my friends visit me because I can’t stand them seeing me like this. I lost my chance with the most incredible woman I’ve ever met. I’m pretty sure I’m going to be made redundant. The world is shit and I feel like shit and I’m lonely. I’m desperately lonely, Jack. Can you fix loneliness? Is that available on the NHS?’
Will’s voice broke.
‘I just want – I just want to try the prednisone. So I can try to, you know. Have a normal life. Please, Jack. Just pass on my request for the prednisone.’
‘Mr. Taylor.’
Will wiped his eyes with the back of his hand. ‘Yes?’
‘Have you considered returning to the office?’
Will carefully placed the phone face down on his bed, pulled the duvet above his head, and screamed.
Megan is a freelance writer based in Somerset, UK. When she’s not writing about gaming and pop culture, she’s writing short stories about humans and how we interact with technology.