Patient Page 4

  My dad unlocks the door.

  ‘Fire! Come now!’

  He races up the stairs ahead of me and pulls a blanket off the bed and whacks the wall like a carpet-beater until the flames have gone and the room just smells hot and acrid. He picks up my child’s night-light candle. The wax is all gone from it. The dish has burnt dry and melted the desktop. The corner of the desktop is all bubbly, like boiling treacle. Scorch marks streak the wall immediately above it, and higher up, where The Good, the Bad and the Ugly once were, only a blackened patch is left. Flecks of ash and paper are on my bed. I look out of the window and see a dark, dry, still night and the big outline of the silent tree.

  Coming round from the anaesthetic some hours later I thought I could see two nurses moving around above me. There was a lot of activity. The reconnecting of lines and tubes, the smacking of latex gloves. It was bright. I heard voices. I was back on ITU, but it felt like somewhere else – like I was just below the water-line in a swimming-pool, unable to fully break the surface, figures above me distorted, faces rippling. The light was dazzling. White light like flaring magnesium. I had the tube from the respirator deep in my throat. It was unbearable. I felt like I was gagging continuously. I felt miles away from everyone, in a tunnel on the edge of waking. I thought I was several feet down into the mattress, and I wanted to reach out to attract attention like a drowner. I was trying to speak, trying to get them to understand that I must have the tube removed, but all one of them was saying was, ‘Calm down. Lie still.’

  I thought I was going to crap myself. Tracey came in. I grabbed at the alphabet board in her hand and spelled out ‘S-h-i-t’.

  ‘You feel shit? Yes, I’m sure,’ she said.

  No, no, no. I shook my head violently and pointed down the bed.

  ‘You want to shit?’ she said.

  I nodded vigorously.

  She asked for a bedpan.

  It was slipped under my arse, but of course nothing happened. It was just a response to the anaesthetic wearing off. I pointed to the tube in my mouth.

  Take it out. Take it out.

  Tracey tried to soothe me. ‘You have to show them that you can breathe on your own before they’ll take it out.’

  I was seething with indignation. I started breathing as fast as I could. In out. In out. I could hear the air in the ventilator like a snorkel. I had to regain control. I felt I was the victim of an overreaction. I needed no help. The nurses watched me for a while longer and then sat me up a little way. The elastic strap was loosened and then one of them eased the respirator free, my mouth wide, the length of plastic tubing knocking against my teeth as it came out. My throat felt sandpapered. I wanted to retch. I gulped in air and blinked in the bright light, Tracey holding my hand.

  Angela, one of the nurses, took me outside the following day. She just came on duty and asked if I fancied a spin in a wheelchair. It seemed ridiculous. How could it possibly be allowed, a day after a week of major surgery? But I was so bored and strung out on painkillers, and my arse ached and my feet were all jumpy. It took fifteen minutes to get me disconnected from all my drips. Temporary stops and bungs were found. I was like a bathroom being capped off by a plumber. Sitting me upright, swivelling my legs round out of bed and into the chair took another five minutes. By the time I was ready I really wanted to get back into bed, but it was too late.

  Tracey came too. We went out of the door. I took the spinal injection with me on my lap – a big syringe mounted into a carry-case, battery-operated, the fluid released from the chamber on a slow timer, running from the needle down a narrow tube into my back. I held it like a grenade. I could hear myself talking me through it –

  But I’ve only just had my last operation. Does the Prof know? These corridors smell of cooked fat. I can smell oranges. Aren’t the floors hard? There are ridges everywhere. I can’t believe they’ve left the epidural in. I’d better not drop this box-pump. Is it feeding me painkiller now? Don’t shut the lift doors on me. That’s better. Hello, I’m on ITU. What? Outside? But I thought we would stay inside. Oh, OK then. Up and over the step. That’s it. It’s so loud. All these people on their lunch-hour. Life as normal. I don’t like this. These paving-stones. I’m hunching. I feel like spun glass. Thin, transparent, breakable. Don’t drop me, because I am powerless. I abdicate all responsibility for myself. You could tip me out and I’d just lie there. This is too far now. Can we go back? You can’t get the chair over that step anyway. Turn around. Home now.

  I began to get used to the language and routines. ‘ITU’ was short for ‘Intensive Therapy Unit’ and an alternative term for what I’d always called Intensive Care. I learnt that I had two bowels – a small bowel, sometimes called the small intestine, where all the digesting is done, and a large bowel, or colon, where the waste is processed. I’d always thought ‘bowel’ was just a colloquial term like ‘guts’ and meant somewhere near your arse.

  The mornings would begin with the 6.30 drug round and the arrival of the nurses on the morning shift. Intravenous drugs were fed into my body through the lines and drips in my neck, chest or arms. Sometimes the fluids would feel as cool as stream water as they flowed up my arm; other times they would sting shockingly as they irritated my thin veins. The lines in my neck and chest penetrated so deep that I felt nothing at all when they were used.

  I was often bad-tempered in the early mornings from no proper sleep. Nurses would try to wash me in the bed and I’d sulk. They’d brush my teeth for me and try to put a comb through my hair. I’d dribble the toothpaste into a cardboard bowl. I didn’t see the point. Sometimes they’d wheel the TV over and turn on breakfast TV and I’d watch something profoundly irrelevant like the business news. It wouldn’t even be light outside.

  Gifts and presents that you may want to bring: Most people are unable to eat or drink normally. Please ask your nurse before bringing in food and drink. Flowers and plants are not a good idea because they can grow bugs in the water which can spread infection to the patients. Silk or dried flowers are a good alternative. Personal items of toiletries are a good idea, i.e. talc, perfume, aftershave, shaving foam, razors, toothpaste, etc. Bars of soap are not a good idea as they get soggy and may also grow bugs. Liquid soap in a dispenser is a good idea. Music tapes or tapes from the family, photographs and cards are good because they help the person to keep in touch with home. (ITU Relatives Leaflet)

  I wanted nothing to get in the way of my long silent hours of search and re-evaluation. I was like an enormous tasking computer, sifting through its millions of data deposit boxes, temporarily inaccessible, freeze-screened, finding, replacing, paginating memories, the hospital monitors above my head flashing like the tasking icon, a busy bee, a spinning clock. I was unable to wear anything, my arms and neck and chest strung with drugs and fluids like a limp marionette, my cock stretched by a catheter, my thighs punctured by the needles from anti-blood-clotting injections, my belly zipped up like a body-bag. I wanted no pretence at comforts. When the periods of momentary anger and searing boredom passed, I wanted to be humble. I wanted none of the trappings relatives are encouraged to bring, and days later, when I did gradually allow rewards back in, it was piece by piece – my ring, my soft slippers. Abstinence. Contemplation. Deprivation. They all seemed more appropriate.

  There is not much space for the storage of personal property. While your relative is ill, they are unlikely to require many items. Hearing aids, glasses and a wristwatch or small clock are good things to have. It’s often nice for the nursing staff to have a photo of the patient before they were ill to relate to. (ITU Relatives Leaflet)

  The days of sedation and surgery bothered me, and bother me still. Where did I go for four days? To theatre and back, no doubt, but how can my mind offer no clue as to how I felt, up there so often, knocked out, and then back down to rest and sleep for days on end? I have no recurrent bad dreams, or nightmares of the surgeon’s work. I endure no persistent, latent anguish or undue suffering. It is as though one day I closed my
eyes and then on another I opened them again. No time passed, and the gap between the days is now neatly joined like edited film.

  So does the body remember? Such invasion, such destruction and trauma – the cutting, the sewing, the bleeding – surely these must leave an imprint? Many alternative therapies and holistic approaches to medicine work from the basis of the body’s memories. It is suggested that the body never forgets an awkward birth or a badly broken bone. Tension and stress within the body can stem from such things, as the body strives to protect itself, and in turn can be translated outwardly into sorrow and distress. But when I grieve now I seem to cry only for a general sense of loss and change that encompasses as much the present and my prospects for the future as it does the past. I sometimes wish it were for something more specific, some hard fact I could focus on and exorcize – a particularly bad hour in theatre, the laborious resecting, something touch-and-go, a vital incision, the feel of dead, matted tissue. Can anaesthetic obliterate so much?

  Some months later, when by invitation I attended a lecture on the rarity of my case at Charing Cross Hospital in front of seventy or eighty doctors linked by closed-circuit TV with other doctors at Westminster, I saw slides of necrotic bowel, rotten and severed. It appeared suddenly, without warning, as images thrown large on the screen in front of me. All I could think of was how it resembled grilled Cumberland sausage. I was fascinated but not involved. I was just part of the audience. It didn’t seem to have anything to do with me. It didn’t upset me. When I try to get close to those moments in theatre, all that I seem to be left with are the birds, the hummingbirds, that were painted on the ceiling of the anaesthetist’s room. They were always the last thing I saw. Birds and tropical trees against a blue sky. The black oxygen mask was cupped back and forth over my mouth, my lungs rising and falling, and then the anaesthetic was administered. Wide awake, as I was on later trips to theatre, I’d start the count to ten, convinced the dose was wrong and that I wouldn’t go under. And every time I’d go instantaneously, as though a hypnotist had clicked his fingers.

  ‘One, two …’

  Hummingbirds, hummingbirds.

  ‘… three, four, fi …’

  Gone.

  Tracey and my mum shared a relatives room opposite the unit. My mum would come in and see me around seven, after the drug round was over. Her entrances were always measured and well timed – the buzz on the unit’s intercom; a slow, soft step across the floor in soft, flat shoes. (I got to recognize her tread, and Tracey’s too, and could distinguish them from those of nurses and doctors.) She would arrive gracefully, kiss my forehead or sometimes my feet, hand me a newspaper, and then sit on a low table by the window with the Daily Mail, all seemingly in one long, slow sweep. She would always ask me how I had slept, and I hated to answer truthfully and say ‘badly’ because that would shift the sympathy straight on to me too early in the day, when sometimes all I wanted was a sweet hello on equal terms without acknowledgement of victim and sympathizer.

  Sometimes, later in the day, after a bad moment when I’d suffered pain, she would get up from her customary position at the foot of the bed, move closer, and take my hand and rub her thumb along the back of it, her palms thick and warm. Even in those moments I felt incomprehensible to her, as though even then, as her little boy again, I was a closed book, too long unread, the main characters forgotten or misremembered. I sensed her willing back time, to have a few moments of my childhood all over again, to be of use, to be able to call the school and say I wasn’t coming in today, or to fetch my favourite food. I felt we were both on unfamiliar ground, her stroking my hand, mother and child again in outward appearance, but each with our minds full and confused. We were often mute and uneasy in each other’s company.

  28 January 1962. Eight weeks old. Benjie sleeps from teatime and has to be woken by damp, pulsating, anxious mother at 3 a.m. Very talkative and gurgling after feed. Waves his arms and ‘sees’ my hand for the first time. There was a week when I rang the doctor to ask if his constant clean nappies were worth worrying about. He still sleeps in his Karry-Kot, as it is still cold. I wash him in the washing-up bowl because of the frozen pipes. Put him out into the perishing but sunny garden today in cap (knitted by me) which could ‘do with an inch’ as my mother said. M&S mittens. Muffled like a baby Eskimo. He needs fattening up. He has only been gaining a few ounces. When he was born from the first he seemed very contented. Brought into the ward morning and evening, the sun poured on to his cot and he rarely had to be banished to the night nursery. His eyes at birth were dark blue, his hair sparse and mid-brown. His eyebrows were indistinguishable, his lashes long, and his complexion was pale. (From my mum’s notes when I was born)

  In the relatives room she chose to sleep on the floor, even though Tracey offered her the bed. I think it was some kind of penance. She claimed she slept well, but at night she would retire at about 9.30, leaving Tracey a final hour in the shadows by my bed. When Tracey finally left me and crept into the darkened room, she told me my mum’s voice would sound from floor level: ‘I’m still awake.’ She’d taken to smoking cheap filter cigarettes to calm herself, only to stub them out after a couple of puffs. She searched for order and understanding all the time, tidying up after Tracey, rearranging, changing outfits during the day, making the beds and little piles of things, getting me to repeat things that doctors had said so she could write down key words to remind herself and use to people on the phone. I found her overview of my illness was patchy. Tracey said she told her some facts several times. Her version as relayed to my dad must have been in turns strange, dramatic, true, nonsensical. And yet, above this turmoil and the wrestling with herself, I thought she still managed to present an image of restraint and togetherness by my bedside, and was able to be funny, and to laugh at her attempts to impose order on her confusion. One morning she told me how, from the window of the relatives room, she had devised an ingenious system to hang her washing out over the Horseferry Road, using two wire coat-hangers, and how she was sleeping with her feet in a waste-paper basket to stop the bedclothes from lying on them and making them so hot that it would keep her awake, worrying.

  If she felt she was in the way of a test or a drug round she would creep away, and her quiet deference to Tracey in the times when I needed comforting must have been hard for her to sustain sometimes, but the positions around the bed were defined early on, with Tracey at my pillow, my mum at the foot. She despaired at my dad’s inability to cope with the proximity of my death. She hated him for it – resented that she was suffering and he wasn’t there to share the burden with her, to hold her hand, to be at her pillow. Tracey told me she would come off the phone to him and would shout and storm around the relatives room, tearing her hair with the unfairness of it all. She would travel back to Oxford by train once or twice a week for forty-eight hours, to check, as she said, ‘he hadn’t fallen in the river’ (one of her longstanding fears, when he was drinking) and try to talk to him, put him to bed when he couldn’t stand up straight, and be with him. But all the time I know she just longed for his support.

  Some nights my half-sister Jennie would come after work, catching the tube up from Richmond. Not that she wouldn’t have come anyway, but I think she used to come for Mum’s benefit too. She knew the situation in Oxford. She was someone else for my mum to talk to. Mum would bring her in, and as I caught her eye as she came across the room she would cock her head to one side and smile poignantly and ruefully at me, uncomplicated, selfless. They’d sit together at the end of the bed, Jennie always convinced she was sitting on something important or too close to a piece of hospital equipment, and when she’d finally finished shuffling and scratching around she’d settle like a hen on a nest and beam at me. My role as her little brother came out strongly to her. She was nine when I was born. A baby for a little girl. She used to regularly bandage me in pretend games of doctors and nurses. I don’t really remember what we talked about when she came to the hospital. I just see her face – happy, sad
, engaged, bound up in the immediacy of the present.

  I am sitting out in a chair today. The sun has just appeared from behind the tall trees outside and is shining on my face through the high windows. The windows are open. I feel air. I close my eyes. I can’t believe I am in here, in this place. Hospital. Intensive Care. With my eyes closed I could be in the garden at home or on a beach, but I know when I open them again I won’t be so I’ll keep them shut for a few more minutes. I am sweating into my dressing-gown, but I don’t care.

  ‘Your turn,’ says Tracey.

  I open my eyes. The Scrabble board is on the invalid-table in front of me.

  ‘Sorry.’

  Tracey began with ‘ACQUIRE’. I could only manage ‘RAT’ in response. She is now forty-five points ahead. I have no energy to think. My mind feels like it is running on a run-down battery. When I try to think it turns over like a car engine after the headlights have been left on all night. My neck is stiff. My shoulders hang like the yoke on underfed cattle. This is the furthest we have got with this game. The last two attempts ended in my conceding after only three words. Yesterday I couldn’t even face starting, so exhausting was the laying out of the board. Match abandoned. My mum is watching us. She is happier today with my colour. Not so waxy and yellow apparently. I stare at my tiles. Nothing. ‘S … N … I … U …’ Wait a minute. SEQUINS! Incredible. I plant the tiles on the board and beam at Tracey.

  ‘What’s that?’ she asks.

  ‘Sequins. And a double-word score. Thirty-two points.’ I am beside myself.

  ‘OK then.’ She looks suspicious, but under the circumstances understandable leniency prevails.

  ‘Are you all right?’ she asks.

  The moment exhausts me. ‘Yes. But I’m going to have to retire now. Good word though.’

  Like a lone diver among sharks, I would watch the cool-eyed doctors and anaesthetists glide round my bed. The doctors on ITU were strange, humourless, intent. They struck me as total scientists – more so than any other doctors I came across. Most of the patients they were treating were living on the slope of death. Patient survival was rooted in the minute analysis of charts and the balancing of chemicals, not so much in warmth of human contact, and so the doctors glided from flickering monitor to flickering monitor amid the sonars of bleeps and alarms, gauging, estimating, quiet, serious. I never struck up a conversation with one of them, just gleaned a few facts and watched them mutter among themselves.