Serenity House

by Christopher Hope

  Dr August Tonks confessed to having learnt much from American standards. ‘We’re seeing the start of what I call patient militancy. They say – let the sick have access to the means of extinction. Why should termination always be doctor-driven? Six months to live and nothing but suffering? Hell, no, we want to go! Give us the tools, say patients to their doctors, and we’ll finish the job! I like that. I like that a lot. You’ve got priests and ministers saying straight out: “We’ve reached critical mass.” There are enough families upset by the time it takes their loved ones to die. Too long. And they’re saying, damn it, that’s not right! I respect that, Cledwyn.’

  ‘And I respect that, August,’ said Mr Fox. ‘A lot.’

  He felt so much respect he called a meeting of all the elders to hear about the new patient militancy. Night Matron was there and Imelda and Jack, licking his lips and grinning like a demon. He didn’t look much like a giant killer, Beryl the Beard decided. That yellow hair, square jaw. More of a farm boy. Mr Fox promised to begin drafting Living Wills that everyone could use. Max Montfalcon, after listening to Dr Tonks, grunted.

  ‘You think people should go willingly when they’re past it?’

  ‘Not past it. Up against it.’

  ‘Somebody else will have to give them a nudge. Take the decision.’

  ‘Someone has to decide now, Mr Montfalcon. Every time we take a patient off a kidney machine. Every time we decide not to resuscitate mechanically. Every time we remove feeding tubes. Every time a kindly family doctor overprescribes for his suffering patient and the family do the rest. Everyone who goes on a machine means we decide against that machine for someone whose need is arguably just as great. We’re talking about merciful release versus merciless machines.’

  ‘It will never work,’ said Max. ‘Believe me. It’s been tried.’

  ‘Not to my knowledge,’ said Dr Tonks. ‘Only the Americans are debating it. What are we going to do with ageing populations and limited resources in hospital and home?’

  ‘Americans,’ said Max. ‘Poor devils. At least, once upon a time, killing each other was a young person’s activity. Now the old will have it on demand. You reach a certain age. It’s found you’re ill. And why? You ate too much ice-cream. You didn’t drink enough mineral water. They have you into hospital and you’re doubly doomed. You have this disease. Failed once. You’re old. Failed twice. So how do they solve this problem? You fill in a form. You make a neat death. Someone divided societies into those who chose the raw or the cooked. From now on it’s the tidy and the untidy. What would happen if you sat down with a patient and asked him to sign a form ensuring a good life?’

  ‘That’, said Dr Tonks, ‘would be an assault on personal freedom.’ He appealed to Jack. ‘What does our American think?’

  Jack thought about it. He closed his eyes. He said: ‘OK!’ It was a start. But it wouldn’t do. Un-fuckin’-real, thought Jack to himself. He put his finger in his ear and wriggled it. Then he said the word. He didn’t like to use the word too often because it was the only one he always had in his head. Ready to fire.

  ‘Video,’ said Jack and pulled his finger out of his ear.

  ‘Now that’, said Dr Tonks in a quiet voice, ‘is one of the most brilliant ideas I’ve ever heard! Don’t get me wrong. I am not on the iron edge in this. You get some pit bulls among the geriatric profession who argue that life should never be extended beyond its productive capacities. I don’t go that far. After all it’s only a step away from that position to saying that life should be terminated as soon as it is not productive. And we all know where that led.’ Dr Tonks gave his warm, brown laugh. ‘Straight to the extermination camps.’

  ‘Oh, right,’ said Mr Fox, relieved that Dr Tonks did not have eventide refuges in mind.

  ‘The camps began in the hospitals,’ Max murmured. ‘Then the hospitals moved to the camps.’

  But Dr Tonks was in full flow. His eyes flashed, his affable smile came and went. He said: ‘Don’t follow you, Mr Montfalcon. Look – I’m not a pit bull. But neither am I a poodle in the med-assist matter, as our American cousins call it. I take more of a Dobermann line. If patient requests – well and good. Patient also to be advised on what lies ahead. Particularly in the EP-LTT frame.’

  ‘What’s that?’ asked Cledwyn Fox.

  ‘Excessive Pain, Low Time Threshold. Less than six months.’

  Mr Fox heard how wonderfully August Tonks dealt with an EP plus LTT case when Serenity House admitted the Gooches: Elsie and her husband Norman. Dr Tonks made them a pot of tea and then chatted about last things. Norman Gooch was a bit testy at first.

  ‘I don’t want to die, Doctor.’

  ‘None of us do, Mr Gooch. But may I respectfully remind you we do have a little cancer. And our cancer is in an advanced stage. Preterminal.’

  ‘I want to live till I die,’ said Norman Gooch, small and wan in his green checked coat and purple tie.

  ‘That’, said Dr Tonks, ‘is not the nub, Mr Gooch. The nub is – do we want our dying to be prolonged?’

  ‘The doctor’s only trying to help,’ Elsie Gooch told her husband. ‘Norman is as stubborn as a mule, Doctor.’

  Dr Tonks smiled warmly. He pressed Norman Gooch’s hand. Norman recoiled. He had not had his hand pressed since he was a boy. ‘The problem may be, Mr Gooch, unless you give instructions to the contrary, that when you would really prefer to be somewhere else, the medical staff won’t be able to act. Fearful of the law. Maybe told by your relatives to keep you going, come what may, while deep inside yourself, Mr Gooch, but unable to utter a word, you are praying to—’

  ‘Leave the room?’

  ‘You’ve taken the words out of my mouth.’

  Norman Gooch thought about this. ‘My GP says six months. What do you say?’

  ‘Without having examined you, Mr Gooch, Norman – may I call you Norman? – I wouldn’t like to commit myself. But if you’ll take a word of advice from a labourer in the vineyard, six months sometimes doesn’t amount to six weeks.’

  ‘Six weeks?’ Mr Gooch unknotted his tie. ‘Hardly seems worthwhile, does it? Why wait till it gets so bad I can’t stand it? Is that what you’re saying? Like taking a cold bath. Might as well jump in?’

  ‘Norman hates cold baths,’ said Elsie Gooch.

  Dr Tonks looked Norman Gooch straight in the eyes, long and deep: ‘That’s up to your, sir. Absolutely. But if that’s what you decide, I would respect your decision. I have a little form here, designed with people like you in mind.’

  ‘Save a lot of bother, wouldn’t it?’ asked Norman Gooch, and now he was holding Dr Tonks’s hand.

  Dr Tonks was true to his word. A nod to Night Matron and it went like magic. Matron told Imelda and Imelda told Jack and just twenty-four hours later, the boys from Dove’s were backing their collection vehicles up to the ramp in the back yard of Serenity House.

  ‘There wasn’t even time to leave his bag in the luggage depository,’ Night Matron told Cledwyn Fox proudly and Mr Fox said, ‘Bless you, Matron.’

  ‘No, bless you, Mr Fox.’

  And Jack said, ‘Boy, oh boy, oh boy!’

  ‘Where would we be without Americans?’ asked Dr Tonks.

  Elsie Gooch followed her husband a week later. It led to the first use of a phrase heard often in Serenity House on winter evenings, when the dovecall signalled lights out and the elders, by wheelchair and Zimmer frame and walking stick, on the arms of key-helpers, made their slow way to bed. The Gooches, it was agreed, had been ‘tonked’.

  CHAPTER SEVEN

  Tales his Mother Told Him

  Not so very long ago, in the Tranquil Pines Mobile Home Park out on Orange Avenue, south of Orlando, after he lost his job in the Kingdom and began lying about, Jack had trouble with his other mother, old Marta. She began dying. It was a time before he began taking it in. He had this selection of unusual videos from the Aardvark Video Emporium and they absorbed him. Except when he got hungry.

  On the day they took old
Marta away, Jack had been watching a fine piece of footage about wild-life in the desert. He liked it because it made him even hungrier.

  Jack had listened for years now to old Marta telling him she was dying, and had simply not believed it. At eighty, she looked so solid still, with her thick grey hair and her clear blue eyes. She gripped his hand – boy, it hurt! – and said: ‘I’ve seen enough of it. Shouldn’t I know what is and is not dying?’

  Jack had not been a very good boy. He still wasn’t such a great boy. But he didn’t try to kill people any more. He didn’t keep going back to houses of correction, like about three times a year. Thirty-five offences by the time he was fifteen. Knives and chains. Stabbings and muggings. Mostly OK, so he’d tried to kill Miss Priam, his English teacher over at George Washington High. But that only because she tried to get him to read when she knew he struggled. Didn’t he say ‘Don’t’ when she pulled out her books and showed him pictures of turtles? She brought the turtles because she knew he looked at the tube a lot and turtles were on the tube. Didn’t he say to her, ‘Can’t’ when she pointed her finger at a turtle and said, ‘Try, Jack. Just try for Miss Priam’? And he’d said, sticking his finger in his ear and pulling the words from so deep in his head it hurt, ‘Gimme zero. Just gimme zero! OK?’ But she pushed him. So he popped her. Who wouldn’t? The metal detector teams had not come round to George Washington High that day. So he had his piece snug beneath his arm. And she took a slug in the chest, did Miss Priam. And had they not staunched the wound with the fucking turtle pages, she would’ve stayed popped and Jack might have stayed in the iron box for ever and ever with even Marta not able to bail him. But the turtles saved Miss Priam and Marta got this lawyer who argued that Jack wasn’t really bad. He just had this reading problem. And the way Miss Priam had pushed him, begged him, taunted him, had sent the poor young lad loco. Marta took him home. Marta hired him a bunch of piccies, his favourite piccies, from the Aardvark Video Special Adult Section. All Tastes Catered For… and sat him down on the rug and Jack had never looked back. Or up, much, either.

  Marta had been looking after him since his mother ‘went West’. Where Jack was when she ‘went West’, as Marta told him she had done, he had no idea. But in Jack’s mind she’d always headed for cowboy country, to work in a saloon, or maybe a nice haberdashery store, selling buttons and bows, that sort of thing. In Jack’s dreams his mother wore a cowboy hat, sometimes she carried a guitar, always she wore white boots. In his dreams nothing ever happened to his mother. Jack was not sure any more which came first – his videos or his dreams. She was the only person in Jack’s dreams to whom nothing happened. She wasn’t, like, shot in the face, the flesh peeling back to show the skull beneath, the teeth flecked with blood. Or disembowelled – one lunge and lift to the sword… No. And always when things got lively in Jack’s dreams it was Jack who was doing the business. He’d fast-forward to action and do it. Then run the action replays. But nothing ever happened to Jack’s mother in his dreams. Early, when he woke, she wasn’t there. Again.

  Instead he had Marta, his other mother, who had looked after him since he couldn’t remember when. She was the one who tried to get him to go to school. She tried to get him to stay in school. Dealt with his probation officer. Kept him in pieces. Bailed him out when he got older and wilder and ran with Fat Mansy and that crowd for a time. Rented him his first videos – now that had really helped to calm him down. And she never minded what he watched. Nothing shocked Marta. She had travelled. Her stories were so good that he thought he must have seen the movie, until he asked for it, down at the Aardvark Emporium, and they said they’d never heard of stuff so good – and the Aardvark had every good thing. Their ads promised: ‘If it’s the goodest! The Aardvark’s got it!’

  ‘Once I worked with a man. He was so tall, Jack. And perfectly polite. He was a doctor and not a doctor. Not a medical doctor, I mean – like our Dr Castro. And he spoke English very well – not like Dr Castro. This man was a kind man. For instance, so you should know what I mean – he never did anything in the productions department in the place where we were. A thousand people in twenty-four hours was the production rate, at this time, Jack. You could see the two large smoke-stacks from the window of our institute – that’s where I worked with the tall guy.

  ‘I was a nurse, mind you, never a doctor. Not medical, anyway. We were both in the wrong place at the wrong time. What could we do but stick together? A surgical nurse who’s got some years in the business knows more than some young doctors. Do you wonder how a nurse can be a nurse one day and almost a doctor the next? Then ask: how can you be a doctor one day and a killer the next? Such miracles! They were happening all the time.

  ‘No, like I say, this man never did production in the place where we were. All he wanted to do was to measure. Heads, mostly. But me, little old me, I did production. Yes – when I had to. Because look – you get them coming in, the new ones. All are thin and sick – but some are dying. And so you say to yourself – if they come into the camp, then in a day or so they’re dead. All Mussulmans. Those were the ones who were all bone and bowing down like they were praying to Mecca. Walking dead. Zombies. So you had to choose. And, anyway, you know you can’t take more than another single soul in the hospital. So you choose. I chose. We were always having to choose in the place where we were. Some people think that they murdered us. Yes, they did. But we murdered us, too.

  ‘But the giant, he had none of this. Heads, heads, heads! That’s all it was with him. “Marta!” he would say. “My kingdom for a head!” That’s a joke out of Shakespeare. This man knew a lot of English. Imagine that – in the place where we were. And he saved me once. I got typhoid. And they had me in the shower party. The trucks came – but then he came over and told them “Let her go – she’s getting better. Can’t you see?” And he said to me, close, hard in my ear, “Take my arm and walk. Walk or die!” And I walked. Another miracle. He was tall and strong and I walked on his arm.’

  Especially, Jack enjoyed Marta’s story about Morris the Mussulman.

  ‘In my life, the life before this one, I had a friend called Morris. He was a pathologist.’

  ‘Path-ol-o-gist!’ Jack loved the round, brown taste of the word. He ate it up and licked his lips.

  ‘In the place where we were, Morris died. That was before I met the giant. I made notes for Morris before he died. He was a doctor, Jack – with a fine sense of humour. He liked to observe his own progress.’

  And what had been the progress of Morris the Mussulman?

  Jack knew it by heart. Let Marta miss a single stage of Morris the Mussulman’s progress and Jack would be on to her in a flash:

  ‘Oedema . . . moderate emaciation … moderate oedema … intensive oedema with lowered plasma … ’

  ‘Death?’ Jack would ask.

  ‘Death,’ Marta confirmed.

  And that was the end of Morris the Mussulman.

  But the giant lived on in Marta’s stories, Marta’s mind where she walked and talked with him. First, she remembered her home.

  ‘In nineteen-forty-one I was in Cracow. Certain people were picked. Parcels. At first just small parcels were chosen. Then more and more. They were posted to the villages in the surrounding countryside. Or they were posted to the ghetto at Podgorze, on the other side of the Vistula. Small parcels.’

  Jack would hold his thumb and forefinger to the light to show how small the parcels had been and Marta always said: ‘A bit bigger, Jack.’

  ‘Then bigger parcels. Then it was decided that everyone should be posted. Everyone in Kazimierz was expelled to Podgorze. Rehoused, they called it. Wypchnać zyda drzwiza on ci piecem wlezie.’

  ‘Is that Polish?’

  ‘It means: “If you throw a Jew out of the door, he will creep back into the house through the stove”. It’s an old Polish proverb. Anyway, it explains why everyone was removed from Kazimierz. Sixty thousand altogether.’

  Then there were ‘the lice’. This was one of the gia
nt’s stories which he had told to Marta. The giant had known a certain Professor Huppe. This professor collected heads. Made plaster casts of them and sent them to the great skeleton collection in Strasbourg. But one day the professor picked lice off a corpse.

  ‘Four,’ said Jack.

  ‘Typhoid fever,’ said Marta.

  ‘Dead in a week,’ said Jack.

  At other times, Marta told another story:

  ‘First there was the selection on the ramp. Then the doctor rides the ambulance across to the showers. Then he decides how many pellets. Then he checks the result. That’s when they put on the gas masks. And it was so funny – even if they looked like doctors first – because when they put on the masks they all looked like pigs. Afterwards forms to fill in. How many treated? How many teeth pulled? The dentists from hell got busy then. Some of the teeth always went missing. But with the people who’d owned them first gone missing too, how were they to be found? Two things were known about the place where we were. The doctor who wasn’t a doctor was a good enough man. And he was rich.’

  The best dreams Jack knew were those that kept you awake. One of the big downers about Marta dying was that she didn’t tell him his favourite stories the way she used to. She just lay there on the big wooden bed with the angels in the painting between the bed-posts. Fat, pink, girlish angels playing fiddles that kind of sagged like they’d been put in the oven by mistake and melted. The picture was in a frame of black wood.