by Melanie Reid
In between interruptions, we learnt to endure the passive tyranny of those long hours, where no limbs stirred, no sheets rustled. These were not normal wards. You have no idea how eerily morgue-like paralysed patients are in bed when they cannot move. Nurses are notoriously superstitious; there are rich stories of ghostly scares on night-time wards with darkened corridors. Delphinium, one of the regular night shift, told me of the fright she had when a patient, paralysed from the neck down and normally as still as a corpse, sat bolt upright as she passed, the result of a sudden, unexpected spasm. Muscle spasms could happen, but rarely as extreme as that.
‘I was like, waaaaaaah. Nearly crapped myself,’ she said. ‘He didn’t even wake up.’
Night time. Even if our bodies were by necessity quiet, our minds were their own torture chambers, forever churning the random nature of the accidents, the screaming bad luck which had damned us to stillness. Why us? Why me? And often, if we did dream, our dreams tormented us by putting us back on our feet again. Dreams so vivid that when we woke, it was especially desolate to rediscover reality. One night I dreamt that Vitamin D tablets were a miracle cure for spinal injury, and because I already took them as supplements I was able to walk again. There I was up on my feet, walking unsteadily round the ward helping my fellow patients reach things from their bedside tables, and waiting for the doctors to arrive so I could tell them the good news. I woke up, convinced it wasn’t a dream, fighting a sickening lurch of hope and then disappointment before cold logic kicked in. I remember one night I even said to myself in my subconscious, now don’t be fooled, this is a dream, you can’t really walk again, and then I dreamt that to test it, I had woken up, and it was true – I could actually walk again. Double-dip dreaming. A plot within a plot. But of course everything remained within the parameters of the dream. Waking that morning for real was particularly cruel.
Always in the night there were the needy patients, the ones who became queasy or overcome with pain, or indeed were just desperate for human contact to break their desolation. We had call buzzers on wires; paraplegics had theirs on the bedside table, because they could reach. Tetraplegics with some arm function had them draped across their bedclothes, as in my case. Those who could move only their heads and shoulders had them by their cheek, so they could turn their head and press them. I hated using mine, but many people didn’t have the same hang-up. There were also the confused souls who couldn’t locate their buzzers, and they would just cry out, ‘Nurse … nurse …’ Of course the nurses couldn’t hear, but the rest of us in the room would be woken, and someone in a nearby bed would press their buzzer instead.
Doobie had a habit of rushing in, crying theatrically: ‘Who’s buzzing NOW?’ and striding crossly towards the patient with the flashing call button above their beds.
‘It’s Elsie,’ the buzzer-ringer would stammer, defensively. ‘She can’t press her buzzer.’
And we lay awake and listened to poor wee Elsie being administered to, because we had no choice. One night, when I was on a further course of antibiotics for a lung infection, I woke with an overwhelming need to vomit. I pressed my buzzer and heard for the first time the distinctive slap, slap of a footfall I would come to dread.
‘What is it?’ she said. Not kindly.
‘I’m sorry but I feel really sick,’ I gasped. I was panicking inside. This had never happened before. I didn’t even know if I could be sick.
She said nothing, but turned on her heel and disappeared. Soon she returned with a papier-mâché NHS sick bowl, the grey bowler hat of despair. Her body language was contemptuous. She thrust, almost threw, it at me, and walked away, leaving me to be sick alone. She didn’t say a word.
It was my first introduction to Nettles.
CHAPTER FOUR
The Angels of Mons
I think one’s feelings waste themselves in words; they ought to be distilled into actions which bring results.
Florence Nightingale
A catastrophe delivers you into an alien landscape, in which you must learn to survive. Paralysis takes you hostage. On the ward, interred long-term, you learn your territory, the space defined by the square of curtain rail suspended from the ceiling, delineating your tiny world of bed and bedside table. You lie and watch and familiarise, as must men behind bars, or animals in a zoo. Unbeknowst to you, you are already practising your next career as one of life’s observers, your useless fingers brushing the raised cot sides of the bed, rhythmically, plaintively, because you are not yet able to hold a book in your hands to amuse yourself. Maybe you will never be able to hold a book. You do not know yet.
As in a prisoner of war camp, your relationship with your guards becomes primary. To achieve this, you first try to grasp their names – hard in the beginning, because most ward staff do not wear name badges, nor do they introduce themselves. They are too busy, plus there is an assumption of automatic familiarity, as most of the patients are there for a long time. Then you must learn to distinguish their uniforms, and work out the caste system so that you can tell nurses from auxiliaries – the nursing assistants. And then the cleaners, in green, typically big powerful women blessed with an extraordinary capacity for hard work. The nurses are bogged down with form-filling and drug administering; the auxiliaries, the ones near enough on a minimum wage, do most of the physical work with patients. They are the ones who clean you up when your bowels burst, who bring you a bowl of cereal in the morning and your milky tea, who roll you and dress you and truss you into back brace and collar, then hoist you into your chair, ready for the day. In the beginning, before you get to know them well, you badge them only as noisy or quiet, kindly or less kind. You judge them intuitively: do they enter your bed space with the body language which says, ‘What can I do to make you as comfortable as possible?’; or do they approach with the clear intention of escaping as swiftly as they can? Soon you can read them by the way they walk, their faces, the tilt of their heads, the readiness of their smile.
Most of the auxiliaries were the biggest-hearted people on the planet; those with least tended to give the most, both in time and emotional warmth. The canteen staff were the same. Many were extroverts, performers, who saw it as their role to entertain us. In Glasgow, everyone’s got a few Billy Connolly genes: they delighted in telling funny stories, often in competition, as they gathered over our still bodies to wash us. I’d lived in Scotland for decades, but I struggled with their rapier-fast Glaswegian. It was like tuning in to snatches of soap opera on foreign TV.
‘And she goes, like, “You never!” And ah goes: “Ah did so. No way he was gonnae get away with that!”’
‘How no?’
‘Have she shown you her latest tattoo?’
‘Who’s she no’ shown it to?’
‘I wouldnae have one down there. I’m, like, “Nice! Not!”’
‘You know me, half daft!!’
‘Bodrum. Half board £49.99.’
‘Ma Jamie he’s went the same. Boggin. I’m, like, waaaaaaaah no-way!’
Defined as logs by a log-roll, we behaved accordingly, not that we had much choice; we lay and listened to the domestic dramas unfolding over our bodies, and as we gained in confidence might start to join in. I preferred that, because listening to them talk among themselves, as if I was unconscious, made me feel staggeringly isolated and lonely. With hindsight, I realise their chat, showboating, exaggerated stories, made a hard job more bearable for them. It was timeless gossip, the conversation of bedsides and parish pumps and public wash-houses for centuries, and I much preferred the colourful stuff to listening to them moan about their shifts and the weather.
They told me about the time one of the auxiliaries had answered the phone. It was someone famous asking to speak to a patient she knew.
‘Aye, fine. Who’s calling?’
‘It’s Sarah, Duchess of York … but you probably know me as Fergie.’
‘Fergie, how are you? It’s Lily here.’
Glasgow’s like that.
; There was Marigold, an exuberant, friendly single mother with a loud voice and a huge heart, who often sang to us and hugged us generously when she saw we were miserable. Begonia worked nights – a cryptic former rock-chick, introverted but humorous. So many were divorced single women who had raised their families alone. Chrysanthemum worked nights too – you got paid more – and spent most of the day caring for her grandchildren so her single daughter could hold down a job. ‘Men? Useless Bs, the lot of them,’ she’d say. No one ever swore in front of patients. Elm was an interesting man who kept a Komodo fighting dragon as a pet. Amaryllis, the wonderful Amaryllis, for whom no request was too much trouble, lived in a council house near the unit and had ongoing problems with a helpless alcoholic who lived upstairs and kept flooding her flat. Clematis, a fearless blonde twenty-one-year-old with generous hips, loved to talk about how she put down men. She’d give Doobie a hard time. ‘Jesus Christ,’ she’d hiss as they rearranged my body, ‘you stink. Do something about it.’ Periwinkle, an indomitably good-hearted woman with her hair pinned in an elaborate beehive, was saving up for her and her husband’s fourth holiday of the year. Turkey, it was always Turkey. She was so sweet. On her days off she often went into the city centre for the young paralysed men in the ward, to buy the fashionable T-shirts they wanted. They adored her.
Crocus was an older woman, a gentle soul who astonished me by telling me she didn’t know how to use a tampon. Candytuft had the build of a marathon runner and was always in a hurry, as if anxious to get to her next cigarette break. Like many of the staff, she had tattoos running the inside of her arm and extending down the outside of her palm. At first, prissily, I found it ugly; it looked as if her hands were dirty. Soon, tattoos ceased to stir me to value judgement: all that mattered, I learnt, was that someone had a kind heart, hands that worked and the time to help me. Helplessness is a great leveller and I became fond of the vast majority of the staff. It was a crappy job and they did it as best they could. They personified the essence of the NHS’s immense soft power – that world-famous humanitarian ethos of unquestioning free care, of embracing whatever sickness or disaster or disease is cast by the tide upon the doorstep. It’s a kind of warm, fuzzy feeling, a mixture of pride, altruism, generosity and compassion, and it’s the NHS’s most persistent asset. It’s what makes staff walk miles through the snow to get to work, or extend their shifts if no cover is available. It’s the ethos that says: It’s what we do. It’s what we’re good at. We might have little, personally, but we are professionals welcoming anyone. Our jobs, working for the NHS, give us importance and status. We belong to something great. As a result, kings and commoners alike get treated, mostly, with courtesy and kindness. A form of unwritten morality. The public have the same sense of ownership. Their warm, fuzzy feeling tells them, It’s free because it’s ours. You notice, after a while, that for some this brings an unrealistic sense of entitlement – to the best of treatment, to decent meals, to shorter waiting times. Which also means an entitlement to moan when these things are not delivered. Just as you notice the many who remain humbly grateful for the care they receive, however compromised it is by lack of resources.
There was, of course, the occasional member of staff like Nettles, whose ignorance made you dread interaction with them, especially in your helpless state. Nettles was small but heavy-footed, blonde and calculating, a woman who, as the old saying goes, you wouldn’t take a broken pay packet home to on a Friday night. I had taken a dislike to her for her lack of compassion over the sick bowl. The feeling was clearly mutual. The next time I spoke to her I could tell, just from the expression on her face, that my English accent jarred. I had lived long enough in Scotland to be sensitive to this. I was, in her eyes, judged simply a snob.
Hospital, in some ways, is like life on steroids, highly coloured. There were all the human emotions you could recognise, hyper-inflated. But it also contained another world of unfamiliar rituals and undercurrents, of strange protocols and jargon. Infection control was an essential but self-perpetuating hospital industry, and when you were learning independence with a constrained body, it often made life as difficult for you as it did for the germs. Every morning, after the cleaners had done the floors, the auxiliary nurses were tasked with sterilising the meagre surfaces in our personal areas: the over-bed table must be cleared and wiped; everything on top of the locker must be put away in the drawer to allow it to be wiped to prevent dust. Only our personal box of straws, a flag of long-term helplessness, could remain out. Every day, trying to become independent, I would place things where I could just about grip them with my feeble right hand. On the table, my glasses, my transistor radio, which I had developed enough finger power to turn on, my headphones, my laptop, my picnic mug with an open handle. With these small totems of normality within reach, I could retreat into my own world and pretend. On the bedside table, there was toothpaste and a toothbrush, which I was just learning to hold, spitting into a plastic beaker. I was fiercely protective of these things. They represented gains, hard-won goals.
And every day, after their break and before lunch, the auxiliaries would descend, like Valkyries, and sweep everything aside, moving, rearranging, pushing the table out of reach, smashing the precious little pretence of privacy. And of them all, the most thoughtless by far was Nettles. I watched her on days when I couldn’t go to the gym, a master of hiding from work she didn’t want to do, but Queen Jobsworth of wiping and cleaning, as she placed my table beyond my reach, swept my possessions into drawers I was too weak to open, unplugged my laptop, and pushed my mug to the back wall. Tidying, always tidying, wiping, intruding, controlling. When I pleaded weakly with her to leave my things out, she gave me a death stare and told me it was against the rules. She was hard and cold and unkind. I started to hate her; I fantasised about shooting her with an AK-47; I learnt to recognise the distinctive drag of her footsteps at night and cowered low.
All totally irrational, of course, and I feel guilt now, but at the time it was hard to describe the daily frustration of seeing stuff inches away, and being unable to reach it. The only way to get hold of it, to be empowered again, was either to use the buzzer to call another hard-pressed member of staff, which I hated doing when it wasn’t urgent, or to wait until a friendlier auxiliary was passing. Like prisoners we learnt which guards to ask favours of. A ward needs a Nettles: she served the purpose of making the rest of the staff look as if they were bathed in a warm light of kindness and compassion.
In her own insensitive way, I suspect, she thought she was just following orders, because the ethos of the rehabilitation ward was teaching patients independence. We were to learn self-help, so that when we were released to our old lives we would be able to cope with as much as possible. New staff recruits were actively taught that they must stand back and let patients struggle to do things for themselves, for only that way would we become accustomed to what life was going to be like at home. Patients weren’t sick, as such, they were disabled and could be lazy; staff mustn’t be too compassionate. Their job was training people for freedom. Re-enablement. Intelligent staff grasped the subtlety of this; they could judge when to hang back and when to weigh in; the less thoughtful, let’s say, weren’t quite so nuanced.
Euphorbia, a senior nurse, was in charge, with Candytuft as her auxiliary, the day she decreed that I would get on a shower chair in the morning and be washed like everyone else. By now, I must have been on the rehabilitation ward for five or six weeks. Euphorbia was impatient with my slow progress conquering low blood pressure, one of the most pervasive side-effects of spinal injury. When you damage your core, you enter profound spinal shock: it is as if your body retreats into itself and makes its final stand deep inside. Military analogies seem apt. The territory you lose is vast. Your whole system falters, stutters, nearly collapses. Whole battalions put down their weapons, hoist the white flag. You lose your limbs, your motor function and your autonomic nervous system, which automatically regulates both your blood pressure and your tempera
ture when you are healthy. Your intestines lose their peristalsis, the process of food through the gut, and your sphincter muscles are knocked out.