The boats lumbered together. She leaned out, placed both palms against the cold steel of the other hull – close enough to make momentary eye contact with a woman in glasses who raised her eyebrows in surprise – braced her feet, and pushed.
And her feet slipped.
Instead of her rubber-soled deck shoes she was wearing sandals that offered no purchase at all. She fell forward, head and both arms over the rail of her boat, and saw her own shocked reflection in the black, oily water. She flailed with her right hand, grabbed the rail, and started to pull herself back up from the rapidly narrowing gap.
And then it was now.
* * *
This moment, the lightless pivot of worlds – between one in which there is sun on water and flowers and wedding rings, and one in which she is a broken, crippled thing – passes, and cannot be recalled.
* * *
The boats bumped and parted as if there was nothing dramatic to see here, people, move along. The sun was no dimmer, the laughter and music no quieter. The woman in glasses got on with her lunch. Rachel pulled herself up properly with her right arm, dragging something heavy that seemed to have clamped itself to her left. When she looked down at what remained of her left arm just below the elbow, she began to scream.
2
AMPUTATION
THE SURGEON WAS AS APOLOGETIC AS THE URGENCY of her injury would allow. His ID badge said MR ADENSON, VASCULAR SURGEON but he was just another in a long list of concerned faces and forgotten names. Names, tags, worried frowns, and the elephant in the room: the massive swathed lump lying in bed beside her. There was an oxygen mask on her face and an IV in her good arm, killing the pain from the bad one. There was even, she discovered with disgust, a tube coming from between her legs. There wasn’t an inch of her that didn’t feel bruised or invaded or like it had been pulled off, twisted, and stuck back on upside down.
A question had been asked, but she couldn’t remember what it was.
‘Mum?’ Rachel moaned, and her mother was there, eyes puffy with weeping. ‘It all hurts. Everything. I just, I can’t…’ She couldn’t see her mother’s face properly; it was blurry, and she couldn’t work out why until Olivia wiped her face and she realised she was crying. ‘I’m sorry…’
‘Oh shh, my darling, whatever for?’
‘Because of Dad… and you said… you said you never wanted to, to see the inside of a hospital again…’
‘Shh, shh, it’s not your fault, my love. You’re hurt, not sick. It’s not your fault.’ Olivia turned to the doctor. ‘And you’re absolutely certain, then?’ she sniffed. ‘There’s no way of saving it?’
Mr Adenson shook his head. ‘The damage is simply too severe and too extensive, I’m afraid.’
Pulverised, they had said. Massive vascular damage. The two narrowboats hadn’t just bounced together and apart with her arm between them, they’d skidded off each other, doing to her flesh what two bricks rubbed together might do to a worm. Her hand hadn’t been squashed so much as smeared.
‘Mum,’ she said. ‘Let them do it.’
So they did it.
* * *
While they operated, she dreamed, but as is the way with such things she could only remember fragments of images when she woke up.
She dreamed of a tree.
It was an ugly tree, ancient and broken. At some point in its history the upper portion of its trunk and boughs had been shorn away – possibly through lightning or storm winds – leaving a squat, wide stump just higher than a tall woman’s head. But this had not killed the tree. A ragged crown of sapling limbs spread out from the blunt top, while thinner, sicklier shoots grew like the questing tendrils of a sea anemone further down the trunk, half-strangled by tumours of mistletoe and ivy, itself so old that its stalks were as thick and twisted and dry as the arms of old men. As she saw it, it came to her that the tree was hollow, and that someone was inside it, because from within that tangled mass she could hear a woman’s weeping.
Then a bare arm pushed free and reached out to her.
* * *
The next time Rachel woke up, the mask was gone, along with the catheter and the worst of the pain, but the IV was still in, and even under all the dressings it was obvious that the limb on the other side was a lot shorter, ending halfway down from the elbow. Thank God it isn’t mine, she thought.
There was another tube coming out of all the dressings, taking fluid away, as if the rest of her body were just some kind of processing plant for pain. The slightest shifting of position was enough to set her whole arm shrieking from shoulder to fingertips – never mind that her fingertips weren’t there any more. Whoever was in charge of the pain centres in her brain didn’t know that and was absolutely losing their shit, sounding the alarm that something was very, very wrong down there. Her throat was raw and her stomach rolled with nausea.
A hand stroked her brow: her mother murmuring, ‘Oh my poor darling, there there, oh my poor darling,’ over and over.
‘Mum?’ she croaked.
Her mother was instantly alert. ‘Yes, darling? Can I get you anything?’
Rachel nodded towards the bandaged stump lying next to her. ‘Whose arm is that?’ she asked. ‘What have they done with my hand?’
Olivia made a strange sort of choking noise and called for the nurse.
* * *
Gradually the nausea and disorientation passed, and Rachel was able to take clearer stock of her situation.
‘Where’s Tom?’ she asked her mother, who was still there and seemed not to have left for – how long was it? Rachel had lost track of time. It must only have been hours, but it felt like days. Maybe she’d always been here.
‘He’s waiting outside, darling. We didn’t want you to have to deal with too much too soon.’
‘I already am. Tell him he can come in.’
Tom came in, and like everyone else the first thing his eyes travelled to was her bandages.
‘Hey,’ she said.
‘Hey.’ His face was haggard with shadows. He was still wearing the same clothes – cargo shorts, deck shoes and a checked shirt and gilet vest – he’d worn on the boat. She’d teased him about it at the time, asking him when the next Young Farmers’ Association meeting was, back when any of that mattered, on the other side of before.
‘Oi, I’m up here.’ Rachel pointed to her face, and his eyes finally met hers. ‘At least you weren’t staring at my boobs.’
He smiled weakly. ‘This is all my fault,’ he started. ‘If I’d had the boat under better control…’
‘And if I hadn’t nagged you into it in the first place,’ she interrupted. ‘And if that other boat hadn’t been there. And if I’d been wearing proper shoes. And and and. Nothing you or I can say will make this grow back.’
‘I know, I just—’
‘It is what it is,’ she said, a little more harshly than she’d intended, but she didn’t have the energy to put up any kind of façade, either brave or gentle. ‘And apologies won’t make it better. I don’t need them. I will need your help, though.’
His eyes widened in surprise.
‘I know,’ she said. ‘You can count the number of times I’ve asked for that on one hand, which is ironic, since that’s all I’ve got now.’
She could almost hear her mother wince, but the smile Tom gave her was almost normal. There you are, she thought. There’s the man I need.
‘You’re incredible,’ he said.
‘No, I’m shit-scared and on some amazing drugs, but I have no choice. What’s happening with the boat?’
He blinked. ‘Seriously? You’re worried about that?’
‘I need something to think about.’ She glanced at her bandages. ‘Something… else. See if you can get, I don’t know, some kind of part refund for the days we didn’t use. Is all our stuff safe?’
‘It’s okay,’ Tom said, stroking her hair. ‘Dad’s got it under control. Oh, there’s this, though.’ He produced a small plastic grip-seal bag and showed her the
contents. ‘They had to cut it off you when they… you know.’
It was her watch – the Mondaine she’d been given for her twenty-first. The strap was sheared through, the glass face was smashed and both the hands were gone. Ha, she thought. Beat you there. I only lost the one. Compared to losing her hand, a broken watch was nothing, but it reminded her of something far more important. ‘Oh shit!’ She turned shocked eyes to him. ‘My ring!’
He shrugged helplessly. ‘It wasn’t there.’
‘What do you mean it wasn’t there?’ She struggled to sit up higher, but that sent a spike of agony into her elbow despite the painkillers, and she cried out.
Olivia leapt to support her. ‘Darling, please, you mustn’t—’
‘What do you mean it wasn’t there?’ Rachel repeated between gasps of pain.
‘What do you want me to say?’ he asked. ‘I mean that it wasn’t there. If it had been, they’d have had to cut it off you too. It must have, I don’t know, snapped under the impact and dropped off. It’s probably at the bottom of the canal.’
‘No…’ she moaned. Her wedding ring. She’d never for one second begrudged the Cooper family’s self-made wealth which had allowed them to bankroll the wedding, but all the same she’d been fiercely proud of having at least arranged the rings – designed by an old school friend who had made good as part of an arts and crafts collective in the Jewellery Quarter. Its twin was on Tom’s hand – the one that was stroking her hair and trying to calm her – a simple band of white and yellow gold fused together.
‘Hey, it’s just a thing,’ he said. ‘Just a thing. It can be replaced. You can’t. You’re okay, and that’s the important thing.’
She gave a hollow laugh and gestured with her bandaged stump. ‘Yeah, what’s left of me.’
Eventually even mothers and husbands had to leave, and night settled on the recovery ward. It was a false darkness, though, like trying to sleep on a long-haul flight with all the lights down and your eye mask on but still aware of the restless souls all around you, busy with whispered conversations and soft footsteps along unseen corridors. Her hand was the same, buzzing and jittering in the empty space below her elbow as if refusing to accept that it didn’t exist any more. She was never going to be able to sleep, she thought, with her mind churning over the seismic effect this was going to have on her life, and the random shooting pains and starbursts of pins and needles.
But she did.
* * *
She surfaced from sleep just far enough to know that her mother was stroking her hand, telling her that everything was going to be all right without speaking; just loving, slow strokes across the back of her hand and down across her fingers.
But it must have been a dream, because when she opened her eyes the ward was still dark, and there was nobody sitting beside her bed.
And it was her missing left hand that had been so lovingly stroked.
3
RECOVERY
THE SURGEON MR ADENSON WAS TALL AND GANGLY, and his long fingers inspected her wound with as much delicacy and precision as any surgical instrument. Just behind him stood her physiotherapist, a small Nigerian woman who had been introduced to Rachel as Abayomi ‘Call me Yomi; it’s less embarrassing for all of us’ Akinsanya. She had a northern accent as broad as her smile but stood very still and self-contained with her arms folded. Rachel watched her suspiciously; she’d heard horror stories about physios from one of her mother’s golfing friends who’d had a knee replacement, and Rachel didn’t want to think about what plans for her arm lurked behind Yomi’s friendly smile. Rachel hissed as Adenson touched a tender spot.
‘Sorry about that,’ he frowned. ‘Sensitive?’
‘Just a bit.’
‘It’s bound to be at first. That’ll pass. There doesn’t appear to be too much swelling, though, which is a good thing. We’ll aim to have that drain out tomorrow afternoon if all goes well, and then a compression dressing to help keep it down.’
‘We’ll sort that hypersensitivity, too,’ nodded Yomi.
‘I hope so. It’s been going off like firecrackers all night.’
‘Those phantom sensations will subside as your nerves get used to their new conditions, don’t worry,’ said Adenson. ‘They can even be a good thing. Not the pain, obviously, but we have found that patients who have a good ability to imagine or mentally recreate the sensations from their lost limb often find it easier to adapt to the use of a prosthesis.’
‘You mean like a hook?’ Rachel shuddered. ‘No thanks.’
‘Don’t worry, love,’ said Yomi. ‘You’ve got options.’
‘The good news there,’ continued the surgeon, ‘is that you’ve got a nice amount of your lower arm to work with – we were able to save it down to just a couple of inches short of your wrist. The more muscle you’ve got to work with, the more control you have of whatever prosthesis you choose. Ms Akinsanya here will be working closely with you to maintain as much flexibility in your elbow as possible and develop those muscles.’
Yomi winked. ‘You’re going to have forearms like Popeye the Sailor Man by the time you’re done.’
‘But my elbow is fine,’ Rachel said, and bent it to show them, despite the twinge this caused.
‘I know, but the tension of the tissues in your arm will have gone skew-whiff, and a prosthetic’s quite a bit heavier than a real hand, so you’ll need a bit of building up.’
Rachel looked at her wound properly for the first time. Her arm ended just where she would have worn her watch, the skin joined over the end in a line of black stitches. It was puffy and still stained yellow with surgical swab, but she could see that when it had healed properly she’d be left with a single straight scar. She waved her right hand in the space just in front of it. My hand used to be in this space, she thought. My flesh. And now it’s gone, but I’m still here. Maybe this is what it feels like to be a ghost.
‘Can I see it?’ she asked Adenson. ‘My old hand, I mean?’
He paused in his exploration of her arm, looking surprised. ‘Ah, I’m afraid not.’
‘Why not? Why can’t I see my hand?’
‘Because we don’t have it any more.’
His bluntness took her by surprise. ‘Well where is it, then? Have you thrown away my hand?’
She saw his eyes flick up and down the recovery ward; she was being loud. Too bloody right she was. That hand had learned to tie shoelaces and bake scones, played terrible recorder at school concerts and scored a decent number of netball goals, stabbed Sally Bonner in the leg with a biro for that thing with the rat in Year 10 Biology, slipped down the front of Ian Wilkinson’s jeans in the back row of a cinema while watching Inglourious Basterds, and even had a wedding ring placed on it.
She was aware that people were talking to her.
‘Mrs Cooper?’ repeated Adenson. Her cheeks were wet. When had she started crying?
She shoved the tears away with the heel of her hand. ‘Okay. Fine. It’s gone. Just where? Tell me that.’
‘Hospital regulations are that the ah, remains from an operation—’
‘Clinical waste,’ she interrupted.
He blinked. ‘Beg pardon?’
‘It’s right there on the bin by the door: please dispose of clinical waste carefully. I’m sorry to ride you, Mr Adenson, I don’t really mean to, but you’ve just cut my hand off and it’s a bit late to be pussy-footing around trying to protect my feelings with euphemisms, don’t you think?’
‘Well then, clinical waste, like your hand, is collected and incinerated off-site by a third-party contractor. It really is gone, I’m afraid.’
‘So it’s ash.’
‘Yes.’
‘Well that’s something, I suppose. Just as long as it’s not sitting in a jar on someone’s shelf for all the medical students to point at and have a laugh.’
‘I assure you, nothing like that would ever happen.’
She looked at him sidelong. ‘Really? I have a friend who used to work in a pub nea
r the medical school; I’ve heard about you medics.’
‘I’m sorry to disappoint you, but despite my job involving cutting parts of people’s bodies off I am in reality a very boring man.’
She reached over with her good – her only – hand and wrapped her fingers in his. ‘No, you’re not,’ she said. ‘You’re a miracle worker and I’m a mardy cow. Honestly, thank you for saving what you could.’
After he’d gone, Yomi showed her the stretching and flexing exercises she wanted Rachel to do to keep the rest of her arm in the best possible condition for when she started physio, and when she left Rachel had a go at imagining the sensations of her non-existent hand. Somewhere in her bag was her phone and on the other side of it a whole world of friends, relatives and co-workers who would either need to be told or were already desperate for news, but she couldn’t face that right now. Instead she concentrated on what it had felt like to wiggle her fingers and make a fist. It was strange seeing the tendons on the underside of her forearm twitching as they tried to move something that wasn’t there any more, but she found that it actually did help to reduce the shooting spasms of pins and needles. Once or twice her imagination succeeded in convincing her that she could actually feel her fingers rubbing together and forming a fist. She imagined punching herself repeatedly in the head while muttering, ‘Stupid! Stupid! Stupid!’ until the nurse asked her if they could get her anything and she said no, she was fine thanks, just as shiny as could be expected given the circumstances. She smiled while giving them the imaginary finger, and then felt horrible about it afterwards.
She managed one hobbling trip to the loo, shepherding her collection of plastic tubes and bags like a mountaineer setting off to conquer Everest, and collapsing back into bed afterwards, just as exhausted.
She thought she was hungry and tried to eat a little hospital food, its blandness calculated to avoid upsetting delicate post-op stomachs, but couldn’t manage it, so she asked for more pain meds to shut up the shouting in her arm, and even as she was marvelling at how much the operation had knocked out of her, slept.
The Hollow Tree Page 2