Double Madness

by Caroline de Costa

  ‘Ah! That narrows the field a bit. Though the bowel resection could take time, tumour might have spread a bit. We could be on a sticky wicket there.’

  ‘Yes, Sir. It is a pity her general practitioner did not refer her earlier, Sir. I understand she’d had bleeding for six months. Her GP attributed it only to her haemorrhoids and did not investigate …’

  ‘Yes, well,’ Mellish considered, ‘Dr Symonds, he’s her GP, isn’t he? He’s an old friend of mine. I might have a word with him. He does refer me a lot of patients though. Got a few problems lately, Trevor Symonds. Spending a bit too long at the nineteenth hole … But yes, if he’d sent her along sooner, her outlook would have been better.’ He took a quick glance at the operating list.

  ‘Very good,’ he said, ‘let’s tee off. While we’ve got the wind behind us.’ Dr Jayasinghe nodded gravely but without comment. From the age of five he had been accustomed to listening to the English news of the BBC World Service with both his parents. His English was as fluent as the Singhalese he spoke at home. The mixed metaphor rankled. But he needed the support of Dr Mellish. Badly.

  Nimal Jayasinghe was working as a surgeon, but his job was a temporary one. He had trained as a surgeon in his native Sri Lanka, and worked as an army surgeon. But this work was not recognised in Australia. Nimal needed to work under Mellish’s supervision for another five months, and have his boss’s approval, so he could register fully as a surgeon in Australia. Then he needed to find another job for next year, preferably here in Cairns. Mellish, he knew, had clout with the committee of selectors for these jobs.

  Without Mellish’s approval Nimal could only continue to work in Queensland in the far west of the state, in an ‘area of need’. He himself would not mind that. But his wife, the pretty, pouty Premala, would not want to go. She would like to stay here in Cairns, to have a nice house here, and a second baby. He did not want to have to tell her they were going to Weipa, or Mt Isa.

  Mellish headed toward the surgeons’ change room. ‘Be a good chap and get the ball rolling, will you, Jayasinghe. Open the abdomen and hold the fort while I just have a cup of coffee …’ In the change room he found Gerry Wheeler, the orthopod. Gerry was gloomy – in London, Australia was already five wickets down for 99.

  The patient safely asleep, George sat down beside her and began to read the day’s paper. It was a sore point with him that Mellish allowed no music in theatre during surgery. Every other surgeon had his or her own favourites so George enjoyed a wide range of musical tastes during the working week. Except on Tuesday mornings. Now he peered from time to time at the readouts on the anaesthetic machine as Nimal painted the skin of the patient’s belly with iodine, then took a scalpel and opened her abdomen layer by layer. The familiar smell of burning flesh filled the theatre as he plied the diathermy probe, sealing off small bleeding vessels so that hardly a drop of blood was spilt. With warm, moist sponges, he packed organs out of the way, giving a clear view of the operation site. As he finished these arrangements, the theatre doors swung open and Mellish entered, drawing on his surgical gloves.

  ‘Ah … Jayasinghe, good lad. Now we can hit the ground running!’ Mellish said. George suppressed a snort and buried himself in the paper.

  Nimal Jayasinghe knew all about hitting the ground running. As surgeon to the Army of the Democratic Socialist Republic of Sri Lanka, he had parachuted, with a full pack, into the northern town of Jaffna, besieged then by the Tamil Tigers. Two crates of surgical equipment were parachuted down from the same flight. It was only the second time he had been in an aeroplane.

  The duty sergeant had laughed at Nimal’s trepidation, agreeably shaking his head in the way of Sri Lankans who hope to oblige.

  ‘Most people,’ he offered helpfully, ‘learn very quickly.’

  Nimal twisted his ankle hitting the rubbish-strewn beach, but still he ran, off the exposed sand, towards the cover of the shell-damaged streets of the town, towards military headquarters and the hospital. He tied up the ankle and began to operate. Arriving in the early morning, he had by lunchtime carried out three laparotomies, patched and plastered a shattered arm, and performed an above-knee amputation.

  Now he played a secondary role as Mellish assessed the spread of this colon cancer. The lymph glands which lay around the blood vessels supplying the bowel, to which the cancer would spread first, were firm. Each one must be found and removed. Mellish reflected a moment.

  ‘Well, Jayasinghe, we’ll just have to try to clear everything out here, and if it does spread to the liver she can have chemotherapy. The late diagnosis has really got her between a rock and a hard place.’

  ‘Indeed, Sir,’ agreed Nimal gravely, ‘she is between the devil and the deep blue sea.’

  Mellish nodded. It was, he thought, much better to have this chap assisting him than one of those damnfool registrars they kept sending him. In the last few months there’d been three of these, including two women. He’d sent them both packing. By Jove he had. Surgery was no place for women, thought Mellish.

  Floating down towards Jaffna, the devil and the deep blue sea had come briefly into Nimal’s brain. The blue sea was Jaffna Lagoon; if the wind blew him too far south, and into it, he would disappear beneath the foam, weighed down by 30kg of pack, the harness, and his army boots. The devil was the Tigers, the snipers in wait at the perimeter of the town. It would only need one accurate shot … And once on the ground, though the fear was less, damped down, it was always there, every day: the fear that the Tigers would overrun the town, bomb and blast their way in. A fear Nimal remembered as located accurately, anatomically, in his own bowels, in the descending colon, the sigmoid colon and the rectum, to be precise.

  After four months, the Sri Lankan Army had broken through and relieved Jaffna, and Nimal had moved back to the relative safety of the military hospital at Anuradhapura, further south. He was happy to be there. His parents, teachers originally from Colombo, had moved to a small town in the North Western Province, within sight of the great rock fortress of Sigiriya, and he was able to visit them when he had leave. But around him, he could see, the whole country continued, literally, to be sandbagged against terrorism; the sandbags were spilling open, and behind them all the infrastructure of the society – the hospitals, schools, post offices, sewage works – was rapidly crumbling in the muggy heat.

  Nimal had lived with the war since he was seventeen. He bore no particular animosity toward the Tamils. Several of his best friends at school had been Tamils. Nimal would like to have stayed in Sri Lanka. But even without the war it would be difficult to establish himself in private practice without contacts. Nimal was a scholarship boy. His parents were on meagre salaries. They had no car, lived in the schoolhouse, owned only a small grove of coconuts. Nimal had been happy when his Colombo uncle had approached his parents with the proposal from Premala’s family, to receive in return her gift of permanent Australian residence. He hoped to be able to bring his parents to Australia, and really wanted to raise his children here. And Premala was really very pretty. He thought of the soft crescent of her right breast, fitting above the fold of her sari. Though here she mostly wore trousers, Western dress.

  More than anything, for Premala – to keep her respect and affection – he must get this job. He had worked conscientiously all year, more than was required of him, in order to impress Mellish. This ran through his mind now as he held retractors, exposed the operation site, mopped up blood, and cut the ends of his boss’s stitches.

  Mellish laid clamps on the bowel. He isolated the tumour, found and extracted the many lymph nodes. He welded the two cut ends of the bowel back together with the technological marvel of the staple gun. He spoke little as he worked.

  He would have liked to discuss the cricket with his assistant. After all, he thought, the chap is Sri Lankan. He must have some interest. The Australians are really taking a hammering and England had made 332 in their first innings. But Jayasinghe seemed lost in his own thoughts, although he was certainly foll
owing the operation, Mellish couldn’t fault him there. Mellish was never quite sure, really, what to say to these Asian chaps.

  At last, the seam across the bowel complete, the final lymph node plucked out, Mellish straightened up.

  ‘Well, Jayasinghe, game, set and match, eh? Just close her up for me while I dictate some notes. Put in a drain. And I might have another cup of coffee while you open the batting on the gallbladder, eh?’

  ‘For Chrissake, Nimal,’ said George, after Mellish had bowled out of the theatre door, ‘we’ll be a while getting organised in here. Don’t let him bully you like he does the registrars. Go get a coffee yourself, and something to eat.’ And Nimal, grateful, took this advice, but returned in time to set up the next case.

  The patient’s gallbladder would be located through a telescope passed though a tiny cut in her belly. The telescope transmitted pictures onto the medical video screen which the staff were wheeling into place – moving smartly, for they had all at some time felt the sharp edge of Mellish’s tongue. All the surgery would be done watching the screen, not the patient.

  Again Nimal prepared the abdomen with iodine, draped the site. Introduced the telescope and displayed the distended gallbladder on the screen.

  ‘Tally ho!’ Mellish cried as he returned and began the main part of the operation. As he selected his instruments, watching the screen, locating and dissecting the thickened wall of the gallbladder from its bed in the liver, he thought again, briefly, of Jayasinghe. They puzzled him, these Asiatics. The man was a good doctor, he would say that. Quite competent with his hands. But … too quiet, too self-effacing. Not a rugby player. Mellish did not know how to begin a conversation with him. And Arthur Mellish did nothing these days that he was not completely sure about.

  Mellish wondered – but only for a moment – if Jayasinghe was married, if he had children. One of those arranged marriages, perhaps? Mellish’s thoughts moved on to a favourite theme: how the town was changing. When he and Winifred first came here, thirty years ago, it was a good place for an Englishman. Doctors were respected. Everyone who was anyone knew everyone of importance in the town. Of course, there were always the Aboriginals. And of course, he’d always been ready to look after them as patients. But they weren’t a bother. They didn’t even hang around in the parks then, just stayed in their own communities. And apart from one Chinese restaurant there were no Asians that he could recall. Now there were Japanese and Greek and Thai restaurants, Vietnamese hot bread shops and Chinese grocery stores. And he even had a black man giving his anaesthetics now, though George O’Malley was technically Canadian and married to an Australian. Of course, he wasn’t a racist, but he didn’t know what to make of it all. Why, just last week he’d dropped by his drycleaners – he’d been going there for thirty years – and found it taken over by Indians. Not that they didn’t do a good job on his trousers. But it wasn’t like when old Bob, who’d been his patient, was running the place. The pace of change, Mellish told himself, is too rapid, we need to keep the ball in our own court, or we’ll be outnumbered by these immigrants and refugees. Bringing all their families in, too, he knew that for a fact. Jayasinghe, for example, how many relatives had he brought into the country with him?

  The size of the town now had, however, made it possible to conceal the only occasion on which he had strayed from the narrow path of marital fidelity. Really, that had been one from left field. He could never have anticipated it. The damnable events that had followed it, though! He’d really taken his eye off the ball there.

  Of course, the woman was a foreigner; couldn’t be trusted. But he’d been off his game, letting that happen. Sometimes he felt so angry he wanted to track them down, the woman and the people with her, so angry he wanted to … to strangle them all with his bare hands, thought Mellish. Fortunately, as long as he kept paying, no-one would have the least idea. Not his colleagues, not his secretary and, most of all, not Winifred.

  With a flourish, Mellish withdrew the detached gallbladder from the patient’s abdomen, and prepared to leave the closing-up to his assistant. But before he could leave, emboldened by necessity, Nimal Jayasinghe spoke. George lowered his paper to listen to this exchange.

  ‘The Selection Committee, Sir, I believe it is meeting next week. I have given your name as a reference, Sir, as you told me, but I’d be grateful, if you were able to … to speak on my behalf …’

  ‘Well, Jayasinghe, I’ll certainly see what I can do. Your work has always been quite satisfactory. But of course, the field is wide open, and there are a lot of candidates.’ He didn’t need to specify: Australian candidates.

  ‘Oh, thank you, Sir.’

  Walking towards the change room, Arthur Mellish thought that he would really like to go into bat for Nimal Jayasinghe. But he’d bumped into Wally Miller, head of the Selection Committee, at a drinks party just last Friday, and Wally had told him exactly who would be shortlisted for the Cairns jobs next year.

  First, Jimmy Marston’s boy. Jimmy was a urologist on the Gold Coast, and was in medical school with Wally. Then Terry Abbott’s son. Terry had a big practice north of Brisbane and sent his sons to the same Brisbane boarding school the Mellish boys attended. And Sara Waterhouse. It was important to interview one woman, Wally said, even though we wouldn’t employ her, and Sara’s a bright girl, her father’s a chest physician and a professor. So there wasn’t any way Nimal Jayasinghe was going to fit into this scheme of things, though Mellish was not going to tell him so. He’d promised Wally he’d keep it under his hat. The interview and selection process must be allowed to run its course, and Dr Jayasinghe informed, regretfully, by post, of the Committee’s decisions.

  Arthur Mellish meditated for a moment on this. Then thought, oh well, he’s not behind the eight-ball, he can go and work out in the country. It’s not as if he’s between the dev— it’s not as if he’s up the creek without a paddle. He’d probably like it out there. And if he does have a wife, she’ll probably be quite happy, used to the climate, and so on.

  With that, he dismissed all thoughts of Dr Jayasinghe, and, throwing a theatre gown over his surgical blues, headed off towards his consulting rooms, and his lunch.

  ‘Well Nimal,’ asked George when Mellish was gone, ‘do you think he’s bowled you an easy one?’

  ‘Ah George,’ said Nimal, rapidly inserting clips to close the patient’s incisions, ‘I don’t think so. I think he just bowled me a googly.’

  Cairns, 1 March 2011

  Paradise Close was a small cul-de-sac on the hill behind the Earlville shopping mall and number eleven was at the very end of it, where the street opened into a turning circle.

  Drew Borgese slowed the unmarked car as he pulled into the street and he and Cass looked around. To their left were numbers one, three and five: all low-set bungalows, unfenced and with tended gardens. Despite Yasi there was an abundance of palms and tropical flowers in these gardens. On their right, numbers two, four and six matched their neighbours across the street. Further down, number seven was a vacant block, neatly mowed, although number nine, also not yet built on, was head-high with weeds. Blocks eight and ten were occupied by a comfortable old Queenslander in the middle of a sprawling garden.

  ‘That’s the original house,’ Drew told Cass, nodding at it. ‘I remember when this was all sugarcane.’ A giant purple bougainvillea had taken over the left side of the old house and now seemed responsible for holding it up. The result was that number eleven was quite isolated from its neighbours. The isolation was increased by the wall of white stucco that ran right around it, cutting it off from the rest of the street and from the vacant land behind it. A black roller door, firmly closed, seemed to be the only way in, at least at the front.

  Three children on bikes outside number five wheeled around to watch the strangers. Drew parked the car and he and Cass got out and surveyed the property. The house itself was quite silent, the only noise the chatter of the children in the street. There was no letterbox. The grass in the nature strip
was recently mowed. Cass noticed that the grass in front of number nine was similarly mowed, despite the wilderness on the block itself, as was the grass in front of the old house. Neighbours must have done the lot, if the inhabitants of number eleven weren’t responsible, and in the last few days.

  In the absence of a doorbell Drew banged on the roller door. ‘Hello! Mr Janvier! Mrs Janvier!’ His cries echoed inside the garage beyond. It was possible to see partly over the front wall. The roller door led directly into a double garage attached to the house, a single-storey white stucco bungalow. Sliding glass doors, closed and with blinds drawn behind them, led onto a neglected garden. There were small palm trees along the side wall of the property and Drew pointed to the many palm fronds that had been blown into the front yard. It seemed this had not been cleared up since Yasi.

  Cass made her way around the left side of the property, at the very edge of the weeds on number nine. Full-length drapes completely covered what must be the side window of the living room but further back a slatted timber blind gave a partial view into the kitchen. No occupant could be seen. The kitchen led onto a back patio and a swimming pool. The pool was filled with debris, palm fronds and tree branches, and thick green slime covered the surface of the water. Several potted plants lay on their sides.

  Drew put his head around the front corner. ‘Anything to see from there?’

  ‘Not a thing. Living room and kitchen, pool. All looks untouched since Yasi at least. Lots of muck in the pool. The house looks empty.’

  ‘I’ll take the other side and meet you at the back.’

  ‘OK.’

  The wall continued around the property, rising to a height of about two metres at the back, so Cass could see nothing more than the roof of the house and the top of what looked like a garden shed close to the back wall. There was another roller door in this wall, and it wasn’t responding to Cass’s efforts to open it.