Little Disasters

by Sarah Vaughan

  ‘Oh, Frankie, we don’t know what the police think.’ Ed can’t restrain himself. ‘But whatever happened, we know it must have been an accident. She wouldn’t have meant to harm Betsey at all.’

  ‘It was an accident.’ Frankie looks from Ed to me, wide-eyed. ‘Mummy didn’t do it.’

  ‘Oh, Frankie . . .’ Ed begins, and I can see that he believes his wife is capable of harming their baby: that, gripped by postnatal depression, she could have caused the injury after all.

  ‘Ed,’ I say, and my voice is a warning that we’re at the tipping point and he risks silencing his son altogether if he doesn’t shut the fuck up. ‘Let’s just listen to Frankie, shall we? Frankie – why do you think Mummy didn’t hurt Betsey?’

  ‘Because she wasn’t even there!’

  From Ed, there is silence, and from me the memory of another pair of siblings left alone together; another accident that could have been fatal. Something shifts in my brain. Two children left alone. And Frankie, like me, believes he’s responsible. I have a sudden inkling that I know what happened here.

  ‘This doesn’t make sense!’ Ed bursts out. ‘What do you mean, she wasn’t even there?’

  He bends down and tries to put his arm around the boy but Frankie shrugs him off, his body vibrating with tension. He does not want to be held. He wants to be heard. It has taken him almost six days to get this secret out and his relief – the relief of a child burdened with too much responsibility, too big a secret – is palpable.

  She wasn’t even there.

  ‘Can you tell us where Mummy was?’ I ask and Frankie visibly softens, his body slumping as if he can relax now the truth is nearly out.

  ‘I don’t know.’ Then a shrug, his voice almost sulky. ‘She went out somewhere.’

  ‘And did Betsey get hurt when she went out?’

  A tiny nod: his mouth tight, his face pinched.

  ‘It was an accident, wasn’t it, Frankie?’

  Another nod.

  ‘And can you tell us who else was involved? Who caused this accident?’

  A sharp intake of breath from Ed as he gets there too, as he understands where my questions are leading. Frankie leans towards me and I put my arm around him, letting him burrow deep into my shoulder. I have never felt more affinity for a child; or more sorrow for him.

  And Jess’s son nods, his face parchment pale, and in little more than a whisper, he finally manages to say it:

  ‘Yes . . . Yes, it was me.’

  JESS

  Friday 19 January, 6.31 p.m.

  Thirty-four

  Jess senses that something is wrong the second she opens the front door. The children are not in the kitchen, where she left them. ‘Frankie? Frankie?’ Panic grips her voice as she runs from room to room and races up the stairs.

  The sound hits her almost straight away. A full-on, anguished wail, followed by Frankie’s pre-emptive cry: the noise he makes when he knows he’s about to be told off, coupled with something darker. It is this that terrifies her more than anything else.

  ‘What happened? What did you do?’ The accusation flies from her as she bursts into the family bathroom and sees Frankie crouched between the changing table and the roll top bath. Betsey is lying on the marble floor next to him, staring at the ceiling, tears streaming down her face.

  She scoops her baby up, cradling her to her chest, feeling the rapid heartbeats. ‘Please be OK, please be OK,’ she whispers her reassurance over and over again.

  ‘I tried to change her nappy. She rolled over. I didn’t see it . . .’ Frankie is gabbling as he rocks forwards and backwards. A soiled nappy is strewn on the floor; the stench makes her want to retch.

  ‘It’s all right. It’s all right.’ It isn’t, not in the slightest, but she can’t be angry with him: her guilt overwhelms her. ‘She’s all right. Look at her: you can see she is. She’s OK,’ she shouts as she gestures to her baby, who is screaming, her face filled with fear and pain.

  Frankie’s burbling segues into a shriek. ‘She’s not OK, she’s not OK,’ he yells, over and over, his voice rising in volume.

  ‘She will be.’ She needs to minimise his hysteria. There is only one person to blame. A bad mother who knew you shouldn’t leave your children.

  Yes, but not to him, she wants to shout. I’m not a bad mother to him.

  ‘Shh, shh,’ she repeats, holding the two of them close, kissing Bets over and over. The top of his head is damp: he reeks of fear.

  ‘You were so stressy,’ he manages, and his words are unbearably sad. ‘I wanted to make things better. I just wanted to make you happy.’

  She bites back a sob. Of course he did. He has no ability to foresee consequences: is the opposite of her with her constant catastrophising, her continual what ifs? He would only have been trying to help, couldn’t have predicted his misplaced enthusiasm would result in this disaster. She tries to gain some composure, to calm this voice that betrays her terror. ‘I know. But you need to tell me what happened. You need to tell me what you did.’

  And so he does, as she kneels next to him on the bathroom floor and Betsey’s cries become more erratic, the initial pain not subsiding but ebbing and flowing until her shrieks dip to a ragged lament.

  In broken sobs, he tells her how Betsey had been lying on the changing table. How he’d managed to remove her nappy and then reached over for a wipe to clean her. He hadn’t held onto her, of course – she doesn’t need to ask him the question; stops herself from asking: ‘Why didn’t you?’ – because he never considered she might roll over like this.

  ‘I don’t know what happened, Mummy. I turned and she was screaming on the floor . . .’

  His eyes are huge like those of the baby in the Superb Deli shop and she knows he expects her to make everything better. Knows, too, the impact on him if anyone discovers this happened because of his misguided desire to help.

  It will break him, her boy who doesn’t quite fit in; who feels his inadequacies so intensely. He is eight years old and he acted out of love. It was an accident that only happened because she left them, she knows that. Knows, too, that she must bear that responsibility. Betsey is crying lustily – a sign that she isn’t concussed, because it’s silent children you need to worry about, isn’t it? – and so her priority is to protect him.

  Her baby’s cries slow and she feels a cold sharp fear at the thought of her negligence being discovered. What will happen if anyone discovers her baby fell because she left her alone with an eight-year-old boy? They will take your children away. They will take them away. It won’t matter that she had the best of intentions. That she thought that by walking away, she was keeping them safe . . .

  She pulls the children tighter until Frankie starts wriggling, disturbed by this excessive closeness; kisses both of them, keeping them close. Kit will be back any moment and she needs to calm them down quickly; must quieten Frankie, in particular, so that her elder son and her husband have no idea.

  She looks at Betsey’s crumpled face. And she checks the back of her head. There’s no bump, thank God: no egg like the boys had when they fell. It feels a little tender, and Betsey screams more furiously when she touches it, but there’s nothing obvious; nothing dramatic to be extra anxious about. Her heart flutters like a bird banging against a window; cold spreads from the pit of her stomach and up through her chest. Perhaps she should get an icepack? And she is just about to do so when the doorbell rings, a disconcertingly melodic chime.

  Frankie jumps up and starts running on the spot, screeching.

  ‘Calm down. You have to calm down.’ She grabs him by the shoulders and tries to hold him still, her fingers digging into him more forcefully than she intended, as she tries to stare into his eyes. Her fear is so extreme it’s as if her mind has fused and all other emotions – compassion, empathy – have been short-circuited. For once she is forensic, decisive, clear about how she needs to be.

  ‘Who is it? Who is it?’ He is frantic. She needs to stop him shouting.


  ‘It will probably be Charlotte. With Kit.’

  He gives the most tortured scream.

  She binds him tight in her arms, not allowing any resistance, feeling his wired body turn quite, quite still.

  And then she whispers to him: ‘I promise it’s going to be OK. But if anyone asks what happened, here’s what I need you to say.’

  LIZ

  Thursday 25 January, 8.30 a.m.

  Thirty-five

  The call from A&E comes just as I arrive at work, and my thoughts are still clouded with Frankie: the burden of this secret, his inconsolable distress.

  Jess’s behaviour swims into focus, too. This is why she lied: to protect her boy, to discourage questions about her poor judgement in parenting. She left her baby alone with her eight-year-old child. I remember dismissing Charlotte’s suggestion and being so blithely disparaging of the idea she would do this. If I’d ever given Jess that impression, no wonder she couldn’t open up to me.

  So I’m preoccupied when my mobile rings and though a call from the hospital is hardly unusual, still, it jangles my thoughts.

  It’s about my mother, of course.

  The words of the A&E nurse filter through: ‘Called an ambulance . . . waiting to be admitted . . . very poorly.’

  And all my guilt at my problematic relationship with this woman I love out of a sense of duty but don’t understand or like very much, floods together with a sense that this is it: the end. Something she might have sensed was encroaching.

  The reason she’s been thinking of Clare.

  *

  She doesn’t look well: jaundiced eyes, a spider’s web of mottled blood vessels on her cheeks. Her eyes are dulled above dark shadows and her tummy’s oddly distended: she’s gaunt apart from this fluid-filled stomach. Not pancreatic cancer, I automatically think.

  She’s lying on a trolley, her skin sheened with sweat, her fingers gripping the sides as if this grounds her. The junior registrar has pulled the curtains around her bay; in this small, blue world, her fear is heightened and intense.

  ‘You came,’ she manages, and my guilt sharpens that this was ever in doubt. Then I think of the times when she’s called and I’ve been working. Of the cancelled visits, when on-call rotas have been changed or Sam and Rosa have been ill, of promises made and broken. I’ve been so much better than Mattie, but then that’s not saying much, is it?

  ‘Of course I came,’ I say, but she can’t reply. A look of something close to terror skims her face and prevents her from speaking. I wait for it to pass.

  ‘You’re in the right place. We’ll get you some help.’ I utter familiar blandishments but I feel impotent. She’s frightened, and it’s little wonder. Her distended stomach suggests acute alcoholic hepatitis. She is horribly ill.

  She smiles at me, or she tries to smile, because suddenly she is lurching forwards, spurred on by the force of something bursting from her. The blood takes all of us by surprise. She is vomiting up the stuff. Crimson. Prolific. Angry. As dramatic as water bursting from a mains.

  The registrar, in scrubs that are soaked through, can’t move for shock. I grab a basin but it’s useless as the blood splatters the curtains, the bed, his face and body, and my mother. It soaks my hands and arms, pools on the bed and floods the floor.

  ‘Variceal bleed. You’ve got to stop it,’ I bark at the junior doctor. He introduced himself but I’ve forgotten his name: his youth and inexperience the only thing that’s relevant at this moment. ‘You need to get a Sengstaken tube down.’

  He seems paralysed with fear.

  ‘Can we have some help?’ I wrench the curtain of the cubicle aside and call out. ‘She’s got probable portal hypertension,’ I tell him. My voice breaks and rises. ‘We’ve got to do it now.’

  My mother is making an awful noise. A choking and gurgling, a belching and bubbling as a fresh rush of blood spews from her. Somehow, a tube is produced along with a more senior registrar and he and this junior struggle to force it down her throat. I want to tell her everything will be all right, but there’s no time, no room, and I stand aside, knowing I need to trust my colleagues. God, but it’s hard. I close my eyes for a second, trying to block out the anarchic chaos of my mother’s bucking body; the senior registrar’s raised voice as panic grips him; the fear that he might not get this patient back.

  JFDI, as Neil might say. His imagined yell stirs me into action. Together, as my mother starts choking on her blood, we get the tube down and exert pressure on her oesophageal veins. She falls back on the bed. Spent. Barely conscious. Alive, for the moment, at least.

  *

  I’m in the hospital canteen. The Chill Out Zone, as it styles itself; a place in which relatives and staff can temporarily escape from the death and pain, the blood and chaos being experienced in the building elsewhere. It’s not particularly relaxing with its tables bolted into the floor, pine seats padded with plastic and a 1980s decor of mustard and brown, but it’s relatively quiet at this time of day and I need a moment to think through what’s happened before I go on the ward.

  I sip a bitter black coffee and taste self-disgust. My mother nearly died. She will probably die soon. She has end-stage liver disease. But the fact that I diagnosed it ahead of the poor junior doctor who treated her is of little consolation. I should have recognised it, and tried to do something about it, long before now.

  It doesn’t always take much to contract this disease, although in her case the couple of glasses of wine I’d told myself she had each night was probably more like half a bottle, supplemented by vodka in her orange juice, and gin sloshed into her mugs of tea. I should have guessed when I saw her empty fridge; when I noted the dramatic weight loss and those swollen ankles and legs; when I ignored the yellowish tinge to her eyes; when I told myself her reddened cheeks were due to rosacea and – and it sounds so bloody ludicrous – the biting winter air.

  I should have seen, but I didn’t because sometimes we only see what we want to see, don’t we?

  It’s the same way I responded to Jess. I should have known from watching her atypical behaviour at the nativity that something was wrong; should have guessed when she brought Betsey in. I should have suspected, not necessarily that she was lying to protect someone, but that she was mentally ill. But, because I’d let our friendship slip, I hadn’t picked up on this after Betsey was born. I’d not taken the time to listen; to ask the right questions; to try to secure the help that could have prevented her from leaving her children and Betsey being hurt. Because I’d dwelt on the Jess I’d known – the woman I perceived as a ‘better’ mother than me; who I’d thought of as highly competent – I missed what should have been obvious.

  And if I haven’t been a good enough doctor, I haven’t been a good enough daughter or friend.

  Time to try to put this right.

  Because, if my mother’s going to die, I have to try to persuade Mattie to come down. To show some of the compassion that I know runs through his veins, because he shows it to the teenagers he works with, and to my children and me.

  Conscious that he’ll be resistant, I pull out my phone.

  *

  It doesn’t go well. The line’s bad: I can hear wind whistling in the background and Mattie’s preoccupied. I’ve caught him at work, just before he discusses orienteering with thirty urban children who have never scaled a Munro before.

  He’s serious and a touch curt. The fact that our mother’s in hospital because of her drinking doesn’t elicit much surprise, and I find myself turning towards the wall of the canteen, my voice a tight whisper, my eyes burning as I try to convey the severity of what’s going on.

  ‘There’s a risk that if you don’t come down, you won’t see her again.’ A pause while I wait for him to jump in; to reassure me that of course he’ll rush down to see her on her deathbed. ‘Matt. Do you understand what I’m saying? If you don’t come down in the next couple of days, I really think it might be too late.’

  ‘I don’t know what good my coming down
would do.’

  ‘It might help her. To know that you forgive her.’

  ‘I’m not sure I can do that,’ he says. His voice quietens and I strain to hear every word. ‘You’re not the only one who’s having nightmares about our early childhood, you know.’

  ‘Really?’

  ‘Yeah. I don’t want to talk about it but you’ve dredged up all sorts of things.’

  ‘I’m sorry.’ I don’t know what else to say.

  ‘Yeah, well. I’ve got to go.’ His voice dips again as he prepares to make his escape and I feel desperation and a quiet, focused rage.

  ‘You can’t just wriggle away from this. I know you can’t bear her but you could do this for me, if not for her . . . Matt, please.’ I’m aware that I sound pathetically childish. ‘I don’t want to have to deal with her death on my own.’

  ‘I’ll think about it,’ he says softly. ‘Look. It’s busy here. I can’t just leave on a whim: I’ve got commitments; we’ve got strict student-staff ratios . . .’

  ‘OK. I understand.’ It’s a convenient excuse but that doesn’t mean it’s not true.

  ‘Will you let me know if she gets worse?’

  ‘I’ll ring you later; tell you if there’s any change. And please, think about it. I’m not crying wolf.’

  ‘I know.’ I can hear his love for me in his voice; the age-old loyalty of a sibling who has shared a problematic childhood; who knows of horrors we daren’t tell others. ‘I know you’d never do that.’

  *

  I finish the call. I need to get back to work. To shrug on a new role: Dr Trenchard, paediatrician. But I find it hard to stop thinking about the pain my mother caused us, and continues to cause my brother; and the secrets – half-known; some still to be guessed at – too.

  I drain my coffee, mentally ticking off the ways in which I’ve been obtuse, or in denial about my mother:

  I closed my eyes to the fact that she has a drink problem.

  I repressed any memories about my baby sister, Clare.