A Moment of Grace

by Patrick Dillon

  The door of Critical Care had notices sellotaped over it, warning of infection. Beyond, a long corridor ended in a huge, dark room. The only light came from monitors, and from the computer screens on a square, raised desk in the middle of the room. Around it were rows of beds, each inhabited by a motionless, corpse-like figure. Nobody spoke. I could see an old woman’s face, brown against the pillow, her eyes bluish and closed, the sheet pulled tight across her shoulders as if she were in a morgue. Beside each figure, drips hung like teardrops in the half-light.

  It felt as if we had walked into an inner sanctum – or a laboratory, the forward station scientists might set up by a volcano, or at the epicentre of an earthquake. We had come closer to death’s realm.

  They pushed Nicola into a side room, vast and empty, with a space in the middle for the bed. A nurse was waiting. As I watched, monitors were pushed into place to either side of her, drips were hooked up, a line for oxygen connected to the tap in the wall. A new screen winked into life high up on her left. I recognised oxygen level and temperature – 39.9. Her oxygen hovered below 90. I didn’t know what the other numbers meant. Nicola lay among the watchful monitors like a sacrifice on an altar. She seemed to be asleep.

  ‘You should go home now.’ The nurse was efficient and no-nonsense, more focused and business-like than the Samaritan nurses, who were disconnecting their equipment to leave. ‘We’ll take care of her.’

  ‘Is she in danger?’ A stupid question: she was in the Critical Care Unit.

  ‘We’ll look after her.’

  Nicola seemed so small. She looked like the other patients I could see through the inner window. I squeezed her fingers and felt their answering pressure, our lifelong conversation reduced to the touch of finger and palm. I laced my fingers into hers and she squeezed them again. Her eyes, briefly open, still had humour in them. What crazy things we do together, she seemed to be saying. I don’t think I was scared. It felt like the evening she was diagnosed, a challenge we would rise to together.

  ‘Go home,’ the nurse repeated.

  But when I left the CCU, I couldn’t find my way to the stairs. The lift seemed to have disappeared. When, eventually, I stumbled on the entrance lobby I wondered if I would ever find my wife again. It felt as if some minotaur had stolen her and taken her to his lair.

  Nicola stayed ten days in Critical Care. My office was planning its annual trip. I phoned in to cancel and spent the time with her. Until then we’d wanted to keep my work going – it was our way of holding something normal in our lives. It had been hard. It was disorientating to move between a busy office and the odd, sequestered world of Samaritan. When I went into the ward, I felt the sudden, overpowering silence that follows when a machine is switched off. That silence echoed within me as I worked. I wanted to be alongside Nicola as she sat by her window, awaiting doctors or test results. Sitting at my desk I thought of the drip hanging over her bed, of the nurses studying charts, of her fingers stitching away at a tapestry. The people around me felt like shadows; I felt like a ghost. But my being there was our token that we had not altogether been banished; that one day we would return.

  Now I just needed to be with her.

  ‘We might beat it with antibiotics,’ the CCU consultant said. ‘More likely, her own immune system will sort it out when her counts rise.’ He was friendly but busy. His expertise was obvious, and reassuring – he had dealt with this before.

  I called Martha to explain Nicola was in the CCU, but they had everything under control. Joe came to visit. We settled into a new routine like refugees in a transit camp, used to the uncertainties of life with cancer. In the CCU, hygiene was everything. A poster above the basin taught us how to wash our hands: palms first, then backs of the hands and laced fingers, before finishing by scrubbing fingernails. Infection had been abstract before, now it was real: we had seen what infection could do.

  One by one, we identified individuals and families in the motionless patients around us. One came from a Roma community. Her family crowded the lobby downstairs, small men in trilbies and women in headscarves, treating sickness – serious sickness – as a community ritual, a dress rehearsal for death. Vulnerable to everything, Nicola stayed in a room by herself. She had her own nurses, giving 24-hour care in 12-hour shifts. One nurse came from Portugal, another from Wales. We hardly ever saw the same face twice – it was as if Guy’s had an inexhaustible supply of nurses. The carers seemed to be skilled in everything: drug dosage, technical equipment, infection control. They changed drips, administered pills, helped Nicola to struggle upright in bed when she needed the toilet, slipped on special socks to prevent blood clots. In their brisk, trained hands, their patients were helpless dolls. Nutrients came from a sagging plastic bag; energy drinks were plucked from a freezer. In a way it was a relief to be surrounded by this constant, slightly impersonal care. There were no decisions to be made. Nicola’s body was in the hands of others.

  Her venetian blind slatted building works at the back of Guy’s. Our radio played on the window sill. When I cycled home in the evenings the air was colder; summer was wearing thin. Nicola was conscious most of the time. Sometimes she hallucinated. It might have been from all the antibiotics she was taking, the doctors said. They told us how most people had nightmares, how they screamed and clutched the sheets. Nicola’s hallucinations, by contrast, were benign: a cartoon fox who appeared at the end of her bed, grinning. It seemed there was nothing bad in her for the chemicals to churn up.

  As the days went by we got to know precisely, from Nicola’s monitors, when the paracetamol was wearing off and another temperature spike rising. Soon it became clear she was getting no worse. The temperature spikes became regular, predictable, and gradually less strong. We followed them on monitors like meteorologists tracking a hurricane that was blowing itself out over a stormy sea. Gradually Nicola’s immune system juddered to life again. The storm was past.

  She was damaged, though. Her thighs had withered from lack of use. When, at last, she swung her legs off the bed, they were too weak to support her weight. A physiotherapist came. Nicola sagged into a chair, exhausted after five minutes of gentle exercises. When I put my arms around her, I could feel her ribs. Slowly we shuffled from one end of the room to the other, me walking backwards, holding her hands. She was worn out after two lengths. The first time we walked out into the main room, the nurses stood and clapped. Determined, Nicola wouldn’t sit down halfway, on the chair the physio pushed behind her: she wanted to make it back to her room by herself. Her face glowed with achievement as she slumped on the bed.

  After ten days they moved her back to Samaritan. She was still weak. It would be days more before they allowed her home. Far worse than her lost strength, though, was the damage the infection had caused to Nicola’s eyes. Sitting up in bed, she put a hand over her right eye, and then her left, staring intently at the wall.

  ‘What’s happened?’

  ‘It’s a shape, like Africa.’

  Only around the periphery could she see clearly. The centre of her vision was blurred, as if someone had scored her eyeballs furiously with an eraser. The doctors thought there must have been bleeding behind her retinas when her platelets were at their lowest. They promised full recovery but warned it would take time. For the moment, it was like looking through glass someone had scratched with a stylus, Nicola said, or looking in a mirror rubbed with oil. She could see a patch the shape of Africa, beyond which everything swirled and distorted.

  I sat on the bed beside her and held her hand. She couldn’t read; she couldn’t easily make out my face. It was as if the world was already starting to melt and slip from her grasp.

  Melting and slipping away – that is how Nicola seems to me now. It’s as if we’re looking through opposite ends of a telescope at her death: Nicola looking forwards and me back. And in the centre, where our eyes should meet, is nothing but a furious erasure.

  It’s like that as I write. I can see clearly at the periphery, but the centre i
s gone. Every time I try to capture Nicola’s face, her voice, the result seems so much less than the person I lived with and loved for twenty-eight years. That’s the absence in these pages, as it is now in my waking and sleeping life. A blur at the centre, where everything has melted.

  I want to find her again. In Rome, when I’m not with Martha and Joe, I walk the streets endlessly, trying to recall her in my memory. My mind keeps wandering. Rome’s streets don’t lead to Nicola; they just lead to other streets. I’m in a maze. I know Rome but I still get lost. I glimpse Nicola in odd moments. Suddenly I’ll find myself thinking about a conversation we had in hospital, or a time we met for a drink before a play. Or I’m sitting in a square – sitting outside a bar while water plays in a fountain and a patch of sunlight lights up a doorway, or a locked church – and she’s there suddenly; and then as quickly she’s gone again, just as I realise it wasn’t her I glimpsed, but a memory of another day, a different moment from which she was absent.

  Most of the time I can’t think about Nicola at all. I’m like a child peering at the sun through his fingers, seeing pink darkness slatted by blinding light.

  Our flat’s above a station. The metro rumbles below us. At three in the morning, Rome’s rubbish collectors grind through the streets, collecting the day’s detritus. At night, my mind runs free, like a madwoman pacing an attic, rummaging the past. I wonder how the earth can bear the twilight’s weight, or find energy to hurl the sun into the sky each morning. I need Rome because it is like the whole world, disjointed, but each step I take along its streets leads me further from Nicola. Yesterday it was six months since her death; tomorrow it will be more. I try to look forward but there is no forward. Like a broken aqueduct my life ends in mid-air, spilling water on darkness.

  When Nicola came out of hospital after her infection, she was so weak she could still barely walk. We tried to go out on Sunday afternoon. She reached the tower block at the end of the road, then said she had to go back. We took it one step at a time, with Nicola clinging to my arm until we reached the door. At home I made tea. Nicola sat on the sofa with her headscarf pulled tight, a fugitive rescued from a monster’s lair.

  ‘We can’t do anything now,’ Dr Anand said, when we visited the clinic next Monday. ‘She needs to recover. The transplant can follow; she needs time. Go away, take some holiday and get some rest. Go away, you both need rest.’

  5

  The path along the river from my sister’s cottage led to the little marina at Woolverstone, a mile and a half away. The first day we went out, Nicola made it only to the stile at the edge of the village. She rested on it, looking at the sunlit field beyond through blurred eyes. The river slipped past to our right, behind trees. Summer had clung on for us. The grass rose up towards a hill, woods, blue sky.

  I’d borrowed the cottage in Pin Mill twenty-eight years before, the autumn we started going out. Nicola came to stay. We went to the pub and ate shrimp, looking out over the river, and the hard where Thames barges sat on the flat mud, rusty-coloured sails furled. Neither of us said anything – but that was the weekend, we both agreed afterwards, when we knew something special was happening. Pin Mill was the place our story began.

  ‘That’s all I can do.’

  ‘Don’t worry.’

  ‘Sorry. We’ll do a bit more each day. They said it will take time.’

  A dog nosed past us, hurrying onwards to some favourite tree or remembered smell. Its owners followed behind, greeting us cheerfully. We waited while they passed. Nicola leaned on my arm – she weighed almost nothing. Slowly we walked back along the path between tall hedges. Someone was mowing their lawn. To our right we could see yachts propped up on cradles, for sale. I’d wandered through them the evening we arrived. It was lucky the cottage was so close to the hard, a gravel track snaking across the mud where Thames barges moored. At high water the whole bay sparkled in the sun. When the tide went out, the river dwindled to a distant silver band, and yachts lay on the flat mud, masts tilted.

  Every evening we sat on a bench with the village green behind us, and watched children play in the stream where Martha and Joe had once waded, making dams. The council had built a new jetty. We watched an elderly couple set off along it to their moored dinghy, carrying hampers of food, a kit bag, oars. That would be us, we thought, in old age. We looked forward to being old together. A man worked on his deck, a ladder propped up from the shingle. Old wooden rowing boats lay on their sides, waiting for the ride to refloat them.

  Beside us the sign for Harry King’s boatyard peeled in the wind, unpainted. The lights from the pub shone on wet mud. It had been a bargeman’s pub, once. Twenty-eight years before there had been an outer snug, where they served beer from casks, and an inner sanctum, a bare, boarded room, where food was served on long tables. New owners had taken it over and turned it into a themed riverside pub with fake barge memorabilia and a ship’s wheel hung on the wall. They had turned something real into something that looked real but wasn’t. It made no sense to us. The food was edible, though, and the memories strong. Beyond, thick trees hung out over the river, sheltering the houseboat colony whose lights we could see winking through late summer leaves.

  ‘Borrow the house whenever you like,’ my sister had said generously. ‘It’s there. No one’s using it.’

  I booked holiday at work and picked Nicola up from Guy’s, where they wanted blood for more tests. The sun was still hot, early in September. I wore shorts, waiting in the car park on one of the taxi spaces. We were euphoric – we’d won a summer holiday after all. We drove east in dark glasses, listening to the radio. Outside Ipswich we stopped at Tesco to load up with weekend food: pasta, crisps, coffee. The road down to Pin Mill was choked with cars, but when we came out on the river we could see lines of moored yachts swinging to the evening tide and beyond them, thick woods on the far bank, and the green dome of an observatory.

  The cottage had just been done up and smelled of fresh carpet. The kitchen was new. We stripped my sister’s bed and put on the duvet we’d brought from London. Stooping to look out of the window, I could see a gravel track, and a corner of mud beyond it. We had books, a laptop for music. The next day we drove into Ipswich and bought cheap speakers from Comet, setting them up on the sitting-room floor and playing Roundhouse music from Nicola’s iPod and the sea interludes from Peter Grimes.

  One thing troubled the doctors: the inflammation in Nicola’s lungs might have been caused by an allergic reaction to chemotherapy. She would need more chemo before her transplant, but they weren’t sure whether it was safe to proceed.

  She’d had an appointment with a lung specialist, who X-rayed her.

  ‘The lungs are quite damaged,’ he said. ‘It’ll heal, but we can’t do anything yet. It’ll take time.’

  He wasn’t sure whether the inflammation had been caused by chemo or not; he thought not. There was something else, though. When Nicola had first gone back into hospital, as the infection blew up, Dr Clay had come to visit her. He was quite straightforward about it: there’d been a mistake; the dose for the last chemo had been lower than intended. They’d departed from the treatment protocol for Acute Myeloid Leukaemia.

  We didn’t mind the mistake – we both worked ourselves; mistakes happen. We admired the honesty with which Dr Clay talked us through possible implications. We had a good idea that one of the junior doctors was responsible, but Dr Clay never said that; he took it entirely on himself. He sat on the end of Nicola’s bed, with his hands wrapped around one of his long legs. What they suggested was a new kind of test. A unit at Guy’s was exploring leukaemia at the molecular level. They could tell, far more accurately than the blood tests we were used to, whether cancer had been banished even from the blood cells’ nuclei. If so, there was nothing to worry about. If not, they would increase the dose next time, or maybe plan in a further round of treatment.

  ‘But we can’t do anything now,’ Dr Anand repeated, in the Monday clinic where we’d done the crossword in a windowl
ess waiting room. ‘We need to see the nuclear test. We need your lungs to recover.’

  Limbo. We walked along the river at Pin Mill. The sun was shining again. Dragonflies danced above the path that slanted across the field. Today, we’d walked further – Nicola was getting stronger all the time. We knew an opening in the hedge where you could get down to the river, on a flat level of grass with an old houseboat moored on it. From there we could see back into the bay of Pin Mill. Nicola had her headscarf on. A yacht sailed up towards Ipswich, its blue spinnaker tugging it on. It moved fast; the tide was coming in.

  ‘I can see the pub,’ Nicola said, looking obliquely towards it. ‘I can see the barges, I can’t see the spinnaker.’ She was looking directly at it. ‘A blue patch, just a blur.’

  She was stoical, as always, not depressed. Glad to be out in the clear sun, glad to be in limbo. We held hands. The shadows under the trees smelled of earth and crushed leaves; nettles filled the hollows either side of the path. Ahead of us we could hear voices, children. Resting on a log, we talked about cancer. How it had enriched us. How much closer we were now, even though we had thought it impossible that we could ever be closer. We talked about the perspective it gave, how the peripheries of our life had come into focus. The centre, which drained away so much energy – careers, meetings, the daily slog; pressure at work, people being difficult; the rush to get home when a meeting overran, or to a concert or play; the effort to pack in exhibitions or dinner parties when a week’s hard work clamoured only for rest – all that had fallen away soundlessly on the day Nicola was diagnosed. We’d barely thought about it since. Other things mattered more: our family, our friends, ourselves.

  We talked about working less, perhaps going down to four days a week. We talked about retiring, something that, a year ago, had seemed unimaginably far off. Nicola and I had both been ambitious. We’d both worked hard, assuming that a successful career was the only way to consummate a successful life, the only way to refine energy or intelligence into something usable. It didn’t seem like that anymore. The only thing that really mattered was each other. That, more than anything else, filled and illuminated our world. Our love had become the garden in which we lived.