A Moment of Grace

by Patrick Dillon

  ‘Did you carry out the test?’ I wanted good news.

  The consultant took me to his office.

  ‘She isn’t strong enough,’ he explained.

  It would be the first of many such conversations. He explained how ill she was. She had reacted badly to the intubation, or maybe had just lurched downwards last night, like a sinking ship shuddering as water pours into its hold. They hadn’t judged her strong enough to bear the procedure.

  His face creased in concern. ‘I have to tell you … she’s really not in a good place.’

  I stayed calm. An instinct: panicking never helped. I needed to help them help her, not get in the way with panic or fear.

  ‘OK,’ I said slowly. ‘So …’ I hesitated. It mustn’t be the end of the road. But there was something else on my mind. I would need to tell Martha and Nicola’s parents how things were, find a way to break the news that things were worse. And then there was Joe.

  I said, ‘There’s something I need to understand. This is my decision, but I need your opinion. Our son is travelling in America. I have to decide whether to ask him to come back.’

  I was asking, Is she going to die? He didn’t answer, quite – he obviously thought it was crazy we’d let Joe go away at all. He didn’t know Nicola.

  He moistened his lips and said cautiously, ‘She’s very ill.’

  Martha was sitting by the bed, holding her mother’s hand. The day slowly passed. From time to time we went out to the park, buying tea on the way, sat on the grass and sipped it. Parakeets flew between trees. In the daytime there was no one in Ruskin Park but drunks and mothers pushing buggies. We talked. Martha and I had been very close when she was a child. Lately, as she grew up and found a boyfriend, we’d drifted away to an adult distance. Now we talked freely again. Her cheerfulness was like a drug. She was like Nicola – so strong, all her instincts full of sense, positive and kind. I wondered how we could ever have been so lucky to have such children. Later, I went out to the hospital car park to get a signal. It was 7am in Los Angeles. The phone droned. I watched porters help an old man into an ambulance and held the phone to my ear.

  ‘Dad?’

  My son’s voice from the other side of the world. Above me pigeons breached the grey clouds over Camberwell. I told him calmly that things were not so good. I said, ‘I think it’s probably best if you come home.’

  ‘OK.’ He didn’t make any fuss, ask questions. I didn’t have to say, Your mother may die. He knew what I meant; its nuance; our hope. He was in LA railway station, just arrived.

  ‘Can I go online, find you a ticket?’

  ‘Leave it, I’ll sort it.’

  ‘Money?’

  ‘I’ll call when I’ve found a flight.’

  He was just nineteen. His voice sounded stronger than mine. An hour later I got a text, Arriving tomorrow, 11.15. I still don’t know how he did it. Around me, when I’d rung off, visitors parked cars; nurses arrived, bags slung over their shoulders; two women smoked on the bench by the steps.

  Meanwhile I called Nicola’s mother. She was matter-of-fact as always. ‘Can she have visitors?’

  ‘Of course. But she is asleep.’

  ‘I know. Peter will want to see her.’ To say goodbye, she didn’t need to say. We made arrangements, rung off. She’d been so strong, like her daughter. I went back in. Nicola was lying unchanged, Martha beside her.

  Martha said, ‘I think we should talk to her. Maybe she can hear.’

  We stood either side of the bed, stooped over Nicola’s pale forehead and closed eyes. And this was when we started telling her stories about our life together, our shared memories, the things we had done.

  Martha said, ‘Mamma, do you remember the time we drove back from the village in France? The car windows were open. It was summer. We played music.’

  I said, ‘And there was the time …’

  It was hard to keep my voice under control. I don’t think I’d ever cried in front of my children before. One after the other, we described times we’d been sailing together, birthdays, evenings at home. Large memories and small, we turned them into stories for Nicola. There was no sign she could hear. Her eyelashes, thick and dark, fluttered, like a trail on the surface of calm water as a dolphin turns beneath. Perhaps she was following us down London streets, or chasing some thought of her own, a fleeting memory disconnected from ours; or perhaps it was just drugs stirring in her body, churning up silt.

  The nurse moved quietly about her work, checking flows, changing canisters of chemicals. She didn’t want to disturb us, but she listened too. Around us, behind curtains, the other patients slept, lost in their own worlds. Our voices grew hoarse. We were both tired, but not as tired as Nicola, my wife, Martha’s mother.

  Words had always been part of our life together. Nicola knew how to turn the world into words, so it could be shared. At her memorial, her friend David gave a beautiful speech about the conversation Nicola had brought into his life. By ‘conversation’ he didn’t mean anything artificial or forced – quite the opposite. He meant her skill at turning life into a flow of words to be shared: words facetious or profound, words that conjured up people, that plumbed the depths of ideas, that allowed new ideas to be born into the world. Words had always flowed between us as we sat in her hospital rooms, waiting for treatment to end. We’d talked since the day we met, but never so much as we did in that final year. Sometimes silence fell – we were good at being silent together, as well – but more often we filled the hours with talk. It wasn’t that we knew our hours were dwindling; neither of us expected Nicola to die. But hours were precious in this new world where everything was precious. Words mattered.

  Nicola couldn’t speak, now she was sedated, so we filled in the words for her. Stories had always been part of our lives. On long car journeys we read books to each other. We told stories to the children each night. In France they slumped on the sofa to listen to Black Hearts in Battersea, Mortal Engines and The Thief Lord. Everyone listened. The house in France was a place made for stories. On long walks through the forests I told the children tales about themselves, and the adventures they had. They always started by getting lost in the woods, or missing the path, or being caught in a storm. All stories start with someone getting lost.

  For Nicola we turned our own life into stories. I found myself telling things in order, trying to disentangle holidays we’d taken; the year we moved house; the year she changed jobs. It was like finding an old album in a chest of drawers, or a kite string tangled one afternoon and left behind for others to unravel. I didn’t know so many years had passed. The past had dust on it; we gently blew it off. Brought back a sunny day on the river; brought back a winter in France, snow, ice thick in the puddles and a pond that creaked when one of the children put a red boot on it. Stories we’d told at Christmas; stories about the past.

  Outside the ward I heard Anne’s voice: she and Peter had arrived. I don’t want to write about their visit, which is for them to remember alone. Martha and I waited outside. I checked my watch, pictured Joe at the airport – he’d have six hours to kill. He had an uncanny knack for travelling. Once, still young, he’d been on a week’s sailing course. Stormbound in the Channel Isles, he had somehow found his way home, and turned up on a quayside in Essex with his backpack, aged thirteen. He had an extraordinary self-sufficiency. His travel blog, which Nicola and I had read while she was on the Transplant Unit, had been a joy. We hadn’t known he could write – perhaps he hadn’t realised himself. His words, beautifully crafted, carried all of his irony and wry humour. His intelligence was of a different kind to Martha’s fierce, terrifyingly quick intellect. He slipped through the seas more quietly, watching and understanding.

  I wanted to be at home when he arrived; Nicola was unchanged. I showered, then stood at the kitchen window, waiting. A bus came, pulled away, and left him bowed on the pavement behind it, stuffing something into his pack. When he stood up he looked older. He’d grown a beard. It was a man who hugged m
e on the doorstep. He’d only been away seven weeks. As a man he’d sit beside me in hospital, by Nicola’s bed or in the consultant’s office as we were told, week after week, that she might die.

  ‘Are you OK?’

  ‘I’m fine. Let me take a shower, then I want to get down to Mum.’

  I was so glad to have him back. I held him close, a strong body – not someone I had to look after. We would look after each other, and have done, all three of us, ever since.

  At King’s he stayed with Nicola while Martha and I went to the park. He and Nicola had last been together in the ward at Guy’s, when they said goodbye. He’d always been close to his mother. Our children are like her in different ways: Joe has her green eyes, Martha has her smile.

  The next day the consultant said, ‘It’s touch and go. She seems stable, at least, which is a good thing.’

  He sounded surprised how strong her body was. They hoped to be able to carry out their test after all, he told me. I’d lost track of days by then, of exactly how long we’d been here, buying tea, walking to the park, whispering memories into Nicola’s silent ear.

  Visiting from upstairs, the transplant consultant, a new man, said, ‘On the plus side, only one of her organs has failed, her lungs. Everything else is looking strong.’

  On the last day of May I wrote to friends, the longest message I’d sent them:

  Some of you have picked up that the last week has been difficult. N seemed to be stable, but her breathing got worse while she was under sedation. That was midweek, I don’t quite remember which day. They’ve got things under control, though, and she’s now stable and slowly recovering. On the downside, Nicola’s lungs are damaged, and the recovery process is going to be very long. The important thing, though, is that they do expect a full lung recovery. And the immune reaction is itself an indication that the bone marrow transplant has worked. So the long-term prospect of having Nicola fully healthy and back to normal still holds as good as ever.

  Martha and Joe are both here. We’re sorting out the garden for when N comes home.

  That was a comfort. Martha disappeared into flowerbeds. Joe and I dug out the edging to the lawn, something Nicola had wanted for ages. Side by side we laboured. Joe hammered in rusty lawn edge with a mallet, while Martha pulled out dandelions and nettles. It was so wonderful to have Joe back; for the three of us to be together.

  I suppose we knew this was the unit we might become.

  After Nicola died – the day she died – we drove to Greenwich. Leaving the hospital is something I can’t think of now. We drove to Greenwich, went into the park and walked. We set each other’s tone. All of us cried, a bit, but never at once; the others linked arms and talked on. We knew how we wanted it to be, after Nicola: the same.

  Behind us in the hospital, we knew, they must be clearing her room, wheeling her bed away. We didn’t think of that; we climbed the hill. Nicola and I had walked there together, between two bouts of chemo. From the top you could see for miles: the curve of the river, London stretching away as far as the eye could see. June, a sunny day, the trees in summer leaf. We walked round Blackheath, had lunch. Walking as if everything was ordinary; so that everything might go on being ordinary, as if our feet on the pavement were the treadmill that turned the world. As if raising a fork, nodding, turning an ignition key were enough, in fact, to create the appearance of life, even when life’s spark had gone out. Seeming brave is nearly as good as being brave. To comment on the Observatory, just as we always had, was enough to keep the Observatory there; if we stopped, darkness might fall. And even if one of us felt puppet-like, an automaton, the others were there; other people were always there, passing us on the drive, scolding children, calling their dogs, to let us know it wasn’t only us; the world was held aloft by other hands too.

  Nicola didn’t die – not then. Her head cocked slightly sideways on the pillow, oxygen kept whistling in her tubes. The nurses turned her. We sat around the bed, squeezed her hands, whispered memories in her ears like ambulancemen breathing air into an accident victim’s lungs. The doctors were pleased and surprised.

  A new consultant called us into the office. ‘We’re hopeful,’ he said cautiously, as if hope was a stick we might steal, like puppies, and run away with. ‘We can do the endoscopy. We think there’s a decent chance we might have a go at waking her up tomorrow. Perhaps the next day.’

  They managed their endoscopy. I waited at work for the results. Nicola’s lungs were in a terrible state, they showed: inflamed, scarred, heavy with fluid. The doctors had a better understanding, though, of what had happened. An infection, probably; but then an immune system reaction on top of it, her new immune system attacking her own lungs and destroying them. But the visiting transplant team were positive.

  ‘She’s engrafted. Her counts are good.’ And they repeated the transplant consultant’s line: ‘Only one of her organs has failed.’

  And lungs, in time, renewed themselves, we’d been told. Months in Intensive Care lay ahead, at best. But that was better than the alternative. There was still a place, a place we could get to someday, where we could be together again with our life restored – or at least some part of it.

  We were with Nicola when they woke her up. I held her hand. We took turns on either side of the bed. Her eyelids flickered and I felt slight answering pressure. We talked to her. The nurse moved behind us like a server at Mass. Then Nicola looked at me, her wonderful eyes, green and brown, unchanged. She saw her son; knew then, confused by drugs, that she had almost died; made a face at his beard. I watched him hug her. Martha cried. From the car park outside I called Nicola’s mother.

  When she was properly awake we explained to Nicola what had happened: the lost days of sedation, the thick tube in her mouth. Another drug had joined the array of antibiotics and antiemetics pumping into her line: Fentanyl, an opiate stronger than heroin. She needed it to tolerate the tube. It didn’t seem to muddle her too much, though. The dose was terrifying but lower than usual, the doctors said; some patients remained virtually asleep. We asked Nicola whether she’d heard the stories we’d whispered to her. She shook her head. Only Nicola could have smiled through tubes and a mask. She squeezed our hands, gave a thumbs-up sign – the tube didn’t stop her communicating. Her face, always so expressive, could frown, look peeved, shine love on all of us. It could nod at the doctors, thank nurses, or answer their questions with a look: Good, Bad, So-so.

  Later that day two porters trundled her into a room of her own. She had a nurse to herself, on a twelve-hour shift. It was that much work, keeping her alive. We got to know them all: Anne-Marie, Carly, Naomi, Andy. I wish I could remember every name, every kind face, every pair of gloved hands expertly disentangling drips, or tapping a keyboard as doses were adjusted.

  Nicola’s new room had a window that looked onto an atrium. Double-glazed, you could hear nothing through it. Her bed was flanked by drips and monitors. A high screen in one corner showed green and red numbers that revealed the secrets of her blood like a survey ship mapping the ocean floor. There wasn’t much room for anything else. Her rings had been taken off; her radio went on a shelf in one corner. A bed table carried the few possessions she’d been reduced to: her phone, her glasses. She couldn’t read anymore, or manage an iPod. All her energy went into recovery, all her strength into clinging to the cliff face. Her nurses played the radio sometimes, but their friendly chatter was her entertainment in the shrinking world she occupied, an island threatened by rising water. Everything was sterilised, each morning. A curtain round the door was drawn when they changed her bedpan, or replaced tubes. Outside was the trolley where the doctors met each morning, labouring over charts and scans like astrologers reading the future in stars.

  While they consulted, we waited elsewhere. We avoided the crowded visitors’ room. Usually, while the doctors worked on her, we went down to the coffee shop, or up to the park. We showed Joe Nicola’s favourite tree, walked him round the bandstand and pond; the goslings were gro
wing up. One afternoon, at home, I found Martha painting on the kitchen table. She was making a watercolour, three-feet wide, of the view from the terrace in France: the hills, the little town of Monflanquin with its church and tumbling roofs. She painted it on eight sheets of A4. We blu-tacked them to the wall opposite Nicola’s bed and put up photographs around it: Martha and Joe as babies; a day out on the beach; her parents; me.

  Looking round, we saw tears in Nicola’s eyes. In the days that followed she used to rearrange the photos sometimes, so she didn’t get bored. She pointed to the pictures she wanted to replace, frowning when we got it wrong. Most of her time was spent propped up, just looking at photographs: her family, the life she so loved.

  One of the nurses brought in a chart to help us communicate. We’d point to vowels or symbols; Nicola would nod or shake her head. It took forever. There was a hierarchy of needs. Is it about how you’re feeling? Are you in pain? The very roots of speech. Seeing how frustrated we were by pointing and nodding, one of the nurses found a whiteboard and some pens. Nicola grabbed them and scribbled busily. Green ink came off on the side of her hand, staining the sheets, but she didn’t care. At last she could communicate properly. Is my mother coming today? As soon as we’d read each line, she snatched the board back, impatient, and wiped it with the side of her hand. Words erased, just like words spoken, are lost. I wish, now, I’d kept everything she wrote. The only time I photographed the board was near the end of Nicola’s life. She’d written on it, I feel v. positive and also content. I love you.

  We met Nicola’s consultants two or three times a week. To start with I met them alone, but Joe wanted to be there too. He wasn’t a child to be protected; he could see this was a trial for all of us equally. From then on he and Martha came in with me, and we sat side by side. It became a weekly ritual: the bad news when a new consultant took over at the start of the week, looked at the scans and read her charts; and then their growing confidence as they gauged Nicola’s strength. None of them ever gave up: they believed, as we did, in Nicola’s tenacity. And her sweet nature spread through the ward. Nurses wanted to care for her. They loved her smile; her gratitude and interest in them, scribbled on her board; and Martha’s and Joe’s friendliness, so like hers. The Frank Stansil Unit became Nicola’s final home.