by Sarah Moss
A mobile number, unknown to my phone. I went up the stairs as I answered. We always do, because there’s not much reception on the ground floor, and so I was on the turn of the stairs, looking up towards the landing, just passing the photo of one-year-old Rose staggering into the outstretched arms of eight-year-old Miriam on the beach at Porthleven. This is Victoria Collier, she said, and it took me a moment to remember that she meant Mrs Collier, Miriam’s headteacher. Still, nothing lurched. Miriam must have argued once too often with her dim English teacher or refused to tie her hair back, one of those venial sins invented by schools to forestall any real rebellion. She’s forever getting detentions, courting them. There’s been an incident, Mrs Collier said, with Miriam. An incident, we found her on the playing field. She got clobbered, I was thinking, someone hit her with a hockey stick or a lacrosse ball, I’ve always hated lacrosse with the balls at head-height, not that Mimi’s given to co-operation with team games, but I could feel fear in my throat, in my ears. Miriam seems all right now, she said, she’s conscious and stable, but she had some kind of faint or – well – collapse. We called an ambulance and she was out for quite a while, longer than they like, so they’re taking her in, just to be on the safe side. In, out, I was thinking, like one of those weather-houses you used to see where the man comes out and the woman goes in when it’s going to rain, or maybe the other way round, but while my mind was working on imagery my body already knew what to do and I was down the stairs, pushing my feet into my shoes, picking up my car keys and bleeping the doors while I unhooked my coat. Can they wait, I said, if she’s conscious and stable can they wait ten minutes. It takes twenty, normally, in the middle of the day with the traffic clear. I got there in eight.
She was all right. That was the first thing I saw. In the cavern of the ambulance she was flat on her back under one of those waffle blankets and there was mud on her face and wires coming out from under the blanket and a bleeping monitor like that of a very early computer parked between her feet like a small dog and she was very pale and her face oddly swollen under an oxygen mask but she was all right. She lifted the mask when she saw me. Hi Dad she said, and rolled her eyes the way she does when she can’t be bothered to rise to Rose’s teasing, as if the whole event were something of a farce. Sorry about the fuss. The mask hissed, like a leak, like an emergency. I looked at the paramedic who was watching the monitor, watching the blood-pressure cuff on Miriam’s arm puffing itself up like a flotation device. In the event of a landing on water, pull the string, blow the whistle. She gets a bit wheezy, I said, she does have asthma. Her mum, my wife, she’s a doctor, a GP. As if that were our excuse. As if having a doctor in the family means you’re allowed to ignore your children’s symptoms, their incidents, until someone else calls an ambulance. Yes, said the paramedic, her blond plait moving on her shoulder as she adjusted Miriam’s blanket, that may be all it is. They’ll just check her over at the hospital. We’ll keep that mask on for now, please, Miriam. If you could sit down here, Dad. I’m not your dad, I thought, though later I would get used to it, to the way medics at the same time as being the deities of hospital life adopt the linguistic position of children. They’re quite right, it doesn’t matter what else I might be. Miriam’s dad. I reached for her hand as I sat down and she smiled at me but she was remote under her blankets and wires, too far away to hold my hand.
It was only when they started the siren that I realised I was not as afraid as I should have been. I look back now and see a last moment of innocence, sitting in the back of an ambulance and believing that Miriam was all right.
There was a roomful, a team, of medics waiting for us, gathered around the bed in Resuscitation as if ready to perform a ritual, to transform bread into human flesh. To sacrifice a virgin.
‘Here they come,’ I heard someone say, and then, almost disappointed, ‘Oh, she’s conscious.’
Miriam had tried to sit up on the stretcher but the wires weren’t long enough. She was craning her head to see where she was going and her face was still white and still puffy, her breathing still odd. There was mud in her hair and I wanted to brush it out, to set things right. Lie down for me now, they said, a little prick coming in your arm now, sorry. The fact that they seemed to know what they were doing, what would happen, both reassured and silenced me: there was, plainly, a narrative being followed, and it was only I who did not know what came next.
the arithmetic of staying alive
It was important to tell people. To let people know that this can happen: your child’s body can stop. Stop breathing, stop beating. At any time, her lungs can close down, the wing-beat that began in her heart before her bones were formed, before the foetus-to-be-Miriam had a spinal cord or a skull, can pause and fall tumbling. And then blood pools in your child’s veins. It stagnates. And your daughter’s cells have no more oxygen, her muscles no more sugar. There is no more movement. No thinking. Where the body’s metronome ticked, there is silence. She goes. She goes away. It can happen. It had happened. I needed to tell people that the world was not as they believed it to be.
I asked Miriam if she’d be all right while I made some calls. She was eating a pot of yogurt by then, sitting up in bed on the High Dependency Unit with the monitors’ wires creeping through the ripped and muddy vestiges of her school uniform. Fasten your shirt, I wanted to say, pull up the blanket, we can see your bra. OK, she said, actually I might watch some TV, since it’s here, since they seem to think we need it along with the oxygen and the intubation kits here on the High Dependency Unit. Are you sure, I thought, because she never watches it at home, accuses her mother of being hooked on the opiate of the masses, stands about pointing out that costume dramas feed the English fetish for poshness, for the adulation of unearned wealth and privilege; that the news is hopelessly parochial and the cookery shows Emma enjoys glorify not only domestic labour but the consumption of exactly the ingredients we’re all being told to avoid. It’s an eating disorder on a national scale, she says, watching Emma watching people ice cakes with butter and cream and chocolate and fill pies with caramel and condensed milk, we’re all obsessed with obesity and weight loss and also fucking baking. Shut up, darling, Emma says, I’ve been working with the obese and malnourished all day, have a biscuit and let me watch a little rubbish before I go to bed. Make your calls, Dad, Mim said, and she pressed a couple of buttons and filled the room with synthetic American laughter.
The nurse sitting on the other side of the room looked up and made a note. Patient watching television? The monitor began to bleep faster and I watched Miriam’s heart-rate rise on its green-on-black screen, watched its scrawled notation rise and fall, erasing and rewriting itself after four or five beats. It’s speeding up, I thought, her heart’s speeding up, but the nurse was unconcerned. Her oxygen level dropped: 95, 94. 95 again. Dad, Miriam said, her eyes on the television, I’m OK, make your calls. I could see that she was OK, that the yogurt and her upright posture were out of place in this room where people were brought to be kept alive. I leant against the radiator. It was far too hot, burned through my trousers, and the discomfort felt correct.
I started with the department, where I was supposed to be teaching the next day. Art History 113: How to Look at a Building. I’m not an academic, not really, just among the unemployed with PhDs who get brought in to do first-year teaching on an hourly-paid contract every September when the University realises that half the faculty are on research leave and the other half consider themselves too important for introductory courses. Hannah the departmental secretary’s phone rang and rang. Mostly I’m a stay-at-home dad. A full-time parent. ‘A man of leisure’, says Emma’s dad, who is a surgeon and the kind of man who shrinks your new cashmere jumper so he’s never asked to run another load of laundry, who has the brass neck to assert that although he can and does implant titanium replacements for worn-out knees and hips, the concept of a washing machine’s spin speed is beyond his comprehension. He means to say that I’m a scrounger, a layabout, his
daughter’s feckless lodger. I’d forgive everything if he were nice to her, if he had ever let Emma imagine herself adequate as doctor, daughter or human being.
I left a message. It’s Adam Goldschmidt, I’m sorry, I can’t come in tomorrow, my daughter – my daughter is in hospital. She stopped breathing. Her heart stopped. Sorry.
I held the phone in my hand. I’d called Emma from the ambulance and she was on her way, had borrowed a colleague’s car. Don’t drive too fast, I thought, don’t get arrested, don’t have an accident. As if there were a plot summary set out somewhere that didn’t include a car crash. You can’t have a respiratory arrest and a car accident in the same family on the same day, Aristotle’s rules don’t allow it. Miriam had finished her yogurt and was watching the television and pleating her fingers in her lap, fiddling with the oxygen probe that was biting her left thumb. Her heart-rate rose as I watched, 73 beats a minute, 76, and then down again, 68, 66, 63. What if it goes on falling, I thought, where’s the nurse, why isn’t she doing something, maybe this is it happening again, 62, 61, is her heart meant to go down into the 50s? Quick. Find someone. 58.
‘Mim?’
She looked up. The swelling had gone down and her colour was back. She seemed ordinary. Apart from the wires, the mud and the ripped clothes. Apart from being on the High Dependency Unit. 61, 63, 64.
‘Yes?’
‘You OK?’
She looked at the monitors, at the red button over her bed. ‘Never better, Dad. Blooming. Can’t you tell?’
‘I meant—’ I meant, are you going to die? Are you going to die again? I meant, are you still breathing?
‘Is Mum coming?’
I nodded. ‘She’s on her way.’
‘Good. Dad, have we still got my phone? I want to tell Sophie and Charlotte I’m OK.’
I stood there. On the screen, bronzed white teenagers in perpetual Hollywood sunshine massed beside a David Hockney pool. I used to worry that the girls would mistake this stuff for real life, that it would teach them to expect clear-skinned boys to ask them for ‘dates’ and to encounter small-scale moral dilemmas from which they could emerge victorious and virtuous in the course of forty-five minutes, but of course our children, better than us, recognise genre, know the difference between stories and real life. A girl jumped into the water fully clothed and bobbled there, crying, her face half-submerged. I could feel my own heart accelerating: she was going to drown, they were all going to stand there and let her drown, and then a boy who’d been talking seriously to another girl on the veranda noticed the girl in the pool and ran, beautifully dived. Ah.
‘Oh Brad, you, like, saved me?’ Miriam mocked. ‘You’re like, my hero? Only we’re still not, like, going to have sex, because I’m, like, pure? And anyway, we like live in a country where they think contraception is, like, a sin, so, as you may have noticed from other imported teen shows, everyone who has sex gets, like, pregnant? Dad, did you bring a book for me?’
‘No,’ I said. ‘Funnily enough, this time I didn’t.’
The nurse made another note, as if sarcasm were one of the things they were looking for.
I wandered back to the window. I should phone more people, I thought. School, I should tell school that she’s OK. That she appears to be OK. And we’ll need someone to collect Rose, we’re probably not going to be out of here in time for the school run. I hadn’t taken the salmon for dinner out of the freezer, would need to cook something else instead, something quick because it was going to be a rush to do homework and dinner and bedtime by the time we got back. Pasta. There was a bag of spinach in the fridge, and I thought also a pot of ricotta. Rose would object. The window overlooked the car park, where people were queuing to buy parking tickets from the machines, opening the doors of their cars and leaning in to get their coats from the back seat, putting their keys in the ignition without thinking about it and fastening their seatbelts to set off home. As if they were safe, or safe enough. You worry, I thought, you worry about your children crossing the road. You worry, after a few days, that her fever might be meningitis not flu, especially when she starts a rash. You worry that bad boys will seduce her and she won’t see what you can see. You worry that her own inexperience and the darkness of the world will harm her, even though you know that only experience of the darkness of the world will protect her, that you can’t and shouldn’t do it yourself for ever. You worry that she will go to the wrong sort of party and take the wrong sort of drugs, or board a plane on the same day as an angry person with nothing to lose. But you don’t worry, it doesn’t cross your mind, that one day she will simply stop breathing, go into cardiac arrest on the school playing fields, not because a car has crushed her or because a virus has made her sick or because a blade has made her bleed or fire has burnt her flesh, no because. How could you live if you worried about that?
I wandered back and watched the screen over her head while she watched the screen over her feet, I because it seemed to tell a truth and she because it seemed to tell a lie. Her oxygen saturation level was dipping, 95, 92, 89 and something began to chime, an urgent note like someone repeatedly ringing a doorbell, beginning to worry, to wonder if the person inside is lying at the bottom of the stairs. The numbers disappeared.
‘Please—’ I said, but the nurse was already there.
She reattached the probe to Miriam’s finger. ‘There,’ she said. ‘That was all. She’s fine. We look at the patient, Dad, before the machines. She’s a good colour.’
I sat in the shiny plastic chair plainly intended for the escort, the guardian, the witness. I watched the monitor as if, eventually, I would learn from it what plot we were following, and as I watched I remembered the last time I had followed the numbers of a beating heart, in another hospital when Rose was being born. We worried then because her heart was slowing with each contraction, not picking up again afterwards as fast as the midwives wanted it to. Oxygen deprivation, Emma hissed between groans. We’re worried that she’s crushing the cord. Even then, we. We medics. I remembered the first time I heard Miriam’s heartbeat, before you could see from the outside that there was anyone else inside Emma’s body, remembered the misshapen homunculus swimming into view on the black-and-white screen, a cinematic special effect, a primitive kind of CGI. After the scan, we got back in the car and when Emma started the engine, the radio came on. The afternoon play, I thought, an odd reprise of War of the Worlds in which the premise was that airliners had flown into skyscrapers in New York. It wasn’t very good and I turned it off so we could talk about the baby.
What was it like, Miriam asked recently, what was it like before the planes hit the World Trade Center? Innocent, I thought, although like all innocence, visible only in retrospect. There were different enemies, I told her, that was all. We’d barely stopped worrying about the Cold War and Mutually Assured Destruction, which was just as scary as faith-based terrorism and in some ways more so. Maybe there was a gap, in the late ’90s, a break from fear, but if so I don’t remember it. But I still do worry about Mutually Assured Destruction, Miriam said, it would be pretty stupid not to. Did you know that no-one knows where most of the weapons-grade plutonium in ex-USSR states has gone now? Well, someone does, obviously, and it’s not hard to guess, but there’s no official record. Oh Jesus, I said, tell me you haven’t been looking up weapons-grade plutonium on the internet again, I thought we’d talked about that. Calm down, she said, I told you, no-one’s going to think a white fifteen-year-old girl poses a terrorist threat. And I told you they bloody are, I said, and even if they weren’t scrapping the Human Rights Bill, it doesn’t apply to terror suspects, we’d never get you back, you have to stop doing things like that. This is not a free country, Miriam. You can’t say anything that comes into your head, not when you’re thinking about bombs and war. She’d shrugged, the way teenagers do when they know better. OK, Dad, but you know the iPad’s registered to you, it’s all coming from your account. Excellent, I said, I’ll have to write a sodding book about terrorism
so we can say it was my research and cover your tracks and even then they’re unlikely to believe that a bloke with a background in the Arts and Crafts movement was suddenly called to research the movements of weapons-grade plutonium around disintegrating nation states. You have to stop it, Miriam. I knew she wouldn’t, knew that the horror of the world she was inheriting represented for my daughter the adulthood we all crave at fifteen. A better parent would have worked out how to censor the internet for her. Better, I supposed, the arms trade than pornography. Maybe.
Her heart-rate was rising, 68, 71, 72, her oxygen levels variable but stable in the mid-90s, her blood pressure 108/72 at the last reading, the arithmetic of staying alive no longer to be taken for granted and writing its headlines above my daughter’s bed.
The air moved. The nurse straightened her notes and her skirt. Even Miriam’s eyes flicked towards the door. A doctor, I thought, a doctor is coming, and the doctor will tell us what happened. Or maybe why it happened, and perhaps what is to be done and when we can go home. Sit up, I wanted to tell Miriam, turn off the television and pay attention. The emergency doctor, I thought, the long-limbed one from the resuscitation room who knew what to do, but it was Emma. I saw her pause less than a second, saw her muscles and her skin, her hair and her clothes, arrange themselves. I saw her allow herself one glance at the monitor as she crossed the room to Miriam.
in hospital time
For days we drifted in hospital time, which is in some ways not unlike toddler time, the weeks and months passed at home while essentially waiting for the child to grow up enough to do something else. The aim is to pass minutes without noticing them, to be pleasantly surprised when you look at the clock. It is an outing to walk down the corridor to refill the plastic jug with fresh water, perhaps glimpsing a new arrival or exchanging smiles with another parent on the way. It is a social event to ask a nurse for a new box of tissues; if you are lucky, she will have time to exchange sentences about the weather or the traffic. Ward round, they say, will be at nine-thirty, and at first you think this means that shortly after that hour someone will come and tell you something you didn’t already know, will move the story along. You are wrong. No-one, it seemed, knew why a healthy fifteen-year-old had gone into a field and stopped breathing. I had, until then, vaguely imagined that medical knowledge was more or less related to the seriousness of the problem, that while doctors might not know why your leg hurts a bit sometimes or you’ve been feeling nauseous for a few days, there would be a good reason for a person to stop breathing. To lie down on a field and die. It’s hard to say, the doctor said when I tried to make her talk to me, there could be several reasons, we’ll need to wait for the test results. It looks as if Miriam might have had some kind of reaction to something. Oh good, I thought, some kind of reaction, some response, there was some trigger or cause and when we know what it was we will be able to avoid it in future. She’s right, Emma said, it’s actually harder to tell when someone’s previously healthy, especially given how fast she recovered. I mean, obviously the history of asthma is interesting and it does look as if she was reacting to something, but even if that’s it, sometimes there’s an underlying – well, let’s wait and see, they’re looking after her very well.