by Fiona Neill
‘Lisa and I have something we want to share with you,’ I hear Dad announce. He puts his arm around Lisa and her top slides off her shoulder to reveal a bony shoulder blade. Lisa smiles. They both have tears in their eyes.
I sit back in my seat, smug that my diagnostic skills are showing such early promise. Dad clears his throat and looks down at the tandoori chicken. I nudge Daisy with my foot and nod my head to indicate that I know what is coming next.
‘I have asked Lisa to marry me and she’s said yes,’ Dad says. His voice is all gravelly.
‘We’re going to do it in Norfolk. Just a small thing, for close friends and family. We’d really like it if both of you would come,’ Lisa says. ‘Rex and Ava would love to see you again. It’s been a long time.’
Like hell they would, I think, as I try to absorb this unexpected news.
‘Don’t decide now,’ Dad quickly intervenes.
I look at Daisy, waiting for her lead, but it doesn’t come. She always has more words than me. Even if she’s not talking they’re running like a loop in her head, whereas I didn’t speak until I was three years old. I wonder if it’s a tactic. Her mouth looks as though she’s trying to say something, but no words come out. I glance over at Daisy.
‘Congratulations,’ I say finally, attempting to fill the vacuum with enthusiasm.
‘Oh yes,’ says Daisy vaguely. ‘Well done.’
My phone vibrates. It’s Connie. She sends a Snapchat of my skeleton wearing her clothes. It’s dressed in a peach-coloured shirt, buttons undone so you can see her bra, and a short skirt. One of its arms is draped around her naked body, the other holds up the skirt to give me a flash of black knickers. Ten seconds and it’s gone. No time to take a screenshot. I feel breathless. I have to go. Carlo must have let her into the house. I don’t trust him. He’s a horny bastard.
‘What’s up?’ asks Daisy.
‘It’s the curry,’ I say, using my hand to fan my mouth. ‘It’s too hot.’
I scoop a spoonful of prawn korma from the dish on the table to speed things up but quickly realize I have taken too much. Half slops on to my already overflowing plate so I attempt to tip the rest on to Daisy’s.
‘No, Maxi!’ She grabs my wrist away so violently that the prawns spill on to the tablecloth instead.
There is something foetal about their appearance that makes me feel slightly sick. Or maybe it’s because they remind me of what’s going on in Lisa’s uterus. But actually it’s because Daisy’s small hands are squeezing my wrist so tightly that blood pools in the tips of her fingers.
‘What the fuck!’ I say.
‘Stop it, Max,’ commands Dad, who thinks we are fighting because that’s what we used to do when he last lived with us and he enjoys playing the role of responsible parent instead of being Mum’s understudy.
We have attracted the attention of the people on the next-door table. You are such a loser, I think. It’s a calm thought, though, as if some underlying truth about Dad has suddenly revealed itself.
‘Let me put it on your plate, Daisy,’ I persist.
I am easily stronger than her and manage to tip the rest of the prawns on top of the small mound of saag gosht. She recoils. I see her lips move again. This time I know what she’s saying because it’s so familiar. Three is a good and safe number. There are now four mounds of food on her plate.
‘Three is fucking irrelevant, Daisy,’ I plead with her. ‘Three is a big pain in the arse.’
‘What’s going on?’ Dad asks. He always gets more demanding when he feels excluded. ‘Tell me what’s going on!’
‘Would some of my drops help?’ Lisa asks.
‘We need to go,’ I say abruptly.
Daisy is already out of her seat. I grab her jacket from the back of the chair, take her by the arm and leave the restaurant. I feel bad for Dad and Lisa, for trampling over their big moment.
‘Sorry,’ I shout back, ‘let me know as soon as you have a date.’
We go into the street and walk for ten minutes until we find a bench outside the pub where we usually have the Bloody Marys. I am nettled with myself for not second-guessing Daisy’s reaction to Dad and Lisa’s news and in turn irritated with them for their clunky timing. At least they managed to keep quiet about the baby. Luckily it’s a clear night. I instruct Daisy to look up at the sky and stare until the stars start to reveal themselves. I run through a few of the biggest constellations, including Cepheus and Ursa Major, and check her breathing is returning to normal. It’s a well-rehearsed routine.
In The Hitchhiker’s Guide to the Galaxy Douglas Adams says the cruellest thing you can do is show someone their exact place in the world, but when Daisy was ill I discovered that the opposite was true. She needed to be reminded of her insignificance in order to diminish the thoughts in her head, which told her that bad things would happen to the people she loved if she didn’t do a million and one crazy things to protect them every minute of the day. It was as if she thought she possessed superpowers.
‘I can’t go through this again,’ she sighs.
‘Nor can I,’ I say. And I absolutely can’t. I suddenly imagine myself dead and a group of students, including Carlo, dissecting my body, trying to work out what has killed an otherwise perfectly healthy young man. But although I obviously haven’t completed my medical degree, as far as I understand, no one can die of guilt. If you could I would have been dead long ago.
Carlo would probably talk about something completely banal like my dick size. It’s such a funny thought. I think about sharing it with Daisy but it occurs to me that talk of dead bodies might trigger her bad words routine. I’m hoping like fuck this is a small relapse rather than some new reality.
‘This is how unimportant you are, Daisy,’ I say, pointing at the sky. ‘You are not God. Nothing you do makes any difference to the way things eventually pan out. Nothing is your fault or responsibility. You don’t have the power to make bad things not happen.’
‘Can you say that again, please, Maxi?’
‘No,’ I say firmly, because she will make me repeat it three times. ‘Do you know that Cepheus has the biggest black hole known to mankind at its centre?’
‘Why didn’t you answer my calls?’ she asks calmly, still staring up at the sky.
‘I was busy,’ I say. I explain that I have girl trouble and a big test coming up on pathogens.
‘We’ll always be there for each other, won’t we?’
Her anxiety has passed and now I’m itching to get back to Connie.
‘Dad and Lisa getting married is no big deal, Daisy. They’ve been together for seven years. I don’t think Mum will even mind that much.’
‘I don’t really care about Venus and Adonis,’ she says, using her old nicknames for Lisa and Dad.
Then what am I doing here? I want to ask her.
When I finally arrive home Connie has gone. Carlo says she didn’t say goodbye. Which implies that she said hello. I want to ask him if he tried to make a move on her but don’t want to show him how insecure I feel. She doesn’t get in touch with me all that day or the next. And in fact it’s another week before I hear from her again.
3
Rosie
Long history. Poor outcome. It’s a simple rule of thumb really. The first file sitting on my desk at Monday’s clinic is so thick that there are now three separate folders stapled together and test results from various scans spewing out of the side. I recognize the name on the front right away. Laura S. Doctors aren’t meant to have favourites but those who deny it are either lying or have an empathy deficit.
Some patients stay with you after they have left the consulting room either because there is an aspect of their illness that is particularly interesting – an anomaly or rare mutation of a tumour, for example – or because despite having had a whole pile of shit heaped on them they manage to retain a sense of humour and dignity. Laura S. belongs to the latter group. I learn more from most of my patients than they ever learn from me.
&
nbsp; The day after Nick left me seven years ago (I found out on a Monday evening) Laura S. was the first patient I saw the next day. Nick had pleaded with me not to go to work that morning – mostly, I think, because he had booked a day off, anticipating it would be our last one together. Big mistake to plan too far into the future, I told him in between sobs, as the awful realization dawned that he had just completely sabotaged the one I had planned for us.
He kept repeating that we needed to put our affairs in order. Are you dying? I had asked. Everything he said sounded as though he was reading from a bad script. He needed space. Don’t we all. He wanted to find himself. That’s a luxury unique to adolescence. Our marriage had been over for years. Then why hadn’t I noticed? He didn’t mention Lisa once and I couldn’t bring myself to discuss her betrayal with him. She had been a part of my life even longer than Nick. The week before this we’d even gone out together with a group of girlfriends and ended up in a karaoke bar duetting ‘Sisters Are Doing It For Themselves’, which I guess in a way she was.
It was too early for anger so it must have been survival instinct rather than petulance that propelled me towards the hospital that day. I told no one at work what had happened, although I went to the canteen for lunch with my team as usual and listened to them chat about who was sleeping with who and the worst mistakes they had made with patients. I didn’t call any friends because who would I go to in a crisis apart from Lisa? Nick and I had agreed to tell the children together that evening because I wasn’t sure I could find the words to explain what had gone wrong when nothing made sense. And there was something up with Daisy. She had been excluded from school a few months ago after an awful incident involving Lisa and Barney’s daughter, Ava. The less said about that the better. Of course I didn’t appreciate it at the time but the worst was to come with her.
Anyway, that morning in late January, Laura S. had sat in front of my desk with her husband waiting for her biopsy results. I had to tell her that not only was the tumour cancerous but it had already spread into her lymph nodes, so she would need her axillary lymph nodes removed as well as a mastectomy. This would be followed by months of chemotherapy and radiotherapy. The news was worse than I had anticipated.
‘What would you do if you were in my position?’ she had asked, when I outlined the treatment possibilities.
I gave her my professional opinion. She thanked me. And I knew right then that work would save me. Even if I had failed at everything else, I could still do my job. If Laura could face up to the challenges that lay ahead of her then surely I could too. The reason I want to explain this is that since then I have always irrationally associated Laura’s survival with my own.
And now, having outlived the medical odds once, Laura S. is sitting in front of me again with her husband. But this time I have to inform her that the cancer has come back. I realize as soon as I look at the bone scan. The Swiss cheese appearance is a dead giveaway. And even before I check the blood results I know her calcium levels will be sky high.
It is the worst kind of news to deliver and I want to answer all of their questions as comprehensively as possible. Her husband always takes notes in a small exercise book with extra-wide lines, the kind children use when they are learning to write letters. But I notice this time that his pen isn’t moving. Instead he is pressing hard on the page, tracing the same circle over and over again. He understands what this means. I feel as crushed as he does.
After this I catch up with my team in the radiology room where they are looking at MRI scans. The consultant radiologist, Deborah Goff, is one of the best there is. She’s been part of my team for twelve years and I count her as a close friend. I blink as my eyes adjust to the darkness and join the back of the group staring up at the large screen on the wall. The first time I saw a radiology room as a medical student it was as mysterious as the control room at NASA. Now I can read the superhighway of fluorescent green and pink veins within seconds. I know right away that the barbed edges and opaque centre of the tumour under review mean that it’s very likely to be malignant.
One of the new registrars, a high-achieving Oxford graduate, is in the middle of presenting the case. I have noticed that her fear of getting something wrong is seriously messing with her clinical judgement. I have spoken to her in private a couple of times about how we learn more from what we get wrong than what we get right, but it hasn’t helped. I quoted from Lady Windermere’s Fan: ‘Experience is the name everyone gives to their mistakes.’ But she didn’t laugh.
Her first consultant has a reputation for being brutal and she’s still traumatized. To her left is someone I don’t recognize, most likely a trainee on rotation in oncology. I vaguely remember signing some paperwork. The way his T-shirt hangs down below the back of his scrubs reminds me of Max.
‘What do you think?’ Deborah asks.
‘Clinical breast examination and more mammographic views?’ the registrar tentatively suggests.
I encourage her to expand on her answer because she is partially correct. She jumps. She obviously hadn’t heard me come into the room. She looks at me and then down at the clinical notes again. She’s too hard on herself.
‘Any other ideas?’ I ask the group.
‘Needle or surgical biopsy,’ the man to the left of her replies confidently. ‘As quickly as possible. The spicules are a dead giveaway.’ Then he apologizes for his careless use of the adjective.
It reminds me of when Daisy was ill and used to try to neutralize bad words with good ones and how I only noticed when Max started referring to his favourite band as The Lifers instead of The Killers. I can almost laugh about this now. Almost.
As he goes on to describe the cloudy centre of the tumour I realize that I recognize his voice. It’s the way the tone goes up at the end of a sentence in that slightly irritating American way. Deborah switches on the light. And suddenly StanTheMan is standing between Deborah and the trainee registrar, bathed in neon light from the screen, so he looks like a celestial vision. Except I can tell from the name tag on his scrubs that in fact he is called Ed Gilmour. So much more prosaic.
‘Well done, Stan,’ I say, giving him a slow clap. No one notices I get his name wrong apart from him.
‘He’s an F2, doing a six-month stint with us in oncology,’ the registrar explains, also forgetting his name.
Not if I can help it.
Ed holds out his hand for me to shake it. ‘I look forward to getting to know you better,’ he says stiffly, then has the good grace to blush because few men know me as intimately as he does. He nervously runs his hand through his thick dark hair and holds my gaze for a beat too long.
It strikes me as strangely fascinating that something that is meant to be as precise as an algorithm on a dating site has the capacity to create so much chaos. After all, science is meant to create order. To be fair on Ed, he looks as appalled as I feel.
This goes some way to explain why I still haven’t opened the brown envelope that I found stuffed through the letter box as I left home this morning. And why I didn’t question how it had arrived when there was no mail at the weekend, or notice the fact it was postmarked two weeks earlier.
It is still sitting at the bottom of my bag after work as I head to the café at the Wellcome Collection museum to meet the person previously known as StanTheMan. We have met here every Thursday for the best part of five months before heading off to a standard room at the Travelodge in Farringdon. The ratio between time spent at the café and time at the hotel has dwindled and now we sometimes skip the drinks part altogether. Today we’ll bypass the hotel bit because I am about to tell him that not only does he have to find a way to ask to move to a different department, but that we can’t see each other any more.
One of the best decisions I made when my friend Josie persuaded me to embark on this Internet dating malarkey was to always meet people here for the first time: if the conversation flounders or there’s no hint of physical attraction you can head for the permanent medical collection wh
ere it’s really easy to accidentally lose someone. Especially if you hide behind the model of the obese man. And you can tell a lot about a man from his reaction to the porcelain fruit containing erotic scenes. Nervous laughter, confessions about foot fetishes, immediate propositions of anal sex. I’ve heard them all. It’s pretty brutal out there.
When we first got a match online and had got through the preliminary chat, Ed had blindsided me by suggesting we meet here before I did. Strictly speaking I should have turned him down because, at twenty-eight, he was three years younger than the lower limit I had set myself, but I allowed myself to be swayed by this coincidence. Although of course I now understand that it was the metadata that made the connection between us rather than some beautiful synergy.
As I walk into the café and look for him at our usual table in the corner beside the gift shop, I berate myself for not realizing earlier that we share similar professional backgrounds. Looking back there were some pretty obvious clues: he talked about working shifts – and judging by his clean fingernails he obviously wasn’t doing manual labour – and he used acronyms a lot. For example, when I accidentally revealed to him where I was born he asked if I was NFN (Normal for Norfolk).
‘Stan,’ I say dryly, sitting down in a chair beside him.