Despite his size, fear followed Sir Seymour like an invisible vapour. You could sense nurses and young doctors scurrying like small forest animals down corridors into dark corners and disappearing through escape hatches at the sound of his entourage approaching.
For he never walked alone. He was constantly accompanied by a dozen fawning, white-jacketed interns and the charge sister for the ward, at whom he would bark instructions or point out faults in cleaning or general administration. A dripping tap or an empty saline drip above a child’s cot or bed would send him into a fearful state.
Nevertheless, his reputation as a doctor was formidable and, in particular, he was famous for his diagnostic skills. While on his rounds he would often approach the cot of a small child, glance at the infant with a cold blue, clinical eye and, without the slightest acknowledgment of the child, finger its limbs, place a cold stethoscope on its tiny chest or examine its ears or eyes. When the bewildered infant commenced to cry he would look carefully at its tongue. Then, still oblivious of the distraught child, he would whisper his findings into the ear of the ward sister as if she were unaware of the child’s illness. Turning to some luckless intern, he would demand that the student examine the bawling infant, diagnose its illness, explain the typical symptoms and articulate the usual treatment.
It was as if Sir Seymour had seen every slapstick British hospital comedy ever made, had missed the melodrama and taken seriously the role of the legendary and fearsome head of hospital. If the intern failed to satisfy with the diagnosis, in a pettifogging voice, tinged with scorn, Sir Seymour would ridicule the student in front of his peers, whereupon he would instruct the sister to reveal the correct diagnosis. On the other hand, if the intern got it more or less right, Sir Seymour would grunt in a highly pronounced way and move on. This grunt, which provided the second part of his nickname, was known among the interns as Splutter’s grunt and was considered the ultimate sign of approval, the imprimatur to go forth and practise medicine with divine confidence.
Benita and I were ushered into a small waiting room by a nurse and left to wait for Sir Seymour. The small room contained no windows and a single ceiling light lit the interior. It was furnished with four, rather scuffed, bentwood chairs, a child’s wicker chair and a low table on which lay a pile of tattered children’s books with most of the covers separated from their innards.
The door leading into Sir Seymour’s surgery was closed. Screwed on to it was a varnished teak plaque with his name, “Sir Seymour Plutta", lettered in gold in Times Roman, complete with black drop shadow. It was very quiet in the waiting room and, though I strained to hear any signs of life, no noise at all came from the other side of the heavy teak door.
We’d been exactly on time, Benita in a salmon pink Chanel suit and me dressed for work in navy blazer and tie and Damon ready to chuckle, as usual. In fact we’d arrived at Camperdown early, not knowing how long it would take to get across town. We’d even waited for several minutes outside the hospital gates in order to arrive precisely on time. Now we sat for forty minutes, whispering to each other for fear of disturbing the medical silence.
We were both a little overwrought, our minds filled with speculation about our baby boy. Benita had become convinced that Damon was a bleeder. I tried to comfort her, pointing out that since the time of the wedding when I’d grabbed him and rushed him to Crown Street maternity hospital for a transfusion, saving his life by less than a hour, he’d been perfect. His birth bruise was gone and he was the pinkest, fattest, loveliest baby with sticky-up hair you’ve ever seen.
“What if he is a bleeder, what will we do?” It was a question Benita asked constantly and to which I had no answer. Instead, I would hide my frustration by feigning irritability.
“Well he isn’t, that’s all! Don’t you think they’d have told us by now?”
“Well then, why are we seeing the specialist at the Children’s Hospital?”
“It’s just routine. Obviously it isn’t serious. They transferred him there from Crown Street. The appointment isn’t until after Christmas…It’s just routine.”
“Well, what if he is, that’s all!”
I knew what she meant but it had become a thing between us. “Is what?”
“A bleeder!”
“Jesus! I wish you’d stop carrying on like a bloody old woman! Damon is a perfectly normal baby!”
I could hear myself inventing the protesting words in an attempt to smother the speculation coming from my wife and, secretly, from my own eroding confidence. Finally the door to Sir Seymour’s surgery opened and a nursing sister emerged carrying a very small baby wrapped in a white hospital blanket. “You can go in now,” she said, not looking at us as she crossed the waiting room. I hurried to open the outer door for her and she passed through it without acknowledging me, her attention on the baby in her arms.
Sir Seymour was seated in an old-fashioned swivel chair behind a large desk in the centre of the room. “Sit, please,” he said without glancing up. In that universal way of all doctors he appeared to be writing on a small filing card. We sat, lowering our bottoms quietly on to the two bentwood chairs facing his desk, companions to those in the waiting room. He continued to write for what seemed like several minutes, sufficient time anyway to examine our surroundings.
The surgery was unremarkable and gave an overall impression of brownness. Brown teak panelling, a single, large, ugly, brown, framed picture showing a bleak, autumnal, Scottish landscape on the far wall. Against the wall to the left of the desk stood a brown, rather lumpy looking, vinyl examination couch with brass studs around its perimeter. Directly above this were several cheaply framed, though important looking, certificates and diplomas. The floor was uncovered and made of dark, frequently polished parquet, the tiny oblong blocks barely visible where years of waxing had filled the spaces between them and smoothed their individual grain to a surface anonymity. Even the olfactory aspect of the surgery gave a hint of gloom; the vague paraffin smell of built-up floor polish seemed entirely appropriate to the sombre nature of the space surrounding us.
Adding to the general sense of depression was a large creamy-yellow porcelain basin against the right-hand wall, with centred stainless steel spout and elbow nudgetaps jutting out of the wall on either side. The lead S-bend under the sink was dented and somewhat lopsided and a paper towel dispenser was fitted high up onto the wall to the side of the sink. Directly below it on the floor stood an old-fashioned scale with T-bar and sliding cast-iron weight counter.
It was just the sort of room in which you expected to hear bad news. I could sense Benita’s growing depression. Sir Seymour looked up at last. “Ah, yes, Mr and Mrs…” he glanced down at his appointment diary, “Courtenay?”
“How do you do, doctor?” we both mumbled, Benita smiling nervously.
Sir Seymour continued without acknowledging our greeting. “Yes, let me see. Your son, Damien, isn’t it?”
“Damon, doctor.”
He ignored my correction and opening a drawer withdrew a small wooden index-card box. Walking his fingertips over the tops of the cards, he removed one and placed it on the desk. “Yes, well. How was your Christmas?” He looked up and flashed us a thin smile adding, “I wanted you to have Christmas first.”
“Fine, thank you, doctor.” I was immediately anxious at his clumsy phrasing.
Sir Seymour continued to look directly at us. “Yes, well. He’s a haemophiliac, I’m afraid.” His expression was almost matter of fact. “I wanted you to get Christmas over first. Any others in your family?” His eyes moved to Benita.
Benita was clearly stunned, not prepared for his question. “A haemophiliac?”
I sensed that she knew what a haemophiliac was, though I had no idea. We’d used the term bleeder without ever putting a medical name to it. At the sound of that word, I grew cold. I knew just enough Latin to know it had something to do with blood. Our worst private fear was about to be plucked from dormancy in our subconscious and planted into our r
eal lives.
“It’s not a disease, so you must put the idea of a cure away from your minds immediately. Haemophilia is caused by a factor missing in your child’s blood, the ingredient which causes it to clot.” He turned his palms upwards and gave a small shrug, “It’s not something we can ever fix.”
Benita is a feisty woman and though clearly distressed she looked directly at the doctor. “I know what a haemophiliac is, doctor. It’s been over a month since his circumcision. Why didn’t you tell us before this?”
Sir Seymour looked at her, surprised at the pique in her voice, or perhaps the idea that he was being asked to explain. “My dear young lady, I thought it best to let Christmas pass.”
I could feel a sharp stab of anger rise up in me. Unknowingly, I was standing at the source of the Nile, the thin first trickle from under rock and fern, the beginning of twenty-four years of a great river of anger and frustration at the arrogance, the careless disregard for feelings and the patronising manner of the Australian medical profession. Nevertheless, I remained silent, too timid to rebuke the great doctor.
Benita’s eyes welled up and her voice was tearful as she spoke. “We had a right to know earlier. He’s my baby!” I put my arm around her, more to stop any further outburst than to comfort her. I was hurt and angry too, but I didn’t want a scene. In fact, I couldn’t imagine one with this vainglorious aristocrat.
“Can anything be done, doctor?” I asked, anxious to sound co-operative.
Sir Seymour seemed oblivious of Benita’s distress. “No, Mr…er…Courtenay. I repeat, there is something missing! In fact it’s the Factor VIII in his blood. He hasn’t any, or damn little. You’ll have to bring him in for a blood transfusion every time he bleeds.”
“Bleeds? You mean if he’s cut?” My mind raced ahead. It didn’t seem too bad. Babies, even small children, don’t get cut too often and we could be super careful bringing him up. In my mind I was already groping for the comforting phrases I would later use to Benita. She was blowing her nose on a tissue, Sir Seymour waiting for her to complete the task so that the nasal noise wouldn’t compete with his voice.
“Bruise, not cut. When he bumps himself he’ll get a haematoma, a bruise, internal bleeding. In his case this generally won’t stop spontaneously and he’ll need a blood transfusion. Superficial cuts and scrapes are of no major concern, it’s the knocks and bumps that do the damage.”
“If it isn’t stopped, this internal bleeding…will he die, doctor?”
“No, not unless the bruising is extensive. A bad automobile accident, for instance, and you find you can’t get him to a hospital for a transfusion fairly quickly." He picked up his fountain pen and leaned back in the swivel chair tapping the capped pen onto his kneecap. “I think the sooner you face up to the fact that your son won’t have a normal life and that life expectancy in his case is limited, the better.” He clearly approved of his direct, no-nonsense manner. “He’ll start to develop arthritis in his teens. Haemophiliacs seldom live beyond their mid forties, though treatment is improving slowly.”
I wasn’t really hearing any of this, my mind still focused on whether Damon could bleed to death. Internal bleeding seemed so much worse than the outside kind. “A blood transfusion, what does it involve?”
“We use a frozen solution called cryoprecipitate, which is basically Factor VIII. We administer it intravenously, using a butterfly needle to get into the vein. It usually stops the bleeding in three or four hours.”
Benita had recovered sufficiently to look up at the doctor who had adopted a slightly arch expression, as though he was growing impatient at my questions but felt it was perhaps too early to terminate the interview.
“Is he in pain when it happens, when he bruises?” Benita asked.
“Yes, well, it’s rather a nasty business. The pressure builds up under the skin and the skin can only expand so much. I imagine it would be very painful, although a child’s pain centre isn’t as highly developed as our own.” He glanced at his watch. “Look, I’ve made an appointment for you to see Dr Robertson. He has an interest in haematology. Your son Damien will be under his immediate care.”
He paused, leaned forward and gave us another tiny, sharp smile. “You are in good company. Tsar Nicholas, the last of the Russian tsars, his son was a haemophiliac.” He smiled thinly again. “You may be assured I’ll keep my eye on the boy. Haemophiliacs are not that common and a classic haemophiliac with virtually no clotting factor whatsoever, well, it’s a bit of a find really. The pathology is damned interesting.”
He leaned forward and, as though he were reinforcing the glance at his watch moments before, he now tapped his fountain pen on the edge of the desk, bringing the interview to a conclusion. “I anticipate we’ll be seeing quite a lot of your young lad here at Camper-down.” He picked up the phone and dialled a single digit. “Sister, is Dr Robertson available to see Mr and Mrs Courtenay now?”
Fuck you, doctor! But the expletive in my mind remained mute: I needed to know one more thing before he dismissed us. “How will we know when he’s bruised himself? I mean, he’s a tiny baby.”
Sir Seymour raised an eyebrow fractionally. It was obvious he thought me rather dim. “Why, he’ll cry, of course.” He rose from his chair. “See Sister at reception. Dr Robertson will answer any further questions you may have.”
I went to shake his hand, but both hands were now clasped behind his back, as though he’d anticipated being touched and had wished to avoid any further personal contact. “Thank you, doctor,” I said lamely. “Thank you for seeing us.” I hated my obsequious manner, yet so intimidated was I in the presence of the “great” Sir Splutter Grunt that I seemed not to be able to help myself. Doctors were, after all, second only to God in those days.
“Yes, thank you,” Benita whispered as we turned to leave. I put my arm around her and we crossed the room. I could hear the protesting squeak of the swivel chair as his bum returned to it. Then the rattle of the telephone receiver being picked up, followed by the “zirrrrit” of the dial face as it triggered a single digit. All this before we’d reached the door. It was just another routine day for Sir Seymour Plutta.
At the door I turned and said again, “Thank you, doctor.”
The handpiece held to his ear, Sir Seymour grunted, a single sharp sound, like a resonant burp. Unknowingly, I’d become a recipient of Splutter’s grunt, though I felt none of the divine confidence it was meant to inspire.
It was almost eighteen months before Damon’s life as a haemophiliac got truly under way. Not yet crawling, but able to stand in his heavily upholstered cot and despite the fact that it stood well away from the wall, he’d managed somehow to bang his head.
We were to learn that bruising is a mysterious thing and often seems to happen without a remembered incident. Human beings are a clumsy lot; we whack and knock and thump and bump ourselves unknowingly a hundred times every day. Only, with a haemophiliac, the clotting factor in the blood doesn’t rush to the rescue in seconds, blotting up the blood to prevent internalised bleeding.
Benita woke to Damon’s crying and nudged me with her elbow. Because I’m an habitual early riser we’d agreed that I’d do the early morning nappy change and allow her to sleep in a bit. It was early, just before five a.m., still dark on a crisp autumn morning. I made my way blearily to Damon’s cot and picked him up, which seemed to comfort him for a moment but, when I laid him down to change his nappy, he started to cry again. I dried him, powdered his pink little bottom and changed him. Then I brought him, still crying, into bed with Benita and went into the kitchen to prepare his bottle. He really was the easiest of children and seldom cried for no reason. I prepared his bottle then ran the cold tap over it, testing it on the inside of my wrist before bringing it in to him.
“He doesn’t seem well, his head feels hot,” Benita said as I entered the bedroom. Benita is notoriously cranky in the mornings, when nothing ever seems to be right. I drew the bedroom curtains to let in the light, but it was
still rather dark and so I switched on the light. “What do you mean?” I asked.
“It feels wrong.” She had one hand resting on top of Damon’s head as she reached for the bottle. “There’s something wrong with his head, it’s bigger or something.” She fed the bottle to Damon who resisted taking it and continued to cry.
“Don’t be silly. It’s just the angle. Babies’ heads always look big. Babies’ heads are big, their bodies have to grow into them.” I took the bottle and tried it on him again and, somewhat to my surprise, he took it, which stopped him crying. “There you are,” I said smugly, confident that I’d solved the problem.
He cried intermittently for the next couple of hours but seemed all right again as I left for work at seven-thirty. “It’s colic or something,” I said expertly. Though his head did seem to have expanded a little, I was reluctant to admit this even to myself. “’Call me if anything happens,” I said to Benita as I kissed her, anxious to escape from her growing concern into the crisp autumn outside.
At noon Benita called me at work, but I was out at the time producing a television commercial at a North Sydney studio. The script called for two voices, with all dialogue on camera, requiring a locked sound stage. The director had called for absolutely no interruption. By the time we’d finished it was after five and the studio receptionist had left for home, having failed to give me Benita’s lunchtime message, relayed through to the film studio by Suzanne my secretary.
I was the creative director at McCann Erickson, a job which I’d inherited almost by default and for which many thought I was both too young and too inexperienced. It meant long hours and a great deal of hard work; I seldom got home before nine at night and often much later.
I justified this to Benita as the break we’d been looking for, the “make or break", I called it. Privately, I told myself that I’d make it up to the kids by rising early each morning to get them off to school and devoting my entire weekend to my family. To some degree, at least, I was to be successful in this. A big career, success with all the trappings, was important to someone with my background. It was up to me to keep the ball in the air. Poor boys don’t get too many second chances. After all, I told myself, “I’m doing all this for them.”
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