I Am, I Am, I Am

by Maggie O'Farrell

The man pulls on my hair, forcing my head back and back. I can see only sky, scurrying clouds, the black arrows of birds. Back at the hostel, Will and I will talk about this moment and we will both say that we thought the man might want more. More violence, more abuse, more horror.

  At the time, I gaze up at the sky, the birds, the fast-moving clouds, and I am thinking about the dense forest behind us, about how I do not want to be dragged in there, not at all. I do not want to see the trees closing over my head, feel the scratch and pluck of bushes against my skin, my clothes, the cold damp of the ground in there. My thoughts are very simple. They pulse through my head: let me go, let me go, not the forest, not the ground, please. I feel the beat of these thoughts. I imagine them passing through the bone of my skull, up the fibres of my hair and transmitting themselves into the man’s hand. Let me go. Please. Also, know this: I will fight you. I will not go quietly. If you try to drag me away, I will battle you. I won’t make it easy. I will struggle, every step of the way, with every last ounce of strength.

  Into my field of vision comes his face, upside-down. He looks at me; I look back at him. He seems to be considering something, going over his options. I hold his gaze. Don’t do it, I will him. Don’t. Take the money and go. I cast about with my hands to find something to hold on to, a branch, a rock, in case he tries to pull me somewhere. But there is nothing, only small pebbles that slide and slip through my fingers.

  He leans forward, over me. Some decision has been reached.

  “Run,” he hisses.

  He yanks me to my feet and pushes me away from him, towards Will.

  “Run!” he urges us again, pointing with his blade away from the town, away from the hostel, away from everything. “You run!”

  We sprint, wordlessly, along the edge of the lake, our breath entering and leaving our chests in sharp jags; my scalp throbs and stings, glowing with agony. I look back over my shoulder to check he isn’t coming after us, with his angry grimace, his broken teeth, his unwashed hair, his machete, curved like a scimitar. I see him hurrying away over the stones, vaulting a fence, disappearing back into the scrubby vegetation.

  Will pulls on my sleeve. We come to a halt and I hunch over, hands on my knees, trying to gulp down as much air as I can. I am nowhere near as fit as Will, who jogs and plays five-a-side football every week.

  “Let’s get out of here,” he says, indicating the path back to town. “Can you run?”

  Later, we sit at a table in the hostel. The owner, on hearing what happened, has scrawled on the whiteboard in reception, in large capital letters: DO NOT WALK BY THE LAKE—THERE ARE ARMED ROBBERS! She has also brought us cups of over-sweetened tea. “For the shock,” she says, patting my shoulder, which makes me flinch. Something has caught up with me now: the fear that, beside the lake, had held itself in check has invaded my body. My arms are shaking. I keep looking over my shoulder. When I raise the cup to my lips, its rim rattles against my teeth.

  In a few months’ time, we will return to London. We will live in the rooms of the flat we have bought. The building work won’t be anywhere near finished but we move in anyway. The roof no longer leaks, the eroding gas lamps will have gone but the toilet flushes with hot water, the walls click and rustle at night, and the garden is filled with rubble. We will circle each other in this flat, retreating to different rooms to work, to write. We don’t know it but these will be our final months as two people.

  Is there something about the experience beside the lake that pushed us forwards, made us exit one stage of life and enter the next? Did my escape from under the machete impress upon both of us the fragility, the mutability of human life? Either way, it won’t be much longer until I take a pregnancy test and sit there in our newly painted flat, staring at the stick, waiting to see if some blue lines are going to rise towards me.

  In the Chilean hostel, Will is feeling the need to talk about the robbery, to get the facts straight, the events in their correct order, to align my version with his. He goes over it, backwards, forwards, from this angle, from that. The way the man came up behind us, the way the wind must have snatched away the sound of his footsteps, the moment Will turned and saw a blade at my neck, how the man must have done it before, how he had clearly honed his method, how he wasn’t that big, Will could have challenged him, could have got the machete away from him, he is sure he could, the way we had passed the man earlier, at the start of the walk, and Will had thought it was odd that he didn’t meet our eyes, didn’t respond to our nodded greeting.

  This last observation makes me raise my head. “You know what?” I say. And I start to tell him something, something I’d never told anyone, something that almost happened when I was eighteen, and on a walk, alone.

  ABDOMEN

  2003

  Credit 2

  I had been distantly aware of a person to my left for some time. It was a man, nearing middle age, in hospital scrubs and mask, standing with his back against the wall of the operating theatre, just outside my field of vision. He was not taking part, but watching, just watching, his hands behind his back, like someone at a tennis match.

  I had wondered, fleetingly, what he was doing there, hanging around at the fringes of an emergency Caesarean section, with apparently nothing to do. But then events overtook me and I stopped wondering about anything at all.

  I still don’t know who this man was and I never will. His scrubs were beige; everyone else’s were blue. Was he a hospital orderly, a surgical student, a porter, a nurse? I have no idea.

  What I did know, at the time of our encounter in the operating theatre, was three things: that the baby was out and somewhere over in the corner, screaming and being attended to, that I was desperate to lay eyes on him, that I was in trouble. My heart was suddenly galloping, as if trying to outrun whatever it was that was catching up with us. Will was being gripped by the arm and hustled away by a nurse. The floor was awash with blood and people were running. It is never a good sign, I’ve found, when medics run. On the whole, they are an unflappable, rational breed with a deliberately neutral demeanour. It’s only when you see this façade slip—if they hurry or raise their voices—that you need to worry.

  The doctors on the other side of a hastily erected curtain were treading red shoe-prints as they worked. One, a young woman from Northern Ireland, was panicking, saying, “I can’t, I can’t, I don’t know how.” I caught sight of a forearm, scarlet to the elbow, swiping at a sweaty brow. The other doctor, a taciturn man in his thirties, said something sharp to her, then fell silent. The anaesthetists who, until a moment ago, were sitting next to me, chatting and joking, were now standing, watching what was happening over the curtain. Their faces were still, stony, careful. One adjusted his half-moon spectacles and did something to the clear, suspended bag on a drip-stand.

  Whatever it was hit my veins almost immediately and I felt myself veer sideways, like a train diverted to a different track, felt something like fog blow over my brain. My eyes rolled back in my skull—I saw the ceiling tiles, moving like a conveyor-belt, I saw the underside of the anaesthetist’s chin, reddish bristles poking through the skin, I saw a defective light flicker on and off. I forced my eyelids to stay open; I pressed my fingernails into my palms. I needed to remain in the here and now. I should not give in to whatever was pulling me under. There was a baby. I needed to stay.

  —

  When I was heavily pregnant I met an off-duty consultant obstetrician at a party.

  “The thing about childbirth,” he slurred to me, in a confidential tone, gesturing with his wine glass towards my stomach, “is that it’s either all fine or it completely fucks up. There’s nothing in between.”

  Not the most comforting pronouncement but perhaps one of the most honest. When I got pregnant, I was blithely unaware of the highly politicised arena of elective Caesareans in the UK. I’d never heard of what was then called the National Institute for Clinical Excellence (or NICE, as it was known to its friends) or its strict surgical guidelines as to how
many Caesareans were permitted per month, per hospital.

  I tripped along to my appointment at a large London hospital with a friendly registrar (who would, months later, be the one to say, “I can’t, I can’t, I don’t know how,” as I was bleeding out on the operating table). I explained to her that, as a child, I’d had a virus that meant I was in a wheelchair for a year and left me with mild muscle, nerve, and brain damage. The neurologists and paediatricians who had looked after me said that, should I ever have children, I would need a Caesarean. I had sustained damage to the neuromuscular junctions in my spine and pelvis, which meant that labour would begin but not progress; the contractions would not be strong enough.

  I wanted to ask the registrar what she thought—I would have preferred a natural childbirth and this diagnosis was, after all, twenty years old. I had rehearsed this speech, pared it back to its bare bones: I knew the registrar would be busy, that there would be long queues in the antenatal department, that I would need to get across the salient information about my childhood encephalitis and no more. All I wanted from her was her opinion: What did she think were my chances of a natural birth? But I got halfway through my speech before the registrar nervously interrupted me.

  “I’ll have to check this with the consultant,” she said, and scurried away.

  I waited. I looked around the room. I studied the lists of foods forbidden during pregnancy. I tried to read my notes upside-down.

  The door flew open. A tall man with severe comb-tracks in his black hair came in, the registrar behind him. She introduced me and he took my proffered hand, but instead of shaking it, he used it to yank me bodily up out of my seat.

  “Get up,” were his first words to me. “Let me see you walk.”

  I wish now I’d left there and then, but at the time I was so astonished I complied.

  “There is nothing wrong with you,” he pronounced, after he’d seen me take two steps. “You will have a normal delivery.”

  I started to ask for clarification but the consultant—we’ll call him Mr. C—talked over me. Caesareans were a cult, he said, a fashion. I had been reading too many gossip magazines. I assured him this was not the case but he shouted me down again: Did I realise that Caesareans constituted major surgery? Why had I allowed myself to be swayed by celebrities? Did I doubt his medical expertise? What was wrong with me, that I was so afraid of a bit of pain?

  Angry now, I attempted to say that I was in fact quite used to pain, but he surveyed me with an expression of utmost contempt.

  “This illness you claim to have had”—he turned at this point to eyeball the registrar, who was hovering by the door—“Encephalitis, was it?” The registrar nodded and Mr. C turned his gaze back to me. “Do you have any proof?” he said, a slight but triumphant smirk curling his lips.

  “Proof?” I repeated, incredulous. “You think I’m lying?”

  Mr. C shrugged but continued to stare at me in a way that seemed practised, habitual. Was this his tried-and-tested method for humiliating pregnant women into submitting to his will? It seemed that way.

  “Well, I suppose I could get my old hospital notes,” I said, after a moment, holding his gaze. “Would that be sufficient proof for you?” You can’t bully me, was the subtext of this. Mr. C saw that and it angered him further. “They’ll date from the early 1980s,” I continued, “and will come from South Wales, but I’m sure that can be arranged.”

  He narrowed his eyes, tapped his pen on the desk. And then Mr. C had had enough of me. He rose to his feet, dismissing me with a wave, and delivered his parting shot: “If you had come to me in a wheelchair, maybe then I would have given you a Caesarean.”

  It was an extraordinary thing to say to anyone, let alone someone who has actually been confined to a wheelchair. It wasn’t Mr. C’s refusal to discuss my case, never mind grant me an elective Caesarean, that horrified me, it was his implication that I was some kind of malingering coward, trying to lie my way into an easy birth. That and his appalling, patronising bullying. Did I realise that a Caesarean was major surgery? No, I thought it was a stroll in the park.

  It was only when I got outside that I started to shake, in much the same way as I had when I was in the grip of viral immobility. Ataxia is the word for it, a wavering of the limbs, a tremble, an inability to walk or coordinate. I leant up against the hospital wall, alongside the smokers, the idling ambulances, people waiting for their taxis, trying to understand, to catch up with what had just happened.

  To be so unheard, so disregarded, so disbelieved: I was unprepared for this. I also felt helpless, blocked in. I wanted to run from that hospital and never go back, but how else would the baby be born? I needed this place. I was trapped, pregnant; this baby would have to come out in less than five months and what would happen if the neurologists’ predictions came true? What then? What if my body was unable to birth this child? I had been foolish, selfish in getting pregnant; I should never have allowed it, if I wasn’t up to the task of giving birth. What had I been thinking?

  People left me alone, stepping around me. A person leaning against a wall outside a hospital, shocked and silent, is not an unusual or unlikely sight. Eventually, a man with a crutch and a drip-stand, nautical tattoos swarming up his arms, limped over and offered me a cigarette. I thanked him and shook my head, pointing to the curve of my stomach.

  “Kids,” he said to me genially, in a strong Cork accent. “They’ll have you in an early grave.”

  —

  When I got home, Will, after some initial shock at my dishevelled appearance, listened to my incoherent, rambling account of the appointment. He paced up and down the living room for a while. Then he phoned the hospital. He spoke to the Northern Irish registrar who said that, yes, I could change hospitals if I wanted to but the other options were quite a distance from where we lived. What might be better, she said, was if I stayed at the hospital but changed consultants. I wouldn’t have to see or speak to Mr. C ever again, if that was what I wanted.

  That was exactly and precisely what I wanted: never to see him again. So I stayed at the local hospital. I changed consultants. I scribbled out every instance of Mr. C’s name from my notes with indelible ink and wrote in the new woman’s name. I obliterated him from all my records, all my plans, all my folders. He was to have nothing more to do with me or my baby.

  As things turned out, the predictions of the neurologists from the 1980s were right. My labour went on and on but didn’t progress: my contractions surged forward, then weakened off. They felt, to me, like the apogee of pain, of agony—it was as if my body was trying to turn itself inside out—but the nurses frowned at the monitor strapped to my belly. Not strong enough, they said. Fading away, they said.

  I kept trying to explain; Will kept trying to explain. The thing is, I said, addressing a midwife whom Will had grabbed by the arm, I had acute encephalitis as a child. Severe cerebellar ataxia. Neurological damage. Vestibular malfunction. Please check my birth-plan, my notes. It’s all in there. My neuromuscular junctions are—here, I yanked the gas-and-air mask off my face—they are…they are…faulty and they said I’d need a…a…Wait, wait, where are you going? Come back.

  On the morning of my third day in labour, who should appear at my bedside but Mr. C. I looked up at him from the bed; he looked back, his lip curled. Did he remember me from our meeting all those months ago? Had he seen the traces of his name scored out of my notes? I wanted to shout, not you, anyone but you, but I knew, in some shape or form, that my baby’s life was in his hands, my life was in his hands. He was the only consultant on duty that morning: there was no other. So I was polite, I was controlled; I didn’t shout, I didn’t ask him to leave. I may have even smiled as I begged him for a Caesarean, from my prone position on a bed, getting out the words between contractions.

  He glanced at the charts of my baby’s dipping heart-rate, read over my notes, perused my birth-plan, then granted me surgery, in the manner of a landowner bestowing a favour on a serf. But Mr. C still
had me down as a hysteric, a fantasist, a malingerer, a reader of celebrity gossip. It would, he said, go down in my records as “by maternal request”—that is, medically unnecessary. This, despite three days of labour, the induction drugs, the non-progression, the diagnosis by neurologists.

  The next day, after my messed-up C-section, the surgeon came to visit, to see how I was, to explain what had gone wrong. The problem, he told me, as I sat up in bed, attempting to breastfeed, had been that the baby had become wedged in what is termed “star-gazer presentation,” a position that makes natural delivery impossible. My labour had been allowed to go on for so long, without progressing, that the baby had turned the wrong way, his spine aligning with mine, and because my cervix hadn’t dilated, his chin was forced down and the widest part of his head was facing the exit. Head down, looking up. Some of us are looking at the stars. His left ear was so crushed and misshapen by the pressure of the contractions-that-went-nowhere that it would require plastic surgery.

  The baby’s wedged and immovable position made it difficult for the surgeons to remove him and, somehow, in the ensuing wrestling and grappling, clutching and heaving, something had ruptured. All that should have stayed inside had come out.

  “What would have happened,” I asked the surgeon, the man who had replaced my intestines and stopped my bleeding, sewn me up and saved my life, “a hundred years ago, if you had a star-gazer baby?”

  The surgeon looked up from his notes. He seemed to be considering the question, debating whether or not to tell me the truth. “You wouldn’t have made it,” he said eventually, going back to whatever it was he was writing.

  “What about the baby?”

  “The baby would have died first,” he said, not looking up. “Then the mother. Of sepsis. Probably days later.”

  Death by childbirth seems such an outdated danger, such a distant threat, particularly in the surroundings of hospitals in the developed world. But a recent survey* ranked the UK at 30 out of 179 countries for maternal health. In the UK, a woman faces a one in 6,900 chance of dying in childbirth, which far exceeds the risk in Poland (19,800), Austria (19,200) or Belarus (45,200). The US ranked lower than the UK, at 33, with a woman facing a one in 1,800 chance of maternal death. At 179 is Somalia. All but two of the eleven lowest-ranking countries in the world are in West and Central Africa.