Blood and Sand

by Frank Gardner

  That was a black day. Naively, I had thought that hard work through physio would be enough to get me back on my feet. I envisaged kick-starting recalcitrant nerves with some sweaty sessions on a static bicycle. Perhaps a bit of gentle hydrotherapy in a warm pool. The idea that I could be paralysed for life had simply not registered until then. I sulked for a day, pouring my fears out to Amanda. Then one evening, while jiggling my hips to keep the blood circulating in my legs, I discovered a muscle twitch in my inner thigh. There was life down there after all, this was a breakthrough. I pressed the call button for the nurse, who was almost as thrilled as I was. The on-call house doctor duly confirmed my hopes: there was nerve activity below the waist. But the next morning Frank Cross brought me down to earth. ‘Don’t get too excited,’ he said, ‘it’s just the first slippered footstep on a long road to recovery.’

  Once I had got over the debilitating effects of that chest bug I picked up in July, I started to get visits from clean-looking girls in crisp white uniforms. They were the physiotherapists, or ‘physio terrorists’ as they were known, although given what had happened to me everyone was too polite to use that phrase in front of me. I was asked to lift miniature sandbags above my head in bed and out to the sides. I quite enjoyed this – it felt good to use the half of my body that was not paralysed – but this was just the warm-up. After a couple of weeks they got me sitting up on the edge of the bed with my legs dangling down to the floor. This I hated. For a start, I felt dizzy and disoriented sitting up after being supine for so long, and secondly my feet swelled up with the rush of blood, turned purple and hurt like mad. But what really depressed me was the sensation I felt for the first time of having two dead logs for legs. I had to use both hands to lift each leg across the bed and down. There was no touch sensation or motor movement in them at all. Weird.

  Of all the physios at Whitechapel, one stood out. Julie Hicks was a slender blonde from New Zealand, in fact she came from the same part of North Island as Amanda’s family, but that was not her prime qualification. Julie was a neuro-physio, which meant she understood which muscle movements corresponded to which nerves. She was also tough as nails. Once, when I was perched on the edge of the bed facing her as she knelt, I lost my balance and pitched forward, inadvertently headbutting her on the forehead. Anyone else would have sworn or at least said ‘Ow,’ but Julie just smiled and said ‘Oh, hello’ in a sort of easy Antipodean backpacker way. I was impressed, and when I eventually moved from the Royal London I hired her – at the BBC insurers’ expense – to come and keep up the physio work three times a week.

  There were some brighter moments in Whitechapel to distract from all the pain and probing. Once I had recovered from the infection and fever, my family and friends started a Murmansk run of gourmet food. Naomi and Aidan, who had rushed over on the night of the shooting to be with Amanda, made regular weekend visits with a Thermos bag full of home-cooked chicken wrapped in pancetta and herbs. My parents came up from the country to Waterloo and then took the Tube through London to visit me at least twice a week with slices of country ham and succulent French peaches. I took great delight in recounting these meals the next day, in mouth-watering detail, to the posse of dieticians who came in to check up on me. I may not have been regaining weight but I was certainly rediscovering a love of food.

  Best of all were the intimate dinners that Amanda arranged. With a nod from the nurse we would be left undisturbed while my wife lit candles in the room, against every hospital regulation, and laid out a white tablecloth. She then unpacked our Wedgwood wedding china and two crystal wine glasses, filling them with iced mango juice or tropical fruit cocktail. We would then feast on chopped avocado and pasta that melted in the mouth followed by little cartons of chocolate mousse. Afterwards we would snuggle up on the bed and watch black-and-white classics like Casablanca on the little TV/DVD that the BBC had bought me. The only hard part was when Amanda had to leave, often close to midnight, and I would go to sleep alone once again.

  In my last week in Whitechapel I was taken down in the lift to somewhere which, for me, held almost as much terror as an Iraqi interrogation chamber: the Colo-rectal Department. The white coats wanted to know if I still had muscle tone down there and proposed a series of progressively uncomfortable tests. I cannot imagine what had possessed the tall and beautiful girl who greeted me to make a career out of inserting things up people’s bottoms, but she did her best to put me at ease. ‘You make yourself comfortable and face the wall while I get everything ready.’ Make myself comfortable? My injuries, combined with the nerve damage and four months of lying in bed on my bum, had left me so sensitive down below that I found myself involuntarily recoiling at the slightest touch.

  She showed me a very thin catheter. ‘Now, Frank, I’m just going to insert this, then inflate it, like so . . . OK, you should now feel as if you need to pass wind.’ I did. ‘And now . . . this should feel like you need to empty your bowels.’ It did. ‘And this . . . should feel like you’re absolutely desperate to go.’

  ‘Arrgh! Yes, it does! Make it stop!’ I half expected her to say, ‘Tell us the truth, Frank, and I can make the pain go away.’

  The colo-rectal nurse had a whole raft of other devices lined up for me, including something that – and I am not joking here – was bubbling away in a miniature steel cauldron. But since I howled at the first touch of her little finger the rest of the exercise had to be aborted and I was wheeled back up to the ward in disgrace. Later my consultant, Frank Cross, came into my room and sat down for a chat. When I told him what had happened he confessed sheepishly that he too had baulked at a similar test.

  By now Melissa and Sasha had got used to seeing me in hospital and they became a familiar sight on the ward. One of their favourite games was to put the unused cardboard bedpans upside-down on their heads so they looked like cowboy hats. ‘Howdy doodie!’ they squawked, their shrill voices carrying way down the corridor. Another time Amanda found them playing doctors, having got hold of a stethoscope that they clamped to each other’s chest, their little faces solemn with concentration. But the journey from our home to the East End of London had been proving increasingly tedious for my family. Often it could take up to two hours each way thanks to cancelled Tube trains or solid traffic. Amanda began urging me to ask for a transfer to a hospital closer to home. But I replied that I was reluctant to leave since I was getting such good care. Amanda then accused me of suffering from Stockholm Syndrome, whereby prisoners fall in love with their captors. She was right. Despite all the unpleasant medical procedures I had grown quite comfortable in my little room up on the fifth floor. It was time to move to the Chelsea and Westminster Hospital.

  They took me in an ambulance, which was a novel experience for me (my rescue in Riyadh having been courtesy of a police patrol car) and I loved it. Lying prone and strapped on to a stretcher, I had Amanda beside me and a constantly changing kaleidoscope outside the window. I saw the Tower of London slide past at an unexpected angle, then a long avenue of plane trees all green and glistening with rain-washed leaves. There was Big Ben, leaning crazily towards me through the treated glass of the ambulance, then more plane trees and suddenly we were in Chelsea.

  It was a shock to be back on a public ward after the cosseted privilege of a room to myself for the past four months. At first I disliked it intensely since my fellow patients all seemed to be grumpy old men with nothing much wrong with them. They would grumble and moan to the nurses and then get up and go off to the loo. I thought, I can’t do that.

  But after a day or two I began to take an interest in them. A couple of beds down lay Ted, a jovial wino who was using the place like a hotel, letting himself out each morning then boozing the day away with his mates in Fulham Broadway. He would roll back in at eight p.m., happily drunk, and regale me with stories of his National Service days in Berlin, guarding Rudolph Hess in the 1950s. Sadly for him he was spotted in the pub by one of the doctors and was promptly given his marching orders. Ted’s best f
riend on the ward was a tiny bearded East Ender of no fixed address. Whenever he was asked to fill in a form he would shake his head sadly. ‘Can’t read,’ he would grunt. Right opposite me was the patient from hell. He would rumble and grumble throughout the night, then empty his guts into his incontinency pads just before each mealtime, effectively putting everyone off their food. There was Sven, a noisy Scandinavian drug addict who told me he had been injecting for nearly forty years and was now having a stab at methadone. Whenever his fix was late he would threaten to go out on to the street and buy heroin from a dealer instead. Sven had a large, suppurating wound on his leg and after a while word got out that he had contracted MRSA. He was swiftly moved to an isolation room while an inquiry was conducted as to how we had found out (we had overheard the nurses discussing him).

  At about this time I had a visit from the Chronic Pain Team. Even their name had a ring of despair about it but I was open to all suggestions. Like most spinal-cord-injury patients I had been suffering a lot from pain in the legs where the nerves had been all jangled up by my injuries. The worst kind of pain felt like I was being kicked on the shins, quite hard, by someone with steel toecaps. It would hit me without warning, causing me to hunch up in agony until it passed. At all times I was aware of a low, aching pain in my legs which sometimes felt like pins and needles. It was not as painful, but was enough to stop me getting to sleep at night. The pain team prescribed a daily course of neuropathic painkillers; they also had a clinical psychologist who tried, unsuccessfully, to get me to ‘breathe through the pain’. I would challenge anybody to ‘breathe through’ being kicked on the shins.

  Being in hospital in Chelsea did wonders for my morale as people flocked to my bedside. My dear friend Khaled Al-Sabah, who had crossed the border into Iraq with me in 1991, generously gave me a brand-new Sony Ericsson P900 mobile phone (my blood-stained BBC mobile was still in the tender care of Scotland Yard’s Anti-Terrorist Branch). He also brought me a bottle of exceptionally good claret, which we drank out of plastic cups with our lukewarm takeaway pizza. Jo Cayford, from the BBC, brought me back a tub of caviar from Moscow – I enjoyed the look on the nurses’ faces when I asked if they would be so good as to bring me my caviar from the communal fridge. John Simpson and his wife Dee ambled over from their Chelsea pad, he fresh from a difficult and dangerous assignment, I fresh from having my colostomy bag changed. Others insisted I get into a wheelchair so we could go off to a restaurant for the evening.

  The first time this happened I did something of a double-take. As I wheeled into an Indian restaurant the waiter bent down towards me and said, ‘I must tell you, sir, that we don’t have disabled access to toilets on this floor.’ I thought, Why is he telling me this? I’m not disabled. And then it hit me. Of course. Disabled. That’s me now. All those little wheelchair signs are going to be part of my world, so I had better get used to asking where the disabled loos are. Up until then I had not paid much attention to what sort of wheelchair I had, telling myself it was just a temporary phase for a few months until I got my legs back. While I still thought that, I did notice that the hospital wheelchair I had been issued with was of a very poor design. Julie, my physio, was horrified when it started to tip backwards as I mounted the tiniest of kerbs. The footplates scraped along the ground half the time, which meant I had to be wheeled backwards into some places, which I hated as it made me feel like even more of an invalid than I already was.

  Despite my paraplegia I was still the healthiest patient on the ward, so before long it was decided that I should be sent to a physio rehab unit for a few months until my intestines had recovered enough to be operated on. The Royal National Orthopaedic Hospital at Stanmore in Middlesex is a bizarre place. Situated on the outer reaches of northwest London, it has a leafy, rural feel to it. It is within earshot of the M1 yet there are deer foraging here in woods and fields. The buildings were in a decrepit state; the corrugated roofs were overgrown with grass and moss, and rainwater often trickled into the corridors. There has since been a multi-million-pound fundraising drive to update it. Yet despite having the air of a 1950s National Service boot camp, it has a reputation for being one of the best places in the country for rehabilitating spinal-injury patients. Unfortunately, nobody explained to me before I went what I could expect to achieve there. I arrived thinking they were going to be concentrating my efforts on walking again; I even told friends at the BBC that they would be trying to get my legs working again. But I was quickly disillusioned.

  On day one, the consultant, Dr Gall, came in to give me an ‘Asia’ test (standing for American Spinal Injuries Association). This involved pushing and tweaking my legs to see how much sensitivity and movement I had left. It was one of the most depressing hours of my life.

  ‘Can you move your toes?’

  ‘No.’

  ‘Can you lift your foot up?’

  ‘No.’

  ‘Can you lift your knee up?’

  ‘No.’

  On almost every test I was scoring 0 or 1 out of 5, indicating nothing more than a flicker of life at most. The consultant shook her head sadly.

  Next came a sensitivity test in a sensitive part of the body. A Jordanian doctor asked me to roll on to my side and pull down my tracksuit bottoms. He then took out something that looked like a map pin and slowly, deliberately, jabbed me in the anus. I felt it all right, I virtually hit the wall with pain. ‘Good,’ he said. ‘If you have sensitivity there that means your injury is incomplete. You are what we call “sensory incomplete”, which means you might have a 20 per cent chance of walking again. But every patient is different.’

  I was keen for them to leave the room, but the ordeal was not over. ‘Now we need you to roll over on to your back,’ said the doctors. Another jab in another sensitive part of the body, more pain and more nods of approval. I half expected them to move on to my eyeballs.

  I was now left alone with my thoughts in a small dark room. There was a window, but it looked out on to a corridor. From somewhere down the passageway I could hear children laughing and playing, and suddenly I felt very, very low. My own children were far away on the other side of London and I would not be tucking them into bed tonight or any time soon. How long had it been now since I had last read them their bedtime story? Four months? Five months? It seemed like a lifetime since I had slept under the same roof as my family and I missed them desperately. On top of this I was having to cope with near continual, undulating pain in my legs, wandering like a torchbeam from my foot to my calf to my shin, then back again.

  The next morning I was introduced to my new physiotherapist, Almari from South Africa, and the special physio gym in which she worked. It was unlike anywhere I had ever seen. Housed in a sort of well-lit warehouse, it consisted of padded plinth beds, wooden standing frames with sheepskin straps, parallel bars, powered rowing machines and a versatrainer on which paraplegics could exercise their limbs. Some patients were on their backs having their flaccid legs manipulated, others were strapped into the standing frames, one was on the assisted cycle machine (it does the pedalling for you) and one was being wheeled in, still in his bed, then winched up in a sort of garden-compost sack then transferred on to a tilting table where he was slowly raised to near vertical. A group of three patients with lesions quite high up their spines was gathered for a balance and coordination lesson, passing a rubber ball endlessly backwards and forwards to each other. Everyone’s wheelchair paraphernalia seemed to have jaunty, toytown names like ‘Quickie’ and ‘Action 3’. I noticed how incredibly skinny everyone’s legs were, especially the calves. A typical example was Ray, a big, broad-shouldered Jamaican with huge biceps and tiny matchstick legs encased in girlie white stockings to prevent deep-vein thrombosis.

  Almari was all business and she needed to be; she was an expert in rehabilitating spinally injured patients while I was new to this, and at first we did not see eye to eye. I was only interested in working towards getting back up on my feet, but she made it clear from the outset th
at I was extremely unlikely ever to be able to walk again without artificial help. Instead, she gently insisted on spending session after session on ‘transfers’, using my arms to shift myself from wheelchair to plinth and back again. I found this frustrating and boring and it was probably not a barrel of laughs for her either, but I later realized it was an essential building block for any kind of mobility.

  Physiotherapy was doubly difficult for me because of the other medical problems caused by my multiple gunshot wounds. Since Dr Bautz’s emergency surgery in Riyadh had effectively sealed off my intestines, whatever I ate came out minutes later through a hole in my side into the plastic ileostomy bag attached to my abdomen. For seven months, until they reconnected my guts in 2005, the effluent was so undigested that it had no bad odour; I even recognized things I had recently eaten. But since it came almost directly from my stomach it was highly acidic, the stomach containing a powerful concentration of hydrochloric acid. This acidic brown matter would often leak under the bag’s adhesive seal, burning my skin red raw. Sometimes I would detect a leak during my daily hour of one-on-one physiotherapy, forcing me to cancel the rest of the session and wheel myself back to the ward for emergency repairs. On most nights I would have to wake up several times to empty the bag, keeping a careful record of volume on the instructions of the gastro consultant in Chelsea. Apparently more than 1.5 litres a day meant I was losing too much liquid and would become dehydrated. ‘Your nutrition is highly precarious,’ he told me. Altogether it became a major distraction from physio.

  There were also sessions with Emma Linley from Occupational Therapy, a down-to-earth girl who later featured on the front pages of the newspapers holding hands with another patient, Abigail Witchalls, who was brought to Stanmore after being stabbed in the neck while wheeling her son in a pushchair near a quiet village in Surrey. Emma taught me how to get dressed in the mornings, coaxing my inflexible, paralysed legs to bend just a little bit more so I could get my socks on and tie my shoelaces, and showing me how to hitch up the waistband of my trousers by rolling from side to side on the bed. I was enrolled in wheelchair-skill lessons, learning how to do a ‘back-wheel balance’ whereby you tip the chair back to lift the front wheels up over a kerb. To be honest, I was not very interested in my wheelchair because I had convinced myself that I would be up and out of it somehow before long. But Emma’s report for my Disability Living Allowance laid it out in black and white: ‘It is estimated that Frank will be a long-term wheelchair user.’