Get Well Soon

by Nick Duerden

  Time passed, but my misery didn’t. Perhaps I was now merely one of the 10 per cent of Britons who suffer from TATT, Tired All the Time, a vague sort of syndrome and evident epidemic that affects 10 million of us. Was that it? I made another appointment with the GP, a locum this time, and friendlier. She asked the same questions, and suggested more blood tests, different ones. ‘Let’s make an appointment again in, say, two weeks. Meantime, take it easy. Rest.’

  The blood test was the fasting kind. No food after six o’clock the evening before. My appointment was for 9.30 a.m. I awoke in the morning with the girls, shortly before seven. I was starving. The usual whirlwind of getting two small children cleaned, dressed, fed and out the door kept me occupied, and I arrived at the surgery with 20 minutes to spare. My rumbling stomach howled out to everyone in the waiting room for attention.

  I was called in after 10. ‘Busy morning,’ said the nurse as she tied a rubber flex around my arm. I watched the veins in my forearm rise, thought of Renton in Trainspotting, and turned to look the other way, testing my eyesight out on the chart pinned to the door: Z H S C T F X U.

  She took a lot of blood, enough to fill six small test tubes. I asked what they were testing for, and she did respond, but it went in one ear and out the other before I could commit any of her answers to memory.

  ‘All done,’ she said, smiling.

  I rolled down my sleeve, smiled back, and stood. The ceiling tilted promptly towards me. I hadn’t expected it to.

  ‘Oh. You’re looking terribly pale,’ the nurse said from somewhere in my peripheral vision. ‘Do you want to lie down for a bit?’

  I laughed, offered up the inevitable blush, and told her I would be fine. I pulled my coat on, said goodbye, then walked up the sloping corridor as it telescoped before me in a way I might have enjoyed had I the faculties, right then, to do so. I needed to sit down, and quickly. The reception area was full. I saw lots of bodies, but all the faces were blurred. There were no spare seats. My back, I realised, was soaking.

  I stumbled through reception on leaden feet. A love song came on the radio, one I hadn’t heard in years. As I reached the front door, it swung open, and in walked a boy, possibly 16, 17. His out-of-focus face was the last thing I saw. Beneath me, my legs had stopped working. I was pitching forward now, cleaving the air, and was not raising my arms to break my fall, even though the raising of arms to break a fall is an instinctive action. My head smashed onto the side of the door, and everything went black.

  I imagine at this point there must have been raised voices, shouting, perhaps a cry for help. I have a low embarrassment threshold, the slightest public faux pas enough to make me rigid with anxiety, so I’m glad I heard none of it. But gradually I became aware of people on either side of me, and movement. Hands were tucked up under my armpits, and I was being dragged forwards. ‘Can you walk?’ somebody, female, asked me. A ludicrous question. Of course I could walk.

  I couldn’t walk. My legs were rubber.

  ‘Deary me,’ said a voice, the commandant’s.

  Now I was in the doctor’s room, laid out cadaverously on a long white table. The table had joints, and could tilt up and down as required, and now I was being tilted backwards, my head hanging towards the floor. ‘Let’s get your blood circulating again,’ said the nurse. ‘You gave us quite a fright there, you know.’

  ‘Fetch him some tea,’ ordered the doctor. ‘Plenty of sugar.’

  ‘I’d prefer coffee,’ I managed.

  Elena was on a promise. Her mother, widowed for five years but reborn as a result and full of adventure, wanted to see New York. She, Elena and Elena’s cousin were going for a full week. It was June, the perfect time to see the city.

  ‘You’ll be fine, yes?’

  I gave the answer that was expected, that I wanted to give, but by now I had been unwell for six months. I had adapted accordingly, and in this way found that I could manage, more or less. Life had shrunk. In many ways, the recession the country was going through had played to my favour: there was no money to send journalists all over the world any more, and so instead we were being reintroduced to the marvels of the telephone, and its 21st-century upgrade, Skype. Now I could to all intents and purposes meet people from every country on earth while never leaving my room, and never changing out of my sweatpants.

  I missed the perpetual thrill of being somewhere else, but I did not miss the jet lag, nor US customs, and besides, I was not yet being denied work. There was always an endless stream of visitors to London, and so I could meet people here instead. If there was less work, that had nothing to do with my being unwell; things were changing, everybody was having to make do.

  Several times a week, then, I would take public transport into town for work appointments, now resisting the temptation to cycle everywhere but instead restricting my movements accordingly, and conserving what, it was now clear, were my fast-diminishing reserves of energy. I would arrive home tired, but fine. I began to rest more, to take things slower. It enabled me to cope, and I needed to cope. My swimming trunks had been put away, at the bottom of a drawer, and with them any semblance of a daily fitness regime I may have had. No more would my wife compliment me on my swimmer’s shoulders, but then she had only ever done that once, and even then it wasn’t really a compliment, merely an observation. Beneath my sweatpants, meanwhile, my calf muscles were growing softer. If I cycled at all now, it was for no more than a few minutes, either to the school to pick up my eldest daughter, or to the train, for which I no longer ran; if one was already on the platform as the station came into my view, I would resolve to miss it. How hard could it be, really, to wait 15 minutes until the next one?

  Weekends had become quiet, spent here, at home and in the neighbourhood, where there were more than enough shops, if shops were what we craved. Everything else could wait.

  That last round of blood tests, all six test tubes’ worth, had come back negative. On paper, I was an advert for radiant health. The doctor, by now frustrated by her inability to offer a clinical diagnosis, referred me to an immunologist. I did not know what an immunologist was, but it put me in mind of tropical diseases. What would an immunologist want with me? A letter came from the hospital in due course, informing me that my appointment was three months away. It was scheduled for the third week of June. Elena went to New York in the second week of that month. For six days, I would be a single parent, which in my current status would prove a challenge. But then I have always liked a challenge.

  Something unexpected happens within the family dynamic when one parent is out of the picture. When there is only one of you, the children can no longer play one off the other, and so the fireworks that can so frequently detonate remain largely dormant. In its place is a most pleasant, if surely temporary, synergy.

  The six days we spent together were lovely. We all missed Elena, but we spoke to her regularly on the phone, and the photographs she emailed back suggested they were having fun. Amaya and Evie, then five and three, ate dinner every night without complaint, and fell asleep after the bedtime story far quicker than I had been anticipating. Even the arguments they had fizzled out quickly. I enjoyed their company, and looking in on them last thing at night, fast asleep, mouths open, limbs akimbo, I felt the fiercest, most prideful love for both.

  But the physical requirements took a lot out of me, those perfunctory day-to-day trials that face any parent: taking one child to school by bike, and then another, by bus, to the crèche, the journey invariably delayed because three-year-olds dawdle, stop and sniff en route like dogs do, the round-trip taking an hour and a half. Then repeated at 3.20, arriving home in time for a dinner that needed, quickly, to be cooked.

  They were in bed by 7.45 and, if I was lucky, asleep by nine. By nine, I was catatonic, my limbs unaccountably heavy. I laughed this off, embarrassed by it. Parents, single parents, do this all the time; my own mother did. Tiredness was nothing to be overly concerned about. It’s what sleep was designed to help alleviate. And each night
I would sleep very soundly indeed. But I would wake each morning desperate to sleep more.

  At the weekend, there were parties to take the girls to, and presents to buy for both to take with them. By the end of Sunday, an eventful day that comprised broken crockery, an argument with a train driver, tears and laughter, I sat on the sofa alone, the girls asleep upstairs, and attempted to tune in properly to what my body was trying to tell me. I did not yet recognise its new language, but was aware at least of a cacophony. It is not enough to say that I felt tired. It was more than that, deeper, more profound, quite terrifying. I barely had the strength to reach for the remote control. My bed, a flight of stairs up, was unthinkable.

  Elena called from JFK before boarding her flight.

  ‘I know I’m always complaining about being tired,’ I told her, ‘but this is different. It’s . . . more.’

  She would be home shortly after dawn. I was glad. I needed her.

  A week later, we visited friends in Wales. I didn’t much want to go, but it had been scheduled. Wales was hilly. Physical exercise would be required.

  On the Saturday, after lunch, we walked down one very steep incline, past fields dotted with sheep and horses and assorted Welsh people. The girls complained all the way. Their legs hurt; they were tired. You’ve seen one sheep, you’ve seen them all. Our friend suggested he walk back up to the house alone and fetch the car to bring us back. I rolled my eyes and tutted. Kids, eh? We both laughed. But once he had gone, I crouched down and hugged them both in gratitude. I wouldn’t have been able to make it back up the hill either.

  A few days later, I would see the immunologist. I was looking forward to it. He would be able to pinpoint what was wrong with me, and tell me how to get better. I’d had enough of this ongoing exhaustion, the nagging sense of a forever-encroaching flu. It got in the way of everything, it was boring, tiresome and dull. But tomorrow I would have a plan, a diagnosis, a course of antibiotics perhaps, magic pills, light at the end of the tunnel.

  What I didn’t know, what I couldn’t know, was that by 10 o’clock tomorrow morning, everything would change and, somewhat melodramatically, life would never be the same again.

  Two

  My appointment with the immunologist is for 10 o’clock. I will have dropped Amaya off at school by 8.55, and the hospital is barely a 10-minute ride away. Under normal circumstances, I would have cycled home first, done a bit of work, and perhaps played a quick tournament of 8 Ball Pool on the iPad – two tournaments if I didn’t win the first – then left at 9.50. But under normal circumstances, I wouldn’t have been seeing an immunologist at all.

  And so I decide to cycle slowly straight from school, a journey that takes me through a cemetery and up an unavoidable hill. I try to ignore the fierce asthmatic burn in my chest and the tremble in my legs as I lock my bike and orient myself.

  Inside the hospital, the corridors lead to more corridors, which lead to a lift, a crowded reception area and a waiting room whose walls are the colour of oatmeal. While I wait, I wonder whether I should be nervous. I am in a place full of sick people, after all. Down yet another corridor, there is a series of doors into which people disappear when they are summoned; I do not know which of them are going in to see my doctor, whom I shall call here Dr Dolittle, if only because for me that was what he did do: little. From the looks on the faces of some of them afterwards, I realise that they go in as people and re-emerge as patients, their eyes downcast, a look of either grim determination or bewildered shock on their faces. I close my book and wait anxiously.

  Eventually, my name is called, reliably mispronounced. Dr Dolittle is tall and pleasant-seeming. Like the doctors on television, he wears a white coat. It flaps around his grey trousers as he moves swiftly from the door to his chair. His office is small and narrow, more oatmeal on the walls, a window that looks out onto nothing much of anything. He tells me to sit and, multi-tasking already, suggests I tell him what is wrong while he reads through the notes sent to him by the GP. He nods a lot, and makes an agreeable sound from the back of his throat that I find soothing. He asks if I have undergone any emotional fallout. A death in the family? How is my marriage? He asks what I do for a living, and looks up when I tell him. He asks how one goes about getting a book published – he has an idea for one – and so for a while we talk about this instead.

  Then we get back to the subject at hand. To illustrate the limitations of my mysterious condition, I tell him what I did yesterday, that I had four jobs, all in town, with ample time to get from one appointment to the next. But because I haven’t been feeling very well of late, I did not rush from one to the next, and did not take unnecessary diversions. I didn’t hire a Boris bike and cycle over Tower Bridge for the sake of it, or phone a friend to meet them across town for a quick sandwich. Instead, I sat in cafés alone, pacing myself, conserving energy. I tell him that my condition has required me to take things slower, and that I tire easily. These are not pleasant sensations, and it doesn’t suit me, but I have almost learned how to operate, and exist, at this temporarily slower pace.

  This prompts more noises from the back of his throat. A good sign, I decide.

  ‘I must say,’ he says, apropos, as far as I can tell, of nothing, ‘you don’t strike me as particularly depressed.’

  ‘No,’ I agree.

  ‘Because that’s what we normally look for in situations like this, where the condition might be chronic fatigue.’

  The two words fall with a thunk at my feet, like a dropped bag of potatoes. Chronic fatigue. Which means what, exactly? Very very very tired? This is the first time anyone has suggested this, with specific reference to me. Instinctively, I shirk from it. It is a label that won’t stick. It has nothing to do with me.

  ‘Or ME, as it’s sometimes also known, although the two are quite different.’

  He asks if I sleep well, whether I am good at relaxing.

  I have heard of ME, or myalgic encephalomyelitis, before, of course. It’s a relic from the ’80s, yuppie flu. All in the mind. It doesn’t exist, not really. Not a medical condition, per se. Afflicts the highly driven, the rapaciously ambitious, those who still believe that greed is good.

  He asks if I have ever considered yoga. And then he says: ‘Could you afford to stop working and live on your wife’s wages for a year?’

  I look up at him now, confused at what he has just said, and at what I think my ears have just heard. He is still taking notes, pursing his lips, and smiling, perhaps to himself.

  ‘No,’ I reply. ‘Why? Do I need to?’

  He laughs. It had been a joke, just a joke. I didn’t get it. ‘No, no,’ he says. ‘Just a worst-case scenario, that’s all.’

  More notes now, eyes cast down on the page, and he says to me that in his experience such conditions are usually linked to emotional issues. He reiterates that I don’t appear to show any signs of depression, so maybe it is something else, but my symptoms are nevertheless consistent with some form of fatigue. And if fatigue persists for more than six months, and mine has, then it is given the awful appellation chronic.

  I have been with him for 10 minutes now; I see him glance at the clock. Turning to me, he offers his diagnosis. I have post-viral fatigue. The virus – flu, presumably – has been in my body for many months now, I have proved incapable of successfully fighting it, and as a result it has worn me comprehensively down. My body needs rest until it can be fully free from the virus. There is no definitive way of telling when this might be. He says that it is important for me to walk at least half an hour every day. Graded exercise therapy, he calls it. And if I can’t do half an hour, then do at least 15 minutes. ‘This,’ he stresses, ‘is important.’

  Sitting in my chair by his desk, I feel six years old again. I am confused. Why wouldn’t I be able to walk for half an hour a day? I have just told him that I had been out for hours yesterday. I want to tell him this, remind him, ask him to explain more, but my time is up. He stands, chuckling good-naturedly, and leads me to the door.


  ‘You’ll be fine,’ Dr Dolittle says, a paternal hand on my shoulder. ‘You’ll be fine. But do some yoga! And relax!’

  He gives me a sheet of paper advertising CBT classes at another hospital for sufferers of ME and chronic fatigue syndrome (CFS), waves me goodbye, then ushers in his next patient, a young woman who doesn’t make eye contact with me as our paths cross.

  I cycle home, downhill all the way. It’s a busy day, two deadlines outstanding, but before starting work, I google those threatening acronyms, ME and CFS. ‘Significantly debilitating’ are the first two words that stand out from the screen to catch my eye. Bad Google; I had been hoping, inexplicably, for a little moderation in its explanation, not shock tactics. ‘No known cure’, I read, by which time my eyesight is failing me, lightbulb flashes exploding in my retinas. I read on. Because everything we experience now must be filtered through the world of celebrity, I find myself scrolling through a long list of famous people who have had it: rock stars and film stars, writers, actors. One describes it as ‘a living hell’. Another has not been able to leave her bedroom for over three years. Another still requires the use of a wheelchair. I am skimming now, unable to take in a sentence to its full stop, palpably terrified of what I might read next. More than a million Americans have it, 600,000 Brits and rising. The ‘total annual cost burden’ to the USA is around $24 billion. I see endless entries that feature the word ‘controversy’. This is an illness, a condition, that seems to make a lot of people angry, reactionary, even murderous in intent.

  By the time I find another reference to it having no known cure, my right hand is grappling for the mouse and clicking away. I will not be googling this again. I put it out of my mind. There is work to be done, lunch, the school run, a resumption of my normal life.