XI
Caitlin said abruptly, ‘Tell me a goodnight story.’
‘What sort? Detective? Thriller? Love story? Horror?’
‘Mm … all of the above. Only it has to be a musical.’
‘OK. I’m going to bore you to sleep. When your eyelids close, don’t fight it. And don’t complain about my singing.’
She snuggled down, gave her pillow a punch, and turned on her side. ‘Begin.’
‘This is the story about the inception of a musical virus, the provenance of a pathogenic theme.’
‘Oh.’
‘Once upon a time there was a famous Russian virtuoso pianist named Yevgeny Poporoffskiovich.’ She giggled. ‘He came from a background of faded gentility in Vladivostok where his father was a retired captain of the Russian navy, and his mother was a music teacher. You might think a naval captain married to a woman of some cultivation and artistic refinement would run a splendid household, but the fact is that Captain Poporoffskiovich’s old submarine, The Professor Multinowski, was a rusting hulk listing in the shallow waters of the harbour at Vla, quietly exuding plutonium 238 into the bay. He had not received his naval pension for six years and Captain and Mrs P struggled to feed, clothe, and shoe their nine children, of whom Yevgeny was the youngest. Their sole income came from the meagre fees Mrs P charged a handful of local families who sent their children for piano lessons. Mrs P taught on an old Broadwood upright which was the P family’s only cherished material possession. They were caught in a terrible poverty trap, the more so as they, along with everybody else, had to pay protection money to the head of the local mafia, a man with a hair lip named Schplizki who chewed tobacco, played backgammon, and was, incidentally, tone deaf.’
‘Why do I get the feeling you are making this up as you go along?’
‘In this self-evidently desperate situation, the Poporoffskiovichs’ sole consolation and only hope lay in the glittering talent of the young Yevgeny. Mrs P knew her last child had an unusually penetrating musical sensibility. Yevgeny had breast-fed so placidly to the sound of the Broadwood even when played by her more modestly talented pupils. From the age of twelve months, the child would sit on his mother’s lap and tap out ancient Russian folk melodies with a chubby finger.’
‘Bollocks.’
‘In no time at all he was playing a Ravel concerto with one hand tied behind his back.’
Caitlin blew a sleepy raspberry.
‘Mrs P was obsessively protective of her son’s prodigious talent. She wished it to be unsullied. In this regard she was rather precious. The equivalent in our culture would be a woman of the middle classes who strives so hard to keep her child away from germs that he ends up with milk intolerance, food allergies, and then asthma. She kept music that she considered second rate from his ears. Folk melody was all right, but nothing that could be considered anarchic. Nothing for which the pianist might forsake a straight back in favour of a slouch. Nothing with attitude. She was particularly frightened of Bill Evans. Look what happened to him.
‘Meanwhile, the economic situation in Vladivostok was getting out of hand. All of Mrs P’s students had quit piano and were working for the town’s Mafiosi as drug peddlers, gun runners, and pimps. Yevgeny’s oldest sister was working in the local brothel.’
‘I don’t think this is a very nice bedtime story.’
‘There was no alternative but to pack the young Yevgeny up and send him to Moscow and then to the Paris Conservatoire to earn his fortune. So they deposited him in a 3rd class carriage of the Orient Express with nothing but an old samovar, a live chicken, a dog-eared Urtext edition of Debussy’s Images – première série, and a letter of introduction to Nadia Boulanger.’
‘Nadia Boulanger? Thought you said there was plutonium in the water at Vladivostok.’
‘Madame Boulanger lived to a ripe old age. In Paris, the young Yevgeny was lionised. With his long wavy hair and dark brooding looks his was a commanding platform presence. He was soon the darling of the concert-going public with his dazzling interpretations of Scriabin and Rachmaninoff. Soon, Yevgeny found he was able to command appearance fees of the sort enjoyed by film stars, international icons, and a handful of superstar operatic tenors. He married a diva, bought a villa in Lucerne and a pied-à-terre in Chelsea, signed a recording contract with EMI, and founded a dynasty.’
‘What about poor Mrs P?’
‘Yevgeny never forgot his family. He sent monthly sums back home. He offered to rehouse them in Switzerland. You can solve any immigration problem in Switzerland with a fat bank account. But Mrs P would not budge. She had become chairperson of a local self-help group in Vladivostok and had decided to take on the protection racketeers. Would Yevgeny come home and play just once for the community? No he would not. He would not go back east, to remember what it was like. Instead, he appeared with his wife the diva at an Aids charity event in some posh hotel in Los Angeles. Rich men in tuxedos, ladies in glittering gowns, $3000 a ticket, you know the sort of thing. The diva was going to sing something from a Broadway musical. Yevgeny was to accompany. Thanks to his upbringing, he had never heard of the song, the musical it came from, nor its renowned and eminently successful composer. You must understand that Yevgeny was like a man who had never seen a television set. You might pass a remark about Coronation Street or EastEnders, and he would look at you as if you were a Martian. At the back of his mind he had the nagging suspicion that his mother would not approve. “You play this pap for these bourgeois, yet you will not play music here, for your people, uh? Is that it?” Yet he consoled himself that the song they were to perform was based on some poems by a great American poet. And after all, Aids research was a noble cause. They gave the performance.
‘And nothing happened. At least, not for a while. Then a trivial and amusing incident occurred during a rehearsal with the Cleveland at Tanglewood. They were having a run through the last movement of the Beethoven first concerto and as he embarked on the second subject, Yevgeny broke into that piece Gustavo Dudamel sometimes does as an encore with the Simón Bolívar, or the Teresa Carreño. El Sistema. They all put on gaudy jackets and look like Wall Street traders. Tico-Tico by Zequinha Abreu. Yevgeny stopped dead and stared, aghast, at his hands. There was a momentary stunned silence from the orchestra, a raucous belly laugh, and a spontaneous burst of applause. Well well! The Great Scowl had a sense of humour after all.’
Caitlin said, ‘I suppose you know you’re as mad as a snake?’
‘Later, seated alone in his hotel bedroom, he stared at his wayward, sinewy fingers. They had betrayed him. Nothing like this must ever be allowed to happen again. He made some heavy pencil jottings in the score.
‘But it was already too late. The virus he had picked up in LA expressed itself again in Carnegie Hall during the slow movement of Rachmaninoff’s fourth concerto. You’ve guessed it. Three blind mice. The mental aberration, the syncope of the musical memory, lasted barely an instant. Yet, barely audible, there had been a titter in the stalls. Next day he feverishly grabbed the review pages of the New York Times. Five stars. He had gotten away with it.
‘But the third time, there could be no cover-up. Complete calamity at the Wigmore. Beethoven again. The Opus 106. The pianist’s Nemesis. The slow movement of the Hammerklavier. Una corda, mezzo voce, appassionato e con molto sentimento.
‘Beautiful dreamer.’
‘Bonkers.’
‘He had become a musical vandal. An absurd Hoffnung figure. He immediately retired from the concert halls of Europe and, following an anguished sabbatical spent with a team of Viennese psychoanalysts in an Alpine sanatorium, he took to the conductor’s podium. His own technique, his unparalleled facility and execution, might have been permanently destroyed by the “gremlins of the trivial” – his own expression (or, as his analysts put it, gremsprechstimmeschaftgeschrottkitschgrübler) – yet surely he could wield a baton?’
‘Barking.’
‘Not so. Merely, his anguish was internalised. The angelic
sounds produced by the orchestra were not the ghastly, strident, screeching, and above all hideously chirpy tunes that now besieged his musical psyche and threatened to push him over the edge. Rachmaninoff’s Symphonic Variations became a Highland jig – “Petronella”. Shostakovich’s Easter Festival Overture, “Hold that Tiger”. The cadenza of the Elgar violin concerto – “It ain’t necessarily so”. The overture to Rossini’s early melodrama, Tancredi, “Lily the Pink”. And the final ecstatic movement of Ravel’s Ma Mère l’Oye …
‘“My Way”.
‘Yevgeny put away his baton. At first, people were kind. That was before Yevgeny became disinhibited. He attended concerts, struggling with the taunts of his internal, hallucinogenic Furies. He would cover his ears and accompany the orchestra with his own tuneless plaint that would inevitably degenerate into a popular song of the day. One night he was ejected from the Musikverein singing “Old Man River”. A trespass order was slapped on him. His wife had left him, he was bankrupt, his creditors had picked his carcass dry. He drifted to Paris and disappeared among the beggars on the left bank. He was in the gutter. His sole confidant was a penny-whistle-playing dwarf who led a subterranean existence in the sewers underneath Pigalle on the border between the ninth and the eighteenth arrondissements. He had reached rock bottom.
‘Then, one night, he had a terrible dream. His mother, old and white haired now, was singing a duet with the tobacco-chewing, backgammon-playing tone-deaf Vladivostok mafioso. It was unutterably kitsch.
‘“Mamma mia”.
‘Next day Yevgeny started busking with a mouth organ in the Paris Metro. A few commuters, putting him down as a pitiful psychotic, tossed a few centimes into a dilapidated cap. In about three months, he had enough to buy a train ticket to the east, to the ocean, as far as the line would go.’
You will know that Yevgeny and I are one and the same. I had committed the cardinal sin of any trafficker in reportage; I had become part of the story. Alastair Cameron-Strange glanced down at the figure under the white sheet and at the auburn hair splayed across the pillow. Caitlin’s breathing was even. He eased himself quietly out of the room.
… and slipped into the front room and for the first time in nearly a year, put a CD on. It was Cantos Sagrados, choral music by James MacMillan. The third track, A Child’s Prayer, some four minutes long, commemorates Dunblane. If this memoir, this confession of mine, has a sound track, then this is it.
All our young lives, MacKenzie and I, we had lived and breathed music. It seems to me that we were borne along in a tide of music. Music was nothing less than life itself, or an ultimate expression of it. And therefore the eschewing of music has to be a kind of death.
Sad music is an indulgence to the young. It is only later that some sadnesses acquire a particularity. There are irreversible sadnesses. I had wanted numbness, not, specifically, numbness against grief. Not even numbness against joy. It was numbness against loss.
15dn: Light music for
pinball (9)
XII
We were all on a retreat. Management had spent a huge amount of money getting cover so that the acute services could come off the floor and, indeed, off site, to indulge in something called ‘team building’. The deliberations of ELSCOMF were being rolled out. I had wanted to give my apologies and was prepared to offer any fabrication of an excuse no matter how outlandish – my twin sister had been in a plane crash, my sister-in-law was having a termination, I was having chemotherapy … but then I remembered we were convening in the Colin Maclaurin Conference Centre at Clerk Maxwell, so I put my hand up and got on the agenda.
The previous evening, I’d caught the late night news on TV and seen a brief clip – I’d often seen similar clips – of a white security van shooting out from a High Court underpass. Women bystanders were shrieking venom at the monster handcuffed within, while the press scrambled along beside the accelerating vehicle, cameras held up to tiny barred windows, snapping multiple exposures like machine guns. Click click click click click. A man was on trial somewhere in the north of England for the murder of a string of prostitutes. It happened periodically. Sharon Blakemore, Diane Penderton, and Seonaid MacAndrew. The names, the names! I always noticed the euphony of the names. And I thought, I might be in a position to thwart the activities of another monster. I need to go back over to Clerk Maxwell.
‘Dr Cameron-Strange–’ MacTaggart made no attempt to suppress a cavernous yawn. He adjusted his half-moons and read from the agenda, his voice heavy with the quotation marks of infinite condescension. ‘A new way of working. Your fifteen minutes await you.’
I took to the dais. I attempted to embrace the audience with a smile.
‘A new way of working indeed.’
There was a kerfuffle at the back. The techs couldn’t find my disc for PowerPoint. I called back reassuringly, ‘It’s okay. I’m not using visual aids.’ This did not relieve the consternation. They just didn’t believe me. My talk was disrupted by a totally irrelevant slide show cast mostly across my face as the techs flicked through the subsequent speakers’ material. I had the dawning suspicion that I wasn’t going to make a connection.
‘All over the world, people associate emergency departments with delay. If you have the misfortune to spend a Saturday evening in ED with a sprained ankle, it’s six hours out of your life. That’s just a fact of life. Gentlemen, I don’t have slides!
‘Those of us who aspire to run a state-of-the-art facility may look down our noses at more chaotic institutions. But you know, it’s schadenfreude. There isn’t an institution in the world has solved this problem. Not one. Would it be possible to turn that off?’
There was another distraction – the photographers. Always they take over. MacTaggart had organised them. There was going to be an abstract of the proceedings in the form of a glossy. It would be a plush job, extremely professional, and it would come out quickly. MacTaggart wanted visual impact. He’d given the snappers free rein. They went mad. They do the same at a wedding, monopolising the bride and groom and putting them through all sorts of improbable scenarios, chasing one another round trees, while the wedding guests gather at the bar, hungry and disgruntled.
‘I want to propose a model of working practice, a modus operandi, whereby, particularly when the department is pressured by sheer numbers, we can keep up. It involves a strict adherence of each individual member of the team to his or her specific role, and it is predicated on absolute trust among the team members.’
Two photographers had advanced down the aisle and were encircling me at close quarters, like big cats on the Serengeti isolating their quarry.
‘I can best describe the method in practice by following, if I may use that hideous expression, the patient journey.’
I could sense I’d lost the audience already. They were distracted. I glanced behind. There was a large ulcerating chancre on screen. I think a wrinkled penis was sprawled across my forehead and nose. I thought of having a tantrum, or walking out. No. Head down, get to the end.
‘We start with triage. Triage is not a consultation. Triage is not history and examination.’ I was lecturing them in a hectoring way I had not intended. ‘Triage is merely a snapshot.’ This, to the accompaniment of a firework display from the paparazzi. I heard a titter.
‘We must not be afraid of a mis-triage. Rather we must have systems down the line robust enough to up-triage, or down-triage, in a timely way.’
Now the sound system began to play up. I was getting feedback. An echo was reverberating around the hall like an air raid tocsin.
‘Next, a word on nursing care. Duplication of activity is the death-watch beetle of emergency medicine. In a specialty whose whole raison d’être is the race against time, don’t indulge in an activity which is better done by somebody else.’ I was dazzled by a flash at point blank range and I think it was maybe this that caused me to speak unwisely. ‘The nurses need to rediscover their traditional values, of kindliness and care. They shouldn’t be indulging in am
ateur doctoring. If they want to take histories and perform examinations, fine – go to Med School. Nurses need to rediscover how to nurse.’
I’d just lost half my audience.
‘As for the doctors, what we need, what I need, is to be freed up. I need to be able to move from patient to patient. The emergency physician is primarily a diagnostician. Indeed, he is primarily a history taker. The history is fantastically potent. Let a competent emergency physician take a history and 99 times out of a 100 he will accurately predict an outcome on that data alone.
‘History and examination are the bread and butter. I need to be able to perform these two tasks at the bedside and, on their basis, say to someone at my elbow, “Do this, this, this, and this.” And move on to the next patient. That way I can get round large numbers. When I return to patient A, like a grandmaster playing a simultaneous chess competition, this, this, this, and this are done. The position on the board has changed. I am able to make a revaluation, perhaps on the basis of test results. Treat, admit, discharge. This is what I do. On no account should I get bogged down with what the North Americans call “scut” work, taking bloods, putting up drips, filling in forms.
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