by James Hannah
“I don’t know. It’s just… I’ve not met anyone who I can relate to. Everyone seems happy to do the robotic thing, treat all the patients like units.” You rake your hand down your face, pummel your eye sockets with the heels of your hands. “I mean, I feel terrible saying it, because here I am, I’ve spent all this money, and you’re being amazingly patient about the whole thing, and I feel like I’m wasting your time.”
I gaze at you, trying to digest everything this means.
“I keep thinking this is not what I went into nursing for. I wanted to make a difference for people, to treat people like humans. But if I ever say anything like that to any of the other students, they look at me like I’m insane. It’s so tiring. More tiring than the actual work.”
Now it’s my turn to stroke your back.
“I just feel like I’ve been so naive about it.”
“Listen, I don’t think you’ve been naive.”
“I’ve been really naive.”
“OK, you’ve been really naive. But all this stuff—at least it’s going to show you what you don’t want to do.”
“But I don’t want to spend three months away from you, feeling like a leper.”
“You’re not a leper, just because everyone else treats you like one. That’s their problem.”
“But three months of it.”
“It’s not forever,” I say. “Look, sleep on it. But I don’t want you to ditch your career just because I’m a walking nervous breakdown. It’s not fair on either of us.”
You pull in and arrange your limbs around me, delicately avoiding my stomach.
“I’ll sleep on it.”
“Good.”
“If I go, are you going to be sick for the whole three months?”
“I’ll be fine. I’ll work. I’ll watch TV.”
“You’ll use the time to do something amazing and creative, I know it.”
“Yeah…I don’t know about that.”
• • •
Ffff—fuck it: press the buzzer.
Push the button to the click.
Ffffff—Jesus, the pain of it.
Ahhh. Sssssurges.
Is this it? What if this is it? This could be it. This is definitely it.
No, no, ridiculoussss.
Oh, all I can think of is you. I love you, I love you, I love you, if this is the last thing I think, I’m so, so sorry, and I love you.
Calmness. Positive thinking. Put it in context. Concentrate yourself away from pain. Walk away from it.
It’s not pain; it’s sensation. It’s—
Owowowow. It’s making me almost laugh with pain.
No, not laugh.
Sheila appears quickly at the door.
“What’s the matter, Ivo? Are you uncomfortable?”
“Yes, yes, pain…just here…”
“Down here, is it?” She lays her hand flat on my lower belly, gently, gently.
“Mmff.”
“Mmm-hmm.” She steps back and checks my chart. “When did you last pop to the bathroom?”
“Mmm—two days.”
I wince again as another surge of pain flashes across my middle.
“OK, OK, lovey. Now, I want you to keep calm, OK? We’re going to get this all under control. Do you trust me?”
“Yeah.”
“Dr. Sood’s in this afternoon, so I’m going to fetch him to take a view.”
As I watch her leave, anxiety seizes my stomach, and the pain lashes back, another whipcrack. I don’t want to be alone—I don’t want to be alone if this is it.
It’s unbearable.
Positive thoughts.
Come on, come on. Think it through, carefully, calmly, calm, calm.
Is it pain anyway? Am I weak? How would I know? Maybe it’s not pain. Maybe I’ve never been in real pain. Maybe only the pain I’ve seen in other people has been the real thing, and I’ve only ever imitated their sucking of the teeth and wincing and cringing and sighing and huffing.
No, no. Calm it. I’m not in pain. Not real pain.
If I were dying, it would be the worst pain imaginable, surely. Is this the worst pain imaginable? No, it is not. What shall we call this? We could call it taken-abackness. It’s like when my knee clicks, or…or when my coat pocket catches on a door handle as I’m passing through and I might say “ow,” and I give off many of the signals of having been in pain. But it’s not pain, is it? It’s just being taken aback. Surprised.
And anyway, they don’t let you feel pain these days. They give you drugs. Like they gave Old Faithful drugs. They don’t let you feel the pain.
Thank God.
Ffffff. “Yeah, he’s in here.”
Sheila enters the room all businesslike, Dr. Sood in tow.
“Good afternoon,” says Sood. “How are things with you today? I gather you’ve been in a little discomfort?”
“Severe headaches,” says Sheila, “shortness of breath, anxiety over…a number of personal matters. And sharp abdominal pains.”
“Mmm.” He cocks his head to one side. “How’s your vision?”
“Light hurts.”
“Breathing is still troubling you, yes?”
“I cough a lot.”
Nice Dr. Sood. He’s calming in a rapid sort of manner. He talks in an efficient, quick, and minimal way. His mouth clicks form an integral part of his speech pattern. To the point, but kindly enough.
He turns to Sheila. “Any general feeling of panic, of distress, or anything like this?”
“We’ve been using oxygen for a few days,” says Sheila. “Regular shortness of breath.”
“Any improvements?”
“Nothing substantial.”
This seems to push him into some kind of decision.
“Hmm. I’m wondering whether we should be administering relief for these symptoms. We can take care of the pain here in your abdomen. But we also have to consider any sort of panicky anxieties you have been experiencing. We could be administering a morphine solution, which should take care of the worst of it and give you a little more space within yourself to control these symptoms better.”
“Morphine? I’m not ready for that, am I?” I look at Sheila. “I don’t think I’m that bad.”
“Well, one of the things we are watching in a case like yours is the contamination of the bloodstream with toxins such as potassium. Do you understand? And the buildup of toxins often leads to an increase in anxiety and irritation in the patient, and, well, if the symptoms are as we believe them to be, then you might find that a mild solution can help you—”
“No, thank you. No.”
I’m surely not far gone enough for morphine, am I?
No, no. I’m not dead yet.
“I just need a little something to…take the edge off.” I look up at Sheila hopefully. “Just a little something.”
“Well, as I say, we can get you some relief for your abdominal pains, which we can probably put down to a spot of trapped wind in your intestine. Sharp, sudden pain.”
As he says it, another flash of pain darts its way through my belly.
“Trapped wind? Seriously, it’s—ffff—it’s really, really bad. I’m sweating here. I’m sweating. It’s—ffff…”
“It can get like that, honestly,” says Sheila. “And it’s to be expected. I’m going to get you something to relieve that, OK?”
“OK. Yes, please.”
“And you do not want the morphine solution?” says Sood.
“No. No, thanks.”
“May I ask why?”
“I don’t want to go there. I…I don’t want to.”
“Addiction is not an issue, if that’s what you’re worried about. It’s entirely up to you and how you would like to handle your symptoms, but just so long as you are aware of the
options available to you. I’d like to register with you the fact that I think a solution of morphine would help you along, ease your symptoms to a point where you’ll be in a good deal fairer fettle than you are now. So I’d like you to bear it in mind going forward.”
The two of them depart, Sheila with a little wink, Sood off to the patient he had come to see in the first place. I’m left here with his final words in mind. Going forward.
Going forward?
To what?
Tell me this is not trapped wind. Trapped wind can’t be this bad. It can’t. Old Faithful’s dead, and I’m here wriggling around with trapped wind. I really hope it isn’t trapped wind.
No, I really hope it is trapped wind.
Sheila returns alone, rotating a small, rattly white box around and about in her hands, trying to find the best way of opening it.
“Here we go now. Don’t worry. It’s nothing we haven’t seen before. Fact of life, isn’t it? We’ve got some suppositories here, joy of joys. They’ll encourage the muscles in your lower intestine to start working a bit to try to help you go to the toilet, all right?”
“Right.”
“Would you like to pop this in yourself? I mean, I can—”
“No, no, fine. I’ll do it.”
“Here you go. If you head over to the toilet, unwrap it, pop it in pointy end first, and wash your hands after.”
She helps me down from my bed and across the room—and I need it.
I need the help.
Jesus.
I try to take in a breath but fail. Cough more, but stop short in pain.
“Oh, you’re all right, lovey. Not at the end of your tether yet, OK? You’re doing very well. Now, you might want to run it under the tap a bit first. I’ll be standing out here, so give me a shout if you need me, won’t you? Don’t be embarrassed. Easier said than done, I know.”
I shuffle into the tiny bathroom and turn to face the mirror. My eyes have yellowing whites, red around the rim.
This is it. Another intestinal episode. The day I thought I was going to die, and it was just a tummy ache.
I am pathetic.
Sheila takes me by the arm as I emerge from the toilet and bears me over to the bed. An old man.
“There you go,” she says tenderly. She fetches me a small paper cup of pills and pours me a glass of water. I throat the pills and shift them with water, shake my head to persuade them down. “That’s it,” she says and smiles. I sit back on my pillows, which she fluffs up behind me. She picks up your blanket from the end of the bed.
My blanket.
“Here you go, lovey.” She drapes it around my shoulders. It feels heavy and comforting, like a hug. “Just imagine those pills working their way up to your head and spreading their magic. And that suppository freeing things up in the opposite direction.”
“Yeah, yeah. Thanks.”
“Now bear in mind you might be taken a bit by surprise at how suddenly it works, all right? So I’ve left a pan by your bed in case you don’t make it. And I don’t want you getting all anxious about that. It’s there to be used, so use it if you need it, OK?”
“OK.”
She looks at me and tuts to herself. “Listen, lovey, I’m not here to twist your arm, but are you sure you’re doing the right thing about the morphine solution? It’s really very mild, and I don’t want to see you distressed. There’s absolutely no need for that.”
“I’m fine,” I say. “I need to stop being pathetic. Get my mind under control.”
“Well, that’s what the morphine would do—give you a bit of space upstairs.”
“Like you say, let it go, get a bit of perspective. I can do this. Mind over matter. Just—are you sure, are you totally sure there’ll be no visitors?”
“Everyone’s aware; all the checks are in place. I’ve left strict instructions with Jackie to make sure everyone signs in at reception, all right, lovey?”
“All right. Thank you.”
“Only…do me a favor. If you want the morphine, go ahead and take it. You don’t get extra points for style in this game.”
“No, I know.”
“Now, have you got everything? How are you progressing on your alphabet?”
“I’m up to the letter I.”
“I? Well, it’s staring you in the face, isn’t it?”
“I’ve thought about intestines.”
“No—insulin.”
“God. Is that an acceptable part of the body?”
“Yes! It’s a hormone, isn’t it? The main thing I remember about it is that it’s produced in your pancreas by the islets of Langerhans.” She draws her arms out wide in a romantic gesture. “It might be my favoritely named part of the body, the islets of Langerhans… And it comes under I. How about that?”
I’m not convinced.
“It’s interesting, though, isn’t it, all the different hormones and potions your body is able to produce, just like that? Amazing, really. That’s what medieval doctors used to think: your whole body was governed by humors. And if they got out of whack, you’d get ill. It’s not that far off what actually happens with your insulin.”
“Yeah.”
“And it makes you think, in a thousand years’ time, they’ll be thinking, What? They used to inject people? In their veins? Seems barbaric.”
Insulin
OK then, OK. Insulin. Another I. The I that defines me. Who would ever think that something as tedious as insulin was ever going to be their biggest enemy? No one. People go through life thinking everything’s going to be fine… No one can be on guard against everything. It’s a slippery slope. So do what I did and be on guard against nothing. Another slippery slope.
Here we go: life is a snowcapped mountain, and all you’ve got to do is choose which direction your slippery slope is going to take. I say choose the sunny side.
They always told me there was nothing I’d done wrong to stop my body’s natural flow of insulin. Not like some people who could never gain control of their weight in these high-sugar, high-fat days. But thinking about it, I don’t think the Mars bar and the pint of Coke I used to have for breakfast every morning in the school holidays will have helped. That must have been a major trauma for the old islets of Langerhans to cope with. Brilliant times, though, at home with Laura while Mum was at work.
I remember saying to her, “Does Coca-Cola really have cocaine in it?”
“Yeah! Yeah, it does. Like a Mars bar has bits of the planet Mars in it.”
Then, at nineteen, the insulin dwindled, and that was more or less that.
My pee started smelling like Candy Hearts.
I couldn’t keep the weight on.
So I got my diagnosis, and the doctor gave me my little pouch with everything in it: the blood sugar tester and the injector pen and the insulin and—
Me, my body; my body, me. I’m all the same but not. I didn’t want it to happen like that. I am my mind. Not my body. But it was like my body wouldn’t let my mind get away with it.
Mum’s still in her work coat, sitting next to me on the sofa. I’m trying to watch the TV, but she’s flipping noisily through Diabetes magazine, which she’s insisted on subscribing to. I think she thinks I’m going to have a look at it, but I look at the cover and it leaves me feeling tired. Static smiling people of mixed ethnicity. They’re happy because they have diabetes in common. Ha ha ha.
“You’ve got to stay on top of it though, kiddo,” she’s saying. “People go blind,” she says. “They lose feet.”
I look her directly in the eye, and I don’t know why, but I start to laugh.
“What?” she says, starting to laugh herself. “It’s not funny. This is serious!”
“I don’t know. It’s…it’s funny for some reason,” I say. “Losing feet. Seriously, Mum, don’t worry about it. I can look after my
self.”
Every night after that, she would say, “Have you got your insulin?”
“Yeah.”
And if not: “What would you do without me, eh?”
• • •
These early evening preloading sessions around Mal’s are getting out of hand. I’ve landed back in the habit with you away on your work placements, because there’s nothing else for me to do. But when you’re actually in-town-but-impossibly-busy, I sometimes think I’d rather be watching TV in bed while you revise at the desk. But you won’t have any of it. I only come over to Mal’s out of something like politeness. Politeness to you and to him.
“Now,” says Mal, “what have I got here?” He roots around in his jacket pocket and retrieves a twisted little plastic bag. “Here, man, look.” He jiggles it enticingly and grins.
“Fucking hell, what is that?”
“What do you think it is?”
I look closer, at the powder, and I don’t want to say it in case I sound stupid.
“H,” he says.
Mal’s car.
It’s the best option.
I clamber and collapse into the back on the driver’s side. Mal swings the front seat down, locks me in. Claustrophobia quickly starts to squeeze my chest. I need to get out; I want to get out. But all exits are blocked. Becca has settled in beside me, and Laura in front of her. Surrounded on all sides with the windows steaming up. No way of opening them. No way out the back.
C’mon, put your seat belt on.
Under way, rubber rumbling on the asphalt through town as Mal manhandles the gears upward, we’re all thrust backward and forward as his feet push the pedals, side to side on the say-so of his hands. I’m fumbling for the seat belt, but I can’t focus. I can’t…get… I don’t know what’s the lack of insulin and what’s the drug, but I’m coming down now; it’s all starting to feel more familiar. Worse than familiar. Yank again at the seat belt but the safety lock’s locked. It’s too awkward, too hard to do. I’m going to leave it off.
Straight orange wash of streetlights replenished on Mal’s seat back, wiped out over his headrest, banished by the black, over and over in rapid rhythm.
Are you good to drive?
Yeah, I’m good to drive.
You’re sure?