He hadn't said anything, but his expression must have been puzzled, because the sister continued without prompting.
"Consequently we've had to perform a tracheotomy. It's actually what we call a mini-tracheotomy, a very simple procedure done under a local anaesthetic. And it'll help us to draw off the congestion." The sister was being very matter-of-fact about what she knew must have been a further shock to Russell.
A few seconds later he was allowed to the bedside, his head like a balloon filled with scalding water, his legs trembling.
His mother's neck was covered in a mass of untidy sticking plaster surrounding one inch of plastic tube with a little pull-off cap attached. Just like you'd see on an inflatable beach-ball. A slimy brown film was drying on it, as if the nurses hadn't cleaned off the latest extraction of sputum properly.
Russell began to feel ill. Along with the new method, fluid was still being drawn off his mother's lungs from the nose tube, but it was now a dense black colour, as if her lungs were rotting away, turning into fecal slime.
He grasped her hand, more to take his mind off how he was feeling than to offer comfort to the unconscious patient. Under her skin he imagined he could see withered fatty tissues, the membranes connecting internal organs stretched and atrophied. Her rapid breathing was unchanged, the oxygen mask over her mouth and nose steaming up with each raspy exhalation. The flesh on her face looked as if it was sloughing off, drawn down around her chin, leaving the skin surrounding her eyes and forehead taut and skeletal.
She's dying, Russell whimpered to himself. The nursing staff must only have been telling him half-truths…
On Saturday, as he stared at the large, framed wall-mounting holding the photographs and names of the intensive care staff, one of the consultants came into the corridor where he was sitting.
"Ah, Mr Bray, isn't it?"
"Yes." He stood up.
"I'm Mr Hastone. I'd like to have a chat before you go through," he said, making Russell's heart plummet. He could not make eye contact, he was so frightened he would be unable to withhold his emotions if the news was bad.
"Did Mr Chambers explain to you about the operation and the after-effects?" he asked.
Russell nodded, trying to remember who Mr Chambers was. Numerous members of the staff had spoken to him over the last few days.
"Then you'll be aware that your mother's kidneys more or less 'shut down' after surgery?"
It had been explained to him that the shock of the operation to repair the aneurysm in her aorta, and the subsequent one following, had caused his mother's kidneys to stop functioning properly. That they'd ceased doing what they were supposed to do and it might take a few days for them to begin working again.
Now he knew something else had gone wrong.
"Mr Chambers has become very concerned that her kidneys aren't beginning to do their job sufficiently well to remove all the poisons in her system, and he decided she would need extra help. To give her kidneys time to recover without having the additional burden they have to contend with at the moment."
"Help?"
"So your mother has been put on a dialysis machine for the time being. We're not really equipped with the best here, but we do have a portable machine. We'll see how she progresses, but it may be that she'll need to be transferred to a hospital with a renal unit."
"Dialysis." Russell rubbed his forehead with the fingers of his right hand. There appeared to be an intangible ball of cotton wool surrounding his head, suffocating hearing, cutting off his vision and choking him.
The sight of the machine, with its aspirated sounds and the dark blood visibly pumping to and from it was a bad enough memory, but seeing his mother's feet was even worse. When he'd entered the ward, the blanket was loose at the bottom of the bed after being draped over a cage to keep her legs untouched. He peeped beneath and saw that the toes on both feet were a blotched and revolting grey-black.
What with everything else, he had been too terrified to ask what was happening to them.
On the way home rain was pummelling the pavements as if it wanted to indent the concrete. What it had succeeded in doing was soaking him so completely he knew it was foolish to have left home without an umbrella. After a few minutes walking, a cold wetness crept around his feet as if his shoes were filling up with chilled blood.
A month must have passed because, as he sorted mail, amongst the business envelopes was the plastic wrapped cover of another issue of Corpuscles. "Where are the living dead?" a banner headline shouted across its cover. Behind the red lettering lurked a mummified face from a film he did not recognize.
"In this place, Russ!"
Russell turned around, confused. Derek, one of his friends, with whom he'd spent his holiday, was looking over his shoulder. Russell realized he had been staring at the magazine and Derek had responded to the rhetorical question on its cover. His idea of a joke.
"Most of this lot," he nodded in general at his colleagues, "are more dead than alive."
"Right." Russell was in no mood for laughs.
"How's your mum?" Derek asked, changing tack and snatching the magazine from Russell's fingers and tossing it into a distant skip.
"She's holding her own," he replied. In fact he was unaware of whether she was nearer this life or the one beyond. What was almost unbearable was that, each time he visited the hospital, the news always got worse. So he never knew whether to believe and trust the doctors or not. And he found he couldn't talk about it to anyone.
"Bum deal," Derek said. "Watch out, here's the gaffer." He began to lift a sack and tip out piles of little boxes, groaning. "Why the fuck do they pack things up so small you can't even get a fucking label small enough to fit on 'em!"
He began tossing them without looking, accurately dispensing boxes, magazines and other envelopes into their appropriate containers.
Russell slid an elastic band off a pack of envelopes from the electricity board. The rubber smelled sickeningly familiar, the envelopes too, a sort of antiseptic tang.
"Why don't you take some time off?" Derek said, returning to Russell's obvious depression. "You'd get special leave," he added.
Russell knew he looked pretty washed out. He was existing merely to attend the hospital every evening, where he would remain for up to two hours mutely watching his mother fight for breath and for life..
"I'm better off coming in," he said. "I'd brood at home."
"Looks like you're doing that here," Derek stated. "Watch out, here's the gaffer."
Russell smiled at Derek's oft-repeated epigram.
At the end of his shift, the tips of Russell's fingers were numb from handling plastic envelopes that had begun to feel like living tissue. His fingers felt as dead as he knew his mother's feet to be.
Outside, the city centre looked changed. The rain had decided to let up, but the surface of the street was wet and gutters had become little rivers. It was the rush hour and the pedestrian zones were choked with shop and office workers heading for the bus stops. Russell felt sure they were mobile only because something else drove them, not their own desires. They were fulfilling a role, playing, unconsciously, the parts destined for them. This was a conclusion that had been forced upon him by the events of the last few weeks.
Hospital patients are like that too, Russell decided. They're unwitting actors, or movie stars, taking the stage for a day or two, swelling larger than life in the limelight of their disease, before vanishing into obscurity. And he knew them all in detail by now: the baby who'd swallowed a plastic top and nearly asphyxiated; the coronary patient on a ventilator; the car accident victim swathed in bandages; the vegetative sleeper for whom life may as well have already departed; and his mother, with a rolling panoply of complications, as if she played several parts in the drama.
He was waiting at the bus stop for home when he realized he should have been going to the hospital. He moved off, made uneasy by his forgetfulness. A hot dog man was serving through a cloud of steam. His customer squeezed
a bloody, watery line of red along his onion covered meat.
Russell turned away in disgust, heading for the bus he needed. His stomach growled for food, but he knew he couldn't eat yet. Not if he wanted it to stay down long enough to digest. His whole body felt raw, abused. As if he was starving himself.
He couldn't recall the details of his life over the past month. Memories faded in and out. He was dreaming his life, it being better than facing the truth, he could hear his mind telling him as if from far away.
At eleven-thirty he was trying to forget that the consultant was worried that his mother's circulation remained a serious predicament, slowing her recovery. She was in a lot of pain, despite the cocktail of analgesics she was being administered, and the pain was further disabling her recuperation.
Nevertheless, that evening his mother had briefly surfaced into consciousness.
Nifedipine, hydrocortisone, atropine. The words he'd sneaked a look at on his mother's chart became a litany, until he realized she was gripping his hand.
"Tell them to let me go," she hissed as he replaced the clipboard. Russell's heart swelled with hope, forcing tears into his eyes. He blinked them away as he stared at his mother. She was awake but, in spite of what she had said, did not appear to be aware of her surroundings or whose hand it was she held. At least the consciousness must mean she was beginning make progress.
He could not face telling her that her feet might have to be amputated. Yet her words hinted that she already knew. When she closed her eyes again he was saved from the necessity.
In his darkened living room, the picture on the blank television screen a reflection of his own vacant face, Russell convinced himself they were experimenting on his mother. The whole medical thing, from start to finish, was a sham. His mother was a guinea-pig. The intensive care unit was a laboratory. The doctors were testing drugs. The surgeons were performing vivisection for the gratification of their immoral souls. The machines that were keeping his mother alive were doing so only that more of the same grisly work might be accomplished.
The long road to the hospital entrance was a patchwork of autumn leaves, flattened by rain, patterning the paving slabs with brown and black blotches like rampant melanomas. The streetlamps highlighted other pedestrians skidding on the slimy mucus each leaf hid beneath itself; runny sores under scabs.
"Oh, hi! Russell Bray, isn't it?" The nearest skidder was a nurse Russell recognized as one of the ITU staff.
He nodded, unable to speak for fear of showing his emotions, knowing she was part of the conspiracy he'd finally uncovered the previous night.
"You might have to wait a bit this evening," she said, halting him with a hand on his arm.
"Oh?" His questioning voice was betraying his fear, but he hoped she wouldn't notice. If they knew he was on to them things could become awkward.
"There's a bit of a panic on in IT. Couple of emergencies came in. They're very busy," she added.
So why wasn't she there, helping them, Russell speculated. "Thanks for telling me," he replied evenly, trying to avoid her spectacled eyes.
"Watch the leaves!" the nurse stated as she stalked off, planting her flat-soled shoes firmly with each step. There was a sort of robotic motion to her walk, but it must have been the nurse's fear of falling over, and not some other vaguely mechanical workings of her body parts, that controlled her gait.
Russell ventured down the long corridor, past the coffee shop, past the chapel, past various wards announcing their function with bright red and white signs, until he turned familiarly, but uncomfortably, into the ITU reception area and waiting room. There was always an atmosphere of calm here, but it never relaxed Russell and never would now he was aware what was going on.
He lifted the phone and jabbed the button. In the earpiece he heard the echo of the distant buzzer. Seconds passed. The phone wasn't answered. He tried again, staring at the notice pinned to one of the double doors: "Absolutely No Admittance - Use Telephone". He looked from that to the photographic portraits of the staff. Some of the pictures had been removed, he saw, their names and occupations printed below blank rectangles, as if they'd suddenly been snuffed out of existence. Others continued to smile amiably, subtly concealing their real motives.
Replacing the receiver, he moved into the waiting room and sat down, intending to give himself five or ten minutes before trying the intercom again. Whenever he'd had to wait before, he always imagined the worst, but all that was happening was that his mother was undergoing physiotherapy, or some other treatment which they thought it better not to allow him to witness.
The magazines lying on top of an empty bookcase were so out of date they were thumbed to tatters, as if their covers were desiccated skin. Plastic flowers in vases looked as waxy as his mother's face. The notice board on the wall held the same information as always, advising visitors to wash their hands.
Yet, something had changed. Russell was unsure yet what it was. The two framed prints on opposing walls, one of two cute puppies, the other a pair of cute kittens, were both still askew. An oval red stain on the carpet, that must have been ink rather than blood because it had never faded, lured Russell's eyes. Every time he'd had to wait he stared at the stain, trying to see a pattern, as if it were a Rorschach test. Somewhere deep within its colour and the green of the carpet was encoded the real reason why his mother was being kept alive.
Above all he must remain controlled. He should act as subtly as the medical staff who were fooling him.
Then he knew. He walked out of the room and looked at the intercom phone on the wall. Its normally green light was red. It had never been red before. There might simply be a fault, of course.
Pressing the button again, he heard the familiar, distant buzzer hiss at the nurses' station. It sounded all right.
Yet the call remained unanswered.
Well damn the sign forbidding his entry. He looked the the blinking display on his watch and realized, dismayed, that he'd waited half an hour. That was plenty long enough.
He barged through the double doors, rehearsing his script for ignoring the mandate of the notice.
The corridor beyond was empty of life. The door to the office where he'd been informed about procedures was open. Russell peered in, ready with his explanation, but there was no one there.
He leaned his head around the entrance to the storeroom/kitchen next and saw that it was dishevelled. A tap was running into a sink unchecked and packages of dressings were strewn about the floor. An instrument tray had toppled off a table, its gleaming contents scattered amongst the dressings in a distribution reminiscent of hieroglyphics.
The emergency must be bigger than even the nurse had suggested, if the staff had found it necessary to treat the tools of their trade so carelessly.
Returning to the corridor, Russell finally came to the darkened ward. The lights were always kept turned low, but nevertheless he could not help feeling suddenly anxious at the ballooning shadows that lurked beyond curtains. There was an absence of the usual sounds. Not the bleep of a monitor, nor the swish of a nurse's starched uniform interrupted the silence.
At first this was all disorienting and unexpected. Additionally there appeared to have been some changes in the layout of the unit, particularly with regard to the whereabouts of his mother's bed. He was about to ask a member of the staff where they'd moved her to, when he realized there were no nurses, doctors, anaesthetists. ITU had become a medical Marie Celeste.
Russell frowned, aware that he was hanging onto the door as if in doubt about entering. His thoughts raced through a litany of words that he knew he must somehow suppress: inflammation, allergies, shock, coronary vasodilator, hypertension, sputum, gangrene.
Sweeping aside a curtain surrounding the nearest bed was both a reaction and an attempt to stem the tide of his thoughts, which he knew were turning themselves into an incantation. He knew what incantations were capable of, and how they led to unconscious acts, to a shackling of the will.
On t
he bed in front of him, a tube, ripped from some anonymous limb, squirted colourless liquid onto the sheets from the syringe pump to which it was attached. The bed's occupant must have been removed in a great hurry, perhaps for emergency surgery, and the nurse had failed to switch off the equipment.
A more sensible part of Russell told him they never worked like that. This place was so ordered. He was trying to work out what was happening, when a rustle of paper returned his attention to the vacant nurses' station.
He could see no one standing behind the high-fronted desk dealing with the paperwork. Perhaps a nurse had dropped a patient's notes and was bending down to pick them up? He walked back towards the desk, blinking, moisture swelling behind his eyelids, desperately wanting to know what had become of his mother and hating not having someone to comfort him.
A hand appeared, slapping against the telephone, bouncing the receiver off its cradle. The fingers looked odd and displaced and curiously transluscent before Russell realized why. The pudgy hand which appeared to be waving at him was that of a baby. Its partner rose into view, grasping the wooden ledge of the desk on its inner side. Russell was unable to see what was happening behind, in the rhombus of one of the ward's shadows.
He ceased walking towards the desk, fright halting him. There was a wheezy intake of breath, not unlike his mother's hideous gurgle, and the child's face was hauled into view by the pale hands. Its features were familiar; it was baby William, who'd come into hospital after swallowing a bottle-top, nearly choking on it. His rotund face still displayed a blue tinge from his near asphyxia. For the first time Russell took notice of the infant's eyes, which were unblinking, staring, but unseeing.
Shivering, Russell realized the baby was too young to have crawled, let alone walked, yet as this impossibility dawned, the child began to move along the desk, scattering papers and pens with its crab-like shuffle. In a moment it crashed noisily to the floor, but the fall did not appear to halt its forward momentum.
Stephen Jones (ed) Page 39