If They Knew

by Joanne Sefton

  She was still taking it in as she stepped back – the extra lines now attaching her mother to various machines, and the ominous red-brown stains on the bed. Then a woman in civvies – an open-neck shirt and some tailored trousers – turned away from the bed and stuck her head out of the room.

  ‘You must be Mrs Marsden’s daughter? I’m Rebecca Evans. I’m a consultant here. There’s a trolley on its way to transfer your mother to the intensive care unit. She should be fine, but we need to take the precaution. I’ll have to ask you and Mr Marsden to stand back please.’

  The woman gestured towards some chairs by the nurses’ station, but Helen had no intention of being herded off into a corner.

  ‘First, tell me what’s going on? This morning she was doing fine. They said she just needed to get the last of the anaesthetic out of her system. Surely she can’t have had a reaction this late?’

  The woman shook her head. ‘It’s not the anaesthetic. I can’t—’

  She stopped speaking as the main ward doors opened and two men wheeled a trolley through at speed. She waved her hand towards the chairs again and this time Helen stepped backward. Without even bothering to check if she’d gone, the consultant turned back to the bed, barking out incomprehensible instructions to the nurses and porters. The transfer was made in seconds, despite all the tubes and wires that Barbara suddenly seemed to have coming out of her.

  Three or four of the nurses hung back. Barbara was out of their hands now. The others advanced down the ward together, surrounding the trolley like it was some kind of battering ram, with Ms Evans setting a brisk pace in her low heels.

  The eldest of the ward nurses came over to where Neil and Helen were standing.

  ‘They’ll let you know when you can see her,’ she said. ‘Come into the office; that way we’ll be ready when they buzz for you.’

  She had a kindly, grandmotherly way about her, and they followed meekly, walking the length of the ward with the eyes of all the patients and visitors moving silently with them. Geranium Ward clearly wasn’t used to seeing much in the way of medical high-drama.

  Helen and Neil sat down and the nurse quickly left, saying something about getting someone to make them a cuppa. She seemed to recognise that they needed a bit of privacy. The office smelt of mints and bleach, with just the faintest trace of cigarette smoke. I’d take one, Helen thought, if someone offered. She’d not smoked since her teens.

  The wall was decorated with a single, faded Monet print in a Perspex frame that reflected all the movement from the ward. Life didn’t stop because of a visit from the crash team. There were still bedpans to be dealt with, antibacterial protocols to follow and endless charts to be checked off and stuffed back into their clipboards.

  ‘She was bringing up blood, Helen.’ Neil’s voice was low, and he looked at the floor rather than her. ‘Not just a bit – it was just gushing out of her. Coming from her nose as well, even one of her ears at one point.’

  Helen thought back to the stains she’d seen on the bed. How awful.

  She just couldn’t understand it. There had been no suggestion of any cancer in Barbara’s digestive system. No one had mentioned any side effects or surgical complications that could look like this. And it had all seemed to be going so smoothly, completely ‘by the book’, as they’d all been saying yesterday. She didn’t know what to say to Neil. She was the one who had read all the leaflets, gone online; she was the one who was meant to know what to expect, and nothing had – nothing could have – prepared her for this.

  There was a niggling voice in her head that said maybe there was a reason for that. Could it be that this was something more sinister than a symptom or a side effect? Jennifer, whoever she was, had promised to make Barbara suffer. And Helen doubted she’d suffered anything in her life like the last few hours. What if the notes weren’t just empty threats? What if this time Jennifer meant it for real? Helen felt giddy. Was she putting two and two together and getting eleven? Or should she listen to the instinct screaming at her that this was anything but an accident?

  She reached out for Neil’s hand, and he let her take it, though his eyes remained fixed on the tight brown weave of the carpet tiles.

  May 1990

  Helen

  Spike Island wasn’t actually an island. It was a bit of land jutting out into the Mersey estuary, with the St Helen’s canal slicing down one side and a great view of a power station. Helen’s heart thrilled with anticipation for the gig. The thing about Stone Roses songs was that they were totally different to any other music she’d ever heard. The guitar riffs didn’t play in her ears, they flowed through her veins.

  She gazed around at the mass of people, all heading in the same direction. Many had Roses T-shirts and, as the crowd thickened, older men materialised with armfuls of cheap knock-offs for those who didn’t.

  ‘Tenner a T-shirt, two for fifteen quid.’

  ‘Buying or selling, buying or selling.’

  Helen grabbed for Darren’s fingers as the crowd pressed in on them, but it was just a bottleneck and soon they were through and heading towards the stage. He dropped her hand so he could rummage in his pockets for Rizlas. She glanced at him, still struggling to believe that the fittest boy in the year had picked her. His T-shirt skimmed his flat stomach and broad shoulders, his dark hair giving just a hint of a shadow through the thin material. She felt her cheeks flush.

  The music from the PA was thumping, but nobody was dancing. Instead they sat or roamed around in little groups, checking their watches and shouting to their mates. They’d only come forty minutes south – the first time Darren had driven on the motorway by himself since he’d passed his test the month before – but somehow this felt like a very different place. The strangest thing, she realised gradually, was the accents. She’d never heard so many Liverpool accents before. These kids didn’t have the hard, nasal voices of the ticket touts, far less Harry Enfield’s slapstick Scouse. Most of them spoke in a gentle, sing-song way. It was nice. They sounded like her mum.

  ‘I wonder if there are any Kiplings here,’ she said to Darren, quietly.

  ‘What?’ He just sounded confused.

  ‘You know; my mum’s family that she never talks about. She’s got a Liverpool accent; if I’ve got cousins or whatever, they’re probably Scousers.’

  Darren pretended to scan the crowd. ‘Nope, don’t see your long-lost twin. Oh! Wait a minute …’

  He’d picked out an ageing hippy with pink dreads and mud splattered up her mirror-embroidered skirt. She had one hand out, leaning against one of the filthy toilet blocks, and she looked as if she might fall down without it.

  ‘Ha ha.’

  ‘Come on, Hels, your mum is a bit weird, isn’t she?’

  Was she? She’d never thought of her as weird before he said it. ‘How do you mean?’

  ‘Like, just odd, you know.’

  ‘Tell me.’

  Darren looked uncomfortable. He stubbed out the last of his joint and began to scratch at his forearm.

  ‘Forget it,’ he muttered. ‘Let’s get some of those chips you were on about before.’

  It was almost nine o’clock by the time the band finally came onstage. As the tension built, the two of them had pushed forward along with the rest of the crowd. The sky was darkening and there were lights – red and purple – picking out parts of the stage and the throng of fans Helen could feel the beat thumping in her chest and see it pulsating through the bodies around her. Everyone was psyched. Everyone knew that this was colossal. They’d tell their grandkids they were here.

  Then the band ran onto the stage, waving their arms and lapping up the applause, Ian Brown kicking a football into the crowd like a returning hero. Everyone around them surged forward even more. Helen didn’t scream, but she gasped, involuntarily, and then felt her own intake of breath echoed by twenty thousand more around her. As one, the crowd sucked the air from the Merseyside sky and for a fraction of a moment it seemed that everything was still – the
lights stopped swinging, the smoke rolling down from the stage seemed to freeze and Helen felt her own heartbeat trip over itself. She felt Darren’s arms around her, anchoring her. She knew he was The One. She wanted to make this last forever.

  Neil

  Nothing could have prepared Neil for the exquisite torture of witnessing Helen shrug off childhood and become – almost – a woman. He felt it most when he saw her dressed up on a Saturday night, giggling with her friends, the lot of them thinking their tiny skirts and mascara-weighted eyes were great and not realising it was the innocence underneath that made them gorgeous. They were good girls, even a bit naive, and they handled themselves like a bunch of kittens dancing through a minefield.

  That night, he waited up for her. He’d tried not to, then made excuses to himself that he was just not feeling tired, that he may as well watch the match he’d recorded at the weekend.

  When the car pulled up, he was dozing, but he sprung to his feet in an instant, frowning as he peered into the street. A moment later she was clattering through the door.

  ‘Dad! What are you doing waiting up?’

  ‘Just snoozing, love. I dozed off.’

  ‘You worry too much.’

  ‘Quite right, I do. Who’s that anyway? It’s not Darren’s car.’

  She hugged him, the same fierce squeeze she’d had as a child. It seemed like moments ago.

  ‘Just a bunch of girls,’ she said, emphasising the girls. ‘They’re from round here, at college in Leyland. Darren and I got separated; it was all pretty manic.’

  Neil swallowed back the interrogation he wanted to launch into. The important thing was she was safe. The rest could wait.

  ‘So … the concert was good?’

  ‘Gig, Dad, you call it a gig.’

  ‘The gig was good, then?’

  She squeezed him again, and when she stepped back and looked up at him, her eyes were bright as electricity. He thought about the article Barbara had pulled from the Sunday supplement a few weeks ago – telltale signs your teen is on drugs. There was something about dilated pupils – or was it narrow pupils? – he couldn’t quite remember.

  ‘Well, I can’t wait to hear about it, but I think I need to get my old bones to bed now.’

  ‘Me too.’

  By the time he’d put away the few dishes from the draining board, locked up and cleaned his teeth, he could hear gentle snoring already coming from her bedroom. He crept in and stroked her forehead, pushing stray hairs off her make-up-smudged face. He could still see that little girl’s face underneath. His precious gift from Barbara, who had never wanted children, but loved him enough to agree, eventually, to just one. Neil had always known he had to get it right with Helen. There would be no second chances.

  Helen

  The day after the gig Helen was in her bedroom, supposedly studying Franco’s Spain for her History A-Level, but mainly humming guitar riffs, when Neil stuck his head round the door.

  ‘Fancy coming out to the greenhouse and giving me a hand with the tomatoes, love?’

  She frowned. ‘I should be revising.’

  ‘And are you?’ His question went unanswered. ‘Come on, a half-hour break will do you good. You can get back to it fresh.’

  ‘Go on then.’

  She wasn’t good company. The memory of the night before was still fizzing inside her like sherbet. She didn’t have much to say, then she giggled into the tomatoes.

  ‘What’s got into you, Duckface?’ asked Neil. ‘Laughing at nothing? First sign of madness, you know.’

  ‘Nothing’s up. And don’t call me that.’

  ‘What? Mad?’

  ‘No. Duckface!’ He always called her Duckface.

  ‘Right you are, Duckbum.’

  ‘I was just thinking about the gig, actually. You see, Dad, most of the people there had Liverpool accents – they reminded me of Mum. Where did she grow up? Do you know that much?’

  Neil’s head jerked forward as he bit down on the twine he was using to tie up the tomato plants. She winced at the noise it made as he found a weak spot and shredded the fibres in his teeth. He always did that and it always went through her. He handed her the short length and she tried to ignore the fact that it was still wet with his spittle at its end.

  ‘Can’t help you, love,’ he said, once five or six lengths of twine had been bitten off. She caught the hint of a frown pass across his brow.

  ‘It just feels weird, you know, knowing nothing about Mum’s side. I’ve tried to ask her, but she just clams up, even when it’s something for school. She says she’s left them behind and we’re her family, us and Nan and Granddad and Auntie Vicky. She says that’s all the family she needed.’

  Neil must have noticed the disappointment in her face and his voice became gentler.

  ‘Look, your mum never told me much of her family, neither. And if there was anything I ever did know, it wouldn’t be my place to tell you. But that only means that you’re even more special to her. Think what you’ve got and what she’s missing, eh? For whatever reason. Don’t be hard on her.’

  ‘All right, Dad.’

  She pushed away her thoughts about her mother and concentrated on the tomatoes. Their viny smell was almost overpowering in the greenhouse – the smell of Neil and summer for as long as Helen could remember. Now it was mixed in with her own cheap body spray – vanilla and something.

  ‘Hels!’

  The shout made her look up. Darren was framed in the back doorway, looking annoyed and cradling his forearm across his chest.

  ‘Darren’s here, Dad, I’m going in.’

  ‘All right, Duckbum, thanks for helping.’

  ‘Hey,’ she called to Darren, breathless from rushing up from the greenhouse. ‘Come up to my room?’

  But Darren shook his head. ‘I’m going into school this afternoon. Special revision class. I just came over to check you’d got home okay.’

  ‘Right. Well I did.’ She waved her hands as if to say ‘here I am’. He could have just phoned if he didn’t have time to stay. And he hadn’t bothered with any other revision classes as far as she was aware.

  ‘What’s up with your arm?’ she said, noticing that he was still holding it.

  ‘Nothing.’

  ‘Don’t talk crap.’

  ‘Accident. I was talking to your mum before I came out. She was waving her Silk Cut around and I got in the way.’ He unfolded the arm from his chest and turned it to show her the neat red branding of a perfect cigarette burn. It wasn’t the sort of burn you got from a glancing touch. She looked up at him, horrified at what her mother must have done, and at a loss for what to say.

  ‘It was my job to bring you home last night, Hels,’ he told her, firmly. ‘I should have done better.’

  August 2017

  Helen

  ‘I’m sorry to have to inform you that it seems there may have been a medical error in relation to your mother’s treatment.’

  ‘An error? What do you mean an error?’ Helen felt her guts lurch. She’d been praying that her worries were ridiculous, repeating it, convincing herself. The doctors would come and tell them that her mum had had a rare side effect or allergic reaction or something, that it was all very distressing but nobody was to blame. ‘An error’ wasn’t in the script. ‘An error’ was only an error if you didn’t know that someone had acted deliberately.

  Ms Evans met her gaze steadily. ‘She was being given heparin. It’s an anticoagulant, which means it thins the blood and prevents internal clotting after surgery.’

  ‘Right.’

  ‘Well, the symptoms she showed – the bleeding – that’s the classic result of a heparin overdose. When we tested, we found the levels in her bloodstream were many times higher than they should have been. It’s administered via pre-filled syringes with different doses.’ For the first time, Ms Evans faltered and glanced at one of the colleagues sitting next to her. ‘Our initial check seems to show two additional doses were logged on your wife’s records.
We’ve undertaken an audit of the drug stocks on the ward, and that also seems to show two extra syringes have been used.’

  They were in another office in the hospital, though this one was much plusher than that afforded to the nurses on Geranium Ward. Ms Evans sat behind a large, modern desk, flanked by Mr Eklund and one of the senior hospital management team. Helen felt herself gripping the edge of the desk.

  ‘How come?’ said Neil. ‘How could this happen?’

  Ms Evans glanced again towards her colleague, who had taken pains to introduce herself as Linda as they had entered the room.

  ‘That, Mr Marsden, we do not currently know,’ she said, speaking very slowly. ‘The hospital will conduct an internal investigation. We will appoint a liaison officer who will keep you abreast of all the findings. Depending on the results, we may have to consider a referral to the Care Quality Commission.’ She paused for breath. ‘I can assure you – I can assure both of you – we will do everything necessary to get to the bottom of this.’

  ‘Too damn right you will!’ said Neil. ‘My wife came in here with cancer. You lot are meant to cure her, not … not let some incompetent student kill her off.’

  ‘I totally recognise the depth of your feelings here, Mr Marsden, we just—’

  Neil bristled through Linda’s attempts to soothe him, but Helen found herself zoning out. Her dad had assumed it was a horrible mistake, but then he didn’t know about the notes. An icy fear spread through her body.

  ‘What happens to Mum in the meantime?’ she asked, forcing herself back into the conversation.

  Ms Evans took over again. ‘Well, she’s very comfortable now in our High Dependency Unit. We’re going to keep her there to be monitored for another couple of hours, but I’m sure we’ll be able to release her back to Geranium Ward to continue her recovery very shortly.’ She rushed on. ‘I believe that Mr Eklund is confident that this episode won’t materially delay her recuperation from surgery or her planned discharge date.’

  Mr Eklund had his elbows on the desk and was holding his hands in a prayer position, with his chin resting on his thumbs. He rocked forward, slightly, apparently nodding his agreement.