But most of them did irritate the hell out of him. He wanted only to make them better, to improve their lives, to apply his skill as accurately and cost-effectively as possible, but the sheer stupidity of the patients and their relatives silted up the process. They poured through his various clinics in their hundreds, enough human-interest stories to fill several tabloids, a great many of which they attempted to tell him in exhaustive and emotional detail when surely they could appreciate that while they were doing so dozens of others were waiting outside in the fearful, interior world of the partially sighted, unable even to resort to Hello! magazine.
He had long since given up on the notion that the eyes were the windows of the soul. Whatever their expression, or the mood, age, condition of their owner, when you looked right into them they were no more than a bundle of tissues, filaments and blood vessels in a poor state of repair. They could certainly be beautiful. The sunken and rheumy eyes of a sick old man with post-retinal occlusion when viewed through the microscope presented a picture like a glowing crimson eclipse, outlined with a fiery halo of trapped light and full of incandescent threads like an opal. He was frequently put in mind of the famous Bacon paintings based on infections of the mouth, full of luscious purple and scarlet, fierce yellow and tropical pink. In the same way that a weed was just a plant growing in a wrong place, so a disease was only repellent because we did not wish it to be there. The condition of blindness might be grey and blundering, but its causes were exquisite.
He knew what his staff said about him, often directly to the patients: ‘He’s the best there is, but no bedside manner.’ The nurses, from the humblest student to the most formidable ward sister, regarded him as some kind of enfant terrible, an attitude he found both patronising and flirtatious and which in his view he did nothing to justify or encourage.
He could not be image-conscious, but he was practical. His patients were not terminally ill, and there were innumerable support systems outside the hospital offering counselling, therapy and material assistance. He considered that he was never less than civil but his task was to home in on the problem, and zap – or anyway relieve – it with the greatest possible despatch. When they rested their often quivering chins on the headrest preparatory to the examination he couldn’t wait to escape their pleading and emotional expressions and address the clinical reality.
Though he had none of his own, he liked children, and was better with them, which was not in fact so surprising. Children, however difficult, were only interested (like him, but for different reasons) in getting out of the place. They were not self-indulgent and they had no desire to unburden themselves. Essentially unregenerate (also like him, some would have said) they operated on a simple, animal level of pleasure and punishment, pain and reward. He pandered to this, keeping a tin of funsize chocolate bars to hand and using them shamelessly and almost always successfully as bribes. It was a clean, brutal tradeoff. He was not unsympathetic. His own perfect eyesight was something he had not taken for granted since a rugby accident in his late-teens had left him with blurred vision for several weeks. The degree of disability, inhibition, even loss of brain and motor function that this had caused had terrified him, and he had never forgotten it.
He knew what the staff thought. They thought he was more tolerant at the beginning of a clinic, but tended to ‘lose it’, as the phrase went, as time went on. He wished he could have locked them in that small room with him and shown them that the process was not one of losing, but gaining. As the day wore on, the time pressures snowballed and the patients became more querulous, so his professional focus sharpened to a pinpoint, bright as a laser. By five o’clock he could see, diagnose, prescribe treatment and deliver prognosis with fearsome speed and accuracy. It wasn’t temper, it was talent, running on adrenalin.
His colleagues’ view was qualitatively different from that of the clinic’s staff. What he got from them, even to some extent the men, especially the younger ones, was the sense that he was an old softie really, unable to deal with emotions and concealing a tender heart beneath a rough exterior. If anything he found this even more maddening. Christabel was one of these, a nice intelligent woman and a competent clinician who quite simply insisted on understanding him better than he did himself.
‘Bo-ob,’ she would say, with a teasing, motherly downward inflection, ‘give yourself a break . . .’ And when he told her bluntly that he had no idea what the fuck she was on about, she’d add something like: ‘Okay, all right, we all handle stuff in our own ways ...’
Sometimes Robert entertained the scary notion that Christabel might have a crush on him. She was unmarried and of an age and type that didn’t play the field. There was probably some sort of dismally inadequate token male friend lurking on the edges of her life with whom she went to arthouse films and Max Boyce concerts, but she came across as essentially unawakened, and the thought of all that seething latency being unleashed on him was frankly terrifying.
One of the things he most liked about his wife was her independence of him. She had banged for Britain in the seventies, all in the best possible taste, and then she had met and married him and become a smart but devoted wife without ever losing one iota of her impregnable separateness and self-esteem. Like her china-smooth palms she seemed to be able to move through life without being marked by it. It had stopped being sexy but it remained admirable. And others admired it too, which was gratifying. They saw him as a lucky dog and a jammy bastard who did absolutely nothing to deserve such good fortune.
He had never until recently been unfaithful in any meaningful way, though there had been encounters. It was quite possible that Sian had known about these but if so she had never shown it. She was far too savvy not to keep her powder dry. Besides, they got on perfectly, and unlike him she had nothing to reproach herself with. Though cool, she wasn’t cold – she had never over the whole period of their relationship taken the sexual initiative but neither had she ever failed fully to respond to him. For the past couple of years when this had scarcely been an issue she had not complained nor even commented on the fact. If she pondered those things at all, she kept her counsel.
If his staff, his colleagues or his patients had had any idea of his state of mind today they would not have kept theirs.
His last patient was a Mrs Jowett, with her daughter. This was a combination he especially dreaded, the querulous elderly person with the combative offspring there to see that full measure was given. And these two were classic examples of the genre. Mrs Jowett was fat and fluttery and tearful; the fortyish daughter who introduced herself as Carol Hopkins, but wore no wedding ring, was a smart-suited business person with the studiedly even manner which he recognised as the result of an hour and a half spent in the crowded waiting area with only Mrs Jowett, the lavatories, and the preliminary checks for diversion.
Beyond acknowledging them at the start, he made a point under these circumstances of ignoring the third party, taking the view that if they had something to add or explain they would do so all too readily without encouragement from him.
He stood back as Hopkins helped her mother lower her broad beam into the adjustable seat, which she did with a tremulous sigh as if this were the crowning indignity in a whole chain of indignities. He studied her notes.
‘Oh, doctor, I do hope you’re going to be able to do something for me ...’
‘That makes two of us, Mrs Jowett.’
‘My life isn’t worth living at the moment.’
‘Is it not? We can’t have that.’
‘Where would you like me to sit?’ asked Hopkins.
This was one of the more asinine regular questions. There were only two other chairs in the room and one was the one by his desk which they had just seen him get out of. Pulling down the headrest and not looking at her he replied: ‘Wherever you like.’
‘Here?’ She indicated the second chair. He didn’t answer and she said more quietly but as if answering for him, ‘Here,’ and sat, putting her own bag and her mo
ther’s bag, coat and stick on the floor next to her.
‘Right, could I ask you to rest your chin on here and look straight ahead?’
Mrs Jowett did so, her brow furrowed with anxiety. It was like having a soulful pleading dog rest its head on your knee.
‘Off again if you would, it needs to be a tad higher.’ Another unhappy sigh. ‘Thank you, here we go.’
To make clear what the priorities were he always began with a brief examination, then asked questions, examined more fully a second time, and pronounced. In this way neither the patient nor the hanger-on was left in any doubt that this was a medical consultation and not a session in the psychiatrist’s chair.
The condition of Mrs Jowett’s eyes was poor, but straightforward. The muscle at the back of the right eye was atrophying, the left would follow suit. Not much could be done with the right eye but the left was operable.
He pushed himself back. ‘Good, up you go.’ He waited, studying the notes again as she made heavy weather of righting herself.
‘Need any help, Mum?’ asked Hopkins pointedly. ‘I’ll manage.’
‘Now then,’ he said. ‘Tell me, please, when you began to notice a deterioration in your sight?’
‘Well, doctor,’ said Mrs Jowett, with that hint of mawkish relish that presaged ill, ‘I’ve been on my own for five years now and I have arthritis as you can probably tell, so life isn’t easy—’
‘When did your eyes start to get bad?’ he repeated, pointedly flagging the single syllables. Hopkins uncrossed her legs and recrossed them in a movement less Sharon Stone than garden shears. ‘Can you remember?’ he asked.
‘Not really,’ replied Mrs Jowett, ‘you don’t at first, it sort of creeps up on you, doesn’t it? And when you’re all on your own there’s a lot of things you find difficult to do. You just have to get on with it, don’t you?’
‘Let’s narrow it down. Two years? One year? Six months?’
‘It’s so hard to say . . .’
‘About nine months, wasn’t it, Mum?’ said Hopkins.
‘Nine months?’
‘If you say so, dear.’
‘It was about nine months, because it was midsummer,’ said Hopkins directly to him this time.
‘Thank you.’
The daughter was equally irritated with the old dear as he was – fed up at having to take time off to do this, fed up with the long wait, dismayed no doubt by her mother’s condition – but the irritation would naturally be directed at him, that was how it worked.
‘And now,’ he said to Mrs Jowett, ‘I’d like you to describe to me the precise difficulties you have with your vision. In your own words.’
The moment the last sentence was out of his mouth he wanted to take it back. It wasn’t something he usually said, he’d added it this time as a palliative to the stroppy Hopkins. But it was too late now, Mrs Jowett had been ‘drawn out’.
‘It’s as though half my life’s been taken away from me,’ she intoned, ‘and the trouble is, I’m so depressed I can’t function properly. Carol came with me to the doctor at home and he gave me some pills for the depression but they didn’t agree with me—’
‘Would you excuse me for a moment?’
Without looking at either of them he left the room and closed the door behind him. There was only one patient left outside, a post-operative check for Tony Woong, and the nurses were clustered round the desk chatting. They didn’t exactly scatter as he came out but they did stiffen perceptibly.
‘Everything all right, Mr Vitelio?’ asked the charge nurse.
‘Yes, thank you.’
He went out into the reception area. The receptionist was tidying up her cubicle.
‘Hallo, Mr Vitelio, all right?’
‘Yes.’
He went to the filtered-water container and poured himself a drink, chugging it down quickly and pouring another. He was slightly breathless. He could feel the receptionist’s eyes on him. ‘Gets so airless, doesn’t it?’
‘It does, yes.’
‘Still, day’s nearly over now . . .’ She glanced at her watch. ‘Been a long one, too.’
This time he didn’t reply, but threw the paper cup in the bin and returned to the clinic. Woong’s patient had gone in, the nurses didn’t look at him.
The moment he got back Mrs Jowett made it three in a row by asking: ‘Are you all right, doctor?’
‘Of course.’
‘Only we thought when you rushed out like that without a word—’
‘I believe I excused myself. Shall we continue?’
‘I’ve forgotten what you were asking.’
‘I think you came here today to tell me about your eyes.’
Hopkins got up. ‘We did, but we’re going now.’
‘I beg your pardon?’
‘Come along, Mum.’
‘What are we doing?’ asked Mrs Jowett as her daughter helped her out of the seat.
‘Leaving.’
‘Are we finished, is that it? What happens next?’
‘Coat, here.’
‘Do I have to come back?’
‘You certainly do,’ said Robert, ‘since we haven’t yet completed the consultation.’
‘Don’t worry, Mum, it’s all organised,’ said Hopkins firmly, handing Mrs Jowett her stick and taking her arm. And then added more quietly to him: ‘It would be just dandy if it wasn’t for the patients, wouldn’t it?’
‘I beg your pardon?’
She raised her voice to its normal level. ‘I’ll make another appointment outside then, Mr Vitelio. And you will be hearing from us, of course.’
‘Good.’
He held the door open for them and Hopkins flashed him a look of pure bile as she passed.
‘Goodbye, doctor,’ said Mrs Jowett. ‘And thank you so much.’
He closed the door and flopped down in the chair recently vacated by Hopkins. If Mrs Jowett hadn’t thanked him he might have maintained his fine fury a bit longer. But the moment she’d left, her wholly undeserved kind words hung in the air like a reproach. She was a nice, polite, sweet-natured woman who was losing her sight and was pathetically grateful for the smallest morsels of comfort. But her daughter was one of the new consumer breed: demanding, uncowed and on the qui vive. When she said she’d be in touch he had no doubt what she meant: a strongly worded complaint would be in the post by the end of the week.
He slumped, eyes closed, over his folded arms. Running through the consultation he was pretty sure he’d said and done nothing that constituted a serious breach of professional behaviour. He’d been testy and unsympathetic, and left the room to have a glass of water – not Dr Kildare, certainly, but no hanging offence either. Still, if Hopkins did write it would mean the third such letter in the past year, which along with his reputation would add to a generally disobliging picture. There was little use in being a first-class clinician if the patients wanted nothing to do with you.
He was suddenly absolutely shattered. And the thought of going home to Sian, with whom he could never bring himself to discuss this, was a bleak one . . .
Stella. He wanted Stella. Craved her. Could picture with almost painful vividness the feel of her sinewy limbs wrapped tight around him, locked on, her fanny and her mouth like two big soft flowers on her twiggy body. Oh, God. He wanted to roger her rigid and then confess all in her arms. He had the feeling, right or wrong, that even if she wouldn’t approve his behaviour she’d understand it, and find something droll and abrasive to say which would make him laugh at himself and stop him feeling like a total shit.
But he had fouled up with her as surely as he’d fouled up with Mrs Jowett. And she was in showbusiness, for Christ’s sake, a planet he could scarcely imagine, teeming with colourful characters both creative and commercial who were hers to command and who probably worshipped her.
There was a knock, he said ‘Come’ and Tony Woong put his head round the door.
‘I’m off then.’
‘Me too.’
; ‘You look shot at if I may say so.’
‘Yes, well, they were firing real bullets today.’
‘So long as you didn’t shoot back. Drink?’
‘No, thanks.’
‘See you Thursday then.’
‘If I’m spared.’
Tony laughed as he closed the door. Robert remained in the chair for another ten minutes without moving, in a state of self-inflicted shock.
When Stella got back to the flat she dropped most of her shopping inside the front door, retrieved the Indian sweets and carried them and another of the bags to the windowseat. With a sticky cube melting like liquid velvet on her tongue she took out the picture she’d bought and propped it up facing her. It was her prize purchase, the one that had as it were paid for the trip. She studied it closely for a couple of minutes and then remembered something else and went to get her purse.
The wad was almost gone but her cards were still disordered. A good thing, because there was the one she was after. She removed it and laid it on the windowseat in front of the picture, pleased with the symmetry of it all. Some benign force had been at work, because she’d gone out with sod all except an attack of the blues and returned with all these riches – and change, just, from a hundred pounds.
The business card read: ‘Derek Jackman – Mr Piano. Your favourite music, pop, show tunes, classical, for that special occasion. Background, cabaret or dancer’. There followed phone and fax numbers and an e-mail address.
She looked at the picture again. It was a Victorian photograph, mounted on card. Because of its age she took it to be carefully posed, but this didn’t detract from its simple emotional effect. A horse lay on the ground, its back to the camera, neck outstretched. A man in uniform lay with his head resting on the horse’s flank, one arm stretched over the animal’s neck. The setting was some kind of broad, grassy valley that reminded her a little of the countryside around her parents’ home, near the White Horse.
In the manner of the day the photographer had supplied a title for his work. It was printed in elegant copperplate beneath the photograph.
The Grass Memorial Page 25