Acland shook his head.
‘Right. Well, I can only go by the medical and regimental reports that came with you, and the newspaper coverage that I’ve just taken off the net, but I’ll tell you as much as I know. If there’s anything you want repeated, raise your hand.’
Acland learned that he’d spent eight weeks attached to one of the UK military bases near Basra. He had taken command of a four-Scimitar, twelve-man reconnaissance troop whose task was to search out insurgent crossing points along the Iraq/Iran border. He and his troopers made two recce patrols, each of three weeks’ duration, which were described by his CO as ‘extremely successful’. Following a few days R&R, his troop was then deployed to recce ahead of a convoy on the Baghdad to Basra highway. As commander, Acland was in the lead Scimitar with his two most experienced troopers, Lance Corporals Barry Williams and Doug Hughes. The vehicle had been attacked by an improvised explosive device buried in a roadside culvert. The two lance corporals had died in the explosion, but Acland had been thrown clear. All three men had been recommended for decoration.
Willis turned a piece of paper towards the young lieutenant.
It was a printout of a newspaper article with a banner headline saying: Our Heroes. To the side, under a photograph of him at his passing-out parade, were two portraits of smiling men, posing with their wives and children, over the caption: devastated families mourn brave dads. His own caption read: seriously injured but alive. ‘Do you recognize them, Charles? This –’ he touched a face– ‘is Barry Williams and this is Doug Hughes.’
Acland stared at the pictures, trying to find something he remembered – a feature, a smile – but he might have been looking at strangers for all the recognition he had of them. He suppressed a surge of panic because he’d shared a Scimitar with these men on two extended recce trips and knew how close he must have grown to them. Or should have done. It didn’t make sense that he could forget his men so easily. ‘No.’
Perhaps Willis noticed his concern, because he told him not to worry about it. ‘You took a hell of a knock to the head. It’s not surprising you have holes in your memory. It’s usually just a question of time before things start to return.’
‘Khow khong?’
‘How long? It depends how bad your concussion is. A few days, perhaps. You won’t remember everything all at once . . . We tend to retrieve memory bit by bit, but—’ He broke off as Acland shook his head.
‘Khow khong –’ he pointed to himself – ‘khere?’
‘How long have you been here?’
Acland nodded.
‘About thirty hours. You’re in a hospital on the outskirts of Birmingham. It’s Tuesday, 28 November. The attack happened on Friday and you arrived here early yesterday. You had a CAT scan during the afternoon and an operation this morning to plate the bones in your left cheek and above your left eye.’ Willis smiled. ‘You’re in pretty good shape, all things considered.’
Acland raised his thumb in acknowledgement, but the conversation had done little to allay his fears or his sense of resentment.
How could he forget eight weeks of his life? How could thirty hours have turned into an eternity? Why had the nurse said his wires were crossed?
What was wrong with him?
*
The days that followed were difficult ones. Acland lost count of the number of times he was told he was lucky. Lucky he’d been thrown clear before the vehicle turned over. Lucky the insurgents were too few in number, or too poorly armed, to follow up the attack by shooting him. Lucky the shrapnel hadn’t entered his brain. Lucky he still had the sight of one eye. Lucky the blast hadn’t destroyed his hearing completely. Lucky he was still alive... For whatever reason, he’d been put in a side room away from other patients. Acland suspected it was his mother’s doing – she had a habit of getting her own way – but he didn’t complain. If the choice was between being stared at by his parents or being stared at by every Tom, Dick and Harry who entered the ward, he was better able to tolerate his parents. But he found their constant presence draining. His father was the worst culprit on the ‘lucky’ front. Unable to understand what his son was saying, or too impatient to work it out, he would take up a stance by the window and keep repeating phrases like ‘The gods were smiling on you that day’, ‘Your mother can’t believe how close we came to losing you’, ‘They told us it was touch and go at the beginning’, ‘Damnedest thing I’ve ever come across.’ For the most part Acland pretended to be asleep, because he was bored with playing the ‘thumbs-up’ game. He didn’t feel lucky and he saw no reason why he should pretend that he did. At twenty-six, he had his whole life in front of him, but it didn’t look like being the life he’d chosen for himself. He felt a cold knot of fear every time his father mentioned the future. ‘The army gives grants for retraining, Charles. What do you think about signing up to an agricultural course for a couple of years? You might as well learn the modern way of doing things at
the taxpayers’ expense.’
Acland stared at the wall in front of him.
‘It was just a thought. Your mother’s keen to have you home. She suggested we put you in the annexe so that you have your own space.’
The idea was abhorrent to Acland. He tolerated his mother’s presence in his room because he had to, but he was becoming increasingly resistant to her touch. Whenever possible, he crossed his arms to avoid having his hand stroked, wondering what she’d been told about his condition that meant he had to be treated like a child. It wasn’t as if she’d caressed him when he was a child. Demonstrations of affection never happened in the Acland household.
The only respite he had was when the medical staff took over and his parents were asked to leave. He appreciated the consultant surgeon, Mr Galbraith, who talked him through his injuries and told him what he could expect in the coming months. Galbraith explained that the damage was to the left-hand side of his face, that he’d lost a considerable portion of soft tissue due to the splitting and burning effects of the shrapnel, and that his eye had been damaged beyond repair. Nevertheless, reconstructive surgery had improved immeasurably in the last decade through the use of microvascular techniques and tissue expanders, and the surgical team was confident of a good outcome.
Galbraith warned Acland that to achieve the best results might take months. Operations could last up to fourteen hours; the patient needed recovery time of weeks between ops; and other specialisms, such as neurosurgery and ophthalmology, might have to be brought in for assessment and assistance. The aim of the team would be to keep impaired nerve functioning to a minimum and to source a donor site that wouldn’t result in a visible difference between the colour and texture of the grafted skin flaps and the skin of the face, particularly in the reconstruction of the lid and socket tissue to accommodate a glass eye.
The surgeon looked for a reaction, but didn’t find one. ‘I hope that’s gone some way to putting your mind at rest, Charles,’ he said. ‘I realize it’s a lot to take in at one go, but the message is an optimistic one. When you’re talking more freely, you can fire as many questions at me as you like.’ He offered a hand. ‘I look forward to knowing you better.’
Acland grasped the hand and held on to it to keep the man from going. What he wanted to say was, ‘Why would I need a neurosurgeon?’ but the words were too complicated. Instead, he touched the side of his head with his other hand and asked, ‘Is brain OK?’
Galbraith nodded. ‘As far as we can tell.’
He released the man’s hand. ‘Why can’t I re – emb – er?’
‘Because you were unconscious for three days and amnesia is a common symptom of traumatic head injury. Are you having problems understanding what’s said to you?’
‘No.’
‘You certainly don’t look as if you are. Dr Willis described you as extremely alert for someone who’d been out cold for three days. Do you remember talking to him?’
‘Yes.’
‘Do you remember the details he gave you about t
he attack?’
‘Yes.’
Galbraith smiled. ‘Then you’ve nothing to worry about. It’s short-term memory loss that’s disabling. Sufferers struggle to understand or retain information . . . They lose skills they once took for granted and have to undergo prolonged therapy to relearn them. Yours is localized or retrograde amnesia, which means you’ve forgotten events within a defined time period. It’s quite normal after concussion . . . but rarely permanent.’ He examined Acland’s inexpressive face. ‘Does that reassure you?’
No ... But the lieutenant stuck his thumb in the air anyway. He couldn’t bear the thought of any more fussing. He’d have no privacy left if anyone knew what was going on inside his head.
Confidential Memo To: Dr Robert Willis, Psychiatric Dept From: Nursing Station 3 Senior Nursing Officer: Samantha Gridling Patient: Lt Charles Acland 893406 Room: 312 Date: 5 December 2006
Thank you for taking my call and apologies for interrupting your session. Further to the brief outline I gave you over the phone, please find further details below. I’ve since questioned my staff to see if anyone else has had a run-in with Charles, and several have reported a refusal to answer questions, being sworn at, an almost permanent anger and suspicion about medication and analgesia. There’s no question in my mind that he’s targeting the female nurses, since none of the male nurses made any complaints.
FYI: One of the auxiliaries – Tracey Fielding – told me he ordered her to ‘take her fucking hands’ off him this morning when she tried to straighten his bed. Tracey says he spoke quite fluently and she had no trouble understanding him. She decided to treat it as a joke and answered, ‘You should be so lucky,’ but abandoned the bed-making because Charles was clearly on edge.
The two incidents I mentioned to you over the phone were also directed at women, myself being one, and both involved violence or threats of violence. They are:
1. Yesterday evening, Charles lost his temper with his mother. She told me she was trying to comb his hair when he caught her by the wrist and forced her arm on to the bed. She said he looked ‘absolutely furious’ and twisted her hand backwards until she was kneeling on the floor. It was only because her husband came into the room and managed to release her that Charles didn’t hurt her badly. Both parents are understandably upset and I suggested they stay away for twenty-four hours. I’d like you to talk to them about going home for good. While no one can condone Charles’s behaviour, it’s clear to all of us that his mother is driving him mad. She calls him ‘her little boy’ (!!!) both to his face and in front of others.
2. As soon as Mr and Mrs Acland left, I went to check on Charles. His door was closed, he’d detached himself from his drips and he was standing by the window. I invited him to get back into bed. When he took no notice, I walked towards the buzzer to call for assistance, and he moved in front of me to stop me doing it. Upright and with clenched fists, he’s over six feet and very intimidating. I warned him that his behaviour was unacceptable, and he said quite clearly, ‘I don’t give a shit.’ To avoid provoking him further, I left the room. When I returned five minutes later with a male nurse and a security guard, Charles was back in bed and reattached to his drips. Correctly! He was very pale, and I think he gave himself a scare, but he’s a damn sight more ‘with it’ than any of us realized. His recovery speed is extraordinary.
I’d appreciate a visit ASAP after your return from Warwick. Pro tem, I’ve re-rostered the staff so that Charles has only male attendants, but there aren’t enough available to make the rota workable for more than 48 hours. I’m also concerned that his mother won’t stay away. FYI: I will be on station till 17.00 but am contactable at home on 821581.
SNO Samantha Gridling, Nursing Station 3
Two
WILLIS DREW UP A CHAIR beside Acland’s bed and placed his notes on his knee. If he’d had any doubt that his presence in the room was unwelcome, it was confirmed by the young man’s stony indifference as he stared at the wall in front of him. ‘I’ve got some good news and some bad news for you, Charles. The good news is that your parents have decided to go home and the bad news is that Tony Galbraith almost certainly gave you an exaggerated picture of what is achievable through reconstructive surgery.’
At least he had Acland’s attention. The lieutenant’s good eye flickered briefly in his direction.
‘The surgeons will do what they can, but in the end you’ll have to decide for yourself how much scarring you’re prepared to live with. It’s about learning to live with a different face. However good your medical team, however well you manage your own expectations, there will always be a gap between what you hope for and what is possible.’
Acland gave a grunt of what sounded like amusement. ‘It must be worse than I thought if a shrink has to break the news.’
Willis avoided remarking on the improvement in his speech. ‘It’s not pretty,’ he agreed frankly. ‘The shrapnel burned the flesh down to the bone and took your eyelid and most of your eye. Realistically, you should expect some permanent scarring and problems with the nerve and muscle functions on that side of your face.’
‘Message received and understood. Will try to be realistic, sir.’
Willis smiled. ‘Robert will do just fine, Charles. I’m not in the army. I’m a civilian psychiatrist who specializes in dealing with trauma.’
‘To the head?’
‘Not necessarily. Most injured men experience difficulty making the transition from active service to inactive patient. I gather you’d rather be out of bed than in it, for example.’
‘There’s nothing wrong with my legs.’
‘Maybe not, but you were damn lucky to make it successfully in and out of bed yesterday. Forget the condition you arrived in . . . and the drugs you’re on . . . and the fact that you had a major operation a week ago . . . your brain hasn’t had time to adjust to mono-vision. By rights you should have gone arse over tit the minute you took your first step.’
‘Well, I didn’t.’
‘No. You seem to have the constitution of an ox and the balance of a tightrope walker.’ He eyed the young lieutenant curiously. ‘How did you manage to catch your mother’s wrist so easily? You should have missed by a mile.’
Acland produced a ball of tissue from under his sheet and tossed it from one hand to the other. ‘I’ve been practising.’
‘Why don’t you want anyone to know?’
A shrug. ‘It’s like a zoo in here . . . with me as the latest exhibit. People keep prodding me to see how I’m going to react. Most of the time I don’t feel like performing.’
‘Is that why you shut your door last night?’
‘Partly.’
‘Why else?’
‘To show that I could. I knew someone would barge in eventually to prove they were doing their job properly.’
‘The senior nurse found you intimidating.’
‘Good.’ He spoke with satisfaction.
Willis made a note. ‘Don’t you like her?’
‘Am I supposed to?’
Strange answer, Willis thought, giving one of his dry smiles. ‘You’re outside my usual remit, Charles. As a rule it takes weeks for patients to become as stroppy as you seem to be. They start by being grateful and compliant and only become irritated when progress isn’t as quick as they’d like.’ He paused. ‘Are you in pain?’
‘If I am I can ask for something.’
The psychiatrist consulted his papers again. ‘Except you never do. According to what I have here, you didn’t use the PCA and you refuse analgesics. Are you really pain-free . . . or is it a macho thing?’ He paused for an answer. ‘You ought to have a continuous dull ache around the site of your surgery, and acute stabs of pain every time you cough or move. Is that not happening?’
‘I can live with it.’
‘You don’t need to. Your recovery won’t happen any faster because you suffer. It might even hinder it.’ He studied the young man’s impassive face. ‘Is your amnesia still worrying you? Are you bl
aming the opiates for it?’
‘How can I remember anything if I turn myself into a zombie?’
‘And you think pain’s any different? It’s just as deadening to the concentration as morphine.’ He watched Acland toss the tissue ball again to prove him wrong. ‘Well, maybe not in your case,’ he said with dry humour. ‘What have you remembered so far?’
‘Nothing much. I had a flashback where I was being driven along a road that I didn’t recognize . . . but now I’m thinking it was a dream.’
‘I doubt it. Snippets of memory always feel like dreams at first. You’ll know they’re real when you can put them in context.’ He leaned forward encouragingly. ‘Being able to recall your command will take the uncertainty out of it. I imagine doubt about your leadership is what’s troubling you the most, isn’t it?’
Acland stared rigidly back at him. He had no intention of discussing his fears with anyone, let alone a psychiatrist.
Willis took off his glasses to give himself an excuse to look away. ‘There’s nothing alarming about your amnesia, Charles,’ he murmured, using a corner of Acland’s sheet to polish the lenses. ‘The brain bruises like any other part of the body when it takes a knock. It just needs time to heal.’
‘That’s OK, then.’
‘You’d be in a lot more trouble if the metal had come at you from a different angle or you hadn’t been wearing your helmet when you were thrown from the vehicle. A pierced or shattered skull is a different kettle of fish entirely. The brain doesn’t recover easily from that kind of damage.’
‘So I was lucky?’
‘Certainly . . . if the only choice was between serious brain damage and concussion. Real good fortune would have been that the shrapnel missed you altogether.’ He replaced his spectacles. ‘I gather you don’t like being told you’re lucky.’
‘What makes you say that?’
‘You lost your temper yesterday morning when one of the auxiliaries urged you to cheer up because you’re better off than some of the others in here.’
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