Patient
Page 9
The staff nurse coughs. He pulls off his latex gloves. The watch on his shirt is upside down. Time stood on its head. Is it twenty past six or ten o’dock? The nurse says I can take my hand out of my mouth now. I have left little red toothmarks on the surface. I suck in saliva. The sterilized stainless-steel trolley is wheeled away silently, and the curtain is pulled back. I look under the bedclothes. The drain looks the same as before.
When I was finally allowed to drink, I had no appetite for tea or coffee but drank sweet soft drinks in crazes – weak Ribena and orange barley water cooled by ice-cubes from the ice-dispenser in the hospital kitchen. I was only allowed little 30 ml capfuls on the hour. They turned into treats. I’d watch the second hand going round on my watch. Thirteen minutes and twenty-one seconds to go, and then I could reach for another capful. It was like knocking back half-measures from a nonalcoholic pub.
Fluids were encouraged, to keep my kidneys well flushed. Sometimes additional bags of saline would be rigged up to add to the fluids from my dripped-feeding system, especially when I was back to Nil By Mouth for a couple of days. I would lose the desire to drink, and lie for hours on end, motionless, except for having to piss. One night I woke to find the sheets and mattress soaking wet. I thought I had wet the bed. I called the night nurse over. The drip in my arm was throbbing, and it was the bandage dressing around it that was wet through. The vein had closed off and the saline was welling up in the site and then dribbling out over my wrist. My arm was fat and red. The nurse pulled the line out and I went back to sleep with my arm supported above me on three pillows. If I laid it on the bed, the stinging and swollen vein kept me awake. In the morning the houseman arrived with his Velcro tourniquet to put another line in. To me, it was like jabbing the needle adaptor on a bicycle pump into the bladder of a football.
My TPN feed-bag was changed every twenty-four hours. Everything was sterilized. Gloves, tongs, bags, paper. As the valve on the bag was opened, I’d watch the fluid run round the twists and bends of the feed-pipe with the same fascination I had as a child with curly straws. The nurse would let a small amount pass out into a tray and then reconnect me. The pumps on the ward were older and less reliable than the flashier ones on ITU. Little air bubbles would get trapped in the collar of the pump, setting off the alarm. A nurse, or sometimes Tracey, would pull the thin flexible pipe free and flick it until the bubbles broke up and dispersed into the milky liquid. The pipe could then be reinserted and the pump started up again. Sometimes this went on all night.
I was gradually encouraged to start eating again. The abscess had been a bad interruption and had set me back a week or two. Nobody had much idea of what I would be able to tolerate. A patient with an 85 per cent loss of small intestine was a new experience for almost everyone, and it still wasn’t clear whether the mechanics of the gut were definitely working and the passage of food was going to be unimpeded. I began again with some soup and a slice of white bread. The senior dietitian came down to see me to explain the basis of a low-residue diet – foods that put the gut under little stress, were easy to absorb, and left little waste behind. She left me with a few guidelines that I could have worked out for myself – rice, boiled potatoes, white meat, fish – and asked me to consider build-up drinks. She ran through the flavours. Tropical fruit, chocolate, lime. A future of boiled cod and lime glucose drinks stretched before me. I wasn’t listening by the end. She left me and told me to pick my meals out carefully from the hospital food trolley.
For the next couple of days I tried a mouthful of cold turkey, mashed potato, tomato soup, all with little enthusiasm. The food on the ward was like old-fashioned school dinners – beef curry, lamb cutlets, boiled carrots, ham rolls, custard – and the smell that rose from the serving-dishes and warming-ovens was like hotel kitchens or cross-Channel-ferry cafeterias. Arnold opposite me would greet each course with an ‘I say!’ and then proceed to eat everything with an eagerness that baffled me. Custard was a big favourite with Arnold. He was dedicated. Every spoonful was appreciated.
In the mornings the shop trolley would come round. White-haired women in cardigans and tweed skirts – all volunteers – would call out ‘Shop trolley!’ in bright, sharp, church-hall voices. The trolley was laden with Lucozade, soft drinks, Handy Andies, chocolate, talcum powder, Rich Tea biscuits, toothpaste. Nobody bought anything. Most of us were barely on water most of the time.
Once a week the library trolley would come round too. Len Deighton, Agatha Christie, Dick Francis. Ghost-written biographies. Books on fishing. All in hardback, with plastic covers dulled by fingering and sunlight.
‘What do you like?’ the woman would say brightly. ‘Detectives? Crime? Something light, or something exciting? How about something romantic?’
‘Have you got anything historical?’ a new man in the next bed asked.
‘Ooh, I don’t think so.’
‘Something factual. A historian. A. J. P. Taylor perhaps.’
‘Hmm, let me see,’ she said, spinning the trolley round. ‘What about The Eagle Has Landed?’
‘No, never mind.’
‘How about Jaws?’
‘No, thank you.’
‘I’ve got some sport,’ she ventured.
‘No. Really.’ He returned to his paper.
‘Golf?’
‘No.’
‘Kevin Keegan?’
A young German came in one evening with stomach pains. He spoke little English, but the nurses – as is the English way – would not slow down the patter of their speech or ease their grammar to help him understand. They just spoke louder.
‘Now then, sir. How are you feeling in yourself?’ said a staff nurse the next morning.
Awkward phrase. He looked puzzled.
The nurse spoke louder, like we do to old people, simply turning the clauses round in her sentence. ‘In yourself. How are you feeling? All right, are we?’
The royal ‘we’. That should fox him.
He struggled to speak. He sounded so German. ‘Sorry … I …’ He opened his eyes wide and shrugged helplessly.
The nurse tried again. She put one hand down on the bed. ‘Any pain?’ Blank response. She sighed a little petulantly and spoke up. ‘ARE YOU IN ANY PAIN?’
Three or four of us looked up at the volume of this. The German started to look round the room for help.
The nurse tried once more. ‘Hurting? Anywhere?’
Still nothing.
She had started to include gestures. It was like a bad round of charades. She put both her hands to her head, placed the palms against her temples, and shook her head from side to side while saying, ‘In your head? Any pain? Pain. Up here. In your head?’
I expect there would be with all that shaking.
Strangely, however, this new action seemed to stimulate meaning, and the German’s eyes brightened. He said loudly, ‘No. I sleeped well.’ He was shaking his head too. For a moment the two of them looked stark staring mad, each shaking their heads, one with her hands clasped round her ears, and talking so loudly.
His girlfriend came in. When she left later he was bored and lonely, sighing loudly and turning over and over on his bed. After two days of not eating he was brought some breakfast. His girlfriend was in to see him early that day. The look on their faces when the food arrived was one of complete astonishment. The British NHS breakfast – Rice Krispies with warm milk, two slices of untoasted white Sunblest, a pat of warm butter, a tiny plastic tub of watery fruitless jam, and coffee made with coffee powder from an industrial-size tin of Maxwell House – is perhaps a weak spot in the service. It hardly surprised me when their astonishment quickly ascended into covert derision. She started to flick Rice Krispies at him. He performed origami with the bread. He looked so much better for this. Perhaps the breakfast is intended to get people back on their feet. Shock therapy. When the doctors came round he was bright-eyed and free of pain. They discharged him. As he left he took out his wallet from the breast pocket of the candy-striped, faded, flan
nelette, fifties-style hospital pyjamas he had been given to wear by the Riverside Health Authority and asked a surgeon who to pay for his stay. When he learnt it had all been on the house he was thoroughly defeated and left the hospital just shaking his head in wonder and disbelief at our free and brilliant shambles.
A week after the abscess operation half my staples were removed. The wound had been oozing a little bit in the middle. A dressing change was in order. Every other staple was to be taken out; the rest a few days later. I lay flat and tipped my head up to watch. Cold sterilizing liquid was rubbed along the site, leaving the clips like a polished single-gauge railway line. I admired the surgeon’s work for a moment. The clips came out quite painlessly. A small lever was pushed under each one and then used to ease out the staple. One of them pinged on to the floor. We laughed at that. The eight-inch healing scar ran down the right-hand side of my belly button. One of the nurses said I was lucky, because sometimes they go straight through it, leaving patients without a belly button at all. Fourteen clips came out. I half expected the whole thing to come apart. A fresh dressing was put on and the nurses went away.
The physios were on to me straightaway for exercise. At first I would walk with one of them over to the TV room or out into the corridor and on to the glass-covered walkway that linked the main hospital block with the Page Street block. It was a little promenade. Patients and relations would use it for a quick smoke. Somehow the glass must have given them the impression of outdoors and fresh air. It must have seemed like their cigarette smoke wouldn’t be noticed, but the corridor was largely enclosed and the smoke would get trapped, leaving it slightly fuggy like a station waiting-room. Signs were regularly left to encourage smokers to go outside, and some of them would slip out on to the balcony alongside. Some people would be chatting, some grieving, others consoling. Patients in wheelchairs on their way to X-ray would pass by with porters. I’d stand and watch people park their cars in the road below. Sometimes I’d see one of my doctors on his way to lunch and have the urge to knock on the window and wave.
‘Sliced you up good and proper then, didn’t they?’
I am in the TV room. I have just given the other man in the room a brief description of what has happened to me. He is wearing green NHS pyjamas and a white martial-arts-style dressing-gown.
‘They’ve cocked me up once already,’ he says. He is smoking Embassy. The short filter ones.
‘Oh yes?’
‘Yeah!’ Scuse my French, but I reckon …’ He leans forward and lowers his voice. ‘… they’re all fucking useless.’
I raise my eyebrows.
‘All of them! Doctors. Surgeons. The lot. They’ve all got their minds on other things. All that private work. Harley Street. They’re all fucking loaded.’ He pulls on his Embassy.
I don’t want to be drawn in. I don’t want to say anything, so I open my eyes in interested disbelief.
‘Take me, right. They’ve been in once already,’ he says. He gestures to his chest. ‘Missed it. Missed it! Can you fucking believe it? Mickey Mouse, I can tell you. I shouldn’t be smoking, though. They don’t like it. Still, you only live once.’ He blows out smoke, affecting boredom, before carrying on. ‘Can you eat, then?’
I shake my head and flick my eyes up to the drip food-bag I’ve got with me.
‘I’m fucking starving. The food you get in here!’ He shakes his head. ‘Is your ward noisy?’
‘I don’t know. No, not really. It’s all right.’
‘I can’t stand it. It’s not the people in the beds; it’s the nurses. Yak, yak, yak, all day long.’
I look at the TV screen. Colour images. The sound is off. A little green megaphone with a cross through it is winking in the top left-hand corner. He starts again.
‘D’you watch this Channel-4 bollocks, then?’
That’s it. Enough. I push myself up out of the chair. ‘No, no. It’s all yours.’ I roll my drip-stand towards the door and over the metal-strip plate in the doorway. I have to take it at speed to get the wheels up and over. Some days it refuses, like a horse at a fence, and the wheels slam to a halt. Today it glides over and I’m away.
The day after my first set of staples came out was a Sunday. My dad popped in on his own. The ice had been broken. He was open and relaxed. He opened his carrier bag and got out a box. He’d been into Oxford specially. He unwrapped the tissue paper and got out the shoes. We admired them greatly, looking at them from all angles. And then he pulled up the bedclothes and put them on my dry, bare feet. I waved them around and kept them on for twenty minutes. He touched my feet gently. I felt his hands on my skin. It felt strange. I realized the only contact we’d had for years was shaking hands.
He used to come home late from Soho clubs, often with two or three friends, when I was very young. I’d hear them come crashing in. They would sit up drinking into the small hours, playing cards and listening to records – Bud Powell, Roland Kirk, Charlie Parker. He brought a couple of musician friends back one night and then came to my room. It was dark. I saw his figure against the landing light. I heard laughter downstairs. The tip of his cigarette was glowing. He lifted me out of the bed. I must have been young. I felt the crisp wool of his suit rough up against my skin, the cigarette packet through his pocket. He carried me downstairs into the sitting-room and sat me down on the carpet in front of the hi-fi speaker. I was still half asleep. The speaker was three feet tall, part of a monophonic sound system, with a brass grill across it. When it wasn’t on, I used to run my hand down its smooth polished sides. It seemed so huge and solid, like the front of an enormous car. I’d hang my Action Men from it, fitting their rubber fingers into the holes and imagined them rock-climbing on a sheer face. My dad settled down with his friends again. The music throbbed over me, warm music, rich in tone, until I fell asleep curled up on the floor.
His first break came with the Carl Barriteau band during the war. Barriteau was from Trinidad. His band was it. Number two in the Melody Maker poll that year. My dad was thrilled. He had volunteered for the Air Force after leaving school in Glasgow but had been given an eighteen-month deferral because he was only seventeen. He met a pianist called McCormack who was homesick for Glasgow and simply offered to exchange his job playing for Barriteau for my dad’s gig with the Jack Chapman band at the Albert Ballroom. My dad jumped at the chance.
One night, after playing in Leamington Spa, he happened to call home. It was 1944, two years since volunteering. He was shocked to learn that his call-up papers had been there for two weeks. The next morning he called Reading and cheekily asked for an extension, saying he was on tour. He was told flatly to report as ordered. He stalled for a day, but at lunch a car drove up and two corporals got out ready to drag him away. He promised to report to Scarborough by ten the next morning and he got away with it.
He got to Scarborough on time. At the call-up he was wearing a pin-stripe suit and Tommy Dorsey glasses with clear glass in, just for effect. A huge corporal was shouting.
‘Anyone ’ere called Watt?’
My dad stepped up. ‘I’ve been on tour with Carl Barriteau.’
‘Carl Barriteau! Let me carry your suitcase.’
He was taken to the induction centre at the Adelphi Hotel, where an officer grilled him.
‘Now, look here, Watt. Explain your absence.’
‘Sorry sir. I did volunteer, sir, but it’s been nearly two years and I was on tour with Carl Barriteau. I play decent piano though.’
He was let off jankers and after the interview, just to cap it off, the officer invited him to the officers’ mess ‘to have a practice’.
In the evening, after he’d gone, I was waiting for a new feeding-system bag to come up. My abscess drain was gone, I had no naso-gastric tube and, after another swelling in my arm, my fluid drip had been temporarily removed. For the first time in weeks I was disconnected from the hospital. I asked suddenly if Tracey could wheel me outside for a push-about. The nurses said OK, and one of them capped off the line in
my chest. I started to get dressed. I wanted to wear real clothes for an hour. My trousers were enormous, and my jacket hung on my shoulders as if over a wire coat-hanger. I was still hunched over. I had Tracey put my new shoes from my dad on my feet, and a nurse fetched us a wheelchair. We went down in the lift and out through reception.
The air outside was evening air – settled on the city, day-old. We passed by the news-stand on the corner, crossed over, and passed along a covered wooden pavement made by a construction company for the building site opposite the hospital. The cars were noisy. Breezes blew. They disturbed me, flicking at my hair, whipping out from the side-streets. An insect landed on my jacket. I flicked it off. A dog barked. It startled me. We crossed over again by the roundabout at Lambeth Bridge and Tracey pushed me into the garden that runs from the bridge up to Westminster. We trundled under trees. I felt tiny, empty, perplexed. Wind off the river rustled the huge canopy of leaves above me. It was loud. I couldn’t speak. The trunks and branches were big and strong, sap-full and lean. The river’s embankment was black and brick. We stopped. Cut into the wall were two steps up and a viewing platform. Tracey pulled me up out of the chair and hugged me. She was tearful. We stood there for minutes, the wind still in the trees, loud and restless, and I stood there limp on her shoulder and I thought how the line of trees was like a tunnel stretching ahead and behind and we were alone and halfway along it.
A few tourists passed. We climbed up to look at the river. I was transfixed by the water. Thick, muscular currents swirled below me. There was so much life in it. By the wall, little eddies rippled on the surface. Waves slapped against the dark stone. I wanted to fall in and be held up, borne afloat, rushed downstream in turning circles of disorientation, under bridges, past children waving and tugs and river boats, police launches and dredgers, and down through the suburbs and the playing-fields and boat clubs to some wide delta with meadows and plains and green hills behind and the shimmering sea, salt flats and seabirds and air so fresh it would tear at my lungs, rich in oxygen and dewiness. Tracey asked if I was cold. I shivered a little. We climbed down and I got back in the chair and we headed back.