Patient

by Ben Watt

  I opened my eyes some time later. Like a dried dishcloth pressed into the shape of a clenched fist, I lay awake. It was late afternoon. My temperature was down. I felt at sea. On land, but at sea – the way the body can still sense the rocking of the boat for an hour after reaching the shore. I sat up for the first time that day and vomited. Pale-green liquid filled the bowl. Like lime cordial. It was good. As though my body was taking action. I felt I’d come back from somewhere. The worst was over. Tracey was still there. Had she ever been away? She pressed her hand against my forehead. Human contact. I felt the curve of her ring.

  We spent our first night away together in Scarborough. We used to catch the train up to Bridlington or Scarborough and spend the days roaming the beaches and the back streets, eating chips and sitting in cafés on the front with pint mugs of tea, watching the hard winds whip in off the North Sea. We stayed at Mrs Thorpe’s guest-house. It was May 1982. Both nineteen. Two Adults Bed and Breakfast £6 per day. Total £12. Paid With Thanks. Rough wool carpet and red linoleum in the room. A plate of Rich Tea and a kettle on the sideboard in the hall when you came in after 9.30. Tinned tomatoes, circular fried eggs and boiled button mushrooms in brine for breakfast.

  We walked round the landscaped lake at Peasholm Park and along Marine Drive and down on to the beach as far as Scalby Mills and rode the out-of-season Astra Glide in overcoats, and then climbed up to the deserted castle and across the freezing headland to the Roman signal station and the ruined chapel by the cliff edge, the keep and bailey behind us. I can’t remember anything we said, only the sea and the grey clouds and the racing winds. I can still see the outline of the priest’s house alongside the chapel, the threshold and step to the door-opening at the west end opening into nothing but sky.

  In 1969 one of my dad’s last major jobs before he thought about packing it all in was a summer season at Scarborough. His love was big bands – big, bluesy, Basie-style – and nobody wanted them any more, except for tea dances. Any TV or radio work was always a compromise. He did thirteen weeks as MD of the pit band for Tommy Cooper at the Floral Hall. He says it was the funniest three months of his life. It was a punishing routine – six nights a week, plus an additional Sunday concert while Cooper, who would hire a private jet to fly south for twenty-four hours, was at home with his feet up.

  He remembers watching the first Apollo moon landing in Tommy Cooper’s hotel room. He was sitting on the edge of the bed with Cooper’s wife while Cooper himself was stretched out in the next room on a special oversized bed like a catafalque calling out for action updates –

  ‘What’s happening in there?’

  ‘Not a lot.’

  Two minutes later.

  ‘What’s happening now?’

  My dad stayed up all that time in a small room at the Station Hotel – a pub really. It was a real turf pub. York races. He picked a lucky Piggott yankee one afternoon, and from then on became known as someone worth touching on. Mum would visit. I went up once with her. We stayed out at a country hotel in the Forge valley called the Hackness Grange. I thought it was fantastic. Cooked breakfast and a pool.

  In the evening I was allowed in the orchestra pit during the show. My dad was involved in a couple of routines, one involving catching a plastic replica bowling-ball as it bounced off Cooper’s foot from the stage, which made me laugh. I clacked round the backstage corridors in a pair of Will Gaines’s tap shoes, knocking on doors and watching The Square Pegs from the wings, wondering what a barber-shop quartet was.

  Two years later we went down to the Bournemouth Winter Gardens, where my dad did one more season. He was just playing piano this time. There was a mixture of comics filling the weeks until the Bruce Forsyth season started. Freddie Starr. Ted Rogers. Top of the bill when I was there were Hope and Keen. I played crazy golf in the afternoons and read the saucy postcards in the revolving stands outside the shops on the seafront, and then met my dad in the theatre canteen for beans on toast before the show and gazed at the chorus girls.

  I went back to Scarborough with Tracey a couple of years after leaving Hull. It was 1986. We were on tour in the North and had a weekend off. It seemed romantic to go back. It was October and chilly, but beautifully bright and clear. The front was one long crescent of people catching one of the last sunny days of the year, pensioners mostly, in cardigans and sun-glasses with ice-lollies and binoculars. We had a bit of money by then, and booked in for a night at the St Nicholas Hotel on St Nicholas cliffs. Three-star, with a grotto leisure club. We felt quite up-market, although the hotel staff rather looked down on us. I had, it must be said, dyed my hair peroxide blond at the time. All the same, I played snooker in the lounge to show off and then paid in cash.

  Arnold has gone from the bed opposite. His children took him home. Leslie has arrived. He seems to know all the nurses. He is very pale, but chirpy. He is wearing a light-blue anorak and carrying a little vinyl holdall. He pulls the curtains round his bed himself, changes, and has pulled them back again and is lying on his bed in his crisply ironed light-blue polyester-mix pyjamas before the nurses have even got back. He pulls a book from his bag. It is a Western. He smooths his fine and immaculately combed white hair down over his head as he reads. He spends a long time on every page, sometimes even turning back a page to reread something.

  A houseman arrives. ‘Come for your top up, Leslie?’

  ‘Yes. Four pints of gold top, please!’

  Leslie, it turns out, is anaemic. He is very patient. He is very pale now I look at him closely – almost see-through, like a phantom. The veins on his skin are like little rivers frozen over.

  His blood-bag doesn’t come up from the laboratory fridge for five hours. He stops the houseman as he passes through. ‘I don’t want to be a nuisance, but I’m hoping to be in Devon on Monday. On my holidays. Any chance …’

  ‘I don’t see why not. What’s the problem?’

  ‘Well, each bag takes eight hours and we haven’t even commenced yet.’

  ‘Right. We’d better get cracking then.’ The houseman turns quickly.

  Leslie stops him unexpectedly. ‘I didn’t want to disturb you from your engagements.’

  ‘Sorry?’

  ‘Your schedule. I don’t want you to feel I am disrupting your busy schedule and the day-to-day necessities.’

  ‘The what? Oh, don’t be silly, Leslie.’

  ‘I know how hospital affairs can impinge, and being only a non-crisis day admission …’

  ‘Yes. Look, I’d better check on this blood.’ He gets away this time.

  Leslie sits back on his bed with his Western.

  A nurse arrives with a dinner menu. ‘Will you be eating on top of your transfusion?’

  Dr Mackworth-Young, my rheumatologist, arrived in the early evening with news that my eosinophils were responding well to the cyclophosphamide, indicating my immune system was generally dampened down. He was sorry about the septicaemia. He had a gentle bedside manner and blond hair that sometimes looked slept-on from the back. He wore old-fashioned clothes, but of immense quality. Derby boots. Leather Oxfords – Church’s, probably. Pinstripe wool suits. Waistcoats. Collarless white shirts with separate collars and brass studs. His senior registrar, Rod, who often came too, was younger and handsome, with the bearing of a triathlete. I expected to find out he did extreme skiing or rock-climbing on his days off. He wore a diver’s watch. Like his consultant, he had winning blue eyes, but not soft and pale and nursery-book, more vivid and holiday-brochure Aegean. He wore modern striped blue shirts to match. They made a good team. How much is reassurance part of recovery?

  They had brought me a name for my illness too, having finally settled on a full diagnosis. Tissue-analysis tests had confirmed it as an autoimmune disease called Churg-Strauss Syndrome, an extremely rare disorder seen in individuals with a background of asthma and hay fever whose immune systems unpredictably and violently respond after further, but not necessarily related, antigenic stimulation. The result, as the immune system
’s antibodies battle overactively with the irritant in the body’s connective tissue (in my case, most likely an allergen connected with my asthma), is wrecked blood vessels and interrupted blood supply (vasculitis), causing potentially fatal organ death. The immune system then roller-coasts out of control and begins no longer to recognize the body’s own tissue, producing antibodies that start to devastate that too – hence the term ‘autoimmune’: literally, ‘antagonistic towards oneself’.

  The critical moment is characterized by the appearance of massive numbers of the immune system’s marshalling forces (hypereosinophilia). Not only is the disease itself rare but the fact that it had chosen to settle in the tissue around my small intestine is rarer still. Most of the few known cases have been seen in the lungs.

  It turns out that a history of asthma going back as far as childhood is uncommon. While it is one of the initial stages in the syndrome, asthma usually develops after the age of twenty, largely in young men. The gap between asthma and onset of the life-threatening vasculitic stage averages out at about three to five years, all of which fitted my pattern. So many of the debilitating symptoms I suffered in the first six months of 1992 are typical of the disease too – fatigue, muscle pain, arthritic pain, fever, hypertension, hoax heart scares, and a sudden improvement in the asthma in the run-up to the life-threatening phase after a noticeable bad downward trend. To paraphrase Joseph Heller, ‘You know it’s something serious when they name it after two guys.’

  The next two days passed in a seamless stretch of time. I floated on the surface of the day-to-day activities of the ward, lying down to sleep and rest, sitting up to vomit. The early blood cultures were matching the later ones, and fungal candida had been found on the tip of the Hickman line that had been removed from my chest. It had, as suspected, got into my bloodstream via my liquid food. With enough evidence to discount an alternative source of infection, my antibiotics were finally stopped, and for good measure the antifungal drug was doubled. I was encouraged to eat and drink a little again. The doctors were concerned about my weight.

  Nurses would come round in the afternoons, sit me up on the edge of the bed, wait for me to vomit, and then help me on to the weighing-chair. Stripped down to my pants, I looked like an enfeebled bantamweight boxer at a bottom-of-the-bill weigh-in. That evening I fiddled with a cheese sandwich and dribbled tomato soup off the spoon and back into the bowl until it was cold.

  My body started calling for sugar. I got a craving for lemonade, and one of the housemen told me old-fashioned lemonade used to have traces of quinine in it, which was supposed to aid digestion. I sent Tracey out on a search for original R. White’s Lemonade. She scoured the local shops but could only find modern brands. I took a bottle anyway, and guzzled two whole glasses chilled with ice the following afternoon before bringing it all back up in one long, hilarious, foaming, bubbling white chunder an hour later. The next day I tried another glass of lemonade at 6.30 a.m., after the early-morning drug round. It came straight back up. I tried a bowl of cornflakes at eight, and that too returned immediately. Suddenly things seemed more serious. The Prof began talking of a blockage again on top of the septicaemia. He ordered another barium meal.

  Little in the ward distracted me during those days. It was the illest I’d been since ITU. It wasn’t until a man arrived in the bed opposite to have his pile removed that I really took much notice. He was due up in theatre that morning, but there had been a delay and he had already had his pre-med. It was one o’clock, and he was so stoned he couldn’t stop laughing. The man in the bed next to him was talking to him.

  ‘Are you all right, mate?’

  Giggling.

  ‘Mate, are you all right?’

  Tittering.

  ‘Shall I call a nurse?’

  More giggling. He was lying on his side like a little boy in bed on the morning of his birthday, likeable, charming, face pushed up into the pillow.

  ‘You won’t be laughing later, after they’ve tied a knot round it and it’s dropped off.’

  Open laughter. The whole ward was laughing. One of the nurses was stiffing a smirk and trying to tell him theatre was sorry for the delay. ‘The porter will be down in ten minutes.’

  ‘Arseholes he will.’

  It was pointless. A wave of good humour was rippling round the room. It made me think of Sid James and Bernie Bresslaw and Hattie Jacques and striped flannelette pyjamas. We were all laughing and smiling while trying not to laugh, grimacing with the pain of bruising and stitching. It was the best feeling in the ward for weeks.

  The porter arrived with a trolley. ‘All set, then?’

  We all collapsed. The man was helped on to the trolley. He was still sniggering to himself. As the porter and the nurse tried to lay him down he kept sitting up, pursing his lips and blowing air out in a weak raspberry. The porter cottoned on, and the whole party – the porter, the patient and two nurses – passed out of the ward on their way up to the operating theatre in a mini-pageant of tittering and clanging oxygen tanks.

  The next day he was back on the ward. He was up and walking around. Still smiling, he looked as though he had got an egg clasped between his buttocks. Earlier on he’d been for his first crap since the operation. He’d come back looking startled. Expecting to see the residue of his last meal floating below him, he had looked down and saw, as I heard him describe to the man in the next bed, ‘a bloody great big piece of bandage in the pan’. They then spent the next half-hour talking about it.

  ‘What I want to know is, How did they get it up there?’

  ‘Search me.’

  ‘I couldn’t believe it. I thought I’d eaten the wrapper off something.’

  ‘I bet you feel better for it, though.’

  ‘Not half.’

  ‘Was it a big ’un? Did the doctor say anything about it?’

  ‘Like a conker, mate.’

  The day I felt stronger again, Tracey suggested a walk across to the TV room. It was only fifty-two paces away. It took a while, but we got there and I tried watching a nature programme. I was slumped into one of the TV room’s toffee-brown leatherette sofas with so little support in it that I was folded up like a half-open jack-knife, so low down my knees obscured my view of the TV screen, like in a dragster or a hot rod. The drip-line in my arm was pulled a little too tight. The stand was too far away and I couldn’t reach it to move it. I couldn’t be bothered to move again.

  There was a commotion outside the door and a family came in – mum, dad, daughter, son and grandad. They sloped in and all tetchily fell into the other leatherette sofa. Grandad sat near me on a chair, in slippers that looked like they had been made from bus-seat upholstery. Mum was wearing a pink sweatshirt with a sequinned pink panther on the front and a towelling shell-suit. Her face was tired and drawn. No make-up. The colour of porridge. She spoke in a kind of hissing shout.

  ‘Stop that!’

  ‘What?’ whined the little boy. He was stabbing his sister with the ring-pull off a can of 7-Up.

  ‘You know very well what.’

  ‘What?’ he whined again.

  ‘Tell him to stop, Mum.’ The little girl, older than the boy, was not really being hurt but saw an opportunity to get him into more trouble.

  ‘Once more and I’m telling your dad!’ hissed Mum.

  It was not as though Dad was unaware of the situation. He was, after all, sitting right next to them all, but he was currently mute and staring vacantly at the TV, absent-mindedly tapping himself on the head with a rolled-up copy of the Mirror.

  The little boy stopped and, with his ring-pull, started trying to slice strips into the arm of the leatherette sofa instead.

  ‘Can I get a Pepsi?’ the girl asked, without taking her eyes off the TV.

  ‘No, you can’t,’ said Mum.

  ‘Plea … se’

  ‘No. You’ve got a drink.’

  ‘Plea … se. It’s only downstairs.’

  ‘I said no.’

  The little boy joined
in. ‘I want a Pepsi too.’

  Suddenly Dad snarled. He made me jump. ‘Shut it. All of you. Can’t you see there is a man here who wants a bit of peace and quiet.’

  Christ, he means me! I kept my eyes on the TV. Tracey was looking straight ahead too. Everyone went quiet. I felt very English and just ignored the comment. My arm was tugged. I thought it was going to be Tracey telling me it was time we went, but it wasn’t Tracey and the sticky tape across my wrist holding the cannula in place started to stretch and pull.

  ‘Dad!’ Mum shouted.

  Grandad had got up and was walking across the room. He was walking straight through my drip-line. He hadn’t noticed. He kept going. I kept thinking he must stop, but he was like an athlete breasting a sagging tape. The drip-stand was starting to roll towards me, and I was being pulled out of the sofa.

  ‘Dad!’

  Tracey started to get to her feet.

  ‘Look out!’

  Grandad looked up and stopped in his tracks. He looked down. Without a word, he sighed, grunted, stepped back, and decided to sit down again. I eased back into my seat.

  ‘Prat!’ said Dad under his breath.

  No one said sorry. Tracey sat back. I stared at the TV. She stared at the TV. We should have left right then but it would have seemed pointed, and anyway if we were going to leave our moment had been five minutes before, just after they’d arrived. It could have seemed like we were just going anyway. We’d blown it. I caught Tracey’s eye in my peripheral vision. Neither of us stirred. We were pinned in our seats by the Englishness of the moment, and plumped for trying to seem undisturbed and natural. I tried to feel the cannula in my arm without drawing attention to it.

  ‘Can we turn over?’ The little girl was getting restless.

  ‘No we can’t.’ Mum again.

  ‘Please.’

  ‘No.’

  ‘This is boring.’

  ‘The man wants to watch it. He was here first.’

  Me again. Please don’t drag me into this.