by Jane Rogers
She puts on smart clothes, leaves sleeping Dan a note, and drives to the police station, where a flustered and overworked desk sergeant is trying to deal with a queue. El gives him the name of the policeman she spoke to yesterday, shows him the receipt she was given for Con’s papers and computer, asks to speak to whoever is in charge of the case. The desk sergeant takes down all her details painstakingly (Name? Address? Phone number? Date the crime was notified?) then vanishes to an inner office for a full five minutes, only to re-emerge with the news that no one can help her at the moment, but someone will phone her later today. He cannot even give her a name.
Chapter 8
Conrad becomes aware of his two hands gripping the ledge where his coffee cup rests. His own long bony fingers; pianists’ fingers, Eleanor used to say, kissing them and pressing her palms against his, laughingly comparing sizes. Such lovely, clever hands, you should have been a surgeon. He sees that the finger ends, beneath his close-bitten nails, are yellowish white with pressure; that the joints, bent like the splayed legs of a spider, are arthritically bulbous; that his chapped skin pulls and creases across the knobbly bones and protruding sinews like an ill-fitting stretch cover draped over an old sofa. He can see his swollen veins, purple worms beneath the skin.
Quickly he releases the ledge, and buries the hands in his pockets like the shameful things they are. People must be staring at him, a madman gripping a shelf like it’s the edge of a cliff, reflected in the mirror for all to see. He pushes himself up from the stool and out into the cold air. There’s a queue of cars all pumping exhaust into the clinging white fog, making a choking mix that catches in his throat. He retraces his steps to the hotel. Now it’s light, perhaps he’ll sleep. He needs to think what to do, but he can’t think until he’s slept. Dull heavy hammer blows are pounding the back of his head, low down, just above the nape of his neck, as if a dogged executioner is trying to chop off his head with the wrong implement. He curls into a foetal position and closes his eyes.
But it’s no good. Closed eyes make the pounding feel louder, like he’s shut inside a box with it, and his heart, beating to a different rhythm, is speeding up. Of course, all that coffee. He shoves the pillows against the wall and sits up in bed, his misshapen head lolling back against the wall. Every time he moves it now, lumpy pain rolls across like thunder from one side to the other. He needs to hold still. Perhaps there’s something wrong. There is the momentary possibility of a smile at this. Perhaps there’s something wrong, eh. That’ll be beyond being holed up in some distant Italian city on the run from an animal rights fanatic and from his treacherous wife and his children (his and not his) and the howling mess of the research and the whole useless shooting match of his life with no inkling where to go or what to do – that’ll be something wrong besides that, will it? And what did you have in mind? Meningitis? Brain tumour? Blessing in disguise, if you ask me.
How ignominious to be ill. To be lying here incapacitated; clucked over by hotel staff, his passport flicked through, a doctor summoned. How pitiful, to have Eleanor sweeping into his room, exasperated and in a rush, arranging for him to be shipped home like some malingering pet.
No. He’s not going to be ill. He holds his neck and head still, gingerly reaching down to pull the blankets higher up his chest. Slowly he closes his left eye. Opens it, closes the right. Watches the way the end of the bed jumps from one side to the other with each blink. What he thought was here – is there. Here. There. What he thought was good is bad. Is it possible to revision it? (To see it again, to re-vision, re-envision perhaps, to have a different vision of it?) What he thought was good is bad. The truth he loved was lies.
But isn’t this a lie too, this reinterpretation of history? This Stalinist revisionism? In each single eye’s opening, each lurch of vision to left or right, good, bad, good, bad, isn’t there simplification?
Of course, dummy, that’s why you have two eyes. Two in one. Both good and bad… ‘Time that tries all, both good and bad’… The shadow of a quote hovers in his mind, some long-ago school-learned quote, ‘both joy and terror / Of good and bad; that makes and unfolds error…’
He knows all this. The good within the bad, the bad within the good. At work: the drugs are good, stop rejection, enable the host to accept the transplant. The drugs are bad, destroying the host’s defences, making him susceptible to every infection going; necessitating killer doses of antibiotics. Take away the good, he dies. Take away the bad, he can’t accept the good and dies. Simply yet intricately knotted together as the two ends of a shoelace in a bow.
Without experience, there’s no innocence. This must be true too: experience doesn’t obliterate innocence. Innocence was once as real as experience now is. Making different assertions, offering an opposite interpretation. Experience can’t wipe it from the record.
Is it that he wishes it could? Those innocent visions: El in the sunlit garden with golden-haired Cara in her arms? His wife and daughter in his bed, milky sweet to wake up to, warm and white and soft as dreams, as melting happiness right there within his grasp – Oh, he would prefer to surgically excise it. Slice the nerves, sew up their ends, lop off the pain.
Yes, tell that to an amputee with a phantom limb. Tell the brain that what can’t be seen isn’t real and can’t be felt. Good plan, Conrad. And the hospital beds – the hospital beds on that paediatric heart ward – the small flotilla of hospital beds with their frail cargo, they can’t be excised either; and since they were good – or rather, he was good, if innocence and ignorance are good – then that element too, that goodness, that innocence, must be compounded into the bitter mix with experience and self-hatred, allowing both conflicting sets of qualities their due.
He was a different person then. He reaches with disbelief for that young man’s conviction. He thought he knew what was right. He had an interview with Saul and Brock. He was tempted by their research. Excited by the challenge they were offering him, and the autonomy he would have in the research. He didn’t like the monkey house, though; he’d never liked the monkey house. (Let that be a warning to you, lanky young man, innocent ignorant cocky young man, who thinks he can, at no cost, re-program his own visceral responses.) He didn’t like its rank cloying smell, he didn’t like the way their eyes followed you, their raised eyebrows, their grimaces. He wanted to make the move, but he dithered.
And El, impatient that he wasn’t making up his mind, said, ‘Why don’t you go to the hospital? Go to the heart ward, children’s surgical. I’ll give Keith a ring, he’ll brief you. Go and see who’s waiting for a transplant.’
Keith suggested he join him on his ward round, took him through the notes in the sister’s office before they started out. ‘There’s four on this ward with chronic heart defects. The little chap in the end bed – Ryan – he’s only recently been picked up, Barth syndrome, you remember that one? Dilated cardiomyopathy. He should have been diagnosed years ago, he’s got all the symptoms – short stature, constant stream of bacterial infections, neutropenia. I’ve got him on anticoagulants and antiarrhythmic drugs but as he gets older the effects’ll become more severe. A transplant is the only option that could offer him a decent quality of life. The little girl in the next bed’s post-op. Hypoplastic left heart syndrome. We’ve just done a Norwood —’
‘Keith, I’m not up to date on this stuff —’
‘Sorry. Norwood procedure, to create communication between the right ventricle and the aorta, and enlarge the ascending aorta – temporary measure, it’ll keep her going for a while, but she needs a new heart. Then Amanda in the end bed, she’s fifteen. Hypertrophic obstructive cardiomyopathy. She’s been in and out, classic symptoms, enlarged septum, shortness of breath, dizziness, fainting, angina pectoris, there’s a murmur. She’s had one op for the obstructive form but it wasn’t wildly successful. All I can do now is keep her on propranolol and hope for a heart. She’s hit the wall, basically, she’s becoming more lethargic da
y by day.’
‘Does she know?’
Keith shrugged. ‘The parents know. Their decision to tell her or not. I don’t think she’ll go home again.’
‘How long —?’
‘Two – three weeks? They degenerate rapidly at the end. And the other, Sally, she’s heading the same way. She’s nine. She’s been one of mine since she was born. She was born with tetralogy of Fallot and pulmonary atresia, blue baby syndrome. So we did surgery at six days to improve blood flow to the lungs, then open-heart surgery when she was twelve months – basically, reconstruction work. She’s had every respiratory disease going, pneumonia, you name it – we had to put her on ECMO for a while. I told the parents she’d need a new valve at some point, but now she’s back in, to be honest it’s not worth opening the poor kid up again just for a new valve. The heart’s worn out, if she doesn’t get a new one… I’ve got her on intravenous milrinone to strengthen heart function but basically we urgently need a match. And to add insult to injury, she’s rhesus negative, so we’re that much less likely to find one.’
‘When did you last do a transplant?’
‘About six weeks ago. We were able to send him home last week.’
‘So you might get one for her —’
Keith shrugged again. ‘If we’re lucky. If someone else is unlucky.’
And then they went out on the ward. The little boy seemed normal enough, sitting up in bed with a pack of felt pens and a big pad, painstakingly completing an intricate drawing of a spacecraft, grinning shyly up at Conrad. The post-operative child was asleep, as was Amanda. She had a pale, slightly podgy face, and her lips were bluish. Sally was propped up on her pillows, engrossed with a handful of finger puppets. She was the size of a four-year-old. Her fine blonde hair stood on end in little tufts.
‘Morning, Sal,’ said Keith. ‘How’s the family?’
Her skin was doughy and her lips also had a purplish tinge, but her eyes were bright. ‘The baby’s been naughty again, and the twins’re fighting.’ She gasped for breath. ‘They’re a shower, a proper shower!’ She wriggled her puppet fingers at them and laughed breathlessly. Keith bent to take her pulse.
‘And how about you?’
‘Running around after these children – I’m at my wits’ end.’ Though light and whispery, her voice mimicked perfectly the cadences of an exasperated woman. ‘A holiday in the sun, that’s what I need.’
‘Maybe you should have a little snooze.’
She looked at Keith. ‘Can I get up today?’
‘I’m afraid not, Sally. Not today.’
She turned her attention away from him immediately, waggling a puppet on her right index finger at the tribe on her left hand. ‘I told you not to fight! Now get up to your room and stay there.’ A gasp for air. ‘I don’t want another peep out of you.’
Staring at the tiny pink and green puppet Con realised it was familiar; Cara had a set of these at home, a last year’s Christmas present. She had played with them obsessively for a couple of weeks then one of them had been lost, feared swallowed by the vacuum, and after tears and recriminations the others had been put to bed in match boxes.
The girl’s voice became tiny. ‘Oh please, Mummy, we’ll be good.’ ‘Please pretty please, can’t we help you sweep the floor?’ She had to gasp for breath but didn’t look up, blanking Keith completely. ‘Get along with you now, no sweets today!’
Keith patted her gently on the head and turned away, but Sal did not acknowledge him. Afterwards Con couldn’t shift her image, her fierce concentration, her breathless energetic voice, the sweetness of her laughter, her blue lips. Or perhaps what he really couldn’t shift was the notion of another child in her place. Another little girl who was equally intent upon her puppet-babies, another little girl whose golden hair and sweet smile caught at his throat. How could you bear it, how could you live, if it was your own child in that hospital bed? ‘There’s nothing else you can do for her?’ he asked Keith, back in the ward office.
Keith rubbed his eyes. ‘Short of going out and murdering a donor, no. I’m going to have to watch her die. Rubbish, isn’t it?’
So Con went to join Saul and Brock, because one day a monkey heart would save a girl like Sally. Blessed in his innocence. A torturer of dumb beasts. Blanking out all he didn’t need to see.
When Con gets up to piss and have a swig of water, he realises the headache has diminished. There’s the sound of a maid vacuuming, which he finds comforting, that sense of order, the day’s routine under way. He hangs out his Non disturbare sign and gets back into bed, pulls the covers up to his ears, and falls into black sleep.
Banging. The glare of fluorescent lights, and banging. Don’t let it be… banging. Banging. It’s hurling itself against the bars, battering, demented, over and over again. And he can’t move. He’s willing it to die, to be over, how can the creature take any more? A moth, thank God for moths, a moth would be dust by now. But this well-constructed vertebrate, this parcel of nerves and bones and tough sinews and tendons and muscle, encased in hard-wearing leather, cushioned by protective fur, this takes a long time to batter itself to death, a good long time, despite the blood oozing and then pumping from its neck. Only when Con’s own face is dripping with its blood does the animal stagger back and slump, to lie twitching on its side. And now all the others are screaming. Screaming, screaming; his head can’t contain so much noise.
Con wakes, unsure how much time has passed, slick with sweat. Six years he worked on the monkey transplant programme with Saul and Brock. Six years of optimism and hard work and terrible futility, punctuated by his wretched visit to the States. By the early nineties funding was drying up, and the in-house monkey-breeding programme was increasingly unsuccessful, so they were having to source monkeys from other research centres and even from overseas, with all the attendant uncertainties about how pathogen-free they might be. Worst of all was the sense that the monkey–human transplant programme might not really be going anywhere anyway; even if they cracked it, even if hyperacute rejection could be stamped out, and the median survival rates increased, there would never be a big enough supply of monkey organs to meet demand, given how slowly and erratically they reproduced in captivity. Brock started talking about moving on in spring ’93. If he went, that would certainly be the end of their funding. When he asked Con to come for a drink to discuss plans, Con assumed he had decided to make the obvious move to the States.
Brock had selected the Square Albert, a big ugly pub in the centre of town – Con understood that it was in order to avoid anyone else from work, and allowed himself to feel flattered. They took their beers to the upper level, and sank back into an alcove. ‘Cheers.’
‘Cheers.’
An appraising stare from under Brock’s sprouting eyebrows, and then a sudden grin. ‘You know what this is about.’
‘Yup.’
‘You know where I’m going?’
‘Boston?’ The most interesting research Con was aware of was happening at New England Deaconess hospital there; they had made a breakthrough with an enzyme that blocked some of the immediate immune reaction. If there was any mileage in it, it would become treatment of choice because it would considerably lessen the dosages of immunosuppressants needed after transplant.
But Brock was shaking his head. ‘I’m going over to the other side. I’m staying right here and I’m going over to the other side.’
‘The other side?’
‘Taking the drug company shilling.’
‘You’ve lost me.’
‘Have you heard of a company called Corastra?’
‘I’ve seen the name – involved in transgenics?’
‘OK. Small UK company founded by a guy I was at school with, very bright man, Christopher Farrell. He trained as a surgeon and went to work in Bristol. Decided the work he was doing – the publicly funded research – had good commercial
application and formed himself a company before he told anyone what he was up to. And now he’s made a killing.’
‘How?’
‘Sold it on to Kneiper.’
‘It sounds a bit unethical.’
Brock shrugged. ‘You want ethics? With no funding and no monkeys and no investment in the future of research in this country, and anyone with an IQ over a hundred decamping to the States? At least Corastra is a British company. At least it’s based here. Kneiper are paying the bills but he’s keeping the Corastra ID.’
‘What’s the work?’
‘Pigs.’
‘You don’t know anything about pigs.’
‘Pig to primate transplants. With the ultimate aim of pig to human xenografts.’
‘It’s mad. The hyperacute rejection across a species divide that wide is instant.’
‘They’re genetically modifying the pigs. They’ve been breeding pigs which are transgenic. They believe they’ll be able to prevent HAR.’
‘They’ve already bred the pigs?’
‘They’ve done trials. And now they’re going for it.’
‘What’s the programme?’
‘Transplant the pig hearts into primates, cynomolgous monkeys. Without HAR it should be possible to use a standard immunosuppressive therapy, cyclosporine, cyclophosphamide and steroids.’
‘And Kneiper picks up the profit on the immunosuppressants?’
‘I don’t know if they’ve patented the transgenic hearts. If they have, that’s where they’ll make their fortunes.’
‘And pigs breed quickly.’
‘Precisely. Two to three litters a year, ten or so per litter. Enough hearts to supply the transplant wants of the world. They’re envisaging a two-year research programme of testing on monkeys, moving on to clinical trials soon after that.’