by Manda Scott
‘Will he do?’ It was my first coherent sentence in over two hours. My throat was dry, like old parchment. I would have killed, cheerfully, for a coffee.
‘I don’t know.’ She pulled up another stool alongside mine. ‘I suppose there’s only one way to find out.’ She disconnected the oxygen line from his tube and suddenly I was ventilating fresh air. I stopped. My fingers ached, robbed of a reason for moving.
‘Now all we have to do is wait for his C02 to rise and see if it kicks him into breathing. If he does nothing in the next minute, you can have your job back.’
We waited ninety seconds. I counted them out as the clock ticked round. Quietly. Not out loud. For something to do. When I looked at Nina, she was doing the same. Except she was counting his heartbeats. Just in case they weren’t there.
It was odd to see him begin to breathe on his own. As if he might, perhaps, have forgotten how. It was odder still to watch him come slowly back to wakefulness. To see him feel the pain, dull at first and then sharper as the stitches gripped in his diaphragm, in the skin of his abdomen, over the steel of the plate in his leg. He only has one eye. But that’s the first time I have seen it look at me, and know who I was, and still feel anything other than murder. He opened his mouth and only pain came out.
I never thought I would feel pity. Not for this cat.
‘Is there nothing we can give him?’
‘We can give him morphine. Now that he’s breathing.’ She cracked open a vial, drew up a tiny fraction of fluid and fed it in through the drip.
In time, the cat breathed more slowly. His eye lost its grip. Wavered. Watched other things in other places. Things that crept up the walls and across the ceiling. Things that joined him in the incubator. The cat purred.
‘He’s hallucinating.’
‘He probably is.’ She should know.
We sat together in silence. The monitors all stayed in rhythm. The cat kept breathing. I thought of other things. Remembered the desert in the back of my throat. Remembered the black hole in my solar plexus. Not entirely unlike a ruptured diaphragm but you can’t see it on X-ray. I remembered work. Tomorrow is Monday and I have to be at work by nine. Seven hours from now, I have to get out of bed. Just now, I could sleep for ever.
‘I don’t suppose you have any coffee?’
‘Nope. We have water. If you want coffee, you have to go to the Lodge and get it. I’m staying here with the cat.’ Nina crossed the room to the fridge and produced another green plastic bottle with yet another daft, kilt-wearing cow on the front. You’re not supposed to keep human food in clinical fridges. Even I know that. She drank the water. I thought seriously about visiting the Lodge. Found I couldn’t be bothered to move. Nina held out the bottle. ‘Caffeine’s a diuretic,’ she said. ‘You’re dehydrated. Everyone dehydrates in theatre. It’s the lights. You won’t get better without some water. And you’ll never sleep if you have coffee now.’
Watch me.
The cat purred at something big and friendly that walked across the roof of his incubator. He rolled over on to his back to watch it. The line of stitches ran neatly along the midline of his abdomen. Around it, a curved arc of bruised tissue stood out starkly against the almost-white and almost-black patches of shaved skin.
I leaned over and looked at it more closely. A footprint.
‘Nina, he’s been kicked.’
She joined me by the incubator. Took a long drink of water. Placed the bottle with care on the floor at her feet. ‘Yes, I know,’ she said.
What?
‘I don’t understand.’
‘It’s obvious,’ she said evenly. ‘If you were really unlucky you might fracture your radius falling from a first-floor window. Or even if you jumped badly off the bed. But you only get a ruptured diaphragm from a high velocity impact. Road traffic cases come in with their diaphragms gone. And the ones that get kicked by horses. Not the falls.’
‘I found him in the woodshed.’ Even for a cat, the nearest horse is ten minutes’ walk away and it’s dead. ‘He wasn’t kicked by a horse.’
She nodded slow agreement. ‘He hasn’t been hit by a car, either. The bruising would be different.’
‘Why didn’t you say something earlier?’
‘Why should I?’ She shrugged. ‘It’s not your business.’
Her eyes were on the fluid pump. She did some mental arithmetic and altered the drip rate. Kept her face in the shadows. Shifting, teasing shadows.
‘What do you mean?’ I asked.
‘I mean it wasn’t you that kicked him. I know you better than that. Even if I don’t, you would hardly kick his guts out and then bring him in to me for surgery.’
‘Thanks.’
‘You’re welcome. Anyway, this is old bruising. And there were fibrin tags forming all round the diaphragm. The lesion’s well over twenty-four hours old. This happened the same time the fire started at the cottage. Close enough. You were in the PM room with me then. It can’t have been you.’
‘But you still could have told me.’
I spent half an hour in the Calcutta hole of her bedroom looking for a footprint when all I needed to do was go to the woodshed and drag out the cat.
And I came so close to missing it.
‘Kellen …’ She bit the edge of one hard-pared nail, kept her eyes on the cat. ‘ … I’ve been trying to talk to you all day and got nowhere. I’ve had more conversation from Dominic and he spends most of his time asleep. Do you think I would have asked you to stay and help me cut if I wasn’t desperate?’
‘I don’t know.’ I didn’t think about it like that.
She took a long, long drink from the bottle. We watched the cat. I thought about footprints and whether it was possible to match foot size to feline bruises, even after thirty-six hours. I thought about coffee and how long it wasn’t till I had to get up in the morning and how long it would take to go up to the Lodge and boil a kettle. I still didn’t do anything about it. There’s a curious apathy that takes over in a clinical unit late at night. A deep-seated reflex from some hidden layer of under-conscious that knows it’s going to be a long night and there’s no point in planning anything as normal as sleep. Or coffee. I breathed in lemongrass and breathed out yearning and tried not to remember anything at all about the night before.
Nina simply sat and drank water.
‘Well,’ she said finally, ‘are we going to talk about it?’
‘Talk about what?’
‘The thing we’re not talking about. Last night.’
‘I don’t know that there’s very much to say.’
Or alternatively, there are a hundred things I could say and all of them push boundaries we have crossed once already.
‘Do you want me to apologise?’
‘For what? Taking advantage of me when I was low on sleep and high on stress? I hardly think so.’
‘That’s unnecessary, Kellen.’
‘I’m sorry.’
‘I know. That’s obvious.’
‘I’m sorry.’
‘Could we not just pretend it didn’t happen? Transient bilateral amnesia? Go back to where we were?’
If only.
‘Is that what you want?’
‘I don’t think what I want comes into it, really, do you?’
I don’t know. I don’t want to think about what you want. Or what I want. It isn’t safe.
‘It should do.’
‘I know. That’s not what I asked.’
‘I know.’
Silence. A wary, pivotal silence. A silence where the one who makes the first move loses. A silence where the only safe thing left to do is to wait.
We waited. I thought about going home. Watched the drips fall through the fluid chamber with the regularity of a water torture. Listened to the clicks of the fluid pump. Tried to make sense of the pattern on the ECG.
The cat purred and watched fantasy television flicker past the walls of the incubator.
Nina sighed, a long, hissing sigh, throug
h clenched teeth.
‘Kellen, if I said that the incubator walls were burning, what would you say?’
Hair pricked upright on the back of my neck.
I really can’t take another night like last night.
Neither can she.
‘Where’s the cat?’ I asked.
‘He’s gone. Vanished. The fire started in the red marks on his abdomen. Burned him up. All that’s left is his skull. It has teeth like a snake. But it talks like Matt. It thinks … it thinks the world would be a better place if I joined the cat.’
‘And what do you think?’
‘Just at this moment, Kellen, I couldn’t care less.’ She sat beside me, less than two feet away. Her voice was flat. Deliberately empty. Her fingers dug into the soft vinyl of the stool. Her eyes were fixed on the cat. I reached out, held her chin. The closest I’ve touched her in twenty-four hours. Turned her face to mine. Her pupils were wide. And black.
She turned her head back, suddenly. Violently. Not quite in control. ‘Don’t, Kellen.’ She let go of the chair and took my hand from her face. ‘You don’t look good without the skin on your face.’ Her voice lost its flatness. Gathered the first jagged edges of panic.
‘What’s happening, Nina?’
She shrugged. ‘The same as always happens. It always starts like this. Normal things start to go just a little bit abnormal. I can cope for a while. Until it gets out of hand.’
‘Is it out of hand now?’
‘Not quite. I can still hold a sane conversation.’ She smiled the ghost of a smile; strained, self-mocking. ‘If this isn’t sane, Kellen, I don’t want to know.’
‘How long?’ I asked. ‘How long has it been running this time?’
‘Since we gave him the morphine. Could have been earlier. It has to be really bad to get in the way when I’m cutting.’
The cat’s drip ran out. The fluid pump bleeped and flashed red. She focused hard on the drip set, a drunk with a mission. A vein pulsed at her temple. ‘Can you change that drip?’ she said. ‘I’m not sure I want to touch what it looks like.’
‘It might bite?’
‘At the very least.’ She grimaced. Spoke slowly through whitening lips. ‘Use Hartmann’s. Warm it up in the microwave first.’
I found the right bottle in the cupboard above her head, gave it three minutes on high, changed the drip. She watched me the way I would watch an unstable schizophrenic, waiting for the flip.
‘Cut down to half the drip rate,’ she said when I’d finished. ‘He didn’t lose too much blood in theatre.’ Her voice came from a long tunnel, each word enunciated with care to reach the far end of sanity.
I took hold of her hand. She took it back again. Carefully. As if both of us were fragile.
I wonder sometimes if it’s hypoglycaemia. It’s always worse when I haven’t eaten.
‘Nina … have you had anything to eat today?’
‘We had pancakes this morning.’ She smiled. Just for a moment, she looked normal. How could I forget?
‘Is that it?’
Frustration made her more lucid. ‘It’s a Sunday, Kellen. Where am I supposed to get something to eat? I’m not about to go down to the cottage to see if there’s anything left in the freezer.’
‘Is there food in the Lodge?’
‘I expect so. There usually is.’
‘If I go and find some, will you still be here when I get back?’
‘I’ll do my best.’
Somehow, this is less than encouraging.
I ran for the Lodge. Found the key, exactly where Steff said it would be; behind the fire extinguisher opposite the door. The remains of the filling from the omelettes was in the fridge. There was fresh bread on a shelf below it and cheese below that. And the jug with the remains of the morning’s coffee. And, thanks be to Jason, two one-litre cartons of orange juice with ‘JGG, PAWS OFF’ written across in indelible ink. I took them both.
She was still there when I got back. Sitting tight on the stool staring at the floor as if it was the only safe place left in the room. I tore the lid of the first carton open and held it where she could see it. ‘Here. Fructose. Get going. It’s safe, I promise.’
She drank. She didn’t like it, but she drank.
‘How are you doing?’ Dumb question, but you have to ask.
‘I’m still here,’ she said and the tunnel was halfway to the Antipodes.
‘It’ll take a good ten minutes to hit your brain.’
‘I know. It always does. I’m not going anywhere.’
‘I know.’ You don’t have to. Everywhere is coming at you.
I sat by her chair and talked her through drinking half the carton. She watched the floor turn to sea water. Conger eels with Matt’s face and my voice gibbered at her about infidelity and commitment. She kept drinking. I stuck the remains of the morning’s coffee in the micro-wave in the corner. The one with ‘ICU only. Absolutely not for human use’ printed across it in green. I made her drink coffee. The conger eels became mealworms and then maggots and they writhed their way up the legs of her chair. The coffee was red and it tasted of blood. It tasted of old, bitter coffee to me. In the incubator, the cat came slowly up to the surface of pain. It stopped watching things run along the plastic of the walls. Watched me and its mother instead. It made one trial flex of its ruined left leg and it howled.
‘Your cat needs more morphine,’ I said.
Talking was hard. ‘In the vial on the side … 0.4 ml … Needles are in the box on the shelf under the syringes.’ She whispered it. Not to wake the maggots.
The vial was there. It holds one ml of morphine. I drew up all that was left—0.6 ml. If she’s self-injecting with morphine, she didn’t get it from here.
I loaded the dope into the cat, watched him float slowly back into dream space. When I turned round to look at his mother, I found her looking back at me. Her eyes were not black.
‘Nina, what can you see?’
‘I can see you.’ She smiled. A slow, quirked smile. It carries the world in it, that smile.
‘Who am I?’
‘Do you really want me to answer that?’
No. Not now.
‘Who are you?’ I asked.
‘Don’t ask difficult questions at this time of night, Kellen Stewart.’
She couldn’t talk like that when she was seeing things.
‘You’re back.’
‘I think so.’ She stretched, a long, joint-cracking cat-stretch. Stuck out the end of one shoeless foot and pushed it gently somewhere up near my ribs. ‘That’s twice in two days you’ve stopped me going over the edge, Dr Stewart.’ Her toes played over the skin of my side. ‘It’s becoming something of a habit.’
I wrapped my hand round her foot. ‘Maybe if you didn’t keep playing in the danger zone, Dr Crawford, you wouldn’t fall over so often.’
And maybe she’s not the only one.
Memory followed in the afterwash of relief. I could have lived without that, just then.
She took her foot away from my ribs. Cocked her head on one side. ‘You’re worried about work, aren’t you?’
‘Fairly.’
‘Is it so very unacceptable?’
‘Yes.’
Her eyes were thoughtful in the gloom, walnut patched with flickering amber reflections from the ECG. She fiddled with the drip rate. For something to do. Her voice was soft when she spoke. ‘I asked you, Kellen, not the other way around. Doesn’t that make a difference?
‘No.’
‘So then don’t tell them. You may not be able to forget, but you don’t have to make a song and dance about it. I won’t.’
Yes, you will. I have been through this too often in the last day and a half. It doesn’t get any better with each revision.
‘Nina …’ I turned round so that I could see her face, so that she could see mine, ‘… you need professional help. I’m not sure I shouldn’t be referring you to psychiatrist as we speak. At the very least, you need a lot of time wit
h a therapist. Whoever it is, it can’t be me. Not now. And the first time you go, maybe the second if you want to spin it out, you need to tell them about last night. You have to. There’s no point otherwise. And then …’ I shrugged. It didn’t seem necessary, then, to spell it all out. ‘On the whole, I’d rather jump before I’m pushed, that’s all.’
‘You’re going to resign?’
‘Yes.’
‘Because of me?’
‘There were two of us, Nina. I could have gone home.’
She moved her head. Amber patches wavered across the bridge of her nose. Somewhere down the ward, a dog yelped in its sleep. She reached out a hand. Her fingers curled around mine. ‘I’m sorry,’ she said. ‘I didn’t realise.’
‘I know.’
‘When will you do it? Tomorrow?’
‘Maybe. More likely Tuesday. I need to think what I’m going to say.’
‘And then what?’
‘I don’t know.’ I haven’t thought that far ahead.
‘So could we … what the hell … ?’
She turned. Her hand fell out of mine. The door to the ward hissed softly shut.
Stephanie Foster stood on the far side of the room. Out of breath, damp from a run. Or from a shower. Or both.
‘Sorry to break up the party,’ she said. ‘Beth said you’d been looking for me. Urgently.’
I made coffee in the Lodge. Brought it down to the ward and found Nina explaining the details of surgery and post-operative care. The cat slept, curled in the corner of the incubator, twitching a brow at the occasional passing mouse in the dream. The monitors blinked life-signs in luminescent colours. Nothing out of the ordinary. Nothing to say that the cat wasn’t going to see out the night.
Steff leaned back against the wall, filling in the noughts and crosses and technical numbers on an intensive care chart. The planes on her face had changed since the morning. Lost a tension I didn’t know they had. Her hair stood vertical and freshly damp. She smelled faintly of shower gel and sweat. As if she had worked out and then showered and then worked out again. When she smiled, it reached up to her eyes and beyond.
Nina Crawford sat on her tall stool beside the incubator and the need to sleep hung from her shoulders like a shroud.