“Michael VOLPE!” Matron intervened, “you will NOT speak to the doctor with such FOUL language!”
“I don’t fucking CARE,” I screeched, the word ‘care’ coming out so high-pitched that it was almost inaudible to humans. “He just twisted my arm, and it fucking hurts like fucking fuck, for fuck’s sake!”
While Matron nearly passed out, the doctor sat quietly, sucking on his pipe. With a warm smile and a nonchalance he could only have honed from twisting lots of broken arms and seeing the reaction, he said, “Let’s get an x-ray and see what’s going on. I don’t think we’ll worry about the bad language too much.” As a nurse gently coaxed me through to the X-ray suite, I was grateful that the doctor had taken the onslaught so well, but the method of his diagnosis had returned to me the violent hurt and trauma of the moment when the injury had at first occurred. Matron’s indignation was the least of my concerns.
The episode of the broken arm was all a bit traumatic when I think about it. The three days of agony had left a deep mark on me, and I felt terribly homesick during those awful seventy-two hours, but for some reason I never once used the payphone in the hall of the neighbouring house to phone Mum. I can only deduce that I did not want to worry her. Actually, as I write, I am not sure that anyone actually informed her of my injury. It is possible I just turned up at home with my arm in the plaster, although I doubt it somehow. It created a sense of vulnerability, a feeling that my tough skin had fallen away.
Did I feel sorry for myself? I honestly don’t think I did. I was in too much genuine pain and felt too dreadful for that, but I cried quietly into my pillow every single night as the pain intensified with darkness and the loneliness I felt in my bunk. I thought about my friend in the plaster of Paris trousers and how he suffered pain every night, and I tried to draw some strength of character from his memory but, it never worked. Only Rob would drop from his bunk to see how I was. Empathy is a quality Rob has always possessed, and he had it even at eleven. Some years ago, he and I went skiing in Italy, where one morning I slipped on ice and crashed to the ground, wailing as I tore several ligaments in my ankle, but Rob’s discomfort and trauma was greater than my own. I don’t think he felt quite the same way in 1977, but he was sensitive enough to appreciate what I might have been feeling and he would look genuinely troubled when he saw my pain. But in my memory, at least, he was the only one.
Maybe it was no more than I deserved.
It occurs to me that maybe the tough guy persona I had been cultivating since I had arrived was now coming back to haunt me; either my other pals were too uncomfortable to show sympathy or they quietly relished my suffering, but I’ll never know. I haven’t yet decided whether Woolverstone’s hard-nosed approach to injury and self-preservation was a good or bad thing. No doubt, its effect differed from character to character, yet, as odd as it sounds, to cry in public, even at so tender an age, was not advisable at Woolverstone. I mean, I might have shed a tear when screaming obscenities at the maths master who booted me from my chair, and I certainly sprung a leak when the doctor performed origami on my forearm, but I never just whimpered or wept at the pure undiluted pain of it all. For the three days before seeing the doctor, I wandered around with a fixed expression of misery and a substantial element of grumpiness too. I don’t think I invited sympathy, and I’m not sure I wanted it anyway, but I never bawled.
It turned out that I had a serious fracture and was put in plaster up to my shoulder, which drew the curtain on my rugby for the year. But it did not put a stop to my British Bulldog career, which continued with renewed vigour now that I had a weapon. The vulnerability I had felt needed exorcising, so I crowned many people foolish enough to try and halt my passage across the lawn and shattered the plaster twice. When I broke the cast, Matron had to take me to Ipswich. On neither occasion did she make it to her favourite shop. That says something about me, but I think it says more about her.
TOP OF THE SLOPE
Life back at home for Mum was marginally improved by not having to worry too greatly about Serge or me. Matteo was his usual self, though, his banditry wasn’t getting any better and one drama or another frequently blemished holidays. He was sixteen by then, was still into girls but had begun to dabble in harder drugs. A policeman kicking the door down at dawn was becoming a frequent event, as were visits by Mum, with Serge and me during school holidays, to various borstals and detention centres. Lou was a photographer’s assistant to Rodney Wright-Watson, a famous art photographer who catalogued the great collections in museums and large private homes, including those of Her Majesty. The job also meant Lou got to use the big saloon that Rodney owned and would occasionally drive Mum up to Woolvo to visit. I never told anybody that he did not own the car.
When I ponder those days, when my brothers were all teenagers, it strikes me how different we all were and still are. Lou was the quietest and most shy, although he wasn’t an angel, being a persistent truant, but he generally kept himself to himself, never wanted to be the centre of attention and could not have been more the opposite of my demonstrative, attention-seeking incarnation. He is probably also the brightest of all of us. Serge was more like me: he too was a show-off, a performer, and was quickly developing a Woolverstone ‘face’ and a fiery temper, more fiery, even, than mine, but he had a better attitude to academia than I did.
Matt had his own problems but was a bit of a cad, a real London boy. I think I would probably have turned out most like him had Woolverstone not intervened. Matt was effusively attached to Mum, though his ‘issues’ were to be a lifelong burden for her, yet she never gave up on him. She once recounted to me that when Matt was born, she and my father had been desperate for a girl that they could name after my nonna (Lou is really Luigi, named after my grandfather). Matt appeared and there was, she said, a sense of disappointment. She carried the guilt of that reaction and blamed herself for how he was appearing to turn out. She certainly paid her dues in that respect; I remember the telephone ringing late one night and hearing Mum erupt into hysteria. Matt was in prison at the time, and the caller, claiming to be an officer of that establishment, was regrettably having to inform her that Matt had died in his cell that evening. I took the phone and the person hung up, but a few calls to the prison established that Matt was fine, and the call had been a hoax. I have no doubt that such episodes (and there were many) ate away at Mum’s spirit relentlessly. In reality, at the age of 52, in May 2013, Matteo would actually die of a sudden cerebral event, but it is hard to discount his life of excess as a factor. He was complex, troubled but enormously good-hearted until the end, and his death was a real blow. When he died, I wrote about the events of a week that still haunt me, and I reproduce it here because I can’t go through writing about it afresh.
* * *
It was a late Saturday afternoon when the hospital called me. My brother Matteo, the voice said, was in intensive care after a bleed on his brain, and his wife, Nicky, had asked them to contact me. “He has had a very significant haemorrhage, Mr Volpe. It’s very grave and we can only offer palliative care,” she said, with a professional sweetness I still find remarkable. She had done this before.
Having rushed to Charing Cross hospital, just two hundred yards from my house, I felt in familiar surroundings, because Matteo had been in their intensive care unit twice within the past four years; an aneurism and, later, septicaemia. But whilst he had reason to thank his lucky stars for surviving both, this time it felt different. I met with a stern but gentle consultant who showed me the CT scan they had done of Matt’s head. Even I could tell that the bloom of brightness that permeated most of the left half of his brain equated to a colossal event that, if he survived, would render him seriously disabled at best. “Have you ever seen anybody live through something this big?” I asked. After a long, thoughtful silence, she replied, “Yes”, but she was offering no solace, just stating a fact, and her pause was designed to test my intuition. My intuition passed, telling me everything I needed to know.
&n
bsp; If A&E is the “poor bloody infantry”, then ICU is where the SAS reside. In a dazzlingly equipped ward of just four patients, Matteo, in a coma, was tended constantly by a nurse in scrubs, testing, examining, watching and entering figures onto a metre-wide chart of bewildering complexity. Matteo was taking his own breaths, but a ventilator was helping him. A good sign? Automated syringes pumped constant streams of powerful sedatives into him to keep him asleep; their withdrawal would be the first big test for him. I was a constant source of questions, wanting to understand every drug, every machine, every bright, flashing and multicoloured reading on the screens. I would look at the charts, trying to work out the meaning of the vast matrix of measurements, vital signs, blood and chemical analysis. And not once did a professional in that ward prevaricate, nor did they lose patience or turn their eyes heavenwards. In the past, I have always found doctors and nurses to be reluctant to engage in anything more than rudimentary, patronising chitchat. This time they indulged, offered more than was asked for, and I knew, deep down, that they were sorry for us, pitying us, perhaps knew that this was all a short road to the inevitable.
Matteo had gotten through the first 24 hours. He was taken off the sedative for the first time on Monday, but a while later it was reintroduced as he showed no sign of awakening and his blood pressure began to fluctuate dangerously. He had reacted to a pinch: a natural reflex, but still a small sign of hope. My conversations with the doctors took on a slowly increasing clinical quality because I wanted to understand and I had to report developments to my brothers in Scotland and the USA. I needed information and wanted to know outcomes. I was in and out of the ward several times daily and I got to know the nurses and doctors. By Tuesday they tried to withdraw sedation again; this time he lasted an hour before destabilising. Still the doctors indulged me, still they answered my questions. By now I was discussing the options with my brothers by email or Skype. Along with Nicky, we had to make decisions on resuscitation, on what criteria we would base a decision to withdraw Matt’s life support; a sense of conscious thought being present, even if seriously disabled? Nicky said cremation had always been Matt’s choice, and I found myself thinking about music for his funeral. I called a soprano friend to ask if she would perform.
At midnight on Wednesday night a doctor I had come to know well telephoned me. Since Saturday I had been waiting for a call to say that Matteo had given up his fight, but this wasn’t quite as dramatic – yet it was the first, painful step. Matt had “blown a pupil” and his blood pressure had crashed. This was the first sign that the bleed was affecting his brain stem, from which there was no return. I sent emails to my brothers. One wrote back, “Go and sit with him, talk to him, tell him we love him, that it is going to be OK, that we are all with him and not to be scared.”
And so I did. I whispered in his ear, in the darkened ward, accompanied by a symphony of bleeps and quiet alarms, and sat with him all through the night, sustained by tea, made for me by his nurse. At 7am, I returned home, and Matteo had made it through the night.
Later at midday of Thursday I returned to the ward to be told that his other pupil had blown and that there really was no hope. The neurological teams had assessed him again too, and their view was the same. So we retired to a private room with two doctors and the head of nursing, a new face. Nicky and I fired questions, and the doctors deflected any that required a definitive timescale or which might offer hope. They handled it beautifully. The head of nursing was also the transplant coordinator for the hospital, and he asked if we would consider donating Matteo’s kidneys. A burst of something resembling joy filled me; yes, that would be something wonderful for Matteo. It would take twelve hours to identify potential recipients, to line up the processes and they explained how it worked, how Matt would be taken to theatre, how in the anaesthetic room next door his support would be withdrawn. After death, five minutes would be allowed to elapse before going into theatre to harvest the organs. The twelve-hour timescale meant 2am for this to happen but Nicky was adamant he would not die during the night because since his aneurism operation, he had become afraid of the dark. Graciously they all agreed this would be fine, and we bartered about whether it should be 8am or 9am. We went for 9am.
I returned to the ward and saw his nurse attaching a bottle of something brown and milky to one of the tubes leading to Matt’s nose. It was his feed, and I at first wondered what the point was, given the conversation I’d had a few moments before. And then I understood.
Matt needed to hold on now so those kidneys could be given to someone. Some family members visited that evening to say goodbye to him and I went home to try to sleep, my appointment with my brother’s death made. Sleep didn’t come easily, but when it arrived, it bludgeoned me, the previous night’s vigil having taken a toll. The meeting with Nicky at 8.30am for coffee was as normal and as benign as any ordinary day but played out with a surreal soundtrack, a numbness and clinical monotone. We went to Matt’s bedside, to be told the two potential recipients had been tested but that tissue typing had revealed there could not be any organ donation. They were sorry, and we were crushed. We resolved that it was “not to be” and proceeded to ask more questions about the mechanics of Matteo’s death.
We were asked if we would like to be with him at the moment of passing, but after some thought decided against it. Will he suffer? No. He was requiring ever-increasing levels of support and it would be swift. Would they give him some morphine just in case? “Yes,” said the doctor, “I promise, I will do it myself.” I stroked Matt’s head and said, “See you later, Matt.”
And then we went for a coffee. After twenty minutes I telephoned the ward and asked if Matteo had died. “Yes, he passed and we are giving last offices, you can come back.”
And so we returned to be with Matt for the last time, only now with no tubes, sallow of cheek, quiet and the machines weren’t purring and chattering, their screens dark. He went very quickly, they said, within five minutes, peacefully, with no struggle. He just stopped living. I can’t yet articulate what I felt on seeing him then, I simply don’t have the words, but it is in my mind’s eye constantly still.
With our NHS under threat, it takes an episode like this to realise what we have. Those doctors and nurses fought for Matt, even though they held little hope of a positive outcome. The treatment would have cost a great deal of money, and during one of my many conversations with doctors, a consultant had said she had only seen one patient with a bleed this extensive leave the ICU alive. With those odds, how many beancounters might balk at the efforts made to improve on that solitary statistic?
The medical team gave him a dignity it is hard to fathom and harder to describe, unless you have seen it given. In all truth, Matt left us on that first Saturday, but had he simply died then, I would not have been there to walk him to his end, to see him living and fighting and being given that chance. And we were, I suppose, more gently introduced to the notion of his passing, spared the suddenness and shock. Hospitals are there to save lives, but they can also help people like Matt to their end whilst performing heroically to try to prevent it. The great monument to our civilised values that the NHS represents is perhaps even more evident in their “failures” and their vainglorious attempts than in their successes. And that is a thing of great distinction that cannot be qualified by cost nor visualised in profit terms.
We asked those mourning at his funeral that donations should be made to the Friends of Charing Cross. They had performed miracles twice before for Matt, but in the process of not doing it a third time, they – and society – had possibly made their greatest gift to him
* * *
My life at the school was settled. I always bemoaned the return from holiday, but I was drifting away from friends at home anyway, so it was nice to get back to what had become my first-choice gang. I liked the sport at school, too, and was forever keen to get back into it. Autumn term was the time for normal fifteen-a-side rugby, spring term was for sevens and summer was for cricket. A
mid the sporting endeavour, it had not really dawned on me that Woolverstone was, above all else, a scholastic enterprise. I knew why I was there, but the hours of sport were when I felt most at home, and to academia I found it hard to apply myself for more than the bare minimum of time. I knew what I was good at and paid more attention to that, but I was insufferably difficult to reach. I did not find the work difficult; I just had a lot of chips on my shoulder and was busy establishing whatever reputation I believed would deliver the status I deserved. It never occurred to me that masters had seen it all before, and I sensed they were not unduly worried. In any case, I was unused to people showing any sort of concern for my welfare beyond that of my brothers and mother, so I probably liked the negative attention I would frequently provoke.
It is easy to see from here that I was an angry boy with an inflated sense of what was right and what was wrong. My being in charge was right; anyone telling me what to do was unequivocally, indisputably wrong. We were still settling into the routines of daily life, working our way through the system, absorbing the constant expectation and trying, ever trying, to rise up to the required level, and occasionally failing to do so wasn’t held against us too fiercely at that stage. Egos are not supposed to amount to much in young boys but mine could have floated one of those cargo tankers on the Orwell.
The school day at Woolverstone was long, finishing at 5.30pm with the end of the final double period of one subject or another. Lunch would be at 12.30pm, and after that it was either a couple of hours free or, if a Tuesday or Thursday, two hours of rugby training, which meant no late lesson. It would all begin with an assembly that took the form of most school assemblies; masters on stage, announcements, hymns and occasional ‘thought for the day’-type pronouncements from Paddy. Assembly was always the place a feud of one kind or another might get resolved as all protagonists came together in one place, and it was common to see a good scrap in the hallway after assembly. It was also the birthday boy’s misery, because the swimming pool was next to the assembly hall and getting thrown into that was never a seasonal event. A celebrant broke ice on his way in once.
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