by Jane Shemilt
“Hello? Can you hear me?”
No answer.
“Does it hurt anywhere?”
Nothing.
“I’m going to lift you up, hold on.”
I slide one arm under her shoulders and the other under her splayed knees. Close up, her white skin is finely wrinkled; there are brown blotches on her cheeks. Her thin lips are pale and her white hair drawn back so tightly the bones of her forehead are outlined. She has the look of a sleeping cat and she weighs no more than a little girl. As I push her door wider open with my shoulders, I am back to doing what I used to do every day, when looking after people was a routine part of life.
BRISTOL, 2009
FIFTEEN TO TEN DAYS BEFORE
The days passed quickly. Ordinary days.
Were they ordinary? It seemed so at the time. In my memory they remain just that: gray-blue days of routine and little dramas. Ordinary, even though they were the last days of family life, ordinary, though it turned out that almost everyone was lying.
I worked in the practice, routine prenatal clinics and daily office patients. At home Ted and I talked, argued, made love when we weren’t too exhausted. Ed had a couple of days off with a bad cold, and I left him undisturbed and sleeping on those mornings, drinks and acetaminophen on his bedside table. Theo got a commendation for his woodland photo series, and Naomi’s rehearsals were more frequent and lasted longer. Ted spent more time at work. His paper was accepted by the Lancet. We celebrated late at night with a bottle of wine.
If the days felt ungraspable, as one slid into the next, at least life was running smoothly onward. The trick was simply to balance it all. Family. Marriage. Career. Painting. If the balance tipped in one direction and work took up more time, no one complained. It sometimes felt as if I was rehearsing for real life, so if it went wrong it didn’t matter. One day I would have it all organized. I would be the perfect mother, wife, doctor, artist. It was just a question of practice. If I made mistakes, I could simply try again.
At work there was always a fresh sense of starting over. Every morning the basin was clean, new blue paper lay on the examination table, the toys tidied away into the box underneath it.
Jade was admitted to hospital on Thursday, November 5. In her letter, the pediatrician’s secretary had mentioned Mr. Price. He’d thrown chairs in the waiting room and broken a window. The police were called and he’d been arrested. I had handed the load on, so I tried to put it from my mind, but I couldn’t shake off the image of his face when I had told him I had come about Jade’s referral. He had seemed so pleased. I decided it was simply that he knew he had been out of control and was relieved that someone was going to stop him.
The following Monday I got to the office early for the quiet space before the patients arrived. I checked the results while I was sipping my first mug of coffee, and Mrs. Blacking’s liver-function tests were still on the screen when the phone rang.
“Dr. Malcolm?”
“Yes?”
I wedged the phone under my chin as I scrolled down. There were red dots by all the liver enzymes on the screen. My hunch had been right. The thin hair, red palms, and the spidery veins on her cheeks had given her away; the forgetfulness wasn’t just the menopause. She hadn’t told me about the bottle of sherry at the back of the cupboard, the one she probably bought with the milk from Tesco’s every day. I sent an e-mail to Jo to ask her to make Mrs. Blacking an appointment.
“. . . from the Children’s Hospital.”
“I’m sorry, I didn’t quite catch—”
“Dr. Chisholm. Pediatric consultant from the Children’s Hospital. You referred Jade Price.”
I put the mug down and held the phone properly.
“Yes, I did. Thank you for—”
“I would like to talk about the case with you, Dr. Malcolm.”
I was glad he was taking this seriously but there wasn’t time now. “Perhaps I could phone you back later this morning? My office hours begin in three minutes.”
“I’d prefer to talk to you in person. I’m free at one—I’ve canceled a meeting.”
I told myself I needed him, so I had to be polite. “One today? I’ll have to see if that’s possible.”
“Please. It would be helpful. My office is on the fifth floor of the Children’s Hospital.”
“I’ll ask Frank, Dr. Draycott, my partner. Perhaps he can—”
“Good. See you later.”
I could see this consultant very clearly. He had wings of gray hair, perfectly brushed. He’d be holding the X-rays in a large, freckled hand, looking at them through silver-rimmed glasses, nodding at the old spiral fractures, the footprint of child abuse. He wouldn’t be thinking about my day, the phone calls, and the visits to hidden flats down roads where parking was impossible. He wouldn’t know about the referrals, the scripts to sign, the feeling of lateness, and the struggle to fit it all in before the end of the day. He wanted to talk to me about Jade, and I knew I had to go.
AT ONE PRECISELY, I tapped the door with “Dr. Chisholm” spelled out in neat gold lettering in a little black frame. He stood up as I went in. He was thin and dark, with intense brown eyes that watched mine closely so that he caught the flicker of surprise.
“It’s okay. Everyone is fooled. Sadly, I lost my Ghanaian accent at Oxford.” His handshake was tight and brief. “Thank you for coming. Sit, please.”
I sat down on a gray plastic chair and he took his place behind the desk. It felt like an interview somehow. I spoke quickly: “Thank you for asking me to meet you. It’s a difficult situation . . .”
“Jade is ill, Dr. Malcolm.”
“Yes. Her father didn’t give anything away, but I think it’s been going on for a while. She’s obviously very depressed.”
“Very ill.” He looked at me without expression.
“The social workers—”
“She has leukemia.” His voice cut smoothly across mine.
“Leukemia?” I was confused, or perhaps he was. He must be talking about another child.
His voice was continuing: “. . . so we are certain no one abused her. Unwashed maybe, lice and so on. Unwitting neglect from inadequate parents, though I suspect she is loved. No, she has acute lymphoblastic leukemia.”
Jesus.
“Blood tests show atypical lymphocytes, blast cells. No clotting capacity. She is dangerously anemic.”
How the hell had I missed that? Everything was suddenly, shatteringly, obvious. She had been passive with exhaustion, not because she was depressed but because she was anemic. The chest infection was secondary to nonfunctioning white cells. The bruises were due to poor clotting, not abuse. She had come back four times and I hadn’t listened, hadn’t believed her mother. A hot wave of guilt was breaking over me.
Dr. Chisholm kept pace with my thoughts and outstripped them.
“We have her on intravenous antibiotics. The MRI scan is booked for tomorrow and then we start the chemotherapy.”
“Do her parents know?”
“Not yet. That’s why I wanted to see you. It’s a delicate situation. In the clinic I told them we needed to admit her to investigate the possibility of nonaccidental injury. They asked if that’s what you had thought.”
“I went to their house specially to inform them.” But that was a mistake, I knew that now. I had judged them partly by their house, by the street it was on. “I tried to tell her father.”
“People choose to hear what they want to.” His eyes flashed before he looked away. “I have no doubt you tried your best, Dr. Malcolm, but I’m afraid they had no idea at all. Mr. Price felt accused; he was angry.”
Angry? He would want to kill. He had blamed “those bloody little blighters at school,” but the suspicion had fallen on him because of me. I could see that bull-like figure hurling the chair through the window in h
elpless rage.
“The tests came back this morning. From here on we take over. I knew this would be a surprise, so I thought I would tell you myself. I also wondered if you wanted to inform her parents. It might be best in the long run for you to discuss the diagnosis with them at this point. Build trust.”
Discuss? What was there to say? That I had made a terrible mistake because I hadn’t believed what they were saying? That I had stereotyped them in the worst possible way?
His eyes looked hard into mine. I couldn’t tell if he was sympathetic or contemptuous.
“What’s the prognosis?”
“Between twenty percent and seventy-five percent five-year survival. We have to wait for the scan results. Jade has an unusually large number of abnormal white cells in her bloodstream, which worsens her prognosis, as you know.” He was still watching me closely. “So, as her first point of contact, what do you want to do?”
I wanted to run away from the guilt that could drown me. I had referred Jade in the end but for the wrong reasons, and too late, months too late.
“I’ll go and see her parents, of course.” I thought for a moment and added, “I’d like to see Jade. At least I can tell them how she is.”
“Follow me.”
He moved smoothly from his desk, through the door, and out into the corridor. I almost had to run to keep up. She looked all right, I’d say to her parents later. She looked better. It wouldn’t be long, I’d tell them. It’s lucky she’s in hospital now. She was laughing—no, perhaps not laughing. She was smiling. I said . . . then she said . . . then she laughed . . .
I wasn’t sure at first why we had stopped at the second bed. There was a little boy in it. Very thin, with closed eyes and spiky fair hair. He looked about six. There was a drip in the arm that lay outside the sheet. Then I saw the giraffe, dirty against the crisp white linen. Some of the bruises were green now, but there were new red and mauve ones too.
“We cut her hair to make it easier to get rid of the lice.” He spoke very quietly. “But it will also help her adjust to the hair loss. We had her permission and the permission of her parents, though, as I say, they don’t know the diagnosis.”
I wondered how long before she would go completely bald with the chemotherapy.
Dr. Chisholm was talking softly; it was as if he’d read my thoughts. “We don’t yet know what combination of drugs we will use. That will depend on the scan.”
“Jade?” I whispered. “Hello, there. It’s the doctor.”
Dr. Chisholm looked at me. His eyes said: Doctor? The doctor?
“Jade has met lots of doctors now.” He sounded dismissive. “She’s asleep.”
I ignored him. “Jade? I’m going to see your mum and dad now. I’ll tell them—I mean, I’ll give them . . .” What? What would I tell them? Was there anything to give them?
Her eyelids flickered open.
Maybe it was because she had heard my voice before or maybe it was because she heard me say Mum and Dad, but for a second, less than a second, she looked at me and she smiled.
It was only as I turned the car on the oily concrete of the hospital underground parking garage that it came to me. Of course, she couldn’t have known it was my fault or that she could have been helped so much earlier if only I had listened.
Chapter 7
DORSET, 2010
ONE YEAR LATER
I am immediately in a warm kitchen, tidy and teeming with color. I take in orange-patterned linoleum, a dark red table, yellow cabinet units with white handles, a bright blue stove, and a red sofa by the wall. A fire is glowing, a television screen flickers from the corner, several large embroidered cats crowd on a chintz-covered armchair. Bertie has followed us in; before I can stop him, he eats the small squashed pile of cat food in a bowl and then settles by the fire with a little grunting sigh. I put the old lady down on the sofa, slide off her shoes, then sit next to her. With my hand on her pulse, I scan the room quickly. There are photos on all the surfaces: an elderly man wearing a cap, digging in a garden, a dark-haired young woman with a baby, a small boy at the edge of the sea, holding another child’s hand. Family everywhere. I am taken back to our kitchen at home, so steeped in family that I used to think if I pressed my ear against the wall I would hear the children’s voices, stored inside. When everything began to go wrong, going home was all I could think about.
BRISTOL, 2009
TEN DAYS BEFORE
I drove away from the hospital as fast as I could, overtaking a student driver and then jumping forward at a crossroads before the lights changed. As I accelerated down Park Road, little groups of words slid and twisted away in my mind.
I thought the bruises . . . there was never long enough . . . I know you told me . . . I’m sorry.
The sun was streaming through the windows at home, lying in unfamiliar lines on the floor. I rarely returned this early. Ana left the kitchen door bolted; no one would be at home now to let me in, so I used the front door. There was a pair of sneakers on their sides, just inside. I picked them up. Ed must be here. He didn’t really need to take his shoes off because we’d taken the carpets out years ago. No curtains either. The rooms were empty spaces, shiny dark wooden floors, a piano, walls of books stacked and sorted. A refectory table so Ted could spread out his papers easily.
Now my footsteps sounded hollow as I walked through the echoing rooms. Despite their ordered perfection, we hardly used them. Ted always worked in his study, the children lived in their bedrooms or the kitchen. I went down the wooden stairs to the basement kitchen and the warmth rose to meet me. I held the sneakers closely against me, too closely because later I saw they had left an uneven muddy smear across my shirt.
Ed was sitting in front of the computer in the living space that opened off the kitchen. As I walked over to see him a screen folded down into the corner and another came up, full of numbers. I was so pleased to see him I felt slightly dizzy. I sat down near him on the arm of the sofa. I wanted to kiss his cheek, which always smelled of warm toast, and rest my hand on his springy dark hair. He winced away as I approached. I had to learn new rules all the time.
“Hi, darling.” I spoke to his back. “You’re home early.”
“Math coursework.” He didn’t look at me.
“Ed, I’m only saying . . .”
“Lessons canceled. There’s a talk about that rapist.”
“Yes?”
He kept his eyes on the screen.
“I gave it a miss. It’s for the girls. How to not walk home on your own, how not to talk to strangers. Tedious.”
“What did they say about the rapist? Why today?” Something else to worry about. “He’s on the other side of Bristol, isn’t he?”
“Christ, questions.” His fist was clenched on the table. “Some teacher thought they saw a random guy lurking about the girls’ boardinghouse.” He looked at me quickly, eyes screwed up, hiding something. “I need to get this done. I’m way past the deadline.”
“Hot chocolate?”
“Yeah, okay.”
I made it quickly; as I put it in front of him, I let my hand rest on his shoulder for a second. Close up, I was surprised that he smelled stale. I hesitated, and he glanced up, frowning.
“Thought you were normally at work,” he muttered.
“Well, I am. Normally.”
“Cutting?” The dark eyebrows lifted, his attention was snagged.
I was startled. “’Course not. Are you?”
“Told you, it’s just a talk for the girls. Once I’ve done this, I’m back on track.”
“Okay. Good.”
I wanted to tell him then that you can spin off track so easily, one mistake and you’ve lost your way.
I let myself sit close to him for a few minutes, absorbing his aura, his tall frame slouched in the chair, large feet with crumpled socks, and the
smooth back of his neck. He turned to look at me again. Checking, not used to my stillness.
I started to explain. “Work things are a bit . . . I’m a bit stuck on something.”
“Yeah?” Shoulders hunched, eyes wary.
“It’s all right, though. I’m sorting it.”
The broad shoulders relaxed. “Only, I need to finish . . .”
“Fine.” I picked up the sneakers again. “These are yours, darling, they’ll need a wash. And, Ed . . . don’t forget to chuck your clothes in the wash sometimes as well . . .”
He took the shoes, gave a little grunt. His face moved close to the screen again. I patted his shoulder briefly and moved away.
In the kitchen I made a cup of tea and looked at the garden through the curling steam. The trunks were fused in the darkening light. I phoned Ted and this time got through. He listened.
“God. That’s hard for you,” he said when I paused. “Sorry, Jen.”
“Don’t be sorry for me, be sorry for Jade.”
“I’ve done the same—worse. Remember what happened with that young girl’s spine? Paralyzed. Terrible.”
“Yes, of course. That was terrible,” I agreed. That mistake had almost led to a court case; Ted’s guilt had deepened into depression. For a second I felt ashamed, I hadn’t thought then to give him the comfort I needed now.
“But everyone knows the risks of neurosurgery. They sign consent forms. You explain things. The Prices didn’t realize there was a risk in trusting me, and I never thought about leukemia. I didn’t manage to hear anything that they said . . .” I stopped, remembering how I had ignored what they had told me, allowing my thoughts to spin in a different direction.
“I’m in the middle of something, Jenny,” he said quickly. “I can’t talk now. I’ll try to get home early. I’ll get some wine.”