by Rob Palk
The earmuffs were supposed to drown out the churning industrial racket an MRI scanner makes and partly succeeded in doing so. It was still incredibly loud.
After a while I started to relish the thud and drone of machinery. It was kind of like listening to krautrock. I became attuned to hidden patterns, oblique rhythms. At the back of the racket, I could make out celestial choirs. Sweet voices lifting in harmony. I wondered if I was dying. The voices were raised up in song to a higher being, ascending in praise while the machines cranked on behind.
The mechanical whirring stopped. The singing continued. ‘I used to love TLC when I was a kid,’ said one of the doctors. ‘I used to try and wear an eyepatch to school. Oh sorry, I shouldn’t have said that.’ She told me I should go upstairs to the waiting room.
Eighteen
‘Marie. It’s me, I’m at Moorfields. Yeah, that’s right, the eye place. Are you sitting down? You’re doing yoga. That doesn’t tell me if you’re seated. I’ve something bad to tell you. Yeah, I know. Sorry. It turns out there’s a blood clot on my brain. Quite a big one. The size of a golf ball, they said. I always thought of golf balls as small before today. What happened is I had a haemorrhage, a bleed, and they say it’s formed this clot. They say if this one goes off it really won’t be good. I might die, is what they are saying. I’m apparently at risk of another bleed. They are all being nice. But that is sort of the least I would hope for. Can you come down?’ Come down in case I die.
There is always a strange sort of fun in giving bad news. Like schadenfreude, if you could have schadenfreude against yourself. But it wasn’t all that much fun knowing my body was trying to kill me.
I’d often enjoyed being alone. Seclusion, down-time, it’s good for you. Except not like this. Not when your body is your enemy. A clot, swollen like a well-fed leech, sat inside my brain. Bumping with each throb of blood against vital neurons, clusters of myself. The bleed seemed to have squashed a bit of my visual cortex, lessening my sight. What might another bleed do, if they didn’t stop it in time? A pop and that could be language gone. A tiny bit more blood, swelling through my veins, and maybe I wouldn’t love Marie any more. Maybe I wouldn’t love anyone. Which part of the brain dealt with love? I was alone and there was something in my head that wanted me killed. Alone was overrated. I sat on the plastic seat and waited for Marie.
She was with me in an hour, rushing through the waiting room, her face charged with tired elation. She was heavy with overnight things. There was a pause while we worked out whether it was safe for us to hug. I hadn’t been given advice on this. As a compromise, I put my arms around her while holding my head at an angle. ‘I love you,’ I said. ‘I love you so much.’
‘I love you, Stuart,’ she said.
‘They want me to go to the brain hospital. In Bloomsbury, Queen Anne Square. They said we could wait for an ambulance.’ Everything was out of my hands. It didn’t feel too bad. I felt carried, taken care of. ‘It’s almost funny when they tell you, they put on this sort of bad news face. Impassive.’
‘Right. Right. You seem to be enjoying this.’
‘I’m not enjoying this.’
We sat and we held on to one another and we waited for the ambulance. As long as we kept on holding, I wasn’t about to die. The waiting room emptied. Eventually we realised the ambulance wouldn’t arrive and Marie led me out into the street to hail a cab.
‘I actually feel okay,’ I said, as the cab pushed through the night. Marie’s lips tightened. Fending off tears, I think. ‘It’s all out of my hands now, isn’t it? And it explains so much. You remember how difficult I’ve been this last few months? Maybe even longer.’ I’d had them for a while now, sudden losses of temper, animal spasms of rage. It wasn’t at all like me. Now I had an explanation.
‘Yes,’ said Marie. ‘Yes I do. I do remember that.’
‘Oh god, Marie, I’m sorry I’ve been difficult. But that was obviously my brain. If you think about it. The pressure that must be in there. It’s amazing, really, that something so physical can get translated into all these complicated feelings and thoughts you see as disembodied.’
‘Don’t get overexcited Stuart, please.’
‘This hospital, it’s supposed to be really good, isn’t it? Like, the very best of its kind? One of the best in the world? I’m definitely not going to die, Marie.’ Saying this would make it true. ‘And if I do, which I won’t, I’ve had a very full life. I’ve still not finished a novel. That’s a shame. But I’ve had lots of . . . I’ve had you. That’s important. A full life.’
‘Can you drive a little quicker please? No, not as fast as that. You’ll jolt him. He really mustn’t be jolted.’ We travelled on, each bump making me shudder, as I clutched onto her wrist. My thumb against her pulse, touching her life.
They had me in orange pyjamas, the sort they use for Guantanamo inmates, Daesh decapitees, prisoners on death row. For reasons nobody told me I had been placed under a ban on fluids, and my headache had come right back. Every so often a nurse would pop through the curtains and take my pulse. There were groans and snores from the neighbouring beds. Marie had stayed until the nurses told her to leave. Now I was alone. Towards dawn one of the patients started singing, a doleful chain-gang hymn. Someone yelled at him to shut up. There were murmurs of agreement round the room.
Nineteen
I woke up to a clean bright ward with a 1950s atmosphere of spick and span. The platonic ideal of the NHS that we carry inside us, all lipstick and bedpans. While I’d been asleep the water veto had been rescinded and there was a cup and a scratched plastic jug on my bedside table. I poured some and gulped it down. My head had settled into the sort of pain you get when you bruise your knee. It was specific, located at the back of my head, an angry dullness. A nurse came and gave me a paracetamol in another cardboard gourd. I was starting to develop respect for paracetamol.
‘You new then?’ said the man in the next bed. His voice sounded thickened by expensive booze, the tone of a dissolute prefect addressing a young grub.
‘Got a blood clot on my brain,’ I said. It was hard not to feel a bit proud.
‘At your age too,’ said the man. He sounded impressed. ‘I’m here because of a stroke.’
‘Me too, maybe, I think. I don’t really know all the terms.’
‘Did yours hurt? Mine didn’t hurt. Lucky. I didn’t even know I’d had one. Reason I’m here is I started talking in binary opposites.’
‘Binary opposites?’
‘No, binary opposites. Was doing it for weeks. If the cat got on the sofa, something which is inevitable in a house like mine, I’d try to say to people, the cat is on the sofa, just making conversation. Observational humour, sort of thing. But instead I’d say the dog is on the bed. And no one understood what I was getting at, our dog, Cassandra, having long since passed away.’
I wondered if a sofa was really the binary opposite of a bed.
‘Come quick my dear, I’d call out, the dog is on the bed. And this alarmed my wife because, our dog having popped her clogs some years before, the sheets would have been in a right state. And I wouldn’t say darling, I’d say Chris, Chris being my brother’s name.’
‘And he’s the opposite of your wife?’
‘I suppose she is. Chris is my sister. Did I just do it again?’
I told him that he had. He smiled the self-forgiving smile of a drunk remembering last night’s debauch.
‘Well I won’t be doing it at all soon. Going to have my operation today.’
‘You mean tomorrow.’
‘No, I mean today. I wasn’t doing it then. It comes and goes. Periodically.’ He retreated into offended silence. A nurse came and deposited fun-size packs of cereal and slices of cooling toast. The ward filled with the sounds of happy chewing.
‘You seem a bright young man,’ said my neighbour. ‘Assuming we both get through this, I might be able to help you out with a thing or two.’
I asked him what sort of thing.
&n
bsp; ‘Russia!’ the man said. He pointed a thick-veined hand at the window, conjuring visions of samovars and Cossacks. ‘Tourism therein. Travel guides is my business. You’d enjoy it, clever lad like you. Sleeper trains and frostbite and women in fur coats.’
‘I think I would enjoy that.’
‘I’m certain that you would,’ said my neighbour. ‘Tell you what. I’ll give you my card, when I’m back from the op. Tomorrow.’
‘You mean today.’
‘Ah. Nothing gets past you. Eh?’ He punched the air in lieu of punching my face and immediately fell asleep. Before I had time to dream of the icy steppes, I saw Marie hurrying across the ward. My face near split with grinning. It was wonderful to see her, to be reminded there was life outside this place.
‘Stu. My god, I’m shattered, I didn’t sleep a wink,’ she said. ‘Well I did, but on the sofa. I was messaging all your friends, telling them the news. Lots of dramatic responses. And after, I just dropped.’ I hugged her as hard as I could. ‘Malkin doesn’t help. He keeps running to the door and scratching, like he thinks you’re coming home. I swear he does it on purpose.’ Manipulative animals, cats. ‘It almost seems not real. You don’t even look ill. I probably look more ill than you do. I brought you your laptop and some books.’
‘I love you,’ I said. It was wonderful having her there. None of the other brain cases had someone beautiful to visit them. It was the one advantage to falling sick at a young age. I thought about my funeral, about the girls in their black dresses, weeping for what was, what might have been. It would be a shame to miss a funeral like that.
Doctors came and went. There were scans and interrogations. I had to push on nurses’ hands a lot, to show I had some strength or could follow simple instructions. I was taken, in a wheelchair, for a scan. Marie took a picture. I looked like the last, suppressed photo of Lenin, a confused and stricken otter in a shawl. Later, they told me, in a measured way, exactly what had happened. I was suffering – they did not say suffering – from an arteriovascular malformation in my brain. This meant certain veins in my brain’s left hemisphere had become tangled and filled with blood. This had caused a near-fatal stroke or haemorrhage which had impacted on my visual cortex, causing, they said, a sight deficit. The peripheral vision on the right side of both eyes had gone away, with my right eye the more affected. They always used this language of deficits, as though the economic lingo would make my illness sexier. The blood clot was a sign my brain was gearing up for a second haemorrhage, one that might prove fatal. The best that I could hope for was it would leave me entirely blind.
The good news was that I had come to the right place. The bad news, or some of it, was that they would need to operate as soon as possible. An operation would save my life and while it wouldn’t restore my sight it would prevent it from getting worse.
Over the days a stream of visitors arrived, while Marie sat, patient, knitting to task her hands. My parents came down from Lancashire, grave and fretful, suddenly aged, pestering the doctors for news about my sight. When I told them it was probably damaged for good, my mum tutted as though I should make more of an effort. My dad had a stern and tired look and asked me a lot about the food and the quality of the pillows. ‘I knew something like this would happen with you living in London,’ said my mum. How drawn her face was, how the worry creased her flesh.
Various friends of Marie’s and mine arrived. A nervous pack of colleagues from Pet Concern, dressed up for that night’s office Christmas do, wondering if I’d make it to work next year. I enjoyed it, holding court. I was an emperor so powerful that I needn’t get out of bed. Rupa from work came down and told Marie not to make too much of a fuss of me. ‘He’s got the nurses for that. Make sure you get some rest.’ My old university friend Alistair, who Marie had adopted lately, as she tended to do with anyone who seemed a bit lost, came and told us of his marital woes. He was through with Lucy for good this time. He’d been working hard to save things but his patience had run out. What’s more she was seeing some bloke.
We said nothing about her recent visit. She hadn’t mentioned a bloke. Poor Alistair, he looked exhausted. His eyes seemed to be retreating into his skull and he kept on tapping his knuckles with the fingers of his other hand. His upsets had dislodged him, sent him spinning. He’d always been blessed with a preternatural confidence and it was odd, painful, seeing him stymied like this.
‘So what you going to do?’
Alistair pressed his fingers against his scalp, unsure even of his words. ‘I don’t know,’ he said. ‘I married her. Divorce seems so enormous. Marriage seemed massive enough.’ The Alistair I’d known in halls had been the first public school boy I’d ever met and back then his assurance and ready expectation that life would go to plan had seemed both bizarre and faintly contagious. He wasn’t supposed to lose his grip on things, just as I wasn’t supposed to be ill, not at this age.
‘Don’t worry about the noise,’ said the man in the next bed. ‘Reminds me of the pub.’ When Alistair had left us, Rupa rolled her eyes. ‘I suppose I should be more forgiving,’ she said. ‘But honestly what a baby. You can tell why she walked out.’ I told her Alistair was all right, that she should show some more compassion. I chuckled as I said it, agreeing with her.
Every time I dozed off a new sightseer would come. Just before the ward’s early closing, Marie’s parents arrived. I was glad that my own parents had gone back to their hotel. Somehow whenever they interacted with Marie’s, they would transform from small-town liberals into nervous stage rustics. Or they’d start describing things as ‘common’, not realising that snobbery was frowned upon in literary circles. As for the Lansdownes, they’d take on an almost reptilian glamour. So it was best they not interact.
‘Stuart, Stuart, oh you’ve got one of those tubes. I hope they know what they’re doing here. There’s a very nice doctor we spoke to on our way in, he said you were behaving yourself. I said that settles it, he’s definitely not well.’ This was Judy. I liked Judy a lot. She’d had, back in the eighties, a reputation for fierceness among the smitten novelists (‘rather like a swan – all very charming until your arm gets broken’ according to one wounded magic realist) but nowadays it didn’t show.
‘We’ve both been extremely worried about you, Stuart,’ said Frank. As always, he had the look of just having thought of a good but unsayable joke. He tweaked at his scarf, or one of them, for his scarves were legion, but he stayed a step back from the bed, a likeably corrupt pontiff offering his blessings.
‘Marie, how are you, dear? You look so tired, darling, are you getting enough sleep?’
‘I have to say Stuart, you’re lucky you aren’t dead. Called up a surgeon friend this afternoon and he said people with your problem normally don’t get this far. Small consolation if you die, but at least you’ve dragged yourself past the post. I’d say that counts as a very real achievement.’
‘Don’t joke darling, please, this isn’t a joking situation.’
‘He’s not going to die, Frank.’ I was living with a woman who called her father by his first name. This never failed to excite me.
‘You, uh, you knitting there, Marie?’
‘Keeps me busy,’ she said. ‘A scarf.’
‘Thought it might be a shroud.’ He looked us over, waiting for the laugh to show he hadn’t gone too far. I supplied it, to oblige. He handed over a hardback wrapped in brown paper and wandered off for a cigarette in the cold. Not stopping smoking was a part of his mystique. I wondered if he enjoyed it. The book was one of his.
I lay back as I had done for all my visitors and tried hard to think of something wise. Serenity, a wider look at things. It could even be something trite. But there was nothing but worry and soreness and, once they were gone, there was fear. I was alone, once more, and scared and the back of my head was pulsing, pulsing, reminding me it was there. I was ten years old again, lying in bed and the noise from downstairs, the telly, the chatter, had suddenly died out leaving only the loudness
of silence, the awful realisation there was nobody there but me. When I ran downstairs they were out in the garden, enjoying a summer night, but there was that moment, just that moment, of frightened solitude.
I think that was the first time I ever felt alone.
Twenty
A doctor came and sat upon my bed. He told us his name was Hilary Edelman. He was middle-aged, thick-haired, with a reddish tinge to his skin as though he’d been lightly dusted with cochineal. He seemed to be very excited about being a doctor. It must be an exciting job. While he explained how he would cure me, he bounced up and down on the mattress with communicative glee. ‘What we’re going to do first,’ he said, bouncing, ‘is flush your veins with a sort of dye substance so we can have a good look, see what we’re doing. We’ll only need a local anaesthetic for that. Then, hopefully today, we can block off the damage with glue, which should isolate it, stop it spreading. That’ll be with a full anaesthetic.’
‘Excuse me,’ I said. ‘Would you be able to keep still a bit? When you bounce it hurts my head.’
‘I wasn’t aware I was bouncing.’
‘He wasn’t really bouncing, Stuart.’
‘You were bouncing a bit.’
‘Are you sure? I don’t think I was. Now, there’s no reason for us to physically enter your skull as we can enter it through a vein in your crotch that’s connected right to the brain.’ He paused as though expecting one of us to try and say something funny. When neither of us did he coughed and carried on. ‘Now obviously there will be forms to sign. The nurses will be able to explain risk and so forth. I should say if you don’t agree to the procedure the chances of a second bleed are about 100 per cent.’
‘You’re still bouncing.’
‘Stuart.’
‘Ah, a reader I see.’ He bounced hard at the sight of the small tower of paperbacks on my bedside table. ‘You, ah, a fan of Ian McEwan at all?’