by John Collee
Dharma Ayurveda
Through this man
You will touch all beings
In yourself
And also in me
Like Cranley, Kingsley was a man of habit but tonight he did not take his usual route home: the slow drag up Leith Walk to Princes Street. Instead he turned left at the Mecca bingo. A narrow cobbled crescent brought him out on Ferry Road. As he headed westwards the black tenements fell away, the pavements broadened.
Two miles further on he turned left again, down the wide boulevard that transects Inverleith park. Driving south now he could see, above the trees, the lights and spires of his old school. Kingsley had spent a long time in this town. But even now, as the hospital to which he had devoted the last decade was threatened with closure, he had no desire to leave. He was happy here, cemented into this buttress of the medical profession. He knew that it was the stability of men like himself which sustained the profession. Just as it was the profession which sustained men like himself.
Rejoining the traffic in Stockbridge he climbed up through the shambles of mews houses where he had lived as a student. He had already dismissed Dhangi from his thoughts. His mind had returned, as it would always return, to his work. He was thinking of Mr Niven. There had been something odd about the feel of Niven's bowel cancer – like Spears's breast lump, that uncanny sensation of warmth.
Chapter 3
White tiled floor, white walls, hot white light. Sandra Spears's white breast, adrift in a sea of green drapes, rose and fell with her breathing.
'OK to cut, Richard?'
A nurse tic-tacked across the floor bundling the drapes from a previous operation. Kingsley felt for the mass. It was less easily palpable than he remembered but he could still identify it – a discrete nodule in the tail of the breast. Overlying the lump there was a barely perceptible reddening of the skin. He hadn't noticed that before. He checked the skin creases, then stretched the skin between finger and thumb. The knife performed a neat ellipse. Jennings, his registrar, dabbed the blood.
Richard Short lifted his gold digital watch off the anaesthetic trolley and squinted at it critically. If this one was malignant he could add a forty-minute mastectomy to the list. That took them to half past three. Then the hemicolectomy. So much for his squash court.
This present anaesthetic was a doddle. Even the bowel resection seemed unlikely to prove taxing. Short yawned and stroked his moustaches. Routine anaesthesia bored him to death. He glanced at his assistant and mentally sketched in the contour suggested by her theatre pyjamas.
Kingsley spoke without looking up. 'How was your holiday?'
'Bloody marvellous. It's been pissing ever since I got back.'
'Good fishing weather . . . diathermy please,' said Kingsley.
He buzzed the small bleeders and they retracted, cauterized, into the subcutaneous fat.
Richard Short looked up. His face appeared over the horizon of Sandra Spears's breast.
'Babcocks,' said Kingsley. A Babcocks forceps slapped into his hand.
'I've never understood the attraction of fishing,' said Short.
'You have to be committed to go out in this.'
Short looked at the drizzle on the window.
'You ought to be committed if you go out in that.'
But then, he reflected, Kingsley was. He watched the surgeon grab the suspicious section in forceps and cut it free from the surrounding tissue. Kingsley did two or three of these operations every week. Had done for years. What sustained his interest? Commitment? Probably Sheila was right – the Presbyterian upbringing. Short himself had been raised on money and cynicism in equal parts. Sometimes he envied Kingsley' s contentment.
Under the drapes Sandra Spears's breathing continued, slow and regular. The breast rose and fell.
Kingsley looked down at his friend and caught him yawning. 'What you need, Richard, is a game of golf.'
But Short could not muster enthusiasm even for his consuming passion. 'Greens are like paddy fields.'
'Small artery forceps,' said Kingsley. The ratchet rang as he clamped them shut. 'We've been golfing in the rain before.'
'Madness,' said Short. 'You just couldn't bear to let me win the hospital cup by default.'
Short's assistant was opening vials with the casual competence of a farmer's daughter cracking eggs. Right now he didn't need a game of golf. On St Lucia he'd been able to identify what he really needed – regular sex.
'Saturday week,' said Kingsley, 'two pounds a stroke.'
'Weather permitting,' said Richard Short. It had never ceased to amaze him how Scotsmen in general, and Kingsley in particular, constructed religions from their hobbies. If Hurricane Alma hit Scotland the weekend golfers would still be out there, dodging the flying gorse bushes and driving into the wind.
'Right, specimen pot. Are pathology expecting this?'
The houseman confirmed that they were.
'OK, chromic, swab, needle . . .' said Kingsley.
'. . . coffee, milk,' said Short. He relinquished his stool to his assistant.
'If you want anything . . .'
'. . . just whistle,' she said.
'. . . just . . . yes, am I getting predictable?' He patted her on the bottom.
Kingsley stood for a moment as his registrar began to close the wound. He hoped they wouldn't have to proceed further. Mastectomy was a mutilation, something he would rather not inflict on a young woman like Sandra Spears. He pulled off his mask and followed the anaesthetist.
In the rest room, Richard Short rummaged in the wall cupboard for the powdered milk he could never find. Kingsley sat heavily on one of the fibre-glass chairs.
'Feeling a bit peaky, Alistair?'
Kingsley looked in the mirror. The inscription 'Hollister Colostomy Bags' superimposed itself on his forehead. 'Funny thing, these last three days, every time I come into the hospital I get. . .'
'Don't tell me, I know the feeling.'
'I'm being serious.'
'So am I.'
Kingsley squeezed the back of his own neck. 'Ever since that character approached me in the car park.'
'Bad vibes is what we call it.'
'It's not what I call it,' said Kingsley. 'I think he's given me the flu. Sheila tells me it's the male menopause.'
'Ha!' Richard Short found the milk. 'Sure she isn't just suggesting you should fuck her more often?'
Kingsley cast his eyes heavenwards. Much as he liked Short, there were times when the man took his contemporary image too far. Kingsley went to a locker and rummaged for the pipe in the pocket of his tweeds. He loaded it in silence.
Richard Short picked up a copy of the British Medical Journal and scanned the list of contents on its cover.
' "Ten cases of phaeochromocytoma associated with medullary carcinoma of the thyroid" – who writes this stuff?'
Kingsley drew on the tobacco. 'It's a good article that.'
'You mean you've read it?' Short was genuinely astounded.
'Yes,' said Kingsley. 'You might find it relevant.'
'You're talking to the man who fell asleep during Jaws,' Short told him, 'and that was a damn sight less boring than this stuff. I wouldn't get past the first paragraph.'
'Have you tried?'
Short threw the magazine back at the table. 'Come on, Alistair, it's small print.'
'I always read the small print,' said Kingsley.
The phone rang. Kingsley answered it immediately, but it was not pathology.
'Take this frozen section,' he continued. 'Half a dozen cells down the microscope. Can't get much smaller than that. Right now it's the most important thing in Sandra Spears's life.'
Short reached for another magazine. 'I was talking about phaeochromocytoma. Tits are different . . . ah! Cosmopolitan, that's more like it.'
Kingsley smiled and said nothing. He knew when he was being goaded.
Twenty minutes later the phone rang again. This time it was the pathologist.
'Dr Mukesh here, p
athology. About this specimen, Spears, Sandra Spears, I don't think I've seen anything like this before . . .'
'You don't have to shout, Mukesh, I'm not senile yet.'
'Sorry, sir.'
'And try not to talk so fast,' said Kingsley.
'No. Sorry. Yes, very strange indeed. Lots of abnormal cells and many many mitotic figures . . .'
'Malignant,' said Kingsley.
'Well, yes, sir; what puzzles me is there's some kind of reaction going on at the periphery. As you know, we normally expect a mild degree of inflammation… but not this . . .'
'Not what?'
'Well it is incredible; there are areas where the disease is almost walled off by white cells.' Mukesh cleared his throat.
'Was it infiltrating?' Kingsley asked.
'Well yes, in parts . . . at least it had been.'
'Are you wanting to take more sections?'
'Don't see it's going to tell us any more, Mr Kingsley.'
'So it's malignant.' Kingsley looked to Short and put his hand to his head.
'Well, what I'm saying,' Mukesh continued, 'is the host seems to be setting up some kind of reaction. She appears almost to be overcoming the cancer.'
'Impossible.'
'Quite agree, at least so one would have thought.'
‘I’m telling you, Dr Mukesh. It's impossible.'
'Well, yes.'
'So we cut,' said Kingsley.
There was silence on the other end of the phone. 'We need a decision, Dr Mukesh. I'm not going to stop here. Removing the lump will have seeded cancer cells throughout the breast. I don't want to tell you your job, but mitotic figures plus infiltration equals cancer. No? And that means mastectomy.'
'I suppose that's right.'
'I'm sure of it; you'll tell me about the paraffin sections?' Kingsley put the phone down and knocked out his pipe.
'What was all that about?' Richard Short was already tying his mask.
'Oh, the new pathologist. Some rare variant he's discovered.'
'Important?'
'Small print.'
'Touché.'
Kingsley smiled wryly. 'Cancer though.' He stood up.
Richard Short dropped the magazine. 'Another bloody marathon.'
Sheila Kingsley moved the rubber plant to get a better view of herself. She rather liked the effect. She slapped her tummy and turned round to check the back view. Kingsley was sitting up in bed. He looked at her over the top of his glasses.
'What's that?'
'It's a leotard. You've seen leotards before,' she told him.
'Now you mention it,' said Kingsley, 'Top of the Pops?'
She was not being drawn.
'Strange thing to wear in bed,' he said.
'I’m not going to wear it in bed.'
'Why d'you put it on then?'
'For my yoga.'
Kingsley undid the top button of his pyjamas and settled down behind the British Journal of Surgery.
She sat upright on the floor, concentrating on her breathing. From Kingsley's viewpoint the lower half of her body was obscured by the foot of the bed.
'When did you take up yoga?'
She didn't look at him. 'I'm going to teach my nine-year olds how to do it.'
Kingsley returned to his journal. After a while he looked up again.
'What does that do?'
'Relaxation – it balances the conflicting forces of Yin and Yang.'
'What's Yin and Yang?'
'They're body forces.'
'How do you know, has anyone measured them?'
'Oh for God's sake, Alistair.'
Kingsley consulted his journal again. Sheila continued her yoga on the carpet. After fifteen minutes she left to take a shower. When she came back to bed he moved over. Her legs were cold. Kingsley was still absorbed in his reading. Sheila picked up a book and put it down. She rolled over and put her chin on his chest.
'What are you reading about?'
'Well it's all a bit technical,' said Kingsley evasively. Then he lowered the magazine. 'Do you want to talk?'
'No,' she lied.
Kingsley settled into the pillows. 'Richard reckons I should make love to you more often.'
She sat up. 'Well there's nothing like bandying your private life about at work.'
'No, he just said it as a joke.'
'I see; you said, "Sheila's getting a bit frisky these days" and Richard looked round from whoever you were operating on at the time and said "Well, Alistair old chap, the thing to do is fuck her more often".'
'No, it wasn't like that.'
'So what was it like?'
'Oh come on, I just said I'd been feeling off colour, and you know how Richard is, he said . . .'
'He said, "Well there's nothing so good for you as humping".'
Kingsley looked at her despairingly. She knew he found that kind of thing offensive. He replaced his spectacles and picked up his journal. Sheila remained sitting. Eventually he put a hand on her bare back. 'Well, would you rather . . .' She observed a diplomatic silence.
'. . . rather make love more often?'
'More of ten than what?'
Kingsley unbuttoned his jacket and caught her round the waist. 'Come here,' he said. She gave a little yelp. They sank under the quilt and her legs twined round his.
'It's all right, darling,' she said as his hands found her buttocks. 'Don't feel you have to comply with every bizarre little whim . . . There is the age difference. You can't be too careful. Maybe I should take a younger lover . . . or Richard could help out . . . how would that suit you . . . then while I'm screwing you can read . . . that . . . that whatever it was . . . ah, that's rather nice.'
Then the phone rang.
It had rung three times, when Sheila pulled away.
'Not important,' said Kingsley.
'Mightn't it be an emergency?'
'Better be.' Kingsley raised his head and disentangled himself, pulling his pyjamas across his erection. He took the receiver. 'Hello.'
A coin dropped. The voice was slightly slurred and louder than was necessary.
'Is that Mr Alistair Kingsley?'
'It is.'
'Roland Spears.'
'Hello, is this vitally important?'
'It is to me.' The voice was suddenly abrasive.
Kingsley wondered who Roland Spears was.
'I just wanted to ask you.' The voice broke, resumed at a more even pitch. 'I just wanted to ask you about the operation on my wife.'
'You're Sandra Spears's husband . . .'
Roland Spears's breathing was deep and rapid.
Kingsley continued: '. . . well, as you will no doubt have been told, the, the mass was malignant, so, as you will appreciate, it was necessary to perform a mastectomy.'
'That's not what I heard.'
'I'm sorry?'
'I heard there was some doubt about the specimen you took.'
Kingsley supported himself on one elbow. He released Sheila's wrist. 'I'm sorry, Mr Spears, I don't know where you got hold of this information. There was no doubt. The cells were malignant.'
'That's not what I heard.'
'Mr Spears, why don't you ring me in the morning and we'll talk this one over . . .'
'Don't patronize me, Kingsley. Strikes me there are times you characters take your professional objectivity too . . .'
'You've had a few to drink, Mr Spears. You may regret saying this in the morning.'
'Listen, you bastard.' Spears was suddenly yelling down the phone. 'You cut off my wife's breast without waiting for a second opinion. For all you know that could have been a bum lab report.'
'I have the utmost confidence in Dr Mukesh.'
'Well I don't have any fucking confidence in either of you.'
'I don't have to listen to this,' said Kingsley quietly.
'I'll tell you what you don't have, Kingsley. You don't have a wife with one breast.'
Kingsley's hand shook as he put down the receiver.
'Who was t
hat?'
'Someone's husband.'
'What did he want?'
'I don't want to talk about it just now.' He kissed her on the forehead.
'Alistair?'
No response.
She turned over and lay facing him.
Kingsley put his hands behind his head and looked at the ceiling.
Chapter 4
'I wouldn't go in there if I was you, Dr Short.'
Kingsley's secretary looked up at him. She was biting the end of a Biro, lips half parted. In between paperwork Rhona spent a lot of time rehearsing the physical vocabulary of her trade: for example this raising of the eyebrows, legs tightly crossed, free foot angled downwards. At times she would groom the middle finger of her left hand, or, as Kingsley paused for dictation, perform elegant, languorous preening movements with one elbow on her knee.
'I just wanted to remind him about the game.'
The rain had abated over the past few days. Now a watery sun sneaked over the crow-step gables.
'Golf?' said Rhona. 'I'll tell him later. He's had a bad morning.'
'What, in theatre?'
'No, something that happened after that.'
'Tell him he's working too hard,' said Short.
'I do.' She smiled sweetly.
Short tore his eyes away from the taut linen curve of her bosom and focused instead on the delicate smile lines at the comers of her mouth. There was something unnervingly crisp about Rhona. From the perfectly aligned seams of her stockings to the unruffled mane of blonde hair she dressed with almost puritanical precision. Hence the speculative rumour amongst most of the middle-grade registrars that the area between her legs was frequently powdered but little used. Short found this concept consistently challenging.