by Damon Galgut
He realizes now that he’s been shouting with all his force, signalling his distress in rings of sound that move outwards from the room. Caroline, he says, oh Caroline. You have to help me. What’s wrong, what has she done. She’s overdosed, she’s taken her medicine. Two hundred and fifty pills, he says, amazed at the figure all over again.
She is much calmer than he is and she brings an air of cool authority into the room. He remembers vaguely that she’s a nurse back in her other life in England, and he’s happy to defer to her when she takes charge. Salt water, she says, we must have salt water. I rush out to the restaurant and come back with two litres of warm, salty water, which we pour into Anna, pinching her nose closed to force her to swallow. Then Caroline goes outside and returns with a long reed she’s broken off somewhere. While I hold Anna’s head back, her mouth open, Caroline forces the reed down her throat. They are working as a team now, two midwives trying to coax a birth, but though the reed goes all the way down, so deep that it comes up with blood on the tip, nothing happens. Their patient is passive, neither helping nor hindering them, but her passivity is like a sort of defiance, from beyond which she watches with amusement. Look at all your striving, too late, too late.
By now it’s clear that the doctor isn’t coming. Somebody calls a taxi and they half-help, half-carry her down the stairs. A crowd has gathered at a respectful distance, watching the drama. We get into the car, all three of us on the back seat, Anna in the middle with a bucket between her knees. As we drive to Margao, with the car repeatedly stalling and struggling to start again, a bizarre conversation unfolds. Why did you do this. Because I want to die. What reason do you have to die. What reason do I have to live. You are a very selfish girl, Caroline announces firmly.
By now Anna has almost lost consciousness, she is swaying and slurring. We discuss where to take her, there is a private doctor nearby, but we decide to go to the government hospital, perhaps their facilities will be better. We have to carry her in when we arrive and load her onto a trolley like a sack of meat. While we are explaining to the doctor what she’s done, the taxi driver appears, plucking at my sleeve. Seven hundred rupees, he insists, about five times the going rate, but I hurl the money at him, this is no time for argument. Anna is signalling weakly to me and when I bend over her she whispers something inaudible. What are you saying, I can’t hear you. She forms the words again and this time I do hear. Tell them what I’ve taken. I have told them, I say, just as she slips away into unconsciousness.
I’ve brought the prescription for the medicine with me to show the doctor and he shakes his head over it. She took all of this. All of it, yes. He must do a stomach pump, he says, and he explains the hospital policy to me. It is extraordinary, he has to repeat it before I fully understand. The treatment, the hospital, are free, though the equipment and drugs are not. But it’s not possible simply to pay for them, they must also physically be bought. So the doctor writes his requirements on a slip of paper, which I must then carry down the corridor, across a courtyard, down another corridor to the pharmacy. A small mob of people jostles in front of the counter, each of them waving their slip of paper, each of them shouting to be heard. I plunge into the crowd, hacking a path with my elbows to the front. My friend is dying, I roar, please help me first.
Maybe the note in my voice reaches them, because they take my slip of paper promptly. There’s a short wait while the bored attendant wanders between the shelves, picking out what is required. A length of tube, a saline solution, some gauze. Then it’s all totalled up, my money is taken, the change is laboriously counted. A sense of unreality has thickened the air, like a dream in which you cannot move, and through this fog I run back up the corridor, across the courtyard, down the next corridor to the room. A surly nurse takes the equipment and pushes the tube down Anna’s throat. The saline solution is pumped in, then sucked back out again. I peer at it hopefully, expectantly, looking for the load of pills, but the fluid is clear.
Nothing, the nurse says. Her stomach is empty.
That isn’t possible.
Look, she says, and performs the operation again. The receptacle fills with its liquid. The nurse slouches off to do something else, leaving the tube in place. Caroline eyes it suspiciously.
I don’t think that’s in her stomach, she says.
What do you mean.
I think she’s put it into her lung. We both stare at the tube. After a moment, Caroline says, I’m going to take it out. She steps forward and pulls the tube from Anna’s throat and at this instant the nurse reappears, shrieking furiously. When Caroline tries to explain she shakes her head, the tube was in her stomach, she insists, don’t tell me my job.
But Caroline is right, later that day they will have to drain Anna’s lung and later still she will develop pneumonia on that side. But all of this is in the future and where they are is very much the present tense. They have moved her upstairs to do a stomach wash, the ingredients for which I again have to rush and buy at the pharmacy. Afterwards I’m detained downstairs by the doctor. He’s telling me that if the stomach wash doesn’t do the job, they will have to move her to the big hospital in Panjim. They have a heart and lung machine there, she is in danger of organ failure, they just don’t have the equipment here in Margao.
By the time I get upstairs and find her, another scene has developed. She is lying in a bed in a ward full of sick women, a thicket of ailing female flesh. They are all Indian and the peculiar drama unfolding in the corner with its cast of foreigners is of intense interest to them. They stare with candid fascination as it becomes clear that the stomach wash has made the sleeping woman’s bowels give way. A stain spreads across the back of her nightdress, a bad smell rises. He looks around wildly in search of a nurse, but of course it doesn’t work like this. The doctor tells us sternly, your friend has made a mess. You must clean it.
Oh God, I say, I can’t believe this. And it’s one of the few occasions in his life when the statement is actually true. This morning I was walking on the beach, now I must clean my dying friend’s shit. Caroline takes control again, becoming terse and efficient. We’ll need rubber gloves and disinfectant and cotton wool. The doctor writes these items on a piece of paper, I run down two flights of stairs and across the hospital to the pharmacy. When I get back Caroline has cut Anna’s nightdress off her, as well as the swimming costume underneath. We roll her onto her side. She is an absolutely unhelpful mass, a dead weight. The other women in the ward find this whole exercise hilarious, they giggle and titter behind their hands.
As we start on the business of cleaning her, it rapidly becomes too much. I put the cotton swab down and say, more to myself than anybody, I don’t know if I can do this. Caroline looks at me and says, let me handle it, I do it as part of my job. As a nurse, she takes care of sick, elderly, often bed-ridden people in England, which is how she makes her money to stay in India. Again I have that rush of gratitude to Caroline, for undertaking this task instead of me.
The watching women rock with merriment as Caroline wipes her clean. I go out into the corridor. I feel far from myself and from the surfaces around me, as if I’m looking down a long dark tunnel at the sunlit world beyond. The doctor, a fat lazy-looking man, comes back. We’re going to have to move her, he says. But not like that.
What do you mean.
She is naked, no. She must be dressed. We cannot take her in the ambulance like that.
But, I say. But. I don’t have a dress. Can’t you, I mean, don’t you have something, a hospital gown or something.
He shakes his head. You must find a dress.
It’s hard to believe, under the circumstances, that modesty should be a priority. I want to seize this plump, complacent man, who seems almost to be enjoying my plight, and shake him till his teeth rattle and he concedes that a dress doesn’t matter, no not at all, at a moment like this. But I know I have no choice. See him rush down the stairs again, along the corridor, out the door to the hospital and along the street to the mai
n road. He goes into a shop, but they don’t sell dresses. For that, they tell him helpfully, he will have to go to the market. So he runs out again and flags down a bus and pays to get on, like any ordinary passenger. See him ride across town to the market, a point of unnatural stillness at the centre of so much flux and movement, and then explode from the bus, rushing from shop to shop, a dress, I must have a dress. Eventually he finds one and pays and flees without waiting for change. Outside there is a man sitting idly on a motorbike, I grab him by the arm. Please, I cry, please take me to the hospital, I’ll pay you, just take me. Sensing the panic, or eager for money, the man bears me away on his little machine, weaving through the traffic.
Back at the hospital he pays the man and runs upstairs. Nothing has changed, Anna still lies in the same position, her naked back to the room. We drag and haul her into the dress and no sooner have we succeeded than she shits in it again. It’s too bad, I say, she’ll have to stay like that. The chorus of women falls about in laughter.
There is an ambulance standing by to take her to Panjim. It’s a drive of an hour and perhaps an hour has elapsed since our arrival here. These stretches of time feel like huge distances, a desert stretching in both directions. By now he knows the score, he will have to supply everything at Panjim, he has to get money and clothes. Before he can even voice the suggestion Caroline has picked up on it, let me ride with her, she says, you go to the room and fetch what you need.
It feels as if he last saw the room a long time in the past, not just a few hours ago. He collects a bag of clothes and some money and is about to leave when he notices Anna’s journal lying on the bed. She has been writing in it obsessively since the journey started, apparently documenting every moment of the trip, and he wonders now if any final message has been penned there. And when he turns with dread to the last pages, there it is, in a big incoherent scrawl. Damon do NOT feel guilty. I know if I go back I will be admitted. Rather die at a high point in my life. On the facing page, another note. Dear Everyone I Love, I cannot live with my illness any more. It is no one’s fault. I love you all and will see you in another lifetime.
There is more, instructions about what to do with her body and money and possessions, some messages to her girlfriend and family and also to Jean. But all of it is written in the same frantic way, spilling all over the page, seemingly under high pressure. He thinks she scribbled it down after she’d swallowed the pills, maybe even while he was sitting outside reading, as the shutters started to come down in her mind.
He closes the book and puts it away, no time to follow this now. Before he can go to the hospital there is a call he must make, a call he’s dreading, to Anna’s lover in Cape Town. What he has to tell her is everything she most dreads and fears, everything she’s worked against for the past eight years. He goes to the public phone booth at the crossroads and dials. He can’t get through and can’t get through and then he reaches the answering machine. But what can he say, there are no words, least of all words to be spoken onto tape. So the message he leaves is bare and basic, just the facts and the number of the hotel. Then there is a silence before he ends off in a different voice, I don’t know what to tell you, it’s not looking good.
The owner of the hotel has offered to drive me to Panjim. I sit silently next to this bald, glowering, middle-aged man, who has dressed up in a blue suit for the occasion, as we travel northward for an hour in his jeep. The hospital is a complex of peeling concrete buildings, looking more like tenement blocks than an institution, on the very edge of the city. Brown bushy scrub, reminding him of Africa, spreads away beyond the perimeter wall.
Anna is still in arrivals, she hasn’t been admitted yet. Caroline is sitting on a bench in the passage outside, looking stricken and sad. The air of assured authority she wore earlier has gone. It will be a while before I discover that the ride in the ambulance with Anna’s inert body has stirred things up for Caroline, things that have nothing to do with where we are now.
I’m sorry, she says in a low voice, but I think your friend is dying.
She means I must prepare myself, but how do you prepare for this. When I go into the ward I have to walk through a crowd of horizontal patients in crisis before I find Anna. She’s an alarming blue colour and sucking air from an oxygen canister with a hoarse, noisy effort. An arrogant doctor is strutting about, dispensing opinions like favours, and when I ask him what her chances are he waves his hand airily. She must go to ICU, he says, then we will see.
Soon afterwards she’s admitted to the ICU ward upstairs and suddenly all the commotion comes to a stop, converted into the painful stillness of waiting. Anna is behind a closed door, out of sight, and the rest of us must sit outside, in a dirty room full of plastic chairs. The attention is all on that door, which hardly ever opens. When it does it’s usually to allow a nurse or doctor out, who will call the name of a patient aloud. When Anna’s name is called, which it often is on that first day, I must run with the script in hand to a separate wing of the hospital, to the familiar scene of clamour and struggle in the pharmacy, and return with whatever drugs or emergency equipment are required, and these missions are a relief from the waiting.
It dawns on me very quickly that, without anybody to help, I can never leave this room. Every hour of every day somebody must be on hand. My dismay at this prospect is tempered when I start speaking to a few of the other people around me, the stories in that room put my own plight into perspective. One family has been taking it in turns, relieving each other in six hour shifts, for months. One woman, who has nobody to assist her, has been literally living there with a bag of clothes and a toothbrush, for five weeks and no end in sight.
Caroline has gone back to the village with the hotel owner and the night yawns away in front of me like a black and empty space. But not long afterwards a Dutch tourist by the name of Sjef arrives, whom I know a little from the past two seasons. He’s come to take over for the night, he says, so that I can go home and sleep. His kindness makes me cry, but I can’t bring myself to leave. It’s my expectation, though I don’t say it aloud, that my friend will die tonight and I want to be here when it happens.
So Sjef and I undertake this first vigil together. At eight o’clock, to my surprise, there’s a stirring in the room, everybody gathering around the door of the ward. What’s going on, I ask, and somebody explains that twice a day, in the night and the morning, the friends and family of patients are allowed inside for five minutes. So we pass into the inner sanctum, with its two rows of beds and its atmosphere of spectral suspension. Anna is on a heart-lung machine, with all kinds of tubes and wires pushed into her. Her face has returned to its normal colour, but in the midst of so much humming technology she herself seems lifeless, a form wrapped around emptiness, a version of the corpse she wants so badly to be.
I touch her hand and whisper to her. You have to fight, I tell her, you have to come back to us. There’s no response at all, and then a nurse walks briskly through, ushering us out.
That first night is very long and almost sleepless. Aside from the missions to the pharmacy, the hours pass in a tedium under the fluorescent lights. The bathroom which everyone must share is filthy, and has two bins overflowing with hospital refuse from which rats scatter in all directions every time the door is opened. When he eventually lies down on the floor to sleep, he puts screws of newspaper into his ears to stop the ubiquitous cockroaches from crawling in.
But morning returns eventually and the door is opened again. Anna is lying exactly as she was last night, a princess frozen by a witch’s spell. For her there is no dirty floor to endure, no passing time, no rats or insects, these elements belong to the rest of us, and to the days that follow. But I’m rescued by Caroline and by Sjef and his English wife Paula, who between them take turns helping me stand guard outside the door. We ride back and forth between the village and the hospital, an hour each way, in overlapping shifts.
The time I spend in the village is mostly occupied with e-mails and phone ca
lls, messages both personal and official stitching across the sea. The biggest ongoing conversation is with Anna’s girlfriend in Cape Town. The devastation is enormous. I can feel her helplessness from the other side of the world, a witness who’s not even present. Of course she wants to come over immediately. But the practicalities are complicated, there is the visa, which will take a few days to organize, and also the flights are still full. But I try to dissuade her for another reason as well. It would be terrible for her to come here, only to discover that Anna doesn’t want her but somebody else instead. The memory of the last few weeks is still heavily with me, all the talk about Jean, her knight in shining armour, who has expressed no interest in rushing to her side, even though he’s been told what’s happened. He’s still a secret, but eventually I have to speak. There is something, I say, something I have to tell you.
Yes.
Anna had an affair over here.
There is a silence. I knew, she says at last, I knew it.
I’m sorry.
With a man.
Yes. She was determined to do it, I say, and any man would do. I’m sorry I couldn’t tell you before. But I thought you should know about it before you come out here. She’s been saying her relationship with you is over, that she wants to be with this guy.
Now I spill out all the details, everything that’s been kept under wraps. We seem to have arrived at some confessional core, where there are no more secrets, no more concealments. We are turning ourselves inside out, as if the truth might absolve us, but it only brings more pain. It may be in this conversation, or perhaps in another soon afterwards, that I walk with the phone into the middle of an empty field next to the hotel and bawl. I’m sorry, I tell her, I’m sorry I said I could look after her, I had no idea what I was taking on.
He returns to Anna’s journal and spends hours reading it, from the very first page. He feels no compunction about delving into her private thoughts and feelings, if she has brought us to this moment of truth, well, let it embrace her too. What he finds there is sad and shocking. It’s as he realized in the end, her act was not a momentary impulse, on the contrary, it was a goal she yearned for from the outset, one she worked herself up to by degrees. Her girlfriend has meanwhile discovered, hidden in their home somewhere, a letter that Anna left behind before her departure. It’s almost, but not quite, a suicide note, further proof that her plans were made far in advance. So she was never on their side, on the side of everybody who loved her and tried to make her well. Instead she was in league with the dark other stranger inside her, the one who wants her dead. It’s hard not to feel profoundly betrayed. Even as they made plans for the trip, with all the talk about how good it would be for her, she was already dreaming up this other scenario, in which she needed him as the helpless bystander, the custodian of her remains. If she recovers, which it begins to seem she might, he doesn’t know how he will ever be able to speak to her again.