by Eve Smith
There’s a delicious silence. His lips twitch. Just as I think he might kiss me the lift bounces to a stop.
I shoulder my bag. ‘Well. Until the next time.’
‘Call me.’
‘I will.’
‘No.’ He shakes his head with a mournful look that almost guilt-trips me. Almost. ‘You won’t.’ The doors slide shut.
I stroll up to the sensor and press my thumb against the screen. There’s a click as the lock releases. My nose embraces the familiar tingle: an earthy, astringent odour that most people would find unpleasant. I shrug off my bag and lean against the door. Sunlight floods the lab, illuminating columns of plants trailing from floor to ceiling. On back-lit shelves stand rows of glass bottles and jars, neatly arranged by size. There was a time when I thought I would turn my back on all this. Make a fresh start. Thank God, I came to my senses. I’d lost enough already. I wasn’t going to lose my career, too.
I wrestle into my lab coat and pull on goggles and gloves. Seedlings at varying growth stages sprout from tubes, lined up in their racks like soldiers on parade. I select a fleshy, triangular leaf from a plant in an adjacent rack: Carpobrotus edulis. The name comes from the Greek: karpos, meaning fruit, and brotus, meaning edible; its salty-sweet fruit can be eaten cooked or raw. I roll the leaf between my fingers, as if I’m skinning up, and slice off a tiny section with a razor. Using the tweezers, I place the specimen on a glass slide and add one drop of distilled water. I attach the coverslip and position it under the microscope.
Commonly known as the sour fig, this plant has attracted a lot of attention, and not only in its native South Africa. These leaves are packed with tannins and flavonoids: they’re widely used as a remedy. Piet’s company, Pharmaplanta, just released results from preclinical HIV-1 trials. My fingers tighten around the focus. Apparently they look very promising. I press my eye to the lens and observe the flat, oblong epidermal cells and the more elongated and spherical mesophyll cells in between. Methanolic extracts of these leaves have, allegedly, inhibited the growth of MRSA, too. My gut twinges. I’ll bet Piet’s loving it, all those multinationals knocking at his door. But, despite their efforts and investment, they still haven’t cracked TB.
I carefully detach a leaf from a different seedling and repeat the procedure. As I slice the section, some of the precious juice oozes down my glove. Carpobrotus falsus, the false fig: the creeper they used on the rhino that fateful night. It’s taken me nearly a decade to track it down. Whereas the sour fig spreads like wildfire to the extent that, in some countries, it’s considered invasive, its sister plant has a much more limited distribution and is a damn sight harder to grow.
I swap the slides over and adjust the focus. Dazzling, green honeycomb-like structures burst into view, interspersed with tiny air spaces: much more compact than the other leaf’s. The varied cell patterns remind me of the scales along a crocodile’s back. The pulp from these leaves has been used to treat the wounds of local tribes for generations, and yet hardly anything about this plant has been documented. On my last trip, an elderly grandmother told me the grisly story behind its name. Taken from the Zulu, ikhambi-ekhohlisayo means deceptive or false cure. With careful preparation, the leaves are said to cure a range of infections, but the succulent purple fruits are highly toxic. Many children over the years have died, thinking the fruit they ate belonged to its sister plant.
I cut another section and place it on its side underneath a different microscope. As I increase magnification, the stomata become visible: tiny breathing pores in the under-surface of the leaf. They look like eyes, staring back at me. Dotted around them are the bright-green chloroplasts, where photosynthesis takes place. Based on my interviews, and some initial tests, I am hoping this plant could be a contender. I now have over a hundred testimonies that claim drinking the juice from its leaves cured them of TB. The question is, even if these stories are true, can the false fig perform against the latest resistant strains?
TB doesn’t announce its presence. Like the best killers, it moves quietly. Catching its victims unawares.
Piet had a point when he lectured me all those years ago. While Aussie flu makes the headlines, a new, lethal strain of TB is silently proliferating, biding its time. Enter the latest challenger: extensively drug-resistant TB. Resistant to the most powerful frontline drugs it’s merrily blasting through our second-line defences too, causing even more devastation than previous MDR-TB strains. It’s not just TB that’s confounding our drug defences either: pan resistance has spread. Respiratory, skin and gut infections. UTIs and STDs. Some strains, like pneumococcus, have developed resistance to new drugs in less than a year. And yet, even though the shelf lives of antibiotics are plummeting, there are still no new classes of drugs in the pipeline. Our arsenal is being depleted. At speed.
So, are the COBRA crisis response meetings in full swing? Are doctors peddling fewer prescriptions? Have farmers stopped pumping healthy animals full of drugs?
The stomata eyes gaze back at me reproachfully. It’s like watching a plane crash, in slow motion. Instead of vengeful angels, we have apathy.
Better hope my hunch about these leaves pays off.
CHAPTER 32
LILY
‘Oh dear. I thought casserole was one of your favourites?’ Natalie regards my plate with something approaching remorse.
‘Sorry, I’m not really that hungry. Perhaps it’s the heat.’
I feel hollow, all bled out. If they opened me up now there’d be nothing but bones and air. Opposite me, Jean spoons in another mouthful. A line of gravy drips down her chin.
‘It’s made with real beef, you know: all organic. From certified farms.’ Natalie gives me an encouraging smile. ‘Not that stuff they grow in the labs.’
I contemplate the glistening chunks of flesh congealing in a sea of gravy. Normally I’d be tucking into seconds. But there is no normal anymore. I dreamt about her again last night. Woke to another wet pillow. All the guilt has returned, all the torturous what-ifs. The thought of actually meeting her consumes me.
‘I remember when we used to eat meat every day,’ says Jean, still chewing. ‘Bangers and mash. Shepherd’s pie. Sunday roast.’ She nods at me, as if she wants me to join in. ‘Those farmers had a lot to answer for.’
My stomach moans, as if in protest. I wonder how many people ended up falling prey to the food they ate. Not exactly a successful business model, killing off your own customers. Quite ironic really. Those poor animals had more antibiotics in their short lives than I’ll ever have.
Jean puts down her fork and smears her lips with a napkin. She waits for Natalie to move on and leans closer: ‘Do you know what’s happened to George?’
The sour meat on her breath mixes with a sickly smell of talcum powder. I wield my own napkin like a shield. ‘What do you mean?’
She runs her tongue around her teeth. ‘Haven’t seen him since yesterday.’
A faint ringing starts in my head, like an alarm that’s just been triggered. I sat next to him yesterday, after tea. I scour the grey and white heads in the lunch hall. Most of them are still eating, dentures battling the stringy bits. No one misses a meat lunch unless they’re ill or vegetarian. George is no vegetarian.
I scan the room again, my heart skittering. ‘Maybe he’s got a visitor,’ I say. ‘Doesn’t he have a daughter in Cornwall?’
Jean’s mouth puckers. I’m not fooling anyone, least of all myself.
Natalie wheels the trolley over and starts clearing dishes. I signal for her to come closer. ‘Where’s George?’
She straightens up as if I’ve said something obscene. Her smile vanishes. She clatters the plates together and stacks them on the trolley.
‘Please, Natalie.’
She tips the leftovers into a tub, her gloved fingers blotted with gravy. Just as I think there’s no point asking, she bends to my ear: ‘I shouldn’t be telling you this.’ Jean strains towards us, the veins bulging out on her neck. ‘But I know you and George
were quite close.’
A million electrical impulses fire across my synapses. Were. She said were. The ringing in my head becomes an intense whine, like the sound of an aircraft engine before take-off.
‘It’s his leg,’ she whispers. ‘They don’t know for sure, but it looks like cellulitis.’
Cellulitis: NC. I shift in my chair, as relief sours to shame. I liked to sit with George. He wasn’t much of a talker but that was fine by me; I took comfort from our quiet companionship. I should have learned by now, surely? Don’t get attached. It’s a whole lot easier on your own.
Across the table, Jean catches my eye. I shake my head.
‘Try not to worry,’ says Natalie. ‘He’s in the San. They’re doing everything they can.’
I think of George languishing at the cold mercy of Dr Barrows and tears prick behind my eyes.
Pam thumps a bowl of rice pudding down in front of me. A dollop of jam bloats out from its centre like an angry spot. The cloying smell of milk sparks a memory that takes my breath away. I press my palms against the table and scrape back my chair.
‘You OK, Lily?’ says Jean, as I scrabble for my walker. I don’t trust myself to answer. I clench the bar, let the fire burn through my fingers. Blunt the images with a different kind of pain.
Instead of turning left to Carroll, I head to the activities lounge, torn between the urge to get away from people and the fear of being on my own in my room. The casserole turns in my belly.
‘Lily?’ Natalie’s at the door; I didn’t hear her come in. She bustles over and touches my arm. ‘I’m so sorry, I wish I hadn’t said anything now. I know how upsetting it is, when friends get ill.’
I swallow. ‘No, really. I appreciate you telling me. All this secrecy. It only makes it worse.’
Her fawn eyes scurry over my face. ‘Please, try not to upset yourself. I know you’ve been a bit down lately. Anne tells me you had some sad news.’
My heart jolts and then I remember. ‘Yes. Yes, I did.’ That’s the problem with lies, they catch you out. I need to be more careful. I wonder if Anne’s told her about the bath incident, too. They probably think it’s the start of dementia. Maybe it is. Graham’s screened the residents, the staff, even the delivery men. Nothing. He’s probably just humouring me and thinks I’ve made the whole thing up.
Natalie curls her apron around her fingers. ‘Is there anything I can do, Lily? I’d like to help.’
Before I can answer, a piercing wail blasts through the room. I clamp my hands over my ears as Natalie yanks out her phone. Her face darkens. She says something but I can’t hear her over the alarm. She points to the door and shouts: ‘This isn’t a drill! You need to get back to your room.’
I wheel into the corridor, panic spiralling in my chest. Residents lurch out of the dining hall with frantic eyes; some still have napkins tucked in their collars. I tell myself it’s probably just one of the staff who’s tripped the system. But the siren continues to pulse.
‘What’s going on?’ asks a woman with tight grey curls who’s grappling with the control on her hearing aid. She blinks at me. ‘Is it a fire drill? Should we be assembling outside?’ A small part of me wants to laugh.
The shuffling and puffing continue as people press past. I check my watch. Almost three minutes.
Anne rushes up. ‘That’s it, everyone, nice and orderly. Back to your rooms.’ Her voice has that sing-song tone that always gives her away.
Jean spots me and elbows her way through. She hisses in my ear: ‘Do you think it’s George?’
I picture George staggering out into the bushes, bandages sagging around his weeping legs. ‘Perhaps.’
Her eyes sparkle. I manage a stoic smile, put my head down and push on.
I only know of one person who ever made it out of the San. That was before they upped the security. They found her in a matter of minutes, secreted in my little arbour; she didn’t even make it past the gates. Maybe she thought she could wait it out, stow away with one of the deliveries. Or sneak out at night, during a change in shift. Not that it would have done her much good. Even back then, residents were all microchipped, like dogs. The only way to get off-grid is by surgically removing it. Which makes me think she wasn’t thinking. That it was some unplanned, primordial instinct: fight or flight. Trouble is, by the time you’re sent to the San, there’s not much fight left.
The carers herd us along as the siren wails. Someone behind mutters something about an alert. My stomach wrenches. It’s not someone trying to get out. It’s someone trying to get in.
Etiquette vanishes as the more able walkers start shoving past the wheelchairs and the frames. There are squawks of protest as the jostling gathers pace. I try to slide my feet a little quicker.
‘Steady now,’ Anne calls. ‘No need to push.’
They ignore her, as rumours burgeon.
It’s the latest convert to EAA.
It’s an escaped patient from one of the Waiting Rooms.
It’s a pro-lifer, stepping up the campaign.
Or maybe, I think, with a jolt, it’s the shadow in the bathroom.
Sweet Jesus. What if they’ve come back for me?
I glance at my watch. Seven minutes: that’s a record. Pam bustles past, checking the windows. ‘Come on, Lily. Hurry up! This is a lock-down.’
Doors open and close; locks thud across, like silenced bullets. As my door swings shut, I wonder how safe we really are. If someone knew the systems, all this security might work against you. Trap you in with your attacker. In your own room.
I stab the remote. My screen flashes. ‘News.’
‘ALERT: A seventy-four-year-old man has escaped from Penworth Hospital for the Elderly. Unconfirmed reports suggest he was in quarantine…’
I stand in the middle of the room, unsure what to do. A man dashes past the window in a black uniform and mask, and I freeze. His head swivels towards me and for a terrible moment our eyes meet. But he carries on running.
The siren stops and sounds again: one short blast followed by another. I know that means something, something important, but I can’t remember what. I stumble to the window and yank the blinds shut. I stuff my hands over my ears as my blood pounds to the same relentless rhythm. After another two minutes I realise the alarm has stopped.
A silence descends that has a volume all of its own. Echoes of the siren reverberate in my head. I think of the other residents, cowering behind their doors. All those breaths being held. All those dormant infections, awaiting their trigger to wake.
There’s a shout outside. A burst of commands and radio static. I glance at the blinds but don’t move. I know how this scene plays out, I don’t need to see it. The ambulance will already be there, back doors open. Someone will be sedated, strapped down, delivered. Order will be restored, and we will carry on as before.
I don’t know how long I stand there, heart drumming against my patch. All I can think of is Kate. That’s the trouble with hope. Just when you think you’ve weaned yourself off it, its devilish little head rears up and sucks you back in.
CHAPTER 33
KATE
Against the background hum of the air-pressure unit, my earpiece relays the staggered sounds of breathing. Behind clear plastic sheets and grey hoses lies a small, white-haired woman, dwarfed by wires and machinery. A pool of sweat is collecting in the hollow at the base of her throat. An image flashes into my mind from that film Pen used to love so much, set in war-torn Egypt. A handsome archaeologist licks the sweat from his lover’s suprasternal notch. That’s what it’s called, that little hollow. My suprasternal notch is overflowing; a continual stream soaks the material under my chin. In fact, my sweat is streaming pretty well everywhere: along my back, between my legs. This bulky yellow suit may save my life, but right now I’m fantasising about shearing it off, sprinting to the antechamber and throwing myself under the shower.
My patient’s eyes flutter, and I move closer. She looks so frail, as if she’s fading into the bedsheets. I don
’t remember Pen looking like that, even at the end. Perhaps it’s because I saw her the way I knew her to be, without the sickness inside her.
I open the comms port. ‘Hello, Mrs Janson, do you remember me? My name is Kate. I’m a nurse. I’m here to look after you.’
There’s a tinny echo as my earpiece feeds back my voice. We must look like monsters to them in this get-up. Whether they can hear me or not, I always try to reassure them. She doesn’t react; her glazed eyes are fixed on the roof of the tent. I check the monitor. She’s reached critical, but these latter stages are so unpredictable; they can last much longer than you think.
The sheet lifts a fraction. Her lips move but no sound comes out. I ask her to repeat it. Her voice is so faint the mic can’t pick it up, but we’re all taught to lip-read for exactly this reason. I press my face closer. I get it the third time.
‘Help me.’
Something inside me sinks. She’s on the maximum pain relief I’m allowed to give her. I hate these cases; why don’t they sign? For some it’s religion. For others it’s fear that it might get abused. But for many, it’s the pressure of family. Even though they’re in agony and there’s nothing more to be done, relatives still object. By the time patients end up on a ward like this one, it’s too late. Even if they want to, they’re no longer deemed capable of changing their minds.
I reach my hand into one of the built-in gloves and stroke her arm. Her skin is an ivory grey. ‘Try to sleep,’ I say. ‘The drugs will help with the pain.’
She squints at me, eyes clouded with fever, and I feel the familiar ache. There’s so much death around me. I used to help people live. I wonder if Mary’s signed a directive. For all I know, she could be in a hospital like this, fighting for her life.
Mrs Janson clasps my glove. ‘Please,’ she mouths silently. ‘I want it to end.’
My hand stiffens. It still upsets me, when they ask. I trained to be a nurse. I never wanted to play God.