by Eve Smith
‘I’m so sorry,’ I whisper, easing out of her grasp. ‘I’m doing everything I can.’
Her ashen face crumples, and she turns away.
I look at the poor woman, heaving out each breath. In the old days, they used to up the morphine. Let patients just slip away. But now everything’s monitored, recorded, analysed. No one’s allowed to slip anywhere, not unless they’ve signed. And I remember what that journalist said all those years ago. Before the AD legislation was passed:
‘I’m not afraid of being dead. I’m just afraid of what you might have to go through to get there.’
I scan Mrs Janson’s records. Seventy-nine. Husband died five years ago. There’s a daughter in Scotland, but she elected not to come for a farewell. It’s easy to judge, but it’s different on the isolation wards. Even if the family do make it, by the time they get here, most patients can’t recognise them.
I check the window. Shani’s there at the console, watching. But she has four of us to contend with this afternoon. I wait until she’s occupied with another chamber, and move to the dispensing unit. I select a vial and collect a fresh bottle of water. After fumbling with the cap, I manage to syringe the contents of the vial in. By the time Shani looks up, the empty vial’s in the waste and the water’s in the isolator trolley.
‘Here you are, Mrs Janson,’ I say, wheeling the trolley over to the tent. ‘Some lovely cool water.’ I say it nice and loud, and push the bottle through the hatch. Mrs Janson doesn’t move. I press the switch and the top part of the bed starts to rise. I place my arms into the gloves and step into the half-suit. ‘This will make you feel better.’
I grasp the bottle and twist. Even though I’ve broken the seal, it’s not easy: not when you’re wearing two sets of gloves. I touch her shoulder. ‘It’ll help.’
Her eyes swerve past me and gradually focus. I check the console: Shani’s got her back to me. ‘Small sips,’ I say with a slow nod.
The corner of Mrs Janson’s mouth twitches. She reaches out a shaky hand. She has to do this, not me. That’s the rule I’ve set myself. She’s so weak I’m worried she might drop it. But she takes the bottle and lifts it to her lips.
‘That’s it,’ I say, a fluttering in my chest. ‘Gentle now. Just a little at a time.’
I watch her throat contract as she swallows and wonder if anyone ever kissed her there. I hope they did.
It takes a while, but she finishes it. Her head rolls back on the pillow.
‘Well done.’ I press the button and the bed descends. ‘That’s it, you rest.’
She mouths two words: ‘Thank you,’ her eyes already elsewhere.
I smooth some strands of hair off her forehead and take her hand. ‘I’m here with you. Don’t be afraid.’
The bottle slips from her fingers. I check the monitor.
When the numbers start to drop I push the water bottle back through the hatch, into the isolator trolley.
I walk round the tent and drop it into hazardous waste.
My bag drops to the floor as I slump against the wall. It’s all I can do to wrestle out of my coat. Mark’s banging pans in the kitchen as if he’s taking part in some kind of performance. I wrinkle my nose. Onions. He never shuts that door when he’s cooking, no matter how many times I tell him. Right now, though, I couldn’t care less.
I wash my hands and stagger to the fridge. Mark looks up, spatula in hand. ‘Hi, love.’
‘Hi.’
I root out a half-empty bottle of Chardonnay. ‘Fancy a glass?’
‘Sure.’ I fetch the large ones. He eyes me over the pan. ‘Tough day?’
‘You could say that.’ I collapse into a chair.
Mark gives a couple more stirs. ‘Well, just make yourself comfy. Your day is about to improve.’
‘Oh yeah?’ I pour him a glass and slug the rest into mine.
‘Firstly, this is an outstanding carbonara.’ He dips a spoon in the pan and takes a pantomime slurp. ‘Cooked to my very own recipe.’
‘What, with extra bacon, you mean?’ I lift the glass to my lips. Cold citrus slides across my tongue.
He wags his spoon at me. ‘A chef does not reveal his secrets.’ He strolls over to the sideboard. ‘And secondly, I think you might be interested in this.’ He holds an envelope aloft in one hand. The weariness slips off me, like a coat.
I press myself out of the chair. My mouth suddenly feels dry and sticky.
Mark hands me the letter but doesn’t quite let go of it. ‘Just remember,’ he says gently, ‘whatever’s in there. It doesn’t change who you are.’
I stare at the envelope. The address is spidery and lopsided, like the scribbling of a child. Just seeing my name written like that sparks a current. I have no idea whether it’s excitement or alarm.
Folded inside are two sheets of good-quality writing paper: the kind Pen used to use. I glance at Mark. He touches my cheek, ever so lightly. I smooth out the pages, resisting the urge to skip to the end. It feels a bit like it did when Janet pulled out my file. Am I to be set adrift once more?
Dear Kate,
Thank you. Thank you so much for writing. I cannot describe how much it means to me. Many years have passed since I held you in my arms. Now, I am an old woman. But I have never forgotten you. You were such a beautiful baby.
I reach for the chair. I feel light, almost giddy. Only now, can I see how heavy it’s been. This waiting. This not knowing. I’ve been carrying it around like a ballast stone for weeks.
‘Everything OK?’ Mark’s voice sounds miles away. I nod but don’t lift my eyes from the page.
You must have many questions. About what I did, and why. But the most important thing to understand is that it was not for a lack of love. Giving you up for adoption was one of the hardest decisions I have ever made.
Her words slice me open. Haul out a part of me I didn’t even know was there. It’s like grieving, for this baby who lost her mother. This baby who was me.
Mark hands me a tissue. As I wipe my eyes I notice the dried black smudges between her words. I think about the paltry records, the request for no contact. Why?
You write that you understand why I changed my name. That you have read about my past. I do not expect you to forgive me. I have done some good things in my life, Kate, and some bad things, things that I regret. You must know that I am far from perfect.
But I did what I thought was best at the time.
All those conversations with Sasha and with Mark. The photos. The countless hours spent trawling articles, as if she were some riddle that could be solved.
You asked about a visit. I would dearly love to see you.
I grab Mark’s hand. ‘She wants to meet!’
Relief spreads across his face. ‘That’s great, love. Really great.’
But it is important, for your own safety and mine, that you address me as Lily, not Mary. The other thing I must ask of you is that you do not refer to me as your mother, although I know this must seem strange.
My smile wilts. Can she not face up to what happened, even now? Am I still such an embarrassment?
If, after reading this, you still want to come, I will try to explain. If you do not, I will understand. Just receiving your letter has brought me more happiness than I deserve.
I will wait to hear from you.
With much love, always,
Lily
The papers sail loose from my fingers. I sit back and grind my knuckles into my eyes.
Mark gently takes my hands. ‘So?’
I give him a tight smile. My head feels sore, as if I’m coming down with something.
‘Take a look.’ I hand him the letter.
He shakes his head. ‘You really don’t have to—’
‘I want you to. It’s important.’ I gaze at his soft, brown eyes, at the cowlick on the top of his forehead and wonder why I needed more.
As he reads, I run over her words again, my hopes rising and falling, buffeted in the storm. She claims she loves me, that she’s
never forgotten me. She wants a visit.
So why do I feel so let down?
‘Wow,’ Mark says eventually. He takes a deep breath. ‘That was honest.’
‘Yeah. That’s one word for it.’ I flex my palms against the table.
Mark edges closer. ‘It seems like she genuinely cares about you, Kate. I know that last bit must be upsetting. But I suppose with her history and everything … she has to be careful.’
‘I guess so.’ I sigh. ‘She doesn’t want me swanning in, blowing her cover.’
The pan simmers away, steam running down the splashback like black tears.
Mark sucks in his lips. ‘What exactly do you think she means by “for your own safety and mine”?’
Honi soit qui mal y pense…
My instincts whisper a warning. There’s something else. Something she’s not saying.
And yet even as I process that thought, another part of my brain is estimating how long it will take for all the visits admin to go through.
‘Who knows?’ I down my wine and thud the glass on the table. There’s a noise like an eggshell cracking; a fracture line appears across the base.
I carve my nail into the cleft until it splinters.
There’s absolutely no way I’m stopping now.
CHAPTER 34
Five years pre-Crisis
Government Experts Warn of Tipping Point as Number of Superbugs Spirals
Global actions and investments ‘falling way short’
In a report released today, Public Health England (PHE) warned of an impending crisis unless antibiotic resistance is addressed. PHE confirmed that, over the past decade, its labs have identified nineteen resistant superbugs that defy all antibiotic treatment. The report also revealed a worrying trend in the number of cases of multidrug-resistant TB. Until recently, TB was mainly prevalent in Africa and Asia, but the latest figures show the ‘white plague’ is on its way back in Europe.
Only last week, the director of the National Infection Service launched a scathing attack on the EPA, which approved the spraying of ‘last resort’ antibiotics in Florida’s orange groves: ‘Sloppy regulation and poor decision-making can no longer be tolerated,’ she said. ‘We are facing the most urgent health risk of our time. More than seventy percent of pathogenic bacteria are resistant to most antibiotics on the market, and our last lines of drug defences have been breached. Patients are dying because we can no longer treat them. Do we value oranges more than people?’
MARY
Throngs of dazed, sweaty faces emerge from shop doorways, breath smoking from their mouths. Above them, Christmas trees jut out at precarious angles, bracketed by metal rods. I navigate the bobble-hatted hordes and the slaps from bulging bags as guitars, violins and sleigh bells compete in a festive din. A girl strolls past with a cardboard carton, licking her sugared lips. The burst of caramel makes my mouth water. My eyes swerve to the kerb. Sure enough it’s there, like a promise: the honey-roasted nuts stand, steaming trays of sticky-sweet heaven piled behind the glass.
I rummage for my purse and get in line. That’s when I notice a convergence on the pavement: an indistinct heap is interrupting the flow. Amidst the rush of legs, slumped against a window, is a body sheathed in a sleeping bag: a man’s, I think, refuse sacks on either side. Behind him, fairy lights tinkle over silver and gold baubles, and herds of ghostly reindeer scamper down the glass. His chin has sunk onto his chest, his face obscured by a baseball cap. Raw, gloveless fingers cling to his quilted cocoon. Most people give him a wide berth, averting their feet as well as their eyes. One shopper strays too close and kicks the tin in front of him; it rolls over a scrap of cardboard with words on it that no one reads.
All of a sudden the man jerks and topples forward, as if someone just yanked his strings. He braces his palms against the pavement, his breath steaming out in violent heaves. I reach him just as some blood splatters onto the concrete, glistening under the lights. A woman jumps back and covers her mouth. Some shoppers slow down to stare, their faces twisted in disgust, others studiously ignore him and hurry past.
I march over, squat down and touch his shoulder. ‘Hi. My name’s Mary.’ The man remains hunched, gasping between coughs; his smell triggers a memory: sickness and sweat. I yank out my phone. ‘I’m going to get help.’
A ragged blanket moves beside him, and a small, wiry head peeps out. Some kind of terrier. It eyes me warily and nudges the man with his snout. He doesn’t respond.
‘I’m calling an ambulance. Can you tell me your name?’
The dog nudges him again, more insistent. One quivering hand lifts and clutches its coat. An ashen face peers out from the cap. My chest tightens: he’s barely more than a boy.
‘Can you understand me?’
His mouth moves but only a wheeze comes out. The dog whines, gazing at him with filmy brown eyes.
‘Tomasz.’ He explodes in another fit of coughing.
A small crowd has gathered, but no one offers any help. It takes another twenty minutes for the ambulance to arrive. When the paramedics set to work the terrier becomes agitated and one of them asks me to take it. I grope around the bags for a lead, but all I can find is a bit of rope. To my surprise, the dog lets me loop it around its neck.
‘Which hospital are you taking him to?’ I ask, after they load him in.
‘University College.’
‘What do you think’s wrong?’
The paramedic’s eyes narrow. ‘You know him, do you?’
I swallow. ‘No.’ I look at the dog. ‘I just want to help.’
The paramedic sighs. ‘Where d’you want to start? This is the second time we’ve picked him up this month.’
I swallow. ‘Is it … TB?’
His mouth flattens. ‘He was diagnosed weeks ago. But they can’t keep him in hospital for six months, they need the beds.’ He shakes his head. ‘He needs a dry, warm place to stay, hot meals. Supervised medication. But no shelter will take him, not in that condition. Same as those other poor buggers.’ His eyes drift to the blanketed, still bodies huddled beneath spray-frosted windows.
‘You come across this a lot, I take it?’
The wrinkles around his eyes deepen. ‘It’s a major issue on the streets, and it’s only getting worse. Especially with the migrants. Even if they’re diagnosed and start treatment, most drop out after they’re discharged. So they get sick again, we pick them up again and they have to start over.’ He rubs his forehead. ‘Many are developing resistance to the drugs, and that’s a real problem. Not to mention the others they’ve infected in the meantime.’ He glances at me. ‘There are no symptoms, not at first. People carry on, not even realising they’ve got it: going to work, dropping the kids at school.’ He shakes his head. ‘Talking of which, you should get yourself checked. Better to be safe.’
I follow him round to the back of the ambulance. ‘What about you? How are medical staff protected?’
‘We’re all given the BCG. But that’s not much use if it’s pulmonary. We should really be wearing masks.’
As the driver turns to shut the doors, Tomasz levers himself up and shouts something. The dog lunges forward, and the rope flies out of my hand. The terrier leaps onto the stretcher; the other paramedic grapples with it, but the dog hunkers down, defying gravity with four paws.
I lean into the back. ‘Tomasz, it’s OK!’ Tomasz lifts his eyes; he looks even frailer under the ambulance’s glare: a ghostly white, like the scampering reindeer. ‘I’ll look after him, don’t you worry. Until you come out.’
The dog noses his face. Tomasz burrows his fingers into its ruff and whispers to it. He pats the dog twice and gives it a firm shove. The paramedic catches it and hands the squirming bundle to me. The doors slam shut.
I march to the bus stop, clutching the terrier tight under one arm, in case it makes a dash for it. I don’t even know its name. I take a seat by the window, keeping my hand firmly on the rope, and resolve to buy a collar and lead. The dog whines a little, paws
up at the window, panting, but eventually it resigns itself to my custody and settles at my feet. It expels a long, deep sigh.
Behind me, someone starts to hack. Instinctively I stiffen. Maybe we should all be wearing masks. So much for progress. Despite the warnings, we’ve allowed the ‘dread disease’, as Dickens called it, to flourish. The TB count in this city has doubled over the past decade: London has become the TB capital of Western Europe. Many of those infected, like Tomasz, are homeless or on the breadline. A recent report attributed the increase to poor housing, inadequate ventilation and overcrowding: exactly the same conditions that triggered the Victorian epidemic. Back then there was no vaccination or cure. TB was responsible for a quarter of all deaths in Europe.
As we crawl past Regent’s Park my phone buzzes: one new message. I read it and take a sharp breath. The dog opens one eye. I dial her number. It rings five times before she deigns to pick up.
‘Ah, Mary. You’ve seen it, then.’
My irritation spikes. I keep my voice level. ‘“Strong South African interest…” Let me guess…’
‘Before you start, I’m really not at liberty to—’
‘It’s Pharmaplanta, isn’t it?’ She doesn’t say anything and my heart sinks.
‘It’s just a partnership, Mary.’
‘Partnership?’ I scoff. ‘Didn’t you know, Jayne? That’s Afrikaans for takeover.’
She sighs. I imagine her drumming the arm of that monstrous, flowery sofa while her effete husband scurries round the AGA baking mince pies.
‘OK. I’m only telling you this because we go back a long way.’
I have a fleeting memory of Jayne at Oxford: serious fringe and serious social climber; she short-circuited her twenties and shot straight into middle age.
She clears her throat. ‘Carpobrotus falsus. They want access to the data.’
My stomach thuds. That fig certainly lived up to its name. I failed. I tried so hard and still failed: years of work, all come to nothing. The chemical properties we isolated from those leaves did ward off the TB bacilli, even the resistant strains. The trouble was, they warded off a lot of other things too. The agents in the drug were so toxic they caused organ damage. Failure, in some cases. After extensive preclinical tests on mice the trial was abandoned.