The Coma

by Alex Garland

  “Carl?”

  I turned. Mary was standing in the doorway, holding their son, Joshua, in her arms.

  “Hi, Mary,” I said.

  “Where’s Anthony?”

  “Outside.” I gestured towards the window. “He’s paying the milkman.”

  “Good. I’ve been getting on at him to do that for ages.” Mary smiled and walked into the kitchen. “So,” she said, scanning the food inside the fridge, half balancing Joshua on her hip. “Are you going to be staying for breakfast?”

  “I hadn’t thought as far as breakfast,” I replied. “This morning has sort of taken me by surprise.”

  8.

  Mary’s back was to me. She was standing by the sink, beating two eggs in a bowl. Beside her, on the cooker, a whole pack of bacon and some fat mushrooms were frying in a pan. A second, smaller pan was melting butter over the flame.

  I held a glass of orange juice in my hand. Joshua had orange juice too, in a closed child’s mug. He sat opposite in a high chair, watching me with wide dark eyes.

  Outside, Anthony continued to talk to the milkman. I could see them both through the window, over Mary’s shoulder, and they looked as if they were sharing a joke.

  “Mary,” I said, making an effort to keep an even tone to my voice. “Have you ever had a nervous breakdown?”

  Mary stopped beating the eggs and poured them straight into the smaller pan. “Scrambled or fried,” she said. “Quick decision required.”

  “Scrambled,” I said, when I realized she wasn’t talking about my state of mind.

  Mary began pushing the eggs around with a wooden spoon. “Yes, I had a breakdown. Years ago, now. I was in my mid-twenties.”

  “Do you remember it well?”

  “Hardly at all. I remember that it ended with a stay in the hospital.”

  “Mine seems to have begun with a stay in the hospital.”

  “Okay,” said Mary. “This is why you arrived here in the middle of the night.”

  “Yes.”

  “You’re afraid you might be having a breakdown.”

  “That’s right.”

  “Is it to do with the attack?”

  “I think so. I think I’ve been traumatized. Psychologically.” I took a gulp of my orange juice, and Joshua mirrored the movement, raising and lowering his hand at the same moment. “Since I was discharged, I’ve been hallucinating pretty much constantly.”

  “Hallucinating?” said Mary, sounding surprised. She pulled the eggs off the heat and turned to me. “Seeing things?”

  “Yes.”

  “That sounds quite . . .” She looked for the word. “Extreme.”

  “It is,” I agreed, and I saw her gaze flick to Joshua.

  “I’m not a danger to anyone,” I said quickly.

  “Are you hallucinating now?”

  I shrugged. “I don’t know. Are you a hallucination?”

  “Not as far as I know.”

  “Okay, so—if I take your word for it—then I’m not hallucinating now.”

  Mary nodded. Then she said, “Tell me about the things you’ve been seeing.”

  I told her about the blood and the bandages, and the blackouts, and the sudden dawn.

  When I had finished, Mary thought for a few moments, then asked, “Are you depressed?”

  I shook my head.

  “Did the doctors put you on any kind of medication?”

  “No.”

  Mary looked at me hard, straight into my eyes, as if she might be able to see past them through to the confusion in my head. “Well, Carl,” she said. “I’m no expert, but you don’t sound to me like you’re having a nervous breakdown. And you don’t come across like it either.”

  “That’s good news.”

  Mary opened her mouth, but hesitated.

  “Or is it?” I said.

  “I don’t know,” she replied. Then she lowered her voice, as if a softer tone would be less likely to alarm me. “Have you wondered if perhaps your hallucinations aren’t the result of psychological damage?”

  “Go on,” I said.

  “As I said, Carl, I’m not an expert. But—you were knocked unconscious.”

  “I know I was,” I said impatiently. “What are you getting at?”

  Mary’s voice softened further. “What if the damage is neurological?”

  Joshua put a hand to the side of his head, echoing my movements again.

  “. . . What if you have brain damage?”

  “Brain damage,” I echoed. It seemed so obvious and so plausible that I don’t how I had failed to consider it until now.

  “I’m sorry,” said Mary. “I don’t mean to be so blunt, but . . .”

  “No,” I replied distantly. “Not at all.”

  “What are you going to do?”

  “I don’t know,” I said. “I suppose I should have a scan . . .”

  “I think that has to be sensible,” said Mary. “At the very least, you need to talk to a doctor.”

  “Yes,” I said. “I should leave at once. Return to the hospital.”

  “That would probably be best,” Mary agreed.

  9.

  “Leaving?” asked Anthony when I passed him on the front lawn. He was still talking to the milkman.

  “Yes,” I said. “I’m going to the hospital.”

  I waited a moment, imagining that Anthony would offer me a lift. But instead he gave me the thumbs-up.

  “Good idea,” he said. “Listen, let me know how it works out.”

  “I will,” I said irritably. “Thanks for all your help.”

  Either he didn’t notice the sarcasm, or he decided to let it go.

  The milkman’s float was parked in the early morning sunshine, now that the sun had risen over the rooftops. The milk was warming. You could smell it in the air and see it in the droplets of condensation on the sides of the glass bottles.

  Judging by the blue and cloudless sky, it was going to be a beautiful day.

  10.

  I’d been walking five minutes before I remembered that I couldn’t catch the train or get a cab because I didn’t have my wallet, and I had forgotten to borrow any money from Anthony or Mary. I considered walking back, but I was feeling increasingly upset at Anthony for his blasé reaction to my condition, and I thought that if I saw him again that morning we might end up having an argument. So I kept going. I didn’t think it would take me longer than an hour to reach the hospital on foot, and I felt I could use the time to think.

  I tried to think with clarity.

  I was probably not suffering from psychological trauma, as I had at first suspected. Instead, as Mary had pointed out, it was more likely that I had some kind of brain damage. Which, to look on the bright side, might be reversible. Even, in some ways, easier to address than psychological trauma—or at least more straightforward. A blood clot between my skull and gray matter could be removed, relieving pressure and bringing a return of normal function. If so, the removal of the blood clot might be a matter of urgency, and by walking slowly to the hospital I was wasting the minutes that were required to save me from permanent brain damage, or even to save my life.

  But I didn’t pick up my pace. I suppose I was being fatalistic, and it simply seemed more likely to me that the damage was irreversible, in which case it made no difference how long I took to get to the hospital. And perhaps it was not only irreversible but stable. In which case I had to consider whether I could successfully operate in the world while in a state of rolling hallucination.

  Would it be possible to hold down a job when continuously uncertain whether it was the middle of the night or mid-morning? Would it be possible to have a relationship with friends whose behavior was inexplicable to me? Looking to the future, would I ever be able to achieve the most basic ambitions of finding a partner and having a family?

  Given my experiences over the last twelve hours, which I wasn’t even sure constituted twelve hours, the answers to all these questions seemed to be no. I couldn’t imagine
being a father if, on arriving at school to collect my kids at the end of the day, I was unable to establish whether I was at a school or at a petrol station. I might not even be able to feel sure of the identities of my children. I might have to wait at the front gates, scanning the small faces, looking for ones that were looking back at me with an expression of familiarity or expectancy.

  The implications of my condition began to explode. It occurred to me suddenly that, for all I knew, I already had a wife and family and I had hallucinated myself into a state where they didn’t exist. I cursed myself for having left my wallet at home. I could have checked it for passport-sized photos or crayon drawings of houses with smiling stick figures standing outside.

  In fact, the implications were almost limitless. If I couldn’t differentiate between hallucination and reality, it was hard to conceive of anything certain I could use to define myself. I might be a different age from the age I believed I was, or a different gender. I might not be walking down a street but standing in a field, or lying in a room. At that moment, on my slow walk to the hospital, it seemed to me that everything was up for grabs. I could be anything with a consciousness.

  A volley of car horns broke me out of the train of thought.

  Anthony and Mary lived in a middle-class suburb of houses and lawns, and hedges, and windows with diamond-shaped lattices made of lead—and many of those who lived in these houses were starting their commute to work. It seems that one of these commuters was attempting to turn his car in the road. The flow of traffic was stopped in both directions.

  I watched as the driver drove a few feet forwards, then backwards, then forwards again, each time managing to bring the car a few degrees around. The horns grew angrier and more varied as more cars joined in, and the three-point turn became a five, then six, then seven. The extra noise seemed to fluster the driver, who made several forwards and reverse moves that hardly rotated the car at all. But eventually the driver found the space to straighten up, and, over-revving first gear wildly, brought the car lurching back down the road in my direction.

  Then, to my surprise, it drew alongside me and braked sharply—smoking its two front tires and provoking another volley of horns from the cars behind.

  The front passenger door swung open, and the driver, whose face I couldn’t see, called for me to get inside.

  11.

  “Would you put your seat belt on?” the driver said, and he accelerated hard.

  As I reached for the seat belt, the driver spun the wheel to turn down a side street, throwing me against the passenger window.

  “Sorry,” the driver said. “We’re in a hurry.”

  I pulled the seat belt across me as fast as I could before he took another corner at the same speed. Which he did, just as I managed to guide the buckle home.

  “Do you remember me?” the driver asked. I looked sideways. The man’s face was in profile; he was concentrating hard on the road ahead. In some ways the profile did look familiar, but I couldn’t place it.

  “No,” I said. “But don’t take offense. The way things are, you could be my brother for all I know.”

  “I’m not your brother.”

  The driver braked quite hard for another corner, and I raised a hand to brace against the dashboard. This time when he swung the car around, we were turning off the residential streets and on to a slip road, joining a dual carriageway.

  “Or my aunt,” I added. “You could be anyone.”

  “I’m not your aunt either,” he said. “I gave you water. I helped you to sit up.”

  I looked at the driver again. And this time I made the connection. It was the expression of concentration on his face—the same expression I had seen when the man was sitting by my bed at the hospital, talking to me, trying to wake me up.

  “I do remember you,” I said. “You’re the nurse.”

  “Yes,” he confirmed. “I’m the nurse.”

  I glanced over at the dashboard. The needle on the speedometer was climbing fast. It passed sixty, then seventy, then eighty, then ninety.

  “We really are in a hurry,” I said. “Where are we going?”

  “Hospital,” the nurse replied, using the inside lane to overtake a string of cars.

  “Then I am in trouble. My condition is going to deteriorate.”

  “It may.”

  I nodded. So much for relaxed fatalism, I thought, and felt a little surge of panic—which was not helped by the way in which our car was continuing to gain speed, now creeping past one hundred. “What happened?” I asked, injecting calm into my voice. “I imagine Mary or Anthony called the hospital and explained to you about my condition, and you tracked me down to—”

  He cut me off. “Carl—there isn’t time for me to answer your questions. I need to ask you questions.”

  “Of course,” I said. “Diagnosis. Okay.”

  “Can you tell me what day it is?”

  I thought for a moment. I wasn’t entirely surprised that I couldn’t provide the answer. In the best of health, I’ve lost track of the days. “No,” I replied.

  “Or what year it is?”

  “. . . No.”

  “What can you tell me about your work?”

  I thought again. And this time, I did feel surprised by the blankness I felt in response to the question. “I work with papers,” I said hesitantly. “I keep the papers in a briefcase with a brass clasp. And I work in a tall building. Somewhere in the center of . . . the city.”

  “What city?”

  I looked out the window at the high-rise flats that lined the dual carriageway. “I don’t know what city this is,” I said. And this time the surge of panic was unstoppable.

  I felt as if I had been standing on the walkway of a dam that was breaking. And now it was broken. The endlessly rising speed of the car was my ejection on a plume of water.

  And for a while, something that I knew was pure hallucination gripped me entirely, as the cars on the road became tumbling blocks of concrete and the road became tumbling foam, and the engine noise became the roar of a torrent that enveloped me.

  12.

  “We’re here,” said the nurse.

  I looked around. We had stopped. We were at the hospital.

  “Is there time to save me?” I asked.

  “I hope so,” the nurse replied.

  “Thank you,” I said. My voice was shaking. “For helping me. For coming to find me.”

  The nurse smiled. “It’s my job.”

  “What’s your name? I’d like to know it.”

  The nurse paused. “You don’t know my name,” he said. “So I can’t tell you what it is.”

  I didn’t understand, and he didn’t give me a chance to ask him to explain. He reached across me and opened the side door. “Come on,” he said. “We should go.”

  part two

  1.

  I was led through the hospital by the nurse, down generic corridors and up disinfected stairwells. The nurse walked quickly and didn’t talk.

  In one ward, a radio was playing over the speaker system, but the volume had been turned down so low that the words of the DJ were inaudible. The patients here were all suffering from injuries to their hands. Every one of them was fully bandaged from the elbows down, and their arms were attached to wires that held them upwards.

  In another ward, I saw that all the patients’ beds were enclosed in plastic tents, as if quarantined. I could see their blurred forms through the sheeting. One figure was sitting up in bed. The man’s head followed us as we passed.

  Finally we came to a pair of swinging doors, and the nurse stopped. Above the doors a sign read: COMA WARD. The nurse looked back at me and gave a slight smile of encouragement. Then we walked in.

  Off a single windowless corridor were twelve rooms, six down each side. The floor was carpeted. The lights in the corridor were dimmed.

  “Do you have any memory of this place?” the nurse said quietly.

  “I think so,” I replied. “A little. It feels . . .
familiar.”

  “Go on.”

  I breathed in through my nose. “It smells familiar. The flowers that people leave for the sick. And . . . dust, or . . .” I suddenly remembered the way my eyes had smarted when I lay down in my bed at home. “Pollen.”

  I took a few steps and glanced in the first door on my right. Inside, I noticed that the lighting was brighter. The patient, a woman, was lying on her side. No machines or wires were attached to her. There was no drama in the sight—she simply looked as if she were asleep.

  When I looked through the open door on my left, however, the patient was propped up on pillows, and clearly awake. The man, who I’d guess was in his twenties, had his eyes open, and his mouth open, and he appeared to be gazing around the room.

  The nurse reacted to my expression with a little shake of his head.

  “Comas like his can be very difficult for the family,” he whispered.

  “He isn’t awake?”

  “No.”

  Looking harder, I saw that the various directions of the man’s gaze had no purpose. They were circular and repeating, and without focus.

  “He’s not seeing anything,” I said.

  “On a scan, there will be no real activity in his brain. It’s the big difference between him and her.” The nurse gestured back at the sleeping woman on the right. “And you,” he added, and continued down the corridor.

  At the far end, at the final door, which was closed, the nurse turned.

  “This is your room,” he said.

  “I’ll be staying here?” I asked.

  “You are staying here,” the nurse replied, and indicated for me to enter.

  2.

  This is the way it is with dreams. One moment I was opening the door to the ward room and seeing myself lying on the bed.

  I was lying on the bed. The bruises I thought had faded and gone were covering my head and shoulders. My eyes were purple and yellow and puffed shut, and my lips were split. A support collar was fastened around my neck.