Should We Stay or Should We Go

by Lionel Shriver

  He went through a period of walking ritually around the floor plan of every house or flat in which he’d lived: the two-up two-down of his childhood in Birmingham, the larger house the family had shifted to when he was sixteen, the residence halls of Imperial College London, his first bedsit in Rotherhithe with Kay . . . With concentration, he could summon a floppy green sofa from the early years of his marriage that he hadn’t pictured in decades, or the rose-patterned wallpaper of his childhood bedroom. He rehearsed the interiors, bodies, and controls of every car he’d ever owned—the Ford Cortina when they married, the Morris Minor Traveller when the kids were small . . . Having never been a dandy, he surprised himself with his keen recollection of his clothing through the years, from the funny corduroy shorts with the blue braces looping around brass buttons that he’d worn in early primary school to the streamlined pinstripe three-piece with a classic red tie that he’d worn professionally in the 1980s. During another phase he thought about foods, cycling his mother’s shepherd’s pie and Kay’s famous cauliflower cheese on a loop like an automated cafeteria. Yet he’d never cared much about food, and he always circled dolefully back to the bangers and mash of Kay’s final birthday. He had exhausted his thoughts on the NHS whilst writing his memoir; besides, it didn’t matter a jot what a silent lump in a bed thought about the health service. He could presumably muse about the purpose of the universe, but he wasn’t a philosopher, and any contemplation along these lines degenerated into a muddle of rage, resentment, and despair that made Kay’s soliloquy on her last night—“It’s taken me ages to realize that I still don’t understand what this is!”—seem like Shakespeare.

  Yet he was not quite mind and only mind, like one of those brains suspended in a jar in the mad-scientist labs of 1950s science fiction films. That would be hellish enough, but perhaps preferable to continuing to inhabit a body over which, eyelids excepted, he could exert no control. By contrast, the torture chamber of the body still exerted control over him. Thus a muscle would cramp, yet he couldn’t stretch to release it. His lips grew dry, and he couldn’t lick them. The temperature in the hospital would drop, and he couldn’t pull a coverlet to his chin; the temperature would rise, and he couldn’t kick the coverlet aside. He could blink, but couldn’t tease sleep from his eye. A stray housefly was a catastrophe; it could crawl his face with impunity. What an unwelcome discovery: how vital it was to be able to readjust one’s legs in bed. Even the ability to discreetly pick one’s own nose was revealed as the height of luxury.

  Technically, Cyril was not altogether deprived of the ability to communicate, but the farce that passed for conversation was wholly dependent on someone else being inhumanly patient with the Esperanto of the eyelid. The nurses were accustomed to asking lacklustre yes or no questions like, “You okay, sweetie?” but the new hires and short-termers often forgot whether it was one or two blinks for “no” even if they bothered to watch. They’d all been informed that he was conscious, but so little power did he possess to impress that awareness upon the staff that in practice most of them talked over him to one another as if he were a dinette set.

  Early on, he did toy with the idea of resuming the composition of Fit for Purpose, as it would have been theoretically possible to blink out one letter at a time with the assistance of the alphabet board. But the sedulous selection of N . . . (blink) H (blink) . . . S (blink) recalled the hair-tearing tedium of searching for “Panorama” in the iPlayer’s on-demand television app: inputting letter by agonizing letter on the onscreen keyboard with the directional buttons of the remote. Besides, a return to his memoir could only have been facilitated by some saint prepared to slowly trace a finger back and forth across three rows of alphabet in order to reap a single W, and who would that be? His children had been brutally clear about just how fascinated they were by the textual culmination of their father’s career. The chances that any of them would see the work through to publication were vanishingly slight. The problem wasn’t only logistical, either. Resuming the manuscript would have required a force of will that was seeping away. In retrospect, he was incredulous that he’d squandered the twilight of his physical competency on the EU. It was no longer faintly obvious why a large bureaucracy in Brussels had ever mattered to him in the slightest.

  The one matter that could wholly absorb him was mental rehearsal of Kay’s eightieth. Having dodged a full reckoning with that night ever since, he had probably plunged into his memoirs as a flight from coming to terms with what he had done. What Kay had done? What he had done. So perfectly deprived of distraction, he finally came to recognize that he had been living in a permanent state of searing self-excoriation from the instant the dead weight of her head had sagged against his shoulder. From that moment forward, he’d been hating himself far more ferociously than his children had ever done. However unacknowledged, the verdict had been instantaneous: if he’d not killed his wife outright, he might as well have. He’d not only been missing her, but grievously ruing the fact that he had allowed dogma to take precedence over the love of his life.

  No one would ever witness a none-too-subtle reordering of this version of events. Lying supine and motionless, lonely and suffocating, the ventilator tube raw in his throat, Cyril not only forgave himself, but thanked himself. Oh, yes, he missed her, all right. But he had spared her. Now Kay would never lie for an eternity staring up at a water spot the shape of Norway. Tipping those tablets into her waiting palm had constituted his purest act of altruism. For when he envisioned his wife slack in his arms, he no longer felt guilt, but envy.

  * * *

  This epiphany onwards, Cyril’s sole purpose became getting his life support withdrawn. Achieving this aim was impeded by the fact that Marshall Evans, the lead doctor on his case, was one of those wet sorts forever trotting out that muddy metaphor, the “slippery slope.” A Catholic tritely attached to the “sanctity of human life,” the neurologist had already been queasy about taking his patient off the ventilator even back when Cyril appeared to have lapsed into a persistent vegetative state. Once the patient’s blinking established that someone was home, his hallowed “human life” became all the more sacred. As a GP, Cyril had encountered plenty of Evans’ ilk—the type who lobbied to keep flagrantly unviable infants alive for as long as medically possible, when the babies were doubtless in pain and were going to die anyway. It was the same type who spent tens of thousands of pounds at the vet on a fifteen-year-old arthritic dog. Besides, Cyril detected in his physician an unhealthy professional fascination with a rare waking coma that the doctor had read about but had never before encountered in practice. Evans wouldn’t readily relinquish such an interesting specimen. With this chap, even passive assisted suicide was going to be a hard sell.

  Consequently, Cyril left no room for ambiguity. As a nurse trailed her finger across the alphabet board and transcribed each letter that elicited a blink, he instructed Dr Evans starkly, P . . . U . . . L . . . L . . . [] . . . T . . . H . . . E . . . [] . . . P . . . L . . . U . . . G . . . [.] Yet all too typically keen to emphasize his status as a former colleague in our NHS, he made the mistake of elaborating: M . . . Y . . . [] . . . C . . . A . . . R . . . E . . . [] . . . I . . . S . . . [] . . . C . . . O . . . S . . . T . . . I . . . N . . . G . . . [] . . . A . . . [] . . . F . . . O . . . R . . . T . . . U . . . N . . . E . . . [.] . . . I . . . [] . . . A . . . M . . . [] . . . A . . . [] . . . B . . . E . . . D . . . [] . . . B . . . L . . . O . . . C . . . K . . . E . . . R . . . [.] From this perfectly rational concern, one that any advocate of a sustainable national health care system should regard as paramount, the neurologist concluded that the patient was suffering from the “low self-esteem” indicative of clinical depression. (Who would NOT be clinically depressed when buried alive?) Cyril was therefore in no fit state to make life and death decisions on his own behalf.

  Consultations with the family were no more availing. If he didn’t stand to benefit from an inheritance, Roy wasn’t fussed either way. Simon was the most decent of the lot, but
as a bean counter for the City, and a bloody Tory to boot, he wasn’t a deep thinker; simplistically, he didn’t want to assume the ethical responsibility for patricide. Hayley was a sadist who wanted to keep her father in living hell for as long as possible as punishment for her mother’s “murder.”

  Stroke victims with locked-in syndrome did not commonly live longer than about four months. Yet if Cyril qua person had lost the will to live, Cyril qua organism was unusually robust. He lived to ninety-three.

  5

  The Precautionary Principle

  “In the course of an hour, she told me about the same chamber concert at St Mark’s three times. She kept asking how ‘Cyril’ was getting on at Barclays and how ‘Cyril’ likes his new flat, so I had to infer she meant Simon. Lastly, I found a stack of freshly laundered towels in her oven. That pact of yours, my dear?” Kay raised grimly. She hadn’t alluded to her husband’s macabre proposal since he’d first mooted the idea in April. “I’m all in.”

  Thus Kay and Cyril Wilkinson’s deal was sealed in October of 1991. Yet, a scant two years later, Kay had a close call with an archetypal White Van Man—who as she advanced into a zebra crossing swerved only at the last minute and crashed into a lamppost, himself much the worse for wear. So near was the miss that it brought home the finality of what her husband planned for them both, should they be so lucky as to make it to the preposterous year of 2020.

  “I’m still shaking,” she said, staggering to a seat at the kitchen table. “He cut so close he restyled my hair.”

  “Can I get you something?” Cyril solicited. “A glass of water?”

  “I don’t want a glass of water! Why are people always offering you a glass of water?”

  “Why so irritable?”

  “I’m not irritable, I’m traumatized. If I’d stepped off the kerb one nanosecond earlier, I wouldn’t be here. When a different future is that vivid—or when a lack of future is that vivid—it splits off into a parallel universe that’s nearly as real as this one.”

  Cyril poured her the too-early dry Amontillado that now, it seemed, ritually accompanied their frank discussions of mortality.

  “I’m not sure I can drink that. I feel a bit sick.”

  He left the glass. If memory served, its contents would evaporate in due course.

  “Listen, my dear, I’ve been thinking,” Kay said. “We never talk about it, as if the whole business is done and dusted. But I’d like to revisit your disagreeable plans for my eightieth birthday.”

  “They’re not my plans. They’re our plans.”

  Kay squinted. “Mmm. That’s not altogether the way it feels.”

  “I can’t change the fact that it was my idea. I’d hate to think that my proposal is permanently tainted purely for the fact that it was my proposal.”

  “But of course you’re the one who would concoct such a scheme. It’s absolutist. It’s uncompromising. It’s an abstract, arbitrary, and overly tidy attempt to head off an unknowable future that’s bound to be messy, complicated, and horribly down to earth. I understand that you don’t like uncertainty, but the alternative can’t be a certainty that’s off the beam.”

  “I don’t apologize for trying to organize our lives with intent, and in concert with our beliefs. We don’t want our avoidance of awkward, unpleasant subjects, and a consequent lack of forethought, to accidentally end up costing the health service perhaps millions of pounds, all lavished on misery—”

  “Oh, put a sock in it.”

  “I thought you liked the idea of getting our affairs in order beforehand—”

  “That’s exactly what I’ve been thinking about,” Kay interrupted, and took a slug of the sherry. “My mother has deteriorated precipitously, and we’ve had to make all these arrangements on the hoof. Scurrying round trying to find a facility that doesn’t reek and where staff don’t torture the dementia patients for sport, only to discover that one more care home in Surrey has suddenly closed after we drive all the way down there. It’s all so last minute, as if it’s a big surprise that she’s old, which anyone could have predicted who can count. What you and I need to do is what nobody does: plan for decay. Stop pretending we’re going to live forever, and stop indulging the standard conceit that we’re frightfully special, so all the wretched things that happen to other old people will never happen to us.”

  Kay laid out a series of practical measures that entailed some sacrifice, but of a more modest nature than the drastic one that her husband had contrived. Cyril was impressed.

  “I’ve never told you this,” Kay added, “but for a while now I’ve been considering taking retirement two years from now and then qualifying as an interior designer. I really do think the conservatory turned out smashing. I’ve quite enjoyed doing up this house, and I think I’d be a dab hand at doing up other people’s as well.”

  “Retire at fifty-five!” Cyril said, recoiling. “That borders on freeloading. And in comparison to addressing this country’s escalating rates of Type 2 diabetes, selecting curtains seems awfully lightweight.”

  “Presently, they’re more likely to be blinds. But don’t get your knickers in a twist. I said I’ve considered it. In light of this discussion, I think not. A second career would be a risk, with no guarantee of panning out financially. It’s probably better for me to put in ten or twelve more years at St Thomas’. Giving interior design a miss makes me sad, but it’s sensible. And no, thank you, no more sherry, not until eight o’clock—which is sensible, too. I should get going on dinner. And whilst I’m at it . . .” She scanned the open refrigerator and rose on tiptoe. “We won’t be needing this.” With a clang, she dropped the black soap-dish box unceremoniously in the bin.

  * * *

  At that time, Kay and Cyril were both still under fifty-five, which made their purchase of long-term care insurance more affordable; most people waited until their sixties, by which point premiums skyrocketed. Nose to the grindstone even longer than she’d promised, Kay continued to work in the endocrinology unit until she was sixty-eight, whereas Cyril stayed on at the clinic in Bermondsey until he turned seventy—the minimum age, he argued to anyone who would listen (i.e., pretty much nobody), until which everyone would need to keep working if the economy in future was not to go belly-up. Putting off drawing down their pensions would increase their payouts when the time came.

  They also made substantial contributions to private pensions. After taking a hit when the dot-com bubble burst, they rebalanced in a more conservative direction, which helped protect their portfolios from devastation when the monster Great Recession arrived in 2008. Continuing to rise in value, the house in Lambeth could prove the ultimate nest egg if either lived long enough to receive a birthday card from the Queen.

  They took no exotic foreign holidays. Kay had wistfully hoped someday to visit Japan or Australia, but such lavish expenditures were imprudent. Instead they took day trips to Brighton, visited the cathedral in Salisbury, and spent the odd weekend in Scarborough. The holiday destinations of their native land were perfectly pleasant, even if these expeditions didn’t sponsor many surprises and it was nearly always cold.

  Meanwhile, penny-pinching was the most painful in relation to their parents. The less than luxurious care home they found for Kay’s mother didn’t smell like pee or anything, but it had the atmosphere of a budget hotel—all plastic chairs and curling fake-wood laminate. Even so, when the money from the sale of the house in Maida Vale was used up, Kay insisted that her brother Percy pitch in his share of the fees. Objecting that his aggrieved ex-wife had secured an outrageous settlement in the divorce and his husband was a skint journeyman actor, Percy was resentful, which turned the siblings’ relationship frosty.

  Once Cyril’s mother died of viral pneumonia, they also made the painful decision to let the jovial live-in Jamaican go. Kalisa might have become one of the family, but Norman could manage mostly on his own, and Cyril’s sister Fiona, who lived nearby, could regularly pop in to check on her father. The economics of th
e decision were cut-and-dried—a full-time salary year after year quickly adds up—but Fiona didn’t appreciate having the responsibility dumped on her by merit of proximity, and she was understandably convinced that her father’s care fell solely to her because she was the girl. That sibling relationship didn’t prosper, either. Worse, although Norman had seemed to manage the loss of his wife with impressive resignation, losing his cheerful Christian companion—who sang whilst she worked, and served up not only a mean plate of plantains but a better than passable sausage lasagne—was more than he could bear. He needed Kalisa more than they realized. Weakened from losing weight, he fell prey to flu and died at eighty-one—which was beginning to seem young.

  The Wilkinsons did extensive research on assisted living facilities, which varied enormously in quality, availability, and solvency. At last they settled on a high-end outfit in Suffolk, just outside Aldeburgh—close enough to London to easily visit friends and family so long as they were still able to travel. Journey’s End was on the coast, which would allow for leisurely beachcombing during the period they remained ambulatory. Its amenities were flash: a gym, a pool, a games room with two snooker tables, a common area with pneumatic, attractively upholstered sofas and colourful cushions. The dining room for functional residents was kitted out like a restaurant, and its menu, as various as The Ivy in Covent Garden, catered to all manner of dietary requirements. They tried it out for lunch, and Cyril was impressed with the steak and ale pie, whereas Kay found it a good sign that they made their chips fresh from proper potatoes.