Guilty

by Siobhan MacDonald

Some people had aortic root replacement to reduce the possibility of aortic rupture and cardiac arrest. Alison had no thoracic scars and no outward indication of heart surgery. Marfan syndrome was not an area that Luke specialised in. There was only a handful of specialists in the country qualified to diagnose and manage it.

  ‘Who are you attending?’ he asked eventually.

  ‘Raymond Grogan. You probably know him.’

  Luke nodded. ‘I know he’s a leading authority on the syndrome.’ Grogan was a brusque individual where male colleagues were concerned, but less harsh with his female colleagues.

  He slipped his hand over the table’s rough oak surface, gathering himself after the shock. He covered Alison’s hand with his. He had no idea what to say, or how to say it. This was not unusual. Alison told him often enough he was poor at expressing his feelings.

  As Luke covered her long thin fingers with his, he considered all the difficulties she must encounter with the burden of the syndrome. Opening his mouth to say so, it struck him that the last thing Alison would want was pity. He leaned in to kiss her. She remained still as his lips rested on hers. Then pulling back, she exhaled as if she’d been holding her breath. She rested her head on his shoulder. They sat like this a while, his hand still covering hers.

  He thought back to all the clues he’d missed. Their honeymoon on Kilimanjaro. It made sense now. At the time he’d thought her behaviour was related to altitude sickness.

  He remembered noting her colour change and realising she was struggling. Even so, he’d been surprised at her reaction when he suggested that they stop. He’d fully expected her to protest. She never backed down from a challenge. Instead, she’d agreed with him that he was right – she didn’t feel so good. She was holding back the rest of the team.

  She’d insisted that Luke head on to the summit without her, despite him arguing it was a honeymoon, that they should stay together. No, she said, you go. Take photographs, lots of them. And so he’d left her behind on oxygen, continuing on to the top with the rest of the team. He’d never have embarked on such a trip if he’d suspected she had Marfan syndrome.

  ‘How long have you known?’ he asked her, stroking her hair in the chilly kitchen.

  ‘Not too long before I met you.’

  She had known all this time?

  She raised her head, appreciating that all of this was a shock to him by the look in her eyes.

  ‘With Mum dying so suddenly of a heart attack, it was always something I meant to get checked out. I wanted to know if I was at risk.’

  That was Alison. Practical as ever.

  ‘I did my research and I went to Raymond Grogan,’ she explained. ‘That’s when I found out.’ She paused. ‘You and I have a lot to thank Raymond for, actually.’ A slow smile spread across her face.

  ‘Really?’ He didn’t feel like smiling.

  ‘Really,’ she confirmed. ‘We wouldn’t be together but for Raymond Grogan. There’d be no us. That’s how I became interested in the whole area of cardiac health, you see. That’s how I got involved in fundraising for children with heart defects. How do you think I came to be at that fundraising lunch where we first met?’

  Luke had never thought about it before. The reason for Alison being at that lunch. He was aware he had social limitations. He understood facts and evidence and worked with what people told him. He knew, however, there were also clues on a social level that he was unaware of. He and Alison could listen to the same conversation, but could draw different inferences. His based on facts and evidence, hers based on the same, but complemented by body language and other signals that passed him by.

  ‘So I take it you’re not a candidate for an aortic root replacement?’ he asked.

  ‘No,’ Alison replied. ‘My condition isn’t severe enough for that. Raymond Grogan said it could be managed by lifestyle choices.’

  The guy was a leading European authority and if he considered the risks acceptable for Alison to continue without a replacement, Luke would have to be content with that. His thoughts turned to her frenetic lifestyle. The fundraising, the public speaking, her endeavours to support his career. Since their return home, there was talk of setting up a PR firm with her friend and neighbour, Roddy Gilligan. And more worrying – her hunting. How on earth could hunting be deemed a safe activity with her condition?

  ‘Your hunting, Alison?’ he ventured. ‘What about the hunting? Jesus, when I think you went halfway up Kilimanjaro as well—’

  ‘Stop right there, Luke.’

  He was startled by her sharpness.

  ‘Do you realise how many times I wanted to tell you about this?’ She looked at him intently. ‘This is precisely why I didn’t.’ Her voice softened. ‘I didn’t tell you when we started going out together because I didn’t want you looking at me as if I were a patient. I can’t live my life wrapped in cotton wool. That would be a death sentence to me. I have to do the things that make me happy. If not, I might as well be dead.’ Her eyes pleaded for understanding.

  ‘But, Alison—’

  ‘No buts, Luke. I’m careful. I do not take unnecessary risks.’

  Unnecessary risks.

  The phrase concentrated his thoughts. She had crystallised the issue. Pregnancy was an unnecessary risk. Of immediate concern was her contraceptive choice. His mind was racing. Alison was taking the contraceptive pill. He’d never queried what type of pill she was on before.

  ‘But the pill?’

  ‘It’s progestin only. Don’t worry.’

  That was something at least. Pills containing oestrogen could lead to blood clots which could be fatal for a Marfan patient. Luke was still unhappy. Progestin-only pills had a higher failure rate. Alison could still fall pregnant. He’d had no idea they’d been playing Russian roulette the past few years.

  ‘You know what, Alison? I really think it would be a good idea for me to come along to your next appointment with Grogan.’

  ‘No, Luke, you’re not doing that.’ Alison shook her head. ‘Look, you’ve already acknowledged that Grogan is an authority on the syndrome, right? You come along with me and I know what you’re like. You’re going to ask all these questions in that abrasive way you do sometimes. The guy is going to feel you don’t trust his judgement. You’ll end up undermining the relationship I have with him, make things awkward. I am perfectly happy with the care I’m getting.’

  He considered her point reluctantly.

  ‘Look, I know it’s tricky,’ she went on, ‘but these things can be managed. I just need to be extra careful when I get pregnant. Blood pressure checks, aortic scans and suchlike.’

  ‘No.’

  It was Alison’s turn to look startled.

  ‘I don’t want you going through all that,’ he said. He’d already thought ahead. ‘Regardless of what Raymond Grogan says, the risks are not acceptable to me. It’s too much pressure on your heart.’ He didn’t want to frighten her but he knew an aortic tear was possible.

  ‘But—’

  ‘Look, Alison, I know this sucks. It’s total shit. It’s not fair. But we have a lot going for us. We can still have a good life together. We don’t have to be like everybody else.’

  Even as he spoke, his words sounded hollow. There was no getting away from it. It was devastating news. It was sinking in that he and Alison would never have children together. It wasn’t like he’d ever spent huge amounts of time thinking about it. But it was there in the back of his mind. Something he was looking forward to. Building forts in the sand like he did as a kid with his own dad. One of the happiest memories he had in the short time he’d had with the man. Building dens and treehouses. Playing soccer in the garden. Now this. It was crushing.

  ‘I feel truly awful about this,’ Alison whispered. ‘I know I’ve let you down.’ Her eyes were pools of hurt. ‘You’d be such a brilliant dad. You deserve more.’

  ‘It’s not your fault,’ Luke said flatly.

  Silence followed.

  He couldn’t think of anythi
ng positive to add. ‘I’d probably be one of those dads that forgets about his kids and leaves them behind in the supermarket,’ he joked eventually. ‘We’re probably better off just you and me.’ He tried to sound convincing.

  ‘You’re only saying that to make me feel better, but thanks.’ Alison looked at him gratefully. ‘It’s just that I always imagined us having kids. I know we’re good together, but it could be even better. It’s just, you know … I feel like things won’t be complete without a family. I think I’ll always feel like I am missing out on something.’

  She put her shoes back on and got to her feet. They both fell into silence again, Luke busy thinking, Alison fixing a dinner plate for Cornelius. He understood Alison’s fears around not telling him sooner. She was afraid he’d cramp her style. Yet he couldn’t help but feel a gnawing, nameless feeling. Keeping him in the dark that long didn’t sit well with him.

  Shouldn’t she have told him before they got married? Why had she not trusted him? Was she afraid he’d lose interest? Or in her sanguine fashion did she really imagine it wouldn’t be a problem? There were endless questions but it didn’t change a thing. They were where they were. All the same, he couldn’t help but wish she’d handled it a bit differently.

  The smell of cooking gradually filled the kitchen. He followed her with his eyes as she went to the Aga, checking on the pie for dinner. Since Cornelius had his heart attack, home cooking was arriving in steady batches from the homes of Crow Hall labourers. The old man also had a steady stream of well-wishers. Luke found himself longing more and more for a place of his own.

  He watched as Alison cut a large slice of meat pie and arranged it on a plate with steaming turnip and potatoes. Fetching a tray and a heavy crystal glass, she poured a generous glass of Cornelius’s favourite red. Despite the heart attack, Cornelius showed little sign of cutting back.

  ‘Can you get the door?’ Alison asked. ‘I want Dad to eat before Harry Halvey arrives.’

  Harry Halvey was an assistant police commissioner.

  Luke went to the door. ‘There are ways and means, Alison.’

  She looked at him curiously, her sombre eyes burning intensely.

  ‘Ways and means,’ he repeated, holding the creaky door.

  She smiled wanly, then, pulling her shoulders back, she headed through the passageway. Luke watched, listening to her humming her way, her footsteps echoing on the tiles. She was an ace at putting on a brave face.

  ‘See you in the morning, Ali,’ he called out. He was heading on to a nightshift. The timing of the bombshell couldn’t have been worse.

  ‘Have a good night, darling,’ she shouted back.

  After what she’d told him, he thought that most unlikely.

  Luke opened his eyes. From underneath his bushy eyebrows, Terence studied him. It was a few moments before the therapist ventured any comment on what he’d heard.

  ‘Well, Luke, your recall is remarkable. You paint a vivid picture of what was obviously a distressing time for you.’

  ‘What you might call a spanner in the works.’ Luke smiled wryly. ‘We humans are a right cantankerous lot. We never know what we want until someone tells us we can’t have it. And then we want it right away.’

  ‘True indeed.’

  ‘It was only after Alison’s disclosure that I realised just how much I wanted a family. I guess I always thought that when I had a child of my own, I’d recreate the perfect childhood, the one I’d wanted. Not the one I had …’

  ‘Oh?’

  Luke shook his head. ‘I have to say I’ve no idea why I brought that up. What am I doing talking about my childhood? This is ridiculous. What on earth does that have to do with anything?’

  ‘It’s a process.’ Terence smiled. ‘A bit like peeling back layers of an onion. Bit by bit before getting to the core. I think we’ve covered enough for today, though. Let’s pick it up again at our next session. All right with you?’

  Luke nodded. He was happy to pause this visit to his past. He remembered the dark nights before he was sent to board at St Aloysius School for Boys. Staring up at the bedroom ceiling in Aunt Christine’s house, wondering whether Mum and Dad could see him from wherever it was they’d gone to. He and Wendy were kids when their parents vanished overnight from their lives.

  Ways and Means

  ‘Would you like me to bring you something up from the canteen? I’m going down shortly.’ Fran was busy cutting dead leaves from the office plants on the windowsill. ‘A sandwich maybe? The ploughman’s lunch?’

  ‘No, thanks.’ Luke was fairly sure any ploughman worth his salt wouldn’t deign to choose the limp, cello-wrapped offering in the hospital canteen. ‘I’m heading out in a bit. I’ll get something then.’

  ‘Just thought I’d ask,’ said Fran with a knowing expression.

  Though she never enquired directly, Luke reckoned Fran suspected he was visiting Terence Black during the day. The therapy sessions were more or less continuous with Terence kindly accommodating Luke in a lunchtime slot. Luke didn’t confirm Fran’s suspicions. He had to remain discreet.

  On the eight-minute journey to Terence’s office that lunchtime, Luke prepared himself for what he was about to disclose. He thought back to his childhood. The one that came to an end at the tender age of five. Five and a half to be exact. Wendy had been ten.

  He remembered his mother bending to kiss him. ‘Be good for Aunt Christine,’ she said. ‘She’s not used to children. I’ll bring you back some fizzy snakes and cola bottles.’

  Luke had loved those long strings of jelly and the way they’d sparkle on his tongue. The jelly cola bottles were the next best thing to Coke. He wasn’t allowed fizzy drinks. Mum said they made him crazy.

  He remembered being in the garden at Aunt Christine’s, his dad slinging him a football. His dad was wearing a jacket with a red flower stuck in it. ‘Get some practice, son,’ he said. ‘We’ll play keepie-uppie when I come back.’

  Luke kept his side of the bargain. He kept out of Aunt Christine’s way. He and Wendy stayed outside in the garden as much as they could. They made a fort at the back behind the greenhouse. And he practised keepie-uppie like he promised. Dad was going to have a hard time beating twenty-three minutes.

  It puzzled him when Mum and Dad didn’t return the following day as promised. Or the day after that either. He’d had no idea that weddings took that long. He was missing school into the bargain. Mum wouldn’t be too pleased about that. And when he asked the adults where his mum and dad were, no one would give him an answer. Well, not one that made sense anyway. It was all very odd. He couldn’t understand it.

  Wendy wouldn’t talk to him either. She went very weird and wouldn’t come out to play in their cool fort in the garden. She stayed in a bedroom under the covers with a book. And Aunt Christine spent all her time whispering on the phone in the hall. He had to go off and play by himself. He got up to twenty-seven minutes in keepie-uppie.

  Everyone was acting strangely. He was sure Wendy must know something. She was older. People often told her stuff they wouldn’t tell him. He knew that because she’d get a look on her face. She had that look now.

  ‘When are Mum and Dad coming back, Wendy?’ he asked for the gazillionth time.

  Then eventually, instead of ignoring him like all the times before, she looked him straight in the eye. He could tell she’d been crying.

  ‘They’re gone to heaven,’ she said.

  ‘Oh,’ he said, knowing that was somewhere good. ‘But when will they be back?’ Wendy still hadn’t answered his question.

  ‘I just told you, they’re gone to heaven.’

  Though he asked repeatedly every day for a week, no one could give him a straight answer. Not long after that, they went to church. Everyone there said nice things about his mum and dad. He remembered thinking it was such a shame they weren’t there to hear it. Afterwards they went to a hotel. He was allowed to have a Coke. He remembered thinking his mum would be really mad when she found out about th
at. No one else seemed to care too much.

  It must have been months afterwards when he first heard the words ‘car crash’. Maybe they’d mentioned those scary words back in the beginning. There used to be a time when he was good at blocking stuff out.

  There was a smell of packet soup in Terence’s office. Luke recognised it from his student days. It had a malodorous, powdery, oniony, smell. He shouldn’t complain. The therapist was forfeiting his lunch break to accommodate him. The waiting area had been empty, as was the reception desk. It was just the two of them.

  Terence was about to sit down in his seat with his cup of soup when he stopped. ‘I didn’t think to ask … would you like a cup of soup?’

  ‘I’ve eaten, thanks,’ lied Luke. The smell was making him gag.

  ‘Good. Good. I can never think when I’m hungry.’ Terence sat, setting the cup in front of him. He peered at his notepad. ‘Last time, you spoke about “ways and means” if I recall correctly? Shall we take it up from there?’

  ‘That’s right.’ Luke nodded, settling back. ‘After finding out about the Marfan’s, I felt that I had to do something about Alison. There was no way I could risk her getting pregnant.’

  He recalled the feelings of responsibility and of dread. How could he forgive himself if anything were to happen to her? He couldn’t leave things to chance. Alison was using a contraceptive pill but it had a higher failure rate than the combined pill that she couldn’t take. Apart from being sure-fire passion killers, condoms were too risky.

  It had taken Luke a long week of agonising. No matter how he dissected the problem, he could find only one solution. He didn’t like it. Not one bit. It seemed so drastic and he worried that he might experience regret and by then it would be too late.

  He didn’t know anyone else who’d done it. Not anyone who had admitted to it at least. It wasn’t exactly the sort of thing you crowed about from the rooftops. And he certainly didn’t want to discuss it with anyone, least of all his colleagues. It was a private matter, between him and Alison. No one else’s business.

  Being on nightshift at that time meant he saw very little of Alison, which was just as well. He wanted to make this decision on his own. He didn’t want her trying to dissuade him. If he revealed what he was thinking she might try to change his mind, and as often happened he might easily find himself agreeing with her. This was something he had to do on his own. He’d go to Dublin. He’d tell Fran he was attending a conference. He didn’t want anyone in St Matthew’s finding out.