The Children Act

by Ian Mcewan

  She liked hospitals. When she was thirteen, a keen high-speed cyclist to school, a slotted drain cover caused her to fly over her handlebars. A brief concussion and traces of blood in her urine kept her in hospital for observation. There was no room in the pediatric ward—a coachful of schoolchildren had returned from Spain with an unidentified stomach virus. She was put in with the women and remained among them for a week of undemanding tests. This was the mid-1960s, when the spirit of the times had not yet begun to question and unpick the starchy medical hierarchies. The high-ceilinged Victorian ward was clean and orderly, the frightening ward sister protective toward her youngest patient, and the old ladies, some of whom, it was clear in retrospect, were in their thirties, adored and cared for Fiona. She never considered their ailments. She was their pet and she was lost to a new existence. Her old routines of home and school dropped away. When one or two nice ladies vanished from their beds during the night she didn’t think about it much. She was well protected from hysterectomies, cancer and death, and passed a glorious week without alarm or pain.

  In the afternoons, after school, her friends would come, awed to be making a grown-up independent hospital visit. When the awe wore off, three or four girls would be round Fiona’s bed shaking and clucking with held-down laughter at nothing much at all—a nurse striding by with a frown, the over-earnest greeting of an ancient lady with no teeth, someone at the far end of the ward being raucously sick behind a screen.

  Before and after lunch, Fiona would sit alone in the day room with an exercise book on her lap, planning futures for herself—a concert pianist, a vet, a journalist, a singer. She made flowcharts of possible lives. The trunk lines branched through university, heroic chunky husband, dreamy children, sheep farm, the eminent life. Back then she had not yet thought of the law.

  On the day she was discharged, she went round the ward in school uniform, satchel swinging from her shoulder, watched by her mother, making tearful farewells and promises to stay in touch. In the decades that followed she was lucky in her health, and only ever in hospital during visiting hours. But she was marked for good. Whatever suffering and fear she saw in family and friends could not dislodge an improbable association of hospitals with kindness, with being noted as special and sheltered from the worst. So now, inappropriately, as the twenty-six-story Edith Cavell Wandsworth General rose above the misty oak trees on the far side of the common, she experienced a moment of pleasurable anticipation.

  She and the social worker looked ahead, past the stuttering windscreen wipers, as the taxi approached a blue neon sign which announced remaining space for six hundred and fifteen cars. On a grassy rise, as on a Stone Age hill fort, stood the Japanese-designed circular tower of glass, with cladding of surgical-scrubs green, built with expensively borrowed money, back in the carefree days of New Labour. The highest floors were lost to the low-slung summer cloud.

  As they walked toward the entrance a cat ran out in front of them from under a parked car and Marina Greene opened the conversation again to give a full account of her own cat, a bold British Shorthair that saw off all the dogs in the neighborhood. Fiona warmed to this solemn young woman with the thin sandy hair who lived in a council house with her three children under five and her policeman husband. Her cat was beside the point. She was not letting anything prejudicial pass between them, but was sensitively aware of the shared concern they were about to confront.

  Fiona allowed herself more freedom. She said, “A cat that stands its ground. I hope you’ve told young Adam that story.”

  Marina said quickly, “I have, actually,” and fell silent.

  They entered a glassed-in atrium the height of the entire building. Mature native trees, rather starved, pushed hopefully upward from the concourse, from among the cheerful chairs and tables of competing coffee and sandwich concessions. Higher up, then even higher, other trees rose from concrete platforms cantilevered into the curving walls. The remotest plants were shrubs silhouetted against the glass roof three hundred feet up. The two women went across the pale parquet, past an information center and an exhibition of unwell children’s art. The long straight run of an escalator brought them to a mezzanine, where a bookshop, florist, newsagent, gift shop and business center were ranged around a fountain. New Age music, airy and unmodulating, merged with the sound of tinkling water. The model was, of course, the modern airport. With altered destinations. At this level there was little sign of illness, none of medical equipment. The patients were finely spread between visitors and staff. Here and there were people in dressing gowns, looking rakish. Fiona and Marina followed signs with motorway lettering. PEDIATRIC ONCOLOGY, NUCLEAR MEDICINE, PHLEBOTOMY. They turned down a wide polished corridor that brought them to a bank of elevators and rode up in silence to the ninth floor, where an identical corridor took them through three left turns toward Intensive Care. They passed a jolly mural of apes swinging through a forest. Now, at last, the uncirculated air tasted of hospital, of cooked food long removed, antiseptic and, fainter, something sweet. Neither fruit nor flowers.

  The nurses’ station faced protectively onto a semicircular array of closed doors, each one with an observation window. The silence, broken only by an electric hum, and the lack of natural light made it feel like the small hours. The two young nurses on the desk, one Filipina, Fiona later learned, the other Caribbean, exclaimed and greeted Marina with high fives. Suddenly the social worker was a different person, an animated black woman in a white skin. She spun round to introduce the judge to the young nurses as “truly high up.” Fiona put out her hand. She could not have performed a high five without withering self-consciousness, and that seemed to be understood. Her hand was taken warmly. In a rapid exchange at the desk it was agreed that Fiona would remain outside while the social worker went in and explained things to Adam.

  When Marina had gone through a door to the far right, Fiona turned to the nurses and asked about their young patient.

  “He’s learning the violin,” the young Filipina woman said. “And driving us crazy!”

  Her friend theatrically slapped her thigh. “He’s strangling a turkey in there.”

  The nurses looked at each other and began to laugh, but quietly, out of consideration for their patients. This was clearly an old and coded joke. Fiona waited. She was feeling at home, but she knew it wouldn’t last.

  Finally she said, “What about this transfusion business?”

  All humor vanished. The Caribbean nurse said, “I pray for him every day. I say to Adam, ‘God don’t need you to do this, darlin’. He loves you anyway. God wants you to live.’ ”

  Her friend said sadly, “He’s made up his mind. You got to admire him. Living for his principles, is it.”

  “Dying, you mean! He knows nothing. This is one confused little puppy.”

  Fiona said, “What does he say when you tell him that God wants him to live?”

  “Nothing. He’s like, Why should I listen to her?”

  Just then, Marina opened the door, raised a hand and went back inside.

  Fiona said, “Well, thank you.”

  In response to a buzzer, the Filipina nurse was hurrying toward another door.

  “You go in there, ma’m,” her friend said, “and please turn him around. He’s a lovely boy.”

  If Fiona’s recollection of stepping into Adam Henry’s room was confused, it was because of the disorienting contrasts. There was much to take in. The place was in semidarkness but for the focused bright light around the bed. In a corner, Marina was just settling herself into a chair with a magazine whose print she could not possibly read in such gloom. The life-support and monitoring equipment around the bed, the high stands, their feed lines and the glowing screens emanated a watchful presence, almost a silence. But there was no silence, for the boy was already talking to her as she entered, the moment was unfurling, or erupting, without her and she was left behind in a daze. He was sitting upright, supported by pillows against a metal backrest, lit as though by a single spot in
a theatrical production. Spread about him on the sheets and spilling out into the shadows were books, pamphlets, a violin bow, a laptop, headphones, orange peel, sweet wrappers, a box of tissues, a sock, a notebook and many lined pages covered in writing. Ordinary teenage squalor, familiar to her from family visits.

  It was a long thin face, ghoulishly pale, but beautiful, with crescents of bruised purple fading delicately to white under the eyes, and full lips that appeared purplish too in the intense light. The eyes themselves looked violet and were huge. There was a mole high on one cheek, as artificial-looking as a painted beauty spot. His build was frail; his arms protruded like poles from the hospital gown. He spoke breathlessly, earnestly, and in those first few seconds she caught nothing. Then, as the door swung closed behind her with a pneumatic sigh, she gathered he was telling her how strange it was, he had known all along that she would visit him, that he thought he had this knack, this feel for the future, that they had read a poem at school in religious studies which said that the future, present and past were all one, and this was what the Bible said too. His chemistry teacher said relativity proved that time was an illusion. And if God, poetry and science all said the same thing, it had to be true, didn’t she think?

  He fell back against the pillows to catch his breath. She had been standing at the foot of his bed. Now she approached the side where there was a plastic chair and said her name and put out her hand. His was cold and damp. She sat down and waited for him to say more. But his head was tilted back and he was looking at the ceiling, still recovering and, she realized, expecting an answer. She became aware of the hiss of one of the machines at her back, as well as a muted rapid bleeping, at the audible threshold, or at least hers. The heart monitor, turned down for the patient’s comfort, was betraying his excitement.

  She leaned forward and said she thought he was right. In her experience in court, if different witnesses who had never spoken to each other all said the same thing about an event, it was more likely to be true.

  Then she added, “But it’s not always. There can be group delusions. People who don’t know each other can be gripped by the same false idea. That certainly happens in courts of law.”

  “Like when?”

  He was still catching his breath, and even these two words were an effort. His gaze remained upward, away from her, while she thought of an example.

  “Some years ago in this country children were taken away from their parents by the authorities, and the parents were prosecuted for what was called satanic abuse, for doing terrible things to their children in secret devil-worshipping rituals. Everyone piled in against the parents. Police, social workers, prosecutors, newspapers, even judges. But it turned out there was nothing. No secret rituals, no Satan, no abuse. Nothing had happened. It was a fantasy. All these experts and important people were sharing a delusion, a dream. Eventually, they all came to their senses and were very ashamed, or they should have been. And very slowly, the children were returned to their homes.”

  Fiona talked as though she herself was in a dream. She felt pleasantly tranquil, even as she guessed that Marina, monitoring the conversation, would be baffled by her remarks. What was the judge doing, talking to the boy about child abuse, within minutes of meeting him? Was she wanting to suggest that religion, his religion, was a group delusion? Marina would have expected the significant opening remark, after some gentle small talk, to be along the lines of, I’m sure you know why I’m here. Instead, Fiona was free-associating, as though to a colleague, about a forgotten institutional scandal of the 1980s. But what Marina thought did not really trouble her. She would do this her own way.

  Adam lay still, taking in what she had said. At last, he turned his head on the pillow and his eyes met hers. She had squandered enough gravitas already and was determined not to look away. His breathing was more or less under control; his look was dark and solemn, impossible to read. That didn’t matter, for she was feeling calmer than she had all day. No great claim. If not calm, then unhurried. The pressure of a waiting court, the necessity of a rapid decision, the consultant’s urgent prognosis were temporarily suspended in the penumbral air-sealed room as she watched the boy and waited for him to speak. She was right to have come.

  To hold his gaze for longer than half a minute or so would have been improper, but she had time to imagine, in the condensing way of thought, what he saw in the chair by his bedside, another grown-up with a view, a grown-up further diminished by the special irrelevance that haunts an elderly lady.

  He looked away just before saying, “The thing about Satan is that he’s amazingly sophisticated. He puts a stupid idea like satanic whatever, abuse, into people’s minds, then he lets it get disproved so everyone thinks that he doesn’t exist after all, and then he’s free to do his worst.”

  Another feature of her unorthodox opening—she had strayed onto his ground. Satan was a lively character in the Witness construction of the world. He had come down to earth, so she had read in her skim through the background material, in October 1914 in preparation for the end days and was working his evil through governments, the Catholic Church and especially the United Nations, encouraging it to sow concord among nations just when they should be readying themselves for Armageddon.

  “He’s free to try and kill you with leukemia?”

  She wondered if she had spoken too directly, but he had an adolescent’s affected resilience. Toughing it out. “Yes. That sort of thing.”

  “And you’re going to let him?”

  He pushed himself against the backrest to sit up, then stroked his chin thoughtfully, in parody of a pompous professor or TV pundit. He was mocking her.

  “Well, since you ask, I intend to crush him by obeying God’s commandments.”

  “Is that a yes?”

  He ignored this, waited a moment, then said, “Have you come to change my mind, straighten me out?”

  “Absolutely not.”

  “Oh yes! I think so!” He was suddenly the mischievous provoking child, hugging his knees through the bedcovers, though feebly, and he was excited again, working up a sardonic voice. “Please, miss, set me on the path of righteousness.”

  “I’ll tell you why I’m here, Adam. I want to be sure you know what you’re doing. Some people think you’re too young to be taking a decision like this and that you’ve been influenced by your parents and the elders. And others think you’re extremely clever and capable and we should just let you get on with it.”

  In the harsh light he rose so vividly before her, the untidy black hair curling over the neckline of his gown, the large dark eyes scanning her face in restless saccades, alert for any deception or false notes. From the bedclothes she caught the scent of talcum powder or soap, and on his breath something thin and metallic. His diet of drugs.

  “Well,” he said eagerly. “What’s your impression so far? How am I doing?”

  He was playing her, all right, drawing her back onto other ground, to a wilder space where he could dance round her, tempt her to say something inappropriate and interesting again. It occurred to her that this intellectually precocious young fellow was simply bored, understimulated, and that by threatening his own life he had set in motion a fascinating drama in which he starred in every scene, and which had brought to his bedside a parade of important and importuning adults. If this was so, she liked him all the more. Serious illness could not smother his vitality.

  So, how was he doing? “Pretty well, so far,” she said, aware she was taking a risk. “You give the impression of someone who knows his own mind.”

  “Thank you,” he said in a voice derisively sweet.

  “But it might just be an impression.”

  “I like to make a good impression.”

  His manner, his humor, had an element of the silliness that can accompany high intelligence. And it was self-protective. He was surely very frightened. It was time to talk him down.

  “And if you know your own mind, you won’t object to discussing practicalities.�
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  “Fire away.”

  “The consultant says that if he could transfuse you and raise your blood count he could add two very effective drugs to your treatment and you’d have a good chance of a complete and fairly quick recovery.”

  “Yes.”

  “And without a transfusion you could die. You understand that.”

  “Yup.”

  “And there’s another possibility. I need to be sure you’ve considered it. Not death, Adam, but a partial recovery. You could lose your sight, you could suffer brain damage or your kidneys could go. Would it please God to have you blind or stupid and on dialysis for the rest of your life?”

  Her question overstepped the mark, the legal mark. She glanced across to where Marina sat in her shadowy corner. She was using the magazine to support a notebook and was writing by feel alone. She did not look up.

  Adam was staring at a space over Fiona’s head. With a wet clicking sound he moistened his lips with a white-coated tongue. Now there was sulkiness in his tone.

  “If you don’t believe in God you shouldn’t be talking about what does or doesn’t please him.”

  “I haven’t said I don’t believe. I’d like to know whether you’ve considered this carefully, that you may be ill and disabled, mentally, physically or both, for the rest of your life.”

  “I’d hate it, I’d hate it.” He turned from her quickly in the attempt to conceal the tears that had suddenly formed. “But if that’s what happens I have to accept it.”

  He was upset, holding his gaze well away from her, ashamed that she could see how easy it had been to deflate his bumptiousness. His elbow, slightly crooked, looked pointed and fragile. Irrelevantly, she thought of recipes, roast chicken with butter, tarragon and lemon, aubergines baked with tomatoes and garlic, potatoes lightly roasted in olive oil. Take this boy home and feed him up.

  They had made useful progress, reached a new stage, and she was about to follow up with another question when the Caribbean nurse came in and held the door wide open. Outside, as though summoned by her fantasy cuisine, was a young man in a brown cotton jacket, barely older than Adam, standing by a trolley of brushed steel containers.