Where We Begin

by Christie Nieman

  They had lied. All of them. I didn’t understand it. They had pretended he was dead. Or said nothing at all. I didn’t understand. He had just attacked someone. Hessel. Maybe killed him. There. In the very next room. But Leonie had spoken so softly to him, this man, my mother’s brother. This man, Basil’s dad. This man, my uncle, who had just saved my mother’s life.

  The last light was disappearing outside and the room was growing dark. Mum was curled tight into a ball, her eyes squeezed shut. I gripped her shoulder. ‘Mum,’ I whispered. I gave her shoulder a little shake. ‘Mum, are you okay?’ But she didn’t move, and without opening her eyes, a tear seeped out from under her lashes and slid down her face. I brushed it away with my fingertips.

  New unfamiliar voices came from the kitchen. Two men and a woman. The crackle and tones of police radios. I heard them giving an all-clear to an ambulance crew, and Leonie saying over the top of it all, ‘He has a brain injury, just so you know,’ and for a moment I thought she meant Hessel. ‘He’s not violent,’ she said. ‘Not usually violent.’

  Another paramedic appeared at our window – a young man, blond, barely older than me – tapping softly on the glass. I left Mum and opened the latch, and the man heaved and the wood creaked and then with a splintering sound the stuck window finally opened.

  A group of paramedics cleared the desk and the floor and helped Mum and me up and out of the window.

  Flashing lights lit the night red and blue. Two ambulances were parked on the gravel patch next to the house. A police car sat idling with the windows dark and rolled up. And further along I saw Leonie’s car, and, in it, Leonie and Basil in a tight embrace, Basil’s shoulders heaving.

  The blond paramedic led Mum away to one of the ambulances, and a kindly looking salt-and-pepper-haired older man took me gently by the arm. ‘You’ve had some pain I heard,’ he said to me. ‘Some bleeding? From a current pregnancy?’ Who were all these people? I felt so bewildered, but I nodded at him. What he was saying seemed true. ‘Okay,’ the man said. ‘Sit here tight with me. We’ll get a patient transport in for you.’ So I sat where he told me and watched as the doors on the back of Mum’s ambulance were shut and it drove quietly away.

  On the way to the hospital in the back of the transport I couldn’t speak. The kindly man stayed with me. He patched the cut above my eye and didn’t try to make me talk. As we drove, the heavens opened and the clouds delivered their promised load, suddenly unimaginably loud on the metal roof of the vehicle, and then quickly gone, eerily quiet again, as if the clouds had thrown every drop they had at us, all in one go, and then found they had nothing left. And when the older paramedic handed me over to the staff at the hospital his voice was so low and gentle, like my dad’s, that tears began to seep out of my eyes. It had all been too much. It was all still too much.

  The intake nurse asked all about the pregnancy and the blood and the pain. They handed me a specimen jar and some forms to fill out and when I got back from the toilet they sat me up, sample in hand, on one of the beds, the thin waterproof foam crackling beneath me as the nurse pulled the curtain around and went to fetch the doctor.

  I waited. The pain was still there, but it felt distant, everything felt distant. In that moment of watching Hessel and my mother, of being powerless, frozen, something had happened: something in me had come apart, I had come apart, from myself. Pain, blood, pregnancy – it was all meaningless. I couldn’t imagine feeling connected to my body ever again.

  A familiar voice sounded on the other side of the curtain: speaking in conference with the nurse it caught my ear, and in a moment the curtain was quickly pulled aside and the owner of the voice stepped into the cubicle. It was Geraldine.

  ‘Anna,’ she said, quietly. ‘Nice to see you again.’ And she pulled the curtain shut behind her and drew up a chair. ‘I’ve got your admission sheet here, about the pregnancy, but I’ve also got that your mum was just brought in by ambulance?’

  ‘Yes,’ I said. I’d managed to speak. It seemed a minor miracle. ‘Is she okay?’ I asked.

  ‘Seems to be,’ said Geraldine, flicking the bit of paper back and forth to look at both sides. ‘Says they’re treating her for shock, and they’ll probably take a scan for clots because, is that right, that she was strangled?’

  ‘Yes, by Hessel.’

  And suddenly there it was in my head again: Hessel’s claws around my mother’s throat. I squeezed my eyes against the visitation. My breath came suddenly short and sharp.

  ‘Anna?’ Geraldine said, laying fingertips lightly on the back of my hand.

  ‘I saw it,’ I heard myself telling Geraldine from somewhere across the room, somewhere on another planet. Was Mum okay? I couldn’t remember when I’d last seen her. The only thing I could remember seeing was her being strangled by Hessel. ‘Is she okay?’ I said again.

  ‘Yes, Anna. She’s okay. She’s going to be okay.’ She took my hand in hers. ‘There’s nothing to be afraid of here. They’ve taken Hessel to a different hospital, to an intensive care unit in the city. And your mum is in good hands here. She’s going to be okay.’

  ‘And Bette?’

  ‘Bette went with Hessel.’ I opened my eyes then, and Geraldine looked sadly at me. ‘Sometimes there’s only so much you can do for someone,’ she said.

  I nodded. Geraldine left the room for a moment and then she was back sitting beside me. ‘Anna, I’ve just put a psych request in for you. Seeing something like that –’

  ‘That’s what you were trying to ask, wasn’t it, or to tell me, when I came in with Bette – that Hessel was dangerous? He totally attacked Mum, like . . .’ I almost didn’t have the words to describe it.

  ‘No, I didn’t know, Anna. I was fishing, yes. I was hoping to know just a tiny bit more before I reported it. Then I went ahead and reported it anyway, but these things go slowly, so – I’m just so sorry I didn’t get in early enough to prevent it –’

  ‘It was really bad. He actually attacked her, really badly.’ Geraldine gave my hand a squeeze. She nodded. She listened. ‘And then Danny attacked Hessel, and then the police were there . . .’

  ‘Danny?’ Geraldine stared at me for a moment. And then her shoulders slumped a little. ‘Poor Leonie,’ she said softly. ‘Poor Basil.’ And then she shook her head and was all professionalism itself. ‘Okay, I want you to listen to me, Anna, okay? Something terrible has happened, and that is not nothing. And you’ve seen it, and that’s not nothing either, and that is going to need some attention. But your mum is okay, and you are going to be okay, and right now I need you to just try to stay calm and be here with me, because you and I, Anna, as a team,’ Geraldine put a gentle hand on my shoulder, ‘we need to investigate this pregnancy and what’s been happening. Okay? Understand?’

  I nodded. The slight pressure from Geraldine’s hand had grounded me. Brought me back to the room.

  ‘Okay?’ she repeated.

  I nodded. ‘Okay,’ I said. ‘I had been thinking . . . I had thought, that with sharp pain like that, that maybe it could be ectopic.’

  Geraldine smiled slightly and nodded. ‘Yes, that is the first thing we need to rule out –’

  ‘Because that’s a medical emergency,’ I said.

  Geraldine smiled more fully. ‘Good knowledge, budding doctor. Go team.’

  I breathed deeply and tried to be calm, to be present, to focus on the medical things in the room, to let myself be distracted by them. Geraldine put on rubber gloves and unscrewed the top of my specimen jar and tore the top off a small packet, dipped the thin cardboard strip in my wee, and laid it neatly back down on the empty packet. ‘Bit yellow,’ she said, offhandedly, gesturing to my specimen. ‘Drink more water.’

  I said – I actually managed to say, ‘There were other things going on so staying hydrated fell down the priority list.’ The blood was returning to my limbs, the breath to my lungs.

  Geraldine folded the top of my pants down away from my lower abdomen. ‘So, blood and pain. When was your last
period?’

  ‘Um, well that’s the weird thing – I did have one about four weeks ago. But it was a light one – that sometimes happens when I’m stressed. And I was stressed.’

  ‘Where are we . . . July. You were stressed about the UCAT?’

  I laughed and my laugh surprised me, and I relaxed some more. ‘Yes.’

  ‘I hated the UCAT, or the UMAT as it was then,’ said Geraldine. ‘Couldn’t do the bloody interpersonal competency questions.’

  ‘Me neither!’ I said. Geraldine began to palpate my stomach. After a while I said, ‘Your interpersonal seems pretty good.’

  ‘Well, thanks for that.’ Geraldine grinned sheepishly. ‘I’ve worked on it.’

  She paused to lean over to look at the urine test. ‘Well, according to this first indicator you’re still pregnant but we’ll need to do a blood test to really know what’s going on.’ And then, catching my interested face, she explained further. ‘Urine tests can still show positive for a while after a miscarriage because of the hCG, so we need to know whether the hCG levels in the blood are going up or down.’

  ‘Okay.’

  ‘Four weeks,’ Geraldine said, thinking to herself. ‘Sickness?’

  ‘Yes,’ I said.

  ‘Ah. So you know that most women don’t start to experience morning sickness until at least six weeks?’

  ‘No. No I didn’t know that.’

  ‘Sometimes implantation bleeding can seem like a period. Timing’s slightly different, but if you’re not paying super-close attention . . .’

  ‘Shit,’ I said.

  ‘We’ll see.’

  Geraldine returned her hands to my abdomen. She had a look on her face like she was listening with her fingers, as if my abdomen was speaking directly to them.

  ‘Now, you tell me if it hurts.’

  In each new hand position she raised her eyebrows at me, and I shook my head – no, no pain. And suddenly I liked her so much – more than that, I wanted to be her. This woman who was using her fingers and her whole focus to try and ‘read’ me; I wanted that level of skill, to be so attuned to another person’s body that it told you things about itself. It looked like magic. And I felt so safe with her, so safe and so privileged. I wanted to make people feel like that. Medicine wasn’t just somewhere to run to, it was something worth heading for.

  ‘I’ll get the nurse to take your blood,’ Geraldine was saying. ‘I am really actually very bad at it, doctor’s prerogative. And then we’ll do a little ultrasound.’ She straightened up and stuck her head out of the curtains and looked around for a nurse. After a moment she stepped back through. ‘The ship is abandoned. How do you usually go with pain, Anna?’

  ‘Pretty good.’

  Geraldine opened a supply cupboard and pulled out a blood-drawing kit. ‘I don’t do this for just anybody, you know.’ She loaded up the needle on the vial. ‘Okay, here I go – just a sharp scratch,’ she said, which was clearly a lie as she dug around in my arm before finding a vein.

  ‘Fucking hell!’ I said.

  ‘Did you know they’ve done research that shows swearing reduces the experience of pain?’

  ‘Fuck! Fuck! Fuck!’ I said.

  ‘Good on you! That’s the way. Okay, done now. Hold that cotton wool there for a moment.’

  Geraldine pressed the nurse’s button and wrote on the vial and scrawled a note on a pathology form, popped it all in a tray on top of the side table, and then disappeared out for a moment and came back trundling a machine. ‘I can’t promise we won’t have to do a transvaginal ultrasound if this doesn’t find anything, but this machine is new and powerful and if that last period wasn’t a period it should give us a pretty good idea of what’s going on.’

  ‘Transvaginal?’

  Geraldine shot me a brief sympathetic look. The nurse popped her head in. ‘You want me to do that, Geraldine?’

  ‘No thanks, Beth, but if you could take that blood and put it in for me, that’d be great. And when you’ve done that, could you contact A&E and let me know the status of . . .’ Geraldine looked to me.

  ‘Cathy Krause,’ I said.

  ‘She came in by ambulance.’

  ‘Yep.’ The nurse grabbed the blood and left as Geraldine squirted gel onto my tummy and leaned over and flicked the switch on the machine.

  ‘Been a while since I’ve done this, too,’ Geraldine said as she pushed the flat wand down hard, digging in above my hip on both sides and angling it sideways and looking at the screen. ‘You’ve set me all sorts of doctor-challenges tonight. That’s the beauty of country doctoring, you get to do it all.’

  In the light from the screen I watched Geraldine’s face closely. She nodded to herself. ‘Okay,’ she said without looking away from the screen. ‘First thing. You ready? I don’t think that last period was a period.’ She glanced at me to see how I was taking that.

  ‘Oh,’ I said. ‘Oh, shit.’

  ‘So, about three weeks implantation bleed, plus four, yes, we’re looking about right for seven to eight weeks.’

  ‘Shit!’

  ‘The good thing about that is that I can see it pretty well here and it looks like it’s in the right place in your uterus. So, unlikely to be ectopic – so that’s great. And I think with your relatively minor pain –’

  ‘Minor?!’

  ‘Okay, well the fact that the pain has lessened and the bleeding has stopped and wasn’t all that much, and the fact that I’m seeing what I’m seeing here – I think we’re in the territory of probably-all-good-let’s-just-watch-closely.’

  ‘Right,’ I said. ‘Are we in the territory of it’s-okay-for-me-to-take-the-abortion-pill?’

  Geraldine wiped the ultrasound wand with a cloth while she thought about that. I could see her tallying up symptoms and indications and contraindications until finally she nodded. ‘I don’t see why not. Seven to eight weeks, no recorded adverse effects on women who do later turn out to have a missed ectopic – yes, it’s safe. But you can’t take it after nine weeks, so it will have to be soon. Do you have the pills already?’

  ‘Yes.’ I gave her the name of the organisation I’d got them from and she nodded. ‘But I may have already mauled one of them – didn’t take it, just kind of . . . nibbled it.’

  She raised her eyebrows at me. ‘Were you planning on taking them by yourself?’

  ‘Um . . .’

  ‘Don’t do that, Anna. Medically speaking it’s not a very good idea.’ And when I didn’t say anything else, she said, ‘And not medically speaking, it’s also probably not a very good idea.’ And then she filled out a new prescription for a fresh set of pills and handed it to me. ‘Any chemist,’ she said.

  The nurse stuck her head back into the room. ‘Anna, your mum is doing well and just staying in tonight for obs. Psych is with her now. Out in the morning after his all-clear, but it’s so late the ward is requesting no visitors tonight.’

  ‘Thank you so much,’ Geraldine said as the nurse dashed off again, and Geraldine began to pack away the ultrasound machine.

  ‘So,’ I said, pointing to the machine. ‘What could you see on there?’ I cleared my throat. ‘Could you see a heartbeat?’

  Geraldine looked at me for a moment. ‘Yes,’ she said.

  ‘Can I see?’ I said. I waited for her to tell me that was also not a very good idea, given that I planned to end the pregnancy. But Geraldine didn’t say anything like that.

  ‘Of course,’ she said.

  We were both silent as Geraldine reapplied gel and pressed the wand into my abdomen and this time turned the screen to face me. A small dark bubble came into view on the monitor, and after trying some different angles on it, Geraldine finally pointed at a little wobbling speck on the screen. ‘Not really much to see exactly, but if I –’ and she flicked a dial on the machine and a speaker clicked on and a quick pulsing ‘pish, pish, pish’ filled the air around us.

  I gasped.

  ‘Amazing,’ I said. ‘It’s amazing.’

  And it
was, after everything that had just happened. This amazing sound, this pulsing, this flickering-on of life. It was so hard to fathom that this happened all the time. This started off every animal that had ever existed, inside every egg and embryo, from worms to horses to people to fish to squid and cockroaches, that electric pulsing. It had started me, in just the same way, inside my mother, and it was still going, there in my chest, would keep going until it stopped and I died, just like worms and horses and fish and squid and cockroaches. And it always stopped, just as often as it started, without fail, in fact. Mine would stop, my mother’s, Basil’s. It was shocking, but the pulsing brought me back to the fact that so often life was only a mere flash inside another creature, what Leonie had said about miscarriages: a moment’s promise and then gone, with no-one even knowing about it.

  And I had got to see it, there on the screen. What a privilege.

  ‘Amazing,’ I said again.

  Geraldine smiled at me. ‘Isn’t it?’

  After Geraldine had packed away the machine and trundled it out I sat alone on the crackling bed. They wanted me to stay while they did some paperwork and arranged some referrals to services in Sydney. I was anticipating that a nurse would come back at some point, hand me some forms, and usher me out the door.

  So I was surprised when Geraldine came in with them herself, and once again drew up a chair and sat beside me. She lay the white envelopes down on the end of the bed.

  ‘I’ve just had a chat with the psychologist,’ she said, ‘and your mother has given permission for us to pass on some of what she talked about with him. In fact, she wanted us to.’

  ‘Oh,’ I said. ‘Okay.’

  ‘She wanted you to know that she has PTSD, post-traumatic stress disorder, diagnosed years and years ago, but it was something she chose to keep from you while you were growing up. Unfortunately it has gone untreated since she was diagnosed.’

  I frowned. ‘I don’t really know what to – did she say why she didn’t want to tell me?’

  ‘No. But sometimes it can be hard for people to talk about PTSD. People often don’t seek treatment until later in life because they feel so uncomfortable disclosing the trauma that caused it in the first place.’