Thinks...

by David Lodge

  ‘Missed me or missed my cooking?’ Carrie says.

  ‘Well both,’ says Ralph. ‘Though Emily made us a terrific meatloaf tonight . . .’ Ralph catches Emily’s eye as he says this. ‘By the way, Greg is here, he helped her with the meal. Is it all right if he sleeps over?’

  ‘If it’s all right by you, fine,’ says Carrie.

  ‘OK, then. See you tomorrow. Love from everybody.’ Ralph puts down the phone and says to Emily. ‘Your mother says it’s all right.’

  ‘Thanks, Messenger,’ says Emily. She goes smiling out of the room.

  Ralph puts a hand to his side, and belches again. He goes to his bathroom and finds a packet of Rennies in the medicine chest. He swallows two of the tablets.

  On Friday morning, before Carrie and Hope have got back home, Ralph goes to see his GP, an Irishman called O’Keefe, whose surgery is on the ground floor of a tall narrow house in a Georgian terrace not far from the Messengers’. ‘I live above the shop,’ he likes to say. He is about Ralph’s age, a little stouter, with a red leathery complexion and big hands. In the hairy tweed sports jackets he favours he looks more like a farmer than a doctor, but he has been a good GP to the family. Ralph has very rarely had occasion to consult him.

  ‘What can I do for you, Professor?’ he says, when the brief formalities of greeting are over. It seems to please O’Keefe to address Ralph in this way.

  ‘It’s only indigestion,’ Ralph says. ‘Intermittent, but I can’t seem to get rid of it. Rennies don’t seem to work any more.’

  ‘Any other symptoms?’

  ‘A sort of sensation of fullness just here.’ Ralph places a hand just below the right side of his rib cage.

  ‘Let’s have a look at you, then. Take off your clothes. You can leave your underpants on.’ O’Keefe gestures to a couch behind a screen in one corner of the room. While Ralph is undressing he washes his hands carefully in a sink, and chats about the weather.

  O’Keefe makes a very thorough examination of Ralph’s abdomen, whistling faintly through his teeth as he palpates the flesh.

  ‘A little bit of middle-aged spread, I’m afraid,’ Ralph says lightly.

  O’Keefe nods. ‘That’s to be expected.’ He pushes, presses, probes with his big spatulate fingers. ‘All right,’ he says. ‘You can put your togs back on.’ He goes back to his desk to write some notes in Ralph’s file, using a gold-nibbed fountain pen.

  ‘Well?’ Ralph says, sitting down in the patient’s chair.

  ‘You’ve got a lump on your liver,’ O’Keefe says, continuing to write.

  ‘What kind of lump?’

  ‘I don’t know. You’ll need to see a specialist.’ O’Keefe looks up at Ralph. ‘Are you covered by private medical insurance, Professor?’

  ‘Yes.’

  ‘There’s a good gastrointestinal man in Bath, Dick Henderson. I’ve played golf with him. I could give him a call, if you like. He might be able to fit you in on Monday.’

  ‘Is there any urgency, then?’ says Ralph.

  ‘There’s no point in wasting time,’ O’Keefe says.

  ‘Are you saying it might be serious?’

  O’Keefe gives Ralph a level look. ‘The liver is a vital organ, Professor.’

  ‘Yes, of course, silly question. Could it be cancer?’

  O’Keefe pauses for a moment before replying. ‘I’d be a liar if I said no,’ he says finally.

  ‘What else might it be?’

  ‘I’ve no idea,’ says O’Keefe. ‘That’s why the sooner we get you to a specialist, the better. He’ll take the weight off your mind.’

  ‘Or not, as the case may be,’ says Ralph. To which O’Keefe makes no reply.

  Shortly after Ralph gets home, O’Keefe’s receptionist rings to say that Mr Henderson can see him at the Abbey Hospital in Bath at eleven-thirty on Monday morning. Ralph accepts the appointment.

  The house is silent, Emily and the two boys being at school. Ralph makes himself a mug of coffee in the kitchen and sits at the table, sipping his drink, and gazing out of the window at the empty yard. Then he goes upstairs to his study and does some work on his computer. Sometimes his fingers stop moving and he stares at the screen for a minute or two, but his eyes are not focused on the text. He clears his workspace, and logs on to the Internet. He goes to a search engine, and enters ‘+liver+cancer’ in the search box. About half an hour later he hears through the open window the sound of a vehicle drawing up on the drive below, a car door opening and shutting, and the sound of Hope’s excited voice. He disconnects from the Internet and hurries downstairs.

  Ralph gives Hope a hug in the hall, sweeping her off her feet and whirling her round on the black-and-white-chequered floor. The child laughs with glee. Then he kisses Carrie and looks at her.

  ‘What’s the matter?’ she says.

  Ralph waits until Hope has scampered off to her room to be reunited with her favourite dolls and toys. Then he tells her about his visit to O’Keefe.

  ‘Who is this guy Henderson?’ is Carrie’s first question.

  ‘I don’t know. O’Keefe thinks very highly of him.’

  ‘I think you should go to a Harley Street specialist. The best.’

  ‘I haven’t got time to be running up and down to London just now,’ Ralph says. ‘There are bound to be tests and so on. Con-Con is only three weeks off. There’s a hell of a lot of work to do.’

  ‘Delegate it.’

  ‘That’s easily said. My deputy is Duggers. Social organization is not his forte. Anyway, let’s not get over-dramatic. It’s probably nothing.’

  ‘Jesus,’ says Carrie. ‘I thought I was through with hospitals and doctors for a spell.’

  ‘Don’t let this spoil your home-coming,’ Ralph says. ‘We’ll just forget about it till Monday. OK?’

  ‘If you say so, Messenger,’ Carrie says, with a tight smile.

  Later, when they are planning the weekend over lunch, Carrie asks if she should invite Helen over to Horseshoes on Sunday.

  ‘No I think not,’ Ralph says.

  ‘It’s just that you said she helped out while I was away –’

  ‘Let’s keep this weekend to ourselves. Just the family,’ Ralph says.

  ‘Fine,’ Carrie says.

  In the afternoon Carrie takes a nap and Ralph goes into the University to catch up on some admin. He phones Helen from his office, and tells her about the lump.

  ‘Oh dear,’ she says. ‘That’s worrying.’

  ‘Well, it was a bit of a shock, I have to admit,’ he says. ‘I went to the doctor’s with indigestion and came out with possible cancer.’

  ‘I’m sure it can’t be anything like that,’ says Helen. ‘You’ve not been behaving like a sick man these last few weeks.’

  ‘Except last Wednesday.’

  ‘That was nothing,’ she says. ‘It can’t be serious.’

  ‘Well, I shall soon find out,’ he says. ‘I have you to thank for making me go to the doctor’s. Something you said, that I should get my indigestion sorted – remember?’

  ‘Yes,’ she says.

  ‘Did you have any suspicion . . .’

  ‘None at all. It was just a casual remark. In a silly irrational way, I wish I hadn’t said it now.’

  ‘No, I’m very grateful. Really.’

  ‘I know.’

  ‘I would’ve had to see a doctor eventually, and the sooner the better.’

  ‘Yes.’

  There is a pause in the conversation, as if neither of them is sure what to say next.

  ‘When shall I see you again?’ Helen says at last.

  ‘I don’t know,’ he says. ‘Not this weekend, if you don’t mind.’

  ‘Of course not,’ she says quickly.

  ‘I’d like to ask you over to Horseshoes, but Carrie’s a bit upset. I think she’d prefer it if we were on our own.’

  ‘Of course, I understand completely.’

  ‘What will you do with yourself?’

  ‘I have lots of work to do. St
udent assessments. The end of the semester suddenly seems very near.’

  ‘I know. This thing couldn’t have happened at a worse time for me, with Con-Con coming up.’

  ‘Tell me how it goes on Monday.’

  ‘I will. I might not be able to call till Tuesday.’

  ‘All right.’

  ‘Bye then.’

  ‘Goodbye Messenger.’

  In spite of her nap, Carrie is still tired from her journey. She and Ralph are alone in the living-room after supper, reading newspapers and drinking herbal tea, when she tells him she is going to bed.

  ‘I’ll come too,’ Ralph says, tossing aside his newspaper. Carrie looks surprised. ‘I’ve missed you,’ he says.

  ‘Have you?’

  ‘Of course.’

  Carrie gets heavily to her feet. ‘I’m exhausted, Messenger. Better leave it till tomorrow night.’

  ‘OK,’ he says. ‘I’ll do some work instead.’

  Outside their bedroom door he kisses her goodnight and proceeds up the extra flight of stairs to his study. He logs on to the Internet again.

  The following Monday, Ralph drives himself to Bath to see the specialist, Mr Henderson. The Abbey private hospital is a new building of sleek glazed brick and brown-tinted windows on a greenfield site on the outskirts of the city. Its reception area and waiting rooms are hushed and comfortable, with fitted carpets and upholstered couches, like a business-class lounge in an airport. After a short wait, Ralph is admitted to a consulting room where Henderson greets him with a smile and shakes his hand. He remarks that he has seen Ralph on television. The consultant appears younger than O’Keefe. He wears a dark blue pinstripe suit with a row of pens and pencils in the breast pocket, and what looks like a golf club tie. His gleaming white teeth protrude slightly, especially when he smiles, which he does rather frequently.

  Once again Ralph strips to his underpants for an examination. Once again his abdomen is pressed and squeezed and probed by knowing professional fingers. Henderson confirms the presence of a lump.

  ‘Could it be cancer?’ Ralph asks.

  ‘Can’t rule it out,’ Henderson says, smiling as if this is good news. ‘I need to find out a bit more about it. I’d like to book you in for an ultrasound scan as soon as possible, and do an endoscopy at the same time. That’s a visual examination of the stomach and small intestine, using fibre optics.’

  ‘Keyhole surgery?’ Ralph asks.

  Henderson laughs heartily. ‘Oh no, it’s done via the mouth and throat. Sounds uncomfortable, but you won’t feel a thing. We’ll give you a local anaesthetic. But you’d better not drive yourself home afterwards.’

  ‘I can go home the same day, then?’

  ‘Absolutely. You’ll need to fast overnight beforehand and take a laxative, to make sure that bowel shadows don’t interfere with the ultrasound.’

  ‘I’ll ask my wife to come with me.’

  ‘Excellent,’ says Henderson. ‘Are you free on Wednesday?’

  ‘I can arrange to be,’ says Ralph. ‘When will you get the results?’

  ‘The same day,’ says Henderson.

  Late on Tuesday morning Helen calls Ralph at his office.

  ‘Helen! Sorry – I was going to call you, but I just haven’t had a moment –’

  ‘It’s all right. I don’t want to be a nuisance, but –’

  ‘Of course you’re not a –’

  ‘It’s just that I won’t be available for the rest of the day,’ Helen says. ‘I’m teaching. I wanted to know how the consultation went.’

  ‘Well, he confirmed there was a lump.’

  ‘Oh.’ Helen sounds despondent.

  ‘Hardly a surprise.’

  ‘No. I suppose not. I couldn’t help hoping your GP might have been mistaken.’

  ‘He’d be a pretty lousy GP in that case,’ says Ralph. ‘There’s not much else to report. I’ve got to go back for some tests on Wednesday.’

  ‘I see. Is there anything I can do?’

  ‘Not really. Carrie is going with me to the hospital.’

  ‘Oh, right.’

  ‘I’ll call you later in the week.’

  ‘Right. I’ll be thinking of you.’

  ‘Thanks. Bye, then, Helen.’

  ‘Goodbye Messenger.’

  He adds, ‘Thanks for calling,’ but she rings off at the same moment.

  Early on Wednesday morning, Ralph drives himself and Carrie to the hospital. He leaves their departure rather late and the rush-hour traffic in Cheltenham is heavy, so he drives fast on the rolling two-lane road to Bath to make up time. ‘Don’t let’s get killed on the way to the hospital,’ Carrie says, as he passes a long Continental trailer-lorry just before a sports car comes over the brow of a hill towards them.

  ‘Well, it would be one way of ending the suspense,’ Ralph says.

  ‘Don’t joke about it, Messenger,’ says Carrie.

  Ralph is given a mild tranquillizer by intravenous injection before the endoscopy, as well as a local anaesthetic mouth spray, and is still slightly woozy when he and Carrie go to Henderson’s consulting room to learn the results of the tests. The consultant reads aloud from the report: ‘“An unusual cystic lesion is seen in the right lobe of the liver with low echogenicity in the centre. Appearance could indicate a necrotic secondary. A CT scan is recommended for evaluation . .”.’ Henderson looks up from the document. ‘I think that’s a good idea. You know what a CT scan is of course?’

  ‘Yes,’ says Ralph.

  ‘I don’t,’ says Carrie.

  Henderson smilingly explains. ‘Oh you mean those things that were in Messenger’s TV programme,’ she says. ‘Showing you cross-sections of people’s brains.’

  ‘Exactly,’ says Henderson. ‘Only in this case it’s the abdomen.’

  ‘What was that about a secondary?’ Ralph asks.

  ‘Your lump could be a secondary cancer metastasized from the bowel. I had a patient like that not long ago. A CT scan may not give us enough information to eliminate that possibility, so if you agree, I’d like to arrange for you to have a colonoscopy at the same time.’

  ‘How long will that take?’

  ‘With preparation, three or four days.’

  ‘In hospital?’

  ‘Well, you could do the preparatory diet at home . . . but it would be easier in hospital. Unless you’re good at fasting.’

  ‘He’s not,’ says Carrie.

  ‘I haven’t got three or four days spare in the next three weeks,’ says Ralph.

  ‘Yes you have,’ says Carrie. ‘How soon can you do it?’ she asks Henderson.

  ‘I could set it up for early next week,’ he says. He looks enquiringly at Ralph. ‘If you come in on Saturday, we could do the preparation over the weekend.’

  ‘All right, set it up,’ says Ralph.

  Carrie takes the wheel for the drive back to Cheltenham. ‘What d’you think of this guy Henderson?’ she says after a while.

  ‘He seems very professional,’ Ralph says. ‘Covering all the bases. Leaving no stone unturned.’

  ‘Why does he smile so much?’

  ‘I think it’s an unconscious habit. A kind of nervous tic. Probably comes from having to give bad news to people so often.’

  ‘I don’t trust him.’

  ‘Why not?’

  ‘I don’t know. I’ve seen so many doctors in the last few weeks . . . You develop a nose for the really smart ones and the so-so ones. Henderson is one hundred per cent so-so.’

  ‘Henderson’s all right. After all, it’s the tests that matter.’

  ‘I think you should go to Harley Street.’

  ‘I’ll stick with Henderson for the time being. Hopefully the tests will be positive. I mean negative. If not, we can always get a second opinion.’

  Carrie puts her left hand on Ralph’s thigh. ‘I don’t want to lose you, Messenger,’ she says, without taking her eyes off the road.

  Ralph shoots her a quick glance. ‘Hey! Don’t talk about losing alrea
dy.’

  ‘I’m sorry. It’s just . . .’

  ‘I know.’ Ralph covers her hand with his and squeezes it. Carrie puts it back on the wheel, and drives in silence for a while.

  ‘We’ll spend whatever it takes to get you the very best treatment,’ Carrie says. ‘Whatever it takes.’

  When they get home there is a message on the answerphone for Ralph from his secretary, saying that the VC’s office has been trying to contact him all day. ‘I think it’s something about the student newspaper,’ the message ends cryptically.

  Ralph goes to his study to phone the VC’s office and is put through immediately to Sir Stan.

  ‘Oh, ’allo Ralph, they tell me you’ve been in hospital all day. Nothing serious I hope?’

  ‘No. Just a few tests.’

  ‘Good. I don’t suppose you saw today’s On Campus?’

  ‘No.’

  ‘Well they’ve run a story about Donaldson’s honorary degree.’

  ‘What on earth for?’

  ‘There’s some sort of peace group in the Students’ Union stirring up trouble. Let me read you a few bits. “University to honour Ministry of Defence mandarin . . . Links with Holt Belling Centre . . . Government funding for Gloucester research into brainwashing techniques and guided weapons . . .” Is there any truth in it?’

  ‘Well, you know that the MoD is funding some of our work, Stan.’

  ‘On brainwashing?’

  ‘I suppose they’re referring to an interactive virtual reality program –’

  ‘Hold on, Ralph, not so much of the jargon.’

  ‘Sorry, Stan,’ Ralph says. ‘For instance, there’s a well-known program called “Eliza” that acts like a psychiatric counsellor. You log on and it asks, How are you today? and you type in I feel like shit and Eliza asks, Why do you feel like shit? and so on and before you know where you are you’ve told her the story of your life and you feel much better.’ On the other end of the line Sir Stan chuckles. ‘The MoD want us to develop a program that acts like an interrogator, for training servicemen how to respond when they’re captured and questioned. I suppose that’s what they mean by “brainwashing techniques”.’

  ‘And the guided weapons?’

  ‘The Ministry is supporting our robotics research for possible application to mine-laying and mine-clearing operations,’ Ralph says.