The Proper Procedure and Other Stories

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The Proper Procedure and Other Stories Page 13

by Theodore Dalrymple


  In the days that followed Mrs Aziz was subjected to every possible test and investigation. Being in hospital for her was like war for an infantryman: ninety-nine per cent boredom, and one per cent terror, the latter when she was rolled on her back into giant machines. Everything was explained to her in a language she could not understand; only once the interpreter came to explain things to her, but she was also of a bad religion and did not like Mrs Aziz, telling her that she should try harder to walk.

  At visiting time all her children came, though never her husband, for he was too ill to do so; they brought her tasty things to eat to make up for the hospital food which was like wet cement mixed with paper. Ahmed was always their spokesman, and asked to speak to the doctor.

  It was only at the fourth time of asking that the doctor came: different from the others that Ahmed had met. She was young and blonde and spoke with a lisp. Her manner was awkward, but at the same time a little aggressive.

  ‘We can’t find anything wrong with your mother,’ she said.

  ‘Well, there must be something wrong with her,’ said Ahmed. ‘She can’t move her leg. She can’t walk.’

  ‘When I said we can’t find anything wrong with your mother,’ said the doctor, ‘I mean nothing physical. The scans don’t show anything that could explain her paralysis.’

  ‘Then why can’t she move her leg?’ asked Ahmed.

  ‘I agree she can’t move her leg,’ said the doctor. ‘But the question is why?’

  ‘Yes,’ said Ahmed. ‘That’s why she’s here.’

  ‘Is there anything that could be upsetting her?’ asked the doctor.

  ‘What d’you mean?’

  ‘Well, something that’s on her mind?’

  ‘Like what?’

  ‘I don’t know. A problem, something like that?’

  ‘What kind of problem?’

  ‘I don’t know. A money problem perhaps.’

  ‘There’s no money problem. She has everything she wants. There’s plenty of money. Anyway, how could a money problem mean she couldn’t walk? There must be something wrong with her.’

  ‘I’m not saying there’s nothing wrong with her, I’m just trying to find out what it might be.’

  ‘Something physical, I mean.’

  ‘Well you see, we haven’t been able to find anything.’

  ‘Does that mean it couldn’t be there?’

  ‘It makes it very unlikely.’

  ‘You never make mistakes, you never miss anything?’

  ‘No, I wouldn’t say that,’ said the doctor. ‘But all the same…’

  ‘I mean, she’s never had a day’s illness in her life, and then suddenly she can’t walk and you’re telling me there’s nothing wrong with her?’

  ‘I’m not saying there’s nothing wrong with her, I’m just saying there’s nothing physical causing it.’

  ‘You mean she’s mad?’

  ‘No, not mad, worried perhaps. Something wrong in the family, perhaps?’

  ‘There’s nothing wrong in the family. We’ve always been a happy, close family. If you don’t believe me, you can ask the others. They’re all here.’

  Ahmed left the room to fetch the others. Soon they all trooped in.

  ‘The doctor asked whether there was anything wrong in the family,’ he said. He was clearly the most senior of them, both in age and accomplishment. ‘She said it could be causing our mother’s paralysed leg. I said that there wasn’t anything wrong. We’ve always been a normal happy family, haven’t we, and we still are. You can ask anyone in our community as well.’

  The others murmured their agreement. Two of them looked angry at the suggestion.

  ‘So you see,’ said Ahmed to the doctor.

  ‘Nevertheless…’ said the doctor.

  ‘You’d better do more tests,’ he said.

  ‘We’ve done them all. There aren’t any more to do.’

  ‘There must be. After all, she still can’t walk.’

  ‘No, she can’t walk, but the question is…’

  ‘Can we take her to another hospital? A private one. We can easily afford it.’

  ‘It’s not a question of money. We’ve done all the necessary tests and we can’t find anything wrong physically to account for her symptoms.’

  ‘But we can take her if we want?’

  ‘Of course. No one can stop you. But you’d be wasting your money.’

  ‘Good. That’s what we’ll do.’

  It took a little time to arrange, but Mrs Aziz went. The new hospital was smaller and quieter. Mrs Aziz had her own room, she could watch films in it in her own language. They asked her what she wanted to eat, and they brought her something that faintly resembled what she had at home. It was quite comfortable.

  They put her through the same tests, though. But this time she was less frightened, both because the staff were more solicitous, even if they couldn’t speak her language, and because she’d had them before and knew what to expect. When Ahmed asked to see the doctor, he came at once.

  He was dressed like the second doctor in the other hospital, but the clothes were more natural to him. He seemed to flow up from the floor in a graceful arc, like a seller of fine arts. He was both friendly and distant, combining the two by some alchemy of his own.

  ‘I’m very glad to say that we haven’t found any serious structural abnormalities in your mother’s nervous system, and therefore I think she’s going to recover completely. In fact, I think she’s improving already.’

  ‘What was wrong with her?’ asked Ahmed.

  ‘Wrong with her? It’s not possible to say exactly. In my opinion, she probably had a virus. Sometimes people get paralyses after a viral infection, for reasons that we don’t yet fully understand. At least ninety-five per cent of such cases recover fully, and I think your mother will be among them.’

  ‘Why didn’t the other hospital tell us that?’ asked Ahmed.

  The doctor smiled with just a hint of sadness.

  ‘It is not always an easy diagnosis to make, and only becomes clear with the passage of time.’

  ‘So what happens now?’ asked Ahmed.

  ‘The problem is that your mother has been so long in bed that she has what we call disuse atrophy of her muscles. That is muscle wasting in layman’s language. She has to be taught how to use them again so that they can be built back up and return to normal.’

  ‘How’s that done?’

  ‘She has to undergo intensive rehabilitation, with lots of physiotherapy. She might also need occupational therapy, to get her back to what she was doing before.’

  ‘How long will it take?’ Ahmed was nervous, because the hospital was costing a fortune.

  The doctor looked Ahmed in the eye. His assessments were quick.

  ‘Well,’ he said, ‘in my opinion she could be just as well rehabilitated in the other hospital as in this. It might be a waste of your money for her to stay here.’

  Ahmed could not control the smile that spread on his face.

  ‘Thank you, doctor,’ he said. ‘We’re all very grateful to you.’

  Mrs Aziz returned to the first hospital, to a ward where those who had had strokes were taught to walk or speak again. Some even had to be taught to eat, for when they tried the food either came out of the sides of their mouth or went down the wrong way and started to choke them. The ward smelt of urine.

  A large Australian girl, bouncing with optimistic energy and strength, came to Mrs Aziz, who was lying in bed. She was a physiotherapist.

  ‘Come on, Jamila,’ she said. ‘Rise and shine.’

  Mrs Aziz looked puzzled. She hadn’t understood.

  ‘It’s time to get out of bed,’ said the physiotherapist.

  ‘I’m tired,’ said Mrs Aziz. ‘Tomorrow better.’

  But the physiotherapist was used to excuses and procrastination.

  ‘Never mind. We’ll get you out in the chair first.’ And she pulled the bedclothes from Mrs Aziz’s recumbent form.

  Mrs Aziz
was soon in the chair. She had not so much moved as been moved into it. Then the physiotherapist, on one knee, started to bend Mrs Aziz’s paralysed leg. Mrs Aziz screamed, though decorously.

  ‘Aw come on, Jamila,’ said the physiotherapist. ‘That didn’t hurt a bit.’ And the bending grew more vigorous.

  ‘Tomorrow,’ said the physiotherapist, looking at her watch, ‘we’ll take our first step. You don’t want to be stuck here forever, do you?’

  When she had gone, Mrs Aziz called for the nurse.

  ‘Bed,’ she said, pointing to it.

  ‘No,’ said the nurse. ‘Not before bedtime. You’ve got to stay out of bed till then.’

  Mrs Aziz hadn’t the words to argue, but in any case there was a tone of finality in the nurse’s voice. How cruel they were here, how lacking in understanding!

  Nights were actually the worst time, even though Mrs Aziz was in bed, for two of the patients in the ward screamed ‘Nurse! Nurse!’ for hours on end. When the nurse came – which wasn’t often – they couldn’t explain what they wanted and resumed their screams straight after she left. Sleep was impossible.

  So when the physiotherapist came and said that the more she practised walking, the sooner she would be out of the hospital, Mrs Aziz began to see the sense of it. Her resistance changed to cooperation; sometimes, indeed, the nurses had to prevent her from walking with her stick out of the ward into the corridor outside.

  ‘What would happen if you fell?’ they said. Happen to us, they meant. Mrs Aziz had to content herself with walking in confines of the ward.

  She was so well that the staff began to speak of her returning home. First, though, they had to make sure that she would be able to manage there. A young woman came up to her as she was walking in the ward.

  ‘Hello,’ she said. ‘I’m Sarah, the occupational therapy student. I’ve come to do an assessment.’

  She led Mrs Aziz into a large room off the ward where Mrs Aziz had not been before. There was a plastic-topped table and some plastic chairs in the middle, and on the far side a stainless-steel sink unit and a gas cooker. Sarah watched Mrs Aziz clean some plates and then boil two kettles, first an electric one and then one on the gas cooker. She remembered to turn the gas off and had no difficulty in pouring the hot water into a teapot and a mug.

  ‘It’s all right,’ said Sarah jovially. ‘I won’t ask you to make sandwiches. I don’t suppose you have them at home.’

  Mrs Aziz was now ready for discharge from the hospital. Ahmed, wreathed in smiles, came to fetch her. The staff, in truth not accustomed to such total success, had become fond of her, and lined up to wave goodbye to her.

  On the way home, Ahmed explained how the doctors had told him that it would be best if Mrs Aziz resumed her normal activities at once because she might have a relapse if she didn’t. But one at least of the children would visit every day to make sure that everything was all right.

  When they arrived home, Mr Aziz was having a snack of tea and barfi. He grunted when she arrived because his mouth was full. And because of his heart, he did not get up.

  It was surprising how well Mrs Aziz managed in the first two days. She cooked pilau rice and several vegetable curries to go with it (Mr Aziz had been told to cut down on meat). She served them to her husband on a tray that he balanced on his knees. Since she used so many spices in the cooking, it was only natural that the balance between them was not quite right for Mr Aziz’s taste: a little more of this, or a little less of that, would have been better.

  Ahmed came on the third day after her discharge from hospital. He had his own key to the house and let himself in. He knew at once that there was something wrong, or at any rate different. The silence had a kind of density to it, it was almost like a physical resistance.

  He walked into the room where his father had sat every day since his heart attack. He was in the chair all right, with the green and black felt picture of the Kaba still on the wall above him, but he was slumped sideways. Blood soaked his grey kurta pyjama. There was blood on the floor too, with a large kitchen knife. Mr Aziz stared sightlessly into infinity.

  Ahmed called out for his mother, breaking the silence as a fragile stone fractures under a blow. Unlike the stone, however, the silence re-established itself.

  Ahmed went into the kitchen. There was no one there. Then he rushed up the stairs into the bedroom. His mother was on the bed staring up at the ceiling. She didn’t turn towards him when he entered. And not only her right leg, but her right arm was completely paralysed.

  8 - Treatment for a King

  King Reginald, the First of that Name, sat down in his throne-room, previously known to his neighbours and his few visitors as his lounge, and began to write a letter. His royal palace, postal address 23, Magnolia Drive, Forehampton, was of course only his temporary residence, until such time as the Usurpers vacated his rightful abode in London.

  The blank page before him, he hesitated: how to address the recipient of his stern missive? She, the intended recipient, had played her part for so long now that she probably had forgotten that she was a fraud, an interloper, an actress. He decided to address her as Mrs Windsor, though on the envelope he would put Mrs Elizabeth Windsor so that there could be no mistake as to whom it was addressed and no excuse for failure to deliver it.

  ‘Dear Mrs Windsor,’ he began, but then paused, his pen hovering over paper. What tone should he adopt? Naturally he was angry, as anyone who had been cheated of his birthright would be. But King Reginald, the First of that Name, was in general a mild-mannered man who slid away from conflict by some kind of social lubrication. And also being at heart a kind man, he understood that, after all these years, it might not be easy for Elizabeth Windsor to move out of the property she wrongfully occupied or abandon her false position that had, from sheer force of habit, become true in her mind. She was now an old woman and had begun her charade at the age of twenty-six. All the same, justice was justice, the law was law, and his right was his right. Did not his escutcheon say, Dieu et mon droit? A certain firmness was therefore called for, without aggression or, in the first instance, threat. Stronger language might be necessary later.

  ‘We, Reginald,’ the royal writer continued, ‘by the Grace of God King of the United Kingdom of Great Britain and Northern Ireland, having been informed that you, Mrs Elizabeth Windsor, and your family and followers, having been in wrongful occupation of several of our palaces throughout our realm, do hereby request and require that you, Mrs Elizabeth Windsor, your family and followers, do vacate the said palaces by a date not later than fourteen (14) days from the date of this Royal Letter, in which case you and your family and followers, staff and servants, will receive our Royal Pardon.’

  His Majesty sat back and read, not without a certain admiration for his own temperance, what he had written.

  ‘Yes,’ he thought, ‘I think that strike the right tone. Firm, not bullying.’

  Strange to relate, although he had been a royal personage since birth (as all true royal personages were), this was the first letter he had ever written in his royal capacity. Equally strange to relate, though he had been born royal, he had not realised it until about three days before. On that day, everything had suddenly become clear to him. For about two weeks beforehand, he had been feeling oddly exalted without being able to put his finger on exactly why. Then, on that day, he had been looking out of his front window when a large black Rolls-Royce went by, followed by several large black saloon cars. He knew at once that it was a sign: it meant that he was King and was meant not to ride in any other vehicle than the large and stately Rolls-Royce. The reason for his previous exultation was now clear to him. It had been justified all along: his instinct had been right.

  Before he was aware that he was King of England (though looking back on his life from his current state of awareness, he had always suspected that there was something different, predestined about him) King Reginald, the First of that Name, had been known as Smith, an excellent alias in so far as i
t could not better have concealed his identity. His job, too, had concealed it well: librarian at Forehampton Branch Library. But his name Reg, as he was sometimes known there, had surely always included some sly and self-deprecating etymological reference to his regal status?

  Two weeks before his exaltation began, he had received a circular informing him that, because of budgetary considerations, the Forehampton branch library was soon to close. At first this news upset him deeply; for although the work was not too strenuous, he believed he had made a significant contribution to the cultural life of the town, for example by setting up a Nature corner in the library for its children. And if the library closed, where would the old widowers with nowhere else to go now go?

  But with the exaltation came the understanding that he was born to something grander than to advise elderly women on which of the latest crime novels to read (which he had not read himself) and to tell children to keep their voices down because this was a library. The closure was surely a sign of Destiny rather than a setback for it came just at an opportune moment. He had taken that destiny into his own hands.

  It was easy enough to sign his letter Reginald R - Reginald Rex – but how to post it? It would have been best, of course, to seal it with wax and a seal, to demonstrate that it was no ordinary missive, but it was difficult these days to find such wax anywhere and impossible in Forehampton. Instead, he wrote OHMS – On His Majesty’s Service – in large red letters on the flap of the envelope. That should be sufficient to let the usurper and her servitors know that it was important.

  His Majesty took the letter to the post office pondering as he passed the semi-detached houses en route whether he should send it recorded delivery. Surely the OHMS by itself should be enough to secure delivery? On the other hand, the fact that someone signed for its receipt would be an implicit acknowledgement by the Usurper (who now had a capital letter in his mind) that Mrs Elizabeth Windsor was her true name and the correct form of address. If ever it came to a case in court this would be evidence.

 

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