He looked over at Lee, who lay on the table, his composure disturbed only occasionally by a quickening of his breath. Rub a piece of raw meat on a wart, bury the meat in the garden before dawn and within a week the wart will vanish. The thighbone’s connected to the hipbone. His hands, now resting in his lap: more bones than any other part of the body. Twenty-seven or something. Scaphoid, trapezium, distal phalange. Flexor carpi. The hands were everything. Industry and destruction. Incredible things, the single most-useful instrument on earth. At medical school there was always the running joke, uttered in mock hysteria: Not the hands! These are my future. Do what you like. Break anything, but not the hands.
The lounge room was a junkyard of furniture and clutter. Several fleshy couches, low side tables. Piles of magazines and books, Persian rugs layered across the wooden floor. Black-and-white photographs in small, silver frames. Three cabinets, each crammed with objects: books, unusual rocks, fossils, jade boxes with intricately carved lids, a glass mortar and pestle, bottles, dried flowers, a dried seahorse, the skull of a bird, a bowl of marbles, a curved dagger in the shape of a crescent moon. The place smelled faintly sweet, of preserved things, of spices, like a museum or apothecary.
He went over to the bookcase and trailed a finger along the broken spines. Gardening books, texts on tropical diseases. Herb guides. Cookbooks. Philosophy. A predictable selection of regulars, such as Huckleberry Finn and Shakespeare, but also more obscure medical classics: Journeys in Diverse Places, written in the sixteenth century; On the Motion of the Heart and Blood in Animals; A Morbid Anatomy of the Human Body. A collection of Freud. The Bible, dense with sorrow, its Psalms alone enough to kill a man through sheer force of lamentation.
Standing there in near darkness, he allowed a well-thumbed Gray’s Anatomy to fall open across his palm. Clumps of pages collapsed to one side and he breathed in the tome’s exhalation of ink and paper, a whiff of mould. As ever, the drawings were breathtaking. Delicate and strong; almost impossibly human. More than a manual on human anatomy, they might have been the blueprints of God. Figure 1194, the anterolateral view of the head and neck. A man looking upwards and to his right, the pencil-drawn surface of his body marked and signposted. His head was tilted back slightly, revealing the triangular shadow of his jugular notch and the ledge of his left clavicle just beneath the skin. There is always so much happening in any living thing; they are never completely still. Wild inhaled again, deep and long. The Masseter imparts fulness to the hinder part of the cheek; if firmly contracted, as when the teeth are clenched, its quadrilateral outline is plainly visible; the anterior border forms a prominent vertical ridge, behind which is a considerable fulness especially marked at the lower part of the muscle.
Carrying a candle in one fist, Wild shambled across and inspected the boy. Lee’s eyes were closed and his skin was waxen, as if all external functions were shutting down in favour of those required deeper in the caverns of his poor body. His lips were apart, revealing teeth and the dark throat beyond. A tiny thread of saliva. Lee’s features were slight and angular, the facial topography as yet undetermined. We end up with the face we deserve, Wild thought, the accumulation of a lifetime’s worth of good and bad decisions. This boy was yet to make those choices. Perhaps he really was an innocent, with a face in waiting, as yet undefined?
Lee’s breathing was shallow. Patient. A patient. To be under medical care. To wait one’s turn. From the Latin patior. To suffer. Beneath his jacket, Lee’s white shirt was dark with blood and his hands were stained with it. There was even a smear of it on his face.
Wild thought of the suitcase full of money and dope. It didn’t make him as happy as it should, considering it could get him a long way from here. He could perhaps even last for some months. But he would eventually exhaust any supplies and have to start all over again. Always the same fears—of running out, of finding himself bereft, of being abandoned to himself alone. Perhaps it was better to have nothing at all? It was a bleak thought. Just leave in the morning and go somewhere else. If not tonight, then Lee would certainly be dead soon. There was not enough food here, no way of reaching help. Not even a telephone that worked. They were miles from anywhere. Nobody would know that Wild had ever been here, let alone left Lee here to die. His escape could be accomplished without too much effort.
Attracted by the candlelight, a moth blurred from the darkness and was gone, leaving in its wake fine scales like snowflakes scattered in Lee’s eyelashes and across his cheeks. The creature reappeared a few seconds later and landed ungracefully on Lee’s face. Its wings were dark brown, a ruffle at the neck like a tatty stole. With antennae roaming above its blunt head, the moth moved in a drunken circle along Lee’s cheek and stopped near his mouth. Perhaps it sensed the stubble there, or a change in temperature. Several times it lifted one furry leg and placed it down again. Its wings trembled in the breeze of Lee’s exhalation. Lee displayed no awareness of the moth. Wild leaned in closer, fascinated, as if expecting the moth to say something. If this were a fairytale the creature might indeed speak, dispense advice in cultured tones, perhaps reveal itself to be a warlock or a king.
What people didn’t realise was that death is a process rather than a single event. Brain cells begin to die after only a few minutes without oxygen, but muscle cells might last a few hours. Bone and skin cells can even stay alive for several days after the heart has stopped beating. The actual moment of death can be hard to pinpoint, but for legal and medical purposes it is considered to be the point of no return. The first time he saw a cadaver Wild was amazed at how much space it occupied, as if death had left mass in exchange for vitality. Almost impossible to believe the object that so resembled a person would never again stand or speak. In laboratories at medical school twenty-five years earlier, he had stood with a dozen other students and watched in disbelief as the dark-yellow flesh of a man’s chest was peeled back like canvas to expose his sternum. It seemed so rude. The thick stench of chemicals settled on their clothes and skin. They shuffled and stared and whispered so as not to offend the man lying before them with his grey mouth agape. The inner world, so nearby. Right there. We forget the skeleton we carry with us at all times. Hard to believe, in many ways as distant as a Bombay slum. Under fizzing fluorescent lights they learned to handle the dead, to name the parts and know how they functioned. The grey lungs of a smoker and the swollen liver of a drinker. They were made to feel powerful and intelligent. Any dread of the inanimate was dispelled by the brutal matter-of-fact, before they were let loose on the living.
But Lee was not quite dead yet. Wild looked at him. Uncertainly, he held out a finger in front of the moth and waited until the creature stepped daintily onto the back of his hand, as if mounting a stage. Carrying the insect, he walked through the darkened house. He left the lounge room and moved down the hall to the front door, went outside onto the creaking verandah and raised his hand into the air above his head. The dark air was very cold and the trees and eaves drizzled with rainwater. He could feel the moth moving on his skin until it found the edge. It waited for another minute with antennae still rotating before blundering into the night.
Wild returned to where Lee lay on the dining table. A newly awoken urgency burned through him. He who wishes to be a surgeon should go to war, wrote Hippocrates. It is often in times of crisis that medicine is compelled to advance. The German wounded fared better than their French counterparts during the Franco-Prussian War thanks to a willingness to use Lister’s ideas on antiseptics. Thus we progress.
As gently as he could, as if handling something newborn, he lifted Lee in his arms. Come on, son.
Wild was aware of Lee’s shallow gaze upon him as he removed the young man’s bloody jacket and shirt, laid him back down on the table and prepared to operate. The boy might even have tried to say something, but it was probably just an anguished groan; he was almost certainly beyond language.
19
Wild shook off his overcoat and arranged the things he would need on a
low metal table he had retrieved from the consulting room: scalpels, needles, dressing, sutures, antiseptic. Forceps, with their long, serrated beaks. From Lee’s torso he peeled away a soggy dressing of toilet paper and dropped the bloody mess to the floor. He waited, breathing heavily, inhaling the stink of blood and antiseptic.
He crouched closer until his face was only an inch or two from Lee’s body, which emanated only the barest warmth. He considered the smattering of hair over Lee’s chest, the visible outline of the pectoralis major. There was an older scar on the right side of Lee’s waist, the opposite side to where he’d been shot. The body has its own dreaming of course, if only one knows how to read the marks and curves. It is possessed, like any geography, of entire histories, each bump and scar the result of some childhood accident or perhaps other, more sinister misadventures. The time during the holidays he fell from a tree in the neighbour’s garden. The day he was hit by a car. Dog bite and knife fight.
Although the area immediately around Lee’s bullet wound was inflamed, there didn’t seem to be any sign of infection. The entry wound was small, its edges already rimmed by scabbing despite the dark blood seeping from it. Perhaps the bullet was not so deep, after all? Wild ran his hands across Lee’s abdomen, searching for any sense of ballooning, for signs of internal bleeding. His fingers traced an arc above Lee’s ninth and tenth ribs, feeling for any clue as to the bullet’s exact location. Of course it might be anywhere, its trajectory having been altered from contact with muscle or bone. He thought of the abdomen, the body’s largest cavity, glistening with viscera: liver, intestines, bladder, stomach, colon.
Lee showed little awareness of what was happening. Wild had arranged all the candles he could find around the lounge room and hung a kerosene lamp from the unpowered chandelier directly overhead. Lee’s pale body stretched away in the uncertain light like a small, damp island. Never before had he been so afraid of another person. He was taut with fear, as if something were muscling for release against his drum of skin.
The air thickened with smoke from the candles and lamp. Wild dabbed at the wound again, holding the cotton wool like a knuckle of bread. He hadn’t laid a hand on a patient since that terrible night, had barely even touched another human being. Physical contact was always the first thing to go. The world shrank from those it deemed unsuitable; even his wife avoided his touch afterwards. Not that he would have wanted to continue his medical duties, even if permitted. Two years in exile from a portion of himself. He wiped his hands dry on his shirt and wondered how on earth to begin.
Although Wild had never treated a bullet wound, he remembered some of the terminology. Yaw and tumble, velocity and pressure. A bullet doesn’t enter a person’s body smoothly, tip first, as people tend to think. The physics obscures the fact that it’s just one thing thunking blindly into another. The bullet shatters and crumples. Damage to tissue is often caused less by the bullet itself than the shock waves it sends through the body, often creating a cavity ahead of where the bullet stops. Almost as if the body accommodates the object’s anticipated trajectory and manufactures its very own injury. Then there are the problems of infection and blood loss. The point of impact is only the beginning.
Again Wild stared at Lee’s face. He always suspected that the screen erected between the surgeon and patient before an operation was not for the patient’s benefit but to partition the surgeon from the reality of slicing into another human being, who is objectified, whose skin is made yellow through antiseptic, whose signs of life are reduced to bleeps and numerical codes. In this way, medicine is the same as art; it’s all about distance. Perhaps, he thought suddenly, that is part of what went wrong on that night. Good surgeons will never address a patient by their first name. An incision is made through a piece of some stranger’s body. A girl with bucked teeth. Some middle-aged man with a wife. Good morning, Mr. Jones. Please, call me Alfred. Well, Mr. Jones, the problem seems to be in the left . . .
Wild prepared an injection of morphine and administered some to Lee. It was a risk, considering the boy’s condition, but some sort of pain relief was necessary. Then he allowed himself the same. The drug moved through him like a dark and cumbersome tide, smoothing his edges, making him fluid and mathematical. He digested the sensation for a few minutes, inhaled deeply and rolled up both shirtsleeves. He placed two fingers against Lee’s cool neck to gauge a pulse, but his watch seemed to have stopped sometime in the past day or so. Probably knocked it against something on that damn train. He suspected that the trouble caused by a bullet wound was mainly below the surface. If the bullet was lodged anywhere but in the half-inch or so of muscle and fat below the skin, then it would have to wait. At least there didn’t seem to be any sort of rattle in the boy’s breathing to indicate a perforated lung.
The house was utterly silent, as if moored to the bottom of the sea. It was unsettling. He worked his trembling hands into a pair of gloves and wondered about leaving the boy there and fleeing, but the idea was a mere cul-de-sac. After all, where would he go after that?
In desperation, Wild thought back to his studies. Back to the basics. Always let the patient know exactly what’s going on. Take them through it. Talk to them, include them in the proceedings. The best doctors have relaxing voices. He thought of Sherman’s refined whisper. He hummed anxiously for a minute, then cleared his throat and began to speak out loud, falteringly at first, just a mumble really, but with a rising momentum like a song discovering itself in the singing. As he did so, he began to work.
Well then, he said. What are we going to do with you? What we’ll do is get this thing out of your body. A bullet. A bullet. We’ll just . . . We’ll see what we can do. With a bit of luck, it’s more or less still in one piece because I don’t think we can go digging around in there looking for bits and pieces. We’ll be OK. We’ll be alright.
I was a good doctor in my day, believe it or not. Before everything fell to pieces. Seems like a lifetime ago, now. Several lifetimes, actually. Incredible how quickly things can happen. Woman once came into my surgery with a two-inch nail jammed under her bloody eye. Walked in off the street into the waiting room like something from a horror movie. Incredible. Don’t know how it happened, she was very cagey about it, but we managed to remove the thing. Eased it out from beneath the eyeball, patched her up and sent her on her way. She was drunk as a skunk, of course. Probably went on back to the pub or something. Drunks are lucky like that. Stupid, but lucky. Probably have their own damn saint. Irish, no doubt. Nobody celebrates their inadequacies like the Irish. Maybe I should have been a drunk. Nobody likes junkies. Not even junkies like other junkies.
He paused with the scalpel above Lee’s body. It was straightforward. He would slice, the skin would peel back slightly at the edges, there would be blood. A bead of sweat trickled down his nose. He would slice, the skin would peel back slightly at the edges, there would be blood. Above him the kerosene lamp growled its throaty, monotone growl. He bent over, close enough to detect the smell of dried mud on Lee’s neck, the uric waft of his own fear.
People sometimes forget that the patient is always the one in charge, he continued in what he hoped was a soothing tone. Directing the traffic, as it were. Everything revolves around the patient. Without him, we are nothing. Respect the patient, Sherman used to say. Listen to what they have to tell you. Watch them and learn. Fantastic man. Great doctor. The best. Of course the things people say are not always the heart of the matter. Good doctors know how to read the signs, to see beyond what people say, to read their body language and so on. Sherman could run his hands over someone’s skin and detect cancers and blockages and organs not working properly; like reading Braille.
Wild lowered the scalpel to Lee’s flesh and moved it horizontally at the point where the imaginary transpyloric and lateral sternal planes met. He was careful not to go too deeply. Nestled somewhere beneath was the colon and, a little further north, the gall bladder. It was possible Lee’s liver had been damaged, but there was nothing he co
uld do about that here. He made a small incision, no more than an inch across.
Lee stiffened and groaned softly, little more than a sigh. He licked his lips, but his eyes remained closed and he made no other outward signs of discomfort, although he must have been in extreme pain. Fresh blood spurted from the incision, paused on the swollen lip of flesh and slunk over the ribs and coagulated on the table.
Still clutching the scalpel in his right hand, Wild stepped back. I’m not up to it, he thought. I can’t do this. Apart from anything else, I’m not allowed to do this. He needed to mop up the blood. He needed to make another incision at a right angle to the first. He needed to find the bullet and remove it and then he had to stitch Lee up again. Damn. He looked around. The archaic domesticity of this house was suddenly rather pathetic: its faded rugs and dried flowers, the footstool beside the couch like an obedient dog. Damn.
Despite his anxiety—or perhaps because of it—he felt exhausted. What he wanted, what he really wanted, was to lie down, sink into the deep couch, curl up and sleep. When she was about two-and-a-half, his daughter, Alice, was convinced she could vanish if she herself couldn’t see. They played hide-and-seek in the garden and when it was her turn to hide she would just stand there with her hands over her eyes, grinning like a mad person at the apparent genius of it. Her straight, dark hair and tiny fingernails. Then the pantomime of searching the bushes and undersides of the house followed by the extravagant surprise at finding her on the lawn in full view. She would be fifteen now, beyond the grip of innocence, although in many ways finally hidden from him, her father. After all these long years, it was he who’d vanished down the rabbit hole.
The Low Road Page 14
