After Isabella

by Rosie Fiore

  When she got to the ICU, the doctor was in with Laura, and she was asked to wait outside. They showed her into the little family room. It was, as these rooms always are, awful – featureless, with waiting room chairs, a waiting room chipboard coffee table and, most awfully, a box of tissues, as if tears were inevitable. She hadn’t been in there long when the doctor came in to see her. She was a slim, tall woman in her mid-fifties, her greying blonde hair drawn back in a messy bun. She looked tired already, even though she had just begun her shift.

  ‘I’m Dr Willis,’ she said and briefly shook hands before sitting down in the chair opposite Esther. ‘I believe you came down from London last night.’

  ‘Yes, I’d been… away from home…’ Esther couldn’t bring herself to say ‘staying with my boyfriend’. ‘And you only had my landline number.’

  ‘That seems to have been the case,’ said the doctor. ‘Your mother had filed some “in case of emergency” details with her GP, and that was the only number we had. I’m sorry.’

  ‘No, I’m sorry. I should have picked up the messages sooner.’

  ‘In most cases, that could have been a problem, but I’m afraid in this instance, twenty-four hours has not… made much difference.’

  ‘Is she…?’

  ‘We have run the full battery of tests, and we have concluded that she is brain-dead. I’m so sorry. The ventilator is keeping her body going, but there is no brain activity at all.’

  ‘So you need me…’ Esther couldn’t finish.

  ‘We wanted to give you a chance to say goodbye and, if you would be willing to consider it, to talk to you about organ donation.’

  ‘Yes, yes of course,’ said Esther quickly. ‘I know Mum wanted to donate her organs. I think she had a card and everything.’

  ‘Would you like to call someone? Get someone to come here to be with you?’

  ‘There’s really no one I could call. Most of all, I want to understand what happened. I spoke to her just a few days ago. She was fine. What changed? I found some medication in her house… Madopar? Did she have Parkinson’s?’

  Dr Willis looked uncomfortable. ‘I know there were some neurological issues and she had recently had a diagnosis… I think it might be best for you to speak to her GP about the details.’

  ‘But that wasn’t what killed her?’

  ‘No.’

  ‘Was it a stroke? A heart attack?’

  ‘We think… Well, it appears that she had carbon monoxide poisoning. When her neighbour found her, she was unconscious and barely breathing. When we got her to the hospital, she suffered a bleed on the brain. We did what we could, but…’

  ‘Carbon monoxide poisoning?’ Esther was horrified. ‘How? Was it a defective appliance? The cooker? Is the house safe?’

  The doctor hesitated. ‘It wasn’t in the house. It was in the garage. It appears… she got into her car and turned on the engine. There was a pipe from the exhaust to the—’

  ‘No!’ said Esther aggressively, as if saying it would make the doctor’s words go away.

  ‘It was an old car,’ the doctor said, somewhat unnecessarily. Esther knew what car her mother drove – a fifteen-year-old Ford Escort.

  ‘But… why?’ The tears were flowing freely down her cheeks. She understood now why there were tissues in the room – it was a room where people received bad news like hammer blows. Dr Willis touched her hand kindly, in sympathy, but didn’t reply. She wasn’t going to speculate. But Esther knew why. If there had been some kind of diagnosis, if Laura had begun to have tremors, to fall, to anticipate a gradual loss of independence and control, she could not have borne it. Knowing that didn’t make it any easier to hear.

  ‘Was your mother religious at all? Would you like us to call a priest?’

  ‘She was. She was a very active member of her church, and I’m sure her own priest would be the best person.’ Esther gulped. ‘Can I call him?’

  ‘Of course.’

  Esther suddenly felt overwhelmed by the oppressive little room. ‘I think… I think I might go and see him, if that’s all right. If we come back… later today… would that be all right?’

  Dr Willis hesitated. ‘Of course. Take as much time as you need.’

  But as she said it, Esther could see she didn’t really mean it. She didn’t mean ‘Take as much time as you need to process this cataclysmic turn of events.’ There wasn’t enough time in the world for that. She meant, ‘Take the time required to manage the immediate practicalities, because we need to turn the machines off, let your mother die and free up the bed for another desperately ill patient.’ Intellectually, Esther could understand this and knew that this was what had to happen, but emotionally she felt at sea – bereft, alone, unable to begin to do what needed to be done. ‘I’ll… I’ll be back,’ she said, standing abruptly.

  She walked blindly through the corridors of the hospital. As if by reflex, she checked her phone. Of course, she’d turned it off when she’d got there, as ordered to by signs on the doors of the ICU. She switched it back on, and immediately it began to bleep. Ten missed calls and multiple voicemails – from Michael, from a wobbly-sounding Lucie, from Stephen and from a couple of work colleagues. She flicked from one message to the next without listening to any of them in their entirety – they all expressed concern and asked for news. How could she begin to reply? Especially to Lucie. Oh God. Lucie. She was going to have to put this all into words… explain it all. And there was still so much she didn’t know. She wasn’t sure she could bear any more revelations.

  A wave of nausea overwhelmed her. She hadn’t eaten anything since the desiccated pastry on the ferry, and she’d had three hours’ sleep. Nevertheless, she was going to be sick. She looked around the reception area of the hospital but couldn’t see a toilet. The car park it would have to be. She ran outside, into the blessed fresh air, found a nearby bush, bent over and retched dryly. Unsurprisingly, nothing came up. She stayed bent over, hands on her knees. Straightening up, walking to her car – that felt like just too much effort. She wanted to crawl under the bush and hide like an injured animal. Then, unexpectedly, she felt a warm hand on her back. She started a little. It must be a passer-by, a good Samaritan.

  ‘Are you all right?’ The voice was concerned, and very familiar.

  ‘Michael,’ she said, turning into his arms.

  ‘You didn’t ring or answer your phone. I thought it had to be bad. I came down as early as I could,’ he said, holding her close.

  In another life, or if they had been different people, Michael would have taken charge. He would have made all the decisions and arrangements and phone calls, and Esther could have collapsed in a grieving heap. But she wasn’t that woman, and he was sensitive enough not to try and be that man. He took her back into the hospital and up to the café, where he ordered food – bacon, eggs and toast – and made her eat. Once she was on her second cup of tea, she was sufficiently revived to tell him. She had to spell it out and actually say the words aloud – carbon monoxide poisoning, attempted suicide, brain-dead. It was horrific, but she managed to say it all without crying or vomiting.

  He listened quietly and asked a few questions. Then he said, ‘What needs to be done?’

  ‘I need to find her priest. He needs to come and give her the last rites. She would want that. Then… they turn the machines off, and she dies, I suppose, or stops breathing, as technically she’s already dead. I don’t know what that will be like. I’ve never seen someone die.’

  ‘Me neither,’ said Michael. ‘Do you want me to be there?’

  ‘Is it all right if I say no? She didn’t know you, and she was very private.’

  ‘Of course. What else can I do to help?’

  ‘I have no idea. Just stay with me, for every moment except for that part. And could you find us a hotel? I don’t think I can bear to stay in her house.’

  ‘Consider it done. I’ll reserve a few rooms. I imagine Lucie will need to come down. Will her dad bring her?’

 
; ‘Oh dear God, I suppose she will. Stephen will come, I imagine. He was fond of my mum. And we’ll have to organize the funeral.’

  ‘Should it be here or in London?’

  ‘Here. Definitely here. This was her community, and where she was born. She wanted to end up here.’

  Michael took out a notebook and in his sloping, tidy handwriting made a list of what needed to be done, in chronological order, checking each step with Esther. He used his phone to look up the number of the church and then handed her the phone to ring it.

  Esther had met Father Daniel a few times on her visits to the island. He was a cheery, ruddy-faced man with a bristle of white beard. She explained who she was and what had happened. He asked where she was and told her he could be there in ten minutes. She hung up, and he duly arrived. She had forgotten that death and bereavement were part of a priest’s day-to-day work and that good priests were good at handling it. He was a very good priest – warm, practical and compassionate – and clearly deeply shaken by Laura’s death. In an odd way, Esther found this even more comforting. It meant that Laura had genuinely meant something to him and also that she was not alone in not having foreseen the awful events.

  He kept shaking his head and saying, ‘I can’t believe it.’

  ‘Did you know she was ill?’

  ‘I knew she had been a little unwell, and she looked frailer. She started walking with a stick, but that’s not unusual for those of us in our seventies. It’s often just a sensible precaution.’

  ‘So she hadn’t told you about the Parkinson’s, or whatever it was?’

  ‘She hadn’t spoken to me about it, no. But you should probably talk to some of her friends. And to Dr Preston. He was her GP.’

  ‘I will,’ said Esther. ‘And now we had better go back to the ward. I get the feeling they’re waiting for us.’

  ‘Let them wait,’ said Father Daniel. ‘What matters is that you feel Laura has the final journey that is best for her, and that you have said your goodbyes as best you can. There’s no hurry. If they give you a hard time, they can deal with me.’

  Impulsively Esther reached across the table and took his hand. ‘Thank you.’

  ‘Not at all. I loved her too. And this is a horrible blow, make no mistake. The Lord and I will be having words over this one.’

  Esther explained that she had some other calls to make and that they needed to check into a hotel. She and Father Daniel arranged to meet in a few hours’ time. She rang Stephen first. He and Lucie were in Southampton, waiting for the ferry. She told him the facts, baldly and briefly. He was shocked but kept his responses brief. She sensed that Lucie was nearby, and he didn’t want to alarm her.

  ‘What should I tell Lucie?’

  ‘I don’t know. I think it’s important for her to know that Nanny Laura is dead. Maybe she doesn’t need to know we’ll have to turn off the life support. As to what she died of… well… I suppose we can address that later. Say you don’t know, or that she got ill suddenly, for now.’

  She and Michael drove in his car to Laura’s house and she went in and packed her things as quickly as she could. He had done a web search and had found a hotel for them. He gave her the address, then dropped her back at the hospital before going on to the hotel to check in and unload their luggage.

  She met Father Daniel outside the hospital, and together they went to the unit. The nurses there were kind and respectful and showed them into Laura’s room. Esther was surprised to find a short, elderly man with a bald head and a fringe of white hair standing beside Laura’s bed. He turned when she came in.

  ‘You must be Esther,’ he said, offering a broad, strong hand for her to shake. ‘Dr Preston.’

  She shook his hand, and he and Father Daniel exchanged nods of greeting. ‘I’m so very sorry,’ he said to Esther. ‘This must be very difficult for you.’

  She wasn’t sure how to respond to that. She had no frame of reference for the situation she found herself in. She looked over at Laura lying on the bed, then went to sit in the chair beside her and took her hand. To her surprise, Laura’s skin was warm. When she’d been there the previous night, she had been in no doubt that Laura was dead, but now she was not so sure. She looked frail and small and still, but there was life and colour in her skin and her chest rose and fell. Esther knew she wasn’t breathing on her own, that it was the ventilator inflating her lungs which was keeping her alive, but it was very hard to see all the usual outward signs of life and yet intellectually accept that she was dead. What if Laura wasn’t brain-dead? What if they switched off the ventilator and killed her? How could she live with herself? She looked up at Dr Preston, who seemed to understand.

  ‘They do a series of tests to determine brain-death,’ he said quietly. ‘They’re performed by two highly experienced doctors who have no involvement in organ transplantation. They are very careful and very thorough about these things, I assure you. I know it’s hard, because she appears still to be with us, but I promise she isn’t.’

  ‘What do we do now?’ she asked the room at large.

  Father Daniel answered. ‘You should have as much time with her as you want. I can stay with you or leave you on your own. When you’re ready, I will pray for her and anoint her with oil. If you want to stay after that, do so. For as long as you need. If you want anyone else to come and say goodbye, that’s also all right. If I have to beat the medical staff off with a drip stand, I will. When, and only when you are ready, you say your goodbyes, and we leave.’

  Dr Preston took over. ‘As you know, she wanted to donate her organs, and the transplant team is on standby. She’ll be taken into surgery, where the ventilator tube will be removed, and within a few minutes her heart will stop. I know it’s hard to say goodbye when she still seems to be alive, so if, after the transplant surgery, you’d like to see her again…’

  ‘No,’ said Esther. ‘No.’

  ‘Do you want us to leave you alone for a while?’ Dr Preston asked gently.

  Esther knew she was supposed to say yes, but she didn’t know what she would say if she was alone with Laura. Whatever she said, she would be saying to herself alone. She was an atheist, she didn’t believe in an immortal spirit. Laura had checked out and gone. And even if Laura could hear, what would she say? ‘How could you? How could you do this to me, to Lucie?’ She felt cold and bleak, and she felt the deep stirrings of anger. She wanted this to be over.

  ‘No,’ she said firmly, not caring what the two men thought. ‘Father Daniel should do the prayers now.’

  She stood beside the bed through the prayers, dry-eyed and still, and watched Father Daniel make the cross on Laura’s forehead in oil. He touched her with great tenderness, and she could hear a catch in his voice. He was affected by this loss. But all Esther could feel was a growing coldness, as if something inside her had turned to ice. She had no idea who this woman was. This breathing corpse was a stranger. All she wanted to do was get away.

  For form as much as anything else, she stroked Laura’s hair and kissed her forehead. And then she heard a voice that didn’t sound like her own saying, ‘Goodbye, Mamma.’ It was as if the voice of a child had risen unbidden from deep inside her, and it startled her so much she began to cry. She stepped back from the bed, shocked, and Father Daniel caught her with an arm around her shoulders.

  ‘Do you want to go now?’ he said softly.

  She nodded.

  ‘Are you sure?’

  ‘Yes.’

  He led her from the room, and she didn’t look back. She could see the nurses and a few people in surgical scrubs standing by the nurses station. In her peripheral vision she saw Dr Preston stepping into the doorway of the room, obviously alerting them that the process could begin. The process.

  The rest of the day passed in a blur. She got into her car and, using the satnav, found her way to the hotel, which was close to her mother’s house, on the banks of the Old Mill Pond. She would have liked to have lain down on the bed, alone or with Michael, and rested
, but while she was at the hospital, Lucie and Stephen had arrived. They were sitting with Michael at a table in the reception area of the hotel, having tea. She didn’t have time to consider the deeply awkward nature of this meeting. Lucie rushed into her arms in a storm of sobs. She held her and comforted her, stroking her hair.

  ‘Is she dead?’ Lucie asked, looking up into Esther’s face, her expression pleading.

  ‘I’m sorry, my darling. Yes she is. She was in no pain at all though.’

  ‘I can’t believe it,’ said Lucie.

  Stephen stood up and gave Esther a self-conscious pat on the shoulder. She managed a weak smile for him.

  ‘Thanks for bringing her,’ she said.

  He nodded, without saying anything, and she found herself grateful for his taciturn and unemotional nature. Stephen didn’t make a fuss. He wouldn’t make a fuss about Laura’s death, nor about having to have tea with his ex-wife’s new boyfriend. She had found his coldness alienating when they were married. Now she was thankful for it. She would have to carry the burden of so many people’s emotions over the coming days; at least his would not be among them.

  She sat down at the table and Lucie poured her a cup of tea. It was lukewarm and a bit stewed, but she drank it anyway. They were all looking at her expectantly.

  ‘They took her body into surgery, for the organ donation,’ she said carefully. ‘I imagine we can start organizing the funeral within the next day or so.’

  ‘Do we need to let anyone else know?’ asked Michael. ‘Other family? Friends?’

  Esther thought. ‘I’ll make a list of cousins and so on, but they’re all quite distant relations. We weren’t a close family. I was an only child. She was an only child.’

  ‘What about your friends?’