Liver: A Fictional Organ With a Surface Anatomy of Four Lobes

by Will Self

  But this wasn’t an office; it was a one-bedroom flat on the fourth floor of a Zü rich apartment block; and, while everything had been done to make it seem, if not lived in, at any rate liveable, the air-freshened atmosphere remained determinedly commercial. It was, Joyce thought, the work place of an osteopath, a New Age healer or perhaps — although she had never seen such a thing — the better kind of prostitute.

  The walls were papered pale yellow, the curtains were blue chiffon. Through an open door she could see a small bedroom. An Alpine landscape hung over the bed, which was a single with a thick mattress and a green coverlet.

  The three of them were sitting at a round table, upon which stood a fresh candle, a garland of dried flowers at its base. The legal papers were spread out on the blue and white check tablecloth. Beside the official registration of her birth sat a camcorder, inside of which was a tiny Joyce trapped for all eternity, saying: ‘I wish it to be known that my death has been entirely voluntary, and that I was subject to no pressure or duress by anyone.’

  Treu und Glauben, that, she knew, was the Swiss’s conception of themselves. Every contract was entered into with full faith and the required credit; to go over the small print was to impugn the other party’s character. Anyway, she had read the papers already — there were copies posted on the organization’s website — so she had signed them all — all except her will, which she had brought from England herself.

  ‘So,’ Dr Hohl said, fetching a silvery cardboard box from a wall-mounted cupboard, ‘you will have a chocolate, yes?’

  They were pimply truffles bedded in tissue paper. Joyce thought back to the Widder Hotel and the complimentary chocolates on the coffee table in her room. They had also been truffles — but white ones, caught in a cage of spun sugar. Very stylish. She and Derry had lived in Bournville for almost thirty years. Then, after his death three years ago, she was left alone in the idealized home. On days when the wind was in the east, the smell from the chocolate factory fell across the privet hedges and the lawns that had been mown into stripes. Everything was sweet, sweet, incredibly sweet.

  The absolute horror of suicide gripped Joyce like a palsy: its mundanity and its profundity. The bulk of life, she now understood, was a succession of erasures, one action cancelling out the last. Not now. Everything that she was doing had a machined finality — if only. if life could’ve been like this. such intensity; and now to die with people not much liked, let alone loved.

  She took one of the truffles and placed it in her mouth. It began to dissolve immediately. As if a spell had been broken, Dr Hohl went back to the cupboard, got out a plastic canister, opened it and began spooning the contents into a glass, while counting out in an undertone, ‘Eins, zwei, drei, vier, fü nf. ’, all the way to ‘fünfzehn’, when he was somehow back at the table, seated, and looking at Joyce with his gold-rimmed green eyes.

  Dr Hohl put the glass full of poison down beside the papers and said, ‘Now, the anti-emetic, yes?’

  It tasted vile — at once ferrous and organic. Joyce almost brought up the stuff meant to stop her retching. This was why the chocolates were needed — to fill her mouth with sweetness, so that the bitterness wouldn’t overwhelm her.

  ‘Und now, another chocolate, yes?’

  Joyce couldn’t fault Dr Hohl’s manner: he was devoid of any inappropriate levity, yet not solemn; deeply concerned and altogether present, while by no means intimate. He had managed to weld all three of them into a highly effective team within minutes of their entering the flat. The evidence of this was that Joyce wanted to please him, so took another truffle — although she didn’t feel like it.

  Only Isobel, Joyce felt, was letting the side down. Her daughter sat sideways on the straight-backed chair, her shoulders rounded in powder-blue cashmere (Joyce’s own) and shaking. She had a wad of Kleenex pressed to her eye, while a second sent out soggy tendrils from where it was lodged in the sleeve of her cardigan. Isobel — who had hardly spoken to Dr Hohl — was being barely polite. Her hair, Joyce noted, was a mess: Medusa snakes of various blonde hues, and it was far too long for a woman of her age.

  Joyce washed down the chocolate sludge with a second gulp of the bitter anti-emetic. ‘Do please to remember’, Dr Hohl said, ‘that at any of these times, Mrs Beddoes, you are able to make the mind change, yes?’

  He had said this at least three times before, and on each occasion Joyce had replied, ‘I understand.’ It was, she grasped, the very call and response of assisted suicide: Dr Hohl was the priest, announcing the credo, and she was the congregation of one that affirmed it.

  Then, suddenly, the anti-emetic was all gone and there were only three truffles left in the box. Joyce couldn’t recall all this eating and drinking, but the pads of her fingers were sticky, and her lips were tacky.

  Dr Hohl poured water into the glass heaped with phenobarbital, then stirred it: ting-ting, ting-ting. It would’ve been better, Joyce thought, to’ve brought Miriam, or even Sandra — anyone, in fact, other than Isobel, who simply can’t cope.

  ‘Perhaps,’ Dr Hohl ventured, ‘you would be finding yourself more comfortable in the bedroom?’

  ‘No, thank you,’ Joyce said. ‘I’d as soon stay here for the meanwhile.’

  ‘In that case’ — he held up the cloudy glass — ‘I must tell you that if you drink this you will die.’ He handed it to Joyce.

  The glass was deadly cool to the touch; she hated her shaking jaundiced hand that held it. A memory came to Joyce, not of her beloved husband, her Derry, about to press his lips to hers, nor even of Isobel’s slathered newborn features, but of a wasp batting against a windowpane.

  It had been late the previous October, a mere six weeks after the diagnosis. The chemo had its own miserable side effects, yet they only partially masked her real symptoms; she knew it wasn’t working. The stop-go of her bowels, the waves of fatigue and dread, the acid bile that rose up when she sang, ‘Confutatis maledictis, Flammis acribus addictis, Voca me cum benedictis!’ And the insomnia. Sitting in the study, the curtains open, she had marvelled at the washed-out world without; it looked as if the greens and reds and blues would never return. Then, a tiny tapping at the pane. It was the wasp — tired, cold, its summer done — struggling for admission to the warmly coloured room.

  ‘M-Mum.’ Isobel had got her act together. ‘Mum.’ She slid a document out from the pile. ‘You haven’t signed this yet and we need someone else to witness it.’

  It was the will; unless Joyce’s signature was on it, her legal heir, Isobel, would be stalled and for the meantime nothing could be done.

  Oh, oh — ooooh! This is why none of it has been as I expected. Where was the fast-approaching darkness? The series of mighty contractions she had imagined, clenching and then releasing, clenching and then releasing her from the world?

  Joyce set down the glass and picked up the will. She folded the pages neatly in half, then began tearing them into small square pieces. ‘I am not’, she said, addressing Dr Hohl alone, ‘going to go through with it.’

  He was unruffled — so impressively so that Joyce nearly relented. ‘I understand exactly, Mrs Beddoes,’ he said. ‘I have been thinking already this morning that it is too soon for you, yes?’

  ‘Maybe, maybe too soon,’ Joyce acknowledged, although she already knew that, having refused the poison once, she might never muster the courage to take it.

  Dr Hohl got up and, wheezing a little, carried the phenobarbital over to the kitchen units in the corner. He put it on the draining board, took down a funnel and a plastic bottle marked gift from a cupboard, then poured the liquid into it. ‘You appreciate’, he called over his shoulder, ‘that the payment you have made is non-refundable.’ He came back and sat down. ‘But it may be left as a deposit for if you will be making the mind change.’

  ‘Yes,’ Joyce said, choosing her words carefully, ‘I do appreciate that, Dr Hohl, and I also appreciate the way everything has been organized by you this morning. Now, if you don’t mind, would it
be possible for you to call us a taxi?’

  There was an old woman waiting for the lift. She had a matching hat and coat in synthetic brown material that looked sweaty, and as if the wearing of it would make you sweat. The three women stood in the breakfast-smelling lobby, listening as the building regurgitated the lift. The doors opened, and the old woman, peering intently at Joyce with glinting-coal eyes, said ‘Bitte’ and ushered them in.

  Dankeschön,’ Joyce replied, summoning up the remains of an ‘evening class in German from two decades before.

  On the way down the old woman scrutinized Joyce. Her gaze was disconcertingly vivacious: a much younger woman looked out at the world, through two eye holes that had been cut in the parchment of her face. She knows. She’s seen, what? Body bags slumped in this lift? She knows — and she approves. I’ve won a hand against Death.

  In the hallway, the old woman left ahead of them, pulling a wheeled shopping bag. Joyce watched her go and hated the kinship that she felt. So what if I live a few weeks longer? I’ll still be like her, trapped and used up. Only moments before Joyce had been a heroine — but now what am I?

  An ambulance and a police car were parked outside in the street. Their crews stood chatting and smoking. They were surprisingly scruffy: a paramedic’s blouse unbuttoned to expose her bra strap; one of the policemen was unshaven. They were waiting for me. Joyce wondered if they were annoyed by this interruption in their schedule, or on permanent call, and therefore would remain in Gertrudstrasse until Dr Hohl — this time with more success — had methodically assisted another terminal case to drink up her phenobarbital.

  A wave of exhilaration had pushed Joyce from the fourth-floor flat, sluiced her down and out of the building. In the street it broke: she was a sick woman, and, while not as old as the one with the shopping bag, old enough. She groped for Isobel’s arm. Isobel, her daughter, who had yet to speak — to acknowledge this astonishing reprieve.

  ‘What’, Isobel said, ‘are you going to do now, Mum?’

  The tone was not quite right; the hand that closed over Joyce’s felt at once diffident and disapproving. She wanted me to go through with it — she’s annoyed that I didn’t go through with it!

  ‘What d’you mean?’ Joyce said. ‘Are you asking what am I going to do with the time left to me before I die, or whether I’m going back to the hotel? You don’t, I may say, Isobel, seem that overjoyed to have me still with you.’

  ‘No. Mum, that’s not what I meant, it’s — ’

  ‘Which? Which of those two options didn’t you mean?’

  ‘It’s just. It’s a shock — the plans you’d made, so carefully. I dunno — I mean — ’

  ‘You’d’ve rather I’d gone through with it, wouldn’t you, my girl? That would’ve suited you fine, wouldn’t it? Let me guess: you’d already decided what you were going to ask for the house, you’d already spoken to a broker about selling off your father’s stock, you’d already thought about all the things you were going to do — is that it?’

  ‘Mum, please. ’ She gestured to the emergency workers. They were staring at the two women — Joyce realized she had been near to shouting. She stared back at them, hard; and they kept on staring back. This must, Joyce thought, be the flip side of Helvetian rectitude, this unselfconscious rudeness. Kyrie eleison.

  Sequentia

  They didn’t talk in the cab, which was an identical Mercedes, with another taciturn Swiss at the wheel. Isobel was crying again, and, even though Joyce had calmed down and was prepared to forgive her daughter (It’s shock — I’m shocked. She may be self-piteous — but then, she is pitiable), she still left her to steep in her own brine. It’s all too irritating. Despite which, there was an odd element of excitement: instead of being dead on that ghastly coverlet, Joyce had the whole day ahead of her; she felt as a schoolgirl does, when some confusion in the Olympian time-tabling of the adult world leaves her with a free double period.

  At the Widder Hotel, the doorman, the concierge and the receptionist Teste David cum Sibylla looked at the two English women with ill-concealed surprise, as, arm in arm, they made their halting progess across the lobby to the lift.

  ‘Mum,’ Isobel said as she unlocked the door to Joyce’s room, ‘I–I mean, we. I mean, you have a return ticket, too. You remember — it was cheaper. The flight’s booked for two o’clock, we’ve gotta pack up now. ’ She trailed off: her mother was giving her a censorious look.

  ‘I don’t know what your father would’ve said about your behaviour today.’ As she spoke Joyce knew this was a low blow; Isobel, for all her self-centredness, had been unswerving in her love for him.

  ‘M-Mum, that’s not fair!’

  Isobel had loved Derry more: it was only to be expected, but it still hurt. She had been so attentive during his last, dreadful illness; while since Christmas she’d spent at best three weekends in Bournville. Joyce had had to ask friends to go with her to the hospital — a shaming thing.

  ‘I don’t know what’s fair, Isobel,’ Joyce hectored her under-performing subordinate. ‘All I do know is that I’m tired’ — through the open doorway she spied blobs of underwear on an armchair, beside it a plastic bag that she knew contained a sodden incontinence pad — ‘and I’m going to lie down for a bit. If you want to take the flight, then it’s your own affair. I haven’t decided what I’m going to do yet, but, rest assured, whatever I do decide, I’ll be fine without you.’

  Joyce went into the room, shut the door firmly behind her and locked it. Then she fell against it and listened to her daughter snuffling like a pathetic puppy requesting admission. Eventually, Isobel went away.

  The mirror behind the sink doubled the pill pots, the bottles, the tubes and the blister packs that Joyce had shakily laid out when she arrived the previous afternoon. It was the same device that cocktail bars used to convince drinkers of their alcoholic largesse.

  Diuretics and antacids, sleeping pills and drugs to tamp down anxiety, painkillers and dietary supplements — marmalade snatched while falling. She had never properly questioned the justness of all these before: this was what you did, you took what you were told to take.

  In the window of a pet shop at the shabby shopping parade in Selly Oak, she had seen them: Scottie’s Liver Treats. Shrivelled, blood-dark excrescences packaged in cellophane. That’s what’s going on inside me. To begin with she had been accusatory of her own body as she watched it wasting in the pier glass she had inherited from her own rangy mother. Is it you, or you, or you? Breasts and bones and blood. But then Phillimore had confessed: he had no real idea where Joyce’s cancer had originated.

  ‘Although the most obvious, ah, tumour is in your liver, this is not where the cancer began — primary liver cancer is almost unknown in the developed world, Jo.’ Phillimore seemed to be taking personal responsibility for this. ‘Except among alcoholics and people with Hepatitis C.’

  ‘So. where?’ She was dreamy during these day-mares.

  ‘Usually, when — as with you — we’ve done a biopsy, we can analyse the cancer cells and discover their origin, but in anything up to 15 per cent of cases this will remain occult.’

  ‘Occult?’ What was he talking about? A silver-bearded wizard? A voodoo priest?

  Phillimore smiled at her consternation — how she loathed him. ‘That’s merely a medical term for something we don’t know — yet.’

  Yet, looking at all these useless salves and inadequate physics, then recalling the lead apron, the scattered footfalls, the spooky hum — it struck Joyce that ‘occult’ was precisely what Phillimore’s treatment of her had been. I. I. It was difficult to grasp — peering through the eye holes of her old woman mask, at the woman in the mirror wearing the old woman mask — but in the suicide flat Joyce had somehow begun talking again with her body; they had recommenced a conversation that was reassuringly prosaic, full of itchy chatter and punctuated by companionable burps. This was a dialogue that excluded Joyce’s questioning mind — for all her body demanded was a compliant
listener, prepared to sit and nod, and occasionally mutter, ‘Yes, yes, of course, dear’ in response to its own moany self-absorption.

  The capsules popped from their blisters straight into the toilet bowl; the pills plopped after them, followed by coils of ointment and splashes of linctus. Then she flushed five times, until the whole business was done.

  There was one thing left: the Oramorph, a sticky solution in a squat bottle. I’m in pain, now — the pain of having to lug Isobel around with her, she even has Derry’s mouth. His mouth! Decisiveness mutated into a deadly impulsiveness; she clenched and twisted the safety cap until it yielded, then took a swig.

  What? To cease upon the Swiss lunch-time? She tittered, then wove through the Teutonic symphony of blond wood and clashing mirrored surfaces to where clean white linen offered quiet sanctuary. She fell across the bed and directly into her own fugue. Mors slopebit et natora, Cum resurget creatura, Judicanti responsura. Scoresby, naked, working himself up into a right old tizzy, bearing down on Joyce, quiff flicking like a baton; his blue-veined marble torso smashed against the bedside table and crumbled into dusty chunks. He’s only plaster! Her horsey neigh took her back and back to the paddock of puberty, where she watched with a queer hot thrill older, richer girls posting up and down. Their jodhpurs stretched into hide, the girls transformed into centaurs with ponytails, their ponytails fanned out, iridescent, becoming peacock tails. The peacocks’ beaks thickened into dolphins’ snouts, the dolphins arched and dived into oceanic tea cups that shrank into dancing Disney crockery. Scoresby chased the string section up a spiral staircase, while ahead of them scampered the Singers. Liber scriptus proferetur, In quo totum continetur, Unde mundus judicetur. Even in drugged sleep, it seemed to Joyce that such a fantasia was pitifully wasted on a dying woman.

  Her watch said it was five when she awoke; she didn’t look at the 24-hour digital clock, and so assumed it must be the following morning, so deeply refreshed did she feel. She picked up the phone and dialled Isobel’s room: no answer. She got up and opened the curtains: fog still nuzzled the panes. She dressed carefully, then further adjusted her clothing in the mirror, turning this way, then that, paying strict attention to the lie of her skirt — was it becoming? She had brought hardly any make-up, only lipstick, and blusher to give life to her moribund complexion; but it didn’t really work, not on such jaundiced skin. Nevertheless, in the bathroom she applied these, marvelling at her own girlishness. Death and Nature shall be astonished, When all creation rises again, To answer to the Judge.