by James Hannah
Silence.
The two of them, there, looking at me.
‘When is it, that you can say, now, here, that what happened was wrong? What happened was wrong, and there’s no going back?’
‘Mal’s gone missing,’ says Laura.
Silence.
Kelvin stares pointedly at the floor.
‘Missing?’
‘He’s been gone over a week. Ten days.’
‘We’ve had a word with the Missing Persons people,’ says Kelvin in a low voice. ‘We’re supposed to try to think of a way to solve as many of the problems he was having as possible. Hopefully let him see that home is worth valuing, and he’s not coming back to the same unchanged mess.’
I look down at my hands, colourless and cold. I begin to rub them firmly together to give them life.
‘And all of it, the whole lot of it, points to you. The situation with you. We want to arrange some contact between you, if that’s agreeable to you, and if–’
‘We think he might try to come here,’ says Laura. ‘He knows he needs to – to sort things out while he’s still got time. While you have time.’
‘Here? He doesn’t know where I am.’
‘He does,’ says Laura, in a small voice. ‘I told him. Before he left.’
‘But–’
Surely, surely they wouldn’t let someone in here if I didn’t want to see them? But they let Laura in, didn’t they? My heart begins to thunder in my chest and all the strength sweeps out of my limbs. Surely this is a place of rest. ‘Get Sheila,’ I say. ‘Tell Sheila I won’t see him in here.’
‘Please, just–’
‘Get Sheila.’
Sheila returns to my room in a flap.
‘Have they gone?’ I ask.
‘Yes, yes, they’ve gone.’
‘No visitors.’
‘I’m so sorry, I thought you knew it was your sister. I thought you were a bit more open to seeing people, because you said let her in.’
‘I thought it was– No, no. No visitors.’
‘I’m sorry, that was my mistake.’ She looks shocked. ‘Who is this person, anyway? The one you don’t want to see?’
‘It’s her boyfriend. He wants to see me. But I don’t want to see him, all right?’
‘Right – well, we do ask everyone to check in at reception, so–’
‘Is there anything more you can do? Security-wise?’
‘OK,’ she says, retrieving a sizeable set of keys from her uniform pocket, ‘here’s what we’ll do.’ Calming voice. Professional voice. ‘Before anything else we’re going to take a while and calm it down and see if we can take it one step at a time, is that OK?’
There’s a familiar tone. That’s a you tone. A keep-it-in-perspective tone. She’s saying come on, come on, don’t let the paranoia leak into everything.
‘We’re all of a dither here, aren’t we, so if it’s OK with you, I want to spend some time on this.’
‘Yeah.’
‘So, first things first, I’m going to get you a bit of something to calm you down a touch, all right? Take the edge off.’
‘No – you’re not listening–’
‘I am, lovey. I’m hearing every word you say. And I just want to take the edge off so we can talk about things calmly, and do the right thing, first time.’
Her eyes stay fixed on me as her head gently nods up and down.
‘OK,’ I say. ‘OK.’
‘I’ll be back in five. Max.’
She leaves the room, picking through her keys for the meds cupboard.
I lie down on the bed, on my side, foetal. Need to focus, focus. Press my head down firmly to feel something. Man, punched deep in the pillow, it honestly actually pounds. Every pulse a hammer blow, each blow muting my hearing, recovering enough in time to be muted again. My heart connected to my head. It’s pressure, isn’t it? It’s making me scrunch my eyes up tight – tight, like tight – and that stops the pound-pound, by making it one long pound for a few moments. It’s my heart, it’s the pulses pulsing, pulsepound, and it will not stop. It’s my heart beating the blood around me, and it just will not stop. I want a stop.
I’ve got my fists up tight, clutching the bedsheets around my jaw. Beneath the sheets, the agitation. It’s all rest; restless rest. My feet shifting in the sheets, right forward, left back; left forward, right back. My only relief, to offset the hell in my head: marching through the linen like a slumbering footsoldier. Now that’s the only sound, the soft shiff, shiff, and the occasional zip of a toenail scratching against the cotton.
It’s the morphine. That’s it, isn’t it? That’s why Mal’s going to come here, it’s a fucking bursting bank of clinical morphine, diamorphine. I’m not joking, I’m not joking, that’s the only outcome. He’s got Kelvin and Laura wrapped round his little finger, and they think he wants to be forgiven. He doesn’t want to be forgiven, he–
And the pain and realization shoots down my neck, and penetrates deep into my back, so deep as to come out the front into my chest, like getting kicked in the kidneys, jars out the breastbone, and blooms up through my chest, tight. Nausea blooms and churns within.
The door sucks shut in the corridor, and I look up at my doorway with a start.
It’s Sheila, finally.
‘OK,’ she says, ‘I’ve got a sedative here, just to get us back on an even keel.’
I sit up and look at her, and she must read my mind.
‘Do you trust me?’ she says.
I nod.
She hands me a pill and a beaker of water, and I take it.
‘Now,’ she says, sitting down on the visitors’ chair, ‘are you able to tell me a little bit about this?’
‘About what?’
‘About the visitor you don’t want to see? It helps if I know what I’m looking for.’
‘It’s a man. His name’s Malachy.’
‘And why does he want to see you?’
‘We used to be friends. He’s been seeing my sister.’
‘OK.’
‘But he’s dangerous. He’s properly bad news. He’s not long out of prison. So, what you were saying about the store full of drugs and needles …?’
She starts to show the right amount of unease. I’m getting through to her, and it’s beginning to encroach on her responsibilities. ‘OK, well, that’s helpful for me to know, at least.’
‘He could do this. I’m sure that’s what he’s after, and I think he’s going to try and come and get me.’
I know how this sounds.
Her face softens in exactly the way I hoped it wouldn’t.
‘He’s going to think I put him in prison. He’s going to wonder why I didn’t fight to keep him out–’
‘Listen,’ she says, sitting lightly on the arm of the visitors’ chair, ‘I’ll look into this, and I’ll make sure we do everything we need to do to keep you feeling safe and secure.’
‘Thank you,’ I say, looking up at her.
‘But I know what you’re like, Ivo. You’re the type of person who’s got this worry-shaped hole in the middle of your head. And it doesn’t matter what’s going on, it doesn’t matter what I do to make things better, you’re going to fill it with whatever’s in front of you at the time. You’re not the first to do this, and I dare say you won’t be the last. So do yourself a favour and keep yourself occupied, all right? It’ll help, I promise.’
Intestine
YEAH, NOW IT comes up.
Intestine.
I could do a whole A to Z of my life’s worth of intestinal misery. What have I ever done to be cursed with a body that deals with any level of stress with a punch straight to the gut?
Three nights I threw up when I moved to secondary school. I didn’t know where any of the classrooms were, I had all new lessons, and I’d been warned these were all going to be much more difficult, I had to wear a new uniform – all that stuff, like a putrefying knot in my belly.
My first day at the garden centre, aged eighteen, I threw
up in the lunch break at the sheer amount of new information they were giving me about how to operate the tills. Within a fortnight I was even doing returns and refunds without having to think about it. It’s easy, it’s easy. But my intestines had to have their moment.
It’s like, something has not been worth doing if I haven’t thrown up in contemplating it.
‘Poor love,’ you say, stroking my back as my stomach muscles spasm again and I am subjected to another involuntary heave of fetid breath and spittle. ‘Come here–’ you hand me a pat of tissue and a tall glass of fresh water. I swill out my mouth and spit it down the toilet. Flush it away.
I slip on your dressing gown and look down.
‘It makes my arms look really long.’
‘It’s pretty. Come on, back to bed.’
I shuffle across the landing, trying hard, trying very hard not to shuffle. It’s all in the mind; I need to stride purposefully, pretend I am coping absolutely fine with your announcement of going away.
I’ll shuffle.
Honestly, who throws up at the merest tiniest little upheaval like their girlfriend going away. I’m an absolute lily.
‘Here you go,’ you say, placing the washing-up bowl on the floor beside the bed and climbing in beside me. ‘What does this mean for the insulin you’ve injected? You’d just eaten – does it mean you’ve got to eat something else to soak up the excess?’
I frown and cough to clear my throat. ‘Ohh, I don’t know. I’ve got a leaflet somewhere about sick days. I think it’s fine. I’ll test in a while and see from that.’
‘OK. As long as you’ve got that covered.’
‘Covered,’ I say, snapping my fingers and winking at you in a funky gesture of all-rightness.
‘Listen,’ you say, ‘Ivo. I’ve decided. I’m not going to go on this secondment.’
‘No, Mia, no, you can’t–’
‘It’s three months away, it’s too much. Especially, you know, if I’m not sure I– Well, I don’t even know if I want to do nursing any more.’
‘What? Why not?’
Your face grows unexpectedly sullen, and you hug your knees through the duvet.
‘I don’t know, it’s just – I’ve not met anyone who I can relate to. Everyone seems happy to do the robotic thing, treat all the patients like units.’ You rake your hand down your face, pummel your eye sockets with the heels of your hands. ‘I mean, I feel terrible saying it, because here I am, I’ve spent all this money, and you’re being amazingly patient about the whole thing, and I feel like I’m wasting your time.’
I gaze at you, trying to digest everything this means.
‘I keep thinking this is not what I went into nursing for. I wanted to make a difference for people, to treat people like humans. But if I ever say anything like that to any of the other students, they look at me like I’m insane. It’s so tiring. More tiring than the actual work.’
Now it’s my turn to stroke your back.
‘I just feel like I’ve been so naïve about it.’
‘Listen, I don’t think you’ve been naïve.’
‘I’ve been really naïve.’
‘OK, you’ve been really naïve. But all this stuff – at least it’s going to show you what you don’t want to do.’
‘But I don’t want to spend three months away from you, feeling like a leper.’
‘You’re not a leper, just because everyone else treats you like one. That’s their problem.’
‘But three months of it.’
‘It’s not for ever,’ I say. ‘Look, sleep on it. But I don’t want you to ditch your career just because I’ve got the constitution of an Oxo cube. It’s not fair on either of us.’
You pull in and arrange your limbs around me, delicately avoiding my stomach.
‘I’ll sleep on it.’
‘Good.’
‘If I go, are you going to be sick for the whole three months?’
‘I’ll be fine. I’ll work. I’ll watch the telly.’
‘You’ll use the time to do something amazing and creative, I know it.’
‘Yeah … I don’t know about that.’
Ffff – fuck it: press the buzzer.
Push the button to the click.
Ffffff – Jesus, the pain of it.
Ahhhh. Sssssurges.
Is this it? What if this is it? This could be it. This is definitely it.
No, no, ridiculoussss.
Oh, all I can think of is you. I love you, I love you, I love you, if this is the last thing I think I’m so, so sorry, and I love you.
Calmness. Positive thinking. Put it in context. Concentrate yourself away from pain. Walk away from it.
It’s not pain, it’s sensation. It’s–
Owowowow. It’s making me almost laugh with pain.
No, not laugh.
Sheila appears quickly at the door.
‘What’s the matter Ivo? Are you uncomfortable?’
‘Yes, yes, pain – just here–’
‘Down here, is it?’ She lays her hand flat on my lower belly, gently, gently.
‘Mmff.’
‘Mm-hm.’ She steps back and checks my chart. ‘When did you last pop to the loo?’
‘Mm – two days.’
I wince again as another surge of pain flashes across my middle.
‘OK, OK lovey. Now, I want you to keep calm, OK? We’re going to get this all under control. Do you trust me?’
‘Yeah.’
‘Dr Sood’s in this afternoon, so I’m going to fetch him to take a view.’
As I watch her leave, anxiety seizes my stomach, and the pain lashes back, another whipcrack, I don’t want to be alone – I don’t want to be alone if this is it.
It’s unbearable.
Positive thoughts.
Come on, come on. Think it through, carefully, calmly, calm, calm.
Is it pain anyway? Am I weak? How would I know? Maybe it’s not pain. Maybe I’ve never been in real pain. Maybe only the pain I’ve seen in other people has been the real thing, and I’ve only ever imitated their sucking of the teeth and wincing and cringing and sighing and huffing.
No, no. Calm it. I’m not in pain. Not real pain.
If I were dying, it would be the worst pain imaginable, surely. Is this the worst pain imaginable? No, it is not. What shall we call this? We could call it taken-abackness. It’s like when my knee clicks, or – or when my coat pocket catches on a door handle as I’m passing through and I might say ‘ow’, and I give off many of the signals of having been in pain. But it’s not pain, is it? It’s just being taken aback. Surprised.
And anyway, they don’t let you feel pain these days. They give you drugs. Like they gave Old Faithful drugs. They don’t let you feel the pain.
Thank God.
Fffff. ‘Yeah, he’s in here–’
Sheila enters the room all businesslike, Dr Sood in tow.
‘Good afternoon,’ says Sood. ‘How are things with you today? I gather you’ve been in a little discomfort?’
‘Severe headaches,’ says Sheila, ‘shortness of breath, anxiety over – a number of personal matters. And sharp abdominal pains.’
‘Mm.’ He sets his head fractionally on one side. ‘How’s your vision?’
‘Light hurts.’
‘Breathing is still troubling you, yes?’
‘I cough a lot.’
Nice Dr Sood. He’s calming in a rapid sort of manner. He talks in an efficient, quick and minimal way. His mouth-clicks form an integral part of his speech pattern. To-the-point, but kindly enough.
He turns to Sheila. ‘Any general feeling of panic, of distress or anything like this?’
‘We’ve been using oxygen for a few days,’ says Sheila. ‘Regular shortness of breath.’
‘Any improvements?’
‘Nothing substantial.’
This seems to push him into some kind of decision.
‘Hm. I’m wondering whether we should be administering relief for these symptoms. We can
take care of the pain here in your abdomen. But we also have to consider any sort of panicky anxieties you have been experiencing. We could be administering a morphine solution, which should take care of the worst of it, and give you a little more space within yourself to control these symptoms better.’
‘Morphine? I’m not ready for that, am I?’ I look at Sheila. ‘I don’t think I’m that bad.’
‘Well, one of the things we are watching in a case like yours is the contamination of the bloodstream with toxins such as potassium, do you understand? And the build-up of toxins often leads to an increase in anxiety and irritation in the patient, and, well, if the symptoms are as we believe them to be, then you might find that a mild solution can help you–’
‘No, thank you. No.’
I’m surely not far gone enough for morphine, am I?
No, No. I’m not dead yet.
‘I just need a little something to – take the edge off.’ I look up at Sheila, hopefully. ‘Just a little something.’
‘Well, as I say, we can get you some relief for your abdominal pains, which we can probably put down to a spot of trapped wind in your intestine. Sharp, sudden pain.’
As he says it, another flash of pain darts its way through my belly.
‘Trapped wind? Seriously, it’s ffff – it’s really really bad. I’m sweating here, I’m sweating. It’s – ffff …’
‘It can get like that, honestly,’ says Sheila. ‘And it’s to be expected. I’m going to get you something to relieve that, OK?’
‘OK. Yes, please.’
‘And you do not want the morphine solution?’ says Sood.
‘No. No thanks.’
‘May I ask why?’
‘I don’t want to go there. I– I don’t want to.’
‘Addiction is not an issue, if that’s what you’re worried about. It’s entirely up to you and how you would like to handle your symptoms, but just so long as you are aware of the options available to you. I’d like to register with you the fact that I think a solution of morphine would help you along, ease your symptoms to a point where you’ll be in a good deal fairer fettle than you are now. So I’d like you to bear it in mind going forward.’
The two of them depart, Sheila with a little wink, Sood off to the patient he had come to see in the first place. I’m left here with his final words in mind. Going forward.
